Journal Information
Vol. 16. Issue 6.
Pages 887-891 (November - December 2010)
Vol. 16. Issue 6.
Pages 887-891 (November - December 2010)
ARTIGO ORIGINAL
Open Access
Efeitos do apoio dos membros superiores sobre a força muscular respiratória e função pulmonar de doentes com doença pulmonar obstrutiva crónica
Effects of arm bracing posture on respiratory muscle strength and pulmonary function in patients with chronic obstructive pulmonary disease
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V. Cavalheria,b, C.A. Camilloa, A.F. Brunettoa,c,#, V.S. Probsta,c, E.M. Cipulo Ramosb, F. Pittaa
a Laboratório de Pesquisa em Fisioterapia Pulmonar (LFIP), Departamento de Fisioterapia, Universidade Estadual de Londrina, Paraná, Brasil
b Programa de Mestrado em Fisioterapia, Departamento de Fisioterapia, UNESP – Universidade Estadual Paulista, Presidente Prudente SP, Brasil
c Departamento de Fisioterapia, Universidade do Norte do Paraná (UNOPAR), Londrina, Paraná, Brasil
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Resumo
Objetivo

Analisar o efeito do apoio de membros superiores sobre a força muscular respiratória e função pulmonar de pacientes com Doença Pulmonar Obstrutiva Crónica (DPOC).

Métodos

Vinte pacientes com DPOC (11 homens) com idade de 67 ± 8 anos e IMC 24 ± 3 Kg · m2, foram submetidos a avaliações de Pressão Inspiratória e Expiratória Máximas (PImax e PEmax, respectivamente) e espirometria com e sem apoio dos membros superiores em ordem aleatória. A avaliação com apoio dos membros superiores foi realizada em posição ortostática, com o apoio dos membros superiores na altura do processo estilóide da ulna, flexão de cotovelos e tronco inclinado à frente, ambos em aproximadamente 30 graus, de modo a promover descarga de peso em membros superiores. A avaliação sem apoio de membros superiores foi realizada também em posição ortostática, porém com os membros superiores relaxados ao lado do corpo. O intervalo entre as avaliações foi de uma semana.

Resultados

A PImax, PEmax e Ventilação Voluntária Máxima (VVM) foram maiores com a utilização do apoio do que sem o apoio (PImax 64 ± 22 cmH2O versus 54 ± 24 cmH2O, p = 0,00001; PEmax 104 ± 37 cmH2O versus 92 ± 37 cmH2O, p = 0,00001 e VVM 42 ± 20 L/min versus 38 ± 20 L/min, p = 0,003). As demais variáveis não apresentaram diferenças estatisticamente significativas.

Conclusão

O apoio de membros superiores resultou em maior capacidade de gerar força e endurance dos músculos respiratórios em pacientes com DPOC.

PALAVRAS-CHAVE:
Extremidade superior
Músculos respiratórios
Espirometria
Doença Pulmonar Obstrutiva Crónica
Abstract
Objective

To analyze the effect of arm bracing posture on respiratory muscle strength and pulmonary function in patients with Chronic Obstructive Pulmonary Disease (COPD).

Methods

20 patients with COPD (11 male; 67 ± 8 years; BMI 24 ± 3 Kg · m2) were submitted to assessments of Maximal Inspiratory and Expiratory Pressures (MIP and MEP, respectively) and spirometry with and without arm bracing in a random order. The assessment with arm bracing was done on standing position and the height of the support was adjusted at the level of the ulnar styloid process with elbow flexion and trunk anterior inclination of 30 degrees promoting weight discharge in the upper limbs. Assessment without arm bracing was also performed on standing position, however with the arms relaxed alongside the body. The time interval between assessments was one week.

Results

MIP, MEP and maximal voluntary ventilation (MVV) were higher with arm bracing than without arm bracing (MIP 64 ± 22 cmH2O versus 54 ± 24 cmH2O, p = 0,00001; MEP 104 ± 37 cmH2O versus 92 ± 37 cmH2O, p = 0,00001 and MVV 42 ± 20 L/min versus 38 ± 20 L/min, p = 0,003). Other variables did not show statistical signifi cant difference.

Conclusion

The arm bracing posture resulted in higher capacity to generate force and endurance of the respiratory muscles in patients with COPD.

KEYWORDS:
Upper limb
Respiratory muscles
Pulmonary function test
Chronic Obstructive Pulmonary Disease
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