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1.
Rev Bras Ter Intensiva ; 33(1): 167-171, 2021.
Artigo em Português, Inglês | MEDLINE | ID: mdl-33886866

RESUMO

The natural history of the disease, and the treatment of post-COVID-19 patients, are still being built. Symptoms are persistent, even in mild cases, and the infection consequences include fatigue, dyspnea, tachycardia, muscle loss, and reduced functional capacity. Regarding cardiopulmonary rehabilitation, there seems to be an improvement in functional capacity, quality of life, and prognosis with the 6-Minute Walk Test used as a prognostic and therapeutic evaluator. Therefore, this case series report aims to present our experience with four cases of different severity levels, involved in a post-COVID-19 cardiopulmonary rehabilitation program. These patients were assessed with the 6-Minute Walk Test, peripheral muscle strength, and double product at rest, to assess the results after a three-month rehabilitation protocol of at least 300 minutes per week. The four patients had their distance covered during the walk test increased between 16% and 94%. Peripheral muscle strength was improved by 20% to six times the baseline values, and double product at rest was reduced by 8% to 42%. The cardiopulmonary rehabilitation program had a positive impact on these cases, improving functional capacity despite the different severity levels in these post-COVID-19 cases.


Assuntos
/reabilitação , Reabilitação Cardíaca/métodos , Dispneia/reabilitação , Fadiga/reabilitação , Força Muscular , Teste de Caminhada , Adulto , Idoso , Exercícios Respiratórios/métodos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Terapia Respiratória/métodos
2.
Medicine (Baltimore) ; 100(13): e25339, 2021 Apr 02.
Artigo em Inglês | MEDLINE | ID: mdl-33787632

RESUMO

BACKGROUND: To the best of our knowledge, no studies have evaluated the effects of inspiratory muscle training (IMT) on recovered COVID-19 patients after weaning from mechanical ventilation. Therefore, this study assessed the efficacy of IMT on recovered COVID-19 patients following mechanical ventilation. METHODS: Forty-two recovered COVID-19 patients (33 men and 9 women) weaned from mechanical ventilation with a mean age of 48.05 ±â€Š8.85 years were enrolled in this pilot control clinical study. Twenty-one patients were equipped to 2-week IMT (IMT group) and 21 matched peers were recruited as a control (control group). Forced vital capacity (FVC%), forced expiratory volume in 1 second (FEV1%), dyspnea severity index (DSI), quality of life (QOL), and six-minute walk test (6-MWT) were assessed initially before starting the study intervention and immediately after intervention. RESULTS: Significant interaction effects were observed in the IMT when compared to control group, FVC% (F = 5.31, P = .041, ηP2 = 0.13), FEV1% (F = 4.91, P = .043, ηP2 = 0.12), DSI (F = 4.56, P = .032, ηP2 = 0.15), QOL (F = 6.14, P = .021, ηP2 = 0.17), and 6-MWT (F = 9.34, P = .028, ηP2 = 0.16). Within-group analysis showed a significant improvement in the IMT group (FVC%, P = .047, FEV1%, P = .039, DSI, P = .001, QOL, P < .001, and 6-MWT, P < .001), whereas the control group displayed nonsignificant changes (P > .05). CONCLUSIONS: A 2-week IMT improves pulmonary functions, dyspnea, functional performance, and QOL in recovered intensive care unit (ICU) COVID-19 patients after consecutive weaning from mechanical ventilation. IMT program should be encouraged in the COVID-19 management protocol, specifically with ICU patients.


Assuntos
Exercícios Respiratórios/métodos , Músculos Respiratórios/fisiopatologia , Desmame do Respirador/métodos , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Projetos Piloto , Estudos Prospectivos , Qualidade de Vida
3.
Medicine (Baltimore) ; 100(4): e23532, 2021 Jan 29.
Artigo em Inglês | MEDLINE | ID: mdl-33530160

RESUMO

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.


Assuntos
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
4.
Cochrane Database Syst Rev ; 12: CD006112, 2020 12 17.
Artigo em Inglês | MEDLINE | ID: mdl-33331663

RESUMO

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.


Assuntos
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
8.
Fisioterapia (Madr., Ed. impr.) ; 42(5): 260-266, sept.-oct. 2020. graf, tab
Artigo em Espanhol | IBECS | ID: ibc-195142

RESUMO

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


Assuntos
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
9.
J Sports Med Phys Fitness ; 60(8): 1101-1109, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32955836

RESUMO

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.


Assuntos
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
10.
Spinal Cord Ser Cases ; 6(1): 87, 2020 09 17.
Artigo em Inglês | MEDLINE | ID: mdl-32943611

RESUMO

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.


Assuntos
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
11.
Hosp. domic ; 4(3): 133-152, jul.-sept. 2020. ilus, tab, graf
Artigo em Espanhol | IBECS | ID: ibc-192943

RESUMO

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


Assuntos
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
12.
Rehabilitación (Madr., Ed. impr.) ; 54(3): 191-199, jul.-sept. 2020.
Artigo em Espanhol | IBECS | ID: ibc-196735

RESUMO

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


Assuntos
Humanos , Doença Pulmonar Obstrutiva Crônica/reabilitação , Pneumopatias/reabilitação , Exercícios Respiratórios/métodos , Modalidades de Fisioterapia , Capacidade Pulmonar Total/fisiologia , Avaliação de Resultado de Intervenções Terapêuticas
13.
PLoS One ; 15(8): e0237010, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32780739

RESUMO

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.


