Effects of home healthcare for adults with chronic respiratory diseases and post-COVID-19 syndrome on hospital bed turnover rate: a protocol of systematic review with meta-analysis.

INTRODUCTION: Chronic respiratory diseases (CRDs) have a high prevalence, morbidity and mortality worldwide. After the COVID-19 pandemic, the number of patients readmitted after hospital discharge increased. For some populations, early hospital discharge and home healthcare may reduce health costs in patients treated at home when compared with those hospitalised. This study aims to systematically review the effectiveness of home healthcare for patients with CRDs and post-COVID-19 syndrome. METHODS AND ANALYSIS: We will search on MEDLINE, CENTRAL, Embase and PsycINFO. We will include randomised controlled trials (RCTs) and non-RCT studies reported in full text and abstracts. No language restriction will be applied. We will include studies related to adults with a diagnosis of CRDs or post-COVID-19 syndrome that compared in-patient hospital care with any home healthcare. We will exclude studies with participants with neurological, mental diseases, cancer or pregnant women. Two review authors will screen abstracts and select the eligible studies. To investigate the risk of bias, we will use the Cochrane 'Risk of Bias' tool for RCT, and the Risk of Bias In Non-randomised Studies-of Interventions for non-RCT. We will use the five Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) considerations to assess the quality of the evidence. Patients and the public will be involved in the preparation, execution and implementation phases of the review. ETHICS AND DISSEMINATION: No ethical approval is required because only published data will be analysed. The publication of the results in peer-reviewed journals and at relevant conferences will guide the direction of future research in the field and healthcare practice. The results will also be disseminated in plain language on social media to disseminate the knowledge to society and the public interested in the topic.

Buteyko method for people with asthma: a protocol for a systematic review and meta-analysis.

INTRODUCTION: Buteyko method is recommended as a non-pharmacological treatment for people with asthma. Although the worldwide interest in the Buteyko method, there is a paucity of studies gathering evidence to support its use. Therefore, we aim to conduct a systematic review and meta-analysis to assess the effects of the Buteyko method in children and adults with asthma. METHODS AND ANALYSIS: We will search on Cochrane Central Register of Controlled Trials, MEDLINE, Embase, US National Institutes of Health Ongoing Trials Register ClinicalTrials.gov and WHO International Clinical Trials Registry Platform for studies focusing on the Buteyko method for children and adults with asthma. The searches will be carried out in September 2021 from database's inception to the present. We will include randomised controlled trials comparing Buteyko method alone with asthma education or inactive control intervention. There will be no restriction on language. Primary outcomes include quality of life, asthma symptoms and adverse events/side effects. Two review authors will independently screen the studies for inclusion and extract data. We will assess the quality of the included studies using the 'Risk of Bias' tool. The certainty of the evidence will be assessed using the GRADE approach. Data synthesis will be conducted using Review Manager software. Reporting of the review will follow the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidance and the Cochrane Handbook for Systematic Reviews of Interventions. ETHICS AND DISSEMINATION: This study will assess and provide evidence for the use of the Buteyko method in people with asthma. We will analyse secondary data and this does not require ethics approval. The findings will be published in peer-reviewed journals, at relevant conferences and will be shared in plain language in social media. Moreover, the findings of this review could guide the direction of healthcare practice and research. PROSPERO REGISTRATION NUMBER: CRD42020193132.

Barriers and facilitators to populational adherence to prevention and control measures of COVID-19 and other respiratory infectious diseases: a rapid qualitative evidence synthesis protocol.

INTRODUCTION: The current COVID-19 pandemic has increased the need for populational adherence to measures for the prevention and control of respiratory infectious diseases. However, their effectiveness depends on the population's preventive behaviour, which may be divergent from public policies. Therefore, this study aims to summarise and evaluate the evidence on barriers and facilitators to populational adherence to prevention and control measures in COVID-19 and other respiratory infectious diseases. METHODS AND ANALYSIS: We will search on MEDLINE, Embase and PsycINFO for studies focusing on adults receiving protective behaviour recommendations to combat COVID-19 and other respiratory infectious diseases. The searches will be carried out from database's inception to the present. We will include studies that use qualitative methods in their data collection and analysis and studies that use mixed methods if they include any qualitative methods of analysis. Studies published in English, Portuguese and Spanish will be included. Two review authors will independently screen the studies for inclusion and extract data. We will assess the quality of the included studies using the Critical Skills Appraisal Programme tool. For the assessment of the confidence in the synthesised findings, we will use the GRADE-Confidence in the Evidence from Reviews of Qualitative research. Data analysis will be conducted using the best-fit framework approach based on adapted dimensions from the Health Belief Model and the Behaviour Change Wheel. ETHICS AND DISSEMINATION: This study will be conducted on published evidence, and thus, no ethical approval is required. The findings of this rapid qualitative evidence synthesis will be disseminated to academic audiences, health policy-makers and the general population. We will publish the results in peer-reviewed journals, present our findings in conferences, and disseminate results via social media. We also aim to present the research findings in plain language and disseminate the knowledge to the general population to increase public interest. PROSPERO REGISTRATION NUMBER: CRD42020205750.

