Home-based inspiratory muscle training in pediatric patients after kidney transplantation: a randomized clinical trial

Carbonera, Raquel Pinto; Barbosa, Ana Paula Oliveira; Normann, Tatiana Coser; Lago, Pedro Dal; Garcia, Clotilde Druck; Lukrafka, Janice Luísa

doi:10.1007/s00467-020-04539-x

Cited by 5 publications

(16 citation statements)

References 34 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Of these, 24 publications were included for full-text review, and 11 randomized controlled trials met the inclusion criteria for meta-analysis (Figure 1). 22–32 The remaining 13 excluded publications and the reasons are presented in Supplementary File 3.…”

Section: Resultsmentioning

confidence: 99%

“…Seven studies with 216 participants provided data on maximal inspiratory pressure 23–26,29,30,32 (Figure 2). Pooled results based on a random effects model showed that respiratory muscle training was associated with significantly higher maximal inspiratory pressure in patients with chronic kidney disease (mean difference = 18.26, z = 3.11, p = 0.002, I 2 = 67.6%, P for heterogeneity = 0.005).…”

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Effect of respiratory muscle training in patients with chronic kidney disease: A systematic review and meta-analysis of randomized controlled trials

et al. 2022

View full text Add to dashboard Cite

Objective This systematic review and meta-analysis aimed to evaluate the effect of respiratory muscle training on respiratory muscle strength, lung function, cardiopulmonary fitness, and quality of life for chronic kidney disease patients. Methods PubMed, Embase, Web of Science Core Collection, and Cochrane Central Register of Controlled Trials published randomized controlled trials that evaluated the effect of respiratory muscle training for chronic kidney disease patients from inception to December 2021, and rerun on September 2022. The quality of included studies was evaluated according to the Cochrane Collaboration's risk of bias tool-2. The outcomes were analyzed as mean differences with a fixed/random effect model. The strength of evidence was evaluated with the Grading of Recommendation, Assessment, Development, and Evaluation approach. Results Eleven randomized controlled trials were included. All but two of the studies were in hemodialysis patients. The follow-up time range was 4 to 12 weeks. Compared to controls, respiratory muscle training significantly improved maximal expiratory pressure (mean difference = 17.36, p = 0.013), maximal inspiratory pressure (mean difference = 18.26, p = 0.002), forced expiratory volume at 1 second (mean difference = 0.20, p= 0.020), forced vital capacity (mean difference = 0.26, p = 0.008), but not for 6-minute walk test (mean difference = 39.85, p= 0.138). Conclusions As a non-pharmacological therapy, respiratory muscle training can effectively improve maximal expiratory pressure, maximal inspiratory pressure, forced expiratory volume at 1 second, and forced vital capacity in patients with chronic kidney disease and is safe for such populations.

show abstract

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Effect of respiratory muscle training in patients with chronic kidney disease: A systematic review and meta-analysis of randomized controlled trials

et al. 2022

View full text Add to dashboard Cite

show abstract

“…A Norwegian study reported that increasing early physiotherapy and follow-up of physical activity after pediatric kidney transplant had a significant positive impact on the cardiorespiratory fitness, quality of life, and mental health of pediatric kidney transplant recipients [38]. Then again, Carbonera et al [39] found that home-based inspiratory muscle training in pediatric kidney transplant recipients did not significantly improve functional capacity or pulmonary function, but surprisingly, improved hemoglobin and hematocrit. The deficit in performance capacity of pediatric kidney transplant recipients seems undeniable, but the challenge of understanding the clinical markers affecting or predicting performance capacity remains.…”

