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Previous issue date: 2016-11-03 / Introdu??o: A asma ? a doen?a cr?nica mais comum em crian?as e se tornou um problema de sa?de p?blica devido aos seus grandes custos em cuidados de sa?de. O m?todo Buteyko ? um exerc?cio respirat?rio, constituindo uma interven??o n?o farmacol?gica de baixo custo que vem sendo utilizada por fisioterapeutas em diferentes pa?ses no tratamento de pacientes asm?ticos. Objetivo: Avaliar os efeitos do m?todo Buteyko como terapia adjunta no tratamento de crian?as asm?ticas. M?todos: Estudo controlado randomizado simples-cego, devidamente cadastrado no ClinicalTrails.gov, que avaliou 32 crian?as de 7 a 12 anos com diagn?stico cl?nico de asma. As crian?as participantes foram aleatoriamente randomizadas em dois grupos: grupo Buteyko e grupo controle. O grupo Buteyko foi formado por 16 crian?as que realizaram 3 semanas de tratamento presencial (2 sess?es semanais) com o M?todo Buteyko. As crian?as tamb?m realizaram o M?todo Buteyko em casa diariamente durante o per?odo do tratamento. O grupo controle foi formado por 16 crian?as que receberam, juntamente com seus pais e/ou respons?veis, interven??es educativas em rela??o ? asma. Foram realizadas avalia??es antropom?tricas, de qualidade de vida por meio do question?rio PAQLQ (Paediatric Asthma Quality of Life Questionnaire), de fun??o pulmonar (espirometria) e de capacidade de exerc?cio (teste de caminhada dos 6 minutos ? TC6M). Al?m disso, foram coletadas informa??es quanto ? ocorr?ncia de hospitaliza??es, visitas ao pronto-socorro, faltas na escola por exacerba??o da doen?a, crises al?rgicas e de asma e uso da medica??o para al?vio de sintomas. As avalia??es ocorreram em dois momentos: antes do in?cio do treinamento e ap?s as 3 semanas de tratamento. Os dados foram analisados por meio do software SPSS 20.0, com n?vel de signific?ncia de 5%. A normalidade dos dados foi verificada pelo teste Shapiro-Wilk. As vari?veis cont?nuas com distribui??o normal foram apresentadas como m?dias e desvios padr?es. Aquelas com distribui??o n?o normal como medianas e intervalos interquartis. As vari?veis categ?ricas foram apresentadas como frequ?ncia. Os testes Mann-Whitney e Wilcoxon foram utilizados para comparar os escores do PAQLQ entre os grupos e intragrupos, respectivamente. A compara??o das vari?veis iniciais e finais para espirometria e dist?ncia percorrida no TC6M dentro do mesmo grupo foi realizada por meio do teste t de student pareado e entre os dois grupos por meio do teste t de student n?o pareado. O teste Exato de Fisher foi realizado para comparar, entre os grupos controle e Buteyko, a ocorr?ncia de crises al?rgicas e de asma, faltas na escola por exacerba??o da doen?a e uso de medica??o de al?vio. Resultados: A compara??o intragrupos mostrou melhora para todos os escores de qualidade de vida em ambos os grupos e melhora no pico de fluxo expirat?rio (PFE) no grupo Buteyko. A compara??o entre os grupos mostrou melhora para dois par?metros de fun??o pulmonar (rela??o do volume expirat?rio for?ado no primeiro segundo com a capacidade vital for?ada - VEF1/CVF e fluxo expirat?rio for?ado entre 25% e 75% da capacidade vital for?ada - FEF25-75%) e menor ocorr?ncia de crises de asma, uso de medica??o para al?vio dos sintomas e faltas na escola por exacerba??o da doen?a no grupo Buteyko. Conclus?o: Dados do presente estudo mostram que o M?todo Buteyko otimizou par?metros de fun??o pulmonar (VEF1/CVF, FEF25-75% e PFE) e relatos de sintomas (crises de asma, uso de medica??o para al?vio dos sintomas e faltas na escola) na popula??o estudada. Tanto o M?todo Buteyko quanto a educa??o sobre asma foram capazes de melhorar a qualidade de vida nas crian?as avaliadas. / Introduction: Asthma is the most common chronic disease among children and became a public health problem due to its high cost in health care. The Buteyko method is a breathing exercise and a low cost and non-pharmacological intervention that has been used by physical therapists in different countries in the