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Medicina clínica y social

versión On-line ISSN 2521-2281

Med. clín. soc. vol.6 no.2 Santa Rosa del Aguaray ago. 2022

https://doi.org/10.52379/mcs.v6i2.253 

Editorial

Muscle strength in patients with chronic renal failure from a kinesiology perspective

1Clínica Physikós, Asunción, Paraguay


The need to improve the patient's quality of life is a reality and the main goal of kinesiology. Advances in research make it possible to assess aspects of the patient that previously did not have the necessary relevance, allowing for improvements in therapeutic criteria in search of better patient satisfaction.

The article entitled "Muscle strength in adult patients with chronic renal failure in the National Hospital and Military Hospital in 2021"1 published in this issue deals with muscle strength in adult patients with CKD, approached from the anthropometric and clinical variables and muscle strength itself. The editorial focuses on the aspects of greatest interest for a kinesiologist.

A great success on the part of the researchers was the use of a strength dynamometer as an objective instrument to evaluate strength in individuals, a device that gives a measurable result compared to conventional strength tests that have a somewhat subjective character on the part of the examiner. In a review of the Efdeportes magazine of Buenos Aires published in December 2004 called "Strength of palmar grip opening with the use of the Jama dynamometer"2 cites the following about the use of the dynamometer in the evaluation of muscle strength: "The evaluation of palmar grip strength has many clinical applications, as it is used as an indicator of total body strength and provides an objective index of the functional integrity of the upper limbs. Several instruments are used to measure palmar grip strength, but none like the dynamometer" as it says there is an "indicator" that can be used as a predictive model for overall muscle strength without taking into account other factors that influence a result or that can give an overall opinion of the patient's muscle strength.

More and more research is needed to include the use of this type of instruments since there are many benefits that can be obtained, such as the knowledge of the state of the patients or persons to be evaluated and also the nobility of the dynamometer such as price, ease of transport and comfort, not to mention all the information they provide to a kinesiologist to develop a plan for the patient seeking to improve the aspect of muscle strength in them.

A review in the journal of nephrology, dialysis and transplantation of Buenos Aires published in March 20153 called "Sarcopenia in patients with and without chronic renal failure: diagnosis, evaluation and treatment" concluded that "the presence of sarcopenia is highly prevalent in the elderly, and in patients with CKD" associating its consequences with other comorbidities such as fractures, reduced mobility, increased health cost, among others. At the present time, the best treatment seems to be the implementation of a physical activity program to maintain and improve the musculoskeletal system with a combination of various exercises. It is important to emphasize that each patient should be evaluated individually, so that, to develop a physical activity program in patients with chronic renal failure should take into account issues such as: whether or not they are dialyzed, the time that the disease has already been installed, the health conditions in which people are in order to adapt the physical activity to their particular needs.

The Andalusian journal of sports medicine published in April and June 2018 "Description of body composition, strength and physical activity in patients with chronic renal failure on hemodialysis in a renal unit in Bogota, Colombia"4 a descriptive cross-sectional study with patients who attended the hemodialysis (HD) program. Physical activity was assessed by means of a physical activity survey of the American College of Sports Medicine adjusted and summarized by the Sports Medicine Service of the Hospital San José de Bogotá, the objective of this survey being to measure physical activity in resting metabolic unit (MET). In this study they observed that "the HD patients studied have an adequate weight for their height, but with less muscle mass and decreased muscle strength for their age". Based on the latter, it would have been interesting if the study of muscle strength in patients with CKD in the National and Military Hospitals had used a group of healthy subjects with the same age range, since these were younger than 40 years, to evaluate them comparatively with the subjects in the population with CKD whose mean age was 51 and 56 in women and men, respectively.

The factor of muscle strength for the functional and emotional state of patients is of utmost relevance if we wish to approach therapy in a more comprehensive and global way, taking patients as a whole in which each factor that influences psychobiosocial levels can contribute for better or worse in the prognosis of a disease.

This is why the inclusion of physiotherapeutic criteria in patients with renal diseases is of utmost relevance and should be part of the scaffolding on which the evidence-based treatment is structured due to the multiple benefits it provides, and thus avoid aggravating the disease with other complications that come hand in hand with the lack of physical activity, decreased strength and above all the sedentary lifestyle that is one of the edges that accelerate deterioration

Referencias

1. Real Delor R, Roy Torales T, Brítez Mendoza J, Encina Villagra D, Giménez J, Gómez M, et. al. Fuerza muscular en pacientes adultos con insuficiencia renal crónica del Hospital Nacional y Hospital Militar en 2021. Med. clín. soc. 2022;6(2):45-52. 10.52379/mcs.v6i2.239 [ Links ]

2. Pimenta de Godoy JR, de Franca Barros J, Moreira D, Silva Júnior W. Força de aperto da preensão palmar com o uso do dinamômetro Jamar: revisão de literatura. Lecturas: Educación Física y Deportes. 2004;10(79). [ Links ]

3. Cusumano AM. Sarcopenia en pacientes con y sin insuficiencia renal crónica: diagnóstico, evaluación y tratamiento. Revista de nefrologia, dialisis y trasplante. 2015;35(1):32-43. [ Links ]

4. Hernández A, Monguí K, Rojas Y, Hernández A, Monguí K, Rojas Y. Descripción de la composición corporal, fuerza muscular y actividad física en pacientes con insuficiencia renal crónica en hemodiálisis en una unidad renal en Bogotá, Colombia. Revista Andaluza de Medicina del Deporte. 2018;11(2):52-56. 10.1016/j.ramd.2016.09.005 [ Links ]

Received: April 02, 2022; Revised: April 03, 2022; Accepted: April 04, 2022

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