Intradialytic exercise and postural control in patients with chronic kidney disease undergoing hemodialysis

Abstract

Introduction: Exercise promotes physiological improvements that reflect better quality of life and survival among chronic kidney disease patients. However, little is known about the effect of exercise on postural control of hemodialysis patients. Objective: To evaluate the effect of intradialytic aerobic exercise on postural balance in patients on hemodialysis. Methods: a pilot study with seven individuals was conducted at the Hemodialysis Center of Bauru State Hospital. The Berg Balance Scale evaluated balance and postural balance was evaluated by the force platform Advance Mechanical Technology Inc. (AMTI -AccuGait). Trunk mean sway amplitude in the anterior-posterior (AP) and medial-lateral (ML) directions and mean velocity in the AP and ML directions were assessed. Secondary outcomes about functional capacity and body composition (DEXA) were evaluated. The aerobic exercise was performed with a ergometric bicycle during the first two hours of hemodialysis session for 50-60 minutes (BORG >12), three times a week for 12-weeks. Results: Four men and three women, 52.86 ± 11.08 years, participated in the study. There was no difference between pre and post-test of postural balance outcomes. Although the results were not statistically

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“…End-stage renal disease (ESRD), the final stage of chronic kidney disease that exists in 8–16% of the population worldwide,1 is characterized as irreversible impairments in kidney function, and its prevalence is increasing annually 2,3. Hemodialysis is an important and commonly used renal replacement therapy (RRT) for ESRD patients 4.…”

Benefícios do exercício físico intradialítico: revisão sistemática

“…Foram selecionados para analise final 19 estudos, 2 estudos quasi-experimentais (17,18) e os restantes estudos randomizados controlados (19,20,21,22,23,24,25,26,27,28,29,30,31,32,33,34,35) .…”

“…Em 2 artigos foram realizados exercícios resistidos (27,34) e em 8 exercícios aeróbios (18,28,29,30,31,32,33,35) . Em 3 artigos compararam intervenções dos dois tipos de exercícios (23,24,26) e em 6 a intervenção combinou exercícios aeróbios e resistidos (17,19,20,21,22,25) . Para os exercícios aeróbios a maioria dos estudos utilizou cicloergómetro e para os resistidos utilizaram pesos e bandas elásticas.…”

“…Quanto aos grupos de intervenção verificamos que 12 artigos têm 2 grupos de comparação (17,18,19,20,22,28,29,30,31,33,34,35) e 5 artigos apresentam 3 grupos de comparação (21,24,25,26,32) . Existem 2 artigos que apresentam 4 grupos de intervenção (23,27) , verificamos que um deles tem um grupo para exercícios resistidos, outro para exercícios aeróbios e mais um para exercícios combinados.…”

“…A força muscular foi avaliada em 4 artigos (20,25,26,33) nos quais se constatou melhoria. Desai et al (20) numa amostra de 18 indivíduos verificou que após um programa de exercícios combinados, houve um aumento da força muscular, nomeadamente na força de preensão manual (p <0,01) e na de força de pinça (p <0,05).…”