Desfechos da terapia manual sobre a biomecânica da deglutição, função respiratória e qualidade de vida de indivíduos com DPOC
Ano de defesa: | 2018 |
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Autor(a) principal: | |
Orientador(a): | |
Banca de defesa: | , , , |
Tipo de documento: | Tese |
Tipo de acesso: | Acesso aberto |
Idioma: | por |
Instituição de defesa: |
Universidade Federal de Santa Maria
Centro de Ciências da Saúde |
Programa de Pós-Graduação: |
Programa de Pós-Graduação em Distúrbios da Comunicação Humana
|
Departamento: |
Fonoaudiologia
|
País: |
Brasil
|
Palavras-chave em Português: | |
Palavras-chave em Inglês: | |
Área do conhecimento CNPq: | |
Link de acesso: | http://repositorio.ufsm.br/handle/1/20831 |
Resumo: | Introduction: pulmonary hyperinflation, a major feature of COPD, results in dysfunction of the respiratory muscles, placing the diaphragm at a mechanical disadvantage and recruitment of accessory breathing muscles. As a result, respiratory function and quality of life (QoL) are impaired. Additionally, deglutition disorders occur frequently, predisposing to the risk of aspiration and exacerbations, attributed to altered thoracoabdominal biomechanics one of the causes of incoordination between breathing/deglutition. Manual Therapy (MT) has been applied in the management of individuals with respiratory dysfunctions, such as the Proprioceptive Neuromuscular Facilitation (PNF) method and the Diaphragmatic Liberation Technique (DLT), providing a better respiratory muscle action. To date, research that has associated both techniques in the management of individuals with COPD has not been found in the literature, as well as its possible implication on deglutition. Objective: to analyze the outcomes of MT on biomechanics of swallowing, respiratory function and QOL of individuals with COPD. Method: 18 individuals with a mean age of 66,06±8,86 years, 61,1% (11) men, and %FEV1 mean 40,28±16,73 were evaluated before and after MT. The measures of the biomechanics of swallowing were: oral transit time, pharyngeal transit time (FTT), number of swallows, vallecular (VL) residues and pyriform sinuses, penetration/aspiration and hiolaringeal excursion in liquid and pasty consistencies. The respiratory function outcomes were: heart rate (HR), respiratory rate (RF), peripheral oxygen saturation (Sats), maximal inspiratory (MIP) and expiratory pressure (MEP), dyspnea (MRC) and QoL (SGRQ). Results: in the biomechanics of swallowing, a significant difference was observed in FTT (p=0,04), residues in VL (p=0,03), maximum hyoid elevation (0,003) and displacement of hyoid (p=0,02) in pasty consistency. In the liquid consistency there was reduction of residues in VL (p=0,001). In the respiratory function, there was a difference in HR (p=0,04), RR (p=0,007), Sats (p<0,0001), MIP and %MIP (p<0,0001), MEP and %MEP (p=0,001). In the QoL the domains symptoms (p=0,001), impact (p=0,001) and total score (p=0,001) differed before and after the program. Conclusion: MT program interfered in the biomechanics of swallowing demonstrated by FTT reduction, VL residues and increased hyoid elevation and displacement in pasty consistency. In the liquid consistency there was reduction of residues in VL. Respiratory function improved vital parameters, increased respiratory muscle strength and improved QoL. |
