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Medicine (Baltimore) ; 100(4): e23532, 2021 Jan 29.
Artigo em Inglês | MEDLINE | ID: mdl-33530160


BACKGROUND: Baduanjin is an ancient technique of physical and breathing exercises (Dao Yin). This technique is divided into eight sections and each section is a motion, so it is called "Baduanjin". It is practice without equipment, simple and easy to learn, whose effect is significant leading to good fitness effect. Diabetes mellitus is a chronic metabolic disease. Clinical studies have reported that Baduanjin can affect the metabolism of blood glucose and blood lipid in diabetic patients, but the reported efficacy is different among different studies. Therefore, the study is aimed to systematically evaluate the size and differences of the impact of Baduanjin on the metabolism of glucose and lipid in diabetic patients. METHODS: Retrieved randomized controlled trials(RCTs) on effects of Baduanjin on glucose and lipid metabolism in diabetic patients from PubMed, Web of Science, the Cochrane Library, Embase, CNKI with computer while mutually retrieved the same things from Chinese Clinical Trial Registry(ChiCTR), Google Academic and Baidu Academic. The retrieval time was from their establishment to October 2020. Then 2 researchers independently extracted relevant data and evaluated the quality of the included literatures, and meta-analysis was conducted on the included literatures using RevMan5.3. RESULTS: This research used outcome indicators like fasting blood glucose, postprandial blood glucose, glycosylated hemoglobin, total cholesterol content and triglyceride content to explore the effect of Baduanjin on glucose and lipid metabolism in diabetic patients specifically. CONCLUSION: The research will provide reliable evidence-based proof for Baduanjin improving glucose and lipid metabolism of diabetic patients. ETHICS AND DISSEMINATION: Private information from individuals will not be published. This systematic review also does not involve endangering participant rights. Ethical approval was not required. The results may be published in a peer-reviewed journal or disseminated at relevant conferences. OSF REGISTRATION NUMBER: DOI 10.17605/ OSF.IO/AGJHQ.

Glicemia/metabolismo , Exercícios Respiratórios/métodos , Diabetes Mellitus/terapia , Metabolismo dos Lipídeos/fisiologia , Medicina Tradicional Chinesa/métodos , Diabetes Mellitus/sangue , Humanos , Metanálise como Assunto , Ensaios Clínicos Controlados Aleatórios como Assunto , Projetos de Pesquisa , Revisões Sistemáticas como Assunto , Resultado do Tratamento
Inflamm Res ; 70(2): 241-247, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-33385239


OBJECTIVES: To investigate the relationship between the dynamic changes of serum 2019-nCoV IgM/IgG and immunity alteration for patients after 6-month hospital discharge. METHODS: One IgM(+) and IgG(-), 32 IgM(+) and IgG(+), 38 IgM(-) and IgG(+), and 40 IgM(-) and IgG(-) patients were included. Demographic data were collected. IgM and IgG antibodies, hypersensitive C-reactive protein (hs-CRP), interleukin-6 (IL-6) and lymphocyte subsets in serum were determined at weeks 0, 2 and 4. RESULTS: The hs-CRP and IL-6 levels of all patients were within the normal ranges. The number of patients with all lymphocyte subset testing items within normal ranges was 12/110 (10.9%) at week 0, 15/110 (13.6%) at week 2 and 18/110 (16.4%) at week 4. The percentages of CD8 + cells, NK cells and B lymphocytes in the IgM(+) and IgG(+) group were quite different from those in the IgM(-) and IgG(+) group and the IgM(-) and IgG(-) group, with much higher percentages of CD8 + cells and much lower percentages of NK cells and B lymphocytes at weeks 0, 2 and 4. Twelve IgM(+) patients in the IgM(+) and IgG(+) group converted to IgM(-), and the percentages of NK cells and B lymphocytes in these patients were significantly increased at week 4. CONCLUSIONS: The changes of serum IgM and IgG are closely related to immunity in patients in the recovery stage. However, immunity does not recover when the patients test negative for these antibodies.

Anticorpos Antivirais/sangue , /imunologia , Imunoglobulina G/sangue , Imunoglobulina M/sangue , /imunologia , Adulto , Idoso , Linfócitos B/imunologia , Exercícios Respiratórios , Linfócitos T CD8-Positivos/imunologia , Feminino , Humanos , Células Matadoras Naturais/imunologia , Contagem de Linfócitos , Masculino , Medicina Tradicional Chinesa , Pessoa de Meia-Idade , Alta do Paciente , Adulto Jovem
Rev. bras. cancerol ; 67(1): e-101211, 2021.
Artigo em Português | LILACS | ID: biblio-1147123


Introdução: A fisioterapia pré-operatória em pacientes oncológicos tem papel fundamental para redução das complicações pós-operatórias. Sabe-se que a avaliação pré-operatória identifica os fatores de risco e é decisiva na redução do desenvolvimento de tais complicações. Objetivo: Verificar o efeito da cinesioterapia pré-operatória e do treino muscular inspiratório nas complicações pulmonares pós-operatórias em pacientes oncológicos. Método: Trinta pacientes foram divididos aleatoriamente em grupo cinesioterapia, grupo treinamento muscular inspiratório e grupo controle, com dez participantes em cada grupo. Foram realizadas avaliação da força muscular respiratória, teste de caminhada de seis minutos e força muscular periférica. Foi utilizado o teste de Wilcoxon para comparação pré e pós-tratamento. Também foi realizado o teste Kruskal Wallis para comparação do resultado pós-tratamento e o teste qui-quadrado para variáveis categóricas. Utilizou--se o teste de Cohen (d) para identificação do tamanho do efeito. Resultados: Nove (90%) indivíduos do grupo controle apresentaram complicações, enquanto, nos grupos cinesioterapia e de treinamento muscular inspiratório, as complicações foram observadas em dois (20%) e três (30%) pacientes, respectivamente. As pressões inspiratória máxima (PImáx) e expiratória máxima (PEmáx) no treinamento muscular inspiratório e a PImáx no grupo cinesioterapia demonstraram impacto clínico quando comparados ao grupo controle. Conclusão: A cinesioterapia e o treinamento muscular inspiratório impactaram na redução das complicações pós-operatórias das cirurgias oncológicas.