Assuntos
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
14.
Ann Palliat Med ; 9(5): 3100-3106, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32787373

RESUMO

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.


Assuntos
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
15.
Trials ; 21(1): 588, 2020 Jun 29.
Artigo em Inglês | MEDLINE | ID: mdl-32600378

RESUMO

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.


Assuntos
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
16.
Ann Otol Rhinol Laryngol ; 129(12): 1186-1194, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-32527195

RESUMO

OBJECTIVES: Expiratory muscle strength training (EMST) is a threshold based device-driven treatment for improving expiratory pressure. EMST proved to be effective in different patient groups to improve cough function. To date, EMST has not been tested in the total laryngectomy population (TL). METHODS: This prospective, randomized case-series study examined feasibility, safety, and compliance of EMST in a group of TL participants and its effects on pulmonary function, physical exertion, fatigue, and vocal functioning. Ten TL participants were included in the study to perform a 4 till 8 weeks of EMST. Objective and subjective outcome measures included manometry, spirometry, cardio pulmonary exercise testing (CPET), voice recordings, and patient reported outcome measures. Group means were reported and estimates of the effect are shown with a 95% confidence interval, using single sample t-tests. RESULTS: Nine participants completed the full study protocol. Compliance to the training program was high. All were able to perform the training, although it requires adjustments of the device and skills of the participants. Maximum expiratory pressure (MEP) and vocal functioning in loudness improved over time. After EMST no changes were seen in other objective and subjective outcomes. CONCLUSIONS: EMST appears to be feasible and safe after total laryngectomy. MEP improved over time but no improvement in the clinically relevant outcome measures were seen in this sample of relatively fit participants. Further investigation of the training in a larger group of participants who report specifically pulmonary complaints is recommended to investigate if the increase in MEP results in clinical benefits. LEVEL OF EVIDENCE: 4.


Assuntos
Exercícios Respiratórios/métodos , Expiração , Laringectomia/reabilitação , Traqueostomia/reabilitação , Idoso , Teste de Esforço , Fadiga , Estudos de Viabilidade , Humanos , Masculino , Manometria , Pessoa de Meia-Idade , Esforço Físico , Projetos Piloto , Voz Alaríngea , Espirometria
17.
Enferm. clín. (Ed. impr.) ; 30(supl.5): 164-167, jun. 2020. tab
Artigo em Inglês | IBECS | ID: ibc-196660

RESUMO

Chronic Obstructive Pulmonary Disease (COPD) is a chronic lung disease characterized by obstruction or obstruction of airflow in a reversible or partial nonreversible airway. Dyspnea is a common symptom in COPD sufferers; this can cause problems with oxygen saturation, or the oxygen saturation value is below normal. Non-pharmacological actions given in the form of breathing exercises can be done by a nurse to help reduce shortness of breath in COPD patients. The exercise is given by adjusting the resting position that is comfortable and comfortable so that the extra breath muscles can work well. The position that can do the position of the tripod with Active Cycle of Breathing and Pursed lips are breathing so that shortness of breath is reduced and SaO2 can have increased so that more oxygen has obtained in Lung Hospital, West Sumatra. This research is quantitative research, with quasi-experimental research methods. They used two pre-test-posttest design groups. The sample in this study amounted to 30 people with quota sampling technique. In this study showed that there was a difference in the increase in oxygen saturation of COPD patients which was effective in the tripod position group with Active Cycle Breathing Technique (ACBT) with a p-value of 0.00 while in the tripod position group with the Active Respiratory and Lip Cycle there was a difference of p-value 0.023. It has concluded that the tripod position with ACT and PBLT could increase oxygen saturation and nasal breathlessness reduced, but the tripod position with ACT is more effective in COP patients because with chronic respiratory patients who are short of breath due to sputum buildup, then with ACT will clean the airway and the flow of the road effective breathing so that shortness of breath have reduced and oxygen saturation increases. Furthermore, it has recommended that in hospitals, especially nurses, in dealing with COPD patients in addition to the correct position of breathing exercises with ACT to help patients


No disponible


Assuntos
Humanos , Resultado do Tratamento , Doença Pulmonar Obstrutiva Crônica/enfermagem , Exercícios Respiratórios/métodos , Terapia Respiratória/enfermagem , Doença Pulmonar Obstrutiva Crônica/reabilitação , Exercícios Respiratórios/enfermagem , Drenagem Postural/métodos
18.
Medicine (Baltimore) ; 99(18): e19826, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32358353

