Associação entre a força muscular respiratória, o nível de independência funcional e o risco de disfagia em idosos pós- AVCi em fase crônica: estudo transversal

Abstract

Introduction: Stroke is one of the main causes of disability and the incidence increases with age. The consequences of stroke often cause permanent limitations. The association between respiratory muscle strength, risk of dysphagia and functional disability have been poorly studied in the chronic phase after stroke. Objective: To analyze whether there is an association between respiratory muscle strength, the level of functional independence and the risk of dysphagia in elderly post-ischemic stroke in the chronic phase. Method: Analytical cross-sectional study approved by the scientific research ethics committee (CAAE 83573318.2.0000.5020 and opinion n° 2.520.8810). The respiratory muscle strength was measured by manovacuometry, the degree of disability by the functional independence measure (FIM) and the risk of dysphagia by the Eating Assessment Toll (EAT-10). Data were presented through tables, with absolute and relative frequencies for categorical data. In the analysis of quantitative data, when the hypothesis of normality was rejected using the Shapiro-Wilk test, the median and quartiles (Q) were calculated. In the analysis of categorical data, the chi-square test was applied. To compare means and medians, Student's t test was used for normal variables and the Mann-Whitney U test for non-normal variables. For the analysis of the correlation between the respiratory muscle strength and the risk of dysphagia, the respiratory muscle strength and the FIM score were used the Spearman test. Data were analyzed using R-Statistics software, version 4.0.2. A significance level of 5% was considered. Results: The respiratory muscle strength of the post-stroke elderly in the chronic phase was lower than that of their controls matched by sex, age and body mass index (PImax and MEP; p<0.001). The respiratory muscle strength of post-stroke elderly in the chronic phase was positively correlated with FIM (PImax: p=0.009; MEP: p<0.001). The risk of dysphagia was negatively correlated with the respiratory muscle strength of post-stroke elderly in the chronic phase (PImax: p=0.001; MEP: p=0.006). Conclusion: Even in the chronic phase of stroke, elderly people have respiratory muscle weakness and this is related to functional restrictions and increases the possibility of developing dysphagia.