Renal Insufficiency, Chronic Urogenital Diseases
Conditions
Interventions
The clinical trial will include three arms, each composed of 22 older adults undergoing hemodialysis, allocated to the Multicomponent Exercise (ME) group, the ME combined with Neuromuscular Electrical
Sponsors
Universidade Comunitária da Região de Chapecó
Universidade Comunitária da Região de Chapecó
Eligibility
Age
60 Years to 75 Years
Inclusion criteria
Inclusion criteria: Older adults of both sexes, aged between 60 and 75 years, undergoing hemodialysis treatment for at least three months, who present hemodynamic and clinical stability confirmed by the following parameters: resting heart rate between 50 and 100 bpm, respiratory rate between 12 and 25 breaths per minute, oxygen saturation greater than 90%, blood pressure between 90/60 mmHg and 160/90 mmHg, and body temperature between 36°C and 37.8°C; laboratory tests performed within the last 30 days showing a minimum hematocrit of 30%, hemoglobin level above 8 g/dL, and platelet count greater than 50,000/mm³; preserved lower-limb muscle strength assessed using the Medical Research Council (MRC) Muscle Strength Scale, with a minimum score of grade 3 for hip flexors, knee extensors, and ankle dorsiflexors; cognitive function will be assessed using the Mini-Mental State Examination (MMSE).
Exclusion criteria
Exclusion criteria: Participants with a diagnosis of cancer or chronic lung disease; those who present musculoskeletal limitations that compromise the execution of the exercise protocol for cycling and strength training or that pose a risk to participant safety, such as in the case of hemodynamically unstable older adults; individuals with a high degree of frailty assessed by the Frailty Scale, without functional independence, using a cutoff point of 5; participants who miss more than three consecutive or alternating sessions; those who present changes in clinical condition that prevent the performance of the physical exercise protocol will have their data excluded from analysis; dialysis fistulas in the lower limbs; very active older adults, assessed using the Short Physical Activity Index (Short IPAQ), to determine the physical activity level of older adults with chronic kidney disease
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| It is expected to find an improvement in dialysis efficacy in the intervention groups, verified through the Kt/V Ratio method (urea clearance × time / distribution volume), based on the observation of a minimum variation of 10% between pre- and post-intervention measurements.;It is expected to find an increase in functionality, including lower-limb functional strength and gait speed, verified through the Katz Index of Independence in Activities of Daily Living, the 30-Second Chair Stand Test, the Timed Up and Go (TUG) Test, the 4-Meter Gait Speed Test, the Handgrip Test, and the Medical Research Council (MRC) Muscle Strength Scale, based on the observation of a minimum variation of 30% between pre- and post-intervention measurements. | — |
Secondary
| Measure | Time frame |
|---|---|
| An increase in handgrip strength is expected, assessed using the Handgrip Strength Test performed with a hand dynamometer, based on the observation of a minimum variation of 20% between the pre- and post-intervention measurements.;It is expected to find an increase in the cross-sectional area of the rectus femoris muscle, verified through the ultrasound examination method, based on the observation of a variation of less than 10% between pre- and post-intervention measurements.;An increase in the levels of the biomarkers urea, creatinine, potassium, calcium, phosphorus, and complete blood count is expected, assessed through blood tests collected at the beginning of the hemodialysis session, based on the observation of a variation of less than 10% between the pre- and post-intervention measurements;An increase in respiratory muscle strength is expected, assessed using the maximal inspiratory pressure and maximal expiratory pressure tests performed with a manovacuometer, based on the observation of a minimum variation of 20% between the pre- and post-intervention measurements.;An increase in pulmonary function is expected, including Forced Vital Capacity and Forced Expiratory Volume in the first second (FEV1), assessed using portable spirometry, based on the observation of a variation greater than 10% between the pre- and post-intervention measurements. | — |
Countries
BR
Contacts
Public ContactRicardo Nicaretta
Universidade Comunitária da Região de Chapecó
Outcome results
None listed