Efeitos agudos da press??o expirat??ria positiva na mobilidade toracoabdominal de pacientes com DPOC

Detalhes bibliográficos
Autor(a) principal: Feitoza, Carla Lima
Data de Publicação: 2016
Tipo de documento: Dissertação
Idioma: por
Título da fonte: Biblioteca Digital de Teses e Dissertações da Uninove
Texto Completo: http://bibliotecatede.uninove.br/handle/tede/1854
Resumo: Introduction: Chronic obstructive pulmonary disease (COPD) is characterized by persistent obstruction that is usually progressive and associated with an inflammatory response in the airways and lungs, by harmful particles or gases. The thoracoabdominal mobility of COPD patients alters as a result of this obstructive process that causes permanent pulmonary hyperinflation, altering respiratory mechanics. As a result, physical efforts can increase minute ventilation by reducing the time to expiration, increasing this hyperinflation. Positive airway expiratory pressure (PEP) is a physiotherapeutic resource that helps reduce air trapping during exacerbations of the COPD patient, but little is known about the effects of PEP on pulmonary hyperinflation. As a rule, PEP with high pressures has been contraindicated. Objective: Evaluate the effects of physical effort and PEP on pulmonary hyperinflation and Thoracoabdominal mobility through optoeletronic plethysmography (OEP) in patients with COPD and in healthy individuals. Materials and Methods: Thoracoabdominal mobility was evaluated by OEP in 30 subjects, in two groups, 15 of them with GOLD (GDPOC) and 15 healthy subjects (GC), with a mean age of 58.1 ?? 11 years, before and after a daily life simulation activity, up and down the step and before and after performing a series of exercise with PEP. Results: Both the age and the anthropometric data of the studied population as weight and height showed no difference. The spirometric variables showed a significant difference, in favor of the CG, as expected. There were no significant differences in the contribution of the thoracoabdominal compartments at rest between groups, except for Ti / Tot in the GDPOC, with median of 0.77 characterizing possible hyperinflation or respiratory muscle fatigue. After physical exertion, for 2 minutes, the GDPOC group showed an increase in the Abd contribution in thoracoabdominal movements, higher than CG (52.2 ?? 12.6% vs. 41.1 ?? 14.6%). After PEP, there was an increase of abdominal compartment in the subjects of the GDPOC (50.5 ?? 19.1% x 36.9 ?? 16.4%). After the PEP the patients of the GDPOC had a normalization of Ti / Ttot, with a median of 0.41. As the analysis of the compartments in the GDPOC there is a greater involvement of the abdominal compartment in three moments evaluated and after PEP this abdominal participation is also greater than in the CG. Conclusion: Physical effort and the use of PEP alter the participation of thoracic and abdominal compartments differently between groups and PEP in COPD seems to contribute to the reduction of hyperinflation.
