Links & Downloads
Man. Ther., Posturology Rehabil. J. 2017; 15
10.17784/mtprehabjournal.2017.15.506 doi: http://dx.doi.org/10.17784/mtprehabjournal.2017.15.506
Abstract:Background: Patients undergone hemodialysis (HD) suffer with energy-protein malnutrition, uremic myopathy and protein catabolism reducing their functional capacity, tolerance to exercise and aspects related to quality of life. Objective: The aim of this study was to evaluate the effects of the two protocols of inspiratory muscle training (IMT) on muscle strength, pulmonary function and related-health quality of life on male HD patients. Methods: Maximal inspiratory pressure (MIP) and maximal expiratory pressure (MEP), peak expiratory flow (PEF), forced expiratory volume in first second (FEV1 ), forced vital capacity (FVC) and the FEV1 /FVC ratio and quality of life were evaluated pre and post six months of IMT in HD patients. IMT was performed by one group using a specific training (Power breathe) device (T-IMT, n=19) and by the other with incentive spirometry (I-IMT, n= 15). Results: Following the inspiratory training, muscle strength improved in both groups. The group that used incentive spirometry had increments in MIP larger (39.8%, p<0.001) than the group that trained with the specific training device (28.3%, p=0.001). The KDQOL-SF dimensions showed significant difference in the T-IMT group in cognitive function (p=0.03), sexual function (p=0.009) and social function dimensions (p=0.04) and in the I-IMT group in the physical function dimension (p=0.03). Conclusion: It was proved that IMT improved muscle strength and I-IMT promoted increments significantly larger in MIP. Aspects of health-related quality of life of HD male patients improved significantly with T-IMT (sexual, social and cognitive functions), while I-IMT ameliorated only physical function.
Keywords:Breathing Exercises, Exercise Therapy, Quality of Life, Hemodialysis.
1. Kopple JD, Storer T, Casburi R. Impaired exercise capacity and exercise training in maintenance hemodialysis patients. Journal of renal nutrition. 2005; 15 (1):44-48.
2. Painter P. Physical functioning in end-stage renal disease patients: update 2005. hemodialysis international. International Symposium on Home Hemodialysis. 2005; 9 (3):218-235.
3. Caimi G, Caimi G, Carollo C, Lo Presti R. Pathophysiological and clinical aspects of malnutrition in chronic renal failure. Nutrition research reviews. 2005; 18 (1):89-97.
4. Kaysen GA, Greene T, Larive B, et al. The effect of frequent hemodialysis on nutrition and body composition: Frequent hemodialysis Network Trial. Kidney international. 2012; 82 (1):90-99.
5. Smogorzewski M, Piskorska G, Borum PR, Massry SG. Chronic renal failure, parathyroid hormone and fatty acids oxidation in skeletal muscle. Kidney Int. 1988; 33 (2):555-560.
6. Gordon PL, Sakkas GK, Doyle JW, Shubert T, Johansen KL. Relationship between vitamin D and muscle size and strength in patients on hemodialysis. Journal of Renal Nutrition. 2007; 17 (6):397-407.
7. Kouidi E, Albani M, Natsis K, et al. The effects of exercise training on muscle atrophy in haemodialysis patients. Nephrology Dialysis Transplantation. 1998; 13 (3):685-699.
8. Workeneh BT, Rondon-Berrios H, Zhang L, et al. Development of a diagnostic method for detecting increased muscle protein degradation in patients with catabolic conditions. J Am Soc Nephrol. 2006; 17 (11):3233-3239.
9. Lewis MI, Fournier M, Wang H, et al. Metabolic and morphometric profile of muscle fibers in chronic hemodialysis patients. J Appl Physiol. 2012; 112 (1):72-78.
10. Weiner P, Ganem R, Zamir D, Zonder H. Specific inspiratory muscle training in chronic hemodialysis. Harefuah. 1996;130(2):73-76, 144.
11. Silva VGd, Amaral C, Monteiro MB, Nascimento DMd, Boschetti JR. Efeitos do treinamento muscular inspiratório nos pacientes em hemodiálise; Effects of inspiratory muscle training in hemodialysis patients. J. bras. nefrol. 2011; 33(1):62-68.
12. Pellizzaro CO, Thome FS, Veronese FV. Effect of peripheral and respiratory muscle training on the functional capacity of hemodialysis patients. Renal failure. 2013; 35 (2):189-197.
13. Daugirdas JT. Second Generation Logatithmic Estimates of Single-Pool Variable Volume Kt/V: An Analyses of Error. Journal American of Society of Nephrology. 1993;14: 1205-1213.
