Chest physiotherapy effectiveness to reduce hospitalization and mechanical ventilation length of stay, pulmonary infection rate and mortality in ICU patients

Introduction: Although physiotherapy is an integral part of the multiprofessional team in most ICUs there is only limited evidence concerning the effectiveness of its procedures. the objectives of this study were to verify if physiotherapy care provided within 24 h/day for hospitalized patients in the ICU reduce the length of stay, mechanical ventilation support, pulmonary infection and mortality compared to a physiotherapy care provided within 6 h/day.Methods: A cohort study was designed to assess differences between one hospital where patients were given physiotherapy care for 24 h/day and another hospital with only 6 h/day. We considered the following as outcome measurements: clinical diagnosis, medication in use, presence of associated diseases, APACHE II and SOFA scores, ICU and mechanical ventilation length of stay, development of pulmonary infections and survival.Results: One hundred and forty-six patients were enrolled. Patients admitted in the service A presented a lower length of stay in mechanical ventilation (p < 0.0001), ICU stay (p = 0.0003), respiratory infections (p = 0.0043) than patients admitted in service B. No difference was found for APACHE II score (p = 0.8) and SOFA scores (p = 0.2) between groups. the mortality risk was OR 1.3 (1.01-2.33) (p = 0.04) for patients in the service B.Conclusion: the presence of a physiotherapist in the intensive care unit contributes decisively to the early recovery of the patient, reducing mechanical ventilation support need, number of hospitalization days, incidence of respiratory infection and risk of mortality. (c) 2012 Elsevier B.V. All rights reserved.Adventist Univ Unasp, Phys Therapy Dept, São Paulo, BrazilFed Univ São Paulo Unifesp, São Paulo, BrazilSão Paulo Med Sch, Inst Heart, São Paulo, BrazilFed Univ Pampa Unipampa, Rio de Janeiro, BrazilFed Univ São Paulo Unifesp, São Paulo, BrazilWeb of Scienc

AVALIAÇÃO NUTRICIONAL EM ESTUDOS COM IDOSOS BRASILEIROS PRATICANTES DE ATIVIDADE FÍSICA

Introduction: Body composition is an important factor in assessing the lifestyle of the elderly, this due to the bodily changes caused by the aging process. Objective: This work aimed to evaluate the presence of nutritional assessment in studies with Brazilian elderly people who practice physical activity. Methods: This is a literature review, carried out in June 2019, with the inclusion of original studies, carried out with a sample of elderly Brazilians, using articles accessed in full, regardless of the year and language of publication, located from searches through from the Virtual Health Library (VHL) portal, using the keywords "idoso" and "Atividade física". Results: 17 articles were selected for this study, of which 47% were performed in the Southern Region of Brazil, 29% used BMI and 12% used BMI to assess frailty. Conclusion: It was found that studies with elderly people who practice physical activity in Brazil, present themselves as a challenging field with little existing production, as well as taking nutritional assessment into account due to its importance and influence on the lifestyle and health of the elderly population.Introdução: A composição corporal é um fator importante na avaliação do estilo de vida de idosos, isso devido as modificações corporais ocasionadas pelo processo de envelhecimento. Objetivo: este trabalho se propôs avaliar a presença da avaliação nutricional em estudos com idosos brasileiros praticantes de atividade física. Métodos: Trata-se de uma revisão da literatura, realizada em junho de 2019, com inclusão de estudos originais, realizados com amostra de idosos brasileiros, utilizando artigos acessados na integra, independente do ano e idioma de publicação, localizados a partir de buscas através do portal da Biblioteca Virtual em Saúde (BVS), com utilização dos descritores “idosos” e “atividade física”. Resultados: Foram selecionados para esse trabalho 17 artigos dos quais 47% foram realizados na Região Sul do Brasil, em 29% houve utilização do IMC e 12% utilizou IMC para avaliação de fragilidade. Conclusão: Constatou-se que estudos com idosos praticantes de atividade física no Brasil, apresentam-se como um campo desafiador e de pouca produção existente, bem como deve-se levar em consideração a avaliação nutricional devido à importância e influência da mesma sobre o estilo de vida e saúde da população idosa

Oxygen and Ventilatory Output during Several Activities of Daily Living Performed by COPD Patients Stratified According to Disease Severity

Objectives: To measure the oxygen and ventilatory output across all COPD stages performing 18 common ADL and identify the activities that present the highest metabolic and ventilatory output as well as to compare the energy expenditure within each disease severity.Materials and Methods: Metabolic (VO2 and VCO2), ventilatory (f and V-E), cardiovascular (HR) and dyspnea (Borg score) variables were assessed in one hundred COPD patients during the completion of eighteen ADL grouped into four activities domains: rest, personal care, labor activities and efforts.Results: the activities with the highest proportional metabolic and ventilatory output (VO2/VO(2)max and VE/MVV) were walking with 2.5 Kg in each hand and walking with 5.0 Kg in one hand. Very severe patients presented the highest metabolic, ventilatory output and dyspnea than mild patients (p<0.05).Conclusions: COPD patients present an increased proportion of energy expenditure while performing activities of daily living. the activities that developed the highest metabolic and ventilatory output are the ones associated to upper and lower limbs movements combined. Very severe patients present the highest proportional estimated metabolic and ventilatory output and dyspnea. Activities of daily living are mainly limited by COPD's reduced ventilatory reserve.Fed Univ São Paulo Unifesp, Pulm Rehabil Ctr, São Paulo, BrazilFed Univ Pampa Unipampa, Uruguaiana, RS, BrazilAdventist Univ, São Paulo, BrazilNove de Julho Univ, São Paulo, BrazilPulm Rehabil Ctr Unifesp, São Paulo, BrazilUniversidade Federal de São Paulo, Pulm Rehabil Ctr, São Paulo, BrazilFed Univ São Paulo Unifesp, Pulm Rehabil Ctr, São Paulo, BrazilPulm Rehabil Ctr Unifesp, São Paulo, BrazilUniversidade Federal de São Paulo, Pulm Rehabil Ctr, São Paulo, BrazilWeb of Scienc

