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O estudo tem por objetivo avaliar a eficácia do exercício físico como ferramenta na reabilitação da capacidade cardiopulmonar de indivíduos pós-covid mediante ao esforço físico. Consistiu em uma pesquisa sistemática de literatura, com abordagem qualitativa, nas bases de dados "Pubmed" e "Scielo" utilizando os descritores "covid-19 and social determinants of health", "covid-19 and physical exercise", "covid- 19 and rehabilitation", "sars-cov-2 and pathophysiology" e "post covid-19". O SARS- CoV-2 faz parte da família dos coronavírus (CoV), sua transmissão acontece principalmente de pessoa para pessoa por meio de gotículas respiratórias. A pandemia causou efeitos avassaladores nas estruturas sociais, nas populações e na economia, e com o isolamento social desencadeou diversos processos de adoecimento físico e mental. A covid afeta diretamente o sistema respiratório, pode comprometer também outras funções orgânicas, podendo obter melhoras através da reabilitação cardiopulmonar. O exercício físico desempenha papel fundamental no processo de reabilitação cardiopulmonar de indivíduos pós infecção pelo vírus da covid-19, acelerando a retomada das atividades de vida diária e consequentemente melhorando sua qualidade de vida.
The study aims to evaluate the effectiveness of physical exercise as a tool to rehabilitate cardiopulmonary capacity of post-covid individuals under physical exertion. It consisted of a systematic literature search, with qualitative approach, in the "Pubmed" and "Scielo" databases using the descriptors "covid-19 and social determinants of health", "covid-19 and physical exercise", "covid-19 and rehabilitation", "sars-cov-2 and pathophysiology" and "post covid-19". SARS-CoV-2 is part of the coronavirus (CoV) family, and is mainly transmitted from person to person via respiratory droplets. The pandemic has had devastating effects on social structures, populations, and the economy, and with social isolation has triggered various physical and mental illness processes. The covid directly affects the respiratory system; it can also compromise other organic functions, and improvements can be achieved through cardiopulmonary rehabilitation. Physical exercise plays a key role in the process of cardiopulmonary rehabilitation of individuals post infection by the covid-19 virus, accelerating the resumption of activities of daily living and consequently improving their quality of life.
El estudio tiene como objetivo evaluar la eficacia del ejercicio físico como herramienta en la rehabilitación de la capacidad cardiopulmonar de individuos post-covid a través del esfuerzo físico. Consistió en una búsqueda bibliográfica sistemática, con enfoque cualitativo, en las bases de datos "Pubmed" y "Scielo" utilizando los descriptores "covid-19 and social determinants of health", "covid-19 and physical exercise", "covid- 19 and rehabilitation", "sars-cov-2 and pathophysiology" y "post covid-19". El SARS- CoV-2 pertenece a la familia de los coronavirus (CoV) y se transmite principalmente de persona a persona a través de las gotitas respiratorias. La pandemia ha tenido efectos devastadores en las estructuras sociales, la población y la economía, y con el aislamiento social ha desencadenado diversos procesos de enfermedad física y mental. El covid afecta directamente al sistema respiratorio, también puede comprometer otras funciones orgánicas, y se pueden conseguir mejoras mediante la rehabilitación cardiopulmonar. El ejercicio físico desempeña un papel clave en el proceso de rehabilitación cardiopulmonar de los individuos tras la infección por el virus covid-19, acelerando la reanudación de las actividades de la vida diaria y, en consecuencia, mejorando su calidad de vida.
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ObjectiveBased on the International Classification of Diseases, Eleventh Revision (ICD-11) and the International Classification of Functioning, Disability and Health (ICF), systematic reviews about the effects of different types of exercise rehabilitation and related interventions on body structure and function, activity and participation, and quality of life in people with spinal cord injury (SCI) were systematically reviewed. MethodsSystematic reviews of exercise rehabilitation and health benefits in patients with spinal cord injury were searched from PubMed, Embase, EBSCO, Web of Science and CNKI, from January, 2015 to January, 2023. ResultsEight English articles were included, from Canada, the United States, South Korea, Australia, Brazil and Netherlands, derived from the fields of physical medicine and rehabilitation, neuromedicine and rehabilitation, and exercise intervention, with the publication date mainly concentrated from 2015 to 2021. A total of 165 randomized controlled trials were involved, with 2 746 participants, aged 18 to 65 years. The diseases were mainly spinal cord injury (complete or incomplete), quadriplegia, paraplegia (thoracic, lumbar and sacral injuries), and motor neuron injury (upper and lower). There were three main types of interventions: passive intervention, using sports assistive devices, such as powered exoskeleton-assisted robots, electric bicycles, etc., and functional electrical stimulation; active interventions, such as stepping exercises; training on flat ground, outdoor walking, and activities of daily living; mixed intervention (active & passive), such as combination of exercise and functional electrical stimulation, combination of exercise and motor assistive devices. The frequency of intervention was ten to 240 minutes a time, two to 18 times a week, with the intensity of low to vigorous, for one to 456 weeks. The intervention sites mainly involved families, community health service centers and sports venues. The health impact mainly involved improving cardiovascular and increasing blood flow velocity in the legs; improving musculoskeletal structure, as well as muscle strength, tolerance and flexibility; relieving spasms and improving reflex excitability of the nervous system; increasing gait speed and walking distance; improving functional independence, such as bowel regularity; improving physical health, such as reducing spasticity and drug use (e.g., baclofen), increasing the immune response to infection, and reducing the risk of disease (vascular dementia and respiratory disease); and improving psychological condition. ConclusionBased on ICD-11 and ICF, this study constructed a research framework for active or passive exercise rehabilitation and related interventions in patients with spinal cord injury. Patients with spinal cord injury can improve their body structure and function, increase their activity and participation, and improve their quality of life and well-being through passive interventions (using motor assistive devices, functional electrical stimulation), active interventions (such as stepping exercises, outdoor walking, etc.), and mixed interventions (combining exercise and functional electrical stimulation, exercise and sports assistive devices).
