I’m tired. I’m weak. I’m in an ICE age. Where to from here?

Steve Cadell

BPhysio, Masters of Rehabilitation (Physiotherapy) Student

Background: ICE/methamphetamine abuse in rural populations is becoming an increasingly serious phenomenon resulting in end stage renal failure (ESRF). Intradialytic therapies are fast becoming necessary to promote functional capacity and maximise quality of life in a younger patient population.

Aim: This systematic review seeks to ascertain whether the prescription of intradialyitic strengthening exercises in adults, (under the age of 65yrs with ESRF) may promote increased functional capacity and strength. Outcome measures include functional capacity assessments, muscle mass on cellular, molecular and tissue levels.

Method: Databases used for this review included SCIENCE DIRECT, PEDro & MEDLINE retrieving 4 appropriate articles based on exclusion criteria.  Exclusion criteria included: not a randomised control trial, abstract only, participants over the age of 65years, required payment, non-English or written before the year 2006.  Articles were rated as 1b evidence (NHMRC) and critically appraised using the PEDro tool.

Discussion/Recommendations: Evidence suggests intradialytic strength/resistance training in patients with ESRF under the age of 65years of age is effective in promoting muscle growth, strength and increased functional capacity. No research is specific to methamphetamine induced ESRF and associated deconditioning therefore further research is required. A qualitative approach understanding the behaviours and emotions associated with methamphetamine related renal failure is necessary to provide a holistic rehabilitation model of care. The ICE/methamphetamine epidemic will require us to manage an aging population concurrently with a prematurely aged demographic. How will we maximise future therapies and resource expenditure in order to preserve life and save “our village?”

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