14. Duarte PS, Ciconelli RM, Sesso R. Cultural adaptation and validation of the “Kidney Disease and Quality of Life--Short Form (KDQOL-SF 1.3)” in Brazil. Brazilian Journal of Medicine and Biology Research. 2005; 38(2):261-270.
15. Black LF, Hyatt RE. Maximal respiratory pressures: normal values and relationship to age and sex. American Review of Respiratory Disease. 1969; 99 (5):696-702.
16. Neder JA, Andreoni S, Lerario M, Nery L. Reference values for lung function tests: II. Maximal respiratory pressures and voluntary ventilation. Brazilian Journal of Medical and Biological Research. 1999; 32 (6):719-727.
17. Neder JA, Andreoni S, Lerario MC, Nery LE. Reference values for lung function tests. II. Maximal respiratory pressures and voluntary ventilation. Brazilian Journal of Medicine and Biology Research. 1999; 32 (6):719-727.
18. Miller MR, Hankinson J, Brusasco V, et al. Standardisation of spirometry. European Respiratory Journal. 2005; 26 (2):319-338.
19. Neder JA, Andreoni S, Castelo-Filho A, Nery LE. Reference values for lung function tests: I. Static volumes. Brazilian Journal of Medical and Biological Research. 1999; 32:703-717.
20. Chuter TA, Weissman C, Mathews DM, Starker PM. Diaphragmatic breathing maneuvers and movement of the diaphragm after cholecystectomy. Chest. 1990; 97 (5):1110-1114.
21. Kisner C, Colby LA. Therapeutic exercise: foundations and techniques. Philadelphia: F. A Davis Company; 2002.
22. Cury JL, Brunetto AF, Aydos RD. Efeitos negativos da insuficiência renal crônica sobre a função pulmonar e a capacidade funcional. Revista Brasileira de Fisioterapia. 2010;14(2):91-98.
23. Bakirci T, Sasak G, Ozturk S, Akcay S, Sezer S, Haberal M. Pleural effusion in long-term hemodialysis patients. Paper presented at: Transplantation proceedings2007.
24. Bavbek N, Akay H, Uz B, et al. The effects of L-carnitine therapy on respiratory function tests in chronic hemodialysis patients. Renal failure. 2010; 32 (2):157-161.
25. Kovačević P, Matavulj A, Veljković S, Rajkovača Z, Ponorac N, Huskić J. Ventilator function improvement in patients undergoing regular hemodialysis: relation to sex differences. Bosnian Journal of Basic Medical Sciences. 2006; 6 (1):29-32.
26. Karacan O, Tutal E, Uyar M, Eyuboglu FO, Sezer S, Ozdemir FN. Pulmonary function in uremic patients on long-term hemodialysis. Renal failure. 2004; 26 (3):273-278.
27. McConnell A. In: McConnell A, ed. Respiratory Muscle Training. Oxford: Churchill Livingstone; 2013:135-147.
28. Bush A, Gabriel R. Pulmonary function in chronic renal failure: effects of dialysis and transplantation. Thorax. 1991; 46 (6):424-428.
29. Bush A, Gabriel R. The lungs in uraemia: a review. Journal of the Royal Society of Medicine. 1985; 78 (10):849.
30. Gehm L, Propp DA. Pulmonary edema in the renal failure patient. The American journal of emergency medicine. 1989; 7 (3):336-339.
31. Rashid-Farokhi F, Pourdowlat G, Nikoonia MR, et al. Uremic pleuritis in chronic hemodialysis patients. hemodialysis international. International Symposium on Home Hemodialysis. 2013; 17 (1):94-100.
32. Levy NB. The sexual rehabilitation of the hemodialysis patient. Sexuality and Disability. 1979; 2 (1):60-65.
33. Korevaar JC, Merkus MP, Jansen MA, Dekker FW, Boeschoten EW, Krediet RT. Validation of the KDQOL-SF: a dialysis-targeted health measure. Quality of life research: an international journal of quality of life aspects of treatment, care and rehabilitation. 2002;11(5):437-447.
34. De Moura Reboredo M, Henrique DMN, De Souza Faria R, Chaoubah A, Bastos MG, De Paula RB. Exercise training during hemodialysis reduces blood pressure and increases physical functioning and quality of life. Artif Organs. 2010; 34 (7):586-593.
35. Painter P, Moore G, Carlson L, et al. Effects of exercise training plus normalization of hematocrit on exercise capacity and health-related quality of life. Am J Kidney Diseas. 2002; 39 (2):257-265.
36. Callaghan P. Exercise: a neglected intervention in mental health care? Journal of psychiatric and mental health nursing. 2004;11(4):476-483.