ABSTRACT
Objective:To explore any effect of high-intensity inspiratory muscle resistance training on exercise capacity and life quality for persons with bronchiectasis.Methods:Sixty patients with bronchiectasis were randomly divided into an observation group and a control group, each of 30. The observation group received two 30-minute sessions of inspiratory muscle resistance training daily using the PowerBreak inspiratory muscle trainer 3 days/week for 8 weeks. The intensity was 70% of the maximum inspiratory pressure (MIP). The control group underwent the same training with the intensity at 10% of the MIP. The severity of illness, pulmonary function, respiratory muscle strength and endurance, exercise capacity and life quality of the two groups were evaluated before and after the intervention.Results:Compared with before the intervention, the average MIP in the observation group and the average distance they walked in the 6min walk test (6MWT) improved significantly. Their average social factor score on the Leicester cough questionnaire had increased significantly, while their average heart rate and self-perceived exertion during the 6MWT had decreased significantly. There were no significant differences in any of these indicators for the control group.Conclusions:High-intensity inspiratory muscle resistance training can significantly improve the exercise capacity and life quality of patients with bronchiectasis. The treatment is worthy of further research and application in the clinic.
ABSTRACT
Introdução: A prática regular de atividade física está associada com melhora do estado de saúde, aumento da capacidade funcional, aumento da força muscular e redução da mortalidade por doenças cardíacas. Apesar dos benefícios de a prática regular de exercício físico estarem consolidados na literatura, as adaptações na força e resistência dos músculos inspiratórios são controversas. Objetivo: Testar a hipótese que não há diferença da força e resistência dos músculos inspiratórios entre indivíduos ativos e sedentários. Métodos:Estudo observacional de corte transversal. Avaliou-se indivíduos entre 18 e 30 anos, ambos os sexos e saudáveis. Os voluntários foram divididos em ativos e sedentários de acordo a classificação da American College of Sports Medicine (ACMS). Os indivíduos tiveram a força máxima dos músculos inspiratórios (FMI) determinada através do dispositivo POWERbreathe® K5 inspiratory muscle trainer, que intula esta variável como Sindex. A resistência dos músculos inspiratórios foi avaliada través de um teste incremental. Para comparação das médias foi aplicada o teste t de student para distribuição simétrica, p< 0,05. O estudo foi aprovado pelo comitê de ética em pesquisa com CAAE : 37781014.4.0000.5544. Resultados: Foram avaliados 92 indivíduos, destes 55 (60%) foram classificados como ativos e 57 (62%) do sexo masculino. Ao realizar a comparação do Sindex entre ativos e sedentários (128±26; 119±24 cmH2O; p=0,85) e da exaustão no teste incremental (65ï±16% e 60ï±16%;p=0,095), respctivamente. Conclusão: Os indivíduos ativos não apresentam músculos inspiratórios mais fortes e resistentes quando comparados com sedentários. [AU]
Introduction: The regular practice of physical activity is associated with improved health status, increased functional capacity, increased muscle strength and reduced mortality from heart disease. Although the benefits of regular exercise are well established in the literature, adaptations in inspiratory muscle strength and endurance are controversial. Objective: To test the hypothesis that there is no difference in the strength and resistance of the inspiratory muscles between active and sedentary individuals. Methods: Cross-sectional observational study. It was evaluated individuals between 18 and 30 years old, both sexes and healthy. The volunteers were divided into active and sedentary according to the classification of the American College of Sports Medicine (ACMS). Individuals had maximal inspiratory muscle strength (IMS) determined through the POWERbreathe® K5 inspiratory muscle trainer, which injects this variable as Sindex. The inspiratory muscle strength was evaluated through an incremental test. For the comparison of the means the student's t-test was applied for symmetrical distribution, p <0.05. The study was approved by the research ethics committee with CAAE: 37781014.4.0000.5544. Results: A total of 92 individuals were evaluated. Of these, 55 (60%) were classified as active and 57 (62%) were male. When comparing Sindex between active and sedentary (128 ± 26/119 ± 24 cmH2O, p = 0.85) and exhaustion in the incremental test (63.2 ± 16.1%. p = 0.095), respectively. Conclusion: Active individuals do not present stronger and stronger inspiratory muscles when compared to sedentary ones. [AU]
Subject(s)
Muscle Strength , MusclesABSTRACT
Dyspnea and decreased exercise capacity are the main factors that limit the daily living activities in patients with chronic respiratory diseases. The cardinal symptoms limiting exercise capacity in most patients with chronic obstructive pulmonary disease (COPD) are dyspnea and fatigue, which could be caused by alveolar ventilation and gas exchange disturbances, skeletal muscle dysfunction and/or cardiovascular failure. Anxiety, lack of motivation and depression were also associated with reduced exercise capacity, probably affecting the perception of symptoms. The relationship between psychological status and mood disorders in patients with COPD and exercise tolerance is complex and not yet fully understood. The origin of the exercise capacity limitation in COPD patients is multifactorial, so the separation of the variables involved for academic purposes is not always feasible. The pathogenic mechanisms may interact in complex ways, as an example, muscle deconditioning and hypoxemia can increase alveolar ventilation causing exercise limitation. Therefore, physical training and supplemental oxygen can reduce ventilatory limitation during exercise without changing lung function and maximum ventilatory capacity. The analysis of these factors could potentially identify reversible conditions that can improve the exercise performance and quality of life ofpatients with COPD, such as hypoxemia, bronchospasm, heart failure, arrhythmias, musculoskeletal dysfunction and myocardial ischemia. This review examines the principal mechanisms contributing to physical activity limitation in patients with COPD: alveolar ventilation and gas exchange abnormalities, cardiovascular and musculoskeletal system dysfunction, and respiratory muscles dysfunction.
La disnea y la disminución de la capacidad de realizar ejercicio son los principales factores que limitan las actividades de la vida diaria en pacientes con enfermedades respiratorias crónicas. Los síntomas cardinales que limitan la capacidad de ejercicio en la mayoría de los pacientes con enfermedad pulmonar obstructiva crónica (EPOC) son la disnea y/o fatigabilidad, los cuales pueden ser ocasionados por trastornos de la ventilación alveolar e intercambio gaseoso, disfunción de los músculos esqueléticos y/o falla cardiovascular. La ansiedad, falta de motivación y depresión también han sido asociadas a una menor capacidad de realizar ejercicio, probablemente afectando la percepción de los síntomas. La relación entre el estado psicológico y los trastornos del ánimo en pacientes con EPOC y la tolerancia al ejercicio es compleja y aún no ha sido completamente dilucidada. El origen de la limitación de la capacidad de ejercicio en pacientes con EPOC es multifactorial, por lo cual la separación de las variables involucradas con fines académicos no siempre es factible realizarlo en los pacientes. Los mecanismos patogénicos pueden relacionarse en forma compleja, a modo de ejemplo, el desacondicionamiento físico y la hipoxemia pueden contribuir a aumentar la ventilación alveolar ocasionando limitación del ejercicio de causa ventilatoria. Por lo tanto, el entrenamiento físico y el suplemento de oxígeno pueden reducir la limitación ventilatoria durante el ejercicio sin modificar la función pulmonar o la capacidad ventilatoria máxima. El análisis de los factores limitantes de la capacidad de ejercicio permite identificar trastornos potencialmente reversibles que pueden mejorar la calidad de vida de los enfermos, tales como la hipoxemia, broncoespasmo, insuficiencia cardiaca, arritmias, disfunción musculoesquelética y/o isquemia miocárdica. En esta revisión se examinan los principales mecanismos que contribuyen a la limitación de la actividad física en pacientes con EPOC:...