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ABSTRACT Introduction: Synchronized swimming is a sport that demands high cardiopulmonary capacity from the athletes, physical conditioning, excellent swimming, and aerobic metabolism preparation. Long-term exposure to cold air is a key factor that affects lung function, affecting the athlete's performance in synchronized swimming. This exposure can lead to inflammation of the athletes' airways, although few studies have analyzed the changes in cardiorespiratory conditioning during competition. Objective: This study aims to analyze the effect of synchronized swimming athletes' cardiopulmonary function on competition performance in cold air environments. Methods: This paper selects volunteer swimmers for the research. Ventilation tests are performed to collect data and to analyze the effect of training on cardiorespiratory conditioning during swimming. Results: There were significant differences in small airway function, generally defined as airways with caliber < 2 mm internal diameter, without cartilage, values measured among synchronized swimmers (P<0.05). There were significant differences in forced vital capacity, and one-second forced expiratory rate between synchronized swimmers (P<0.05). Conclusion: Synchronized swimmers may have their small airway function impaired due to the inherent characteristics of the sport. Level of evidence II; Therapeutic studies - investigation of treatment outcomes.
RESUMO Introdução: O nado sincronizado é um esporte que exige alta capacidade cardiopulmonar dos atletas, condicionamento físico, excelente natação e preparo do metabolismo aeróbico. A exposição a longo prazo ao ar frio é um fator essencial que afeta a função pulmonar, afetando o desempenho do atleta no nado sincronizado. Essa exposição pode levar à inflamação das vias aéreas dos atletas, apesar de poucos estudos analisarem as alterações do condicionamento cardiorrespiratório durante a competição. Objetivo: O objetivo deste estudo é analisar o efeito da função cardiopulmonar dos atletas de nado sincronizado sobre o desempenho da competição em ambientes com ar frio. Métodos: Este artigo seleciona nadadores voluntários à pesquisa. Testes de ventilação são executados para a coleta dos dados, além de análise do efeito do treinamento sobre o condicionamento cardiorrespiratório durante a natação. Resultados: Houve diferenças significativas na função das vias aéreas de pequeno porte, geralmente definidas como vias aéreas com calibre < 2 mm de diâmetro interno, sem cartilagem, valores medidos entre nadadores sincronizados (P<0,05). Houve diferenças significativas na capacidade vital forçada e taxa expiratória forçada de um segundo entre nadadores sincronizados (P<0,05). Conclusão: Nadadores sincronizados podem ter a função das suas vias aéreas de pequeno porte prejudicadas devido às características inerentes do esporte. Nível de evidência II; Estudos terapêuticos - investigação dos resultados do tratamento.
RESUMEN Introducción: La natación sincronizada es un deporte que exige a las atletas una alta capacidad cardiopulmonar, un acondicionamiento físico, un excelente nado y una preparación del metabolismo aeróbico. La exposición prolongada al aire frío es un factor esencial que afecta a la función pulmonar, lo que repercute en el rendimiento del atleta en la natación sincronizada. Esta exposición puede provocar la inflamación de las vías respiratorias de los atletas, aunque son pocos los estudios que analizan los cambios en el acondicionamiento cardiorrespiratorio durante la competición. Objetivo: El objetivo de este estudio es analizar el efecto de la función cardiopulmonar de las atletas de natación sincronizada en el rendimiento de la competición en ambientes de aire frío. Métodos: Este artículo selecciona nadadores voluntarios para la investigación. Se realizan pruebas de ventilación para la recogida de datos, así como el análisis del efecto del entrenamiento en el acondicionamiento cardiorrespiratorio durante la natación. Resultados: Hubo diferencias significativas en la función de las vías respiratorias pequeñas, generalmente definidas como vías respiratorias con calibre < 2 mm de diámetro interno, sin cartílago, valores medidos entre los nadadores sincronizados (P<0,05). Hubo diferencias significativas en la capacidad vital forzada y en la tasa de espiración forzada de un segundo entre las nadadoras sincronizadas (P<0,05). Conclusión: Las nadadoras de natación sincronizada pueden tener la función de las vías respiratorias pequeñas alterada debido a las características inherentes a este deporte. Nivel de evidencia II; Estudios terapéuticos - investigación de los resultados del tratamiento.