Pediatric Asthma Control and Communication Instrument: translation into Portuguese and cross-cultural adaptation for use in Brazil.

OBJECTIVE: To translate the Pediatric Asthma Control and Communication Instrument (PACCI) to Portuguese and adapt it for use in Brazil, ensuring the cultural validity of the content and semantic equivalence of the target version. METHODS: The Brazilian Portuguese-language version of the PACCI was developed according to the most commonly used methodology, which included the following steps: translation; synthesis of the translation; review by the author of the original questionnaire; back-translation; synthesis of the back-translation; review by a native external researcher who is a native speaker of English; approval of the author of the original questionnaire; review by a specialist in Portuguese; review by a multidisciplinary committee of experts to determine the agreement of the items, considering the clarity of each and its appropriateness in the cultural context; cognitive debriefing; and development of the final version. The cognitive debriefing involved 31 parents/legal guardians of children 1-21 years of age with a clinical diagnosis of asthma, as defined by the Global Initiative for Asthma, with the objective of determining the comprehensibility and clarity of the items for the target population. RESULTS: The multidisciplinary committee of experts indicated that the items on the questionnaire were clear and comprehensible, with kappa values above 0.61, indicating substantial agreement. In the cognitive debriefing, the parents/legal guardians presented no difficulties in understanding any of the items (agreement > 0.90); therefore, no further changes were needed. CONCLUSIONS: The translation and cross-cultural adaptation of the PACCI for use in Brazil were successful.

Association between quality of life, severity of asthma, sleep disorders and exercise capacity in children with asthma: a cross-sectional study.

OBJECTIVE: To assess the association between quality of life, asthma severity, sleep disorders and exercise capacity in children with asthma. METHODS: We evaluated 45 children with asthma of both sexes aged between 7 and 12 years, diagnosed by a pediatrician/pulmonologist and classified according to the IV Brazilian Guidelines for Asthma Management: severity (intermittent/mild and moderate/severe) and control (controlled, partially controlled and uncontrolled). Quality of life (QoL), presence of sleep disorders and exercise capacity were respectively assessed using the following instruments: Pediatric Asthma Quality of Life Questionnaire (PAQLQ); Sleep Disturbance Scale for Children (SDSC); and six-minute step test (6MST). RESULTS: Intermittent/mild and moderate/severe asthma were observed in 51.1% and 48.9% of the children evaluated, respectively. Only 8.89% of the sample had uncontrolled asthma. In the regression model, a better QoL was observed in children with lower asthma severity, lower SDSC total score and lower levels of dyspnea induced by the 6MST (ß=-0.395, p=0.003; ß=-0.338, p=0.011; ß=-0.352, p=0.008; respectively). These factors explained 31% of the PAQLQ total score variation. Other variables (such as cardiorespiratory variables, spirometry, asthma control and number of steps in 6MST) did not predict quality of life. CONCLUSIONS: Lower asthma severity (intermittent/mild), fewer symptoms of sleep disorder, and lower exercise-induced dyspnea predicts better quality of life in children with asthma.

Pediatric Asthma Control and Communication Instrument: translation into Portuguese and cross-cultural adaptation for use in Brazil / Pediatric Asthma Control and Communication Instrument: tradução e adaptação transcultural para a língua portuguesa falada no Brasil

ABSTRACT Objective: To translate the Pediatric Asthma Control and Communication Instrument (PACCI) to Portuguese and adapt it for use in Brazil, ensuring the cultural validity of the content and semantic equivalence of the target version. Methods: The Brazilian Portuguese-language version of the PACCI was developed according to the most commonly used methodology, which included the following steps: translation; synthesis of the translation; review by the author of the original questionnaire; back-translation; synthesis of the back-translation; review by a native external researcher who is a native speaker of English; approval of the author of the original questionnaire; review by a specialist in Portuguese; review by a multidisciplinary committee of experts to determine the agreement of the items, considering the clarity of each and its appropriateness in the cultural context; cognitive debriefing; and development of the final version. The cognitive debriefing involved 31 parents/legal guardians of children 1-21 years of age with a clinical diagnosis of asthma, as defined by the Global Initiative for Asthma, with the objective of determining the comprehensibility and clarity of the items for the target population. Results: The multidisciplinary committee of experts indicated that the items on the questionnaire were clear and comprehensible, with kappa values above 0.61, indicating substantial agreement. In the cognitive debriefing, the parents/legal guardians presented no difficulties in understanding any of the items (agreement > 0.90); therefore, no further changes were needed. Conclusions: The translation and cross-cultural adaptation of the PACCI for use in Brazil were successful.

