Avaliação da força muscular respiratória e pico de fluxo expiratório em idosos com acidente vascular cerebral: estudo comparativo
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2014
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O Acidente Vascular Cerebral pode afetar a função respiratória em termos de anormalidade na mecânica pulmonar e força dos músculos respiratórios, e essas alterações podem gerar condições não favoráveis como fadiga, dispneia e tosse fraca, predispondo os utentes afetados pela doença a riscos de infeções respiratórias. Em consequência, a avaliação muscular respiratória em idosos com AVC em processo de reabilitação é de importância fundamental, pois auxilia no diagnóstico, prevenção e tratamento de complicações respiratórias.
Objetivos: Comparar a força muscular respiratória entre idosos com AVC e idosos sem a doença de forma a confirmar a ação dessa patologia nos músculos respiratórios.
Método: Foi realizado um estudo de caso-controlo, transversal, com 15 idosos (5 homens e 10 mulheres) com o primeiro episódio de AVC e sem antecedentes de outras doenças neurológicas, com média de idade de 73±7,1 anos, e tempo de lesão entre 2 a 14 meses (média de 6,3±3,7 meses), que deveriam apresentar quadro de hipertonia e hemiplegia/paresia. O grupo de Controlo foi composto por 16 idosos (6 homens e 10 mulheres), sem antecedentes de doenças neurológicas, com idade média de 81,6±5,1 anos. Como critério de inclusão, os utentes de ambos os grupos não deveriam apresentar antecedentes de doenças respiratórias, insuficiência cardíaca grave (grau III e IV) e histórico de tabagismo ativo. A avaliação foi realizada através de medições de pressão expiratória máxima (Pemax), pressão inspiratória máxima (Pimax), pico de fluxo expiratório (PFE), Índice de Barthel (IB) e antropometria (peso, altura e índice de massa corporal).
Resultados: Os idosos do grupo AVC apresentaram valores significativamente (p<0,001) inferiores de Pemax (45,7±14,3 cmH2O), Pimax (37,5±12,6 cmH2O) e PFE (101,3±33,1 l/min) comparativamente ao grupo Controlo, com Pemax (70,4±18,3cmH2O), Pimax (61,4±10,3 cmH2O) e PFE (264,0±59,3 l/min). Observou-se correlação positiva e significativa entre a IB e Pimax, Pemax e PFE e entre IMC e Pemax.
Conclusões: Os resultados mostram uma diferença significativa da força muscular respiratória entre os grupos avaliados, sugerindo que a função muscular respiratória é influenciada pela ocorrência de AVC, pois os idosos afetados pela doença apresentaram fraqueza muscular inspiratória e expiratória, caracterizada pela redução da Pimax, Pemax e PFE comparativamente ao grupo controlo.
Stroke can impact the respiratory function related to abnormalities in pulmonary mechanics and strength of respiratory muscles. These changes can generate unfavourable conditions as fatigue, dyspnoea and weak coughing, predisposing the stroke patients to respiratory infections risks. Thus, the respiratory muscle evaluation in stroke affected elderly under rehabilitation is very important, as it helps on the diagnosis, prevention and treatment of respiratory complications. Objectives: Compare the respiratory muscle strength between stroke affected elderly and non-stroke elderly in order to confirm the action of this pathology on the respiratory muscle. Method: It was applied a transversal case-control study with 15 elderly (5 men and 10 women) affected by the first stroke and without other neurological diseases history, with an average age of 73±7.1 years, and strobe occurred between 2 to 14 months before the assessment (average of 6.3±3.7 months), which should present hypertonia and hemiplegia/paresis. The Control group was composed by 16 elderly (6 men and 10 women), without neurological diseases history, with average age of 81.6±5.1 years. The inclusion criteria for the study includes the absence of respiratory disease, severe health disease (III and IV levels) and active smoking history. The evaluation was performed through maximum expiratory pressure (MEP), maximum inspiratory pressure (MIP), peak flow (PF), Barthel Index (BI) and anthropometry (weight, height and Body Mass Index). Results: Stroke affected group presented results significantly (p<0.001) lower of MEP (45.7±14.3 cmH2O), MIP (37.5±12.6 cmH2O) and PF (101.3±33.1 l/min) relatively to the control group, with MEP (70.4±18.3cmH2O), MIP (61.4±10.3 cmH2O) and PF (264.0±59.3 l/min). It was observed also the positive and significant correlation between BI and MIP, MEP and PF, and BMI and MEP. Conclusions: The results showed significant difference in the respiratory muscle strength between the evaluated groups, suggesting the influence of the stroke on the respiratory muscle strength, because the stroke affected elderly presented muscle weakness on the inspiration and expiration from the reduction of MIP, MEP and PF in comparison with control group.
Stroke can impact the respiratory function related to abnormalities in pulmonary mechanics and strength of respiratory muscles. These changes can generate unfavourable conditions as fatigue, dyspnoea and weak coughing, predisposing the stroke patients to respiratory infections risks. Thus, the respiratory muscle evaluation in stroke affected elderly under rehabilitation is very important, as it helps on the diagnosis, prevention and treatment of respiratory complications. Objectives: Compare the respiratory muscle strength between stroke affected elderly and non-stroke elderly in order to confirm the action of this pathology on the respiratory muscle. Method: It was applied a transversal case-control study with 15 elderly (5 men and 10 women) affected by the first stroke and without other neurological diseases history, with an average age of 73±7.1 years, and strobe occurred between 2 to 14 months before the assessment (average of 6.3±3.7 months), which should present hypertonia and hemiplegia/paresis. The Control group was composed by 16 elderly (6 men and 10 women), without neurological diseases history, with average age of 81.6±5.1 years. The inclusion criteria for the study includes the absence of respiratory disease, severe health disease (III and IV levels) and active smoking history. The evaluation was performed through maximum expiratory pressure (MEP), maximum inspiratory pressure (MIP), peak flow (PF), Barthel Index (BI) and anthropometry (weight, height and Body Mass Index). Results: Stroke affected group presented results significantly (p<0.001) lower of MEP (45.7±14.3 cmH2O), MIP (37.5±12.6 cmH2O) and PF (101.3±33.1 l/min) relatively to the control group, with MEP (70.4±18.3cmH2O), MIP (61.4±10.3 cmH2O) and PF (264.0±59.3 l/min). It was observed also the positive and significant correlation between BI and MIP, MEP and PF, and BMI and MEP. Conclusions: The results showed significant difference in the respiratory muscle strength between the evaluated groups, suggesting the influence of the stroke on the respiratory muscle strength, because the stroke affected elderly presented muscle weakness on the inspiration and expiration from the reduction of MIP, MEP and PF in comparison with control group.
Descrição
Orientação: Maria do Céu Gonçalves Costa; co-orientação: Carlos Manuel dos Santos Moreira
Palavras-chave
SAÚDE, CUIDADOS CONTINUADOS, AVC, IDOSOS, RESPIRAÇÃO, HEALTH, CONTINUING CARE, CEREBRAL VASCULAR ACCIDENT, ELDERLY, RESPIRATION, MESTRADO EM CUIDADOS CONTINUADOS INTEGRADOS