A pulmonary rehabilitation program is an effective strategy to improve forced vital capacity, muscle strength, and functional exercise capacity similarly in adults and older people with post-severe COVID-19 who required mechanical ventilation.

BACKGROUND: It is internationally known that our population is aging. At the same time, some patients with COVID-19, due to their symptoms, required mechanical ventilation (MV) and subsequent pulmonary rehabilitation (PR). This study aimed to compare the effects of a multimodal PR program "ADULT" versus "OLDER" people with COVID-19 who were on MV. METHODS: The intervention consisted of an 8-week hybrid PR program (2x week). Forced vital capacity (FVC) was measured at the beginning and end of PR, upper and lower limb strength was obtained through hand grip strength (HGS) and the sit-to-stand test (STST), respectively, and functional exercise capacity was measured with the 6-minute walking test (6MWT). RESULTS: The main results were an increase in the FVC in the ADULT and OLDER groups (time effect, P = 0.000; η2 = 0.27), an increase in HGS in the ADULT and OLDER groups (time effect, P = 0.000; η2 = 0.52), in the same way, the number of repetitions on the STST increased in the ADULT and OLDER groups (time effect, P = 0.000; η2 = 0.55). Finally, the distance covered on the 6MWT increased in the ADULT and OLDER groups (time effect, P = 0.000; η2 = 0.65). CONCLUSIONS: The PR program is an effective strategy to improve FVC, muscle strength, and functional exercise capacity similarly in adults and older people with post severe COVID-19 who required MV.

Submandibular Skinfold Thickness Cut-off Values in Relation to Body Mass Index and Percentage Body Fat Among Chilean Adolescents.

The present study evaluates submandibular skinfold (SMS) cutoff values to estimate excess weight for BMI and percentage body fat (%BF) among Chilean adolescents. The results show an optimal area under the cutoff curve value of 83% among girls and 91% in boys to estimate SMS concerning %BF and BMI. The SMS cutoff value estimating obesity by %BF was 10 mm among girls and 9 mm among boys, 10 mm among girls, and 7 mm among boys by BMI. Our results showed that SMS is significantly associated with anthropometric parameters for obesity.

Eight Weeks of Supervised Pulmonary Rehabilitation Are Effective in Improving Resting Heart Rate and Heart Rate Recovery in Severe COVID-19 Patient Survivors of Mechanical Ventilation.

Background and Objectives: Patients who survive severe COVID-19 require significant pulmonary rehabilitation. Heart rate (HR) has been used as a safety variable in the evaluation of the results of interventions in patients undergoing pulmonary rehabilitation. The aim of this research was to analyse HR during a pulmonary rehabilitation program in post-severe COVID-19 patients who survived mechanical ventilation (MV). The study includes the initial and final evaluations and aerobic training sessions. Materials and Methods: Twenty patients (58 ± 13 years, 11 men) were trained for 8 weeks. A 6-minute walk test (6 MWT) was performed and, subsequently, a supervised and individualised training plan was created. Resting heart rate (RHR), heart rate recovery (HRR), heart rate at minute 6 (HR6 min) and the product of HR6 min and systolic blood pressure (HR6 minxSBP) were measured at 6 MWT. In addition, HR was measured at each training session. Results: After 8 weeks of pulmonary rehabilitation, patients decreased their RHR from 81.95 ± 9.36 to 73.60 ± 9.82 beats/min (p < 0.001) and significantly increased their HRR from 12.45 ± 10.22 to 20.55 ± 7.33 beats/min (p = 0.005). HR6 min presented a significant relationship with walking speed and walked distance after the pulmonary rehabilitation period (r = 0.555, p = 0.011 and r = 0.613, p = 0.011, respectively). HR6 minxSBP presented a significant relationship with walking speed and walked distance after training (r = 0.538, p = 0.014 and r = 0.568, p = 0.008, respectively). In the pulmonary rehabilitation sessions, a significant decrease in HR was observed at minutes 1, 6 and 15 (p < 0.05) between sessions 1 and 6 and at minute 1 between sessions 1 and 12. Conclusions: Eight weeks of individualised and supervised pulmonary rehabilitation were effective in improving RHR and HRR in COVID-19 patients surviving MV. HR is an easily accessible indicator that could help to monitor the evaluation and development of a pulmonary rehabilitation program in COVID-19 patients who survived MV.

Predictive value of invasive mechanical ventilation parameters for mortality in COVID-19 related ARDS: a retrospective cohort study.

