Keywords
kidney transplantation
physical exercise
strength
functional capacity
Sf36 quality of life
immunosuppression
How to Cite
Abstract
Background: in Mexico, chronic kidney disease presents an exponential increase, kidney transplantation has become the best treatment option. Despite this, transplant recipients have lower functional capacity and quality of life compared to healthy individuals, which is associated with a sedentary lifestyle, added to the musculoskeletal effects of immunosuppressants. However, the research is limited.
Purpose: to evaluate the impact of a home program of strength exercises, aerobic endurance, balance and flexibility of mild-moderate intensity in transplant patients.
Methodology: 9 patients (29.5, 2 years) participated, manual grip strength was evaluated by means of a dynamometer, flexibility through the sit and reach test, agility-balance and strength in the lower limb by means of the “sit to stand” and the “get up and go” respectively, functional capacity through the 6-minute walk test, and quality of life through the SF36 health questionnaire.
Results: Statistically significant improvements were shown in manual dynamometry (P 0.005), sit and reach test (P 0.016), Sit to stand test (P0.0011), 6-minute walk test (P 0.012). In the SF36 questionnaire, there was improvement in physical function (P0.03) and general health (P0.01), there were no changes in laboratory tests and glomerular filtration rate.
Conclusion: a home program of combined mild-moderate intensity exercise seems to have a positive effect on the functional capacity and quality of life of kidney transplant recipients, however, more research is needed to evaluate adherence to the program.
References
Rojas-Padilla I, Zambrano-Ríos D, Matta-Miramar A. Evaluación de la influencia del estado nutricional en el control de Diabetes mellitus tipo 2. Duazary. 2020;17(2):10-9. https://doi.org/10.21676/2389783X.3232
Aguilera-Méndez A, Nieto-Aguilar R, Serrato-Ochoa D, Manuel-Jacobo GC. La hipertensión arterial y el riñón: El dúo fatídico de las enfermedades crónicas no transmisibles. Investig Cienc Univ Autónoma Aguascalientes. 2020;(79):84-92. https://doi.org/10.33064/iycuaa2020792961
Rafael L, López-Ocañac LR. Carga de la enfermedad renal crónica en México. Rev Med Inst Mex Seguro Soc. 2017;55(2):118-23.
Ruiz-Mejía R, Ortega-Olivares LM, Méndez-Durán A. El gran reto del Gobierno en la salud pública de México: la nefropatía diabética cómo causa principal de enfermedad renal crónica. Gac Médica Bilbao [Internet]. 2020;117(3):245-56. Disponible en: http://gacetamedicabilbao.eus/index.php/gacetamedicabilbao/article/view/806
Aldrete-Velasco J, Chiquete E, Rodríguez-García J, Rincón-Pedrero R, Correa-Rotter R, Peña-García R, et al. Mortalidad por enfermedad renal crónica y su relación con la diabetes en México. Med Interna Mex. 2018;34(4):536-50.
Sánchez-Cedillo A, Cruz-Santiago J, Mariño-Rojas FB, Hernández-Estrada S, García-Ramírez C. Carga de la enfermedad: insuficiencia renal, diálisis-hemodiálisis y trasplante renal en México. Costo de la enfermedad. Rev Mex Traspl. 2020;9(1):15-25. https://doi.org/10.35366/94025
Cenatra. Reporte anual 2019 de donación y trasplantes en México [Internet]. 2019. p. 1-81. Disponible en: http://cenatra.salud.gob.mx/transparencia/trasplante_estadisticas.html
Mathur S, Janaudis-Ferreira T, Wickerson L, Singer LG, Patcai J, Rozenberg D, et al. Meeting report: Consensus recommendations for a research agenda in exercise in solid organ transplantation. Am J Transplant. 2014;14(10):2235-45. https://doi.org/10.1111/ajt.12874
