RESUMO O objetivo deste trabalho foi avaliar o perfil e a prevalência da síndrome de Burnout em fisioterapeutas intensivistas das redes públicas da cidade do Recife, comparando-os entre unidades adultas, pediátricas e neonatais. Realizou-se um estudo descritivo de corte transversal em cinco hospitais públicos portadores de Unidade de Terapia Intensiva, por meio de um questionário sociodemográfico para fatores estressantes e do Maslach Burnout Inventory (MIB) para avaliar a prevalência da síndrome. Os resultados indicaram um percentual de 48,72% de Burnout para profissionais de UTI de cuidado adulto e 47,06% para unidades pediátricas e neonatais, considerando-se nível grave em apenas uma dimensão. Foram encontrados escores elevados nos indicadores de exaustão emocional, com 56,42% em UTI adulto e 64,71% em unidades pediátricas e neonatais. O indicador despersonalização apresentou 12,82% em UTI adulto e 29,41% nas demais. Já realização profissional obteve valores de 17,65% em UTI pediátricas e neonatais e de 33,33% em cuidado adulto. A prevalência da síndrome de Burnout se mostrou elevada entre os fisioterapeutas avaliados. Diante disso, observa-se a necessidade do desenvolvimento de medidas preventivas e modelos de intervenção para que tal efeito seja minimizado.

Background and Purpose Dyspnea, fatigue, and reduced exercise tolerance are common in post‐COVID‐19 patients. In these patients, rehabilitation can improve functional capacity, reduce deconditioning after a prolonged stay in the intensive care unit, and facilitate the return to work. Thus, the present study verified the effects of cardiopulmonary rehabilitation consisting of continuous aerobic and resistance training of moderate‐intensity on pulmonary function, respiratory muscle strength, maximum and submaximal tolerance to exercise, fatigue, and quality of life in post‐COVID‐19 patients. Methods Quasi‐experimental study with a protocol of 12 sessions of an outpatient intervention. Adults over 18 years of age ( N = 26) with a diagnosis of COVID‐19 and hospital discharge at least 15 days before the first evaluation were included. Participants performed moderate‐intensity continuous aerobic and resistance training twice a week. Maximal and submaximal exercise tolerance, lung function, respiratory muscle strength, fatigue and quality of life were evaluated before and after the intervention protocol. Results Cardiopulmonary rehabilitation improved maximal exercise tolerance, with 18.62% increase in peak oxygen consumption (VO2peak) and 29.05% in time to reach VO 2 peak. VE/VCO 2 slope reduced 5.21% after intervention. We also observed increased submaximal exercise tolerance (increase of 70.57 m in the 6‐min walk test, p = 0.001), improved quality of life, and reduced perceived fatigue after intervention. Discussion Patients recovered from COVID‐19 can develop persistent dysfunctions in almost all organ systems and present different signs and symptoms. The complexity and variability of the damage caused by this disease can make it difficult to target rehabilitation programs, making it necessary to establish specific protocols. In this work, cardiopulmonary rehabilitation improved lung function, respiratory muscle strength, maximal and submaximal exercise tolerance, fatigue and quality of life. Continuous aerobic and resistance training of moderate intensity proved to be effective in the recovery of post‐COVID‐19 patients.

Introduction: Cardiac rehabilitation programs reduce the risk of death and acute events related to the disease through the association of various modalities of exercise. When implemented in high-intensity interval training (HIIT) programs, it may allow for gradual adaptation of the skeletal muscles to greater exercise intensities. The present systematic review aimed to determine whether HIIT promoted a greater increase in exercise tolerance in comparison with continuous aerobic training in individuals with heart failure. Methods: A systematic search for articles indexed in the PubMed/MEDLINE, LILACS, SciELO, PEDro, Scopus, and Web of Science databases was carried out. The descriptors used for the search followed the description of the MeSH/DeCS terms with no language or year of publication restrictions. When possible, a meta-analysis was performed and the quality of the evidence was evaluated using the GRADE scale. Results: The broad search strategy resulted in 5258 titles, and a total of 7 articles were included in the qualitative synthesis. A low quality of evidence was observed demonstrating that interval training is superior to continuous aerobic training for improving peak oxygen uptake, which reflects an increase in functional capacity of these individuals and moderate quality of evidence regarding improved quality of life and left ventricular ejection fraction. Conclusion: High-intensity interval training and continuous training provide benefits for patients, however, the quality of evidence still does not allow us to indicate whether there is a superiority of HIIT over conventional continuous exercise training using the variables analyzed.

