Inspiratory Muscle Training in the Severity of Obstructive Sleep Apnea, Sleep Quality and Excessive Daytime Sleepiness: A Placebo-Controlled, Randomized Trial.

PURPOSE: Exercise programs have been considered as an adjuvant treatment in obstructive sleep apnea (OSA). However, few studies have focused on the effects of the inspiratory muscle training (IMT) in reducing the severity and the symptoms of OSA. PATIENTS AND METHODS: A randomized controlled trial was conducted and approved by the local Ethics Committee. All subjects signed the informed consent form and were randomized into 2 groups: a) IMT group (n = 8), 8 weeks of IMT with 75% of maximal inspiratory pressure (MIP) and b) placebo group (n = 8): subjects performed IMT without load. RESULTS: IMT group showed reduction in the apnea-hypopnea index (AHI) (p = 0.01), in the Berlin questionnaire score (p = 0.001) and an increase in inspiratory muscle strength (p = 0.018). IMT group demonstrated a reduction in the AHI (31.7 ± 15.9 events/h vs 29.9 ± 15.8 events/h; p <0.001), in the Berlin questionnaire scores (2.6 ± 0.5 vs 1.2 ± 0.5; p = 0.016), Pittsburgh Sleep Quality Index (PSQI) score (7.2 ± 3.6 vs 3.7 ± 1.3; p = 0.008), in the Epworth Sleepiness Scale (ESS) (12.5 ± 4.0 vs 7.7 ± 3.0; p = 0.008) and increase in MIP (83.6 ± 26.5 cmH2O and 127.9 ± 32.5 cmH2O; p = 0.010). CONCLUSION: The IMT promotes discrete changes in the AHI and improves sleep quality and excessive daytime sleepiness in OSA. Moreover, IMT is a cheap, useful and simple home-based training program and can be considered as an adjunct therapy for OSA patients.

Estudo comparativo entre eletrogoniometria e fotogrametria digital / Comparative study between electrogoniometry and digital photogrammetry

Objetivo: Avaliar a replicabilidade da fotogrametria digital emrelação à eletrogoniometria no movimento de flexão docotovelo. Material e Métodos: A amostra constituiu-se de 20sujeitos (8 homens, 12 mulheres; 20,1 ± 1,7 anos; 60,9 ± 9,3kg e 169 ± 8,8 cm), saudáveis, ativos, submetidos aeletrogoniometria e fotogrametria digital. Os sujeitos foramposicionados sentados, com o membro superior direitoapoiado em uma mesa, ombro fletido a 90° e antebraçosupinado. O ângulo de flexão do cotovelo foi medido com esem fixação do eletrogoniômetro, em três diferentes posições(fechado, intermediário e aberto) de forma aleatória,utilizando-se um goniômetro manual (CARCI) adaptado comum potenciômetro linear e uma câmera digital (Sony, DSCS750),e posteriormente processados nos softwares BioMede Fisio Office 2010, respectivamente. Os dados foramanalisados no Statistical Package of Social Science (SPSS– 15.0), pelo teste de correlação intraclasse (ICC) para avaliara reprodutibilidade das medidas da eletrogoniometria efotogrametria inter-avaliadores e inter-instrumentos.Resultados: Observou-se forte reprodutibilidade dafotogrametria em todas as medidas, inter-avaliadores(ICC>0,85; P<0,01) e inter-instrumentos (ICC>0,93; P<0,01).Conclusão: Os resultados deste estudo permitem concluirque a fotogrametria digital possui alto índice de confiabilidade,tanto inter-avaliadores quanto inter-instrumentos e, portanto,pode ser utilizada na prática fisioterapêutica.

Objective: To evaluate the digital photogrammetry replicabilitycompared to electrogoniometry on the elbow flexionmovement. Material and Methods: The sample wascomposed by 20 healthy and active subjects (8 men and 12women; 20.1 ± 1.7 years; 60.9 ± 9.3 kg and 169.0 ± 8.8 cm),submitted to electrogoniometry and digital photogrammetry.The subjects were in sitting position with the right arm restingon a table; the shoulder was flexed at 90 degrees with asupinated forearm. The elbow flexion angle was measuredwith and without fixing the electrogoniometer in three differentpositions (closed, intermediate, open) randomly, using amanual goniometer (CARCI) adapted with a linearpotentiometer and a digital camera (Sony, DSC-S750), andsubsequently processed in the Biomed and Fisio Officesoftwares, respectively. Data were analyzed on the StatisticalPackage for Social Science (SPSS – 15.0) using the intraclasscorrelation (ICC) test to evaluate the reproducibility ofthe electrogoniometry and photogrammetry measures, interevaluatorsand inter-instruments. Results: It was observeda strong reproducibility of the electrogoniometry andphotogrammetry for all measures, inter-evaluators (ICC>0.85;P<0.01) and inter-instruments (ICC>0.93; P<0.01).Conclusion: The results of this study showed that the digitalphotogrammetry has high levels of reliability, both interevaluatorsand inter-instruments and thus can be used forphysical therapy practice.