SUMMARY OBJECTIVE: To analyze the sociodemographic and clinical factors associated with the perceived benefits and barriers to physical activity (PA) in subjects with liver cirrhosis. METHODS: This cross-sectional study assessed 102 outpatients with liver cirrhosis regarding the clinical and sociodemographic profile and the perceived benefits and barriers to PA by the Exercise Benefits and Barriers Scale and muscle strength. A Generalized Step-Forward linear regression analysis was used to identify the factors associated. RESULTS: The participants were 59±10 years and 60.8% were men. Around 29.4% had ascites decompensation. Perceived benefits and barriers were associated with the presence of ascites (95%CI −0.079 – 0.03; p=0.06 and 95%CI 0.003 – 0.217; p=0.045, respectively). In the group with ascites, both benefits and barriers were associated with muscle strength. In the group without ascites, benefits were associated with cardiovascular risks and no association was observed with barriers to physical activity. CONCLUSIONS: Perceived benefits and barriers to physical activity are associated with intrinsic factors such as the presence of ascites and cardiovascular risk in individuals with liver cirrhosis. The results of this study highlight key elements that must be considered for increasing physical activity in this population.

FUNDAMENTO: Na população geral, a prática regular de exercícios físicos se associa à melhora da capacidade funcional e à redução de eventos cardiovasculares. Já em portadores de doença renal crônica, uma população com significativo comprometimento da capacidade funcional e elevadas taxas de mortalidade cardiovascular, poucos estudos avaliam os efeitos da atividade física. OBJETIVO: Avaliar o efeito do treinamento aeróbico durante as sessões de hemodiálise, sobre a capacidade funcional e a pressão arterial de pacientes renais crônicos. MÉTODOS: Foram avaliados 14 pacientes portadores de doença renal crônica sob tratamento hemodialítico, antes e depois de 12 semanas de treinamento aeróbico realizado durante as sessões de hemodiálise. Os pacientes foram submetidos a monitorização ambulatorial da pressão arterial de 24 horas, teste de caminhada de 6 minutos e teste cardiopulmonar de exercício antes e depois do período de treinamento. RESULTADOS: Após o treinamento, observou-se aumento significativo da distância percorrida no teste de caminhada de 6 minutos de 509 ± 91,9 m para 555 ± 105,8 m, além de redução significativa da pressão arterial sistólica de 151 ± 18,4 mmHg para 143 ± 14,7 mmHg, da pressão arterial diastólica de 94 ± 10,5 mmHg para 91 ± 9,6 mmHg e da pressão arterial média de 114 ± 13,0 mmHg para 109 ± 11,4 mmHg. CONCLUSÃO: O treinamento aeróbico realizado durante as sessões de hemodiálise contribuiu para a melhora da capacidade funcional e para o controle da hipertensão arterial dos pacientes portadores de doença renal crônica.

BACKGROUND: In the general population, regular practice of physical exercises is associated with improved physical capacity and reduction of cardiovascular events. Concerning patients with chronic kidney disease, a population with significant impairment of physical capacity and high rates of cardiovascular mortality, few studies have evaluated the effects of physical activity. OBJECTIVE: To evaluate the effect of aerobic exercise during hemodialysis on the physical capacity and blood pressure of patients with chronic renal failure. METHODS: We evaluated 14 patients with chronic kidney disease under hemodialysis, before and after 12 weeks of aerobic exercise performed during hemodialysis sessions. Patients underwent ambulatory blood pressure monitoring for 24 hours, 6-minute walk test and cardiopulmonary exercise test before and after the exercise period. RESULTS: After the exercise, there was a significant increase in the distance walked during the 6-minute walk test from 509 ± 91.9 m to 555 ± 105.8 m, and a significant reduction in systolic blood pressure of 151 ± 18.4 mmHg to 143 ± 14.7 mmHg, diastolic blood pressure of 94 ± 10.5 mmHg to 91 ± 9.6 mmHg and average arterial pressure from 114 ± 13.0 mmHg to 109 ± 11.4 mmHg. CONCLUSION: Aerobic exercise conducted during hemodialysis sessions contributed to the improvement of physical capacity and control of hypertension in patients with chronic kidney disease.

Pacientes portadores de doença renal crônica (DRC) submetidos a tratamento dialítico apresentam alterações físicas e psicológicas que predispõem ao sedentarismo. Nesta população, a prescrição rotineira de exercícios físicos não é uma prática freqüente, especialmente no nosso país. No entanto, alguns autores têm demonstrado que um programa de exercícios para estes pacientes contribui para o melhor controle da hipertensão arterial, da capacidade funcional, da função cardíaca, da força muscular e, conseqüentemente, da qualidade de vida. Além dos benefícios relacionados ao sistema cardiovascular, a realização do exercício traz benefícios secundários, pois quebra a monotonia do procedimento, melhora aderência e pode aumentar a eficácia da diálise. Na presente revisão, os autores discutem aspectos da realização de exercícios físicos em pacientes portadores de DRC em diálise e apresentam dados iniciais de sua experiência com a aplicação de exercícios supervisionados durante as sessões de hemodiálise.

Patients with chronic kidney disease (CKD) on dialysis present physical and psychological limitations that induce to a sedentary life stile. The prescription of exercise for this population has not been common, especially in our country. In the last few years though, some authors have shown that exercising for these patients improves hypertension control, cardiac function, muscular strength, functional capacity and, consequently, their quality of life. Besides the benefits related to the cardiovascular system, exercise training during hemodialysis reduces the monotony of the procedure, improves adherence and contributes to the increase of dialysis efficacy. In this review, the authors discuss some aspects of exercise training in patients with CKD on dialysis and present their preliminary data of supervised exercises during hemodialysis sessions.