Made available in DSpace on 2015-04-14T13:53:23Z (GMT). No. of bitstreams: 1 409899.pdf: 394958 bytes, checksum: 725eceacf76d56711ddf95f28b391161 (MD5) Previous issue date: 2008-03-11 / Introdu??o: O envelhecimento est? associado com a perda progressiva do desempenho do sistema ventilat?rio. A avalia??o da for?a da musculatura ventilat?ria ? importante para monitoramento das altera??es nas press?es ventilat?rias. No entanto, os valores de normalidade da press?o inspirat?ria m?xima (PIM) e da press?o expirat?ria m?xima (PEM) ainda s?o controversos na literatura. Objetivo: Verificar os valores da PIM e PEM em indiv?duos idosos. M?todos: A amostra foi definida atrav?s de um mapeamento distrital da cidade de Porto alegre, onde foram selecionados indiv?duos com idade igual ou superior a 60 anos, de forma randomizada, respeitando a proporcionalidade de cada regi?o. Foram inclu?dos neste estudo 509 indiv?duos, com idade igual ou superior a 60 anos, divididos em tr?s faixas et?rias, nos quais foram avaliados medidas de PIM e PEM atrav?s de manovacuometria. Resultados e conclus?es: os resultados indicam que as press?es ventilat?rias geradas pelos homens s?o maiores do que as mulheres nas tr?s faixas et?rias estudadas, que as press?es ventilat?rias apresentam correla??o negativa com a idade e que o efeito do aprendizado parece afetar mais mulheres do que os homens e apenas da primeira medida em rela??o ?s outras

Submitted by Setor de Tratamento da Informa??o - BC/PUCRS (tede2@pucrs.br) on 2016-05-17T11:17:38Z No. of bitstreams: 1 DIS_CRISTHIELE_TAIS_WOSZEZENKI_PARCIAL.pdf: 460185 bytes, checksum: 0a97ea104058f0cf129ef176df86e909 (MD5) / Made available in DSpace on 2016-05-17T11:17:38Z (GMT). No. of bitstreams: 1 DIS_CRISTHIELE_TAIS_WOSZEZENKI_PARCIAL.pdf: 460185 bytes, checksum: 0a97ea104058f0cf129ef176df86e909 (MD5) Previous issue date: 2016-03-28 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior - CAPES / Objectives: To generate reference values for two inspiratory muscle endurance protocols (IME) in healthy children and adolescents. Methods: An observational, cross-sectional study was conducted including healthy children and adolescents between 4 and 18 years old. Body weight, height, maximal inspiratory pressure (MIP) and IME (using two protocols) measurements were performed. In the incremental threshold loading a fixed load of 30% of the MIP with an increase of 10% every 2 minutes was used. In the a fixed load of 70% of the MIP was used and the time limit (Tlim) to exhaustion was measured. Results: In total, 462 participants were included, 281 performed the incremental threshold loading and 181 the maximum load protocol. There were moderate and positive correlations between IME and age, MIP, height and weight in the incremental threshold loading. However, the regression model showed that MIP and age were the best variables to predict RMI. In the maximum load protocol, weak and positive correlations with age, weight and height were found. In the regression model for this protocol, only age and height influenced the endurance. The prediction power (R2) for the incremental threshold loading was 0.65, while for the maximum load protocol was 0.15. Reproducibility measured by the intraclass correlation coefficient (ICC) was higher in the incremental threshold loading (0.96) compared to the maximum load protocol (0.69). Conclusion: The IME in healthy children and adolescents can be explained by age, height and MIP. The incremental threshold loading showed better results and should be the model of choice when evaluating IME in the pediatric age group. / Objetivos: Gerar valores de refer?ncia para dois protocolos de resist?ncia muscular inspirat?ria (RMI) em crian?as e adolescentes saud?veis. M?todos: Estudo observacional, transversal, em crian?as e adolescentes saud?veis de 4 a 18 anos. Foram realizadas as mensura??es de peso, altura, press?o inspirat?ria m?xima (PIMAX) e RMI, utilizando-se dois protocolos. No protocolo de carga incremental foi utilizada uma carga fixa de 30% da PIMAX com incremento de 10% a cada 2 minutos. J? no protocolo de carga m?xima foi utilizada uma carga fixa de 70% da PIMAX e mensurado o tempo limite (Tlim) alcan?ado at? a exaust?o. Resultados: Foram inclu?dos 462 participantes, sendo 281 correspondentes ao protocolo de carga incremental e 181 ao de carga m?xima. No protocolo de carga incremental, houve correla??es moderadas e positivas entre a RMI e a idade, PIMAX, peso e altura. No entanto, o modelo de regress?o demonstrou que a PIMAX e a idade foram as melhores vari?veis para predi??o da RMI. J? no protocolo de carga m?xima, foram encontradas correla??es fracas e positivas com a idade, peso e altura. No modelo de regress?o, apenas a idade e altura influenciaram na endurance. A for?a de predi??o (R2) do protocolo de carga incremental foi de 0,65, enquanto o de carga m?xima foi de 0,15. A reprodutibilidade mensurada pelo coeficiente de correla??o intraclasse (ICC) foi maior no protocolo incremental (0,96) em compara??o ao de carga m?xima (0,69). Conclus?o: A RMI em crian?as e adolescentes saud?veis pode ser explicada em fun??o da idade, altura e PIMAX. O protocolo de carga incremental apresentou melhores resultados e deve ser o modelo de escolha para avalia??o da RMI na faixa et?ria pedi?trica.

Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2016-04-15T22:11:58Z No. of bitstreams: 1 IngridGuerraAzevedo_DISSERT.pdf: 2031705 bytes, checksum: eb74d521336e77556d793f40b4e8a342 (MD5) / Approved for entry into archive by Arlan Eloi Leite Silva (eloihistoriador@yahoo.com.br) on 2016-04-20T00:46:41Z (GMT) No. of bitstreams: 1 IngridGuerraAzevedo_DISSERT.pdf: 2031705 bytes, checksum: eb74d521336e77556d793f40b4e8a342 (MD5) / Made available in DSpace on 2016-04-20T00:46:41Z (GMT). No. of bitstreams: 1 IngridGuerraAzevedo_DISSERT.pdf: 2031705 bytes, checksum: eb74d521336e77556d793f40b4e8a342 (MD5) Previous issue date: 2014-10-21 / O objetivo deste estudo foi estabelecer um padr ? o de normaliza??o da eletromiografia de superf?cie para os m?sculos respirat?rios esternocleidom astoideo (ECOM), escaleno (ESC) e reto abdominal ( RA ) . M?todos : Foram avaliados sujeitos saud?veis em rela??o a dados antropom?tricos, espirometria e s EMG durante a execu??o de cinco manobras distintas : sniff teste, press?o inspirat?ria m?xima (PIm?x), press?o expirat?ria m?xima (PEm?x) e c ontra? ? o Volunt?ria M ? xima Isom?trica (CVMI) dos m?sculos RA , ECOM e ESC. Para coloca??o dos eletrodos, a pele foi preparada com abras?o, seg uida de tricotomia, nas seguintes regi?es para aquisi??o dos sinais de eletromiografia: (1) ECOM: ter?o inferior da dist?ncia entre o processo mastoide e a articula??o esternoclavicular; (2) ESC: 5 cm para a direita a partir da articula??o esternoclavicula r e, neste ponto, 2 cm para cima e (3 ) RA : ao n?vel da cicatriz umbilical, 4 cent?metros ? direita . Na an?lise das vari?veis eletromiogr?ficas, a normalidade dos dados foi avaliada pelo teste Shapiro - Wilk . Compara??es entre as manobras inspirat?rias estudadas foram realizadas por meio do teste de Friedman e para manobras expirat?rias, teste de Mann Whitney . Ao dividir a amostra entre homens e mulheres, foi aplicado o teste de Mann - Whitney e Teste t de student de acordo com a normalidade dos dados . Re sultados : 35 sujeitos aceitaram participar do estudo, mas 5 foram exclu?dos ( IMC>25 kg/m? ) . A amostra foi composta por 30 sujeitos (1 5 mulheres), idade m?dia 25,7 ? 6,42 anos , IMC 22,2 ? 1,73 kg/m? e ?ndices espirom?tricos dentro dos limites considerados normais. A CVMI para os m?sculos ECOM, ESC e RA foi a que apresentou maior valor de RMS . Conclus?o: A manobra de CVMI para ECOM, ESC e RA foi a que apresentou maiores valores de RMS . Quando comparamos a RMS das manobras estudadas entre os grupos, n?o houve diferen?a significativa entre eles. / Aim : To evaluate and to standardize surface electromyography (sEMG) normalization procedures for respiratory muscles by comparing muscle activation during Maximal Voluntary Isometric Contraction (MVIC) and Maximal Respiratory Pressures (MIP, MEP and sniff test). Methods: Healthy subjects were evalua ted regarding demographics, spirometry and sEMG during the five maneuvers: sniff test, MIP , MEP and Maximal Voluntary Isometric C ontraction (MVIC) of RA, SCM and SC A . For electrode placement, skin was prepared with abrasion, followed by shaving in the foll owing regions for acquisition of el ectromyographic signals: (1) SC M: lower third of the distance between the mastoid process and t he sternoclavicular joint; (2) SC A : 5 cm to the right from the sternoclavicular joint and at this point, up to 2 cm; and (3 ) RA: the level of umbilicus, 4 cm to the right. In electromyographic variables analysis , the data normality was assessed by Shapiro - Wilk test. Comparisons among studied maneuvers were performed by Friedman Test and Dunn?s post - hoc for multiple comparisons a mong inspiratory maneuvers, and Mann Whitney test for expiratory maneuvers. Subgroups differences between genders were performed by Student's t test or Mann - Whitney test according to data normality. Results: 35 subjects participated in the study, b ut 5 we re excluded (BMI> 25 kg/ m?). Sample consisted of 30 subjects (1 5 women), mean age 27.3?7.43 years, BMI 22.2 ? 1.69 kg/m? and spirometric indices within normal limits. Specific MVIC for SCM, SCA and RA showed the highest RMS. When we grouped sample into gender we found no difference among RMS values for the studied SCM maneuvers, while for SCA, MVIC SCM / SCA was the one with the highest RMS and for RA, MVIC RA in men. Once considering women, MVIC SCM/SCA showed the highest RMS for SCM, SCA and MVIC RA showed t he highest value for RA. Conclusion: MVIC for SCM, SCA and RA muscles showed the highest RMS values. When comparing RMS between the studied groups, there was no significant difference between men and women.

Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2017-04-27T20:40:34Z No. of bitstreams: 1 VictorHugoBritoDeOliveira_DISSERT.pdf: 277158 bytes, checksum: 0ba49c674fe5f359024d07446ff0cf55 (MD5) / Approved for entry into archive by Arlan Eloi Leite Silva (eloihistoriador@yahoo.com.br) on 2017-04-27T20:50:43Z (GMT) No. of bitstreams: 1 VictorHugoBritoDeOliveira_DISSERT.pdf: 277158 bytes, checksum: 0ba49c674fe5f359024d07446ff0cf55 (MD5) / Made available in DSpace on 2017-04-27T20:50:43Z (GMT). No. of bitstreams: 1 VictorHugoBritoDeOliveira_DISSERT.pdf: 277158 bytes, checksum: 0ba49c674fe5f359024d07446ff0cf55 (MD5) Previous issue date: 2016-01-18 / Introdu??o: O treinamento muscular inspirat?rio (TMI) tem sido considerado uma op??o na revers?o ou preven??o da diminui??o da for?a dos m?sculos respirat?rios, com v?rios efeitos positivos em diversas popula??es. Objetivo: Verificar a toler?ncia ao exerc?cio, for?a muscular respirat?ria e espessura e mobilidade diafragm?tica antes e ap?s o protocolo de TMI de carga baixa e moderada intensidade de 9 semanas. Metodologia: Em um ensaio cl?nico controlado, randomizado e duplo-cego, 24 participantes de ambos os sexos, idade entre 18 e 29 anos, saud?veis, sedent?rios foram divididos em dois grupos: Treinamento (G55%) e Controle (G10%). Foram realizados o teste do degrau de seis minutos (TD6), manovacuometria, espirometria e ultrassonografia do m?sculo diafragma. O grupo treinamento (G55%) realizou o protocolo com carga de 55% da PIm?x e o grupo controle (G10%) com 10%. Todos treinaram 2x por dia, 6x por semana, durante 9 semanas com reavalia??o da PIm?x a cada duas semanas para reajuste de carga. Os dados foram analisados atrav?s do programa SPSS 20.0 com n?vel de signific?ncia de 5%. Resultados: Houve melhora significativa na quantidade de degraus subidos (G55%: p=0,03; G10% p=0,001) for?a muscular inspirat?ria (G55%: p=0,020; G10%: p=0,010), frequ?ncia card?aca (G10%: p=0,025) e redu??o da percep??o de dispneia (G10%: p=0,032). N?o foi verificada diferen?a significativa na for?a muscular expirat?ria (G55%: p=0,089; G10%: p=0,242), espessura do diafragma em CRF (G55%: p=0,070; G10% p=0,857), espessura do diafragma em CPT (G55%: p=0,480; G10%: p=0,551) e mobilidade (G55%: p=0,317; G10%: p=0,057). Houve diferen?a intergrupo apenas na PIm?x no momento p?s treinamento (p=0,032) Conclus?o: Protocolos com cargas leve e moderada promovem melhora na for?a muscular inspirat?ria e no desempenho do TD6, no entanto n?o houve diferen?a intergrupo. O protocolo utilizado n?o foi capaz de promove altera??es morfol?gicas no diafragma. / Background: The inspiratory muscle training (IMT) is an option for increased respiratory muscle strength, with several positive effects in various populations. Objective: Evaluate exercise tolerance, respiratory muscle strength and thickness and diaphragmatic mobility before and after IMT protocol of 9 weeks. Methodology: In a controlled clinical trial, randomized, double-blind, 24 participants were divided into two groups: Training (G55%) and control (G10%). It was performed the six-minute step test (TD6), manometer, spirometry and ultrasound of the diaphragm. The training group (G55%) held the protocol with 55% MIP load and the control group (G10%) with 10%. All trained 2x a day, 6 times per week for 9 weeks with reassessment of MIP every two weeks for load adjustment. Data were analyzed using the SPSS 20.0 program with 5% significance level. Results: There was a significant difference in the amount of steps ascended (G55%: p=0.03; G10%: p=0.001) inspiratory muscle strength (G55%: p=0.02; G10%: p=0.01), variation heart rate (G10%: p=0.025) and perception of dyspnea (G10%: p=0.032). There was no significant difference in expiratory muscle strength (G55%: p=0.089; G10%: p=0.242), thickness CRF (G55%: p=0.070; G10% p=0.857), thickness of CPT (G55%: p=0.480; G10%: p =0.551) and mobility (G55%: p=0.317; G10%: p=0.057). There was only intergroup difference in MIP in the post training time (p=0.032). Conclusion: Protocols with mild and moderate loads promote improvement in inspiratory muscle strength and performance of the TD6, however there was no intergroup difference. The protocol used was not able to promote morphological changes in the diaphragm.

Made available in DSpace on 2015-04-14T13:32:57Z (GMT). No. of bitstreams: 1 437894.pdf: 860608 bytes, checksum: 959e5f29761ace404c63333ec242952c (MD5) Previous issue date: 2012-03-15 / The evaluation of respiratory muscle strength is a noninvasive and easily applicable method, used for the measurement of maximal inspiratory pressure (MIP) and maximal expiratory pressure (MEP). However, there are no reference values for children in preschool age, which makes it difficult to standardize the results and complicates the assessment of respiratory muscle function. Thus, the objective of present study was to generate reference values for respiratory muscle strength in healthy children and adolescents aged between three to twelve years old. Participants were recruited from three schools and selected after a respiratory disease questionnaire analysis and attainment of informed and written consent by parents or guardians. All participants included in the study had normal spirometry and measures of height and weight were performed in the same day. The evaluation of respiratory muscle strength was performed by a single examiner following the guidelines for pulmonary function tests. The association between MIP and MEP values with the potential predictive variables was analyzed using a multiple linear regression model. A total of 171 participants were selected and distributed evenly by age. The age, height, weight and FVC showed moderate to strong correlations with both respiratory pressures. However, the regression model showed that the height and weight were the best variables to predict MIP in both sexes and age and weight to predict MEP. The power of prediction (R2) ranged from 46 to 58%. The intraclass correlation coefficient was used in a subgroup and demonstrated an excellent reproducibility between tests. In conclusion, the results of present study demonstrate that the behavior of respiratory muscle strength in healthy preschool and school children can be explained by age, height and weight. / A avalia??o da for?a muscular respirat?ria ? um m?todo n?o invasivo e de f?cil aplicabilidade, utilizado para a mensura??o da press?o inspirat?ria m?xima (PIMAX) e da press?o expirat?ria m?xima (PEMAX). No entanto, ainda n?o existem valores de refer?ncia para crian?as em idade pr?-escolar, impossibilitando a normaliza??o dos resultados obtidos e dificultando a avalia??o da fun??o muscular respirat?ria. Assim, o objetivo deste estudo foi gerar valores de refer?ncia para a for?a muscular respirat?ria em crian?as e adolescentes saud?veis de tr?s a doze anos de idade. Os participantes foram recrutados atrav?s de tr?s escolas e selecionados ap?s an?lise do question?rio de doen?as respirat?rias e assinatura do termo de consentimento pelos pais ou respons?veis. Todos os participantes inclu?dos no estudo possu?am exame espirom?trico normal e medidas de peso e altura no dia da mensura??o. A avalia??o da for?a muscular respirat?ria foi realizada por um ?nico avaliador seguindo as diretrizes para testes de fun??o pulmonar. A associa??o entre os valores de PIMAX e PEMAX com as potenciais vari?veis preditoras foram analizadas utilizando-se um modelo de regress?o linear m?ltipla. Um total de 171 participantes foram selecionados e distribu?dos uniformemente por faixa et?ria. A idade, altura, peso e CVF apresentaram correla??es de moderada ? forte com ambas as press?es respirat?rias. No entanto, o modelo de regress?o demonstrou que a altura e o peso foram as melhores vari?veis para predi??o da PIMAX em ambos os sexos e o peso e a idade para a PEMAX. A for?a de predi??o (R2) variou de 46 a 58%. O coeficiente de correla??o intraclasse foi utilizado em um subgrupo e demonstrou excelente reprodutibilidade entre os testes. Em conclus?o, os resultados do presente estudo demonstram que o comportamento da for?a muscular respirat?ria em pr?-escolares e escolares saud?veis pode ser explicado em fun??o da idade, altura e peso.