The 2019 coronavirus (COVID-19) can generate acute respiratory distress syndrome (ARDS), requiring advanced management within the Intensive Care Unit (ICU) using invasive mechanical ventilation (IMV However, managing this phenomenon has seen learning and improvements through direct experience. Therefore, this study aims were to describe the assessment of the different IMV variables in patients with post-COVID-19 hospitalized in the ICU and their relation with mortality. Observational and retrospective study. The sample was divided into two, the surviving group (SG) and the non-surviving group (NSG). Clinical data were extracted from the electronic clinical file and the respiratory therapist record sheet. The following information was obtained: Patient medical history: gender, age, co-morbidities, arterial gases, days on IMV, and IMV parameters. Out of a total of 101 patients, the total mortality was 32%. There was a significant decrease in respiratory rate (RR) (29.12 ± 4.24-26.78 ± 3.59, p = 0.006), Driving pressure (DP) (11.33 ± 2.39-9.67 ± 1.84, p = 0.002), Ventilatory rate (VR) (2.26 ± 0.66-1.89 ± 0.45, p = 0.001) and a significant rise in Static compliance (Cest) (35.49 ± 8.64-41.45 ± 9.62, p = 0.003) and relation between Arterial oxygen pressure/Inspirated oxygen fraction (PaO2/FiO2) (201.5 ± 53.98- 227.8 ± 52.11, p = 0.008) after 72 h of IMV, within the NSG compared to the SG. Apart from these points, multi-morbidity (HR = 3.208, p = 0.010) and DP (HR = 1.228, p = 0.030) and VR variables (HR = 2.267, p = 0.027) had more death probabilities. The results of this study indicate that there was a significant increase in RR, DP, VR, and CO2 and a significant drop in Cest and PaO2/FiO2 among the NSG compared with the SG. Apart from this, the DP and VR variables, multi-morbidity and being male. have more possibility of death.

Retrospective Analysis of the Ventilatory Workload Kinetic Index during Stability and Crisis in Patients with Asthma and COPD in a Monitored Program.

To assess ventilatory evolution through the Ventilatory Workload Kinetic Index (VWKI) in patients with asthma and chronic obstructive pulmonary disease (COPD) during stability and exacerbation. Retrospective analysis. Conducted at the Padre Alberto Hurtado Hospital, Santiago, Chile. Ten patients with asthma and fifty-five with COPD participated. Sixty-five clinical records were reviewed. The VWKI in stability and exacerbation of these patients was extracted. When analyzing the baseline with the peak in both asthma and COPD, there was a significant increase in the VWKI. Similarly, the loads, translations, and supports significantly increased from the baseline to the peak. However, in the loads, there were no changes in airway resistance for asthma or in cough for COPD. Likewise, the supports for asthma and COPD showed no changes in the O2. The VWKI determined ventilatory issues in outpatients and made locating the greatest compromise in loads, translations, or supports possible.

Effects of a pulmonary rehabilitation program on pulmonary function, exercise performance, and quality of life in patients with severe COVID-19.

BACKGROUND: Severe coronavirus 2019 disease (COVID-19) causes acute hypoxemic respiratory failure requiring invasive mechanical ventilation (IMV). Once these symptoms are resolved, patients can present systemic deterioration. OBJECTIVE: The two objectives of this study were as follows: to describe the results of a pulmonary rehabilitation program (PRP), which is divided into three groups with different numbers of sessions (12, 24, and 36), and to associate the variables of pulmonary function, exercise performance, and functionality with the number of sessions and functional improvement. DESIGN: Prospective, observational study. METHODS: PRP consisted of aerobic + strength + flexibility exercises under the supervision and individualized into 12, 24, or 36 sessions (12s, 24s, and 36s), depending on the evolution of each patient. At the beginning of the study and immediately after the intervention, forced vital capacity (FVC), maximal inspiratory pressure, 6-minute walk test (6MWT), sit-to-stand test (STS), maximal handgrip strength (HGS), Fatigue Assessment Scale, Post-COVID-19 Functional Status (PCFS), and health-related quality of life (HRQoL) were measured. RESULTS: The proposed PRP demonstrated a positive effect on pulmonary function, exercise performance, and HRQoL, regardless of the number of sessions. A higher score on the PCFS and more days on IMV were associated with the increased likelihood of needing more sessions, whereas more meters on the 6MWT in the initial evaluation was associated with a reduced likelihood of needing more sessions. Finally, more repetitions on the STS and less distance covered on the initial 6MWT were associated with a greater improvement in exercise performance evaluated with the 6MWT. CONCLUSION: Supervised and individualized PRP for patients with severe post-COVID-19 improves pulmonary function, exercise performance, functionality, and quality of life. Functionality, distance covered on the 6MWT, and the days on IMV are central to the scheduling of the number of sessions for these patients.

Comparison of distance covered, physiological cost, and perceived exertion in four six-minute walk test protocols.

