The adverse effects of exercise
Los efectos adversos del ejercicio
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class="elsevierStylePara">Dear Editor:</p><p class="elsevierStylePara">The publication of the article Physiotherapy during haemodialysis: results from a force-resistance programme by Eva Segura Orti, Vicente Rodilla-Alama and Juan Francisco Lisbon Parraga (Nefrología 2008;28(1): 67-72),<span class="elsevierStyleSup">1</span> which demonstrated the need for and importance of physical exercise in chronic renal patients¿ routines, was very important. However, we felt the need to comment on a few points such as the adverse effects of exercise and programme adherence.</p><p class="elsevierStylePara">As recent studies have shown, patients with chronic renal failure are more susceptible to adverse events during exercise. For example, a patient could suffer ruptured tendons, fractures, muscle injuries and cardiovascular complications.<span class="elsevierStyleSup">2,3</span> Cheema et al.<span class="elsevierStyleSup">4</span> in 2005 demonstrated in their review that exercise can induce hypotension and gastrointestinal haemorrhage, as well as fatigue, sweating and pain in the feet.</p><p class="elsevierStylePara">In our study, in a university hospital in southern Brazil, twelve patients who participated in an intradialytic physiotherapy programme had, at five months, an average adherence rate of 83.66%. The exercise was carried out approximately thirty minutes after beginning haemodialysis, using a programme similar to that used in the above-mentioned study. The main complaint reported during the exercise was cramp (n = 6), followed by pain (n = 3), hypotension (n = 2) and excessive fatigue (n = 1).</p><p class="elsevierStylePara">At present, we have no knowledge of any specific studies on the risks of intradialytic exercise, but we do know that they are higher than in the general population: a prevalence of cardiovascular disease and myoskeletal corrections.<span class="elsevierStyleSup">3</span> Standardisation in surveying these risks could help improve the prescription of intradialytic exercise and allow comparison between results from across haemodialysis departments.</p>" "pdfFichero" => "P-E-S-A131-EN.pdf" "tienePdf" => true "bibliografia" => array:2 [ "titulo" => "Bibliography" "seccion" => array:1 [ 0 => array:1 [ "bibliografiaReferencia" => array:4 [ 0 => array:3 [ "identificador" => "bib1" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "Segura E , Rodilla-Alama V, Lisbon JF. Physiotherapy during hemodialysis: results of a progressive resistance-training program. Nefrología 2008;28 (1):67-72. <a href="http://www.ncbi.nlm.nih.gov/pubmed/18336134" target="_blank">[Pubmed]</a>" "contribucion" => array:1 [ 0 => null ] "host" => array:1 [ 0 => null ] ] ] ] 1 => array:3 [ "identificador" => "bib2" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "Shah MK. Simultaneous bilateral quadriceps tendon rupture in renal patients. Clin Nephrol 2002;58:118-21. <a href="http://www.ncbi.nlm.nih.gov/pubmed/12227683" target="_blank">[Pubmed]</a>" "contribucion" => array:1 [ 0 => null ] "host" => array:1 [ 0 => null ] ] ] ] 2 => array:3 [ "identificador" => "bib3" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "Johansen KL. Exercise and dialysis. Hemodialysis International 2008;12(3):290-300. <a href="http://www.ncbi.nlm.nih.gov/pubmed/18638081" target="_blank">[Pubmed]</a>" "contribucion" => array:1 [ 0 => null ] "host" => array:1 [ 0 => null ] ] ] ] 3 => array:3 [ "identificador" => "bib4" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "Cheema BSB, Singh MAF. Exercise Training in Patients Receiving Maintenance Hemodialysis: A Systematic Review of Clinical Trials. Am J Nephrol 2005;25:352-64. <a href="http://www.ncbi.nlm.nih.gov/pubmed/16088076" target="_blank">[Pubmed]</a>" "contribucion" => array:1 [ 0 => null ] "host" => array:1 [ 0 => null ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/20132514/0000002900000004/v0_201502091627/X2013251409003433/v0_201502091628/en/main.assets" "Apartado" => array:4 [ "identificador" => "35436" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Letters to the Editor" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/20132514/0000002900000004/v0_201502091627/X2013251409003433/v0_201502091628/en/P-E-S-A131-EN.pdf?idApp=UINPBA000064&text.app=https://revistanefrologia.com/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/X2013251409003433?idApp=UINPBA000064" ]
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