Article information
El objetivo de este trabajo fue analizar los efectos de un programa de fuerza resistencia en pacientes con insuficiencia renal crónica terminal durante la hemodiálisis en la capacidad de ejercicio, capacidad funcional y calidad de vida. 16 pacientes en hemodiálisis fueron asignados al grupo control (N = 8) o al grupo de intervención (N = 8) según su propia elección. El grupo de intervención realizó un programa de ejercicio durante la hemodiálisis de 6 meses de duración. El grupo control permaneció sedentario. Las pruebas realizadas al inicio y al final del programa en el grupo de intervención fueron una prueba de esfuerzo (protocolo Naughton), medidas funcionales (prueba de 6 minutos marcha y prueba de sentado a de pie y de nuevo a sentado de 10 repeticiones y en 60 segundos) y el cuestionario de SF-36 para evaluar la calidad de vida, mientras que el grupo control completó el cuestionario SF- 36. En los resultados, el grupo de intervención aumentó los metros recorridos en la prueba de marcha (399,57 ± 39,56 metros al inicio; 471,71 ± 70,63 metros al final p < 0,01). Tanto el tiempo de la primera prueba de paso de sentado a de pie (22,52 ± 4,77 segundos al inicio; 17,71 ± 1,79 segundos al final, p < 0,05) como las repeticiones en la segunda prueba (p < 0,05) mejoraron de forma significativa. Tras la realización del programa, el componente mental de la calidad de vida aumentó de forma significativa en el grupo de intervención comparado con el valor inicial (41,74 ± 9,25 al inicio; 50,61 ± 12,13 al final, p < 0,05), mientras que el grupo control mostró un descenso significativo (p < 0,05). La comparación entre grupos también mostró una diferencia significativa en el componente mental tras la intervención (p < 0,05). Se concluye que un programa de reforzamiento muscular durante la hemodiálisis mejora la capacidad funcional y la calidad de vida.
Palabras clave:
Calidad de vida
Palabras clave:
Ejercicio
Palabras clave:
Reforzamiento
Palabras clave:
Hemodiálisis
During the last decades, aerobic exercise programs have shown beneficial effects on quality of life of End Stage Renal Disease (ESRD) patients, but there is still little evidence on the benefits of resistance training programmes. The aim of this study was to analyze the effects of a short strengthening exercise program for ESRD during hemodialysis on exercise and functional capacity and on quality of life. Methods: 16 hemodialysis patients were assigned, according to their own election, to exercise (N = 8) or control group (N = 8). The experimental group performed a 6-month duration intradialytic exercise program supervised by a physiotherapist, consisting of a battery of isometric and isotonic exercises for the lower limbs. Control group remained sedentary. A graded exercise test (Naughton protocol), functional measurements («6 mintutes walking test» 6MWT and «sit to stand to sit tests» STS-10 and STS-60), and the SF-36, to assess quality of life were measured pre and post intervention in the experimental group, while the control group only completed the SF- 36 questionnaire. Results: Considering the experimental group, both time and METS increased after the intervention, although it was not significant. Meters measured in the 6MWT significantly increased after the intervention (399,57 ± 39,56 meters pre-intervention; 471,71 ± 70.63 meters post-intervention p < 0,01). Both time on the STS-10 (22,52 ± 4,77 seconds pre-intervention; 17,71 ± 1,79 seconds post-intervention p < 0,05) and repetitions on the STS-60 (28,57 ± 5,12 repetitions pre-intervention; 31,42 ± 2,443 repetitions post-intervention p < 0,05) significantly improved after the intervention. After training, the mental component scale of the SF-36 significantly increased in the experimental group compared to baseline (41,74 ± 9,25 before; 50,61 ± 12,13 after, p < 0,05), while the control group showed a significant decrease (48,19 ± 16,1 before; 33,7 ± 13,8 after, p < 0,05). Comparison between groups also showed a significant difference in the mental component scale after the intervention (p < 0,05). Conclusion: It is concluded that a strengthening exercise program during hemodialysis improves the functional capacity of ESRD patients (walking and standing from a seat) and improves the mental component of quality of life perceived by dialysis patients.
Keywords:
Quality of life
Keywords:
Exercise
Keywords:
Strengthening
Keywords:
Hemodialysis
Full text is only aviable in PDF
Bibliography
[1]
2- Goldberg AP, Geltman EM, Gavin JR, Carney RM, Hagberg JM, Delmez JA, et al. Exercise training reduces coronary risk and effectively rehabilitates hemodialysis patients. Nephron. 1986;42:311-16.
[2]
3- Johansen K, Shubert T, Doyla J, Soher B, Sakkas G, Kent-Braun J. Muscle atrophy in patients receiving hemodialysis: effects on muscle. Kidney Int. 2003;63:291-97.
[3]
4- Kouidi E, Albani M, Natsis K, Megalopoulos A, Gigis P, Guiba-Tziampiri O, et al. The effects of exercise training on muscle atrophy in hemodialysis patients. Nephrol Dial Transplant. 1998;13:685-99.