Objective: There is evidence that indicates that the Walked Distance (WD) in the 6-Minute Walk Test (6MWT) would be sensitive to the type of track and encouragement. The aim of study was compared the impact of track type and verbal encouragement provided in the 6MWT on WD, physiological cost, perceived exertion, and gait efficiency in healthy young adults unfamiliar with the test. Method: WD, heart rate, subjective sensation of dyspnea (SSD), and fatigue (SSF) were measured in four 6MWT protocols: i) 30 m linear track and protocolized encouragement (LT + PE), ii) 30 m linear track and constant encouragement (LT + CE), iii) 81 m elliptical track and protocolized encouragement (ET + PE), and iv) 81 m elliptical track and constant encouragement (ET + CE). In addition, the Gait Efficiency Index (GIE) associated with physiological cost, dyspnea and fatigue was calculated and compared between the different protocols. Results: The WD was significantly higher in the ET + CE protocol. The percentage of the heart rate reserve used (%HRRu) at minute 6 was higher in the ET + CE protocol. The SSD and SSD had difference in startup time between the protocols. The GEI was higher in %HRRu, SSD, and SSF for the ET + CE protocol. Conclusion: The ET + CE protocol showed a significant increase in WD during the 6MWT in healthy young adults. Although it obtained the highest physiological cost, it did not present perceptual differences when entering cardiopulmonary assessment windows relevant to a more efficient test for the participant. It is advisable to discuss, based on the findings, the fundamental objective of the 6MWT and national and international recommendations to achieve a result as close as possible to the real maximal effort.

Implications of Airway Resistance and Conductance on the Respiratory Rate in individuals With Various Nutritional States Exposed To Exercise.

Purpose: To determine how airway resistance (RAW) and airway conductance (GAW) affect inspiratory time (iT) and expiratory time (eT) in subjects with different nutritional states using the step test. Methods: Forty-eight participants were recruited and divided into three groups: 16 normal weight (NW), 16 overweight (OW), and 16 obese (OB). A lung function test and anthropometric evaluation were performed. iT and eT were measured using a sonographic device before and after the step test. Results: Body Mass Index (BMI) and Body Fat Percentage (BF%) were significantly higher (P<0.0001; P<0.0001, respectively) in OB group. RAW was significantly higher in the OB group (P=0.004), and GAW (P=0.004) was significantly lower in the same group. At rest, the Respiratory Rate (RR) was significantly higher in OB group (P<0.05), while iT and eT showed no significant differences. On the other hand, after the step test, eT was significantly lower (P=0.016), with the multiple linear regression model being the best predictor of post-exercise eT, including BF%/GAW and BF%/sGAW (explained variability of 15.7% and 14.6%, respectively). Conclusion: Nutritional status can significantly impact lung function; at rest, there was a decrease in lung volumes and an increase in RR in OB subjects. In addition, there was a significant decrease in eT of OB subjects post-exercise. Finally, a significant relationship of BF%/GAW and BF%/sGAW with post-exercise eT was noted.

Use of the speed achieved on the 6MWT for programming aerobic training in patients recovering from severe COVID-19: an observational study.

INTRODUCTION: Patients who suffered severe COVID-19 need pulmonary rehabilitation. Training may be prescribed objectively based on the maximum speed in the six-minute walk test. The objective of this study was to determine the effects of a personalized pulmonary rehabilitation program based on the six-minute walk test speed for post-COVID-19 patients. METHODS: Observational quasi-experimental study. The pulmonary rehabilitation program consisted of 8 weeks of training, twice a week for 60 minutes per session of supervised exercise. Additionally, the patients carried out home respiratory training. Patients were evaluated by exercise test, spirometry and the Fatigue Assessment Scale before and after the eight-week pulmonary rehabilitation program. RESULTS: After the pulmonary rehabilitation program, forced vital capacity increased from 2.47 ± 0.60 to 3.06 ± 0.77 L (p < .001) and the six-minute walk test result increased from 363.50 ± 88.87 to 480.9 ± 59.25 m (p < .001). In fatigue perception, a significant decrease was observed, from 24.92 ± 7.01 to 19.10 ± 7.07 points (p < .01). Isotime evaluation of the Incremental Test and the Continuous Test showed a significant reduction in heart rate, dyspnoea and fatigue. CONCLUSION: The eight-week personalized pulmonary rehabilitation program prescribed on the basis of the six-minute walk test speed improved respiratory function, fatigue perception and the six-minute walk test result in post-COVID-19 patients.KEY MESSAGESCOVID-19 is a multisystem disease with common complications affecting the respiratory, cardiac and musculoskeletal systems.The 6MWT speed-based training plan allowed for increased speed and incline during the eight-week RP program.Aerobic, strength and flexibility training reduced HR, dyspnoea and fatigue in severe post-COVID-19 patients.

[Maximum isometric force of the quadriceps and hamstrings and functionality after total knee arthroplasty]. / Fuerza isométrica máxima de cuádriceps e isquiotibiales y funcionalidad luego de la artroplastia total de rodilla.

