Effectiveness Of Pulmonary Rehabilitation Once A Week For Patients With Obstructive Pulmonary Disease [eficácia Da Reabilitação Pulmonar Uma Vez Na Semana Em Portadores De Doença Pulmonar Obstrutiva]

Background: Obstructive pulmonary diseases may interfere negatively with patients' quality of life (QOL): Specific QOL questionnaires such as the Chronic Respiratory Questionnaire (CRQ) have been used to quantify the impact of the disease and measure the effects of different rehabilitation protocols. Objective: To evaluate the effectiveness of pulmonary rehabilitation performed once a week in association with exercises at home among patients with obstructive pulmonary disease, by means of CRQ comparisons, maximum respiratory pressures (MIP and MEP) and six-minute walking distanoe test (6MWD), before and after treatment. Methods: This study was developed in the physical therapy outpatient clinic of the, hospital. Thirty-four patients of both sexes with obstructive pulmonary disease were evaluated, and nineteen (mean age: 60.8 ± 14.2 years) wese included in the study. These subjects all underwent physiotherapeutic evaluation and reevaluation with the CRQ and measurements of MIP, MEP and 6MWD. The physical therapy consisted of respiratory, aerobic apd resistance exercises once a week for 12 weeks together with home exercises twice a week. Results. The Wilcoxon test Spearman correlation were used. Statistically significant differences between evaluations before and after rehabilitation were found for all CRQ domains (p≤ 0.05), MIP (p= 0.01) and MEP (p= 0.002). Conclusion: The proposed program improved QOL and promoted increases in maximim respiratory pressures among these patients with obstructive pulmonary disease, even though the current literature suggests that higher frequency of training is needed. © Revista Brasileira de Fisioterapia.116475480Costa, D., Jamami, M., Bases fundamentais da espirometria (2001) Rev Bras Fisioter, 5 (2), pp. 95-102Dweik, R., Stoller, J.K., Doenças pulmonares obstrutivas: DPOC, asma e doenças relacionadas (2000) Scalan C, Wilkins R, Stoller JK. Fundamentos da terapia respiratória de Egan, pp. 439-478. , São Paulo: Manole;Bettencourt, A.R.C., Oliveira, M.A., Femandes, A.L.G., Bogossian, M., Educação de pacientes com asma: Atuação do enfermeiro. (2002) J Pneumol, 28, pp. 45-52IV Diretizes brasileiras para o manejo da asma. J Bras Pneumol. 2006;32(7);447-74II Consenso brasileiro sobre Doença Pulmonar Obstrutiva Crônica - DPOC. 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(2006) Rev Bras Fisioter, 10 (4), pp. 449-455Silva, T.L.P., (2005) Efeito do treinamento fisico em mulheres asmáticas, , dissertação, São Carlos SP, Universidade Federal de São Carlos;Sewell, L., Singh, S.J., Williams, J.E.A., Collier, R., Morgan, M., How long should outpatient pulmonary rehabilitation be? A randomized controlled trial of four-weeks versus seven-weeks (2006) Thorax, 61, pp. 767-771Zanchet, R.C., Viegas, C.A.A., Lima, T., A eficácia da reabilitação pulmonar na capacidade de exercicio, força da musculatura inspiratária e qualidade de vida de portadores de doença pulmonar obstrutiva crônica. (2005) J Bras Pneumol, 31, pp. 118-124Gold, Global Inicative for Chronic Obstructive Lung Disease. 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Continuous Positive Airway Pressure (cpap) After Lung Resection: A Randomized Clinical Trial [pressão Positiva Contínua Nas Vias Aéreas (cpap) Após Ressecção Pulmonar: Ensaio Clínico Randomizado]

CONTEXT AND OBJECTIVE: Noninvasive mechanical ventilation during the postoperative period (PO) following lung resection can restore residual functional capacity, improve oxygenation and spare the inspiratory muscles. The objective of this study was to assess the efficacy of continuous positive airway pressure (CPAP) associated with physiotherapy, compared with physiotherapy alone after lung resection. DESIGN AND SETTING: Open randomized clinical trial conducted in the clinical hospital of Universidade Estadual de Campinas. METHOD: Sessions were held in the immediate postoperative period (POi) and on the first and second postoperative days (PO1 and PO2), and the patients were reassessed on the discharge day. CPAP was applied for two hours and the pressure adjustment was set between 7 and 8.5 cmH2O. The oxygenation index (OI), Borg scale, pain scale and presence of thoracic drains and air losses were evaluated. RESULTS: There was a significant increase in the OI in the CPAP group in the POi compared to the Chest Physiotherapy (CP) group, P = 0.024. In the CP group the OI was significantly lower on PO1 (P = 0,042), than CPAP group. The air losses were significantly greater in the CPAP group in the POi and on PO1 (P = 0.001, P = 0.028), but there was no significant difference between the groups on PO2 and PO3. There was a statistically significant difference between the groups regarding the Borg scale in the POi (P < 0.001), but there were no statistically significant differences between the groups regarding the pain score. 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