Incontinência urinária

Inclui referência

Efetividade e segurança do treinamento físico domiciliar sobre a capacidade de exercício em pacientes com DPOC usuários de oxigenoterapia domiciliar prolongada : ensaio controlado randomizado

Orientador: Silvia Regina ValderramasCoorientador: Anna Raquel S. GomesTese (doutorado) - Universidade Federal do Paraná, Setor de Ciências da Saúde , Programa de Pós-Graduação em Medicina Interna. Defesa : Curitiba, 10/12/2018Inclui referências: p. 49-54Resumo: Pacientes com DPOC em estágio mais avançado da doença e que necessitam utilizar oxigenoterapia domiciliar prologada (ODP), apresentam dificuldade em participar de programas de reabilitação pulmonar (RP) devido à gravidade da doença, mas principalmente pela dificuldade de transporte (pois os cilindros de oxigênios são muito pesados), recursos disponíveis (caros para reabastecer), segurança e necessidades individualizadas dos pacientes. No intuito de atender esta demanda, o treinamento físico (TF) domiciliar tem sido comumente utilizado. No entanto, a maioria dos programas são realizados sem supervisão. O objetivo deste estudo foi analisar a efetividade do treinamento físico domiciliar supervisionado sobre a capacidade de exercício em pacientes com DPOC usuários de ODP. Em um ensaio clínico controlado e randomizado realizado no domicilio, pacientes com DPOC usuários de ODP foram divididos em dois grupos: Grupo treinamento físico (GT) que realizou treinamento de resistência e fortalecimento muscular, 60 minutos, duas vezes por semana, durante 12 semanas, supervisionadas presencialmente e Grupo orientações por Cartilha (GC), que recebeu uma cartilha contendo a descrição de alguns exercícios físicos e foram orientados a realizar duas vezes por semana, durante 12 semanas. Todos os participantes foram avaliados antes e após o período de intervenção em relação à: capacidade de exercício (Teste Degrau 6 minutos - TD6min e Teste de sentar e levantar de 1 min - STST); dispneia (Escala do Medical Research Council - MRC), fadiga (Fatigue Severity Scale - FSS-BR) e qualidade de vida (COPD Assessment Test - CAT). Após 12 semanas de tratamento, foram analisados 44 pacientes (70 ± 7,5 anos, VEF1: 32,4 ± 13,5 % do valor previsto) [(GT, n=22) e (GC, n=22)]. Somente os pacientes alocados no GT apresentaram aumento significante no TD6min (p=0,001), no MRC (p= 0,013), no FSS (p= 0,015) e CAT (p=0,001). Não ocorreram efeitos adversos. O programa de treinamento físico domiciliar supervisionado foi efetivo e seguro na melhora da capacidade de exercício, dispneia, fadiga e qualidade de vida em pacientes com DPOC usuários de ODP. Palavras-chave: Exercício. Doença Pulmonar Obstrutiva Crônica. Oxigenoterapia.Abstract: COPD patients in advanced stage of the disease who need long-term home oxygen therapy (LTHOT) have difficulty participating in pulmonary rehabilitation (PR) programs in part because of the severity of the disease but primarily because of the difficulty involving transport, because the heavy oxygen cylinders, the high cost of refilling the cylinders and issues related to patients' safety and individual needs. In order to meet the needs of these patients, home-based exercise training (ET) is frequently used. However, most of the programs are unsupervised. The main objective of this study was to analyze the effectiveness of supervised home-based exercise training on exercise capacity in COPD patients on LTHOT. In a home-based controlled randomized clinical trial, COPD patients on LTHOT were divided into two groups: an exercise-training group (EG), consisting of patients who received supervised resistance and muscle-strength training in twice-weekly 60-minute sessions during twelve weeks; and a booklet-based group (BG), consisting of individuals who received a booklet with description of physical exercises which they were advised to perform twice a week during 12 weeks. All participants were assessed before and after the intervention in terms of exercise capacity (6-minute step test, 6MST, and 1-minute sitto- stand test, STST); dyspnea (Medical Research Council scale, MRC); fatigue (fatigue severity scale, FSS-BR); and quality of life (COPD assessment test, CAT). After 12 weeks of treatment, 44 patients were evaluated (70 ± 7.5 years, FEV1: 32.4 ± 13.5 % of the predicted value) (EG, n=22; BG, n=22). Only the patients in the EG had a statistically significant increase in the 6MST (p=0.001), MRC (p= 0.013), FSS (p= 0.015) and CAT (p=0.001). No adverse effects were observed. The supervised homebased exercise-training program proved to be effective and safe in improving exercise capacity, dyspnea, fatigue and quality of life in COPD patients on LTHOT. Keywords: Exercise. Chronic Obstructive Pulmonary Disease. Oxygen Therapy

