Short period of high-intensity inspiratory muscle training improves inspiratory muscle strength in patients with chronic kidney disease on hemodialysis: a randomized controlled trial |
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| Institution: | 1. Department of Physical Therapy, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, RS, Brazil;2. Department of Physiology, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil;1. Division of Medicine, Faculty of Medical Sciences, University College London, London, UK;2. School of Nursing and Midwifery, Queen''s University Belfast, Belfast, UK;3. School of Psychology, Ulster University Magee Campus, Londonderry, UK;4. UCL Centre for Nephrology, Royal Free Hospital, University College London, London, UK;5. East and North Hertfordshire University NHS Trust, Stevenage, UK;7. Department of Nephrology, Centre Hospitalier Lyon Sud, University Lyon, CARMEN, Pierre-Benite, France;11. Division of Nephrology and Hypertension, Medicine, Pediatrics and Public Health, University of California, California;12. School of Medicine, Dentistry and Biomedical Sciences, Queens University Belfast & Regional Nephrology Unit, Belfast City Hospital, Belfast HSC Trust, Belfast, UK;8. Department of Nephrology, Antrim Area Hospital, Northern HSC Trust, Co., Antrim, UK;9. School of Medicine, University of Manchester, Manchester, UK;71. Department of Social Sciences and Social Work, Bournemouth University, UK;112. Columbia University Medical Centre / New York Presbyterian Hospital, New York;123. Regional Nephrology Unit, Belfast City Hospital, Belfast HSC Trust, Belfast, UK;84. NIHR Newcastle Biomedical Research Centre, Newcastle University, Newcastle upon Tyne, UK;1. Universidade do Estado de Santa Catarina (UDESC), Florianópolis, SC, Brazil;2. Universidade Estadual de Campinas – UNICAMP, Campinas, São Paulo, Brazil;1. Departamento de Nefrología, Hospital General de México “Dr. Eduardo Liceaga”, Mexico City, Mexico;2. Departamento de Nefrología y Metabolismo Mineral, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico;3. Department of Kinesiology and Community Health, University of Illinois, Urbana, Illinois;4. Division of Nutritional Sciences, University of Illinois, Urbana, Illinois;5. Facultad de Medicina, Universidad Panamericana, Mexico City, Mexico;7. Departamento de Cardiología, Hospital General de México “Dr. Eduardo Liceaga”, Mexico City, Mexico;1. Department of Clinical Science, Karolinska Institutet, Stockholm, Sweden;2. Department of Medicine, Karolinska Institutet, Stockholm, Sweden;3. Division of Physical Therapy, Karolinska University Hospital, Stockholm, Sweden;4. Division of Nephrology, Danderyd University Hospital, Stockholm, Sweden;1. Division of Nephrology, Department of Medicine, University of Washington Kidney Research Institute, Seattle, WA;2. Department of Anesthesiology and Pain Medicine, University of Washington, Seattle, WA;3. Veterans Affairs Puget Sound Healthcare System, University of Washington, Seattle, WA;4. Intramural Research Program, National Institute on Aging, National Institutes of Health, Baltimore, MD;1. Department of Physiotherapy, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran;2. Nephrology Research Center, Tehran University of Medical Sciences, Tehran, Iran |
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| Abstract: | BackgroundChronic kidney disease is a complex disease that impacts multiple organs and systems (including musculoskeletal and cardiorespiratory) leading to reduction of functional capacity.ObjectiveThe aim of this study was to investigate the effect of a short period of high intensity inspiratory muscle training on maximum inspiratory pressure, functional capacity and endothelial function of chronic kidney disease patients on hemodialysis.MethodsThis randomized controlled trial enrolled 25 patients who were allocated into two groups: intervention (IMTG = 14) and control (CG = 11) groups. Intervention patients received the exercise protocol over a period of 5 weeks, 6 times per week, with each session consisting of 5 sets of 10 repetitions with an initial load of 50% progressing to 70% of maximum inspiratory pressure , measured weekly. The primary outcome was inspiratory muscle strength and the secondary outcomes were functional capacity and endothelial function evaluated before and after the training protocol.ResultsThe inspiratory muscle training induced a marked improvement in maximum inspiratory pressure which was evident after the training period (mean difference 19.0 cmH2O – 95%CI 0.4–37.5; IMTG: 102 ± 25.7 cmH2O vs CG: 83 ± 19.2; p = 0.046). The magnitude of maximum inspiratory pressure improvement was 33.5% at the end of the protocol for the IMTG. Functional capacity and endothelial function did not vary between or within groups.ConclusionA short period of high-intensity inspiratory muscle training for five weeks was able to improve inspiratory muscle strength of chronic kidney disease patients on hemodialysis (ClinicalTrials.gov registration NCT03082404). |
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| Keywords: | Chronic kidney disease Kidney dialysis Respiratory exercises Rehabilitation Respiratory muscle |
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