Tratamento cardiorrespiratório de pacientes com Síndrome Pós-Poliomielite
DOI:
https://doi.org/10.34024/rnc.2018.v26.9862Palabras clave:
síndrome pós-poliomielite, transtornos respiratórios, reabilitaçãoResumen
Objetivo. Síndrome pós-polio (SPP) é uma condição que afeta sobreviventes da poliomielite aguda, anos após a recuperação de um ataque agudo inicial do vírus. Na maioria das vezes, os sobreviventes da polio começam a apresentar nova paresia gradual nos músculos que foram previamente afetados pela infecção. A incidência real de doenças cardiovasculares em indivíduos que sofrem de SPP não é conhecida. Entretanto, há indícios para suspeitar de que sujeitos com SPP podem estar em maior risco. Método. Realizou-se uma busca de artigos nas bases de dados: Bireme, Scielo e Pubmed, utilizando as seguintes palavras-chave: síndrome pós-poliomielite, função cardiorrespiratória e reabilitação, nos idiomas Inglês, Francês e Espanhol. Embora tenhamos selecionado um número expressivo de artigos, somente foram considerados os duplo-cegos, randomizados-controlados, além de consensos. Resultados. Certas características da SPP, tais como fadiga muscular, paresia, dor muscular e/ou articulares podem resultar em descondicionamento por inatividade física, além de obesidade e dislipidemia. Dificuldades respiratórias são comuns e podem resultar em hipoxemia. Conclusão. Somente quando avaliados e tratados em tempo hábil, alguns pacientes são capazes de obter os benefícios do uso dos músculos respiratórios auxiliares em termos de qualidade de vida.
Descargas
Citas
2.Esteban J. Polio paralytic: new problems: postpolio syndrome. Rev Esp Salud Publica 2013;87:517-22. https://doi.org/10.4321/S1135-57272013000500010
3.Trojan DA, Cashman NR. Post-poliomyelitis syndrome. Muscle Nerve 2005;319:6-19. https://doi.org/10.1002/mus.20259
4.Bach JR, Alba AS. Pulmonary dysfunction and sleep disordered breathing as post-polio sequelae: evaluation and management. Orthopedics 1991;14:1329-37. https://doi.org/10.3928/0147-7447-19911201-07
5.Trojan DA, Arnold DL, Shapiro S, Bar-Or A, Robinson A, Le Cruguel JP, et al. Fatigue in post-poliomyelitis syndrome: association with disease-related, behavioral, and psychosocial factors. PM R 2009;1:442-9. https://doi.org/10.1016/j.pmrj.2009.03.003
6.Fischer JR, Headley J. Post-polio breathing and sleep problems revisited. Post-Polio Health 2004;20:5-7.
7.Garip Y, Eser F, Bodur H, Baskan B, Sivas F, Yilmaz O. Health related quality of life in Turkish polio survivors: impact of post-polio on the health related quality of life in terms of functional status, severity of pain, fatigue, and social, and emotional functioning. Rev Bras Reumatol Engl Ed 2017;57:1-7.
https://doi.org/10.1016/j.rbre.2014.12.006
8.Silva TM, Moreira GA, Quadros AAJ, Pradella-Hallinan M, Tufik S, Oliveira ASB. Analysis of sleep characteristics in post-polio syndrome patients. Arq Neuropsiquiatr 2010;68:535-40.
https://doi.org/10.1590/s0004-282x2010000400011
9.Siegel H, McCutchen C, Dalakas MC, Freeman A, Graham B, Alling D, et al. Physiologic events initiating REM sleep in patients with the postpolio syndrome. Neurology 1999;52:516-22.
https://doi.org/10.1212/wnl.52.3.516
10.Laffont I, Julia M, Tiffreau V, Yelnik A, Herisson C, Pelissier J. Aging and sequelae of poliomyelitis. Ann Phys Rehabil Med 2010;53:24-33.
https://doi.org/10.1016/j.rehab.2009.10.002
11.Romigi A, Maestri M. Circadian fatigue or unrecognized restless legs syndrome? The post-polio syndrome model. Front Neurol 2014;5:115. https://doi.org/10.3389/fneur.2014.00115
12.Vasconcelos OM, Prokhorenko OA, Salajegheh MK, Kelley KF, Livornese K, Olsen CH, et al. Modafinil for treatment of fatigue in post-polio syndrome: a randomized controlled trial. Neurology 2007;68:1680-6. https://doi.org/10.1212/01.wnl.0000261912.53959.b4
13.Acler M, Bocci T, Valenti D, Turri M, Priori A, Bertolasi L. Transcranial direct current stimulation (tDCS) for sleep disturbances and fatigue in patients with post-polio syndrome. Restor Neurol Neurosci 2013;31:661-8. https://doi.org/10.3233/RNN-130321
14.Gawne AC, Wells KR, Wilson KS. Cardiac risk factors in polio survivors. Arch Phys Med Rehabil 2003;84:694-6. https://doi.org/10.1016/S0003-9993(02)04836-0
15.Orsini M, Souza JA, Araújo Leite MA, Teixeira S, Sá Ferreira A, Bastos VH, et al. Previous acute polio and post-polio syndrome: recognizing the pathophysiology for the establishment of rehabilitation programs. Neurol Int 2015;7:5452. https://doi.org/10.4081/ni.2015.5452
16.Matyja E. Post-polio syndrome. Part II. Therapeutic management. Neurol Neurochir Pol 2012;46:372-8.
17.Halstead LS, Rossi CD. New problems in old polio patients: results of a survey of 539 polio survivors. Orthopedics 1985;8:845-50.
