Determining factors of functioning in hemodialysis patients using the international classification of functioning, disability and health.

BACKGROUND: Hemodialysis (HD) treatment affects functioning, physical activity level, clinical biomarkers, and body composition. However, the association between these variables with functioning, considering International Classification of Functioning, Disability and Health (ICF) domains remains unclear. Thus, the aim of this study was to investigate the possible association between physical activity, biomarkers, and body composition with functioning in HD patients in reference to the ICF. METHODS: Eighty HD patients performed different tests grouped according to ICF domain: Body structure and function - handgrip strength (HS), 5-repetition sit-to-stand test, and 60-s sit-to-stand test (5-STS, 60-STS, respectively); Activity - short physical performance battery (SPPB); and Participation - participation scale questionnaire. Physical activity [Human Activity Profile questionnaire (HAP)], body composition (Dual-energy X-ray absorptiometry), Parathormone (PTH), and alkaline phosphatase were analyzed as possible variables associated with ICF domains. Data analyses were performed using simple and multiple regression models adjusted for age, duration of HD, and diuresis volume. RESULTS: In the body structure and function domain, appendicular lean mass, PTH level, and age were associated with HS (R2 = 0.558); HAP and PTH were associated with 5-STS (R2 = 0.263); and HAP, PTH, duration of HD, and age were associated with 60-STS (R2 = 0.337). In the activity domain, HAP, PTH, alkaline phosphatase, duration of HD, age, and body fat were associated with SPPB (R2 = 0.689). Finally, only HAP was associated with the participation scale (R2 = 0.067). CONCLUSION: Physical activity and PTH levels are determinant protagonists of functioning in all ICF domains in hemodialysis patients.

Whole-Body Vibration Exercise in Different Postures on Handgrip Strength in Healthy Women: A Cross-Over Study.

OBJECTIVE: To compare the effect of Whole-Body Vibration Exercise (WBVE) applied in push-up modified and half-squat positions, on handgrip strength (HS) and on the electromyography registry (EMGrms) of the flexor digitorum superficialis muscle (FDSM) of the dominant hand. METHODS: Nineteen healthy women (age 23.40 ± 4.03 years, bodyweight: 58.89 ± 9.87 kg), performed in a randomized order five different tests: (S1) Control; (S2) Push-up modified; (S3) Push-up placebo; (S4); Half-squatting; (S5) Half-squatting placebo. The HS and the EMGrms were assessed at baseline and immediately after the tests. ANOVA two-way design mixed test, with Tukey post hoc, was used to evaluate the HS, EMGrms and the ratio between EMGrms and HS, i.e., neural ratio (NR). Thus, the lower NR represents the greater neuromuscular modifications. The statistical significance level was set up at p < 0.05. RESULTS: WBVE on S2 increased HS compared to the stimulus applied to the S4 (p = 0.0001). The increase in HS was associated with a reduction in the EMGrms of the FDSM (p < 0.001) and a lower NR (p < 0.0001), i.e., greater neuromuscular modifications, in the S2 compared to the S4 after the tests. CONCLUSION: The distance of the stimulus and the positioning on the vibratory platform influence the maximum muscular strength due to neuromuscular modifications of hands in healthy women.