Avaliação do uso da Escala Modificada de Borg na crise asmática

Acute effects of mat Pilates session on heart rate and rating of perceived exertion

AIMS

The aim of this study was to analyze the acute effects of Heart Rate (HR) and Rating of Perceived Exertion (RPE) for 21 of 34 original Mat Pilates (MP) exercises, to estimate maximum oxygen consumption (VO_2max), and energy expenditure (EE) of a MP session.

METHODS

Ten participants volunteered (26.30 ± 3.98 yrs) to measure the intensity of each exercise; HR and RPE were monitored immediately after the end of each exercise. VO_2maxwas estimated using the Astrand-Ryhming step submaximal test, and EE by a linear regression equation. HR and RPE mean values and standard deviations were calculated for each exercise.

RESULTS

The maximum value for each participant normalized the EE and VO_2max values, which were ranked from highest to lowest. The percentage of the mean values of HR_max and RPE_max in each exercise showed significant, strong and positive correlation (p = 0.82; p = 0.001). In 10 exercises, HR was 60% higher than HR_max. The mean values of EE and VO_2max were 213.71 ± (76.41) Kcal and 34.69 ml (Kg^.min)^-1 (±3.5), respectively, for the entire MP session. Half of the exercises achieved moderate intensity in HR with low estimated VO_2max during the whole MP session. However, if the MP session of this study was practiced five times per week, it would meet the weekly American College of Sports Medicine (ACSM) EE recommendations.

CONCLUSION

The 21 MP exercises monitored in this study promote considerably acute and high increments in HR and RPE.

Pediatric Glittre ADL-test in cystic fibrosis: Physiological parameters and respiratory mechanics

Background: To evaluate the functional capacity in children and adolescents with cystic fibrosis (CF) through the pediatric Glittre ADL-test (TGlittre-P) and its implications for respiratory mechanics, physiological parameters and clinical markers. Methods: Impulse oscillometry system (IOS) parameters, vital signs (heart rate, respiratory rate and blood pressure), perception of dyspnea and peripheral oxygen saturation (SpO₂) were assessed before and immediately after the TGlittre-P. Test performance was correlated with age, quality of life, disease severity, nutrition, spirometry and IOS parameters. Results: Twenty-six patients were included thirteen boys, mean age of 9.54 ± 1.94 and FEV₁ of 71.45%±22.67%. The mean time to complete the test was 2.94 min, similar to that predicted for healthy children. There was a correlation of time with age, as well as with some IOS parameters. Disease severity, spirometric parameters, nutritional aspects and quality of life (QoL) were correlated with performance in the TGlittre-P. Immediate increase of vital signs and decline in SpO₂ were observed after the test, without an impact on IOS parameters. Conclusion: Patients with CF showed similar performance and changes of vital signs at the TGlittre-P compared to reference values for healthy children. There were no immediate changes in parameters for the assessed respiratory mechanics. Also, there was no correlation of time to complete the TGLittre-P test with respiratory mechanics, physiological parameters and clinical markers.

Investigation of alpha band of the electroencephalogram before and after a task of proprioceptive neuromuscular facilitation

The proprioceptive neuromuscular facilitation (PNF) sets up a feature of treatment developed with the objective to facilitate and improve the motor performance. The aim of this study was to investigate in healthy female individuals the effects of electrophysiological of a diagonal of the PNF upper limb. The sample consisted of 30 female participants aged between 18 to 28 years, randomly divided into 3 groups (G1, G2, and G3). The three groups had 2 moments of electroencephalographic signal detection, before and after the task. The statistical neurophysiological design allowed the analysis of the relative power of alpha band in three leads (Fz, F7, and F8). Thus, a three-way mixed factorial analysis of variance (ANOVA) was performed to investigate the factor inter subjects (groups) and intrasubjects (areas and moments), a two-way ANOVA to investigate the interactions between the three factors, and a one-way ANOVA to analyze separately the factors time and area. A P≤0.05 was considered as significance level. The results showed significant increase of alpha band in the three groups analyzed, being more evident to the G2 group. Therefore, the PNF can be considered favorable also in relation to the cortical behavior, reinforcing its use in rehabilitation processes, especially in the clinical practice of physiotherapy.

Reported dyspnea and fatigue using different scales during the physical effort in COPD

Abstract Introduction: Therapy choice and its progression for patients with Chronic Obstructive Pulmonary Disease (COPD) should be based on their symptoms and clinical condition according to reports of dyspnea and fatigue. Therefore patient-reported scales have presented a key role during the communication with the patient. Objective: To verify if patients with COPD prefer the Modified Borg Scale (MBS), Visual Analogue Scale (VAS), Glasses Scale (GS), Faces Scale (FS) or Ratings of Perceived Exertion (RPE) during the six-minute walk test(6MWT), and to compare and correlate the scales with each other, with peripheral oxygen saturation (SpO2) and heart rate (HR). Methods: 28 patients with COPD (50% had mild to moderate COPD and 50% had severe to very severe) were evaluated by a respiratory and cognitive assessment. Additionally, they performed the 6MWT, in which the scales were applied simultaneously (random order) and patients reported their preference in the end of the test. Results: 57% of patients were illiterate or presented incomplete primary education and most of them (67%) chose the FS or GS. Significant positive correlations were observed between instruments for both dyspnea and fatigue in the end of the 6MWT, which the strongest was between MBS and FS (r = 0.95). Nevertheless, there was no correlation between the scales and SpO2 and HR. Conclusion: As the majority of patients preferred pictured to numerical scales we suggest their use as a resource for therapeutic evaluation; MBS might be replace by FS, even though they have different scores and not scaled proportionally. However, this change must be carefully considered because there is the risk of dubious interpretation.