Gonarthrosis is a highly prevalent disease in older adults. The objective of this research was to identify changes in quadriceps muscle strength and their impact on the functionality of total knee replacement (TKA) operated patients undergoing kinesitherapy at Hospital El Carmen de Maipú (HEC). All TKA operated patients were measured, pre and post intervention, maximum isometric strength (MIF), Time Up and Go, Standing and sitting test, Unipodal support and the WOMAC scale. The operated and contralateral MIF is higher in flexion and extension when comparing both genders (p < 0.0001; p < 0.0001, respectively). In the up and go and the standing and sitting test, performance was significantly higher for males than for females (p = 0.001; p = 0.007, respectively). In the WOMAC, there were significant differences before and after the intervention in men and women (p < 0.0001; p < 0.0001, respectively). Patients with a body mass index (BMI) > 30 kg/m2 are 3 times less likely [OR = -3.498; CI (0.062-1.067)] to receive treatment in a period of less than 50 days. On the other hand, injuries to the non-dominant (left) knee have a 4 times greater chance of stay in treatment in less than 50 days [(OR = 2.71; CI (1.000-16.252)]. There was an increase in MIF of the knee treated post-intervention, in both genders. Functionality increased in men and women, after the intervention.

La gonartrosis es una enfermedad de alta prevalencia en adultos mayores. El objetivo de esta investigación fue identificar los cambios en la fuerza muscular del cuádriceps y su efecto en la funcionalidad de los pacientes operados de artroplastia total de rodilla (ATR) sometidos a kinesiterapia en el Hospital El Carmen de Maipú (HEC). A todos los operados de ATR se les midió, pre y post intervención, fuerza isométrica máxima (FIM), Time Up and Go, test de pararse y sentarse, apoyo unipodal y la escala WOMAC. La FIM de la rodilla operada y la no operada, es mayor en flexión y extensión al comparar ambos géneros (p < 0.0001; p < 0.0001, respectivamente). En el up and go y la prueba pararse y sentarse el rendimiento fue significativamente superior para el género masculino en relación al femenino (p = 0.001; p = 0.007, respectivamente). En el WOMAC, existieron diferencias significativas pre y post intervención en hombres y mujeres (p < 0.0001; p < 0.0001, respectivamente). Los pacientes con un índice de masa corporal (IMC) > 30 kg/m2 tienen 3 veces menos posibilidades [OR = -3.498; IC (0.062-1.067)] de permanecer en tratamiento en un plazo menor a 50 días. Por otra parte, las lesiones en la rodilla no dominante (izquierda) tiene 4 veces más posibilidades de tratamiento inferior a 50 días [(OR = 2.71; IC (1.000-16.252)]. Existió un aumento de la FIM de la rodilla tratada post intervención, en ambos géneros. La funcionalidad aumentó en hombres y mujeres, posterior a la intervención.

Association between air flow limitation and body composition in young adults.

BACKGROUND: Body composition (BC) influences respiratory system mechanics, provoking air flow limitation (AFL). The objective of this study was to determine the relationship of AFL in small- and medium-caliber airways with BC in young adults. METHODS: Eighty-three individuals were recruited (40 men and 43 women). To determine AFL, the following measurements were taken: forced expiratory volume in the first second (FEV1), forced expiratory flow between 25 and 75% (FEF25-75%), airway resistance (Raw), and specific airway resistance (sRaw). The measured BC variables were body mass index (BMI), body fat percentage (%BF), and fat-free mass (FFM). Binary logistical regression analysis was used to estimate the association between the AFL variables and %BF, BMI, and %FFM, adjusting for weight and gender. RESULTS: Among men, a relationship was observed between Raw and %BF (r = 0.728; p < 0.0001) and sRaw and BMI (r = 0.617; p < 0.0001). Among women, significant relationships were reported between Raw and BMI (r = 0.615; p < 0.0001) and sRaw and BMI (r = 0.556; p < 0.0001). Among participants with a BMI over 30 kg/m2, higher risks of increased Raw (OR = 26.8; p = 0.009) and sRaw (OR = 9.3; p = 0.002) were observed. Furthermore, higher %BF was associated with greater risks for increased Raw (OR = 14.04; p = 0.030) and sRaw (OR = 4.14; p = 0.028). In contrast, increased %FFM (OR = 0.14; p = 0.025) was a protective factor for lung function. CONCLUSION: Increased %BF is associated with increased AFL in small-caliber airways. Furthermore, increased %FFM is associated with decreased risk for Raw and sRaw in women. Therefore, evidence indicates that increased %FFM is a protective factor for adequate lung function.

Shoulder Pain in COVID-19 Survivors Following Mechanical Ventilation.

COVID-19 has caused a certain proportion of patients to be hospitalized in intensive care units (ICU) and may cause musculoskeletal and neurological deficits following intubation and mechanical ventilation. The aim of this study was to quantify and describe the presence of shoulder pain in patients released from hospitals after suffering COVID-19. Patients with positive Apley tests were sent to a physiatrist for a clinical evaluation, ultrasound and electromyography (EMG). This evaluation was completed with a pain scale, joint range and shoulder muscle strength evaluations. Of the one-hundred-sixteen patients, seventy eight entered the respiratory rehabilitation program. Twenty patients were sent to the multidisciplinary shoulder team for positive Apley scratch tests. Of these twenty patients, one had only an EMG, ten had only ultrasounds, seven had an EMG and ultrasound and two did not need complementary tests. The twenty patients were sent to the physical therapist, with all presenting pain and diminished joint range and muscle strength in the affected shoulder. In this context, shoulder pain could be associated with the prone position in the ICU. We suggest time control and position change for patients on mechanical ventilation in a prone position with COVID-19.