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Background: Patients with SARS-CoV-2 present signs and symptoms that primarily involve the respiratory system. The sequelae result in impaired quality of life, pneumonia, dyspnea, fatigue, and joint pain. Objective: To sustain with scientific evidence the importance of respiratory physiotherapy and its effects on post-acute COVID-19 adult patients. Material and methods: A systematic review was conducted in four databases (Scopus, Web of Science, PubMed, and ScienceDirect). The searching period was carried out in February 2021 with a total of one 1229 potential studies. Finally, 5 studies that met the eligibility criteria were included: two clinical trials, two case reports and one cross-sectional study. The methodological quality of the articles was evaluated. Results: Respiratory muscle training, targeted breathing, and strength training provide significant data of improvement of functional performance. Evidence shows positive effects of respiratory physiotherapy in post-acute COVID-19 adult patients, since it increases resistance to exercise, it decreases fatigue, reduces dyspnea, improves functionality and quality of life. Conclusions: More future studies, such as randomized controlled trials, studies including lower age range groups, and individualized approaches, need to be developed.
Introducción: los pacientes con SARS-CoV-2 presentan signos y síntomas que involucran principalmente el sistema respiratorio. Las secuelas son consecuencia de un deterioro de la calidad de vida, neumonía, fatiga, disnea y dolor articular. Objetivo: tener el sustento científico que permita evidenciar la importancia de la fisioterapia respiratoria y sus efectos sobre los pacientes adultos post-COVID-19 de fase aguda. Material y métodos: se hizo una revisión sistemática de la literatura en cuatro bases de datos (Scopus, Web of Science, PubMed y ScienceDirect). La búsqueda fue realizada en febrero de 2021 con un total de 1229 estudios. Finalmente, se incluyeron cinco estudios que cumplieron con los criterios de elegibilidad: dos ensayos clínicos, dos reportes de caso y un estudio transversal. La calidad metodológica de las publicaciones fue evaluada. Resultados: el entrenamiento de la musculatura respiratoria, las respiraciones dirigidas y el fortalecimiento general dan datos significativos en la mejora de la funcionalidad. La evidencia demuestra que hay efectos positivos de la fisioterapia respiratoria en pacientes adultos post-COVID-19, pues aumenta la resistencia al ejercicio, disminuye la fatiga, se reduce la disnea, mejora la funcionalidad y la calidad de vida. Conclusiones: es necesario que se desarrollen más ensayos clínicos aleatorizados y estudios de grupos de menor rango de edad y con enfoques individualizados.
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COVID-19 , Qualidade de Vida , Adulto , COVID-19/terapia , Estudos Transversais , Humanos , Modalidades de Fisioterapia , SARS-CoV-2RESUMO
Abstract Introduction: The aim of this study was to evaluate the delayed chest closure (DCC) results in patients who underwent lung transplantation. Methods: Sixty patients were evaluated retrospectively. Only bilateral lung transplantations and DCC for oversized lung allograft (OLA) were included in the study. Six patients who underwent single lung transplantation, four patients who underwent lobar transplantation, two patients who underwent retransplantation, and four patients who underwent DCC due to bleeding risk were excluded from the study. Forty-four patients were divided into groups as primary chest closure (PCC) (n=28) and DCC (n=16). Demographics, donor characteristics, and operative features and outcomes of the patients were compared. Results: The mean age was 44.5 years. There was no significant difference between the demographics of the groups (P>0.05). The donor/recipient predicted total lung capacity ratio was significantly higher in the DCC group than in the PCC group (1.06 vs. 0.96, P=0.008). Extubation time (4.3 vs. 3.1 days, P=0.002) and intensive care unit length of stay (7.6 vs. 5.2 days, P=0.016) were significantly higher in the DCC group than in the PCC group. In the DCC group, postoperative wound infection was significantly higher than in the PCC group (18.6% vs. 0%, P=0.19). Median survival was 14 months in all patients and there was no significant difference in survival between the groups (16 vs. 13 months, P=0.300). Conclusion: DCC is a safe and effective method for the management of OLA in lung transplantation.
