Banca de DEFESA: MARINA LYRA LIMA CABRAL FAGUNDES

Uma banca de DEFESA de MESTRADO foi cadastrada pelo programa.
STUDENT : MARINA LYRA LIMA CABRAL FAGUNDES
DATE: 18/11/2020
TIME: 14:30
LOCAL: AUDITÓRIO DO DEPTO DE FISIOTERAPIA
TITLE:

Evaluation of the effects of pulmonary reexpansion devices in subjects with stroke sequelae

KEY WORDS:

Breath; physiotherapy; stroke; kinematics

PAGES: 60
BIG AREA: Ciências da Saúde
AREA: Fisioterapia e Terapia Ocupacional
SUMMARY:

Introduction: Volume incentive spirometry (VIs) and positive expiratory pressure (PEP) are two low-cost physiotherapeutic resources that are easy to transport and use and that promote pulmonary expansion in subjects after a stroke. Objective: To evaluate the effects of 3 pulmonary reexpansion protocols in stroke patients submitted to three pulmonary expansion protocols: a) Volume Incentive Spirometry (VIs), b) Positive Expiratory Pressure (PEP) and c) both devices (PEP + VIs ). Methodology: This is an observational analytical study that included individuals affected by an episode of stroke, for at least three months, of both sexes, aged over 18 years. The evaluations took place over two days, with a minimum interval of one week. On the first day, participants were assessed for respiratory muscle strength (MIP and MEP) and lung function (spirometry) as well as completing the Mini Mental State Examination (MMSE) and the National Institutes of Health Stroke Scale (NIHSS). The evaluation of the variation in the volumes of the chest wall and its compartments (ribcage pulmonary (RCp); ribcage abdominal (RCa) and abdomen (AB)) was performed by optoelectronic plethysmography (OEP) on the second day. The evaluation took place in 3 consecutive steps: 2 minutes of rest (spontaneous breathing - QB), 2 minutes of the randomized intervention technique (protocol) and 2 minutes of recovery. The rest time between the devices was defined by stabilizing vital signs. The sample calculation was performed in a pilot study of 5 individuals, by the tidal volume in the chest wall, with effect size 1.09 and power of 0.90, totaling 15 subjects for the study. Results: 18 individuals (12M), age 56.11 ± 12.28 years, were analyzed. Although the volume variation in the chest wall was greater when using PEP + VIs compared to isolated devices, there was no significant difference between the valves for these variables. When we divided the rib cage into hemiparetic and normoparetic sides, there was a significant difference (p <0.05) when analyzing the hemipathic sides in the ribcage pulmonary compartment (RCp) between PEP 0.24 [0.15-0.32] and VIs 0.37 [0.25-0.43]. The percentage of contribution was higher, comparing the hemithorax, on the normoparetic side, being statistically significant in PEP (19%) when compared to the hemiparetic side (14%). In addition, when comparing only the affected sides, there was a statistical difference in RCp greater in VIs (22%) when compared to the other two devices (PEP - 19%) and PEP + VIs - 20%) and in the abdomen (AB) , being higher in PEP (26%) when compared to VIs (20%) and in PEP + VIs (24%) when compared to VIs (20%). In the analysis of asynchrony, the study showed that there is an increase in the phase angle <0.05 with the use of the PEP and PEP + VIs protocols between the QB-valve and valve-recovery, with no change in the use of the isolated VIs. In addition, significantly higher values were obtained in PEP + VIs compared to VIs in the abdominal ribcage versus abdomen (θCTAxAB) and in PEP when compared to VIs in the pulmonary ribcage versus abdomen (θCTPxAB). Conclusion: The use of isolated volume incentive spirometry had superior effects on pulmonary reexpansion and less asynchrony when compared to the use associated with positive expiratory pressure and the use of isolated PEP in post-stroke patients.

BANKING MEMBERS:
Externo ao Programa - 2419223 - GERSON FONSECA DE SOUZA
Externa à Instituição - JESSICA DANIELLE MEDEIROS DA FONSECA - F.M.Nassau
Presidente - 5566309 - VANESSA REGIANE RESQUETI FREGONEZI