ObjectiveTo evaluate the variation in mobility during hospitalization in an intensive care unit and its association with hospital mortality.MethodsThis prospective study was conducted in an intensive care unit. The inclusion criteria included patients admitted with an independence score of ≥ 4 for both bed-chair transfer and locomotion, with the score based on the Functional Independence Measure. Patients with cardiac arrest and/or those who died during hospitalization were excluded. To measure the loss of mobility, the value obtained at discharge was calculated and subtracted from the value obtained on admission, which was then divided by the admission score and recorded as a percentage.ResultsThe comparison of these two variables indicated that the loss of mobility during hospitalization was 14.3% (p < 0.001). Loss of mobility was greater in patients hospitalized for more than 48 hours in the intensive care unit (p < 0.02) and in patients who used vasopressor drugs (p = 0.041). However, the comparison between subjects aged 60 years or older and those younger than 60 years indicated no significant differences in the loss of mobility (p = 0.332), reason for hospitalization (p = 0.265), SAPS 3 score (p = 0.224), use of mechanical ventilation (p = 0.117), or hospital mortality (p = 0.063).ConclusionThere was loss of mobility during hospitalization in the intensive care unit. This loss was greater in patients who were hospitalized for more than 48 hours and in those who used vasopressors; however, the causal and prognostic factors associated with this decline need to be elucidated.

ResumoIntrodução: O processo do envelhecimento associado às doenças crônico-degenerativas conduz ao declínio funcional e/ ou cognitivo, resultando em redução da qualidade de vida e diminuição da autonomia e independência. Abstract Introduction:The aging process associated with chronic degenerative diseases leads to functional decline and/or cognitive impairment resulting in reduced quality of life and decreased autonomy and independence. Objective: To compare the functional and cognitive capacity of elderly in a geriatric rehabilitation unit in the city of Salvador, Bahia. Methodology: This is an observational descriptive cross-sectional analysis using medical records. The medical records of elderly patients admitted in the Rehabilitation Unit of the Geriatric Center of Obras Sociais Irmã Dulce were selected from January to December 2011. The charts were evaluated for sociodemographic, length of stay, clinical diagnosis, scores of the Modified Barthel Index (MBI) and the Mini-Mental State Examination (MMSE) on admission and discharge. Results: A total of 38 records met the inclusion criteria. 73.68% of the patients were male. The age ranged from 62 to 94 years and length of stay from 34 to 179 days. The most prevalent diseases were hypertension (68.42%), stroke (57.89%), restriction of mobility (42.10%), double incontinence (28.94%), diabetes mellitus (23.98 %) and vascular dementia (21.05%). The observed changes in the MBI scores did not change the functional levels of the elderly. Cognitive changes were observed in 81.57% on admission and 63.15% on discharge. Only individuals with 1-3 years of education changed levels of cognition. Conclusion: The process of aging associated with chronic degenerative diseases influences on the functionality and cognition of the studied population. The results provided evidence for the establishment of goals and treatment plans that promote the rehabilitation of the elderly.

A síndrome pós-pólio (SPP) é a recidiva dos sintomas da poliomielite anterior aguda (PAA), e o quadro é caracterizado por fraqueza muscular flácida assimétrica, com frequente comprometimento respiratório e de deglutição, além dos distúrbios de sono. O presente estudo relata o caso de uma paciente idosa, em ventilação mecânica domiciliar. Investiu-se no treinamento muscular inspiratório (TMI) com Powerbreathe® por 30 repetições por 2 vezes ao dia, durante 4 semanas, associado a um programa de exercícios físicos. Tal estratégia apresentou como desfecho o desmame da ventilação mecânica (VM), assim como melhora concomitante na Pimax e Mensuração de Independência Funcional (MIF), retornando ao final deste curto programa de reabilitação a realizar atividades laborais em domicílio. O presente relato de caso conclui que o emprego da TMI em pacientes com SPP pode ser uma estratégia promissora para o desmame ventilatório.Palavras-chave: síndrome pós-pólio, treinamento muscular inspiratório, powerbreathe.

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