Muscular resistance program for lower limbs improves uremic sarcopenia

Authors

DOI:

https://doi.org/10.11606/issn.2317-0190.v30i1a203815

Keywords:

Sarcopenia, Resistance Training, Lower Extremity, Vitamin D Deficiency, Renal Insufficiency, Chronic, Renal Dialysis

Abstract

Chronic renal failure (CRF) is characterized by the irreversible deterioration of the nephrons, which causes a chronic condition with impaired physical performance of individuals, mainly of the lower limbs (LL), due to uremic sarcopenia and vitamin D deficit. Objective: To evaluate the efficiency of a muscular resistance program for the lower limbs of patients with CRF. Methods: Five patients with CRF participated in the rehabilitation program that took place thirty minutes before the beginning of hemodialysis (HD), twice a week, each session lasted 20 minutes, totaling 14 sessions, the first and last ones were destinated for evaluation. The intervention consisted of functional circuit and resistance exercises, isotonic with open and closed kinetic chain. The 30-second sit-and-stand test and the one maximum repetition test (1MR) were evaluated. Results: After application, it was found that post muscle strength (2.92 ± 1.10) was statistically higher than pre (1.90 ± 1.29, p= 0.02), in addition to showing that the variables of load progression and post muscle strength are directly correlated (r² 0.976, p= 0.005). The performance in the 30-second sit and stand test showed a significant difference pre (6.8 ± 2.28) and post intervention (10.4 ± 1.67, p= 0.004). Conclusion: The lower limbs muscular resistance program was effective, as it increased functional physical performance with gains in muscle strength and endurance in hemodialysis patients.

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References

Paixão Duarte TT, Chagas Costa L, Lima WL, Silva Magro MC. Influência de fatores clínicos na lesão renal aguda. Cienc Enferm. 2020;26(6):1–9. Doi: https://doi.org/10.4067/s0717-95532020000100205

Ammirati AL. Chronic Kidney Disease. Rev Assoc Med Bras (1992). 2020;66Suppl 1(Suppl 1):s03-s09. Doi: https://doi.org/10.1590/1806-9282.66.S1.3

Garcia Sanchez JJ, Thompson J, Scott DA, Evans R, Rao N, Sörstadius E, et al. Treatments for chronic kidney disease: a systematic literature review of randomized controlled trials. Adv Ther. 2022;39(1):193-220. Doi: https://doi.org/10.1007/s12325-021-02006-z

Aguiar LK, Ladeira RM, Machado IE, Bernal RTI, Moura L, Malta DC. Fatores associados à doença renal crônica segundo critérios laboratoriais da Pesquisa Nacional de Saúde. Rev Bras Epidemiol. 2020;23:e200101. Doi: https://doi.org/10.1590/1980-549720200101

Neves PDMM, Sesso RCC, Thomé FS, Lugon JR, Nascimento MMN. Inquérito brasileiro de diálise 2019. J Bras Nefrol. 2021;43(2):217–27. Doi: https://doi.org/10.1590/2175-8239-JBN-2020-0161

Vanden Wyngaert K, Van Craenenbroeck AH, Holvoet E, Calders P, Van Biesen W, Eloot S. Composite Uremic Load and Physical Performance in Hemodialysis Patients: A Cross-Sectional Study. Toxins (Basel). 2020;12(2):135. Doi: https://doi.org/10.3390/toxins12020135

Sabatino A, Cuppari L, Stenvinkel P, Lindholm B, Avesani CM. Sarcopenia in chronic kidney disease: what have we learned so far? J Nephrol. 2021;34(4):1347-72. Doi: https://doi.org/10.1007/s40620-020-00840-y

Merino García E, Pérez del Barrio MP, Borrego Hinojosa J, Borrego Utiel FJ, Sánchez Perales MC. Renal lymphomatous infiltration in patient with nefrotic syndrome. Nefrología. 2018;38(1):92–4. Doi: https://doi.org/10.1016/j.nefro.2016.12.004