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Humanos , Adulto , Transplante de Pulmão/efeitos adversos , Transplante de Pulmão/métodos , Turquia , Estudos Retrospectivos , Resultado do Tratamento , Aloenxertos , PulmãoRESUMO
RESUMEN Introducción: La capacidad de ejercicio de los pacientes con insuficiencia cardíaca avanzada mejora después del trasplante cardíaco (TXC). La prueba de ejercicio cardiopulmonar (PECP) es reconocida como el estudio "estándar de oro" para la evaluación de la capacidad de ejercicio aeróbico. El objetivo del estudio fue analizar las características de la PECP realizada en receptores de TXC. Material y métodos: Se realizó un estudio de corte transversal. Se incluyeron pacientes mayores de 18 años receptores de TXC desde el 1 de noviembre de 2013 hasta el 30 de junio de 2019, que hubieran realizado una PECP dentro del primer año posterior al trasplante. Se analizaron variables clínicas y de la PECP. Resultados: Se incluyeron 122 pacientes (edad media 50,1 ± 11,8 años, 77,0% hombres). El consumo de oxígeno (VO2) pico fue de 23,3 ± 5,3 mL/min/kg y el 45,9% alcanzó el umbral anaeróbico. El 68,0% y el 28,7% de la población mostró valores de pulso de oxígeno y de la pendiente de la eficiencia del VO2 (OUES) normales, respectivamente. El 46,7%, 23,0% y 3,3% presentaron una reducción leve, moderada o grave de la capacidad funcional, respectivamente. El valor de OUES fue bajo en el 80,0%, 71,4% y 92,9% de los pacientes con disminución de la capacidad funcional de origen cardiovascular, periférico y mixto, respectivamente. Conclusión: En esta población de receptores de TXC, la proporción de sujetos con capacidad funcional reducida o valores de OUES alterados fue considerable. La evaluación de estos pacientes a través de la PECP podría favorecer la derivación temprana a centros de rehabilitación cardiovascular.
ABSTRACT Background: Exercise capacity of patients with advanced heart failure improves after heart transplantation (HTX). Cardiopulmonary exercise test (CPET) is recognized as the "gold standard" study for the evaluation of aerobic exercise capacity. Objective: The aim of this study was to analyze the characteristics of CPET in HTX recipients. Methods: A cross-sectional study was performed in patients over 18 years of age undergoing HTX from November 1, 2013 to June 30, 2019, and with a CPET within the first year after transplantation. Clinical and CPET variables were analyzed. Results: A total of 122 patients with mean age of 50.1 ± 11.8 years and 77.0% men were included in the study. Peak oxygen consumption (VO2) was 23.3 ± 5.3 mL/min/kg and 45.9% of patients achieved the anaerobic threshold. In 68.0% and 28.7% of cases, the population presented normal oxygen pulse and oxygen uptake efficiency slope (OUES) values, respectively. Mild, moderate, or severe reduced functional capacity was found in 46.7%, 23.0%, and 3.3% of patients, respectively. Oxygen uptake efficiency slope was low in 80.0%, 71.4% and 92.9% of patients with decreased functional capacity of cardiovascular, peripheral, and mixed origin, respectively. Conclusion: In this population of HTX recipients, a considerable proportion of subjects showed reduced functional capacity or abnormal OUES values. The evaluation of these patients through CPET could favor early referral to cardiovascular rehabilitation centers.
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INTRODUCTION: The aim of this study was to evaluate the delayed chest closure (DCC) results in patients who underwent lung transplantation. METHODS: Sixty patients were evaluated retrospectively. Only bilateral lung transplantations and DCC for oversized lung allograft (OLA) were included in the study. Six patients who underwent single lung transplantation, four patients who underwent lobar transplantation, two patients who underwent retransplantation, and four patients who underwent DCC due to bleeding risk were excluded from the study. Forty-four patients were divided into groups as primary chest closure (PCC) (n=28) and DCC (n=16). Demographics, donor characteristics, and operative features and outcomes of the patients were compared. RESULTS: The mean age was 44.5 years. There was no significant difference between the demographics of the groups (P>0.05). The donor/recipient predicted total lung capacity ratio was significantly higher in the DCC group than in the PCC group (1.06 vs. 0.96, P=0.008). Extubation time (4.3 vs. 3.1 days, P=0.002) and intensive care unit length of stay (7.6 vs. 5.2 days, P=0.016) were significantly higher in the DCC group than in the PCC group. In the DCC group, postoperative wound infection was significantly higher than in the PCC group (18.6% vs. 0%, P=0.19). Median survival was 14 months in all patients and there was no significant difference in survival between the groups (16 vs. 13 months, P=0.300). CONCLUSION: DCC is a safe and effective method for the management of OLA in lung transplantation.
