Introduction: Chronic kidney disease (CKD) is a global public health problem with systemic repercussions, compromising muscle function and making patients less exercise tolerant. Objective: To verify the contribution of peripheral muscle strength in the exercise capacity of patients in hemodialysis (HD), as well as to compare peripheral muscle strength and exercise capacity between renal patients and healthy individuals. Method: 50 patients with chronic kidney disease (CKD) who performed HD and 13 healthy subjects underwent anthropometric evaluation, evaluation of peripheral muscle strength, pulmonary function test and exercise capacity assessment. Results: Simple linear regression indicated that the peripheral muscle strength contributed 41.4% to the distance walked in the six-minute walk test (R2 0.414; p < 0.001), showing that for every 1 Kgf reduced in the right lower limb the patient it stops walking 0.5m while for every 1 Kgf reduced in the lower left limb the patient stops walking 0.8m. In addition, it was observed that patients with CKD had a reduction in right lower limb muscle strength (129.44 ± 48.05 vs. 169.36 ± 44.30, p = 0.002), left (136.12 ± 52, 08 vs 168.40 ± 43.35, p = 0.01) and exercise capacity (421.20 ± 98.07 vs. 611.28 ± 80.91, p < 0.001) when compared to healthy pairs. Conclusion: Peripheral muscle weakness is an important limiting factor for exercise in CKD and patients on HD experience a decline in peripheral muscle strength and exercise capacity when compared to healthy individuals.
Cirrhosis causes systemic and metabolic changes that culminate in various
complications, such as compromised pulmonary function, ascites, hepatic
encephalopathy, weight loss, and muscle weakness with significant physical
function limitations. Our aim is to evaluate the effects of training with
neuromuscular electrical stimulation (NMES) on the muscular and functional
capacity of patients with cirrhosis classified as Child-Pugh B and C. A total of
72 patients diagnosed with cirrhosis will be recruited and randomized to perform
an NMES protocol for 50 minutes, 3 times a week, for 4 weeks. The evaluations
will be performed at the beginning and after 12 sessions, and patients will be
submitted to a pulmonary function test, an ultrasound evaluation of the rectus
femoris, an evaluation of peripheral muscle strength, a submaximal exercise
capacity test associated with an evaluation of peripheral tissue oxygenation, a
quality of life evaluation, and orientation about monitoring daily physical
activities. The evaluators and patients will be blinded to the allocation of the
groups. Training Group will be treated with the following parameters: frequency
of 50 Hz, pulse width of 400 μs, rise and fall times of 2 s, and on:off 1:1;
Sham Group: 5 Hz, 100 μs, on:off 1:3. The data will be analyzed using the
principles of the intention to treat. This study provides health professionals
with information on the benefits of this intervention. In this way, we believe
that the results of this study could stimulate the use of NMES as a way of
rehabilitating patients with more severe cirrhosis, with the objective of
improving these patients’ functional independence.
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