Physical training associated with blood flow restriction increased cephalic vein diameters in both groups and was effective in increasing the diameter of the radial artery; however, it did not demonstrate superiority over the exercise group protocol without blood flow restriction.
WBV training improves MVIC of knee extensors in patients with CKD on HD in the interdialytic period. WBV training could be considered in the management of patients with CKD.
Whole-body vibration (WBV) is considered a type of physical activity based on the assumption that it results in an increase in muscle strength and performance and, therefore, may be a promising way to exercise patients with COPD. A comprehensive database search (PubMed/MEDLINE, LILACS, CINAHL, Web of Science, Scopus, and COCHRANE Library) for randomized trials, including original articles, that compared WBV groups versus control groups was conducted and studies were selected for comparison. The effect of WBV treatment was compared for minimum clinically important differences. The statistical heterogeneity among the studies was assessed using the I statistic; the results are expressed as percentages. Inconsistencies of up to 25% were considered low, those between 50 and 75% were considerate moderate, and those > 75% were considered high. Risk of bias was classified based on the Cochrane Collaboration tool, the meta-analysis was conducted using RevMan 5.3 software, and the level of evidence was assessed using the GRADE system. The primary outcome was functional exercise capacity. Secondary outcomes were quality of life, performance in activities of daily living, muscle strength of the lower limbs, and possible adverse effects assessed clinically or by subject reports. We included 4 articles involving 185 subjects for analysis. All subjects in the groups undergoing WBV showed improvement in distance walked in the 6-min walk test compared with the control group (57.85 m, 95% CI 16.36-99.33 m). Regarding the secondary end points, just one article reported improved quality of life and activities of daily living. The only article that assessed muscle strength found no difference between the groups. The quality of evidence for functional exercise capacity outcome was considered moderate. WBV seems to benefit subjects with COPD by improving their functional exercise capacity, without producing adverse effects. The quality of evidence is moderate, but the degree of recommendation is strong. (International Prospective Register of Systematic Reviews, http://www.crd.york.ac.uk/prospero, 2015:CRD42015027659.).
To investigate whether whole body vibration (WBV) training increases the explosive force of the knee extensors in chronic kidney disease (CKD) patients. Fourteen CKD patients undergoing hemodialysis were randomly allocated in WBV training or Sham group. Explosive force parameters (contractile impulse [CImp] and relative rate of force development [RFDr]) obtained in early (30 and 50 msec) and late phases (100 and 200 msec) of the knee extensors force/time curve. CImp and RFDr obtained at the early phase of force/time curve reduced after the intervention period, with a smaller decline for WBV (CImp at 50 msec [~−15% and −51%, P=0.038], RFDr at 30 msec [~−22% and −52%, P=0.044] and RFDr at 50 msec [~−11% and −54%; P=0.008]). In the late phase there was a lower decline for WBV group compared to Sham group, respectively: CImp: 100 msec (~−8% and −55%, P=0.025), 200 msec (~−3% and −46%, P= 0.025); RFDr 100 msec (~0.01% and −56%, P=0.033), 200 msec (~−5% and −36%, P=0.004). Three months of WBV training may attenuate the explosive force reduction in CKD patients.
Aims: The purpose of this research is to evaluate the effectiveness of upper limb exercises to improve arteriovenous fistula maturation in patients with chronic kidney disease. Methods: A bibliographic search was carried out from February to August 2015 in the following databases: PUBMED, CINAHL, Web of Science, SCOPUS, LILACS, SCIELO and CENTRAL. Results: Three studies were included, involving 134 participants (total). According to the total effect estimation, a mean difference of 0.36 (-0.95–1.67) was found for vein diameter, meanwhile a mean difference of 107.87 (-3.90–219.64) was found for blood flow. Conclusion: It was not possible to determine the effect size of the treatment due to a high bias risk of all included studies. Given this, the available evidence is still insufficient to support the prescription of upper limb exercises in order to improve arteriovenous fistula maturation. Therefore, randomised and controlled clinical trials monitored by methodological rigour should be developed in order to verify if the AVF maturation process can be evidenced through exercise.
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