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2021-05-10T22:41:08Z2021-05-10T22:41:08Z2018-07-05http://repositorio.ufsm.br/handle/1/20831Introduction: pulmonary hyperinflation, a major feature of COPD, results in dysfunction of the respiratory muscles, placing the diaphragm at a mechanical disadvantage and recruitment of accessory breathing muscles. As a result, respiratory function and quality of life (QoL) are impaired. Additionally, deglutition disorders occur frequently, predisposing to the risk of aspiration and exacerbations, attributed to altered thoracoabdominal biomechanics one of the causes of incoordination between breathing/deglutition. Manual Therapy (MT) has been applied in the management of individuals with respiratory dysfunctions, such as the Proprioceptive Neuromuscular Facilitation (PNF) method and the Diaphragmatic Liberation Technique (DLT), providing a better respiratory muscle action. To date, research that has associated both techniques in the management of individuals with COPD has not been found in the literature, as well as its possible implication on deglutition. Objective: to analyze the outcomes of MT on biomechanics of swallowing, respiratory function and QOL of individuals with COPD. Method: 18 individuals with a mean age of 66,06±8,86 years, 61,1% (11) men, and %FEV1 mean 40,28±16,73 were evaluated before and after MT. The measures of the biomechanics of swallowing were: oral transit time, pharyngeal transit time (FTT), number of swallows, vallecular (VL) residues and pyriform sinuses, penetration/aspiration and hiolaringeal excursion in liquid and pasty consistencies. The respiratory function outcomes were: heart rate (HR), respiratory rate (RF), peripheral oxygen saturation (Sats), maximal inspiratory (MIP) and expiratory pressure (MEP), dyspnea (MRC) and QoL (SGRQ). Results: in the biomechanics of swallowing, a significant difference was observed in FTT (p=0,04), residues in VL (p=0,03), maximum hyoid elevation (0,003) and displacement of hyoid (p=0,02) in pasty consistency. In the liquid consistency there was reduction of residues in VL (p=0,001). In the respiratory function, there was a difference in HR (p=0,04), RR (p=0,007), Sats (p<0,0001), MIP and %MIP (p<0,0001), MEP and %MEP (p=0,001). In the QoL the domains symptoms (p=0,001), impact (p=0,001) and total score (p=0,001) differed before and after the program. Conclusion: MT program interfered in the biomechanics of swallowing demonstrated by FTT reduction, VL residues and increased hyoid elevation and displacement in pasty consistency. In the liquid consistency there was reduction of residues in VL. Respiratory function improved vital parameters, increased respiratory muscle strength and improved QoL.Introdução: a hiperinsuflação pulmonar, característica principal da DPOC, resulta em disfunções da musculatura respiratória, colocando o diafragma em desvantagem mecânica e recrutamento dos músculos acessórios da respiração. Como resultado, a função respiratória e a qualidade de vida (QV) ficam prejudicadas. A biomecânica toracoabdominal alterada nestes casos é uma das causas de incoordenação entre respiração/deglutição que pode estar associada à presença dos transtornos de deglutição predispondo os indivíduos ao risco aspirativo. A Terapia Manual (TM) tem sido aplicada no manejo de indivíduos com disfunções respiratórias, como o método de Facilitação Neuromuscular Proprioceptiva (FNP) e a Técnica de Liberação Diafragmática (TLD), para proporcionar melhor ação da musculatura respiratória. Até o momento, pesquisas que tenham associado ambas as técnicas no manejo de indivíduos com DPOC não foram encontradas na literatura, bem como sua possível implicação sobre a deglutição. Objetivo: analisar os desfechos da terapia manual sobre a biomecânica da deglutição, função respiratória e QV de indivíduos com DPOC. Método: foram avaliados 18 indivíduos com idade média 66,06±8,86 anos, 61,1% (11) homens e %VEF1 médio 40,28±16,73 antes e após programa de