Raíssa de Oliveira Borja

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.

Prediction equations for maximal respiratory pressures of Brazilian adolescents

BACKGROUND The literature emphasizes the need for studies to provide reference values and equations able to predict respiratory muscle strength of Brazilian subjects at different ages and from different regions of Brazil. OBJECTIVES To develop prediction equations for maximal respiratory pressures (MRP) of Brazilian adolescents. METHOD In total, 182 healthy adolescents (98 boys and 84 girls) aged between 12 and 18 years, enrolled in public and private schools in the city of Natal-RN, were evaluated using an MVD300 digital manometer (Globalmed®) according to a standardized protocol. Statistical analysis was performed using SPSS Statistics 17.0 software, with a significance level of 5%. Data normality was verified using the Kolmogorov-Smirnov test, and descriptive analysis results were expressed as the mean and standard deviation. To verify the correlation between the MRP and the independent variables (age, weight, height and sex), the Pearson correlation test was used. To obtain the prediction equations, stepwise multiple linear regression was used. RESULTS The variables height, weight and sex were correlated to MRP. However, weight and sex explained part of the variability of MRP, and the regression analysis in this study indicated that these variables contributed significantly in predicting maximal inspiratory pressure, and only sex contributed significantly to maximal expiratory pressure. CONCLUSION This study provides reference values and two models of prediction equations for maximal inspiratory and expiratory pressures and sets the necessary normal lower limits for the assessment of the respiratory muscle strength of Brazilian adolescents.

Prediction equations for spirometry in four- to six-year-old children

OBJECTIVE To generate prediction equations for spirometry in 4- to 6-year-old children. METHODS Forced vital capacity, forced expiratory volume in 0.5s, forced expiratory volume in one second, peak expiratory flow, and forced expiratory flow at 25-75% of the forced vital capacity were assessed in 195 healthy children residing in the town of Sete Lagoas, state of Minas Gerais, Southeastern Brazil. The least mean squares method was used to derive the prediction equations. The level of significance was established as p<0.05. RESULTS Overall, 85% of the children succeeded in performing the spirometric maneuvers. In the prediction equation, height was the single predictor of the spirometric variables as follows: forced vital capacity=exponential [(-2.255)+(0.022×height)], forced expiratory volume in 0.5s=exponential [(-2.288)+(0.019×height)], forced expiratory volume in one second=exponential [(-2.767)+(0.026×height)], peak expiratory flow=exponential [(-2.908)+(0.019×height)], and forced expiratory flow at 25-75% of the forced vital capacity=exponential [(-1.404)+(0.016×height)]. Neither age nor weight influenced the regression equations. No significant differences in the predicted values for boys and girls were observed. CONCLUSION The predicted values obtained in the present study are comparable to those reported for preschoolers from both Brazil and other countries.

Comparação das pressões respiratórias máximas entre escolares das redes pública e privada

Objective: To compare the values of maximal inspiratory pressures (MIP) and maximal expiratory pressures (MEP) between students from public and private schools. Methods: Observational cross-sectional study of 144 children from public and private schools. Maximal respiratory pressures were measured with an MVD300 (Globalmed). Student’s t-test was applied to compare average pressures and chi-square test was used to compare the frequency of children who performed or not physical activity. Results: Students from private and public schools showed a mean MIP of 77.0±21.5 and 65.7±18.7cmH 2 O (p=0.002) and MEP of 90.1±22.5 and 79.4±19.0cmH 2 O (p=0.005),OBJETIVO: Comparar los valores obtenidos de las presiones inspiratorias maximas (PImax) y presiones espiratorias maximas (PEmax) entre estudiantes de las redes publica y privada de ensenanza. METODOS: Estudio observacional de tipo descriptivo transversal. Se evaluo a 144 ninos en las dos redes de ensenanza. Las presiones respiratorias maximas fueron medidas con el MVD300 (Gobalmed®). Se aplico la prueba t de Student no pareada para comparar los promedios de las variables y la prueba de chi cuadrado para comparar la frecuencia de ninos que realizaban o no actividad fisica. RESULTADOS: Los alumnos de las escuelas privadas y publicas presentaron, respectivamente, promedio de PImax 77,0±21,5 y 65,7±18,7cmH2O (p=0,002) y PEmax 90,1±22,5 y 79,4±19,0cmH2O (p=0,005). Los muchachos de las escuelas privadas y publicas presentaron promedios de PImax 85,0±20,8 y 74,4±17,1cmH2O (p=0,051) y PEmax 98,5±2,5 y 89,2±16,3cmH2O (p=0,103), respectivamente. Las muchachas de las escuelas privadas y publicas presentaron promedios de PImax 70,0±19,8 y 60,2±17,8cmH2O (p=0,027) y PEmax 82,6±20,0 y 73,2±18,1cmH2O (p=0,035), respectivamente. Un 40% de los alumnos de la red publica y un 95% de los alumnos de la red privada realizaban actividad fisica. Los ninos que realizaban o no actividad fisica presentaron PImax 76,0±20,7 y 63,2±20,0cmH2O (p=0,002) y PEmax 89±21,6 y 77,4±20,5cmH2O (p=0,006), respectivamente. CONCLUSIONES: La fuerza muscular respiratoria de los alumnos de la red privada fue significativamente superior a la de los alumnos de la red publica, especialmente entre las muchachas, y posiblemente esa diferencia este relacionada a la practica de actividad fisica, observada con mas frecuencia en las escuelas privadas.

