Efeitos do treinamento muscular inspiratório de alta intensidade na espessura diafragmática em pacientes pós-revascularização do miocárdio: ensaio clínico randomizado
Autor(a) principal: | |
---|---|
Data de Publicação: | 2019 |
Tipo de documento: | Dissertação |
Idioma: | por |
Título da fonte: | Biblioteca Digital de Teses e Dissertações do UFSM |
Texto Completo: | http://repositorio.ufsm.br/handle/1/28369 |
Resumo: | Moderate to high intensity inspiratory muscle training (IMT) has shown the presence of a clinical picture (CR) in patients undergoing coronary artery bypass grafting (CABG). Currently, the inclusion of IMT in Phase II has gained strength, since the repercussions on lung function and the reduction of functional capacity are still present late.Ultrasonography has been shown to be useful in assessing the anatomical characteristics of many muscle groups and considered as an alternative proposal for function analysis and diaphragmatic thickness.The present study aimed to evaluate the impact of the addition of moderate to high intensity TMI associated with short-term aerobic and resistive exercise on diaphragmatic thickness in post-CABG patients in Phase II of CR. This was a randomized double-blind clinical trial involving 19 post-CABD patients randomly divided into intervention group (GI; n = 10) submitted to moderate to high intensity IMT associated with aerobic and resistance exercise, with progression of TMI and sham group (GS; n = 9) who performed IMT combined with aerobic and resistance exercise, whose IMT load was minimal and maintained constant for 12 weeks, twice weekly, 5 sets of 10 repetitions. Pre-and post-intervention were evaluated: initial evaluation (anamnesis), diaphragmatic thickness (ultrasonography), quality of life (MacNew QLMI), respiratory muscle strength (manovacuometry), functional capacity (distance walked in the 6-minute walk test - DPTC6M) , respiratory muscle resistance (incremental test and constant test) and palmar grip strength (FPP). In the statistical analysis, the normality of the variables was evaluated by the Shapiro-Wilk test. Continuous variables were presented in mean ± standard deviation (SD) and 95% confidence interval (95% CI), as well as categorical variables in absolute frequencies and percentages. The intragroup comparison was performed using Student's T-test. The comparison between groups was performed using two-way ANOVA. The size of the effect was determined from Cohen's d. The level of significance was 5% (p <0.05). There was a significant 13% increase in diaphragmatic muscle thickness in IG (0.02cm 95% CI 0.001 to 0.036, Cohen d 0.66). In relation to MIP, there was a significant increase of 31% in IG (26.60cmH2O 95% CI 16.37 to 36.8; Cohen d 0.38). The variable inspiratory muscle resistance showed a significant of 29% increase in the PimáxS in the GI (16.1cmH2O 95% CI 0.46 to 31.74, Cohen d 0.85). DPTC6M and PEmax showed a significant increase in both GI and GS, with no significant difference in comparison between groups. In the comparison between groups, no significant differences were observed for all evaluated outcomes. The results found in this study suggest that MRI of moderate to high intensity in the short term improved diaphragmatic thickness, maximal inspiratory pressure and sustained maximum inspiratory pressure in post- CABG patients. |
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2023-03-24T12:52:00Z2023-03-24T12:52:00Z2019-08-09http://repositorio.ufsm.br/handle/1/28369Moderate to high intensity inspiratory muscle training (IMT) has shown the presence of a clinical picture (CR) in patients undergoing coronary artery bypass grafting (CABG). Currently, the inclusion of IMT in Phase II has gained strength, since the repercussions on lung function and the reduction of functional capacity are still present late.Ultrasonography has been shown to be useful in assessing the anatomical characteristics of many muscle groups and considered as an alternative proposal for function analysis and diaphragmatic thickness.The present study aimed to evaluate the impact of the addition of moderate to high intensity TMI associated with short-term aerobic and resistive exercise on diaphragmatic thickness in post-CABG patients in Phase II of CR. This was a randomized double-blind clinical trial involving 19 post-CABD patients randomly divided into intervention group (GI; n = 10) submitted to moderate to high intensity IMT associated with aerobic and resistance exercise, with progression of TMI and sham group (GS; n = 9) who performed IMT combined with aerobic and resistance exercise, whose IMT load was minimal and maintained constant for 12 weeks, twice weekly, 5 sets of 10 repetitions. Pre-and post-intervention were evaluated: initial evaluation (anamnesis), diaphragmatic thickness (ultrasonography), quality of life (MacNew