Abstract
Chronic kidney disease consists in the slow, progressive and irreversible loss in renal function and it is considered a social and economic problem worldwide, since it is linked to numerous diseases, as well as to higher public health spending. It is known that dialysis patients undergo a long period of restricted physical activity reflects in dysfunctions in various organical systems and in the quality of their lives. To verify the results of physical therapy intervention in patients on hemodialysis, for respiratory muscle function, grip strength and quality of life. Experimental, nonrandomized, quantitative and qualitative of a sample of 13 patients, 43.69 ± 9.28 years, on hemodialysis in the hospital Santa Casa de Diamantina/MG, selected by convenience. All patients were evaluated for maximal respiratory pressures (PI(max) e PE(max) ) and peak expiratory flow (PFE), before and after physiotherapy, which consisted of 3 sessions per week for a period of 2 months weeks: exercises for upper limbs, with technique PNF and breathing diaphragmatic; strengthening exercises for lower limbs and use of exerciser ball. Statistical analysis was performed using the student-t test and significance value at p < 0.05. Respective means for the variables before and after intervention were: PImáx (97.69 ± 28.3 cmH2O e 98.46 ± 23.39 cmH2O) p = 0.93; PEmáx (83.07 ± 31.19 cmH(2)O e 88.46 ± 14.0 cmH(2)O) p = 0.46 e PF (375.38 ± 75.23 L/min e 416.15 ± 57.37 L/min) p = 0.02. The dynamometer average pre intervention was: 57.23 ± 17.39 kgf and post intervention: 56.61 ± 16.09 kgf. In the SF-36, which evaluates the quality of life, improvement was observed in the eight domains, except the item 'vitality'. Of all the variables measured only the PFE was statistically significant. The proposed physical therapy protocol did not promote significant improvements in those variables, the statistical point, explaining in part the small sample size, time of protocol and proposed interventions.
Highlights
Chronic kidney disease consists in the slow, progressive and irreversible loss in renal function and it is considered a social and economic problem worldwide, since it is linked to numerous diseases, as well as to higher public health spending
Chronic kidney disease can be defined, according to the Brazilian Society of Nephrology,[2] as the slow, progressive, and irreversible loss of renal function, a condition in which the kidneys have no functionality as a consequence of damage to the nephrons,[1,2,3] resulting in incapacity of the organism to maintain renal metabolic and hydroelectrolytic balance.[4,5]
We believe that the mean peak expiratory flow (PEF) can have shown a significant increase due to the capacity of improving pulmonary expansion through the simple and effective technique of diaphragmatic breathing
Summary
Chronic kidney disease consists in the slow, progressive and irreversible loss in renal function and it is considered a social and economic problem worldwide, since it is linked to numerous diseases, as well as to higher public health spending. Objective: To verify the results of physical therapy intervention in patients on hemodialysis, for respiratory muscle function, grip strength and quality of life. Conclusion: The proposed physical therapy protocol did not promote significant improvements in those variables, the statistical point, explaining in part the small sample size, time of protocol and proposed interventions. A new and challenging area for physical therapy is the physical and functional rehabilitation of patients with chronic kidney disease (CKD).[1] Chronic kidney disease can be defined, according to the Brazilian Society of Nephrology,[2] as the slow, progressive, and irreversible loss of renal function, a condition in which the kidneys have no functionality as a consequence of damage to the nephrons,[1,2,3] resulting in incapacity of the organism to maintain renal metabolic and hydroelectrolytic balance.[4,5] Renal dysfunction is characterized by a glomerular filtration rate (GFR) lower than 60 mL/ min/1.73m2, for more than three months, and, when GFR reaches levels lower than 15 mL/min/1.73m2, the renal dysfunction is called end-stage CKD.[6]. According to data from the study by Coelho et al (2008),12 96% of the dialyses in our country are performed at units of the Brazilian Public Unified Health Care System (SUS).
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