BackgroundLeft ventricular global longitudinal strain value (GLS) can predict functional capacity in patients with preserved left ventricular ejection fraction (LVEF) heart failure (HF) and to assess prognosis in reduced LVEF HF.ObjetiveCorrelate GLS with parameters of Cardiopulmonary Exercise Test (CPET) and to assess if they could predict systolic HF patients that are more appropriated to be referred to heart transplantation according to CPET criteria.MethodsSystolic HF patients with LVEF < 45%, NYHA functional class II and III, underwent prospectively CPET and echocardiography with strain analysis. LVEF and GLS were correlated with the following CPET variables: maxVO2, VE/VCO2 slope, heart rate reduction during the first minute of recovery (HRR) and time needed to reduce maxVO2 in 50% after physical exercise (T1/2VO2). ROC curve analysis of GLS to predict VO2 < 14 mL/kg/min and VE/VCO2 slope > 35 (heart transplantation’s criteria) was performed.ResultsTwenty six patients were selected (age, 47 ± 12 years, 58% men, mean LVEF = 28 ± 8%). LVEF correlated only with maxVO2 and T1/2VO2. GLS correlated to all CPET variables (maxVO2: r = 0.671, p = 0.001; VE/VCO2 slope: r = -0.513, p = 0.007; HRR: r = 0.466, p = 0.016, and T1/2VO2: r = -0.696, p = 0.001). GLS area under the ROC curve to predict heart transplantation’s criteria was 0.88 (sensitivity 75%, specificity 83%) for a cut-off value of -5.7%, p = 0.03.ConclusionGLS was significantly associated with all functional CPET parameters. It could classify HF patients according to the functional capacity and may stratify which patients have a poor prognosis and therefore to deserve more differentiated treatment, such as heart transplantation.

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Objetivo: Investigar os efeitos do treinamento cognitivo associado ao exercício físico no desempenho cognitivo de idosos com Doença de Alzheimer (Dos Santos Picanco et al.). Metodologia: Foi realizada uma revisão sistemática com metanálise de ensaios clínicos controlados e cross-over. A busca na literatura foi realizada nas bases de dados Pubmed / MEDLINE, LILACS, SciELO, PEDro, Scopus, CINAHL e Web of Science, utilizando os descritores MeSH / DeCS. O risco de viés foi avaliado de acordo com as recomendações do Cochrane Handbook for Systematic Reviews of Interventions e a metanálise foi realizada com o software RevMan 5.3. Resultados: Dos 1126 artigos obtidos na busca, nove foram escolhidos para a síntese qualitativa e dois para a metanálise. Os dados da metanálise mostraram diferenças significativas no tamanho do efeito para as funções executivas e atenção avaliadas pelo Teste do Desenho do Relógio (Z = 3,05; p = 0,002) e funções cognitivas frontais avaliadas pela Bateria de Avaliação Frontal (Z = 3,56; p = 0,0004). Na análise qualitativa, sete estudos demonstraram efeitos positivos do treinamento cognitivo associado ao exercício físico na manutenção e melhora das funções cognitivas de idosos com DA. Conclusão: Apesar das limitações encontradas nos estudos disponíveis sobre o tema, pode-se sugerir que o treinamento cognitivo associado ao exercício físico apresenta benefícios no desempenho cognitivo de idosos com DA. No entanto, a escassez de estudos desenvolvidos com melhor rigor metodológico limita generalizações desses resultados.

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Background: Individuals affected by heart failure (HF) may present fatigue, dyspnea, respiratory muscle weakness, and sympathetic activity hyperstimulation of the myocardium, among other symptoms. Conducting cardiac rehabilitation (CR) programs can be associated with inspiratory muscle training. The aim of this study was to evaluate the efficacy of inspiratory muscular training (IMT) associated with a CR program on modulating myocardial sympathetic activity and maximal functional capacity, submaximal functional capacity, thickness, and mobility of the diaphragm muscle in patients with HF. Methods: We will conduct a clinical, controlled, randomized, double-blind trial that will include sedentary men and women who are 21-60 years old and who have diagnosed systolic HF and a left ventricular ejection fraction of less than 45%. Participants will be randomly assigned to one of two groups: experimental and control. The control group will follow the conventional CR protocol, and the experimental group will follow the conventional CR protocol associated with IMT 7 days a week. The two proposed exercise protocols will have a frequency of three times a week for a period of 12 weeks. The sympathetic innervation of the cardiac muscle, the maximum and submaximal functional capacity, diaphragm mobility and thickness, and the quality of life of the participants will be evaluated before and after the intervention protocol.