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ObjectiveTo analyze the disease and functioning characteristics of older adults with sarcopenia, the main exercise rehabilitation interventions, and its health benefits. MethodsLiterature related to exercise rehabilitation for older adults with sarcopenia was searched in PubMed, Medline, Embase, Cochrane Library and CNKI, from 2013 to 2023. The quality of included systematic reviews were evaluated. ICD-11 and ICF classification systems, and PICO framework from PRISMA guideline were used to report characteristics of the disease and functioning of the population, the exercise rehabilitation interventions, and its health benefits. ResultsFinally, seven systematic reviews from Netherlands, Spain, China, Brazil and Mexico were included, covering 98 related randomized controlled trials, involving 19 794 participants. These systematic reviews mainly came from the journals in the fields of aging, rehabilitation, nutrition, public health and physical exercise, and were published between 2018 and 2023. Exercise rehabilitation for sarcopenia were categorized into three types: exercise rehabilitation, exercise rehabilitation combined with nutritional supplementation, and exercise rehabilitation combined with nursing care. Interventions primarily included aerobic training, resistance training, gait training, strength training, and balance and flexibility exercises. The intervention frequency was six to 150 minutes, one to five times a week, with intensities ranging from low to high, over a duration of six to 144 weeks. The health benefits for older adults with sarcopenia from exercise rehabilitation were reflected in improvement in physical function and structure, and enhancement in activity and participation. In terms of body function and structure, exercise rehabilitation improved muscle strength, control, coordination, gait, balance, leg extension, leg press, back strength and grip strength, and increased muscle quality. In terms of activity and participation, exercise rehabilitation improved physical activity performance, such as walking speed and time of five-repetition chair stand test. ConclusionExercise rehabilitation for sarcopenia includes exercise rehabilitation, exercise rehabilitation combined with nutritional supplementation, and exercise rehabilitation combined with nursing care. Exercise rehabilitation can improve the physical function and structure, and enhance activity and participation.
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Introdução: Pacientes submetidos a grandes cirurgias abdominais apresentam riscos de complicações pós-operatórias. A mobilização precoce vem sendo implementada e cada vez mais aplicada, no intuito de prevenir esses eventos. Objetivo: Demonstrar se a mobilização precoce está associada à melhor funcionalidade no pós-operatório de cirurgias abdominais. Métodos: Revisão integrativa de literatura realizada por meio de uma busca bibliográfica junto aos bancos de dados: BVS, Scielo, PedRO e Pubmed por meio dos descritores: mobilização precoce, deambulação precoce, cuidados pós-operatórios, período pós-operatório, estado funcional, exercício físico, reabilitação, funcionalidade e cirurgia abdominal, nos idiomas inglês, português e espanhol. Resultados: A amostra final foi constituída por 08 artigos científicos, que foram estruturados em forma de quadro para apresentação de suas principais características, dos métodos e os principais resultados. Conclusão: A mobilização precoce está associada ao retorno rápido à funcionalidade da linha de base pré- operatória, as atividades de vida diária, independência funcional, além do tempo de internação mais curto e menor duração dos desagradáveis sintomas pós-operatórios.
Introduction: Patients undergoing major abdominal surgery are at risk of postoperative complications. Early mobilization has been implemented and increasingly applied in order to prevent these events. Objective: to demonstrate whether early mobilization is associated with better functionality in the postoperative period of abdominal surgeries. Methods: an integrative literature review carried out through a literature search in the following databases: BVS, Scielo, PedRO and Pubmed using the descriptors: early mobilization, early ambulation, postoperative care, postoperative period, functional status, physical exercise, rehabilitation, functionality and abdominal surgery, in English, Portuguese and Spanish. Results: The final sample consisted of 08 scientific articles, which were structured in the form of a table to present their main characteristics, methods and main results. Conclusion: Early mobilization interferes with the rapid return to preoperative baseline functionality, activities of daily living, functional independence, in addition to a shorter hospital stay and shorter duration of unpleasant postoperative symptoms.
