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1.
Appl Physiol Nutr Metab ; 49(1): 64-76, 2024 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-37690126

RESUMO

TAKE HOME MESSAGE: Cancer symptoms negatively affect health-related quality of life (HRQoL) in patients with cancer awaiting liver resection. Prehabilitation maintained HRQoL after surgery. Future studies should test whether relieving cancer symptoms can improve HRQoL.


Assuntos
Neoplasias , Qualidade de Vida , Humanos , Exercício Pré-Operatório , Carga de Sintomas , Cuidados Pré-Operatórios/métodos , Cuidados Pré-Operatórios/reabilitação , Resultado do Tratamento , Fígado , Complicações Pós-Operatórias/prevenção & controle
2.
Urologie ; 62(10): 1025-1033, 2023 Oct.
Artigo em Alemão | MEDLINE | ID: mdl-37682348

RESUMO

Against the background of typical geriatric multimorbidity and with the particular vulnerability of geriatric patients, polypharmacy deserves special attention. In accordance with the guidelines, medication should not only be reviewed regularly, but also on an ad hoc basis and with each hospital stay-and also in the context of prehabilitation. Thus, not only substances that interfere with the currently planned intervention, anesthesia, or risk of bleeding should be considered, but any medication that increases common risks for geriatric patients. These include drugs that cause or increase a tendency to fall, induce delirium, or alter the comedication through potential drug-drug interactions. Measures to minimize the risk include the following: exact documentation of medications, structured and complete transfer of information, patient and family training about any side effects that may occur, a recall system for possible laboratory checks, and compliance with the instructions for taking the medication.


Assuntos
Revisão de Medicamentos , Multimorbidade , Polimedicação , Cuidados Pré-Operatórios , Idoso , Humanos , Polimedicação/prevenção & controle , Hospitalização , Interações Medicamentosas , Cuidados Pré-Operatórios/reabilitação , Cuidados Pré-Operatórios/normas
3.
Urologie ; 62(10): 1041-1047, 2023 Oct.
Artigo em Alemão | MEDLINE | ID: mdl-37620505

RESUMO

Against the background of a continuous improvement of established treatment outcomes and the compatibility of health economic considerations, pre- and perioperative processes are constantly being developed and further optimized. In recent years, the concept of prehabilitation has gained increasing importance as a proactive approach to preparing patients for mostly surgical cancer treatment and improving their physical and mental health. Prehabilitation in oncology is a systematic process aimed at improving the physical, psychosocial, and nutritional condition of patients before and during cancer treatment. The goal of prehabilitation is to enhance patients' ability to cope with the physiological stress of cancer treatment and improve their overall health and well-being. In addition, prehabilitation has the potential to reduce costs for the healthcare system.


Assuntos
Cuidados Pré-Operatórios , Prostatectomia , Neoplasias da Próstata , Humanos , Masculino , Cuidados Pré-Operatórios/economia , Cuidados Pré-Operatórios/métodos , Cuidados Pré-Operatórios/psicologia , Cuidados Pré-Operatórios/reabilitação , Prostatectomia/economia , Prostatectomia/métodos , Prostatectomia/reabilitação , Resultado do Tratamento , Neoplasias da Próstata/economia , Neoplasias da Próstata/psicologia , Neoplasias da Próstata/cirurgia , Adaptação Psicológica
5.
Multimedia | Recursos Multimídia | ID: multimedia-7249

RESUMO

Fisiologia do sistema respiratório. Volumes e capacidades pulmonares. Obesidade como fator de risco. Terapia incentivadora da inspiração.


