Guia para prática clínica: fisioterapia em pacientes com Doença Pulmonar Obstrutiva Crônica (DPOC)

Langer, Daniël; Probst, Vanessa S.; Pitta, Fábio; Burtin, Chris; Hendriks, Erik; Schans, Cees P. van der; Paterson, W.; Verhoef-Dewijk, M. C. E; Straver, Renata V.M.; Klaassen, Mariska P M; Troosters, Thierry; Decramer, Marc; Ninane,; Delguste, Pierre; Muris, Jean; Gosselink, Rik

doi:10.1590/s1413-35552009005000034

Cited by 26 publications

(37 citation statements)

References 90 publications

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“…It consisted of stretching of the upper and lower limbs and treadmill exercise started at 80% of the speed and inclination obtained in the exercise treadmill test. 28 The training intensity was adjusted over the weeks by using the sensation of dyspnea as a parameter, keeping it between 4 and 6 on the Borg CR 10 scale, 29 and always keeping the heart rate at 85% of maximum. Oxygen was supplemented during exercise, when the S pO 2 was below 88%.…”

Section: Physical Training Programmentioning

confidence: 99%

Effects of Inspiratory Muscle Training and Calisthenics-and-Breathing Exercises in COPD With and Without Respiratory Muscle Weakness

et al. 2015

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BACKGROUND: Patients with COPD may experience respiratory muscle weakness. Two therapeutic approaches to the respiratory muscles are inspiratory muscle training and calisthenics-andbreathing exercises. The aims of the study are to compare the effects of inspiratory muscle training and calisthenics-and-breathing exercises associated with physical training in subjects with COPD as an additional benefit of strength and endurance of the inspiratory muscles, thoracoabdominal mobility, physical exercise capacity, and reduction in dyspnea on exertion. In addition, these gains were compared between subjects with and without respiratory muscle weakness. METHODS: 25 subjects completed the study: 13 composed the inspiratory muscle training group, and 12 composed the calisthenics-and-breathing exercises group. Subjects were assessed before and after training by spirometry, measurements of respiratory muscle strength and test of inspiratory muscle endurance, thoracoabdominal excursion measurements, and the 6-min walk test. Moreover, scores for the Modified Medical Research Council dyspnea scale were reported. RESULTS: After intervention, there was a significant improvement in both groups of respiratory muscle strength and endurance, thoracoabdominal mobility, and walking distance in the 6-min walk test. Additionally, there was a decrease of dyspnea in the 6-min walk test peak. A difference was found between groups, with higher values of respiratory muscle strength and thoracoabdominal mobility and lower values of dyspnea in the 6-min walk test peak and the Modified Medical Research Council dyspnea scale in the inspiratory muscle training group. In the inspiratory muscle training group, subjects with respiratory muscle weakness had greater gains in inspiratory muscle strength and endurance. CONCLUSIONS: Both interventions increased exercise capacity and decreased dyspnea during physical effort. However, inspiratory muscle training was more effective in increasing inspiratory muscle strength and endurance, which could result in a decreased sensation of dyspnea. In addition, subjects with respiratory muscle weakness that performed inspiratory muscle training had higher gains in inspiratory muscle strength and endurance but not of dyspnea and submaximal exercise capacity. (ClinicalTrials.gov registration NCT01510041.)

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Section: Physical Training Programmentioning

confidence: 99%

Effects of Inspiratory Muscle Training and Calisthenics-and-Breathing Exercises in COPD With and Without Respiratory Muscle Weakness

et al. 2015

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“…A eletroestimulação é uma alternativa recente na reabilitação pulmonar. Langer et al 44 relatam o uso da eletroestimulação na melhora da força muscular e capacidade de exercício em pacientes com doença pulmonar obstrutiva crônica (DPOC) em musculatura apendicular. Outros autores encontraram resultados semelhantes nesta população, mas estes estudos tinham como objetivo a melhora de parâmetros cardiovasculares, através do fortalecimento de musculatura distal e não da tosse especificamente 21,25,27 .…”

Section: Resultsunclassified

Eficácia da eletroestimulação muscular expiratória na tosse de pacientes após acidente vascular encefálico

Meireles

Queiroz

et al. 2012

Fisioter. Pesqui.

