Original article
Effects of arm bracing posture on respiratory muscle strength and pulmonary function in patients with chronic obstructive pulmonary disease
Efeitos do apoio dos membros superiores sobre a força muscular respiratória e função pulmonar de pacientes com doença pulmonar obstrutiva crônica
V. Cavalheria,b, C.A. Camilloa, A.F. Brunettoa,c,#, V.S. Probsta,c, E.M. Cipulo Ramosb, F. Pittaa,
Corresponding author
a Laboratório de Pesquisa em Fisioterapia Pulmonar (LFIP), Departamento de Fisioterapia, Universidade Estadual de Londrina, Paraná, Brazil
b Programa de Mestrado em Fisioterapia, Departamento de Fisioterapia, UNESP - Universidade Estadual Paulista, Presidente Prudente, SP, Brazil
c Departamento de Fisioterapia, Universidade do Norte do Paraná (UNOPAR), Londrina, Paraná, Brazil
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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.</p> <span class="elsevierStyleSectionTitle">Results</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">MIP, MEP and maximal voluntary ventilation (MVV) were higher with arm bracing than without arm bracing (MIP 64<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>22 cmH<span class="elsevierStyleInf">2</span>O <span class="elsevierStyleItalic">versus</span> 54<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>24 cmH<span class="elsevierStyleInf">2</span>O, <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>,00001; MEP 104<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>37 cmH<span class="elsevierStyleInf">2</span>O <span class="elsevierStyleItalic">versus</span> 92<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>37 cmH<span class="elsevierStyleInf">2</span>O, <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>.00001, and MVV 42<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>20 L/min <span class="elsevierStyleItalic">versus</span> 38<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>20 L/min, <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>.003). Other variables did not show statistical significant difference.</p> <span class="elsevierStyleSectionTitle">Conclusion</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">The arm bracing posture resulted in higher capacity to generate force and endurance of the respiratory muscles in patients with COPD.</p>" ] "pt" => array:2 [ "titulo" => "Resumo" "resumen" => "<span class="elsevierStyleSectionTitle">Objetivo</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Analisar o efeito do apoio de membros superiores sobre a força muscular respiratória e função pulmonar de pacientes com Doença Pulmonar Obstrutiva Crônica (DPOC).</p> <span class="elsevierStyleSectionTitle">Métodos</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Vinte pacientes com DPOC (11 homens) com idade de 67<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>8 anos e IMC 24<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>3 Kg · m<span class="elsevierStyleSup">−2</span>, 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.</p> <span class="elsevierStyleSectionTitle">Resultados</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">A PImax, PEmax e Ventilação Voluntária Máxima (VVM) foram maiores com a utilização do apoio do que sem o apoio (PImax 64<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>22 cmH<span class="elsevierStyleInf">2</span>O <span class="elsevierStyleItalic">versus</span> 54<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>24 cmH<span class="elsevierStyleInf">2</span>O, <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0,00001; PEmax 104<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>37 cmH<span class="elsevierStyleInf">2</span>O <span class="elsevierStyleItalic">versus</span> 92<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>37 cmH<span class="elsevierStyleInf">2</span>O, <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0,00001 e VVM 42<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>20 L/min <span class="elsevierStyleItalic">versus</span> 38<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>20 L/min, <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0,003). As demais variáveis não apresentaram diferenças estatisticamente significantes.</p> <span class="elsevierStyleSectionTitle">Conclusão</span><p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">O apoio de membros superiores resultou em maior capacidade de gerar força e <span class="elsevierStyleItalic">endurance</span> dos músculos respiratórios em pacientes com DPOC.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:19 [ 0 => array:3 [ "identificador" => "bib1" "etiqueta" => "1." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The effect of posture on respiratory activity of the abdominal muscles" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "T. Kera" 1 => "H. 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