Avaliação entre força muscular respiratória e função pulmonar por meio deexercício em crianças e adolescentes com asma: ensaio clínicocontrolado

Abstract

OBJECTIVE: Evaluate the strength of respiratory muscles, presence ofbronchospasm induced by exercise (BIE) and classify the severity and measure the frequency of bronchospasm in asthmatic and non-asthmatic children and teenagers. METHODS: By means of a controlled trial, 30 asthmatic e 30 non-asthmatic children and teenagers of both sexes, age varying between 6 and 14 years old, scholars wereassessed at the Laboratório de Função Pulmonar do Ambulatório Bias Fortes, between October of 2005 and may 2006. A physiotherapeutic evaluation, respiratory muscular strength and pulmonary function measurements and a bronchial provocative test by running on a threadmill (6 to 8 minutes). The measurements of the respiratory muscular strength and pulmonary function were performed at sixpredetermined times: before the exercise and after 5, 10, 15, 20 e 30 minutes. The protocol elaboration, data bank and statistical analysis were electronically processed by the softwares Mintab (version 14.0) e SPSS (version 13.0). In order to describe the sample, analysis using measurements with central tendency (mean and median) and variability (standard deviation) were performed in the study of the children andteenagers characteristics and comparison test between proportions of the physical activity frequency between the two groups. The qui-quadrado test was adopted to determine the equality or difference of gender between the two groups, the classification of BIE and the severity of the asthma. The students t- test was used for comparisons of age, weight, height, body mass index (BMI), maximal inspiratory pressure (MIP), maximal expiratory pressure (MEP), forced vital capacity (FVC),forced expiratory volume in the first second (FEV1) before and 5, 10, 15, 20 e 30 minutes after the exercise between the experimental and control group. The Pareated t-test was used to verify MIP, MEP, FVC, FEV1 at the basal level and after use of bronchodilatador. Results were considered statistically significant with p 0,05. RESULTS: In 50% (15) of the 30 asthmatic children and teenagers, BIE was observed in this, 7(23,55) they had diagnosis of light asthma; 5(16%) moderate asthma; and 3(10%), serious asthma and 8 demonstrated light BIE. The asthmaticchildren and teenagers demonstrated reduction with statistical significance in FVC, FEV1, MIP, MEP compared to the control group subjects, before and after physical activity. CONCLUSION: BIE occurred exclusively with asthmatic subjects. The evaluation of the respiratory muscular strength detected deficit with statistical significancethroughout the evaluation period. In such case, the best characterization and systematic evaluation of the respiratory muscular strength, in conjunction with pulmonary function, suggest to a major contribution of the propedeutic and therapeutic intervention on the asthmatic children and teenagers.