Rehabilitation Programs for Cystic Fibrosis - View from a CF Center

Abstract

Abstract:Background: Rehabilitation programs are comprehensive interventions which effectively improve the health status and reduce costs in chronic respiratory illnesses. Because patients with cystic fibrosis have been discouraged to participate for concerns of microbial cross infection, the efficacy of systematic rehabilitation is unknown for this group. Methods:We retrospectively studied 142 cystic fibrosis patients aged 2-46 years who participated in rehabilitation programs taking place in Germany/Switzerland and in Israel, focusing on changes in lung function and weight.Results: During 172 stays in 97 patients in Israel and 68 stays in 45 patients rehabilitating in Germany/Switzerland, overall lung function and weight improved. Outcome did not differ between Israel and German/Swiss sites. Interestingly, lung function improved during the initial phase of the stay, whereas weight gain was sustained throughout. The study uncovered gaps in reporting sufficient individual outcome information back to the admitting centre.Conclusions: Rehabilitation programs specified for cystic fibrosis patients need to be assessed prospectively to optimize treatment of this life limiting condition.

Reference Values for the Six-Minute Walk Test in Healthy Children and Adolescents: a Systematic Review

“…Among the studies, the corridor length ranged from 15 to 50 meters [14,20] . Most of the studies used a corridor of 30 meters [15-17,21,23-25] , 2 studies used a corridor from 40 to 50 meters [18,11] and 2 from 15 to 25 meters [14,19] .…”

“…In health children, the 6MWT has been proposed to be a reliable and valid functional test for assessing exercise tolerance [7] . Up to the present moment the literature brings the use of the 6MWT in children/adolescents with, congenital heart disease [6] , severe cardiac impairment (pre cardiac transplantation or pulmonary) [8] , cardiovascular disease, atherosclerosis, hypertension, and obesity in youth [9] , asthma [10] , cystic fibrosis [11] , end-stage renal disease [12] and pulmonary hypertension [13] .…”

Polimorfismos -765G>C e 8473T>C no gene COX2 e 57460C>T no gene IFRD1 como modificadores da gravidade da fibrose cística

“…Sexo, raça e idade dos pacientes portadores de fibrose cística com as duas mutações identificadas no gene CFTR com relação aos polimorfismos -765G>C, 8473T>C e 57460C>T . O principal fator ambiental na variabilidade clínica da FC é o acesso ao tratamento (69). No nosso centro de referência (HC/Unicamp), o tratamento é garantido pelo sistema público de saúde, o que possibilita acesso igualitário a todos pacientes incluídos na pesquisa, e não concerne como fator adicional ponderável a análise de viés para as análises estatísticas.…”