Efeitos do treino muscular inspiratório na função pulmonar, oxigenação muscular e capacidade funcional em idosos
DOI:
https://doi.org/10.47197/retos.v66.110752Palavras-chave:
exercício, NIRS, idosos, terapia respiratóriaResumo
Antecedentes e objetivo. O treino muscular inspiratório (TMI) gera efeitos positivos no desempenho físico, mas existem poucas evidências sobre os efeitos na restauração muscular em idosos. O objetivo do estudo foi avaliar o impacto de um programa de treino muscular inspiratório (TMI) de 4 semanas na força inspiratória dinâmica máxima, função pulmonar, oxigenação muscular e capacidade funcional em idosos funcionalmente independentes.
Materiais e métodos. Doze idosos randomizados (GA= n6, 68,8 2,6 anos; GCS=n6, 71,5 4,7 anos) completaram o estudo. Foi aplicado um programa de EMI de 4 semanas, juntamente com recomendações gerais de atividade física. As atividades de vida diária, fluxo e volumes pulmonares, força inspiratória dinâmica máxima (índice S), fluxo inspiratório máximo (MIF), taxa de ressaturação muscular (ΔTSIreoxy) foram avaliadas através do NIRS e da bateria Senior Fitness Test antes e após a intervenção. Resultados. Melhorias no GE no teste de levantar da cadeira (p=0,013; η²p=0,474), teste de rosca bíceps (p=0,015; η²p=0,463) e teste de marcha de 6 minutos (p=0,011; η²p=0,495), enquanto no grupo controlo foram observadas alterações apenas no teste de rosca direta do bíceps (p=0,004; η²p=0,589). Observou-se um aumento do GE no índice S (p=0,038; η²p=0,363) com um elevado efeito no fluxo inspiratório máximo (MIF) (p=0,138; η²p=0,206), por fim o GE apresentou um elevado tamanho de efeito na velocidade de restauração muscular no final do exercício (p=0,213; η²p=0,187; Δ=-31%).
Conclusões. Um programa curto de EMI aumenta o índice S, a capacidade física e a taxa de oxigenação muscular. A EMI pode ser uma estratégia de intervenção complementar nos idosos para melhorar a sua aptidão física e resposta vascular periférica.
Referências
Bherer, L., Langeard, A., Kaushal, N., Vrinceanu, T., Desjardins-Crépeau, L., Langlois, F., & Kramer, A. (2021). Physical Exercise Training Effect and Mediation through Cardiorespiratory Fitness on Dual-Task Performances Differ in Younger–Old and Older–Old Adults. Journals Gerontol. Ser. B, 76(2), 219–228. https://doi.org/10.1093/geronb/gbz066
Carrion, B., Wells, A., Mayhew, J. & Koch, A. (2019). Concordance among Bioelectrical Impedance Anal-ysis Measures of Percent Body Fat in Athletic Young Adults. Int. J. Exerc. Sci., 12(4), 324-331. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6355131/
Chung, S., Rosenberry, R., Ryan, T., Munson, M., Dombrowsky, T., Park, S., Nasirian, A., Haykowsky, M. & Nelson, M. (2018). Near‐infrared Spectroscopy Detects Age‐related Differences in Skeletal Mus-cle Oxidative Function: Promising Implications for Geroscience. Physiol. Rep., 6(3), e13588. https://doi.org/10.14814/phy2.13588
Cohen, J. (1988). Statistical power analysis for the behavioral sciences (2nd ed ed.). Hillsdale, NJ: Law-rence Erlbaum.
