Repercussion of physiotherapy intradialytic protocol for respiratory muscle function, grip strength and quality of life of patients with chronic renal diseases

J Bras Nefrol. 2010 Dec;32(4):355-66.
[Article in English, Portuguese]

Abstract

Introduction: 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.

Objective: To verify the results of physical therapy intervention in patients on hemodialysis, for respiratory muscle function, grip strength and quality of life.

Methodology: 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.

Results: 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.

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.

MeSH terms

  • Adult
  • Chronic Disease
  • Clinical Protocols
  • Female
  • Hand Strength*
  • Humans
  • Kidney Diseases / physiopathology*
  • Kidney Diseases / therapy*
  • Male
  • Middle Aged
  • Physical Therapy Modalities*
  • Quality of Life*
  • Renal Dialysis*
  • Respiratory Muscles / physiopathology*
  • Surveys and Questionnaires
  • Young Adult