Journal Information
Vol. 16. Issue 6.
Pages 892-898 (November - December 2010)
Vol. 16. Issue 6.
Pages 892-898 (November - December 2010)
ARTIGO ORIGINAL
Open Access
Força muscular respiratória e qualidade de vida em pacientes com distrofia miotónica
Respiratory muscle strength and quality of life in myotonic dystrophy patients
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T. Lucena Araújoa, V. Regiane Resquetib, S. Brunoc, I. Guerra Azevedod, M.E. Dourado Júniore, G. Fregonezif
a Physiotherapy
b Physiotherapy, Fellow in PneumoCardioVascular Physical Therapy Laboratory, Department of Physical Therapy, Universidade Federal do Rio Grande do Norte, Natal, Brasil
c Physiotherapy, Master Degree Physical Therapy Program, PneumoCardioVascular Physical Therapy Laboratory, Department of Physical Therapy, Universidade Federal do Rio Grande do Norte, Natal, Brasil
d Physiotherapy
e Physician Neurology. Electroneuromyography Service and Neuromuscular Disease Ambulatory, Onofre Lopes University Hospital, Universidade Federal do Rio Grande do Norte, Natal, Brasil
f Physiotherapy, Master Degree Physical Therapy Program, PneumoCardioVascular Physical Therapy Laboratory, Department of Physical Therapy, Universidade Federal do Rio Grande do Norte, Natal, Brasil
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Resumo
Introdução

Na distrofia miotónica (DM) estudos sobre qualidade de vida relacionada à saúde (QVRS) ainda são escassos e a sua relação com a força muscular respiratória não foi determinada. Este estudo teve como objetivo a avaliação da força muscular respiratória e da QVRS, além de determinar as relações entre estas variáveis na DM.

Métodos

Foi avaliada a função pulmonar, as pressões respiratórias máximas inspiratórias e expiratórias (PImáx e PEmáx, respectivamente), pressão nasal inspiratória de sniff (SNIP), e a QVRS através do questionário genérico SF-36 em 23 pacientes (13 homens, idade 40 ± 16 anos) com DM.

Resultados

Os valores encontrados da força muscular respiratória foram de 71 ± 20 cmH2O (64% preditivo), 76 ± 32 cmH2O (70% preditivo), e 79 ± 28 cmH2O (80% preditivo) para PEmax, PImax e SNIP respectivamente. Encontramos diferenças significativas nos domínios de SF-36 de função física 58,7 ± 31,4 vs. 84,5 ± 23 (p < 0,01, 95% CI = 1,6-39,9) e problemas físicos 43,4 ± 35,2 vs. 81,2 ± 34 (p < 0,001, 95% CI = 19,4-6,1) comparado com os valores de referência. A análise de regressão linear demonstrou que a PImax explica 29% da variação da função física, 18% dos problemas físicos e 20% da vitalidade.

Conclusão

Indivíduos com DM têm uma redução da força muscular expiratória. A QVRS pode ser mais prejudicada em alguns domínios da atividade física, o que pode sofrer influência das variações da força muscular inspiratória.

PALAVRAS-CHAVE:
Pressões respiratórias máximas
Sniff teste
Doença neuromuscular
SF-36
Músculos respiratórios
Abstract
Introduction

Studies on quality of life in myotonic dystrophy (MD) are scarce and the relationship between respiratory muscle strength and health-related quality of life (HRQoL) has yet to be determined. The present study aims to investigate respiratory muscle strength and HRQoL and their relationship in MD patients.

Methods

Twenty-three patients (13 men, aged 40 ± 16 years) with MD were evaluated for pulmonary function, maximal inspiratory and expiratory pressure (MIP and MEP, respectively), sniff nasal inspiratory pressure (SNIP) and HRQoL using the Short Form (SF-36) quality of life questionnaire.

Results

Respiratory muscle strength values were 71 ± 20 cmH2O (64% predicted), 76 ± 32 cmH2O (70% predicted), and 79 ± 28 cmH2O (80% predicted) for MEP, MIP, and SNIP respectively. Signifi cant differences were found in the SF-36 domains of physical functioning 58.7 ± 31.4 vs. 84.5 ± 23 (p < 0.01, 95% CI = 1.6-39.9) and physical problems 43.4 ± 35.2 vs. 81.2 ± 34 (p < 0.001, 95% CI = 19.4-6.1) when compared with the reference values. According to single linear regression analysis, MIP explains 29% of the variance in physical functioning, 18% of physical problems and 20% of vitality.

Conclusions

Individuals with MD have reduced expiratory muscle strength. HRQoL may be more impaired in some physical domains, which might be influenced by variations in inspiratory muscle strength.

KEYWORDS:
Maximal respiratory pressures
Sniff test
Neuromuscular disease
SF-36
Respiratory muscles
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