Navegando por Palavras-chave "respiratory physiotherapy"

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    Do Directed Cough Maneuvers Improve Cough Effectiveness in the Early Period After Open Heart Surgery? Effect of Thoracic Support and Maximal Inspiration on Cough Peak Expiratory Flow, Cough Expiratory Volume, and Thoracic Pain
    (Daedalus Enterprises Inc, 2008-08-01) Fiore Junior, Julio Flavio [UNIFESP]; Chiavegato, Luciana Dias [UNIFESP]; Denehy, Linda; Paisani, Denise de Moraes [UNIFESP]; Faresin, Sonia Maria [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Univ Melbourne
    BACKGROUND: Directed cough maneuvers are often included in physiotherapy management aimed at preventing postoperative pulmonary complications after open heart surgery, but there is little scientific evidence of the effectiveness of directed cough maneuvers. METHODS: We conducted a randomized intra-subject crossover trial to evaluate the effect of thoracic support (patient holds his or her hands over the incision) and maximal inspiration on cough peak expiratory flow (CPEF), cough expiratory volume (CEV), and incision pain during cough in the early period after open heart surgery. Cough evaluation was undertaken on the first and second morning after surgery. On both measurement days the subject did a baseline cough (baseline cough 1) then, in a random sequence, performed 3 cough conditions: an additional baseline cough (baseline cough 2), supported cough, and supported cough preceded by maximal inspiration. In these test conditions a P < .008 was deemed to indicate a statistically significant difference. RESULTS: Twenty-one subjects participated. Thoracic support alone did not significantly affect CPEF or CEV (Bonferroni adjusted P > .008). With a maximal inspiration and thoracic support, CPEF and CPEV were significantly higher than in all other cough conditions (Bonferroni adjusted P < .008). Pain during cough was not influenced by the different cough conditions (P > .05). There was no significant difference in the cough variables or pain during the different cough conditions on the first day versus the second measurement day. CONCLUSIONS: Maximal inspiration increased CPEF and CEV, but the method of thoracic support we used did not reduce pain during cough or influence the cough values we measured.
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    Utilization of Positive-Pressure Devices for Breathing Exercises in the Hospital Setting: A Regional Survey in Sao Paulo, Brazil
    (Daedalus Enterprises Inc, 2010-06-01) Fiore Junior, Julio Flavio [UNIFESP]; Chiavegato, Luciana Dias [UNIFESP]; Paisani, Denise de Moraes [UNIFESP]; Colucci, Daniela Barros Bonfim [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Univ City Sao Paulo
    BACKGROUND: The use of breathing exercises with positive-pressure devices during hospitalization aims to prevent the development of nosocomial pulmonary complications or to facilitate recovery from pulmonary conditions already present. Although this type of intervention has potential benefits and theoretical advantages over more conventional respiratory physiotherapy techniques, the literature on the effects of breathing exercises with positive-pressure is controversial and inconsistent. OBJECTIVE: To evaluate the extension of the use of breathing exercises with positive-pressure devices by physiotherapists in Sao Paulo, Brazil. METHODS: A list of hospitals located in the city of Sao Paulo was obtained through the Municipal Secretary of Health. Physiotherapists at 43 hospitals were surveyed about their use of exercises with positive-pressure devices in: patients after abdominal, thoracic, and cardiac surgery; patients with chronic obstructive pulmonary disease; patients with pneumonia; and patients with neuromuscular disease. RESULTS: 120 physiotherapists responded to the questionnaire. All the respondents used breathing exercises with positive-pressure devices in their clinical practice, with all types of patients addressed in the questionnaire. The devices most frequently used were continuous positive airway pressure (78%) and intermittent positive-pressure breathing (73%). The most frequently cited indications for positive-pressure breathing exercises were atelectasis and oxygenation impairment. CONCLUSIONS: Despite a lack of evidence of benefit from breathing exercises with positive-pressure in the hospital setting, this type of intervention is used extensively in clinical practice for a wide variety of patients and conditions.