Cortopassi, F., Gurung, P. & Pinto-Plata, V. (2017). Chronic Obstructive Pulmonary Disease in Elderly Patients. Clin Geriatr Med., 33(4), 539-552. https://doi.org/10.1016/j.cger.2017.06.006
Ferraro, F., Gavin, J., Wainwright. T. & McConnell, A. (2022). Association Between Inspiratory Muscle Function and Balance Ability in Older People: A Pooled Data Analysis Before and After Inspira-tory Muscle Training. J. Aging Phys. Act., 30(3), 421–433. https://doi.org/10.1123/japa.2020-050
Fortes, J., Borges, M., Marques, M., Oliveira, R., Rocha, L., Castro, M., Esquivel, M & Borges, D. (2021). Effects of Inspiratory Muscle Training Using an Electronic Device on Patients Undergoing Car-diac Surgery: A Randomized Controlled Trial. Int. J. Cardiovasc. Sci., 34(1), 44–52. https://doi.org/10.36660/ijcs.20190093
Graham, B., Steenbruggen, I., Miller, M., Barjaktarevic, I., Cooper, B., Hall, G., Hallstrand, T., Kaminsky, D., McCarthy, K. & McCormack, M. (2019). Standardization of Spirometry 2019 Update. An Official American Thoracic Society and European Respiratory Society Technical Statement. Am. J. Respir. Crit. Care Med., 200(8), e70–e88. https://doi.org/10.1164/rccm.201908-1590ST
Guralnik, B., Hansen, O., Henrichsen, H., Beltrán-Pitarch, B., Østerberg, F., Shiv., L., Marangoni, T., Stilling-Andersen, A., Cagliani, A., Hansen, M., Nielsen, P., Oprins, H., Vermeersch, B., Adelmann, C., Dutta, S., Borup, K., Mihiretie, B. & Petersen, D. (2021). 3ω Correction Method for Eliminating Re-sistance Measurement Error Due to Joule Heating. Rev. Sci. Instrum. 92(9). https://doi.org/10.1063/5.0063998
Hamaoka, T., McCully, K., Niwayama, M. & Chance, B. (2011). The Use of Muscle Near-Infrared Spec-troscopy in Sport, Health and Medical Sciences: Recent Developments. Philos. Trans. R. Soc. A Math. Phys. Eng. Sci., 369(1955), 4591–4604. https://doi.org/10.1098/rsta.2011.0298
Hopman-Rock, M., van Hirtum, H., de Vreede, P. & Freiberger, E. (2019). Activities of Daily Living in Older Community-Dwelling Persons: A Systematic Review of Psychometric Properties of In-struments. Aging Clin. Exp. Res., 31, 917–925. https://doi.org/10.1007/s40520-018-1034-6
Hurst, C., Weston, K., McLaren, S. & Weston, M. (2019). The Effects of Same-Session Combined Exercise Training on Cardiorespiratory and Functional Fitness in Older Adults: A Systematic Review and Meta-Analysis. Aging Clin. Exp. Res. 31, 1701–1717. https://doi.org/10.1007/s40520-019-01124-7
Jones, B., Parry, D. & Cooper, C. (2018). Underwater Near-Infrared Spectroscopy Can Measure Training Adaptations in Adolescent Swimmers. PeerJ., 6, e4393. https://doi.org/10.7717/peerj.4393
Jones, S., Chiesa, S., Chaturvedi, N. & Hughes, A. (2016). Recent developments in near-infrared spectros-copy (NIRS) for the assessment of local skeletal muscle microvascular function and capacity to utilise oxygen. Artery Res., 16, 25-33. https://doi.org/10.1016/j.artres.2016.09.001
Joshi, P. (2024). Pulmonary Diseases in Older Patients: Understanding and Addressing the Challen-ges. Geriatrics (Basel), 9(2), 34. https://doi.org/10.3390/geriatrics9020034
Kim, S., Shin, M., Lee, J., Huh, S. & Shin, Y. (2022). Effects of a New Respiratory Muscle Training Device in Community-Dwelling Elderly Men: An Open-Label, Randomized, Non-Inferiority Trial. BMC Geriatr., 22, 155. https://doi.org/10.1186/s12877-022-02828-8
