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为接受每日短时血液透析的患者实施抗阻训练计划:一项可行性研究。

Implementing a resistance training programme for patients on short daily haemodialysis: A feasibility study.

作者信息

Ribeiro Heitor S, Cunha Vinícius A, Dourado Gustavo Í, Duarte Marvery P, Almeida Lucas S, Baião Victor M, Inda-Filho Antônio J, Viana João L, Nóbrega Otávio T, Ferreira Aparecido P

机构信息

Faculty of Physical Education, University of Brasília, Brasília, Brazil.

Interdisciplinary Research Department, University Centre ICESP, Brasília, Brazil.

出版信息

J Ren Care. 2023 Jun;49(2):125-133. doi: 10.1111/jorc.12423. Epub 2022 May 8.

Abstract

BACKGROUND

Kidney failure patients receiving haemodialysis experience protein-energy wasting, muscle mass loss and physical function impairment. Intradialytic exercise interventions seem to modify these features, but they are often not implemented as a clinical routine.

OBJECTIVE

To investigate the feasibility of implementing a supervised intradialytic resistance training programme as a clinical routine for patients receiving short daily haemodialysis.

DESIGN

A prospective longitudinal study.

PARTICIPANTS

Eighteen patients in a supervised intradialytic resistance training programme for 8 months.

MEASUREMENTS

It consisted of a warm-up, lower- and upper-limb resistance exercises and a cool-down. Patients performed the resistance training during the first half of haemodialysis, twice a week, supervised by exercise physiologists and physiotherapists. The feasibility was assessed by the total and partial adherences, the reasons for refusing or for not exercising and the intradialytic complications.

RESULTS

From a total of 953 potential exercise sessions, 759 were performed, with a 79.6% adherence rate. In the first 9 weeks, the adherence rate was 86.6% and the lowest rate was in the 19-27 weeks (73.5%). The main intradialytic complication during exercise sessions was hypotension (n = 31; 4.1%). The highest number of complications was reported during the first 9 weeks (n = 27; 9.1%). The main reasons for refusing or for not performing the intradialytic exercise sessions were clinical complications previous to exercise time (n = 63; 32.5%) and self-reported indisposition (n = 62; 32.0%).

CONCLUSIONS

The intradialytic resistance training programme, supervised by exercise physiologists and physiotherapists, had very low complications, achieved a high long-term adherence rate and showed to be feasible as a clinical routine for patients receiving short daily haemodialysis.

摘要

背景

接受血液透析的肾衰竭患者会出现蛋白质能量消耗、肌肉量减少和身体功能受损。透析期间的运动干预似乎可以改善这些特征,但它们通常未作为临床常规实施。

目的

探讨将有监督的透析期间阻力训练计划作为接受每日短程血液透析患者的临床常规实施的可行性。

设计

一项前瞻性纵向研究。

参与者

18名患者参加了为期8个月的有监督的透析期间阻力训练计划。

测量

该计划包括热身、下肢和上肢阻力运动以及放松运动。患者在血液透析的前半段进行阻力训练,每周两次,由运动生理学家和物理治疗师监督。通过总依从性和部分依从性、拒绝或不运动的原因以及透析期间的并发症来评估可行性。

结果

在总共953次潜在运动课程中,进行了759次,依从率为79.6%。在前9周,依从率为86.6%,最低率出现在第19 - 27周(73.5%)。运动期间主要的透析期间并发症是低血压(n = 31;4.1%)。并发症数量最多的报告出现在前9周(n = 27;9.1%)。拒绝或不进行透析期间运动课程的主要原因是运动时间之前的临床并发症(n = 63;32.5%)和自我报告的身体不适(n = 62;32.0%)。

结论

由运动生理学家和物理治疗师监督的透析期间阻力训练计划并发症非常少,实现了较高的长期依从率,并且作为接受每日短程血液透析患者的临床常规显示是可行的。

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