Introduction: Preoperative physiotherapy in cancer patients plays a fundamental role in reducing postoperative complications. It is known that the preoperative assessment identifies risk factors and is critical in reducing the development of such complications. Objective: Identify the effect of preoperative kinesiotherapy and inspiratory muscle training on postoperative pulmonary complications in cancer patients. Method: Thirty patients were randomly divided into a kinesiotherapy group, inspiratory muscle training group and control group, with 10 participants in each group. Respiratory muscle strength assessment, 6-minute walk test and peripheral muscle strength were performed. The Wilcoxon test was used for comparison before and after treatment. The Kruskal Wallis test was also performed to compare the post-treatment result and the Chi-square test for categorical variables. The Cohen test (d) was also performed to identify the effect size. Results: Nine (90%) individuals in the control group had complications, while in the kinesiotherapy and inspiratory muscle training groups, complications were observed in two (20%) and three (30%) patients, respectively. Maximum inspiratory pressure (MIP) and maximum expiratory pressure (MEP) in inspiratory muscle training and MIP in the kinesiotherapy group demonstrated clinical impact when compared to the control group. Conclusion: Kinesiotherapy and inspiratory muscle training impacted the reduction of postoperative complications of oncology surgeries.

Introducción: La fisioterapia preoperatoria en pacientes oncológicos tiene un papel fundamental en la reducción de las complicaciones posoperatorias. Se sabe que la evaluación preoperatoria identifica factores de riesgo y es decisiva para reducir el desarrollo de tales complicaciones. Objetivo: Verificar el efecto de la kinesioterapia preoperatoria y el entrenamiento de los músculos inspiratorios sobre las complicaciones pulmonares postoperatorias en pacientes con cáncer. Método: Treinta pacientes fueron divididos aleatoriamente en un grupo de kinesioterapia, un grupo de entrenamiento de los músculos inspiratorios y un grupo de control, con diez participantes en cada grupo. Se realizó una evaluación de la fuerza de los músculos respiratorios, la prueba de marcha de seis minutos y la fuerza de los músculos periféricos. Se utilizó la prueba de Wilcoxon para comparar antes y después del tratamiento. También se realizó la prueba de Kruskal Wallis para comparar el resultado postratamiento y la prueba de chi-cuadrado para variables categóricas. También se realizó la prueba de Cohen (d) para identificar el tamaño del efecto. Resultados: Nueve (90%) individuos en el grupo de control tuvieron complicaciones, mientras, en los grupos de kinesioterapia y entrenamiento de los músculos inspiratorios, se observaron complicaciones en dos (20%) y tres (30%) pacientes, respectivamente. Las presiones inspiratorias (MIP) y espiratorias máximas (MEP) en el entrenamiento de los músculos inspiratorios y MIP en el grupo de kinesioterapia demostraron un impacto clínico en comparación con el grupo de control. Conclusión: La kinesioterapia y el entrenamiento de los músculos inspiratorios impactaron en la reducción de las complicaciones posoperatorias de las cirugías oncológicas

Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Cuidados Pré-Operatórios , Modalidades de Fisioterapia , Neoplasias/complicações , Exercícios Respiratórios/efeitos adversos , Neoplasias/cirurgia
Medicine (Baltimore) ; 99(51): e23646, 2020 Dec 18.
Artigo em Inglês | MEDLINE | ID: mdl-33371099


ABSTRACT: This study identified the effects of pursed-lip breathing (PLB), forward trunk lean posture (FTLP), and combined PLB and FTLP on total and compartmental lung volumes, and ventilation in patients with chronic obstructive pulmonary disease (COPD). Sixteen patients with mild to moderate COPD performed 2 breathing patterns of quiet breathing (QB) and PLB during FTLP and upright posture (UP). The total and compartmental lung volumes and ventilation of these 4 tasks (QB-UP, PLB-UP, QB-FTLP, PLB-FTLP) were evaluated using optoelectronic plethysmography. Two-way repeated measures ANOVA was used to identify the effect of PLB, FTLP, and combined strategies on total and compartmental lung volumes and ventilation. End-expiratory lung volume of ribcage compartment was significantly lower in PLB-UP than QB-UP and those with FTLP (P < .05). End-inspiratory lung volume (EILV) and end-inspiratory lung volume of ribcage compartment were significantly greater during PLB-FTLP and PLB-UP than those of QB (P < .05). PLB significantly and positively changed end-expiratory lung volume of abdominal compartment (EELVAB ) end-expiratory lung volume, EILVAB, tidal volume of pulmonary ribcage, tidal volume of abdomen, and ventilation than QB (P < .05). UP significantly increased tidal volume of pulmonary ribcage, tidal volume of abdomen, and ventilation and decreased EELVAB, end-expiratory lung volume, and EILVAB than FTLP (P < .05). In conclusion, combined PLB with UP or FTLP demonstrates a positive change in total and compartmental lung volumes in patients with mild to moderate COPD.

