pressure in healthy adults.docx
- 文档编号:25369065
- 上传时间:2023-06-07
- 格式:DOCX
- 页数:11
- 大小:140.65KB
pressure in healthy adults.docx
《pressure in healthy adults.docx》由会员分享,可在线阅读,更多相关《pressure in healthy adults.docx(11页珍藏版)》请在冰豆网上搜索。
pressureinhealthyadults
Evaluationoftheeffectoflearningonthefullextentofinspiratoryandexpiratorypressureinhealthyadults
BeatrizBrancoGiuliani1;GlauciaCristianeOlavo1;KátiadeSouzaMachado1;LuizCarlosdeAbreu2;VitorEngraciaValenti3;RodrigoDaminelloRaimundo1,2,4
1.FaculdadesMetropolitanasUnidas,DepartamentodeFisioterapia,SãoPaulo,Brasil
2.FaculdadedeMedicinadoABC,LaboratóriodeDelineamentodePesquisaseEscritaCientífica,SantoAndré,Brasil
3.FaculdadedeFilosofiaeCiências,UNESP,DepartamentodeFonoaudiologia,Marília,SãoPaulo,Brasil
4.FaculdadedeSaúdePúblicadaUSP,DepartamentodeSaúdeMaterno-Infantil,SãoPaulo,Brasil
E-mail:
bia.branco@
Receivedin October132015.
FirstReviewin November182015.
Acceptedin November252015.
ABSTRACT
BACKGROUND:
Measurementsofmaximalinspiratoryandexpiratorypressureareusedtoassessthepressuredevelopedbytherespiratorymusclesandthepassiveelasticrecoilofthepulmonarysystem.Suchmeasurementsarealsousedascriteriaforweaningfrommechanicalventilation,todeterminethefunctionalconsequencesofseveralsystemicdiseasesandthedevelopmentoflungdiseasesandneuromusculardisorders.Thetestinanoutpatientsettingiseasytoperform,welltoleratedandhaspredictivevalue.
OBJECTIVE:
Toverifythepresenceofalearningeffectinmeasurementsofmaximalinspiratoryandexpiratorypressures.
METHODS:
Weperformed15sequentialmeasurementsofMaximalInspiratoryPressureand15ofMaximalExpiratoryPressurein71individuals.Resultsforbothserieswerecomparedthroughouteachseries.
RESULTS:
Thecomparisonbetweenthefirstandtheothermeasurementsshowednostatisticallysignificantdifferences.(p>0.05).
CONCLUSIONS:
Therewasnolearningeffectwith15repeatedmeasurementsofMaximalInspiratoryorExpiratoryPressureinhealthyadults.
Keywords:
Inspiratorypressure;Learningeffect;Respiratorymuscles.
RESUMO
INTRODUÇÃO:
Medidasdepressãoinspiratóriamáximaepressãoexpiratóriamáximasãousadosparaavaliaraforçadesenvolvidapelosmúsculosrespiratórios.Taismedidassãotambémutilizadascomocritériosparaodesmamedaventilaçãomecânica,paradeterminarasconseqüênciasfuncionaisdeváriasdoençassistêmicasedodesenvolvimentodedoençaspulmonareseneuromusculares.
OBJETIVO:
Verificarapresençadoefeitodeaprendizadonasmensuraçõesdepressãoinspiratóriaeexpiratóriamáximas.
MÉTODO:
Foramrealizadas15mediçõesseqüenciaisdepressãoinspiratóriamáximae15depressãoexpiratóriamáximaem71indivíduos.Osresultadosparaambasassériesforamcomparadosaolongodecadasérie
RESULTADOS:
Ascomparaçõesentreaprimeiraeasdemaismedidasnãoapresentaramdiferençasestatisticamentesignificativas(p>0,05).
CONCLUSÃO:
Nãohouveefeitoaprendizadoem15medidasrepetidasdepressãoinspiratóriamáximaoupressãoexpiratóriamáximaemadultossaudáveis.
