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Diferencias clínicas y pronósticas de la enfermedad pulmonar obstructiva crónica en mujeres derivadas a rehabilitación respiratoria: una visión con enfoque de género [转诊至呼吸康复中心的女性慢性阻塞性肺病的临床和预后差异:性别观点]。
Q3 Medicine Pub Date : 2024-10-01 DOI: 10.1016/j.rh.2024.100871
C. Acuña-Pardo , V. Dávalos-Yerovi , C. Ramírez-Fuentes , Y.G. Curbelo-Peña , C. Rodriguez-Hernandez , M. Tejero-Sánchez

Introduction

Respiratory rehabilitation programmes improve clinical and functional outcomes in patients with chronic obstructive pulmonary disease (COPD), but it is unknown whether their impact differs between men and women.

Objectives

To assess possible sex differences in semiology, comorbidities and prognosis in COPD patients referred to respiratory rehabilitation.

Material and methods

Post-hoc analysis of a prospective cohort of COPD patients referred to rehabilitation from December 2012 to January 2020. Mortality and hospitalisations adjusted for sex, age, severity and body mass index were assessed. Statistical tests used: Chi-square, Student's t, linear regression model and Kaplan-Meier survival curve.

Results

Of 173 patients (age 66.6 years; 70% severe COPD), there were 36 (20.8%) women. Compared to men, women were younger (–4.8 years [95% CI 1.5-8.0; P=.004]) and reported greater dyspnoea on the modified Medical Research Council scale (+0.4 points [95% CI 0.1-0.9; P=.026]). During follow-up, 21 (12.2%) patients died and 79 (45.9%) required ≥2 hospital admissions, with no significant differences between sexes. Despite having lower comorbidity (–0.8 Charlson index points [95% CI –1.3 to –0.3, P=.004]), women had a higher prevalence of depression (53.6% vs. 22.7%, P=.001) and anxiety (37% vs 16.7%, P=.020) than men.

Conclusions

Prognosis in terms of mortality and hospital admissions is not different between men and women. Women have a higher degree of dyspnoea and less comorbidity than men, although the prevalence of anxiety and depression is higher.
简介:呼吸康复计划可改善慢性阻塞性肺病(COPD)患者的临床和功能预后,但其对男性和女性的影响是否存在差异尚不得而知:呼吸康复计划可改善慢性阻塞性肺病(COPD)患者的临床和功能预后,但其对男性和女性的影响是否存在差异尚不清楚:材料与方法:对前瞻性慢性阻塞性肺病(COPD)患者进行事后分析:对2012年12月至2020年1月期间转诊至康复中心的慢性阻塞性肺病患者进行前瞻性队列事后分析。根据性别、年龄、严重程度和体重指数调整死亡率和住院率。使用的统计检验结果:在 173 名患者(年龄 66.6 岁;70% 患有严重慢性阻塞性肺病)中,有 36 名女性(20.8%)。与男性相比,女性更年轻(-4.8 岁 [95% CI 1.5-8.0;P=.004]),且在改良医学研究委员会量表中报告的呼吸困难程度更高(+0.4 分 [95% CI 0.1-0.9;P=.026])。在随访期间,21 名患者(12.2%)死亡,79 名患者(45.9%)需要≥2 次入院治疗,男女之间无明显差异。尽管合并症较少(-0.8个Charlson指数点[95% CI -1.3 to -0.3,P=.004]),但女性抑郁症(53.6% vs. 22.7%,P=.001)和焦虑症(37% vs. 16.7%,P=.020)的发病率高于男性:就死亡率和住院率而言,男性和女性的预后并无不同。女性呼吸困难程度较高,合并症较少,但焦虑症和抑郁症的发病率较高。
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引用次数: 0
Recomendaciones de No hacer en rehabilitación y medicina física desde distintos ámbitos de intervención [康复和物理医学中不应该做的建议:不同干预领域的汇编]。
Q3 Medicine Pub Date : 2024-10-01 DOI: 10.1016/j.rh.2024.100870
C. Colomer Font , M.J. Lillo Gonzalez , L. Lopez de Munain Marques , J. Formigo Couceiro , M.E. Martínez Rodríguez , B. Alonso Álvarez , M.P. Sanz Ayán , M.E. Santandreu Jimenez , R. Martin Mourelle , V. Pujol Blaya , C. de Miguel Benadiba , P. Sanchez Tarifa , H. Bascuñana Ambrós

Introduction and objective

Certain medical practices, both diagnostic and therapeutic, that have not been proven to be effective and do not add value to healthcare, are not uncommon. The aim of this document is to provide a list of «Not to do» recommendations in the medical specialty of Physical Medicine and Rehabilitation.