TM. As medidas da biomecânica da deglutição foram: tempo de trânsito oral, tempo de trânsito faríngeo (TTF), número de deglutições, resíduos em valéculas (VL) e seios piriformes, penetração/aspiração e movimentação do hioide na deglutição das consistências líquida e pastosa. Já os desfechos da função respiratória foram: frequência cardíaca (FC), frequência respiratória (FR), saturação periférica de oxigênio (SpO2), pressões inspiratória (PIMÁX) e expiratória (PEM) máximas, sensação de dispneia (MRC) e QV (SGRQ). Resultados: na biomecânica da deglutição foi observada diferença significativa no TTF (p=0,04), resíduos em VL (p=0,03), elevação máxima do hioide (p=0,003) e deslocamento do hioide (p=0,02) na consistência pastosa. Na consistência líquida observou-se apenas redução de resíduos em VL (p=0,001). Na função respiratória houve diferença na FC (p=0,04), FR (p=0,007), SpO2 (p<0,0001), PIMÁX e %PIMÁX (p<0,0001), PEM e %PEM (p=0,001). Na QV vida os domínios sintomas (p=0,001), impacto (p=0,001) e pontuação total (p=0,001) diferiram antes e após o programa. Conclusão: o programa de TM interferiu na biomecânica da deglutição demonstrada pela redução do TTF, resíduos em VL e maior elevação e deslocamento do hioide na consistência pastosa. Na consistência líquida houve redução de resíduos em VL. Na função respiratória houve melhora dos parâmetros vitais, aumento da força muscular respiratória e melhora na QV.Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPESporUniversidade Federal de Santa MariaCentro de Ciências da SaúdePrograma de Pós-Graduação em Distúrbios da Comunicação HumanaUFSMBrasilFonoaudiologiaAttribution-NonCommercial-NoDerivatives 4.0 Internationalhttp://creativecommons.org/licenses/by-nc-nd/4.0/info:eu-repo/semantics/openAccessDPOC (Doença Pulmonar Obstrutiva Crônica)Terapia manualTranstornos da deglutiçãoQualidade de vidaFunção respiratóriaManual therapyDeglutition disordersRespiratory functionQuality of lifeCNPQ::CIENCIAS DA SAUDE::FONOAUDIOLOGIADesfechos da terapia manual sobre a biomecânica da deglutição, função respiratória e qualidade de vida de indivíduos com DPOCOutcomes of manual therapy on biomechanics of swallowing, respiratory function and quality of life in individuals with COPDinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/doctoralThesisMancopes, Renatahttp://lattes.cnpq.br/9897341072714640Pasqualoto, Adriane SchmidtDumke, AneliseBolzan, Geovana de PaulaAlbuquerque, Isabella Martins deAlmeida, Sheila Tamanini dehttp://lattes.cnpq.br/8303461662333873Steidl, Eduardo Matias dos Santos400700000003600d7ce0251-a99c-477a-baaf-6ed8e04d61563d100551-cd09-4d01-9374-63ac8745901b10914cf2-ba2b-41e0-8189-9fe6e5df21d3016819ea-504c-4f94-818b-e6fb9fe72355472cc93c-2c67-4450-b861-82ddc2f07e78c6c7935e-3ee4-4cc9-aa46-a4be4b7eadd3aa9102e5-5cfa-47ab-9c1a-4a2c39e1d4c7reponame:Manancial - Repositório Digital da UFSMinstname:Universidade Federal de Santa Maria (UFSM)instacron:UFSMCC-LICENSElicense_rdflicense_rdfapplication/rdf+xml; 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dc.title.por.fl_str_mv |
Desfechos da terapia manual sobre a biomecânica da deglutição, função respiratória e qualidade de vida de indivíduos com DPOC |
dc.title.alternative.eng.fl_str_mv |
Outcomes of manual therapy on biomechanics of swallowing, respiratory function and quality of life in individuals with COPD |
title |
Desfechos da terapia manual sobre a biomecânica da deglutição, função respiratória e qualidade de vida de indivíduos com DPOC |
spellingShingle |
