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Abstract(s)
A Doença Pulmonar Obstrutiva Crónica é uma doença do aparelho respiratório inferior frequente, prevenível e tratável, caracterizada por sintomas respiratórios persistentes e progressivos e limitação do fluxo aéreo. Constitui uma das principais causas de morbilidade e mortalidade do mundo, com tendência a aumentar, sendo necessário intervir para melhorar a qualidade de vida destes doentes crónicos. Uma mais valia neste processo é a Reabilitação Respiratória, um componente central no tratamento dos doentes, dado os diferentes mecanismos e técnicas que engloba.
O objetivo deste trabalho é avaliar as repercussões da reabilitação respiratória na doença pulmonar obstrutiva crónica e identificar aqueles que mais beneficiam com esta terapêutica. Com este fim, foi realizada uma pesquisa em bases de artigos científicos como a PubMed com os campos de busca: DPOC AND reabilitação respiratória; COPD AND pulmonary rehabilitation, COPD AND physiotherapy e Rehabilitation COPD, bem como documentos de entidades reconhecidas de saúde dos últimos 10 anos.
Todos os doentes beneficiam da participação num programa de reabilitação, contudo evidencia-se que as melhorias são superiores nos doentes com maior gravidade, altamente sintomáticos e com risco de exacerbações (Grupos B, C e D), ou seja, deve ser prescrita a indivíduos sintomáticos com FEV1 previsto inferior a 50% e considerada em indivíduos sintomáticos ou limitados pelo exercício com FEV1 previsto superior a 50%.
Os programas têm como principais componentes o treino físico nas diferentes vertentes, a educação e a cessação tabágica, podendo ser considerados outros como o aconselhamento nutricional, terapia ocupacional e apoio psicossocial. Apesar de não ser consensual, defende-se que a duração de um programa de reabilitação respiratória não deve ser inferior a 8 semanas.
Após uma avaliação inicial dos doentes, estabelece-se um programa estruturado e individualizado, com os diferentes componentes supracitados. A Reabilitação Respiratória demonstrou benefícios comprovados em diferentes parâmetros nomeadamente na dispneia, na capacidade de exercício e na qualidade de vida. A médio-longo prazo contribui para a diminuição das exacerbações, hospitalizações e custos em saúde. Neste período, os doentes devem ficar capacitados para que no futuro controlem os sintomas da sua doença, adotem as atitudes corretas em diferentes situações do seu quotidiano e possuam ferramentas suficientes para prolongar os efeitos positivos do programa.
Conclui-se que a reabilitação respiratória é uma modalidade terapêutica com inúmeros benefícios comprovados, sobretudo a nível clínico. Contudo, ainda continua a ser subutilizada mundialmente, com identificação de inúmeros obstáculos a contornar no futuro, tanto na adesão do doente ao programa, como desconhecimento pelos profissionais de saúde.
Chronic Obstructive Pulmonary Disease is a common, preventable and treatable lower respiratory tract disease characterized by persistent and progressive respiratory symptoms and airflow limitation. It is one of the main causes of morbidity and mortality in the world, with a tendency to increase and it is necessary to intervene to improve the quality of life of these chronic patients. An added value in this process is Respiratory Rehabilitation, a central component in the treatment of patients, given the different mechanisms and techniques that it encompasses. The objective of this study is to evaluate the repercussions of respiratory rehabilitation in chronic obstructive pulmonary disease and to identify those who benefit most from this therapy. To this end, a research was carried out in databases of scientific articles such as PubMed with the search fields: COPD AND respiratory rehabilitation; COPD AND pulmonary rehabilitation, COPD AND physiotherapy and Rehabilitation COPD, as well as documents of recognized health entities of the last 10 years. All patients benefit from participation in a rehabilitation program, however, it is evident that the improvements are superior in patients with greater severity, highly symptomatic and at risk of exacerbations (Groups B, C and D), that is, it should be prescribed to individuals symptomatic patients with predicted FEV1 of less than 50% and considered in symptomatic or limited individuals with predicted FEV1 exercise greater than 50%. The programs have as main components the physical training in the different aspects, the education and the smoking cessation, being possible to be considered others as the nutritional advice, occupational therapy and psychosocial support. Although not consensual, it is argued that the duration of a respiratory rehabilitation program should not be less than 8 weeks. After an initial evaluation of the patients, a structured and individualized program is established, with the different components mentioned above. Respiratory Rehabilitation has demonstrated proven benefits in different parameters, namely dyspnea, exercise capacity and quality of life. In the medium to long term, it contributes to the reduction of exacerbations, hospitalizations and health costs. In this period, patients should be empowered to control the symptoms of their illness in the future, to adopt the correct attitudes in different situations of their daily life, and to have sufficient tools to prolong the positive effects of the program. It is concluded that respiratory rehabilitation is a modality with numerous proven benefits, especially at the clinical level. However, it continues utilized worldwide, with the identification of innumerable obstacles to be overcome in the future, both in patients' adherence to the program and in the lack of knowledge of health professionals.
Chronic Obstructive Pulmonary Disease is a common, preventable and treatable lower respiratory tract disease characterized by persistent and progressive respiratory symptoms and airflow limitation. It is one of the main causes of morbidity and mortality in the world, with a tendency to increase and it is necessary to intervene to improve the quality of life of these chronic patients. An added value in this process is Respiratory Rehabilitation, a central component in the treatment of patients, given the different mechanisms and techniques that it encompasses. The objective of this study is to evaluate the repercussions of respiratory rehabilitation in chronic obstructive pulmonary disease and to identify those who benefit most from this therapy. To this end, a research was carried out in databases of scientific articles such as PubMed with the search fields: COPD AND respiratory rehabilitation; COPD AND pulmonary rehabilitation, COPD AND physiotherapy and Rehabilitation COPD, as well as documents of recognized health entities of the last 10 years. All patients benefit from participation in a rehabilitation program, however, it is evident that the improvements are superior in patients with greater severity, highly symptomatic and at risk of exacerbations (Groups B, C and D), that is, it should be prescribed to individuals symptomatic patients with predicted FEV1 of less than 50% and considered in symptomatic or limited individuals with predicted FEV1 exercise greater than 50%. The programs have as main components the physical training in the different aspects, the education and the smoking cessation, being possible to be considered others as the nutritional advice, occupational therapy and psychosocial support. Although not consensual, it is argued that the duration of a respiratory rehabilitation program should not be less than 8 weeks. After an initial evaluation of the patients, a structured and individualized program is established, with the different components mentioned above. Respiratory Rehabilitation has demonstrated proven benefits in different parameters, namely dyspnea, exercise capacity and quality of life. In the medium to long term, it contributes to the reduction of exacerbations, hospitalizations and health costs. In this period, patients should be empowered to control the symptoms of their illness in the future, to adopt the correct attitudes in different situations of their daily life, and to have sufficient tools to prolong the positive effects of the program. It is concluded that respiratory rehabilitation is a modality with numerous proven benefits, especially at the clinical level. However, it continues utilized worldwide, with the identification of innumerable obstacles to be overcome in the future, both in patients' adherence to the program and in the lack of knowledge of health professionals.
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Keywords
Doença Pulmonar Obstrutiva Crónica Reabilitação Respiratória