Gardênia Maria H. Ferreira

Effectiveness of low-intensity aquatic exercise on COPD: A randomized clinical trial

BACKGROUND Despite the growing number of studies reporting therapeutic success in water environments, research involving aquatic exercise among patients with Chronic Obstructive Pulmonary Disease (COPD) is scarce. This study evaluates the impact of low-intensity water and floor exercises on COPD. METHODS Forty two individuals with moderate to very severe COPD, divided into 3 groups: Control Group (CG), Floor Group (FG) and the Aquatic Group (AG). All participants were assessed using spirometry, respiratory muscle strength (MIP and MEP), the 6-Minute Walk Test (6MWT), Medical Research Council (MRC), BODE index and the St Georges Respiratory Questionnaire (SGRQ). RESULTS A difference was recorded after intervention for the 6MWT in the AG (p = 0.02); for VEF(1) in the FG (p = 0.00) and AG (p = 0.01); for MIP in the FG (p = 0.01) and AG (p = 0.02); for MEP in the FG (p = 0.02) and AG (p = 0.01); the MRC fell in the AG (p = 0.00). The FG showed improved quality of life evidenced by the total score on the SGRQ (p = 0.00). The BODE index decreased in the FG (p = 0.00) and AG (p = 0.01). CONCLUSION Results show that both forms of low-intensity physical exercise benefit patients with moderate and very severe COPD. The AG exhibited additional benefits in physical ability, indicating a new therapeutic modality targeting patients with COPD.

Treinamento muscular inspiratório em crianças com leucemia aguda: resultados preliminares

OBJECTIVE: To evaluate the effect of inspiratory muscle training in children with acute leukemia. METHODS: This is a quasi-experimental study with a control group. Fourteen patients with 5-14 years old and a diagnosis of acute leukemia were evaluated regarding their thoracic mobility and respiratory muscle strength. They were divided in two groups (A and B). Group A received domiciliary inspiratory muscle training during 15 minutes, twice a day, for ten weeks, with a Threshold® device using a load of 30% of the maximal inspiratory pressure, readjusted after weekly evaluations. Group B patients were tested regarding their maximum respiratory pressures in their first evaluation and after ten weeks. Student t-test was used to evaluate maximum inspiratory and expiratory pressures between groups Pearsons correlation test examined the association of inspiratory and expiratory pressures with the different loads, using SPSS 15.0 software. RESULTS: A significant improvement of 35% was observed in the maximum inspiratory and expiratory pressures in group A at the end of the training. There was a strong positive correlation between the used load levels and maximal inspiratory (p<0.0001) and expiratory (p=0.0001) pressures. CONCLUSIONS: Inspiratory muscle training can be effective for improving inspiratory muscle strength in children beeing treated for acute leukemia.

Força muscular respiratória e perfil postural e nutricional em crianças com doenças neuromusculares

INTRODUCTION: Neuromuscular diseases that affect childrens are degenerative and chronic disorders that lead to functional, muscular and nutritional impairments. OBJECTIVE: Assess respiratory strength, postural and nutritional profile in childrens with neuromuscular disorder followed in on ambulatory outpatients clinics. MATERIALS AND METHODS: Patients with neuromuscular diseases were assessed in relation to respiratory muscle strength (PImax and PEmax), postural profile, walk capacity and nutrition assessment that includes body mass index, muscular mass and body fat percentage. RESULTS: Forty-one patients were included in the study. Male childrens were predominant in the group, 82,9% (n = 34) of them, while female were 17,1% (n = 7). The mean age was 9,65 ± 3,11 years. The most common disorder was Duchenne Miotonic Dystrophy, found in 43.9% (n = 18) of the children, followed by Spinal Muscular Atrophy, 9,75% (n = 4), Congenital muscular dystrophy, 7,31% (n = 3), Erbs scapulohumeral Dystrophy, Polyneuropathy and Congenital Myopathy, all in 4,9% (n = 2), while Progressive Muscular Dystrophy, Myasthenia Gravis, Charcoot Marie Toot, Emery Dreifuss was found in 2,43% (n = 1) of them. We found a decrease in respiratory muscle strength (PImax = 81 ± 24,3 cmH2O, 91% predict and PEmax = 70 ± 29,6 cmH2O, 72% predict), more evident in expiratory muscles. Lumbar hyperlordosis were found in 26 (64%) of the patients, 9 patients (22%) lost their ability to walk. In relation to nutritional profile, 90% (n = 30) showed one high incidence of muscular reserve loss and 52% (n = 13) of the patients body fat was bellow acceptable range. CONCLUSION: Multidisciplinary evaluation of children neuromuscular diseases may assist in establishing early Physical Therapy intervention to improve the quality of life of both patients and caregivers.

Intensidades de treinamento resistido e pressão arterial de idosas hipertensas - um estudo piloto

BACKGROUND: The optimum intensity of resistance training for hypertensive elderly has not been studied yet and the few studies in the literature used training with distinct intensities. Objective: To verify the effect of two resistance training intensities on blood pressure (BP) of elderly women with controlled hypertension. METHODS: Sixteen older women with hypertension controlled by anti-hypertensive drug were randomly divided into two groups. Nine patients were submitted to moderate resistance training (G1) and seven patients were submitted to mild resistance training (G2). The patients underwent eight weeks of resistance training, with frequency of three times per week on alternate days in the afternoon. The exercises performed were: leg press, bench press, knee extension, lat pull-down, knee flexion, shoulder abduction, standing cable hip abduction and biceps curl. RESULTS: G1 patients presented reduction in both resting values in diastolic blood pressure (DBP) p<0.03 and mean arterial pressure (MAP) p<0.03. G2 presented decrease in resting values of MAP (p<0.03) and a tendency to decrease in DBP (p<0.06). Magnitude of values decrease in both groups was higher than the ones reported in the literature. CONCLUSION: Both light and moderate training promoted cardiovascular benefits, even when initiated at old age. Moreover, both can be indicated as supporting treatment for older women with hypertension controlled by medication.

Influência do treinamento resistido realizado em intensidades diferentes e mesmo volume de trabalho sobre a pressão arterial de idosas hipertensas

Systemic arterial hypertension (HBP) is a multifactorial disease with high prevalence in the elderly population, hence resistance exercise (RE) is recommended for that disease. However, the literature lacks studies that demonstrate the acute hypotensive effect of RE in hypertensive elderly subjects. This study aimed to compare the effect of post -exercise hypotension (PEH) for 60 minutes between two sessions of resistance exercises performed at different intensities, but with the same load-repetition ratio in hypertensive elderly elderly women. The sample consisted of 32 women, randomly divided into two groups: 16 patients in the light intensity group (G1) and 16 patients in high intensity group (G2), both with the same training volume. After two weeks of adaptation, the elderly women performed three sessions of resistance exercise and immediately after them, their systolic and diastolic blood pressure were measured for 1 hour every 10 minutes. For statistical analysis Students t test for independent samples, Fisher exact and analysis of variance one-way ANOVA, with p < 0.05 considered significant were used. There was not significant difference of systolic and diastolic blood pressure after exercise in the individuals in groups G1 and G2, neither intra-group. However, there was a tendency for blood pressure reduction in G1 compared to G2. Our data suggest that the sequence of resistance exercise with duration of three sessions did not result in PEH in hypertensive elderly patients, with no significant differences in systolic and diastolic pressure between the groups with light and high intensity.

Observational practice of incentive spirometry in stroke patients

Highlights • Stroke patients performed differently to healthy individuals when learning to use incentive spirometry.• Stroke patients can benefit from learning rehabilitation techniques.• Observational techniques improve the performance of tasks in stroke patients.