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6. Conclusão geral

A realização deste estágio foi enriquecedora, tendo existido a oportunidade de lidar com diversas patologias, enriquecendo o conhecimento sobre como intervir nas patologias e as características inerentes às mesmas. Todo o trabalho envolvente do estágio, foi uma mais valia para o desenvolvimento de capacidades, tais como a capacidade de planear em segurança para as diferentes patologias, capacidade de compreensão de anormalidades decorrentes no treino ou após o mesmo e o planeamento temporal de incremento de cargas. Relativamente aos objetivos de estágio, adquirir e desenvolver conhecimento sobre esta população específica, de modo a intervir da forma mais adequada foi alcançada devido à realização frequente de fichas de estudo, revisão da literatura realizada (para submeter a publicação em breve) e devido a todo o apoio estrutural recebido. O apoio ao programa de exercício físico foi um sucesso, aumentando em 20% o número de participantes no mesmo, o que fez com que superasse as expectativas, nossas e da instituição. Por último, foi diagnosticado uma lacuna no programa existente e foi criado e implementado um programa de estímulo ao equilíbrio. Os dados provisórios iniciais obtidos demonstraram que foi possível obter resultados significativos ao nível do aumento da taxa de equilíbrio postural.

A existência de uma equipa multidisciplinar é essencial para o bom funcionamento e compreensão dos problemas surgidos. A conexão social também se tornou uma ferramenta imprescindível para o bom funcionamento do programa e o seu aumento de adesão, conseguindo manter a realização do programa sem polémicas.

7. Bibliografia

Abdel-Rahman, E. M., Yan, G., Turgut, F., & Balogun, R. A. (2011). Long-term morbidity and mortality related to falls in hemodialysis patients: role of age and gender–a pilot study. Nephron clinical practice, 118(3), c278-c284.

Alexander, N. B. (1996). Differential diagnosis of gait disorders in older adults. Clinics in

geriatric medicine, 12(4), 689-703.

Apovian, C. M., Frey, C. M., Wood, G. C., Rogers, J. Z., Still, C. D., & Jensen, G. L. (2002). Body mass index and physical function in older women. Obesity, 10(8), 740-747. Arneson, T. J., Li, S., Liu, J., Kilpatrick, R. D., Newsome, B. B., & Peter, W. L. S. (2013).

Trends in hip fracture rates in US hemodialysis patients, 1993-2010. American Journal

of Kidney Diseases, 62(4), 747-754.

Bao, Y., Dalrymple, L., Chertow, G. M., Kaysen, G. A., & Johansen, K. L. (2012). Frailty, dialysis initiation, and mortality in end-stage renal disease. Archives of internal

medicine, 172(14), 1071-1077.

Barnea, N., Drory, Y., Iaina, A., Lapidot, C., Reisin, E., Eliahou, H., & Kellermann, J. (1980). Exercise tolerance in patients on chronic hemodialysis. Israel journal of medical

sciences, 16(1), 17-21.

Bastos, M. G., Bregman, R., & Kirsztajn, G. M. (2010). Chronic kidney diseases: common and harmful, but also preventable and treatable. Revista da Associacao Medica Brasileira,

56(2), 248-253.

Block, G. A., Klassen, P. S., Lazarus, J. M., Ofsthun, N., Lowrie, E. G., & Chertow, G. M. (2004). Mineral metabolism, mortality, and morbidity in maintenance hemodialysis.

Journal of the American Society of Nephrology, 15(8), 2208-2218.

Bohannon, R. W. (2006). Single Limb Stance Times: A Descriptive Meta‐Analysis of Data From Individuals at Least 60 Years of Age. Topics in Geriatric Rehabilitation, 22(1), 70-77. Braithwaite, R. S., Col, N. F., & Wong, J. B. (2003). Estimating hip fracture morbidity,

mortality and costs. Journal of the American Geriatrics Society, 51(3), 364-370. Bramell-Risberg, E., Jarnlo, G.-B., Minthon, L., & Elmståhl, S. (2005). Lower gait speed in

older women with dementia compared with controls. Dementia and geriatric

cognitive disorders, 20(5), 298-305.

Castaneda, C., Gordon, P. L., Uhlin, K. L., Levey, A. S., Kehayias, J. J., Dwyer, J. T., . . . Singh, M. F. (2001). Resistance training to counteract the catabolism of a low-protein diet in patients with chronic renal insufficiency: a randomized, controlled trial.

32

Cheng, P.-T., Liaw, M.-Y., Wong, M.-K., Tang, F.-T., Lee, M.-Y., & Lin, P.-S. (1998). The sit- to-stand movement in stroke patients and its correlation with falling. Archives of

physical medicine and rehabilitation, 79(9), 1043-1046.

