Evaluation of respiratory muscle strength and endurance, peripheral muscle strength, and functional capacity in patients with COPD / Avaliação da força e resistência muscular respiratória, força muscular periférica e capacidade funcional em pacientes com DPOC

This is an analytical, observational and cross-sectional study conducted from August 2017 to February 2020 in patients with Chronic Obstructive Pulmonary Disease (COPD) that aimed to assess respiratory muscle strength and endurance, peripheral muscle strength and functional capacity in patients with COPD. Respiratory muscle function was assessed using strength and endurance, peripheral muscle strength using the handgrip test, and functional capacity using the six-minute walk test (6MWT). The sensation of dyspnea was assessed by modified Medical Research Council and risk of exacerbation/hospitalization according to the classification of the Global Initiative for Chronic Obstructive Lung (GOLD). For statistical analysis, the Kolmogorov Smirnov, Chi-square, Pearson's correlation, Student t, ANOVA, and Bonferroni tests were performed with a significance level of 0.05. Forty patients were analyzed. There was a reduction in inspiratory and peripheral muscle strength in 97.5% (p <0.001) and 80% of patients (p = 0.001), respectively, in addition to a decrease in functional capacity in 97.4% (p <0.001) of individuals evaluated. There was a correlation between the GOLD classification with 6MWT (p=0.005) and inspiratory muscle strength (p=0.041), in addition to a relation between distance traveled and spirometric severity of obstruction (p=0.049). We conclude that there was a significant reduction in respiratory and peripheral muscle strength and functional capacity. The higher the degree of obstruction, the worse the performance on the 6MWT. In addition, patients who walked less have a higher risk of exacerbation and hospitalization, as well as those who have less respiratory muscle strength

Oxidative stress and immune system analysis after cycle ergometer use in critical patients

OBJECTIVE: The passive cycle ergometer aims to prevent hypotrophy and improve muscle strength, with a consequent reduction in hospitalization time in the intensive care unit and functional improvement. However, its effects on oxidative stress and immune system parameters remain unknown. The aim of this study is to analyze the effects of a passive cycle ergometer on the immune system and oxidative stress in critical patients. METHODS: This paper describes a randomized controlled trial in a sample of 19 patients of both genders who were on mechanical ventilation and hospitalized in the intensive care unit of the Hospital Agamenom Magalhães. The patients were divided into two groups: one group underwent cycle ergometer passive exercise for 30 cycles/min on the lower limbs for 20 minutes; the other group did not undergo any therapeutic intervention during the study and served as the control group. A total of 20 ml of blood was analysed, in which nitric oxide levels and some specific inflammatory cytokines (tumour necrosis factor alpha (TNF-α), interferon gamma (IFN-γ) and interleukins 6 (IL-6) and 10 (IL-10)) were evaluated before and after the study protocol. RESULTS: Regarding the demographic and clinical variables, the groups were homogeneous in the early phases of the study. The nitric oxide analysis revealed a reduction in nitric oxide variation in stimulated cells (p=0.0021) and those stimulated (p=0.0076) after passive cycle ergometer use compared to the control group. No differences in the evaluated inflammatory cytokines were observed between the two groups. CONCLUSION: We can conclude that the passive cycle ergometer promoted reduced levels of nitric oxide, showing beneficial effects on oxidative stress reduction. As assessed by inflammatory cytokines, the treatment was not associated with changes in the immune system. However, further research in a larger population is necessary for more conclusive results