Exercícios Respiratórios , Postura , Doença Pulmonar Obstrutiva Crônica/reabilitação , Ventilação Pulmonar , Terapia Respiratória/métodos , Idoso , Estudos Transversais , Humanos , Medidas de Volume Pulmonar , Pessoa de Meia-Idade
Cochrane Database Syst Rev ; 12: CD006112, 2020 12 17.
Artigo em Inglês | MEDLINE | ID: mdl-33331663


BACKGROUND: Cystic fibrosis is the most common autosomal recessive disease in white populations, and causes respiratory dysfunction in the majority of individuals. Numerous types of respiratory muscle training to improve respiratory function and health-related quality of life in people with cystic fibrosis have been reported in the literature. Hence a systematic review of the literature is needed to establish the effectiveness of respiratory muscle training (either inspiratory or expiratory muscle training) on clinical outcomes in cystic fibrosis. This is an update of a previously published review. OBJECTIVES: To determine the effectiveness of respiratory muscle training on clinical outcomes in people with cystic fibrosis. SEARCH METHODS: We searched the Cochrane Cystic Fibrosis and Genetic Disorders Group Trials register comprising of references identified from comprehensive electronic database searches and handsearches of relevant journals and abstract books of conference proceedings. Date of most recent search: 11 June 2020. A hand search of the Journal of Cystic Fibrosis and Pediatric Pulmonology was performed, along with an electronic search of online trial databases. Date of most recent search: 05 October 2020. SELECTION CRITERIA: Randomised controlled studies comparing respiratory muscle training with a control group in people with cystic fibrosis. DATA COLLECTION AND ANALYSIS: Review authors independently selected articles for inclusion, evaluated the methodological quality of the studies, and extracted data. Additional information was sought from trial authors where necessary. The quality of the evidence was assessed using the GRADE system. MAIN RESULTS: Authors identified 20 studies, of which 10 studies with 238 participants met the review's inclusion criteria. There was wide variation in the methodological and written quality of the included studies. Four of the 10 included studies were published as abstracts only and lacked concise details, thus limiting the information available. Eight studies were parallel studies and two of a cross-over design. Respiratory muscle training interventions varied dramatically, with frequency, intensity and duration ranging from thrice weekly to twice daily, 20% to 80% of maximal effort, and 10 to 30 minutes, respectively. Participant numbers ranged from 11 to 39 participants in the included studies; five studies were in adults only, one in children only and four in a combination of children and adults. No differences between treatment and control were reported in the primary outcome of pulmonary function (forced expiratory volume in one second and forced vital capacity) or postural stability (very low-quality evidence). Although no change was reported in exercise capacity as assessed by the maximum rate of oxygen use and distance completed in a six minute walk test, a 10% improvement in exercise duration was found when working at 60% of maximal effort in one study (n = 20) (very low-quality evidence). In a further study (n = 18), when working at 80% of maximal effort, health-related quality of life improved in the mastery and emotion domains (very low-quality evidence). With regards to the review's secondary outcomes, one study (n = 11) found a change in intramural pressure, functional residual capacity and maximal inspiratory pressure following training (very low-quality evidence). Another study (n=36) reported improvements in maximal inspiratory pressure following training (P < 0.001) (very low-quality evidence). A further study (n = 22) reported that respiratory muscle endurance was longer in the training group (P < 0.01). No studies reported significant differences on any other secondary outcomes. Meta-analyses could not be performed due to a lack of consistency and insufficient detail in reported outcome measures. AUTHORS' CONCLUSIONS: There is insufficient evidence to suggest whether this intervention is beneficial or not. Healthcare practitioners should consider the use of respiratory muscle training on a case-by-case basis. Further research of reputable methodological quality is needed to determine the effectiveness of respiratory muscle training in people with cystic fibrosis. Researchers should consider the following clinical outcomes in future studies; respiratory muscle function, pulmonary function, exercise capacity, hospital admissions, and health-related quality of life. Sensory-perceptual changes, such as respiratory effort sensation (e.g. rating of perceived breathlessness) and peripheral effort sensation (e.g. rating of perceived exertion) may also help to elucidate mechanisms underpinning the effectiveness of respiratory muscle training.

Exercícios Respiratórios/métodos , Fibrose Cística/terapia , Inalação/fisiologia , Músculos Respiratórios/fisiologia , Adulto , Criança , Fluxo Expiratório Forçado , Humanos , Qualidade de Vida , Ensaios Clínicos Controlados Aleatórios como Assunto , Capacidade Vital
Trials ; 21(1): 1023, 2020 Dec 14.
Artigo em Inglês | MEDLINE | ID: mdl-33317615


BACKGROUND: The prevalence of mental health disorders is increasing globally, and the prevalence of COVID-19 has made it worse. Evidence has indicated a major mental health burden and elevated anxiety associated with the new coronavirus outbreak in the general population. This study aims to evaluate an evidence-based web application (Naranj) for stress management among Iranian college students. METHODS AND DESIGN: This study aims to present a protocol related to a randomized controlled trial among Iranian college students. The study will be conducted on 100 students from two colleges of Shiraz University of Medical Sciences in Iran. The participants will be randomly assigned to the intervention and control groups. The intervention group participants will be provided with a web application, whereas the control group ones will be provided with an app unrelated to stress management. The primary outcome for this study will be the Perceived Stress Scale, and the two groups will be compared with respect to stress level and sleep quality. DISCUSSION: A web application will be developed according to psychological theories and will be scientifically approved for managing college students' stress and improving their sleep quality during the COVID-19 outbreak. TRIAL REGISTRATION: Iranian Registry of Clinical Trials IRCT20160427027647N2 . Registered on 14 May 2020.