RESUMO

BACKGROUND: Chronic obstructive pulmonary disease (COPD) is an irreversible disease characterized by cough, sputum production, and dyspnea, and has a high prevalence and mortality. Pulmonary rehabilitation (PR) is a management that improves the quality of life for COPD patients; however, PR is not readily accessible. Therefore, we developed lung-conduction exercises (LCE) that can be performed without any limitations. LCE consists of breathing, stretching, and tapping to relieve dyspnea in COPD patients. METHODS/DESIGN: This randomized, assessor-blind, multicenter trial aims to recruit 54 patients with moderate and severe COPD. Subjects will be randomly allocated to a control group (only medication), an LCE group (medication + LCE, 5 times a week), or a PR group (medication + PR, 5 times a week). The 6-minute walk distance, pulmonary function tests (forced expiratory volume at 1 second, forced vital capacity, and forced expiratory volume at 1 second/forced vital capacity), modified Borg scale, modified medical research council dyspnea scale, COPD assessment test, and St. George respiratory questionnaire will be measured before starting the trial and after the 4th and 8th weeks to determine motor performance, lung function, and dyspnea. CONCLUSION: We aim to demonstrate that LCE is effective in improving symptoms and psychosomatic stability in COPD patients. Therefore, this trial will play an important role in fortifying the foundation of clinical application.


Assuntos
Exercícios Respiratórios/métodos , Terapia por Exercício/métodos , Doença Pulmonar Obstrutiva Crônica/terapia , Terapia Respiratória/métodos , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Pulmão/fisiopatologia , Masculino , Pessoa de Meia-Idade , Doença Pulmonar Obstrutiva Crônica/fisiopatologia , Ensaios Clínicos Controlados Aleatórios como Assunto , Testes de Função Respiratória , Método Simples-Cego , Resultado do Tratamento
19.
Indian J Gastroenterol ; 39(2): 196-203, 2020 04.
Artigo em Inglês | MEDLINE | ID: mdl-32436177

RESUMO

BACKGROUND: The diagnosis of rumination syndrome is frequently overlooked, and under-recognized; children are subjected to unnecessary testing and inappropriate treatment for a condition which can be diagnosed clinically and managed easily. In the first ever systematic exploration of this condition from India, we present a prospective study on children with chronic vomiting in which rumination emerged as the predominant cause. METHODS: This was a prospective study in which all consecutive children (5-18 years) presenting with chronic or recurrent vomiting of at least 2-month duration were enrolled. Clinical history was assessed by a physician-administered questionnaire. All subjects underwent standard testing followed by additional investigations as required. The ROME III criteria were used. RESULTS: Fifty children (28 boys, age 12.2 + 3 years) were enrolled. Diagnosis was rumination syndrome 30, cyclical vomiting 8, functional vomiting 6, intestinal tuberculosis 4, intestinal malrotation 1, and superior mesenteric artery syndrome 1. Children with rumination syndrome had a relapsing and remitting (12, 40%) or a chronically symptomatic course (18, 60%). These children received incorrect diagnoses (26, 87%) or no diagnosis (3, 10%) and extensive investigation before referral. Before referral, children with rumination syndrome were treated with a median of four drugs (range 1 to 9); two underwent surgery (appendectomy) for their symptoms while one child was subjected to electroconvulsive therapy. Overall, resolution after treatment was seen in 26 (87%) with a relapse in 8 (27%) children. CONCLUSION: The diagnosis of rumination syndrome is delayed and these children are often inappropriately treated. Therapy in the form of diaphragmatic breathing has a good success rate.


Assuntos
Síndrome da Ruminação/complicações , Síndrome da Ruminação/terapia , Vômito/etiologia , Adolescente , Exercícios Respiratórios/métodos , Criança , Doença Crônica , Diagnóstico Tardio , Erros de Diagnóstico , Diafragma/fisiologia , Feminino , Humanos , Prescrição Inadequada , Masculino , Estudos Prospectivos , Recidiva , Síndrome da Ruminação/diagnóstico , Procedimentos Desnecessários
20.
Medicine (Baltimore) ; 99(20): e20309, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32443381

RESUMO

BACKGROUND: This study will evaluate the effectiveness and safety of respiratory muscle training (RMT) for patients with obstructive sleep apnea (OSA). METHODS: Randomized controlled trials will be retrieved through electronic database searches from MEDLINE, EMBASE, Cochrane Library, CINAHL, Scopus, CBM, and CNKI from the beginning to the present. All electronic databases will be searched without any language limitation. Two researchers will independently select studies, collect data, and assess study quality, respectively. RevMan 5.3 software will be used for statistical analysis. RESULTS: The primary outcome is severity of OSA, as measured by polysomnography or any relevant tools. The secondary outcomes are hypopnea index, apnea index, respiratory event index, respiratory disturbance index, sleep-related quality of life, and any expected or unexpected adverse events. CONCLUSION: The results of this study will summarize current evidence of RMT for the treatment of patients with OSA. SYSTEMATIC REVIEW REGISTRATION: INPLASY202040051.


Assuntos
Exercícios Respiratórios/métodos , Apneia Obstrutiva do Sono/terapia , Humanos , Polissonografia , Qualidade de Vida , Ensaios Clínicos Controlados Aleatórios como Assunto , Projetos de Pesquisa , Índice de Gravidade de Doença
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