title: [Functional state and indications for a rehabilitation program of patients in a dialysis center: a multidisciplinary study with ergonomic, physiatrical and psychological evaluation].
abstract: The following study describes the functional status of the entire chronic hemodialysis ambulatory population in treatment at our center. The patients were evaluated from 3 points of view: ergonomic, phyiatric and psychological, thus going a snapshot picture in time of their status. Based on these three evaluations, the need for rehabilitation intervention was determined and rehabilitation treatment program was elaborated. The ergonomic evaluation determined the maximal sustained workload (MSW) from O2 consumption, minute ventilation, heart rate, subjective perception of fatigue and dyspnea. The phyiatric examination included a thorough musculoskeletal examination, application of a functional ability instruments (Karnofsky + FIM) and then integrated the results with the ergonomic + psychologic testing in order to generate phyiatric prescription. The psychologist had a conversation with all patients and applied 2 instruments for evaluation of health-related quality of life (CBA-H + SIP). The results of these studies indicated a markedly compromised aerobic capacity, which worsened with age in years rather than with years in dialysis. Phyiatric prescription were considered necessary in 78% of the patients with major goals being re-conditioning and joint mobilization in order to diminish the fragility of independence in this population. The psychological arm of the study revealed good adaptation to chronic dialysis in 75% of the population, with however absorption of a passive lifestyle. The remaining 25% of the population showed severe psychological distress and social withdrawal. Psychological support for this population is necessary to identify families at risk for stress and poor adaptability as well as to help motivate patients who require rehabilitation to participate in therapy.
authors.affiliation: Fondazione S. Maugeri, Clinica del Lavoro e della Riabilitazione, IRCCS, Centro Medico di Pavia.
authors.forename: G
authors.initials: G
authors.lastname: Villa
authors.forename: E M
authors.initials: EM
authors.lastname: Capodaglio
authors.forename: D
authors.initials: D
authors.lastname: Jurisic
authors.forename: I
authors.initials: I
authors.lastname: Giorgi
authors.forename: A
authors.initials: A
authors.lastname: Salvadeo
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006804:Ergonomics; D005069:Evaluation Studies as Topic; D005260:Female; D006801:Humans; D008019:Life Style; D008297:Male; D008875:Middle Aged; D010045:Outpatients / Q000523:psychology; D010809:Physical Fitness; D026741:Physical Therapy Modalities; D011581:Psychological Tests; D011788:Quality of Life; D012046:Rehabilitation; D006435:Renal Dialysis