Effects of Exercise in Patients with Obstructive Sleep Apnoea.

Obstructive sleep apnoea (OSA) constitutes a public health problem, with various systemic consequences that can increase cardiovascular morbidity and mortality as well as increase healthcare expenditure. This review discusses the rationale and effects of using general physical exercise, oropharyngeal exercises, and respiratory muscle training as an adjunctive treatment for patients with sleep apnoea. The recommended treatment for OSA is the use of continuous positive airway pressure, which is a therapy that prevents apnoea events by keeping the airways open. In the last decade, coadjuvant treatments that aim to support weight loss (including diet and physical exercise) and oropharyngeal exercises have been proposed to lower the apnoea/hypopnoea index among patients with OSA. Based on the available evidence, health professionals could decide to incorporate these therapeutic strategies to manage patients with sleep apnoea.

Physical activity assessments in children with congenital heart disease: A systematic review.

AIM: To describe the physical activity (PA) of children with congenital heart disease (CHD) according to different assessment methods and compare their results with the World Health Organization (WHO) recommendations. METHODS: A systematic review was conducted using five databases. We included cross-sectional, longitudinal, observational studies and clinical trials in a paediatric population with CHD. In publications with indirect measurement, the score in each dimension was considered. Similarly, moderate-to-vigorous PA (MVPA) was considered as the main outcome in articles with direct measurement. RESULTS: A total of 1103 articles were found, and 16 primary articles were considered. Eight articles evaluated PA with indirect methods, six with direct methods and two used both methods, representing 1649 subjects evaluated. It was found that 46% of children with CHD do not exceed WHO recommendations for MVPA, with no differences depending on the severity of CHD. CONCLUSION: There are a variety of ways to measure PA in children with CHD. In the articles that objectively evaluated PA, the most measured outcome was the MVPA, which shows that the MVPA time was shorter in about half of the children with CHD than what is recommended by WHO.

Consenso chileno de técnicas de kinesiología respiratoria en pediatría / Chilean consensus about pediatric chest physioterapy

Chest physiotherapy is currently an outstanding therapeutic tool for the management of pediatric respiratory patients. Many and varied techniques, manual and assisted, have been developed, some requiring patient collaboration. The development of knowledge and the pathophysiological understanding of respiratory diseases in recent years has generated the need to agree on the terminology, the fundamentals and the application of each of the kinesthetic techniques of respiratory treatment in the pediatric field. The objective of this document was to compile the available literature related to the physiological mechanisms, indications, procedural aspects and most frequently used techniques in our country, with the purpose of being a guideline for the clinical practice of professionals and students. The following techniques were included: prolonged slow expiration, slow expiration with glottis opened, autogenic drainage, assisted autogenic drainage, active cycle, compression/decompression, airway clearance, forced expiration techniques, cough and respiratory exercises.

La kinesiología respiratoria es actualmente una herramienta terapéutica destacada para el manejo de los pacientes respiratorios pediátricos. Se han desarrollado muchas y variadas técnicas, manuales y asistidas, algunas requiriendo colaboración del paciente. El desarrollo del conocimiento y la comprensión fisiopatológica de las enfermedades respiratorias en los últimos años ha generado la necesidad de consensuar la terminología, los fundamentos y la aplicación de cada una de las técnicas kinésicas de tratamiento respiratorio en el ámbito pediátrico. El objetivo de este documento fue recopilar la literatura disponible relacionada con los mecanismos fisiológicos, indicaciones, aspectos procedimentales y técnicas más utilizadas en nuestro país, con el propósito de ser una directriz que oriente la práctica clínica de profesionales y estudiantes en formación. Se incluyeron así las siguientes técnicas: espiración lenta prolongada, espiración lenta con glotis abierta, drenaje autógeno, drenaje autógeno asistido, ciclo activo, presión/descompresión, bloqueos torácicos, técnicas de espiración forzada, tos y ejercicios respiratorios.