چکیده:
ﻣﻘﺪﻣﻪ : ﻫﻤﻮدﯾﺎﻟﯿﺰ ﯾﮑﯽ از روش ﻫﺎی درﻣﺎن ﺟﺎﯾﮕﺰﯾﻦ ﮐﻠﯿﻪ در ﺑﯿﻤﺎران ﻣﺒﺘﻼ ﺑﻪ ﻣﺮﺣﻠﻪ اﻧﺘﻬﺎﯾﯽ ﺑﯿـﻤـﺎری ﮐﻠﯿﻮی ﻣﯽ ﺑﺎﺷﺪ . ﺑﺎ وﺟﻮد درﻣﺎن ﻣﻨﻈﻢ ﻫﻤﻮدﯾﺎﻟﯿﺰ، ﺑﯿﻤﺎران ﻫﻤﭽﻨﺎن از ﻣﺠﻤﻮﻋﻪ ای از ﻋﻼﯾﻢ ﺗﺤﺖ ﻋﻨـﻮان ﺳﻨﺪرم اورﻣﯽ رﻧﺞ ﻣﯽ ﺑﺮﻧﺪ ﺑﻄﻮری ﮐﻪ ﻋﺪم ﮐﻔﺎﯾﺖ دﯾﺎﻟﯿﺰ ﯾﮑﯽ از اﺻﻠﯽ ﺗﺮﯾﻦ ﻋﻮاﻣﻞ ﻣﺮگ و ﻣﯿﺮ در اﯾـﻦ ﺑﯿﻤﺎران اﺳﺖ . ﻫﺪف از اﯾﻦ ﭘﮋوﻫﺶ ﺗﻌﯿﯿﻦ ﺗﺎﺛﯿﺮ ﺗﻤﺮﯾﻨﺎت ذﻫﻨﯽ و ﺟﺴﻤﯽ ﺣﯿﻦ دﯾﺎﻟﯿﺰ ﺑﺮ ﮐﻔﺎﯾﺖ دﯾـﺎﻟـﯿـﺰ ﺑﯿﻤﺎران ﻫﻤﻮدﯾﺎﻟﯿﺰی ﺑﻮد. ﻣﻮاد و روش ﻫﺎ: در اﯾ ﻦ ﮐﺎرآزﻣﺎﯾﯽ ﺑﺎﻟﯿﻨﯽ ، 66 ﺑﯿﻤﺎر ﻫﻤﻮدﯾﺎﻟﯿﺰی ﺑﺎ روش ﺗﺨﺼـﯿـﺺ ﺗﺼـﺎدﻓـﯽ اﻧﺘﺨﺎب ﺷﺪﻧﺪ و در دو ﮔﺮوه ﺷﺎﻫﺪ و آزﻣﻮن ﻗﺮار ﮔﺮﻓﺘﻨﺪ . ﮔﺮوه آزﻣﻮن ﺗﻮﺳﻂ ﮐﺎرﺷﻨﺎس ارﺷﺪ ﺗﺮﺑﯿﺖ ﺑﺪﻧﯽ ﺗﺤﺖ آﻣﻮزش ﺗﻤﺮﯾﻨﺎت ﺑﺮﻧﺎﻣﻪرﯾﺰی ﺷﺪه ﺣﯿﻦ دﯾﺎﻟﯿﺰ ﺑﻪ ﻣﺪت 2 ﻣﺎه، ﺑﺮای دو ﺟﻠﺴﻪ در ﻫﻔﺘﻪ ﻗﺮار ﮔﺮﻓﺘﻨﺪ . ﻣﯿﺰان ﮐﻔﺎﯾﺖ دﯾﺎﻟﯿﺰ ﺑﺎ اﺳﺘﻔﺎده از ﻓﺮﻣﻮل Kt/v ، ﻗﺒﻞ، ﯾﮏ ﻣﺎه ﺑﻌﺪ و دو ﻣﺎه ﺑﻌﺪ از ﻣﺪاﺧﻠﻪ اﻧﺪازهﮔﯿﺮی و ﺑﺎ ﯾﮑﺪﯾﮕﺮ ﻣﻘﺎﯾﺴﻪ ﺷﺪ. اﻃﻼﻋﺎت ﺑﺎ اﺳﺘﻔﺎده از ﻧﺮم اﻓﺰار SPSS ﻣﻮرد ﺗﺠﺰﯾﻪ و ﺗﺤﻠﯿﻞ ﻗﺮار ﮔﺮﻓﺖ. ﯾﺎﻓﺘﻪ ﻫﺎ : ﻣﯿﺎﻧﮕﯿﻦ ﮐﻔﺎﯾﺖ دﯾﺎﻟﯿﺰ ﻗﺒﻞ از ﻣﺪاﺧﻠﻪ 0/27± 1/22 ﺑﻮد . ﻣﯿﺎﻧﮕﯿﻦ ﮐﻔﺎﯾﺖ دﯾﺎﻟﯿﺰ ﻗﺒﻞ و ﺑﻌﺪ از ﻣﺪاﺧﻠﻪ در ﮔﺮوه آزﻣﻮن ﺑﻪ ﺗﺮﺗﯿﺐ 0/17 ± 1/12 و 0/29± 1/31 ، ) 0/001= P ( و در ﮔﺮوه ﺷـﺎﻫـﺪ ﺑـﻪ ﺗﺮﺗﯿﺐ 0/31 ± 1/32 و 0/3 ± 1/31، )0/45=P ( ﺑﻮد. ﻧﺘﯿﺠﻪﮔﯿﺮی: ﺗﻤﺮﯾﻨﺎ ت ﺟ ﺴﻤﯽ و ذﻫﻨﯽ ﺣﯿ ﻦ دﯾﺎﻟﯿﺰ ﺑﻪ ﻋﻨﻮان ﯾﮏ رو ش درﻣﺎﻧﯽ ﻣﮑــﻤــﻞ ﺑﻪ دﻟﯿﻞ ﻋﺪم ﮔﺮﻓﺘﻦ وﻗﺖ اﺿﺎﻓﯽ از ﺑﯿﻤﺎر، ﮐﻢ ﻫﺰﯾﻨﻪ، ﺳﺎده، ﻗﺎﺑﻞ اﺟﺮاﯾﯽ و اﻧﻌﻄﺎف ﭘﺬﯾﺮ ﺑـﻮدن ﺟـﻬـﺖ اﻓﺰاﯾﺶ ﮐﻔﺎﯾﺖ دﯾﺎﻟﯿﺰ و ﺑﻬﺒﻮد ﮐﯿﻔﯿﺖ زﻧﺪﮔﯽ ﺑﯿﻤﺎران ﻫﻤﻮدﯾﺎﻟﯿﺰی ﺗﻮﺻﯿﻪ ﻣﯽ ﮔﺮدد.