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spelling Costa, DirceuCosta, DirceuJorge, Luciana Maria Malos?? SampaioForti, Eli Maria Pazzianottohttp://lattes.cnpq.br/2042457855322823Feitoza, Carla Lima2018-07-17T20:55:37Z2016-12-13Feitoza, Carla Lima. Efeitos agudos da press??o expirat??ria positiva na mobilidade toracoabdominal de pacientes com DPOC. 2016. 52 f. Disserta????o( Programa de P??s-Gradua????o em Ci??ncias da Reabilita????o) - Universidade Nove de Julho, S??o Paulo.http://bibliotecatede.uninove.br/handle/tede/1854Introduction: Chronic obstructive pulmonary disease (COPD) is characterized by persistent obstruction that is usually progressive and associated with an inflammatory response in the airways and lungs, by harmful particles or gases. The thoracoabdominal mobility of COPD patients alters as a result of this obstructive process that causes permanent pulmonary hyperinflation, altering respiratory mechanics. As a result, physical efforts can increase minute ventilation by reducing the time to expiration, increasing this hyperinflation. Positive airway expiratory pressure (PEP) is a physiotherapeutic resource that helps reduce air trapping during exacerbations of the COPD patient, but little is known about the effects of PEP on pulmonary hyperinflation. As a rule, PEP with high pressures has been contraindicated. Objective: Evaluate the effects of physical effort and PEP on pulmonary hyperinflation and Thoracoabdominal mobility through optoeletronic plethysmography (OEP) in patients with COPD and in healthy individuals. Materials and Methods: Thoracoabdominal mobility was evaluated by OEP in 30 subjects, in two groups, 15 of them with GOLD (GDPOC) and 15 healthy subjects (GC), with a mean age of 58.1 ?? 11 years, before and after a daily life simulation activity, up and down the step and before and after performing a series of exercise with PEP. Results: Both the age and the anthropometric data of the studied population as weight and height showed no difference. The spirometric variables showed a significant difference, in favor of the CG, as expected. There were no significant differences in the contribution of the thoracoabdominal compartments at rest between groups, except for Ti / Tot in the GDPOC, with median of 0.77 characterizing possible hyperinflation or respiratory muscle fatigue. After physical exertion, for 2 minutes, the GDPOC group showed an increase in the Abd contribution in thoracoabdominal movements, higher than CG (52.2 ?? 12.6% vs. 41.1 ?? 14.6%). After PEP, there was an increase of abdominal compartment in the subjects of the GDPOC (50.5 ?? 19.1% x 36.9 ?? 16.4%). After the PEP the patients of the GDPOC had a normalization of Ti / Ttot, with a median of 0.41. As the analysis of the compartments in the GDPOC there is a greater involvement of the abdominal compartment in three moments evaluated and after PEP this abdominal participation is also greater than in the CG. Conclusion: Physical effort and the use of PEP alter the participation of thoracic and abdominal compartments differently between groups and PEP in COPD seems to contribute to the reduction of hyperinflation.Introdu????o: A doen??a pulmonar obstrutiva cr??nica (DPOC) ?? caracterizada por obstru????o persistente que ?? geralmente progressiva e associada a uma resposta inflamat??ria nas vias a??reas e pulm??es, por part??culas ou gases nocivos. A mobilidade toracoabdominal de portadores de DPOC se altera em decorr??ncia deste processo obstrutivo que causa hiperinsufla????o pulmonar permanente, alterando a mec??nica respirat??ria. Em decorr??ncia disso, esfor??os f??sicos podem aumentar a ventila????o minuto reduzindo o tempo h??bil para a expira????o, aumentando essa hiperinsufla????o. A press??o expirat??ria positiva (PEP) ?? um recurso fisioterap??utico que auxilia na redu????o do aprisionamento de ar durante as exacerba????es do paciente com DPOC, por??m pouco se sabe sobre os efeitos do PEP em tal cirunst??ncia de hiperinsufla????o pulmonar, na qual, via de