Efeito agudo do treino de equilíbrio no controle postural estático em pacientes submetidos à hemodiálise

Abstract

Introduction: Patients with chronic kidney disease undergoing dialysis have musculoskeletal, neurological and cardiovascular impairments that, added to the effects of the dialysis process, contribute to changes in postural balance and increased risk of falls. Therefore, it is important to investigate interventions that minimize these changes and reduce the risk of falling in this population. Objectives: To evaluate the acute effect of balance training on postural control and static balance in patients with chronic kidney disease undergoing hemodialysis. Materials and methods: A randomized blind clinical trial study with a single intervention was carried out, the patient being the control itself, in which adult patients with chronic kidney disease undergoing dialysis treatment for at least three months were included. Before the second hemodialysis session of the week, the patient underwent an assessment of balance, measured by displacement of the center of pressure using a force platform and muscle activation of the bilateral anterior tibial and medial gastrocnemius muscles using surface electromyography. Subsequently, a randomization was performed to apply the intervention or placebo. A new balance assessment was performed after the application of the protocol and another after hemodialysis. In the subsequent hemodialysis session, paired with the previous one, the participant underwent the same sequence of assessments of balance and electromyography, and also received balance training or placebo training according to the order defined at randomization. Results: Six patients were included ((50% male, 57.1 ± 7.4 years), undergoing hemodialysis for 86.0 ± 109.3 months. There were no significant differences between the placebo and intervention sessions, or between the pre and post hemodialysis moments, at mean speed, in the ellipse area, in total, mediolateral and anteroposterior displacements. Electromyographic analysis was hampered by technical issues in the synchronization of signals. Conclusion: An acute balance training protocol did not promote changes in postural control and static balance in patients with chronic kidney disease undergoing hemodialysis.