Postural Control and Functional Performance Changes with Inspiratory Muscle Training in Chronic Kidney Disease Patient

Rian Dewi Auriani, Vitriana, Farida Arisanti
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Abstract

ABSTRACTIntroduction: Approximately 60-75% of chronic kidney disease (CKD) patients have a uremic syndrome that may cause damage to muscle cells, including the diaphragm as respiratory muscle, which is known involved in maintaining postural stability and balance. This study aims to see the effects ofinspiratory muscle training on postural control and functional performance in CKD patients undergoing hemodialysis twice a week.Methods: This single-blind randomized controlled trial enrolled 36 participants (45±9 years) allocated randomly into the intervention and control group, receiving intensity of 50% and 10% Maximum Inspiratory Pressure (MIP), respectively. Postural sway (95% ellipse area, anteroposterior (AP), and mediolateral (ML) sway) measured using a force platform in static standing with feet apart (FP1) and together (FP2), and functional performance by Short Physical Performance Battery (SPPB), assessed at pre-and postintervention.Results: After 8-week, intervention group demonstrated greater improvements on MIP (233.45% vs 141.65%; p=0.0001). Postural sway FP1 and FP2 not significantly improved in intervention group (p > 0.05). The control group showed a significant increase (p = 0.007) in the SPPB score.Conclusion: The inspiratory muscle training has not significantly improved postural control nor functional performance in patients with chronic kidney disease on hemodialysis. Further research is needed.Keywords: chronic kidney disease, hemodialysis, inspiratory muscle training, physical performance,postural control
慢性肾病患者的体位控制和功能表现随吸气肌训练的改变
摘要:大约60-75%的慢性肾脏疾病(CKD)患者有尿毒症综合征,可能导致肌肉细胞损伤,包括膈肌和呼吸肌,膈肌参与维持姿势的稳定性和平衡。本研究旨在观察呼吸肌肉训练对每周进行两次血液透析的CKD患者姿势控制和功能表现的影响。方法:采用单盲随机对照试验,36例受试者(45±9岁)随机分为干预组和对照组,分别给予最大吸气压力(MIP)强度50%和10%。在干预前和干预后,分别用力平台测量两脚分开(FP1)和两脚一起(FP2)静态站立时的体位摇摆(95%椭圆面积、前后位(AP)和中外侧(ML)摇摆),并通过短物理性能电池(SPPB)评估功能表现。结果:8周后,干预组在MIP方面表现出更大的改善(233.45% vs 141.65%;p = 0.0001)。干预组体位摇摆FP1、FP2无明显改善(p > 0.05)。对照组患者SPPB评分显著升高(p = 0.007)。结论:吸气肌训练对慢性肾病血液透析患者的姿势控制和功能表现没有明显改善。需要进一步的研究。关键词:慢性肾病,血液透析,吸气肌训练,体能表现,体位控制
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