Effects of Respiratory Muscle Training and Respiratory Exercise in Exercise Tolerance, Performing Daily Life Activities and Quality of Life of Patients With COPD.
试验速览
- 阶段
- 不适用
- 发起方
- 入组人数
- 40
- 试验地点
- 2
研究概览
简要总结
In patients with chronic obstructive pulmonary disease (COPD) breaths at an abnormally high lung volume causes the inspiratory muscle to operate at non-optimal lengths, which reduce their maximal contractile forces. In addition, causes non thoraco abdominal synchronize, reduced inspiratory muscle strength and is associated with dyspnea and decreased exercise capacity. For these patients inspiratory muscle training (IMT) is a widely employed form of rehabilitation also targeting the respiratory muscle. In addition, patients often experience shortness of breath and a decline in exercise tolerance, resulting in disability in the performance of activities of daily living (ADL). The aims of this trial are to evaluate the effects of inspiratory muscle training associated with aerobic training on strength and endurance of inspiratory muscle, thoracic abdominal synchrony, exercise tolerance and quality of life patients with COPD. To compare the responses with the effects of aerobic training plus exercises of the trunk and upper limbs, and stretching of large muscle groups of the trunk. To compare difference in the perception of dyspnea during the ADL set (Borg Scale) with perception of dyspnea self-reported in the Medical Research Council (MRC), the London Chest Activity of Daily Living (LCADL) and the Pulmonary Functional Status and Dyspnea Questionnaire - Modified version (PFSDQ-M) before start the protocol. To investigate changes on perception of dyspnea (Borg scale), metabolic and ventilatory responses during a standard set of ADL tasks after a physical training and to evaluate and compare changes on perception of dyspnea. The hypothesis are that the ventilatory efficiency during the performance of ADL and the dyspnea reported from borg scale, the LCADL and the PFSDQ-M that quantifies the functional performance (change in activity levels) are improved during the IMT in conjunction with general exercise training in patients with COPD. The MIT increases the strength and endurance of inspiratory muscle, the exercise capacity and the quality of life compared to the general physical training. However, compared to the thorax abdominal synchronizes, higher modification is verified in the general physical training group with specific exercise to torso, limbs and stretching of the higher muscle group.
详细描述
Methodology Sample Is a prospective longitudinal. Forty patients with COPD to moderate to very severe obstruction (ratio [FEV1/FVC] <70%) and FEV1 <80% predicted (RABE et al., 2008), age ranging from 50 to 80 years old, both sexes will be assessed and treated. All subjects carry out spirometry before and after bronchodilator (BD) under medical supervision.
Experimental Procedure Patients with COPD will undergo a physical assessment of general and specific respiratory system and receive guidance on the tests and treatments proposed in this study. All of them will be instructed to maintain the medication prescribed.
The evaluation will include the following tests: medical history, St George's Respiratory Questionnaire, Medical Research Council (MRC), assessing the strength and endurance of respiratory muscle, spirometry, maximal exercise testing endurance test of the lower limbs, the Six Minute Walk Test and plethysmography of inductance.
Assessment of respiratory muscle strength The assessment of respiratory muscle strength will consist of measures of maximal inspiratory pressure (MIP) and maximal expiratory pressure (MEP), performed according to Black and Hyatt (1969). The measures will be carried out using a manometer scaled in cmH2O (Ger-Ar) fitted with an adapter nozzle, which contains a hole two millimeters in diameter to eliminate the pressures of facial muscles. The subjects carry out the measures in standing posture using a nose clip. The MIP will be measured by a maximal inspiration, preceded by a maximal expiration starting from residual volume, and MEP will be measured by a maximal expiration, preceded by a maximal inspiration based on the total lung capacity. The inspiratory and expiratory must be maintained for at least one second. Will be performed at least three and maximum five measures will be considered acceptable if there is a difference of 10% or less between them. The highest value will be used for statistical analysis. The patients will be allowed a one-minute rest between measurements.
Assessment of respiratory muscle endurance Incremental and constant tests After measurements of MIP the endurance of the inspiratory muscles using the PowerBreathe® will be evaluate.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Treatment
- 盲法
- None
入排标准
- 年龄范围
- 50 Years 至 80 Years（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •the patients with clinical diagnosis of COPD presenting FEV1/FVC < 70% and FEV1 < 80% predicted by pulmonary function observed and were classified as patients with moderate to very severe obstruction (RABE et al., 2008),
- •clinically stable with no history infection or exacerbation of the respiratory symptoms or
- •a change in medication for two months preceding the study.
- •the patients were non oxygen dependent, smokers or former smokers.
排除标准
- •patients with clinical diagnosis of COPD presenting FEV1/FVC ≥ 70% FEV1 ≥ 80% predicted (RABE et al., 2008)
- •who present respiratory, cardiac, rheumatic, musculoskeletal, orthopedic and neuromuscular disorders associated that may prevent them of the testing and intervention proposed,
- •that are experiencing swelling in lower limbs,
- •that change the type of medication during the study,
- •uncontrolled hypertension patients,
- •saturation below 90% at rest and
- •did not agree to sign the formal consent form proposed.
研究者
Renata Pedrolongo Basso, Principal Investigator
Master Degree
Universidade Federal de Sao Carlos