Assuntos
Cuidados Pré-Operatórios/reabilitação , Modalidades de Fisioterapia/organização & administração , Cirurgia Bariátrica/reabilitação , Exercícios Respiratórios , Obesidade/reabilitação , Obesidade/cirurgia , Fenômenos Fisiológicos Respiratórios , Fatores de Risco
6.
Tohoku J Exp Med ; 251(4): 279-285, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32759553

RESUMO

Low preoperative physical function in cancer patients is associated with postoperative complications; however, there have been no reports on the benefits of in-hospital preoperative rehabilitation on preoperative physical function in patients with pancreatic cancer. Therefore, the aim of this study was to quantitatively determine the effects of preoperative in-hospital rehabilitation provided under the supervision of a physiotherapist, on preoperative physical function in patients with pancreatic cancer. The study subjects were 26 patients (15 males, 11 females; age 71.2 ± 8.5 years, range: 51-87 years), including four patients with preoperative chemotherapy, scheduled for surgery for pancreatic cancer. Muscle strengthening exercises and aerobic exercises were conducted 11.9 ± 5.1 days prior to surgery. Cardiopulmonary exercise testing, 6-minute walk distance, and the Functional Independence Measure score were measured before and after the rehabilitation program. We also investigated the relation between the rehabilitation program and incidence of postoperative complications. All 26 study patients completed the preoperative rehabilitation program and no adverse events were noted. Peak oxygen uptake during cardiopulmonary exercise testing and 6-minute walk distance increased significantly after the rehabilitation program. The Functional Independence Measure score remained constant throughout the intervention. No wound infection, delirium, deep vein thrombosis, or respiratory complications were encountered postoperatively. In-hospital preoperative rehabilitation under the supervision of a physiotherapist significantly improved physical function and maintained physical activity in patients with pancreatic cancer. Such improvements may contribute toward preventing serious postoperative complications, resulting in better outcomes.


Assuntos
Hospitais , Neoplasias Pancreáticas/reabilitação , Neoplasias Pancreáticas/cirurgia , Desempenho Físico Funcional , Cuidados Pré-Operatórios/reabilitação , Idoso , Idoso de 80 Anos ou mais , Teste de Esforço , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
7.
London; National Institute for Health and Care Excellence; June 4, 2020. 40 p.
Monografia em Inglês | BIGG - guias GRADE | ID: biblio-1179114

RESUMO

This guideline covers care before, during and after a planned knee, hip or shoulder replacement. It includes recommendations to ensure that people are given full information about their options for surgery, including anaesthesia. It offers advice for healthcare professionals on surgical procedures and ensuring safety during operations. It also offers guidance on providing support and rehabilitation before and after surgery.


Assuntos
Humanos , Cuidados Pré-Operatórios/reabilitação , Artroplastia de Substituição/enfermagem , Artroplastia de Substituição/reabilitação , Manejo da Dor
8.
London; National Institute for Health and Care Excellence; Jan. 29, 2020. 48 p.
Monografia em Inglês | BIGG - guias GRADE | ID: biblio-1179121

RESUMO

This guideline covers managing colorectal (bowel) cancer in people aged 18 and over. It aims to improve quality of life and survival for adults with colorectal cancer through management of local disease and management of secondary tumours (metastatic disease).


Assuntos
Humanos , Neoplasias Colorretais/diagnóstico , Neoplasias Colorretais/prevenção & controle , Neoplasias Colorretais/tratamento farmacológico , Cuidados Pré-Operatórios/reabilitação , Biomarcadores Tumorais/análise , Procedimentos Clínicos/organização & administração , Antineoplásicos/uso terapêutico
10.
JAMA Surg ; 153(12): 1081-1089, 2018 12 01.
Artigo em Inglês | MEDLINE | ID: mdl-30193337