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Transplante de Pulmão , Adulto , Aloenxertos , Humanos , Pulmão , Transplante de Pulmão/efeitos adversos , Transplante de Pulmão/métodos , Estudos Retrospectivos , Resultado do Tratamento , TurquiaRESUMO
OBJECTIVE: To verify the concurrent validity between the inspiratory muscle strength (IMS) values obtained in static (maximal inspiratory pressure [MIP]) and dynamic (S-Index) assessments. METHODS: Healthy individuals were submitted to two periods of evaluation: i) MIP, static maneuver to obtain IMS, determined by the Mueller's maneuver from residual volume (RV) until total lung capacity (TLC); ii) and S-Index, inspiration against open airway starting from RV until TLC. Both measures were performed by the same evaluator and the subjects received the same instructions. Isolated maneuvers with differences < 10% were considered as reproducible measures. RESULTS: Data from 45 subjects (21 males) were analyzed and that showed statistical difference between MIP and S-Index values (133.5 ± 33.3 and 125.6 ± 32.2 in cmH2O, respectively), with P=0.014. Linear regression showed r2=0.54 and S-Index prediction formula = 39.8+(0.75×MIP). Pearson's correlation demonstrated a strong and significant association between the measures with r=0.74. The measurements showed good concordance evidenced by the Bland-Altman test. CONCLUSION: S-Index and MIP do not present similar values since they are evaluations of different events of the muscular contraction. However, they have a strong correlation and good agreement, which indicate that both are able to evaluate the IMS of healthy individuals.
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Pressões Respiratórias Máximas , Músculos Respiratórios , Feminino , Humanos , Masculino , Contração Muscular , Força Muscular , Adulto JovemRESUMO
Abstract Objective: To verify the concurrent validity between the inspiratory muscle strength (IMS) values obtained in static (maximal inspiratory pressure [MIP]) and dynamic (S-Index) assessments. Methods: Healthy individuals were submitted to two periods of evaluation: i) MIP, static maneuver to obtain IMS, determined by the Mueller's maneuver from residual volume (RV) until total lung capacity (TLC); ii) and S-Index, inspiration against open airway starting from RV until TLC. Both measures were performed by the same evaluator and the subjects received the same instructions. Isolated maneuvers with differences < 10% were considered as reproducible measures. Results: Data from 45 subjects (21 males) were analyzed and that showed statistical difference between MIP and S-Index values (133.5 ± 33.3 and 125.6 ± 32.2 in cmH2O, respectively), with P=0.014. Linear regression showed r2=0.54 and S-Index prediction formula = 39.8+(0.75×MIP). Pearson's correlation demonstrated a strong and significant association between the measures with r=0.74. The measurements showed good concordance evidenced by the Bland-Altman test. Conclusion: S-Index and MIP do not present similar values since they are evaluations of different events of the muscular contraction. However, they have a strong correlation and good agreement, which indicate that both are able to evaluate the IMS of healthy individuals.
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Humanos , Masculino , Feminino , Adulto Jovem , Músculos Respiratórios , Pressões Respiratórias Máximas , Força Muscular , Contração MuscularRESUMO
The aim of the study was to investigate the relationship between slow and forced vital capacity (SVC-FVC) difference with dynamic lung hyperinflation (DH) during the 6-min walking test (6MWT) in subjects with chronic obstructive pulmonary disease (COPD). Twenty-four subjects with COPD (12 males; 67 ± 6 years; forced expiratory volume in first second [FEV1] 56 ± 18% predicted) performed lung function tests by spirometry and plethysmography. DH was assessed by serial measurements of inspiratory capacity (IC) performed during the 6MWT and defined as ∆IC ≥ 150 mL or 10%. IC decrease significantly during the 6MWT (ΔCI: - 0.48 ± - 0.40 L; P < 0.0001), and 18 individuals (75%) presented DH. There was significant difference when comparing IC measured at rest with the other serial IC measurements (P < 0.0001). Correlation between the SVC-FVC difference and DH during the 6MWT was r = - 0.38; P = 0.06. The SVC-FVC difference presented only weak correlation with the development of DH during the 6MWT in patients with COPD.