Gillis KA, Patel RK, Jardine AG. Cardiovascular complications after transplantation: Treatment options in solid organ recipients. Transplant Rev [Internet]. 2014;28(2):47-55. Disponible en: http://dx.doi.org/10.1016/j.trre.2013.12.001
Bauman AE, Reis RS, Sallis JF, Wells JC, Loos RJF, Martin BW, et al. Correlates of physical activity: Why are some people physically active and others not? Lancet. 2012;380(9838):258-71. https://doi.org/10.1016/j.trre.2013.12.001
Balaska A, Pistolas Di, Koukoulaki M, Alassas Di, Drakopoulos S, Kaklamanos I, et al. Changes in Health-Related Quality of Life in Greek Adult Patients Two Years after Successful Renal Transplantation. Bantao J. 2016 jun. 27;14(1):30-3. https://doi.org/10.1515/bj-2016-0007
Adrichem EJ Van, Ageing H, Care AH, Dekker R, Krijnen WP, Ageing H, et al. Physical Activity, Sedentary Time, and Associated Factors in Recipients of Solid-Organ Transplantation. Phys Ther. 2018;98(8):646-57. https://doi.org/10.1093/ptj/pzy055
Oterdoom LH, van Ree RM, de Vries APJ, Gansevoort RT, Schouten JP, van Son WJ, et al. Urinary Creatinine Excretion Reflecting Muscle Mass is a Predictor of Mortality and Graft Loss in Renal Transplant Recipients. Transplantation. 2008 ag. 15;86(3):391-8. https://doi.org/10.1097/TP.0b013e3181788aea
Huang KS, Cheah SC, Kee TY, Ng CL. Physical function and body composition in kidney transplant recipients over time with physiotherapy intervention. Proc Singapore Healthc. 2015 en. 1;24(4):208-12. https://doi.org/10.1177/2010105815611817
Yang D, Robinson L, Selinski C, Bajakian T, Mejia C, Harhay MN. Physical Function in Kidney Transplantation: Current Knowledge and Future Directions. Curr Transplant Reports. 2020;7(2):46-55. https://doi.org/10.1007/s40472-020-00271-5
Chen G, Gao L, Li X. Effects of exercise training on cardiovascular risk factors in kidney transplant recipients: a systematic review and meta-analysis. Ren Fail. 2019 en. 1;41(1):408-18. https://doi.org/10.1080/0886022X.2019.1611602
Greenwood SA, Koufaki P, Mercer TH, MacLaughlin HL, Rush R, Lindup H, et al. Effect of exercise training on estimated GFR, vascular health, and cardiorespiratory fitness in patients with CKD: A pilot randomized controlled trial. Am J Kidney Dis. 2015 mzo. 1;65(3):425-34. https://doi.org/10.1053/j.ajkd.2014.07.015
Pit’ha J, Králová Lesná I, Stávek P, Mahrová A, Racek J, Sekerková A, et al. Effect of exercise on markers of vascular health in renal transplant recipients. Physiol Res [Internet]. 2015;64(6):945-9. https://doi.org/10.33549/physiolres.933123
Hernández-Sánchez S, Carrero JJ, Morales JS, Ruiz JR. Effects of a resistance training program in kidney transplant recipients: A randomized controlled trial. Scand J Med Sci Sport. 2021;31(2):473-9. https://doi.org/10.1111/sms.13853
Takahashi A, Hu SL, Bostom A. Physical Activity in Kidney Transplant Recipients: A Review. Am J Kidney Dis. 2018;72:433-43. https://doi.org/10.1053/j.ajkd.2017.12.005
Hiraki K, Shibagaki Y, Izawa KP, Hotta C, Wakamiya A, Sakurada T, et al. Effects of home-based exercise on pre-dialysis chronic kidney disease patients: A randomized pilot and feasibility trial. BMC Nephrol. 2017;18(1):1-7. https://doi.org/10.1186/s12882-017-0613-7
Gomes TS, Aoike DT, Baria F, Graciolli FG, Moyses RM, Cuppari L. Effect of Aerobic Exercise on Markers of Bone Metabolism of Overweight and Obese Patients With Chronic Kidney Disease. J Ren Nutr. 2017;27(5):364-71. https://doi.org/10.1053/j.jrn.2017.04.009
