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Letter to the Editor
When the Need is Greater Than Feasible
Cuando la necesidad es mayor de lo factible
Carlos Alfredo Fraile Oliveroa,
Corresponding author
fraile.carlos@gmail.com

Corresponding author.
, José Ramón Jarabo Sarcedab, Carlos Cerdán Santacruzc, Passio Santos Capad, Pedro Daniel Arribas Manzanale, Rafael Barriusof, Florentino Hernando Tranchob
a Thoracic Surgery Department, University Hospital Arnau de Vilanova, Lérida, Spain
b Thoracic Surgery Department, University Hospital Clínico San Carlos, Madrid, Spain
c General Surgery Department, University Hospital de la Princesa, Madrid, Spain
d Department of Physical Medicine and Rehabilitation, University Hospital Clínico San Carlos, Madrid, Spain
e Department of Physical Medicine and Rehabilitation, University Hospital Clínico San Carlos, Madrid, Spain
f Tribalyte Technologies, Spain
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    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">An unexpected cruel pandemic has been able to paralyze not only our lives but also&#44; somehow&#44; our hopes&#46; Digital transformation in healthcare has become essential to survive&#44; subsist and resist&#46; Huge efforts are made to generate impact and visibility&#44; measured in &#8220;likes&#8221; or followers&#59; however&#44; we have not been able to work as a &#8220;global&#8221; system on tools generating value in terms of health among citizens&#46; There are thousands of Smartphones applications available to download but in most cases it is difficult to validate their quality and regulate their content&#44; both mandatory to properly manage patients&#8217; data and achieve adequate dissemination of scientific information&#46;<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">1</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">Benefits of pulmonary rehabilitation are well known&#44; not only within chronic processes but also after acute events&#44; such as pneumonia or thoracic surgical procedures&#46; Up to now&#44; the only way to corner the virus is social distancing&#44; and due to person-to-person spread of the virus occurs mainly via respiratory droplets&#44; some respiratory exercises are discouraged without wearing appropriate personal protective equipment&#46;<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">2</span></a> Thus&#44; some patients have limitations to get access to pulmonary rehabilitation&#44; which could result in suboptimal recovery or even developing pulmonary complications once they are supposed to have overcome COVID-19&#46; In this setting&#44; chances for e-Health tools turn into imperatives&#44; and health community is compelled to provide patients with global and affordable resources transcending social and geographical issues&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">A group of Spanish thoracic surgeons and physiotherapists from Hospital Cl&#237;nico San Carlos in Madrid created Fissios App<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">3</span></a> &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#41;&#44; a free Smartphone application that guides patients scheduled for a thoracic surgical procedure through a chest physical exercises program&#46; A series of basic and simple exercises are displayed to teach&#44; from the basic correct position to muscle strengthening techniques or secretion drainage&#46; This method uses animations that show the ranges of movement complemented by a text panel explaining their execution in detail&#46; All of this is meant to be done in a safe and self-sufficient manner&#46; The initial experiences were very satisfactory and were positively evaluated by most of the users through feedback questionnaires&#46;<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">4</span></a> Several scientific societies have commented on the advantages of respiratory physiotherapy in patients affected by COVID-19&#44; mainly at the time of discharge and those patients with mild symptoms&#46;<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">5</span></a> At <span class="elsevierStyleItalic">Fissios App</span> we continue with our commitment and responsibility by preparing a &#8220;COVID-19 section&#8221; of the App that allows us to specifically guide all the patients that happily overcome the disease&#44; in a special and instructive way&#44; under the hypothesis that the performance of respiratory physiotherapy exercises may improve their recovery&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0020" class="elsevierStylePara elsevierViewall">Perhaps after all this&#44; at last&#44; the &#8220;mutualist&#8221; mentality will arrive and we will be able to learn that&#44; if we do not protect the group&#44; individual success will be of little use and that transcendence lies in surviving as a species&#46; Perhaps after all this&#44; it will happen that&#44; for really important issues such as the health of individuals and that of the collective&#44; feasible may exceed needs&#44; and we will thus be permanently prepared to face new challenges&#46;</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Conflicts of interest</span><p id="par0025" class="elsevierStylePara elsevierViewall">None&#46;</p></span></span>"
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Article information
ISSN: 03002896
Original language: English
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