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Avaliação muscular respiratória e de membros superiores em pneumopatas

Respiratory and upper limbs muscle evaluation in patients with lung diseases

Carlos Eduardo Nunes Soares, Priscila Batista Almeida, Érica da Fonseca Travassos, Catarine Maria Gomes Macedo, Tiago Branco de Siqueira, Cibelle Andrade Lima, Flavio Maciel Dias Andrade, Eduardo Eriko Tenório França

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Resumo

Introdução: A intolerância ao exercício, manifestação comum em pneumopatas, aumenta a sensação de dispnéia, reduz a capacidade funcional e a qualidade de vida. Alguns pneumopatas mostram diminuição da força dos músculos ventilatórios e de membros, sugerindo a presença de fraqueza muscular que contribui para a percepção da dispnéia e intolerância ao exercício. Objetivo: correlacionar a força e a resistência muscular respiratória com a força de membros superiores em pneumopatas e comparar com indivíduos sem doença pulmonar. Materiais e Método: Tratou-se de um estudo analítico, observacional do tipo transversal onde foram analisados 80 voluntários, divididos em dois grupos: grupo controle (GC), composto por 40 indivíduos sem história de doença pulmonar pregressa e hábito tabágico e grupo pneumopata (GP), composto por 40 indivíduos com pneumopatias diversas. Foram avaliados a pressão inspiratória (Pimáx) e expiratória (Pemáx) máximas, o índice de resistência à fadiga (IRF) e a força de preensão palmar. Foram utilizados os testes estatísticos de Kolmogorov-Smirnov, Qui-quadrado, Mann-Whitney e a correlação de Spearman. As diferenças foram consideradas signifi cativas quando p<0,05. Resultados: Na análise comparativa intergrupos verifi couse valores signifi cativamente menores de Pimáx, Pemáx e força de preensão palmar no GP (p<0,0001). Uma associação positiva foi observada entre Pimáx e Pemáx com a força de preensão palmar em ambos os grupos (GP: r= 0,48 e r= 0,68 respectivamente e GC: r= 0,52 e r= 0,51 respectivamente). Conclusão: Em indivíduos com pneumopatias diversas, houve redução da força dos músculos inspiratórios, expiratórios e de membros superiores, observando-se também associação positiva entre a força dos músculos ventilatórios e a força de preensão palmar. Esta associação também foi observada em indivíduos sem pneumopatia.

Palavras-chave

Musculatura respiratória, Força muscular, Fraqueza muscular.

Abstract

Introduction: Exercise intolerance, which is common in patients with lung diseases, increases dyspnea, decreases functional capacity and quality of life. Some of these patients show respiratory and limb muscle weakness, which contributes to dyspnea perception and exercise intolerance. Objective: to correlate respiratory muscle strength and resistance with upper limb strength in patients with lung disease and compare with subjects without respiratory diseases. Materials and Method: It was performed an analytic, transversal, observational study, in which 80 volunteers were allocated into two groups: control group (CG): composed by 40 individuals without history of lung disease and smoking; and lung disease group (LDG): composed by 40 patients with diff erent lung diseases. Maximal inspiratory (MIP) and maximal expiratory pressures (MEP), fatigue resistance index (FRI) and hand-held dynamometry were recorded. Th e tests KolmogorovSmirnov, Qui-square, Mann-Whitney and Spearman were used. Diff erences were considered signifi cant when p<0,05. Results: Th e comparison between groups showed signifi cant lower values of MIP, MEP and hand-held dynamometry on the LDG. A positive association was observed between MIP and MEP with hand-held dynamometry in both groups (LDG: r= 0,48 and r= 0,68 respectively and CG: r= 0,52 and r= 0,51 respectively). Conclusion: In subjects with lung disease, there was decrease on strength of inspiratory, expiratory and upper limb muscles, as well as a positive association between respiratory muscles strength and hand-held dynamometry in both groups.

Keywords

Respiratory muscles, Muscle strength, Muscle weakness.

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