Kurzaj, M., Dziubek, W., Porębska, M. & Rożek-Piechura, K. (2019). Can Inspiratory Muscle Training Improve Exercise Tolerance and Lower Limb Function After Myocardial Infarction? Med. Sci. Monit. Int. Med. J. Exp. Clin. Res., 25, 5159–5169. https://doi.org/10.12659/MSM.914684
Labata-Lezaun, N., González-Rueda, V., Llurda-Almuzara, L., López-de-Celis, C., Rodríguez-Sanz, J., Bosch, J., Vicente-Rodríguez, G., Gorczakowska, D., Araluze-Arizti, P. & Pérez-Bellmut, A. (2023). Effectiveness of multicomponent training on physical performance in older adults: A systematic review and meta-analysis. Arch Gerontol Geriatr., 104:104838. https://doi.org/10.1016/j.archger.2022.104838
Labott, B., Held, S. & Donath, L. (2020). Grip Strength-Endurance in Ambitious and Recreational Climb-ers: Does the Strength Decrement Index Serve as a Feasible Measure? Int. J. Environ. Res. Public Health, 17(24), 9530. https://doi.org/10.3390/ijerph17249530
Lachman, M., Lipsitz, L., Lubben, J., Castaneda-Sceppa, C. & Jette, A. (2018). When Adults Don’t Exercise: Behavioral Strategies to Increase Physical Activity in Sedentary Middle-Aged and Older Adults. Innov. Aging, 2, igy007. https://doi.org/10.1093/geroni/igy007
Langhammer, B. & Stanghelle, J. (2015). The Senior Fitness Test. J Physiother, 61(3),163. https://doi.org/10.1016/j.jphys.2015.04.001
Mahoney, F. & Barthel. D. (1965). Functional Evaluation: The Barthel Index: A Simple Index of Inde-pendence Useful in Scoring Improvement in the Rehabilitation of the Chronically Ill. Md. State Med. J. https://www.kcl.ac.uk/nmpc/assets/rehab/tools-bi-functional-evaluation-the-barthel-index.pdf
Manifield, J., Winnard, A., Hume, E., Armstrong, M., Baker, K., Adams, N., Vogiatzis, I., & Barry, G. (2021). Inspiratory Muscle Training for Improving Inspiratory Muscle Strength and Functional Capacity in Older Adults: A Systematic Review and Meta-Analysis. Age Ageing, 50(3), 716–724. http://doi.org/10.1093/ageing/afaa221
Martin-Sanchez, C., Calvo-Arenillas, J., Barbero-Iglesias, F., Fonseca, E., Sanchez-Santos, J. & Martin-Nogueras, A. (2020). Effects of 12-Week Inspiratory Muscle Training with Low Resistance in Patients with Multiple Sclerosis: A Non-Randomised, Double-Blind, Controlled Trial. Mult. Scler. Relat. Disord., 46, 102574. https://doi.org/10.1016/j.msard.2020.102574
McCreery, J., Mackintosh, K., Mills-Bennett, R. & McNarry, M. (2021). The Effect of a High-Intensity PrO2Fit Inspiratory Muscle Training Intervention on Physiological and Psychological Health in Adults with Bronchiectasis: A Mixed-Methods Study. Int. J. Environ. Res. Public Health, 18(6), https://doi.org/10.3390/ijerph18063051
Mehani. S. (2017). Comparative Study of Two Different Respiratory Training Protocols in Elderly Pa-tients with Chronic Obstructive Pulmonary Disease. Clin. Interv. Aging., 1705–1715. https://doi.org/10.2147/CIA.S145688
Mehmet, H., Yang, A. & Robinson, S. (2020). Measurement of Hand Grip Strength in the Elderly: A Scop-ing Review with Recommendations. J. Bodyw. Mov. Ther., 24, 235–243. https://doi.org/10.1016/j.jbmt.2019.05.029
Mello, E., Oliveira, A., T. Santanna, T., Soares, P., Rodrigues. G. (2024). Updates in inspiratory muscle training for older adults: A systematic review. Arch Gerontol Geriatr, 127, 105579. https://doi.org/10.1016/j.archger.2024.105579
