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Previous issue date: 2015-03-11 / In recent decades it has seen considerable increase in the proportion of elderly people in Brazil. The main causes of mortality in the elderly are cardiovascular and respiratory diseases in 2006 these accounted for respectively 38% and 13% of causes of death in elderly Brazilians. Cardiac surgeries are responsible for high mortality rates. Patients undergoing coronary artery bypass graft surgery (CABG) at high risk of developing pulmonary complications such as atelectasis, pneumonia and pleural effusion. These complications increase the hospital stay and the need for financial resources. After CABG physiotherapist is required to perform Cardiopulmonary and Metabolic Rehabilitation program (CPMR), whose main goal is to help the patient return ace their social and professional activities in the best possible physical condition. Generally CPMR phase I includes stretching, breathing and aerobic exercise by hiking in hospital corridors and training ladder. The bicycle ergometer is a device that has frequently been used by physiotherapists, for the realization thereof does not require the patient support its own weight during training, and also the workload that can be easily adjusted according to each fitness individual. Thus, the objective of this study was to evaluate pulmonary function and the anxiety state of the CABG subjects after undergoing phase I rehabilitation using the cycle ergometer. For this, we performed a randomized, blinded to the evaluator, with patients from 50 years of age, undergoing CABG at the Hospital S?o Lucas. For this, the individuals who agreed to participate were randomly divided into two phase I rehabilitation groups: control group or cycle ergometer group. The control group patients underwent conventional physiotherapy, as the physiotherapy service protocol of the Hospital S?o Lucas. The patients in the intervention group underwent the same protocol of chest physiotherapy, however, the physical therapy was replaced by the use of a cycle ergometer. They were evaluated in the preoperative period and after rehabilitation phase I, the following respiratory parameters: peak expiratory flow, forced expiratory volume in one second, inspiratory and expiratory pressure. Still, the state of anxiety was assessed. The study included 19 patients, and 9 in the control group and 10 in the intervention group. In intra-group comparisons, a significant reduction was observed in maximal expiratory pressure and forced expiratory volume in one second in the control group. A significant reduction in forced expiratory volume in one second in the intervention group was also observed. In intergroup comparisons without adjustment, the average values of maximal inspiratory and expiratory pressure and the inventory Trait-State Anxiety part 1 after the intervention were significantly higher in the intervention group. Based on the fact that intervention group showed similar results in the evaluated parameters, the control group, it can be concluded that the cycle ergometer can be considered as a new safe option exercise for cardiac rehabilitation phase I. / Nas ?ltimas d?cadas tem se observado aumento consider?vel na propor??o de idosos no Brasil. As principais causas de mortalidade em idosos s?o as doen?as cardiovasculares e respirat?rias, em 2006 estas representaram respectivamente 38% e 13% das causas de morte em idosos brasileiros. As cirurgias card?acas s?o respons?veis por altas taxas de mortalidade. Pacientes submetidos a Cirurgia de Revasculariza??o do Mioc?rdio (CRM) apresentam alto risco de desenvolver complica??es pulmonares, tais como atelectasias, pneumonia e derrame pleural. Estas complica??es aumentam o tempo de interna??o hospitalar e a necessidade de recursos financeiros. Ap?s a CRM o fisioterapeuta ? requisitado para realizar o programa de Reabilita??o Cardiopulmonar e Metab?lica (RCPM), cujo objetivo principal ? contribuir para o retorno do paciente ?s suas atividades sociais e laborais nas melhores condi??es f?sicas poss?veis. Geralmente a RCPM fase I inclui alongamentos, exerc?cios respirat?rios e aer?bicos atrav?s de caminhadas nos corredores do hospital e treino em escada. O cicloerg?metro ? um equipamento que tem sido frequentemente empregado pelos fisioterapeutas, pois a realiza??o do mesmo n?o exige que o paciente suporte o pr?prio peso durante o treinamento, e tamb?m a carga de trabalho que pode ser facilmente ajustada de acordo com o condicionamento f?sico de cada indiv?duo. Dessa forma, o objetivo do presente trabalho foi avaliar a fun??o pulmonar e o estado de ansiedade dos indiv?duos submetidos a CRM ap?s a fase I de reabilita??o com o uso do cicloerg?metro. Para isso, realizou-se um ensaio cl?nico randomizado, cegado para o avaliador, com os pacientes a partir de 50 anos de idade, submetidos ? CRM no Hospital S?o Lucas da PUCRS. Para isso, os indiv?duos que aceitaram participar da pesquisa foram randomicamente divididos em dois grupos de reabilita??o fase I: grupo controle ou grupo cicloerg?metro. Os pacientes do grupo controle realizaram a fisioterapia convencional, conforme o protocolo do servi?o de fisioterapia do Hospital S?o Lucas da PUCRS. Os pacientes alocados no grupo interven??o realizaram o mesmo protocolo de fisioterapia respirat?ria, entretanto, a fisioterapia motora foi substitu?da pelo uso do cicloerg?metro. Foram avaliados no per?odo pr?-operat?rio e ap?s a reabilita??o fase I, os seguintes par?metros respirat?rios: pico de fluxo expirat?rio, volume expirat?rio for?ado no primeiro segundo, press?o inspirat?ria e expirat?ria m?xima. Ainda, foi avaliado o estado de ansiedade. Participaram do estudo 19 pacientes, sendo que, 9 no grupo controle e 10 no grupo interven??o. Nas compara??es intra-grupo, observou-se uma redu??o significativa na press?o expirat?ria m?xima e volume expirat?rio for?ado no primeiro segundo no grupo controle. Tamb?m foi observada uma redu??o significativa do volume expirat?rio for?ado no primeiro segundo no grupo interven??o. Nas compara??es intergrupos, sem o ajuste, os valores m?dios da press?o inspirat?ria e expirat?ria m?xima e o invent?rio de ansiedade tra?o-estado parte 1 ap?s a interven??o foram significativamente mais altos no grupo interven??o. Com base no fato de que grupo interven??o apresentou resultados semelhantes, nos par?metros avaliados, ao grupo controle, pode-se concluir que o cicloerg?metro pode ser considerado como uma nova op??o segura de exerc?cio para a reabilita??o card?aca fase I.
| Identifer | oai:union.ndltd.org:IBICT/oai:tede2.pucrs.br:tede/6144 |
| Date | 11 March 2015 |
| Creators | Trevisan, Margarete Diprat Trevisan |
| Contributors | Myskiw, Jociane de Carvalho |
| Publisher | Pontif?cia Universidade Cat?lica do Rio Grande do Sul, Programa de P?s-Gradua??o em Gerontologia Biom?dica, PUCRS, Brasil, Instituto de Geriatria e Gerontologia |
| Source Sets | IBICT Brazilian ETDs |
| Language | Portuguese |
| Detected Language | English |
| Type | info:eu-repo/semantics/publishedVersion, info:eu-repo/semantics/doctoralThesis |
| Format | application/pdf |
| Source | reponame:Biblioteca Digital de Teses e Dissertações da PUC_RS, instname:Pontifícia Universidade Católica do Rio Grande do Sul, instacron:PUC_RS |
| Rights | info:eu-repo/semantics/openAccess |
| Relation | 4438661476953179033, 600, 600, 600, 2296420844541114010, -969369452308786627 |
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