Introducción: Los pacientes sometidos a cirugías abdominales mayores corren el riesgo de sufrir complicaciones postoperatorias. La movilización temprana se ha implementado y aplicado cada vez más para prevenir estos eventos. Objetivo: Demostrar si la movilización temprana se asocia con una mejor funcionalidad después de la cirugía abdominal. Métodos: Revisión bibliográfica integrativa realizada a través de una búsqueda bibliográfica en las siguientes bases de datos: BVS, Scielo, PedRO y Pubmed utilizando los descriptores: early mobilisation, early ambulation, postoperative care, postoperative period, functional status, physical exercise, rehabilitation, functionality and abdominal surgery, en inglés, portugués y español. Resultados: La muestra final consistió en 08 artículos científicos, que se estructuraron en forma de tabla para presentar sus principales características, los métodos y los principales resultados. Conclusión: La movilización temprana se asocia con un rápido retorno a la funcionalidad de base preoperatoria, a las actividades de la vida diaria, a la independencia funcional, así como a una estancia hospitalaria más corta y a una menor duración de los síntomas postoperatorios desagradables.
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Humans , Male , Female , Adult , Postoperative Care , Thoracic Surgery , Early Ambulation , Postoperative Complications , Postoperative Period , Rehabilitation , Exercise , Libraries, Digital , Abdomen , Functional StatusABSTRACT
Objective:To search, evaluate and integrate the best evidence of exercise rehabilitation intervention after PCI in patients with acute myocardial infarction, so as to provide evidence-based basis for clinical doctors and nurses to intervene in exercise rehabilitation of patients.Methods:We searched PubMed, China National Knowledge Infrastructure, Wanfang Data and other domestic and foreign databases, guide websites and professional association websites about the evidence of exercise rehabilitation intervention in patients with acute myocardial infarction after PCI. The search period is from January 2010 to June 2021. The quality of the included literature was evaluated by two researchers, and the literature evidence in accordance with the quality standard was extracted.Results:A total of 20 articles were included, and 39 pieces of evidence were summarized from 11 aspects, such as the establishment of multidisciplinary team, evaluation, exercise prescription, exercise monitoring and so on.Conclusions:This study summarized the best evidence of exercise rehabilitation intervention in patients with acute myocardial infarction after PCI, and provided theoretical support for clinical practice. It is suggested to combine the clinical situation and patients' wishes to promote the transformation of the best evidence to clinical practice.
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Objective:To search and analyze the relevant evidence of exercise rehabilitation in heart transplant patients and summarize the best evidence.Methods:The best practice information book, evidence summary, guidelines, expert consensus and systematic review of exercise rehabilitation for heart transplant patients in CNKI, Wanfang, CBM, PubMed, Embase, Cochrane Library, UpToDate, BMJ Best Practjce, National Institute for Health and Clinical Excellence (NICE), International Guidelines Network (GIN), Scottish Intercollegiate Guidelines Network (SIGN), New England Medicine (NEJM), Joanna Briggs Institute (JBI) Evidence-based Health Care Center in Australia, American Health Care Policy Research Institute (AHRQ), American Heart Association (AHA), American College of Cardiology (ACC), American Association for Cardiopulmonary Rehabilitation (AACVPR), European Society of Cardiology (ESC), International Society for Heart and Lung Transplantation (ISHLT) were searched by computer.Results:A total of 10 articles were included, including 1 clinical decision, 2 guidelines, 1 expert consensus and 6 systematic reviews; after evaluation, a total of 21 best evidences in 7 aspects: exercise effectiveness, exercise timing, exercise assessment, exercise modality, exercise duration, pre-habilitation, exercise compliance were summarized.Conclusions:This study summarizes the best evidence of exercise rehabilitation in patients undergoing heart transplantation and provides a reference for medical staff to develop exercise rehabilitation programs for patients after heart transplantation.
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Objective:To evaluate and summarize the best evidence of exercise instructions for patients with atrial fibrillation.Methods:A comprehensive search about evidence on exercise rehabilitation in patients with atrial fibrillation was conducted in following databases: Joanna Briggs Institute (JBI) Library, The Agency for Healthcare Research and Quality (AHRQ), National Institute for Health and Clinic Excellence (NICE), Scottish Intercollegiate Guidelines Network (SIGN), Registered Nurses′ Association of Ontario (RNAO), Physiotherapy Evidence Database (PEDro), American College of Physicians (ACP), Cochrane Library, PubMed, Embase, CINAHL, Medlive, China National Knowledge Infrastructure (CNKI), WanFang Database, VIP Database, and China Biology Medicine (CBM). The retrieval period was from the inception of databases to January 2021. Two researchers with evidence-based nursing background assessed the quality of the literature independently and identified the level of evidence.Results:A total of 16 articles were included, including 4 guidelines, 4 systematic reviews, 4 expert consensuses, 4 randomized controlled trials. Combined with professional judgment, 35 pieces of best evidence in 7 aspects were summarized, including exercise benefits, the appropriate crowd, exercise evaluation, exercise mode, exercise intensity, exercise time, exercise supervision and safety.Conclusions:Regular exercise is safe and beneficial for patients with atrial fibrillation. Clinical staff should guide patients to exercise moderately by applying the best evidence with scientific exercise intervention, promoting patients′ physical and mental health.