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Pulmão/fisiopatologia , Doença Pulmonar Obstrutiva Crônica/fisiopatologia , Capacidade Vital , Idoso , Estudos Transversais , Tolerância ao Exercício , Feminino , Volume Expiratório Forçado , Humanos , Masculino , Pessoa de Meia-Idade , Pletismografia , Doença Pulmonar Obstrutiva Crônica/diagnóstico , Espirometria , Fatores de Tempo , Teste de CaminhadaRESUMO
OBJECTIVE: To assess and compare long-term pulmonary outcomes in former preterm-born, very low birth weight (VLBW) children with and without bronchopulmonary dysplasia (BPD) born in the surfactant era. STUDY DESIGN: Pulmonary function tests (ie, spirometry, body plethysmography, and gas transfer testing) were performed in children with a history of VLBW and BPD (n = 28) and compared with a matched preterm-born VLBW control group (n = 28). Medical history was evaluated by questionnaire. RESULTS: At time of follow-up (mean age, 9.5 years), respiratory symptoms (36% vs 8%) and receipt of asthma medication (21% vs 0%) were significantly more frequent in the preterm-born children with previous BPD than in those with no history of BPD. The children with a history of BPD had significantly lower values for forced expiratory volume in 1 second (z-score -1.27 vs -0.4; P = .008), forced vital capacity (z-score -1.39 vs -0.71 z-score; P = .022), and forced expiratory flow rate at 50% of forced vital capacity (z-score -2.21 vs -1.04; P = .048) compared with the preterm control group. CONCLUSION: Preterm-born children with a history of BPD are significantly more likely to have lung function abnormalities, such as airway obstruction and respiratory symptoms, at school age compared with preterm-born children without BPD.
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Obstrução das Vias Respiratórias/etiologia , Asma/etiologia , Displasia Broncopulmonar/fisiopatologia , Recém-Nascido Prematuro , Recém-Nascido de muito Baixo Peso , Pulmão/fisiopatologia , Obstrução das Vias Respiratórias/epidemiologia , Asma/epidemiologia , Displasia Broncopulmonar/complicações , Displasia Broncopulmonar/diagnóstico , Criança , Feminino , Seguimentos , Volume Expiratório Forçado , Alemanha/epidemiologia , Humanos , Incidência , Masculino , Prognóstico , Testes de Função Respiratória , Estudos Retrospectivos , Instituições Acadêmicas , Fatores de Tempo , Capacidade VitalRESUMO
OBJECTIVE: To compare TLC and RV values obtained by the single-breath helium dilution (SBHD) method with those obtained by whole-body plethysmography (WBP) in patients with normal lung function, patients with obstructive lung disease (OLD), and patients with restrictive lung disease (RLD), varying in severity, and to devise equations to estimate the SBHD results. METHODS: This was a retrospective cross-sectional study involving 169 individuals, of whom 93 and 49 presented with OLD and RLD, respectively, the remaining 27 having normal lung function. All patients underwent spirometry and lung volume measurement by both methods. RESULTS: TLC and RV were higher by WBP than by SBHD. The discrepancy between the methods was more pronounced in the OLD group, correlating with the severity of airflow obstruction. In the OLD group, the correlation coefficient of the comparison between the two methods was 0.57 and 0.56 for TLC and RV, respectively (p < 0.001 for both). We used regression equations, adjusted for the groups studied, in order to predict the WBP values of TLC and RV, using the corresponding SBHD values. It was possible to create regression equations to predict differences in TLC and RV between the two methods only for the OLD group. The TLC and RV equations were, respectively, ∆TLCWBP-SBHD in L = 5.264 − 0.060 × FEV1/FVC (r2 = 0.33; adjusted r2 = 0.32) and ∆RVWBP-SBHD in L = 4.862 − 0.055 × FEV1/FVC (r2 = 0.31; adjusted r2 = 0.30). CONCLUSIONS: The correction of TLC and RV results obtained by SBHD can improve the accuracy of this method for assessing lung volumes in patients with OLD. However, additional studies are needed in order to validate these equations. .
