Percepção de avaliadores e pacientes sobre um protocolo de avaliação fisioterapêutica proposto para o período pós-COVID-19: estudo transversal
Perception of evaluators and patients about a physiotherapeutic evaluation protocol proposed for the post-COVID-19 period: cross-sectional study
Iara Buriola Trevisan, Amanda Pinheiro dos Santos Gadioli, Camila dos Santos Pereira, Ivone Ferreira da Nóbrega Silva, Leandra Navarro Benatti
Resumo
Introdução: a fisioterapia tem papel fundamental na recuperação de pacientes no período pós-COVID-19, porém, é importante um método de avaliação fisioterapêutica sistematizado para auxílio dos profissionais. Objetivo: avaliar a percepção de avaliadores e pacientes sobre um modelo de avaliação no pós-COVID-19. Métodos: estudo transversal que avaliou sobreviventes da COVID-19, utilizando-se um protocolo que incluiu coletar informações sobre: estado funcional pós-COVID-19, sinais, sintomas, medidas antropométricas, tolerância ao esforço, força muscular, equilíbrio, mobilidade, disfunções respiratórias, fadiga, distúrbios do sono e qualidade de vida. Ao final de cada avaliação, avaliadores e pacientes responderam um questionário sobre a percepção do grau de dificuldade do processo avaliativo. Resultados: três alunas do último ano da graduação em Fisioterapia, avaliaram 25 indivíduos com idade média de 47,2±21,3 anos, sendo o tempo médio de duração das avaliações foi de 58±11 minutos. Sobre a dificuldade para realizar os testes clínicos, 40% relataram dificuldade moderada, 40% disseram ter sido fácil, 16% muito fácil e um relatou como extremamente difícil. A maioria (64%) apontou facilidade para responder às perguntas das escalas/questionários e 96% concordaram totalmente que o avaliador executou a avaliação de forma clara. Os avaliadores concordaram sobre a viabilidade da avaliação em ambiente ambulatorial. Conclusão: os resultados foram satisfatórios quanto à aplicabilidade do protocolo de avaliação fisioterapêutica proposto para pacientes pós- COVID-19. A percepção dos pacientes e dos avaliadores foi positiva no que se refere ao baixo grau de dificuldade para a realização dos testes e escalas/questionários e também quanto à clareza e à objetividade da avaliação.
MATERIAL SUPLEMENTAR
Este artigo acompanha material suplementar:
PROPOSTA DE FICHA DE AVALIAÇÃO FISIOTERAPÊUTICA PARA PACIENTES PÓS COVID - 19
Palavras-chave
Abstract
Background: physiotherapy plays a fundamental role in the recovery of patients in the post-COVID-19 period, however, a systematized physiotherapeutic assessment method is important to help professionals. Aim: to assess the perception of evaluators and patients regarding a post-COVID-19 assessment model. Methods: cross-sectional study that assessed COVID-19 survivors, using a protocol that included information on: post-COVID-19 functional status, signs, symptoms, anthropometric measurements, exercise tolerance, muscle strength, balance, mobility, respiratory dysfunctions, fatigue, sleep disorders, and quality of life. At the end of each assessment, evaluators and patients answered a questionnaire about their perception of the degree of difficulty of the assessment process. Results: three final-year undergraduate students in Physiotherapy evaluated 25 individuals with a mean age of 47.2±21.3 years, and the mean duration of the assessments was 58±11 minutes. Regarding the difficulty in performing the clinical tests, 40% reported moderate difficulty, 40% said it was easy, 16% very easy, and one reported it as extremely difficult. The majority (64%) found it easy to answer the questions on the scales/questionnaires and 96% strongly agreed that the evaluator performed the assessment clearly. The evaluators agreed on the predictions of the assessment in an outpatient setting. Conclusion: the results were satisfactory regarding the applicability of the proposed physiotherapy evaluation protocol for post-COVID-19 patients. The perception of patients and evaluators was positive regarding the low degree of difficulty in carrying out the tests and scales/questionnaires and also regarding the clarity and objectivity of the evaluation.