Made available in DSpace on 2015-04-14T13:33:08Z (GMT). No. of bitstreams: 1 456334.pdf: 876900 bytes, checksum: 9a3a16228d37d2decb9f9e991320abe6 (MD5) Previous issue date: 2014-03-05 / Objectives : To evaluate inspiratory muscle strength and endurance in children and adolescents with cystic fibrosis (CF) in comparison with healthy subjects. Methods : This cross-sectional observational study evaluated CF patients (6 to 18 years old) and healthy subjects paired in a 1:2 proportion, for sex, age, height and weight. Spirometry, impulse oscillometry, plethysmography, manovacuometry and a protocol of inspiratory muscle endurance were performed. Data were analyzed using Student s t test and Pearson correlation coefficient. Results : Thirty four patients with CF were included in the study with a mean age of 12.6?2.9 years and twenty of them were boys (58.8%). The mean percentage of maximal inspiratory pressure (MIP%) was 118.5?25.8 and the endurance (percentage of MIP) was 60.9?13.3. Sixty eight healthy subjects were included and they presented a mean MIP% of 105.8?18.0 and an endurance of 65.3?12.3 of. CF patients had higher MIP% than healthy subjects and no significant difference in the endurance was shown. When restricting the analysis to CF patients without colonization by Pseudomonas aeruginosa and with forced expiratory volume in one second (FEV1) greater than 80% of predicted values, MIP% values were significantly higher and inspiratory muscle endurance was lower, in comparison with the control group. MIP correlated more significantly with forced vital capacity (r=0.44, p=0.01) and FEV1 (r=0.41, p=0.01), while endurance correlated better with total airway resistance (r=0.35, p=0.04) and with central airway resistance (r=0.48, p=0.04). Conclusion : Children and adolescents with CF present changes in inspiratory muscle strength and endurance that are associated differently with levels of pulmonary impairment. Furthermore, the significant strength associations are better related to pulmonary function parameters, while endurance is to airway resistance. / M?todos : Estudo observacional, transversal, em pacientes com FC (6 a 18 anos) e indiv?duos saud?veis pareados na propor??o de 1:2 por sexo, idade, altura e peso. Foram realizados espirometria, oscilometria de impulso, pletismografia, manovacuometria e protocolo de endurance muscular inspirat?ria. Para an?lise de dados utilizou-se os testes t de student e a correla??o linear de Pearson. Resultados : Foram inclu?dos 34 pacientes com FC, m?dia de idade de 14,0?2,7, sendo 20 pacientes (58,8%) do sexo masculino, com m?dia de press?o inspirat?ria m?xima percentual (PIMAX%) de 118,5?25,8 e de endurance (percentual da PIMAX) de 60,9?13,3. Tamb?m foram inclu?dos 68 indiv?duos saud?veis com m?dia de PIMAX% de 105,8?18,0 e de endurance de 65,3?12,3. Os pacientes com FC apresentaram maior PIMAX% do que os saud?veis e n?o apresentaram diferen?a significativa na endurance. Ao analisar separadamente os pacientes com FC sem coloniza??o por Pseudomonas aeruginosa e com volume expirat?rio for?ado no primeiro segundo (VEF1) maior do que 80% do previsto a PIMAX% foi significativamente maior nos pacientes com FC e a endurance muscular inspirat?ria foi menor em compara??o com os saud?veis. A PIMAX se correlacionou com capacidade vital for?ada (r=0,44; p=0,01) e com VEF1 (r=0,41; p=0,01) e a endurance se correlacionou com resist?ncia total das vias a?reas (r=0,35; p=0,04) e com a resist?ncia central das vias a?reas (r=0,48; p=0,04). Conclus?o : Crian?as e adolescentes com FC apresentam altera??es da for?a e da endurance muscular inspirat?ria que s?o distintas em diferentes n?veis de comprometimento pulmonar. Al?m disso, a for?a parece estar mais relacionada com par?metros da fun??o pulmonar e a endurance com a resist?ncia das vias a?reas.

Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2016-08-25T20:50:26Z No. of bitstreams: 1 RafaelaPedrosa_TESE.pdf: 1323757 bytes, checksum: 727bbc784837359d1c499ef30f3fc2ba (MD5) / Approved for entry into archive by Arlan Eloi Leite Silva (eloihistoriador@yahoo.com.br) on 2016-08-26T20:53:53Z (GMT) No. of bitstreams: 1 RafaelaPedrosa_TESE.pdf: 1323757 bytes, checksum: 727bbc784837359d1c499ef30f3fc2ba (MD5) / Made available in DSpace on 2016-08-26T20:53:53Z (GMT). No. of bitstreams: 1 RafaelaPedrosa_TESE.pdf: 1323757 bytes, checksum: 727bbc784837359d1c499ef30f3fc2ba (MD5) Previous issue date: 2016-01-18 / Introdu??o: O treinamento muscular inspirat?rio (TMI) tem sido considerado uma op??o na revers?o ou preven??o da diminui??o da for?a dos m?sculos respirat?rios, no entanto, pouco se sabe sobre as adapta??es desses m?sculos decorrentes do treinamento com carga. Objetivos: Investigar o efeito do TMI sobre a adapta??o neural e estrutural do m?sculo diafragma, em jovens sedent?rios, comparar os efeitos do TMI de intensidade leve com os do TMI de intensidade moderada sobre a espessura, mobilidade e atividade el?trica do diafragma e na for?a dos m?sculos inspirat?rios e estabelecer um protocolo para a realiza??o de uma revis?o sistem?tica com a finalidade de avaliar os efeitos do treinamento muscular respirat?rio em crian?as e adultos com doen?as neuromusculares. Materiais e M?todos: Ensaio cl?nico controlado, randomizado e duplo-cego, com uma amostra de 28 adultos jovens, saud?veis e sedent?rios, divididos em dois grupos: treinamento com carga leve (G10%) e treinamento com carga moderada (G55%). Os volunt?rios realizaram, durante 9 semanas, um protocolo de TMI domiciliar, com o POWERbreathe?. O G55% treinou com carga de 55% press?o inspirat?ria m?xima (PIm?x) e o G10% utilizou uma carga de 10% da PIm?x. O treinamento foi realizado em sess?es de 30 repeti??es, duas vezes/dia, seis dias/semana. A cada duas semanas foi avaliada a PIm?x e reajustada a carga. A amostra foi submetida, antes e ap?s o TMI, ? avalia??o atrav?s de ultrassonografia, eletromiografia de superf?cie, espirometria e manovacuometria. Os dados foram analisados pelo SPSS 20.0, foram realizados o Teste t-Student para amostras pareadas para comparar espessura diafragm?tica, PIm?x e PEm?x antes e ap?s o protocolo de TMI e Wilcoxon para comparar os valores de RMS e frequ?ncia mediana (Fmed) tamb?m antes e ap?s protocolo de treinamento. Em seguida, foram realizados o Teste t-Student para amostras independentes para comparar mobilidade e espessura diafragm?tica, PIm?x e PEm?x entre os dois grupos e o teste de Mann-Whitney para comparar os valores de RMS e Fmed tamb?m entre os dois grupos. Paralelamente ao estudo experimental, foi desenvolvido um protocolo com apoio da Colabora??o Cochrane sobre TMI em pessoas com doen?as neuromusculares. Resultados: Houve, nos dois grupos, aumento da for?a muscular inspirat?ria (P<0,05) e expirat?ria no G10% (P=0,009), aumento no RMS e espessura do m?sculo relaxado no G55% (P=0,005; P=0,026) e n?o houve altera??o na FMed (P>0,05). A compara??o entre os dois grupos demonstrou diferen?a no valor RMS (P=0,04) e n?o apresentou diferen?a na espessura e mobilidade do diafragma e for?a dos m?sculos respirat?rios. Conclus?es: Foi identificado aumento da atividade neural e da estrutura diagram?tica, com consequente aumento da for?a muscular respirat?ria, ap?s o TMI com carga moderada. Dessa forma, a adapta??o da musculatura respirat?ria ao treinamento com carga moderada ocorre de forma mais acelerada que a adapta??o do m?sculo perif?rico ao treinamento. TMI com carga de 10% da PIm?x n?o pode ser considerado como dose placebo, pois aumenta a for?a muscular inspirat?ria e TMI com intensidade moderada ? capaz de potencializar o recrutamento de fibras musculares do diafragma e promover sua hipertrofia. O protocolo para realiza??o da Revis?o Sistem?tica foi publicado na The Cochrane Library. / Background: The inspiratory muscle training (IMT) has been considered an option in reversing or preventing decrease in respiratory muscle strength, however, little is known about the adaptations of these muscles arising from the training with charge. Objectives: To investigate the effect of IMT on the diaphragmatic muscle strength and function neural and structural adjustment of diaphragm in sedentary young people, compare the effects of low intensity IMT with moderate intensity IMT on the thickness, mobility and electrical activity of diaphragm and in inspiratory muscles strength and establish a protocol for conducting a systematic review to evaluate the effects of respiratory muscle training in children and adults with neuromuscular diseases. Materials and Methods: A randomized, double-blind, parallel-group, controlled trial, sample of 28 healthy, both sexes, and sedentary young people, divided into two groups: 14 in the low load training group (G10%) and 14 in the moderate load training group (G55%). The volunteers performed for 9 weeks a home IMT protocol with POWERbreathe?. The G55% trained with 55% of maximal inspiratory pressure (MIP) and the G10% used a charge of 10% of MIP. The training was conducted in sessions of 30 repetitions, twice a day, six days per week. Every two weeks was evaluated MIP and adjusted the load. Volunteers were submitted by ultrasound, surface electromyography, spirometry and manometer before and after IMT. Data were analyzed by SPSS 20.0. Were performed Student's t-test for paired samples to compare diaphragmatic thickness, MIP and MEP before and after IMT protocol and Wilcoxon to compare the RMS (root mean square) and median frequency (MedF) values also before and after training protocol. They were then performed the Student t test for independent samples to compare mobility and diaphragm thickness, MIP and MEP between two groups and the Mann-Whitney test to compare the RMS and MedF values also between the two groups. Parallel to experimental study, we developed a protocol with support from the Cochrane Collaboration on IMT in people with neuromuscular diseases. Results: There was, in both groups, increased inspiratory muscle strength (P <0.05) and expiratory in G10% (P = 0.009) increase in RMS and thickness of relaxed muscle in G55% (P = 0.005; P = 0.026) and there was no change in the MedF (P> 0.05). The comparison between two groups showed a difference in RMS (P = 0.04) and no difference in diaphragm thickness and diaphragm mobility and respiratory muscle strength. Conclusions: It was identified increased neural activity and diagrammatic structure with consequent increase in respiratory muscle strength after the IMT with moderate load. IMT with load of 10% of MIP cannot be considered as a placebo dose, it increases the inspiratory muscle strength and IMT with moderate intensity is able to enhance the recruitment of muscle fibers of diaphragm and promote their hypertrophy. The protocol for carrying out the systematic review published in The Cochrane Library.

Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2016-04-26T19:45:45Z No. of bitstreams: 1 KardecAlecxandroAbrantesAguiar_DISSERT.pdf: 4668983 bytes, checksum: 26e8aeb4451a6538eca7c5b635c0e2a4 (MD5) / Approved for entry into archive by Arlan Eloi Leite Silva (eloihistoriador@yahoo.com.br) on 2016-04-29T19:23:00Z (GMT) No. of bitstreams: 1 KardecAlecxandroAbrantesAguiar_DISSERT.pdf: 4668983 bytes, checksum: 26e8aeb4451a6538eca7c5b635c0e2a4 (MD5) / Made available in DSpace on 2016-04-29T19:23:00Z (GMT). No. of bitstreams: 1 KardecAlecxandroAbrantesAguiar_DISSERT.pdf: 4668983 bytes, checksum: 26e8aeb4451a6538eca7c5b635c0e2a4 (MD5) Previous issue date: 2015-04-30 / Introdu??o: A asma ? uma doen?a inflamat?ria cujas crises podem se reverter espontaneamente ou com tratamento farmacol?gico. A exposi??o prolongada aos seus efeitos pode comprometer a a??o dos m?sculos respirat?rios. Assim, embora o alongamento destes m?sculos seja visto como t?cnica de potencial benef?cio no tratamento e controle das pneumopatias cr?nicas, poucos estudos avaliaram asm?ticos. Objetivos: Avaliar os efeitos agudos de um protocolo de alongamento de m?sculos respirat?rios sobre os volumes pulmonares, frequ?ncia respirat?ria, volume minuto, ?ndice de velocidade de encurtamento de m?sculos respirat?rios e toler?ncia ao exerc?cio em asm?ticos com doen?a controlada. Materiais e m?todos: estudo crossover, randomizado, duplo-cego no qual a amostra foi composta por asm?ticas alocadas em dois grupos: grupo alongamento (GA) e grupo placebo (GP). O GA recebeu um protocolo de alongamento, enquanto o GP, manobra placebo. As vari?veis foram analisadas durante o exerc?cio utilizando pletismografia optoeletr?nica. An?lise estat?stica: as m?dias dos volumes pulmonares, frequ?ncia respirat?ria, volume minuto e ?ndice de velocidade de encurtamento dos m?sculos respirat?rios entre os grupos foram comparadas pela Two-way ANOVA com post hoc de Bonferroni. O tempo de toler?ncia ao exerc?cio e a percep??o de esfor?o foram comparados pelo teste t pareado. Foi considerado como valor de signific?ncia estat?stica p < 0,05. Resultados: Foram avaliadas 11 asm?ticas com m?dia de idade de 35,5 ? 7,8 anos, IMC de 24,4 ? 2,4 Kg/m2 , CVF e VEF1 igual a 95,8 ? 10,3 e 85,3 ? 11,5 % do valor predito, respectivamente. N?o houve diferen?as nos volumes pulmonares entre os grupos (alongamento versus placebo) durante o exerc?cio, ocorrendo diferen?as na an?lise intragrupo entre suas etapas (p < 0,01). A frequ?ncia respirat?ria e volume minuto foram similares nos grupos (p = 0,68 e 0,52). O ?ndice de velocidade de encurtamento dos m?sculos inspirat?rios da caixa tor?cica pulmonar foi menor no grupo alongamento, particularmente nos momentos de pedalada com carga (GP = 0,571 ? 0,222; GA = 0,533 ? 0,204 L/s) e recupera??o (GP = 0,591 ? 0,222; GA = 0,531 ? 0,244 L/s), por?m n?o existiu diferen?a com signific?ncia estat?stica (p = 0,27). O tempo de toler?ncia ao exerc?cio foi similar entre os grupos (GP = 245 ? 109 seg versus GA = 218 ? 55,5 seg, p = 0,31). A varia??o do escore de Borg para percep??o de fadiga se mostrou menor no GA (6,86 ? 0,55 versus 7,59 ? 0,73, p = 0,02). Conclus?o: O alongamento de m?sculos respirat?rios, considerando seus efeitos agudos, n?o modifica os volumes pulmonares, frequ?ncia respirat?ria, volume minuto e ?ndice de velocidade de encurtamento de m?sculos respirat?rios de asm?ticos com doen?a controlada. Os resultados sugerem que o alongamento n?o influenciou a toler?ncia ao exerc?cio com carga constante, embora tenha sido relatada menor sensa??o de fadiga nos indiv?duos que se submeteram ? t?cnica. / Introduction: Asthma is an inflammatory disease which attacks may reverse spontaneously or with pharmacological treatment. Prolonged exposure to its effects may impair action of the respiratory muscles. Thus, while the stretching these muscles is seen as a potential technique benefit in the treatment and control of chronic lung disease, few studies evaluated asthmatics. Objectives: Assess the acute effects of a stretching protocol of respiratory muscles on lung volumes, respiratory rate, minute volume, shortening velocity index of respiratory muscles and exercise tolerance in asthmatics with controlled disease. Materials and methods: crossover, randomized, double-blind study in which the sample was composed of asthmatic allocated into two groups: stretching group (GA) and placebo group (PG). The GA received a stretching protocol, while the GP, placebo maneuver. The variables were analyzed during the exercise using plethysmography optoelectronics. Statistical analysis: the mean of lung volumes, respiratory rate, minute volume and velocity of shortening index of the respiratory muscles between groups were compared by two-way ANOVA with Bonferroni post hoc. The exercise tolerance time and perceived exertion were compared between groups by paired t test. Was considered significant statistical value p <0.05. Preliminary results: We assessed 11 asthmatic with a mean age of 35.5 ? 7.8 years, BMI 24.4 ? 2.4 kg / m2, FVC and FEV1 equal to 95.8 ? 10.3 and 85.3 ? 