Abstract
Abstract Introduction: Exercise promotes physiological improvements that reflect better quality of life and survival among chronic kidney disease patients. However, little is known about the effect of exercise on postural control of hemodialysis patients. Objective: To evaluate the effect of intradialytic aerobic exercise on postural balance in patients on hemodialysis. Methods: a pilot study with seven individuals was conducted at the Hemodialysis Center of Bauru State Hospital. The Berg Balance Scale evaluated balance and postural balance was evaluated by the force platform Advance Mechanical Technology Inc. (AMTI - AccuGait). Trunk mean sway amplitude in the anterior-posterior (AP) and medial-lateral (ML) directions and mean velocity in the AP and ML directions were assessed. Secondary outcomes about functional capacity and body composition (DEXA) were evaluated. The aerobic exercise was performed with a ergometric bicycle during the first two hours of hemodialysis session for 50-60 minutes (BORG >12), three times a week for 12-weeks. Results: Four men and three women, 52.86 ± 11.08 years, participated in the study. There was no difference between pre and post-test of postural balance outcomes. Although the results were not statistically significant, except for the lean body mass and leg lean mass, the presented pilot study suggests improved functional balance and lower limb strength. Conclusion: The 12-weeks of aerobic exercise protocol during hemodialysis despite inducing gains in lean body mass and leg lean mass, was not able to promote improvements in postural control of chronic renal failure patients on hemodialysis.
Highlights
Exercise promotes physiological improvements that reflect better quality of life and survival among chronic kidney disease patients
Little is known about the effect of exercise on postural control of hemodialysis patients
The hemodialysis center has capacity to treat ~164 patients, these patients are divided into two groups according to the day of the week (Monday, Wednesday, Friday or Tuesday, Friday, Saturday) and in three shifts according to the time of day
Summary
Exercise promotes physiological improvements that reflect better quality of life and survival among chronic kidney disease patients. Individuals with chronic kidney disease have a progressive and irreversible loss of renal function, but a complex syndrome comprised of metabolic changes involving uremia and abnormal electrolyte balance [2], anemia [3], impaired hormonal response [4], cardiopulmonary diseases [5], oxidative stress [6], chronic inflammation and impaired immune system [7]. Concomitant to these characteristics, the clinical profile of these patients is associated with reduced muscle strength and endurance [8]. Recent data have shown that chronic renal failure patients on hemodialysis have lower postural control and balance compared to healthy individuals [11, 12], higher risk of falling incidence than the general population and the elderly [13], and high risk of fractures, given the high prevalence of osteoporosis in this population [4, 14]
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