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        "titulo" => "Abstract"
        "resumen" => "<span class="elsevierStyleSectionTitle">Rationale</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Exercise capacity in COPD patients depends on the degree of airflow obstruction&#44; the severity of the hypoxaemia and skeletal muscle function&#46; Muscle atrophy and weakness are considered systemic consequences of COPD and are associated with reduced exercise capacity&#46;</p> <span class="elsevierStyleSectionTitle">Aims</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">To investigate the correlation between mild hypoxaemia and muscular strength&#44; muscular fatigue and functional capacity in COPD patients&#46;</p> <span class="elsevierStyleSectionTitle">Methods</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Ten patients enrolled on a PRP at the Hospital Universit&#225;rio de Bras&#237;lia &#8211; HUB were included in this study&#46; Lung function was evaluated by spirometry and arterial blood gas analysis&#46; Functional evaluation was made using the 6MWT and using isometric contraction of deltoid and quadriceps muscles&#46;</p> <span class="elsevierStyleSectionTitle">Results</span><p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">There were positive correlations between PaO<span class="elsevierStyleInf">2</span>&#44; quadriceps strength &#40;r<span class="elsevierStyleSup">2</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;61 and p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;007&#41; and PaO<span class="elsevierStyleInf">2</span> and the 6MWT &#40;r<span class="elsevierStyleSup">2</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;96&#44; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;001&#41;&#46; There were negative correlations between PaO<span class="elsevierStyleInf">2</span> and median frequency of quadriceps &#40;r<span class="elsevierStyleSup">2</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>-0&#46;42 and p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;04&#41;&#46; We observed significant correlation between quadriceps strength and the 6MWT &#40;r<span class="elsevierStyleSup">2</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;67 and p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;001&#41;&#46; There was negative correlation between median frequency of quadriceps and the 6MWT &#40;r<span class="elsevierStyleSup">2</span> &#61; -0&#46;42 and p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;04&#41;&#46; We did not observe any correlation between PaO<span class="elsevierStyleInf">2</span> and strength or median frequency of deltoid muscle&#46;</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">PaO<span class="elsevierStyleInf">2</span> has important correlations with muscular function variables&#46; The main negative impact of mild hypoxaemia and precocious limb muscular disability on COPD patients is decreased functional capacity&#46;</p>"
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        "resumen" => "<span class="elsevierStyleSectionTitle">Introdu&#231;&#227;o</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">A capacidade de exerc&#237;cio em portadores de DPOC depende da gravidade da limita&#231;&#227;o ao fluxo a&#233;reo&#44; do grau de hipoxemia e da fun&#231;&#227;o muscular esquel&#233;tica&#46; Nesses doentes&#44; a atrofia e a fraqueza da musculatura perif&#233;rica s&#227;o consideradas consequ&#234;ncias sist&#233;micas da DPOC e est&#227;o associadas &#224; redu&#231;&#227;o da capacidade de exerc&#237;cio&#46;</p> <span class="elsevierStyleSectionTitle">Objectivos</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Investigar a poss&#237;vel correla&#231;&#227;o entre hipoxemia moderada e o comprometimento muscular perif&#233;rico na DPOC&#46;</p> <span class="elsevierStyleSectionTitle">Doentes e m&#233;todos</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Dez doentes encaminhados ao Programa de Reabilita&#231;&#227;o Pulmonar do Hospital Universit&#225;rio de Bras&#237;lia foram inclu&#237;dos neste estudo&#46; A fun&#231;&#227;o pulmonar foi avaliada por espirometria&#44; gasometria arterial e avalia&#231;&#227;o funcional pelo teste de caminhada de seis minutos&#44; sinal electromiogr&#225;fico e for&#231;a de delt&#243;ide e quadric&#237;petes&#46;</p> <span class="elsevierStyleSectionTitle">Resultados</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">As