11, 5% of the predicted value, respectively. There were no differences in lung volumes between groups (stretching versus placebo) during exercise, occurring differences in intra-group analysis of its stages (p <0.01). The respiration rate, and minute volume were similar in both groups (p = 0.68 and 0.52). The shortening velocity index of the inspiratory muscles pulmonary rib cage was lower in the stretching group, particularly in moments of pedaling load (GP = 0.571 ? 0.222, 0.533 ? 0.204 GA = L / s) and recovery (GP = 0.591 ? 0.222, GA = 0.531 ? 0.244 L / s), however there was no statistically significant difference (p = 0.27). The time of exercise tolerance was similar between groups (GP = 245 ? 109 seconds versus 218 ? GA = 55.5 sec, p = 0.31). The change in Borg score for perception of fatigue was lower in GA (6.86 ? 0.55 versus 7.59 ? 0.73, p = 0.02). Conclusion: The stretching of respiratory muscles, considering its acute effects, does not modify the pulmonary volumes, respiratory rate, minute volume and the shortening velocity index of respiratory muscles of asthma patients with controlled disease. The results suggest that the technique did not influence exercise tolerance with constant load, although it was observed a lower sense of fatigue in individuals who underwent technique.

Made available in DSpace on 2014-12-17T15:16:16Z (GMT). No. of bitstreams: 1 ThalitaMFM_DISSERT.pdf: 2032843 bytes, checksum: 9ea6f3e9fb105a501058c91a0eb94bfc (MD5) Previous issue date: 2012-01-05 / Introduction: The leukemias are the most common malignancy in children and adolescents. With the improvement in outcomes, there is a need to consider the morbidity to generate the protocols used in children under treatment. Aim: To evaluate pulmonary function in children with acute leukemia. Method: This study is an observational cross sectional. We evaluated 34 children distributed in groups A and B. Group A comprised 17 children with acute leukemia in the maintenance phase of chemotherapy treatment and group B with 17 healthy students from the public in the city of Natal / RN, matched for gender, age and height. The thoracic mobility was evaluated by thoracic expansion in the axillary and xiphoid levels. Spirometry was measured using a spirometer Microloop Viasys ? following the rules of the ATS and ERS. Maximal respiratory pressures were measured with digital manometer MVD300 (Globalmed ?). The maximal inspiratory pressure (MIP) and maximal expiratory pressure (MEP) were measured from residual volume and total lung capacity, respectively. The data were analyzed using the SPSS 17.0 software assigning the significance level of 5%. Descriptive analysis was expressed as mean and standard deviation. T'student test was used to compare unpaired values found in group A with group B values, as well as with the reference values used. To compare the respiratory coefficients in the axillary level with the xiphoid in each group, we used paired testing t student. Results: Group A was significantly decreased thoracic mobility and MIP compared to group B, and MIP compared to baseline. There was no significant difference between spirometric data from both groups and the values of group A with the reference values Mallozi (1995). There was no significant difference between the MIP and MEP values and lower limits of reference proposed by Borja (2011). Conclusion: Children with acute leukemia, myeloid or lymphoid, during maintenance phase of chemotherapy treatment have reduced thoracic mobility and MIP. However, to date, completion of clinical treatment, the spirometric variables and the strength of the expiratory muscles appear to remain preserved in children between five and ten years / Introdu??o: As leucemias constituem a doen?a maligna mais frequente em crian?as e adolescentes. Com a melhora no progn?stico, surge a necessidade de considerar a morbidade que os protocolos utilizados geram nas crian?as em tratamento. Objetivo: Avaliar a fun??o pulmonar de crian?as com leucemia aguda. M?todo: Trata-se de um estudo observacional do tipo anal?tico transversal. Foram avaliadas 34 crian?as, alocadas nos grupos A e B. O grupo A foi formado por 17 crian?as com leucemia aguda na fase de manuten??o do tratamento quimioter?pico e o grupo B por 17 estudantes saud?veis da rede p?blica do munic?pio de Natal/RN, pareados em rela??o a g?nero, idade e altura. A mobilidade tor?cica foi avaliada por meio de cirtometria tor?cica nos n?veis axilar e xif?ide. A espirometria foi mensurada utilizando o espir?metro Microloop Viasys? seguindo as normas da ATS e ERS. As press?es respirat?rias m?ximas foram mensuradas com o manovacu?metro digital MVD300 (Globalmed?). As press?es inspirat?rias m?ximas (PIm?x) e as press?es expirat?rias m?ximas (PEm?x) foram medidas a partir do volume residual e da capacidade pulmonar total, respectivamente. Os dados foram analisados atrav?s do software SPSS 17.0 atribuindo-se o n?vel de signific?ncia de 5%. A an?lise descritiva foi expressa atrav?s de m?dia e desvio padr?o. Foi utilizado o teste t student n?o pareado para compara??o dos valores encontrados no grupo A com os valores do grupo B, bem como com os valores de refer?ncia utilizados. Para compara??o entre os coeficientes respirat?rios no n?vel axilar com o n?vel