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Objective:To construct the exercise rehabilitation index system and exercise program for cardiac surgery patients after cardiopulmonary bypass, in order to provide basis for exercise rehabilitation.Methods:By literature analysis and group discussion, initial expert consultation letters were drawn up, and the Delphi method was used to conduct two rounds of consultation with 20 experts in the field of cardiac rehabilitation, and the exercise rehabilitation program was constructed on the basis of index system.Results:Response rate of two rounds of consultation was 100%, respectively. Experts ′ authority coefficients of the two rounds of consultation were 0.882 5 and 0.935 0 respectively. The Kendall coordination coefficients of the first and second level indexes were all statistically significant. The index system included 10 first-class indicators and 48 second-class indicators, forming a three-level exercise rehabilitation program. Conclusions:The index system and exercise rehabilitation program are scientific and practical, which provide reference for the implementation of exercise rehabilitation.
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Objective:To explore the clinical effect of phase Ⅰ cardiac rehabilitation exercise on patients with acute myocardial infarction after percutaneous transluminal coronary intervention (PCI).Methods:Convenient sampling method was adopted, totally 84 acute myocardial infarction patients after PCI was randomized into an observation group and control group. Both groups accepted general nursing care. The observation group also accepted the phase Ⅰ cardiac rehabilitation exercise. Cardiac ultrasonic, the 6-minute walk test were used to evaluate the patients′ cardiac function and exercise tolerance, the SF-12 were used to evaluate the quality of life.Results:After repeated measurement ANOVA, before the intervention, there was no significant difference in cardiac function and quality of life between the two groups ( P>0.05); before discharge, the 6-minute walk distance of the observation group was longer than that of the control group, and the difference was significant( F value was 5.279, P=0.024). At 1 month after discharge, there were significant differences in the LVEF( F value was 8.119, P=0.006) and 6-minute walking distance( F value was 9.829, P=0.002) between the two groups ( P<0.05), analysis of the six items of SF-12 including general health( F value was 6.905, P=0.010), physical functioning( F value was 10.595, P=0.002), role physical( F value was 11.168, P=0.001), bodily pain( F value was 12.548, P=0.001), mental health( F value was 7.362, P=0.008) and vitality( F value was 13.692, P<0.001) having shown significant differences between the two groups. At 3 months after discharge, there were significant differences in the LVEF( F value was 11.156, P=0.001), 6-minute walk distance( F value was 16.554, P<0.001)and quality of life in all dimensions between the two groups ( P<0.05). Conclusion:Phase Ⅰ cardiac rehabilitation exercise can improve cardiac function and the quality of life in patients with acute myocardial infarction undergoing PCI, and enhance the exercise tolerance.
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Objective To analyze the overall functioning of children with learning disabilities, and develop individualized exercise rehabilitation protocol using International Classification of Functioning, Disability and Health (ICF). Methods Based on the theoretical framework of ICF and the disease diagnosis of International Classification of Diseases (ICD-11), and with the perspective of child development, the functional profiles of cognition, understanding, attention, thinking, motor, and activity and participation of children with learning disabilities were analyzed. A function-oriented and individulized exercise rehabilitation protocol for children with learning disabilities was constructed in light of ICF bio-psycho-social health paradignm and the theory of somatic and mental interaction. Results The functional performance of children with learning disabilities mainly demonstrated in mental dysfunction in physical functioning in the activities and participation limitations, such as learning and applying knowledge, general tasks and demands, and communication. For the environment factors, products and technology for education, products and technology for culture, recreation and sports, and services, systems and policies could also affect children with learning disabilities. Physical activity was beneficial for children with learning disabilities to improve mental and motor functioning and to effectively enhance intellectual, cognitive, attentional, communication, and mobility skills for the overall development of the children. Physical activity for children with learning disabilities was selected according to WHO guidelines for physical activity and sedentary behavior for children, and moderate to vigorous physical activity for at least 60 minutes, as well as high-intensity training no less than three times a week, together with appropriate physical games and leisure physical activities could effectively improve learning outcomes and reduce learning disabilities. Conclusion The health condition, functioning and motor development of children with learning disability had been analyzed using ICD-11 and ICF, and with the theories of somatic and metal interaction and ICF bio-psycho-social model, the holistic and function-oriented exercise rehabilitation program was developed that recommended at least 60 minutes of moderate intensity physical activity, including aerobic exercise and physical games, per day, and at least three times a week of high intensity physical activity of no less than 30 minutes, including plyometrics and physical competition. The development of individualized function-based exercise rehabilitation programs incorporating the learning disability and motor function characteristics of children could effectively improve the cognitive, attentional, and thinking functions of children with learning disabilities, reduce learning disabilities, and promote the overall development of children.
