Tatiana Onofre1, Julio Flavio Fiore Junior2, César Ferreira Amorim1, Suzana Tanni Minamoto3, Denise de Moraes Paisani4, Luciana Dias Chiavegato1. 1. Universidade Cidade de São Paulo, Programa de Fisioterapia, São Paulo - SP, Brazil. 2. McGill University, Steinberg-Bernstein Centre for Minimally Invasive Surgery and Innovation, Health Centre, Montréal - QC, Canada. 3. Universidade Estadual Paulista, Escola de Medicina, Departamento de Clínica Médica, Botucatu - SP, Brazil. 4. Universidade de São Paulo, Escola de Medicina, Departamento de Fisioterapia, São Paulo - SP, Brazil.
Abstract
INTRODUCTION: Cardiorespiratory and musculoskeletal dysfunctions are common in the postoperative period of kidney transplant patients and are often accompanied by low exercise tolerance. OBJECTIVE: The purpose of this study was to evaluate the impact of an early physiotherapy program during hospital stay on functional capacity and peripheral and respiratory muscle strengthafter kidney transplant. METHODS: An open, randomized clinical trial was conducted in patients undergoing living donor kidney transplant. Sixty-three patients were included (intervention group-IG: n = 30; control group-CG: n = 33). IG received an early physiotherapy program from first postoperative day until hospital discharge and CG received standard care. The variables of interest were measured preoperatively and at discharge except for respiratory muscle strength and vital capacity (VC), which were also measured on the first postoperative day. Functional capacity was evaluated through six-minute walk test (6MWT); peripheral and respiratory muscle strength using a dynamometer and manovacuometer, respectively; and VC through spirometer. RESULTS: After surgery, there was a reduction in functional walking capacity and peripheral muscle strength without different between groups (p > 0.05); however, respiratory muscle strength was significantly higher in IG (p < 0.001) at hospital discharge, when comparing with CG. CONCLUSIONS: An early physiotherapy program during hospitalization for patients undergoing living donor kidney transplant caused a lower reduction in respiratory muscle strength and without additional benefits in the functional capacity, when compared to a control group, although the clinical relevance of this finding is uncertain.
RCT Entities:
INTRODUCTION: Cardiorespiratory and musculoskeletal dysfunctions are common in the postoperative period of kidney transplant patients and are often accompanied by low exercise tolerance. OBJECTIVE: The purpose of this study was to evaluate the impact of an early physiotherapy program during hospital stay on functional capacity and peripheral and respiratory muscle strength after kidney transplant. METHODS: An open, randomized clinical trial was conducted in patients undergoing living donor kidney transplant. Sixty-three patients were included (intervention group-IG: n = 30; control group-CG: n = 33). IG received an early physiotherapy program from first postoperative day until hospital discharge and CG received standard care. The variables of interest were measured preoperatively and at discharge except for respiratory muscle strength and vital capacity (VC), which were also measured on the first postoperative day. Functional capacity was evaluated through six-minute walk test (6MWT); peripheral and respiratory muscle strength using a dynamometer and manovacuometer, respectively; and VC through spirometer. RESULTS: After surgery, there was a reduction in functional walking capacity and peripheral muscle strength without different between groups (p > 0.05); however, respiratory muscle strength was significantly higher in IG (p < 0.001) at hospital discharge, when comparing with CG. CONCLUSIONS: An early physiotherapy program during hospitalization for patients undergoing living donor kidney transplant caused a lower reduction in respiratory muscle strength and without additional benefits in the functional capacity, when compared to a control group, although the clinical relevance of this finding is uncertain.
Authors: Luke A Baker; Daniel S March; Thomas J Wilkinson; Roseanne E Billany; Nicolette C Bishop; Ellen M Castle; Joseph Chilcot; Mark D Davies; Matthew P M Graham-Brown; Sharlene A Greenwood; Naushad A Junglee; Archontissa M Kanavaki; Courtney J Lightfoot; Jamie H Macdonald; Gabriella M K Rossetti; Alice C Smith; James O Burton Journal: BMC Nephrol Date: 2022-02-22 Impact factor: 2.388