Treinamento muscular inspiratório e exercícios respiratórios em adultos asmáticos: repercussão na qualidade de vida e na função pulmonar

Abstract

The respiratory muscles are sensitive to a suitable training program, and can be worked in order to improve their strength and endurance. This study treats with an experimental design with pre and post-test. The purpose is to verify if the effects of a program of inspiratory muscle training and breathing exercises alter the quality of life and pulmonary function in asthmatic patients. We evaluated 33 patients who were randomly divided into three groups, each group consisting of 11 patients. The group 1 (G1) had a treatment of therapeutic breathing exercises associated with inspiratory muscle training and a program of asthma education; group 2 (G2), was subjected to therapeutic breathing exercises and educational program; and group 3 (G3) only participated in the educational program. It is important to emphasize that all medications was protocoled. The patients was subjected to a clinicfunctional evaluation, constituted of a medic evaluation and some tests like manovacuometry for measurement of inspiratory and expiratory pressures, spirometry, and a questionnaire of quality of life in asthma. The patients was subjected in a muscle training protocol for 6 weeks with 3 weekly treatment visits, and an educational program that was conducted in 3 moments, in the beginning in the first, fourth and sixth week. The analysis was performed by observing some criteria. The qualitative variables were analyzed using the Fisher Exact Test and the test for McNemar observations at two moments, and between means (quantitative variables) was applied the T of Student test was performed for a paired comparisons before and after treatment and ANOVA in the scores between the groups. The software used was R 2.11 fixed in an alpha level of significance below or equal to 0,05 and a coefficient of confidence of 95%. In the comparative analysis of muscular strength variables (PImax e PEmax) and spirometry pre and post-intervention, an increase in the PImax from - 67,45 ± 24,3 to - 106,18 ± 14,41 (p< 0,001) in G1, and in the spirometry the CVF increased from 78,64 ± 23,89 to 95,9 ± 17,38 (p= 0,003), VEEF1 from 71,78 ± 24,52 to 84.06 ± 22,64, VEEF1/CVF from 82,3 ± 14,38 to 92,38 ± 9,62 and FEF 25/75 from 64,7 ± 35,3 to 75 ± 32,38. There was no significant increase of PImax and PEmax in G2 and G3. The CVF of G2 presented a significant increase from 79,41± 14,22 to 90,41 ± 10,91 and VEEF1 from 62,59 ± 16,61 to 75,15± 11,36. Regarding quality of life, there was an improvement in all 3 groups, but only in G1 this improvement was statistically significant in all domains of the questionnaire of quality of life (p <0.005). It is believed that the inspiratory muscle training provides an improvement in the mechanical muscle, promoting lung function, thus improving the quality of life of adults with asthma.