Eficácia de um manual de orientação domiciliar de reabilitação pulmonar em pacientes com DPOC

Abstract

It is recognized that home-based pulmonary rehabilitation programs show success, managing to increase exercise capacity and quality of life in patients with COPD. This study aimed to determine if a physical therapy guidance manual would facilitate the maintenance of the benefits acquired during the outpatient pulmonary rehabilitation after three months of its completion. Methods: Randomized clinical trial with inclusion of 50 patients with COPD, of both genders (28 women and 22 men). All patients were evaluated before outpatient rehabilitation, after 12 weeks of outpatient rehabilitation and then divided randomly into two groups, where one would receive the rehabilitation manual for home use (MG) and the other only verbal recommendations (CG) to continue performing the exercises at home. Both groups were evaluated a third time after 12 weeks of home period. All evaluations included Six-Minutes Walk Test (6MWT), Six-Minutes Step Test (6MST), COPD Assessment Test (CAT) and measurement of dyspnea using mMRC (modified Medical Research Counsil) scale. Results: After the period of outpatient rehabilitation, all patients showed improvement of respiratory symptoms and in the results of the 6MWT and 6MST. Comparing the results of the 6MWT and 6MST between outpatient discharge and after 12 weeks at home, MG presented maintenance of the benefits acquired in rehab (distance achieved in the 6MWT after pulmonary rehabilitation was 419.9 ± 92.62 m and 420.1 ± 97.51 m after 12 weeks at home, the 6MST results were also similar in the two periods, being 302.4 ± 127.77 steps after rehabilitation and 303.6 ± 123.72, after the home period), unlike CG which fell the results after rehabilitation, returning to values close to those of enrollment (6MWT = 403.3 ± 70,36m after rehabilitation and 356.9 ± 76,1m after 12 weeks at home; 6MST = 314, 9 ± 120.33 steps after rehabilitation and 276 ± 117.39 steps after home time). Conclusion: The use of a simple, illustrated manual facilitated the maintenance of the benefits acquired in the outpatient pulmonary rehabilitation over a period of three months after its termination.