15° Congresso Brasileiro de Clínica Médica e 5° Congresso Internacional de Medicina de Urgência e Emergência

Dados do Trabalho


Título

Aerobic training with and without blood flow restrictio and autonomic response to hemodialysis

Fundamentação/Introdução

Background: Exercise has been found to ameliorate heart rate variability (HRV) in hemodialysis (HD) patients, but exercise effect on change in HRV during HD or according to volemic state has not been evaluated.

Objetivos

Aim: To evaluate the effect of a 16-week exercise intervention, with and without BFR, on HRV before (overhydrated) and after (dry weight) a HD session, and its change during the HD session.

Delineamento e Métodos

Design: A crossover study nested in a randomized controlledtrial. Setting: a dialysis center in a University hospital. Patients: Adult chronic kidney disease patients on HD for three months or moreIntervention: Patients were randomized for control group (no exercise), conventional aerobic exercise (AE) or blood flow restriction (BFR) exercise. The 16-week intervention was applied trice weekly for 20 minutes during the HD session

Resultados

Outcomes: HRV high frequency power (HFabs), low frequency power (LFabs), LF/HF ratio, LF normalized (LFnu), and RMSSD, were measured before and after a HD session before and after the 16-week exercise intervention. Results: Thirty-nine patients were included in the study.The RMSSD increase during HD was blunted after training in the AE group in comparison with other groups. In the hypervolemic state there was no difference in any HRV parameter from baseline to post training period. The HFabs decreased in exercise group in the dry weight state, after the intervention (-40.8 [95% CI -124.0 to 7.5] vs. +3.7 [95% CI -16.3 to 27.8] in control group)

Conclusões/Considerações finais

Conclusions: A 16-week intradialytic exercise intervention reduced the parasympathetic drive on sinoatrial node after a hemodialysis session, especially in AE group. Further research is required to assess the association between this change in autonomic balance and prognosis of hemodialysis patients.

Palavras-chave

hemodialysis
Aerobic training

Área

Clínica Médica

Autores

Luiz Henrique Gehrke, Rafael da silva Trindade , Anna Caroline de tunes silva Azevedo , Rafaela Catto, Larissa Ribas Ribeiro , Daniel Nogueira