Atividade física e qualidade de vida de crianças e adolescentes com fibrose cística

Introdução: A fibrose cística (FC) é uma doença genética, multissistêmica, caracterizada pela disfunção do gene regulador da condutância transmembrana (CFTR), consequente obstrução das vias aéreas, perda progressiva da função pulmonar e limitação ao exercício. A atividade física (AF) realizada regularmente pode trazer benefícios para a saúde física, mental, melhora da qualidade de vida (QV) e do prognóstico de pacientes com FC. A prática de AF deve ser parte integrante das rotinas de tratamento destes pacientes e estimulada desde a infância pela equipe multiprofissional. Objetivo: Avaliar o impacto da prática de AF auto-relatada na qualidade de vida relacionada à saúde (QVRS) de crianças e adolescentes com FC. Métodos: Neste estudo transversal, foram recrutados em ambulatório pacientes entre 6 e 17 anos com diagnóstico confirmado de FC. Os pacientes responderam questões sobre as práticas de AF, questionário de QVRS e foram coletadas variáveis clínicas. Os pacientes foram classificados em dois grupos conforme a prática semanal de AF: realiza AF ≥ 3 vezes por semana e realiza AF ≤ 2 vezes por semana. Resultados: Completaram o estudo 66 pacientes, 72,7% (n=48) realizavam AF ≥ 3 vezes por semana e 27,2% (n=18) realizavam AF ≤ 2 vezes por semana. A média de idade dos pacientes avaliados foi de 12,3 ± 3,2 anos, VEF1 90,0 ± 24,1 % do previsto e CVF 95,0 ± 20,4 % do previsto. Observou-se diferença estatisticamente significativa para sexo (p=0,014) escore clínico (p=0,033), número de hospitalizações no ano (p=0,002) e número de dias internado no último ano (p=0,020). Para as variáveis de QVRS de acordo com a realização da AF encontramos diferença estatisticamente significativa para os domínios: físico (p=0,003), emoção (p=0,048) e digestão (p=0,015) Conclusão: O grupo que realiza AF ≥ 3 vezes por semana apresentou melhor escore clínico, QVRS e menor tempo de hospitalização no último ano.Introduction: Cystic fibrosis (CF) is a genetic disease, multisystemic, characterized by dysfunction of the transmembrane conductance regulatory gene (CFTR), consequent airway obstruction, progressive loss of lung function and limitation of exercise. Regular physical activity (PA) can bring benefits to physical health, mental health, quality of life (QOL), and prognosis of CF patients. The practice of PA should be an integral part of the treatment routines of these patients and stimulated since childhood by the multiprofessional team. Objective: To evaluate the impact of self-reported PA on health-related quality of life (HRQOL) in children and adolescents with CF. Methods: In this cross-sectional study, patients between 6 and 17 years of age with a confirmed diagnosis of CF were recruited in the outpatient clinic. The patients answered questions about the practices of PA, HRQoL questionnaire and clinical variables were collected. Patients were classified into two groups according to weekly PA practice: PA performed ≥ 3 times per week and performed PA ≤ 2 times per week. Results: The study was completed in 66 patients, 72.7% (n = 48) had PA ≥ 3 times per week and 27.2% (n = 18) had PA ≤ 2 times per week. The mean age of the patients evaluated was 12.3 ± 3.2 years, FEV1 90.0 ± 24.1% of predicted and FVC 95.0 ± 20.4% of predicted. We obtained statistically significant difference for sex (p = 0.014), clinical score (p = 0.033), number of hospitalizations in the year (p = 0.002) and number of days hospitalized in the last year (p = 0.020). For the HRQoL variables according to the performance of the PA, we found a statistically significant difference for the domains: physical (p = 0.003), emotion (p = 0.048) and digestion (p = 0.015). Conclusion: The PA ≥ 3 times per week group presented better clinical score, HRQoL, and shorter hospitalization time in the last year

Adherence to inhalation therapy and quality of life in children with cystic fibrosis: a cross-sectional study

Introduction: Inhalation therapy is a crucial part of the cystic fibrosis (CF) treatment regimen. Drugs that assist in mucociliary clearance and inhaled antibiotics are used by most patients. Methods: This is a cross-sectional study where patients with CF and their caregivers answered questionnaires regarding their adherence to inhalation therapy and QoL. Demographic, spirometric, and bacteriological data, as well as S-K scores and hospitalization frequencies were also collected. Results: We included 66 patients in this study; participants had a mean age of 12.3 years and Z-scores of -1.4 for forced expiratory volume in 1 second and 48.6 for body mass index. Patients were divided into 2 groups according to their self-reported adherence to inhalation therapy: high adherence (n = 46) and moderate/low adherence (n = 20). When comparing both groups, there was no statistically significant differences in age, sex, family income, and S-K score (p > 0.05). The high-adherence group had had shorter hospitalization periods in the previous year (p = 0.016) and presented better scores in the following domains of the QoL questionnaire: emotion (p = 0.006), eating (p = 0.041), treatment burden (p = 0.001), health perception (p = 0.001), and social (p = 0.046). Conclusions: A low self-reported adherence to inhalation therapy recommendations was associated with longer hospitalizations in the previous year and with a decrease in QoL in pediatric patients with CF

