de Alvarenga Guilherme Medeiros, Remigio Gamba Humberto, Elisa Hellman Lilian, Ganzert Ferrari Vanusa, Michel de Macedo Rafael
Graduate Program in Electrical and Computer Engineering from Universidade Tecnológica Federal do Paraná, Curitiba, PR, Brazil; Specialization Program in Physiotherapy on Gerontology from Universidade Positivo, Curitiba, PR, Brazil.
Graduate Program in Electrical and Computer Engineering from Universidade Tecnológica Federal do Paraná, Curitiba, PR, Brazil.
Open Respir Med J. 2016 Feb 29;10:12-9. doi: 10.2174/1874306401610010012. eCollection 2016.
The progressive and chronic course of COPD, characterized by difficulty in breathing, can be aggravated by periods of increased symptoms (exacerbation). The treatment often involves in-hospital care and among the interventions applied in COPD patients, physical therapy prompts good results. However the most used techniques are not properly pinpointed and there is no consensus in the literature regarding its effectiveness.
A systematic review was performed to identify which physical therapy treatment was applied in these cases. The following bibliographic databases were consulted: PubMed, and Bireme Portal, Periódicos Capes. Controlled randomized clinical trials that is under went physical therapy intervention in patients hospitalized for exacerbated COPD without the use of NIV (non-invasive ventilation) were included in the study. The PEDro scale, which has a score of 0-10, was used to evaluate the quality of studies included in this review.
The electronic search yielded a total of 302 references published in English, of which only 6 met the criteria for inclusion and exclusion.
It is possible to infer that physiotherapy's techniques used in patients hospitalized for COPD exacerbation, based on this review, were the high frequency chest wall oscillation (HFCWO) on the chest; relaxing massage and active exercises, electrical stimulation via electro-acupuncture; strengthening of the quadriceps; the ELTGOL bronchial drainage technique (expiration with the glottis open in the lateral posture) and an incentive spirometer.
慢性阻塞性肺疾病（COPD）呈进行性发展且病程漫长，其特征为呼吸困难，症状加重期（急性加重）会使病情恶化。治疗通常包括住院治疗，在针对COPD患者的干预措施中，物理治疗效果良好。然而，最常用的技术并未得到恰当明确，且文献中对于其有效性也未达成共识。
进行了一项系统评价，以确定在这些病例中采用了哪种物理治疗方法。查阅了以下文献数据库：PubMed、Bireme门户、Capes期刊。纳入研究的是在未使用无创通气（NIV）的情况下因COPD急性加重而住院的患者接受物理治疗干预的对照随机临床试验。使用评分为0至10分的PEDro量表来评估本评价中纳入研究的质量。
电子检索共获得302篇英文发表的参考文献，其中只有6篇符合纳入和排除标准。
基于本评价可以推断，在因COPD急性加重而住院的患者中使用的物理治疗技术包括：胸部高频胸壁振荡（HFCWO）；放松按摩和主动运动、电针电刺激；股四头肌强化训练；ELTGOL支气管引流技术（侧卧位声门开放呼气）和激励肺活量计。
