Abstract
To compare the effects of two physical therapy exercise in-hospital programs in pulmonary function and functional capacity of patients in the postoperative period of heart transplantation. Twenty-two heart transplanted patients were randomized to the control group (CG, n=11) and training group (TG, n=11). The control group conducted the exercise program adopted as routine in the institution and the training group has had a protocol consisting of 10 stages, with incremental exercises: breathing exercises, resistance training, stretching and walking. The programs began on the first day after extubation and stretched until hospital discharge. Assessed pulmonary function, distance walked in six minutes walk test (6MWT) and peripheral muscle strength by one repetition maximum test (1RM). Similar behavior was observed between the two groups treated, with statistically significant increases between the first and second test of the following variables: FVC (59% in CG and 35.2% in TG); MIP (8.6% in CG and 53.5% in TG), MEP (28.8% in CG and 40.7% in TG) and 6MWT (44.5% in CG and 31.4% in TG). There was an increase of peripheral strength by 1RM test, over time, to the muscle groups of the elbow flexors, shoulder flexors, hip abductors and knee flexors. Heart transplant patients benefit from exercise programs in hospital, regardless of the program type applied. A new training proposal did not result in superiority compared to routine programme applied. Exercise protocols provided improves in ventilatory variables and functional capacity of this population.
Highlights
Heart failure (HF) is a clinical syndrome being the final common pathway of heart disease caused by structural or functional abnormalities, acquired or inherited, leading to worsening of filling capacity and ventricular ejection
Heart transplant patients benefit from exercise programs in hospital, regardless of the program type applied
A new training proposal did not result in superiority compared to routine programme applied
Summary
Heart failure (HF) is a clinical syndrome being the final common pathway of heart disease caused by structural or functional abnormalities, acquired or inherited, leading to worsening of filling capacity and ventricular ejection. The heart becomes unable to maintain the tissues demands resulting in symptoms such as fatigue, dyspnea and intolerance to physical exertion [1,2]. In advanced stages of HF (functional classes III and IV), heart transplantation (HT) becomes a treatment able to restore hemodynamic function, improve quality of life and survival. It is recommended for patients whose symptoms do not respond to drug therapy or other surgical procedures [3]. Since the first human HT performed in South Africa by Christiaan Barnard in 1967, HT has improved since its initial experimental stage to devote these days as a treatment of choice for patients with end-stage HF, especially after the development of immunosuppressive therapy [4]. The survival of patients submitted to HT is 80%, 70% and 60% in one, five and 10 years, respectively [3]
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