Banca de DEFESA: RENCIO BENTO FLORENCIO

Uma banca de DEFESA de DOUTORADO foi cadastrada pelo programa.
DISCENTE : RENCIO BENTO FLORENCIO
DATA : 27/07/2018
HORA: 14:00
LOCAL: Auditório do Departamento de Fisioterapia - UFRN
TÍTULO:

RESPIRATORY KINEMATICS IN RESTRICTIVE LUNG DISEASES.

PALAVRAS-CHAVES:

Optoeletronic plethysmography; breathing pattern; thoracoabdominal asynchrony; pulmonary reexpansion; stroke; Parkinson’s disease.

PÁGINAS: 142
GRANDE ÁREA: Ciências da Saúde
ÁREA: Fisioterapia e Terapia Ocupacional
RESUMO:

Introduction: The respiratory system is composed of several structures from the morphofunctional point of view, but the chest wall and lungs perform great influence under the pulmonary evaluation process. Additionally, such a process depends on neurological control by the central nervous system (CNS), responsible for the control and generation of respiratory rhythm due to several neuronal groups. After the respiratory rhythm is generated, breathing is initiated by the active breathing of the inspiratory muscles, the ability to generate an inspiratory force between the external and internal environment of the chest wall (CW). What are the occurrences that limit the mobility of the patient and the pulmonary patients, can compromise the speedofthe ventilatory pattern andlung volumes, as is the case of some neurological diseases that evolve with ventilatory pattern and dependent on complementary therapies for a pulmonary reexpansion. Whatever the situations that limit the mobility of the CW or that affect the respiratory muscles directly, can compromise the efficiency of the ventilatory pattern and lung volumes, as is the case of some neurological diseases that evolve with restrictive respiratory pattern and depend on complementary therapies for pulmonary reexpansion. Aims: 1) To evaluate and compare the kinematics of the chest wall and its compartments during spontaneous breathing in subjects with restrictive disease versus healthy; 2) To evaluate and compare the kinematics of the chest wall of healthy subjects submitted to the use of three different devices for pulmonary reexpansion. Methodology: 1) Seventy-six individuals were evaluated (29 healthy, 27 with Parkinson 's disease - PD, and 20 post-stroke), through pulmonary function (spirometry), respiratory muscle strength (manovacuometry). Subsequently, the subjects were placed in a seated position to evaluate the variation of total and compartmental chest wall volumes and thoracoabdominal asynchrony by optoelectronic plethysmography (POE) for 3 minutes in quiet breathing. The subjects were also divided into groups according to the length of diagnosis to evaluate the variation of volumes and asynchrony. 2) Twelve healthy individuals of both genders with normal pulmonary function and respiratory muscle strength were evaluated by optoelectronic plethysmography (OEP) to evaluate the volume variations of the chest wall and it is compartments during the use of three different resources to promote pulmonary reexpansion: volume- oriented incentive spirometry (EI-v), positive expiratory pressure (PEP) and the combination of the two techniques mentioned above (EI-vp) were used to promote pulmonary reexpansion. The evaluations were distributed in three distinct days, one day for each resource and the first day the spirometry and manovacuometry tests were performed. Subjects were randomized (randomization.com) to the order of execution of the resources and evaluation in OEP, which occurred in 3 consecutive steps: 2 minutes of quiet breathing (QB), 2 minutes of protocol and 2 minutes of quiet breathing in recovery. The target respiration in EI-v was defined as 80% of the inspiratory capacity previously evaluated in spirometry. Breathing with the PEP adopted a free ventilatory pattern, however, a 10 cmH2O load was established for all subjects. Results: 1) Volume of the pulmonary rib cage volume (VRCp) was significantly lower in subjects with restrictive disease compared to healthy subjects (p<0.05). Post-stroke subjects with paradoxical movement presented lower volumes for the chest wall and its compartments, when compared to healthy (p <0.05), whereas the individuals in the PD group with paradoxical movement had lower values only for VRCp (p < 0.05); 2) During the use of IS-vp, a greater volume variation on chest wall (VCW) and its compartments were observed when compared to IS-v (p<0.05) and only for VCW and pulmonary rib cage (VRCp) when compared to PEP (p<0.05). The IS-vp device was able to generate a lower asynchrony between RCp versus AB (p<0.05) and RCp versus abdominal rib cage (RCa) when compared to IS-v (p<0.05). Conclusions: 1) Post-stroke individuals and with Parkinson's disease present a ventilatory pattern, with reduced chest wall volumes and presence of thoracoabdominal asynchrony, even in the absence of significant pulmonary function impairment. In addition, half of the individuals post-stroke and with PD presented paradoxical movement. 2) The combined use of EI-v with PEP was able to increase total and compartmental chest wall volumes, as well as improve compartment synchronism among compartments, appearing as an important tool in the treatment of patients with restrictive ventilatory pattern.

MEMBROS DA BANCA:
Presidente - 1545315 - GUILHERME AUGUSTO DE FREITAS FREGONEZI
Externo ao Programa - 2419223 - GERSON FONSECA DE SOUZA
Externo ao Programa - 5566309 - VANESSA REGIANE RESQUETI FREGONEZI
Externo à Instituição - ANTONIO JOSÉ SARMENTO DA NÓBREGA - UFRN
Externo à Instituição - JOCELINE CASSIA FEREZINI DE SA - UFRN