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Introduction: Functional and neuromuscular exercises are important tools in rehabilitation centers, however they are little explored in hospital protocols. Objective: To determine whether functional and neuromuscular exercises are more effective in reducing hospital stay and controlling blood pressure (BP) of hospitalized individuals than routine hospital physiotherapy. Methods: Hospitalized patients for non-cardiac illnesses and without hypertension were included, which were randomized to the control group (CG), who performed breathing exercises, active-free exercises for upper/lower limbs and walk in the hallway, or to functional rehabilitation group (FRG), which underwent neuromuscular exercises for upper/lower limbs, cycle ergometer and up/down stairs training. Both groups received intervention 2x/day. BP was measured at admission, during hospitalization and at discharge. Statistical analysis was performed by adopting a confidence interval of 95% and a 5% significance level. Results: Forty-two volunteers were evaluated, of which 26 met the eligibility criteria. However, six were excluded, four due to hospital stay less than three days and two for not completing the treatment protocol. The average age in the CG was 72±11 versus 73±8 in the FRG. There were no statistical differences in BP levels at admission. There was a reduction in the BP only in the FRG during hospitalization (p<0.01) and at discharge (p<0.01). The CG presented longer time (days) of hospitalization — 7.2±1.8 versus 5.5±1.3 of the FRG (p<0.05). Conclusion: Functional and neuromuscular exercises seem more effective in reducing the length of hospital stay and blood pressure control, of hospitalized individuals that routine hospital physiotherapy.
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2. Dantas CM, Silva PFS, Siqueira FHT, Pinto RMF, Matias S, Maciel C, et al. Influência da mobilização precoce na força muscular periférica e respiratória em pacientes críticos. Rev Bras Ter Intensiva. 2012;24(2):173-78. http://dx.doi.org/10.1590/S0103-507X2012000200013
3. Gosselink R, Bott J, Johnson M, Dean E, Nava S, Norrenberg M, et al. Physiotherapy for adult patients with critical illness: recommendations of the European Respiratory Society and European Society of Intensive Care Medicine Task Force on Physiotherapy for Critically III Patients. Intensive Care Med. 2008;34(7):1188-99. http://dx.doi.org/10.1007/s00134-008-1026-7
4. Silva APP, Maynard K, Cruz MR. Efeitos da fisioterapia motora em pacientes críticos: uma revisão de literatura. Rev Bras Ter Intensiva. 2010;22(1):85-91. http://dx.doi.org/10.1590/S0103-507X2010000100014
5. Moore GE, Painter P, Brinker KR, Stray-Gundersen J, Mitchell JH. Cardiovascular response to submaximal stationary cycling during hemodialysis. Am J Kidney Dis. 1998;31(4):631-7.
6. Monteiro WD. Força muscular: uma abordagem fisiológica em função do sexo, idade e treinamento. Rev Bras Ativ Fís Saúde. 1997;2(2):50-66.
7. Martin UJ, Hincapie L, Nimchuk M, Gaughan J, Criner GJ. Impact of whole body rehabilitation in patients receiving chronic mechanical ventilation. Crit Care Med. 2005;33(10):2259-65. http://dx.doi.org/00003246-200510000-00017
8. Umpierre D, Stein R. Efeitos hemodinâmicos e vasculares do treinamento resistido: implicações na doença cardiovascular. Arq Bras Cardiol. 2007; 89(4):256-62. http://dx.doi.org/10.1590/S0066-782X2007001600008
9. Herdy AH, López-Jimenez F, Terzic CP, Milani M, Stein R, Carvalho T, et al. Diretriz Sul-Americana de Prevenção e Reabilitação Cardiovascular. Arq Bras Cardiol. 2014;103(2 Supl 1):1-31. http://dx.doi.org/10.5935/abc.2014S003
10. Serafim TS, Jesus ES, Pierin AM. Influence of knowledge on healthy lifestyle in the control of hypertensive. Acta Paul Enferm. 2010;23(5):658-64. http://dx.doi.org/10.1590/S0103-21002010000500012
11. Viana PADC, Oliveira FTO, Esquivel MS, Tudella GO, Gardenghi G, Petto J. Exercício neuromuscular no pós-operatório de cirurgia cardíaca. Rev DERC. 2014;20(1):18-21.
12. Sociedade Brasileira de Cardiologia. VI Diretrizes Brasileiras de Hipertensão. Arq Bras Cardiol. 2010;95(1 Supl 1):1-51.
13. Pinheiro CHJ, Medeiros RAR, Pinheiro DGM, Marinho MJF. Modificação do padrão respiratório melhora o controle cardiovascular na hipertensão essencial. Arq Bras Cardiol. 2007;88(6):651-9. http://dx.doi.org/10.1590/S0066-782X2007000600005
14. Adams GM. Exercise physiology: laboratory manual. Boston: McGraw-Hill; 1998.
15. Coleman A, Freeman P, Steel S, Shennan A. Validation of the Omron MX3 Plus oscilometric blood pressure monitoring device according to the European Society of Hypertension International protocol. Blood Press Monit. 2005;10(3):165-8.
16. Tan B. Manipulating resistance training program variables to optimize maximum strength in men: a review. J Strength Cond Res. 1999;13(3):289-304.
17. Deschenes MR, Kraemer WJ. Performance and physiologic adaptations to resistance training. Am J Phys Med Rehabil. 2002;81(suppl):S3-16. http://dx.doi.org/10.1097/01.PHM.0000029722.06777.E9
18. Kraemer WJ, Ratamess NA. Fundamental of resistance training: progression and exercise prescription. Med Sci Sports Exerc. 2004;36(4):674-88. http://dx.doi.org/00005768-200404000-00017
19. Pontes-Júnior FL, Prestes J, Leite RD, Rodriguez D. Influência do treinamento aeróbio nos mecanismos fisiopatológicos da hipertensão arterial sistêmica. Rev Bras Ciênc Esporte. 2010;32(2-4):229-44. http://dx.doi.org/10.1590/S0101-32892010000200016
20. Brito LC, Queiroz ACC, Forjaz CLM. Influence of population and exercise protocol characteristics on hemodynamic determinants of post-aerobic exercise hypotension. Braz J Med Biol Res. 2014;47(8):626-36. http://dx.doi.org/10.1590/1414-431X20143832
21. Araújo AJS, Santos ACV, Souza KS, Bastos M, Aires VJSF, Fioretto ET, et al. Treinamento resistido controla a pressão arterial de ratos hipertensos induzidos por I-NAME. Arq Bras Cardiol. 2013;100(4):339-46. http://dx.doi.org/10.5935/abc.20130051
22. Cordeiro AL, Barbosa AFN, Leitão LP, Araújo PAS, Carvalho S. Efeitos hemodinâmicos do treino em cicloergômetro em pacientes no pós-operatório de cirurgia cardíaca. Rev DERC. 2014;20(3):90-3.
23. Burtin C, Clerckx B, Robbeets C, Ferdinande P, Langer D, Troosters T, et al. Early exercise in critically ill patients enhances short-term functional recovery. Crit Care Med. 2009;37(9):2499-505. http://dx.doi.org/10.1097/CCM.0b013e3181a38937