A associação de técnicas de equilíbrio e condicionamento cardiorrespiratório diminui o risco de quedas e melhora a capacidade funcional em mulheres

RESUMO Verificou-se a efetividade da associação do treino de equilíbrio no solo com o treino cardiorrespiratório na água sobre a capacidade funcional e o risco de quedas em mulheres adultas. Esse ensaio clínico não controlado unicego foi composto por 24 mulheres (60,79±5,51), submetidas a três meses de treinamento. Instrumentos: Short Physical Performance Battery (SPPB), Quick Screen Clinical Falls Risk Assessment (QSCFRA) e Teste de Caminhada de Seis Minutos (TC6). Houve melhora dos índices de equilíbrio, mas sem significância estatística. Ocorreu melhora significativa para o risco de quedas (p<0,001) e TC6 (p=0,049), com aumento médio de 39,58±95,5 m na distância percorrida. Houve correlações significativas entre TC6 e SPPB pré-treinamento (r=0,56, p=0,008), idade e QSCFRA (r=0,538, p=0,012) e comorbidades e QSCFRA (r=0,696; p=0,006). Verificou-se efetividade na associação dos treinos propostos sobre a diminuição do risco de quedas e melhora da capacidade funcional.

A case study of the effect of cardiovascular training on cerebral palsy

Abstract Introduction: Cerebral palsy (CP) is a non-progressive disorder characterized by changes in muscle tone and voluntary movement, leading to adaptive changes in muscle length and in some cases, resulting in bone deformities and increased energy expenditure while performing activities of daily living. Objective: The aim of this study was to investigate the effects of cardiovascular training by an adult with athetoid CP. Methods: The sample was composed of one patient with athetoid CP. The instruments used were the timed ten-meter walk test; the SF-36 quality of life questionnaire, a six-minute walk test and the Timed Up and Go test. Using an exercise bike and resistance exercises for the upper limbs, the patient underwent 24 sessions lasting fifty minutes each during eight weeks. Results: In all tests, significant improvement was observed at four and eight weeks, especially in the first four, and progressed in the following four weeks. In the post-training period, improvement was observed when compared to pre-training values. The SF-36 questionnaire on quality of life showed increase in some areas and decrease in others. Conclusion: Patients with CP can benefit from a physical training program, which can improve their quality of life and be included in their rehabilitation protocol.

Avaliação da pressão positiva expiratória final utilizando o aparelho fisioterápico Quake

O objetivo deste estudo foi avaliar, em voluntários saudáveis, o valor médio da pressão positiva expiratória final (PEEP) na utilização do recurso fisioterápico Quake, relativamente novo no mercado. Participaram 62 indivíduos de ambos os sexos, entre 18 e 30 anos, que foram submetidos a: prova de função pulmonar; avaliação do pico de fluxo expiratório, da sensação subjetiva de esforço (escala de Borg) e da saturação de oxigênio; e à utilização do aparelho, acoplado a um manovacuômetro, para efetuar duas seqüências respiratórias, de 10 e 20 incursões por minuto, monitoradas por retroalimentação visual. Os dados foram tratados estatisticamente. Foi observada diferença significativa entre os valores das pressões geradas apenas na seqüência de 10 incursões por minuto (p=0,03). Na comparação das pressões entre as seqüências, os valores foram significativamente menores na de 10 incursões (29,42±8,04 cmH2O; p=0,03). Não foram encontradas correlações entre as pressões e as variáveis da espirometria, idade e pico de fluxo expiratório. Foi observada uma fraca correlação significativa antes (r=0,36; p=0,003) e depois (r=0,31; p=0,014) da seqüência de 20 incursões entre as pressões nessa seqüência e os escores de fadiga na escala de Borg, tendo o mesmo ocorido com a saturação de oxigênio. A PEEP gerada pelo Quake em indivíduos saudáveis varia de acordo com a frequência em incursões por minuto, sendo maior durante a seqüência mais rápida, que também gera maior cansaço.

Review of dyspnoea quantification in the emergency department: is a rating scale for breathlessness suitable for use as an admission prediction tool?

Acute shortness of breath is a potential marker of serious cardiopulmonary disease and requires rapid assessment. In our current health-care system, increasing pressure on the ED to limit costs and waiting times has resulted in the development of many clinical decision aids and admission prediction tools designed to assist ED physicians in meeting these demands. However, most of these tools are disease specific, and none are currently available for application to patients presenting to the ED with shortness of breath. Although somewhat limited, current evidence supports the utilization of a simple dyspnoea rating scale, to assist in the streamlining of clinical severity assessments and urgency evaluations, and to potentially provide useful information to facilitate rapid and accurate site-of-care decisions in this setting.

The use of Borg's modified scale in asthma crises

OBJECTIVE: Verify the correlation of the improvement of the degree of dyspnea by BME with improved pulmonary performance verified by Expiratory Flow Peak (EFP) and Peripheral Oxygen Saturation (PO2S). METHODS: Analytical, cross-sectional study with 124 patients during an asthma crisis, who received care at a Pneumology emergency service. Heart rate, respiratory frequency EFP, PO2S were evaluated before and after treatment of asthma crisis, and they were questioned about their perception of dyspnea by BME. RESULTS: In the pre-treatment stage, high scale values were related to low EFP values, inverting this relation after treatment. There was also a slight correlation between EFP, PO2S and the perception of dyspnea measured by the patient through BME. CONCLUSION: The scale does not replace other clinical parameters, and can be used as an additional tool, provided that the patient is correctly informed about the scale values.