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-Aceito para publicação: out. 2012 -Fonte de financiamento: nenhuma -Conflito de interesse: nada a declarar -Apresentação em evento científico: Este estudo teve seus resultados parciais apresentados de forma oral na VII Jornada Científica da Faculdade ASCES e foi apresentado na íntegra em formato de pôster no XVI Simpósio Internacional de Fisioterapia Respiratória (XVI SIFR) -Parecer de aprovação no Comitê de Ética e Pesquisa da Faculdade ASCES nº 119/10.ABSTRACT | Individuals with sequelae of stroke present as a common complication hypotonia and weakness of trunk muscles, in special the rectus abdominal muscle which is the main muscle activated for cough. The electrical stimulation (ES) is being widely used to fiber recruitment in many muscle groups and pathologies. The present study aimed to evaluate the efficiency of electrical stimulation with median frequencies (ETMF) in expiratory muscles strength and cough in patients with sequels of stroke. It is a quasi-experimental study (before and after) where 11 individuals were selected after stroke between 40 and 65 years, both sexes and hemodynamically stable. Patients were evaluated about clinic and respiratory scores (ventilometer, peak of expiratory flow (PEF) and manometer (MIP and MEP) and submitted to the protocol, which consisted of ETMF in expiratory muscle (abdominals rectus) with the unit of Russian current with 2,500 Hz carrier frequency modulated at 40 Hz for 15 minutes by 15 sessions. In the initial assessment evidenced decreasing in inspiratory and expiratory muscular strength (MIP, MEP) and PEF when compared to predicted values in literature. In the end of ETMF it happened an increase in MIP, MEP without statistical significance (p=0.18 and p=0.29) but the PEF has had an increase of 283.73 L/minute to 347.27 L/minute (p=0.03). It can be seen that the ETMF was effective in the improvement of the parameters evaluated, with PEF being the greatest impact and statistical significance, RESUMO | Indivíduos com sequelas de acidente vascular encefálico (AVE) apresentam como complicação comum a hipotonia de tronco com consequente fraqueza da sua musculatura, em especial, o reto abdominal que é o principal músculo acionado para a tosse. As correntes elétricas têm sido amplamente utilizadas para recrutamento de fibras musculares nas mais diversas patologias. O presente estudo teve como objetivo avaliar a eficácia da eletroestimulação transcutânea de média frequência (ETMF) na força muscular expiratória e tosse de pacientes com sequela de AVE. Trata-se de um estudo quase-experimental (antes e depois) onde foram selecionados 11 indivíduos pós-AVE entre 40 a 65 anos, ambos os sexos e estáveis hemodinamicamente. Os pacientes foram avaliados quanto a parâmetros clínicos e pneumofuncionais (ventilometria, pico de fluxo expiratório (PFE) e manovacuometria) e submetidos ao protocolo, que constava de ETMF no músculo reto abdominal com o aparelho de corrente Russa, frequência portadora de 2.500 Hz modulada a 40 Hz, durante 15 minutos, por 15 sessões. Na avaliação inicia...

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“…O maior valor da tabela é denominado como grau de esforço máximo, e o menor, como sensação de esforço experimentada em repouso. 11 Foram monitorados: pressão arterial (PA), frequência cardía-ca (FC), frequência respiratória (FR) e saturação de oxigênio por oximetria de pulso (SpO 2 ).…”

Section: Relato De Casounclassified

Capacidade funcional de candidata ao transplante de fígado após fisioterapia: relato de caso

Nascimento

Filho

Martines

et al. 2018

Rev. Fac. Ciênc. Méd. Sorocaba

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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, ...

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Guia para prática clínica: fisioterapia em pacientes com Doença Pulmonar Obstrutiva Crônica (DPOC)

Cited by 26 publications

References 90 publications

Effects of Inspiratory Muscle Training and Calisthenics-and-Breathing Exercises in COPD With and Without Respiratory Muscle Weakness

Effects of Inspiratory Muscle Training and Calisthenics-and-Breathing Exercises in COPD With and Without Respiratory Muscle Weakness

Eficácia da eletroestimulação muscular expiratória na tosse de pacientes após acidente vascular encefálico

Capacidade funcional de candidata ao transplante de fígado após fisioterapia: relato de caso

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