Intervenção Baseada em Internet , Estresse Psicológico/terapia , Estudantes/psicologia , Terapia de Aceitação e Compromisso , Adulto , Exercícios Respiratórios , Medicina Baseada em Evidências , Humanos , Irã (Geográfico) , Ensaios Clínicos Controlados Aleatórios como Assunto , Terapia de Relaxamento , Sono , Estresse Psicológico/psicologia , Resultado do Tratamento , Universidades , Adulto Jovem
Cochrane Database Syst Rev ; 10: CD013400, 2020 10 28.
Artigo em Inglês | MEDLINE | ID: mdl-33112424


BACKGROUND: Congenital heart disease (ConHD) affects approximately 1% of all live births. People with ConHD are living longer due to improved medical intervention and are at risk of developing non-communicable diseases. Cardiorespiratory fitness (CRF) is reduced in people with ConHD, who deteriorate faster compared to healthy people. CRF is known to be prognostic of future mortality and morbidity: it is therefore important to assess the evidence base on physical activity interventions in this population to inform decision making. OBJECTIVES: To assess the effectiveness and safety of all types of physical activity interventions versus standard care in individuals with congenital heart disease. SEARCH METHODS: We undertook a systematic search on 23 September 2019 of the following databases: CENTRAL, MEDLINE, Embase, CINAHL, AMED, BIOSIS Citation Index, Web of Science Core Collection, LILACS and DARE. We also searched and we reviewed the reference lists of relevant systematic reviews. SELECTION CRITERIA: We included randomised controlled trials (RCT) that compared any type of physical activity intervention against a 'no physical activity' (usual care) control. We included all individuals with a diagnosis of congenital heart disease, regardless of age or previous medical interventions.  DATA COLLECTION AND ANALYSIS: Two review authors (CAW and CW) independently screened all the identified references for inclusion. We retrieved and read all full papers; and we contacted study authors if we needed any further information. The same two independent reviewers who extracted the data then processed the included papers, assessed their risk of bias using RoB 2 and assessed the certainty of the evidence using the GRADE approach. The primary outcomes were: maximal cardiorespiratory fitness (CRF) assessed by peak oxygen consumption; health-related quality of life (HRQoL) determined by a validated questionnaire; and device-worn 'objective' measures of physical activity. MAIN RESULTS: We included 15 RCTs with 924 participants in the review. The median intervention length/follow-up length was 12 weeks (12 to 26 interquartile range (IQR)). There were five RCTs of children and adolescents (n = 500) and 10 adult RCTs (n = 424). We identified three types of intervention: physical activity promotion; exercise training; and inspiratory muscle training. We assessed the risk of bias of results for CRF as either being of some concern (n = 12) or at a high risk of bias (n = 2), due to a failure to blind intervention staff. One study did not report this outcome. Using the GRADE method, we assessed the certainty of evidence as moderate to very low across measured outcomes. When we pooled all types of interventions (physical activity promotion, exercise training and inspiratory muscle training), compared to a 'no exercise' control CRF may slightly increase, with a mean difference (MD) of 1.89 mL/kg-1/min-1 (95% CI -0.22 to 3.99; n = 732; moderate-certainty evidence). The evidence is very uncertain about the effect of physical activity and exercise interventions on HRQoL. There was a standardised mean difference (SMD) of 0.76 (95% CI -0.13 to 1.65; n = 163; very low certainty evidence) in HRQoL. However, we could pool only three studies in a meta-analysis, due to different ways of reporting. Only one study out of eight showed a positive effect on HRQoL. There may be a small improvement in mean daily physical activity (PA) (SMD 0.38, 95% CI -0.15 to 0.92; n = 328; low-certainty evidence), which equates to approximately an additional 10 minutes of physical activity daily (95% CI -2.50 to 22.20). Physical activity and exercise interventions likely result in an increase in submaximal cardiorespiratory fitness (MD 2.05, 95% CI 0.05 to 4.05; n = 179; moderate-certainty evidence). Physical activity and exercise interventions likely increase muscular strength (MD 17.13, 95% CI 3.45 to 30.81; n = 18; moderate-certainty evidence). Eleven studies (n = 501) reported on the outcome of adverse events (73% of total studies). Of the 11 studies, six studies reported zero adverse events. Five studies reported a total of 11 adverse events; 36% of adverse events were cardiac related (n = 4); there were, however, no serious adverse events related to the interventions or reported fatalities (moderate-certainty evidence). No studies reported hospital admissions. AUTHORS' CONCLUSIONS: This review summarises the latest evidence on CRF, HRQoL and PA. Although there were only small improvements in CRF and PA, and small to no improvements in HRQoL, there were no reported serious adverse events related to the interventions. Although these data are promising, there is currently insufficient evidence to definitively determine the impact of physical activity interventions in ConHD. Further high-quality randomised controlled trials are therefore needed, utilising a longer duration of follow-up.

Exercícios Respiratórios , Aptidão Cardiorrespiratória/fisiologia , Exercício Físico/fisiologia , Cardiopatias Congênitas/reabilitação , Adolescente , Adulto , Viés , Criança , Feminino , Humanos , Masculino , Força Muscular , Consumo de Oxigênio/fisiologia , Qualidade de Vida , Ensaios Clínicos Controlados Aleatórios como Assunto
Fisioterapia (Madr., Ed. impr.) ; 42(5): 260-266, sept.-oct. 2020. graf, tab
Artigo em Espanhol | IBECS | ID: ibc-195142


ANTECEDENTES Y OBJETIVO: El envejecimiento implica una reducción de la masa muscular y la fuerza muscular. El objetivo del estudio fue valorar la efectividad de un protocolo de ejercicios específicos de facilitación neuromuscular propioceptiva (FNP) sobre la fuerza muscular respiratoria. MATERIAL Y MÉTODO: Estudio experimental con 69 mujeres mayores no institucionalizadas y voluntarias participantes en un programa de ejercicio físico. Fueron divididas aleatorizadamente en 2 grupos. El grupo intervención recibió un protocolo de tratamiento respiratorio específico basado en metodología de la FNP con 2 sesiones semanales de 50 min durante 8 semanas. El grupo control no recibió intervención adicional. Se evaluó la fuerza de la musculatura respiratoria mediante la presión inspiratoria máxima (PIM) y la presión espiratoria máxima (PEM). RESULTADOS: Se registró un aumento estadísticamente significativo (p < 0,001) y clínicamente relevante en el grupo de intervención en la PIM 13,84mb (IC 95%: 9,017-18,671) y la PEM 25,69 mb (IC 95%: 20,373-31,002). Se obtuvieron diferencias con significación estadística entre los grupos: PIM 20,00mb (IC 95%: 11,13-28,88; p < 0,001) y PEM 27 mb (IC 95%: 19,75-35,012; p < 0,001). CONCLUSIÓN: El trabajo muscular respiratorio específico con FNP mejoró las presiones respiratorias, lo que puede mejorar la fuerza y la función respiratorias en adultos mayores. Este tratamiento puede utilizarse como una intervención preventiva para minimizar las implicaciones del envejecimiento sobre la pérdida de masa y fuerza muscular