¿Hipotonía o Flacidez en Rehabilitación? Una Recomendación desde el Origen Etimológico / Hypotonia or Flaccidity in Rehabilitation? A Recommendation from the Etymological Origin

El músculo estriado es un tejido organizado que utiliza la energía química para realizar trabajo físico, el cual se genera a partir de la contracción muscular. Un tono muscular adecuado es necesario para el movimiento eficiente y la realización de actividad básica del cuerpo humano. Las alteraciones del tono muscular en la práctica clínica se clasifican como hipertonía, que es el aumento del tono en los músculos esqueléticos y/o lisos, e hipotonía o flacidez, que es la disminución del tono del músculo esquelético. Los términos hipotonía y flacidez son ampliamente utilizados por los clínicos en la rehabilitación y ambos hacen referencia a una disminución del tono muscular. Este estudio analizó y evaluó el origen etimológico de los términos Hipotonía y Flacidez y la implicancia de sus definiciones. Para determinar el origen etimológico se realizó una búsqueda de los términos en el Diccionario médico-biológico, histórico y etimológico y Diccionario Latino-Español Español-Latino. Para determinar la definición en español se utilizó el Diccionario de Términos Médicos de La Real Academia de Medicina de España; el Diccionario de la Lengua española; el Diccionario Panhispánico de Términos Médicos; la Biblioteca Nacional Médica y la Biblioteca Virtual de Salud de Centro Latinoamericano y del Caribe. Para determinar el uso de estos términos en el ámbito clínico, se realizó una búsqueda en artículos científicos del ámbito neurológico según el criterio de los autores. Por consiguiente, el término más adecuado para referirse a una disminución de tono muscular en rehabilitación sería Hipotonía, de esta manera y según el origen de la lesión, se pueden utilizar los términos Hipotonía central e Hipotonía periférica, si es que están afectadas estructuras asociadas al sistema nervioso central o periférico, respectivamente. Se sugiere que estos términos sean considerados tanto en la práctica clínica como en la docencia cuando existan alteraciones en el sistema nervioso central o periférico que tengan como consecuencia un bajo tono muscular.

SUMMARY: Striated muscle is an organized tissue that utilizes chemical energy to perform physical work, generated through muscle contraction. Proper muscle tone is essential for efficient movement and basic bodily functions. Clinical practice categorizes muscle tone alterations as hypertonia, an increase in tone in skeletal and/or smooth muscles, and hypotonia or flaccidity, a decrease in skeletal muscle tone. These terms are widely used in rehabilitation to denote decreased muscle tone. This study examined the etymological origins of the terms Hypotonia and Flaccidity and their respective definitions. Etymological research utilized the Diccionario Médico- biológico, histórico y etimológico and Diccionario Latino-Español Español-Latino. Spanish definitions were sourced in Diccionario de Términos Médicos de La Real Academia de Medicina de España; Diccionario de la Lengua española; Diccionario Panhispánico de Términos Médicos; Biblioteca Nacional Médica and Biblioteca Virtual de Salud de Centro Latinoamericano y del Caribe. The clinical use of these terms was assessed through neurology articles per authors' criteria. Consequently, Hypotonia is deemed the more suitable term for describing decreased muscle tone in rehabilitation contexts. Depending on the lesion's origin, terms like Central Hypotonia and Peripheral Hypotonia may be used when structures associated with the central or peripheral nervous systems are affected, respectively. It is suggested that these terms be adopted in clinical practice and teaching when addressing alterations in central or peripheral nervous systems resulting in reduced muscle tone.

Relation among body mass index, waist-hip ratio, and pulmonary functional residual capacity in normal weight versus obese Chilean children: A cross-sectional study. / Relación de los índices de masa corporal y cintura-cadera con la capacidad residual funcional pulmonar en niños chilenos obesos versus normopeso: un estudio transversal.