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Objective To analyze the overall functioning of children with learning disabilities, and develop individualized exercise rehabilitation protocol using International Classification of Functioning, Disability and Health (ICF). Methods Based on the theoretical framework of ICF and the disease diagnosis of International Classification of Diseases (ICD-11), and with the perspective of child development, the functional profiles of cognition, understanding, attention, thinking, motor, and activity and participation of children with learning disabilities were analyzed. A function-oriented and individulized exercise rehabilitation protocol for children with learning disabilities was constructed in light of ICF bio-psycho-social health paradignm and the theory of somatic and mental interaction. Results The functional performance of children with learning disabilities mainly demonstrated in mental dysfunction in physical functioning in the activities and participation limitations, such as learning and applying knowledge, general tasks and demands, and communication. For the environment factors, products and technology for education, products and technology for culture, recreation and sports, and services, systems and policies could also affect children with learning disabilities. Physical activity was beneficial for children with learning disabilities to improve mental and motor functioning and to effectively enhance intellectual, cognitive, attentional, communication, and mobility skills for the overall development of the children. Physical activity for children with learning disabilities was selected according to WHO guidelines for physical activity and sedentary behavior for children, and moderate to vigorous physical activity for at least 60 minutes, as well as high-intensity training no less than three times a week, together with appropriate physical games and leisure physical activities could effectively improve learning outcomes and reduce learning disabilities. Conclusion The health condition, functioning and motor development of children with learning disability had been analyzed using ICD-11 and ICF, and with the theories of somatic and metal interaction and ICF bio-psycho-social model, the holistic and function-oriented exercise rehabilitation program was developed that recommended at least 60 minutes of moderate intensity physical activity, including aerobic exercise and physical games, per day, and at least three times a week of high intensity physical activity of no less than 30 minutes, including plyometrics and physical competition. The development of individualized function-based exercise rehabilitation programs incorporating the learning disability and motor function characteristics of children could effectively improve the cognitive, attentional, and thinking functions of children with learning disabilities, reduce learning disabilities, and promote the overall development of children.
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OBJECTIVES@#To systematically evaluate the effect of exercise rehabilitation on exercise capacity and quality of life in children with bronchial asthma.@*METHODS@#PubMed, Cochrane Library, Web of Science, EBSCO, China National Knowledge Infrastructure, Weipu Data, and Wanfang Data were searched for randomized controlled trials (RCTs) on the effect of exercise rehabilitation on children with bronchial asthma published up to February 2021. RevMan 5.3 was used to perform a Meta analysis.@*RESULTS@#A total of 14 studies were included, with 990 subjects in total. The Meta analysis showed that compared with the conventional treatment group, the exercise rehabilitation group had significantly better exercise capacity (distance covered in the 6-minute walk test: @*CONCLUSIONS@#Current evidence shows that exercise rehabilitation has a positive effect in improving exercise capacity and quality of life in children with bronchial asthma. Due to limited number and quality of studies included in the analysis, further research is needed.
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Child , Humans , Asthma , China , Exercise Therapy , Exercise Tolerance , Quality of LifeABSTRACT
Coronary heart disease is the leading cause of death in the United States and many developed countries. Percutaneous coronary intervention (PCI) is an important means to treat coronary heart disease. However, PCI can not eliminate the risk factors of coronary heart disease. As an important auxiliary means of PCI, cardiac rehabilitation can significantly slow down the progress of atherosclerosis, reduce cardiovascular events, improve patients′ exercise tolerance and the quality of life of patients. It have been developing vigorously in developed countries and achieved remarkable results. This paper will review the effects of cardiac exercise rehabilitation and the research on cardiac exercise rehabilitation in different clinical stages.
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A cirurgia de revascularização miocárdica é o principal tratamento para a doença arterial coronariana avançada e se mostra eficaz, porém seu potencial para complicações pós-operatórias interfere diretamente na evolução dos pacientes. Para minimizar os efeitos deletérios da cirurgia, a fisioterapia deve ser iniciada logo que possível. OBJETIVOS: Revisar os conhecimentos a respeito da atuação fisioterapêutica no pós-operatório de revascularização miocárdica. MATERIAIS E MÉTODOS: Constituiu-se de uma revisão sistemática nas bases de dados PubMed, SciELO, BVS e PEDro por meio do cruzamento das palavras-chave revascularização miocárdica, exercício físico e reabilitação. Foram incluídos ensaios clínicos randomizados de origem portuguesa e inglesa, publicados entre 2014 a 2019 que relacionassem a atuação fisioterapêutica no pós-operatório de CRM. Foram excluídos os artigos duplicados, estudos que apresentaram intervenção apenas na fase pré-operatória, que compararam a utilização de métodos farmacológicos ou outros procedimentos cirúrgicos, intenções de pesquisa, inadequação ao tema proposto e score PEDro inferior a 5. RESULTADOS: 12 estudos foram incluídos por preencherem os critérios de elegibilidade. A amostra total foi de 435 pacientes adultos, de ambos os sexos com idades entre 30 e 70 anos. Estes foram submetidos a exercícios aeróbios, anaeróbios e respiratórios, eletroterapia, fototerapia e ventilação mecânica não invasiva. CONCLUSÃO: As condutas comumente realizadas pela fisioterapia na fase de pós-operatório de revascularização miocárdica incluem técnicas relacionadas a fisioterapia respiratória e mobilização progressiva. Dentre as intervenções empregadas o exercício aeróbio tem sido a modalidade com maior número de evidências a respeito dos seus benefícios.
