Hemodynamic effects of cycle ergometer in critical cancer patients: relation length of stay and type of treatment
Lins, Wylisson Marcelo Almeida; Leão, Ana Cristina Machado; Bergmann, Anke
Abstract
Introduction: In recent years, with the implementation of new chemotherapy protocols, radiation and surgery, there was an improvement in cancer patient’s prognosis. However, both the treatment and the disease itself generate a series of complications, worsening clinical condition, which may lead to the need for admission to the intensive care unit (ICU). Physical therapy works on physical and functional recovery of these individuals, using manual and / or mechanical features, among them the cycle ergometer is gaining prominence, but there is in the literature any study evaluating the use of this technique in critical cancer patients. Objective: To evaluate the influence length of stay and type of treatment on hemodynamic behavior in response to an active cycle ergometer in cancer patients in intensive care. Methods: We performed a single active intervention cycle ergometer lower limb (no load) for 10 minutes. The variables included heart rate and mean arterial blood pressure and systolic blood pressure, which were evaluated in four stages: rest, 5 and10 minutes of activity and 10 minutes of recovery. Data on the patient and his or her medical history were previously obtained from their medical records. Results: The study included 23 patients, most were males; under the age of 65; hospital stays shorter than 14 days. It was observed that elderly patients, females, patients with a long hospital stay greater than 14 days, and patients in a clinical hospital showed higher variations in heart rate, mean arterial blood pressure and systolic blood pressure during the entire activity. Conclusion: The results of this study indicate that no individual had clinical complications during exercise. Hemodynamic changes occurred more frequently in the group of elderly patients, clinical and longer hospital stays.
Keywords
References
1. Soares M, Carvalho M, Salluh J, Ferreira C, Luiz R, Rocco J et al. Effect of age on survival of critically ill patients with cancer. Crit Care Med. 2006; PAP.
2. Courneya K. Exercise in Cancer Survivors: An Overview of Research. Med Sci Sports Exerc. 2003; 35(11):1846-1852.
3. Desai S, Law T, Needham D. Long-term complications of critical care. Crit Care Med. 2011; 39(2): 371-379.
4. Perme C, Chandrashekar R. Early Mobility and Walking Program for Patients in Intensive Care Units: Creating a Standard of Care. Am J Crit Care. 2009;18(3):212-221.
5. Topp R, Ditmyer M, King K, Doherty K, Hornyak J. The Effect of Bed Rest and Potential of Prehabilitation on Patients in the Intensive Care Unit. AACN Adv Crit Care. 2002; 13(2):263-276.
6. Stiller K. Safety Issues That Should Be Considered When Mobilizing Critically Ill Patients. Crit Care Clin. 2007; 23(1):35-53.
7. Morris P, Goad A, Thompson C, Taylor K, Harry B, Passmore L et al. Early intensive care unit mobility therapy in the treatment of acute respiratory failure. Crit Care Med. 2008; 36(8): 2238-2243.
8. Feliciano V, Albuquerque C, Andrade F, Dantas C, Lopez A, Ramos F et al. A influência da mobilização precoce no tempo de internamento na Unidade de Terapia Intensiva. ASSOBRAFIR Ciência. 2012; 03(02): 31-42.
9. Burtin C, Clerckx B, Robbeets C, Ferdinande P, Langer D, Troosters T et al. Early exercise in critically ill patients enhances short-term functional recovery. Crit Care Med. 2009; 37(9): 2499-2505.
10. Pires-Neto R, Pereira A, Parente C, Sant’Anna G, Daguer Esposito D, Kimura A et al. Caracterização do uso do cicloergômetro para auxiliar no atendimento fisioterapêutico em pacientes críticos. Rev Bras Ter Intensiva. 2013; 25(1): 39-43.
11. Teasdale G, Jennett B. Assessment of coma and impaired consciousness. The Lancet. 1974;304(7872):81-84.
12. Bohannon, R. and Smith, M. (1987). “Interrater reliability of a modified Ashworth scale of muscle spasticity.” Physical Therapy 67(2): 206.
13. Wilmore J, Costill D, Kenney L. Fisiologia do esporte e do exercício. 5ª ed. Barueri: Manole; 2013.
14. Guyton A, Hall J. Tratado de fisiologia médica. Madrid: Elsevier; 2011.
15. Stiller K, Phillips A. Safety aspects of mobilising acutely ill inpatients. Physiother Theory Pract. 2003; 19(4):239-257.
16. Weissman C. Effect of routine intensive care interactions on metabolic rate. CHEST J. 1984; 86(6):815.
17. Stiller K, Phillips A, Lambert P. The safety of mobilisation and its effect on haemodynamic and respiratory status of intensive care patients. Physiother Theory Pract. 2004; 20(3):175-185.
18. Farinatti P, Soares P, Monteiro W, Duarte A, Castro L. Cardiovascular responses to passive static flexibility exercises are influenced by the stretched muscle mass and the Valsalva maneuver. Clinics. 2011; 66(3):459-464.
19. Freitas E, Bersi R, Kuromoto M, Slembarski S, Sato A, Carvalho M. Efeitos da mobilização passiva nas respostas hemodinâmicas agudas em pacientes sob ventilação mecânica. Rev Bras Ter Intensiva. 2012; 24(01): 72-78.
20. MacDonald J, MacDougall J, Hogben C. The effects of exercise duration on post-exercise hypotension. J Hum Hypertens. 2000; 14(2):125-129.
21. Jones H, Pritchard C, George K, Edwards B, Atkinson G. The acute postexercise response of blood pressure varies with time of day. Eur J Appl Physiol. 2008; 104(3):481-489.
22. Almeida K, Novo A, Carneiro S, Araújo L. Análise das Variáveis Hemodinâmicas em Idosos Revascularizados após Mobilização Precoce no Leito. Rev Bras Cardiol. 2014; 27(03): 165-171.
23. Moraes M, Bacurau R, Ramalho J, Reis F, Casarini D, Chagas J et al. Increase in kinins on post-exercise hypotension in normotensive and hypertensive volunteers. Biol Chem. 2007; 388(5).
24. MacDonald J, MacDougall J, Hogben C. The effects of exercising muscle mass on post exercise hypotension. J Hum Hypertens. 2000; 14(5):317-320.
25. Schmitz K, Courneya K, Matthews C, Demark-Wahnefried W, Galvão D, Pinto B et al. American College of Sports Medicine Roundtable on Exercise Guidelines for Cancer Survivors. Med Sci Sports Exerc. 2010; 42(7): 1409-1426.
Facebook
Google+
Twitter
LinkedIn
Mendeley
StumbleUpon
CiteULike
Reddit
Email