Efeitos de um programa de exercícios multicomponentes intradialíticos, em portadores de doença renal crônica: ensaio clínico randomizado

Abstract

Chronic kidney disease (DRC) consists of kidney damage and progressive loss of kidney function and is frequently associated with, so-called, civilization diseases, in particular cardiovascular disease and diabetes. From the diagnosis, changes in individual routine begin usually associated with changes in mood, level of physical activity and sedentary behavior, as well as the negative emotional states, such as depression, anxiety, stress and sleep disorders. Most patients with CKD (PDRC) are about 60% more active when compared to the population without DRC. The decrease in peripheral and respiratory muscle strength observed in the PDRC is a multifactorial consequence and it is not fully clear. Hemodialysis (HD) can cause inflammatory damage that may occur after the beginning of dialysis treatment and results on several complications, for example, the status of low-grade chronic infection. Although the consensus that body exercise is important and beneficial, we can observe that most training methodologies during HD use isolated and / or combined valences. However, an approach that uses a multicomponent exercise program (PEM) is still not much clear in DRC. The present study aimed to evaluate the effects of a program with multicomponent exercises (PEM), on muscle respiratory strength, functional functions, inflammatory markers, as well as health quality of life (QVRS) in the PDRC. Thirty-eight PDRC were randomized to GC n = 19 and GT n = 19. The GT performed 12 weeks of the PEM, which consisted of aerobic training (TA), inspiratory muscle training (TMI) and resistance training (TR), intradialitic, in different days, three times a week. The walking speed tests (TC6), acceleration time (TUG), hand pressure and respiratory muscle strength PI max and PE max were included. KDQOL SFTM 1.3 was used to measure quality of life. The adherence to the protocol was 92%, and the PDRC revealed significant changes in SL30, TUG, TC6, PPd, PPe, PI max, PE max, and QVRS or emotional aspect. Twelve weeks of PEM resulted in improvements in functional capacity, breathing muscle strength and emotional well-being in the PDRC. From the second proposit, was to evaluate the effects of a PEM on the physical activity level and on the psychobiological parameters, depression, mood and patients sleep quality with DRC (PDRC). To assess the physical activity level an accelerometer was used. Questionnaires about depression, sleep quality and mood were applied. The PDRC showed significant improvement in AFMV scores and depression, fatigue and vigor. Twelve weeks of intradialitic PEM appears to contribute to AFMV levels and acute mood scores: depression, fatigue and vigor in PDRC.