Association Between the Results of the Timed Up-andGo Test Adjusted for Disease Severity and Sarcopenia in Patients with Chronic Obstructive Pulmonary Disease: a Pilot Study

OBJECTIVES: Loss of muscle mass and/or physical performance, a condition commonly known as sarcopenia, is prevalent in chronic obstructive pulmonary disease (COPD) and is associated with adverse outcomes. The aim of this study was to investigate the association between functional performance and sarcopenia in COPD patients classified by disease severity according to the Global Initiative for Chronic Obstructive Lung Disease (GOLD) criteria. METHODS: The study was a cross-sectional observational and the sample size consisted of 35 COPD patients (69.24±1.54 years, 20 men). Physical performance was assessed with the timed up-and-go (TUG) test. Sarcopenia was assessed according to the European Working Group on Sarcopenia in Older People criteria. RESULTS: The frequency of sarcopenia was 20% and was more prevalent among individuals classified with greater disease severity, GOLD III, n=4 patients (23%) and GOLD IV, n=3 patients (27%), p=0.83. The mean time to complete the TUG test was 11.66±4.78 s. Binary logistic regression revealed an association between the TUG test and sarcopenia adjusted by disease severity (OR=1.55, 95% CI: 1.03-8.23, p=0.04). CONCLUSION: Our findings showed that worse performance in the TUG test leads to a substantial increase in the chance of COPD patients presenting sarcopenia

Incontinência urinária

Inclui referência

Efetividade e segurança do treinamento físico domiciliar sobre a capacidade de exercício em pacientes com DPOC usuários de oxigenoterapia domiciliar prolongada : ensaio controlado randomizado

Orientador: Silvia Regina ValderramasCoorientador: Anna Raquel S. GomesTese (doutorado) - Universidade Federal do Paraná, Setor de Ciências da Saúde , Programa de Pós-Graduação em Medicina Interna. Defesa : Curitiba, 10/12/2018Inclui referências: p. 49-54Resumo: Pacientes com DPOC em estágio mais avançado da doença e que necessitam utilizar oxigenoterapia domiciliar prologada (ODP), apresentam dificuldade em participar de programas de reabilitação pulmonar (RP) devido à gravidade da doença, mas principalmente pela dificuldade de transporte (pois os cilindros de oxigênios são muito pesados), recursos disponíveis (caros para reabastecer), segurança e necessidades individualizadas dos pacientes. No intuito de atender esta demanda, o treinamento físico (TF) domiciliar tem sido comumente utilizado. No entanto, a maioria dos programas são realizados sem supervisão. O objetivo deste estudo foi analisar a efetividade do treinamento físico domiciliar supervisionado sobre a capacidade de exercício em pacientes com DPOC usuários de ODP. Em um ensaio clínico controlado e randomizado realizado no domicilio, pacientes com DPOC usuários de ODP foram divididos em dois grupos: Grupo treinamento físico (GT) que realizou treinamento de resistência e fortalecimento muscular, 60 minutos, duas vezes por semana, durante 12 semanas, supervisionadas presencialmente e Grupo orientações por Cartilha (GC), que recebeu uma cartilha contendo a descrição de alguns exercícios físicos e foram orientados a realizar duas vezes por semana, durante 12 semanas. Todos os participantes foram avaliados antes e após o período de intervenção em relação à: capacidade de exercício (Teste Degrau 6 minutos - TD6min e Teste de sentar e levantar de 1 min - STST); dispneia (Escala do Medical Research Council - MRC), fadiga (Fatigue Severity Scale - FSS-BR) e qualidade de vida (COPD Assessment Test - CAT). Após 12 semanas de tratamento, foram analisados 44 pacientes (70 ± 7,5 anos, VEF1: 32,4 ± 13,5 % do valor previsto) [(GT, n=22) e (GC, n=22)]. Somente os pacientes alocados no GT apresentaram aumento significante no TD6min (p=0,001), no MRC (p= 0,013), no FSS (p= 0,015) e CAT (p=0,001). Não ocorreram efeitos adversos. O programa de treinamento físico domiciliar supervisionado foi efetivo e seguro na melhora da capacidade de exercício, dispneia, fadiga e qualidade de vida em pacientes com DPOC usuários de ODP. Palavras-chave: Exercício. Doença Pulmonar Obstrutiva Crônica. Oxigenoterapia.Abstract: COPD patients in advanced stage of the disease who need long-term home oxygen therapy (LTHOT) have difficulty participating in pulmonary rehabilitation (PR) programs in part because of the severity of the disease but primarily because of the difficulty involving transport, because the heavy oxygen cylinders, the high cost of refilling the cylinders and issues related to patients' safety and individual needs. In order to meet the needs of these patients, home-based exercise training (ET) is frequently used. However, most of the programs are unsupervised. The main objective of this study was to analyze the effectiveness of supervised home-based exercise training on exercise capacity in COPD patients on LTHOT. In a home-based controlled randomized clinical trial, COPD patients on LTHOT were divided into two groups: an exercise-training group (EG), consisting of patients who received supervised resistance and muscle-strength training in twice-weekly 60-minute sessions during twelve weeks; and a booklet-based group (BG), consisting of individuals who received a booklet with description of physical exercises which they were advised to perform twice a week during 12 weeks. All participants were assessed before and after the intervention in terms of exercise capacity (6-minute step test, 6MST, and 1-minute sitto- stand test, STST); dyspnea (Medical Research Council scale, MRC); fatigue (fatigue severity scale, FSS-BR); and quality of life (COPD assessment test, CAT). After 12 weeks of treatment, 44 patients were evaluated (70 ± 7.5 years, FEV1: 32.4 ± 13.5 % of the predicted value) (EG, n=22; BG, n=22). Only the patients in the EG had a statistically significant increase in the 6MST (p=0.001), MRC (p= 0.013), FSS (p= 0.015) and CAT (p=0.001). No adverse effects were observed. The supervised homebased exercise-training program proved to be effective and safe in improving exercise capacity, dyspnea, fatigue and quality of life in COPD patients on LTHOT. Keywords: Exercise. Chronic Obstructive Pulmonary Disease. Oxygen Therapy

