Efeitos da técnica breath stacking após cirurgia abdominal alta: ensaio clínico randomizado
Autor(a) principal: | |
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Data de Publicação: | 2020 |
Tipo de documento: | Dissertação |
Idioma: | por |
Título da fonte: | Biblioteca Digital de Teses e Dissertações do UFSM |
Texto Completo: | http://repositorio.ufsm.br/handle/1/22644 |
Resumo: | Introduction: Upper abdominal surgery is used for the diagnosis and treatment of several diseases or dysfunctions, but it can lead to postoperative pulmonary complications. Physiotherapy uses techniques, such as Breath Stacking (BS), that promote pulmonary reexpansion and prevent relevant outcomes. Objective: To evaluate the effects of BS on lung function, vital signs, peripheral oxygenation, thoracoabdominal mobility and pain in the surgical incision in the postoperative period (PO) of upper abdominal surgery (UAS) and analyze BS security. Method: Randomized clinical trial that took place at the General Surgery Unit, University Hospital of Santa Maria, Santa Maria - RS. Subjects undergoing upper abdominal surgery were recruited. They were randomized to the group which received conventional physical therapy associated with BS (BSG; n=18) and to the control group (CG; n=16) which received only conventional physical therapy. The primary end points were forced vital capacity (FVC) and tidal volume (TV). Secondary outcomes were: vital signs, peripheral oxygen saturation, thoracoabdominal mobility, painful perception in the surgical incision, lung volumes and capacities and maximum respiratory pressures. BS safety was assessed by the incidence of gastrointestinal, hemodynamic and respiratory repercussions. The evaluations took place on the 2nd day from PO (between 24 and 48 hours after surgery) and at hospital discharge. Both groups had two daily sessions, from the 2nd day PO until hospital discharge. BS was applied in two daily sessions of up to 20 min. GraphPad Prism 5 program was used for data analysis. The variables with normal distribution were analyzed by parametric tests and those with asymmetric distribution by non-parametric tests. The test was accepted by the UFSM Ethics and Research Committee and registered in the Clinical Trials (NCT04418700). Results: The mean age was 53 years in the CG and 46 in the GBS. FVC increased in both groups at hospital discharge, with a greater effect on BSG. FEV1, FEV1 / FVC, PEF and FEF25-75% increased only in BSG, with an effect superior to that of CG. The minute volume and TV increased in the BSG, but without differing from the CG. MIP and MEP increased in both groups, with a greater effect on BSG. Reduction of respiratory rate (RR) and increase of SpO2 only in BSG. SpO2 increased after BS, however, without changes in the degree of dyspnea and vital signs withoutsigns of respiratory distress or gastrointestinal and hemodynamic repercussions. Conclusion: BS is safe and effective for recovering lung function, peripheral oxygenation and reducing respiratory work in the PO of UAS. |
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2021-10-28T11:22:26Z2021-10-28T11:22:26Z2020-10-21http://repositorio.ufsm.br/handle/1/22644Introduction: Upper abdominal surgery is used for the diagnosis and treatment of several diseases or dysfunctions, but it can lead to postoperative pulmonary complications. Physiotherapy uses techniques, such as Breath Stacking (BS), that promote pulmonary reexpansion and prevent relevant outcomes. Objective: To evaluate the effects of BS on lung function, vital signs, peripheral oxygenation, thoracoabdominal mobility and pain in the surgical incision in the postoperative period (PO) of upper abdominal surgery (UAS) and analyze BS security. Method: Randomized clinical trial that took place at the General Surgery Unit, University Hospital of Santa Maria, Santa Maria - RS. Subjects undergoing upper abdominal surgery were recruited. They were randomized to the group which received conventional physical therapy associated with BS (BSG; n=18) and to the control group (CG; n=16) which received only conventional physical therapy. The primary end points were forced vital capacity (FVC) and tidal volume (TV). Secondary outcomes were: vital signs, peripheral oxygen saturation, thoracoabdominal mobility, painful perception in the surgical incision, lung volumes and capacities and maximum respiratory