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INTRODUCTION: Coronary artery bypass grafing (CABG) is responsible for the decrease in pulmonary function and functionality. In this case the virtual reality is an alternative to reduce the impact of the surgical procedure. OBJECTIVE: To evaluate the effect of virtual reality on pulmonary function and functional independence in patients undergoing CABG. METHODOLOGY: This is a clinical trial. In the preoperative period, pulmonary function was assessed using maximum inspiratory pressure (MIP), maximum expiratory pressure (MEP), vital capacity (VC), peak expiratory flow (PEF) and functionality through the measurement of functional independence (FIM) and time up and go (TUG). On the first postoperative day, patients were randomized into two groups: the control group (CG), submitted to conventional physiotherapy, and the virtual rehabilitation group (VRG), increased through virtual reality. On the day of hospital discharge, patients were reassessed. RESULTS: 56 patients were analyzed, 25 in the CG, with a mean age of 51 ± 10 years, male prevalence 17 (68%), 31 in the VRG aged 54 ± 8 years, 21 (68%) men. All variables showed an intragroup reduction. At the end, the MIP of the CG was 74 ± 15 vs 92 ± 12 cmH2O of the VRG (P < 0.001), the MEP of the GC was 54 ± 14 vs 75 ± 16 cmH2O of the VRG (P < 0.001), the VC was 1.9 ± 0.6 ml/Kg in GC vs 2.4 ± 0.7 ml/Kg in VRG (P = 0.22), PEF in GC was 231 ± 28 vs 311 ± 26 L/min in VRG (P < 0.001), TUG of CG 22 ± 9.1 seconds vs 10 ± 1.6 seconds in the VRG (P < 0.001), the CG's FIM was 112 ± 5 vs 120 ± 3 in the GRV (P < 0.001). CONCLUSION: Based on the results obtained, it was found that the intervention with virtual reality was effective in reducing the loss of pulmonary function and functional independence after CABG.
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Introdução: A Mensuração da Independência Funcional (MIF) é utilizada para avaliar a condição funcional dos pacientes sendo dividida em domínios aplicada nos pacientes submetidos a cirurgia cardíaca devido ao seu alto potencial de efeitos deletérios. Objetivo: Analisar o comportamento dos domínios da MIF em pacientes submetidos a revascularização do miocárdio. Métodos: Trata-se de um estudo de coorte. No momento da admissão hospitalar foi avaliada a funcionalidade através da MIF e computado os seis domínios. No dia da alta da Unidade de Terapia Intensiva (UTI) foi novamente aplicada a MIF para comparação com o pré-operatório e correlação com o tempo de permanência na UTI. Resultados: Foram analisados 38 pacientes sendo 21 (55,3%) homens, a média de idade 57,3 ± 13,3 anos. O tempo médio de estadia na UTI 2,9 ± 1,3 dias sendo a MIF pré 125,7 ± 0,5 e a pós 87,4 ±16,8 (p <0,001). Em relação aos domínios percebeu-se uma redução em todos com exceção da Comunicação que passou de 14 para 13,1 ± 2,1 (p=0,24) e Cognição 20,9 ± 0,1 para 19,2 ± 4,4 (p=0,24). Porém, percebeu-se uma correlação forte entre o tempo de permanência na UTI com os domínios comunicação (r -0,76 e p < 0,01) e cognição (r -0,77 e p<0,01). Conclusão: Conclui-se que a funcionalidade é reduzida devido a cirurgia cardíaca e que o tempo de permanência na UTI tem relação direta com a piora da comunicação e cognição. [AU]
Introduction: Functional Independence Measurement (MIF) is used to evaluate the functional status of patients being divided into domains and should be applied in patients undergoing cardiac surgery due to their high potential for deleterious effects. Objective: To analyze the behavior of MIF domains in patients submitted to myocardial revascularization. Materials and Methods: This is a cohort study. At the time of hospital admission, the functionality was evaluated through the MIF and computed the six domains. After the surgery on the day of discharge from the Intensive Care Unit (ICU), the MIF was again applied for comparison with the preoperative period and correlation with the length of stay in the ICU. Results: A total of 38 patients were analyzed: 21 (55.3%) men, mean age was 57.3 ± 13.3 years. The mean ICU stay was 2.9 ± 1.3 days, with a FIM of 125.7 ± 0.5 and a mean of 87.4 ± 16.8 (p <0.001). In relation to the domains, a reduction was observed in all of them, with the exception of Communication from 14 to 13.1 ± 2.1 (p = 0.24) and Cognition 20.9 ± 0.1 to 19.2 ± 4, 4 (p = 0.24). However, there was a strong correlation between ICU stay time with the communication domains (r -0.76 and p <0.01) and cognition (r -0.77 and p <0.01). Conclusion: It is concluded that the functionality is reduced due to cardiac surgery and that the time spent in the ICU is directly related to the worsening of communication and cognition. [AU]