Myocardial revascularization surgery is the main treatment for advanced coronary artery disease and has proven to be effective, but its potential for postoperative complications directly interferes in the evolution of patients. To minimize the deleterious effects of the surgery, physiotherapy should be started as soon as possible. OBJECTIVES: To review the knowledge about the physiotherapeutic performance in the postoperative period of myocardial revascularization. MATERIALS AND METHODS: It consisted of a systematic review in the PubMed, SciELO, BHS and PEDro databases through the crossing of the key words myocardial revascularization, physical exercise and rehabilitation. Randomized clinical trials of Portuguese and English origin published between 2014 and 2019 that related the physiotherapeutic performance in the postoperative period of myocardial revascularization were included. Duplicate articles, studies that presented intervention only in the preoperative phase, studies which compared the use of pharmacological methods or other surgical procedures, research intentions, studies that showed inadequacy of the proposed subject and PEDro score below 5 were excluded. RESULTS: 12 studies were included because they met the eligibility criteria. The total sample included 435 adult patients of both sexes aged between 30 and 70 years. They were submitted to aerobic, anaerobic and respiratory exercises, electrotherapy, phototherapy and noninvasive mechanical ventilation. CONCLUSION: The procedures commonly performed by physiotherapy in the postoperative phase of myocardial revascularization include techniques related to respiratory physiotherapy and progressive mobilization. Among the interventions employed, aerobic exercise has been the most evident modality in terms of numbers regarding its benefits.
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Myocardial Revascularization , Rehabilitation , ExerciseABSTRACT
Objective:To analyze the cardiopulmonary function of stable patients with pulmonary arterial hypertension (PAH), and to explore effects of the cardiopulmonary exercise testing (CPET)-based individualized moderate-intensity exercise prescription on cardiopulmonary functional reserve and exercise capacity in patients with PAH. Methods:From April, 2018 to July, 2019, 31 stable patients with PAH (PAH group) and 32 healthy counterparts (normal group) were enrolled. All subjects underwent CPET. PAH group was assessed with 6-Minute Walking Test (6MWT), and then was divided into exercise group (n = 16) and control group (n = 15). Both groups were treated with ordinary targeted drugs, while the exercise group was additionally provided with an individualized moderate-intensity exercise prescription of △50% power treadmill training, five days a week for eight weeks. CPET and 6MWT were conducted again after intervention. Results:Before intervention, body mass, body mass index (BMI), force vital capacity (FVC), forced expiratory volume in one second (FEV1), maximum voluntary ventilation (MVV), anaerobic threshold (AT), peak heart rate (HRpeak), peak systolic blood pressure (SBPpeak), peak load power (WRpeak), peak oxygen uptake (VO2peak), peak oxygen pulse (VO2/HRpeak), peak cardiac output (COpeak), peak minute ventilation (VEpeak), peak end-tidal carbon dioxide (PETCO2peak), peak pulse oxygen saturation (SpO2peak) and oxygen uptake efficiency plateau (OUEP) were significantly lower (t > 2.419, P < 0.05), and the rest heart rate (HRrest), peak dead space to tidal volume ratio (VD/VTpeak), minimum ventilatory equivalent for carbon dioxide (Lowest VE/VCO2) and slope of ventilatory equivalent for carbon dioxide (VE/VCO2 slope) were higher (|t| > 2.615, P < 0.05) in PAH group than in the normal group. After intervention, FEV1, MVV, VO2peak (ml/min/kg) and VO2/HRpeak decreased in the control group (t > 2.272, P < 0.05); FVC, FEV1, MVV, AT, SBPpeak, WRpeak, VO2peak, VO2/HRpeak, COpeak, VEpeak, PETCO2peak, SpO2peak and 6-Minute Walking Distance (6MWD) increased (|t| > 2.167, P < 0.05), while the average Lowest VE/VCO2 and VE/VCO2 slope decreased (t > 2.264, P < 0.05) in the exercise group. Compared with the control group, the FEV1/FVC, AT, WRpeak, VO2peak, VO2/HRpeak, COpeak and 6MWD increased in the exercise group (|t| > 2.168, P < 0.05). Conclusion:The holistic cardiopulmonary function of stable patients with PAH decreases. CPET-based individualized moderate-intensity exercise could enhance the cardiopulmonary functional reserve and exercise capacity of patients with PAH.