regra, a PEP com altas press??es tem sido contraindicada. Objetivo: Avaliar os efeitos da press??o expirat??ria positiva na mobilidade toracoabdominal e na hiperinsufla????o induzida pelo exerc??cio f??sico, por meio da Pletismografia optoeletr??nica (POE). Material e M??todo: A mobilidade toracoabdominal foi avaliada pela POE em 30 indiv??duos, em dois grupos, sendo 15 com DPOC n??vel II pelo GOLD (GDPOC) e 15 indiv??duos saud??veis (GC), com idade m??dia de 58,1??11 anos, antes e ap??s uma atividade de simula????o de vida di??ria, subir e descer degrau e, antes e ap??s realizarem uma s??rie de exerc??cio com PEP. Resultados: Tanto a idade quanto os dados antropom??tricos da popula????o estudada como peso e altura n??o mostraram diferen??a. J?? as vari??veis espirom??tricas mostraram diferen??a significativa, ?? favor do GC, conforme o esperado; n??o houve diferen??as significativas na contribui????o dos compartimentos toracoabdominal, em repouso, entre os grupos, com exce????o do Ti/Tot no GDPOC, com mediana de 0,77 caracterizando poss??vel hiperinsufla????o ou fadiga muscular respirat??ria. Ap??s o esfor??o f??sico, por 2 minutos, houve altera????o na mobilidade toracoabdominal no grupo GDPOC, apresentou aumento da contribui????o do compartimento abdominal, maior que o CG (52,2??12,6% x 41,1??14,6%). O mesmo aumento houve ap??s a PEP, no GDPOC (50,5??19,1% x 36,9??16,4%). Ap??s a PEP os pacientes do GDPOC tiveram uma normaliza????o de Ti/Ttot, com mediana de 0,41. Quanto a an??lise dos compartimentos no GDPOC h?? uma participa????o maior do compartimento abdominal nos tr??s momentos avaliados sendo que ap??s PEP essa participa????o abdominal tamb??m ?? maior do que no GC. Conclus??o: O esfor??o f??sico e o uso de PEP alteram a participa????o de compartimentos tor??cicos e abdominais, de forma diferente entre os grupos e, a PEP na DPOC parece contribuir para a redu????o da hiperinsufla????o.Submitted by Nadir Basilio (nadirsb@uninove.br) on 2018-07-17T20:55:37Z No. of bitstreams: 1 Carla Lima Feitoza.pdf: 1039396 bytes, checksum: 54b4b08906cba375881a20315af80122 (MD5)Made available in DSpace on 2018-07-17T20:55:37Z (GMT). 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dc.title.por.fl_str_mv Efeitos agudos da press??o expirat??ria positiva na mobilidade toracoabdominal de pacientes com DPOC
dc.title.alternative.eng.fl_str_mv Acute effects of positive expiratory pressure in the thoracoabdominal mobility of patients with COPD
title Efeitos agudos da press??o expirat??ria positiva na mobilidade toracoabdominal de pacientes com DPOC
spellingShingle Efeitos agudos da press??o expirat??ria positiva na mobilidade toracoabdominal de pacientes com DPOC
Feitoza, Carla Lima
DPOC
press??o expirat??ria positiva
pletismografia
COPD
positive expiratory pressure
plethysmography
CIENCIAS DA SAUDE
title_short Efeitos agudos da press??o expirat??ria positiva na mobilidade toracoabdominal de pacientes com DPOC
title_full Efeitos agudos da press??o expirat??ria positiva na mobilidade toracoabdominal de pacientes com DPOC
title_fullStr Efeitos agudos da press??o expirat??ria positiva na mobilidade toracoabdominal de pacientes com DPOC
title_full_unstemmed Efeitos agudos da press??o expirat??ria positiva na mobilidade toracoabdominal de pacientes com DPOC
title_sort Efeitos agudos da press??o expirat??ria positiva na mobilidade toracoabdominal de pacientes com DPOC
author Feitoza, Carla Lima
author_facet Feitoza, Carla Lima
author_role author
dc.contributor.advisor1.fl_str_mv Costa, Dirceu
dc.contributor.referee1.fl_str_mv Costa, Dirceu
dc.contributor.referee2.fl_str_mv Jorge, Luciana Maria Malos?? Sampaio
dc.contributor.referee3.fl_str_mv Forti, Eli Maria Pazzianotto
dc.contributor.authorLattes.fl_str_mv http://lattes.cnpq.br/2042457855322823
dc.contributor.author.fl_str_mv Feitoza, Carla Lima
contributor_str_mv Costa, Dirceu
Costa, Dirceu
Jorge, Luciana Maria Malos?? Sampaio
Forti, Eli Maria Pazzianotto
dc.subject.por.fl_str_mv DPOC
press??o expirat??ria positiva
pletismografia