DOI da versão traduzida: https://doi.org/10.47066/2966-4837.2024.0003en
Keywords
Referências
1. Wu F, Zhao S, Yu B, Chen YM, Wang W, Song ZG, et al. A new coronavirus associated with human respiratory disease in China. Nature. 2020;579(7798):265-9. http://doi. org/10.1038/s41586-020-2008-3. PMid:32015508.
2. Lu R, Zhao X, Li J, Niu P, Yang B, Wu H, et al. Genomic characterisation and epidemiology of 2019 novel coronavirus: implications for virus origins and receptor binding. Lancet. 2020;395(10224):565-74. http://doi. org/10.1016/S0140-6736(20)30251-8. PMid:32007145.
3. Nalbandian A, Sehgal K, Gupta A, Madhavan MV, McGroder C, Stevens JS, et al. Post-acute COVID-19 syndrome. Nat Med. 2021;27(4):601-15. http://doi.org/10.1038/s41591-021- 01283-z. PMid:33753937.
4. Delbressine JM, Machado FV, Goërtz YM, van Herck M, Meys R, Houben-Wilke S, et al. The impact of post-COVID-19 syndrome on self-reported physical activity. Int J Environ Res Public Health. 2021;18(11):6017. http://doi.org/10.3390/ ijerph18116017. PMid:34205086.
5. Lopez-Leon S, Wegman-Ostrosky T, Perelman C, Sepulveda R, Rebolledo PA, Cuapio A, et al. More than 50 Long-term effects of COVID-19: a systematic review and meta-analysis. Sci Rep. 2021;11(1):16144. http://doi.org/10.1038/s41598- 021-95565-8. PMid:34373540.
6. Nogueira IC, Fontoura FF, Carvalho CR. Recomendações para avaliação e reabilitação pós-COVID-19. São Paulo: Assobrafir; 2021.
7. Machado FV, Meys R, Delbressine JM, Vaes AW, Goërtz YM, van Herck M, et al. Construct validity of the post COVID-19 functional status scale in adult subjects with COVID-19. Health Qual Life Outcomes. 2021;19(1):40. http://doi. org/10.1186/s12955-021-01691-2. PMid:33536042.
8. Cacau LA, Mesquita R, Furlanetto KC, Borges DL, Forgiarini Júnior LA, Maldaner V, et al. Avaliação e intervenção para a reabilitação cardiopulmonar de pacientes recuperados da COVID-19. ASSOBRAFIR Ciência. 2020;11(1 Supl Supl1):183- 93. http://doi.org/10.47066/2177-9333.AC20.covid19.018.
9. Trevisan IB, Benatti LN, Cruz MMA. Impactos da pandemia da COVID-19 na prática fisioterapêutica. In: Balancieri MF, Bellini MZ, editores. Saúde e COVID-19: estudos e práticas multiprofissionais em tempo de pandemia. Curitiba: CRV; 2022. p. 71-93.
10. Benatti LN, Trevisan IB, Zambianqui LP, Zancheta GA, Munhoz PP. Manual para avaliação fisioterapêutica de pacientes pós-COVID-19. In: Freitas DRJ, editor. Principais temas da pesquisa em Ciências Biológicas. Ponta Grossa: Atena; 2023. p. 39-62. http://doi.org/10.22533/at.ed.6442321084.
11. Holland AE, Spruit MA, Singh SJ. How to carry out a field walking test in chronic respiratory disease. Breathe. 2015;11(2):128-39. http://doi.org/10.1183/20734735.021314. PMid:26306113.
12. Calabrese M, Garofano M, Palumbo R, Di Pietro P, Izzo C, Damato A, et al. Exercise training and cardiac rehabilitation in COVID-19 patients with cardiovascular complications: state of art. Life. 2021;11(3):259. http://doi.org/10.3390/ life11030259. PMid:33801080.
13. Núñez-Cortés R, Rivera-Lillo G, Arias-Campoverde M, Soto-García D, García-Palomera R, Torres-Castro R. Use of sit-to-stand test to assess the physical capacity and exertional desaturation in patients post COVID-19. Chron Respir Dis. 2021;18:1479973121999205. http://doi. org/10.1177/1479973121999205. PMid:33645261.
14. Almeida ST, Soldera CLC, de Carli GA, Gomes I, Resende TL. Análise de fatores extrínsecos e intrínsecos que predispõem a quedas em idosos. Rev Assoc Med Bras. 2012;58(4):427- 33. http://doi.org/10.1590/S0104-42302012000400012. PMid:22930020.
15. Bretan O, Júnior JES, Ribeiro OR, Corrente JE. Risco de queda em idosos da comunidade: avaliação com o teste Timed up and go. Rev Bras Otorrinolaringol. 2013;79(1):18-21. http:// doi.org/10.5935/1808-8694.20130004. PMid:23503902.
16. Bongers T, O’Driscoll BR. Effects of equipment and technique on peak flow measurements. BMC Pulm Med. 2006;6(1):14. http://doi.org/10.1186/1471-2466-6-14. PMid:16787543.
17. Hazarika A, Mahajan V, Kajal K, Ray A, Singla K, Sehgal IS, et al. Pulmonary function, mental and physical health in recovered COVID-19 patients requiring invasive versus non-invasive oxygen therapy: a prospective follow-up study post-ICU discharge. Cureus. 2021;13(9):e17756. http://doi. org/10.7759/cureus.17756. PMid:34659969.
18. Schlüssel MM, Anjos LA, Kac G. A dinamometria manual e seu uso na avaliação nutricional. Rev Nutr. 2008;21(2):233-5. http://doi.org/10.1590/S1415-52732008000200009.
19. Novaes RD, Miranda AS, Silva JO, Tavares BVF, Dourado VZ. Equações de referência para a predição da força de preensão manual em brasileiros de meia idade e idosos. Fisioter Pesqui. 2009;16(3):217-22. http://doi.org/10.1590/ S1809-29502009000300005.
20. Ciesla N, Dinglas V, Fan E, Kho M, Kuramoto J, Needham D. Manual muscle testing: a method of measuring extremity muscle strength applied to critically ill patients. J Vis Exp. 2011;(50):2632. PMid:21505416.
21. Zhu Y, Wang Z, Zhou Y, Onoda K, Maruyama H, Hu C, et al. Summary of respiratory rehabilitation and physical therapy guidelines for patients with COVID-19 based on recommendations of World Confederation for Physical Therapy and National Association of Physical Therapy. J Phys Ther Sci. 2020;32(8):545-9. http://doi.org/10.1589/ jpts.32.545. PMid:32884178.
22. Jácome C, Cruz J, Oliveira A, Marques A. Validade, confiabilidade e capacidade de identificação do estado de queda da escala de equilíbrio de Berg, BESTest, Mini-BESTest e Brief-BESTest em Pacientes com DPOC. Fisioterapia. 2016;96:1807–1815.
23. Vitale JA, Bonato M, Borghi S, Messina C, Albano D, Corbetta S, et al. Home-based resistance training for older subjects during the COVID-19 outbreak in Italy: preliminary results of a six-months RCT. Int J Environ Res Public Health. 2020;17(24):9533. http://doi.org/10.3390/ijerph17249533. PMid:33352676.
24. Kim S, Oh J, Kim YI, Ban HJ, Kwon YS, Oh IJ, et al. Differences in classification of COPD group using COPD assessment test (CAT) or modified Medical Research Council (mMRC) dyspnea scores: a cross-sectional analyses. BMC Pulm Med. 2013;13(1):35. http://doi.org/10.1186/1471-2466-13-35. PMid:23731868.
25. Hewlett S, Dures E, Almeida C. Measures of fatigue: Bristol Rheumatoid Arthritis Fatigue Multi-Dimensional Questionnaire (BRAF MDQ), Bristol Rheumatoid Arthritis Fatigue Numerical Rating Scales (BRAF NRS) for severity, effect, and coping, Chalder Fatigue Questionnaire (CFQ), Checklist Individual Strength (CIS20R and CIS8R), Fatigue Severity Scale (FSS), Functional Assessment Chronic Illness Therapy (Fatigue) (FACIT-F), Multi-Dimensional Assessment of Fatigue (MAF), Multi-Dimensional Fatigue Inventory (MFI), Pediatric Quality Of Life (PedsQL) Multi-Dimensional Fatigue Scale, Profile of Fatigue (ProF), Short Form 36 Vitality Subscale (SF-36 VT), and Visual Analog Scales (VAS). Arthritis Care Res. 2011;63(Suppl 11):S263-86. PMid:22588750.