OBJETIVO: Comparar resultados de CPT e VR obtidos pelo método de diluição de hélio em respiração única (DHRU) com aqueles obtidos por pletismografia de corpo inteiro (PCI) em indivíduos com função pulmonar normal, portadores de distúrbio ventilatório obstrutivo (DVO) e portadores de distúrbio ventilatório restritivo (DVR) com diferentes níveis de gravidade e elaborar equações para estimar CPT e VR por DHRU. MÉTODOS: Estudo transversal retrospectivo com 169 indivíduos, dos quais, respectivamente, 93, 49 e 27 apresentavam DVO, DVR e espirometria normal. Todos realizaram espirometria e determinação de volumes pulmonares pelos dois métodos. RESULTADOS: Os valores de CPT e VR foram maiores por PCI que por DHRU. A discrepância entre os métodos foi mais acentuada no grupo com DVO e se relacionou com a gravidade da obstrução ao fluxo aéreo. No grupo com DVO, o coeficiente de correlação da comparação entre os dois métodos foi de 0,57 e 0,56 para CPT e VR, respectivamente (p < 0,001 para ambos). Para predizer os valores de CPT e VR por PCI utilizando os respectivos valores por DHRU foram utilizadas equações de regressão, corrigidas de acordo com os grupos estudados. Somente foi possível criar equações de regressão para predizer as diferenças de CPT e VR entre os dois métodos para pacientes com DVO. Essas equações foram, respectivamente, ∆CPTPCI-DHRU em L = 5,264 − 0,060 × VEF1/CVF (r2 = 0,33; r2 ajustado = 0,32) e ∆VRPCI-DHRU em L = 4,862 − 0,055 × VEF1/CVF (r2 = 0,31; r2 ajustado = 0,30). CONCLUSÕES: A correção de CPT e VR obtidos por DHRU pode melhorar a acurácia desse método para avaliar os volumes pulmonares em pacientes com DVO. Entretanto, estudos adicionais ...
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Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Hélio , Pneumopatias Obstrutivas/diagnóstico , Índice de Massa Corporal , Testes Respiratórios/métodos , Estudos Transversais , Modelos Lineares , Pneumopatias Obstrutivas/fisiopatologia , Medidas de Volume Pulmonar/métodos , Pletismografia Total , Estudos Retrospectivos , Volume Residual/fisiologia , Índice de Gravidade de Doença , EspirometriaRESUMO
OBJETIVO: Verificar alterações na capacidade funcional dos pacientes que se submetem à cirurgia de revascularização do miocárdio (CRM) por meio do teste de caminhada de seis minutos (TC6) no seguimento de dois anos. MÉTODOS: Estudo de coorte prospectivo, no qual foram arrolados 215 pacientes submetidos a CRM, 13 não preencheram os critérios de inclusão. Foram 202 pacientes avaliados no pré-operatório, 13 morreram no período da internação e seis no seguimento de dois anos. Quatro pacientes foram considerados perdas de seguimento. Foram acompanhados 179 pacientes no período de 2 anos, classificados em ativos e sedentários, conforme a prática de atividade física no tempo livre e submetidos ao TC6 no préoperatório e 2 anos depois. RESULTADOS: Dos 202 pacientes avaliados no pré-operatório da CRM, 67 por cento eram do sexo masculino, com idade média de 63 (± 9,75) anos. Pré e após 2 anos da CRM, 52 pacientes se mantiveram ativos e as distâncias caminhadas foram 359m (± 164,47) e 439m (± 171,34), respectivamente, P= 0,016. A distância caminhada no pré e pós-operatório, dos 45 pacientes que permaneceram sedentários, foi, respectivamente, 255m (± 172,15) e 376m (± 210,92) P<0,001. Oitenta e dois pacientes transitaram entre estes dois grupos, 71 passaram de sedentários para ativos e caminharam 289m (± 157,15) no pré e 380m (± 125,44) no pós-operatório, P= 0,001; os 11 pacientes que eram ativos e passaram a sedentários caminharam no pré 221m (± 191,91) e, no pós-operatório, 384m (± 63,73) P= 0,007. CONCLUSÃO: A capacidade funcional dos pacientes submetidos à CRM melhorou de forma importante no seguimento de médio prazo.
