Abstract
The aim of this study was to analyze the effects of physical training (PT) on physical fitness and quality of life (QoL) of patients undergoing hemodialysis (HD). For this purpose, 22 patients were randomly divided into a nonintervention group (control, n=11) and an intervention group (n=11). Patients in the intervention group were submitted to PT (consisting of aerobic exercise, strength training, and stretching) during HD, three times/week, for 4 months. Physical fitness was evaluated by the six-minute walk test (T6), respiratory muscle strength (RMS) testing, chair-stand test (CST), and abdominal strength test. The SF-36 was used to evaluate QoL. In addition, a semistructured interview was applied to evaluate the patient's perception of the benefits of PT. After PT, patients in the intervention group showed an increase in the distance walked in the T6 (p<0.004), RMS (inspiratory pressure: p<0.002; expiratory pressure: p<0.001), CST (p<0.001), and abdominal strength test (p<0.001). In addition, improvement of QoL was observed in the following domains: physical functioning (p<0.001), physical role functioning (p<0.003), pain (p<0.04), general health (p<0.02), and emotional well-being (p<0.01). The interviews permitted to divide the patient's perception of the benefits of PT into three categories: physical, psychological, and social benefits. In conclusion, PT improved the physical fitness and QoL of patients on HD as demonstrated by the assessment of the researchers and by the perception of the patients themselves.
Highlights
According to the 2010 Brazilian dialysis census[1], the annual prevalence of patients enrolled in dialysis programs in Brazil was 483 million people, 22.4% of them living in the southern region
In addition to this loss in physical function, studies have emphasized that these patients have a poor perception of quality of life (QoL), a fact interfering with their rehabilitation[6,7]
With respect to respiratory muscle strength expressed as respiratory pressures, the present study showed that regular physical exercises significantly increased PImax and PEmax in the intervention group
Summary
According to the 2010 Brazilian dialysis census[1], the annual prevalence of patients enrolled in dialysis programs in Brazil was 483 million people, 22.4% of them living in the southern region. Hemodialysis (HD) was the most frequent type used by 89.7% of the patients[1]. Hemodialysis patients experience a monotonous and restricted daily life[2]. Activities are limited after the beginning of treatment, a fact contributing to physical inactivity and incapacity[3]. A reduction in maximal oxygen uptake (about 50%) and muscle strength (30 to 40%) is observed in HD patients when compared to healthy subjects[5]. In addition to this loss in physical function, studies have emphasized that these patients have a poor perception of quality of life (QoL), a fact interfering with their rehabilitation[6,7]
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