Material and method

For the development of this project, which is coordinated by the Vocalía de Sociedades Filiales, Sociedades Autonómicas y Grupos de Trabajo de la Sociedad Española de Rehabilitación (SERMEF), specific recommendations are requested from Grupos de Trabajo and Sociedades Filiales of each specific field of Physical Medicine and Rehabilitation, as experts in the corresponding intervention areas. A maximum of three recommendations per sub-specialty area are selected.

Results

Recommendations «Not to do» are collected from SENR/SERDACE/NRN (Sociedad Española de Neurorrehabilitación/Sociedad Española de Rehabilitación en Daño Cerebral/Grupo de Trabajo Neurorrehabilitación Norte), SORECAR (Sociedad Española de Rehabilitación Cardiorrespiratoria), ArtroReha (Grupo de Trabajo de Rehabilitación en Artrosis), GTRVEST (Grupo de Trabajo de Rehabilitación Vestibular), GTLINF (Grupo de Trabajo de Rehabilitación de Linfedema), GTRO (Grupo de Trabajo de Rehabilitación en Osteoporosis), Rehabilitación Parálisis Facial. Out of a total of 35 recommendations, supported by scientific evidence and medical experience, 18 have been selected. The selection criteria are based on the relevance, pragmatism and specificity of the recommendations. Each recommendation is accompanied by a text that clarifies and/or develops the statement.

Conclusions

This project includes a series of recommendations, by expert rehabilitation physicians, of actions not to be performed while delivering medical assistance. SERMEF offers a list of recommendations «Not to do in Rehabilitation and Physical Medicine», supported by scientific evidence and clinical experience.
导言和目的:某些医疗行为,无论是诊断性还是治疗性的,都没有被证明是有效的,也没有增加医疗保健的价值,这种情况并不少见。本文件旨在为物理医学与康复医学专业提供一份 "不可做 "的建议清单:本项目由西班牙康复协会(SERMEF)的附属协会、自治协会和工作小组声援组织(Vocalía de Sociedades Filiales, Sociedades Autonómicas y Grupos de Trabajo)协调制定,要求物理医学与康复各具体领域的工作小组和附属协会作为相应干预领域的专家提出具体建议。每个分专业领域最多选择三项建议:ArtroReha (Grupo de Trabajo de Rehabilitación en Artrosis), GTRVEST (Grupo de Trabajo de Rehabilitación Vestibular), GTLINF (Grupo de Trabajo de Rehabilitación de Linfedema), GTRO (Grupo de Trabajo de Rehabilitación en Osteoporosis), Rehabilitación Parálisis Facial。在总共 35 项有科学证据和医学经验支持的建议中,有 18 项被选中。选择标准基于建议的相关性、实用性和具体性。每项建议都附有文字说明,对声明进行了澄清和/或阐释:本项目包括一系列由康复医师专家提出的建议,内容涉及在提供医疗援助时不得采取的行动。在科学证据和临床经验的支持下,SERMEF 提供了一份 "康复和物理医学不可做 "的建议清单。
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引用次数: 0
Rehabilitación: cambio de etapa e inicio de una nueva era [康复:阶段性变化和新时代的开始]。
Q3 Medicine Pub Date : 2024-10-01 DOI: 10.1016/j.rh.2024.100869
J. Chaler
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引用次数: 0
Adaptación transcultural de la escala «sistema de evaluación del equilibrio» (Mini-BESTest) en pacientes con accidente cerebrovascular 针对中风患者的 Mini-BESTest 平衡评估系统量表的跨文化调整
Q3 Medicine Pub Date : 2024-09-27 DOI: 10.1016/j.rh.2024.100868
M.D. Maldonado , V. Abud , M.T. García

Objective

The purpose of this study is to adapt cross-culturally to Chilean Spanish the assessment scale “Balance Assessment Systems (Mini-BESTest)” so that it can be applied to patients with stroke. Since stroke is a syndrome that compromises the patient's balance, an essential ability to perform activities of daily living safely, the study of different alternatives to improve the living conditions of patients is considered essential.

Materials and methods

Observational, descriptive, cross-sectional study. The process consisted of six stages: direct translation, translation synthesis, back translation, author approval, pre-test, and final consensus. In the pretest, the adapted scale was applied to a sample of stroke patients receiving rehabilitation therapy, who were able to stand up on their own, walk, and follow simple instructions.