Reference values and factors related to thoracic mobility in Brazilian children

OBJECTIVE: To provide reference values and to evaluate the factors influencing thoracic mobility in children aged 7 to 11 years old. METHODS: A total of 166 children were assessed from public and private schools (90 girls and 76 boys) in the city of Natal (Northeast Brazil). Demographic and anthropometric data were collected, and the thoracic perimeter was assessed by cirtometry. Non-paired Students t-test and variance analysis compared xiphoid respiratory coefficient between sex and ages, respectively. Axillary respiratory coefficient differences between sex and ages were tested by Mann-Whitney and Kruskal-Wallis tests, respectively, with differences located by Duncan post-hoc test. Spearman and Pearson correlation coefficients were used to verify the association between independent variables with the assessed coefficients. RESULTS: Xiphoid and axillary perimetry means were 5.00±1.59 and 4.75±1.56cm, respectively. There was a low correlation, without statistical significance, between xiphoid respiratory coefficient and age, sex, weight, height, and body mass index. The axillary respiratory coefficient was correlated with weight and height. Differences were found in the axillary respiratory coefficient in the age groups between 8-10 (p=0.03) and 10-11 years old (p=0.02). CONCLUSIONS: Reference values for thoracic cirtometry were provided for children aged between seven and 11 years old. Sex, age, weight, height, and body mass index did not influence xiphoid respiratory coefficient. The axillary respiratory coefficient was different between ages, from eight years onwards, being significantly influenced by height and weight regardless of sex.

Pressões respiratórias máximas de pico e sustentada na avaliação da força muscular respiratória de crianças

OBJECTIVES: to compare peak and sustained values of PImax and PEmax in a sample of schoolaged children. METHODS: a descriptive observational crosssection analysis. 144 healthy boys and girls between the ages of 7 and 11 were evaluated. An anthropometric assessment was performed and measurements of peak and sustained respiratory muscle strength with the use of a digital manometer. The child chose at random what initial respiratory pressure to hold. The measurement of PImax was taken from total lung capacity and the measurement of PEmax from residual volume. Data was analyzed using SPSS 17.0 and was attributed a significance level of 5%. RESULTS: the following findings were produced bythe study: 78.53 ± 22.53 cmH2O for PIpeak and 72.95 ± 21.22 cmH2O and 86.25 ± 21.8 cmH2O for PIsust and PEsust respectively. The values obtained throughpeak respiratory pressures (PIpeak and PEpeak) were significantly higher than the measurements obtained for sustained respiratory pressures (PIsust and PEsust)regardless of gender or age assessment (p=0.001). CONCLUSIONS: the use of measures in assessing peak maximum respiratory pressure, more easily obtained in clinical practice, may undermine the real measurements of respiratory muscle strength in children between 7 and 11 years of age.

