Alterações do exercício físico aquático na qualidade de vida, nos marcadores bioquímicos e no risco de sarcopenia de indivíduos com doença renal crônica em estágio não dialítico: um estudo piloto

Abstract

The present study aimed to verify the alterations of an aquatic physical exercise protocol lasting 4 weeks on the quality of life, biochemical markers, and risk of sarcopenia in individuals with non-dialytic stage chronic kidney disease. This was a non-randomized clinical trial, conducted as a pilot study. The sample population comprised a total of 7 participants, including 3 men and 4 women, aged between 18 and 75 years. General characterization parameters were evaluated (Health and Lifestyle Questionnaire); sarcopenia risk (SARC-F); perception of quality of life (WHOQOL-BREF); functional capacity (handgrip test and 4-meter gait speed); biochemical parameters (blood and urine). Aquatic physical exercises were utilized for intervention over 4 weeks, twice a week, for 40 minutes each session, comprising varied exercises, static and in motion, targeting all muscle groups. The data were analyzed using Paired T-Test and expressed as calculated mean and standard deviation. Paired T-Test was employed to verify withinparticipant comparisons. Results: Regarding the estimated sarcopenia risk with calf circumference, there was a decrease in the risk presence from 85.7% to 42.85%, and handgrip strength increased in both arms, from 24.9 ± 5.3 kg to 27.4 ± 3.3 kg for the right arm, and from 24.7 ± 5.5 kg to 26.5 ± 4.4 kg for the left arm. Gait speed also improved from 3.9 ± 0.3 seconds to 3.15 ± 0.3 seconds over the 4-meter course. Regarding quality of life, there was an improvement in the group's perceptions in the physical dimension (3.3 ± 0.6 to 3.6 ± 0.4), psychological dimension (3.8 ± 0.2 to 3.9 ± 0.6), social relationships (3.4 ± 0.3 to 3.7 ± 0.4), and environment (3.5 ± 0.3 to 3.6 ± 0.5). Concerning biochemical markers, there was a decrease in the following variables: urine specific gravity (1015 ± 4.29 to 1012 ± 4.69), urine color index (3.66 ± 0.44), protein (110 ± 126 mg/dL to 96.42 ± 116.3 mg/dL), and urine glucose (600 ± 400 mg/dL to 514 ± 416.3 mg/dL). No significant results were found in the comparison of means for any of the variables (due to sample size error) and significance in the Paired T-Test. Conclusion: After 4 weeks of aquatic exercises, individuals with conservative stage CKD showed improvements in physical fitness and functional capacity, such as: reduction of sarcopenia risk with calf circumference; improvement in quality of life perceptions in physical, psychological, social, and environmental dimensions; increased muscle strength; and subtle improvement in some biochemical markers (urine specific gravity, urine color index, protein, and urine glucose). Aquatic exercise appears as a promising alternative for the non-pharmacological treatment of the chronic kidney population, suggesting its importance for future public health research.