Reabilitação cardiopulmonar e metabólica fase I no pós-operatório de cirurgia de revascularização do miocárdio utilizando cicloergômetro: um ensaio clínico randomizado

• Autor(a) principal: Trevisan, Margarete Diprat Trevisan
• Data de Publicação: 2015
• Tipo de documento: Tese
• Idioma: por
• Título da fonte: Biblioteca Digital de Teses e Dissertações da PUC_RS
• Texto Completo: http://tede2.pucrs.br/tede2/handle/tede/6144
• topic: GERONTOLOGIA BIOMÉDICA; REVASCULARIZAÇÃO MIOCÁRDICA; REABILITAÇÃO (MEDICINA); EXERCÍCIOS AERÓBICOS; CIENCIAS DA SAUDE::MEDICINA

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 São 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 São 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.