Comparación de las presiones respiratorias máximas entre escolares de las redes pública y privada

Objective: To compare the values of maximal inspiratory pressures (MIP) and maximal expiratory pressures (MEP) between students from public and private schools. Methods: Observational cross-sectional study of 144 children from public and private schools. Maximal respiratory pressures were measured with an MVD300 (Globalmed). Student’s t-test was applied to compare average pressures and chi-square test was used to compare the frequency of children who performed or not physical activity. Results: Students from private and public schools showed a mean MIP of 77.0±21.5 and 65.7±18.7cmH 2 O (p=0.002) and MEP of 90.1±22.5 and 79.4±19.0cmH 2 O (p=0.005),OBJETIVO: Comparar los valores obtenidos de las presiones inspiratorias maximas (PImax) y presiones espiratorias maximas (PEmax) entre estudiantes de las redes publica y privada de ensenanza. METODOS: Estudio observacional de tipo descriptivo transversal. Se evaluo a 144 ninos en las dos redes de ensenanza. Las presiones respiratorias maximas fueron medidas con el MVD300 (Gobalmed®). Se aplico la prueba t de Student no pareada para comparar los promedios de las variables y la prueba de chi cuadrado para comparar la frecuencia de ninos que realizaban o no actividad fisica. RESULTADOS: Los alumnos de las escuelas privadas y publicas presentaron, respectivamente, promedio de PImax 77,0±21,5 y 65,7±18,7cmH2O (p=0,002) y PEmax 90,1±22,5 y 79,4±19,0cmH2O (p=0,005). Los muchachos de las escuelas privadas y publicas presentaron promedios de PImax 85,0±20,8 y 74,4±17,1cmH2O (p=0,051) y PEmax 98,5±2,5 y 89,2±16,3cmH2O (p=0,103), respectivamente. Las muchachas de las escuelas privadas y publicas presentaron promedios de PImax 70,0±19,8 y 60,2±17,8cmH2O (p=0,027) y PEmax 82,6±20,0 y 73,2±18,1cmH2O (p=0,035), respectivamente. Un 40% de los alumnos de la red publica y un 95% de los alumnos de la red privada realizaban actividad fisica. Los ninos que realizaban o no actividad fisica presentaron PImax 76,0±20,7 y 63,2±20,0cmH2O (p=0,002) y PEmax 89±21,6 y 77,4±20,5cmH2O (p=0,006), respectivamente. CONCLUSIONES: La fuerza muscular respiratoria de los alumnos de la red privada fue significativamente superior a la de los alumnos de la red publica, especialmente entre las muchachas, y posiblemente esa diferencia este relacionada a la practica de actividad fisica, observada con mas frecuencia en las escuelas privadas.

Comparison of maximal respiratory pressures between schoolchildren from public and private schools

Objective: To compare the values of maximal inspiratory pressures (MIP) and maximal expiratory pressures (MEP) between students from public and private schools. Methods: Observational cross-sectional study of 144 children from public and private schools. Maximal respiratory pressures were measured with an MVD300 (Globalmed). Student’s t-test was applied to compare average pressures and chi-square test was used to compare the frequency of children who performed or not physical activity. Results: Students from private and public schools showed a mean MIP of 77.0±21.5 and 65.7±18.7cmH 2 O (p=0.002) and MEP of 90.1±22.5 and 79.4±19.0cmH 2 O (p=0.005),OBJETIVO: Comparar los valores obtenidos de las presiones inspiratorias maximas (PImax) y presiones espiratorias maximas (PEmax) entre estudiantes de las redes publica y privada de ensenanza. METODOS: Estudio observacional de tipo descriptivo transversal. Se evaluo a 144 ninos en las dos redes de ensenanza. Las presiones respiratorias maximas fueron medidas con el MVD300 (Gobalmed®). Se aplico la prueba t de Student no pareada para comparar los promedios de las variables y la prueba de chi cuadrado para comparar la frecuencia de ninos que realizaban o no actividad fisica. RESULTADOS: Los alumnos de las escuelas privadas y publicas presentaron, respectivamente, promedio de PImax 77,0±21,5 y 65,7±18,7cmH2O (p=0,002) y PEmax 90,1±22,5 y 79,4±19,0cmH2O (p=0,005). Los muchachos de las escuelas privadas y publicas presentaron promedios de PImax 85,0±20,8 y 74,4±17,1cmH2O (p=0,051) y PEmax 98,5±2,5 y 89,2±16,3cmH2O (p=0,103), respectivamente. Las muchachas de las escuelas privadas y publicas presentaron promedios de PImax 70,0±19,8 y 60,2±17,8cmH2O (p=0,027) y PEmax 82,6±20,0 y 73,2±18,1cmH2O (p=0,035), respectivamente. Un 40% de los alumnos de la red publica y un 95% de los alumnos de la red privada realizaban actividad fisica. Los ninos que realizaban o no actividad fisica presentaron PImax 76,0±20,7 y 63,2±20,0cmH2O (p=0,002) y PEmax 89±21,6 y 77,4±20,5cmH2O (p=0,006), respectivamente. CONCLUSIONES: La fuerza muscular respiratoria de los alumnos de la red privada fue significativamente superior a la de los alumnos de la red publica, especialmente entre las muchachas, y posiblemente esa diferencia este relacionada a la practica de actividad fisica, observada con mas frecuencia en las escuelas privadas.

