Electrical neuromuscular stimulation had a positive impact on pulmonary function and functional capacity, leading to better physical performance in patients on hemodialysis.

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Purpose Exercise is recommended for patients undergoing hemodialysis, to reduce the decrease in functional capacity secondary to the progression of chronic kidney disease. A cycle ergometer can be easily added to an exercise routine during hemodialysis sessions. The purpose of this article was to assess the results of a training protocol with the cycle ergometer during hemodialysis sessions on the respiratory function and functional capacity of patients with chronic kidney disease on hemodialysis. Method In this randomized clinical trial (NCT no. 02834026), 39 patients undergoing hemodialysis were randomly allocated into two groups: the treatment group (TG, n = 20), who underwent a cycle ergometer protocol training, and the control group (GC, n = 19), not trained. The TG attended 24 training sessions, three times a week, during the intradialytic period. Training intensity was aimed at keeping the heart rate between 50 and 70% of its maximum. All participants were evaluated before and after the eight consecutive weeks of follow-up and had biochemicals data, anthropometric, functional, and respiratory outcomes evaluated. Results A significant difference was observed between groups in forced vital capacity, forced expiratory volume in the first second, peak expiratory flow, maximal inspiratory and expiratory pressure, and Borg score and distance covered in the six-minute walk test. Improvement was also observed in biochemical and Kt/V test results for the TG. Conclusion The systematic training regimen with a cycle ergometer resulted in benefits in the respiratory function and functional capacity in patients with chronic kidney disease undergoing hemodialysis.

O treinamento físico vem se mostrando efetivo para minimizar as consequências deletérias do processo de envelhecimento, porém o Pilates, ainda não foi foco de estudos controlados em idosos, assim, objetivamos avaliar o impacto do método Pilates na qualidade de vida de indivíduos na terceira idade. Participaram deste estudo prospectivo e randomizado, 44 voluntários, acima de 60 anos, de ambos os sexos, divididos em dois grupos: controle (22 idosos que não realizaram exercícios) e intervenção (22 idosos que realizaram um protocolo constituído por exercícios com o método Pilates). O protocolo no grupo intervenção foi aplicado por um fisioterapeuta, duas vezes por semana, com sessões de 60 minutos mantidas por dois meses. Para análise da qualidade de vida foi aplicado antes e após o protocolo os questionários WHOQOL-BREF e OLD em ambos os grupos. Após a realização dos dois meses de protocolo podemos observar o aumento da pontuação de todos os domínios dos questionários de qualidade de vida no grupo de intervenção concluindo que o protocolo pode ser um produto importante influenciando positivamente a qualidade de vida da população idosa submetida ao método Pilates.

The introduction of a CPAP protocol during hemodialysis sessions had a positive impact on pulmonary function and physical capacity in CKD patients.

Objective: The medial longitudinal arch is the main structure of load bearing and shock absorption of the foot. The evaluation of medial longitudinal arch, such as the navicular height, the medial longitudinal arch angle and the Feiss line should be performed with the subtalar joint in the neutral and relaxed position. Our study analyzed the correlation between the measurements of the subtalar joint in neutral and relaxed positions during the evaluation tests of the medial longitudinal arch. Methods: This is a cross-sectional study, in which 51 healthy volunteers (102 feet; 36 women; 28 ± 5 years, 1.66 ± 0.10 m; 24.5 ± 4.5 kg/m2) had their navicular height, medial longitudinal arch angle and Feiss line measured in the neutral and relaxed positions. The correlation between the measures was evaluated using Pearson’s test. Results: A strong correlation of the 102 feet Feiss line measurements between neutral and relaxed positions (r = 0.81) was observed, and a moderate correlation between the medial longitudinal arch angle (r = 0.78) and between navicular height in neutral and relaxed positions (r = 0.76). Conclusion: The measurements of the longitudinal medial arch between the neutral and relaxed positions are strongly correlated. Therefore, it is not necessary to measure the medial longitudinal arch in both neutral and relaxed positions. Level of Evidence II, Diagnostic Studies - Investigating a diagnostic test.

Investigar por meio de uma revisão sistemática o impacto do uso de cicloergômetro na função respiratória, cardiovascular, capacidade aeróbica, funcional e qualidade de vida em pacientes com doença renal crônica durante a hemodiálise. Métodos: A pesquisa buscou referências de janeiro de 2010 a dezembro de 2018. Foram incluídas as bases Pubmed, Scielo, PEDro, Lilacs e Cochrane Library e foram usadas palavras-chave pré-selecionadas. Os artigos encontrados foram avaliados pela escala PEDro. A busca e análise foram realizadas por dois autores de forma independente. Resultados: Um total de 81 artigos foi identificado, no entanto apenas quatro atendiam aos critérios de inclusão e exclusão. Devido ao pequeno número de artigos incluídos e à sua heterogeneidade, seus resultados não puderam ser submetidos à metanálise e foram apresentados de forma descritiva. Conclusão: O exercício aeróbico com uso de cicloergômetro realizado durante as sessões de hemodiálise promove melhora da capacidade aeróbia e condicionamento físico e por consequência na qualidade de vida.Palavras-chave: doença renal crônica, diálise renal, terapia por exercício, técnicas de exercício e de movimento.

IntroductionBronchiectasis is a chronic disorder characterised by permanent and irreversible abnormal dilation of the bronchi and bronchioles, primarily caused by repeated cycles of pulmonary infections and inflammation, which lead to reduced mucociliary clearance and to the excessive production of sputum. Patients with non-cystic fibrosis bronchiectasis may be predisposed to hypoxemia during sleep, or to symptoms that may lead to arousals and thereby reduce the quality of life, because of the irreversible dilation of the bronchi and the presence of secretions and airflow obstruction.Methods and analysisFor this cross-sectional observational study, patients with a clinical diagnosis of non-cystic fibrosis bronchiectasis will be recruited from the Bronchiectasis Clinic of the Pneumology Department of the Santa Casa de Misericordia Hospital and the Federal University of São Paulo (São Paulo, Brazil). Patients of either sex will be included if high-resolution CT of the thorax and classic sweat test confirms they have non-cystic fibrosis bronchiectasis, are between 18 and 80 years old, use long-acting bronchodilators, are clinically stable for a least 1 month, agree to participate in the study and they sign a statement of informed consent. The first part of the study will involve a clinical evaluation, maximal respiratory pressures, spirometry and the Saint George's Respiratory Questionnaire. The Sleep Laboratory of the Master's and Doctoral Postgraduate Program in Rehabilitation Sciences of the Nove de Julho University (São Paulo, Brazil) will perform the polysomnographic studies, Berlin Questionnaire, Epworth Sleepiness Scale, waist and neck circumferences, modified Mallampati classification and tonsil index.Ethics and disseminationThis protocol has been approved by the Human Research Ethics Committees of Santa Casa de Misericordia Hospital (process number 178/2012) and Human Research Ethics Committee of Nove de Julho University (process number 370474/2010). All participants will sign a statement of informed consent. The study findings will be published in peer-reviewed journals and presented at conferences.