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Vol. 41. Issue 11.
Pages 601-606 (November 2005)
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Vol. 41. Issue 11.
Pages 601-606 (November 2005)
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Efecto del entrenamiento muscular inspiratorio sobre la fuerza muscular y la calidad de vida en pacientes con limitación crónica del flujo aéreo. Ensayo clínico aleatorizado
Effect of inspiratory muscle training on muscle strength and quality of life in patients with chronic airflow limitation: a randomized controlled trial
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P. Seróna,
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pseron@ufro.cl

Correspondencia: Profª. P. Serón. Facultad de Medicina. Universidad de La Frontera. Manuel Montt, 112. Temuco. Chile.
, P. Riedemannb, S. Muñozc, A. Doussoulinb,d, P. Villarroelb,c, X. Ceab
a Departamento de Cirugía y Traumatología. Capacitación, Investigación y Gestión para la Salud Basada en Evidencias (CIGES). Facultad de Medicina. Universidad de la Frontera. Temuco.Chile
b Departamento de Medicina Interna. CIGES. Facultad de Medicina. Universidad de la Frontera. Temuco.Chile
c Departamento de Salud Pública. CIGES. Facultad de Medicina. Universidad de la Frontera. Temuco. Chile
d Departamento de Pediatría. CIGES. Facultad de Medicina. Universidad de la Frontera. Temuco. Chile
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Objetivo

La limitación crónica del flujo aéreo (LCFA) es causa importante de morbimortalidad. Para su manejo se describe la rehabilitación pulmonar, que incluye el entrenamiento muscular inspiratorio. El objetivo del presente estudio fue evaluar la efectividad del entrenamiento muscular inspiratorio par mejorar variables fisiológicas y funcionales.

Pacientes y métodos

Ensayo clínico controlado y aleatorizado en 35 pacientes con LCFA, de los que 17 recibieron una intervención experimental y 18 una de control. La ntervención experimental consistió en un programa de 2 meses de entrenamiento de músculos inspiratorios usando un dispositivo que administraba una resistencia de un 40% de la presión inspiratoria máxima. Se evaluaron la fuerza muscular inspiratoria, la tolerancia al ejercicio, la función respiratoria y la calidad de vida.

Resultados

El tratamiento experimental mostró una mejoría significativa en la fuerza muscular inspiratoria (p=0,02). Todos los pacientes mejoraron a lo largo del tiempo independientemente del tratamiento experimental (p<0,001); la presión inspiratoria máxima aumentó en 8,9 cmH2O por mes de entrenamiento; asimismo, hubo un aumento de 0,56 puntos en el cuestionario que evaluó la calidad de vida relacionada con la salud.

Conclusión

La utilización específica de un dispositivo de carga umbral es efectiva en el fortalecimiento muscular inspiratorio, medido a través de la presión inspiratoria máxima, al primer mes de entrenamiento en pacientes con LCFA. Es necesario estudiar su efecto a largo plazo y su impacto sobre la calidad de vida en un mayor número de pacientes.

Palabras clave:
Calidad de vida relacionada con la salud
Limitación crónica del flujo aéreo
Rehabilitación pulmonar
Músculos respiratorios
Ensayo clínico
Objective

Chronic airflow limitation (CAL) is a significant cause of illness and death. Inspiratory muscle training has been described as a technique for managing CAL. The aim of the present study was to evaluate the effectiveness of inspiratory muscle training on improving physiological and functional variables.

Patients and methods

Randomized controlled trial in which 35 patients with CAL were assigned to receive either an experimental (n=17) or control (n=18) intervention. The experimental intervention consisted of 2 months of inspiratory muscle training using a device that administered a resistive load of 40% of maximal static inspiratory mouth pressure (PImax). Inspiratory muscle strength, exercise tolerance, respiratory function, and quality of life were assessed.

Results

Significant improvement in inspiratory muscle strength was observed in the experimental training group (P=.02). All patients improved over time in both groups (P<.001). PImax increased by 8.9 cm H2O per month of training. Likewise, the health-related quality of life scores improved by 0.56 points.

Conclusion

Use of a threshold loading device is effective for strengthening inspiratory muscles as measured by PImax after the first month of training in patients with CAL. The long-term effectiveness of such training and its impact on quality of life should be studied in a larger number of patients.

Key words:
Health-related quality of life
Chronic airflow limitation
Respiratory rehabilitation
Respiratory muscles
Randomized controlled trial
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Estudio financiado por la Dirección de Investigación y Desarrollo de la Universidad de La Frontera, Temuco, Chile (proyecto IN 00/01).

Copyright © 2005. Sociedad Española de Neumología y Cirugía Torácica
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