RESUMO Objetivo: Realizar a tradução e a adaptação transcultural do Pediatric Asthma Control and Communication Instrument (PACCI) para o contexto da população brasileira, e assegurar a validade de conteúdo e equivalência semântica da versão adaptada. Métodos: A versão do PACCI para a língua portuguesa falada no Brasil foi desenvolvida de acordo com a metodologia mais comumente utilizada, que incluiu as seguintes etapas: tradução; síntese da tradução; revisão de um pesquisador nativo de língua inglesa; tradução reversa; síntese da tradução reversa; revisão de um pesquisador nativo de língua inglesa; apreciação do autor do questionário original; revisão por especialista em língua portuguesa; revisão do comitê multiprofissional de especialistas para verificar a concordância dos itens, considerando a clareza e a adequação dos itens ao contexto cultural; desdobramento cognitivo; e desenvolvimento da versão final. O desdobramento cognitivo foi realizado com 31 pais/responsáveis por crianças e adolescentes de 1-21 anos, com diagnóstico clínico de asma de acordo com a Global Initiative for Asthma, com o objetivo de verificar a compreensão e a clareza dos itens na população-alvo. Resultados: O comitê multiprofissional de especialistas indicou que os itens do questionário se apresentaram claros e compreensíveis, com valores de kappa superiores a 0,61, indicando concordância substancial. Considerando o procedimento de desdobramento cognitivo, os pais/responsáveis não apresentaram dificuldades de compreensão (concordância > 0,90) não havendo necessidade de modificações da versão final em português. Conclusões: O PACCI apresenta-se adequadamente traduzido e transculturalmente adaptado para uso na população brasileira.

Aplicabilidade de um questionário genérico de avaliação de qualidade de vida para crianças asmáticas / Applicability of a generic questionnaire for quality of life assessment for asthmatic children

RESUMO Objetivo: Avaliar se o instrumento genérico Pediatric Quality of Life Inventory (PedsQL 4.0) é aplicável à avaliação da qualidade de vida relacionada à saúde (QVRS) de crianças asmáticas, quando comparado ao instrumento específico Pediatric Asthma Quality of Life Questionnaire (PAQLQ). Métodos: Foram avaliadas 30 crianças com idade entre sete e onze anos de idade e diagnóstico de asma havia, pelo menos, seis meses. Ambos os questionários foram respondidos no mesmo dia, por meio de entrevista. Os dados foram analisados com o auxílio do Statistical Package for the Social Sciences (SPSS), versão 20.0, atribuindo-se o nível de significância de 5%. Resultados: Não ocorreram diferenças significativas na qualidade de vida das crianças avaliadas de acordo os sexos. As crianças asmáticas classificadas como praticantes e não praticantes de atividade física obtiveram escores significativamente diferentes no domínio relacionado à saúde física (PedsQL 4.0). Crianças com diferentes níveis de gravidade e controle da asma apresentaram diferenças significativas nos escores obtidos em dois dos três domínios avaliados por meio do PAQLQ. Ao serem avaliadas com o instrumento PedsQL 4.0, nenhuma diferença significativa foi observada na qualidade de vida das crianças com diferentes níveis de controle e gravidade da asma. As medidas de qualidade de vida de crianças asmáticas obtidas pelos instrumentos PedsQL 4.0 e PAQLQ apresentaram correlação moderada e significativa (r=0,415, p=0,02). Conclusões: O instrumento PedsQL 4.0 diferenciou as crianças com diferentes níveis de atividade física. No entanto, ele não foi sensível para diferenciar a qualidade de vida relacionada à saúde em crianças com diferentes níveis de gravidade e controle da asma.