Fisioterapia respiratória : um problema de crianças e adolescentes com fibrose cística

Objective: To evaluate the level of self-reported adherence to physical therapy recommendations in pediatric patients (6-17 years) with cystic fibrosis (CF) and to ascertain whether the different levels of adherence correlate with pulmonary function, clinical aspects, and quality of life. Methods: This was a cross-sectional study. The patients and their legal guardians completed a questionnaire regarding adherence to physical therapy recommendations and a CF quality of life questionnaire. We collected demographic, spirometric, and bacteriological data, as well as recording the frequency of hospitalizations and Shwachman-Kulczycki (S-K) clinical scores. Results: We included 66 patients in the study. Mean age, FEV1 (% of predicted), and BMI were 12.2 ± 3.2 years, 90 ± 24%, and 18.3 ± 2.5 kg/m2, respectively. The patients were divided into two groups: high-adherence (n = 39) and moderate/poor-adherence (n = 27). No statistically significant differences were found between the groups regarding age, gender, family income, and total S-K clinical scores. There were statistically significant differences between the high-adherence group and the moderate/poor-adherence group, the latter showing lower scores for the “radiological findings” domain of the S-K clinical score (p = 0.030), a greater number of hospitalizations (p = 0.004), and more days of hospitalization in the last year (p = 0.012), as well as lower scores for the quality of life questionnaire domains emotion (p = 0.002), physical (p = 0.019), treatment burden (p < 0.001), health perceptions (p = 0.036), social (p = 0.039), and respiratory (p = 0.048). Conclusions: Low self-reported adherence to physical therapy recommendations was associated with worse radiological findings, a greater number of hospitalizations, and decreased quality of life in pediatric CF patients

Fisioterapia respiratória : um problema de crianças e adolescentes com fibrose cística

Objective: To evaluate the level of self-reported adherence to physical therapy recommendations in pediatric patients (6-17 years) with cystic fibrosis (CF) and to ascertain whether the different levels of adherence correlate with pulmonary function, clinical aspects, and quality of life. Methods: This was a cross-sectional study. The patients and their legal guardians completed a questionnaire regarding adherence to physical therapy recommendations and a CF quality of life questionnaire. We collected demographic, spirometric, and bacteriological data, as well as recording the frequency of hospitalizations and Shwachman-Kulczycki (S-K) clinical scores. Results: We included 66 patients in the study. Mean age, FEV1 (% of predicted), and BMI were 12.2 ± 3.2 years, 90 ± 24%, and 18.3 ± 2.5 kg/m2, respectively. The patients were divided into two groups: high-adherence (n = 39) and moderate/poor-adherence (n = 27). No statistically significant differences were found between the groups regarding age, gender, family income, and total S-K clinical scores. There were statistically significant differences between the high-adherence group and the moderate/poor-adherence group, the latter showing lower scores for the “radiological findings” domain of the S-K clinical score (p = 0.030), a greater number of hospitalizations (p = 0.004), and more days of hospitalization in the last year (p = 0.012), as well as lower scores for the quality of life questionnaire domains emotion (p = 0.002), physical (p = 0.019), treatment burden (p < 0.001), health perceptions (p = 0.036), social (p = 0.039), and respiratory (p = 0.048). Conclusions: Low self-reported adherence to physical therapy recommendations was associated with worse radiological findings, a greater number of hospitalizations, and decreased quality of life in pediatric CF patients

Respiratory therapy : a problem among children and adolescents with cystic fibrosis

Objective: To evaluate the level of self-reported adherence to physical therapy recommendations in pediatric patients (6-17 years) with cystic fibrosis (CF) and to ascertain whether the different levels of adherence correlate with pulmonary function, clinical aspects, and quality of life. Methods: This was a cross-sectional study. The patients and their legal guardians completed a questionnaire regarding adherence to physical therapy recommendations and a CF quality of life questionnaire. We collected demographic, spirometric, and bacteriological data, as well as recording the frequency of hospitalizations and Shwachman-Kulczycki (S-K) clinical scores. Results: We included 66 patients in the study. Mean age, FEV1 (% of predicted), and BMI were 12.2 ± 3.2 years, 90 ± 24%, and 18.3 ± 2.5 kg/m2, respectively. The patients were divided into two groups: high-adherence (n = 39) and moderate/poor-adherence (n = 27). No statistically significant differences were found between the groups regarding age, gender, family income, and total S-K clinical scores. There were statistically significant differences between the high-adherence group and the moderate/poor-adherence group, the latter showing lower scores for the “radiological findings” domain of the S-K clinical score (p = 0.030), a greater number of hospitalizations (p = 0.004), and more days of hospitalization in the last year (p = 0.012), as well as lower scores for the quality of life questionnaire domains emotion (p = 0.002), physical (p = 0.019), treatment burden (p < 0.001), health perceptions (p = 0.036), social (p = 0.039), and respiratory (p = 0.048). Conclusions: Low self-reported adherence to physical therapy recommendations was associated with worse radiological findings, a greater number of hospitalizations, and decreased quality of life in pediatric CF patients