Results

The process of cross-cultural adaptation to Chilean Spanish of the Mini-BESTest evaluation scale was satisfactorily completed. Interrater reliability obtained percentages of agreement greater than 92% and all were statistically significant, which suggests an excellent level of agreement. There was a trend for subacute patients to require a greater repetition of the command.

Conclusions

Mini-BESTest shows an excellent level of agreement among physiotherapists. These findings offer the possibility of continuing with the validation process of the scale. It is suggested to repeat the instructions to patients with subacute stroke.
本研究的目的是将 "平衡评估系统(Mini-BESTest)"评估量表改编成智利西班牙语,使其适用于中风患者。由于中风是一种损害患者平衡能力的综合症,而平衡能力是安全进行日常生活活动的基本能力,因此研究不同的替代方法以改善患者的生活条件被认为是至关重要的。研究过程包括六个阶段:直接翻译、翻译综合、回译、作者认可、预试和最终共识。在预试中,将改编后的量表应用于接受康复治疗的中风患者样本,这些患者能够自行站立、行走并听从简单的指令。结果将迷你贝斯特评估量表改编为智利西班牙语的跨文化改编过程圆满完成。互测信度的一致率超过 92%,且均具有统计学意义,这表明一致率达到了极高的水平。有一种趋势表明,亚急性患者需要重复更多的指令。这些发现为继续验证量表提供了可能性。建议对亚急性中风患者进行重复指导。
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引用次数: 0
From confusion to clarity: Strategies for effective communication in skeletal muscle rehabilitation 从混乱到清晰:骨骼肌康复中的有效沟通策略
Q3 Medicine Pub Date : 2024-09-23 DOI: 10.1016/j.rh.2024.100867
R. Tedeschi
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引用次数: 0
Diabetes mellitus doble. Doble desafío para la prescripción de ejercicio. Revisión sistemática 双重糖尿病。运动处方的双重挑战。系统回顾
Q3 Medicine Pub Date : 2024-08-13 DOI: 10.1016/j.rh.2024.100866
L.M. Trujillo , A. von Oetinger

Double diabetes (DD) refers to patients with type 1 diabetes who have developed insulin resistance. The objective of this review is to update relevant information on the prescription of physical activity, pharmacological adjustments and consumption of carbohydrates in DD. A systematic search for scientific articles was carried out in the following databases: PubMed, Cochrane, EBSCO, WoS, ScienceDirect and Medline. The evidence analyzed shows that both physical activity (PA) and physical exercise (PE) are essential to achieve metabolic control in people with DD. Physiological considerations such as: insulin adjustments, insulin injection sites, time to perform PA and PE, absolute and relative contraindications are essential to avoid complications, especially hypoglycemia.

双重糖尿病(DD)是指已出现胰岛素抵抗的 1 型糖尿病患者。本综述旨在更新有关 DD 的体育锻炼处方、药物调整和碳水化合物摄入量的相关信息。我们在以下数据库中对科学文章进行了系统检索:PubMed、Cochrane、EBSCO、WoS、ScienceDirect 和 Medline。分析的证据表明,体力活动(PA)和体育锻炼(PE)对于实现 DD 患者的代谢控制至关重要。要避免并发症,尤其是低血糖症,必须考虑生理因素,如胰岛素调整、胰岛素注射部位、进行 PA 和 PE 的时间、绝对和相对禁忌症等。
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引用次数: 0
Telerrehabilitación en patología musculoesquelética de miembro superior e inferior 远程康复治疗上下肢肌肉骨骼病症
Q3 Medicine Pub Date : 2024-07-11 DOI: 10.1016/j.rh.2024.100860
S. Benot-López , J. López-Moyano , B. Ferrer-González , R. Martínez Pérez Moreira , J.A. Expósito-Tirado

Chronic musculoskeletal conditions cause pain and disability and have significant impact on morbidity worldwide. Tele-rehabilitation is proposed as an alternative or complement to improve patient's muscle function, pain, and quality of life. However, the satisfaction of both patients and professionals must be assessed, together with the patient's daily life activity independence. A search of the literature was made to locate assessment reports, systematic reviews and reports from regulatory bodies with support from a documentarian from the Andalusian Health Technologies Assessment Area (AETSA). For this purpose, the following sources were used: Medline, EMBASE, INAHTA (international network of health technologies assessment) and PEDro (Physiotherapy Evidence Database) from 2014 onwards. Subsequently a secondary search was carried out on the articles selected in the initial search. A search of open clinical trials was also carried out in the database: www.ClinicalTrials.gov

Initially 345 articles were identified. Duplicated articles (57) were excluded. By first analysing the title and abstract 238 articles were excluded. The full texts of the remaining 30 articles were analysed. Finally 18 articles were included.