Prescribed enteral diet versus infused diet

Objective: To evaluate the prescribed volume of enteral feeding versus the volume infused, identifying the diet for interruption, and expenses generated by these interruptions. Methods: Observational study with adults and elderly patients receiving enteral nutrition in a private hospital in São Paulo. Data collection was performed by means of electronic medical records. Results: The infused volume was significantly lower than the amount prescribed in the five days of monitoring in the entire sample. The main complication in the experimental diet was diarrhea. Spending on non-diet administration amount to 41.4% of the amount spent for this service. Conclusion: This study contributes to the performance and nutritionist performance in conjunction with the multidisciplinary team in Nutrition Therapy aiming at the improvement of the patient

Malformações congênitas: um relato de reabilitação fisioterapêutica em paciente com transposição das grades artérias.

Objetivo: descrever uma abordagem fisioterapêutica na reabilitação neuropsicomotora e respiratória pediátrica em paciente com transposição das grandes artérias. Relato de caso: paciente R. S. C. R, sexo masculino, nascido de parto cesáreo, com diagnóstico clínico de malformações congênitas, portador de Transposição das Grandes Artérias – TGA, Comunicação Interatrial – CIA e Comunicação Interventricular Ampla – CIV. Avaliado aos 09 meses de idade com diagnóstico fisioterapêutico de atraso no desenvolvimento neuropsicomotor. Conclusão: esse relato de caso evidenciou efetiva abordagem fisioterapêutica na reabilitação neuropsicomotora e respiratória de uma criança com TGA + CIA + CIV em acompanhamento clínico, resultando em melhora neuropsicomotora identificada pelo melhor controle cervical e maior tempo na posição sentada, e melhora do desconforto respiratório passando de moderado para leve

Impact of a structured aquatic therapy program on patients with knee osteoarthritis

A osteoartrite é uma doença articular degenerativa, reumática crônica, multifatorial de alta prevalência, atinge 10% da população com mais de 65 anos. Afeta igualmente ambos os sexos, sendo que na mulher a incidência é maior após o período da menopausa. Esta doença compreende 65% das causas de incapacidade, atrás somente de doenças cardiovasculares e mentais. A reabilitação do paciente com artrose é um processo complexo que envolve procedimentos especializados Objetivo: Avaliar os efeitos de um programa de hidrocinesioterapia sobre a capacidade de realização de atividades da vida diária em pacientes com osteoartrite. Métodos: Este é um estudo prospectivo, onde vinte e seis pacientes com histórico de osteoartrite de joelho foram submetidos a um programa de tratamento em hidrocinesioterapia, com frequência de duas vezes por semana com duração de 50 minutos cada sessão. O programa consistia de quatro fases, sendo elas: aquecimento, alongamento, fortalecimento e relaxamento. Estes pacientes foram avaliados pré e pós-tratamento. Utilizando como método de avaliação a goniometria, escala de dor EVA e Teste de Caminhada de Seis Minutos. Resultados: Houve melhora significante da amplitude de movimento ao realizar flexão dos joelhos acometidos, também foi visto diminuição significativa da dor e melhora significante na capacidade de realização das atividades de vida diária avaliada por meio da distância percorrida no teste de caminhada de seis minutos. Conclusão: Houve melhora da capacidade de realizar AVD e da capacidade física, assim como redução do quadro álgico e aumento da amplitude de movimentoOsteoarthritis is a pervasive, chronic rheumatic, multifactorial, degenerative joint disease, afflicting 10% of the population over 65 years of age. It affects both genders, and in women the incidence is higher after menopause. This disease comprises 65% of the causes of disability, exceeded only by cardiovascular and mental disorders. The rehabilitation of patients with osteoarthritis is a complex process that involves specialized procedures Objective: To evaluate the effects of a hydrotherapy program on the ability to perform activities of daily living in patients with osteoarthritis. Method: This is a prospective study where twenty-six patients with knee osteoarthritis history underwent a treatment program in aquatic therapy, often twice a week lasting 50 minutes each session. The program consisted of four phases, namely: warming up, stretching, strengthening, and relaxation. These patients were evaluated before and after treatment. Assessments were done with the goniometer, EVA pain scale, and Six Minute Walk Test. Results: There was significant improvement in range of motion when performing flexion of the affected knees, as well as a significant decrease in pain and a significant improvement in the ability to perform the activities of daily living, assessed by the distance walked in the six-minute walk test. Conclusion: There was an improved ability to perform ADLs and inn physical capacity, as well as reduced pain and increased range of motio