INTRODUCTION: Obesity is associated with a rapid decrease in ventilatory function. The most common way of assessing nutritional status and measuring abdominal fat and hips are the body mass index (BMI) and the waist-hip ratio (WHR). There is scarce evidence suggesting their relation to functional residual capacity (FRC). Our objective was to determine the relation among BMI, WHR, and FRC in obese children in the city of Talca, Chile. POPULATION AND METHODS: Male and female children were recruited (6-12 years). Weight, height, BMI, WHR, and pulmonary function were assessed; the latter with body plethysmography. Depending on data distribution, Student's t test or the Mann-Whitney U test were used for independent samples, while Pearson's or Spearman's r test was used to establish the correlation between WHR and FRC. RESULTS: Children were divided into normal weight (n = 18) and obese (n = 18). A significant reduction in FRC (p = 0.025) was reported in obese children, while a reverse association was observed between WHR and FRC, which was moderate in normal weight children (s = -0.489; p = 0.03) and high in obese children (r = -0.681; p = 0.001). CONCLUSIONS: Obese children showed a lower FRC compared to normal weight children, which, in turn, was associated with WHR. These results are indicative of the systemic effects caused by obesity on children's ventilatory function and the need to use body fat distribution indicators at an early age.

Introducción. La obesidad está asociada a un descenso acelerado de la función ventilatoria. Las formas más frecuentes de evaluar el estado nutricional y medir la grasa abdominal y las caderas son el índice de masa corporal (IMC) y el índice cintura-cadera (ICC). Existe escasa evidencia que sugiera su relación con la capacidad residual funcional (CRF). Nuestro objetivo fue determinar la relación entre el IMC, el ICC y la CRF en niños obesos de la ciudad de Talca, Chile. Población y métodos. Se reclutaron niños de ambos sexos (6-12 años). Se evaluaron peso, talla, IMC, ICC y función pulmonar a través de pletismografía corporal. Dependiendo de la distribución de los datos, se utilizó la prueba t de Student o U de Mann-Whitney para muestras independientes y, la prueba r de Pearson o Spearman para establecer la correlación entre ICC y CRF. Resultados. Los niños se dividieron en normopeso (n= 18) y obesos (n= 18). Se reportó una disminución significativa de la CRF (p= 0,025) en niños obesos y una relación inversa entre ICC y CRF, la cual fue moderada en niños normopeso (s= -0,489; p= 0,03) y alta en obesos (r= -0,681; p= 0,001). Conclusiones. Los niños obesos mostraron una menor CRF respecto de los normopeso, que, a su vez, se relacionó con el ICC. Estos resultados indican efectos sistémicos que produce la obesidad en la función ventilatoria en niños y la necesidad de incorporar indicadores de distribución de grasa corporal a temprana edad.

Impact of Kinesiotherapy Rehabilitation on Quadriceps Femoris Muscle Strength and Functionality in Total Hip Arthroplasty Patients / Impacto de la Rehabilitación con Kinesioterapia en la Fuerza y Funcionalidad del Músculo Cuádriceps Femoral en Pacientes con Artroplastía Total de Cadera

SUMMARY: The objective was measure quadricep strength after Total Hip Arthroplasty (THA) and kinetic treatment and then determine its impact on the functional recovery of patients with hip osteoarthritis. A total of 79 (25 were male and 54 were female) patients with THA. Exclusion criteria were previous extra-system kinetic treatment, operated on for hip fracture, not completing the treatment. Maximum Isometric Strength (MIS), Time Up and Go (TUG), Modified Harris Hip Score. There was a significant increase in the MIS of the post-treatment operated knee extension in both men and women (p < 0.0001 SE = 0.43; p < 0.0001 SE = 1.22, respectively). In the TUG, the execution time was significantly lower post-treatment in both men and women (p < 0.0001 SE = 0.77; p < 0.0001 SE = 0.94, respectively). The final Harris score increased significantly post-treatment in male and female (p < 0.0001 SE = 2.90; p < 0.0001 SE = 1.96, respectively). the association between MIS and the Harris score, it was noted that, for a 1 kg increase in this measure compared to the initial assessment, the Harris score, after 12 weeks of treatment, increased by 0.179 points (β = 0.179; p = 0.050). The conclusions were Indicate an increase in knee extension MIS of the operated hip after treatment in both sexes. At the same time, functionality increased post-treatment in both male and female.

El objetivo del estudio fue medir la fuerza del músculo cuádriceps femoral después de la artroplastia total de cadera (THA, por sus siglas en inglés) y el tratamiento kinésico, para determinar su impacto en la recuperación funcional de pacientes con osteoartritis de cadera. En el estudio participaron 79 pacientes con THA (25 hombres y 54 mujeres). Se excluyeron quienes tuvieron tratamiento Kinésico previo fuera del hospital, operación por fractura de cadera y no completar el tratamiento. Las principales medidas tomadas fueron: Fuerza Máxima Isométrica (MIS), Time UP and GO (TUG), Puntuación Modificada de Harris de Cadera. Hubo un aumento significativo en la MIS de la extensión de rodilla del lado operado después del tratamiento tanto en hombres (p<0,0001, EE=0,43) como en mujeres (p<0,0001, EE=1,22). En el TUG, el tiempo de ejecución fue significativamente menor después del tratamiento en hombres (p<0,0001, EE=0,77) y mujeres (p<0,0001, EE=0,94). La puntuación final de Harris aumentó significativamente después del tratamiento en hombres (p<0,0001, EE=2,90) y mujeres (p<0,0001, EE=1,96). En cuanto a la asociación entre MIS y la puntuación de Harris, se observó que por cada aumento de 1 kg en esta medida en comparación con la evaluación inicial, la puntuación de Harris aumentó en 0,179 puntos después de 12 semanas de tratamiento (β=0,179; p=0,050). En conclusión se observó un aumento en la MIS de la extensión de rodilla del lado operado después del tratamiento en ambos sexos. Al mismo tiempo, la funcionalidad aumentó después del tratamiento tanto en hombres como en mujeres.