Colberg, S. R., Sigal, R. J., Fernhall, B., Regensteiner, J. G., Blissmer, B. J., Rubin, R. R., . . . Braun, B. (2010). Exercise and type 2 diabetes: the American College of Sports Medicine and the American Diabetes Association: joint position statement. Diabetes

care, 33(12), e147-e167.

Cook, W. L., Tomlinson, G., Donaldson, M., Markowitz, S. N., Naglie, G., Sobolev, B., & Jassal, S. V. (2006). Falls and fall-related injuries in older dialysis patients. Clinical

journal of the American Society of Nephrology, 1(6), 1197-1204.

Cunningham, J., Danese, M., Olson, K., Klassen, P., & Chertow, G. M. (2005). Effects of the calcimimetic cinacalcet HCl on cardiovascular disease, fracture, and health-related quality of life in secondary hyperparathyroidism. Kidney international, 68(4), 1793- 1800.

Delgado, C., Shieh, S., Grimes, B., Chertow, G. M., Dalrymple, L. S., Kaysen, G. A., . . . Johansen, K. L. (2015). Association of self-reported frailty with falls and fractures among patients new to dialysis. American journal of nephrology, 42(2), 134-140. Deligiannis, A., Kouidi, E., Tassoulas, E., Gigis, P., Tourkantonis, A., & Coats, A. (1999).

Cardiac effects of exercise rehabilitation in hemodialysis patients. International

journal of cardiology, 70(3), 253-266.

Deligiannis, A., Kouidi, E., & Tourkantonis, A. (1999). Effects of physical training on heart rate variability in patients on hemodialysis. The American journal of cardiology,

84(2), 197-202.

DePaul, V., Moreland, J., Eager, T., & Clase, C. M. (2002). The effectiveness of aerobic and muscle strength training in patients receiving hemodialysis and EPO: a randomized controlled trial. American Journal of Kidney Diseases, 40(6), 1219-1229.

Desmet, C., Beguin, C., Swine, C., Jadoul, M., & Group, U. C. d. L. C. (2005). Falls in hemodialysis patients: prospective study of incidence, risk factors, and complications.

American Journal of Kidney Diseases, 45(1), 148-153.

Diesel, W., Noakes, T. D., Swanepoel, C., & Lambert, M. (1990). Isokinetic muscle strength predicts maximum exercise tolerance in renal patients on chronic hemodialysis.

American Journal of Kidney Diseases, 16(2), 109-114.

Ensrud, K. E., Blackwell, T., Mangione, C. M., Bowman, P. J., Bauer, D. C., Schwartz, A., . . . Whooley, M. A. (2003). Central nervous system active medications and risk for fractures in older women. Archives of internal medicine, 163(8), 949-957.

Etgen, T., Chonchol, M., Förstl, H., & Sander, D. (2012). Chronic kidney disease and cognitive impairment: a systematic review and meta-analysis. American journal of nephrology,

35(5), 474-482.

Fazendeiro, J. (2011). Manual de hemodiálise para enfermeiros. Coimbra, Almedina,

Fouque, D., Vennegoor, M., Ter Wee, P., Wanner, C., Basci, A., Canaud, B., . . . Martin-Malo, A. (2007). EBPG guideline on nutrition. Nephrology Dialysis Transplantation,

22(suppl_2), ii45-ii87.

Gardner, A. W., & Poehlman, E. T. (1995). Exercise rehabilitation programs for the treatment of claudication pain: a meta-analysis. Jama, 274(12), 975-980.

Garrison, R. J., Kannel, W. B., Stokes, J., & Castelli, W. P. (1987). Incidence and precursors of hypertension in young adults: the Framingham Offspring Study. Preventive

medicine, 16(2), 235-251.

Gehlsen, G. M., & Whaley, M. H. (1990). Falls in the elderly: Part II, Balance, strength, and flexibility. Archives of physical medicine and rehabilitation, 71(10), 739-741.

Gribble, P. A., & Hertel, J. (2004). Effect of hip and ankle muscle fatigue on unipedal postural control. Journal of Electromyography and Kinesiology, 14(6), 641-646. Hall, J. E., Kuo, J. J., da Silva, A. A., de Paula, R. B., Liu, J., & Tallam, L. (2003). Obesity-

associated hypertension and kidney disease. Current opinion in nephrology and

hypertension, 12(2), 195-200.

