Efeitos de um programa de reabilitação física na capacidade funcional e aspectos biopsicossociais em pacientes pós-transplante hepático

Abstract

Introduction: Liver transplantation (LTx) represents a great therapeutic advance, being the treatment of choice for patients with acute or chronic irreversible liver diseases. It is known that physical exercise can improve functional performance and decrease postoperative symptoms, promoting a better quality of life. Currently, there is space to develop and define an ideal rehabilitation program, with adequate exercise protocols to keep patients undergoing LTx in good physical condition. Objective: To evaluate the effects of a physical rehabilitation program on functional capacity and biopsychosocial aspects in post-liver transplant patients. Methods: A non-randomized clinical trial study, carried out from August 2017 to March 2020 with patients 30 days after the operation of LTx. Patients were divided into two groups matched according to sex, age and MELD, physical exercise group (PEG) or educational intervention group (EG). The physical rehabilitation program takes place for 8 weeks, 3 times a week, with an average duration of 60 to 80 minutes. The PEG protocol consisted of muscle stretching, interval warm-up exercise, conditioning for the lower limbs and strength training for the upper limbs, developed at Hospital Universitário Walter Cantídio. The EG erected a Post-txH Patient Manual, with similar physical exercises to the GEF to be performed at home. A total of 67 patients were recruited, 30 for the PEG and 24 for the EG. Lung function, quality of life (QL), fatigue, anxiety, depression, sexuality, sleep and functional capacity were measured before and after the study protocol. Results: There were improvements in lung function (p <0.001), functional capacity (p <0.001), fatigue (p <0.001), levels of anxiety and depression (p <0.001), sexuality (p <0.001) and sleep (p <0.001) after the physical exercise program in both the GEF and the EG, with difference between the intergroup mean differences for functional capacity (p <0.0001), and lung function. There was no improvement in QL in GE. The variables fatigue, anxiety, depression and sleep did not difference intergroup (p> 0.05). Conclusion: The physical rehabilitation program improved lung function, QL, fatigue, levels of anxiety and depression, sexuality, sleep and functional exercise capacity in patients 30 days after the operation of LTx.