QLMI), respiratory muscle strength (manovacuometry), functional capacity (distance walked in the 6-minute walk test - DPTC6M) , respiratory muscle resistance (incremental test and constant test) and palmar grip strength (FPP). In the statistical analysis, the normality of the variables was evaluated by the Shapiro-Wilk test. Continuous variables were presented in mean ± standard deviation (SD) and 95% confidence interval (95% CI), as well as categorical variables in absolute frequencies and percentages. The intragroup comparison was performed using Student's T-test. The comparison between groups was performed using two-way ANOVA. The size of the effect was determined from Cohen's d. The level of significance was 5% (p <0.05). There was a significant 13% increase in diaphragmatic muscle thickness in IG (0.02cm 95% CI 0.001 to 0.036, Cohen d 0.66). In relation to MIP, there was a significant increase of 31% in IG (26.60cmH2O 95% CI 16.37 to 36.8; Cohen d 0.38). The variable inspiratory muscle resistance showed a significant of 29% increase in the PimáxS in the GI (16.1cmH2O 95% CI 0.46 to 31.74, Cohen d 0.85). DPTC6M and PEmax showed a significant increase in both GI and GS, with no significant difference in comparison between groups. In the comparison between groups, no significant differences were observed for all evaluated outcomes. The results found in this study suggest that MRI of moderate to high intensity in the short term improved diaphragmatic thickness, maximal inspiratory pressure and sustained maximum inspiratory pressure in post- CABG patients.O treinamento muscular inspiratório (TMI) de moderada a alta intensidade tem sido incluído em programas de reabilitação cardíaca (RC), em pacientes submetidos à cirurgia de revascularização do miocárdio (CRM). Atualmente, tem ganhado força a inclusão do TMI na Fase II, já que as repercussões na função pulmonar e a redução da capacidade funcional ainda se fazem presentes tardiamente. A ultrassonografia tem se mostrado útil na avaliação das características anatômicas de muitos grupos musculares e considerada como uma proposta alternativa de análise da função e espessura diafragmática. O presente estudo teve como objetivo avaliar o impacto da adição do TMI de moderada a alta intensidade associado ao exercício aeróbico e resistido, de curto prazo, sobre a espessura diafragmática em pacientes pós-CRM na Fase II da RC. Trata-se de um ensaio clínico randomizado duplo cego, envolvendo 19 pacientes pós-CRM aleatoriamente divididos em grupo intervenção (GI; n=10) submetidos ao TMI de moderada a alta intensidade associado ao exercício aeróbico e de resistência, com progressão da carga do TMI e grupo sham (GS; n=9) que realizou o TMI combinado ao exercício aeróbico e de resistência, cuja carga do TMI foi mínima e mantida constante, durante 12 semanas, 2 vezes por semana, 5 séries de 10 repetições. Pré e pós-intervenção foram avaliadas: avaliação inicial (anamnese), espessura diafragmática (ultrassonografia), qualidade de vida (MacNew QLMI), força muscular respiratória (manovacuometria), capacidade funcional (distância percorrida no teste de caminhada de 6 minutos – DPTC6M), resistência muscular respiratória (teste incremental e teste constante) e força de preensão palmar (FPP). Na análise estatística a normalidade das variáveis foi avaliada pelo teste de Shapiro-Wilk. As variáveis contínuas foram apresentadas em média ± desvio padrão (DP) e intervalo de confiança de 95% (IC 95%), já as variáveis categóricas em frequências absolutas e porcentagens. A comparação intragrupo foi realizada através do teste T de Student. Já a comparação entre grupos foi realizada por meio da ANOVA de duas vias. O tamanho do efeito foi determinado a partir do d de Cohen. O nível de significância foi de 5% (p <0,05). Houve aumento significativo de 13% na espessura muscular diafragmática no GI (0,02cm IC 95% 0,001 a 0,036; Cohen d 0,66). Em relação á PImáx houve aumento significativo de 31% no GI (26,60cmH2O IC 95% 16,37 a 36,8; Cohen d 0,38). A variável resistência muscular inspiratória apresentou aumento significativo de 29% na PimáxS no GI (16,1cmH2O IC 95% 0,46 a 31,74; Cohen d 0,85). A DPTC6M e a PEmáx apresentaram aumento significativo tanto no GI quanto no GS, não havendo diferença significativa na comparação entre os grupos. Na comparação entre os grupos, não foram evidenciadas diferenças significativas para todos os desfechos avaliados. Os resultados encontrados neste estudo sugerem que o TMI de moderada a alta intensidade a curto prazo, melhorou a espessura diafragmática, pressão inspiratória máxima e pressão inspiratória máxima sustentada em pacientes pós-CRM.porUniversidade Federal de Santa MariaCentro de Ciências da SaúdePrograma de Pós-Graduação em Reabilitação FuncionalUFSMBrasilCiências da SaúdeAttribution-NonCommercial-NoDerivatives 4.0 