Effect of an exercise program with blood flow restriction on the muscular strength of patients with chronic kidney disease: A randomized clinical trial.

INTRODUCTION: An arteriovenous fistula (AVF) is performed in chronic kidney disease (CKD) patients before hemodialysis, who may benefit from exercise. The aim of this study was to evaluate the effect of an exercise program associated with partial limb blood flow restriction (BFR) on handgrip strength (HGS) and forearm circumference of CKD patients. METHODS: A total of 26 patients with CKD were randomized to the BFR experimental group (EG, n = 12) and to the non-BFR control group (CG, n = 14) prior to AVF, and underwent isometric exercises for the flexor muscles of the fingers and elbow where the AVF will be performed. RESULTS: There were no differences at the end of eight weeks of training between the EG and CG groups [F (1.23) = 0.03, p = 0.96] regarding the HGS and the forearm circumference [F (1.23) = 0.90, p = 0.76], however muscle strength [F (1.23) = 189.84, p < 0.001] and forearm circumference [F (1.23) = 540.90, p < 0.001] improved between baseline and the results at the end of the program. CONCLUSION: Partial BFR training was not superior to the CG for the outcomes evaluated in this study. Further studies should be conducted so that an indication of an exercise protocol for the evaluated outcomes is prescribed in order to be effectively offered in clinical practice.

Effects of whole-body vibration on muscle strength, quadriceps muscle thickness and functional capacity in kidney transplant recipients: A randomized controlled trial.

BACKGROUND: Whole-body vibration (WBV) may be an alternative of physical training for kidney transplant recipients. OBJECTIVE: To evaluate the effect of a training program on quadriceps muscle strength and thickness, distance walked in the 6-min walking test (6MWT), respiratory muscle strength and quality of life in adult kidney transplant recipients. DESIGN: Randomized controlled clinical trial. METHOD: Twelve kidney transplant recipients of both genders who underwent WBV training (35 Hz) twice a week for 12 weeks on alternate days (WBVG), and training with a Sham Group (SG) were evaluated before and after intervention. RESULTS: No difference was observed in quadriceps muscle strength and thickness between groups, however a large (d = 0.81) and a small (d = 0.44) effect size were observed after the training, respectively. Both groups improved the execution time of Sit-to-Stand Test before and after analysis, but this effect did not show superiority between them, however there was a large effect size provided by training (d = 1.11). No changes were observed between groups in relation to inspiratory muscle strength, but training effects could be observed by the effect size after the study period (d = 0.59). No changes were observed regarding the distance walked in the 6MWT and the effect size was small (d = 0.31). CONCLUSION: WBV program would induce physiological responses that must be taken into consideration in adults' kidney transplant recipients. Our results show considerable effect sizes were observed for muscle strength and quadriceps thickness, inspiratory muscle strength, and 6MWT walking distance, although no difference was observed between groups at the end of the study.