Introduction: The new corona virus (2019-nCoV OR HCOV-19 or CoV2), has emerged in China as the main cause of viral pneumonia (COVID-19, Coronavirus Disease-19). Objective: To provide evidence-based Physiotherapy and functionality in patients with adult and pediatric COVID-19. Methods: This is an integrative literature review using the MedLine / PubMed databases, library of Latin American and Caribbean Literature in Health Sciences (LILACS) and Physiotherapy Evidence Database (PEDRo). Results: Part of the patients with covid 19 show signs of respiratory deficiency with hypoxemia, with low severity in children. Impaired functionality is also expected. Conclusion: COVID-19 causes low pulmonary compliance and important changes in lung function with hypoxemia and cardiovascular repercussions. These changes lead to the need for Physiotherapy and the management of oxygen therapy and ventilatory support (invasive and non-invasive) for these patients.

BackgroundThe early institution of inspiratory muscle training on hospitalised patients with no established respiratory deficits could prevent in-hospital adverse outcomes that are directly or indirectly associated to the loss of respiratory muscle mass inherent to a prolonged hospital stay. The objective of the clinical trial is to assess the impact of inspiratory muscle training on hospital inpatient complications.MethodsThis is a double-blind randomised controlled trial. Subjects in the intervention group underwent an inspiratory muscle training loaded with 50% maximum inspiratory pressure twice daily for 4 weeks from study enrolment. Patients were randomly assigned to an inspiratory muscle training group or a sham inspiratory muscle training group. All patients received conventional physiotherapy interventions. Baseline and post-intervention respiratory and peripheral muscle strength, functionality (performance of activities of daily living), length of hospital stay, and death were evaluated. Clinical outcomes were assessed until hospital discharge. This study was approved by the Institutional Hospital Ethics Committee (03/2014).ResultsThirty-one patients assigned to the inspiratory muscle training group and 34 to the sham inspiratory muscle training group were analysed. Patients in the inspiratory muscle training group had a shorter mean length of hospital stay (35.3 ± 2.7 vs. 41.8 ± 3.5 days, p < 0.01) and a lower risk of endotracheal intubation (relative risk (RR) = 0.36; 95% confidence interval (CI) 0.27–0.97; p = 0.03) as well as muscle weakness (RR = 0.36; 95% CI 0.19–0.98; p = 0.02) and mortality (RR = 0.23; 95% CI 0.2–0.94; p = 0.04). The risk of adverse events did not differ significantly between groups.ConclusionInspiratory muscle training was a protective factor against endotracheal intubation, muscle weakness, and mortality.Trial registrationClinicalTrials.gov, ID: NCT02459444. Registered on 19 May 2015.

Introdução: A sarcopenia, a polineuropatia do paciente crítico e fraqueza muscular respiratória são algumas das possíveis condições responsáveis por essa incapacidade física após a hospitalização prolongada. Objetivo: Relatar o efeito do treinamento muscular inspiratório e programa de exercícios físicos na capacidade muscular respiratória e funcional de uma série de casos de pacientes pós-hospitalização. Métodos: Série de casos, do uso do TMI e reabilitação física domiciliar em pacientes em deshospitalização. O protocolo respiratório empregou carga aproximada de 50% da pressão inspiratória máxima (Pimax), realizado em duas séries de 30 repetições por dia durante sete dias por semana. As variáveis mensuradas antes e após as intervenções foram Pimax, Capacidade Vital (CV) PFI (Pico de fluxo inspiratório), força muscular periférica (MRC) e independência funcional (índice de Barthel completo e domínio mobilidade da Medida de Independência Funcional (MIF). Resultados: A amostra foi composta por dez pacientes com idade média 73,7±13,6 anos e tempo de internação hospitalar 18,6±10,9 dias, sendo que a adesão as intervenções foi de 82,0%. Nas 459 sessões de TMI houveram 25 eventos adversos ocorridos durante os ajustes de carga, porém sem necessidade de exclusão após retorno a carga inspiratória prévia. Após quatro semanas das intervenções, observou-se aumento significativo da Pimax, PFI e CV, além de ganhos na força muscular periférica e capacidade funcional. Conclusão: O TMI associado a reabilitação física em pacientes críticos após hospitalização promoveu ganhos na função respiratória e capacidade funcional após quatro semanas de intervenção.

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Introduction: Although the recognition that the ICU is one of the major responsible for the evolution in health care in the last century, society continues with a stereotyped view, considering it as an aggressive, invasive, tense and traumatizing environment.Objective: To review the literature to compare the perception of ICU patients about this environment and the professionals who work there.Methods: A search was made in the scientific literature through queries in the electronic databases Lilacs, Medline, Pubmed and Scielo, from the descriptors: perception, patients and intensive care unit and their correlates in English. We included original scientific studies of descriptive, experimental or causal -comparative typology; published between 1995-2015; dependent variable perception of patients on the ICU; patients who have been hospitalized; samples composed of individuals older than 18 years and preserved cognitive ability; clarity in the samples and analyzes.Results: A total of 63 articles were found, of which 50 were excluded because they did not meet the inclusion criteria. Eight articles were used for analysis and discussion, being grouped in tables. Conclusion:This literature review concludes that the ICU presents several stressors, both sensory factors and emotional factors provoked by the experiences and uncertainty of the outcome in the face of disease. The role of the interdisciplinary team is a fundamental point to address the resolution of these stressors.

Background: The shoulder complex has a high prevalence of injuries. It is fundamental to quantify the muscle strength and identify muscular imbalances that predispose to lesions. The aim was to test concurrent validation of the muscle strength assessment with a hand held dynamometer (HHD) for shoulder joint muscles, and measure the accuracy and diagnostic agreement between instruments for assessing the strength of this joint with the hand held dynamometer and isokinetic dynamometer (ID) in a population of healthy individuals Methods: healthy individuals aged between 18 and 40 years were included. The HHD was used to test the isometric contraction of the main shoulder movements. Isometric contraction was performed for 3 seconds. Assessments with HHD and DI were performed on the same day, with a minimum interval of 90 minutes between tests. The study was approved by the Ethics Committee by report No.1537948. Concurrent validation was calculated with Pearson’s correlation, the accuracy obtained by the ROC curve and agreement by Kappa test. Results: The HHD showed concurrent validation between 0.51 – 0.83, with sensitivity between 0.90 and 0.98 and specificity between 0.64 and 0.89 for shoulder movements. The HHD demonstrated moderately-strong to excellent concurrent validity. Conclusion: These results are encouraging for the routine use of this portable and lower cost instrument in quantification of the pique torque of the shoulder muscles. Moreover, this instrument showed good accuracy and moderate to high agreement in comparison with diagnosis of the gold standard instrument.

Introduction: Hand-held dynamometry (HHD) is a technique used for evaluating muscle strength. The reproducibility and reliability of this instrument have been little reported. Method: Healthy individuals aged >18 years were recruited. Isometric strength was tested for ten upper limb muscle groups. The fixed method was performed using a system with suction cups connected to the dynamometer through an inelastic belt. However, during the non-fixed method, the examiner supported the device with the hand. The reproducibility and reliability were calculated using the intraclass correlation coefficient (ICC). Result: A total of 25 right-handed volunteers participated. The reliability ICC values (0.89-0.99) of the non-fixed method were higher than those of the fixed method (0.43-0.85). The reproducibility of the non-fixed method was also superior to that of the fixed method. Discussion: The comparison between the HHD methods suggested the non-fixed method has greater reproducibility and reliability.