Breathing exercises in upper abdominal surgery: a systematic review and meta-analysis / Exercícios respiratórios em cirurgia abdominal alta: revisão sistemática e metanálise

BACKGROUND: There is currently no consensus on the indication and benefits of breathing exercises for the prevention of postoperative pulmonary complications PPCs and for the recovery of pulmonary mechanics. OBJECTIVE: To undertake a systematic review of randomized and quasi-randomized studies that assessed the effects of breathing exercises on the recovery of pulmonary function and prevention of PCCs after upper abdominal surgery UAS. METHOD: Search Strategy: We searched the Physiotherapy Evidence Database PEDro, Scientific Electronic Library Online SciELO, MEDLINE, and Cochrane Central Register of Controlled Trials. Selection Criteria: We included randomized controlled trials and quasi-randomized controlled trials on pre- and postoperative UAS patients, in which the primary intervention was breathing exercises without the use of incentive inspirometers. Data Collection and Analysis: The methodological quality of the studies was rated according to the PEDro scale. Data on maximal respiratory pressures MIP and MEP, spirometry, diaphragm mobility, and postoperative complications were extracted and analyzed. Data were pooled in fixed-effect meta-analysis whenever possible. RESULTS: Six studies were used for analysis. Two meta-analyses including 66 participants each showed that, on the first day post-operative, the breathing exercises were likely to have induced MEP and MIP improvement treatment effects of 11.44 mmH2O (95%CI 0.88 to 22) and 11.78 mmH2O (95%CI 2.47 to 21.09), respectively. CONCLUSION: Breathing exercises are likely to have a beneficial effect on respiratory muscle strength in patients submitted to UAS, however the lack of good quality studies hinders a clear conclusion on the subject.

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Transparent reporting of studies relevant to physical therapy practice / Como escrever de forma transparente artigos científicos relevantes para a prática da Fisioterapia

BACKGROUND: There was a clear grow, in the last 2 decades, of up to 6 fold in scientific articles that are directly relevant to physical therapy practice. However, along with this fast grow; little attention has been given to transparency when reporting research methods and results. More recently, groups of researchers around the world have made successful attempts to address this issue by creating guidelines that will help researchers not only on the preparation of manuscripts but also on making sure that important details related to design and methodology are controlled and reported. OBJECTIVE: To present four specific reporting guidelines, which are best known as "statements". DISCUSSION: A network named EQUATOR (Enhancing the Quality and Transparency of Health Research) was created with the main mission of providing basic principles for responsible and transparent reporting. The EQUATOR network encompasses, among others, the CONSORT statement which is related to randomized controlled trials; the PRISMA statement, which is related to systematic reviews and meta-analysis; the STROBE Statement, which is related to observational studies; and the STARD statement, which is related to reporting of accuracy of diagnostic tests. Some journals have recommended the use of these statements, while in others their use is mandatory. The goal of the use of these statements by journals is to guarantee fast decisions regarding publication and the best possible quality of reporting. Ultimately, it will help readers, including physical therapists, to make better decisions in clinical practice.

CONTEXTUALIZAÇÃO: Nas últimas duas décadas, ocorreu um nítido crescimento, de até seis vezes, do número de artigos científicos que são diretamente relevantes para a prática da Fisioterapia. No entanto, junto com esse rápido crescimento, tem-se dado pouca atenção à transparência de como são descritos os métodos e os resultados desses estudos. Mais recentemente, grupos de pesquisadores ao redor do mundo têm feito tentativas bem sucedidas para resolver esse problema por meio da criação de diretrizes que auxiliam os pesquisadores não apenas na preparação dos manuscritos, mas também garantem que detalhes importantes relacionados ao delineamento e à metodologia do estudo sejam devidamente descritos. OBJETIVO: Apresentar quatro diretrizes específicas para descrever artigos científicos, que são mais conhecidas como "recomendações". DISCUSSÃO: Uma rede denominada EQUATOR (Melhorando a Qualidade e a Transparência da Pesquisa em Saúde) foi criada com a missão principal de fornecer os princípios básicos de como escrever artigos científicos de forma clara e fidedigna. A rede EQUATOR engloba, entre outros, as recomendações CONSORT, que estão relacionadas com estudos controlados aleatorizados; as recomendações PRISMA, que estão relacionadas com revisões sistemáticas e meta-análises; as recomendações STROBE, que estão relacionadas com estudos observacionais e as recomendações STARD, que estão relacionadas com a descrição de estudos referentes à precisão de testes diagnósticos. Algumas revistas científicas têm apoiado a utilização dessas recomendações, enquanto, em outras revistas, o uso é obrigatório. O objetivo da utilização dessas recomendações pelas revistas científicas é garantir a tomada rápida de decisões relativas à publicação e à melhor qualidade possível de como o artigo científico foi reportado. Em última análise, essas recomendações irão ajudar os leitores, incluindo fisioterapeutas, a tomarem melhores decisões na prática clínica.