Banca de QUALIFICAÇÃO: JOÃO PAULO RODRIGUES PACHECO

Uma banca de QUALIFICAÇÃO de MESTRADO foi cadastrada pelo programa.
STUDENT : JOÃO PAULO RODRIGUES PACHECO
DATE: 08/01/2025
TIME: 09:00
LOCAL: https://meet.google.com/ypt-daat-ccy
TITLE:

Effectiveness of cycle ergometer exercise on postoperative functional capacity in adult patients after cardiac surgery: a systematic review with meta-analysis

KEY WORDS:

 Keywords: Thoracic Surgery; Exercise; Adult; Systematic Review; Cardiac Rehabilitation; Physical Therapy Modalities.

PAGES: 58
BIG AREA: Ciências da Saúde
AREA: Saúde Coletiva
SUMMARY:

Introduction: The effectiveness of exercise with a cycle ergometer on functional capacity, length of stay in the intensive care unit (ICU), hospital length of stay, and cardiac complications remains inconsistent after cardiac surgery. Objective: To systematically synthesize the evidence on the use of cycle ergometer exercise in adult patients after cardiac surgery. Methods: This study is a systematic review with a meta-analysis of randomized clinical trials. Searches were conducted in the following data sources: MEDLINE (Medical Literature Analysis and Retrieval System Online), EMBASE, PEDro (Physiotherapy Evidence Database), PubMed, AMED (Allied and Complementary Medicine Database), CINAHL (Cumulative Index of Nursing and Allied Health), LILACS (Latin American and Caribbean Health Sciences Literature), SciELO (Scientific Electronic Library Online), Scopus, and CENTRAL (Cochrane Central Register of Controlled Trials), as well as clinical trial registries: https://clinicaltrials.gov/ and https://ensaiosclinicos.gov.br/, and in the references of the five included studies. PROSPERO: CRD42022378883. Randomized clinical trials involving adult patients undergoing cardiac surgery that compared cycle ergometer exercise with usual care, evaluating functional capacity, ICU length of stay, hospital length of stay, and rates of cardiac complications, were included. The methodological robustness, certainty of evidence, and quality of reporting interventions in the included randomized clinical trials were assessed using the Risk of Bias 2 (ROB 2) tool, GRADE (Grading of Recommendations, Assessment, Development and Evaluation), and TIDieR (Template for Intervention Description and Replication). Meta-analysis was conducted when at least two trials assessed an outcome of interest. Results: The systematic review with meta-analysis included five randomized clinical trials. The predominant sex was male (64.8%), with an average age of 61.5 years, and 19.9% were former smokers. Overall, the studies were classified as 45.71% with low risk of bias, 28.57% with uncertain risk of bias, and 25.71% with high risk of bias. In evaluating the quality of reporting of the interventions in the studies included in this review, considering the aggregation of the studies, 45% were classified as not reported, 16.7% as partially reported, and 38.3% as adequately reported, with an average of 11.2 ± 0.83. The results indicated that the use of the cycle ergometer was superior to usual care without a cycle ergometer in increasing functional capacity (MD 0.42; 95% CI 0.03 to 0.81) and in reducing ICU length of stay (MD - 0.34; 95% CI -0.68 to -0.01). No differences were found in hospital length of stay between the cycle ergometer and usual care (MD -1.14; 95% CI -2.94 to 0.66). Only one study recorded the rate of cardiac complications. Conclusion: It was concluded that there was no difference between aerobic exercise with a cycle ergometer and usual care in patients post-cardiac surgery regarding hospital length of stay. However, aerobic exercise with a cycle ergometer may help improve functional capacity and reduce ICU length of stay. On the other hand, this study indicates very low certainty of evidence for all outcomes, and new randomized controlled trials with greater methodological robustness and sample size are needed to clarify these uncertainties. Keywords: Thoracic Surgery; Exercise; Adult; Systematic Review; Cardiac Rehabilitation; Physical Therapy Modalities.

COMMITTEE MEMBERS:
Externa à Instituição - JULIANA RIBEIRO FONSECA FRANCO DE MACEDO
Interno - 2233748 - ALEX BRUNO LOBATO RODRIGUES
Interna - 2039588 - AMANDA ALVES FECURY
Presidente - 2094874 - ELINALDO DA CONCEICAO DOS SANTOS