Nishi H, Takemura K, Higashihara T, Inagi R. Uremic sarcopenia: clinical evidence and basic experimental approach. Nutrients. 2020;12(6):1814. Doi: https://doi.org/10.3390/nu12061814

Yao P, Bennett D, Mafham M, Lin X, Chen Z, Armitage J, et al. Vitamin D and calcium for the prevention of fracture: a systematic review and meta-analysis. JAMA Netw Open. 2019;2(12):e1917789. Doi: https://doi.org/10.1001/jamanetworkopen.2019.17789

Zhang S, Miller DD, Li W. Non-musculoskeletal benefits of vitamin d beyond the musculoskeletal system. Int J Mol Sci. 2021;22(4):2128. Doi: https://doi.org/10.3390/ijms22042128

Otobe Y, Rhee CM, Nguyen M, Kalantar-Zadeh K, Kopple JD. Current status of the assessment of sarcopenia, frailty, physical performance and functional status in chronic kidney disease patients. Curr Opin Nephrol Hypertens. 2022;31(1):109-28. Doi: https://doi.org/10.1097/MNH.0000000000000763

Simões M, Gregório ML, Godoy MF, Accioly MF. Respiratory and muscular effects of a physiotherapy protocol carried out during hemodialysis in individuals with chronic renal failure: preliminary results. Mot Rev Educ Fis. 2020;26(3):e10200001. Doi: https://doi.org/10.1590/S1980-6574202000030001

Silva JS, Sousa TS, Silva CFR, Siqueira F, Onofre T. Respiratory muscle strength and quality of life in chronic kidney disease patients undergoing hemodialysis. Fisioter Mov. 2021;34:e34113. Doi: https://doi.org/10.1590/fm.2021.34113

Brown LE, Weir JP. ASEP Procedures recommendation I: accurate assessment of muscular strength and power. JEPonline. 2001;4(3):1-21.

Jones CJ, Rikli RE, Beam WC. A 30-s chair-stand test as a measure of lower body strength in community-residing older adults. Res Q Exerc Sport. 1999;70(2):113-9. Doi: https://doi.org/10.1080/02701367.1999.10608028

Uth N, Sørensen H, Overgaard K, Pedersen PK. Estimation of VO2max from the ratio between HRmax and HRrest--the Heart Rate Ratio Method. Eur J Appl Physiol. 2004;91(1):111-5. Doi: https://doi.org/10.1007/s00421-003-0988-y

Camarda SRA, Tebexreni AS, Páfaro CN, Sasai FB, Tambeiro VL, Juliano Y, et al. Comparação da freqüência cardíaca máxima medida com as fórmulas de predição propostas por Karvonen e Tanaka. Arq Bras Cardiol. 2008;91(5):311–4. Doi: https://doi.org/10.1590/S0066-782X2008001700005

American College of Sports Medicine. American College of Sports Medicine position stand. Progression models in resistance training for healthy adults. Med Sci Sports Exerc. 2009;41(3):687-708. Doi: https://doi.org/10.1249/MSS.0b013e3181915670

Gonçalves IMF, Pessoa MB, Leitão AS, Godoy GP, Nonaka CFW, Alves PM. Salivary and Serum Biochemical Analysis from Patients with Chronic Renal Failure in Hemodialysis: A Cross-Sectional Study. Pesqui Bras Odontopediatria Clin Integr. 2021;21:e0036. Doi: https://doi.org/10.1590/pboci.2021.091

Malta DC, Machado IE, Pereira CA, Figueiredo AW, Aguiar LK, Almeida WS, et al. Avaliação da função renal na população adulta brasileira, segundo critérios laboratoriais da Pesquisa Nacional de Saúde. Rev Bras Epidemiol. 2019;22(suppl 2):E190010.SUPL.2. Doi: https://doi.org/10.1590/1980-549720190010.supl.2

Huidobro E JP, Tagle R, Guzmán AM. Creatinina y su uso para la estimación de la velocidad de filtración glomerular. Rev Med Chil. 2018;146(3):344-350. Doi: https://doi.org/10.4067/s0034-98872018000300344

