Exercícios funcionais e neuromusculares são importantes ferramentas em centros de reabilitação, porém são pouco explorados em protocolos hospitalares. objetivo: Verificar se exercícios funcionais e neuromusculares são mais eficazes na redução do tempo de internamento e controle da pressão arterial (PA) dos indivíduos hospitalizados do que a fisioterapia hospitalar de rotina. Métodos: Foram incluídos pacientes hospitalizados por enfermidades não cardiológicas e sem hipertensão arterial sistêmica, sendo estes randomizados para grupo controle (GC), que realizou exercícios respiratórios, exercícios ativo-livres para membros superiores/ inferiores e caminhada no corredor, ou grupo de reabilitação funcional (GRF), submetido a exercícios neuromusculares para membros superiores/inferiores, cicloergômetro e treino de subir/descer degraus. Ambos os grupos receberam intervenção 2x/dia. A PA foi aferida na admissão, durante o internamento e na alta hospitalar. O tratamento estatístico foi realizado adotando-se intervalo de confiança de 95% e nível de significância de 5%. resultados: Avaliados 42 voluntários, dos quais 26 atenderam aos critérios de elegibilidade. Porém, seis foram excluídos, quatro por permanência hospitalar inferior a três dias e dois por não completarem o protocolo de tratamento. A média de idade no GC foi de 72±11 versus 73±8 no GRF. Não houve diferenças estatísticas da PA na admissão. Evidenciou-se redução da PA apenas no GRF durante o internamento (p<0,01), assim como na alta hospitalar (p<0,01). O GC apresentou maior tempo (dias) de internação 7,2±1,8 versus 5,5±1,3 do GRF (p<0,05). Conclusão: Exercícios funcionais e neuromusculares parecem mais eficazes na redução do tempo de internamento e controle da PA dos indivíduos hospitalizados do que a fisioterapia hospitalar de rotina.Palavras-chave: serviço hospitalar de fisioterapia; pressão arterial; terapia por exercício; medicina física e reabilitação; tempo de internação. ABStrACt introduction:Functional and neuromuscular exercises are important tools in rehabilitation centers, however they are little explored in hospital protocols. objective: To determine whether functional and neuromuscular exercises are more effective in reducing hospital stay and controlling blood pressure (BP) of hospitalized individuals than routine hospital physiotherapy. Methods: Hospitalized patients for non-cardiac illnesses and without hypertension were included, which were randomized to the control group (CG), who performed breathing exercises, active-free exercises for upper/lower limbs and walk in the hallway, or to functional rehabilitation group (FRG), which underwent neuromuscular exercises for upper/lower limbs, cycle ergometer and up/down stairs training. Both groups received intervention 2x/day. BP was measured at admission, during hospitalization and at discharge. Statistical analysis was performed by adopting a confidence interval of 95% and a 5% significance level. results: Forty-two volunteers were evaluated, of which 26 met the eligibility criteria. However, six...
Congestive heart failure is a pathology that limits the patient's physical function. This study analyzed one patient who was submitted to a cardiac rehabilitation program associated to Continuous Positive Airway Pressure (CPAP), by assessing the results of the six-minute walk test (6MWT) and a questionnaire on the quality of life and performing an echocardiographic assessment before the study and after six weeks. The distance walked by the patient increased from 152.5 m to 520.44 m at the 6MWT. The Minnesota questionnaire score decreased from 62 to 18. Ejection fraction increased from 33% to 36%. Therefore, the management chosen for this case improved the patient's physical performance and quality of life. Key wordsHeart failure; exercise; rehabilitation; quality of life. symptom relief. This improvement is attained through the increase in the intrathoracic pressure, which decreases the left ventricular (LV) preload and afterload such as the transmural pressure, culminating with an increased stroke volume and outflow volume. Thus, it can be stated that the CPAP improves the mechanics of a failing heart 4 .The main characteristic of these patients is the intolerance to physical exercise, detected through dyspnea and fatigue; based on this presupposed concept, it becomes necessary to promote a cardiovascular rehabilitation program for these patients, with the objective of allowing the patient with cardiopathy to resume an active and productive life as soon as possible 2 . MethodsThe present is a case study of a 51-year-old female patient with heart failure of Chagasic origin, who presented NYHA (New York Heart Association) functional class (FC) III 2 , without any musculoskeletal or pulmonary comorbidities. The patient was submitted to an echocardiogram, answered a quality of life questionnaire (adapted Minnesota Living with Heart Failure Questionnaire) 2 and performed the Six-minute Walk Test 5 (6MWT) before initiating the Cardiac Rehabilitation protocol and after the six-week program was completed. The patient was followed by the same examiner throughout the entire study, who was blinded to the treatment.The training protocol consisted of four weekly sessions for a period of six weeks, during which a continuous positive pressure of 10cmH 2 O was applied to the airways during the entire session time (CPAP ResMed LightWeight II).The training sessions consisted of aerobic activity on a treadmill or bicycle ergometer (Reebok TR1 and Reebok Power Bike, respectively), alternately on each day and resistance exercises for the upper and lower limbs (dumbbells and Reebok ankle weights, respectively), also alternately on each day.During the training sessions, the patient was always followed by the same examiner. During the first week of training, the aerobic activity lasted 20 minutes and three types of resistance exercises were performed. On the second week of training, the aerobic activity lasted 25 minutes and 4 resistance exercises were performed. From the third to the sixth weeks of training, the aerobic activity las...
INTRODUÇÃO: Hipertensão arterial é uma condição mórbida presente em grande parte dos adultos. Estudos evidenciam que exercícios físicos de moderada intensidade e curta duração têm efeitos satisfatórios na redução da pressão arterial. OBJETIVO: Mensurar a duração do efeito hipotensor de uma única sessão de reabilitação cardíaca a partir da prática de exercício aeróbico de curta duração e moderada intensidade. MATERIAIS E MÉTODOS: O estudo foi prospectivo e quase-experimental. Participaram do estudo nove voluntários hipertensos e sedentários (cinco do sexo feminino e quatro do masculino), monitorizados pelo exame de medida ambulatorial da pressão arterial por 12 horas e 30 minutos. Foi realizada uma única sessão de treinamento aeróbico por dez minutos em bicicleta ergométrica numa intensidade moderada. RESULTADOS: Houve redução tanto na PAS (pressão arterial sistólica) como na PAD (pressão arterial diastólica) (ANOVA, p < 0,001) durante as 12 horas de estudo. CONCLUSÃO: Uma sessão de exercício físico de curta duração com intensidade moderada foi suficiente para reduzir os níveis pressóricos dos voluntários analisados por um período de 12 horas.
Congestive heart failure is a pathology that limits the patient's physical function. This study analyzed one patient who was submitted to a cardiac rehabilitation program associated to Continuous Positive Airway Pressure (CPAP), by assessing the results of the six-minute walk test (6MWT) and a questionnaire on the quality of life and performing an echocardiographic assessment before the study and after six weeks. The distance walked by the patient increased from 152.5 m to 520.44 m at the 6MWT. The Minnesota questionnaire score decreased from 62 to 18. Ejection fraction increased from 33% to 36%. Therefore, the management chosen for this case improved the patient's physical performance and quality of life.
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