Telerreabilitação de indivíduos com fibrose cística

Abstract

Context: Cystic Fibrosis (CF) is a genetic disease that can affect multiple body systems. Additionally, it may impair protein absorption, leading to muscle mass loss and a diminished response to physical exercise. Although physical activity is beneficial for individuals with CF, there is no structured protocol with progressive load increases designed exclusively for remote monitoring through telerehabilitation. This study aims to evaluate the effects of a specific exercise protocol based on progressive difficulty levels and load increments. Objective: To create a protocol for load increment and increased difficulty level in exercise execution and to evaluate the effect of this protocol in telerehabilitation for individuals with CF. Methods: This is a randomized clinical trial consisting of a control group, which receives general guidance from the CF outpatient clinic, and an experimental group, which follows a structured exercise protocol with a flowchart for load progression. The experimental group is instructed on exercise execution during the assessment, supported by instructional videos, and monitored via messaging apps and video calls. The exercise sessions last approximately 40 minutes per day and include a warm-up, resistance exercises, and a cool-down phase targeting major muscle groups. The frequency is three times per week over 12 weeks. Participants are assessed before and after the intervention regarding clinical and socioeconomic aspects, muscle strength, fatigue, quality of life, functionality, pulmonary function, and oxidative stress. Results: A protocol was developed, including warm-up, muscle resistance exercises, and cool-down phases for major muscle groups. The exercises were structured into three progressive levels, corresponding to the first, second, and third months of implementation based on difficulty levels. The protocol follows a mixed approach concerning overload, incorporating a flowchart for individualized load progression according to each participant’s response, as determined by the Borg Scale and execution time. To date, results have been analyzed for eighteen participants, mostly male, white, and adolescents. These participants had not undergone physiotherapy in the past year, were eligible for the triple combination modulator, had been hospitalized due to respiratory infections, and engaged in some form of physical activity. Numerical and percentage data were presented regarding muscle strength, functional capacity tests, spirometry, fatigue levels, and quality of life. Socioeconomic and physical activity level assessments were categorized. Final Considerations: The exercise protocol and flowchart for load progression were successfully developed. The follow-up has been conducted effectively, despite some challenges inherent to this type of study. Registration number in REBEC U1111-1277-5378.