pressures. BS safety was assessed by the incidence of gastrointestinal, hemodynamic and respiratory repercussions. The evaluations took place on the 2nd day from PO (between 24 and 48 hours after surgery) and at hospital discharge. Both groups had two daily sessions, from the 2nd day PO until hospital discharge. BS was applied in two daily sessions of up to 20 min. GraphPad Prism 5 program was used for data analysis. The variables with normal distribution were analyzed by parametric tests and those with asymmetric distribution by non-parametric tests. The test was accepted by the UFSM Ethics and Research Committee and registered in the Clinical Trials (NCT04418700). Results: The mean age was 53 years in the CG and 46 in the GBS. FVC increased in both groups at hospital discharge, with a greater effect on BSG. FEV1, FEV1 / FVC, PEF and FEF25-75% increased only in BSG, with an effect superior to that of CG. The minute volume and TV increased in the BSG, but without differing from the CG. MIP and MEP increased in both groups, with a greater effect on BSG. Reduction of respiratory rate (RR) and increase of SpO2 only in BSG. SpO2 increased after BS, however, without changes in the degree of dyspnea and vital signs withoutsigns of respiratory distress or gastrointestinal and hemodynamic repercussions. Conclusion: BS is safe and effective for recovering lung function, peripheral oxygenation and reducing respiratory work in the PO of UAS.Introdução: A cirurgia abdominal alta é utilizada para diagnóstico e tratamento de diversas doenças ou disfunções, porém pode acarretar complicações pulmonares pós operatórias. A fisioterapia utiliza técnicas, como a Breath Stacking (BS), que promovem a reexpansão pulmonar e previnem desfechos relevantes. Objetivo: Avaliar os efeitos da BS sobre a função pulmonar, sinais vitais, oxigenação periférica, mobilidade toracoabdominal e dor na incisão cirúrgica no pós operatório (PO) de cirurgia abdominal alta (CAA) e analisar a segurança da BS. Método: Ensaio clínico randomizado que ocorreu na Unidade de Cirurgia Geral, do Hospital Universitário de Santa Maria, Santa Maria - RS. Foram recrutados sujeitos submetidos à cirurgia abdominal alta. Os mesmos foram randomizados para o grupo que recebeu a fisioterapia convencional associada à BS (GBS; n=18) e para o grupo controle (GC; n=16), que recebeu somente a fisioterapia convencional. Os desfechos primários foram a capacidade vital forçada (CVF) e o volume corrente (VC). Os desfechos secundários foram: sinais vitais, saturação periférica de oxigênio, mobilidade toracoabdominal, percepção dolorosa na incisão cirúrgica, volumes e capacidades pulmonares e pressões respiratórias máximas. A segurança da BS foi avaliada pela incidência de repercussões gastrintestinais, hemodinâmicas e respiratórias. As avaliações ocorreram no 2º dia de PO (entre 24 e 48h após a cirurgia) e na alta hospitalar. Ambos os grupos realizaram duas sessões diárias, do 2º dia PO até a alta hospitalar. A BS foi aplicada em duas sessões diárias de até 20 min. Utilizado o programa GraphPad Prism 5 para análise dos dados. As variáveis com distribuição normal foram analisadas por testes paramétricos e as com distribuição assimétrica por testes não paramétricos. O ensaio foi aceito pelo Comitê de ética e pesquisa da UFSM e registrado no Clinical Trials (NCT04418700). Resultados: A média de idade foi de 53 anos no GC e de 46 no GBS. A CVF aumentou em ambos os grupos na alta hospitalar, com efeito superior no GBS. O VEF1, a relação VEF1/CVF, o PFE e a FEF25-75% aumentaram apenas no GBS, com efeito superior ao GC. O volume minuto e VC aumentaram no GBS, mas sem diferir do GC. A PImáx e PEmáx se elevaram em ambos os grupos, com maior efeito no GBS. Houve redução da FR e aumento da SpO2 apenas no GBS. A SpO2 aumentou após a BS, porém, sem alterações no grau de dispneia e nos sinais vitais sem que tenha ocorrido sinais de desconforto respiratório ou repercussões gastrintestinais e hemodinâmicas. Conclusão: A BS é segura e eficaz para a recuperação da função pulmonar, da oxigenação periférica e redução do trabalho respiratório no PO de CAA.Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPESporUniversidade Federal de Santa MariaCentro de Ciências da SaúdePrograma de Pós-Graduação em Reabilitação FuncionalUFSMBrasilCiências da SaúdeAttribution-NonCommercial-NoDerivatives 4.0 Internationalhttp://creativecommons.org/licenses/by-nc-nd/4.0/info:eu-repo/semantics/openAccessCirurgiaAbdômenVentilação pulmonarTécnicas de fisioterapiaSurgeryAbdomenPulmonary ventilationPhysical therapy techniquesCNPQ::CIENCIAS DA SAUDE::FISIOTERAPIA E TERAPIA OCUPACIONALEfeitos da técnica breath stacking após cirurgia abdominal alta: ensaio clínico randomizadoEffects of the breath stacking technique after upper abdominal surgery: randomized clinical trialinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/masterThesisSilva, Antônio Marcos Vargas dahttp://lattes.cnpq.br/9981854873337898Paiva, Dulciane NunesTrevisan, Maria Elainehttp://lattes.cnpq.br/6753686505755569Fernandes, Débora da Luz4008000000086006006006006003adc79b5-5189-4ba7-9dd0-246e3b4f37341a8695f5-04d3-4bbe-a4fe-ea42823b1349bcb6e2b3-8a74-45a6-8efb-d0bb1a7ab003104cf38d-fc87-44eb-b36b-d7d1c6d8ba83reponame:Biblioteca Digital de Teses e Dissertações do UFSMinstname:Universidade Federal de Santa Maria (UFSM)instacron:UFSMORIGINALDIS_PPGRF_2020_FERNANDES_DEBORA.pdfDIS_PPGRF_2020_FERNANDES_DEBORA.pdfDissertaçãoapplication/pdf1628185http://repositorio.ufsm.br/bitstream/1/22644/1/DIS_PPGRF_2020_FERNANDES_DEBORA.pdfa63dd167b5375eb2f2895663f2238ad4MD51CC-LICENSElicense_rdflicense_rdfapplication/rdf+xml; charset=utf-8805http://repositorio.ufsm.br/bitstream/1/22644/2/license_rdf4460e5956bc1d1639be9ae6146a50347MD52LICENSElicense.txtlicense.txttext/plain; charset=utf-816http://repositorio.ufsm.br/bitstream/1/22644/3/license.txtf8fcb28efb1c8cf0dc096bec902bf4c4MD53TEXTDIS_PPGRF_2020_FERNANDES_DEBORA.pdf.txtDIS_PPGRF_2020_FERNANDES_DEBORA.pdf.txtExtracted texttext/plain105260http://repositorio.ufsm.br/bitstream/1/22644/4/DIS_PPGRF_2020_FERNANDES_DEBORA.pdf.txt269baf92db25c85a0bb06308097d73e0MD54THUMBNAILDIS_PPGRF_2020_FERNANDES_DEBORA.pdf.jpgDIS_PPGRF_2020_FERNANDES_DEBORA.pdf.jpgIM Thumbnailimage/jpeg4138http://repositorio.ufsm.br/bitstream/1/22644/5/DIS_PPGRF_2020_FERNANDES_DEBORA.pdf.jpg8fd44e9e4a3a10f237d639c673e6e1fdMD551/226442021-10-29 03:02:47.754oai:repositorio.ufsm.br:1/22644Q3JlYXRpdmUgQ29tbW9ucw==Biblioteca Digital de Teses e Dissertaçõeshttps://repositorio.ufsm.br/ONGhttps://repositorio.ufsm.br/oai/requestatendimento.sib@ufsm.br||tedebc@gmail.comopendoar:2021-10-29T06:02:47Biblioteca Digital de Teses e Dissertações do UFSM - Universidade Federal de Santa Maria (UFSM)false |
dc.title.por.fl_str_mv |
Efeitos da técnica breath stacking após cirurgia abdominal alta: ensaio clínico randomizado |
dc.title.alternative.eng.fl_str_mv |
Effects of the breath stacking technique after upper abdominal surgery: randomized clinical trial |
title |
Efeitos da técnica breath stacking após cirurgia abdominal alta: ensaio clínico randomizado |
spellingShingle |
Efeitos da técnica breath stacking após cirurgia abdominal alta: ensaio clínico randomizado Fernandes, Débora da Luz Cirurgia Abdômen Ventilação pulmonar Técnicas de fisioterapia Surgery Abdomen Pulmonary ventilation Physical therapy techniques CNPQ::CIENCIAS DA SAUDE::FISIOTERAPIA E TERAPIA OCUPACIONAL |
title_short |
Efeitos da técnica breath stacking após cirurgia abdominal alta: ensaio clínico randomizado |
title_full |
Efeitos da técnica breath stacking após cirurgia abdominal alta: ensaio clínico randomizado |
title_fullStr |
Efeitos da técnica breath stacking após cirurgia abdominal alta: ensaio clínico randomizado |
title_full_unstemmed |
Efeitos da técnica breath stacking após cirurgia abdominal alta: ensaio clínico randomizado |
title_sort |
Efeitos da técnica breath stacking após cirurgia abdominal alta: ensaio clínico randomizado |
author |
Fernandes, Débora da Luz |
author_facet |
Fernandes, Débora da Luz |
author_role |
author |
dc.contributor.advisor1.fl_str_mv |
Silva, Antônio Marcos Vargas da |
dc.contributor.advisor1Lattes.fl_str_mv |
http://lattes.cnpq.br/9981854873337898 |
dc.contributor.referee1.fl_str_mv |
Paiva, Dulciane Nunes |
dc.contributor.referee2.fl_str_mv |
Trevisan, Maria Elaine |
dc.contributor.authorLattes.fl_str_mv |
http://lattes.cnpq.br/6753686505755569 |
dc.contributor.author.fl_str_mv |
Fernandes, Débora da Luz |
contributor_str_mv |
Silva, Antônio Marcos Vargas da Paiva, Dulciane Nunes Trevisan, Maria Elaine |
dc.subject.por.fl_str_mv |
Cirurgia Abdômen Ventilação pulmonar Técnicas de fisioterapia |
topic |
Cirurgia Abdômen Ventilação pulmonar Técnicas de fisioterapia Surgery Abdomen Pulmonary ventilation Physical therapy techniques CNPQ::CIENCIAS DA SAUDE::FISIOTERAPIA E TERAPIA OCUPACIONAL |