correla&#231;&#245;es entre PaO<span class="elsevierStyleInf">2</span> e a for&#231;a quadric&#237;ptica &#40;r<span class="elsevierStyleSup">2</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;61 e p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;007&#41; e a dist&#226;ncia percorrida no TC6 &#40;r<span class="elsevierStyleSup">2</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;96 e p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41; foram positivas e significativas&#46; Houve correla&#231;&#227;o negativa e significativa entre PaO<span class="elsevierStyleInf">2</span> e a frequ&#234;ncia mediana de quadric&#237;petes &#40;r<span class="elsevierStyleSup">2</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>-0&#44;42 e p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;04&#41;&#46; Observ&#225;mos tamb&#233;m correla&#231;&#227;o significativa entre for&#231;a de quadric&#237;petes e o TC6 &#40;r<span class="elsevierStyleSup">2</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;67 e p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41;&#46; Assim como houve correla&#231;&#227;o negativa e significativa entre a frequ&#234;ncia mediana de quadric&#237;petes&#44; e o TC6 &#40;r<span class="elsevierStyleSup">2</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>-0&#44;42 e p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;04&#41;&#46; N&#227;o encontr&#225;mos correla&#231;&#227;o significativa entre a PaO<span class="elsevierStyleInf">2</span> e for&#231;a ou frequ&#234;ncia mediana do m&#250;sculo delt&#243;ide&#46;</p> <span class="elsevierStyleSectionTitle">Conclus&#227;o</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">A PaO<span class="elsevierStyleInf">2</span> tem correla&#231;&#227;o importante e significativa com vari&#225;veis de fun&#231;&#227;o muscular perif&#233;rica&#46; A hipoxemia moderada e a disfun&#231;&#227;o muscular perif&#233;rica precoce possuem como principal impacto negativo a deteriora&#231;&#227;o da capacidade funcional de portadores de DPOC&#46;</p>"
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                      "titulo" => "Global strategy for the diagnosis&#44; management and prevention of chronic obstructive pulmonary disease &#8211; GOLD Executive Summary"
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Vol. 14. Issue 6.
Pages 769-785 (November - December 2008)
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Vol. 14. Issue 6.
Pages 769-785 (November - December 2008)
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Correlation between mild hypoxaemia and limb skeletal muscle function in chronic obstructive pulmonary disease – Pilot study
Correlação entre hipoxemia moderada e função muscular esquelética periférica na doença pulmonar obstrutiva crónica – Estudo-piloto
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Sérgio Leite Rodrigues1,8,
, César Augusto Melo e Silva2, César Ferreira Amorim3, Terezinha Lima4, Fernanda Almeida Ribeiro5, Carlos Alberto de Assis Viegas6, Verônica Amado7
1 Fisioterapeuta, Mestre em Ciências da Saúde, Universidade de Brasília – UnB / Physiotherapist, MsC, Health Sciences, Universidade de Brasília – UnB
2 Fisioterapeuta, Doutor em Ciências Médicas, Universidade de Brasília – UnB / Physiotherapist, Doctor of Medical Sciences, Universidade de Brasília – UnB
3 Engenheiro electrónico, Mestre em Engenharia Biomédica, Universidade do Vale do Paraíba – UNIVAP / Electronic Engineer, MsC, Biomedical Engineering, Universidade do Vale do Paraíba – UNIVAP
4 Médica, Mestre em Ciências da Saúde, Universidade de Brasília / Physician, MsC, Health Sciences, Universidade de Brasília
5 Fisioterapeuta, Especialista em Fisioterapia Pneumofuncional, Universidade de Brasília / Physiotherapist, Respiratory Physiotherapy specialist, Universidade de Brasília
6 Médico, Doutor da Universidade de Brasília – UnB, Universidade de Brasília – UnB / Physician, Doctor at the Universidade de Brasília – UnB, Universidade de Brasília – UnB
7 Chefe do Serviço de Pneumologia / Head, Pulmonology Unit: Hospital Universitário de Brasília – HUB Rua L2 Norte Quadras 605 CEP 70840-901 Brasília – DF Brasil
8 Chefe do Centro de Fisioterapia / Head, Physiotherapy Unit: Sérgio Leite Rodrigues Hospital Universitário de Brasília – HUB Rua L2 Norte Quadras 605 CEP 70840-901 Brasília – DF Brasil
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Abstract
Rationale

