About this trial
Non-communicable chronic diseases (NCDs) affect approximately 30% of the adult global population, significantly impacting respiratory function and quality of life. Pulmonary and cardiovascular rehabilitation has proven to be an effective therapeutic intervention for managing respiratory symptoms and cardiovascular and improving functional capacity in patients with chronic respiratory conditions. The objective of this study is to evaluate the effects of the pulmonary and cardiovascular rehabilitation program on users of the physical therapy service of CECOM of UNICAMP related to functional capacity, quality of life and respiratory variables after 3 months of the program. Candidates for the pulmonary rehabilitation program are users diagnosed with chronic obstructive pulmonary disease (COPD), pulmonary emphysema, pulmonary fibrosis, asthma or other lung disease. Candidates for the cardiovascular rehabilitation program are users diagnosed with: infarction (AMI), myocardial revascularization surgery, coronary angioplasty, stable angina, valve replacement, chronic heart failure and who meet the criteria for phase III of cardiovascular rehabilitation. They should be referred to physical therapy by the cardiologist with complementary exams and exercise test. The program's assessment will consist of: anamnesis, analysis and recording of complementary exams, physical assessment (weight, height, BMI, cardiac and pulmonary auscultation, blood pressure, heart rate, peripheral oxygen saturation, respiratory muscle strength), functional capacity (six-minute walk test) and quality of life (questionnaire). The program will include aerobic exercises on a treadmill or stationary bike with an intensity between 50-70% of the reserve HR, below the ischemic thresholds. It will also include peripheral muscle strength exercises for the upper and lower limbs, in addition to respiratory muscle training for lung disease patients.
Eligibility criteria
This trial does not accept healthy volunteersQualifiers
Candidates for the pulmonary rehabilitation program: users diagnosed with chronic obstructive pulmonary disease (COPD), pulmonary emphysema, pulmonary fibrosis, asthma or other lung disease.
Candidates for the cardiovascular rehabilitation program: users diagnosed with acute myocardial infarction, myocardial revascularization surgery, coronary angioplasty, stable angina, valve replacement, chronic heart failure and who meet the criteria for phase III of cardiovascular rehabilitation.
Referral with medical clearance for rehabilitation
Disqualifiers
Patients with any contraindication to aerobic or muscle-strengthening physical exercise, such as significant arrhythmias, untreated heart disease, myocarditis, recent or untreated pulmonary embolism, and uncontrolled systemic arterial hypertension, among other conditions.
Trial design
Single group
Treatments tested in this trial
Exercise
Other interventioneffect of exercise after three months (comparison of the patient with himself)
Treatment groups
Trial outcomes
Primary outcomes
Functional Capacity
The Six-Minute Walk Test (6MWT) is used to measure functional capacity. For the test, the study participant walks in a flat 30-meter corridor for 6 minutes and the evaluator marks the final distance covered. This distance is normalized according to age and individual anthropometric characteristics in a solution validated in the literature. This distance represents the functional capacity that can be within or below that predicted by the literature.
Inspiratory muscle strength
Using an analog manometer, inspiratory muscle strength was assessed by means of maximum inspiratory pressure (MIP) in cmH2O. During this procedure, the patient was comfortably seated in a chair with his/her feet flat on the floor and, using a nose clip, was instructed to take a maximal deep inspiration into the mouthpiece of the device after a complete exhalation. The average of three dimensions was recorded. Both the absolute value of the estimates and the predicted value according to the literature were recorded using the following equations according to Neder et al., 1999
Expiratory muscle strength
Using an analog manometer, exspiratory muscle strength was assessed by means of maximum inspiratory pressure (MEP) in cmH2O. During this procedure, the patient was comfortably seated in a chair with his/her feet flat on the floor and, using a nose clip, was instructed to take a maximal deep expiration into the mouthpiece of the device after a complete inspiration. The average of three dimensions was recorded. Both the absolute value of the estimates and the predicted value according to the literature were recorded using the following equations according to Neder et al., 1999
Secondary outcomes
Quality of life
We will use the St. George's Respiratory Questionnaire or SF-36
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