Aoike DT, Baria F, Kamimura MA, Ammirati A, Cuppari L. Home-based versus center-based aerobic exercise on cardiopulmonary performance, physical function, quality of life and quality of sleep of overweight patients with chronic kidney disease. Clin Exp Nephrol. 2018;22(1):87-98. https://doi.org/10.1007/s10157-017-1429-2
Calella P, Hernández-Sánchez S, Garofalo C, Ruiz JR, Carrero JJ, Bellizzi V. Exercise training in kidney transplant recipients: a systematic review. J Nephrol. 2019 ag. 16;32(4):567-79. https://doi.org/10.1007/s40620-019-00583-5
Villanego F, Naranjo J, Vigara LA, Cazorla JM, Montero ME, García T, et al. Impacto del ejercicio físico en pacientes con enfermedad renal crónica: revisión sistemática y metaanálisis [Internet]. Nefrol. 2020;40:237-52. https://doi.org/10.1016/j.nefro.2020.01.002
Fernández-Lara MJ, Ibarra-Cornejo JL, Aguas-Alveal EV, González-Tapia CE, Quidequeo-Reffers DG. Beneficios del ejercicio físico en pacientes con enfermedad renal crónica en hemodiálisis. Enfer Nefrol. 2018;21(2):167-81. https://doi.org/10.4321/S2254-28842018000200008
Junqué-Jiménez A, Montoya-Ariza Á, Fernández-Parra Y, Andreu-Periz D, Segura-Ortí E. Resultados de un programa de ejercicio físico domiciliario en pacientes con enfermedad renal. Enfer Nefrol. 2020;23(4):371-9. https://doi.org/10.37551/S2254-28842020038
Nixon AC, Bampouras TM, Gooch HJ, Young HM, Finlayson KW, Pendleton N, et al. Home-based exercise for people living with frailty and chronic kidney disease: A mixedmethods pilot randomised controlled trial. PLoS One. 2021;16(7):1-16. https://doi.org/10.1371/journal.pone.0251652
Tang Q, Yang B, Fan F, Li P, Yang L, Guo Y. Effects of individualized exercise program on physical function, psychological dimensions, and health-related quality of life in patients with chronic kidney disease: A randomized controlled trial in China. Int J Nurs Pract. 2017;23(2):1-8. https://doi.org/10.1111/ijn.12519
Valdés-Badilla P, Concha-Cisternas Y, Guzmán-Muñoz E, Ortega-Spuler J, Vargas-Vitoria R. Valores de referencia para la batería de pruebas Senior Fitness Test en mujeres mayores chilenas físicamente activas. Rev Med Chile. 2018;146(10). https://doi.org/10.4067/S0034-98872018001001143
Rikli RE, Jones J. Senior fitness test manual. 2da edición. Human Kinetics;2013.
Pérez-Loredo J, Lavorato CA, Negri AL. Tasa de filtración glomerular medida y estimada. Numerosos métodos de medición (Parte I). Rev Nefrol Diálisis Transpl. 2015;35(3):1-7.
Bautista-González IJ. Diseño y validación de una escala de percepción de la velocidad para monitorizar la intensidad en el entrenamiento de la fuerza. Universidad de Granada; 2013.
Corrêa H, Deus L, Neves R, Reis A, de Freitas G, de Araújo T, et al. Influence of Angiotensin Converting Enzyme I/D Polymorphism on Hemodynamic and Antioxidant Response to Long-Term Intradialytic Resistance Training in Patients With Chronic Kidney Disease. J Strength Cond Res. 2021;35(10):2902-9. https://doi.org/10.1519/JSC.0000000000004096
Aguayo M, Newmann A, Lobo B, Cárdenas S, Silva O, Aguayo PM, et al. Investigación original Efectividad de un entrenamiento cardiorrespiratorio, muscular y ventilatorio en el rendimiento aeróbico de pacientes hemodializados. Rev Colomb Nefrol. 2020;7(1).
Fernández-Lázaro D, Mielgo-Ayuso J, Lázaro-Asensio MP, Martínez AC, Caballero-García A, Fernández-Lázaro CI. Intradialytic physical exercise in chronic kidney disease: A systematic review of health outcomes. Arch Med del Deport. 2020;37(6):419-29. https://doi.org/10.18176/archmeddeporte.00017
Méndez OA, Mora JL, Reyes JP, Ariza GE. Efectos de un programa de ejercicio aeróbico submáximo sobre el rendimiento cardiorrespiratorio y la potencia anaeróbica. 2020;22(40):279-92.
