DESCRITORES Unidade de Terapia intensiva Funcionalidade Mobilização precoce KEYWORDS Intensive Care Unit Functionality Early mobilizationJustificativa e Objetivos: A incidência de complicações decorrentes dos efeitos deletérios da imobilidade na unidade de terapia intensiva contribui para o declínio funcional, aumento do tempo de internação e redução da funcionalidade. A fisioterapia é capaz de promover a recuperação e preservação da funcionalidade, podendo minimizar estas complicações -através da mobilização precoce. Objetivos: Avaliar a funcionalidade e independência de pacientes que realizaram a saída do leito precocemente na Unidade de Terapia Intensiva. Métodos: Ensaio clínico controlado e randomizado, realizado com pacientes internados na Unidade de Terapia Intensiva (UTI) do Hospital Santa Cruz com prescrição médica de fisioterapia. Os pacientes foram divididos em grupo de fisioterapia convencional -grupo controle e o grupo intervenção, que realizou o protocolo de mobilização precoce, promovendo a saída do leito. A funcionalidade foi medida em três tempos (retroativo a internação, na alta da UTI e na alta hospitalar) através do instrumento Functional Independence Measure (FIM). Resultados: Dados preliminares mostram que o grupo intervenção (n=4) apresentou menor perda da funcionalidade após a alta da UTI, com déficit de 19%, tendo recuperado até a alta hospitalar 97% da medida pré-hospitalização, enquanto o grupo controle (n=5) apresentou maior perda na UTI com 47,6%, e tendo alta hospitalar com apenas 72% do seu índice basal. Conclusão: Houve menor perda e melhor recuperação da taxa de funcionalidade na amostra estudada quando submetida a um protocolo de mobilização precoce e sistematizado, bem como menor tempo de internação. Backgound and Objectives:The incidence of complications arising from the deleterious effects of immobility in the intensive care unit contributes to functional decline, increased length of hospital stay and reduced functionality. Physical therapy is able to promote recovery and preservation of functionality, which can minimize these complications -through early mobilization. To evaluate the functionality and independence of patients who underwent a early bed output in the Intensive Care Unit. Methods:A randomized controlled clinical trial was conducted with patients admitted to the Intensive Care Unit (ICU) of the Santa Cruz Hospital and having a physiotherapy prescription. The patients were divided into conventional therapy group-control group and intervention group, who performed the protocol of early mobilization, promoting the bed output. The functionality was measured three times (retroactive to hospitalization, at discharge from the ICU and on hospital discharge) through the instrument Functional Independence Measure (FIM). Results: Preliminary data indicates that the intervention group (n = 4) presented lower loss of Relação entre saída precoce do leito na unidade de terapia intensiva e funcionalidade pós-alta: um estudo piloto Avaliation between precocious out of bed in the ...
BackgroundThe pathophysiological changes of COPD tend to worsen with progression, triggering limiting symptoms and implying the decrease in the activities of daily living and quality of life. The COPD Assessment Test (CAT) is a questionnaire designed to measure the impact of COPD on the health status. The aim of this study was to evaluate the impact of the disease through the CAT in a Brazilian sample of COPD patients and to correlate symptoms at rest with the CAT score in these patients.MethodsStudy of cases with COPD patients was conducted by pulmonary rehabilitation program (RP). Respiratory rate (RR) and symptoms (dyspnea by Modified Borg Scale Dyspnea Index; symptoms by CAT) were analyzed at the beginning of the RP.ResultsThe study analyzed 28 COPD patients, both genders, age 65.93 ± 7.84 years and many patients ranging from severe and very severe disease. The majority of patients were rated by CAT with low impact-disease (n = 13/46, 4%);medium (n = 11/39, 3%) and the high impact-diseases were observed in a few subjects (n = 4/14.3%). The difference between all CAT scores was significant, p = 0.000. There was a positive correlation between respiratory rate and CAT scores impact-level (r = 0.585, p = 0.001). The results obtained by the Borg Scale revealed a high presence of symptoms in these COPD patients but no association with CAT.ConclusionThe CAT is a sensitive tool to assess the current health status of COPD patients, and in Southern Brazil it is positively correlated with respiratory rate.
Introduction Chronic Obstructive Pulmonary Disease (COPD) is considered a disease with high morbidity and mortality, even though it is a preventable and treatable disease. Objective To assess the effectiveness of an audiovisual educational material about the knowledge and self-management in COPD. Methods Quasi-experimental design and convenience sample was composed of COPD patients of Pulmonary Rehabilitation (PR) (n = 42), in advanced stage of the disease, adults of both genders, and with low education. All subjects answered a specific questionnaire before and post-education audiovisual session, to assess their acquired knowledge about COPD. Results Positive results were obtained in the topics: COPD and its consequences, first symptom identified when the disease is aggravated and physical exercise practice. Regarding the second and third symptoms, it was observed that the education session did not improve this learning, as well as the decision facing the worsening of COPD. Conclusion COPD patients showed reasonable knowledge about the disease, its implications and symptomatology. Important aspects should be emphasized, such as identification of exacerbations of COPD and decision facing this exacerbation.
KEYWORDS COPD Pulmonary Rehabilition Interdisciplinary Health TeamJustificativa e Objetivos: A falta de adesão e a não obediência aos tratamentos recomendados é um problema muito comum que preocupa e interfere no sucesso da assistência aos portadores de Doença Pulmonar Obstrutiva Crônica-DPOC. Este estudo comparou o perfi l dos portadores de DPOC aderentes e não aderentes a um programa de reabilitação pulmonar. Métodos: Estudo observacional exploratório prospectivo, envolvendo 24 portadores de DPOC do programa de Reabilitação Pulmonar, alocados em dois grupos conforme participação integral do tratamento proposto: Grupo Aderente (GA=18 sujeitos) e Não-aderente (GN=06 sujeitos). O tratamento ocorreu em 08 semanas, 3x/semana, com duração de 1 hora e 30 minutos, composto por equipe multiprofi ssional (fi sioterapeuta, profi ssional de educação física, nutricionista, farmacêutica, psicólogo e médico pneumologista). Resultados: O GA não diferiu do GN quanto à situação sociodemográ-fi ca, antropométrica, capacidade cardiorrespiratória de exercício e função respiratória. GN apresentou mais comorbidades quando comparadas ao GA e em média maior quantidade de medicamentos utilizados. Todos os pacientes caracterizaram-se com redução da qualidade de vida e correlações entre a função cardiorrespiratória e qualidade de vida foi observada para ambos os grupos. Conclusão: Nossos resultados revelam que o estadiamento avançado da doença e o agravamento da sintomatologia foram fatores determinantes para a adesão dos portadores de DPOC ao programa de reabilitação pulmonar. Background and Objectives:The lack of adherent and non-adherent to recommended treatment is a very common problem that interferes with the successful care and assistance to people with Chronic Obstructive Pulmonary Disease-COPD. This study compared the profi le of COPD patients that were adherent with non-adherent to a pulmonary rehabilitation program. Methods: was done an exploratory prospective observational study involving 24 patients with COPD Pulmonary Rehabilitation Program, divided into two groups according to full participation of the proposed treatment: Adhesive Group (GA = 18 subjects) and non-adherent (GN = 06 subjects). The treatment occurred in 08 weeks, 3 times a week, lasting 1 hour and 30 minutes, assisted by a multidisciplinary team composed by physiotherapist, physical education professional, nutritionist, pharmacist, psychologist and pneumologist. Results: The GA did not differ from GN about the situation sociodemographic, anthropometric, cardiopulmonary exercise capacity and respiratory function. Janaína
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