Banca de QUALIFICAÇÃO: CATHARINNE ANGELICA CARVALHO DE FARIAS
Uma banca de QUALIFICAÇÃO de DOUTORADO foi cadastrada pelo programa.DISCENTE : CATHARINNE ANGELICA CARVALHO DE FARIAS
DATA : 30/05/2018
HORA: 08:00
LOCAL: AUDITÓRIO DO DEPTO DE FISIOTERAPIA
TÍTULO:
EFFECTS OF RESPIRATORY MUSCLE TRAINING WITH DIFFERENT MODALITIES IN PATIENTS WITH OBSTRUCTIVE PULMONARY DISEASE (COPD) - CONTROLLED RANDOM CLINICAL TRIAL
PALAVRAS-CHAVES:
COPD, Pulmonary Rehabilitation, Respiratory Muscle Training
PÁGINAS: 89
GRANDE ÁREA: Ciências da Saúde
ÁREA: Fisioterapia e Terapia Ocupacional
RESUMO:
Introduction: Respiratory Muscular Training (RMT) has been described for more than 40 years in the medical literature. Despite the long time and countless articles, as well as published systematic reviews on the effects of RMT in patients with Chronic Obstructive Pulmonary Disease (COPD), there is no consensus on the additional effects that RMT could provide on relevant clinical aspects of the disease, such as exercise intolerance and dyspnea in its association with Pulmonary Rehabilitation (PR), being a non-pharmacological gold standard intervention for patients with COPD. Objective: to analyze the additional effects of RMT with different therapeutic modalities associated to a Pulmonary Rehabilitation program in patients with COPD in exercise capacity and dyspnea. METHODS: This is a blinded randomized clinical trial, composed so far by 23 subjects with COPD Diagnosis, randomly assigned to three groups: PR (RP), PR associated with Inspiratory Muscular Training - IMT with resistance to flow conical (PR + IMTRFC) and PR associated with RMT endurance modality by normocapnic hyperpnea (PR + RMTNH). The protocol lasts 10 weeks with a frequency of 3 days a week, supervised, composed of health education, energy conservation techniques, individual aerobic training on treadmill with load of 70% of the maximum speed reached in the incremental test (ISWT), strengthening for all groups. The PR + IMTRFC group underwent training with an initial loading of 35% of MIP obtained at the initial evaluation, and progressions of 5% each week up to a limit of 80% of MIP, reevaluated and adjusted weekly. The PR + IMTRFC group underwent training with an initial loading of 35% of MIP obtained at the initial evaluation, and progressions of 5% each week up to a limit of 80% of MIP, reevaluated and adjusted weekly. The PR + RMTHNgroup underwent training with a pouch equivalent to 50% of vital capacity, with a respiratory rate estimated at 35 times the value of forced expiratory volume in the first second (about 50% of MVV), with a re-evaluation after 5 weeks and increments of 2 to 3 minutes per week so that by the end of the sixth week the patient was holding a 10-minute training time and at the end of 10 weeks the time was about 20 minutes. Anthropometric characteristics, pulmonary function, respiratory muscle strength and endurance, exercise capacity (6MWT and ISWT), pulmonary volumes associated with submaximal endurance test, upper and lower limb muscle strength, dyspnea (mMRC), state (BODE index), before and after the intervention period. The sample calculation determined a final number of 18 patients per group, totalizing 54 individuals, with a power of 80%. Results: Twenty-three patients (52.2%) were male, with a mean age of 64.4 ± 5.3 years and 22 (95.7%) with a BMI above 21 kg / m2. As preliminary results,we found an increase in exercise capacity only in the groups that performed PR associated with RMT (p = 0.014 and p = 0.0002). Respiratory muscle strength showed an increase in both PR + RMT groups (p = 0.0004 and p = 0.0002). In addition, PR + RMTNH subjects also presented a significant increase in maximal expiratory pressure (p = 0.013). A reduction in dyspnea was observed only in the PR + RMTNH group (p = 0.006), but also showed a reduction in the risk of dying after the training period (p = 0.036). Conclusions: Preliminary results demonstrated additional gains to the protocols that added RMT to PR programs with additional clinical advantages to RMT endocrine modality by normocapnic hyperpnea.
MEMBROS DA BANCA:
Externo ao Programa - 2211046 - LUCIEN PERONI GUALDI
Interno - 1149619 - SELMA SOUSA BRUNO
Presidente - 5566309 - VANESSA REGIANE RESQUETI FREGONEZI