RESUMO

Importance: Preserving functional capacity is a key element in the care continuum for patients with esophagogastric cancer. Prehabilitation, a preoperative conditioning intervention aiming to optimize physical status, has not been tested in upper gastrointestinal surgery to date. Objective: To investigate whether prehabilitation is effective in improving functional status in patients undergoing esophagogastric cancer resection. Design, Setting, and Participants: A randomized clinical trial (available-case analysis based on completed assessments) was conducted at McGill University Health Centre (Montreal, Quebec, Canada) comparing prehabilitation with a control group. Intervention consisted of preoperative exercise and nutrition optimization. Participants were adults awaiting elective esophagogastric resection for cancer. The study dates were February 13, 2013, to February 10, 2017. Main Outcomes and Measures: The primary outcome was change in functional capacity, measured with absolute change in 6-minute walk distance (6MWD). Preoperative (end of the prehabilitation period) and postoperative (from 4 to 8 weeks after surgery) data were compared between groups. Results: Sixty-eight patients were randomized, and 51 were included in the primary analysis. The control group were a mean (SD) age, 68.0 (11.6) years and 20 (80%) men. Patients in the prehabilitation group were a mean (SD) age, 67.3 (7.4) years and 18 (69%) men. Compared with the control group, the prehabilitation group had improved functional capacity both before surgery (mean [SD] 6MWD change, 36.9 [51.4] vs -22.8 [52.5] m; P < .001) and after surgery (mean [SD] 6MWD change, 15.4 [65.6] vs -81.8 [87.0] m; P < .001). Conclusions and Relevance: Prehabilitation improves perioperative functional capacity in esophagogastric surgery. Keeping patients from physical and nutritional status decline could have a significant effect on the cancer care continuum. Trial Registration: ClinicalTrials.gov Identifier: NCT01666158.


Assuntos
Neoplasias Esofágicas/reabilitação , Exercício Físico/fisiologia , Estado Nutricional/fisiologia , Cuidados Pré-Operatórios/reabilitação , Neoplasias Gástricas/reabilitação , Idoso , Neoplasias Esofágicas/fisiopatologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias Gástricas/fisiopatologia , Caminhada/fisiologia
11.
Spine (Phila Pa 1976) ; 43(10): 713-719, 2018 05 15.
Artigo em Inglês | MEDLINE | ID: mdl-28885297

RESUMO

STUDY DESIGN: A cross-sectional survey in the Netherlands and Sweden. OBJECTIVE: To investigate Dutch and Swedish spinal surgeons' opinions on spinal fusion pre- and postoperative rehabilitation. SUMMARY OF BACKGROUND DATA: Lumbar spinal fusion surgery is increasingly provided in patients with chronic low back pain. No guidelines however exist for pre- and postoperative rehabilitation and it is unknown what opinions spinal surgeons currently have about pre- and postoperative rehabilitation. METHODS: A survey was circulated to Dutch and Swedish spinal surgeons. Reminders were sent after 4 and 8/9 weeks. Data of completed questionnaires of orthopedic- and neurosurgeons currently performing lumbar spinal fusion were included for analysis. Analysis comprised a range of descriptive summaries (numerical, graphical, and tabular). RESULTS: Surveys of 34 Dutch and 48 Swedish surgeons were analyzed. Surgeons provided preoperative information on postoperative mobilization. Spinal fusion techniques varied, but technique did not influence postoperative treatment. Swedish surgeons recommended slightly faster mobilization than Dutch (direct vs. 1-day postoperative), and more activities the first day (sitting, standing, walking). Stair climbing was the most reported discharge criterion; however, time point to start varied. More Swedish surgeons referred to postoperative physiotherapy than Dutch (88% vs. 44%). Time-point to start home activities varied from 1 week to more than 6 months. Pain increase was allowed for less than 24 hours (The Netherlands 81%, Sweden 92%). CONCLUSION: Findings reflect variability in lumbar spinal fusion rehabilitation in two European countries, especially in postoperative phase. The study proposes many new research topics and acts as starting point for future research valuable for the spinal community. LEVEL OF EVIDENCE: 3.