Internationalhttp://creativecommons.org/licenses/by-nc-nd/4.0/info:eu-repo/semantics/openAccessTreinamento muscular inspiratórioReabilitação cardíacaRevascularização miocárdicaInspiratory muscular trainingCardiac rehabilitationCNPQ::CIENCIAS DA SAUDE::FISIOTERAPIA E TERAPIA OCUPACIONALEfeitos do treinamento muscular inspiratório de alta intensidade na espessura diafragmática em pacientes pós-revascularização do miocárdio: ensaio clínico randomizadoEffects of high-intensity inspiratory muscle training on diaphragmatic thickness in patients post-revascularization of myocardial: randomized clinical trialinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/masterThesisAlbuquerque, Isabella Martins dehttp://lattes.cnpq.br/5579735303815692Fontoura, Fabrício Faria daPasqualoto, Adriane Schmidthttp://lattes.cnpq.br/5140706265530246Silva, André Felipe Santos da4008000000086006006006006008f5a03c4-2456-4901-b97d-967566f82ae4c2b79b6b-9014-4707-b41b-5af1b82bf7ceda29a034-b9b8-4204-bb76-c6ac9c209c0f6cf60556-a194-4343-8c58-064ded341269reponame:Biblioteca Digital de Teses e Dissertações do UFSMinstname:Universidade Federal de Santa Maria (UFSM)instacron:UFSMORIGINALDIS_PPGRF_2019_SILVA_ANDRE.pdfDIS_PPGRF_2019_SILVA_ANDRE.pdfDissertaçãoapplication/pdf3327921http://repositorio.ufsm.br/bitstream/1/28369/1/DIS_PPGRF_2019_SILVA_ANDRE.pdfe97496afcb0e2a9ac1b6a2037f3bcfe4MD51CC-LICENSElicense_rdflicense_rdfapplication/rdf+xml; charset=utf-8805http://repositorio.ufsm.br/bitstream/1/28369/2/license_rdf4460e5956bc1d1639be9ae6146a50347MD52LICENSElicense.txtlicense.txttext/plain; charset=utf-816http://repositorio.ufsm.br/bitstream/1/28369/3/license.txtf8fcb28efb1c8cf0dc096bec902bf4c4MD531/283692023-03-24 09:52:00.86oai:repositorio.ufsm.br:1/28369Q3JlYXRpdmUgQ29tbW9ucw==Biblioteca Digital de Teses e Dissertaçõeshttps://repositorio.ufsm.br/ONGhttps://repositorio.ufsm.br/oai/requestatendimento.sib@ufsm.br||tedebc@gmail.comopendoar:2023-03-24T12:52Biblioteca Digital de Teses e Dissertações do UFSM - Universidade Federal de Santa Maria (UFSM)false |
dc.title.por.fl_str_mv |
Efeitos do treinamento muscular inspiratório de alta intensidade na espessura diafragmática em pacientes pós-revascularização do miocárdio: ensaio clínico randomizado |
dc.title.alternative.eng.fl_str_mv |
Effects of high-intensity inspiratory muscle training on diaphragmatic thickness in patients post-revascularization of myocardial: randomized clinical trial |
title |
Efeitos do treinamento muscular inspiratório de alta intensidade na espessura diafragmática em pacientes pós-revascularização do miocárdio: ensaio clínico randomizado |
spellingShingle |
Efeitos do treinamento muscular inspiratório de alta intensidade na espessura diafragmática em pacientes pós-revascularização do miocárdio: ensaio clínico randomizado Silva, André Felipe Santos da Treinamento muscular inspiratório Reabilitação cardíaca Revascularização miocárdica Inspiratory muscular training Cardiac rehabilitation CNPQ::CIENCIAS DA SAUDE::FISIOTERAPIA E TERAPIA OCUPACIONAL |
title_short |
Efeitos do treinamento muscular inspiratório de alta intensidade na espessura diafragmática em pacientes pós-revascularização do miocárdio: ensaio clínico randomizado |
title_full |
Efeitos do treinamento muscular inspiratório de alta intensidade na espessura diafragmática em pacientes pós-revascularização do miocárdio: ensaio clínico randomizado |
title_fullStr |
Efeitos do treinamento muscular inspiratório de alta intensidade na espessura diafragmática em pacientes pós-revascularização do miocárdio: ensaio clínico randomizado |
title_full_unstemmed |
Efeitos do treinamento muscular inspiratório de alta intensidade na espessura diafragmática em pacientes pós-revascularização do miocárdio: ensaio clínico randomizado |
title_sort |
Efeitos do treinamento muscular inspiratório de alta intensidade na espessura diafragmática em pacientes pós-revascularização do miocárdio: ensaio clínico randomizado |
author |
Silva, André Felipe Santos da |
author_facet |
Silva, André Felipe Santos da |
author_role |
author |
dc.contributor.advisor1.fl_str_mv |
Albuquerque, Isabella Martins de |
dc.contributor.advisor1Lattes.fl_str_mv |
http://lattes.cnpq.br/5579735303815692 |
dc.contributor.referee1.fl_str_mv |
Fontoura, Fabrício Faria da |
dc.contributor.referee2.fl_str_mv |
Pasqualoto, Adriane Schmidt |
dc.contributor.authorLattes.fl_str_mv |
http://lattes.cnpq.br/5140706265530246 |
dc.contributor.author.fl_str_mv |
Silva, André Felipe Santos da |
contributor_str_mv |
Albuquerque, Isabella Martins de Fontoura, Fabrício Faria da Pasqualoto, Adriane Schmidt |
dc.subject.por.fl_str_mv |
Treinamento muscular inspiratório Reabilitação cardíaca Revascularização miocárdica |
topic |
Treinamento muscular inspiratório Reabilitação cardíaca Revascularização miocárdica Inspiratory muscular training Cardiac rehabilitation CNPQ::CIENCIAS DA SAUDE::FISIOTERAPIA E TERAPIA OCUPACIONAL |
