Interferência da Prática de Tai Chi Chuan na Saúde Mental de Pessoas Com Lesão da Medula Espinhal / Interference of Tai Chi Chuan practice in the mental health of spinal cord injury people

Este estudo constou de um experimento descritivo de car�ter quali-quantitativo, com objetivo de avaliar a interfer�ncia da pr�tica do Tai Chi Chuan na sa�de mental de pessoas com les�o da medula espinhal nos par�metros autoestima, ansiedade e depress�o. Foi composto por um grupo de interven��o constitu�do de oito pessoas com les�o da medula espinhal que praticaram aulas de Tai Chi Chuan por um per�odo de seis meses, e grupo controle com oito integrantes que apenas realizavam o tratamento de fisioterapia. Os resultados demonstraram-se significativos para o grupo de interven��o quanto � ansiedade e depress�o (p= 0,021) e autoestima (p=0,015). Os benef�cios da pr�tica do Tai Chi Chuan t�m significado importante na melhora da sa�de mental e f�sica de pessoas com defici�ncia f�sica causada por les�o da medula espinhal. Desta forma, sugerimos mais estudos sobre a interven��o da pr�tica do Tai Chi Chuan como complemento no processo de reabilita��o da popula��o.

This study consisted of a quali-quantitative descriptive experiment aimed at assessing the interference of Tai Chi Chuan practice in the mental health of people with spinal cord injury, regarding the parameters self-esteem, anxiety and depression. It was composed by a intervention group consisting of eight people with spinal cord injury, who practiced Tai Chi Chuan classes for a period of six months, and a control group with eight members that just performed the physiotherapy treatment. There were significant results for the intervention group regarding the anxiety and depression (p=0,021) and self-esteem (p=0,015). We conclude that the practice of Tai Chi Chuan has an important meaning in improving the mental health of people with physical disabilities caused by a spinal cord injury. Thus, we suggest more studies on the practice of Tai Chi Chuan as complement of the rehabilitation process of the population.

Efeitos da mobilização passiva nas respostas hemodinâmicas agudas em pacientes sob ventilação mecânica / Effects of passive mobilization on acute hemodynamic responses in mechanically ventilated patients

OBJETIVO: Avaliar as respostas hemodinâmicas agudas da mobilização passiva de pacientes sob ventilação mecânica. MÉTODOS: Estudo de investigação clínica do tipo transversal, quantitativa e observacional. Incluindo pacientes internados na unidade de terapia intensiva, sedados e sob ventilação mecânica. A infusão de drogas sedativas e analgésicas visava o grau de sedação de 4 a 6 de acordo com a escala de Ramsay. A mobilizaçao passiva consistiu em movimentos de flexo-extensão de quadril e joelho durante cinco minutos. Após 10 minutos de repouso, foram realizados mais cinco minutos de mobilização passiva com flexo-extensão de ombro. As mensurações hemodinâmicas (freqüência cardíaca, pressão arterial sistólica e diastólica e pressão arterial média) foram realizadas 1 minuto antes da realização do protocolo e no primeiro minuto após o término. O duplo produto e a medida do consumo ou captação de oxigênio pelo miocárdio foram obtidas por meio de fórmulas. RESULTADOS: Entre junho a dezembro de 2011 foram incluídos 13 pacientes (69,2% homens) com idade média de 69,1 ± 15,8 anos. A mobilização passiva de membros inferiores e de membros superiores provocou aumentos da frequência cardíaca, do duplo produto e do consumo ou captação de oxigênio pelo miocárdio com diferença estatisticamente significante. Entretanto a pressão arterial média não apresentou diferença significativa. CONCLUSÃO: Os resultados sugerem que a mobilização passiva de membros inferiores e superiores em pacientes sedados sob ventilação mecânica influencia de forma segura nos efeitos hemodinâmicos agudos, particularmente na frequência cardíaca, porém sem alterar significativamente a pressão arterial média.

OBJECTIVE: To assess the effects of passive mobilization on acute hemodynamic responses in mechanically ventilated patients. METHODS: This cross-sectional, quantitative, observational study enrolled patients who were admitted to the intensive care unit, sedated and mechanically ventilated. The infusion of sedative and analgesic drugs aimed to maintain a Ramsay scale sedation level of 4 to 6. Passive mobilization consisted of hip and knee flexion-extension movements for five minutes. After 10 minutes of rest, an additional five minutes of flexion-extension passive movements was performed for the shoulders. Hemodynamic assessments (heart rate and systolic, diastolic and mean blood pressure) were performed one minute before the mobilization protocol and one minute after each phase. The double product and myocardial oxygen consumption were calculated using appropriate formulas. RESULTS: A total of 13 patients (69.2% male, with a mean age of 69.1 ± 15.8 years) were admitted from June to December, 2011. Passive mobilization led to statistically significant increases in heart rate, double product and myocardial oxygen consumption. However, mean blood pressure was not significantly altered. CONCLUSIONS: Our results suggest that passive mobilization of mechanically ventilated and sedated patients is safe and provides beneficial effects on acute hemodynamic parameters, particularly heart rate, although mean blood pressure is not significantly altered.

Effects of passive mobilization on acute hemodynamic responses in mechanically ventilated patients. / Efeitos da mobilização passiva nas respostas hemodinâmicas agudas em pacientes sob ventilação mecânica.

OBJECTIVE: To assess the effects of passive mobilization on acute hemodynamic responses in mechanically ventilated patients. METHODS: This cross-sectional, quantitative, observational study enrolled patients who were admitted to the intensive care unit, sedated and mechanically ventilated. The infusion of sedative and analgesic drugs aimed to maintain a Ramsay scale sedation level of 4 to 6. Passive mobilization consisted of hip and knee flexion-extension movements for five minutes. After 10 minutes of rest, an additional five minutes of flexion-extension passive movements was performed for the shoulders. Hemodynamic assessments (heart rate and systolic, diastolic and mean blood pressure) were performed one minute before the mobilization protocol and one minute after each phase. The double product and myocardial oxygen consumption were calculated using appropriate formulas. RESULTS: A total of 13 patients (69.2% male, with a mean age of 69.1 ± 15.8 years) were admitted from June to December, 2011. Passive mobilization led to statistically significant increases in heart rate, double product and myocardial oxygen consumption. However, mean blood pressure was not significantly altered. CONCLUSIONS: Our results suggest that passive mobilization of mechanically ventilated and sedated patients is safe and provides beneficial effects on acute hemodynamic parameters, particularly heart rate, although mean blood pressure is not significantly altered.