Desfechos da terapia manual sobre a biomecânica da deglutição, função respiratória e qualidade de vida de indivíduos com DPOC Steidl, Eduardo Matias dos Santos DPOC (Doença Pulmonar Obstrutiva Crônica) Terapia manual Transtornos da deglutição Qualidade de vida Função respiratória Manual therapy Deglutition disorders Respiratory function Quality of life CNPQ::CIENCIAS DA SAUDE::FONOAUDIOLOGIA |
title_short |
Desfechos da terapia manual sobre a biomecânica da deglutição, função respiratória e qualidade de vida de indivíduos com DPOC |
title_full |
Desfechos da terapia manual sobre a biomecânica da deglutição, função respiratória e qualidade de vida de indivíduos com DPOC |
title_fullStr |
Desfechos da terapia manual sobre a biomecânica da deglutição, função respiratória e qualidade de vida de indivíduos com DPOC |
title_full_unstemmed |
Desfechos da terapia manual sobre a biomecânica da deglutição, função respiratória e qualidade de vida de indivíduos com DPOC |
title_sort |
Desfechos da terapia manual sobre a biomecânica da deglutição, função respiratória e qualidade de vida de indivíduos com DPOC |
author |
Steidl, Eduardo Matias dos Santos |
author_facet |
Steidl, Eduardo Matias dos Santos |
author_role |
author |
dc.contributor.advisor1.fl_str_mv |
Mancopes, Renata |
dc.contributor.advisor1Lattes.fl_str_mv |
http://lattes.cnpq.br/9897341072714640 |
dc.contributor.advisor-co1.fl_str_mv |
Pasqualoto, Adriane Schmidt |
dc.contributor.referee1.fl_str_mv |
Dumke, Anelise |
dc.contributor.referee2.fl_str_mv |
Bolzan, Geovana de Paula |
dc.contributor.referee3.fl_str_mv |
Albuquerque, Isabella Martins de |
dc.contributor.referee4.fl_str_mv |
Almeida, Sheila Tamanini de |
dc.contributor.authorLattes.fl_str_mv |
http://lattes.cnpq.br/8303461662333873 |
dc.contributor.author.fl_str_mv |
Steidl, Eduardo Matias dos Santos |
contributor_str_mv |
Mancopes, Renata Pasqualoto, Adriane Schmidt Dumke, Anelise Bolzan, Geovana de Paula Albuquerque, Isabella Martins de Almeida, Sheila Tamanini de |
dc.subject.por.fl_str_mv |
DPOC (Doença Pulmonar Obstrutiva Crônica) Terapia manual Transtornos da deglutição Qualidade de vida Função respiratória |
topic |
DPOC (Doença Pulmonar Obstrutiva Crônica) Terapia manual Transtornos da deglutição Qualidade de vida Função respiratória Manual therapy Deglutition disorders Respiratory function Quality of life CNPQ::CIENCIAS DA SAUDE::FONOAUDIOLOGIA |
dc.subject.eng.fl_str_mv |
Manual therapy Deglutition disorders Respiratory function Quality of life |
dc.subject.cnpq.fl_str_mv |
CNPQ::CIENCIAS DA SAUDE::FONOAUDIOLOGIA |
description |
Introduction: pulmonary hyperinflation, a major feature of COPD, results in dysfunction of the respiratory muscles, placing the diaphragm at a mechanical disadvantage and recruitment of accessory breathing muscles. As a result, respiratory function and quality of life (QoL) are impaired. Additionally, deglutition disorders occur frequently, predisposing to the risk of aspiration and exacerbations, attributed to altered thoracoabdominal biomechanics one of the causes of incoordination between breathing/deglutition. Manual Therapy (MT) has been applied in the management of individuals with respiratory dysfunctions, such as the Proprioceptive Neuromuscular Facilitation (PNF) method and the Diaphragmatic Liberation Technique (DLT), providing a better respiratory muscle action. To date, research that has associated both techniques in the management of individuals with COPD has not been found in the literature, as well as its possible implication on deglutition. Objective: to analyze the outcomes of MT on biomechanics of swallowing, respiratory function and QOL of individuals with COPD. Method: 18 individuals with a mean age of 66,06±8,86 years, 61,1% (11) men, and %FEV1 mean 40,28±16,73 were evaluated before and after MT. The measures of