Avaliação do broncoespasmo induzido pelo exercício avaliado pelo Peak Flow Meter em adolescentes obesos

Abstract

Introduction: Children and adolescents who are overweight have a higher prevalence of exerciseinduced bronchospasm (EIB), as compared to eutrophics. Spirometry and peak flow meter are important evaluation methods of lung function. However, the applicability of the peak expiratory flow (peak flow meter) in the detection of EIB in children and adolescents who are overweight is not known, hence the development of this research. Objectives: To evaluate and compare the onset of exercise-induced bronchospasm (EIB) in children and adolescents non-asthmatic who are overweight, evaluated by spirometry and the peak flow meter (PEF). Methods: The study included 39 volunteers above the 85th percentile (OB) and 30 normal weight (EU), with the age of 8 to 15 years. The evaluation of lung function before and after bronchial provocation test was performed by spirometry and peak flow meter, according to the protocol of Del Río-Navarro et al, (2000). The EIB was considered positive when the volunteer showed a reduction ≥ 10% of baseline FEV 1 or ≥ 20% reduction in PEF PFM and/or PEF E . Results: The detection of the BIE, the prevalence of obese group was 26% measured by peak flow meter (PEF PFM ) and 23% for FEV 1 . The time of the BIE occurred with the first 15 minutes post-exercise in both parameters: (PFE PFM ) and FEV 1 . Conclusion: The obese volunteers presented similar time and prevalence of EIB, when evaluated by both methods of pulmonary assessment. The easy handling and low cost from this method created greater accessibility for the general population from the peak flow meter, which shows its importance as part of an educational program in the initial diagnosis of EIB in large airway caliber.

Lung function and functional capacity in school age children

“…between 9 and 17 years of age. As documented by Silva et al (13), the mechanical load of fat deposit in the thoracic and abdominal regions of children can affect the pulmonary growth, promoting losses in the ventilator function and consequently reducing the volumes and capacities.…”

“…Seven children were excluded from the study who presented one or more of the following limitations: presence of cognitive and/or motor function capable of compromising the accomplishment of the test, children with evidence of cough, wheezing, expectoration and dyspnea, according to the recommendations by Matiello et al (10), as well as children who did not properly complete any of the tests proposed (Figure 1). On the eve of the tests, the volunteers were instructed to avoid the intake of coffee, tea, chocolate and soft drinks, nor engage in vigorous exercises 2h before the test (6). The tests of children who had a cold or history of fever the night before were rescheduled.…”

“…It can also be considered an indirect pulmonary strength index (5). Its measure is used as a non-invasive method to detect air low alterations, asthma, exercise-induced bronchoconstriction and chronic obstructive pulmonary disease (COPD) (6).…”

Desempenho e indicadores cardiorrespiratórios em crianças no teste progressivo máximo

“…Esta diferença da força muscular das meninas pode se dar pela influência das características morfológicas e fisiológicas, próprias do sexo feminino, como: fibras musculares de menor tamanho e quantidade, massa muscular mais baixa e percentual de gordura maior 6,19 . Um estudo aponta a prevalência de broncoespasmo induzido pelo exercício em crianças obesas, 26% responderam na avaliação com o peakflow e 23% deste grupo responderam com a redução do volume expiratório forçado no primeiro segundo, assim verifica a importância da medida do peakflow como parte integrante em programas voltados às crianças 20 . A prevalência da ocorrência de BIE também é observada em crianças com excesso de peso 21 .…”

Relationship between peak expiratory flow and impaired functional capacity in obese individuals

“…8,9 Changes in respiratory function can be identified using a peak flow meter, which evaluates peak expiratory flow (PEF), that is, the maximum flow generated during a forced expiration. 10 This is a simple, non-invasive, lowcost technique that exhibits good reliability because of its…”