Submitted by PPG Gerontologia Biom?dica (geronbio@pucrs.br) on 2017-11-20T10:28:02Z No. of bitstreams: 1 FERREIRA_OLIVEIRA_LEONARDO_TESE.pdf: 7911824 bytes, checksum: 45902ffd315db92b8af53a56e81440f3 (MD5) / Approved for entry into archive by Caroline Xavier (caroline.xavier@pucrs.br) on 2017-11-28T17:26:16Z (GMT) No. of bitstreams: 1 FERREIRA_OLIVEIRA_LEONARDO_TESE.pdf: 7911824 bytes, checksum: 45902ffd315db92b8af53a56e81440f3 (MD5) / Made available in DSpace on 2017-11-28T17:33:51Z (GMT). No. of bitstreams: 1 FERREIRA_OLIVEIRA_LEONARDO_TESE.pdf: 7911824 bytes, checksum: 45902ffd315db92b8af53a56e81440f3 (MD5) Previous issue date: 2017-09-04 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior - CAPES / Introduction: Botulinum toxin is a zinc-dependent metalloprotease and promotes cleavage of the receptor responsible for botulinum toxin type A with consequent paralysis at the neuromuscular junction. In addition to blocking the release of acetylcholine, it inhibits the local release of pain-related neuropeptides. Although more recognized in aesthetics, it is indicated in the treatment of several disorders. Objective: To evaluate the efficacy and duration of the effect of botulinum toxin type A (incobotuliniumtoxin A) applied to the frontal muscle of women, being reconstituted in zinc gluconate compared to dilution in physiological solution. Methods: This is a prospective, double-blind study. The sample size was 48 females, over 50 years of age and divided into two groups, being calculated using the G-Power program to verify the association between variables. For this purpose an effect of 0.5, a power of the test of 80% and a level of confidence of 95% were used. The comparison between the two groups was performed by the Mann-Whitney test. The non-parametric test was chosen because the variables had no normal distribution (Kolmogorov-Smirnov p> 0.05). The various moments were compared by the Kruskall-Wallis test. In the control group, Incobotuliniumtoxin A flasks (100 U) were diluted in 2 mL of 0.9% sodium chloride physiological solution. In the case group, it was diluted with 2 mL of a 0.02% zinc gluconate solution. Participants were monitored using the Merz-Esthetics validated scale of resting and moving frontal lines and documented by means of digital photography, the results of which were analyzed by Wilcoxon's non-parametric test to compare the frontal lines before and after the application. To characterize the groups, descriptive statistics methods were used as frequencies and percentages for categorical variables and median, minimum and maximum for quantitative variables. The chi-square and Manny-Whitney tests were used to verify the homogeneity of the groups in relation to the clinical variables. Results: The results showed that there is no relationship between race, ethnicity, smoking and sunscreen use with the toxin effect in the two groups. For the variables age and amount weekly zinc intake the Manny-Whitney test result indicated that there was no significant difference in the groups. In the control group, at 14 weeks of application, there was a 66% reduction of the effects in patients with resting frontal wrinkles and a 75% reduction in the desired effect on movement. In the case group, after 14 weeks of application, there was a 100% reduction in effects in patients with resting frontal wrinkles and 75% in movement. Conclusion: The data identify that patients' life habits do not influence the final outcome of the procedure and that the duration of the effect is not related to the dilution of the product with a substance other than the classic dilution with physiological solution. However, the study showed that patients who ingest alcoholic beverages using Botulinum toxin diluted in 0.02% zinc gluconate seem to have better efficacy. / Introdu??o: A toxina botul?nica ? uma metaloprotease dependente de zinco e promove a clivagem do receptor respons?vel pela toxina botul?nica tipo A com consequente paralisia na jun??o neuromuscular. Al?m de bloquear a libera??o de acetilcolina, inibe a libera??o local de neuropept?dios relacionados com a dor. Embora mais reconhecida na est?tica, ? indicada