Treinamento muscular inspiratório na apneia obstrutiva do sono do idoso : ensaio clínico randomizado
Autor(a) principal: | |
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Data de Publicação: | 2018 |
Tipo de documento: | Tese |
Idioma: | por |
Título da fonte: | Biblioteca Digital de Teses e Dissertações da UFRGS |
Texto Completo: | http://hdl.handle.net/10183/188676 |
Resumo: | In obstructive sleep apnea (OSA), repeated efforts against the occluded airway overloads the inspiratory muscles. Age-related muscle fiber loss makes inspiratory force of older persons a subject of interest. The present study aims to gauge the effect of inspiratory muscle training (IMT) on the apnea-hypopnea index (AHI) of older persons with OSA. Methods: In a randomized trial 34 OSA patients, aged 65 years or older, were randomly allocated to IMT or sham-IMT groups. Subjects underwent 8 weeks of training consisting of 30 maximal inspirations followed by 15 minutes of tidal breathing through a PowerBreathe® device, respectively, loaded or unloaded twice daily. The load was increased every two weeks in the IMT group to keep it at 50-80% of the maximal inspiratory pressure (MIP). All patients repeated the respiratory polygraphy, diaphragm thickness (DT), spirometry, and manovacuometry at 8 weeks. Results: Patients in the IMT group completed the protocol with an average reduction in AHI of 1.6 events per hour (95% confidence interval -4.8 to 1.6). In the sham-IMT group the AHI increased by 3.9 events per hour (95%CI 0.1 to 7.7). Significant group×time interaction was observed in generalized estimating equations (GEE) model for AHI (P=0.023) and for MIP (P<0.001). No significant group×time interaction was observed for maximal expiratory pressure (P=0.069), spirometry (P=0.075) and DT (P=0.176). Conclusion: Although the IMT increased MIP in elderly persons, the reduction in AHI obtained suggests limited clinical usefulness if OSA therapy is intended. |
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Fischer, Marcia KraideMartinez, Denis2019-02-12T02:33:28Z2018http://hdl.handle.net/10183/188676001085519In obstructive sleep apnea (OSA), repeated efforts against the occluded airway overloads the inspiratory muscles. Age-related muscle fiber loss makes inspiratory force of older persons a subject of interest. The present study aims to gauge the effect of inspiratory muscle training (IMT) on the apnea-hypopnea index (AHI) of older persons with OSA. Methods: In a randomized trial 34 OSA patients, aged 65 years or older, were randomly allocated to IMT or sham-IMT groups. Subjects underwent 8 weeks of training consisting of 30 maximal inspirations followed by 15 minutes of tidal breathing through a PowerBreathe® device, respectively, loaded or unloaded twice daily. The load was increased every two weeks in the IMT group to keep it at 50-80% of the maximal inspiratory pressure (MIP). All patients repeated the respiratory polygraphy, diaphragm thickness (DT), spirometry, and manovacuometry at 8 weeks. Results: Patients in the IMT group completed the protocol with an average reduction in AHI of 1.6 events per hour (95% confidence interval -4.8 to 1.6). In the sham-IMT group the AHI increased by 3.9 events per hour (95%CI 0.1 to 7.7). Significant group×time interaction was observed in generalized estimating equations (GEE) model for AHI (P=0.023) and for MIP (P<0.001). No significant group×time interaction was observed for maximal expiratory pressure (P=0.069), spirometry (P=0.075) and DT (P=0.176). Conclusion: Although the IMT increased MIP in elderly persons, the reduction in AHI obtained suggests limited clinical usefulness if OSA therapy is intended.application/pdfporApneia obstrutiva do sonoIdosoExercícios respiratóriosDiafragmaEspirometriaObstructive apneaSleepElderlyTreatmentInspiratory muscle trainingTreinamento muscular inspiratório na apneia obstrutiva do sono do idoso : ensaio clínico randomizadoMuscular inspiratory training in sleep apnea : MARITSA Trialinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/doctoralThesisUniversidade Federal do Rio Grande do SulFaculdade de MedicinaPrograma de Pós-Graduação em Medicina: Ciências MédicasPorto Alegre, BR-RS2018doutoradoinfo:eu-repo/semantics/openAccessreponame:Biblioteca Digital de Teses e Dissertações da UFRGSinstname:Universidade Federal do Rio Grande do Sul (UFRGS)instacron:UFRGSTEXT001085519.pdf.txt001085519.pdf.txtExtracted Texttext/plain246489http://www.lume.ufrgs.br/bitstream/10183/188676/2/001085519.pdf.txtace0ad008f281efed6d8f8800927620dMD52ORIGINAL001085519.pdfTexto completoapplication/pdf2255047http://www.lume.ufrgs.br/bitstream/10183/188676/1/001085519.pdf43a84409235519b08c6473450fc082ffMD5110183/1886762022-04-05 04:42:21.938023oai:www.lume.ufrgs.br:10183/188676Biblioteca Digital de Teses e Dissertaçõeshttps://lume.ufrgs.br/handle/10183/2PUBhttps://lume.ufrgs.br/oai/requestlume@ufrgs.br||lume@ufrgs.bropendoar:18532022-04-05T07:42:21Biblioteca Digital de Teses e Dissertações da UFRGS - Universidade Federal do Rio Grande do Sul (UFRGS)false |