BACKGROUND AND OBJECTIVE: Aging results in reduced muscle mass and strength. The aim was to evaluate the effectiveness of a proprioceptive neuromuscular facilitation (PNF) exercise protocol on respiratory muscle strength. MATERIAL AND METHODS: An experimental study of 69 elderly, non-institutionalized female volunteers who participated in a physical exercise programme. They were randomly divided into 2 groups. The intervention group performed a specific respiratory treatment protocol using the PNF technique. The control group did not receive an additional intervention. The PNF treatment consisted of 2 weekly sessions lasting 50 minutes over an 8-week time period. Respiratory muscle strength was measured for both groups by maximal inspiratory pressure (MIP) and maximal expiratory pressure (MEP). RESULTS: There was a statistically significant (P <. 001) and clinically relevant increase in the intervention group in MIP 13.84 mb (95% CI: 9.017-18.671) and MEP 25.69 mb (95%CI: 20.373-31.002). There was also a statistically significant difference between groups: MIP 20.00 mb (95% CI: 11.13-28.88; P < .001) and PEM 27mb (95% CI: 19.75-35.012; P < .001). CONCLUSIONS: The PNF respiratory treatment improved respiratory pressures, which may improve respiratory strength and function in older adults. This treatment can be used as prevention to minimize the loss of muscle mass and strength as a result of aging

Humanos , Feminino , Idoso , Idoso de 80 Anos ou mais , Exercícios Respiratórios/instrumentação , Atenção Primária à Saúde , Força Muscular/fisiologia , Exercícios Respiratórios/métodos , Saúde do Idoso
Spinal Cord Ser Cases ; 6(1): 87, 2020 09 17.
Artigo em Inglês | MEDLINE | ID: mdl-32943611


INTRODUCTION: Respiratory complications (RC) are a leading cause of death after spinal cord injury (SCI) due to compromised immune function and respiratory muscle weakness. Thus, individuals with SCI are at high risk of developing COVID-19 related RC. Results of a SCI clinical trial showed a supervised respiratory muscle training (RMT) program decreased risk of developing RC. The feasibility of conducting unsupervised RMT is not well documented. Four publications (n = 117) were identified in which unsupervised RMT was performed. Significant improvements in respiratory outcomes were reported in two studies: Maximal Inspiratory and Expiratory Pressure (MIP40% and MEP25%, respectively), Peak Expiratory Flow (PEF9%), seated and supine Forced Vital Capacity (FVC23% and 26%, respectively), and Peak Cough Flow (28%). This review and case report will attempt to show that an inspiratory muscle training (IMT) home exercise program (HEP) is feasible and may prepare the respiratory system for RC associated with COVID-19 in patients with SCI. CASE PRESENTATION: A 23-year-old with tetraplegia (P1), history of mechanical ventilation, and hospitalization for RC, completed 27 IMT HEP sessions in one month. MIP and sustained MIP (SMIP) increased from baseline by 28% and 26.5%, respectively. Expiratory volumes and rates also improved (FVC, FEV1, and PEF: 11.7%, 8.3%, and 14.2%, respectively). DISCUSSION: The effects of COVID-19 on patients with SCI remains inconclusive, but recent literature and the results of this case suggest that unsupervised IMT is feasible and may limit the severity of RC in patients with SCI who contract COVID-19.

Betacoronavirus , Exercícios Respiratórios/métodos , Infecções por Coronavirus/prevenção & controle , Inalação/fisiologia , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Infecções Respiratórias/prevenção & controle , Traumatismos da Medula Espinal/terapia , Infecções por Coronavirus/fisiopatologia , Humanos , Masculino , Pneumonia Viral/fisiopatologia , Quadriplegia/complicações , Quadriplegia/fisiopatologia , Quadriplegia/terapia , Infecções Respiratórias/fisiopatologia , Traumatismos da Medula Espinal/complicações , Traumatismos da Medula Espinal/fisiopatologia , Adulto Jovem
J Sports Med Phys Fitness ; 60(8): 1101-1109, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32955836


BACKGROUND: Minimizing the energy required for breathing muscles is based on the adaptation of the respiratory muscles which is reflected in the reduction of breathing frequency (BF) and tidal volume (VT) increase. This may be influenced through a targeted BE and the quality of breathing may be linked to endurance performance. Aim of this study was assess dynamic ventilation parameters at different load intensities and their changes due to the systematic breathing exercise (BE). METHODS: Study recruit 36 runners of both sexes with a mean age 16.8±1.6 years. A random distribution was performed. The intervention program consisted of a set of BE aimed at the activation of the diaphragm. We monitored the dynamics of ventilation parameters at intensities 2, 3, 4 W/kg during a stepped test on a bicycle ergometer. RESULTS: The BE was focused on the activation of the diaphragm for a 12.2±3.6 minutes per day, sixteen weeks. After eight weeks, there were significant changes in VT and BF (P<0.05). After sixteen weeks there was a significant increase in VT of 5.7-18.3% (P<0.01), depending on the load level, BF values decreased significantly by 5.4-14.4% (P<0.01). VE and VO2 values were without changes. There were no significant changes in the control group. CONCLUSIONS: It was confirmed that the two-month BE intervention focused on the activation of the diaphragm is sufficient and resulted in a significant change in the values of dynamic ventilation parameters. After four months of intervention, the changes are significantly greater compared with values found after a two-month intervention period.