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OBJECTIVE@#To investigate the application status of Chinese medicine (CM) in cancer rehabilitation, so as to provide references for improving the level of CM cancer rehabilitation.@*METHODS@#A survey questionnaire regarding "application status of CM rehabilitation in cancer patients" for oncologists (doctor version) and cancer patients (patient version) were developed, respectively. From September 2014 to November 2016, a total of 1,000 doctors from oncology department in 48 hospitals and 2,000 cancer patients from CM oncology department from 8 hospitals in China were recruited in this survey. The psychological, nutrition and exercise rehabilitation guidance for cancer patients provided by doctors, their mastery conditions regarding cancer staging treatment and CM syndrome differentiation, and recommendation from doctors on CM rehabilitation were investigated. Cancer patients' awareness on the importance of psychological, nutrition and exercise rehabilitation, as well as their knowledge and needs for rehabilitation were also analyzed. The impact of gender, age, professional title, hospitals grades of physicians on their knowledge of cancer staging treatment and CM syndrome differentiation, and the relationship between gender, age, education level and economic conditions and patient's knowledge along with the needs of CM rehabilitation were further analyzed.@*RESULTS@#Totally 1,000 questionnaires were issued to doctors and 963 questionnaires returned, among which 948 were valid representing a response rate of 94.80%. A total of 2,000 questionnaires were issued to patients and 1,705 valid data finally returned with a response rate of 85.25%. The survey showed that cancer patients generally paid much attention to psychological, nutritional and sports rehabilitation, and had a strong demand for CM rehabilitation. Knowledge of CM rehabilitation was not well provided by oncologists, and the rehabilitation guidance as well as CM rehabilitation measures were obviously insufficient in cancer patients. Educational and economic levels were positively correlated with cognition level of CM rehabilitation knowledge among cancer patients (Kendall-tau_b correlation coefficients=0.130, 0.057, respectively; P<0.05). Gender and education level were positively correlated with the patients' willingness for taking CM measures (Kendall-tau_b correlation coefficient=0.057, 0.105, respectively; P<0.05). Age was negatively correlated with intention of applying CM measures (kendall-taub correlation coefficient=-0.105, P<0.05).@*CONCLUSIONS@#Health education and professional training for both cancer patients and oncologists should be strengthened and CM rehabilitation knowledge among cancer patients and oncologists should be improved, so as to give full play to CM in cancer rehabilitation.
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Introdução: Os benefícios da atividade física na população geral estão bem estabelecidos, gerando melhora da qualidade de vida e diminuição significativa do risco de desenvolver doenças cardiovasculares e metabólicas. A perda da massa muscular com redução da força muscular e do desempenho físico é um problema relevante em indivíduos com câncer. O exercício físico com fim terapêutico constitui um valioso instrumento da reabilitação para estes pacientes. Objetivo: Descrever o impacto do treinamento físico combinado em dois pacientes com linfoma. Casuística e Métodos: Descreve-se o caso de dois pacientes com linfoma, sendo um do sexo masculino, com 30 anos de idade, com linfoma tipo Hodgkin e outro do sexo feminino, com 29 anos de idade com linfoma tipo não Hodgkin. Em ambos os pacientes foram avaliados o hemograma, as variáveis respiratórias, a capacidade física funcional, força de preensão palmar, funcionalidade e teste de repetições máximas antes e após treinamento físico combinado. Resultados: O treinamento físico combinado demonstrou melhora nas variáveis respiratórias, na capacidade física funcional, na força muscular global e na funcionalidade dos pacientes com linfoma. Conclusão: É possível concluir que o treinamento físico combinado pode trazer benefícios nos aspectos físicos e funcionais dos pacientes em tratamento oncológico. Sugere-se que o treinamento físico combinado seja incluído na reabilitação destes pacientes.
Introduction: The benefits of physical activity in the general population are well established, leading to improved quality of life and a significant reduction in the risk of developing cardiovascular and metabolic diseases. Loss of muscle mass with reduced muscle strength and physical performance is a relevant problem in individuals with cancer. Physical exercise for therapeutic purposes is a valuable rehabilitation tool for these patients. Objective: To describe the impact of combined physical training in two patients with lymphoma. Patients and Methods: We describe the case of two patients with lymphoma, a 30-year-old male patient with hodgkin's lymphoma and a 29-year-old female with non-hodgkin's lymphoma. The blood count, respiratory variables, functional physical capacity, palmar grip strength, functionality and maximal repetition test in the pre and post combined physical training were evaluated in both patients. Results: Combined physical training evidenced improvement in respiratory variables, functional physical capacity, overall muscle strength and functionality of patients with lymphoma. Conclusion: It is possible to conclude that the combined physical training can bring benefits in the physical and functional aspects of the patients in cancer treatment. It is suggested that combined physical training be included in the rehabilitation of the patient with cancer.