Filip?i? T, Bogataj Š, Pajek J, Pajek M. Physical activity and quality of life in hemodialysis patients and healthy controls: A cross?sectional study. Int J Environ Res Public Health. 2021;18(4):1-10. https://doi.org/10.3390/ijerph18041978
González-Cantero JO, González-Becerra VH, Salazar-Estrada JG. Gaudibilidad y percepción de estado de salud en una muestra mexicana. Acta Colomb Psicol. 2019;22(2):13-20. https://doi.org/10.14718/ACP.2019.22.2.2
Romero-Reyes M, Moreno-Egea A, Gómez López VE, Alcántara-Crespo M, Crespo-Montero R. Análisis comparativo entre la calidad de vida del paciente trasplantado renal y el paciente en hemodiálisis. Enfer Nefrol. 2021;24(2):129-38. https://doi.org/10.37551/S2254-28842021015
Flores LF, Torres BM. Vista de instrumentos de evaluación de la calidad de vida en pacientes con enfermedad renal crónica en hemodiálisis: Una revisión sistemática. Rev Nefrol Dial Traspl [Internet]. 2020;40:129-38. Disponible en: https://www.revistarenal.org.ar/index.php/rndt/article/view/522/1018
Díaz-Muñoz GA, Callejas-Martínez P, Cuesta-Malagón V. Concordancia-conformidad entre los dinamómetros de mano Camry y Jamar en adultos. Rev Nutr Clínica y Metab. 2018;1(1):35-41. https://doi.org/10.35454/rncm.v1n1.075
de Villar LOP, Martínez-Olmos FJ, Junqué-Jiménez A, Amer-Cuenca JJ, Martínez-Gramage J, Mercer T, et al. Test-retest reliability and minimal detectable change scores for the short physical performance battery, one-legged standing test and timed up and go test in patients undergoing hemodialysis. PLoS One. 2018;13(8):1-16. https://doi.org/10.1371/journal.pone.0201035
Cobo-Mejía EA, González ME, Castillo LY, Niño DM, Pacheco AM, Sandoval-Cuellar C. Confiabilidad del Senior Fitness Test versión en español, para población adulta mayor en Tunja-Colombia. 2016;33(6):382-6.
Ayala F, Sainz-De Baranda P, De Ste-Croix M, Santonja F. Reliability and validity of sit-and-reach tests: Systematic review. Rev Andaluza Med del Deport. 2012;5(2):57-66. https://doi.org/10.1016/S1888-7546(12)70010-2
American Thoracic Society. Statement: Guidelines for the Six-Minute Walk Test. 2002;166:111-7. https://doi.org/10.1164/ajrccm.166.1.at1102
Oguchi H, Tsujita M, Yazawa M, Kawaguchi T, Hoshino J, Kohzuki M, et al. The efficacy of exercise training in kidney transplant recipients: a meta-analysis and systematic review. Clin Exp Nephrol. 2019 febr. 15;23(2):275-84. https://doi.org/10.1007/s10157-018-1633-8
Hernández-Sánchez S, Carrero JJ, García-López D, Herrero-Alonso JA, Menéndez-Alegre H, Ruiz JR. Forma física y calidad de vida en pacientes trasplantados de riñón: estudio de casos y controles. Med Clin (Barc). 2016;146(8):335-8. https://doi.org/10.1016/j.medcli.2016.01.017
Tong A, Gill J, Budde K, Marson L, Reese PP, Rosenbloom D, et al. Report of the Standardized Outcomes in Nephrology-Kidney Transplantation. Transplantation. 2018;101(8):1887-96. https://doi.org/10.1097/TP.0000000000001774
Moya-Nájera D, Borreani S, Moya-Herraiz Á, Calatayud J, López-Andújar R, Colado JC. ¿Es perjudicial el ejercicio físico para el trasplantado de hígado? Revisión de la literatura. Cir Esp. 2016;94(1):4-10. https://doi.org/10.1016/j.ciresp.2015.07.002
Chan W, Chin SH, Whittaker AC, Jones D, Kaur O, Bosch JA, et al. The Associations of Muscle Strength, Muscle Mass, and Adiposity With Clinical Outcomes and Quality of Life in Prevalent Kidney Transplant Recipients. J Ren Nutr. 2019;29(6):536-47. https://doi.org/10.1053/j.jrn.2019.06.009
Esposito P, Furini F, Gregorini M, Pattonieri EF, Corradetti V, La Porta E, et al. Global Performance Status Score: A New Tool to Assess Physical Performance in Kidney Transplant Patients. Transplant Proc. 2017;49(6):1270-5. https://doi.org/10.1016/j.transproceed.2017.02.052
Aoike DT, Baria F, Kamimura MA, Ammirati A, de Mello MT, Cuppari L. Impact of home-based aerobic exercise on the physical capacity of overweight patients with chronic kidney disease. Int Urol Nephrol. 2015;47(2):359-67. https://doi.org/10.1007/s11255-014-0894-8
Yamamoto S, Matsuzawa R, Kamitani T, Hoshi K, Ishii D, Noguchi F, et al. Efficacy of Exercise Therapy Initiated in the Early Phase After Kidney Transplantation: A Pilot Study. J Ren Nutr. 2019;(19):1051-2276.
Gallagher-Lepak S. Functional capacity and activity level before and after renal transplantation. ANNA J. 1991;18(4):378-82.
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.