Introduction: Postoperative pulmonary complications are a major source of mortality and morbidity. Respiratory physiotherapy, which is often used to prevent and treat these complications, can be started preoperatively in order to assess and guide the patients. Objective: To establish the effectiveness of a preoperative physiotherapy program for patients submitted to elective coronary artery bypass surgery as regards to the reduction in the hospital stay and prevention of pulmonary complications, changes in pulmonary volumes and inspiratory muscle force. Method: This was a randomized clinical trial. The study group consisted of 86 patients submitted to elective coronary artery bypass surgery at the Instituto de Cardiologia do Rio Grande do Sul. The intervention group (44 patients) was assessed and received physiotherapeutic guidance with written manuals at least 15 days before surgery. The control group (42 patients), on the other hand, received routine guidance on the day of hospital entry. Results: A significant reduction in the hospital stay (p<0.05) was observed in the intervention group. No differences were found between the groups in respect to the change of lung volumes, inspiratory muscle force and occurrence of pulmonary complications as seen by X-ray. Conclusion: Patients who had preoperative instruction are better prepared to cooperate with postoperative treatment. As these patients understand the purpose of pre-and postoperative physiotherapy, the limitations resulting from the surgical process and the physiotherapeutic technique proposed, they may ultimately have a shorter stay in hospital. Descriptors: Physical therapy. Preoperative care. Myocardial revascularization. Resumo Introdução: As complicações pulmonares pós-operatórias são uma fonte significativa de mortalidade e morbidade. A fisioterapia respiratória é freqüentemente utilizada na A efetividade de uma proposta fisioterapêutica pré-operatória para cirurgia de revascularização do miocárdio Effetiveness of a preoperative physiotherapeutic approach in myocardial revascularization 135 LEGUISAMO, CP ET AL-Effetiveness of a preoperative physiotherapeutic approach in myocardial revascularization
Objective: The coronary artery bypass graft surgery is an option of treatment for cardiovascular diseases, and the patients who underwent such procedure can suffer from preoperative anxiety. The aim of this study is to verify the effects of physiotherapeutic instructions at the anxiety level on patients undergone coronary artery bypass graft surgery.Methods: Randomized clinical trial, with the sample composed by 51 individuals, 27 on the control group and 24 on the intervention; on which it was assessed the anxiety (Beck Scale for Anxiety) and pain (Visual Analog Scale) levels on the pre-and postoperative period and only the second group received instructions about the surgery procedures and ventilatory exercises. For statistical analysis the Wilcoxon, Mann-Whitney and Spearman tests were used.Results: The lower anxiety levels were observed in patients that received the intervention on the period before surgery (9.6 ± 7.2 versus 13.4 ± 5.9, P=0.02). On the control group, the difference among the anxiety levels before and after the surgery was statistically significant (P= 0.003). The female individuals presented more anxious before the surgery compared to the male ones (P=0.058). It was also verified a relationship between lenght of stay at hospital and postoperative anxiety (P=0.05), where the more anxious individuals remained more time at the hospital.Conclusion: Patients oriented and instructed about physiotherapeutic ventilatory exercises and hospital routine, presented their levels of anxiety reduced on the preoperative compared to the control group. However, at the postoperative, both groups presented their anxiety levels reduced without significant difference between them.
Descriptors: Anxiety. Myocardial revascularization. Physical therapy (Specialty).Resumo Introdução: A cirurgia de revascularização é uma opção de tratamento para as doenças cardiovasculares, sendo que os indivíduos a esta submetidos podem sofrer quadros de ansiedade pré-operatória.
Background: Despite the increasingly careful attempts to reduce perioperative risks, pulmonary complications following surgery are still very common, leading to longer length of hospital stays or death.
A maioria dos pacientes portadores de claudicação intermitente, um aspecto clínico da doença arterial periférica, tem importante limitação nas atividades físicas e redução na qualidade de vida. O objetivo deste estudo foi realizar uma revisão da literatura sobre a intervenção através de exercícios em portadores de doença arterial obstrutiva periférica com claudicação intermitente. Trata-se de uma revisão de artigos científicos consultados nos bancos de dados da BIREME, PubMed e SciELO, através das fontes LILACS e MEDLINE e a partir dos descritores em Ciências da Saúde claudicação intermitente, doenças vasculares periféricas, reabilitação, exercício e terapia por exercício. Concluiu-se que, apesar da variabilidade dos regimes de caminhada identificados na literatura, o treino aeróbio, de uma forma geral, proporciona benefícios a pacientes portadores de doença arterial obstrutiva periférica com claudicação intermitente, principalmente na melhora do desempenho de caminhada, o que pode ter impacto significativo na qualidade de vida desses pacientes.
Trata-se de um ensaio clínico randomizado que verificou a associação da força muscular com o risco de quedas de idosos institucionalizados. Os idosos foram divididos em grupo-controle (G1) e grupo-intervenção (G2), e avaliados na linha de base e pós-intervenção. Por meio do Timed Up and Go Test (TUGT), do teste de Força de Preensão Manual (FPM), e do teste de Levantar da Cadeira (LC), observou-se que o programa de exercícios físicos proposto contribuiu na manutenção ou melhora da força muscular dos idosos e, consequentemente, na melhora do risco de quedas.
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