no tratamento de diversos transtornos. Objetivo: Avaliar a efic?cia e dura??o do efeito da toxina botul?nica tipo A (incobotuliniumtoxina A) aplicada no m?sculo frontal de mulheres, sendo reconstitu?da em gluconato de zinco comparada a dilui??o em solu??o fisiol?gica. M?todos: Trata-se de um estudo prospectivo e duplo-cego. O tamanho da amostra foi de 48 indiv?duos do sexo feminino, acima de 50 anos de idade e dividida em dois grupos, sendo calculado com a utiliza??o do programa G-Power para verificar a associa??o entre vari?veis. Para tanto utilizou-se um efeito de 0,5, um poder do teste de 80% e um n?vel de confian?a de 95%. A compara??o entre os dois grupos foi realizada pelo teste de Mann-Whitney. A escolha pelo teste n?o param?trico ocorreu devido as vari?veis n?o apresentarem distribui??o normal (Kolmogorov-Smirnov p>0,05). Os diversos momentos foram comparados pelo teste Kruskall-Wallis. No grupo controle, os frascos de incobotuliniumtoxina A (100 U) foram dilu?dos em 2 mL de solu??o fisiol?gica de cloreto de s?dio 0,9%. No grupo caso, diluiu-se com 2 mL de uma solu??o de gluconato de zinco 0,02%. O acompanhamento das participantes foi realizado por meio da escala validada Merz-Aesthetics de linhas frontais em repouso e em movimento e documentado por meio de fotografia digital, cujo os resultados foram analisados pelo teste n?o param?trico de Wilcoxon para comparar as linhas frontais antes e depois da aplica??o. Para caracterizar os grupos, foram utilizados m?todos da estat?stica descritiva como frequ?ncias e percentuais para vari?veis categ?ricas e mediana, m?nimo e m?ximo para as quantitativas. A verifica??o da homogeneidade dos grupos em rela??o as vari?veis cl?nicas foram realizadas pelo teste qui-quadrado e Manny-Whitney. Resultados: Os resultados obtidos mostraram que n?o h? rela??o entre ra?a, etilismo, tabagismo e uso de protetor solar com o efeito da toxina nos dois grupos. Para as vari?veis idade e quantidade ingesta de zinco semanal o resultado do teste Manny-Whitney indicou que n?o existe diferen?a significativa nos grupos. No grupo controle, em 14 semanas da aplica??o houve redu??o de 66% dos efeitos nos pacientes com as rugas do frontal em repouso e redu??o de 75% do efeito desejado em movimento. No grupo caso, ap?s 14 semanas da aplica??o, houve redu??o de 100% dos efeitos nos pacientes com as rugas do frontal em repouso e de 75% em movimento. Conclus?o: Os dados identificam que os h?bitos de vida das pacientes n?o influenciam no resultado final do procedimento, e que a dura??o do efeito n?o est? ligado ? dilui??o do produto com subst?ncia diferente da dilui??o cl?ssica com solu??o fisiol?gica. Contudo, o estudo demostrou que os pacientes que ingerem bebida alco?lica que utilizaram a toxina botul?nica dilu?da em gluconato de zinco 0,02% parecem ter uma melhor efic?cia.

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.

Made available in DSpace on 2015-04-14T13:34:59Z (GMT). No. of bitstreams: 1 424910.pdf: 8819126 bytes, checksum: 343a796019090b4026f34fd8be325684 (MD5) Previous issue date: 2010-05-03 / INTRODU??O: A popula??o mundial est? envelhecendo. No processo fisiol?gico do envelhecimento, a perda de massa (sarcopenia) e for?a muscular nos idosos ? respons?vel pela redu??o de mobilidade, aumento da incapacidade funcional e depend?ncia f?sica nesta popula??o. OBJETIVO: Este estudo teve como objetivo comparar os ganhos de for?a e massa muscular em idosos independentes em um protocolo de resist?ncia, utilizando cintas el?sticas (grupo 1) e pesos e caneleiras (grupo 2). PACIENTES E M?TODOS: Estudo experimental com delineamento longitudinal. A amostra do estudo foi constitu?da por 43 sujeitos. A aplica??o do protocolo foi executada na seguinte ordem: a) avalia??o inicial (medidas antropom?tricas, bioimped?ncia, caracter?sticas s?cio-demogr?ficas, h?bitos de vida, patologias, hereditariedade, medica??es, testes de for?a); b) per?odo de adapta??o neuromuscular; c) protocolos de resist?ncia visando ganho de for?a; d) avalia??o final. A amostra foi estratificada, randomicamente, em dois grupos: grupo 1 cintas el?sticas (n = 21) e grupo 2 halteres e caneleiras (n = 22). Adotou-se