18.Weinberg J, Borg J, Bevegård S, Sinderby C. Respiratory response to exercise in postpolio patients with severe inspiratory muscle dysfunction. Arch Phys Med Rehabil 1999;80(9):1095-100. https://doi.org/10.1016/s0003-9993(99)90067-9
19.Dolmage TE, Avendano MA, Goldstein RS. Respiratory function during wakefulness and sleep among survivors of respiratory and non-respiratory poliomyelitis. Eur Respir J 1992;5:864-70.
20.Lane DJ, Hazleman B, Nichols PJR. Late onset respiratory failure in patients with previous poliomyelitis. Q J Med 1974;43:551-68.
https://doi.org/10.1093/oxfordjournals.qjmed.a067405
21.Dean E, Ross J, Road JD, Courtenay L, Madill KJ. Pulmonary function in individuals with a history of poliomyelitis. Chest 1991;100:118-23. https://doi.org/10.1378/chest.100.1.118
22.Lira CA, Minozzo FC, Sousa BS, Vancini RL, Andrade MS, Quadros AA, et al. Lung function in post-poliomyelitis syndrome: a cross-sectional study. J Bras Pneumol 2013;39:455-60. https://doi.org/10.1590/S1806-37132013000400009
23.Ward NS, Hill NS. Pulmonary function testing in neuromuscular disease. Clin Chest Med 2001;22:769-81. https://doi.org/10.1016/S0272-5231(05)70065-4
24.Midgren B. Lung function and clinical outcome in postpolio patients: a prospective cohort study during 11 years. Eur Respir J 1997;10:146-9.
https://doi.org/10.1183/09031936.97.10010146
25.Boitano LJ. Management of airway clearance in neuromuscular disease. Respir Care 2006;51:913-22.
26.Bach JR, Gonçalves MR, Hon A, Ishikawa Y, De Vito EL, Prado F, et al. Changing trends in the management of end-stage neuromuscular respiratory muscle failure: recommendations of an international consensus. Am J Phys Med Rehabil 2013;92:267-77. https://doi.org/10.1097/PHM.0b013e31826edcf1
27.Wolfe LF, Joyce NC, McDonald CM, Benditt JO, Finder J. Management of pulmonary complications in neuromuscular disease. Phys Med Rehabil Clin N Am 2012;23:829-53. https://doi.org/10.1016/j.pmr.2012.08.010
28.Bach JR, Bakshiyev R, Hon A. Noninvasive respiratory management for patients with spinal cord injury and neuromuscular disease. Tanaffos 2012;11:7-11.
29.Orsini M, Lopes AJ, Menezes SL, Oliveira AB, Freitas MR, Nascimento OJ, et al. Current issues in the respiratory care of patients with amyotrophic lateral sclerosis. Arq Neuropsiquiatr 2015;73:873-6. https://doi.org/10.1590/0004-282X20150132
30.van Kralingen KW, Ivanyi B, Keimpema AR, Venmans BJ, Visser M, Postmus PE, et al. Sleep complaints in postpolio syndrome. Arch Phys Med Rehabil 1996;77:609-11. https://doi.org/10.1016/s0003-9993(96)90304-4
31.Steljes DG, Kryger MH, Kirk BW, Millar TW. Sleep in postpolio syndrome. Chest 1990;98:133-40.
https://doi.org/10.1378/chest.98.1.133
32.Bhat S, Gupta D, Chokroverty S. Sleep disorders in neuromuscular diseases. Neurol Clin 2012; 30:1359-87.
https://doi.org/10.1016/j.ncl.2012.08.010
33.Aboussouan LS. Sleep-disordered breathing in neuromuscular disease. Am J Respir Crit Care Med 2015;191:979-89. https://doi.org/10.1164/rccm.201412-2224CI
34.Kang JH, Lin HC. Comorbidity profile of poliomyelitis survivors in a Chinese population: a population-based study. J Neurol 2011;258:1026-36. https://doi.org/10.1007/s00415-010-5875-y
35.Greenland P, Alpert JS, Beller GA, Benjamin EJ, Budoff MJ, Fayad ZA, et al. 2010 ACCF/AHA guideline for assessment of cardiovascular risk in asymptomatic adults: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol 2010;56:e50-103. https://doi.org/10.1016/j.jacc.2010.09.001
36.Stöllberger C, Blazek G, Wegner C, Finsterer J. Neurological comorbidity affects prognosis in left ventricular hypertrabeculation/noncompaction. Heart Lung 2012;41:594-8. https://doi.org/10.1016/j.hrtlng.2012.03.002
37.Nollet F, Beelen A, Sargeant AJ, Visser M, Lankhorst GJ, Jong BA. Submaximal exercise capacity and maximal power output in polio subjects. Arch Phys Med Rehabil 2001;82:1678-85. https://doi.org/10.1053/apmr.2001.27390
38.Kriz JL, Jones DR, Speier JL, Canine JK, Owen RR, Serfass RC. Cardiorespiratory responses to upper extremity aerobic training by postpolio subjects. Arch Phys Med Rehabil 1992;73:49-54.
39.Dean E, Ross J. Effect of modified aerobic training on movement energetics in polio survivors. Orthopedics 1991;14:1243-6. https://doi.org/10.3928/0147-7447-19911101-13
40.Voorn EL, Gerrits KH, Koopman FS, Nollet F, Beelen A. Determining the anaerobic threshold in postpolio syndrome: comparison with current guidelines for training intensity prescription. Arch Phys Med Rehabil. 2014;95(5):935-40.
https://doi.org/10.1016/j.apmr.2014.01.015
41.Vreede KS, Henriksson J, Borg K, Henriksson M. Gait characteristics and influence of fatigue during the 6-minute walk test in patients with post-polio syndrome. J Rehabil Med 2013;45:924-8. https://doi.org/10.2340/16501977-1209