Credits: Vitor Hugo Loni
Work involving physical exercise and the population affected by chronic kidney disease is very minimal. Thinking about it, today Physical Educator Vitor Hugo Loni addressed the issue in his monograph, sent to us, which we will summarize the results and discussion.
The author used 20 volunteers, 10 affected by the disease and who underwent hemodialysis and 10 healthy, the intention was to compare some variables between the two groups in its current state, unprecedented intervention.
The assessments made by the teacher were: blood pressure measurement using a sphygmomanometer in order to evaluate the systolic and diastolic blood pressure before and after the stress tests. Used the grip dynamometer test by both the left and right hand arm and abdominal flexion resistance 1 minute.
The results of their study, the author has produced a comparison between the groups, and in the strength indicators and muscular endurance, found significant differences between groups in the variables hold left manual, right hand grip and arm bending, abdominal test 1 minute was higher in healthy subjects, however, not significant.
Regarding PA, the author measured this variable before and after each evaluation (arm bending, manual and abdominal hold). In the handgrip no significant difference between groups. The arm bending only significant difference in systolic blood pressure, the same occurred in the abdominal test.
The age of the population selected by Vitor had an average of 40 years, age is a very decisive factor for CRF patients, because the longer have the need for treatment, the greater are the losses related to muscle mass and physical abilities (Deligiannis, 2004). Another element is that people who develop the IRC with older tend to have a higher resistance to treatment, and reduced survival.
Regarding body composition IRC carriers, this is very much affected by the structure of the musculoskeletal system, which tend to be mostly a structure and functions outside the normal range, this abnormality is called “uremic myopathy” (Deligiannis, 2004) .
This myopathy is the result of several factors, such as malnutrition and the low intake of energy nutrients, a displayed deregulation of protein synthesis and the ability to metabolize amino acids, which limits the supply of material for protein synthesis, keeping active normally protein degradation, which leads to catabolism and anabolism not, the trend to physical inactivity and sedentary lifestyle presented by CRF patients, adverse effects caused either by excess parathyroid hormone as the uremic toxins, difficulty in metabolizing vitamin D, depletion carnitine, and several other disorders of electrolyte that comes to generating abnormalities in the autonomic nervous system and so a constant loss of physical conditioning (Deligiannis, 2004).
Volker (2004), analyzes the reduction of physical activity and exercise, caused by diseases, are the main causes of lean mass loss in this population.
Ikizler and Himmelfarb (2006) state that individuals dependent on hemodialysis suffer from various catabolic processes, from uremia caused by the lack of a proper exercise program where the protein level and energy are constantly decreasing both low muscle fibers skeletal as visceral proteins. What makes the complicated pathophysiology, by a variety of factors and with little explanation and proven theories, yet it is clear that the irregularities in muscle function in the performance of exercises and physical activities in IRC will gradually worsened over time.
It has been proven that people who require hemodialysis show a much smaller amount of amino acids compared with people without this condition, this state is similar to someone constantly fasting, where it is clear the need for a good diet and supplementation during practice exercises or there will be significant anabolic effects in the treatment (JOHANSEN et al., 2006).
Regarding the prescription of exercise in patients with CRF, Stores et al. (2005) state that resistance exercises do not promote high elevations of blood pressure in IRC subjects, holds your prescription, and also contribute to improving muscle strength, work rate, peak VO2 max, decreased fatigue and physical function . Thus rehabilitation programs with this type of training protocol generate morphological and metabolic benefits improving work capacity and independence.
The post hemodialysis presented fatigue is linked to the decline of patient survival rate (Kutner et al., 1997; Aukrust et al., 2007). Thus Heidenheim et al. (2003) noted that the time of recovery after dialysis fatigue to individuals who pass by hemodialysis three times per week decreased from 397 minutes to 44 minutes daily individuals with hemodialysis.
The work produced by Loni (2013) is one of the few related to this population, so many gaps remain.
The physical exercise appears as a possibility to minimize the deleterious effects of the disease derivatives.