2006 OPEN FORUM Abstracts
Integrative physiotherapy approach in patients with cardiovascular disease and COPD co-morbidity - a pilot study
Walkyria Oliveira Sampaio, Ingrid de
Castro Bolina Faria, Letícia Tertuliano Melo, Juliana Diniz Pereira, Cristiane
Cenachi Coelho, Elizabeth Portugal Pimenta Velloso. Uni-BH-Centro Universitário
de Belo Horizonte. Minas Gerais - Brazil .
Contact: walkyria.sampaio@gmail.com
Introduction: Cardiovascular diseases (CVD) are
the most relevant comorbidity for patients affected by chronic obstructive
pulmonary disease (COPD). The CVD-COPD association progressively increases the
imbalance between oxygen delivery and oxygen demand, worsing the exercise
intolerance. Relatively minor attention has been paid to this congruent status
during the physiotherapy approach.
Objective: To evaluate the effect of a
cardiorespiratory integrative rehabilitation program on low exercise tolerance
in patients with CVD-COPD association.
Methods:
five patients with CVD-COPD and low exercise tolerance were included.
The program consisted of a 10 week aerobic training (upper limb cycloergometer
exercising followed by a treadmill walking) combined with specific respiratory
muscle training. Non-invasive ventilation (NIV, IPAP=10 cmH2O, EPAP=5 cmH20)
was used during aerobic training to reach the calculated target heart rate zone
(60-70% maximal heart rate). Inspiratory muscle training was performed using a
pressure load inspiratory muscle trainer (Threshold®, maximum patient load, 15
min). Evaluations of inspiratory and expiratory endurance (load), maximum
inspiratory and expiratory muscle strength (MIP and MEP, respectively, predict
values), upper limb endurance (load/time), heart rate, blood pressure and
achieved distance during six minute walking test were performed before and
after the program completion.
Results: It
was observed a significant increase in the achieved distance during six minute
walking test (p<0.05). The MIP (75.65±21.08 to 98.82±26.53 cmH2O, p=0.044) and MEP (89.59±33.49 to 121.09±31.54 cmH2O,
p=0.026) also increased significantly.
There was no significant alteration in the other parameters evaluated.
Conclusion: the achievement of adequate target heart rate
using NIV during the aerobic training seems to allow these patients to break
the inner cycle of inactivity, optimizing the cardio-respiratory conditioning.
Overall, this approach could prevent the worsening of the cardiovascular
morbidity in COPD patients.