Palavras-chave:
pressãoinspiratóriamáxima;efeitoaprendizagem;músculosrespiratórios.
INTRODUCTION
Assessmentofmusclestrengthisanimportanttooltoquantifyvoluntarymotorfunctionandphysicalperformance.Currently,thereareavarietyoftestsandscalesgraduatingpotencyandresistanceinmuscularstructures;respiratorymusclestrengthmaybeevaluatedthroughspecifictestssuchasmaximalinspiratorypressure(MIP)andmaximalexpiratorypressure(MEP).1 Thetestthatevaluatesthesepressuresreflectsthetorquegeneratedbytherespiratorymusclesonthelungparenchyma,intheinspiratoryandexpiratorygestures,duringanactivecycle.Itisastaticmaneuverwithanoccludedairwayvoluntarilyheldwiththesupportofamanometer.2
Pressuremeasurementsduringthemaneuverreflectthepressuresdevelopedbytherespiratorymuscles,inadditiontothepassiveelasticrecoilofthepulmonarysystemincludingthepulmonaryparenchymaandthechestwall.3
Themeasurementsofrespiratorystrengthareconsideredrealisticestimatesofisometricandisotoniccontractionofthemusclesoftheribcage.4Suchmeasurementsareusedtodeterminethefunctionalconsequencesofseveralsystemicdiseasesandthedevelopmentofpulmonaryandneuromusculardisorders;theyarealsousedascriteriaforweaningpatientsfromtheventilator.1
Thesearelowcostandeasytoperformtestsinoutpatientsettingsandarewelltoleratedbysedentarypatients,evenbythosewhohavesomephysicalweakness;thereforetheyareoftenusedinclinicalpractice,intheprocessoffunctionalevaluationorreevaluationoftreatmentprotocols.1,2,4
Today,therearenostudiesaimedtoascertainwhetheronlythreerepetitionswouldbeenoughtoevaluatethemaximumvaluesofrespiratorypressuresofpatients;soweaimedtoevaluatetheeffectsoflearningonthevaluesobtainedinthemeasurementtechniqueofMIPandMEPbyrecordingvaluesfoundin15repetitionsforeachpressureOurmainobjectivewastoverifythepresenceofanylearningeffectonmaximalinspiratoryandexpiratorypressuresinhealthyyoungadults.
METHOD
Thiswasaprospectivestudyincluding71volunteers,9men(13%),62women(87%)withameanageof26±6years,meanheight1.66±0.09m,meanweight67±13kgandmeanBMI24±3.5kg/cm2.ThestudywasapprovedbytheInstitutionalEthicsCommittee(case#388476)andparticipantssignedanappropriateinformedconsentform.Thisconsentformattestedthevoluntarynatureoftheirparticipationwiththerighttowithdrawatanytime,withoutpersonalloss.
Youngadultsaged18to35years,withnopulmonary,cardiacorneurologicalprerequisitesandwhoagreedtoparticipatevoluntarilyinthestudydiseaseswereincluded.
Theinclusioncriterionappliedtopersonswhoexertphysicalactivityforatleast30minutesmoreoftenthanthreetimesperweek;theexclusioncriteriaappliedtopersonswithinfectionsintheupperandlowerairwaysanddrinkers.
Initiallyitwasexplainedtotheparticipantsthat15measurementsofMIPand15ofMEPwouldbetaken,andthatsuchmeasurementswouldbecollectednoninvasively.Asingleexaminercollectedallthemeasurementsinastandardizedway.
Anthropometricdatawererecordedonastandardform(age,sex,weight,height,andBMI).Bloodpressurewasmeasuredusingasphygmomanometer(Tycos®)previouslycalibratedandastethoscope(Litmann®).Heartrate(HR)andoxygensaturationweremeasuredusingaportableoximeter(Nonin®).Therespiratoryratewasobtainedvisuallyandrecordedwiththeaidofawatch.
