Prática assistencial da fisioterapia na fibrose cística após a introdução dos moduladores de CFTR de alta eficiência: estudo de métodos mistos
Physiotherapy clinical practice in cystic fibrosis after the introduction of highly effective CFTR modulators: a mixed-methods study
Maria Ângela Gonçalves de Oliveira Ribeiro, Bruna Ziegler, Evanirso da Silva Aquino, Márcio Vinícius Fagundes Donadio, Luize Souto Ceolin, Jorge Eduardo Cortz Sernaglia, Ana Carolina da Silva Almeida, Bruno Fernandes Costa Ferreira, Celize Cruz Bresciani, Edilene do Socorro Nascimento Falcão Sarges, Fernanda Maria Vendrúsculo, Letícia Pereira do Amaral Cidade Silva, Nelbe Nesi Santana, Paloma Lopez Francisco Parazzi, Renata Maba Gonçalves Wamosy, Sheyla Haun, Camila Isabel Santos Schivinski
Resumo
Introdução: Os avanços no diagnóstico e tratamento da fibrose cística (FC) resultaram no aumento significativo da sobrevida e qualidade de vida, assim como a incorporação dos moduladores da CFTR de alta eficiência no Sistema Único de Saúde no Brasil, o que impactou no atendimento fisioterapêutico. Objetivo: Identificar prática assistencial do fisioterapeuta, considerando a introdução dos moduladores da CFTR de alta eficiência, além de suas dificuldades e barreiras no manejo de pessoas com FC. Métodos: Conduziu-se um estudo observacional transversal com fisioterapeutas atuantes em centros de referência para tratamento da FC (CRFC) e em serviços particulares. Aplicou-se um questionário via Google Forms com 19 perguntas para coletar informações sobre a assistência fisioterapêutica, incluindo rotinas, uso de tecnologias e desafios enfrentados. Para análise dos dados foi utilizada estatística descritiva e de frequências, e os dados foram armazenados em uma planilha do Excel. Resultados: Cinquenta fisioterapeutas responderam ao questionário. A maioria dos participantes possui mais de cinco anos de experiência com a FC (80%), e a modalidade de atendimento híbrido é predominante (34%). A prescrição de exercícios físicos, indicação de ventilação não invasiva e utilização de avaliações padronizadas fazem parte da assistência fisioterapêutica e, mesmo após a introdução dos moduladores, a continuidade da fisioterapia (42%) e o estímulo à prática de atividade física regular (80%) são rotinas dos profissionais. No entanto, os fisioterapeutas enfrentam desafios, como a adesão ao tratamento após a introdução dos moduladores da CFTR de alta eficiência (52%) e padronização no manejo da doença (13%). Conclusão: Os achados sugerem que o manejo fisioterapêutico da fibrose FC no contexto dos moduladores da CFTR de alta eficiência demanda cuidado individualizado, integrado e baseado em evidências, frente aos desafios assistenciais ainda presentes no país.
Palavras-chave
Abstract
Background: Introduction: Advances in the diagnosis and treatment of cystic fibrosis (CF) have resulted in a significant increase in survival and quality of life, as well as the incorporation of highly effective CFTR modulators into the Brazilian Unified Health System (SUS), which has impacted physiotherapy care. Aim: To identify aspects of the physiotherapist’s clinical practice, considering the introduction of highly effective CFTR modulators, as well as the difficulties and barriers in managing individuals with CF. Methods: A cross-sectional observational study was conducted with physiotherapists working in Cystic Fibrosis Reference Centers (CFRC) and in private services. A questionnaire containing 19 questions was administered via Google Forms to collect information on physiotherapy care, including routines, use of technologies, and challenges faced. Descriptive and frequency statistics were used for data analysis, and the data were stored in an Excel spreadsheet. Results: Fifty physiotherapists responded to the questionnaire. Most participants had more than five years of experience in CF (80%), and the hybrid model of care was predominant (34%). The prescription of physical exercise, recommendation of noninvasive ventilation, and use of standardized assessments are part of physiotherapy care. Even after the introduction of modulators, continuity of physiotherapy (42%) and encouragement of regular physical activity (80%) remain routine practices among professionals. However, physiotherapists face challenges such as treatment adherence after the introduction of highly effective CFTR modulators (52%) and standardization in disease management (13%). Conclusion: The findings suggest that physiotherapeutic management of CF in the context of highly effective CFTR modulators requires individualized, integrated, and evidence-based care, considering the healthcare challenges still present in the country.
Keywords
Referências
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Submetido em:
25/09/2025
Aceito em:
21/05/2026
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