Exercícios Respiratórios/métodos , Resistência Física/fisiologia , Respiração , Músculos Respiratórios/fisiologia , Adolescente , Diafragma/fisiologia , Teste de Esforço , Feminino , Humanos , Masculino , Corrida/fisiologia , Volume de Ventilação Pulmonar
Medicine (Baltimore) ; 99(37): e22109, 2020 Sep 11.
Artigo em Inglês | MEDLINE | ID: mdl-32925755


BACKGROUND: Patients with the Corona Virus Disease 2019 (COVID-19) often see their respiratory, physical, and psychological functions impaired to varying degrees, especially for the elderly patients. Timely respiratory rehabilitation intervention for such patients may improve their prognoses. However, its relative effectiveness has not been proved. Therefore, this study is purposed to determine the effect of respiratory rehabilitation on elderly patients with COVID-19. METHODS: This study will search the following electronic databases: Embase, MEDLINE, PubMed, Cochrane Library, China national knowledge infrastructure database, Wan Fang database, Chinese Science and Technology Periodical Database, and Chinese Biomedical Literature Database, with the retrieval period running from their inception to August 2020. All randomized controlled trials of respiratory rehabilitation training on elderly patients with COVID-19 are collected, and the data are selected and extracted independently according to the pre-designed inclusion/exclusion criteria. Cochrane bias risk assessment tool is used to evaluate the method quality and bias risk. All data analyses will be implemented by using Revman5.3 and Stata14 software. RESULTS: This study will make a high-quality and comprehensive evaluation of the efficacy of respiratory rehabilitation training on elderly patients with COVID-19. CONCLUSION: The conclusions of this systematic review will deliver more convincing evidence. ETHICS AND DISSEMINATION: The private information collected from individuals will not be published. And this systematic review will also not involve impairing the participants' rights. Ethical approval is not required. The results may be published in a peer-reviewed journal or disseminated in relevant conferences.

Exercícios Respiratórios , Infecções por Coronavirus , Pandemias , Pneumonia Viral , Sistemas de Apoio Psicossocial , Idoso , Betacoronavirus , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/psicologia , Infecções por Coronavirus/reabilitação , Humanos , Metanálise como Assunto , Pneumonia Viral/epidemiologia , Pneumonia Viral/psicologia , Pneumonia Viral/reabilitação , Prognóstico , Projetos de Pesquisa , Revisões Sistemáticas como Assunto , Resultado do Tratamento
Hosp. domic ; 4(3): 133-152, jul.-sept. 2020. ilus, tab, graf
Artigo em Espanhol | IBECS | ID: ibc-192943


PROPÓSITO: Ante la crisis sanitaria que vive el país y el mundo actualmente, se confeccionó este documento por la iniciativa autónoma de kinesiólogos de doce unidades de Hospitalización Domiciliaria (HD) de hospitales públicos de Chile, con el fin de unificar criterios en base a sus experiencias y la evidencia científica disponible para poder realizar una atención kinésica respiratoria segura en pacientes con sospecha o confirmados para COVID-19. Además, este documento tiene el objetivo de ser una guía para quienes tengan la necesidad de protocolizar y/o estandarizar su atención en HD, pudiendo ser adaptado según la necesidad y disponibilidad de recursos e infraestructura de cada unidad. Es importante señalar, que este documento puede variar según la evolución de esta pandemia y la actualización de la evidencia científica. CAMPO DE APLICACIÓN: Este documento está diseñado para ser aplicado en el domicilio de los pacientes adultos y pediátricos ingresados a las Unidades de Hospitalización Domiciliaria (UHD) con sospecha de infección por SARS-CoV-2 o con resultado positivo para COVID-19

PURPUSE: Given the health crisis that the country and the world are currently experiencing, this document was prepared by the autonomous initiative of kinesiologists from twelve Hospital at Home units of public hospitals in Chile, in order to unify criteria based on their experiences and the available scientific evidence in order to carry out safe respiratory physiotherapy care in patients with suspected or confirmed COVID-19. In addition, this document is intended to be a guide for those who need to protocolize and / or standardize their care at Hospital at home, and can be adapted according to the need and availability of resources and infrastructure of each unit. It is important to note that this document may vary depending on the evolution of this pandemic and the updating of scientific evidence. SCOPE: This document is designed to be applied in the home of adult and pediatric patients admitted to Hospital at Home Units (UHD) with suspected SARS-CoV-2 infection or with a positive result for COVID-19

Humanos , Exercícios Respiratórios/métodos , Síndrome Respiratória Aguda Grave/reabilitação , Vírus da SARS/patogenicidade , Infecções por Coronavirus/epidemiologia , Modalidades de Fisioterapia/organização & administração , Serviços Hospitalares de Assistência Domiciliar/organização & administração , Controle de Doenças Transmissíveis/métodos , Ventilação não Invasiva/estatística & dados numéricos , Precauções Universais/métodos , Guias como Assunto
Rehabilitación (Madr., Ed. impr.) ; 54(3): 191-199, jul.-sept. 2020.
Artigo em Espanhol | IBECS | ID: ibc-196735


Los programas de rehabilitación pulmonar están diseñados para promover la capacidad aeróbica y el mejoramiento de la calidad de vida de pacientes con deficiencias pulmonares crónicas, facilitando la participación y la integración en sus diferentes áreas de desempeño y en las actividades de la vida diaria mediante la prescripción y la ejecución de ejercicio físico, así como la educación relacionada con los factores de riesgo y vida saludable. Se considera un proceso multidisciplinar donde interactúan diferentes profesionales del área de la salud que durante el acompañamiento al paciente a través de su proceso de rehabilitación tienen como objetivo orientar cambios en su estilo de vida encaminados a mejorar los niveles de actividad física, los factores nutricionales, el ejercicio y el manejo de la diabetes, disminuir el peso corporal y lograr adherencia a los medicamentos y la cesación de tabaco, basados en las teorías del cambio comportamental. El objetivo principal de los programas de rehabilitación pulmonar es empoderar al usuario de su autocuidado y facilitar el manejo de la enfermedad pulmonar crónica