Validation of the Portuguese version of the London Chest Activity of Daily Living Scale (LCADL) in chronic obstructive pulmonary disease patients

INTRODUCTION: While there are several subjective English tools, such as the London Chest Activity of Daily Living scale (LCADL), aimed at assessing dyspnoea during activities of daily living (ADL) in patients with Chronic Obstructive Pulmonary Di- sease (COPD), none of these questionnaires has ever been translated into Portuguese. The aim of this study was to investigate the validity and reproducibility of the LCADL's Portuguese version in patients with COPD. METHODS: 31 patients with COPD (17 male; 69+/-7 years; FEV1 44+/-15 %predicted) completed the Portuguese version of the LCADL twice with a 1-week interval. The traditional Saint George Respiratory Questionnaire (SGRQ), already validated in Portuguese, was used as the criterion method. RESULTS: There were no significant differences between test and retest of the LCADL. Intraclass Correlation Coefficient between test and retest concerning the different scale components was Self-care r=0.96; Domestic r=0.99; Physical r=0.92; Leisure r=0.95; Total Score r=0.98. There were significant correlations of the LCADL Total Score with the SGRQ's different components and total score (0.36<r<0.74; p<0.05 for all). The LCADL Total Score was also significantly correlated with the 6-minute walking distance test (r= -0.48; p=0.006). CONCLUSION: The Portuguese version of the LCADL is valid and reproducible in patients with COPD, making this study a new and important tool for assessing the limitations of performing ADL in this population

Short-Term Effects of Using Pedometers to Increase Daily Physical Activity in Smokers: A Randomized Trial

BACKGROUND: In adults it is recommended that the minimum of 10,000 steps/day should be performed in order to consider an individual as active. The pedometer, a small device that counts steps, has been used to monitor and/or motivate physical activity in various populations. OBJECTIVE: To investigate the short-term effects of a protocol using a pedometer or an informative booklet to increase daily physical activity in apparently healthy smokers who reached or did not reach the minimum public health recommendation of 10,000 steps/day. METHODS: Subjects were randomly assigned to 2 groups: group pedometer (GP, n = 23), who wore a pedometer every day during 1 month, aiming to achieve 10,000 steps/day; and group booklet (GB, it = 17), who received a booklet with encouragement to walk as much as possible in everyday life. Each group was subdivided according to their baseline daily physical activity level: active (subjects who achieved 10,000 steps/day), and inactive (those who did not achieve this minimum). RESULTS: Only the physically inactive GP increased significantly its daily physical activity (pre vs post 7,670 [6,159 9,402] steps/day vs 10,310 [9,483-11,110] steps/day, P < .001), with a concomitant increase in the 6-min walking test (6MWT) distance (mean and interquartile range 540 m [501-586 m] vs 566 m [525-604 m], P = .03). In GP, Delta post-pre steps/day correlated significantly with baseline number of steps/day (r = -0.63, P = .01), but not with 6MWT. In the inactive subjects (summing GP and GB), there were significant correlations between steps/day and cigarettes/day, pack-years, and Fagerstrom questionnaire (r = -0.55, -0.40, and -0.59, P <= .05 for all). Furthermore, improvement in steps/day in the inactive subjects of GP was correlated with baseline cigarettes smoked per day, pack-years, and Fagerstrom questionnaire (r = 0.51, 0.65 and 0.53, P <= .05 for all). CONCLUSIONS: Physically inactive smokers improve their daily physical activity level by using a simple tool (pedometer), and larger improvement occurs in subjects with the lowest levels of physical activity.Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq