. Programa de Pós-Graduação Interdisciplinar em Ciências da Saúde, Universidade Federal de São Paulo - UNIFESP - Campus Baixada Santista. Santos (SP) Brasil.
. Departamento de Fisioterapia Cardiorrespiratória e Musculoesquelética, Faculdade de Fisioterapia, Universidade Federal do Rio de Janeiro - UFRJ - Rio de Janeiro (RJ) Brasil.
J Bras Pneumol. 2022 Sep 5;48(4):e20220121. doi: 10.36416/1806-3756/e20220121. eCollection 2022.
To identify the indications for physiotherapy and to evaluate physiotherapy practices in patients with COVID-19 admitted to the ICU (on mechanical ventilation) or to the ward (spontaneously breathing).
An online, 50-item survey was completed by physiotherapists who had been treating hospitalized patients with COVID-19 in Brazil.
Of the 644 physiotherapists who initiated the survey, 488 (76%) completed it. The main reasons for indications for physiotherapy in both settings reported as "very frequently" and "frequently" both in the ICU and the ward by most respondents were oxygenation improvement (> 95%) and prevention of general complications (> 83%). Physical deconditioning was considered an infrequent indication. When compared with mobilization strategies, the use of respiratory interventions showed great variability in both work settings, and techniques considered effective were underutilized. The most frequently used respiratory techniques in the ICU were positioning (86%), alveolar recruitment (73%), and hard/brief expiratory rib cage compression (46%), whereas those in the ward were active prone positioning (90%), breathing exercises (88%), and directed/assisted cough (75%). The mobilization interventions reported by more than 75% of the respondents were sitting on the edge of the bed, active and resistive range of motion exercises, standing, ambulation, and stepping in place.
The least common reason for indications for physiotherapy was avoidance of deconditioning, whereas oxygenation improvement was the most frequent one. Great variability in respiratory interventions was observed when compared with mobilization therapies, and there is a clear need to standardize respiratory physiotherapy treatment for hospitalized patients with COVID-19.
确定 COVID-19 患者在 ICU（机械通气）或病房（自主呼吸）接受物理治疗的适应证，并评估物理治疗实践。
对在巴西治疗 COVID-19 住院患者的物理治疗师进行了一项在线的 50 项调查。
在开始调查的 644 名物理治疗师中，有 488 名（76%）完成了调查。在 ICU 和病房中，大多数受访者认为“非常频繁”和“频繁”的主要适应证都是改善氧合（>95%）和预防全身并发症（>83%）。身体功能下降被认为是一个不常见的适应证。与动员策略相比，呼吸干预的使用在这两种工作环境中都存在很大的差异，并且被认为有效的技术没有得到充分利用。在 ICU 中最常使用的呼吸技术是体位（86%）、肺泡复张（73%）和硬式/短暂呼气胸廓压迫（46%），而在病房中最常使用的呼吸技术是主动俯卧位（90%）、呼吸练习（88%）和定向/辅助咳嗽（75%）。超过 75%的受访者报告的动员干预措施包括坐在床边、主动和抵抗性的关节活动度运动、站立、走动和原地踏步。
物理治疗适应证中最不常见的原因是避免身体功能下降，而改善氧合是最常见的原因。与动员疗法相比，呼吸干预存在很大的差异，需要为 COVID-19 住院患者标准化呼吸物理治疗。
