COPD
Conditions
Keywords
Proprioceptive neuromuscular facilitation, Pulmonary Rehabilitation, muscle activation, COPD
Brief summary
To evaluate the activation of accessory respiratory muscles and the effects of stretching these muscles in patients with COPD.
Detailed description
All subjects (sixty men) will perform spirometry, measure of inspiratory capacity (IC) and maximal inspiratory and expiratory pressures (MIP and MEP). Baseline blood pressure (BP), respiratory rate (RR), heart rate (HR), sensation of dyspnea (Borg Scale) and oxygen saturation (pulse oximetry, SpO2) will be collected prior to the performance of pulmonary function tests. The electrical activity of the scalene (ESC), sternocleidomastoid (SCM) and external intercostal muscles (INTER) will be measured by surface electromyography (sEMG) at rest and during the maneuvers of IC, MIP and MEP. Control group: The control group will perform isotonic concentric contraction of the biceps (two sets of five push-ups elbow in both arms) with the individual sitting in a chair with back support. Intervention group: The contract-relax method of proprioceptive neuromuscular facilitation (PNF) technique will be used for stretching of ESC, ECM and external intercostals muscles. The contraction of agonist muscles against the resistance imposed by the physiotherapist (isometric contraction) is maintained for 6 seconds. After that, the patient will be asked to relax the muscles for 6 seconds without losing range of motion, and then the muscle will be lengthened. This procedure is repeated until the maximum amplitude of motion of the neck and upper limb is reached. The stretching will be performed on the right and left sides of the body. Statistical analysis will be carried out with the Statistical Package for the Social Sciences, version 18.0 (SPSS Inc., Chicago, IL, USA). Normality of data distribution will be assessed by the Shapiro-Wilk test. Values will be presented as mean ± standard deviation (SD) or median (25-75%). To compare the differences between the baseline characteristics between the groups the t test for independent samples will be used. The effect of the intervention will be evaluated by paired t test. For the analysis of the electromyographic signal will be use the Wilcoxon T test. Statistical significance is accepted at p \< 0.05.
Interventions
PROCEDUREPNF
The contract-relax method of proprioceptive neuromuscular facilitation (PNF) technique will be used for stretching of ESC, ECM and external intercostals muscles. The contraction of agonist muscles against the resistance imposed by the physiotherapist (isometric contraction) will be maintained for 6 seconds. After that, the patient is oriented to relax the muscles for 6 seconds without losing range of motion, and then the muscle will be lengthened. This procedure is repeated until the maximum amplitude of motion of the neck and upper limb is reached. The stretching will be performed on the right and left sides of the body.
PROCEDURESham
Isotonic concentric contraction of the biceps (two sets of five push-ups elbow in both arms) with the individual sitting in a chair with back support.
Sponsors
Federal University of Rio Grande do Sul
Universidade Federal do Pampa
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Subject)
Eligibility
Sex/Gender
MALE
Age
40 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
* Control group: Men without respiratory symptoms and lung disease, with normal spirometry. * Interventional group: Men diagnosed with severe to very severe COPD (forced expiratory volume in one second / forced vital capacity - FEV1/FVC \<0.7 and FEV1 \<50% predicted after bronchodilator use); clinically stable over the past 4 weeks.
Exclusion criteria
* History of fracture in the spine and / or upper limb * Herniated disc * Connective tissue disease * Ischemic heart disease or uncontrolled hypertension * Obesity (BMI\> 30 kg/m2) * Aortic aneurysm * Recent abdominal or thoracic surgery * Glaucoma * Retinal detachment
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change in inspiratory capacity | One day | Change in inspiratory capacity |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Change in maximal respiratory pressure (MIP and MEP) | One day | Change in maximal respiratory pressure (MIP and MEP) |
| Change in electromyographic activity of accessory respiratory muscles | One Day | Change in electromyographic activity of accessory respiratory muscles |
Countries
Brazil
Outcome results
None listed