慢性肌肉骨骼疾病会导致疼痛和残疾,并对全世界的发病率产生重大影响。有人建议将远程康复作为一种替代或补充方法,以改善患者的肌肉功能、疼痛和生活质量。然而,必须对患者和专业人员的满意度以及患者日常生活活动的独立性进行评估。在安达卢西亚卫生技术评估区(AETSA)的一位文献专家的支持下,我们对文献进行了搜索,以查找评估报告、系统性综述和监管机构的报告。为此,使用了以下资料来源:Medline、EMBASE、INAHTA(国际卫生技术评估网络)和 PEDro(物理疗法证据数据库)。随后,对初步检索中选择的文章进行了二次检索。此外,还在数据库中对公开临床试验进行了搜索:www.ClinicalTrials.govInitially,共发现 345 篇文章。排除了重复文章(57 篇)。首先分析了标题和摘要,排除了 238 篇文章。对其余 30 篇文章的全文进行了分析。最后纳入了 18 篇文章。
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引用次数: 0
Resultados de un programa de rehabilitación respiratoria en pacientes receptores de trasplante pulmonar: estudio cuasiexperimental [肺移植受者呼吸康复计划的成果:一项准实验研究]。
Q3 Medicine Pub Date : 2024-07-09 DOI: 10.1016/j.rh.2024.100862
V. Davalos-Yerovi , A. Gómez-Garrido , R. Garcia-Gutiérrez , C. Berastegui , V. Pujol-Blaya , P. Launois , M. Tejero-Sánchez , B. Canut , Y.G. Curbelo , D. Sánchez-Rodríguez

Introduction

Lung transplant (LT) is the ultimate option for end-stage lung diseases. Malnutrition and sarcopenia, common in LT recipients, can be reversible with adequate exercise and nutrition. This study aims to assess changes in physical performance and aerobic capacity after a 10-week rehabilitation program (RP) in LT recipients, as well as to describe the prevalence of sarcopenia and malnutrition before and after RP and their influence on clinically relevant outcomes.

Materials and methods

Quasi-experimental study, before and after a 10-week PR in first-time TP recipients, aged over 18 years, from January 2022 to September 2023. Aerobic exercise capacity was assessed through the 6-minute walking test (6MWT) and peak oxygen consumption (VO2peak); and physical performance was measured using the Short Physical Performance Battery (SPPB). Additionally, the prevalence of sarcopenia was described according to the criteria of the European Working Group on Sarcopenia in Older People (EWGSOP2) and malnutrition according to the criteria of the Global Leadership Initiative on Malnutrition (GLIM).

Results

Of the 41 patients, 56% had sarcopenia and 80% had malnutrition. After RP, the distance walked in the 6MWT increased by 66.3 m (p = 0.004) in men and 61 m (p = 0.001) in women. VO2peak increased in men by a mean of 3.1 ml/min/kg (p = 0.024). Physical performance improved significantly in both men and women according to the Short Physical Performance Battery (SPPB), with clinically relevant differences of 1.6 pts (p < 0.001) and 1.2 pts (p = 0.012), respectively. The prevalence of sarcopenia decreased to 24% and malnutrition to 61%.

Conclusions

RP proved to be an effective and safe intervention for LT recipients. In addition to improvements in skeletal muscle strength and exercise capacity, a reduction in the prevalence of sarcopenia and malnutrition was also observed.

