标题：The effects of inspiratory muscle strengthening on MIP and quality of life of elderly nursing home patients. (Los efectos del beneficio de la fuerza del músculo inspiratorio en la PIM y la calidad de vida de los pacientes mayores de la clínica de reposo).
期刊名称：RICYDE. Revista Internacional de Ciencias del Deporte. doi:10.5232/ricyde
印刷版ISSN：1885-3137
出版年度：2008
卷号：4
期号：10
页码：13-24
语种：English
出版社：Ramón Cantó Alcaraz (Publisher)
摘要：Abstract The objective of this study was to compare the effects of inspiratory muscle strengthening on maximal inspiratory pressure (MIP) and on quality of life among elderly nursing home patients. The study population was divided in two groups: experimental group- EG (n=21, 76.48 2.12 years) and control group- CG (n=13, 75.69 2.26 years). The World Health Organization Quality of Life Group (WHOQOL-100) questionnaire was used to evaluate the quality of life of the subjects. A Manovacuometer (analogical, with an operational interval of –150 to +150 cmH2O; Critical Med/USA-2002) was used to evaluate MIP. The study protocol consisted of a gradual increase in workload (50%-100%); the sessions lasted 20 minutes and were composed of 7 series of strengthening (2 minutes each) with a 1-minute interval between the series, 3 times a week for 10 weeks. Variance analysis of multivariate repeated measurements demonstrated significant differences only for MIP between CG (32,69±17,03 cmH2O versus 23,08±10,71 cmH2O) and EG (31,67±11,11 cmH2O versus 55,24±23,26 cmH2O), and the latter was higher than the former (p= 0,00000). Therefore, we concluded that inspiratory muscle strengthening led to an increase in MIP that did not improve quality of life. However, further studies should be done in this population to validate a quality of life questionnaire specific for the elderly. Palabras clave / Key words : nursing home patients | MIP | quality of life | pacientes de la clinica de reposo | PIM | calidad de vida Resumen El objetivo de este estudio era comparar los efectos de la musculatura inspiratoria que consolidaban en la presión inspiratoria máxima (PIM) y en la calidad de la vida entre pacientes mayores de la clínica de reposo. Dividieron a la población del estudio en dos grupos: grupo experimental EG. (n=21,76.48 2.12 años) y grupo de control CG (n=13, 75.69 2.26 años). El cuestionario de la Organización Mundial de la Salud sobre calidad de vida (WHOQOL-100) fue utilizado para valorar la calidad de vida de los participantes. Un Manovacuometer (analógico, con un intervalo operacional - de 150 a +150 cmH2O; Med/USA-2002 crítico) fue utilizado para evaluar la MIP. El protocolo del estudio consistió en un aumento gradual en la carga de trabajo (50%-100%); las sesiones duraron 20 minutos y fueron compuestas de 7 series de consolidación (2 minutos cada uno) con un 1 intervalo minucioso entre la serie, 3 veces a la semana por 10 semanas. El análisis de variación de medidas repetidas multivariante demostró diferencias significativas solamente para la MIPS entre CG (32,69±17,03 cmH2O contra 23,08±10,71 cmH2O) y EG. (31,67±11,11 cmH2O contra 55,24±23,26 cmH2O), y el último era más alto que el anterior (p= 0.00000). Por lo tanto, concluimos que el músculo inspiratorio que consolidaba condujo a un aumento en la MIPS que no mejoró la calidad de la vida. Sin embargo, otros estudios se deben hacer en esta población para validar el cuestionario de calidad de vida para los ancianos. doi:10.5232/ricyde2008.01002 --------------------------------------------------------------------- References/referencias Chaunchaiyakul, R., Goeller, H., Clarke, J.R. and Taylor, N.A.S. (2004). The impact of aging and habitual physical activity on static respiratory work at rest and during exercise. Am J Physiol Lung Cell Mol Physiol 287, 1098-106. doi:10.1152/ajplung.00399.2003 PMid:15246978 Cimen, O.B., Ulubas, B., Sahin, G., Calikoglu, M., Bagis, S. and Erdogan, C. (2003). Pulmonary function tests, respiratory muscle strength and endurance of patients with osteoporosis. South Med J, 96(5), 423-426. doi:10.1097/01.SMJ.0000054229.42761.CF Covey, M.K., Larson, J.L., Wirtz, S.E., Berry, J.K., Pogue, N.J. and Alex, C.G. (2001). High-intensity inspiratory muscle training in patients with chronic obstructive pulmonary disease and severely reduced function. J Cardiopulm. Rehabil, 21(4), 231-440. doi:10.1097/00008483-200107000-00008 PMid:11508185 De Vet, H.C.W., Ader, H.J., Terwee, C.B. and Pouwer, F. (2005). Are factor analytical techniques used appropriately in the validation of health status questionnaires? A systematic review on the quality of factor analysis of the SF-36. Qual Life Re,s 14(6), 1203-1218. doi:10.1007/s11136-004-5742-3 PMid:16047498 