Andrade Francini Porcher, Borba Gabrielle Costa, da Silva Kacylen Costa, Ferreira Tatiane de Souza, de Oliveira Samantha Gonçalves, Antunes Verônica Verleine Hörbe, Veronese Francisco Veríssimo, Rovedder Paula Maria Eidt
Ciências Pneumológicas Post-Graduation Program, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil.
Division of Nephrology, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, Brazil.
Semin Dial. 2022 Mar;35(2):181-189. doi: 10.1111/sdi.13020. Epub 2021 Sep 18.
Chronic kidney disease (CKD) is a factor that predisposes to gradual physical deconditioning from its early stages leading to cardiorespiratory fitness and musculoskeletal system impairment. We evaluated the effects of combined and periodized intradialytic exercise training on cardiopulmonary fitness and respiratory function in HD subjects.
A randomized controlled trial with HD subjects was allocated into two groups: exercise group (EXG) and usual care group (UCG). EXG performed a 12-week combined and periodized intradialytic training. UCG maintained the HD routine.
Thirty-nine HD subjects were analyzed (EXG = 20; UCG = 19). The EXG in comparison with the UCG showed improvements in peak oxygen consumption (Δ3.1[0.4-5.5] vs. -0.2[-2.0-1.5] ml/kg/min; p = 0.003), forced expiratory volume in the first second (Δ0.1[-0.0-0.1] vs. -0.0[-0.1-0.0] L; p = 0.022), forced vital capacity (Δ0.1[0.0-0.2] vs. -0.1[-0.2-0.0] L; p = 0.005), peak expiratory flow (Δ0.4[-0.7-1.2] vs. -0.1[-0.5-0.2] L; p = 0.046), and maximal inspiratory pressure (Δ7.35[-8.5-17.5] vs. -4.0[-18.0-12.0] cmH O; p = 0.028). The EXG, different from the UCG, did not worsen the maximal expiratory pressure (Δ0.1[-8.8-7.5] vs. -2.5[-15.0-9.0] cmH O; p = 0.036). Besides, EXG showed a significant improvement in quadriceps strength (32.05 ± 10.61 vs. 33.35 ± 11.62 kg; p = 0.042).
The combined and periodized intradialytic exercise training improved cardiopulmonary fitness, respiratory function, inspiratory muscle strength, and quadriceps strength, beyond maintaining the expiratory muscle strength in HD subjects.
慢性肾脏病（CKD）是一个从早期阶段就使机体逐渐出现身体机能下降的因素，会导致心肺功能和肌肉骨骼系统受损。我们评估了联合周期性透析内运动训练对血液透析（HD）患者心肺功能和呼吸功能的影响。
一项针对HD患者的随机对照试验被分为两组：运动组（EXG）和常规护理组（UCG）。EXG进行了为期12周的联合周期性透析内训练。UCG维持HD常规治疗。
对39例HD患者进行了分析（EXG = 20例；UCG = 19例）。与UCG相比，EXG在峰值耗氧量（Δ3.1[0.4 - 5.5] vs. -0.2[-2.0 - 1.5] ml/kg/min；p = 0.003）、第一秒用力呼气量（Δ0.1[-0.0 - 0.1] vs. -0.0[-0.1 - 0.0] L；p = 0.022）、用力肺活量（Δ0.1[0.0 - 0.2] vs. -0.1[-0.2 - 0.0] L；p = 0.005）、呼气峰值流速（Δ0.4[-0.7 - 1.2] vs. -0.1[-0.5 - 0.2] L；p = 0.046）和最大吸气压力（Δ7.35[-8.5 - 17.5] vs. -4.0[-18.0 - 12.0] cmH₂O；p = 0.028）方面有改善。与UCG不同，EXG并未使最大呼气压力恶化（Δ0.1[-8.8 - 7.5] vs. -2.5[-15.0 - 9.0] cmH₂O；p = 0.036）。此外，EXG在股四头肌力量方面有显著改善（32.05 ± 10.61 vs. 33.35 ± 11.62 kg；p = 0.042）。
联合周期性透析内运动训练改善了HD患者的心肺功能、呼吸功能、吸气肌力量和股四头肌力量，且维持了呼气肌力量。
