Respiratory and muscular effects of a physiotherapy protocol carried out during hemodialysis in individuals with chronic renal failure: preliminary results.

Abstract

To analyze whether the proposed physiotherapy protocol during hemodialysis (HD) increases knee extensor muscle strength, palmar grip strength, respiratory muscle strength, lung function, and functional capacity of individuals with Chronic Renal Insufficiency (CRI) on HD. Methods: A preliminary results study, in which physical therapy intervention was performed in 11 subjects (49.2 ± 8.6 years) with CRI on HD treatment. Initially, Heart Rate Variability (HRV) was collected, with the individual at rest, for 15 minutes, and later, HRV linear and non-linear analyses were performed using HRV Kubios Premium Software. The protocol was performed in the first two hours of the HD session, three times a week for eight weeks, consisting of respiratory exercises, aerobic exercises, and electrical stimulation associated with progressive resistive exercises. The variables evaluated were respiratory muscle strength, knee extensor muscle strength, palmar grip strength, lung function, and functional capacity. Student's t-tests for paired samples and Wilcoxon's tests for non-parametric samples were used considering a significance level of 5%. Results: There was a significant increase in expiratory muscle strength (p = 0,012; Cohen's d = 0,59), knee extensor muscle strength (p = 0,025; Cohen's d = 0,77), palmar grip strength (P = 0,001; Cohen's d = 0,52) and functional capacity (P = 0,009; Cohen's d = 0,83). Conclusion: The proposed protocol is effective in increasing knee extensor muscle strength, palmar grip strength, expiratory muscle strength, and functional capacity of individuals with CRI on HD.

Awareness Among Medical Professionals about the Role of Physiotherapists in Patients with Chronic Renal Failure

“…A significant health concern affecting millions of adults and elderly individuals is Chronic Renal Failure (CRF). CRF is the result of diverse pathways of complaints that, over the course of months or years, permanently damage the structure and function of the kidney 1 . It is irreversible and impacts all of the body's systems.…”

“…CRF can be considered a syndrome with adverse effects on systems in the body, including cardiovascular, nervous, respiratory, musculoskeletal, immune, and endocrine systems 1 .Well-known health conditions that result from CRF, such as high blood pressure, diabetes mellitus, malnutrition, bone disorders, and heart vessel disease, have a significant impact on physical function and quality of life in CRF patients 2 . Symptoms related to physiotherapy in CRF include muscle weakness, reduced ©2023 The Academy of Environmental Biology, India exercise tolerance, malnutrition, myopathy, neuropathy, decreased muscle strength, decreased endurance, cardiac and vascular dysfunction, decreased aerobic capacity, and psychological and behavioral changes.…”

“…Reduced Heart Rate Variability (HRV) can result caused from microalbuminuria and macroalbuminuria, along with a decreased glomerular filtration rate. Factors such as age, diabetes mellitus, sedentary lifestyle, and arterial hypertension can influence low autonomic cardiac modulation 1 . In patients undergoing dialysis, there is a low peak oxygen uptake (VO 2 peak).…”

“…In CRF the musculoskeletal system is the secondmost affected physiological system. Uremic muscle loss in CRF patients is intricate and advances similarly to sarcopenia 1 . The staging of sarcopenia encompasses not just the reduction in muscle mass but also considers the influence of inadequate body composition on muscle strength and mobility 2 Muscle weakness is a common symptom resulting from factors like hormonal imbalance, malnutrition, chronic anemia, lifestyle changes, loss of muscle mass, and weakness due to muscle fiber atrophy.…”