Headley, S., Germain, M., Mailloux, P., Mulhern, J., Ashworth, B., Burris, J., . . . Welles, R. (2002). Resistance training improves strength and functional measures in patients with end-stage renal disease. American Journal of Kidney Diseases, 40(2), 355-364. Herzog, C. A., Ma, J. Z., & Collins, A. J. (1998). Poor long-term survival after acute

myocardial infarction among patients on long-term dialysis. New England journal of

medicine, 339(12), 799-805.

Hiatt, W. R., Regensteiner, J. G., Hargarten, M. E., Wolfel, E. E., & Brass, E. P. (1990). Benefit of exercise conditioning for patients with peripheral arterial disease.

Circulation, 81(2), 602-609.

Ifudu, O. (1998). Care of patients undergoing hemodialysis. New England journal of medicine,

339(15), 1054-1062.

Ikizler, T. A., Pupim, L. B., Brouillette, J. R., Levenhagen, D. K., Farmer, K., Hakim, R. M., & Flakoll, P. J. (2002). Hemodialysis stimulates muscle and whole body protein loss and alters substrate oxidation. American Journal of Physiology-Endocrinology And

Metabolism, 282(1), E107-E116.

Isaacs, R. B., Lobo, P. I., Nock, S. L., Hanson, J. A., Ojo, A. O., & Pruett, T. L. (2000). Racial disparities in access to simultaneous pancreas-kidney transplantation in the United States. American Journal of Kidney Diseases, 36(3), 526-533.

Ismail, N., Hakim, R. M., Oreopoulos, D. G., & Patrikarea, A. (1993). Renal replacement therapies in the elderly: Part 1. Hemodialysis and chronic peritoneal dialysis.

American Journal of Kidney Diseases, 22(6), 759-782.

Jassal, Coulshed, Douglas, & Stout. (1997). Autonomic neuropathy predisposing to arrhythmias in hemodialysis patients. American Journal of Kidney Diseases, 30(2), 219-223. Jassal, Douglas, & Stout. (1998). Prevalence of central autonomic neuropathy in elderly

34

European Dialysis and Transplant Association-European Renal Association, 13(7),

1702-1708.

Johansen, K. L. (1999). Physical Functioning and Exercise Capacity in Patient on Dialysis.

Advances in renal replacement therapy, 6(2), 141-148.

Johansen, K. L. (2007). Exercise in the end-stage renal disease population. Journal of the

American Society of Nephrology, 18(6), 1845-1854.

Johansen, K. L., Chertow, G. M., Jin, C., & Kutner, N. G. (2007). Significance of frailty among dialysis patients. Journal of the American Society of Nephrology, 18(11), 2960-2967. Johansen, K. L., & Painter, P. (2012). Exercise in individuals with CKD. American Journal of

Kidney Diseases, 59(1), 126-134.

Kenney, W. L., Wilmore, J., & Costill, D. (2015). Physiology of sport and exercise 6th edition: Human kinetics.

Koufaki, P., Mercer, T. H., & Naish, P. F. (2002). Effects of exercise training on aerobic and functional capacity of end‐stage renal disease patients. Clinical physiology and

functional imaging, 22(2), 115-124.

Kouidi, E., Albani, M., Natsis, K., Megalopoulos, A., Gigis, P., Guiba-Tziampiri, O., . . . Deligiannis, A. (1998). The effects of exercise training on muscle atrophy in haemodialysis patients. Nephrology, dialysis, transplantation: official publication of

the European Dialysis and Transplant Association-European Renal Association, 13(3),

685-699.

Kressig, R. W., Wolf, S. L., Sattin, R. W., O'grady, M., Greenspan, A., Curns, A., & Kutner, M. (2001). Associations of Demographic, Functional, and Behavioral Characteristics with Activity‐Related Fear of Falling Among Older Adults Transitioning to Frailty. Journal

of the American Geriatrics Society, 49(11), 1456-1462.

Kurella, M., Covinsky, K. E., Collins, A. J., & Chertow, G. M. (2007). Octogenarians and Nonagenarians Starting Dialysis in the United StatesOctogenarians and Nonagenarians Starting Dialysis in the United States. Annals of internal medicine, 146(3), 177-183. Kutner, N. G. (2008). Promoting functioning and well-being in older CKD patients: review of

recent evidence. International urology and nephrology, 40(4), 1151.

Launer, L. J., Harris, T., Rumpel, C., & Madans, J. (1994). Body mass index, weight change, and risk of mobility disability in middle-aged and older women: the epidemiologic follow-up study of NHANES I. Jama, 271(14), 1093-1098.

Levey, A. S., & Coresh, J. (2012). Chronic kidney disease. The lancet, 379(9811), 165-180. Li, M., Tomlinson, G., Naglie, G., Cook, W. L., & Jassal, S. V. (2007). Geriatric comorbidities,

such as falls, confer an independent mortality risk to elderly dialysis patients.

