The goal of this clinical trial is to evaluate the effects of intradialytic aerobic exercise on muscle capacity, functionality and motivation of patients with chronic kidney disease undergoing hemodialysis.
The main question it aims to answer are:
• Is intradialytic aerobic exercise at moderate intensity effective in improving peripheral muscle function, functional status and motivation in patients with chronic kidney disease?
diagnosis of chronic kidney disease undergoing renal replacement therapy via hemodialysis
aged 20 to 65 years
low body mass index at overweight (21 kg/m2 to 29.9 kg/m2)
regular renal replacement therapy via hemodialysis for 6 months, without acute complications related to the diagnosis and/or comorbidities for the period of 3 months prior to the evaluation and intervention.
patients who do not reach a score equal to or above 20 assessed by the Mini Mental State Examination
severe heart failure according to the New York Heart Association classification
musculoskeletal alteration that prevents the correct execution of the assessment activities
who have participated in other exercise protocols in the last 6 months prior to the present study
Parallel
Aerobic exercise
Other interventionThe training group will receive aerobic exercise and the intensities will be controlled considering the percentage of estimated maximum heart rate. The training will be performed with a cycle ergometer with a total of 40 minutes of intradialytic aerobic exercise in the training group. To reduce the effects of intolerance to aerobic exercise, a week of adaptation will be performed, with a frequency of three sessions, in the first two hours of hemodialysis, lasting 40 minutes at maximum heart rate intensity of up to 74% and BORG up to 4 (low intensity). Afterwards, the patients will perform the prediction training for 12 weeks, at the frequency of three training sessions per week in the first two hours of hemodialysis. Each training session will start with a 5-minute warm-up at low intensity, 30 minutes of main training with maximum heart rate intensity 55% to 74% and BORG 5 to 7 (moderate intensity) and will end with a 5-minute cool-down at low intensity.
six minute step test
A step 20 centimeters high will be used and the patient will be instructed to go up and down it as many times during the 6 minutes, according to free cadence and will be instructed not to use the upper limbs
muscle strength
measured by dynamometry, the records will be in newtons.
Daily life physical activity
number of steps for seven days by triaxial accelerometer
Behavior Regulation Questionnaire for Physical Exercise
The questionnaire ranges from 0 to 24 for self-regulation indices and 0 to 4 for each type of regulation, namely external, introjected, identified, integrated and intrinsic regulation
index of self-determination and basic psychological needs
The score varies from 1 to 5, with 1 being total disagreement and 5 total agreement for variables related to the link between competence and autonomy.
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