Temeljna življenjska aktivnost gibanje - pomen telesne vadbe pri hemodializnem bolniku : diplomsko delo

Matjašič, Darija (author), Thaler, Darja (mentor), Bogataj, Špela (comentor), Mlinar, Suzana (reviewer)

Uvod: Hemodializni bolniki imajo slabše gibalne sposobnosti in so v povprečju manj telesno aktivni kot zdrava populacija. Učinki različnih vadbenih programov so pri teh bolnikih slabo raziskani. V največ primerih telesna vadba poteka v obliki med-dializnega kolesarjenja. Namen: Namen diplomskega dela je bil ugotoviti vpliv dveh programov telesne vadbe na gibalno sposobnost, telesno sestavo in na krvne parametre pri hemodializnih bolnikih. Prvi program vadbe oziroma kontrolni program vadbe je vseboval med-dializno kolesarjenje. Drugi program vadbe oziroma eksperimentalni program pa je poleg med-dializnega kolesarjenja vseboval še pred-dializno vodeno telesno vadbo. Metode dela: Pred pričetkom vadbe smo 29 bolnikom, ki so pristali k sodelovanju v raziskavi, testirali moč zgornjih in spodnjih okončin. To smo izvedli s testom moč stiska pesti (dinamometer) in s testom 10 ponovitev vstajanja s stola. Vsem bolnikom smo z bioimpedanco izmerili sestavo telesa (pusta telesna masa in maščobna masa). Pri priključitvi na dializo smo vzeli tudi vzorec krvi in analizirali določene parametre (c-reaktivni protein, hemoglobin, holesterol itd.). Po začetnem testiranju smo bolnike naključno razdelili v dve skupini – kontrolno in eksperimentalno skupino. Eksperimentalna skupina je pred vsako dializo (3x tedensko) izvajala vodeno telesno vadbo z usposobljenim vaditeljem. Nato smo medicinske sestre tem bolnikom po priključitvi na dializni aparat prinesle še prilagojeno kolo za med-dializno kolesarjenje in jih med vadbo nadzorovale ter motivirale. Kontrolna skupina je izvajala samo program med-dializnega kolesarjenja po istem načinu kot eksperimentalna skupina. Obe vadbi sta potekali na vsak dializni dan (3x tedensko) v obsegu dveh mesecev (8 tednov). Po koncu tega obdobja smo ponovili vsa testiranja in primerjali rezultate. Rezultati: 27 bolnikov je uspešno zaključilo raziskavo. Eksperimentalna skupina je v primerjavi s kontrolno skupino statistično značilno izboljšala svoj rezultat v testu moč stiska pesti (p<0,001) in v testu 10 ponovitev vstajanja s stola (p=0,009). Pri eksperimentalni skupini smo zaznali statistično značilno znižanje LDL-holesterola (p=0,027). Razprava in zaključek: Z raziskavo smo ugotovili, da imata oba programa vadbe pozitivne učinke na hemodializne bolnike. Boljše rezultate pri bolnikih dosežemo z dodatkom funkcionalne vadbe k med-dializnem kolesarjenju. Telesna vadba je za bolnike koristna, izvedljiva in varna.

• Language: Slovenian
• Keywords: diplomska dela, zdravstvena nega, hemodializa, kronična ledvična bolezen, telesna vadba, med-dializno kolesarjenje, rehabilitacija
• Work type: Bachelor thesis/paper
• Typology: 2.11 - Undergraduate Thesis
• Organization: ZF - Faculty of Health Sciences
• Place of publishing: Ljubljana
• Publisher: [D. Matjašič]
• Year: 2022
• Number of pages: 31 str.
• PID: 20.500.12556/RUL-135559
• UDC: 616-083
• COBISS.SI-ID: 101895171
• Publication date in RUL: 19.03.2022

Secondary language

• Language: English
• Title: The basic life activity movement - the importance of physical exercise of a hemodialysis patient : diploma work

Abstract

Introduction: Hemodialysis patients have poorer motor skills and are on average less physically active than the healthy population. The effects of various exercise programs in these patients are poorly studied. In most cases, physical activity is performed in the form of cycling during dialysis. Purpose: The aim of this work was to investigate the effects of two exercise programs on physical performance, body composition, and blood parameters of hemodialysis patients. The first exercise program or control program included intradialytic cycling. The second exercise program or experimental program included guided functional training before dialysis in addition to cycling during dialysis. Methods: Before the intervention, we tested upper and lower extremity strength in 29 patients who agreed to participate in the study. This was done with the hand-grip strength test (dynamometer) and with the 10-repetition sit-to-stand test. Body composition (lean body mass and fat mass) was measured in all patients with bioimpedance. When connected to dialysis, we also took a blood sample and analyzed certain parameters (c-reactive protein, hemoglobin, cholesterol, etc.). After the initial tests, patients were randomly divided into two groups - a control and an experimental group. Before each dialysis (3 times per week), the experimental group performed guided functional training with a kinesiologist. After dialysis started, nurses brought an adapted bicycle for intradialytic cycling and monitored and motivated them during the exercises. The control group performed only the intradialytic cycling program in the same way as the experimental group. Both exercises took place on each dialysis day (3 times per week) for a period of two months (8 weeks). At the end of this period, we repeated all tests and compared the results. Results: 27 patients successfully completed the study. Compared to the control group, the experimental group statistically significantly improved their result in the hand-grip strength test (p < 0.001) and the 10-repetition sit-to-stand test (p = 0.009). The experimental group showed a statistically significant decrease in LDL cholesterol (p = 0.027). Discussion and conclusion: The research found that both exercise programs have positive effects on hemodialysis patients. Better patient outcomes are achieved when functional training is added to intradialytic cycling. Physical exercise is beneficial, feasible, and safe for dialysis patients.

• Keywords: diploma theses, nursing care, hemodialysis, chronic kidney disease, exercise, intradialytic cycling, rehabilitation