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Intervención fisioterápica en el anciano con limitación funcional para las actividades de la vida diaria: estudio comparativo de la efectividad de dos protocolos de entrenamiento específico de la musculatura respiratoria vs. controlCebrià i Iranzo, Maria dels Àngels 28 November 2011 (has links)
Introducción.La pérdida generalizada de masa y fuerza muscular asociada al envejecimiento es causa de deterioro funcional y discapacidad física, especialmente en el anciano de edad avanzada. En este contexto, la función respiratoria puede verse gravemente comprometida, cuando al descenso fisiológico de la fuerza de la musculatura respiratoria (MR), se le suman la comorbilidad y la inmovilidad.
Estudios previos han demostrado que el entrenamiento específico de la MR se acompaña de la mejora significativa de la fuerza y la resistencia de esta musculatura, tanto en sujetos sanos como en enfermos. Por lo tanto, puede tratarse de una intervención efectiva para mejorar y mantener las características de la MR, así como prevenir el deterioro clínico y funcional del anciano más vulnerable.
Objetivo. Evaluar y comparar entre sí la efectividad de dos protocolos de entrenamiento específico de la MR en la mejora de su fuerza y resistencia, en el anciano institucionalizado con importante limitación funcional.
Material y métodos.Setenta y un ancianos institucionalizados con incapacidad para deambular (90% mujeres;edadmedia ± Sx, 85 ± 6 años) fueron asignados aleatoriamente a un grupo control (n= 24) y dos grupos entrenados (grupo Threshold,n= 23; grupo Pranayama, n= 24). Los grupos experimentales siguieron un protocolo de entrenamiento supervisado, cinco días a la semana durante seis semanas consecutivas. Las principales variables de este estudio, las presiones respiratorias estáticas máximas (PImax y PEmax) y la ventilación máxima voluntaria (VMV), fueron medidas en cuatro momentos temporales (semanas 0, 4, 7 y 10) para cada uno de los tres grupos definidos.
Resultados. Contrariamente a nuestra hipótesis, el entrenamiento mediante Threshold® IMT no reveló efecto significativo en la fuerza y la resistencia de la MR. Sin embargo, los ejercicios de ventilación controlada, descritos como Pranayama, reflejaron un aumento significativo de la fuerza de laMR sobre los grupos control y Threshold(PImax F6,204= 6,774, p< 0,001, η2= 0,166; PEmax F6,204= 4,257, p< 0,001, η2= 0,111). Adicionalmente, el Pranayama mostró un efecto significativamente mayor de la resistencia de la MR respecto al grupo control (VMV F6,204= 5,322, p< 0,001, η2= 0,135).
Conclusión. El entrenamiento mediante Pranayama es una modalidad de ejercicio efectiva y bien tolerada por el anciano que no puede deambular autónomamente. Por lo tanto, es una alternativa beneficiosa para el mantenimiento y mejora de la fuerza y resistencia de la MR en el anciano con perdida significativa de movilidad y capacidad de ejercicio. / The global loss of muscle mass and strength associated with aging is a cause of functional impairment and disability, particularly in the frail elderly. Respiratory function can be severely compromised if there is a decrease of respiratory muscle (RM) strength complicated by the presence of comorbidities and physical immobility.
Previous studies have shown that RM training is an effective method to increase RM strength, both in healthy people and patients. In this case, RM training may be regarded as a beneficial alternative to improve RM function, and thus prevent physical deterioration in this population.
The purpose of this study was to assess and compare the effect of two specific RM training protocols on the RM strength and endurance in an elderly population, who were unable to engage in general exercise conditioning. The hypothesis was that RM training would improve RM strength and endurance in the experimental groups vs. control group, who did not participate in RM training.
Methods. Seventy-one institutionalized elderlypeople with an inability to walk (90% female, age 85 ± 6 years) were randomly assigned to a control group (n=24), Threshold group (n=23) or Pranayama group (n=24). Both experimental groups performed a supervised RM training, 5 days/week for six consecutive weeks. The maximum inspiratory and expiratory pressures (MIP and MEP) and the maximum voluntary ventilation (MVV) were assessed at four time points in each of the three groups.