Franco AO, Starosta RT, Roriz-Cruz M. The specific impact of uremic toxins upon cognitive domains: a review. J Bras Nefrol. 2019;41(1):103-111. Doi: https://doi.org/10.1590/2175-8239-JBN-2018-0033

Pajek M, Jerman A, Osredkar J, Ponikvar JB, Pajek J. Association of uremic toxins and inflammatory markers with physical performance in dialysis patients. Toxins (Basel). 2018;10(10):403. Doi: https://doi.org/10.3390/toxins10100403

Franca Gois PH, Wolley M, Ranganathan D, Seguro AC. Vitamin D deficiency in chronic kidney disease: recent evidence and controversies. Int J Environ Res Public Health. 2018;15(8):1773. Doi: https://doi.org/10.3390/ijerph15081773

Khelifi N, Desbiens LC, Sidibé A, Mac-Way F. Vitamin D analogues and fracture risk in chronic kidney disease: a systematic review and meta-analysis of randomized controlled trials. JBMR Plus. 2022;6(4):e10611. Doi: https://doi.org/10.1002/jbm4.10611

Dzik KP, Kaczor JJ. Mechanisms of vitamin D on skeletal muscle function: oxidative stress, energy metabolism and anabolic state. Eur J Appl Physiol. 2019;119(4):825-39. Doi: https://doi.org/10.1007/s00421-019-04104-x

Ahmed Sharif D. The Effectiveness of vitamin D supplementation on oxidative and inflammatory markers in patients suffering from end-stage renal disease, a randomized controlled trial. Cell Mol Biol (Noisy-le-grand). 2022;68(5):7-15. Doi: https://doi.org/10.14715/cmb/2022.68.5.2

Grgic J, Lazinica B, Schoenfeld BJ, Pedisic Z. Test-Retest Reliability of the One-Repetition Maximum (1RM) Strength Assessment: a Systematic Review. Sports Med Open. 2020;6(1):31. Doi: https://doi.org/10.1186/s40798-020-00260-z

Rosa CSDC, Nishimoto DY, Souza GDE, Ramirez AP, Carletti CO, Daibem CGL, et al. Effect of continuous progressive resistance training during hemodialysis on body composition, physical function and quality of life in end-stage renal disease patients: a randomized controlled trial. Clin Rehabil. 2018;32(7):899-908. Doi: https://doi.org/10.1177/0269215518760696

Theodorakopoulou MP, Boutou AK, Pella E, Alexandrou ME, Patoulias D, Kassimatis E, et al. Cardiorespiratory fitness in kidney transplant recipients compared to patients with kidney failure: a systematic review and meta-analysis. Transpl Int. 2021;34(10):1801-11. Doi: https://doi.org/10.1111/tri.13961

Yeh ML, Wang MH, Hsu CC, Liu YM. Twelve-week intradialytic cycling exercise improves physical functional performance with gain in muscle strength and endurance: a randomized controlled trial. Clin Rehabil. 2020;34(7):916-26. Doi: https://doi.org/10.1177/0269215520921923

Zhou Y, Hellberg M, Svensson P, Höglund P, Clyne N. Sarcopenia and relationships between muscle mass, measured glomerular filtration rate and physical function in patients with chronic kidney disease stages 3-5. Nephrol Dial Transplant. 2018;33(2):342-348. Doi: https://doi.org/10.1093/ndt/gfw466

Gadelha AB, Cesari M, Corrêa HL, Neves RVP, Sousa CV, Deus LA, et al. Effects of pre-dialysis resistance training on sarcopenia, inflammatory profile, and anemia biomarkers in older community-dwelling patients with chronic kidney disease: a randomized controlled trial. Int Urol Nephrol. 2021;53(10):2137-47. Doi: https://doi.org/10.1007/s11255-021-02799-6

Published

2023-03-31

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Original Article

How to Cite

1.
Sampaio LS, Campos R. Muscular resistance program for lower limbs improves uremic sarcopenia. Acta Fisiátr. [Internet]. 2023 Mar. 31 [cited 2024 Jul. 18];30(1):27-33. Available from: https://periodicos.usp.br/actafisiatrica/article/view/203815