Nephrology Dialysis Transplantation, 23(4), 1396-1400.

Liu‐Ambrose, T., Donaldson, M. G., Ahamed, Y., Graf, P., Cook, W. L., Close, J., . . . Khan, K. M. (2008). Otago home‐based strength and balance retraining improves executive functioning in older fallers: a randomized controlled trial. Journal of the American

Luukinen, H., Koski, K., Laippala, P., & Kivelä, S.-L. (1995). Predictors for recurrent falls among the home-dwelling elderly. Scandinavian journal of primary health care,

13(4), 294-299.

Macário, F. (2013). Tratamento substitutivo renal da doença renal crónica estádio V em Portugal. Relatório do Gabinete de Registo da Sociedade Portuguesa de Nefrologia.

Available from: URL: http://www. spnefro.

pt/comissoes_gabinetes/Gabinete_registo_2012/registo_2012. pdf.

Mahoney, R. (1965). Barthel index (BI). Surya Shah, PhD, OTD, MEd, OTR, FAOTA, Professor

Occupational Therapy and Neurology, Visiting Professor Neurorehabilitation, University of Tennessee Health Sciences Center, 930, 1.

Mannarino, E., Pasqualini, L., Menna, M., Maragoni, G., & Orlandi, U. (1989). Effects of physical training on peripheral vascular disease: a controlled study. Angiology, 40(1), 5-10.

Marques, M. C. (2004). O trabalho de força no alto rendimento desportivo: Da teoria à

prática.

Matvéiev, L., & Ruas, M. (1986). Fundamentos do treino desportivo.

Mayer, G., Thum, J., & Graf, H. (1989). Anaemia and reduced exercise capacity in patients on chronic haemodialysis. Clinical Science, 76(3), 265-268.

Medeiros, P. (2012). O seu treinador pessoal: A Esfera dos Livros.

Medicine, A. C. o. S. (2012). ACSM's resource manual for guidelines for exercise testing and

prescription: Lippincott Williams & Wilkins.

Medicine, A. C. o. S. (2013). ACSM's guidelines for exercise testing and prescription: Lippincott Williams & Wilkins.

Medicine, A. C. o. S., & Ehrman, J. K. (2010). ACSM's resource manual for guidelines for

exercise testing and prescription: Wolters Kluwer Health/Lippincott Williams &

Wilkins.

Miniño, A. M., Anderson, R. N., Fingerhut, L. A., Boudreault, M. A., & Warner, M. (2006). Deaths: injuries, 2002. National vital statistics reports, 54(10), 1-124.

Moore, G., Durstine, J. L., & Painter, P. (2016). ACSM's Exercise Management for Persons

With Chronic Diseases and Disabilities, 4E: Human Kinetics.

Morrison, S., Colberg, S. R., Mariano, M., Parson, H. K., & Vinik, A. I. (2010). Balance training reduces falls risk in older individuals with type 2 diabetes. Diabetes care, 33(4), 748- 750.

Nowicki, M., Zwiech, R., Dryja, P., & Sobański, W. (2009). Autonomic neuropathy in hemodialysis patients: questionnaires versus clinical tests. Clinical and experimental

nephrology, 13(2), 152-155.

Oh-Park, M., Fast, A., Gopal, S., Lynn, R., Frei, G., Drenth, R., & Zohman, L. (2002). Exercise for the dialyzed: aerobic and strength training during hemodialysis. American journal

36

Organization, W. H. (2007). Everybody's business--strengthening health systems to improve health outcomes: WHO's framework for action.

Organization, W. H. (2010). Global recommendations on physical activity for health.

Painter, P., Carlson, L., Carey, S., Paul, S. M., & Myll, J. (2000). Physical functioning and health-related quality-of-life changes with exercise training in hemodialysis patients.

American Journal of Kidney Diseases, 35(3), 482-492.

Painter, P., & Zimmerman, S. W. (1986). Exercise in end-stage renal disease. American

Journal of Kidney Diseases, 7(5), 386-394.

Panorchan, K., Nongnuch, A., El-Kateb, S., Goodlad, C., & Davenport, A. (2015). Changes in muscle and fat mass with haemodialysis detected by multi-frequency bioelectrical impedance analysis. European journal of clinical nutrition, 69(10), 1109.

Pereira, M. (2007). Verificar a Eficácia de Diferente smodalidades de Exercício Físico, no

Aumento do Equilíbrio, em Idosos.