Results. Contrary to our original hypothesis, Threshold® IMT did not reveal a significant effect on the RM strength and endurance, when compared to the outcomes in the control group. However, Pranayama exercises reflected a significant increase in RM strength, over the control and Threshold groups (MIP F6,204= 6,774, p< 0,001, 2= 0,166; MEP F6,204= 4,257, p< 0,001, 2= 0,111). Additionally, the Pranayama RM trainingwas significantlybetter in increasing RM endurance when compared to the MVVmeasured in the control group (MVV F6,204= 5,322, p< 0,001, 2= 0,135).
Conclusion.Pranayama RM training is an effective and well-tolerated exercise regimen in the elderly population. Therefore, RM training is effective in improving RM strength and endurance in a functionally impaired elderly population.
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Physiotherapy Intervention for Preventing the Respiratory Muscle Deterioration in Institutionalized Older Women with Functional ImpairmentCebrià i Iranzo, Maria dels, Arnall, David Alan, Igual Camacho, Celedonia, Tomás, José Manuel, Meléndez, Juan Carlos 01 January 2013 (has links)
Introduction: In elderly seniors (>80 years), respiratory function may be compromised when, in addition to the presence of comorbidity and loss of mobility, there is also reduced respiratory muscle (RM) strength. The literature has shown that RM training could be an effective method to improve RM function and prevent clinical deterioration, particularly in population with RM weakness.The main purpose of this paper was to assess the effectiveness of RM training on the respiratory muscle strength and endurance of institutionalized elderly women with functional impairment. Method: Fifty-four residents (mean=85 years, SD=6.7) were randomly assigned to either a control (n=27) or training (n=27) group. A supervised training program was developed with Threshold®IMT, five times per week for 6-weeks. The main variables of the intervention were: maximum inspiratory pressure (PImax), maximum expiratory pressure (PEmax) and maximal voluntary ventilation (MVV), all of which were measured at weeks 0, 4, 7 and 10. Results: Statistical analysis revealed no significant differences in PImax (F3,114=1.04, p=0.368, R2=0.027), PEmax (F3,114=1.86, p=0.14, R2=0.047) and MVV (F3,114=1.74, p=0.162, R2=0.044) between the two groups after the intervention. However, the workload significantly improved with the training sessions (F5,100=72.031, p<0.001, R2=0.791). Conclusion: In a 6-week interval-based training program, the threshold loading device does not significantly improve parameters related to RM strength and endurance of the study population.
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Physiotherapy Intervention for Preventing the Respiratory Muscle Deterioration in Institutionalized Older Women with Functional ImpairmentCebrià i Iranzo, Maria dels, Arnall, David Alan, Igual Camacho, Celedonia, Tomás, José Manuel, Meléndez, Juan Carlos 01 January 2013 (has links)
Introduction: In elderly seniors (>80 years), respiratory function may be compromised when, in addition to the presence of comorbidity and loss of mobility, there is also reduced respiratory muscle (RM) strength. The literature has shown that RM training could be an effective method to improve RM function and prevent clinical deterioration, particularly in population with RM weakness.The main purpose of this paper was to assess the effectiveness of RM training on the respiratory muscle strength and endurance of institutionalized elderly women with functional impairment. Method: Fifty-four residents (mean=85 years, SD=6.7) were randomly assigned to either a control (n=27) or training (n=27) group. A supervised training program was developed with Threshold®IMT, five times per week for 6-weeks. The main variables of the intervention were: maximum inspiratory pressure (PImax), maximum expiratory pressure (PEmax) and maximal voluntary ventilation (MVV), all of which were measured at weeks 0, 4, 7 and 10. Results: Statistical analysis revealed no significant differences in PImax (F3,114=1.04, p=0.368, R2=0.027), PEmax (F3,114=1.86, p=0.14, R2=0.047) and MVV (F3,114=1.74, p=0.162, R2=0.044) between the two groups after the intervention. However, the workload significantly improved with the training sessions (F5,100=72.031, p<0.001, R2=0.791). Conclusion: In a 6-week interval-based training program, the threshold loading device does not significantly improve parameters related to RM strength and endurance of the study population.
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