Objective: To compare MIP and MEP determined in healthy subjects with those predicted using the equations proposed in another study, and, if necessary, to suggest new equations for MIP and MEP to be used in the Brazilian population. Methods: The study sample comprised 60 healthy males and 60 healthy females, 20-80 years of age (20 subjects per ten-year age bracket). Maximal respiratory pressures were determined following a standardized protocol. Results: Regarding MIP, the measured values were significantly lower than those predicted for both males (31%) and females (24%). There were no significant differences between measured and predicted MEP in either gender. We found that age presented the greatest power to predict MIP and MEP in both genders. New equations were proposed. Conclusions: The previously proposed equations were unable to predict MIP and MEP for all of the subjects in our sample. Therefore, the results of this study can facilitate the prediction of respiratory muscle strength in healthy adult subjects in Brazil. Further studies, involving subjects from different regions of the country, could lead to the development of better tables or equations for maximal respiratory pressures in the Brazilian population. ResumoObjetivo: Comparar PImáx e PEmáx medidas em indivíduos saudáveis com os valores previstos utilizando-se as equações propostas em outro estudo e, se necessário, sugerir novas equações para PImáx e PEmáx para a população brasileira. Métodos: Participaram do estudo 60 homens e 60 mulheres saudáveis com idades entre 20 e 80 anos (20 indivíduos por faixa etária de 10 anos). As pressões respiratórias máximas foram determinadas segundo um protocolo padronizado. Resultados: Os valores medidos de PImáx foram significativamente menores que aqueles previstos tanto para homens (31%) e mulheres (24%). Não houve diferenças significativas entre a PEmáx medida e prevista nos dois gêneros. A idade provou ser a variável com melhor poder preditivo para PImáx e PEmáx nos dois gêneros. Novas equações foram propostas. Conclusões: As equações propostas no estudo prévio não foram capazes de predizer PImáx e PEmáx de todos os indivíduos de nossa amostra. Portanto, os resultados deste estudo podem facilitar a predição da força muscular respiratória de adultos saudáveis no Brasil. Novos estudos, com indivíduos de diferentes regiões do país, poderão contribuir para o desenvolvimento de melhores tabelas ou equações para as pressões respiratórias máximas na população brasileira. MethodsThe study sample comprised 120 healthy subjects (60 males and 60 females), 20-80 years of age, residing in the city of São Carlos, located in the state of São Paulo, Brazil. Each of the six ten-year age brackets used in the study included 10 male and 10 female subjects.The volunteers were selected according to the criteria of having a BMI between 18.0 and 29.5 kg/m 2(8) and being a nonsmoker. Subjects with a history of respiratory or cardiovascular disease were excluded, as were those with any neuromuscular disease that would p...
In accordance with the results of this study, peripheral muscle strength as measured by HS and 1RM is not related to the severity indexes for COPD, unlike UL and LL muscle strength. Therefore, UL and LL measurements now have an additional importance in COPD evaluation.
BACKGROUND: Diaphragmatic breathing (DB) is widely used in pulmonary rehabilitation (PR) of patients with chronic obstructive pulmonary disease (COPD), however it has been little studied in the scientific literature. The Pilates breathing (PB) method has also been used in the rehabilitation area and has been little studied in the scientific literature and in COPD. OBJECTIVES: To compare ventilatory parameters during DB and PB in COPD patients and healthy adults. METHOD: Fifteen COPD patients (COPD group) and fifteen healthy patients (healthy group) performed three types of respiration: natural breathing (NB), DB, and PB, with the respiratory pattern being analyzed by respiratory inductive plethysmography. The parameters of time, volume, and thoracoabdominal coordination were evaluated. After the Shapiro-Wilk normality test, ANOVA was applied followed by Tukey's test (intragroup analysis) and Student's t-test (intergroup analysis; p<0.05). RESULTS: DB promoted increase in respiratory volumes, times, and SpO2 as well as decrease in respiratory rate in both groups. PB increased respiratory volumes in healthy group, with no additional benefits of respiratory pattern in the COPD group. With respect to thoracoabdominal coordination, both groups presented higher asynchrony during DB, with a greater increase in the healthy group. CONCLUSIONS: DB showed positive effects such as increase in lung volumes, respiratory motion, and SpO2 and reduction in respiratory rate. Although there were no changes in volume and time measurements during PB in COPD, this breathing pattern increased volumes in the healthy subjects and increased oxygenation in both groups. In this context, the acute benefits of DB are emphasized as a supporting treatment in respiratory rehabilitation programs.
O objetivo do estudo foi demonstrar o efeito de dois protocolos da estimulação diafragmática elétrica transcutânea (EDET) sobre a força muscular respiratória de mulheres saudáveis, sendo um protocolo segundo Geddes et al. (1988) e outro padronizado pelo equipamento Phrenics. Mulheres saudáveis foram divididas em 3 grupos: Controle (n=7); EDET com Phrenics (n=7) e EDET com Dualpex (n=7), sendo o tratamento realizado 2 vezes por semana, durante 6 semanas (12 sessões). Foram avaliadas a pressão inspiratória máxima (PImáx) e pressão expiratória máxima (PEmáx), antes e após o tratamento. A análise estatística foi realizada pelo teste Shapiro-Wilk e Kruskal Wallis com pós-hoc de Dunn (p<0,05). Os dois grupos experimentais apresentaram aumento na PImáx (Phrenics: 32,9%; Dualpex: 63,2%) e na PEmáx (Phrenics: 44,7%; Dualpex: 60,9%), diferentemente do Controle que não apresentou diferença. Em conclusão, os dois protocolos de EDET promoveram aumento da força muscular inspiratória e expiratória em mulheres saudáveis.
INTRODUCTION:Bariatric surgery has become increasingly more recommended for the treatment of morbidly obese individuals for whom it is possible to identify co-morbidities other than alterations in pulmonary function. The objective of this study was to evaluate the effects of conventional chest physiotherapy (CCP) and of conventional physiotherapy associated with transcutaneous electrical diaphragmatic stimulation (CCP+TEDS) on pulmonary function and respiratory muscle strength in patients who have undergone Roux-en-Y gastric bypass.METHODS:In total, 44 female patients with an average age of 37 ± 7.3 years and an average body mass index (BMI) of 47.4 ± 6.5 K/m² were selected as candidates for Roux-en-Y gastric bypass laparoscopy. They were evaluated for pulmonary volume and flow using spirometry and maximum respiratory pressure through manovacuometry during the preoperative period and on the fifteenth and thirtieth postoperative days.RESULTS:No differences were detected between CCP and CCP+TEDS, and both factors contributed to the maintenance of pulmonary flow and volume as well as inhalation muscle strength. Exhalation muscle strength was not maintained in the CCP group at fifteen or thirty days postoperative, but it was maintained in patients treated with conventional chest physiotherapy + transcutaneous electric diaphragmatic stimulation.DISCUSSION:These results suggest that both conventional chest physiotherapy and conventional chest physiotherapy + transcutaneous electric diaphragmatic stimulation prevent the reduction of pulmonary function during the Roux-en-Y gastric bypass postoperative period, and that transcutaneous electric diaphragmatic stimulation also contributes to expiratory muscle strength.
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