Martins do Valle Felipe, Valle Pinheiro Bruno, Almeida Barros Ariane Aparecida, Ferreira Mendonça William, de Oliveira Ana Carla, de Oliveira Werneck Gustavo, de Paula Rogério Baumgratz, Moura Reboredo Maycon
Pulmonary and Critical Care Division, University Hospital of Federal University of Juiz de Fora, Juiz de Fora, Brazil.
School of Medicine, Federal University of Juiz de Fora, Juiz de Fora, Brazil.
Disabil Rehabil. 2020 Dec;42(25):3638-3644. doi: 10.1080/09638288.2019.1606857. Epub 2019 Apr 29.
We evaluated the effects of supervised intradialytic resistance training on physical activity in daily life (PADL), muscle strength, physical capacity and quality of life (QoL) in hemodialysis patients. Twenty-four hemodialysis patients were randomly assigned to either a 12-weeks moderate-intensity resistance training or a control period. An accelerometer evaluated PADL for seven consecutive days, measuring the time spent in different activities and positions of daily routine and the number of steps taken. Muscle strength, physical capacity and QoL were evaluated. After 12 weeks of training, we did not find significant difference (post-pre values) in walking time (-1.2 ± 18.3 vs. -9.2 ± 13.1 min/day); standing time (-10.2 ± 28.6 vs. 3.2 ± 20.1 min/day); sitting time (20.8 ± 58.9 vs. -30.0 ± 53.0 min/day); lying down time (-9.3 ± 57.9 vs. 34.6 ± 54.0 min/day); number of steps taken [-147 (1834) vs. -454 (2066)] and muscle strength in training and control group, respectively. There was a significant increase in the six-minute walking test distance (48.8 ± 35.9 vs. 6.9 ± 45.9 m, < 0.05) and some domains of QoL in the training compared to the control group. PADL was not modified after 12 weeks of intradialytic resistance training in hemodialysis patients. However, the exercise program was able to increase the physical capacity and some domains of QoL.Implications for rehabilitationPhysical activity in daily life was not modified after 12 weeks of intradialytic resistance training in hemodialysis patients.The exercise program was able to increase the physical capacity, efficacy of dialysis and some domains of quality of life in hemodialysis patients.The protocol used in this study was safe since no complications were observed during and after resistance training.These results should be interpreted with caution because we applied a moderate resistance training in both lower limbs and in the contralateral arteriovenous fistula upper limb, using perceived exertion by Borg scale to exercise prescription. Moreover, the safety protocol evaluation was not conducted.
我们评估了有监督的透析期间阻力训练对血液透析患者日常生活中的身体活动（PADL）、肌肉力量、身体能力和生活质量（QoL）的影响。24名血液透析患者被随机分配到为期12周的中等强度阻力训练组或对照组。使用加速度计连续7天评估PADL，测量日常不同活动和姿势所花费的时间以及步数。评估肌肉力量、身体能力和生活质量。训练12周后，我们发现训练组和对照组在步行时间（-1.2±18.3 vs. -9.2±13.1分钟/天）、站立时间（-10.2±28.6 vs. 3.2±20.1分钟/天）、坐姿时间（20.8±58.9 vs. -30.0±53.0分钟/天）、躺卧时间（-9.3±57.9 vs. 34.6±54.0分钟/天）、步数[-147（1834）vs. -454（2066）]和肌肉力量方面（前后值）均无显著差异。与对照组相比，训练组的六分钟步行试验距离（48.8±35.9 vs. 6.9±45.9米，P<0.05）和生活质量的某些领域有显著增加。血液透析患者进行12周的透析期间阻力训练后，PADL未发生改变。然而，该运动方案能够提高身体能力和生活质量的某些领域。
康复意义
血液透析患者进行12周的透析期间阻力训练后，日常生活中的身体活动未发生改变。
该运动方案能够提高血液透析患者的身体能力、透析效果和生活质量的某些领域。
本研究中使用的方案是安全的，因为在阻力训练期间和之后未观察到并发症。
这些结果应谨慎解释，因为我们对双下肢和对侧动静脉内瘘上肢均进行了中等强度的阻力训练，使用Borg量表的主观用力程度来制定运动处方。此外，未进行安全方案评估。
