Browsing by Author "Miranda, Sara"
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- Reference values for respiratory muscle strength in portuguese healthy peoplePublication . Alves, Ana; Miranda, Sara; Machado, Ana; Paixão, Cátia; Oliveira, Ana; Rebelo, Patrícia; Cruz, Joana; Jácome, Cristina; Marques, AldaBackground: Maximal inspiratory (MIP) and expiratory pressures (MEP) are measures to assess respiratory muscle strength. Reference values are population-specific and are lacking for the respiratory muscle strength of the Portuguese population. Overcoming this absence is important, to avoid over- or underestimation of such values and to facilitate the identification of Portuguese individuals with respiratory muscle weakness, so tailored interventions can be delivered. Reference values for respiratory muscle strength in portuguese healthy people. Objective: To determine reference values for MIP and MEP in middle aged and older Portuguese healthy people. Methods: A cross-sectional study was conducted in the north and center regions of Portugal. Healthy participants were recruited from community centers. MIP and MEP were assessed using a respiratory pressure gauge (MicroRPM, CareFusion, Kent, United Kingdom). Descriptive statistics were used to determine reference values by age decades (50-59; 60-69; 70-79 and >80 years) and sex. Independent sample t-tests were used to analyse differences between sex in each age decade and one-way ANOVA with Bonferroni-correction to compare age decades. Results: A total of 164 healthy participants were included in this study (67.7±9.7yrs, n=79♂, 28.0±4.8kg/m2). MIP and MEP reference values are shown in table 1. MIP and MEP values were higher in males (92.3±26.3; 139.1±35.2 cmH2O) than in females (78.3±23.4; 104.3±25.6 cmH2O) (p<0.001). MIP mean values were significantly different among age decades (F=5.4; p=0.002), specifically between 50-59 and >80years decades (p=0.01) and between 60-69 and >80years decades (p=0.003). The mean values of MEP were not significantly different across age decades. Conclusion: In Portuguese healthy people, respiratory muscle strength differs between males and females and among age decades. This is part of an ongoing work that will increase the sample size to characterise respiratory muscle strength in the Portuguese healthy population.
- Relationship between 1-minute sit-to-stand and respiratory muscle strength in COPDPublication . Alves, Ana; Miranda, Sara; Machado, Ana; Paixão, Cátia; Oliveira, Ana; Rebelo, Patrícia; Cruz, Joana; Jácome, Cristina; Marques, AldaBackground: It has been suggested that patients with chronic obstructive pulmonary disease (COPD) with respiratory muscle weakness achieve poorer results in exercise capacity tests, namely in the six-minute walk test (6MWT). The 1-minute sit-to-stand test (1-min STST) is simple to perform and a reliable and valid indicator of functional exercise capacity that correlates well with the 6MWT. However, its association with respiratory muscle strength in COPD is poorly studied. Objective: To explore the relationship between the 1-min STST and maximum inspiratory (MIP) and expiratory pressures (MEP) in patients with COPD. Methods: A cross-sectional study was conducted in the center and north regions of Portugal. Outpatients with COPD were recruited from routine pulmonology appointments. The 1-min STST and MIP/MEP were collected and predicted percentages (pp) of MIP/MEP were calculated using the equation set by Neder and colleagues. Correlations between the number of repetitions in the 1-min STST and MIPpp/MEPpp were explored by sex using Spearman coefficient correlation. Results: 376 outpatients with COPD (66.3±10.2y; 76.1%♂; FEV1 61.1±23.4pp; 101.6±8.0% ♂MIPpp; 79.2±5.2% ♀MIPpp; 110.9±8.1% ♂MEPpp; 76.7±6.5% ♀MEPpp) were included in this study. When the correlation was assessed by sex, low positive correlations were found between 1-min STST and MIP/MEPpp in males (r=0.37, p<0.001) (Fig.1). There was no significant correlation between 1-min STST and of MIP/MEPpp in females (p>0.05). Conclusion: 1-min STST correlated significantly with predicted respiratory muscle strength in male patients with COPD. Patients with respiratory muscle impairment seem to have worse functional capacity than those with better MIP and MEP. Thus, respiratory muscle training may play an important role in the improvement of functional capacity in patients with COPD with respiratory muscle weakness.
- The ABCD assessment tool: relationship with the clinical outcomes of patients with COPDPublication . Marques, Alda; Miranda, Sara; Paixão, Cátia; Valente, Carla; Andrade, Lília; Cruz, Joana; Jácome, Cristina; Machado, AnaThe ABCD assessment tool for patients with chronic obstructive pulmonary disease (COPD) has recently been revised. Few studies have evaluated patients’ clinical characteristics based on this classification, although it may be important to adjust interventions to patients’ specific needs. This study explored the distribution of the most used clinical outcomes in patients with COPD across ABCD groups. A cross sectional study was conducted. Patients with COPD were recruited from routine pulmonology appointments and primary care centres in Portugal. Assessments included a spirometric test, quadriceps muscle strength (QMS) with handheld dynamometer, inspiratory muscle strength with the maximal inspiratory pressure (MIP), functional performance with the 1-minute sit-to-stand test (1-min STS) and health-related quality of life with the Saint George Respiratory Questionnaire (SGRQ). Patients were classified into ABCD groups based on the modified British Medical Research Council dyspnoea questionnaire and history of exacerbations in the previous year. One-way ANOVA and Bonferroni corrections for multiple comparisons were used to explore differences between groups. Three hundred and twenty-nine patients with COPD (253 (77%) male, 67±10 years old, forced expiratory volume in one second 60±25 % of predicted, forced vital capacity 81±23 % of predicted, body mass index 28±16 kg/m2; 73 (22%) GOLD I, 133 (40%) GOLD II, 90 (27%) GOLD III, 33 (10%) GOLD IV) participated. Group A was the most prevalent (131; 40%), followed by groups B (95; 29%), D (70; 21%) and C (33; 10%). Patients from groups B and D, which are the most symptomatic, presented the worst results for all outcomes (Figure 1). Patients from ABCD groups present different clinical characteristics. The ABCD classification appears to be important to discriminate patients with worst outcomes, hence it may be useful to personalise treatments according to patients’ needs and clinical characteristics.