REHABILITACIÓN EN CUIDADOS PALIATIVOS

Minosso, Jéssica Sponton Moura; Souza, Luciene Jacinto de; Oliveira, Maria Amélia de Campos

doi:10.1590/0104-07072016001470015

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LITERATURE REVIEWS • Texto contexto - enferm. 25 (03) • 2016 • https://doi.org/10.1590/0104-07072016001470015 linkcopiar

REHABILITACIÓN EN CUIDADOS PALIATIVOS

Autoría SCIMAGO INSTITUTIONS RANKINGS

El objetivo de este estudio fue describir las actividades y los efectos de la rehabilitación funcional en pacientes que reciben cuidados paliativos. Es una revisión integradora que utiliza las bases de datos LILACS, BDENF, Coleciona SUS (Brasil) y PUBMED. Se seleccionaron 20 artículos, después caracterizados con diseños de mediano y bajo impacto, y más de la mitad se clasificó con niveles de evidencia II, III, IV y con muestras no siempre consistentes con los diseños de investigación. Todavía, los resultados revelaran el potencial de la rehabilitación para mejorar el estado funcional, la calidad de vida y los síntomas como dolor y ansiedad en esta población, a través de intervenciones muchas veces infravaloradas en cuidados paliativos. Se concluye que la rehabilitación es una estrategia viable para combatir el deterioro funcional y mejorar la calidad de vida de los pacientes en cuidados paliativos.

DESCRIPTORES:
Cuidados paliativos; Actividades cotidianas; Rehabilitación

Descriptors/s	PubMed	LILACS	BDENF	Coleciona SUS	Total
Rehabilitation AND palliative care	397	7	-	-	404
Disability AND palliative care	68	1	-	-	69
Daily living activities AND palliative care	113	-	-	-	113
Recovery of function AND palliative care	19	-	-	-	19

Authors	Year Country	Place	Design (sample)
Buss T¹²	2009 Poland	Home and hospice	Quasi-experimental study (n=49)
Cheville AL¹³	2013 USA	Home	Randomized clinical trial (n=66)
Clemens KE¹⁴	2010 Germany	Hospital	Retrospective study (n=90)
Granda-Cameron, C¹⁵	2010 USA	Clinic	Longitudinal study (n=11)
Gulde I¹⁶	2011 Sweden	_	Qualitative study (n=11)
Guo Y¹⁷	2011 USA	Clinic	Retrospective study (n=60)
Henke CC¹⁸	2013 Germany	Hospital	Randomized clinical trial (n=46)
Javier NS⁵	2011 USA	University	Literature review
Jensen W¹⁹	2014 Germany	Clinic	Pretest/posttest design with control group (n=26)
Jensen W²⁰	2014 Germany	Clinic	Retrospective study (n=572)
Jones L²¹	2013 England	Clinic and home	Randomized clinical trial (n=41)
Kasven-Gonzalez N²²	2010 USA	Hospital	Case study (n=1)
Litterini AJ²³	2013 USA	Community center and hospital	Pretest/posttest design with control group (n=52)
Maddocks M²⁴	2013 England	Research center	Systematic review (n=11)
Oechsle K²⁵	2011 Germany	Clinic	Cross-sectional study (n=53)
Oldervoll LM²⁶	2011 Norway	University	Randomized clinical trial (n=231)
Saarik J²⁷	2010 England	Hospice	Longitudinal study (n=28)
Selman LE²⁸	2011 England	Hospice	Quasi-experimental study (n=18)
Sturm I²⁹	2014 Germany	Hospital	Quasi-experimental study (n=40)
van Dam van Isselt EF³⁰	2013 Holland	Assisted living home	Case study (n=3)

Authors	Interventions	Outcomes	Evidence level
Buss T¹²	Kinesiotherapy	Reduced intensity of fatigue.	II
Cheville AL¹³	Domestic exercise program involving walks and strength training	Improvements in mobility, fatigue and sleep quality of patients in stage IV of lung and colorectal cancer.	I
Clemens KE¹⁴	Lymphatic drainage	Most patients demonstrated improvements in the intensity of the symptoms (pain and dyspnea) after manual lymphatic drainage.	III
Granda-Cameron C¹⁵	Multidisciplinary program	Weight gain, increase in body cell mass indicator and reduction of symptom load.	II
Gulde I¹⁶	Physical exercise guided by physiotherapist	Structuring of routine, reduction of feeling of fatigue, increased feeling of bodily control, increased hope.	III
Guo Y¹⁷	Physiotherapy, occupational therapy, speech, language and hearing therapy and rehabilitation nursing interventions	Asthenic patients in inpatient regimen with solid tumors or hematological cancer can obtain rehabilitation benefits and reach significant functional gain.	III
Henke CC¹⁸	Additional strength and resistance training	The training positively affected the functionality, resistance and strength, demonstrating that even patients in palliative chemotherapy should receive interventions that increase the physical activity.	I
Javier NS⁵	Varying rehabilitation interventions	The studies demonstrated benefits of rehabilitation for the functional capacity, quality of life, mobility, fatigue, pain, wellbeing, dyspnea, emotional status and cognitive function.	IV
Jensen W¹⁹	Aerobic or resistance training in group	Aerobic and resistance training was feasible for patients with gastrointestinal cancer submitted to palliative chemotherapy. Both training programs produced improvements in cancer-related symptoms, as well as in physical activities of daily living.	I
Jensen W²⁰	Physical exercise or physiotherapy	Physical exercises and physiotherapy were feasible for more than 90% of terminal cancer patients. Physical exercises, relaxation therapy and respiratory training were the most easily applicable measures. Prospective clinical trials are needed to assess the efficacy of specific physical exercise and physiotherapy programs in terminal cancer patients.	III
Jones L²¹	Rehabilitation exercises at home	The intervention significantly reduced the unattended needed of cancer survivors, probably with a good cost-effectiveness relation. The program should be implemented in larger populations, followed by an assessment.	I
Kasven-Gonzalez N²²	Physiotherapy and occupational therapy	Improvements in the perceived quality of life, balance, strength, mobility and sociability.	III
Litterini AJ²³	Resistance or cardiovascular exercises	Advanced cancer patients seem to benefit from exercising to improve their functional mobility.	I
Maddocks M²⁴	Neuromuscular electric stimulus	Neuromuscular electric stimulus was an effective medium to reduce muscle weakness in adults with progressive conditions, such as COPD, chronic cardiac diseases and cancer. Further research is needed to clarify its place in clinical practice through the determination of the ideal parameters for a neuromuscular electric stimulation program.	I
Oechsle K²⁵	Physical exercises	Positive and statistically significant correlation between physical exercise and quality of life. About 2/3 of the critically ill patients demonstrated interest in participating in physical exercise programs.	II
Oldervoll LM²⁶	Physical exercise group	The fatigue intensity was not reduced, but the physical performance improved significantly after eight weeks of physical exercise. Therefore, physical exercise can be an appropriate approach to maintain the physical capacity in cancer patients with advanced stages of incurable diseases.	I
Saarik J²⁷	Fatigue management program	Reduction of fatigue intensity.	II
Selman LE²⁸	Yoga and dance therapy	The results suggest that yoga and dance therapy can benefit PC patients.	II
Sturm I²⁹	Dance classes	Dancing can be an appropriate and effective approach to treat cancer-related fatigue.	II
van Dam van Isselt EF³⁰	Geriatric Rehabilitation Program	Case studies showed that a geriatric rehabilitation program for chronic obstructive pulmonary disease (COPD) can offer substantial benefits as part of PC rehabilitation aspects.	III

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