Effects of a Conventional Versus Adapted Intradialytic Cardiovascular and Metabolic Rehabilitation Program With Inspiratory Muscle Training: A Randomized Controlled Trial
Chronic Renal Failure; Renal Dialysis; Exercise Therapy.
BACKGROUND: Chronic Kidney Disease (CKD) is characterized by the inability of the kidneys to filter blood and maintain the body’s homeostasis. Individuals diagnosed with this condition often present multiple adverse effects across various organ systems, notably reduced muscle strength, a condition frequently associated with protein degradation and consequent generalized muscle atrophy. Physical exercise is essential in the management of this population, as it can promote improvements in quality of life. Inspiratory Muscle Training (IMT), which has shown efficacy in increasing respiratory muscle strength, has emerged as a relevant strategy to complement the rehabilitation of these individuals.OBJECTIVES: To compare a conventional intradialytic cardiovascular and metabolic rehabilitation protocol with a conventional protocol combined with inspiratory muscle training in patients with CKD undergoing hemodialysis. METHODS: Randomized, controlled, assessor- and statistician-blinded clinical trial. The target population consisted of individuals diagnosed with CKD who were undergoing hemodialysis at the Santa Rita Nephrology Center in Santa Cruz-RN, Brazil. The following variables were evaluated: social, anthropometric, and clinical profile; maximal respiratory pressures; pulmonary function; cardiorespiratory capacity; peripheral muscle strength; and quality of life. Participants were randomized into a Control Group (conventional training) and an Intervention Group (conventional training + IMT). The intervention lasted 12 weeks. Statistical analysis was performed using GraphPad Prism. Two-way ANOVA was applied for intra- and intergroup comparisons, with p<0.05 considered statistically significant. RESULTS: There were no statistically significant differences in maximal respiratory pressures, pulmonary function, or lower limb strength. Statistically significant improvements were observed in cardiorespiratory capacity, handgrip strength, and in some domains of quality of life.