ABSTRACT
Aunque la historia de Kinesiología Respiratoria en Chile es relativamente breve, al igual que nuestra profesión, a lo largo de la historia mundial han existido hitos relevantes para el aprendizaje y desarrollo de los diferentes procedimientos que ejecutamos hoy en día. La evolución en los procesos investigativos y las mejoras tecnológicas han permitido que la Kinesiología Respiratoria se apegue a la ciencia y que el uso de técnicas y procedimientos se acerquen cada vez más a lo estrictamente efectivo de acuerdo a la evidencia.
Although the history of Respiratory Physiotherapy in Chile is relatively new, as is our profession, throughout world history there have been relevant milestones for the learning and development of the different procedures that we perform today. The evolution in research processes and technological improvements have allowed Respiratory Physiotherapy to stick to science and the use of techniques and procedures are increasingly closer to the strictly effective according to the evidence.
ABSTRACT
Abstract Objective: To estimate the effectiveness of Neuromuscular Electrostimulation (NMES) in adults with COPD undergoing MV. Method: A sensitive search was performed in MEDLINE, Embase, CENTRAL, CINAHL and other resources. Randomized Controlled Clinical Trials (RCTs) or non-RCTs that enrolled adults with COPD on MV due to an exacerbation of their disease were included. Two independent reviewers screened, extracted information, and assessed the risk of bias (RoB 2 tool) and the certainty of evidence (GRADE approach) from the included studies. Results: Four RCTs (144 participants) were included. Subjects who underwent NMES were able to move from bed to chair independently in less time (MD = 4.98 days less; 95% CI -8.55 to -1.47; 2 RCTs; low certainty of the evidence) and they were fewer days on MV (MD = 2.89 days less; 95% CI -4.58 to -1.21); 3 RCTs; low certainty of the evidence) than the control group. However, the effect of NMES on muscle strength is unclear (very low certainty of the evidence). Conclusions: NMES may improve functional independence and decrease MV time in adults with COPD; however, its effectiveness on muscle strength is uncertain. More and better RCTs are needed to determine with greater certainty the effectiveness of NMES in this population.
ABSTRACT
INTRODUCCIÓN: La rehabilitación y las acciones de terapia física se han ido adaptando a la era de la telesalud, permitiendo aumentar la accesibilidad y mejorar la continuidad de la atención en poblaciones con discapacidades y alejadas geográficamente. En la actualidad, y debido a expansión de la infección por SARS-CoV-2, muchos profesionales han debido adaptar su trabajo a una modalidad de telerehabilitación, por lo que es necesario acceder a la mejor evidencia disponible de manera resumida y oportuna. Es en este contexto que se ha desarrollado el presente protocolo, con el objetivo de evaluar la efectividad de la telerehabilitación como estrategia de atención en terapia física para diferentes condiciones, poblaciones y contextos. MÉTODO Y ANÁLISIS: Se conducirá una revisión global o revisión de revisiones, en un formato de revisión rápida siguiendo las recomendaciones PRISMA-P. Se incluirán revisiones sistemáticas de diferentes condiciones, poblaciones y contextos, donde la intervención a evaluar es la telerehabilitación en terapia física. Los desenlaces de interés a considerar son la efectividad clínica dependiendo de la condición específica, la funcionalidad, calidad de vida, satisfacción, adherencia y seguridad. Se realizará una búsqueda en las bases de datos MEDLINE/PubMed, EMBASE y Cochrane Library. La selección de los estudios será realizada en duplicado con resolución de discrepancias por un tercer revisor. La extracción de datos y la evaluación del riesgo de sesgos serán realizadas por un revisor con verificación no independiente de un segundo revisor. Los hallazgos serán reportados cualitativamente a través de tablas y figuras. ÉTICA Y DISEMINACIÓN: Se considera el cumplimiento de los principios éticos del valor de la pregunta de investigación, rigor metodológico, investigadores científicamente cualificados, evaluación independiente del protocolo y publicación puntual y precisa de los resultados. Se espera publicar la revisión completa en al menos un artículo y los resultados se difundirán ampliamente en diversos niveles de decisión.
INTRODUCTION: Rehabilitation and physical therapy have been adapting to the telehealth era, increasing accessibility and improving the continuity of attention in geographically remote populations with disabilities. Due to the spread of infection by SARS-CoV-2, many professionals have had to adapt their work to telerehabilitation practices, which require the best evidence at short notice and in summarized form. In this context, this protocol has been developed to evaluate the effectiveness of telerehabilitation as a care strategy in physical therapy for different conditions, populations, and contexts. METHOD AND ANALYSIS: An overview will be carried out in the format of a rapid review. It will include systematic reviews of different conditions, populations, and contexts, where the intervention to be evaluated is telerehabilitation by physical therapy. The outcomes considered will be clinical effectiveness depending on the specific condition, functionality, quality of life, satisfaction, adherence, and safety. A search will be carried out of the MEDLINE/PubMed, EMBASE, and Cochrane Library databases. Studies will be selected in duplicate with any discrepancies resolved by a third reviewer. Data extraction and risk of bias assessment will be carried out by a reviewer with non-independent verification by a second reviewer. The findings will be reported qualitatively by tables and figures. ETHICS AND DISSEMINATION: The principles of the value of the research question, the methodological rigor, scientifically qualified investigators, an independent evaluation of the protocol, and timely and accurate publication of the results will be complied with. The complete review will lead to the publication of at least one article, and the results will be widely disseminated at various levels of decision-making.