Assuntos
Cuidados Pós-Operatórios/reabilitação , Cuidados Pré-Operatórios/reabilitação , Doenças da Coluna Vertebral/cirurgia , Fusão Vertebral/reabilitação , Cirurgiões , Inquéritos e Questionários , Estudos Transversais/métodos , Feminino , Humanos , Vértebras Lombares/cirurgia , Masculino , Países Baixos/epidemiologia , Doenças da Coluna Vertebral/epidemiologia , Suécia/epidemiologia
12.
Med Arch ; 72(6): 439-443, 2018 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-30814777

RESUMO

INTRODUCTION: Osteoarthritis (OA) is the most common joint disease in the world. At the end stage of the disease, usually when patients cannot handle the pain anymore, the knee replacement surgery is the most common and effective treatment to reduce pain and improve functionality. The effect of preoperative exercise (prehabilitation) for patients undergoing total knee arthroplasty (TKA) is still controversial. AIM: To investigate the effect of prehabilitation on postoperative outcome and compare the results of the intervention with the control group. MATERIAL AND METHODS: This prospective study included 20 patients with a diagnosis of gonarthrosis, aged 48-70, who were randomly allocated to either the intervention group or control. Ten patients (intervention group) underwent a 6-week home-based exercise program before the TKA surgery. All patients were assessed by Knee Score (KS), Function Score (FS), and Body Mass Index (BMI) according to the following schedule: 6 weeks before surgery (for intervention group it meant before the prehabilitation program), just prior to surgery (for intervention group it meant after the prehabilitation program), after the surgery, at 3rd month, 6th month, and 12th month postoperatively. They were all operated by the same surgeon, for the primary total knee replacement (Zimmer NexGen Complete Knee Solution) at the Clinic for Orthopaedics and Traumatology, Clinical Centre University of Sarajevo, from October 2016 to June 2017. RESULTS: There is statistically significant difference for Knee and Function Score between the intervention and control group in testing time: just before surgery-meaning that KS and FS increased after the prehabilitation program. Knee Score was significantly different between the two observed groups postoperatively, 3 months postoperatively and 6 months postoperatively, while the Function Score was not significantly different in that period. Prehabilitation program provides better preoperative KS and FS, and better KS up to 6 months postoperatively. However, 12 months postoperatively there was no significant difference between the intervention and control group for the Knee and Function Score. CONCLUSION: Prehabilitation brings significant difference regarding the Knee Score in favor of the intervention group preoperatively and up to 6 months postoperatively.


Assuntos
Artroplastia do Joelho/reabilitação , Terapia por Exercício/métodos , Osteoartrite do Joelho/cirurgia , Cuidados Pré-Operatórios/métodos , Amplitude de Movimento Articular/fisiologia , Recuperação de Função Fisiológica/fisiologia , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Osteoartrite do Joelho/fisiopatologia , Osteoartrite do Joelho/reabilitação , Período Pós-Operatório , Cuidados Pré-Operatórios/reabilitação , Estudos Prospectivos , Fatores de Tempo , Resultado do Tratamento
13.
Surgery ; 160(4): 1070-1079, 2016 10.
Artigo em Inglês | MEDLINE | ID: mdl-27476586

RESUMO

BACKGROUND: Evidence suggests that multimodal prehabilitation programs comprising interventions directed at physical activity, nutrition, and anxiety coping can improve functional recovery after colorectal cancer operations; however, such programs may be more clinically meaningful and cost-effective if targeted to specific subgroups. This study aimed to estimate the extent to which patients with poor baseline functional capacity improve their functional capacity. METHODS: Data for 106 participants enrolled in a multimodal, prehabilitation program before colorectal operations were analyzed. Low baseline functional capacity was defined as a 6-minute walking test distance (6MWD) of less than 400 m. Participants were categorized as higher fitness (6MWD ≥ 400 m, n = 70) or lower fitness (6MWD <400 m, n = 36). Changes in 6MWD over the preoperative period, and 4 weeks and 8 weeks after the operation were compared between groups. Secondary outcomes included patient-reported physical activity and health status, postoperative complications, duration of hospital stay, and readmissions. Less-fit patients were then compared with subjects in the rehabilitation arm of the original studies who had a baseline 6MWD <400 m. RESULTS: Participants with lower baseline fitness had greater improvements in functional walking capacity with prehabilitation compared to patients with higher fitness (+46.5 [standard deviation 53.8] m vs +22.6 [standard deviation 41.8] m, P = .012). At 4 weeks postoperatively, patients with lower baseline fitness were more likely to be recovered to their baseline 6MWD than those with higher fitness. (74% vs 50%, P = .029). There were no differences in secondary outcome. Less-fit patients had a greater improvement through all the preoperative period compared to the control group. CONCLUSION: Patients with lower baseline walking capacity are more likely to experience meaningful improvement in physical function from prehabilitation before and after a colorectal cancer operation.


