Luciana Chiavegato

Effects of early mobilisation in patients after cardiac surgery: a systematic review.

BACKGROUND Early mobilisation is prescribed after cardiac surgery to prevent postoperative complications, decrease length of hospital stay, and augment return to daily activities. OBJECTIVE To evaluate the evidence for the effects of early mobilisation in patients after cardiac surgery on length of hospital stay, functional capacity and postoperative complications. DATA SOURCES The data sources used were Medline, Embase, CINAHL, PEDro, Web of Science and Cochrane Central Register of Controlled Trials. STUDY SELECTION Randomised controlled trials of early mobilisation after cardiac surgery. Study selection was not restricted by language or publication time. STUDY APPRAISAL AND SYNTHESIS METHODS The methodological quality of each article was appraised with the PEDro scale. All review phases (selection, data extraction and appraisal) were conducted by two investigators, and a third investigator provided consensus. RESULTS Nine trials were selected. The PEDro scale showed that the studies had a low risk of bias (range 5 to 9 points). The trials revealed diversity in techniques used for mobilisation, as well as periods considered early for the start of the intervention. Early mobilisation groups had improved outcomes compared with control groups without treatment. Generally, these advantages did not differ when groups of interventions were compared. LIMITATIONS It was not possible to perform a meta-analysis due to the variability of the interventions proposed as early mobilisation. CONCLUSIONS Regardless of the techniques used as mobilisation, the essential point is to avoid bed rest. Early mobilisation seems to be important to prevent postoperative complications, improve functional capacity and reduce length of hospital stay in patients after cardiac surgery.

Effectiveness of conventional physical therapy and Pilates' method in functionality, respiratory muscle strength and ability to exercise in hospitalized chronic renal patients: A study protocol of a randomized controlled trial

BACKGROUND Patients with chronic kidney disease can present compromised functional abilities, and hospitalization may further contribute to their health deterioration and loss of functional independence. OBJECTIVES To compare the effectiveness between Pilates Method and Conventional Physical Therapy in functionality, exercise capacity and respiratory muscle strength in hospitalized patients with chronic kidney disease. METHODS 56 patients will be randomized into Control (usual care) or Pilates groups. Functionality (Barthel Index), exercise capacity (Step Test) and respiratory muscle strength (Manovacuometry) will be evaluated during pre-intervention, after the 5th and 10th sessions or at discharge in both groups. The statistical analysis will be calculated using linear mixed models and based on intention-to-treat. The level of significance will be set at α = 5%. This study is the first to develop a Pilates protocol for hospitalized chronic renal failure patients and the results will provide additional treatment options for these patients and for physiotherapists.

Effect of conventional physical therapy and Pilates in functionality, respiratory muscle strength and ability to exercise in hospitalized chronic renal patients: a randomized controlled trial

Objective: To compare the effect of conventional physical therapy and Pilates on function, restoration, and exercise ability in hospitalized chronic renal patients. Methods: A total of 56 inpatients were randomized into two groups: Conventional physical therapy and Pilates. The primary outcomes were functionality (Barthel Index), respiratory muscle strength (manovacuometry), and ability to exercise (step test) evaluated in the following periods: preintervention, after the 5th session, and after the 10th session or at discharge. Three months after randomization, the Barthel Index was applied over the phone. At the end of the 10 sessions or at discharge, the length of hospital stay was calculated and the level of satisfaction with physical therapy care was assessed (MedRisk). Linear mixed models were used for the primary outcomes and the Student’s t-test was used for length of stay and satisfaction. Results: There was no significant between-group difference in functionality (MD −1.3; 95% CI −2.8 to 5.4), inspiratory and expiratory muscle strength (MD −1.3; 95% CI −7.3 to 4.5/MD −4.5; 95% CI −0.7 to 9.7, respectively), performance in the step test (MD −3.3; 95% CI −6.2 to 12.8), patient satisfaction with physical therapy care (MD −2.0; 95% CI −5.1 to 9.1), and length of stay (MD 4.5; 95% CI −15.9 to 6.8). Conclusion: Both interventions, conventional physical therapy and Pilates, showed improvements and there is no difference between them. Therefore both can be used in chronic renal patients.

Effect of time of exposure to environmental risk on the lung function of foundry workers: a cross-sectional study.

[Purpose] This cross-sectional study aimed to compare foundry workers of the metallurgical industry with high and low exposure time and with a control group. [Subject and Methods] The workers were evaluated for pulmonary function and peak expiratory flow (PEF), respiratory symptoms, smoking habits, and physical activity level. Descriptive statistical analysis and ANOVA one-way test were used. [Results] The mean age was 33.9 ± 8.25 years (18–59), pulmonary function: FVC: 95 ± 18% of predicted, FEV1: 95.0 ± 15.8% of predicted, FEV1/FVC ratio of 0.82 ± 0.09, and PEF = 499.7 ± 118.5 l/min. Overall, 85.1% of workers were classified that physically active, 7.93% of workers reported respiratory symptoms, and 14.28% reported being smokers. There was no statistically significant difference between groups for the variables of lung function. [Conclusion] The pulmonary function is preserved in foundry workers independently of exposure time.

Effects of TENS in living kidney donors submitted to open nephrectomy: A randomized placebo‐controlled trial

Pain is a negative factor in the recovery process of postoperative patients. It causes pulmonary alterations and complications, and it also affects functional capacity. Several studies have investigated the effects of transcutaneous electrical nerve stimulation (TENS) during the postoperative period. However, no studies have assessed the effects of TENS on kidney donors. Thus, the aim of the present study was to evaluate the effect of TENS on pain, walking function, respiratory muscle strength and vital capacity in kidney donors.

Effects of transcutaneous electrical nerve stimulation on pain, walking function, respiratory muscle strength and vital capacity in kidney donors: a protocol of a randomized controlled trial.

BackgroundPain is a negative factor in the recovery process of postoperative patients, causing pulmonary alterations and complications and affecting functional capacity. Thus, it is plausible to introduce transcutaneous electrical nerve stimulation (TENS) for pain relief to subsequently reduce complications caused by this pain in the postoperative period. The objective of this paper is to assess the effects of TENS on pain, walking function, respiratory muscle strength and vital capacity in kidney donors.Methods/designSeventy-four patients will be randomly allocated into 2 groups: active TENS or placebo TENS. All patients will be assessed for pain intensity, walk function (Iowa Gait Test), respiratory muscle strength (maximal inspiratory pressure and maximal expiratory pressure) and vital capacity before and after the TENS application. The data will be collected by an assessor who is blinded to the group allocation.DiscussionThis study is the first to examine the effects of TENS in this population. TENS during the postoperative period may result in pain relief and improvements in pulmonary tests and mobility, thus leading to an improved quality of life and further promoting organ donation.Trial registrationRegistro Brasileiro de Ensaios Clinicos (ReBEC), number RBR-8xtkjp.

Predictive validity analysis of six reference equations for the 6-minute walk test in healthy Brazilian men: a cross-sectional study

Highlights • The Brazilian reference equations use different variables in their composition.• The predictive validity of equations presented great variability in limits of agreement.• The Brazilian reference equation proposed by Britto et al. (BMI) came closest to the walked distance for these individuals.

Teste da sacarina e de palato de rã: ferramentas para estudo do transporte mucociliar

Disorders in mucociliary transport (MCT) can affect the clearance of respiratory secretions. MCT can be measured either in vivo, using substances such as sac...