Banca de DEFESA: LAYANA MARQUES DE OLIVEIRA

Uma banca de DEFESA de MESTRADO foi cadastrada pelo programa.
DISCENTE : LAYANA MARQUES DE OLIVEIRA
DATA : 27/08/2018
HORA: 14:00
LOCAL: Auditório do Departamento de Fisioterapia
TÍTULO:

Acute effects of different postures on peak cough flow and electromyographic activation of respiratory muscles in with Duchenne muscular dystrophy

PALAVRAS-CHAVES:

Duchenne Muscular Dystrophy, Cough Flow Peak, Posture, Respiratory Muscles.

PÁGINAS: 71
GRANDE ÁREA: Ciências da Saúde
ÁREA: Fisioterapia e Terapia Ocupacional
RESUMO:

Introduction: Duchenne Muscular Dystrophy (DMD) is the most common form of myopathy affecting children of the male gender. As the disease progresses, respiratory muscle involvement leads to muscle weakness and reduced lung and chest expansion, with retention of secretions, due to the inability to generate an effective cough. Several factors determine the effectiveness of coughing. Since posture acts on peak cough flow (CPF) and respiratory muscle activity in DMD is not yet established. Objective: To evaluate and compare the acute effects of different postures on CPF variations and electromyographic activation of respiratory muscles in subjects with DMD versus healthy paired subjects. Methods: CPF, tidal volume (VT) of the chest wall compartments (pulmonary thoracic cavity and the abdominal thoracic cavity) and abdomen (AB) were evaluated through Optoelectronic Plethysmography and respiratory muscle activation: sternocleidomastoid (SCM) scalene (ESC), abdominal rectus (RA) and external oblique (EO) through surface electromyography (EMGs). The evaluation was performed in three positions: supine, supine with head elevated at 45^o (45^o) and supine with head elevated at 80^o (80^o) in subjects with DMD, Duchenne group (DG), paired with healthy subjects, control group (CG). Results: 35 individuals with DMD were assessed (23 excluded), of whom 12 subjects composed the DG being paired with 12 healthy subjects, who composed the CG. It was observed a significant increase of the CPF in 80^o in the DG when compared to the supine position (4.89 ± 2.11 vs 3.59 ± 1.59, p <0.01), without differences in the CG. The intergroup analysis showed that the DG presented lower CPF values (p <0.001) compared to the control group, in the respective positions: supine (3.59 ± 1.91 vs 10.11 ± 4.63, p <0.001); 45° (3.92 ± 1.59 vs 9.18 ± 4.36, p <0.01); and 80^o (4.89 ± 2.11 vs 10.35 ± 3.79, p <0.01), respectively. In the inspiratory phase of cough, an increase in inspiratory air volume of the chest wall (p <0.05) at position 80^o was observed compared to the 45^o position of the CG, with no significant differences in the DG. In the expiratory phase of cough, an increase in inspiratory air volume (p <0.05) was observed in 80^o compared to supine position of the DG, with no statistical differences in the CG. Both the inspiratory and expired chest wall volume were higher at the 80^o position of the CG (p <0.05) compared to the respective DG position. During the inspiratory phase of cough, intragroup analysis of EMGs showed an increase in SCM activation by 80o (p <0.01) in relation to supine position in both groups, and an increase in ESC (p <0, 05) was observed at position 80o to position 45o, only in the GD. Intergroup analysis showed a greater activation of ESC at 80o (p <0.05) and RA and EO at the three positions (p <0.001) in the DG compared to the respective CG positions, during the inspiratory phase of the cough . During the expiratory phase, greater ECM activation was observed in the supine position (p <0.05) in the DG compared to the respective CG position, with no intergroup differences. Our results show that cough is favored the more erect the positioning, with greater activation of the inspiratory muscles in individuals with DMD in the inspiratory phase. While the healthy posture did not influence the PFT values, only the activation of the inspiratory muscles during the inspiratory phase of the cough.

MEMBROS DA BANCA:
Externo ao Programa - 2553737 - MARIO EMILIO TEIXEIRA DOURADO JUNIOR
Presidente - 5566309 - VANESSA REGIANE RESQUETI FREGONEZI
Externo à Instituição - VERÔNICA FRANCO PARREIRA - UFMG