Impact of Exercise Modalities on Peripheral and Central Components of Cardiorespiratory Capacity in Heart Transplantation Patients: A Systematic Review and Meta-Analysis.

Background and Objectives: To analyze the effects of aerobic, resistance, and combined training on peripheral and central components related to cardiorespiratory capacity after HTx. Materials and Methods: No time restriction was applied for study inclusion. MEDLINE/PubMed; EMBASE, CENTRAL, and PEDro databases were investigated. Studies reporting heart transplanted patients older than 19 years following aerobic, resistance, and combined training according. The outcomes included: V'O2 peak, VE/V'CO2 slope, heart rate (HR peak), systolic and diastolic blood pressure (SBP and DBP peak), maximum repetition test(1RM), sit-to-stand test, and flow-mediated dilation (FMD). The studies were selected by consensus. Four hundred ninety-two studies initially met the selection criteria. Cochrane handbook was used for abstracting data and assessing data quality and validity. Independent extraction by two observers was applied. Results: Isolated aerobic training leads to a greater increase in V'O2 peak than combined training compared to the control group (p < 0.001, I2 = 0%). However, no significant differences were found in the subgroup comparison (p = 0.19, I2 = 42.1%). HR peak increased similarly after aerobic and combined training. High-intensity interval training (HIIT) was better than moderate continuous intensity to increase the V'O2 after long term in HTx. Still, there is scarce evidence of HIIT on muscle strength and FMD. No change on VE/V'CO2 slope, FMD, and SBP, DBP peak. 1RM and the sit-to-stand test increased after resistance training (p < 0.001, I2 = 70%) and CT (p < 0.001, I2 = 0%) when compared to control. Conclusions: Aerobic and combined training effectively improve VO2 peak and muscle strength, respectively. HIIT seems the better choice for cardiorespiratory capacity improvements. More studies are needed to examine the impact of training modalities on VE/V'CO2 slope and FMD.

Perfil epidemiológico e clínico de pacientes com queimaduras atendidos pela fisioterapia na Universidade Estadual de Goiás / Epidemiological and clinical profile of the burned patients under physiotherapeutic care in the State University of Goiás / Perfil epidemiológico y clínico de pacientes con secuelas de quemaduras en tratamiento fisioterapéutico en la Universidad Estadual de Goiás

OBJETIVO: Verificar o perfil epidemiológico e clínico de pacientes com sequelas de queimaduras, e determinar quais as condutas foram mais utilizadas no tratamento fisioterapêutico. MÉTODO: Estudo transversal, retrospectivo, observacional por meio da análise de prontuários. RESULTADOS: Dentre os 2401 prontuários analisados de pacientes que receberam alta no período de 2006 a 2013, 146 (6,08%) continham o diagnóstico clínico de queimaduras. Este total de pacientes foi separado por idade: crianças e adolescentes, adultos e idosos. O perfil epidemiológico de crianças e adolescentes, com idade média de 6,89±6,5 anos, revelou que o sexo masculino (57,1%) de etnia negra (51,02%) apresentava maior prevalência. Já a amostra de adultos e idosos apontou maior prevalência para sexo feminino (56,7%) de etnia branca (48,45%). No perfil clínico e de atendimento fisioterapêutico de crianças e adolescentes, o agente etiológico inflamável foi o mais frequente (49%), membros superiores foram as regiões mais acometidas (91,7%), sendo o objetivo de melhorar a cicatrização (89,79%) e a cinesioterapia (87,75%) as condutas mais utilizadas. Para adultos e idosos, a queimadura por atrito foi mais prevalente (33%), membros inferiores foram as regiões mais acometidas (43,6%); quanto ao objetivo, melhorar a força muscular, amplitude de movimento e flexibilidade (86,59%) foi o mais frequente; e a cinesioterapia (86,6%), a conduta mais adotada.(AU)

OBJECTIVE: To verify the epidemiological and clinical profile of patients with burn sequelae and to determine what practices were most prevalent in the physiotherapeutic treatment. METHODS: This is a cross-sectional, retrospective, observational study through the analysis of medical records. RESULTS: Of the 2,401 health records analyzed from patients who were discharged from 2006 to 2013, 146 (6.08%) contained a diagnosis of burn injuries. The total amount of patients was split by age: children and adolescents, adults and the elderly. The epidemiological profile of children and adolescents with a mean age of 6.89±6.5 years showed a higher prevalence of male patients (57.1%) of black ethnicity (51.02%). In turn, the sample of adults and elderly showed a higher prevalence of females (56.7%) of white ethnicity (48.45%). In the clinical and physiotherapeutic profile of children and adolescents, flammable products were the most frequent etiologic agent (49%) and the upper limbs were the most affected body areas (91.7%). Wound healing improvement (89.79%) and kinesiotherapy (87.75%) were the most frequent treatments. For adults and the elderly, friction burns were the commonest (33%), lower limbs were the most affected areas (43.6%), whereas the objective of enhancing muscle strength, range of motion and flexibility (86.59%) was the most frequent and kinesiotherapy (86.6%) the most commonly used treatment. CONCLUSION: The epidemiological findings found here indicate the profile of the burned patient under physiotherapeutic care in Goiânia as it provided support for a more directed physiotherapeutic intervention towards the needs of such population.(AU)

Objetivo: Verificar el perfil epidemiológico y clínico de pacientes con secuelas de quemaduras, y determinar cuáles conductas fueron más utilizadas en el tratamiento fisioterapéutico. Métodos: Estudio transversal, retrospectivo, observacional a través del análisis de prontuarios. Resultados: De los pacientes que recibieron alta en el período de 2006 hasta 2013, 146 (6,098%) tenían como diagnóstico "quemaduras". Este total de pacientes fue separado por edad: niños y adolescentes, adultos y mayores. El perfil epidemiológico de los niños y adolescentes con edad media de 6,89±6,5 años, reveló que el sexo masculino (57,1%) de etnia negra (51,02%) presentaba mayor prevalencia. La amuestra de adultos y mayores apuntó prevalencia del sexo femenino (56,7%) de etnia blanca (48,45%). En el perfil clínico y de atendimiento fisioterapéutico de niños y adolescentes, el agente etiológico Inflamable fue lo más frecuente (49%), miembros superiores fueron las regiones más acometidas (91,7%), siendo el objetivo de mejorar la cicatrización (89,79%) y la cinesioterapia (87,75%) las conductas más utilizadas. Para los adultos y mayores, la quemadura por atrito fue la más prevalente (33%), miembros inferiores fueron las regiones más acometidas (43,6%), y referente al objetivo, mejorar la fuerza muscular, amplitud de los movimientos y flexibilidad (86,59%) fue lo más frecuente y la cinesioterapia (86,6%), la conducta más adoptada. Conclusión: los hallados epidemiológicos aquí encontrados sugieren el perfil del paciente quemado en atendimiento fisioterápico en Goiânia, forneciendo subsidios para una investigación fisioterápica más direccionada a las necesidades de esta población.(AU)