Mętel, S., Kostrzon, M., Adamiak, J. & Janus, P. (2023). Respiratory Muscle Function in Older Adults with Chronic Respiratory Diseases after Pulmonary Rehabilitation in Subterranean Salt Chambers. J. Clin. Med. 12, 5120. https://doi.org/10.3390/jcm12155120
Mikkelsen, M., Juhl, C., Lund, C., Jarden, M., Vinther, A., & Nielsen, D. (2020). The Effect of Exercise-Based Interventions on Health-Related Quality of Life and Physical Function in Older Patients with Cancer Receiving Medical Antineoplastic Treatments: A Systematic Review. Eur. Rev. Aging Phys. Act., 17(18), 1–15. https://doi.org/10.1186/s11556-020-00250-w
Miller, A. & Enright, P. (2012). PFT Interpretive Strategies: American Thoracic Society/European Res-piratory Society 2005 Guideline Gaps. Respir. Care, 57(1), 27–135. https://doi.org/10.4187/respcare.01503
Mills, D., Johnson, M., Barnett, Y., Smith, W., & Sharpe, G. (2015). The Effects of Inspiratory Muscle Training in Older Adults. Med. Sci. Sport. Exerc., 47(4), 691–697. https://doi.org/10.1249/MSS.0000000000000474
Nanda, R., Liu, M., Yau, C., Shatsky, R., Pusztai, L., Wallace, A., Chien, A., Forero-Torres, A., Ellis, E., Han, H., Clark, A., Albain, K., Boughey, J., Jaskowiak, N, Elias, A., Isaacs, C., Kemmer, K., Helsten, T., Ma-jure, M.,… Esserman, L. (2020). Effect of Pembrolizumab plus Neoadjuvant Chemotherapy on Pathologic Complete Response in Women with Early-Stage Breast Cancer: An Analysis of the Ongoing Phase 2 Adaptively Randomized I-SPY2 Trial. JAMA Oncol. 6(5), 676–684. https://doi.org/10.1001/jamaoncol.2019.6650
Nagano, A., Wakabayashi, H., Maeda, K., Yokura, Y., Miyazaki, S., Mori, T. & Fujiwara, D. (2021). Respira-tory Sarcopenia and Sarcopenic Respiratory Disability: Concepts, Diagnosis, and Treatment. J Nutr Health Aging, 25(4), 507-515. https://doi.org/10.1007/s12603-021-1587-5
Ostchega, Y., Dillon, C., Hughes, J., Carroll, M. & Yoon, S. (2007). Trends in Hypertension Prevalence, Awareness, Treatment, and Control in Older US Adults: Data from the National Health and Nu-trition Examination Survey 1988 to 2004. J. Am. Geriatr. Soc. 55 (7), 1056–1065. https://doi.org/10.1111/j.1532-5415.2007.01215.x
Shalaeva, E. & Messerli, F. (2023). What Is Resistant Arterial Hypertension? Blood Press, 32(1), 2185457. https://doi.org/10.1080/08037051.2023.2185457
Paradis-Deschênes, P., Joanisse, D., Mauriège, P., Billaut, F. (2020). Ischemic Preconditioning Enhances Aerobic Adaptations to Sprint-Interval Training in Athletes without Altering Systemic Hypoxic Signaling and Immune Function. Front. Sport. Act. Living, 2, 1-16. https://doi.org/10.3389/fspor.2020.00041
Perrey, S. & Ferrari, M. (2018). Muscle Oximetry in Sports Science: A Systematic Review. Sport. Med., 48, 597–616. https://doi.org/10.1007/s40279-017-0820-1
Richardson, J. (2011). Eta squared and partial eta squared as measures of effect size in educational re-search. Educ. Res. Rev., 6, 135–147. https://doi.org/10.1016/j.edurev.2010.12.001
Rodrigues, G., Dal Lago, P. & da Silva Soares, P. (2021). Time-Dependent Effects of Inspiratory Muscle Training and Detraining on Cardiac Autonomic Control in Older Women. Exp. Gerontol., 150, 111357. https://doi.org/10.1016/j.exger.2021.111357