dc.subject.eng.fl_str_mv |
Surgery Abdomen Pulmonary ventilation Physical therapy techniques |
dc.subject.cnpq.fl_str_mv |
CNPQ::CIENCIAS DA SAUDE::FISIOTERAPIA E TERAPIA OCUPACIONAL |
description |
Introduction: Upper abdominal surgery is used for the diagnosis and treatment of several diseases or dysfunctions, but it can lead to postoperative pulmonary complications. Physiotherapy uses techniques, such as Breath Stacking (BS), that promote pulmonary reexpansion and prevent relevant outcomes. Objective: To evaluate the effects of BS on lung function, vital signs, peripheral oxygenation, thoracoabdominal mobility and pain in the surgical incision in the postoperative period (PO) of upper abdominal surgery (UAS) and analyze BS security. Method: Randomized clinical trial that took place at the General Surgery Unit, University Hospital of Santa Maria, Santa Maria - RS. Subjects undergoing upper abdominal surgery were recruited. They were randomized to the group which received conventional physical therapy associated with BS (BSG; n=18) and to the control group (CG; n=16) which received only conventional physical therapy. The primary end points were forced vital capacity (FVC) and tidal volume (TV). Secondary outcomes were: vital signs, peripheral oxygen saturation, thoracoabdominal mobility, painful perception in the surgical incision, lung volumes and capacities and maximum respiratory pressures. BS safety was assessed by the incidence of gastrointestinal, hemodynamic and respiratory repercussions. The evaluations took place on the 2nd day from PO (between 24 and 48 hours after surgery) and at hospital discharge. Both groups had two daily sessions, from the 2nd day PO until hospital discharge. BS was applied in two daily sessions of up to 20 min. GraphPad Prism 5 program was used for data analysis. The variables with normal distribution were analyzed by parametric tests and those with asymmetric distribution by non-parametric tests. The test was accepted by the UFSM Ethics and Research Committee and registered in the Clinical Trials (NCT04418700). Results: The mean age was 53 years in the CG and 46 in the GBS. FVC increased in both groups at hospital discharge, with a greater effect on BSG. FEV1, FEV1 / FVC, PEF and FEF25-75% increased only in BSG, with an effect superior to that of CG. The minute volume and TV increased in the BSG, but without differing from the CG. MIP and MEP increased in both groups, with a greater effect on BSG. Reduction of respiratory rate (RR) and increase of SpO2 only in BSG. SpO2 increased after BS, however, without changes in the degree of dyspnea and vital signs withoutsigns of respiratory distress or gastrointestinal and hemodynamic repercussions. Conclusion: BS is safe and effective for recovering lung function, peripheral oxygenation and reducing respiratory work in the PO of UAS. |
publishDate |
2020 |
dc.date.issued.fl_str_mv |
2020-10-21 |
dc.date.accessioned.fl_str_mv |
2021-10-28T11:22:26Z |
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2021-10-28T11:22:26Z |
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info:eu-repo/semantics/masterThesis |
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masterThesis |
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http://repositorio.ufsm.br/handle/1/22644 |
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por |
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por |
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400800000008 |
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Attribution-NonCommercial-NoDerivatives 4.0 International http://creativecommons.org/licenses/by-nc-nd/4.0/ |
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openAccess |
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Universidade Federal de Santa Maria Centro de Ciências da Saúde |
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Programa de Pós-Graduação em Reabilitação Funcional |
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UFSM |
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Brasil |
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Ciências da Saúde |
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Universidade Federal de Santa Maria Centro de Ciências da Saúde |
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