Pulmonary rehabilitation programmes aim to improve aerobic capacity and enhance quality of life in patients with chronic pulmonary disease, facilitating their participation and integration in different areas and activities of daily living, through the prescription and performance of physical exercise, as well as education on risk factors and healthy living. In multidisciplinary processes, various health professionals work together to support patients through the rehabilitation process, guiding lifestyle changes to improve their level of physical activity, nutritional factors, smoking cessation, diabetes management, medication adherence and weight loss, based on theories of behavioural change. The main objective of pulmonary rehabilitation programmes is to empower users in self-care and facilitate long-term management of chronic lung disease

Humanos , Doença Pulmonar Obstrutiva Crônica/reabilitação , Pneumopatias/reabilitação , Exercícios Respiratórios/métodos , Modalidades de Fisioterapia , Capacidade Pulmonar Total/fisiologia , Avaliação de Resultado de Intervenções Terapêuticas
PLoS One ; 15(8): e0237010, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32780739


This study analyzed the physiological adjustments caused by the use of the Elevation training mask® (2.0), an airflow restriction mask (ARM) during continuous exercise. Eighteen physically active participants (12 men and 6 women) were randomized to two protocols: continuous exercise with mask (CE-ARM) and continuous exercise without mask (CE). Exercise consisted of cycling for 20 minutes at 60% of maximum power. Metabolic variables, lactate, and gas concentration were obtained from arterialized blood samples at pre and post exercise. Continuous expired gases and myoelectric activity of the quadriceps were performed at rest and during the test. We observed no reduction in oxygen saturation in CE-ARM, leading to lower pH, higher carbon dioxide, and greater hematocrit (all p <0.05). The expired gas analysis shows that the CE-ARM condition presented higher oxygen uptake and expired carbon dioxide concentrations (p <0.05). The CE-ARM condition also presented lower ventilatory volume, ventilatory frequency, and expired oxygen pressure (p <0.05). No changes in electromyography activity and lactate concentrations were identified. We conclude that using ARM does not induce hypoxia and represents an additional challenge for the control of acid-base balance, and we suggest the use of ARM as being suitable for respiratory muscle training.

Exercício Físico/fisiologia , Consumo de Oxigênio/fisiologia , Ventilação Pulmonar/fisiologia , Adulto , Exercícios Respiratórios/métodos , Dióxido de Carbono/sangue , Teste de Esforço/métodos , Feminino , Voluntários Saudáveis , Humanos , Hipóxia/metabolismo , Pulmão/metabolismo , Masculino , Máscaras , Oxigênio/sangue , Respiração , Testes de Função Respiratória
Ann Palliat Med ; 9(5): 3100-3106, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32787373


BACKGROUND: Coronavirus disease 2019 (COVID-19) caused by a new Betacoronavirus severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is currently a global pandemic. Gathered clinicopathological evidence in COVID-19 patients shows that alveoli injuries and interstitial changes are the major mechanisms of impaired O2/CO2 exchange. Few rehabilitation exercises concerning COVID-19 patients were reported. Here, we present a modified version of rehabilitation exercises based on the underlying mechanism of the disease to mild cases of COVID-19. These exercises aimed to improve the pulmonary function of patients and ease the expectoration process. Additionally, an essential branch of Traditional Chinese Medicine (TCM) named acupressure was integrated into the exercises to facilitate the recovery and maintenance of pulmonary function. METHODS: From March 4, 2020 to May 5, 2020, a total of 60 COVID-19 patients who completed the full course of MRE were enrolled in this observational study. The diagnostic and classification criteria were based on the 7th edition of Diagnosis and Treatment Guideline of COVID-19 published by the National Health Commission of the People's Republic of China. We prospectively gathered patients' reported outcomes concerning respiration-related symptoms at four different time points, including: (I) at admission; (II) at the time of hospital discharge; (III) two weeks after discharge; (IV) four weeks after discharge. The reported respiratory symptoms included dry cough, productive cough, difficulty in expectoration, and dyspnea. RESULTS: In total, 60 confirmed mild COVID-19 cases were enrolled with a median age of 54 years old. The baseline prevalence for dry cough, productive cough, difficulty in expectoration, and dyspnea were 41.7%, 43.3%, 35.0%, and 50.0%, respectively. The pronounced decline in symptom prevalence was recorded over time. Interestingly, four weeks after discharge, we noticed a lower remission rate in productive cough and difficulty in expectoration. CONCLUSIONS: The modified rehabilitation exercises were retrieved from the Eight-Section Brocade, and are specifically designed for rehabilitation of COVID-19 patients at home or health facilities. Based on current findings on pronouncedly improved remission rate in respiratory symptoms, we recommend the MRE as suitable rehabilitation exercise to smooth respiration and ease the expectoration process in mild COVID-19 cases.

