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Master's Dissertation
DOI
10.11606/D.5.2016.tde-20042016-113329
Document
Author
Full name
Karen Brandão Evaristo
E-mail
Institute/School/College
Knowledge Area
Date of Defense
Published
São Paulo, 2015
Supervisor
Committee
Carvalho, Celso Ricardo Fernandes de (President)
Gimenes, Ana Cristina Oliveira
Lunardi, Adriana Claudia
Title in Portuguese
Comparação entre exercício aeróbio e respiratório no controle clínico e inflamação pulmonar de pacientes com asma persistente moderada ou grave: ensaio clínico aleatorizado
Keywords in Portuguese
Asma
Controle clínico
Inflamação
Terapia por exercício
Abstract in Portuguese
A asma é uma doença inflamatória crônica das vias aéreas caracterizada por obstrução reversível, inflamação e hiperresponsividade a diversos estímulos. O exercício, seja ele de caráter aeróbio ou respiratório, é muito utilizado no tratamento de pacientes asmáticos, porém, pouco se sabe sobre os benefícios desses exercícios no processo inflamatório e no manejo clínico dessa doença. Objetivo: Comparar o efeito do exercício aeróbio e respiratório no controle clínico, inflamação pulmonar e capacidade funcional de pacientes com asma persistente moderada ou grave. Métodos: Foram estudados 50 adultos asmáticos divididos aleatoriamente em dois grupos: aeróbio (GA; n=28) e respiratório (GR; n=22). O tratamento foi realizado em 2 sessões semanais, durante 3 meses, totalizando 24 sessões com duração de 40 minutos cada uma, sendo que o GA praticou exercício aeróbio em esteira ergométrica e o GR praticou exercícios respiratórios baseados na técnica de Yoga. Ambos os grupos participaram de um programa educacional constituído de 2 aulas antes do início das intervenções. Antes e após as intervenções foram avaliados: o controle clínico (Asthma Control Questionnaire - ACQ, Asthma Control Test - ACT e diário de sintomas), a inflamação pulmonar (celularidade no escarro e fração exalada de óxido nítrico - FeNO), a capacidade funcional (Incremental shuttle walking test) e a função pulmonar (espirometria). Foi utilizado o teste Komolgorov-Smirnov para verificar a normalidade dos dados e a análise de variância (ANOVA) de dois fatores com medidas repetidas, associado ao post hoc de Holm Sidak para comparar as diferenças entre e intra-grupos. Resultados: Houve melhora do controle clínico avaliado pelo ACQ apenas no GA (p < 0,05), assim como a diminuição na porcentagem de eosinófilos no escarro (p < 0,05) e o aumento nos dias livres de sintomas (p < 0,05). Ambos os grupos melhoraram o controle clínico avaliado pelo ACT e a capacidade funcional (p < 0,05). Conclusão: Esses resultados sugerem que ambos os exercícios proporcionam benefícios para pacientes com asma persistente moderada e grave, porém, o exercício aeróbio resultou em mais benefícios clínicos
Title in English
Comparison between aerobic and breathing exercises on clinical control and airway inflammation of patients with moderate or severe persistent asthma: a randomized trial
Keywords in English
Asthma
Clinical control
Exercise therapy
Inflammation
Abstract in English
Asthma is a chronic inflammatory disease of the airway characterized by reversible obstruction, inflammation and hyperresponsiveness of various stimuli. Aerobic or breathing exercise, have been used on treatment of asthmatic patients, however, little is known about the benefits of these exercises in clinical management and inflammatory process of the disease. Objective: To compare the effect of aerobic and breathing exercise in clinical control, airway inflammation and functional capacity of patients with moderate or severe persistent asthma. Methods: 50 asthmatic adults were randomly divided into two groups: aerobic (AG; n = 28) and breathing group (BG, n = 22). The treatment was composed of two weekly sessions, during three months, totaling 24 sessions with duration of 40 minutes each. AG practiced aerobic exercise in a treadmill, while BG practiced breathing exercises based on Yoga technique. Both groups participated of an education program that consists of two classes before the interventions. Before and after the interventions were evaluated: clinical control (Asthma Control Questionnaire - ACQ, Asthma Control Test - ACT, and symptoms diary), airway inflammation (cellularity in sputum and fraction exhaled nitric oxide - FeNO), functional capacity (incremental shuttle walking test) and lung function (spirometry). It was used Komolgorov-Smirnov test to verify the normality of the data and analysis of variance two way with repeated measures (ANOVA), associated to post hoc of Holm Sidak to analize differences between and within groups. Results: There was improvement of clinical control evaluated by ACQ only in AG (p < 0.05), as a decrease in eosinophil percentage in sputum (p < 0.05) and an increase in free days of symptoms (p < 0,05). Both groups improved clinical control evaluated by ACT and functional capacity (p < 0.05). Conclusion: These data suggest that both exercises provide benefits to patients with moderate or severe persistent asthma, however, the aerobic exercise resulted in more clinical benefits
 
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Publishing Date
2016-04-25
 
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