[Effects of overweight and obesity on the pulmonary volumes of patients with breast cancer]. / Efectos del sobrepeso y la obesidad sobre los volúmenes pulmonares de pacientes con cáncer de mama.

INTRODUCTION: Introduction: obesity and breast cancer (BC) are two diseases with known symptoms; however, the association of both and its impact on the respiratory system is poorly investigated. Objective: to describe the effects of overweight and obesity on the pulmonary volumes of patients with breast cancer from the city of Talca. Method: forty-one women diagnosed with BC were divided into three groups: nine patients with breast cancer and normal weight (BC + NW), 18 with breast cancer and overweight (BC + OW) and 14 with breast cancer and obesity (BC + O). Forced vital capacity and lung volumes were measured, ANOVA or Kruskal-Wallis was used for the statistical analysis, and for the Pearson or Spearman correlations, a level of significance of p < 0.05 was considered. Results: patients with BC + NW had a greater residual volume than those with BC + OW and BC + O (both p < 0.05). Functional residual capacity (FRC) was significantly higher in patients with BC + NP versus patients with BC + OW and BC + O (both p < 0.05). The total lung capacity was significantly higher in patients with BC + NW versus BC + OW and BC + O (p < 0.01 and p < 0.001, respectively). Between the BMI and FRC, a negative and significant correlation was found in the patients with BC + O (p = 0.049). Finally, in patients with BC + O a positive and significant correlation was observed between height and FRC (p = 0.01). Conclusions: the decrease in pulmonary volumes is exacerbated when patients with BC present malnutrition by excess. In addition, it is negatively correlated with the BMI in patients with BC + O.

INTRODUCCIÓN: Introducción: la obesidad y el cáncer de mama (CM) son dos enfermedades con sintomatología conocida, sin embargo, la asociación de ambas y su repercusión en el sistema respiratorio están escasamente investigadas. Objetivo: describir los efectos del sobrepeso y la obesidad sobre los volúmenes pulmonares de pacientes con cáncer de mama de la ciudad de Talca. Método: cuarenta y una mujeres con diagnóstico de CM se dividieron en nueve pacientes con cáncer de mama y normopeso (CM + NP), 18 con cáncer de mama y sobrepeso (CM + SP) y 14 con cáncer de mama y obesidad (CM + O). Se midieron la capacidad vital forzada y los volúmenes pulmonares. Para el análisis estadístico se utilizó ANOVA o Kruskal-Wallis y para las correlaciones, Pearson o Spearman. Se consideró un nivel de significancia de p < 0,05. Resultados: las pacientes con CM + NP tuvieron un mayor volumen residual que las pacientes con CM + SP y CM + O (ambos p < 0,05). La capacidad residual funcional (CRF) fue significativamente mayor en pacientes con CM + NP versus pacientes con CM + SP y CM + O (ambos p < 0,05). La capacidad pulmonar total fue significativamente superior en pacientes con CM + NP versus CM + SP y CM + O (p < 0,01 y p < 0,001; respectivamente). Entre IMC y CRF se encontró una correlación negativa y significativa en las pacientes con CM + O (p = 0,049). Por último, en las pacientes con CM + O se observó una correlación positiva y significativa entre talla y CRF (p = 0,01). Conclusiones: la disminución en los volúmenes pulmonares se ve exacerbada cuando las pacientes con CM presentan malnutrición por exceso; además, se correlaciona negativamente con el IMC en pacientes con CM + O.

Composición Corporal y Capacidad Física en Pacientes con COVID-19 Hospitalizados en una Unidad de Cuidados Intensivos / Body Composition and Physical Capacity in Patients with COVID-19 Hospitalized in a Intensive Care Unit

