Can patent foramen ovale affect rehabilitation? The uncommon association of platypnea-orthodeoxia syndrome and stroke.

Platypnea-orthodeoxia is a rare syndrome characterized by dyspnea and deoxygenation induced by a change to a sitting or standing from a recumbent position. It is the result of posturally accentuated intracardiac or pulmonary right-to-left shunt leading to arterial oxygen desaturation. Only few cases of platypnea-orthodeoxia syndrome are reported in the literature and the association between stroke and platypnea-orthodeoxia syndrome with evidence of patent foramen ovale is extremely rare. We describe the case of a 67-year-old female admitted to our Rehabilitation Unit for disabling basilar stroke due to paradoxical embolism from patent foramen ovale that during the first days of rehabilitation showed signs and symptoms of platypnea-orthodeoxia syndrome. To remove a life-threatening condition for the patient and in order to develop the normal rehabilitation project, that was stopped by the platypnea-orthodeoxia syndrome, the patient fastly underwent to percutaneous closure of patent foramen ovale. The stabilization of oxygen arterial saturation with postural changes and the disappearance of symptoms of POS allowed to develop the rehabilitation project with progressive neurological improvement.

Estudio de la disnea según la escala de Borg en un grupo de pacientes diagnosticados de asma bronquial que han seguido y recibido entrenamiento de fisioterapia respiratoria / Study of dyspnea according to Borg & apos; s scale in a group of patients diagnosed of bronchial asthma who have followed and received respiratory physiotherapy training

Introducción: el asma, según la OMS, la presentan alrededor de 275.000.000 de personas en el mundo. Gran componente de la morbilidad del asma resulta de la disnea de esfuerzo y la limitación que produce sobre la actividad física del paciente. La evaluación de la intensidad de la disnea al final del ejercicio suministra valiosa información sobre los factores que determinan la limitación del ejercicio. La escala de Borg es una herramienta ampliamente utilizada para la medición subjetiva de este síntoma.Objetivo: comprobar si un grupo de pacientes experimenta una disminución en su percepción de la disnea tras un programa de reeducación respiratoria.Metodología: estudio longitudinal prospectivo en que se observaron las diferencias en la escala de Borg antes y después del programa de reeducación de la respiración abdominodiafragmática y entrenamiento de la musculatura de las extremidades en un grupo de 12 pacientes diagnosticados de asma.Resultados: se obtuvo una significación de 0,012 en la prueba de homogeneidad marginal, lo que significa una influencia positiva de nuestro tratamiento.Conclusiones: los resultados apoyan la hipótesis de que la fisioterapia respiratoria es capaz de mejorar de forma general el síntoma de la disnea en pacientes asmáticos que han seguido un programa de reeducación respiratoria(AU)

Introduction: According to the WHO, asthma is suffered by approximately 250 million people in the world. A large part of the asthma morbidity comes from exertional dyspnea that limits the patient's physical activity. Evaluation of intensity of dyspnea at the end of exercise provides valuable information about the factors that define exercise limitation. Borg's Scale is a widely used tool to measure this symptom.Objective: To verify if a group of patients feel a decrease in their perception of dyspnea after the respiratory reeducation program.Method: A longitudinal prospective study in which differences were observed between Borg's Scale before and after the reeducation program based on diaphragmatic breathing and limb muscles training in a group of 12 patients diagnosed of asthma.Results: A 0.012 significance was obtained in the marginal homogeneity test. This means that there was a positive influence of our treatment.Conclusions: The results of our study support the hypothesis that respiratory reeducation is able to improve, as a whole, the dyspnea symptom in asthmatic patients who have participated in a breathing reeducation program(AU)