Using the spirometry to indicate respiratory exercises for elderly with Parkinson’s disease

Abstract

Introduction: Respiratory dysfunction is the main cause of death in Parkinson's disease (PD) patients and bronchoaspiration pneumonia is the most common clinical respiratory complication. Objective: To assess respiratory function of elderly with PD in mild to moderate phase of the disease. Methods: A cross-sectional study was carried. Elderly in 2 to 3 PD Hoehn & Yahr stage have participated. A single researcher has evaluated maximal inspiratory pressure (MIP), maximal expiratory pressure (MEP), thoracoabdominal amplitude, forced vital capacity (FVC) and expiratory volume in the first second (FEV1). Results: Sixty elderly have participated and their all spirometry and manovacuometry parameters presented significant differences (p < 0.05) comparing with predicted values, except for FVC (p = 0.25). Only umbilical level did not reach normal values on cirtometry parameters. Patients classified as a restrictive disorder presented significant decrease in thoracic expandability. However the participants classified as an obstructive disorder showed significant decrease in expiratory muscle strength and peak expiratory flows. Conclusion: Elderly in mild or moderate phase of PD presented reduction in respiratory parameters. Spirometry showed to be an important tool to evaluate respiratory function and to indicate the modality of respiratory exercise. Our results suggest the indication of thoracic flexibility exercises for patient with PD classified as restrictive disorder and strength exercise of respiratory muscles for those classified as obstructive disorder.

Association between Respiratory Function and Motor Function in Different Stages of Parkinson’s Disease

“…This may be because reduced PEF values might be explained by respiratory muscle weakness. According to Melo et al [27], the participants classified as an obstructive disorder present a significant reduction in expiratory muscle strength and maximal expiratory flow. It seems that the reduction in respiratory muscle strength may be associated with aging process, neurological impairments, reduction of rib cage movement, and flexed posture [28].…”

“…It seems that the reduction in respiratory muscle strength may be associated with aging process, neurological impairments, reduction of rib cage movement, and flexed posture [28]. These characteristics reduce muscle capacity to generate forced flows, contributing to the reduction of pulmonary volumes and respiratory pressures, especially the maximum expiratory pressure, which will worsen with the evolution of the disease [27].…”

Análise da mobilidade toracoabdominal de idosos com doença de parkinson, submetidos ao treinamento funcional, bicicleta estacionária e exergame: um ensaio clínico randomizado

“…A doença de Parkinson (DP) é considerada uma enfermidade neurodegenerativa que se caracteriza como um distúrbio dos neurônios dopaminérgicos da substância negra do mesencéfalo 1,2 . Dentro do seu quadro sintomático, destacam-se as alterações posturais, temores, rigidez e bradicinesia 3 .…”

A Gestão Do Serviço De Imunização E Campanhas De Vacinação Na Atenção Primária À Saúde: Papel Do Enfermeiro Líder

“…Esses autores demonstraram que o declínio da capacidade de andar gera um impacto negativo na forma como os pacientes compreendem sua mobilidade, avaliada através do questionário de QV PDQ-39. Esses achados são evidências de que as limitações motoras, principalmente associadas ao déficit no equilíbrio e ao declínio da capacidade de andar, induzem negativamente a percepção dos domínios como a mobilidade e AVD'S, demonstrando pior percepção geral de QV dos indivíduos com DP39 .Outro grupo de autores19 evidenciou que existe um decréscimo da função respiratória, capacidade funcional e QV na DP. Tais achados podem ter sido favorecidos pelas alterações motoras, apresentados por esse grupo, como, bradicinesia, tremor de repouso, com consequente instabilidade postural e comprometimento da marcha e do equilíbrio, bem como pelas alterações estruturais do sistema respiratório, que aumentam a suscetibilidade a broncoaspiração, pneumonia, internações hospitalares e óbito.…”