dc.subject.eng.fl_str_mv |
Inspiratory muscular training Cardiac rehabilitation |
dc.subject.cnpq.fl_str_mv |
CNPQ::CIENCIAS DA SAUDE::FISIOTERAPIA E TERAPIA OCUPACIONAL |
description |
Moderate to high intensity inspiratory muscle training (IMT) has shown the presence of a clinical picture (CR) in patients undergoing coronary artery bypass grafting (CABG). Currently, the inclusion of IMT in Phase II has gained strength, since the repercussions on lung function and the reduction of functional capacity are still present late.Ultrasonography has been shown to be useful in assessing the anatomical characteristics of many muscle groups and considered as an alternative proposal for function analysis and diaphragmatic thickness.The present study aimed to evaluate the impact of the addition of moderate to high intensity TMI associated with short-term aerobic and resistive exercise on diaphragmatic thickness in post-CABG patients in Phase II of CR. This was a randomized double-blind clinical trial involving 19 post-CABD patients randomly divided into intervention group (GI; n = 10) submitted to moderate to high intensity IMT associated with aerobic and resistance exercise, with progression of TMI and sham group (GS; n = 9) who performed IMT combined with aerobic and resistance exercise, whose IMT load was minimal and maintained constant for 12 weeks, twice weekly, 5 sets of 10 repetitions. Pre-and post-intervention were evaluated: initial evaluation (anamnesis), diaphragmatic thickness (ultrasonography), quality of life (MacNew QLMI), respiratory muscle strength (manovacuometry), functional capacity (distance walked in the 6-minute walk test - DPTC6M) , respiratory muscle resistance (incremental test and constant test) and palmar grip strength (FPP). In the statistical analysis, the normality of the variables was evaluated by the Shapiro-Wilk test. Continuous variables were presented in mean ± standard deviation (SD) and 95% confidence interval (95% CI), as well as categorical variables in absolute frequencies and percentages. The intragroup comparison was performed using Student's T-test. The comparison between groups was performed using two-way ANOVA. The size of the effect was determined from Cohen's d. The level of significance was 5% (p <0.05). There was a significant 13% increase in diaphragmatic muscle thickness in IG (0.02cm 95% CI 0.001 to 0.036, Cohen d 0.66). In relation to MIP, there was a significant increase of 31% in IG (26.60cmH2O 95% CI 16.37 to 36.8; Cohen d 0.38). The variable inspiratory muscle resistance showed a significant of 29% increase in the PimáxS in the GI (16.1cmH2O 95% CI 0.46 to 31.74, Cohen d 0.85). DPTC6M and PEmax showed a significant increase in both GI and GS, with no significant difference in comparison between groups. In the comparison between groups, no significant differences were observed for all evaluated outcomes. The results found in this study suggest that MRI of moderate to high intensity in the short term improved diaphragmatic thickness, maximal inspiratory pressure and sustained maximum inspiratory pressure in post- CABG patients. |
publishDate |
2019 |
dc.date.issued.fl_str_mv |
2019-08-09 |
dc.date.accessioned.fl_str_mv |
2023-03-24T12:52:00Z |
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2023-03-24T12:52:00Z |
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info:eu-repo/semantics/publishedVersion |
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info:eu-repo/semantics/masterThesis |
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masterThesis |
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publishedVersion |
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http://repositorio.ufsm.br/handle/1/28369 |
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http://repositorio.ufsm.br/handle/1/28369 |
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por |
language |
por |
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400800000008 |
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600 600 600 600 600 |
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Attribution-NonCommercial-NoDerivatives 4.0 International http://creativecommons.org/licenses/by-nc-nd/4.0/ |
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Universidade Federal de Santa Maria Centro de Ciências da Saúde |
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Programa de Pós-Graduação em Reabilitação Funcional |
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UFSM |
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Brasil |
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Ciências da Saúde |
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Universidade Federal de Santa Maria Centro de Ciências da Saúde |
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