Adriane Schmidt Pasqualoto

Can the single-breath helium dilution method predict lung volumes as measured by whole-body plethysmography?

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.

Deglutição orofaríngea, nutrição e qualidade de vida no indivíduo com doença pulmonar crônica

PURPOSE Describe efficacy and safety of deglutition, nutritional risk, and quality of life in deglutition, and associate nutritional risk with quality of life in individuals with chronic pulmonary disease. METHODS The participants were 17 individuals with chronic pulmonary disease evaluated using the following instruments: Volume-Viscosity Swallow Test (V-VST), Quality of Life in Swallowing Disorders (SWAL-QOL) questionnaire, Mini Nutritional Assessment (MNA), and body mass index (BMI). RESULTS Changes in efficacy were observed in nine (52.94%) individuals and impairments in efficacy and safety were found in two (11.77%) individuals. All individuals were considered eutrophic by the nutritional assessment. Correlation was observed between nutritional risk and domains 3 (r=-0.803; p=0.05) and 5 (r=0.636; p=0.026) of the SWAL-QOL questionnaire. CONCLUSION Changes in efficacy and safety of deglutition were observed; however, no nutritional risk was evidenced in the sample evaluated. Correlation between nutritional risk and quality of life in deglutition was also observed.

Ligações telefônicas para manejo da ansiedade de pacientes em tratamento radioterápico e de seus familiares

Aim: To describe the evaluation that cancer patients and their families make about the telephone calls made in order to reduce their anxiety during radiotherapy treatment. Method: a descriptive and exploratory study of quantitative and qualitative approach, performed in a radiotherapy clinic of a teaching hospital in Rio Grande do Sul/Brazil. Twenty patients who started radiotherapy participated and also 20 families. An interview was conducted for data collection. Data analysis occurred through an organization into categories and after, descriptive statistical analysis. Results: Most patients and families showed moderate anxiety at the beginning of radiotherapy, and rated as important the reception of the telephone calls to ease the anxiety, since the feelings of tranquility and incentive/ encouragement were propitiated by the calls. Final Remarks: Telephone calls reflected positively on the feeling of relief of anxiety of the radiotherapy patients and their families.

Physical therapy performance in the rehabilitation of survivors of the Kiss nightclub tragedy: an experience report

Introduction : As a result of a fire in the Kiss nightclub that occurred in the city of Santa Maria - RS, 242 people were killed, of whom 235 died on the day of the episode, asphyxiated by the inhalation of toxic smoke. Approximately 1,000 more were injured. Objective : To report the experience of a group of physical therapists, professors at the Federal University of Santa Maria (UFSM), in the rehabilitation of survivors of the fire, victims of burns and inhalation injury. Materials and methods : Quantitative and qualitative study, in which an evaluation protocol of physical functional ability was designed to identify rehabilitation needs. Results : Two hundred seventy patients (147 men, mean age 26.72 ± 9.5 years) were examined, of which approximately 70% had some type of clinical modification or functional impairment that indicated the need for rehabilitation. The most prevalent respiratory signs and symptoms were: dry or productive cough (59.2%); abnormal respiratory pace (11.4%); fatigue (35.92%); dyspnea (17.7%); and chest pain (16.6%). Neurological symptoms such as persistent headache (88.51%), memory loss (11.4%), and paresthesia (8.1%) were also reported. Musculoskeletal injuries (14.7%) and extensive burns (8.8%) were also observed. One hundred and eighty-nine patients were referred to outpatient physical therapy and, of these, 22 still remain at the Outpatient Physical Therapy Unit of the University Hospital of (HUSM). Conclusions : Despite the vast professional experience of this group of physical therapists, the situations experienced were unique and unprecedented, both professionally and personally, and reinforced the importance of joining forces within an emergency care unit, as well as the importance of comprehensive and multi-professional outpatient monitoring.

EFEITOS DE UM TREINAMENTO MUSCULAR RESPIRATÓRIO SOBRE A CAPACIDADE FUNCIONAL DE UM PACIENTE ASMÁTICO

Introducao: A asma representa uma sindrome clinica caracterizada por obstrucao variavel das vias aereas, a hiperresponsividade bronquica. Atualmente sabe-se que a inflamacao bronquica constitui o principal fator fisiopatogenico da doenca, independente de sua etiologia, e contribui para a sua gravidade, exacerbacoes e alteracoes estruturais que ocorrem devido a cronicidade da doenca. Objetivo: Avaliar as respostas ao treinamento da musculatura inspiratoria em um paciente asmatico grave, analisando os desfechos desse treinamento sobre a forca muscular, capacidade funcional e a sensacao de dispneia. Metodo: Relatamos um caso de asma grave submetido a treinamento muscular respiratorio por nove semanas. Foram avaliadas a forca muscular respiratoria, a capacidade funcional e a sensacao de dispneia antes e apos a intervencao. Resultados: O treino realizado mostrou um aumento na forca muscular expiratoria (27,2%) e na inspiratoria (23,2%) e na capacidade funcional. Conclusao: O treinamento muscular respiratorio evidenciou o aumento na forca muscular respiratoria, aumento na distância percorrida no TC6 e diminuicao da sensacao de dispneia.

FISIOTERAPIA RESPIRATÓRIA: uso de técnicas de reequilíbrio toracoabdominal e pompage

A fisioterapia respiratoria busca a melhora da condicao respiratoria de seus pacientes com o emprego das mais diversas tecnicas manuais e instrumentais. Dentre as manuais encontram-se a pompage e o reequilibrio toracoabdominal (RTA). O instrumento audiovisual sobre as tecnicas manuais fez parte de um projeto de ensino do componente curricular Fisioterapia Respiratoria I no ano de 2009. Foram abordadas nesse material as tecnicas de pompages e RTA. As pompages auxiliam na liberacao dos bloqueios miofasciais e nas estases dos liquidos lacunares, alem de promoverem o relaxamento muscular quando realizadas no sentido das fibras musculares que possuam contratura, encurtamentos e retracoes. O RTA visa a obter a melhora da ventilacao e da obstrucao bronquica, mediante a normalizacao do tonus muscular e equilibrio ventilatorio. O desenvolvimento do recurso audiovisual com as tecnicas manuais objetiva proporcionar aos estudantes de Fisioterapia um material de apoio para as aulas praticas.