Controle de tronco e função respiratória em indivíduos com distrofia muscular de Duchenne
Arquivos
Data
2020-05-27
Autores
Freitas, Bruna de Souza [UNIFESP]
Orientadores
Sá, Cristina dos Santos Cardoso de [UNIFESP]
Tipo
Dissertação de mestrado
Título da Revista
ISSN da Revista
Título de Volume
Resumo
Introdução: A progressão da fraqueza muscular é a principal consequência da Distrofia Muscular de Duchenne (DMD). Instrumentos de avaliações específicos são necessários para a escolha correta da prática clínica. Estudos prévios apontam que o controle de tronco e uma função respiratória íntegra contribui para qualidade de vida melhor e é essencial para realização de atividades de vida diária. Objetivo: Avaliar o controle de tronco e função respiratória dos indivíduos com DMD. Método: Trata-se de um estudo transversal. A amostra foi composta por 66 indivíduos com diagnóstico de DMD, sendo 27 deambuladores e 39 cadeirantes, de seis a 26 anos. Foram submetidos à avaliação quanto ao aspecto cognitivo pelo Mini Exame do Estado Mental (MEEM); pela Avaliação Segmentar do Tronco (SATCo-Br) e por meio do escoliômetro; e aspectos respiratórios pela análise da CVF tanto em vazão volumétrica quanto em percentis por meio da espirometria, Manovacuometria e Medida de Fluxo da Tosse, e o estadiamento da doença classificado pela Escala Vignos. Resultados: Os indivíduos deambuladores tiveram melhor controle de tronco em relação aos indivíduos cadeirantes. A análise de comparação entre os grupos com as variáveis respiratórias apontou diferença significativa da CVF (l/min), da CVF (%) e dos valores de Peak Flow Meter; a análise entre os grupos, com escoliose e Peak Flow Meter e a CVF (%) apontou interação significativa; existe correlação fraca e positiva entre o nível de controle de tronco e a CVF (%) e existe correlação fraca e negativa entre o nível de controle de tronco e os valores do Peak Flow Meter. Conclusão: O controle de tronco e a função respiratória pelas variáveis da CVF (%) e PEmáx, são melhores nos indivíduos deambuladores. O nível de controle de tronco foi melhor nos deambuladores enquanto que, no grupo cadeirante, o comprometimento estava muito prejudicado. Houve correlação fraca entre o controle de tronco e a função respiratória.
Introduction: Progression of muscle weakness is the main consequence of Duchenne Muscular Dystrophy (DMD). Specific assessment instruments are necessary for the correct choice of clinical practice. Previous studies indicate that trunk control and healthy respiratory function contribute to a better quality of life and is essential for performing activities of daily living. Objective: To evaluate the control of trunk and respiratory function of individuals with DMD. Method: This is a cross-sectional study. The sample consisted of 66 individuals diagnosed with DMD, 27 ambulators and 39 wheelchair users, from six to 26 years old. They were submitted to evaluation regarding the cognitive aspect by the Mini Mental State Examination (MMSE); by the Segmental Assessment of Trunk Control (SATCo-Br) and through the scoliometer; and respiratory aspects by FVC analysis both in volumetric flow and percentiles through spirometry, Manovacuometry and Cough Flow Measurement, and the staging of the disease classified by the Vignos Scale. Results: The ambulant individuals had better trunk control in relation to the wheelchair users. The comparison analysis between the groups with the respiratory variables showed a significant difference in FVC (l/min), FVC (%) and peak flow meter values, analysis between the groups, with scoliosis and Peak Flow Meter and FVC (%) pointed out significant interaction; there is a weak and positive correlation between the level of trunk control and FVC (%) and there is a weak and negative correlation between the trunk control level and the Peak Flow Meter values. Conclusion: Trunk control and respiratory function by FVC variables (%) and Mepmax, are better in ambulators. The level of trunk control was better in the ambulators, while in the wheelchair group, the involvement was greatly impaired. There was a weak correlation between trunk control and respiratory function.
Introduction: Progression of muscle weakness is the main consequence of Duchenne Muscular Dystrophy (DMD). Specific assessment instruments are necessary for the correct choice of clinical practice. Previous studies indicate that trunk control and healthy respiratory function contribute to a better quality of life and is essential for performing activities of daily living. Objective: To evaluate the control of trunk and respiratory function of individuals with DMD. Method: This is a cross-sectional study. The sample consisted of 66 individuals diagnosed with DMD, 27 ambulators and 39 wheelchair users, from six to 26 years old. They were submitted to evaluation regarding the cognitive aspect by the Mini Mental State Examination (MMSE); by the Segmental Assessment of Trunk Control (SATCo-Br) and through the scoliometer; and respiratory aspects by FVC analysis both in volumetric flow and percentiles through spirometry, Manovacuometry and Cough Flow Measurement, and the staging of the disease classified by the Vignos Scale. Results: The ambulant individuals had better trunk control in relation to the wheelchair users. The comparison analysis between the groups with the respiratory variables showed a significant difference in FVC (l/min), FVC (%) and peak flow meter values, analysis between the groups, with scoliosis and Peak Flow Meter and FVC (%) pointed out significant interaction; there is a weak and positive correlation between the level of trunk control and FVC (%) and there is a weak and negative correlation between the trunk control level and the Peak Flow Meter values. Conclusion: Trunk control and respiratory function by FVC variables (%) and Mepmax, are better in ambulators. The level of trunk control was better in the ambulators, while in the wheelchair group, the involvement was greatly impaired. There was a weak correlation between trunk control and respiratory function.
Descrição
Citação
FREITAS, Bruna de Souza. Controle de tronco e função respiratória em indivíduos com distrofia muscular de Duchenne. 2020. 62 f. Dissertação (Mestrado Interdisciplinar em Ciências da Saúde) - Instituto de Saúde e Sociedade, Universidade Federal de São Paulo, Santos, 2020.