Although the best protocol of exercise for patients on dialysis is not yet clear, in our sample of haemodialysis patients the combination of aerobic and resistance training was more effective than resistance training alone to improve functional performance.

Previous studies have suggested that exercise during hemodialysis (HD) could increase the efficacy of solute removal, although this hypothesis has not been conclusively evaluated. The goal of this study was to compare the removal of low-molecular weight solutes between HD sessions, with and without aerobic exercise. It was a controlled clinical trial, including HD patients in a randomly cross-over design, such that each patient received a HD session with exercise (intervention) and the next one without exercise (control), three times each. In the exercise sessions, patients pedaled on a cycle ergometer for 60 minutes. The total mass of removed urea, potassium, creatinine, and phosphate were calculated from the solutes concentration in dialysate (continuous spent sampling of dialysate). This was evaluated in a total of 132 HD sessions of patients with a mean age of 54 ± 15 years, 75% male and HD vintage of 3 (2-13) years. Phosphate removal in dialysate during intervention sessions was significantly higher (5.6 [2.5-18.9] vs. 5.1 [1.5-11.2] mg/min) than during control sessions, P = 0.04. The median mass of phosphate removed during control HD session was 1226 (367.8-2697.2) vs. 1348.6 (613.0-4536.2) mg/session during intervention sessions. The exercise did not modify the removal of urea (control 122.6 [61.3-286.0] vs. exercise 112.4 [51.1-250.3] mg/min, P = 0.44), creatinine (control 5.6 [2.5-13.8] vs. exercise 5.6 [2.5-12.8] mg/min, P = 0.49), or potassium (control 13.3 [11.2-15.8] vs. exercise 13.8 [6.6-15.8] mEq/min, P = 0.49). Aerobic exercise during HD increases the efficacy of phosphate removal, without changing urea, creatinine and potassium removal. The implications of this finding in mineral and bone disease and cardiovascular disease need to be evaluated on future clinical trials.

Objective: To evaluate the addition of blood flow restriction to passive mobilization in patients in the intensive care unit. Design: The study was a within-patient randomized trial. Setting: Two intensive care units in Belém, from September to October 2017. Subjects: In total, 34 coma patients admitted to the intensive care unit sector, and 20 patients fulfilled the study requirements. Interventions: All participants received the passive mobilization protocol for lower limbs, and blood flow restriction was added only for one side in a concurrent fashion. Intervention lasted the entire patient's hospitalization time. Main outcome measurement: Thigh muscle thickness and circumference. Results: In total, 34 subjects were enrolled in the study: 11 were excluded for exclusion criteria, 3 for death, and 20 completed the intervention (17 men and 3 women; mean age: 66 ± 4.3 years). Despite both groups presented atrophy, the atrophy rate was lower in blood flow restriction limb in relation to the

Objective: to describe reported health promotion actions directed towards chronic non-communicable disease (CNCD) patients, the support of physical education professionals (PEP) and the implementation of actions to promote body practices and physical activity (BPPA) by the Family Health Support Center (FHSC) teams, according to Brazilian municipality context variables. Methods: this was a cross-sectional study, forming part of the 2013/2014 National Primary Health Care Access and Quality Improvement Program (PMAQ), by means of interviews with FHSC professionals. Results: the action most reported by the teams was evaluation and rehabilitation of psychosocial conditions (90.8%); promotion of BPPA was the sixth most performed action, and was more prevalent in the Brazilian Southeast region (89.6%), in medium-sized municipalities (88.7%), with medium human development index (HDI) (86.7%); PEP provided support to 87% of the teams. Conclusion: FHSC were found to make an important contribution to BPPA.