Associação entre força muscular inspiratória e variáveis de funcionalidade em pessoas idosas com DPOC: um estudo transversal

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Diana Luiza Theis
Maria Júlia Andreta Barros da Silva
Adriane Schmidt Pasqualoto
Tamires Daros dos Santos
Isabella Martins de Albuquerque

Resumo

Introdução: A força muscular inspiratória relaciona-se com variáveis funcionais na doença pulmonar obstrutiva crônica (DPOC). Porém, a literatura é escassa considerando especificamente pessoas idosas com DPOC. Objetivo: Investigar se a força muscular inspiratória está relacionada com variáveis funcionais em pessoas idosas com DPOC. Métodos: Estudo transversal no qual foram elegíveis pessoas idosas, com diagnóstico clínico de DPOC (critérios da GOLD) e candidatos à reabilitação. As seguintes variáveis foram mensuradas: pressão inspiratória máxima (PImáx) (manovacuometria), capacidade funcional (teste de caminhada de seis minutos), mobilidade funcional (Timed Up and Go Test), medo de queda (Falls Efficacy Scale-International), força de preensão palmar (FPP) (dinamometria), resistência muscular periférica (teste de sentar e levantar de 30 segundos), qualidade de vida relacionada à saúde (QVRS) (Questionário do Hospital Saint George na Doença Respiratória) e o impacto da DPOC no estado de saúde (COPD Assessment Test). Resultados: 32 pessoas idosas (68,63±5,35 anos, 17 sexo masculino) com DPOC moderada a muito grave participaram do estudo. A PImáx correlacionou-se negativamente e fortemente com mobilidade funcional (r=-0,706; p<0,0001). Houve correlação positiva e moderada da PImáx com capacidade funcional (r=0,431; p=0,014), a FPP (r=0,565; p<0,001) e resistência muscular periférica (r=0,546; p=0,001). A PImáx apresentou correlação negativa moderada com medo de queda (r=-0,539; p=0,001). Não houve associação entre PImáx com QVRS (r=-0,089; p=0,628) e com impacto da DPOC no estado de saúde (r=-0,297; p=0,098). Conclusão: A força muscular inspiratória foi associada com variáveis de funcionalidade, como mobilidade, capacidade funcional, medo de quedas, força e resistência muscular periférica em pessoas idosas com DPOC.

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Theis, D. L., Silva, M. J. A. B. da, Pasqualoto, A. S., Santos, T. D. dos, & Albuquerque, I. M. de. (2025). Associação entre força muscular inspiratória e variáveis de funcionalidade em pessoas idosas com DPOC: um estudo transversal. ABCS Health Sciences, 50, e025225. https://doi.org/10.7322/abcshs.2024206.3002
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Referências

1. Al Wachami N, Guennouni M, Iderdar Y, Boumendil K, Arraji M, Mourajid Y, et al. Estimating the global prevalence of chronic obstructive pulmonary disease (COPD): a systematic review and meta-analysis. BMC Public Health. 2024;24(1):297. https://doi.org/10.1186/s12889-024-17686-9

2. Halpin DMG, Celli BR, Criner GJ, Frith P, Varela MVL, Salvi S, et al. The GOLD Summit on chronic obstructive pulmonary disease in low- and middle-income countries. Int J Tuberc Lung Dis. 2019;23(11):1131-41. https://doi.org/10.5588/ijtld.19.0397

3. Global Initiative for Chronic Obstructive Lung Disease (GOLD). 2024 GOLD Report: Global strategy for prevention, diagnosis, and management of COPD. Available from: https://goldcopd.org/2024-gold- report/.

4. Cao Y, Li P, Wang Y, Liu X, Wu W. Diaphragm Dysfunction and Rehabilitation Strategy in Patients With Chronic Obstructive Pulmonary Disease. Front Physiol. 2022; 13:872277. https://doi.org/10.3389/fphys.2022.872277

5. Vilaró J, Ramirez-Sarmiento A, Martínez-Llorens JMA, Mendoza T, Alvarez M, Sánchez-Cayado N, et al. Global muscle dysfunction as a risk factor for readmission to hospital due to COPD exacerbations. Respir Med. 2010;104(12):1896-902. https://doi.org/10.1016/j.rmed.2010.05.001