Enright, S., Chatham, K., Ionescu, A.A., Unnithan, V.B. and Shale, D.J. (2004). Inspiratory Muscle Training Improves Lung Function and Exercise Capacity in Adults with Cystic Fibrosis. Chest, 126, 405-411. doi:10.1378/chest.126.2.405 PMid:15302725 Fleck, M.P.A., Borges, Z.N., Bolognesi, G. and Rocha, N.S. (2003). Desenvolvimento do WHOQOL, módulo espiritualidade, religiosidade e crenças pessoais. Rev Saúde pública, 37(4), 446-455. doi:10.1590/S0034-89102003000400009 Fregonezi, G.A.F., Resqueti, V.R.R., Guell, R., Pradas, J. and Casan, P. (2005). Effects of 8-week, interval-based inspiratory muscle training and breathing retraining in patients with generalized myasthenia gravis. Chest, 128,1524-1530. doi:10.1378/chest.128.3.1524 PMid:16162753 Gerritsen, D.L., Steverink, N., Ooms, M.E. and Ribbe, M.W. (2004). Finding a useful conceptual basis for enhancing the quality of life of nursing home residents. Qual Life Res, 13, 611-624. doi:10.1023/B:QURE.0000021314.17605.40 PMid:15130025 Katsura, H., Yamada, K., Wakabayashi, R. and Kida, K. (2005). The impact of dyspnoea and leg fatigue during exercise on health-related quality of life in patients with COPD. Respirology, 10, 485-490. doi:10.1111/j.1440-1843.2005.00729.x PMid:16135172 Klefbeck, B. and Hamrah-Nedjad, J. (2003). Effect of inspiratory muscle training in patients with multiple sclerosis. Arch Phys Med Rehabil, 84(7), 994-999. doi:10.1016/S0003-9993(03)00133-3 Kraemer, W.J., Koziris, L.P., Ratamess, N.A., Hakkinen, K., Triplett-McBride, N.T. and Fry, A.C. (2002). Detraining produces minimal changes in rhysical performance and hormonal variables in recreationally strength-trained men. Journal Strength and Conditioning Research, 16(3), 373-382. PMid:12173951 Laoutaris, I., Dritsas, A., Brown, M.D., Manginas, A., Alivizatos, P.A. and Cokkinos, D.V. (2004). Inspiratory muscle training using an incremental endurance test alleviates dyspnea and inproves functional status in patients with cronic heart failure. Eur J Cardiovasc Prev Rehabil, 11(6), 489-496. doi:10.1097/00149831-200412000-00008 Liaw, M.Y., Lin, M.C., Cheng, P.T., Wong, M.K. and Tang, F.T. (2000). Resistive inspiratory muscle training: its effectiveness in patients with acute complete cervical cord injury. Arch Phys Med Rehabil, 81(6), 752-756. PMid:10857519 Mahler, D.A. and Mackowiak, J.I. (1995). Evaluation of the short-form 36-item questionnaire to measure health-related quality of life in patients with COPD. Chest, 107(6), 1585-1589. doi:10.1378/chest.107.6.1585 PMid:7781351 Marcell, T.J. (2003). Sarcopenia: causes, consequences and preventions. Biological Sciences and medical Sciences, 58, M911-M916. Neder, J.A., Andreoni, S., Lerario, M.C. and Nery, L.E. (1999). Reference values for lung function tests. II. Maximal respiratory pressures and voluntary ventilation. Braz J Med Biol Res, 32(6), 719-727. doi:10.1590/S0100-879X1999000600007 Pine, M.J., Murphy, A.J. and Watsford, M.L. (2005). Role of respiratory system function in the age-related decline of human functional capacity. Australasian Journal on Ageing, 24(3), 153-156. doi:10.1111/j.1741-6612.2005.00104.x Steiner, M.C. and Morgan M.D.L. (2001). Enhancing physical performance in chronic obstructive pulmonary disease. Thorax, 56, 73-77. doi:10.1136/thorax.56.1.73 PMid:11120909 PMCid:1745895 Sturdy, G., Hillman, D., Green, D., Jenkins, S., Cecins, N. and Eastwood, P. Feasibility of High-Intensity Interval-Based Respiratory Muscle Training in COPD. Chest, 123, 142-150. doi:10.1378/chest.123.1.142 PMid:12527615 Uijl, S.G., Houtman, S., Folgering, H.T.M. and Hopman, M.T.E. (1999). Training of the respiratory muscles in individuals with tetraplegia. Spinal Cord, 37(8), 575-579. doi:10.1038/sj.sc.3100887 PMid:10455534 Van-Der-Esch, M., Van-T-Hul, A.J., Heijmans, M. and Dekker, J. (2004). Respiratory muscle performance as a possible determinat of exercise in patients with ankylosing spondylitis. Aust J Physiother, 50(1), 41-45. PMid:14987191 Volianitis, S., McConnell, A.K. and Jones, D.A. (2001). Assessment of maximum inspiratory pressure: prior submaximal respiratory muscle activity (warm-up) enhances maximum inspiratory activity and attenuates the learning effect of repeated measurement. Respiration, 68(1), 22-27. doi:10.1159/000050458 PMid:11223726 Weiner, P., Magadle, R., Beckerman, M. and Bear-Yanay, N. (2002). The relationship among inspiratory muscle strenght, the perception of dyspnea and inhaled beta2-agonist use in patients with asthma. Can Respir J, 9(5), 307-312. PMid:12410322 ---------------------------------------------------------------------
关键词：nursing home patients;MIP;quality of life;pacientes de la clinica de reposo;PIM;calidad de vida