26. Falavigna A, de Souza Bezerra ML, Teles AR, Kleber FD, Velho MC, da Silva RC, et al. Consistency and reliability of the Brazilian Portuguese version of the Mini-Sleep Questionnaire in undergraduate students. Sleep Breath. 2011;15(3):351-5. http://doi.org/10.1007/s11325-010- 0392-x. PMid:20652835.
27. EuroQol Research Foundation. EQ-5D-3l user guide [Internet]. The Netherlands: EuroQol; 2018 [citado em 2023 Dez 26]. Disponível em: https://euroqol.org/publications/ user-guides
28. Fernández-de-las-Peñas C, Palacios-Ceña D, Gómez- Mayordomo V, Florencio LL, Cuadrado ML, Plaza-Manzano G, et al. Prevalence of post-COVID-19 symptoms in hospitalized and non-hospitalized COVID-19 survivors: a systematic review and meta-analysis. Eur J Intern Med. 2021;92:55-70. http://doi.org/10.1016/j.ejim.2021.06.009. PMid:34167876.
29. Rossato MS, Brilli E, Ferri N, Giordano G, Tarantino G. Observational study on the benefit of a nutritional supplement, supporting immune function and energy metabolism, on chronic fatigue associated with the SARS-CoV-2 post-infection progress. Clin Nutr ESPEN. 2021;46:510-8. http://doi.org/10.1016/j.clnesp.2021.08.031. PMid:34857243.
30. Sousa KCA, Gardel DG, Lopes AJ. Postural balance and its association with functionality and quality of life in non‐hospitalized patients with post‐acute COVID‐19 syndrome. Physiother Res Int. 2022;27(4):e1967. http://doi.org/10.1002/ pri.1967. PMid:35842844.
31. Besnier F, Bérube B, Malo J, Gagnon C, Grégoire CA, Juneau M, et al. Cardiopulmonary rehabilitation in long-COVID-19 patients with persistent breathlessness and fatigue: the COVID-rehab study. Int J Environ Res Public Health. 2022;19(7):4133. http://doi.org/10.3390/ijerph19074133. PMid:35409815.
32. Daynes E, Gerlis C, Chaplin E, Gardiner N, Singh SJ. Early experiences of rehabilitation for individuals post- COVID to improve fatigue, breathlessness exercise capacity and cognition: a cohort study. Chron Respir Dis. 2021;18:1-4. http://doi.org/10.1177/14799731211015691. PMid:33957805.
33. Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020;395(10223):497-506. http:// doi.org/10.1016/S0140-6736(20)30183-5. PMid:31986264.
34. Poudel AN, Zhu S, Cooper N, Roderick P, Alwan N, Tarrant C, et al. Impact of Covid-19 on health-related quality of life of patients: a structured review. PLoS One. 2021;16(10):e0259164. http://doi.org/10.1371/journal. pone.0259164. PMid:34710173.
35. American Physical Therapy Association. Physical therapy evaluation reference table [Internet]. Alexandria, VA: APTA; 2020 [citado em 2023 Dez 26]. Disponível em: https://www.apta.org/contentassets/ d3065561ef7643ad9a88f282c6083faa/apta-evalcodes-pocketguide
36. Brasil. Conselho Federal de Fisioterapia e Terapia Ocupacional – COFFITO. Resolução nº 555, de 28 de março de 2022. Institui a Classificação Brasileira de Diagnósticos Fisioterapêuticos – CBDF e dá outras providências. Diário Oficial da União; Brasília; 2022. Disponível em: https://www. coffito.gov.br/nsite/?p=21882
Submetido em:
26/12/2023
Aceito em:
05/09/2024
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