Efeitos da adição do treinamento muscular inspiratório à fisioterapia convencional sobre a força muscular respiratória, função pulmonar e capacidade funcional na doença de Parkinson

Abstract

Individuals with Parkinson's disease (PD), in addition to motor impairment, may present respiratory system disorders. Currently, there are few studies with emphasis on muscle and pulmonary dysfunction, and which verify the benefits of inspiratory muscle training (IMT) added to conventional physical therapy in this population. Aim: Evaluate whether IMT added to conventional physical therapy is effective for the improvement of respiratory muscle strength, lung function and functional capacity in PD. Materials and methods: A randomized and controlled trial was conducted with 14 participants with idiopathic PD, aged between 40 and 80 years, in the stages I to III by modified Hoehn and Yahr scale. Respiratory muscle strength was assessed by manovacuometry and pulmonary function by spirometry. The functional capacity was evaluated by the 6-minute walk test. After the evaluations, these participants were randomly assigned to two groups: the IMT group (IMTG), which performed Powerbreathe® for 36 sessions, eight series of two minutes each, with one minute of rest between them, totaling 23 minutes, at 60% of the maximum inspiratory pressure (MIP); and the sham group (SG), which performed the same training protocol, but with 9 cmH2O, the minimum load of equipment. All participants were submitted to the same conventional physical therapy protocol. After the intervention, all participants were re-evaluated. Results: Our data indicate that groups, IMTG and SG, showed significant improvement in MIP (cmH2O) and MIP (% pred). Regarding the variables of maximum expiratory pressure (MEP), spirometric and distance covered in the 6MWT (6MWTD), there was no significant difference after training. Conclusion: Inspiratory muscle strength was improved independently of the protocol of training used, which means, that the minimum load added to conventional physical therapy was able to affect the inspiratory muscle strength in mild to moderate PD.