the biomechanics of swallowing were: oral transit time, pharyngeal transit time (FTT), number of swallows, vallecular (VL) residues and pyriform sinuses, penetration/aspiration and hiolaringeal excursion in liquid and pasty consistencies. The respiratory function outcomes were: heart rate (HR), respiratory rate (RF), peripheral oxygen saturation (Sats), maximal inspiratory (MIP) and expiratory pressure (MEP), dyspnea (MRC) and QoL (SGRQ). Results: in the biomechanics of swallowing, a significant difference was observed in FTT (p=0,04), residues in VL (p=0,03), maximum hyoid elevation (0,003) and displacement of hyoid (p=0,02) in pasty consistency. In the liquid consistency there was reduction of residues in VL (p=0,001). In the respiratory function, there was a difference in HR (p=0,04), RR (p=0,007), Sats (p<0,0001), MIP and %MIP (p<0,0001), MEP and %MEP (p=0,001). In the QoL the domains symptoms (p=0,001), impact (p=0,001) and total score (p=0,001) differed before and after the program. Conclusion: MT program interfered in the biomechanics of swallowing demonstrated by FTT reduction, VL residues and increased hyoid elevation and displacement in pasty consistency. In the liquid consistency there was reduction of residues in VL. Respiratory function improved vital parameters, increased respiratory muscle strength and improved QoL. |
publishDate |
2018 |
dc.date.issued.fl_str_mv |
2018-07-05 |
dc.date.accessioned.fl_str_mv |
2021-05-10T22:41:08Z |
dc.date.available.fl_str_mv |
2021-05-10T22:41:08Z |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/doctoralThesis |
format |
doctoralThesis |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://repositorio.ufsm.br/handle/1/20831 |
url |
http://repositorio.ufsm.br/handle/1/20831 |
dc.language.iso.fl_str_mv |
por |
language |
por |
dc.relation.cnpq.fl_str_mv |
400700000003 |
dc.relation.confidence.fl_str_mv |
600 |
dc.relation.authority.fl_str_mv |
d7ce0251-a99c-477a-baaf-6ed8e04d6156 3d100551-cd09-4d01-9374-63ac8745901b 10914cf2-ba2b-41e0-8189-9fe6e5df21d3 016819ea-504c-4f94-818b-e6fb9fe72355 472cc93c-2c67-4450-b861-82ddc2f07e78 c6c7935e-3ee4-4cc9-aa46-a4be4b7eadd3 aa9102e5-5cfa-47ab-9c1a-4a2c39e1d4c7 |
dc.rights.driver.fl_str_mv |
Attribution-NonCommercial-NoDerivatives 4.0 International http://creativecommons.org/licenses/by-nc-nd/4.0/ info:eu-repo/semantics/openAccess |
rights_invalid_str_mv |
Attribution-NonCommercial-NoDerivatives 4.0 International http://creativecommons.org/licenses/by-nc-nd/4.0/ |
eu_rights_str_mv |
openAccess |
dc.publisher.none.fl_str_mv |
Universidade Federal de Santa Maria Centro de Ciências da Saúde |
dc.publisher.program.fl_str_mv |
Programa de Pós-Graduação em Distúrbios da Comunicação Humana |
dc.publisher.initials.fl_str_mv |
UFSM |
dc.publisher.country.fl_str_mv |
Brasil |
dc.publisher.department.fl_str_mv |
Fonoaudiologia |
publisher.none.fl_str_mv |
Universidade Federal de Santa Maria Centro de Ciências da Saúde |
dc.source.none.fl_str_mv |
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Universidade Federal de Santa Maria (UFSM) |
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UFSM |
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UFSM |
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Manancial - Repositório Digital da UFSM |
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Manancial - Repositório Digital da UFSM |
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MD5 MD5 MD5 MD5 MD5 |
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Manancial - Repositório Digital da UFSM - Universidade Federal de Santa Maria (UFSM) |
repository.mail.fl_str_mv |
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