treatment of patients with asthma. Objective: To assess the effects of the Buteyko method as an adjunct therapy to medical treatment of children with asthma. Methods: Single-blind randomized controlled trial registered on ClinicalTrails.gov that assessed 32 children aged 7 to 12 years old with asthma diagnose. Children were randomized into two groups: Buteyko group and control group. Buteyko group consisted of 16 children who underwent three weeks of treatment (two sessions per week) with the Buteyko method. Children also performed the Buteyko Method daily at home during the treatment period. Control group consisted of 16 children who received, along with their parents and / or guardians, educational interventions on asthma. We assessed quality of life by the PAQLQ (Paediatric Asthma Quality of Life Questionnaire), lung function (spirometry) and exercise capacity (six-minute walk test). Moreover, we collected data regarding occurrence of admissions to hospital, visits to the emergency room and days off school due to asthma exacerbations, episodes of allergy and asthma exacerbations, and reliever medication usage. Assessments were held in two moments: before and after the three weeks of treatment. Data were analyzed by the SPSS software with a significant level of 5%. Data normality was analyzed by the Shapiro-Wilk test. Continuous variables with normal distribution were expressed as means and standard deviations. Those with a non-normal distribution as median and interquartile ranges. Categorical variables were expressed as frequency. The Mann-Whitney U and Wilcoxon tests were used to compare the scores of PAQLQ between and intragroups, respectively. Between and intragroup comparison of the spirometry variables and the 6-minute walk test distance was performed by the paired and unpaired t test. The Fisher exact test was used to compare the occurrence of visits to the emergency room and days off school due to asthma exacerbations, episodes of allergy and asthma exacerbations, and reliever medication usage between groups. Results: Intragroup analysis showed an improvement in all quality of life scores in both groups and in peak expiratory flow (PEF) in the Buteyko group. Between-group analysis showed an improvement in two lung function parameters (forced expiratory volume in 1s / forced vital capacity ratio - FEV1/FVC and forced expiratory flow between 25 and 75% of forced vital capacity - FEF25-75%) and fewer occurrence of episodes of asthma exacerbations, reliever medication usage and days off school due to asthma exacerbations in the Buteyko group. Conclusion: Data from the present showed that the Buteyko Method was effective to improve some lung function (FEV1/FVC, FEF25-75% and PEF) and symptoms parameters (episodes of asthma exacerbations, reliever medication usage and days off school due to asthma exacerbations). Both the Buteyko Method and asthma education improved quality of life in the children assessed.
| Identifer | oai:union.ndltd.org:IBICT/oai:repositorio.ufrn.br:123456789/22535 |
| Date | 03 November 2016 |
| Creators | Freitas, Diana Am?lia de |
| Contributors | 72298863415, http://lattes.cnpq.br/1736384836028397, Silva, Baldomero Antonio Kato da, 63747235115, http://lattes.cnpq.br/6675687901015335, Ferreira, Gardenia Maria Holanda, 21268843334, http://lattes.cnpq.br/4934425482168899, Yamauchi, Liria Yuri, 17035091882, http://lattes.cnpq.br/3898949209852523, Nogueira, Patricia Angelica de Miranda Silva, 02545172421, http://lattes.cnpq.br/1788918737416095, Mendon?a, Karla Morganna Pereira Pinto de |
| Publisher | PROGRAMA DE P?S-GRADUA??O EM FISIOTERAPIA, UFRN, Brasil |
| Source Sets | IBICT Brazilian ETDs |
| Language | Portuguese |
| Detected Language | English |
| Type | info:eu-repo/semantics/publishedVersion, info:eu-repo/semantics/doctoralThesis |
| Source | reponame:Repositório Institucional da UFRN, instname:Universidade Federal do Rio Grande do Norte, instacron:UFRN |
| Rights | info:eu-repo/semantics/openAccess |
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