RESUMOTransplante de fígado é um dos procedimentos cirúrgicos mais complexos e invasivos no campo da contemporaneidade médica. A mortalidade pós-cirúrgica está diretamente ligada à experiência da equipe multidisciplinar responsável, sendo a doença hepática avançada responsável por diversas alterações metabólicas. O objetivo do estudo foi avaliar o impacto de um programa de reabilitação física sobre a capacidade funcional em candidata ao transplante de fígado. Foi analisada uma paciente do sexo feminino, de 43 anos, com diagnóstico médico de cirrose biliar primária (fibrose porta portal) havia 6 anos, apresentando antecedentes de hipertensão arterial, diabetes mellitus e dislipidemia. A participante foi avaliada antes do início do protocolo de treinamento, e após, por meio de uma avaliação específica. Inicialmente, foi realizado tratamento fisioterapêutico: (I) avaliação dos sinais vitais; (II) 20 minutos de condicionamento físico, quando os primeiros minutos de exercícios iniciais e os finais foram direcionados ao aquecimento e ao resfriamento, respectivamente; (III) fortalecimento do quadríceps femoral na cadeira extensora; e (IV) 5 minutos de desaquecimento com alongamentos. Assim, este estudo proporcionou melhor abordagem quanto às limitações pessoais e às características da doença, servindo como parâmetro a um futuro programa de tratamento fisioterapêutico, baseado na reabilitação e melhora da capacidade funcional. Palavras-chave: transplante de fígado; cirrose hepática; mortalidade; atividades cotidianas; reabilitação; fisioterapia. ABSTRACTLiver transplantation is the most complex and invasive surgical procedures in the field of contemporary medical. The postoperative mortality is directly related to the experience of responsible multidisciplinary team, with advanced liver disease responsible for various metabolic disorders. The aim of this study was to evaluate the impact of a physical rehabilitation program on functional capacity in candidate for liver transplant. A female patient, 43 years old, with a diagnosis of primary biliary cirrhosis (portal fibrosis) for six years was analysed. She presented history of hypertension, diabetes mellitus, and dyslipidaemia. The patient was evaluated before the start of the training protocol and after it by means of a specific evaluation. The physical therapy done initially: (I) assessment of vital signs; (II) 20-minute fitness, in which the first few minutes of exercise and the last ones were directed to heating and cooling, respectively; (III) strengthening of the quadriceps in the leg extension; (IV) 5-minute cool-down with stretching. This study provided better approach for the personal limitations and characteristics of the disease, to serve as a parameter to a future physiotherapy program based on the rehabilitation and improvement of functional capacity. Keywords: liver transplantation; liver cirrhosis; mortality; activities of daily living; rehabilitation; physical therapy specialty. INTRODUÇÃOA cirrose é um distúrbio clínico em pacientes com doença hepática, ...
Conflito de interesses: NãoContribuição dos autores: APM delineamento do estudo, etapas de execução, tabulação, análise e interpretação dos dados, discussão dos achados, redação do manuscrito. EAMT concepção e elaboração, orientação do projeto, delineamento do estudo, análise e interpretação dos dados e elaboração do manuscrito.LGM concepção e elaboração do projeto, coleta de dados, análise e interpretação dos dados e delineamento do estudo. Contato para correspondência: Adriano Petrolini Mateus E-mail: adriano_petro@hotmail. Abstract Introduction:Idiopathic pulmonary fibrosis is a non-infectious chronic disease of unknown cause. One of the therapeutic strategies for patients with chronic respiratory disease with no possibility of cure is the pulmonary rehabilitation program. Objectives: Evaluate through the six-minute walk test questionnaire and Saint George Respiratory Questionnaire the effects of 36 pulmonary rehabilitation sessions in preoperative lung transplantation in patients with idiopathic pulmonary fibrosis. Patients and Method:The selected patient was a candidate for lung transplantation. He had a clinical diagnosis of Idiopathic Pulmonary Fibrosis and underwent 36 sessions of pulmonary rehabilitation. Data analysis was performed to collect and compare information from the six--minute walk test and quality of life. Data were collected before and after 36 weeks of pulmonary rehabilitation. Results: Before the pulmonary rehabilitation, the six-minute walk test showed a respiratory rate of 20 and 30 incursions per minute, respectively. After the intervention, the test showed 15 and 25 incursions per minute, respectively. Before and after the pulmonary rehabilitation, the teste showed a peak heart rate of 148 and 131 beats per minute. The recovery time of peripheral oxygen saturation was of five minutes and thirty seconds before and two minutes after reevaluation; the walking distance was 270 meters before and 513 meters after 36 sessions of pulmonary rehabilitation. Through the application of the Saint George Respiratory Questionnaire, it was noted an improvement in the following domains after pulmonary rehabilitation: symptoms, activity, impact, and total. The observation of these data characterizes functional and quality of life improvement for this patient. Conclusion: For this patient, 36 pulmonary rehabilitation sessions provided a positive impact on functional capacity and quality of life.
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