简介肺移植(LT)是治疗终末期肺病的最终选择。肺移植受者常见的营养不良和肌肉疏松症可以通过适当的运动和营养得到逆转。本研究旨在评估肺移植受者在接受为期 10 周的康复计划(RP)后身体表现和有氧能力的变化,并描述康复计划前后肌肉疏松症和营养不良的发生率及其对临床相关结果的影响:准实验研究:2022 年 1 月至 2023 年 9 月,对首次接受 TP 的 18 岁以上患者进行为期 10 周的康复训练前后的情况。有氧运动能力通过 6 分钟步行测试(6MWT)和峰值耗氧量(VO2peak)进行评估;体能通过短期体能测试(SPPB)进行测量。此外,根据欧洲老年人肌肉疏松症工作组(EWGSOP2)的标准描述了肌肉疏松症的患病率,并根据全球营养不良领导倡议(GLIM)的标准描述了营养不良的患病率:在 41 名患者中,56% 患有肌肉疏松症,80% 患有营养不良。康复训练后,男性 6MWT 步行距离增加了 66.3 米(p=0.004),女性增加了 61 米(p=0.001)。男性的 VO2 峰值平均增加了 3.1 毫升/分钟/公斤(p=0.024)。根据短期体能测试(SPPB),男性和女性的体能均有明显改善,临床相关性差异为 1.6 pts(p结论:事实证明,康复训练对长期卧床者来说是一种有效而安全的干预措施。除了骨骼肌力量和运动能力得到改善外,还观察到肌少症和营养不良的发病率有所下降。
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引用次数: 0
Seguridad y eficacia de un programa de ejercicio terapéutico en jóvenes intervenidos de hernia diafragmática congénita 对接受先天性膈疝手术的年轻人实施治疗性运动计划的安全性和有效性
Q3 Medicine Pub Date : 2024-06-20 DOI: 10.1016/j.rh.2024.100859
A.B. Castillo Velásquez , M. Supervia , D. Pelaez Mata , J.C. de Agustín Asensio , M.O. Arroyo Riaño

Introduction and objective

Patients with congenital diaphragmatic hernia (CDH) can have up to 40 times more frequency of muskuloskeletal deformities and decreased perception of physical activity tan their pairs. The objective of this study is to evaluate the safety and efficacy of an individualized exercise program in late adolescents and young adults with repaired CDH, as well as a description of their basal status.

Material and methods

Non randomized prospective trial of 13 patients with repaired CDH between 1997-2005. An initial physical exploration and a pre-post assessment of bioimpedance (BIA), dynamometry, maximal inspiratory and expiratory pressure (MIP/MEP), 6-minute walk test (6MWT), physical activity level (IPAQ) and quality of life (QoL) was made. The training program last for 4 weeks. For the statistical analysis, the Student's t test for paired samples and Wilcoxon test were used.

Results

77% (n = 10) were male with a mean age of 19.23 ± 2.13 years. In baseline BIA, 62% (n = 8) had truncal sarcopenia that improved in −0.43 ± 0.58, and P = .016. MIP, MEP, 6MWT and QoL tests increased by −7.27 ± 8.26 cmH2O, P = .008; −11.91 ± 10.20 cmH2O, P = .002; −70.63 ± 17.88 m, P = .001; −42,19 ± 26.79, P = .00 respectively. The IPAQ did not change significantly (P = 0.86), however the time dedicated to muscle strengthening increased. No adverse effects were reported.

Conclusions

A personalized rehabilitation program is safe and could improve the respiratory muscle strength and truncal sarcopenia as well as the submaximal effort capacity in late adolescents and young adults with repaired CDH.

引言和目的:先天性膈疝(CDH)患者的肌肉骨骼畸形发生率是同类患者的 40 倍,而且他们对体育锻炼的感知能力下降。本研究的目的是评估个性化锻炼计划对已修复 CDH 的晚期青少年和年轻成人的安全性和有效性,以及对其基础状态的描述。材料和方法1997-2005 年间对 13 名已修复 CDH 患者进行的非随机前瞻性试验。对患者进行了初步体格检查,并对生物阻抗(BIA)、测力计、最大吸气和呼气压力(MIP/MEP)、6分钟步行测试(6MWT)、体力活动水平(IPAQ)和生活质量(QoL)进行了前后评估。训练计划为期 4 周。结果77%(n = 10)为男性,平均年龄为(19.23 ± 2.13)岁。在基线 BIA 中,62%(n = 8)的躯干肌肉疏松症在 -0.43 ± 0.58 时有所改善,P = .016。MIP、MEP、6MWT 和 QoL 测试分别增加了 -7.27 ± 8.26 cmH2O,P = .008;-11.91 ± 10.20 cmH2O,P = .002;-70.63 ± 17.88 m,P = .001;-42,19 ± 26.79,P = .00。IPAQ 没有明显变化(P = 0.86),但用于肌肉强化的时间有所增加。结论 个性化康复计划是安全的,可改善 CDH 修复后的青少年和年轻人的呼吸肌力量、躯干肌肉疏松症以及亚最大努力能力。
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引用次数: 0
El proceso de revisión: una llamada a nuevos revisores 审查过程:征集新审查员
Q3 Medicine Pub Date : 2024-06-18 DOI: 10.1016/j.rh.2024.100861
J. Chaler , E. Marco
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引用次数: 0
期刊
Rehabilitacion
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