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ABSTRACT Objective: To review the effects of the hammock positioning on clinical parameters of preterm newborn infants (PTNB) admitted to the Neonatal Intensive Care Unit (NICU). Data sources: This was a systematic review performed by searching the Pubmed, Lilacs, SciELO and PEDro databases. Intervention studies in English, Portuguese and Spanish that evaluated the effects of hammock positioning on clinical parameters of PTNB admitted to the NICU were selected. Three search strategies were used: 1) hammock positioning OR patient positioning AND intensive care units AND infant, newborn; 2) hammock positioning OR patient positioning AND intensive care units; 3) hammock positioning OR patient positioning AND intensive care units, neonatal. There was no restriction on the year of publication of the articles. Methodological quality was assessed by the PEDro scale. Data synthesis: Among 597 articles, only six were included and 139 neonates with gestational ages between 26 and 37 weeks and an average gestational weight

IntroductionSeveral tests may be used to assess exercise intolerance in severe therapy-resistant asthma (STRA), including the gold standard cardiopulmonary exercise test (CPET) and the modified shuttle test (MST).ObjectiveTo correlate the distance achieved in the MST with peak oxygen uptake (VO2peak) and to compare the maximal heart rate (HRmax) obtained in both tests in children and adolescents with STRA.MethodsThis is a cross-sectional study, with 19 children and adolescents with STRA. Demographic, anthropometric, clinical data, and spirometric values were collected. CPET and the MST were performed in two consecutive visits. HRmax, pulse oxygen saturation, and dyspnea were compared between tests. The distance achieved in the MST was correlated with VO2peak.ResultsNineteen patients with a mean age of 11.5 ± 2.5 years were included. The mean HRmax (bpm) achieved was 180.8 ± 12.10 for the MST and 187.6 ± 9.35 for CPET, whereas the mean HRmax as a percentage of predicted (HRmax%) was 90.7 ± 6.5 for the MST and 93.8 ± 4.5 for CPET. A difference of only 6 bpm was found for HRmax (p = 0.10) and of 3% for HRmax% (p = 0.06) between tests. A strong correlation was found between the MST (r = 0.79; p = 0.001) and VO2peak measured through CPET. However, there were no correlations between the MST and both body mass index (r = −0.14; p = 0.564) and forced expiratory volume in the first second – FEV1 (r = −0.02; p = 0.917).ConclusionThe results demonstrate that the MST distance strongly correlates with VO2peak, measured through CPET, and the main physiological variable responses were similar between both tests. Our results provide additional data for the use of the MST to assess exercise capacity in children and adolescents with STRA.

ABSTRACT Objective: To evaluate exercise capacity in children and adolescents with post-infectious bronchiolitis obliterans. Data source: This is a systematic review based on data from PubMed, Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS), Scientific Electronic Library Online (SciELO), and Physiotherapy Evidence Database (PEDro). We used the following search strategy: “Exercise capacity OR Exercise Test OR Physical fitness OR Functional capacity OR Six-minute walk test OR Shuttle walk test OR Cardiopulmonary exercise test AND Bronchiolitis obliterans.” We selected studies that evaluated exercise capacity through maximal/submaximal testing in children and adolescents with post-infectious bronchiolitis obliterans, and no other associated disease. We searched articles in English, Portuguese, and Spanish, without restrictions regarding the period of publication. The methodological quality was assessed by the Agency for Healthcare Research and Quality (AHRQ) protocol. Data synthesis: Out of the 81 articles found, only 4 were included in this review. The studies totaled 135 participants (121 with post-infectious bronchiolitis obliterans and 14 healthy), with sample sizes between 14 and 58 subjects. All patients underwent spirometry to evaluate pulmonary function, indicating an obstructive ventilatory pattern. Among them, 3/4 had their physical performance assessed by the six-minute walk test and 2/4 by the cardiopulmonary exercise testing. These test results were compared to those of a control group (1/4) and presented as percentage of predicted and/or in meters (3/4). Lastly, 3/4 of the studies showed reduced exercise capacity in this population. The studies included were classified as having high methodological quality. Conclusions: Findings of the study demonstrate that children and adolescents with post-infectious bronchiolitis obliterans have reduced exercise capacity.