Análise da força de preensão palmar, sensibilidade cutânea manual e uso funcional das mãos em crianças e adolescentes com doença renal crônica em hemodiálise

A Doença Renal Crônica (DRC), em estágio terminal, pode gerar prejuízos significativos quando ocorre na infância e na adolescência. O objetivo deste estudo foi avaliar a força muscular de preensão palmar, a sensibilidade cutânea manual e o uso funcional das mãos em crianças e adolescentes em tratamento hemodialítico. Trata-se de um estudo transversal, descritivo e analítico, que incluiu 21 indivíduos que realizaram hemodiálise (11 por via cateter e 10 por fístula) comparados com 21 controles, pareados por idade e sexo. Para a análise da força de preensão palmar foi aplicado o dinamômetro Jamar®, para a sensibilidade, o teste de monofilamentos de Semmes Weinstein® e para o uso funcional das mãos, o teste de Jebsen-Taylor. O uso funcional das mãos foi mais comprometido no grupo em hemodiálise em relação ao controle (mão dominante p=<0,001, não dominante p=0,001). A força de preensão palmar foi menor no grupo em hemodiálise comparado ao controle (p=<0,001) e a sensibilidade apresentou alteração apenas para o grupo com fístula, referente à inervação do mediano (p=<0,001). Crianças e adolescentes com DRC podem apresentar alterações importantes na força de preensão palmar, no uso funcional das mãos e na sensibilidade. Resultados como estes podem substanciar ações multidisciplinares com essa população.

The Chronic Kidney Disease (CKD) in its terminal stage can cause significant damage when it occurs in childhood and adolescence. The objective of this study was to evaluate muscle strength of palmar grasp, manual cutaneous sensitivity and functional hand use in children and adolescents on hemodialysis. This is a cross-sectional, descriptive and analytical study that included 21 participants undergoing hemodialysis (11 via catheter and 10 per fistula), compared to 21 control participants matched by age and sex. The Jamar® dynamometer was administered to measure the palmar grip strength; the Semmes Weinstein® monofilament for cutaneous sensitivity, and the Jebsen-Taylor test for the functional use of the hands. The functional use of the hands was more compromised in the hemodialysis group in relation to the control (dominant hand p = <0.001, non-dominant p = 0.001). Palmar grasp strength was lower in the hemodialysis group compared to the control (p = <0.001) and the sensitivity suffered changes only in the fistula group because of possible damages to the median nerve (p = 0.001). Children and adolescents with CKD may present important changes in palmar grasp strength, functional use of hands and sensitivity. These results can substantiate multidisciplinary actions with this population.

The Chronic Kidney Disease (CKD) in its terminal stage can cause significant damage when it occurs in childhood and adolescence. The objective of this study was to evaluate muscle strength of palmar grasp, manual cutaneous sensitivity and functional hand use in children and adolescents on hemodialysis. This is a cross-sectional, descriptive and analytical study that included 21 participants undergoing hemodialysis (11 via catheter and 10 per fistula), compared to 21 control participants matched by age and sex. The Jamar® dynamometer was administered to measure the palmar grip strength; the Semmes Weinstein® monofilament for cutaneous sensitivity, and the Jebsen-Taylor test for the functional use of the hands. The functional use of the hands was more compromised in the hemodialysis group in relation to the control (dominant hand p = <0.001, non-dominant p = 0.001). Palmar grasp strength was lower in the hemodialysis group compared to the control (p = <0.001) and the sensitivity suffered changes only in the fistula group because of possible damages to the median nerve (p = 0.001). Children and adolescents with CKD may present important changes in palmar grasp strength, functional use of hands and sensitivity. These results can substantiate multidisciplinary actions with this population.The Chronic Kidney Disease (CKD) in its terminal stage can cause significant damage when it occurs in childhood and adolescence. The objective of this study was to evaluate muscle strength of palmar grasp, manual cutaneous sensitivity and functional hand use in children and adolescents on hemodialysis. This is a cross-sectional, descriptive and analytical study that included 21 participants undergoing hemodialysis (11 via catheter and 10 per fistula), compared to 21 control participants matched by age and sex. The Jamar® dynamometer was administered to measure the palmar grip strength; the Semmes Weinstein® monofilament for cutaneous sensitivity, and the Jebsen-Taylor test for the functional use of the hands. The functional use of the hands was more compromised in the hemodialysis group in relation to the control (dominant hand p = <0.001, non-dominant p = 0.001). Palmar grasp strength was lower in the hemodialysis group compared to the control (p = <0.001) and the sensitivity suffered changes only in the fistula group because of possible damages to the median nerve (p = 0.001). Children and adolescents with CKD may present important changes in palmar grasp strength, functional use of hands and sensitivity. These results can substantiate multidisciplinary actions with this population.