Subject(s)
Humans , Male , Female , Adult , Rehabilitation/methods , Exercise , Lymphoma/rehabilitationABSTRACT
Objective:To investigate the experience of rehabilitation exercise for the prevention of upper limb lymphedema in patients with breast cancer rehabilitation, to provide feasible and operative activities and exercise rehabilitation information for clinical health care personnel to guide exercise rehabilitation programs for breast cancer patients after discharge. Methods:From July, 2017 to June, 2018, individualized face-to-face in-depth interviews were performed in breast cancer rehabilitation patients who had been performing upper limb lymphedema exercise for more than three times a week. The content analysis was used to analyze the data. Results:Totally, 13 candidates for breast cancer rehabilitation were selected to provide experience, and their experience of breast cancer rehabilitation in preventing upper limb lymphedema were extracted, including the type, name, time, frequency and intensity of exercise, precautions, and detailed operational experience in sports rehabilitation. Conclusion:The exercise rehabilitation experience of breast cancer rehabilitation patients in preventing upper limb lymphedema have been drawn, which may enrich and refine the current behavior guidelines for breast cancer rehabilitation patients to prevent upper limb lymphedema, and help to deepen the prevention of breast cancer rehabilitation. The understanding of the actual situation of upper limb lymphedema provides a reference for preventive interventions for the development of lymphedema in medical staff.
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Objective@#To explore the effects of exercise rehabilitation on the depression and anxiety state and quality of life in patients with chronic heart failure.@*Methods@#400 cases of chronic heart failure patients were selected as the research objects.They were randomly divided into control group(n=200)and exercise rehabilitation group(n=200) by random number table.Two groups were given symptomatic treatment and routine care on a regular basis, and exercise rehabilitation group again on this foundation to give rehabilitation therapy for 3 weeks.Self-rating anxiety scale(SAS) and Self-rating depression scale(SDS)were used to score the anxiety and depression of the two groups before and after rehabilitation.The SF-36 was used to assess the quality of life of patients.Rehabilitation satisfaction questionnaire was used to investigate the satisfaction degree of rehabilitation.@*Results@#There was no significant difference in SAS and SDS scores between the two groups before intervention (P>0.05). After intervention, the SAS and SDS scores of the two groups were significantly lower than those before intervention (P<0.05). SAS and SDS scores in exercise rehabilitation group ((27.47±4.82)vs(45.63±5.61))were significantly lower than those in control group ((43.17±4.81) vs (59.61±4.18))(P<0.05). Before intervention, there was no significant difference in the scores of SF-36 scale between the two groups (P>0.05). After intervention, the scores of SF-36 scale were significantly increased in the two groups, and the difference was statistically significant compared with that before intervention (P<0.05). All the factors of SF-36 in exercise rehabilitation group were significantly higher than those in control group (mental health: (72.06±7.48)vs(64.34±7.01), emotional function: (81.06±7.01)vs(76.05±6.92), social function: (81.14±7.83)vs(71.26±7.65), overall health: (70.14±8.05)vs(61.26±7.95), energy: (74.56±7.81)vs(69.46±7.40), the body pain: (68.51±7.36)vs(60.26±7.51), physical limitations: (64.99±7.31)vs(59.62±7.53 ), physiological function: (69.71±7.63)vs(63.84±7.04), all P<0.05). The satisfaction of the exercise rehabilitation group (92.5%)was significantly higher than that of the control group(75.0%) (P<0.05).@*Conclusion@#Exercise rehabilitation training can not only improve the anxiety and depression of patients with chronic heart failure, but also effectively improve the quality of life of patients.Exercise rehabilitation training has a high degree of recognition, and is worthy of extensive application in clinical practice.
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Objective To explore the influence of cardiac exercise rehabilitation on cardiac function and quality of life(QOL) in acute myocardial infarction(AMI) after percutaneous coronary intervention (PCI).Methods Totally 190 patients with AMI who was successfully performed by PCI were randomly divided into exercise rehabilitation group (n =95),control group (n =95).Patients in Control group were given medical routine guidance including drug treatment and rehabilitation training.These in exercise rehabilitation group were given exercise rehabilitation intervention inside and outside of hospital and follow-up.The cardiac function,major adverse cardiac events (MACE) after PCI between two groups were compared.The change of QOL evaluated by WHOQOL BREF between two groups at different time was analyzed.Results At 6 months after PCI,the LVESD,LVEDD,LVEF in exercise rehabilitation group were obviously improved than those before discharge,and significantly better than those in control group (P ＜ 0.05).At 3,6 months after PCI,the WHO-QOL-BREF score of each dimension was significantly increased than those before discharge (P ＜ 0.05),and the psychological,social relations dimension scores in exercise rehabilitation group were significantly higher than those in control group (P ＜ 0.05).There was significant different on physical dimension score between two groups at 6 months after PCI (P ＜ 0.05).The incidence of MACE within 30 days in exercise rehabilitation group was 9.5 ％,which was significantly lower than that in control group 20.0％ (P ＜ 0.05).Conclusion Cardiac exercise rehabilitation after PCI for AMI patients can contribute to improve heart function,reduce postoperative MACE,and improve the QOL.