Assuntos
Cirurgia Colorretal/métodos , Limitação da Mobilidade , Modalidades de Fisioterapia , Cuidados Pré-Operatórios/reabilitação , Caminhada/fisiologia , Idoso , Estudos de Coortes , Neoplasias Colorretais/patologia , Neoplasias Colorretais/reabilitação , Neoplasias Colorretais/cirurgia , Cirurgia Colorretal/mortalidade , Cirurgia Colorretal/reabilitação , Terapia Combinada , Bases de Dados Factuais , Avaliação da Deficiência , Feminino , Seguimentos , Humanos , Tempo de Internação , Masculino , Pessoa de Meia-Idade , Aptidão Física/fisiologia , Prognóstico , Recuperação de Função Fisiológica , Estudos Retrospectivos , Estatísticas não Paramétricas , Análise de Sobrevida , Fatores de Tempo , Resultado do Tratamento
15.
JBI Database System Rev Implement Rep ; 13(1): 146-87, 2015 01.
Artigo em Inglês | MEDLINE | ID: mdl-26447015

RESUMO

BACKGROUND: Major surgery can induce functional decline and pain, which can also have negative implications on health care utilization and quality of life. Prehabilitation is the process of optimizing physical functionality preoperatively to enable the individual to maintain a normal level of function during and after surgery. Prehabilitation training can be a combination of aerobic exercises, strength training, and functional task training to suit individual needs. OBJECTIVES: To evaluate the impact of prehabilitation on physical functional status, health care utilization, quality of life, and pain after surgery. INCLUSION CRITERIA: Studies of adult surgical patients, excluding day surgery patients.Any preoperative exercise interventions identified in the study as part of a prehabilitation or preoperative exercise program, versus usual care.Randomized controlled trials.Functional status, health care utilization, quality of life and pain. SEARCH STRATEGY: Published (CINAHL, CENTRAL, EMBASE, MEDLINE, PEDro) and unpublished studies between 1996 and March 2013 were searched extensively. METHODOLOGICAL QUALITY: All studies were assessed independently by two reviewers for relevance, eligibility and methodological quality. DATA COLLECTION: Data from included papers were extracted using a modified data extraction tool. DATA SYNTHESIS: Where possible, study results were pooled in statistical meta-analysis. Alternatively, results are presented in narrative and table form. RESULTS: A total of 3167 citations were identified; after removal of duplicates, assessment for relevance and eligibility, 33 studies underwent critical appraisal. Seventeen studies met the quality criteria and were included in quantitative synthesis. Thirteen studies were conducted in orthopedics (mainly knee or hip arthroplasty for osteoarthritis), one in colorectal, two in cardiac and one in upper gastrointestinal/hepatobiliary. Function, pain and quality of life were quantified according to prehabilitation dose and postoperative months. Prehabilitation, at any dose, did not demonstrate benefits in objective and self-reported function at any of the postoperative time points. Prehabilitation did not demonstrate benefits in quality of life or pain; however, there was significant evidence that prehabilitation doses of more than 500 minutes reduced the need for postoperative rehabilitation, but no significant reduction was found in readmissions or nursing home placement. CONCLUSIONS: Results from this review reveal that prehabilitation has no significant postoperative benefits in function, quality of life and pain in patients who have had knee or hip arthroplasty for osteoarthritis; however, there is evidence that prehabilitation may reduce admission to rehabilitation in this population. The evidence on postoperative benefits of prehabilitation in other surgical populations is limited; however, preliminary evidence does not demonstrate better outcomes. IMPLICATIONS FOR PRACTICE: There is no evidence that prehabilitation provides benefits in function, pain or quality of life in patients who have had arthroplasty for osteoarthritis; however prehabilitation doses of more than 500 minutes might reduce acute rehabilitation admissions. The evidence is insufficient to provide recommendations on the benefits of prehabilitation in other surgical populations. IMPLICATIONS FOR RESEARCH: Future prehabilitation studies are not recommended in patients with osteoarthritis for whom arthroplasty is planned. However, should prehabilitation be tested in other surgical populations, programs must consider patient suitability, setting, delivery of intervention and clinical effectiveness. It is also recommended that the exercises prescribed should be maintained and adhered to after surgery. Most importantly, prehabilitation studies must have adequately powered sample sizes.