[4]
5- Deligiannis A. Exercise rehabilitation and skeletal muscle benefits in hemodialysis patients. Clin Nephrol. 2004;61(S1):S46-S50.
[5]
6- Diesel W, Emms M, Knight BK, Noakes TD, Swanepoel CR, Van Zyl Smit R, et al. Morphologic features of the myopathy associated with chronic renal failure. Am J Kidney Dis. 1993;22(5):677-84.
[6]
7- Johansen K, Doyla J, Sakkas G, Kent-Braun J. Neural and metabolic mechanisms of excessive muscle fatigue in maintenance hemodialysis patients. Am J Physiol Regul Intergr Comp Physiol. 2005;289:R805-13.
[7]
8- Segura E. Social and demographic variables related to psychosocial aspects of ESRD in Valencia. Oral Communication. 3rd International Congress of Quality of Life in ESRD; 2004 March 9-11; Thessaloniki, Greece: Nephrology Department Aristotle Univesity Thessaloniki; 2004. p. 35
[8]
9- Tanaka K, Morimoto N, Tashiro N, Hori K, Katafuchi R, Fujimi S. The features of psychological problems and their significance in patients on hemodialysis with reference to social and somatic factors. Clin Nephrol. 1999;51:161-76.
[9]
10- Heiwe S, Tollbäck A, Clyne N. Twelve weeks of exercise training increases muscle function and walking capacity in elderly predialysis patients and healthy subjects. Nephron. 2001;88:48-56.
[10]
11- Painter PL, Nelson-Worel JN., Hill MM, Thornbery DR, Shelp WR, Harrington AR, et al. Effects of exercise training during hemodialysis. Nephron. 1986;43:87-92.
[11]
12- Kouidi EJ. Central and Peripheral adaptations to physical training in patients with end-stage renal disease. Sports Med. 2001;31(9):651-65.
[12]
13- Goldberg AP, Hagberg JM, Delmez JA, Haynes ME, Harter HR. Metabolic effects of exercise training in hemodialysis patients. Kidney Int. 1980;18:754-61.
[13]
14- Kouidi E, Grekas D, Deligiannis A, Tourkantonis A. Outcomes of long-term exercise training in dialysis patients: comparison of two training programs. Clin Nephrol. 2004;61(S1):S31-S38.
[14]
15- Painter P, Moore G, Carlson L, Paul S, Myll J, Phillips W, et al. Effects of exercise training plus normalization of hematocrit on exercise capacity and health-related quality of life. Am J Kidney Dis. 2002;39(2):257-65.
[15]
16- Parsons TL, Toffelmire EB, King-Vanvlack CE. The effect of an exercise program during hemodialysis on dialysis efficacy, blood pressure and quality of life in end-stage renal disease (ESRD) patients. Clin Nephrol. 2004;61:261-74.
[16]
17- Van Vilsteren MCBA, De Greef MHG, Huisman RM. The effects of a low-to-moderate intensity pre-conditioning exercise programme linked with exercise counselling for sedentary haemodialysis patients in The Nederlands: results of a randomized clinical trial. Nephrol Dial Transplant. 2005;20:141-46.
[17]
18- Nindl BC, Headley SA., Tuckow AP, Pandorf CE, Diamandi A, Khosravi MJ, et al. IGF-I system responses during 12 weeks of resistance training in end-stage renal disease patients. Growth Horm IGF Res. 2004;14:245¿50.
[18]
19- Headley S, Germain M, Mailloux P, Mulhern J, Ashworth B, Burris J, et al. Resistance training improves strength and functional measures in patients with end-stage renal disease. Am J Kidney Dis. 2002;40:355-64.
[19]
20- Fitts SS, Guthrie MR. Six-minute walk by people with chronic renal failure. Am J Phys Med Rehabil. 1995;74:54-58.
[20]
21- Csuka M, McCarty DJ. Simple method for measurement of lower extremity muscle strength. Am J Med. 1985;78:77-81.
[21]
22- Alonso J, Prieto L, Antó JM. La versión española del SF-36 Health Survey (Cuestionario de Salud SF-36): un instrumento para la medida de los resultados clínicos. Med Clin (Barc). 1995;104:771-76.
[22]
23- Painter P, Carlson L, Carey S, Paul SM, Myll J. Physical functioning and health-related quality of life changes with exercise training in hemodialysis patients. Am J Kidney Dis. 2000;35(3):482-92.
[23]
24- Cappy CS, Ablonka J, Schroeder ET. The effects of exercise during hemodialysis on physical performance and nutrition assessment. J Ren Nutr. 1999;9(2):63-70.
[24]
25- Molsted S, Eidemak I, Sorensen HT, Kristensen JH. Five months of physical exercise in hemodialysis patients: effects on aerobic capacity, physical function and self-rated health. Nephron Clin Pract. 2004;96:c76-c81.
[25]
26- Alonso J, Regidor E, Barrio G, Prieto L, Rodriguez C, De La Fuente L. Valores poblacionales de referencia de la versión española del Cuestionario de Salud SF-36. Med Clin (Barc). 1998;111:410-16.