Ryan, T., Southern, W., Reynolds, M. & McCully, K. (2013) A cross-validation of near-infrared spectros-copy measurements of skeletal muscle oxidative capacity with phosphorus magnetic resonance spectroscopy. J Appl Physiol (1985), 115(12), 1757-1766. https://doi.org/10.1152/japplphysiol.00835.2013
Seixas, M., Almeida, L., Trevizan, P., Martinez, D., Laterza, M., Vanderlei, L. & Silva, L. (2020). Effects of Inspiratory Muscle Training in Older Adults. Respir. Care, 65(4), 535–544. https://doi.org/10.4187/respcare.06945
Volianitis, s., McConnell, A. & Jones, A. (2001). Assessment of Maximum Inspiratory PressurePrior Submaximal Respiratory Muscle Activity (‘Warm-Up’) Enhances Maximum Inspiratory Activity and Attenuates the Learning Effect of Repeated Measurement. Respiration, 68(1), 22–27. https://doi.org/10.1159/000050458
Webb, K., Dominelli, P., Baker, S., Klassen, S., Joyner, M., Senefeld, J. & Wiggins, C. (2022). Influence of High Hemoglobin-Oxygen Affinity on Humans during Hypoxia. Front. Physiol., 12, 763933. https://doi.org/10.3389/fphys.2021.763933
Wearing, J., Konings, P., Stokes, M. & de Bruin, E. (2018). Handgrip Strength in Old and Oldest Old Swiss Adults–a Cross-Sectional Study. BMC Geriatr., 18, 1–9. https://doi.org/10.1186/s12877-018-0959-0
Wickerson, L. (2019). Oxygenation during Exercise in Individuals with Interstitial Lung Disease. Uni-versity of Toronto (Canada), ISBN 1088331440.
World Medical Association. (2013). Declaration of Helsinki: Ethical Principles for Medical Research Involving Human Subjects. JAMA, 310(20), 2191–2194. https://.doi:10.1001/jama.2013.281053
Downloads
Publicado
Edição
Secção
Licença
Direitos de Autor (c) 2025 Rodrigo Yáñez-Sepúlveda, Gladys Orellana-Lepe, Matías Monsalves-Álvarez, Marcelo Tuesta, Aldo Vásquez-Bonilla, Lilian Castro-Tapia, Pamela Ruiz, Jacqueline Páez-Herrera, Jorge Olivares-Arancibia, María Martínez-Olcina, Ildefonso Alvear-Órdenes, Alejandro Martínez-Rodríguez
Este trabalho encontra-se publicado com a Licença Internacional Creative Commons Atribuição-NãoComercial-SemDerivações 4.0.
Autores que publicam nesta revista concordam com os seguintes termos:
- Autores mantém os direitos autorais e assegurar a revista o direito de ser a primeira publicação da obra como licenciado sob a Licença Creative Commons Attribution que permite que outros para compartilhar o trabalho com o crédito de autoria do trabalho e publicação inicial nesta revista.
- Os autores podem estabelecer acordos adicionais separados para a distribuição não-exclusiva da versão do trabalho publicado na revista (por exemplo, a um repositório institucional, ou publicá-lo em um livro), com reconhecimento de autoria e publicação inicial nesta revista.
- É permitido e os autores são incentivados a divulgar o seu trabalho por via electrónica (por exemplo, em repositórios institucionais ou no seu próprio site), antes e durante o processo de envio, pois pode gerar alterações produtivas, bem como a uma intimação mais Cedo e mais do trabalho publicado (Veja O Efeito do Acesso Livre) (em Inglês).
Esta revista é a "política de acesso aberto" de Boai (1), apoiando os direitos dos usuários de "ler, baixar, copiar, distribuir, imprimir, pesquisar, ou link para os textos completos dos artigos". (1) http://legacy.earlham.edu/~peters/fos/boaifaq.htm#openaccess