Assuntos
Artroplastia de Quadril/reabilitação , Artroplastia do Joelho/reabilitação , Terapia por Exercício/métodos , Cuidados Pré-Operatórios/reabilitação , Idoso , Atenção à Saúde/estatística & dados numéricos , Exercício Físico/fisiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Dor/prevenção & controle , Cuidados Pós-Operatórios/reabilitação , Qualidade de Vida/psicologia , Ensaios Clínicos Controlados Aleatórios como Assunto , Resultado do Tratamento
17.
NeuroRehabilitation ; 29(2): 153-6, 2011.
Artigo em Inglês | MEDLINE | ID: mdl-22027076

RESUMO

A sudden unilateral loss or impairment of vestibular function causes vertigo, dizziness and impaired postural function. In most occasions, everyday activities supported or not by vestibular rehabilitation programs will promote compensation and the symptoms subside. As the compensatory process requires sensory input, matching performed motor activity, both motor learning of exercises and matching to sensory input are required. If there is a simultaneous cerebellar lesion found during surgery of the posterior cranial fossa, there may be a risk of a combined vestibulo-cerebellar lesion, with reduced compensatory abilities and with prolonged or sometimes permanent disability. On the other hand, a slow gradual loss of unilateral function occurring as the subject continues well everyday activities may go without any prominent symptoms. We therefore implemented a pre treatment plan before planned vestibular lesions (prehab). This was first done in subject undergoing gentamicin treatment for Meniere's disease (MD). Subjects perform vestibular exercises for 14 days before the first gentamicin installation and then continue doing so until free of symptoms. Most subjects would only experience slight dizziness while losing vestibular function. We then expanded the approach to patients with brainstem tumours requiring surgery but with remaining vestibular function to ease postoperative symptoms and reduce risk of combined cerebello-vestibular lesions. This patient group was given gentamicin installations trans-tympanically before tumour sugary and then underwent prehab. In all cases there was a caloric loss, loss of VOR evident in the head impulse tests, impaired subjective vertical and horizontal, and reduced caloric function induced by the pre-surgery gentamicin treatment. The prehab eliminated spontaneous and positional nystagmus, subjective symptoms, and postural function up before surgery and allowed for rapid postoperative recovery.The concept of 'pre-lesion rehabilitation' where training is introduced before a planned lesion and if possible paralleled with a gradual function loss expands the potential of rehabilitation. Here it was used for vestibular lesions but it is possible that similar approaches may be developed for other situations, which include foreseeable loss of function.


Assuntos
Doença de Meniere/fisiopatologia , Doença de Meniere/reabilitação , Cuidados Pré-Operatórios/reabilitação , Vestíbulo do Labirinto/fisiologia , Adulto , Idoso , Feminino , Gentamicinas/efeitos adversos , Humanos , Masculino , Pessoa de Meia-Idade , Inibidores da Síntese de Proteínas/efeitos adversos , Adulto Jovem
18.
Clin Rehabil ; 24(7): 614-22, 2010 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-20530651