um n?vel de signific?ncia de 5%. As associa??es entre as vari?veis categ?ricas e o grupo de pesquisa foram analisadas por meio do Teste de Quadrado ou Exato de Fisher. As vari?veis quantitativas na condi??o inicial ou basal foram comparadas por meio do Teste t de Student. A ANOVA com medidas repetidas foi utilizada para comparar os resultados dos protocolos de resist?ncia nos dois momentos da investiga??o (inicial e final) entre os dois grupos. RESULTADOS: Os dois grupos foram homog?neos com rela??o ?s vari?veis de interesse da pesquisa na condi??o basal. Houve diferen?as significativas (p<0,05) entre os dois momentos do ensaio para as seguintes vari?veis: di?metro da coxa, cintura, dobras cut?neas, percentagem de gordura, percentagem de massa livre de gordura corporal, peso massa livre de gordura corporal, peso massa de gordura corporal, ?gua corporal, teste de sentar e levantar e teste de for?a de bra?o. N?o foram observadas diferen?as entre os resultados dos dois protocolos de resist?ncia. 8 CONCLUS?O: Os exerc?cios de resist?ncia, realizados com cintas el?sticas e pesos tradicionais, mostram-se eficazes na recupera??o da perda de massa muscular e no aumento da for?a muscular em idosos independentes.

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

Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2017-04-17T23:18:24Z No. of bitstreams: 1 PalommaRussellySaldanhaDeAraujoOliveira_TESE.pdf: 10724965 bytes, checksum: fb9786f1f1478cf8fcd17d5aeb59d620 (MD5) / Approved for entry into archive by Arlan Eloi Leite Silva (eloihistoriador@yahoo.com.br) on 2017-04-20T23:10:05Z (GMT) No. of bitstreams: 1 PalommaRussellySaldanhaDeAraujoOliveira_TESE.pdf: 10724965 bytes, checksum: fb9786f1f1478cf8fcd17d5aeb59d620 (MD5) / Made available in DSpace on 2017-04-20T23:10:05Z (GMT). No. of bitstreams: 1 PalommaRussellySaldanhaDeAraujoOliveira_TESE.pdf: 10724965 bytes, checksum: fb9786f1f1478cf8fcd17d5aeb59d620 (MD5) Previous issue date: 2016-12-12 / Os m?sculos respirat?rios constituem um dos pilares essenciais da ventila??o. Altera??es na sua estrutura e morfologia em sujeitos com Doen?a Pulmonar Obstrutiva Cr?nica (DPOC) podem influenciar sintomas e sinais cl?nicos como dispneia, tosse ineficaz, intoler?ncia ao exerc?cio e insufici?ncia respirat?ria. O Treinamento Muscular Respirat?rio (TMR), especialmente dos m?sculos inspirat?rios na modalidade limiar de carga press?rica, tem sido utilizado h? mais de 30 anos como terapia coadjuvante em indiv?duos saud?veis e pacientes com DPOC. Ampla variedade de dispositivos para TMR est?o dispon?veis comercialmente, por?m s?o importados, possuem custo elevado e suas caracter?sticas s?o destinadas ao treino individual de grupos musculares ou possuem ajustes de cargas inadequados para pacientes com DPOC. Embora, diversas revis?es sistem?ticas tenham sido realizadas desde 1992 acerca do Treinamento Muscular Inspirat?rio (TMI) em sujeitos com DPOC e postuladas algumas evid?ncias sobre o TMI, falhas metodol?gicas na estrat?gia de busca das revis?es pr?vias e a baixa qualidade metodol?gica dos estudos inclu?dos contribu?ram para o estabelecimento de uma evid?ncia vol?til sobre os benef?cios do TMI. Objetivos: desenvolver um dispositivo de Treinamento do Ciclo Respirat?rio (TCR), integrado para m?sculos inspirat?rios e expirat?rios; verificar os efeitos agudos de diferentes combina??es de cargas inspirat?rias e/ou expirat?rias sobre a atividade muscular respirat?ria, cinem?tica da caixa tor?cica e din?mica dos volumes pulmonares em sujeitos saud?veis com dispositivo semelhante ao desenvolvido; bem como verificar as evid?ncias do TMI sobre a dispneia e capacidade do exerc?cio em sujeitos com DPOC. Metodologia: envolveu tr?s modalidades de pesquisa: i) o desenvolvimento tecnol?gico do dispositivo de TCR, ii) estudo transversal e iii) revis?o sistem?tica associada ? metan?lise. Resultados: i) cria??o de um produto de inova??o tecnol?gica aplicado ? sa?de, denominado ?Equipamento de Treinamento do Ciclo Respirat?rio (TCR) com resist?ncia tipo limiar de carga press?rica?, com dep?sito de patente de inven??o no INPI (BR 1020160253047); ii) mediante estudo transversal, o equipamento