ABSTRACT
Abstract Introduction Chronic obstructive pulmonary disease (COPD) not only restricts airflow but also induces sys-temic manifestations in individuals with the disease. Objective To evaluate the effect of a water-based aero-bic exercise program on respiratory muscle strength, thoracic mobility, dyspnea, and functional capacity in patients with COPD. Methods We conducted a blind randomized controlled trial with 22 patients with COPD, dividing them into a control group (CG) and a training group (TG). The TG participated in 24 sessions of a water aerobic exercise program, while the CG only partici-pated in the evaluations. Maximal respiratory pressure (MRP), dyspnea, and functional capacity were measured. Results When comparing the MRP values (cmH2O) in the pre- and post-training conditions, the results revealed a significant improvement in the TG [maximal inspiratory pressure (MIP): 74.8 ± 15.3 vs. 83.9 ± 17.2; maximal expi-ratory pressure (MEP): 141.5 ± 30.7 vs. 157.6 ± 32.9], whereas no difference was observed for the CG (MIP: 55.5 ± 21.8 vs. 54.4 ± 18.4; MEP: 116.2 ± 40.3 vs. 109.3 ± 38.9). Regarding thoracic mobility in the pre- and post-training conditions, no significant difference was found for the CG, whilst for the TG there was a significant in-crease at the axillary level (cm) (5.9 ± 1.8 vs. 7.7 ± 1.1). With respect to functional capacity, there was a signifi-cant increase in walking distance during the six-minute walking test only in the TG when comparing pre- and post-training conditions (462.1 ± 62.9 vs. 538.5 ± 63.7). Lastly, the dyspnea results demonstrated that after the training period there was a major reduction in the scores of Medical Research Council (3.1 ± 0.8 vs. 1.9 ± 0.7) and Borg CR-10 scales (5.2 ± 0.8 vs. 3.7 ± 0.3) only for the TG. Conclusion The water aerobic exercise training promoted beneficial changes in respiratory mus-cle strength, thoracic mobility, functional capacity and dyspnea among patients with COPD.
Resumo Introdução A doença pulmonar obstrutiva crônica (DPOC) não apenas restringe o fluxo aéreo, mas também induz mani-festações sistêmicas em indivíduos com a doença. Objetivo Avaliar o efeito de um programa de exercícios aeróbicos aquáticos na força muscular respiratória (FMR), mobilidade torácica, dispneia e capacidade funcional em pacientes com DPOC. Métodos Realizou-se um ensaio clínico randomizado cego com 22 pacientes com DPOC, divi-dindo-os em grupo controle (GC) e grupo treinamento (GT). O GT participou de 24 sessões de um programa de exercícios aeróbicos aquáticos, enquanto o GC participou somente das avaliações. Foram me-didas a pressão respiratória máxima, (PRM) dispneia e capa-cidade funcional. Resultados Ao comparar os valores da PRM (cmH2O) nas condições pré e pós-treinamento, os resultados revelaram melhora significativa no GT [pressão inspiratória má-xima (PImáx): 74,8 ± 15,3 vs. 83,9 ± 17,2; pressão expiratória máxima (PEmáx): 141,5 ± 30,7 vs. 157,6 ± 32,9], enquanto não observou-se diferença para o GC (PImáx: 55,5 ± 21,8; vs. 54,4 ± 18,4; PEmáx: 116,2 ± 40,3 vs. 109,3 ± 38,9). Em relação à mobilidade torácica nas condições pré e pós-treinamento, não foi encontrada diferença significativa para o GC, enquanto para o GT houve um aumento significante no nível axilar (cm) (5,9 ± 1,8 vs. 7,7 ± 1,1). Com relação à capacidade funcional, houve aumento significativo da distância percorrida durante o teste de caminhada de 6 minutos apenas no GT quando comparadas as condições pré e pós-treinamento (462,1 ± 62,9 vs. 538,5 ± 63,7). Por fim, os resultados da dispneia demonstraram que após o período de treinamento houve uma redução importante nas pontuações do Medical Research Council (3,1 ± 0,8 vs. 1,9 ± 0,7) e nas escalas Borg CR-10 (5,2 ± 0,8 vs. 3,7 ± 0,3) apenas para o GT. Conclusão O trei-namento físico aquático promoveu alterações benéficas na força muscular respiratória, mobilidade torácica, capacidade funcional e dispneia em pacientes com DPOC.
ABSTRACT
PURPOSE: Chronic obstructive pulmonary disease promotes systemic repercussions, which can be minimized with physical exercise. This study investigated the effects of a water-based aerobic interval training program on the autonomic modulation of heart rate (HR), quality of life (QoL), and functional capacity (FC) of patients with chronic obstructive pulmonary disease. METHODS: Nineteen patients with chronic obstructive pulmonary disease were enrolled in this randomized clinical trial and allocated to either the usual care group (n = 9) or training group (n = 10). Before and after 24 sessions of water-based physical training, the patients underwent evaluation of autonomic modulation of HR by analyzing the HR variability, QoL using the St George's Respiratory Questionnaire, and FC using 6-min walk test distance. RESULTS: The results showed significant improvement when comparing the variables of HR variability, QoL, and FC in the training group in the pre- and post-training conditions (P < .05). In the usual care group, there was no significant difference for any of the variables. Negative correlations were found between HR variability and QoL (r =-0. 55; P = .01) and 6-min walk test distance and QoL (r =-0.49; P = .02). CONCLUSION: Water-based physical training promoted beneficial adaptations in the autonomic modulation of HR, QoL, and FC of patients with chronic obstructive pulmonary disease.