6. Gea J, Martínez-Llorens J. Muscle Dysfunction in Chronic Obstructive Pulmonary Disease: Latest Developments. Disfunción muscular en la enfermedad pulmonar obstructiva crónica: novedades. Arch Bronconeumol. (Engl Ed). 2019;55(5):237-8. https://doi.org/10.1016/j.arbres.2018.07.016

7. Liu X, Li P, Wang Z, Lu Y, Li N, Xião L, et al. Evaluation of isokinetic muscle strength of the upper limb and the relationship with pulmonary function and respiratory muscle strength in stable COPD patients. Int J Chron Obstruct Pulmon Dis. 2019;14:2027-36. https://doi.org/10.2147/COPD.S214737

8. Wei L, Li P, Liu X, Wang Y, Tang Z, Zhao H, et al. Multidimensional Frailty Instruments Can Predict Acute Exacerbations Within One Year in Patients with Stable Chronic Obstructive Pulmonary Disease: A Retrospective Longitudinal Study. Int J Chron Obstruct Pulmon Dis. 2024;19:859-71. https://doi.org/10.2147/COPD.S448294

9. Souza Y, Suzana ME, Medeiros S, Macedo J, Costa CH. Respiratory muscle weakness and its association with exercise capacity in patients with chronic obstructive pulmonary disease. Clin Respir J. 2022;16(2):162-6. https://doi.org/10.1111/crj.13449

10. Suleymanova AK, Baranova IA. Evaluation of the relationship between the parameters of peripheral skeletal and respiratory muscles in patients with chronic obstructive pulmonary disease. Ter Arkh. 2020;92(3):36-41. https://doi.org/10.26442/00403660.2020.03.000448

11. American Thoracic Society/European Respiratory Society. ATS/ERS Statement on respiratory muscle testing. Am J Respir Crit Care Med. 2002;166(4):518-624. https://doi.org/10.1164/rccm.166.4.518

12. Pessoa IMBS, Houri Neto M, Montemezzo D, Silva LAM, Andrade AD, Parreira VF. Predictive equations for respiratory muscle strength according to international and Brazilian guidelines. Braz J Phys Ther. 2014;18(5):410-18. https://doi.org/10.1590/bjpt-rbf.2014.0044

13. Liwsrisakun C, Pothirat C, Chaiwong W, Techatawepisarn T, Limsukon A, Bumroongkit C, et al. Diagnostic ability of the Timed Up & Go test for balance impairment prediction in chronic obstructive pulmonary disease. J Thorac Dis. 2020;12(5):2406-14. https://doi.org/10.21037/jtd.2020.03.47

14. Camargos FFO, Dias RC, Dias JMD, Freire MTF. Adaptação transcultural e avaliação das propriedades psicométricas da Falls Efficacy Scale - International em idosos Brasileiros (FES-I-Brasil). Braz J Phys Ther. 2010;14(3):237-43. https://doi.org/10.1590/S1413-35552010000300010

15. ATS Committee on Proficiency Standards for Clinical Pulmonary Function Laboratories. ATS statement: guidelines for the six-minute walk test. Am J Respir Crit Care Med. 2002;166(1):111-17. https://doi.org/10.1164/ajrccm.166.1.at1102

16. Britto RR, Probst VS, Andrade AFD, Samora GAR, Hernandes NA, Marinho PEM, et al. Reference equations for the six-minute walk distance based on a Brazilian multicenter study. Braz J Phys Ther. 2013;17(6):556-63. https://doi.org/10.1590/S1413-35552012005000122

17. Bohannon RW, Kindig J, Sabo G, Duni AE, Cram P. Isometric knee extension force measured using a handheld dynamometer with and without belt-stabilization. Physiother Theory Pract. 2012;28(7):562-8. https://doi.org/10.3109/09593985.2011.640385

18. Novaes RD, Miranda AS, Silva JO, Tavares BVF, Dourado VZ. Equações de referência para a predição da força de preensão manual em brasileiros de meia idade e idosos. Fisioter Pesqui. 2009;16(3):217-22. https://doi.org/10.1590/S1809-29502009000300005

19. Jones CJ, Rikli RE, Beam WC. A 30-s chair-stand test as a measure of lower body strength in community-residing older adults. Res Q Exerc Sport. 1999;70(2):113-19. https://doi.org/10.1080/02701367.1999.10608028