RESUMO

OBJECTIVE: Investigation of the feasibility and preliminary effect of a short-term intensive preoperative exercise programme for elderly patients scheduled for elective abdominal oncological surgery. DESIGN: Single-blind randomized controlled pilot study. SETTING: Ordinary hospital in the Netherlands. SUBJECTS: Forty-two elderly patients (>60 years). INTERVENTIONS: Patients were randomly assigned to receive a short-term intensive therapeutic exercise programme to improve muscle strength, aerobic capacity, and functional activities, given in the outpatient department (intervention group; n =22), or home-based exercise advice (control group; n=20). MAIN MEASURES: Parameters of feasibility, preoperative functional capacity and postoperative course. RESULTS: The intensive training programme was feasible, with a high compliance and no adverse events. Respiratory muscle endurance increased in the preoperative period from 259 +/- 273 to 404 +/- 349 J in the intervention group and differed significantly from that in the control group (350 +/- 299 to 305 +/- 323 J; P<0.01). Timed-Up-and-Go, chair rise time, LASA Physical Activity Questionnaire, Physical Work Capacity and Quality of Life (EORTC-C30) did not reveal significant differences between the two groups. There was no significant difference in postoperative complications and length of hospital stay between the two groups. CONCLUSION: The intensive therapeutic exercise programme was feasible and improved the respiratory function of patients due to undergo elective abdominal surgery compared with home-based exercise advice.


Assuntos
Neoplasias Abdominais/cirurgia , Procedimentos Cirúrgicos Eletivos , Terapia por Exercício , Complicações Pós-Operatórias/prevenção & controle , Cuidados Pré-Operatórios/métodos , Neoplasias Abdominais/complicações , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Aptidão Física , Projetos Piloto , Complicações Pós-Operatórias/etiologia , Complicações Pós-Operatórias/fisiopatologia , Cuidados Pré-Operatórios/reabilitação , Método Simples-Cego
19.
In. Pérez Coronel, Pablo L. Rehabilitación cardiáca integral. La Habana, Ecimed, 2009. , ilus.
Monografia em Espanhol | CUMED | ID: cum-46113
20.
Eur J Phys Rehabil Med ; 44(3): 253-61, 2008 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-18500213

RESUMO

AIM: Surgeon decision making for non-operative anterior cruciate ligament (ACL) treatment and postoperative rehabilitation is influenced by a myriad of factors. The aim of this study was to investigate intercontinental differences in surgeon decision making for care of the ACL deficient patient. The authors hypothesized that significant variation in clinical decision of ACL deficient patients existed among surgeons in different continents. METHODS: This study involved a survey design, which met the checklist for reporting results of internet e-surveys (CHERRIES) guidelines. The survey was administered to orthopedic surgeons in 15 countries and involved standardized follow up and design. Questions related to non-operative care management and postoperative/rehabilitative management were provided to each respondent. Statistical analyses included multivariate comparisons among continents and regression findings for likelihood of targeting longer term non-operative treatment. RESULTS: Over six hundred (634) surgeons completed the survey, representing six continents. Continental variations were found in non-operative surgical decision making and postoperative/rehabilitative management. Significant differences were noted in nearly all clinical decision making categories. CONCLUSION: Variations do exist across continents in the non-operative and postoperative/rehabilitative management of patients with an ACL tear. Continental variations and disparate emphases such as activity level, age during injury, and bracing influenced treatment decision making, which could lead to variations in outcomes, costs, and appropriate care.


Assuntos
Lesões do Ligamento Cruzado Anterior , Ligamento Cruzado Anterior/cirurgia , Procedimentos Ortopédicos/reabilitação , Cuidados Pós-Operatórios/reabilitação , Padrões de Prática Médica/estatística & dados numéricos , Cuidados Pré-Operatórios/reabilitação , Adulto , Criança , Pesquisas sobre Atenção à Saúde , Humanos , Internacionalidade , Procedimentos Ortopédicos/estatística & dados numéricos , Modalidades de Fisioterapia/estatística & dados numéricos , Cuidados Pós-Operatórios/estatística & dados numéricos , Cuidados Pré-Operatórios/estatística & dados numéricos , Reabilitação/organização & administração , Reabilitação/estatística & dados numéricos , Ruptura/reabilitação , Ruptura/cirurgia
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