Comparação da redução na força muscular de membros superiores e membros inferiores após um protocolo de fadiga em pacientes com Doença Pulmonar Obstrutiva Crônica (DPOC)
Comparison between the reduction in muscle force in upper and lower limbs after a fatigue protocol in patients with Chronic Obstructive Pulmonary Disease (COPD)
Heloíse Valéria Possani, Maria José de Carvalho, Vanessa Suziane Probst, Fabio de Oliveira Pitta, Antonio Fernando Brunetto
Resumo
Introdução: A Doença Pulmonar Obstrutiva Crônica (DPOC) tem sido associada a uma disfunção músculoesquelética com diminuição da força muscular (FM) e aumento da fadigabilidade. Essa disfunção, entretanto, não é homogênea havendo relatos na literatura de predomínio em membros inferiores. Objetivos: Quantificar a redução na FM que ocorre após um protocolo de fadiga em membros inferiores (extensores de joelho – Ej) e superiores (flexores de cotovelo – Fc) em pacientes com DPOC e avaliar se essa redução é similar entre Ej e Fc. Materiais e Metodologia: 8 pacientes (5 homens) com DPOC moderada/grave realizaram o teste de 1 Repetição Máxima (1RM) de Fc e Ej. O protocolo de fadiga foi aplicado com 3 séries de 10 contrações com 80% da 1RM. A FM de Fc e Ej foi avaliada utilizando o dinamômetro portátil MicroFet 2 (HogganHealth, EUA) antes do protocolo, imediatamente ao seu final e 5, 10 e 25 minutos após o seu final. A escala de Borg foi utilizada antes e após a coleta dos dados para avaliar a sensação de dispnéia (EBD) e fadiga (EBF) reportada pelos pacientes. Resultados: Houve diferença estatisticamente significante na EBF antes e após o protocolo (p=0.008 tanto para Fc como para Ej). Nos Fc foi observada diferença estatisticamente significante entre a avaliação realizada no 5o e no 10o minuto em relação a antes do protocolo (p<0.01 e p<0.001, respectivamente). Quanto aos Ej, houve apenas tendência de diferença estatística no 5o e no 10o minuto em relação a antes do protocolo (p=0.08 para ambos). Discussão: A FM média de Fc foi similar à de Ej em termos absolutos antes do protocolo, o que indica que os resultados do presente estudo não foram influenciados pela FM basal. Conclusão: Foi observado um predomínio na fadigabilidade dos flexores de cotovelo em relação aos extensores de joelho em pacientes com DPOC.
Palavras-chave
Abstract
Introduction: Chronic Obstructive Pulmonary Disease (COPD) has been associated with a muscle dysfunction with reduction in muscle force (MF) and increased fatigability. This dysfunction, however, is not homogeneous, with reports in the literature indicating predominance in lower limbs. Objective: To quanfity the MF reduction occuring after a fatigue protocol in lower limbs (knee extensors – Ke) and upper limbs (elbow flexors – Ef) in patients with COPD and to assess whether this reduction is similar between Ke and Ef. Materials and Methods: 8 patients (5 men) with moderate/severe COPD performed a 1 repetitium maximum test (1RM) of Ke and Ef. The fatigue protocol was performed with 3 series of 10 contractions with 80% of the 1RM. MF of Ke and Ef was assessed with a portable dynamometer MicroFet 2 (HogganHealth, United States) before the protocol, immediatly after its completion and 5, 10 e 25 minutes after its completion. The Borg scale was applied before and after data collection in order to assess the sensation of dyspnea (BSD) and fatigue (BSF) reported by the patients. Results: There was statistically significant difference in BSF before and after the protocol (p=0.008 both for Ke and Ef). There was statistically significant difference in MF of the Ef assessed in the 5th and 10th minute when compared to before the protocol (p<0.01 and p<0.001, respectively). Concerning the Ke, there was only a trend of statistical difference in the 5th and 10th minute when compared to before the protocol (p=0.08 for both). Discussion: Mean MF of the Ef was similar to the Ke in absolute terms before the protocol, indicating that the present results were not influenced by the baseline MF. Conclusion: Fatigability was more pronounced in elbow flexors than in knee extensors in patients with COPD.
Keywords
References
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