OBJECTIVE: To check changes in the functional capacity of patients undergoing coronary artery bypass grafting (CABG) by testing six-minute walk test (6MWT) following two years. METHODS: A prospective cohort study where 215 patients were enrolled who underwent CABG, 13 did not meet the criteria for inclusion. 202 patients were evaluated preoperatively, 13 died during hospitalization and 6 in the follow up of two years. Four patients were considered lost follow up. This study followed 179 patients for two years classified into active and sedentary, according to physical activity in leisure time and to the 6MWT preoperatively and 2 years later. RESULTS: One hundred and twenty patients were evaluated in the day before CABGS, being 67 percent male with an average age of 63 (± 9.75) years. Before surgery and 2 years later, 52 were active and the 6MWT distances performed had been 359m (± 164.47) and 439m (± 171.34), respectively; P= 0.016. Forty five patients were classified as sedentary before and 2 years after surgery. The 6MWT distances walked before and after surgery had been 255m (± 172.15) and 376m (± 210.92), respectively; P < 0.001. Eighty two patients transited between these two groups, 71 passed from sedentary to active and had walked before and after surgery 289m (± 157.15) and 380m (± 125.44), respectively; P= 0.001. The 11 patients who were active and passed to the sedentary group walked 221m (± 191.91) and 384m (± 63.73), respectively; P= 0.007. CONCLUSION: The functional capacity of the patients submitted to CABGS had a significant improvement in a medium period of follow-up.
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Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Ponte de Artéria Coronária/reabilitação , Teste de Esforço , Comportamento Sedentário , Caminhada/fisiologia , Métodos Epidemiológicos , Teste de Esforço/métodos , Período Pós-Operatório , Período Pré-OperatórioRESUMO
FUNDAMENTO: Durante a infância e adolescência, o sedentarismo, o excesso de peso e a alimentação inadequada são fatores de risco para doenças crônicas, sobretudo obesidade, hipertensão arterial sistêmica e diabete melito. A intervenção precoce pode prevenir o desenvolvimento dessas complicações. OBJETIVO: Verificar a presença de fatores de risco cardiovasculares (obesidade e hipertensão arterial) e suas possíveis interações com a capacidade cardiorrespiratória. Métodos: Estudo transversal composto de amostra estratificada por conglomerados, de 1.666 escolares, com idades entre 7 e 17 anos, 873 (52,4 por cento) do sexo masculino e 793 (47,6 por cento) do sexo feminino. Avaliaram-se as pressões arteriais sistólica (PAS) e diastólica (PAD), índice de massa corporal (IMC), percentual de gordura ( por centoG) e capacidade cardiorrespiratória. Ainda, PAS e PAD foram correlacionadas com circunferência da cintura (CC), relação cintura-quadril (RCQ), somatório de dobras cutâneas (ΣDC) e capacidade cardiorrespiratória. RESULTADOS: A avaliação do IMC dos escolares evidenciou 26,7 por cento de sobrepeso ou obesidade e 35,9 por cento com o percentual de gordura acima de moderadamente alto. Com relação aos níveis pressóricos, encontraram-se 13,9 por cento e 12,1 por cento de escolares limítrofes e hipertensos, para PAS e PAD, respectivamente. Houve associação entre hipertensão, obesidade e capacidade cardiorrespiratória. Observou-se correlação significativa em relação à PAS e PAD, para todas as variáveis analisadas, apresentando, ainda, uma relação fraca a moderada com as variáveis idade, peso, estatura, IMC e circunferência da cintura. CONCLUSÃO: A presença da hipertensão arterial associada à obesidade e seu reflexo na capacidade cardiorrespiratória reforçam a importância de se propor, já na infância, um estilo de vida mais ativo e saudável.