Maximalrespiratorypressureswereevaluatedbymeansofapreviouslycalibratedmanometer(CommercialMedical®).AccordingtotheAmericanThoracicSociety,3 measurementswereperformedwiththepatientseated,withoccludednostrils,andwiththechestsupportedbythechairandthefeetonthefloor.Inthispositionthepatientwasinstructedtoholdthemanometer,insertthedisposablemouthpiecebetweentheteethandtotightlyoccludethelips,inordertopreventairleakage.
Thefollowingguidelineswerepreviouslyestablishedinastandardway:
TomeasureMaximalInspiratoryPressure,thefollowingverbalcommandsweregiven:
"Youwillexpelalltheairyoucan,thenyouwillplacethemouthpiecebetweenyourteethandcloseyourlips,topreventanyairescape.Then,pullairinatonce,asstronglyasyoucan."Duringthecourseofthismaximalinspirationeffort,theverbalstimulus"pull,pull,pull,"wasrepeated.
TomeasureMaximalExpiratoryPressure,thefollowingverbalcommandwasgiven:
"youwillpullinalltheairyoucan,thenplacethemouthpiecebetweenyourteethandcloseyourlips,sothattheairdoesnotescape.Thenreleasetheairatonce,asfastandashardasyoucan."Duringthemaximalexpiration,theverbalstimulus"push,push,push"wasrepeated.
Betweenmeasurements,thevolunteerswereinstructedtobreathenormally,duringamonitoredintervalkeptbetween20and30seconds.3 Allmeasurementpointsweresustainedfor1.5seconds.
Thevalueswererecordedonastandardformandkeptfromtheindividuals.Thesubjectswerealsonotinformedaboutthenumberofmeasurementsstillremaining.
StatisticalAnalysis
ForstatisticalanalysisSPSSversion13.0wasused;standardstatisticalmethodswereusedtocalculatethemeansandstandarddeviations.ThenormalGaussiandistributionofthedatawasverifiedbytheShapiro-Wilkgoodness-offittest(zvalueof>1.0).ForparametricdistributionsweappliedANOVAforrepeatedmeasurestestfollowedbytheBonferroniposttest.ThecalculationofANOVAforrepeatedmeasurementswasusedtocomparethefirstmeasurementwiththefollowingonesandshowednostatisticallysignificantvariance.ComparisonsbetweengroupswereperformedusingthepairedStudent'sttestforparametricsampledistribution.Thestatisticalsignificancelevelis<0.05withapowerof95%,withaconfidenceintervalat5%.
RESULTS
Table1presentsthestandarddeviationandstatisticalsignificanceforeachMIPmeasurementalongtheseriesof15repeats.Nostatisticalsignificance(p>0.05)wasobservedbetweenthefirstandthesubsequentmeasurementsofMIP.
Table2presentsthestandarddeviationandstatisticalsignificanceforeachMEPmeanmeasurement.Nostatisticalsignificance(p>0.05)wasdetectedbetweenthefirstandthesubsequentmeasurementsofMEP.
Table3showstheaverageminimumandaveragemaximumvaluesforMIPandMEP.Thelackofstatisticalsignificance(>0.05)alsoreflectsthelackofindividuallearning.
DISCUSSION
Theanalysisofthedatashowsthattherewasnolearningeffectinthisgroup.BlackandHyatt(1969)werethefirsttoevaluateMIPandMEPandhadalreadyproposeditsroleinthediagnosisandprognosisofvari
- 配套讲稿:
如PPT文件的首页显示word图标,表示该PPT已包含配套word讲稿。双击word图标可打开word文档。
- 特殊限制:
部分文档作品中含有的国旗、国徽等图片,仅作为作品整体效果示例展示,禁止商用。设计者仅对作品中独创性部分享有著作权。
- 关 键 词:
- pressure in healthy adults
![提示](https://static.bdocx.com/images/bang_tan.gif)