Objective: To evaluate the effects that passive cycling exercise, in combination with conventional physical therapy, have on peripheral muscle strength, duration of mechanical ventilation, and length of hospital stay in critically ill patients admitted to the ICU of a tertiary care university hospital. Methods: This was a randomized clinical trial involving 38 patients (≥ 18 years of age) on mechanical ventilation who were randomly divided into two groups: control (n = 16), receiving conventional physical therapy; and intervention (n = 22), receiving conventional physical therapy and engaging in passive cycling exercise five days per week. The mean age of the patients was 46.42 ± 16.25 years, and 23 were male. The outcomes studied were peripheral muscle strength, as measured by the Medical Research Council scale, duration of mechanical ventilation, and length of hospital stay. Results: There was a significant increase in peripheral muscle strength (baseline vs. final) in both groups (control: 40.81 ± 7.68 vs. 45.00 ± 6.89; and intervention: 38.73 ± 11.11 vs. 47.18 ± 8.75; p < 0.001 for both). However, the range of increase in strength was higher in the intervention group than in the control group (8.45 ± 5.20 vs. 4.18 ± 2.63; p = 0.005). There were no significant differences between the groups in terms of duration of mechanical ventilation or length of hospital stay. Conclusions: The results suggest that the performance of continuous passive mobilization on a cyclical basis helps to recover peripheral muscle strength in ICU patients.

ObjectiveTo investigate the efficiency of short-term inspiratory muscle training program associated with combined aerobic and resistance exercise on respiratory muscle strength, functional capacity and quality of life in patients who underwent coronary artery bypass and are in the phase II cardiac rehabilitation program.MethodsA prospective, quasi-experimental study with 24 patients who underwent coronary artery bypass and were randomly assigned to two groups in the Phase II cardiac rehabilitation program: inspiratory muscle training program associated with combined training (aerobic and resistance) group (GCR + IMT, n=12) and combined training with respiratory exercises group (GCR, n=12), over a period of 12 weeks, with two sessions per week. Before and after intervention, the following measurements were obtained: maximal inspiratory and expiratory pressures (PImax and PEmax), peak oxygen consumption (peak VO2) and quality of life scores. Data were compared between pre- and post-intervention at baseline and the variation between the pre- and post-phase II cardiac rehabilitation program using the Student's t-test, except the categorical variables, which were compared using the Chi-square test. Values of P<0.05 were considered statistically significant.ResultsCompared to GCR, the GCR + IMT group showed larger increments in PImax (P<0.001), PEmax (P<0.001), peak VO2 (P<0.001) and quality of life scores (P<0.001).ConclusionThe present study demonstrated that the addition of inspiratory muscle training, even when applied for a short period, may potentiate the effects of combined aerobic and resistance training, becoming a simple and inexpensive strategy for patients who underwent coronary artery bypass and are in phase II cardiac rehabilitation.

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O câncer de mama é apontado como o tipo de câncer mais prevalente no mundo. No Brasil, as taxas de mortalidade por câncer de mama continuam elevadas, observando-se diferenças inter-regionais. Foi realizado um estudo ecológico de série temporal (1980-2002) na Região Sul, com dados anuais do Departamento de Informação e Informática do SUS (DATASUS), para avaliar o comportamento do coeficiente de mortalidade por câncer de mama, padronizado por idade. Utilizou-se regressão linear simples e múltipla para estimar as taxas de mortalidade e as diferenças entre os três Estados. O Rio Grande do Sul parte de um patamar mais elevado e apresenta maior taxa média de mortalidade (14,45), sendo significativamente diferente (p < 0,001) quando comparado com Santa Catarina (8,93) e Paraná (9,95). Observou-se um aumento anual de 0,47 óbito na taxa de mortalidade por câncer de mama, independente do Estado. Conclui-se que há uma tendência similar de aumento da mortalidade por câncer de mama nos três Estados da Região Sul, com índices significativamente maiores no Rio Grande do Sul, enfatizando-se a importância da identificação dos fatores relacionados a esse quadro alarmante e o estabelecimento de medidas efetivas a fim de reverter esses números.