BACKGROUND: Regular aerobic exercise in patients with cystic fibrosis (CF) improves aerobic conditioning and delays disease progression, resulting in better quality of life. The purpose of this study was to evaluate the effect of an aerobic exercise program based on verbal and written guidelines on maximum exercise capacity using a cardiopulmonary exercise test, quality of life, and the self-reported aerobic exercise practice of children and adolescents with CF. METHODS: This randomized controlled trial followed guidelines for physical exercise in a CF center. Subjects were assigned to 2 groups: intervention (group 1), with 17 subjects; and control (group 2), also with 17 subjects. Data were collected from October 2010 to October 2011, and the study population comprised 7-20-y-old children and adolescents with CF. The intervention consisted of handing out a manual with guidelines for aerobic physical exercises and reinforcing recommendations in telephone calls every 2 weeks. RESULTS: Thirty-four subjects were included in the study, 20 of whom were boys (58.5%). The groups were similar at baseline. In group 1, 6 subjects (35.2%) reported practicing physical exercises regularly. The mean age was 13.4 ؎ 2.8 y, the mean percent-ofpredicted FEV 1 was 95.5 ؎ 17.9%, and the mean peak oxygen uptake (V O 2 ) relative to body mass was 34.9 ؎ 9.0 mL/kg/min. In group 2, 4 subjects (23.5%) reported practicing physical exercises regularly. The mean age was 12.7 ؎ 3.3 y, the mean percent-of-predicted FEV 1 was 100.1 ؎ 21.2%, and the mean peak V O 2 was 33.2 ؎ 8.2 mL/kg/min. In group 1, there was a significant increase in physical exercise practice as reported by subjects after 3 months of intervention compared with group 2 (P ؍ .01). No statistically significant differences were found for the other variables. CONCLUSIONS: Verbal and written guidelines for aerobic exercise, together with supervision over the telephone, had a positive impact on the self-reported regular physical exercise practice of children and adolescents. However, no improvement was found in lung function and maximum exercise capacity or domains of the quality of life questionnaire.
Objetivo: Avaliar a prevalência da polineuromiopatia do doente crítico (PNMDC), através da mensuração de força muscular, correlacionando com o tempo de ventilação mecânica (VM), desmame e período de internação em unidade de terapia intensiva.Materiais e Métodos: Estudo transversal prospectivo, onde participaram do estudo homens e mulheres maiores de 18 anos. Foram realizadas avaliações por pesquisadores treinados, durante a pausa da sedação e com paciente apto para desmame. A força muscular periférica foi avaliada através da escala MRC (Medical Research Council), e a força de preensão palmar através de DPP (dinamometria de preensão palmar) da mão dominante. As variáveis quantitativas foram descritas por média e desvio padrão; as categóricas, por frequências absolutas e relativas. Para verificar as correlações entre os dados foi realizado o teste de correlação de Spearman, com nível de significância estatística de 5%.Resultados: Amostra de 39 pacientes com predomínio do sexo masculino (n=21; 53,8%), média de idade de 63,67±17,61. Observou-se um total de 66,7% (n=26) pacientes que preenchiam algum critério para diagnóstico de polineuromiopatia. A prevalência de PNMDC, diagnosticada pela tabela do MRC foi observada em 23 pacientes (59%), enquanto que utilizando a DPP, em 10 indivíduos (25,6%). Quando associadas, as avaliações diagnósticas detectaram 7 polineuropatas (17,9%). Não foram observadas correlações entre diagnóstico de PNMDC, com o tempo de VM, de UTI ou de desmame.Conclusão: As ferramentas utilizadas para diagnóstico de PNMDC, de forma isolada ou associadas, identificaram a prevalência de pacientes fracos. Não foram identificadas correlações entre tal fraqueza e tempo maior em VM, tempo de desmame e permanência prolongada na UTI.
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