topic DPOC
press??o expirat??ria positiva
pletismografia
COPD
positive expiratory pressure
plethysmography
CIENCIAS DA SAUDE
dc.subject.eng.fl_str_mv COPD
positive expiratory pressure
plethysmography
dc.subject.cnpq.fl_str_mv CIENCIAS DA SAUDE
description Introduction: Chronic obstructive pulmonary disease (COPD) is characterized by persistent obstruction that is usually progressive and associated with an inflammatory response in the airways and lungs, by harmful particles or gases. The thoracoabdominal mobility of COPD patients alters as a result of this obstructive process that causes permanent pulmonary hyperinflation, altering respiratory mechanics. As a result, physical efforts can increase minute ventilation by reducing the time to expiration, increasing this hyperinflation. Positive airway expiratory pressure (PEP) is a physiotherapeutic resource that helps reduce air trapping during exacerbations of the COPD patient, but little is known about the effects of PEP on pulmonary hyperinflation. As a rule, PEP with high pressures has been contraindicated. Objective: Evaluate the effects of physical effort and PEP on pulmonary hyperinflation and Thoracoabdominal mobility through optoeletronic plethysmography (OEP) in patients with COPD and in healthy individuals. Materials and Methods: Thoracoabdominal mobility was evaluated by OEP in 30 subjects, in two groups, 15 of them with GOLD (GDPOC) and 15 healthy subjects (GC), with a mean age of 58.1 ?? 11 years, before and after a daily life simulation activity, up and down the step and before and after performing a series of exercise with PEP. Results: Both the age and the anthropometric data of the studied population as weight and height showed no difference. The spirometric variables showed a significant difference, in favor of the CG, as expected. There were no significant differences in the contribution of the thoracoabdominal compartments at rest between groups, except for Ti / Tot in the GDPOC, with median of 0.77 characterizing possible hyperinflation or respiratory muscle fatigue. After physical exertion, for 2 minutes, the GDPOC group showed an increase in the Abd contribution in thoracoabdominal movements, higher than CG (52.2 ?? 12.6% vs. 41.1 ?? 14.6%). After PEP, there was an increase of abdominal compartment in the subjects of the GDPOC (50.5 ?? 19.1% x 36.9 ?? 16.4%). After the PEP the patients of the GDPOC had a normalization of Ti / Ttot, with a median of 0.41. As the analysis of the compartments in the GDPOC there is a greater involvement of the abdominal compartment in three moments evaluated and after PEP this abdominal participation is also greater than in the CG. Conclusion: Physical effort and the use of PEP alter the participation of thoracic and abdominal compartments differently between groups and PEP in COPD seems to contribute to the reduction of hyperinflation.
publishDate 2016
dc.date.issued.fl_str_mv 2016-12-13
dc.date.accessioned.fl_str_mv 2018-07-17T20:55:37Z
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dc.type.driver.fl_str_mv info:eu-repo/semantics/masterThesis
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dc.identifier.citation.fl_str_mv Feitoza, Carla Lima. Efeitos agudos da press??o expirat??ria positiva na mobilidade toracoabdominal de pacientes com DPOC. 2016. 52 f. Disserta????o( Programa de P??s-Gradua????o em Ci??ncias da Reabilita????o) - Universidade Nove de Julho, S??o Paulo.
dc.identifier.uri.fl_str_mv http://bibliotecatede.uninove.br/handle/tede/1854
identifier_str_mv Feitoza, Carla Lima. Efeitos agudos da press??o expirat??ria positiva na mobilidade toracoabdominal de pacientes com DPOC. 2016. 52 f. Disserta????o( Programa de P??s-Gradua????o em Ci??ncias da Reabilita????o) - Universidade Nove de Julho, S??o Paulo.
url http://bibliotecatede.uninove.br/handle/tede/1854
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dc.publisher.department.fl_str_mv Sa??de
publisher.none.fl_str_mv Universidade Nove de Julho
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