Acupressão/métodos , Exercícios Respiratórios/métodos , Infecções por Coronavirus/reabilitação , Exercícios de Alongamento Muscular/métodos , Pneumonia Viral/reabilitação , Adulto , Resistência das Vias Respiratórias , Betacoronavirus , Infecções por Coronavirus/fisiopatologia , Tosse/fisiopatologia , Dispneia/fisiopatologia , Terapia por Exercício/métodos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias , Pneumonia Viral/fisiopatologia , Troca Gasosa Pulmonar , Índice de Gravidade de Doença , Resultado do Tratamento
J. Hum. Growth Dev. (Impr.) ; 30(2): 291-300, May-Aug. 2020. ilus, tab
Artigo em Inglês | LILACS, Index Psicologia - Periódicos técnico-científicos | ID: biblio-1114938


INTRODUCTION: Asthma is characterized by a narrowing and inflammation of the bronchi, with symptoms of dyspnea, fatigue and exercise limitation. Physical therapy includes inspiratory muscle training and breathing exercises, given that an increase in inspiratory muscle strength and resistance can improve the symptoms of the diseaseOBJECTIVE: To describe the effects of inspiratory muscle training (IMT) and breathing exercises in children with asthmaMETHODS: This is a systematic review of the literature using the Cochrane, PubMed Scopus e Web of Science databases. The following descriptors were used: asthma, inspiratory muscle training, breathing exercises and child in Portuguese, English and Spanish. Two independent evaluators screened studies that used breathing exercises and IMT in children with asthmaRESULTS: Of a total of 312 titles, eight studies were included, of which six are randomized clinical trials and two are observational studies All the studies included breathing exercises, with the objective of adjusting breathing patterns and pulmonary ventilation, reducing pulmonary hyperinflation, bronchospasm and sensation of dyspnea. However, as these exercises were not performed solely, the effects of this intervention could not be verified. Two studies performed IMT and showed an increase in maximal respiratory pressureCONCLUSION: Breathing exercises are widely used in clinical practice as part of the management of asthma in children; however it is not possible to measure the effects in this population. IMT seems to improve inspiratory and expiratory muscle strength, but its indication in the pediatric population is not a standard procedure

INTRODUÇÃO: Asma é caracterizada por estreitamento e inflamação dos brônquios, com sintomas de dispneia, fadiga e limitação aos exercícios. O tratamento fisioterapêutico engloba treinamento muscular inspiratório e exercícios respiratórios, pois o aumento da força e resistência da musculatura inspiratória podem melhorar os sintomas da doençaOBJETIVO: Descrever os efeitos do treinamento muscular inspiratório (TMI) e dos exercícios respiratórios na criança com asmaMÉTODO: Revisão sistemática da literatura conduzida nas bases de dados Cochrane, PubMed, Scopus e Web of Science. Utilizou-se os descritores: asma, treinamento muscular inspiratório, exercícios respiratórios e criança e seus correlatos em inglês e espanhol. Dois avaliadores independentes elencaram estudos que realizaram intervenção com exercícios respiratórios e TMI na criança com asmaRESULTADOS: De um total de 312 títulos, foram incluídos oito estudos, dos quais seis são ensaios clínicos randomizados e dois observacionais. Todos os trabalhos incluíram exercícios respiratórios, com o objetivo de adequar o padrão respiratório e a ventilação pulmonar, reduzir a hiperinsuflação pulmonar, o broncoespasmo e a sensação de dispneia, porém como não foram realizados de forma isolada, comprometeu a verificação dos efeitos dessa intervenção. Dois estudos realizaram TMI e evidenciaram aumento nas pressões respiratórias máximasCONCLUSÃO: Exercícios respiratórios são muito utilizados na prática clínica como parte do manejo da criança com asma, entretanto ainda não é possível mensurar seus efeitos nessa população. O TMI parece melhorar a força muscular inspiratória e expiratória, mas sua indicação na população pediátrica ainda não é rotineira

Humanos , Masculino , Feminino , Criança , Asma , Exercícios Respiratórios , Criança
Trials ; 21(1): 588, 2020 Jun 29.
Artigo em Inglês | MEDLINE | ID: mdl-32600378


BACKGROUND: In December 2019, 27 cases of pneumonia, of unknown cause, were identified in the province of Hubei (China). The WHO declared the situation as a Public Health Emergency of International Concern, and it was finally declared a global pandemic on March 11, 2020. The Spanish Government obliges the entire population to remain confined to their homes, with the exception of essential basic services, to stop the spread of COVID-19. Home isolation implies a notable physical deconditioning. Telerehabilitation methods have reported positive experiences, and we propose to study in affected patients of COVID-19, due to the general house confinement of the entire Spanish population. METHODS: Patients will be recruited in the regions of Andalusia, Murcia, and Valencia (Spain). Patients will remain confined to their homes, and there, they will carry out their assigned exercise program, which will be controlled telematically. Evaluators will attend to carry out all measurements at the beginning, during, and end of the study, telematically controlled. The patients will be randomly divided into three groups, two of them will perform a home exercise program (breathing exercises or non-specific exercises for muscle toning) and the third group will perform sedentary activities, using mental activation techniques, and will act as a sham group. We will evaluate respiratory variables and other variables of the physical state through physical tests, effort, and perceived fatigue. The data will be statistically analyzed, and the hypotheses will be tested between the groups, using the SPSS software, v.24, considering a 95% confidence interval. DISCUSSION: We will analyze the results, in terms of the level of fatigue and perceived exertion, physical health, and maintenance of respiratory activity of two types of exercise programs, toning and respiratory, applied in patients affected by COVID-19 during the period of home confinement. We intend to investigate a field not previously studied, such as the repercussion of carrying out a toning and respiratory exercise program in these patients, in historical circumstances that no one had previously observed in Spain, since the general population has never been forced to remain confined in their homes, due to a pandemic infection, by a coronavirus (COVID-19). Observing the effects that these two home exercise programs could produce in patients infected with COVID-19, we will try to better analyze and understand the mechanisms that are associated with the worsening of breathing in this type of patient. TRIAL REGISTRATION: Brazilian Clinical Trial Registry RBR-6m69fc . Registered on March 31, 2020.

Betacoronavirus , Exercícios Respiratórios/métodos , Infecções por Coronavirus/reabilitação , Pneumonia Viral/reabilitação , Ensaios Clínicos Controlados Aleatórios como Assunto , Telerreabilitação/métodos , Adolescente , Adulto , Idoso , Método Duplo-Cego , Humanos , Pessoa de Meia-Idade , Avaliação de Resultados em Cuidados de Saúde , Pandemias , Adulto Jovem