Inspiratory muscle training in COPD patients
Susana Garcia1
Margarida Rocha2
Paula Pinto3
António M. F. Lopes4
Cristina Bárbara5
]]> Resumo
Objectivo: Pretendemos investigar os efeitos de um protocolo específico de treino dos músculos inspiratórios (TMI) no comportamento da dispneia, da função pulmonar, da força dos músculos respiratórios, da tolerância ao exercício e da qualidade de vida, num grupo de doentes com doença pulmonar obstrutiva crónica (DPOC).
Amostra: Constituída por treze doentes com DPOC moderada a muito grave distribuídos por um grupo de controlo (n=5) com um valor médio de FEV1 de 43,9 ± 10,1% do valor teórico e um grupo experimental (n=8) com um valor médio de FEV1 de 57,8 ± ± 12,1 % do valor teórico. O grupo experimental foi sujeito a TMI por cinco semanas consecutivas e o grupo de controlo não efectuou qualquer tipo de treino, sendo apenas aconselhado a continuar com as actividades diárias até então praticadas.
Resultados: A aplicação do protocolo específico de TMI melhorou significativamente a pressão máxima inspiratória (PImax) no grupo experimental (Pimax inicial - 83,3± 21,4 versus Pimax final- 98,4±17,8 cmH2O; p<0,01). O mesmo aconteceu com o score de sintomas do St. George Respiratory Questionnaire (SGRQ) no grupo experimental (score inicial 58±2,2 versus score final 50±2,1; p<0,05), não se tendo verificado qualquer alteração nas variáveis avaliadas no grupo de controlo.
Conclusões: A aplicação do treino de músculos inspiratórios em doentes com DPOC moderada a muito grave induziu melhoria da força dos músculos inspiratórios com repercussão na melhoria da qualidade de vida no que diz respeito aos sintomas.
Palavras-chave: DPOC, TMI.
Abstract
Aim: The aim of this study was to evaluate the impact a specific inspiratory muscle training (IMT) protocol had on dyspnoea, lung function, respiratory muscle pressure, tolerance to exercise and quality of life in a group of patients with ch ronic obstructive pulmonary disease (COPD).
Population: We studied 13 patients with moderate to very severe COPD divided into a control group (n=5) with an average FEV1 43.9 ± 10.1% of predicted value and an IMT group (n=8) with FEV1 57.8 ± 12.1 % of predicted value. While this study group underwent IMT for five consecutive weeks, the control group did not undergo any kind of training.
]]> Results: Using a specific IMT protocol significantly improved maximal inspiratory pressure (MIP) in the study group (initial MIP – 83.3± 21.4 versus final MIP- 98.4±17.8 cmH2O; p<0.01). The same result was seen with the St. George Respiratory Questionnaire (SGRQ) score in the study group (initial score 58±2.2 versus final score 50±2.1; p<0.05). No changes were recorded in the variables studied in the control group.Conclusions: The use of IMT in patients with moderate to very severe COPD induced an improvement in inspiratory muscle force with a consequent improvement in the quality of life in relation to symptoms.
Key-words: COPD, IMT.
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1 Fisioterapeuta da Unidade de Readaptação Funcional Respiratória do Hospital de Pulido Valente (HPV) / Physiotherapist, Respiratory Rehabilitation Unit, Hospital de Pulido Valente (HPV).
2 Técnica de cardiopneumologia da Unidade de Fisiopatologia Respiratória do HPV / Cardiopulmonology technician, Respiratory Physiopathology Unit, HPV.
3 Mestre em Patologia Respiratória. Assistente Hospitalar do HPV. Assistente Convidada da Faculdade de Ciências Médicas de Lisboa (FCML). Investigadora do Centro de Estudos de Patologia Respiratória da FCML / MA in Respiratory Pathology. Consultant, HPV. Guest Consultant, Lisbon School of Medical Sciences (FCML). Researcher, FCML Centre for Respiratory Pathology Studies.
4 Mestre em Fisioterapia. Professor Auxiliar Convidado da Escola Superior de Saúde do Alcoitão / MA in Physiotherapy. Guest Assistant Professor, Alcoitão Escola Superior de Saúde.
5 Coordenadora da Unidade de Fisiopatologia Respiratória do HPV. Assistente Hospitalar Graduada do HPV. Professora Auxiliar Convidada da FCML. Investigadora do Centro de Estudos de Patologia Respiratória da FCML / Head, Respiratory Physiopathology Unit, HPV. Specialist Consultant, HPV. Guest Assistant Professor, FCML. Researcher, FCML Centre for Respiratory Pathology Studies.
]]> Recebido para publicação/Received for publication: 07.01.25
Aceite para publicação/accepted for publication: 07.11.14
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