Efetividade da reabilitação pulmonar como tratamento coadjuvante da doença pulmonar obstrutiva crônica

Rodrigues, Sérgio Leite; Viegas, Carlos Alberto de Assis; Lima, Terezinha

doi:10.1590/s0102-35862002000200002

Cited by 26 publications

(36 citation statements)

References 9 publications

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“…PR is currently considered a standard procedure for optimizing the clinical treatment of COPD patients with dyspnea and limitations in daily activities 1,2,4,13,27 . Although PR is considered useful for most patients in the moderate to advanced stages of the disease, the availability of such programs is limited, which stimulated the investigation of the most common limiting factors, especially current smoking.…”

Section: Discussionmentioning

confidence: 99%

Influência do tabagismo atual na aderência e nas respostas à reabilitação pulmonar em pacientes com DPOC

Santana¹,

Squassoni²,

Neder³

et al. 2010

Rev. bras. fisioter.

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Objective: To investigate the modulating effects of current smoking on adherence and responses to pulmonary rehabilitation (PR) in patients with chronic obstructive pulmonary disease (COPD). Methods: In a prospective study, 18 ex-smokers and 23 current smokers (GOLD stages II-III) were enrolled in a 12-week multidisciplinary, supervised PR program. The patients were assessed clinically and as to subjective variables (dyspnea and health-related quality of life) and objective variables (body composition, pulmonary function and 6-min walking distance). The degree of nicotine dependence in current smokers was assessed by the Fagerström test. Program completion defined PR "adherence".Results: There was a significant association between current smoking and non-adherence to PR with 30.4% vs. 11.1% and odds ratio=2.9(1.6-4.1; p<0.01). However, the current smokers who completed the program (n=16) had a similar absentee rate to the ex-smokers, as well as similar gains in the subjective (quality of life) and objective (walked distance) items. Additionally, there was a significant reduction in daily cigarette consumption and in the degree of nicotine dependence in current smokers (p<0.05). Conclusions: Although current smoking is negatively related to PR adherence, COPD smokers who complete the PR can have similar gains in functionality and quality of life compared to ex-smokers. Moreover, PR may be related to decreased nicotine dependence, even without a formal smoking withdrawal program.Key words: COPD; rehabilitation; exercise; smoking; physical therapy. ResumoObjetivo: Investigar o possível efeito modulador do tabagismo atual na aderência e nos efeitos da reabilitação pulmonar (RP) em pacientes com doença pulmonar obstrutiva crônica (DPOC). Métodos: Em um estudo prospectivo, 18 pacientes ex-tabagistas e 23 tabagistas atuais (GOLD estádios II-IV) foram incluídos num programa multidisciplinar de RP com duração de 12 semanas. Os pacientes foram submetidos à avaliação clínica e à de variáveis subjetivas (dispneia e qualidade de vida) e objetivas (composição corporal, função pulmonar e teste da caminhada de 6 minutos). Nos pacientes tabagistas, obteve-se o nível de dependência da nicotina pela escala de Fagerström. A interrupção da RP antes do término previsto foi considerada indicativa de não aderência ao programa. Resultados: A proporção de pacientes não-aderentes à RP foi maior nos tabagistas do que nos ex-tabagistas (30,4% vs 11,1%, respectivamente; razão de chance=2,9 (1,6-4,1); p<0,01). Entretanto, os tabagistas atuais que completaram o programa (n=16) apresentaram taxa de absenteísmo à RP similar ao observado nos ex-tabagistas, assim como ganhos equivalentes nas respostas subjetivas (qualidade de vida) e objetivas (distância caminhada).Adicionalmente, houve redução significante no número de cigarros consumidos diariamente e no grau de dependência da nicotina nos tabagistas atuais (p<0,05). Conclusões: Embora o tabagismo atual reduza a aderência à RP, pacientes tabagistas com DPOC que completam tais programas a...

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Section: Discussionmentioning

confidence: 99%

Influência do tabagismo atual na aderência e nas respostas à reabilitação pulmonar em pacientes com DPOC

Santana¹,

Squassoni²,

Neder³

et al. 2010

Rev. bras. fisioter.

