ABSTRACT
BACKGROUND: Pulmonary rehabilitation programs improve exercise capacity and quality of life in patients with COPD. Domiciliary strategies to maintain these benefits have been proposed. OBJECTIVE: This study aimed to determine whether a rehabilitation manual would facilitate the maintenance of the benefits acquired during out-patient pulmonary rehabilitation. METHODS: Fifty subjects with stable COPD were included (26 women and 24 men). All the subjects were evaluated during screening and after 12 wk of out-patient rehabilitation, and then were randomly divided into 2 groups, with one group that received the rehabilitation manual for home use (manual group) and the other group only received verbal recommendations (control group). At this point, the 2 groups were similar. After 12 wk at home, both groups were evaluated a third time. All evaluations included a 6-min walk test (6MWT), 6-min step test, COPD Assessment Test, and measurement of dyspnea by using the modified Medical Research Council dyspnea scale. RESULTS: When comparing the results of the 6MWT and 6-min step test done at out-patient discharge and after 12 wk at home, the manual group presented no differences (6MWT, 0 ± 25 m; 6-min step test, 1 ± 32 steps), whereas the control subjects lost part of the gain obtained during rehabilitation (6MWT -46 ± 36 m; 6-min step test -39 ± 33 steps). There was a significant difference between the groups (P < .05). When comparing the same time points, the change in the COPD Assessment Test score was -1 ± 1 for the manual group and 1 ± 2 for the control group (P = .01). For the modified Medical Research Council dyspnea scale, the change in score was 0 ± 1 for the manual group and 1 ± 1 for the control group (P = .01). CONCLUSIONS: The use of a simple, well-illustrated manual facilitated the maintenance of the benefits acquired in out-patient pulmonary rehabilitation over a period of 3 months after study termination.
Subject(s)
Manuals as Topic , Pulmonary Disease, Chronic Obstructive/rehabilitation , Self Care , Aged , Aged, 80 and over , Dyspnea/etiology , Exercise Therapy , Female , Humans , Male , Middle Aged , Pulmonary Disease, Chronic Obstructive/complications , Symptom Assessment , Walk TestABSTRACT
As quedas adquirem maior relevância com o aumento da população idosa em termos de saúde pública e de aspectos socioeconômicos. As médias do tempo de realização do Timed Get Up and Go (TGUG) em pacientes idosos ambulatoriais com relato de quedas acidentais e recorrentes foram comparadas neste estudo de corte longitudinal retrospectivo. Observa-se que o tempo de realização do TGUG, em média, foi significativamente maior nos idosos com relato de quedas recorrentes...
Falls obtain more relevance with the rise of the aged population in terms of public health and socioeconomic issues. The averages of the time to perform the Timed Get Up and Go test (TGUG) in ambulatory elderly patients with story of accidental and recurrent falls were compared in this retrospective and longitudinal study. It is noted that the time to perform the TGUG, in average, was significantly higher in the elderly with story of recurrent falls...
Subject(s)
Humans , Aged , Accidental Falls , Aged , Postural BalanceABSTRACT
As quedas adquirem maior relevância com o aumento da população idosa em termos de saúde pública e de aspectos socioeconômicos. As médias do tempo de realização do Timed Get Up and Go (TGUG) em pacientes idosos ambulatoriais com relato de quedas acidentais e recorrentes foram comparadas neste estudo de corte longitudinal retrospectivo. Observa-se que o tempo de realização do TGUG, em média, foi significativamente maior nos idosos com relato de quedas recorrentes.(AU)
Falls obtain more relevance with the rise of the aged population in terms of public health and socioeconomic issues. The averages of the time to perform the Timed Get Up and Go test (TGUG) in ambulatory elderly patients with story of accidental and recurrent falls were compared in this retrospective and longitudinal study. It is noted that the time to perform the TGUG, in average, was significantly higher in the elderly with story of recurrent falls.(AU)
Subject(s)
Humans , Aged , Accidental Falls , Postural Balance , AgedABSTRACT
A polineuromiopatia do paciente crítico é uma afecção comumem pacientes graves em unidade de terapia intensiva, expostos aseus fatores de risco, sendo muitas vezes subdiagnosticada e capazde causar prejuízo funcional ao paciente, incluindo a capacidadeventilatória, desencadeando insufi ciência respiratória agudapor incompetência neuromuscular. A presente revisão, realizadaatravés de pesquisa sistemática da literatura, objetiva identifi carse as alterações da contratilidade muscular na polineuromiopatiado paciente crítico, focando na musculatura diafragmática e daparede torácica, podem interferir no desmame do paciente. Dessemodo, apresentar-se-ão os aspectos fi siopatológicos da doença, umabreve avaliação física desses aspectos e dados científi cos atuais quedemonstrem a interferência negativa dessa afecção muscular sobreo desmame da ventilação mecânica. Conclui-se existirem estudosevidentes de que a polineuromiopatia do paciente crítico aumentao tempo do paciente na ventilação mecânica e atrasa o desmamedesta, aumentando o risco de falha na extubação, necessidade detraqueostomia, morbidade e mortalidade associadas à internaçãohospitalar prolongada. É importante que o fi sioterapeuta estejaatento à presença dessa doença, com o objetivo de agir precocementepara minimizar seus efeitos deletérios. Por fi m, ressalta-se anecessidade de mais estudos que foquem essa doença como causade falha no desmame da ventilação mecânica...
Critical illness polyneuromyopathy is a common disease in severelyill patients hospitalized in critical care units and exposed to itsrisk factors. Frequently it is underdiagnosed and capable of impairingthe patients function, including the ventilatory capacity, which canunleash acute respiratory failure, caused by neuromuscular incompetence.Th e objective of this systematic literature review was toidentify if the physiopathological changes in contractile properties ofmuscle in patients with critical illness polyneuromyopathy, focusingin the diaphragm and thoracic muscles, may interfere with weaningfrom mechanical ventilation. It will be shown the physiopathologicalaspects of this disease, a brief physical exam and scientifi c datathat demonstrate that this muscular illness aff ects negatively theweaning. We concluded that there are scientifi c studies which showthat critical illness polyneuromyopathy increases patients time inmechanical ventilation and delays its weaning, increasing the rateof failed extubation, need of tracheostomy, morbidity and mortalityassociated with prolonged hospitalization. It is important that thephysical therapist detect this illness earlier, in order to prevent itsdeleterious eff ects. Finally, it is suggested the need of further studiesthat focus this disease as cause of weaning failure...
Subject(s)
Humans , Ventilator Weaning , Muscular Diseases , Physical Therapy Specialty , Polyneuropathies , Respiration, ArtificialABSTRACT
Faz-se uma revisäo dos princípios de inaloterapia, demonstrando sua importância no tratamento das doenças broncopulmonares. Comentam-se os diversos fatores a serem considerados para uma inaloterapia eficaz, como o tamanho das partículas, densidade da névoa, medicaçäo, volume e tempo, tipo de aparelhagem, tipo de respiraçäo e posiçäo do paciente e correta eliminaçäo das secreçöes. Descrevem-se as diferenças entre nebulizaçäo e umidificaçäo e suas respectivas indicaçöes, concluindo que, para maior eficácia do método, há necessidade da correta prescriçäo do médico e correta execuçäo por fisioterapeutas respiratórios