comercialmente dispon?vel para treinamento de m?sculos inspirat?rios e/ou expirat?rios n?o ? capaz de deflagrar adequadamente aumento na atividade el?trica dos m?sculos respirat?rios, embora provoque altera??es nos volumes correntes da parede tor?cica e seus compartimentos; e iii) artigo cient?fico intitulado ?Inspiratory muscle training for Chronic Obstructive Pulmonary Disease? evidenciando que, embora o TMI combinado ao cuidado padronizado sozinho versus cuidado padronizado sozinho proporcione melhora na qualidade de vida e que TMI combinado ? Reabilita??o Pulmonar versus Reabilita??o Pulmonar induza ? redu??o na dispneia em sujeitos com DPOC, n?o h? evid?ncia conclusiva para suportar ou refutar o TMI em pacientes com DPOC. Conclus?o: A presente pesquisa substancia a necessidade de constru??o de um novo equipamento de TMR para m?sculos inspirat?rios e expirat?rios, bem como fornece subs?dios para o desenvolvimento de estudos futuros para investiga??o de uma nova modalidade de TMR, denominada TCR, com produ??o de conhecimento na ?rea de biotecnologia. Adicionalmente, contribui para tomada de decis?o cl?nica, pol?tica e financeira sobre a inclus?o ou n?o do TMI como modalidade terap?utica para sujeitos com DPOC. / Respiratory muscles are one of the essential cornerstone of ventilation. Alterations in its structure and morphology in subjects with Chronic Obstructive Pulmonary Disease (COPD) could influence symptoms and signs such as dyspnea, ineffective coughing, exercise intolerance and respiratory failure. Respiratory Muscular Training (RMT), especially inspiratory muscles training, as a threshold modality, has been used for more than 30 years as adjuvant therapy in healthy individuals and patients with COPD. A wide variety of RMT devices are available commercially, but they are imported, have a high cost and their characteristics are intended for the individual training of muscle groups or have inadequate loads adjustments for COPD patients. Although several systematic reviews have been carried out since 1992 on the effects of IMT in subjects with COPD and some evidence has been proposed, some considerations should be made about these revisions.The methodological failures in the search strategy for previous reviews and the low methodological quality of the included studies contributed to the establishment of weak evidence on the benefits of the IMT. Aim: to develop a Respiratory Cycle Training (RCT) device, integrated for inspiratory and expiratory muscles, to verify the acute effects of different combinations of inspiratory and/or expiratory loads in the respiratory muscle activity, kinematics of the chest wall and dynamics of pulmonary volumes in healthy subjects with a device similar to that developed, as well as to analyze the evidence of the effects of IMT on dyspnea and exercise capacity in subjects with COPD. Methodology: involved three research modalities: i) the technological development of the RCT device, ii) cross-sectional study, and iii) systematic review associated with the meta-analysis. Results: i) creation of a technological innovation product applied to health, called "Respiratory Cycle Training equipment (RCT) with threshold load", with patent filing at INPI (BR 1020160253047); ii) through a cross-sectional study, commercially available equipment for inspiratory and / or expiratory muscle training is not capable of adequately triggering an increase in the electrical activity of respiratory muscles, although it causes changes in the current volumes of the chest wall and its compartments; and (iii) a scientific paper entitled "Inspiratory muscle training for Chronic Obstructive Pulmonary Disease", showing that although IMT combined with standardized care alone versus standardized care alone provides improved quality of life and that IMT combined with Pulmonary Rehabilitation versus Pulmonary Rehabilitation induces reduction in dyspnea in individuals with COPD, but there is not conclusive evidence to support or refute IMT in patients with COPD. Conclusion: The present study substantiates the need to construct a new RMT equipment for inspiratory and expiratory muscles, as well as provides subsidies for the development of future studies to investigate a new type of RMT, called TCR, with knowledge production in the area of biotechnology. In addition, it contributes to clinical, political and financial decision making regarding the inclusion or not of IMT as a therapeutic modality for subjects with COPD. / 2018-03-02