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“…21 Along with them, the Medical Research Council scale (MRC) 22 was also used to evaluate dyspnea and the BODE index was calculated (B -body mass index; Oairflow obstruction; D -dyspnea; E -exercise capacity). 23 The evaluations were applied sequentially by the same evaluator before the intervention, as well as after the intervention, during the reevaluation.…”

Section: Methodsmentioning

confidence: 99%

“…26 The UL exercises were performed with dumbbells, with a load of 50% of the maximum weight as measured in the incremental test for UL. 21 The first and the second diagonal of the Neuro-proprioceptive Facilitation Method 27 was used because of its functionality and the ability to recruit several UL muscle groups that are needed in the daily life activities. Each cycle of diagonal movement was performed for two minutes followed by a resting period of one minute, and, during the limb elevation, the patient was requested to exhale.…”

Section: Methodsmentioning

confidence: 99%

Muscle training program in patients with severe chronic obstructive pulmonary disease

2016

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Objective: The objective of this study was to analyze the effects of a muscle training program with neuromuscular electrical stimulation (NMES) for lower limbs (LL) and active resisted exercises for upper limbs (UL) for patients with severe Chronic Obstructive Pulmonary Disease. Methods: With a sample of 5 subjects (65.2 ± 6.09 years), the initial and final evaluations were: One-RepetitionMaximum testing; Sit-to-stand test; perimetry of the thigh; 6-minute walk test; Saint George's Respiratory Questionnaire; Medical Research Council scale for dyspnea and the BODE index. The intervention was performed three times a week and was composed of 18 sessions of 30-minute NMES followed by 30 minutes of exercise for the UL based on the diagonal Kabat method. The NMES parameters were: 50Hz of frequency, 6s on and 8s off, increase slope of 2s and decrease slope of 2s, pulse width of 400µs, and intensity defined as patient tolerance and increased from 1 to 5mA each day. Results: The results have shown an increase in muscle strength (p = 0.01) and of muscle resistance (p = 0.01). There was an improvement tendency in the quality of life (p = 0.16) and in the cardiorespiratory fitness (p = 0.11). Conclusion: The association of physical exercises with diagonals and NMES can be a beneficial resource for the treatment of patients with severe COPD. It is suggested, however, the need for new researches with a wider sample size for assuring these benefits.

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“…Due to the compromising of the lung histo-architecture generated by pneumo-disease, pulmonary rehabilitation does not help the patient in his state of air flux obstruction, but aids him in decreasing the systemic deficiencies and dysfunctions as the result of secondary processes of pulmonary disease such as, for example, peripheral muscle and respiratory dysfunctions, nutritional abnormalities, cardiovascular deficiencies, and skeletal, sensorial and psychosocial perturbations 4 .…”

Section: Introductionmentioning

confidence: 99%

Avaliação do aprendizado de pacientes com doença pulmonar obstrutiva crônica em um programa de reabilitação pulmonar

Galvez¹,

Malaguti²,

Battagim³

et al. 2007

Rev. bras. fisioter.

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Background: Patients who undergo pulmonary rehabilitation programs also participate in an educational program with classes covering matters related to their disease and treatment. Such programs aim to provide patients with the knowledge needed for them to be able to deal with their disease and its repercussions. Objective: To evaluate whether the educational program applied to patients undergoing pulmonary rehabilitation has effective results regarding their learning. Method: This was a prospective study involving 22 patients who underwent a pulmonary rehabilitation program. Their mean age was 63 years (SD ± 11.8). Initially, a questionnaire developed and validated by the Pulmonary Rehabilitation Center of UNIFESP/LESF was applied to evaluate the patients' knowledge about the disease before and after the educational intervention. The patients were divided into two groups: one with the educational program and the other serving as a control group (no educational program). The educational program group answered the questionnaire twice (before and after the intervention), and the control group answered only once. Results: The patients who underwent the educational program presented an increase in the percentage of correct answers, from before to after the intervention (69% versus 84%, respectively), and a decrease in the percentage of mistakes, from before to after the intervention (20% versus 14%, respectively). Conclusion: The educational program applied to patients in the pulmonary rehabilitation program was effective to increase the patients' knowledge about their disease, its consequences and its treatment.

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Efetividade da reabilitação pulmonar como tratamento coadjuvante da doença pulmonar obstrutiva crônica

Abstract: Introdução: O paciente portador de DPOC diminui sua atividade física global devido a piora progressiva da função pulmonar como conseqüência de qualquer forma de esforço físico por ele realizado. A reabilitação pulmonar (RP)

Cited by 26 publications

References 9 publications

Influência do tabagismo atual na aderência e nas respostas à reabilitação pulmonar em pacientes com DPOC

Influência do tabagismo atual na aderência e nas respostas à reabilitação pulmonar em pacientes com DPOC

Muscle training program in patients with severe chronic obstructive pulmonary disease

Avaliação do aprendizado de pacientes com doença pulmonar obstrutiva crônica em um programa de reabilitação pulmonar

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