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BACKGROUND: Patients with cystic fibrosis develop decreased exercise capacity. However, the main factors responsible for this decline are still unclear. Thus, the objective of this study was to evaluate the factors influencing exercise capacity assessed with the modified shuttle test (MST) in individuals with cystic fibrosis. METHODS: A cross-sectional study was carried out in subjects with a diagnosis of cystic fibrosis who were 6-26 y old and were regularly monitored at 2 cystic fibrosis reference centers in Brazil. Individuals who were unable to perform the tests or who exhibited hemodynamic instability and exacerbation of respiratory symptoms were excluded. Anthropometric, clinical, and genotype data were collected. In addition, lung function and exercise capacity were evaluated with the MST. RESULTS: 73 subjects (mean age 12.2 6 4.9 y and FEV 1 76.8 6 23.3%) were included. The mean distance achieved in the MST was 765 6 258 m (71.6% of predicted). The distance achieved on the MST correlated significantly with age (r 5 0.49, P < .001), body mass index (r 5 0.41, P < .001), resting heart rate (r 5 20.51, P < .001), and FEV 1 (r 5 0.24, P 5 .042). Subjects with FEV 1 > 67% of predicted (P 5 .02) and those with resting heart rate < 100 beats/min (P 5 .01) had a greater exercise capacity. Resting heart rate, age, and FEV 1 (%) were found as significant variables to explain the distance achieved on the MST (R 2 5 0.48, standard error 5 191.0 m). CONCLUSIONS: The main determinants of exercise capacity assessed with the MST in individuals with cystic fibrosis were resting heart rate, age, and lung function.

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Esse documento tem por objetivo apresentar recomendações para mobilização precoce e exercícios terapêuticos em pacientes pediátricos acometidos pela COVID-19, ou em suspeita da doença, no ambiente hospitalar, bem como para reabilitação pós alta. Independente da fase de tratamento, ressalta-se a extrema necessidade do uso de equipamentos de proteção individual pelo fisioterapeuta. Com o objetivo de prevenir/minimizar a fraqueza muscular adquirida na UTI, recomenda-se a utilização de protocolo de mobilização precoce baseado na mobilização funcional segura e progressiva, apropriando atividades ao nível de desenvolvimento neuropsicomotor. A reabilitação hospitalar está indicada aos pacientes na unidade de internação e a avaliação da capacidade funcional poderá ser utilizada nos pacientes mais estáveis, para conduzir a intervenção. Como a reabilitação ambulatorial presencial deve ser evitada durante a pandemia de COVID-19, recomenda-se a Telereabilitação. No entanto, ressalta-se a necessidade da primeira avaliação ser presencial para correta prescrição de treinamento e especial atenção para dispneia e dessaturação durante o telemonitoramento.

BACKGROUND: The treatment of cystic fibrosis involves the use of drugs delivered by nebulizer systems, and adequate functioning of the compressors and nebulizers is essential. We hypothesized that compressors of nebulizer systems used by individuals with cystic fibrosis would not work properly. Therefore, we aimed to assess the performance of the compressors from nebulizer systems used by individuals with cystic fibrosis. METHODS: This is a cross-sectional study to assess the performance of compressors from nebulizer systems used by subjects with cystic fibrosis registered at the Cystic Fibrosis Patient Association in Minas Gerais, Brazil. Compressors ( Proneb Ultra II) brought by the individuals were tested with new nebulizer parts (Pari LC plus) to assess the variables of nebulization efficiency, including residual volume, solution output, and aerosol output rate. Compression performance was assessed by measuring the operating pressure using a PARI PG101 manometer. RESULTS: The performance of 146 compressors was analyzed. Fifty-seven (39%) of the compressors were ineffective, with operating pressure values well below the manufacturer's technical reference and the compressor time used for a median time of 36 (15 days to 156 months). The systems with low pressure values demonstrated significantly worse results for nebulization efficiency variables, and a significant correlation was found between residual volume (r 5 -0.5, P < .001), solution output (r = +0.5, P < .001), and aerosol output rate (r = +0.5, P < .001), and operating pressure values. CONCLUSIONS: A significant number of compressors generate low operating pressure values. These systems showed a compromised efficiency of nebulization, indicating that the pressure generated by the compressor is a critical aspect of treatment efficiency.

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