dc.title.pt_BR.fl_str_mv |
Treinamento muscular inspiratório na apneia obstrutiva do sono do idoso : ensaio clínico randomizado |
dc.title.alternative.en.fl_str_mv |
Muscular inspiratory training in sleep apnea : MARITSA Trial |
title |
Treinamento muscular inspiratório na apneia obstrutiva do sono do idoso : ensaio clínico randomizado |
spellingShingle |
Treinamento muscular inspiratório na apneia obstrutiva do sono do idoso : ensaio clínico randomizado Fischer, Marcia Kraide Apneia obstrutiva do sono Idoso Exercícios respiratórios Diafragma Espirometria Obstructive apnea Sleep Elderly Treatment Inspiratory muscle training |
title_short |
Treinamento muscular inspiratório na apneia obstrutiva do sono do idoso : ensaio clínico randomizado |
title_full |
Treinamento muscular inspiratório na apneia obstrutiva do sono do idoso : ensaio clínico randomizado |
title_fullStr |
Treinamento muscular inspiratório na apneia obstrutiva do sono do idoso : ensaio clínico randomizado |
title_full_unstemmed |
Treinamento muscular inspiratório na apneia obstrutiva do sono do idoso : ensaio clínico randomizado |
title_sort |
Treinamento muscular inspiratório na apneia obstrutiva do sono do idoso : ensaio clínico randomizado |
author |
Fischer, Marcia Kraide |
author_facet |
Fischer, Marcia Kraide |
author_role |
author |
dc.contributor.author.fl_str_mv |
Fischer, Marcia Kraide |
dc.contributor.advisor1.fl_str_mv |
Martinez, Denis |
contributor_str_mv |
Martinez, Denis |
dc.subject.por.fl_str_mv |
Apneia obstrutiva do sono Idoso Exercícios respiratórios Diafragma Espirometria |
topic |
Apneia obstrutiva do sono Idoso Exercícios respiratórios Diafragma Espirometria Obstructive apnea Sleep Elderly Treatment Inspiratory muscle training |
dc.subject.eng.fl_str_mv |
Obstructive apnea Sleep Elderly Treatment Inspiratory muscle training |
description |
In obstructive sleep apnea (OSA), repeated efforts against the occluded airway overloads the inspiratory muscles. Age-related muscle fiber loss makes inspiratory force of older persons a subject of interest. The present study aims to gauge the effect of inspiratory muscle training (IMT) on the apnea-hypopnea index (AHI) of older persons with OSA. Methods: In a randomized trial 34 OSA patients, aged 65 years or older, were randomly allocated to IMT or sham-IMT groups. Subjects underwent 8 weeks of training consisting of 30 maximal inspirations followed by 15 minutes of tidal breathing through a PowerBreathe® device, respectively, loaded or unloaded twice daily. The load was increased every two weeks in the IMT group to keep it at 50-80% of the maximal inspiratory pressure (MIP). All patients repeated the respiratory polygraphy, diaphragm thickness (DT), spirometry, and manovacuometry at 8 weeks. Results: Patients in the IMT group completed the protocol with an average reduction in AHI of 1.6 events per hour (95% confidence interval -4.8 to 1.6). In the sham-IMT group the AHI increased by 3.9 events per hour (95%CI 0.1 to 7.7). Significant group×time interaction was observed in generalized estimating equations (GEE) model for AHI (P=0.023) and for MIP (P<0.001). No significant group×time interaction was observed for maximal expiratory pressure (P=0.069), spirometry (P=0.075) and DT (P=0.176). Conclusion: Although the IMT increased MIP in elderly persons, the reduction in AHI obtained suggests limited clinical usefulness if OSA therapy is intended. |
publishDate |
2018 |
dc.date.issued.fl_str_mv |
2018 |
dc.date.accessioned.fl_str_mv |
2019-02-12T02:33:28Z |
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info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/doctoralThesis |
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doctoralThesis |
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publishedVersion |
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http://hdl.handle.net/10183/188676 |
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001085519 |
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por |
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