Exercise capacity in COPD patients depends on the degree of airflow obstruction, the severity of the hypoxaemia and skeletal muscle function. Muscle atrophy and weakness are considered systemic consequences of COPD and are associated with reduced exercise capacity.

Aims

To investigate the correlation between mild hypoxaemia and muscular strength, muscular fatigue and functional capacity in COPD patients.

Methods

Ten patients enrolled on a PRP at the Hospital Universitário de Brasília – HUB were included in this study. Lung function was evaluated by spirometry and arterial blood gas analysis. Functional evaluation was made using the 6MWT and using isometric contraction of deltoid and quadriceps muscles.

Results

There were positive correlations between PaO2, quadriceps strength (r2=0.61 and p=0.007) and PaO2 and the 6MWT (r2=0.96, p=0.001). There were negative correlations between PaO2 and median frequency of quadriceps (r2=-0.42 and p=0.04). We observed significant correlation between quadriceps strength and the 6MWT (r2=0.67 and p=0.001). There was negative correlation between median frequency of quadriceps and the 6MWT (r2 = -0.42 and p=0.04). We did not observe any correlation between PaO2 and strength or median frequency of deltoid muscle.

Conclusions

PaO2 has important correlations with muscular function variables. The main negative impact of mild hypoxaemia and precocious limb muscular disability on COPD patients is decreased functional capacity.

Key-words:
Six-minute walk test
muscle strength
hypoxaemia
COPD
pulmonary rehabilitation
electromyography
Resumo
Introdução

A capacidade de exercício em portadores de DPOC depende da gravidade da limitação ao fluxo aéreo, do grau de hipoxemia e da função muscular esquelética. Nesses doentes, a atrofia e a fraqueza da musculatura periférica são consideradas consequências sistémicas da DPOC e estão associadas à redução da capacidade de exercício.

Objectivos

Investigar a possível correlação entre hipoxemia moderada e o comprometimento muscular periférico na DPOC.

Doentes e métodos

Dez doentes encaminhados ao Programa de Reabilitação Pulmonar do Hospital Universitário de Brasília foram incluídos neste estudo. A função pulmonar foi avaliada por espirometria, gasometria arterial e avaliação funcional pelo teste de caminhada de seis minutos, sinal electromiográfico e força de deltóide e quadricípetes.

Resultados

As correlações entre PaO2 e a força quadricíptica (r2=0,61 e p=0,007) e a distância percorrida no TC6 (r2=0,96 e p=0,001) foram positivas e significativas. Houve correlação negativa e significativa entre PaO2 e a frequência mediana de quadricípetes (r2=-0,42 e p=0,04). Observámos também correlação significativa entre força de quadricípetes e o TC6 (r2=0,67 e p=0,001). Assim como houve correlação negativa e significativa entre a frequência mediana de quadricípetes, e o TC6 (r2=-0,42 e p=0,04). Não encontrámos correlação significativa entre a PaO2 e força ou frequência mediana do músculo deltóide.

Conclusão

A PaO2 tem correlação importante e significativa com variáveis de função muscular periférica. A hipoxemia moderada e a disfunção muscular periférica precoce possuem como principal impacto negativo a deterioração da capacidade funcional de portadores de DPOC.

Palavras-chave:
Teste de caminhada de seis minutos
força muscular
hipoxemia
DPOC
reabilitação pulmonar
electromiografia
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Trabalho realizado no Serviço de Pneumologia do Hospital Universitário de Brasília e no Centro de Fisioterapia e Reabilitação do Hospital Universitário de Brasília / Work carried out at the Serviço de Pneumologia do Hospital Universitário de Brasília and at the Centro de Fisioterapia e Reabilitação do Hospital Universitário de Brasília.

Copyright © 2008. Sociedade Portuguesa de Pneumologia
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