Exercício resistido em pacientes com doença renal crônica em hemodiálise: influência na força muscular, capacidade funcional e qualidade de vida

Abstract

The incidence of patients with Chronic Kidney Disease (CKD) on dialysis in Brazil has increased over the years. The individuals with CKD who need dialysis treatment often exhibit muscle weakness, anemia, depression, metabolic and respiratory disorders, which interferes negatively on the quality of life. This study evaluated the effect of intradialytic resistance exercise protocol on muscle strength of the lower limbs, functional capacity, dialysis adequacy (Kt/V), quality of life and level of depression in patients with CKD before and after training. The study included 107 patients aged between 18 and 60 years, of both sexes, on hemodialysis for at least 1 year, sedentary and nonsmokers. We excluded people with infectious diseases, history of myocardial ischemia less than six months, patients with motor or cognitive response to the questionnaire of quality of life (KDQOL- SFTM) or depression scale (BDI). Patients were randomly divided into two groups: stretching (GA) and training (GT). The GA received intervention only to perform stretching in the lower limbs and the GT was subjected to stretching of the lower limbs associated with resistance exercise protocol in the lower limbs for 8 weeks with a frequency of three times a week. Each session was performed for 45 minutes in the first two hours of dialysis. The results were expressed as mean ± standard deviation. Differences in the frequencies were tested using the chi-square test. For the continuous variables were used the parametry assumptions tested and were subjected to "t" test or Mann-Whitney (descriptive p < 0,05). Muscle strength of lower limbs, functional capacity and the Kt/V, measured by the difference between the value before and after the intervention, were increased (p <0,05) in GT compared to GA. Furthermore, the level of depression was reduced in GT compared to GA. In the questionnaire of quality of life, was observed the increase for the domains: pain (p <0,01), general health (p <0,01), social function (p = 0.01), energy/fatigue (p <0,01), physical health composition (p <0,01) and mental health composition (p = 0.02) after training in comparison to stretching. The results of this study showed that exercise resisted held in intradialytic stage, three times a week for two months increases muscle strength of the lower limbs, functional capacity and the Kt/V associated with a positive impact on quality of life and levels of depression.