Section: Discussionmentioning

confidence: 99%

Physical performance capacity after pediatric kidney transplant and clinical parameters associated with physical performance capacity

et al. 2022

View full text Add to dashboard Cite

Background History of chronic kidney disease and kidney transplantation is known to influence physical performance capacity. The aim of this study was to compare the physical performance of pediatric kidney transplant recipients to healthy controls and to find possible correlations between clinical parameters and physical performance capacity. Methods Twenty-four pediatric kidney transplant recipients (62.5% boys) were tested at a median age of 10.8 years. Physical performance capacity was tested with a test set including six different components assessing muscle endurance, strength, speed, and flexibility. The control group consisted of 273 healthy age-matched schoolchildren. Clinical parameters were collected as part of routine follow-up protocol. The majority of patients (62.5%) had congenital nephrotic syndrome of Finnish type (CNS) as primary diagnosis, and therefore, the results of CNS recipients were compared to the other disease groups. Results The physical performance capacity in pediatric kidney transplant recipients was lower compared to healthy controls. Surprisingly, no statistically significant correlation was found between graft function and physical performance capacity. The CNS patients scored worse than patients with other diagnoses in all test domains except for sit-and-reach and shuttle run, but the differences did not reach statistical significance. Conclusion The physical performance of pediatric kidney transplant recipients is reduced, especially in those with congenital nephrotic syndrome. Clinical parameters, including graft function, did not predict physical performance capacity, suggesting that the reduced physical performance seems to be of multivariable cause. Graphical abstract

show abstract

Section: Bodymentioning

confidence: 99%

“…Conversely, findings from a randomized control trial of 31 KTx recipients from Brazil (mean age 11.6 years), whom underwent home-based inspiratory muscle training for 6 weeks, showed improvements in predicted maximal inspiratory pressure, but not in exercise capacity assessed via the 6MWT. 56 In summary, CKD (across all stages) is associated with impaired exercise capacity, physical performance, and muscle strength in children. Potential mediators of the impact of CKD on these outcomes are likely multi-factorial and include growth retardation, acidosis, poor nutritional status, and low physical activity.…”

Section: Paediatric Dynapeniamentioning

confidence: 99%

Physical activity and the ‘pediatric inactivity triad’ in children living with chronic kidney disease: a narrative review

Wilkinson

O’Mahoney

Highton

et al. 2022

Therapeutic Advances in Chronic Disease

View full text Add to dashboard Cite

The ‘paediatric inactivity triad’ (PIT) framework consists of three complex inter-related conditions that influence physical inactivity and related health risks. In those living with chronic kidney disease (CKD), a multi-factorial milieu of components likely confound the PIT elements, resulting in a cycle of decreased physical functioning and reduced physical activity. In this review, we explore and summarize previous research on each of the three principal PIT components (exercise deficit disorder, dynapenia, and physical illiteracy) in the pediatric CKD population. We found those living with CKD are significantly physically inactive compared to their peers. Physical inactivity occurs early in the disease process and progressively gets worse as disease burden increases. Although physical activity appears to increase post-transplantation, it remains lower compared to healthy controls. There is limited evidence on interventions to increase physical activity behaviour in this population, and those that have attempted have had negligible effects. Studies reported profound reductions in muscle strength, physical performance, and cardiorespiratory fitness. A small number of exercise-based interventions have shown favourable improvements in physical function and cardiorespiratory fitness, although small sample sizes and methodological issues preclude the generalization of findings. Physical activity must be adapted and individualized to the needs and goals of the children, particularly those with acute and chronic medical needs as is the case in CKD, and further work is needed to define optimal interventions across the life course in this population if we aim to prevent physical activity declining further.

show abstract

Home-based inspiratory muscle training in pediatric patients after kidney transplantation: a randomized clinical trial

Cited by 5 publications

References 34 publications

Effect of respiratory muscle training in patients with chronic kidney disease: A systematic review and meta-analysis of randomized controlled trials

Effect of respiratory muscle training in patients with chronic kidney disease: A systematic review and meta-analysis of randomized controlled trials

Physical performance capacity after pediatric kidney transplant and clinical parameters associated with physical performance capacity

Physical activity and the ‘pediatric inactivity triad’ in children living with chronic kidney disease: a narrative review

Contact Info

Product

Resources

About