BACKGROUND: During childhood and adolescence, physical inactivity, excess weight, and poor nutrition are risk factors for chronic diseases, especially obesity, hypertension, and diabetes mellitus. Early intervention can prevent the development of these complications. OBJECTIVE: To determine the presence of cardiovascular risk (obesity and hypertension) in schoolchildren and its potential interactions with cardio-respiratory fitness. METHODS: This was a cross-sectional study conducted in a stratified cluster sample of 1,666 schoolchildren, aged between 7 and 17 years, 873 (52.4 percent) of them male and 793 (47.6 percent) of them female. The following variables were evaluated: systolic blood pressure (SBP), diastolic blood pressure (DBP), body mass index (BMI), body fat percentage (BF percent), and cardio-respiratory fitness. SBP and DBP were correlated with waist circumference (WC), waist-hip ratio (WHR), sum of skin folds (ΣSF), and cardio-respiratory fitness. RESULTS: A BMI assessment of the students showed that 26.7 percent of them were overweight or obese, and 35.9 percent had body fat percentage over moderately high. As to blood pressure, we found that 13.9 percent and 12.1 percent of the students were borderline or hypertensive, for SBP and DBP, respectively. There was an association among hypertension, obesity, and cardio-respiratory fitness. There was a significant correlation of SBP and DBP with all variables, and also a weak to moderate correlation with age, weight, height, BMI, and waist circumference. CONCLUSION: The presence of hypertension associated with obesity and its effects on cardio-respiratory fitness stress the importance of recommending, since childhood, a more active and healthy lifestyle.
Assuntos
Adolescente , Criança , Feminino , Humanos , Masculino , Hipertensão/epidemiologia , Obesidade/epidemiologia , Capacidade Pulmonar Total/fisiologia , Determinação da Pressão Arterial , Pesos e Medidas Corporais , Brasil/epidemiologia , Estudos Transversais , Doenças Cardiovasculares/etiologia , Doenças Cardiovasculares/prevenção & controle , Hipertensão/complicações , Estilo de Vida , Obesidade/complicações , Fatores de Risco , Fatores SexuaisRESUMO
RACIONAL: O transplante hepático é utilizado para o tratamento de doenças hepáticas em estado avançado, quando a sobrevida e a função hepática são aumentadas após o procedimento. OBJETIVO: Avaliar e comparar a função pulmonar, a condição funcional e a qualidade de vida de pacientes candidatos ao transplante hepático e após a realização do procedimento cirúrgico no período de 1, 3, 6, 9 e 12 meses de pós-operatório. MÉTODOS: Trabalho transversal, observacional, com amostra de conveniência, composta por 30 pacientes, divididos em seis grupos (com cinco indivíduos em cada grupo), nos seguintes tempos: pré-transplante, 1, 3, 6, 9 e 12 meses de pós-operatório. Todos os indivíduos foram avaliados em um único momento, quando foram mensurados a capacidade vital forçada, o volume expiratório forçado no primeiro segundo, as pressões inspiratória e expiratória máxima, a distância percorrida no teste de caminhada de 6 minutos e os domínios relacionados à qualidade de vida através do questionário de qualidade de vida auto-aplicativo "Short Form 36". RESULTADOS: Houve melhora em todas as variáveis ao comparar o período pré-transplante com os consecutivos meses de pós-operatório, onde a pressão inspiratória máxima, a distância percorrida e o domínio da capacidade funcional apresentaram mudanças estatisticamente significantes. CONCLUSÃO: O transplante hepático é uma alternativa para o tratamento das doenças hepáticas avançadas e proporciona aos pacientes benefícios nas condições respiratórias e funcionais, contribuindo para melhora da qualidade de vida.
BACKGROUND: The liver transpslantation is used for treatment of end-stage liver disease, where the survival and liver function are markedly improved after transplantation. AIM: To evaluate and compare lung function, functional capacity and quality of life in patients submitted to liver transplantation after 1, 3, 6, 9 and 12 months of procedure. METHODS: Observational study with convenience groups composed by 30 patients, which had been divided in six groups (5 subjects each), in preoperative period and in the period of 1, 3, 6, 9 and 12 months after liver transplantation. All the individuals were evaluated at the same time, verificating the measurement of the forced vital capacity, forced expiratory volume in one second, maximum inspiratory and expiratory pressure, distance and domains related to quality of life. RESULTS: According to the explanation, it was observed improvement in all variables in subsequent groups to the liver transplantation in periods of 1, 3, 6, 9 and 12 months when compared to the preoperative group. The most significant changes occurred during the maximum inspiratory pressures, the distance and physical functioning. CONCLUSIONS: The liver transplantation as an alternative treatment for advanced liver disease, gives the patients benefits in respiratory and physical-functional conditions with improvement of life quality.