20. Tveter AT, Dagfinrud H, Moseng T, Holm I. Health-related physical fitness measures: reference values and reference equations for use in clinical practice. Arch Phys Med Rehabil. 2014;95(7):1366-73. https://doi.org/10.1016/j.apmr.2014.02.016

21. Sousa TC, Jardim IR, Jones P. Validação do Questionário do Hospital Saint George na Doença Respiratória (SGRQ) em pacientes portadores de doença pulmonar obstrutiva crônica no Brasil. J Pneumologia. 2000;26(3):119-28. https://doi.org/10.1590/S0102-35862000000300004

22. Jones PW, Tabberer M, Chen WH. Creating scenarios of the impact of COPD and its relationship to COPD Assessment Test (CAT™) Scores. BMC Pulm Med. 2011;11:42. https://doi.org/10.1186/1471-2466-11-42

23. Paranhos R, Figueiredo Filho DB, Rocha EC, Silva Júnior JA, Neves JAB, Santos MLWD. Desvendando os Mistérios do Coeficiente de Correlação de Pearson: o retorno. Leviathan (São Paulo). 2014;8:66-95. https://doi.org/10.11606/issn.2237-4485.lev.2014.132346

24. Develi E, Subasi F, Aslan GK, Bingol Z. The effects of core stabilization training on dynamic balance and pulmonary parameters in patients with asthma. J Back Musculoskelet Rehabil. 2021;34(4):639-48. https://doi.org/10.3233/BMR-191803

25. Florian CA, Corina PC, Adelina M, Vlad C, Cristian O, Emanuela V. Respiratory Muscle Training and Its Impact on Balance and Gait in Patients with Severe COPD. Medicina (Kaunas). 2024;60(2):257. https://doi.org/10.3390/medicina60020257

26. Fonseca J, Machado FVC, Santin LC, Andrello AC, Schneider LP, Belo LF, et al. Handgrip Strength as a Reflection of General Muscle Strength in Chronic Obstructive Pulmonary Disease. COPD. 2021;18(3):299-306. https://doi.org/10.1080/15412555.2021.1919608

27. Gea J, Agustí A, Roca J. Pathophysiology of muscle dysfunction in COPD. J Appl Physiol (1985). 2013;114(9):1222-34. https://doi.org/1152/japplphysiol.00981.2012

28. Zanini A, Aiello M, Cherubino F, Zampogna E, Azzola A, Chetta A, et al. The one repetition maximum test and the sit-to-stand test in the assessment of a specific pulmonary rehabilitation program on peripheral muscle strength in COPD patients. Int J Chron Obstruct Pulmon Dis. 2015;10:2423-30. https://doi.org/10.2147/COPD.S91176

29. Oliveira-Zmuda GG, Soldera CLC, Jovanov E, Bós ÂJG. Timed Up and Go test phases as predictors of future falls in community-dwelling older adults. Fisioter Mov. 2022;35:e35142. https://doi.org/10.1590/fm.2022.35142

30. Chuatrakoon B, Ngai SPC, Sungkarat S, Uthaikhup S. Balance Impairment and Effectiveness of Exercise Intervention in Chronic Obstructive Pulmonary Disease-A Systematic Review. Arch Phys Med Rehabil. 2020;101(9):1590-602. https://doi.org/10.1016/j.apmr.2020.01.016

31. Oliveira CC, Annoni R, Lee AL, McGinley J, Irving LB, Denehy L. Falls prevalence and risk factors in people with chronic obstructive pulmonary disease: A systematic review. Respir Med. 2021;176:106284. https://doi.org/10.1016/j.rmed.2020.106284

32. Ceyhan Y, Tekinsoy Kartin P. The effects of breathing exercises and inhaler training in patients with COPD on the severity of dyspnea and life quality: a randomized controlled trial. Trials. 2022;23(1):707. https://doi.org/10.1186/s13063-022-06603-3

33. Karloh M, Rocha SAV, Pizzichini MMM, Cavalli F, Matte DL, Pizzichini E, et al. Is the COPD Assessment Test sensitive for differentiating COPD patients from active smokers and nonsmokers without lung function impairment? A population-based study. J Bras Pneumol. 2018;44(3):213-19. https://doi.org/10.1590/S1806-37562017000000149