Background Pulmonary diseases represent a great cause of disability and mortality in the world, and given the progression of these pathologies, pulmonary rehabilitation programs have proven to be effective for people with chronic respiratory diseases. During the COVID-19 pandemic, telerehabilitation has become an alternative for patients with such diseases. Objective The aim of this study was to compare the outcomes (ie, functional capacity and quality of life) of telerehabilitation to those of usual care among patients who previously participated in face-to-face pulmonary rehabilitation programs. Methods We conducted a quasi-experimental retrospective study from April 2020 to August 2021. A total of 32 patients with chronic lung diseases were included and divided into the control and intervention groups. The intervention group performed telerehabilitation synchronously twice per week and was supervised by a physical therapist during breathing, strengthening, and aerobic exercises. Changes in the degree of dyspnea and leg discomfort were assessed based on changes in Borg scale scores. The control group did not perform any activities during the period of social isolation. Functional capacity was assessed with the 6-minute walk test, and quality of life was assessed with the Medical Outcomes Study 36-item Short Form Health Survey. Results The telerehabilitation group’s mean 6-minute walk distance decreased by 39 m, while that of the control group decreased by 120 m. There was a difference of 81 m between the groups’ mean 6-minute walk distances (P=.02). In relation to the quality of life, telerehabilitation was shown to improve the following two domains: social functioning and mental health. Conclusions Telerehabilitation programs for patients with chronic lung diseases can ease the deleterious effects of disease progression, be used to maintain functional capacity, and improve aspects of quality of life.
Patients with CHD are less active if compared with controls and have limited functional capacity, related to muscle weakness and fatigue. The aim of this study was to evaluate the peripheral and respiratory muscle strength of children and adolescents with CHD with systematic review and meta-analysis. The review included observational and randomised control trial studies which evaluated peripheral and respiratory muscle strength in children and adolescents with CHD under 18 years old. The peripheral muscle strength was evaluated through dynamometry and respiratory muscle strength through manovacuometry. In studies that compared patients with CHD and respective control groups, it was possible to perform a meta-analysis. A total of 5634 articles met the criteria of eligibility, 15 were included in the systematic review, and 4 were included in the meta-analysis. Twelve studies assessed peripheral muscle strength with a reduction in patients with CHD. In the meta-analysis, patients with CHD had lower muscle strength than controls (−34.07 nm; 95% CI, −67.46 to −0.68; I2 47%; p for heterogeneity = 0.05), and the meta-analysis of the handgrip muscle strength showed no significant difference between patients with CHD and controls (0.08 nm; 95% CI, −6.39 to 6.55; I2 98%; p for heterogeneity <0.00001). The meta-analysis in the present study showed lower limb muscle strength in patients with CHD in comparison to controls. In contrast, no difference was found regarding hand grip strength. Also, the review showed lower respiratory muscle strength in patients with CHD, yet no meta-analysis was possible to perform.
BACKGROUND Pulmonary diseases represent a great cause of disability and mortality in the world and, considering the progression of these pathologies, pulmonary rehabilitation programs are proven to be effective. During the COVID-19 pandemic, telerehabilitation becomes an alternative for these patients. OBJECTIVE The aim of this study was to determine results in outcomes such as functional capacity and quality of life when comparing telerehabilitation to usual care in patients previously participating in face-to-face pulmonary rehabilitation program. METHODS A quasi-experimental retrospective study realized between Abril 2020 to August 2021. Thirty-two patients with chronic diseases were included, divided between control and intervention groups. The intervention group performed telerehabilitation synchronously twice a week supervised by a physical therapist with breathing, strengthening and aerobic exercises. Dyspnea and leg wear were adjusted by changing BORG. The control group did not perform any activity during the period of social isolation. Quality of life was assessed by the minute walk test and quality of life by the Medical Outcomes Study 36-item Short Form Health Survey. RESULTS The telerehabilitation group reduced 39 meters in the six-minute walk test, while the control group reduced 120 meters. There was difference of 81 meters between the groups (p=0.02). In relation to the quality of life of telerehabilitation was shown improve in two domains, social functioning and mental health. CONCLUSIONS telerehabilitation program for these patients can ease the deleterious effects of disease progression and maintain functional capacity and improve aspects of quality of life.
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