Las unidades de cuidados intensivos (UCI) y agudos han sido los contenedores del avance de la pandemia por COVID-19. Sin embargo, la estadía prolongada en esta unidad puede repercutir sobre la composición corporal (CC) y la capacidad derealizar ejercicio de los pacientes. El objetivo de esta investigación fue determinar si existe relación entre composición corporal (CC) y la prueba de caminata en 6 minutos (PC6m). Se reclutaron 17 personas (8 mujeres y 9 hombres). Se tomaron las siguientes medidas: PC6m, se consideró su distancia recorrida (DRPC6m) y su velocidad (VelPC6m). Las variables de CC medidas fueron índice de masa corporal (IMC), masa grasa (MG), masa libre de grasa (MLG) y masa magra (MM). La DRPC6m sólo mostró relación significativa con la MM corporal (MMC). Por otra parte, la VelPC6m tuvo una relación significativa con la MMC. Además de esto, la MLG del miembro inferior derecho y la MLG del miembro inferior izquierdo mostraron una relación con la VelPC6m (r=0,422; p=0,041 y r=0,417; p=0,025, respectivamente). También la MM del miembro inferior derecho y la MM del miembro inferior izquierdo se relacionaron significativamente con la VelPC6m (r=0,422; p=0,030 y r=0,420; p=0,042). En conclusión, existe relación entre composición corporal y VelPC6m. Esto permitiría aproximarse de manera rápida al nivel de funcionalidad con la que ingresa un paciente a un programa de rehabilitación.

SUMMARY: The intensive care units (ICU) and acute care units have been the containers for the advance of the COVID-19 pandemic. However, prolonged stay in this unit can impact patients' body composition (WC) and ability to exercise. This research aimed to determine if there is a relationship between body composition (BC) and the 6-minute walk test (6mWT). 17 people were recruited (8 women and 9 men). The following measurements were taken: 6mWT, its distance traveled (6mWTDT) and its speed (6mWTS) were considered. The WC variables measured were body mass index (BMI), fat mass (FM), fat-free mass (FFM), and lean mass (LM). 6mWTDT only showed a significant relationship with body LM (BLM). On the other hand, 6mWTS had a significant relationship with BLM. In addition to this, the FFM of the right lower limb and the FFM of the left lower limb showed a relationship with 6mWTS (r=0.422; p=0.041 and r=0.417; p=0.025, respectively). Also, the LM of the right lower limb and the LM of the left lower limb were significantly related to the 6mWTS (r=0.422; p=0.030 and r=0.420; p=0.042). In conclusion, there is a relationship between body composition and 6mWTS. This would allow us to quickly approach the level of functionality with which a patient enters a rehabilitation program.

The impact of obesity on specific airway resistance and conductance among schoolchildren. / Influencia de la obesidad sobre la resistencia y conductancia específica de la vía aérea en niños escolares.

INTRODUCTION: Child and adolescent obesity is an epidemiological problem in developing countries. Its prevalence among preschoolers and schoolchildren is over 30%. It has been associated with a wide range of health complications, including rapid loss of lung function leading to changes in physiology and ventilatory mechanics. The objective of this study was to analyze the association between obesity and the increase in specific airway resistance (sRaw) in a sample of obese children and adolescents from the district of Talca. MATERIAL AND METHOD: In a sample of 36 subjects with an average age of 9.38 ± 1.99 years, divided into 2 groups (normal weight and obese), the tricipital, subscapular, and abdominal skinfolds and lung volumes were measured. For the statistical analysis, data normality was determined and then the Student's t test or the Mann-Whitney U test and Pearson's or Spearman's correlations were used, as applicable. A value of p < 0.05 was considered statistically significant. RESULTS: When comparing normal weight and obese subjects, a significant increase in sRaw and a significant reduction in specific airway conductance (sGaw) were observed in obese subjects. In addition, an adequate and significant correlation was observed between sRaw and fat percentage. CONCLUSIONS: Obese subjects showed an increased sRaw and a reduced sGaw.

INTRODUCCIÓN: La obesidad infantojuvenil es un problema epidemiológico en los países en vías de desarrollo. Su prevalencia entre los niños en edad preescolar y escolar supera el 30%. Esta se asocia a una amplia variedad de complicaciones de salud, entre ellas, una acelerada pérdida de la función pulmonar, que provoca cambios en la fisiología y mecánica ventilatoria. El objetivo de este estudio fue estudiar la asociación entre obesidad y aumento de la resistencia específica de las vías aéreas (specific resistance airway; sRaw, por sus siglas en inglés) en una muestra infantojuvenil obesa de la comuna de Talca. MATERIAL Y MÉTODO: En una muestra de 36 sujetos con un promedio de edad de 9,38 ± 1,99 años, dividida en dos grupos, peso normal y obesos, se midieron los pliegues tricipital, subescapular, abdominal y volúmenes pulmonares. Para el análisis estadístico, se determinó la normalidad de los datos y, posteriormente, se utilizaron los test t de Student o U de Mann-Whitney y Pearson o Spearman según correspondiera. Se consideró un nivel de significancia estadística de p < 0,05. RESULTADOS: Al comparar sujetos de peso normal con obesos, se observó un aumento significativo de la sRaw y una disminución significativa de la conductancia específica de la vía aérea en sujetos obesos. Además, se observó una correlación buena y significativa entre sRaw y porcentaje de grasa. CONCLUSIONES: Los sujetos obesos mostraron un aumento de la sRaw y disminución de la conductancia específica de la vía aérea.