Made available in DSpace on 2014-12-17T14:13:41Z (GMT). No. of bitstreams: 1 DaniellaCB_TESE.pdf: 1456295 bytes, checksum: daf0a0f4cae3c76b4bf08c373b4a9fa4 (MD5) Previous issue date: 2011-07-13 / Introduction: Chagas Disease is a serious public health problem, with 5 million infected individuals in Brazil. Of these, approximately 30% develop chronic Chagas cardiomyopathy (CCC), where the main symptoms are fatigue and dyspnea. Objective: To correlate maximal exercise capacity with pulmonary function, inspiratory muscle strength and quality of life in patients with CCC. Methodology: Twelve individuals suffering from CCC were evaluated (7 men), with a mean age of 54.91? 8.60 years and the following inclusion criteria: functional class II and III according to the New York Heart Association (NYHA); left ventricle ejection fraction below 45%; clinical stability (> 3 months); symptom duration > 1 year, body mass index (BMI) < 35Kg/m2 and non-smokers or ex-smokers with a history of smoking <10 packs/day. All subjects were submitted to spirometry, manometer testing, maximal cardiopulmonary exercise testing (CPX) and a quality of life questionnaire (Minnesota). Results: A negative correlation was observed between VO2m?x and MLHFQ scores (r=-0.626; p=0.03) and a positive association with MIP (r=0.713; p=0.009). Positive correlations were also recorded between MIP and spirometric variables [FEV1(r=0.825;p=0.001 ), FVC(r=0.66;p=0.01 and FEF25-75%(r=0.639;p=0.02)]. Conclusion: The present study demonstrated that in patients with CCC: VO2MAX is directly related to inspiratory muscle strength and quality of life, while deteriorating lung function is directly associated with respiratory muscle weakness / O treinamento muscular inspirat?rio (TMI) realizado por meio do exerc?cio com limiar de carga inspirat?ria ? utilizado na reabilita??o de indiv?duos com insufici?ncia card?aca cr?nica (ICC). Este trabalho ser? apresentado em tr?s artigos. O primeiro artigo teve como objetivo comparar a cinem?tica ventilat?ria de pessoas saud?veis em rela??o a pacientes com ICC associada ? cardiomegalia e a fraqueza diafragm?tica; o segundo artigo teve como objetivo avaliar os dados funcionais de pacientes com ICC ap?s serem submetidos a programa de TMI e o terceiro e ?ltimo artigo teve como objetivo analisar um subgrupo de pacientes chag?sicos (CCC) durante o exerc?cio m?ximo. Foi observado que a presen?a da cardiomegalia e da fraqueza muscular inspirat?ria s?o comuns em pacientes com ICC. Mecanismos exatos de a??o destes dois fatores associados ou isolados na determina??o dos sintomas respirat?rios nestes pacientes ainda s?o desconhecidos. De acordo com este primeiro estudo, uma menor ventila??o na regi?o diafragm?tica levaria a uma maior percep??o da dispn?ia durante o exerc?cio subm?ximo nesta popula??o. Al?m disso, as mudan?as observadas no padr?o de distribui??o regional da ventila??o nos pacientes com ICC em rela??o aos indiv?duos saud?veis podem servir como base para outros estudos prospectivos utilizando o TMI. O segundo artigo original demonstrou que o TMI para pacientes portadores de ICC mostrou-se eficaz para melhora na for?a muscular, capacidade funcional e qualidade de vida para esta popula??o. Este trabalho tamb?m observou o comportamento da distribui??o dos volumes pulmonares para o sistema t?raco-abdominal nesta popula??o, elucidando que maiores volumes nos compartimentos da caixa tor?cica abdominal e abdominal podem refletir em uma maior efetividade da contra??o diafragm?tica. Concluindo, o terceiro e ?ltimo artigo trouxe elucida??es para os pacientes portadores de CCC: o VO2M?X est? diretamente relacionado com a for?a dos m?sculos inspirat?rios e a qualidade de vida nestes doentes, enquanto que a deterioriza??o da fun??o pulmonar sugere refletir em uma fraqueza dos m?sculos da inspira??o