Pinto, B. M., Marcus, B. H., Patterson, R. B., Roberts, M., Colucci, A., & Braun, C. (1997). On- site versus home exercise programs: psychological benefits for individuals with arterial claudication. Journal of Aging and Physical Activity, 5(4), 311-328.

Polner, K., Szeifert, L., Vámos, E., Ambrus, C., Molnár, M., Ladányi, E., . . . Kopp, M. (2011). Psychosocial characteristics and self-reported functional status in patients on maintenance dialysis in Hungary. Clinical nephrology, 76(6), 455.

Reboredto, M. d. M., Paula, R. B. d., Henrique, D. M. N., & Bastos, M. G. (2007). Exercício físico em pacientes dialisados. Rev. bras. med. esporte, 427-430.

Roberts, Jeffrey, C., Carlisle, G., & Brierley, E. (2007). Prospective investigation of the incidence of falls, dizziness and syncope in haemodialysis patients. International

urology and nephrology, 39(1), 275-279.

Roberts, Kenny, R. A., & Brierley, E. (2003). Are elderly haemodialysis patients at risk of falls and postural hypotension? International urology and nephrology, 35(3), 415-421. Roshanravan, B., Khatri, M., Robinson-Cohen, C., Levin, G., Patel, K. V., De Boer, I. H., . . .

Kestenbaum, B. (2012). A prospective study of frailty in nephrology-referred patients with CKD. American Journal of Kidney Diseases, 60(6), 912-921.

Rubenstein, L., & Josephson, K. (1992). Falls in the elderly: causes and preventive approaches. Falls, Balance, and Gait Disorders in the Elderly. Amsterdam: Elsevier, 21-38.

Ruivo. (2015). Manual de Avaliação e Prescrição de Exercício. Lisboa. Ruivo, R. (2015). Manual de Avaliação e Prescrição de Exercício.

Sattin, R. W., LAMBERT HUBER, D. A., DEVITO, C. A., RODRIGUEZ, J. G., ROS, A., BACCHELLI, S., . . . Waxweiler, R. J. (1990). The incidence of fall injury events among the elderly in a defined population. American journal of epidemiology, 131(6), 1028-1037. Schlicht, J., Camaione, D. N., & Owen, S. V. (2001). Effect of intense strength training on

Journals of Gerontology Series A: Biological Sciences and Medical Sciences, 56(5),

M281-M286.

Silva, D. K., & Nahas, M. V. (2008). Prescrição de exercícios físicos para pessoas com doença vascular periférica. Revista brasileira de Ciência e Movimento, 10(1), 55-61.

Stopka, C., Wolper, R., Scott, K., Seeger, J., Ballinger, R., & Graves, J. (1998). Pain-free exercise training for people with peripheral vascular disease? PALAESTRA-MACOMB

ILLINOIS-, 14, 20-23.

Sundberg, C. J., Jansson, A., Edling, C., & Wadman, M. (2010). Physical activity in the prevention and treatment of disease. Professional Associations for Physical Activity. Tentori, F., McCullough, K., Kilpatrick, R. D., Bradbury, B. D., Robinson, B. M., Kerr, P. G., &

Pisoni, R. L. (2014). High rates of death and hospitalization follow bone fracture among hemodialysis patients. Kidney international, 85(1), 166-173.

Tinetti, M. E., & Powell, L. (1993). Fear of falling and low self-efficacy: a cause of dependence in elderly persons. Journal of gerontology.

Tinetti, M. E., Speechley, M., & Ginter, S. F. (1988). Risk factors for falls among elderly persons living in the community. New England journal of medicine, 319(26), 1701- 1707.

Tinetti, M. E., & Williams, C. S. (1997). Falls, injuries due to falls, and the risk of admission to a nursing home. New England journal of medicine, 337(18), 1279-1284.

Tinetti, M. E., & Williams, C. S. (1998). The effect of falls and fall injuries on functioning in community-dwelling older persons. The Journals of Gerontology Series A: Biological

Sciences and Medical Sciences, 53(2), M112-M119.

Toussaint, N. D., Elder, G. J., & Kerr, P. G. (2010). A rational guide to reducing fracture risk

in dialysis patients. Paper presented at the Seminars in dialysis.

Tzankoff, S. P., & Norris, A. H. (1978). Longitudinal changes in basal metabolism in man.

Journal of Applied Physiology, 45(4), 536-539.

Vestergaard, P. (2008). Skeletal effects of central nervous system active drugs: anxiolytics, sedatives, antidepressants, lithium and neuroleptics. Current drug safety, 3(3), 185- 189.

Wilmore, J., Costill, D., & Kenney, W. (1999). Prescription of exercise for health and fitness.

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