Background: Hemodialysis is one of the renal replacement thera-pies in patients with end stage of renal disease. Despite regular treat-ment for hemodialysis, the hemodialytic patients suffer from a series of symptoms collectively known as uremic syndrome, so that inade-quate dialysis has been known as one of the important causes of mor-tality in these patients. The current study was conducted with the aim of specifying the effect of intradialytic physical and mental exercises on the quality of dialysis among these patients.
Materials and Methods: The current study was a clinical trial that 66 dialytic patients were selected via purposeful sampling and as-signed into two groups, namely the control and the experimental. The latter group went through planned intradialytic exercises by a senior expert in physical education twice a week for two months. The dialy-sis adequacy for both groups was measured using Kt/v formula be-fore, one and two months after the intervention and then compared. Collected data were analyzed by means of SPSS 18 software.
Result: The mean of the dialysis adequacy before the intervention was measured to be 1.22 ± 0.27. Moreover, the mean of dialysis ade-quacy both before and after intervention in the experimental group was respectively 1.12 ± 0.17 and 1.31 ± 0.28 (P = 0.001); it was 1.32 ± 0.31 and 1.31 ± 0.30 in the control group (P = 0.45).
Conclusion: The intradialytic physical and mental exercises are prescribed as supplementary therapies due to their taking away no extra-time from the patients, being cost efficient, easy, applicable, and flexible in increasing the dialysis adequacy and, therefore, im-proving the quality of life among the hemodialytic patients.