Cardiorespiratory function of patients undergoing surgical correction of Scheuermann's hyperkyphosis

The aim of this study was to analyze the impact of surgical correction of the thoracic deformity on the cardiorespiratory function of patients with moderate-severe Scheuermann’s hyperkyphosis (SK). A series of 23 adolescents with SK who underwent surgery through an only posterior approach using all pedicle screw constructs were included in the study. Cardiorespiratory parameters were measured during a maximal exercise tolerance test before and 2 years after surgery. Heart rate, oxygen saturation (SatO2), maximum oxygen uptake (VO2 max), ventilatory capacity at maximal exercise (VEmax), and energy costs were recorded. There were statistically significant differences in the forced vital capacity (FVC) (P < 0.05), total VO2max (ml/min) (P < 0.01), maximum expired volume (VEmax) per minute (P < 0.01) and cardiovascular efficiency (HR/VO2 ratio) (P < 0.05). None of these changes were clinically relevant. There were no changes in the VO2max per kg of body mass. The magnitude of the kyphosis correction did not correlate with the change in normalized VO2max or VEmax. In conclusion, patients with moderate-severe SK improve their baseline respiratory limitations and the tolerance to maximum exercise 2 years after surgery. However, the slight cardiorespiratory functional improvements should not necessarily be attributed to the surgery, and could also be caused solely by the residual growth of the lungs and thorax. Furthermore, respiratory functional changes are under thresholds considered as clinically relevant.

Oxygen saturation

This chapter describes how desaturation during a cardiopulmonary exercise test (CPET) is uncommon. A fall of more than 4% from resting values is considered abnormal. Oxygen desaturation is usually caused by lung or pulmonary vascular disease, reflecting ventilation–perfusion inequality or impaired diffusion. Occasionally, a right-to-left shunt will open up in the heart during exercise. Some elite athletes show exercise-induced arterial hypoxaemia, when the ability of their muscles to utilize oxygen cannot be met by the subject’s ventilatory capacity.

Development and Evaluation of a Classified and Tailored Community-Based Exercise Program According to the Mobility Level of People with Stroke Using the Knowledge to Action Framework

Attempts to classify the mobility levels of people with stroke (PWS) for a tailored exercise program in community settings have been few. We developed and evaluated a classified and tailored community-based (CTC) exercise program according to the mobility level of PWS. Forty-two PWS were classified into the Supine and Sitting, Sitting and Standing, and Standing and Gait groups, based on a newly developed classification model and participated in a group-based CTC exercise program for 1 h/day twice/week for 10 weeks. The health outcome measures were blood pressure, lipid profile, glucose control, body composition, ventilatory capacity, and physical and psychological function. The rate of agreement on classification results among the physiotherapists was analysed. For all participants, significant improvements were noted in the blood pressure, lipid profile, body composition, ventilatory capacity, and physical and psychological function. The lower mobility groups showed significant improvements in a greater number of health outcomes than the higher mobility group. The physiotherapists’ agreement regarding the classification results was 91.16 ± 5.14%, verifying the model’s possible high relevance to the community. The effective improvement in participant health implied that the CTC exercise program was well tailored to the participants’ mobility levels, particularly the lower mobility groups.

Pathophysiology of worsening lung function in COVID-19

Introduction: The new coronavirus pneumonia (COVID-19) has emerged as the main threats to global health since December 2019. Addressing part of the pulmonary pathophysiology involved in the disease is important to help interested health professionals better understand the different aspects of this complex pathology. Aim: This article aims to present part of the pathophysiological process involved in pulmonary complications associated with Covid-19. Methods: An integrative literature review was carried out, with articles published between 2019 and 2020, in the Google and PubMed databases, using the following search terms: coronavirus, COVID-19, pulmonary complications, pneumonia. Results: 6 articles were included, addressing the proposed theme. Conclusion: The individual's infection with COVID-19 has the potential to cause significant changes in ventilatory capacity, leading to diffuse pulmonary impairment and worsening gas exchange. Further studies are needed to clarify the pathophysiology of this complex disease with a high potential for contagion, morbidity and mortality.Keywords: coronavirus infections, communicable diseases, pneumonia.

THE USE OF INTERMITTENT NORMOBARIC HYPOXIA IN CHILDREN'S NEUROLOGY (REVIEW)

The present review summarizes the data about the use of intermittent normobaric hypoxia (INH) in the treatment and prevention of both acute and chronic diseases of the nervous system in children. The INH method is used in pregnant women with fetoplacental insufficiency, anemia and for mental disorders correction. The INH efficiency in relation to such pathology as cerebral palsy, epilepsy, enuresis, sleep disturbances, autonomic dysfunction is proved. The age dependence of bioelectric activity of the brain in practically healthy persons (age from 8 to 21 years) on hypoxic factor and the most sensitive period of age from 13 to 16 years is shown. The results the own studies have shown that the children which are born and live in radioactive contaminated areas (RCA), the course of INH sessions led to the restoration of somatovegetative status: activation of higher vegetative centers, optimization of sympathetic and parasympathetic links; positive influence on the activity of the cardiovascular system; ventilatory capacity of lungs; blood parameters.