title: Effects of a respiratory physiotherapeutic program in liver transplantation candidates.
abstract: BACKGROUND
  Candidates for liver transplantation may have malnutrition, fatigue, loss of muscle mass and function. The combination of these factors leads to overall physical disability and physical inactivity.
  
  
  OBJECTIVE
  The aim of the study was to evaluate the effects of a respiratory physiotherapeutic program on liver transplantation candidates.
  
  
  METHODS
  Forty-two patients were evaluated by respiratory muscle strength, surface electromyography of the rectus abdominis and diaphragm, and spirometry. We also applied the SF-36. The patients were divided into two groups: 12 randomly assigned to the control group and 5 in the intervention group. The intervention consisted of an explanatory and illustrative manual to be followed at home with diaphragmatic breathing exercises, diaphragmatic isometric exercise, Threshold IMT, lifting the upper limbs with a bat, and strengthening the abdominals.
  
  
  RESULTS
  Significant difference was found between initial forced expiratory flow (FEF)25-75% (P = .042) and final FEF25-75 in the intervention group. The control group had significant difference (P = .036) in the diaphragm RMS between initial time and end time. In conclusion, the control group showed greater electrical activity of the diaphragm after 3 months.
  
  
  CONCLUSIONS
  The intervention group benefited from the exercise, thus improving the FEF25-75%.
authors.affiliation: Faculty of Medical Science, State University of Campinas, Campinas, Brazil.
authors.forename: V
authors.initials: V
authors.lastname: Limongi
authors.affiliation: Faculty of Medical Science, State University of Campinas, Campinas, Brazil.
authors.forename: D C
authors.initials: DC
authors.lastname: dos Santos
authors.affiliation: Faculty of Medical Science, State University of Campinas, Campinas, Brazil.
authors.forename: A M O
authors.initials: AM
authors.lastname: da Silva
authors.affiliation: Clinical Hospital, State University of Campinas, Campinas, Brazil.
authors.forename: E C
authors.initials: EC
authors.lastname: Ataide
authors.affiliation: Clinical Hospital, State University of Campinas, Campinas, Brazil.
authors.forename: M F T
authors.initials: MF
authors.lastname: Mei
authors.affiliation: Clinical Hospital, State University of Campinas, Campinas, Brazil.
authors.forename: E Y
authors.initials: EY
authors.lastname: Udo
authors.affiliation: State University of Campinas, Campinas, Brazil.
authors.forename: I F S F
authors.initials: IF
authors.lastname: Boin
authors.affiliation: State University of Campinas, Campinas, Brazil. Electronic address: stucchi.raquel@gmail.com.
authors.forename: R S B
authors.initials: RS
authors.lastname: Stucchi
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001945:Breathing Exercises / Q000379:methods*; D003964:Diaphragm / Q000503:physiopathology*; D004576:Electromyography; D058625:End Stage Liver Disease / Q000503:physiopathology* / Q000601:surgery; D005260:Female; D005540:Forced Expiratory Flow Rates; D006801:Humans; D016031:Liver Transplantation; D008168:Lung / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D053580:Muscle Strength / Q000502:physiology*; D011300:Preoperative Care / Q000379:methods*; D011446:Prospective Studies; D011788:Quality of Life; D017568:Rectus Abdominis / Q000503:physiopathology; D013147:Spirometry; D016896:Treatment Outcome; D055815:Young Adult