Valores de referencia y factores relacionados con la movilidad torácica en niños brasileños

OBJECTIVE: To provide reference values and to evaluate the factors influencing thoracic mobility in children aged 7 to 11 years old. METHODS: A total of 166 children were assessed from public and private schools (90 girls and 76 boys) in the city of Natal (Northeast Brazil). Demographic and anthropometric data were collected, and the thoracic perimeter was assessed by cirtometry. Non-paired Students t-test and variance analysis compared xiphoid respiratory coefficient between sex and ages, respectively. Axillary respiratory coefficient differences between sex and ages were tested by Mann-Whitney and Kruskal-Wallis tests, respectively, with differences located by Duncan post-hoc test. Spearman and Pearson correlation coefficients were used to verify the association between independent variables with the assessed coefficients. RESULTS: Xiphoid and axillary perimetry means were 5.00±1.59 and 4.75±1.56cm, respectively. There was a low correlation, without statistical significance, between xiphoid respiratory coefficient and age, sex, weight, height, and body mass index. The axillary respiratory coefficient was correlated with weight and height. Differences were found in the axillary respiratory coefficient in the age groups between 8-10 (p=0.03) and 10-11 years old (p=0.02). CONCLUSIONS: Reference values for thoracic cirtometry were provided for children aged between seven and 11 years old. Sex, age, weight, height, and body mass index did not influence xiphoid respiratory coefficient. The axillary respiratory coefficient was different between ages, from eight years onwards, being significantly influenced by height and weight regardless of sex.

Valores de referência e fatores relacionados à mobilidade torácica em crianças brasileiras

OBJECTIVE: To provide reference values and to evaluate the factors influencing thoracic mobility in children aged 7 to 11 years old. METHODS: A total of 166 children were assessed from public and private schools (90 girls and 76 boys) in the city of Natal (Northeast Brazil). Demographic and anthropometric data were collected, and the thoracic perimeter was assessed by cirtometry. Non-paired Students t-test and variance analysis compared xiphoid respiratory coefficient between sex and ages, respectively. Axillary respiratory coefficient differences between sex and ages were tested by Mann-Whitney and Kruskal-Wallis tests, respectively, with differences located by Duncan post-hoc test. Spearman and Pearson correlation coefficients were used to verify the association between independent variables with the assessed coefficients. RESULTS: Xiphoid and axillary perimetry means were 5.00±1.59 and 4.75±1.56cm, respectively. There was a low correlation, without statistical significance, between xiphoid respiratory coefficient and age, sex, weight, height, and body mass index. The axillary respiratory coefficient was correlated with weight and height. Differences were found in the axillary respiratory coefficient in the age groups between 8-10 (p=0.03) and 10-11 years old (p=0.02). CONCLUSIONS: Reference values for thoracic cirtometry were provided for children aged between seven and 11 years old. Sex, age, weight, height, and body mass index did not influence xiphoid respiratory coefficient. The axillary respiratory coefficient was different between ages, from eight years onwards, being significantly influenced by height and weight regardless of sex.