Impacto de um protocolo precoce de fisioterapia em pacientes transplantados renais

• Ano de defesa: 2011
• Autor(a) principal: Gama, Tatiana Onofre
• Tipo de documento: Dissertação
• Tipo de acesso: Acesso aberto
• Idioma: por
• Instituição de defesa: Universidade Cidade de São Paulo; Brasil; Pós-Graduação; Programa de Pós-Graduação Mestrado em Fisioterapia; UNICID
• Palavras-chave em Português: Transplante renal; Fisioterapia respiratória; Força muscular; Tolerância ao exercício; FISIOTERAPIA E TERAPIA OCUPACIONAL
• Link de acesso: https://repositorio.cruzeirodosul.edu.br/handle/123456789/1148

Background: Chronic kidney disease (CKD) is a major public health problem, causing progressive and irreversible loss of renal function, and serious cardiorespiratory and musculoskeletal disorders. With renal transplantation there is an improvement in these conditions, however, is unknown if these changes return to normal, so needs to be evaluated. Physical therapy has been widely used in the postoperative period however there is few studies with this kind of patients due this population is considered to have high morbidity which directly affects the quality of life and social life. Objectives: To evaluate the impact of a the early physical therapy protocol in exercise capacity, respiratory and peripheral muscle strength and vital capacity (VC) in patients undergoing renal transplantation during the period of hospitalization. Materials and Methods: All patients transplant (living donor) candidates were recruited at the Hospital of the Kidney and Hypertension from February to August 2011. All patients underwent preoperative evaluation, which evaluated respiratory muscle strength (MIP and MEP) by manometer and vital capacity through the spirometer , measured muscle strength of upper and lower limbs (dynamometer) and the six minute walk test, (6MWT), which were reevaluated on the 1st postoperative day and at discharge. Post renal transplantation patients were randomized into two groups: CG – control (only physiotherapy guidelines of preexisting protocol) and IG-intervention who received respiratory and motor physiotherapy) Results: Of 63 patients enrolled, 33 (52.4%) were in the control group (CG) and 30 (47.6%) in the intervention group (IG). The average age, time of dialysis and the presence of hypertension and diabetes were similar in both groups. When analyzing the variables studied, the IG were statistically significant different in MIP (Mean difference between groups -20.21, 95% CI -26.14 to 14.27), MEP (Mdiff 16:39, 95% CI 8:54 to 24:27) and VC (Mdiff 310.69, 95% CI 81.66 to 539.76) compared to CG, considering the preoperative period to discharge. There were no significant differences in peripheral muscle strength or 6MWT. The number of postoperative complications and hospital length of stay were similar between groups. Conclusion: Although we found a statistically significant difference in favor of the intervention group for lung function and respiratory muscle strength, both groups had a satisfactory outcome at discharge