xif?ide em cada grupo, utilizou-se o teste t student pareado. Resultados: O grupo A apresentou diminui??o significativa da mobilidade tor?cica e da PIm?x quando comparado ao grupo B, bem como da PIm?x quando comparada aos valores de refer?ncia. N?o houve diferen?a significativa entre os dados espirom?tricos dos dois grupos avaliados e os valores do grupo A com os valores de refer?ncia de Mallozi (1995). Tamb?m n?o existiu diferen?a significativa entre os valores de PIm?x e PEm?x e os valores de limites inferiores propostos como refer?ncia por Borja (2011). Conclus?o: As crian?as com leucemia aguda, linf?ide ou miel?ide, durante o per?odo de manuten??o do tratamento quimioter?pico apresentam redu??o da mobilidade tor?cica e da for?a muscular inspirat?ria. Entretanto, at? este momento, de conclus?o do tratamento quimioter?pico, as vari?veis espirom?tricas e a for?a dos m?sculos expirat?rios parecem manter-se preservadas em crian?as entre cinco e dez anos

Made available in DSpace on 2014-12-17T15:16:16Z (GMT). No. of bitstreams: 1 AlineMCF_DISSERT.pdf: 1723122 bytes, checksum: 0a4e97f29c8c006b640688fc375b18da (MD5) Previous issue date: 2012-02-28 / The reduction of physiological capacity present in the process of aging causes a marked decline in lung function. The exercise does promote several positive changes in the physical health of people and protect the cardiorespiratory function. The aim of this study was to investigate the effects of a program of Pilates exercices on the strengh and electrical activity of respiratory muscles of elderly. This is a randomized, controlled clinical trial, evaluating 33 elderly aged 65 and 80 (70.88 ? 4.32), healthy, sedentary, without cognitive impairment and able the practice physical activity. The sample was divided into two groups, one experimental group with 16 elderly women who did Pilates exercises and a control group (17) that was not submitted to the exercises, but received educational booklets on aging and health care. The elderly were evaluated initially and after a period of three months, taking into account the Maximal Inspiratory Pressure (MIP) and Maximal Expiratory Pressure (MEP), obtained by Manovacuometry and intensity of EMG activity was measured using the values of Root Mean Square (RMS) for the diaphragm and rectus abdominis muscles, during the course of diaphragmatic breathing and MIP maneuver. Data were analyzed using SPSS version 17.0. For all tests, we used a significance level or p value < 0.05 and confidence interval 95%. RMS in diaphragm and rectus abdominis muscles in both tests increased, but the data were significant for the rectus abdominis during diaphragmatic breathing (p = 0.03) and the diaphragm during the MIP maneuver (p = 0.01). There was no significant variation of the MIP and MEP. Pilates exercises were responsible for increasing the electrical activation of the diaphragm and rectus abdominis muscles in a group of healthy elderly, but had no influence on changes in strength of respiratory muscles / A deteriora??o das fun??es fisiol?gicas est?o ligadas ao decl?nio do desempenho f?sico dos indiv?duos idosos. O exerc?cio promove altera??es positivas na sa?de, incluindo benef?cios cardiorrespirat?rios e aperfei?oamento do desempenho muscular e funcional, sendo fator de desacelera??o ou revers?o de preju?zos causados pelo envelhecimento. O M?todo Pilates ? muito utilizado na pr?tica cl?nica visando promover o reequil?brio muscular com exerc?cios que d?o ?nfase ao powerhouse, exigindo que o indiv?duo mantenha a mente concentrada no n?cleo do corpo o tempo todo, atrav?s da respira??o. Apesar da grande popularidade do m?todo, h? car?ncia de estudos cient?ficos com aplica??o na Fisioterapia e com abordagens cinesiol?gica, fisiol?gica e/ou biomec?nica, em especial envolvendo os m?sculos respirat?rios. O objetivo foi investigar os efeitos de um programa de exerc?cios de Pilates sobre a for?a e atividade el?trica dos m?sculos respirat?rios de idosas. Foram avaliadas 33 idosas saud?veis, sedent?rias, sem defici?ncia cognitiva e aptas ? pr?tica de exerc?cio f?sico e divididas em 2 grupos, Controle (n=17), que recebeu cartilhas educativas com orienta??es sobre envelhecimento e sa?de e Experimental (n=16), que al?m das cartilhas, passou por um programa de 24 sess?es de exerc?cios de Mat Pilates. As idosas foram avaliadas inicialmente e ap?s um per?odo de tr?s meses, levando-se em conta as medidas das press?es respirat?rias est?ticas m?ximas (PIm?x e PEm?x) e o RMS dos m?sculos diafragma e reto abdominal em dois testes diferentes. Foi utilizado o teste T de Student para compara??o entre os grupos e adotado um n?vel de signific?ncia p valor < 0,05 e intervalo de confian?a de 95%. A idade m?dia foi de 70,88 anos (?4,32). O RMS aumentou nos dois m?sculos avaliados em ambos os testes, por?m os dados foram significativos para o reto abdominal durante a respira??o diafragm?tica (p = 0,03) e para o diafragma durante a manobra de PIm?x (p = 0,01). N?o houve varia??o significativa dos valores de for?a. Os exerc?cios de Pilates alteraram a atividade el?trica, mas n?o tiveram influ?ncia na for?a dos m?sculos respirat?rios num grupo de idosas saud?veis