ABSTRACT Objective: To determine the applicability of the generic instrument Pediatric Quality of Life Inventory (PedsQL 4.0) to assess health-related quality of life of asthmatic children compared to the specific instrument Pediatric Asthma Quality of Life Questionnaire (PAQLQ). Methods: This research involved the evaluation of 30 children aged seven to eleven years, who had been diagnosed with asthma for at least six months prior to research. Both quality of life questionnaires were applied to children by an interviewer over the period of one day. Data were analyzed using the Statistical Package for the Social Sciences (SPSS) 20.0, with significance level set at 5%. Results: No differences in quality of life was found when genders were compared. Asthmatic children classified as practitioners and non-practitioners of physical activity had different scores in the physical health-related domain (PedsQL 4.0). The scores of children with different levels of asthma severity and control were significantly different in two out of three domains evaluated by PAQLQ. When assessed by PedsQL 4.0, no significant difference was observed as to quality of life of children with different levels of asthma control and severity. Quality of life measurements of asthmatic children by PedsQL 4.0 and PAQLQ instruments had a moderate and significant correlation (r=0.415, p=0.02). Conclusions: PedsQL 4.0 could distinguish children practicing different levels of physical activity, but it was not sensitive enough to distinguish health-related quality of life among children with different levels of asthma severity and control.

APPLICABILITY OF A GENERIC QUESTIONNAIRE FOR QUALITY OF LIFE ASSESSMENT FOR ASTHMATIC CHILDREN. / APLICABILIDADE DE UM QUESTIONÁRIO GENÉRICO DE AVALIAÇÃO DE QUALIDADE DE VIDA PARA CRIANÇAS ASMÁTICAS.

OBJECTIVE: To determine the applicability of the generic instrument Pediatric Quality of Life Inventory (PedsQL 4.0) to assess health-related quality of life of asthmatic children compared to the specific instrument Pediatric Asthma Quality of Life Questionnaire (PAQLQ). METHODS: This research involved the evaluation of 30 children aged seven to eleven years, who had been diagnosed with asthma for at least six months prior to research. Both quality of life questionnaires were applied to children by an interviewer over the period of one day. Data were analyzed using the Statistical Package for the Social Sciences (SPSS) 20.0, with significance level set at 5%. RESULTS: No differences in quality of life was found when genders were compared. Asthmatic children classified as practitioners and non-practitioners of physical activity had different scores in the physical health-related domain (PedsQL 4.0). The scores of children with different levels of asthma severity and control were significantly different in two out of three domains evaluated by PAQLQ. When assessed by PedsQL 4.0, no significant difference was observed as to quality of life of children with different levels of asthma control and severity. Quality of life measurements of asthmatic children by PedsQL 4.0 and PAQLQ instruments had a moderate and significant correlation (r=0.415, p=0.02). CONCLUSIONS: PedsQL 4.0 could distinguish children practicing different levels of physical activity, but it was not sensitive enough to distinguish health-related quality of life among children with different levels of asthma severity and control.

OBJETIVO: Avaliar se o instrumento genérico Pediatric Quality of Life Inventory (PedsQL 4.0) é aplicável à avaliação da qualidade de vida relacionada à saúde (QVRS) de crianças asmáticas, quando comparado ao instrumento específico Pediatric Asthma Quality of Life Questionnaire (PAQLQ). MÉTODOS: Foram avaliadas 30 crianças com idade entre sete e onze anos de idade e diagnóstico de asma havia, pelo menos, seis meses. Ambos os questionários foram respondidos no mesmo dia, por meio de entrevista. Os dados foram analisados com o auxílio do Statistical Package for the Social Sciences (SPSS), versão 20.0, atribuindo-se o nível de significância de 5%. RESULTADOS: Não ocorreram diferenças significativas na qualidade de vida das crianças avaliadas de acordo os sexos. As crianças asmáticas classificadas como praticantes e não praticantes de atividade física obtiveram escores significativamente diferentes no domínio relacionado à saúde física (PedsQL 4.0). Crianças com diferentes níveis de gravidade e controle da asma apresentaram diferenças significativas nos escores obtidos em dois dos três domínios avaliados por meio do PAQLQ. Ao serem avaliadas com o instrumento PedsQL 4.0, nenhuma diferença significativa foi observada na qualidade de vida das crianças com diferentes níveis de controle e gravidade da asma. As medidas de qualidade de vida de crianças asmáticas obtidas pelos instrumentos PedsQL 4.0 e PAQLQ apresentaram correlação moderada e significativa (r=0,415, p=0,02). CONCLUSÕES: O instrumento PedsQL 4.0 diferenciou as crianças com diferentes níveis de atividade física. No entanto, ele não foi sensível para diferenciar a qualidade de vida relacionada à saúde em crianças com diferentes níveis de gravidade e controle da asma.

Prediction equations for spirometry in four- to six-year-old children / Equações de predição da espirometria em crianças de quatro a seis anos

Abstract Objective To generate prediction equations for spirometry in 4- to 6-year-old children. Methods Forced vital capacity, forced expiratory volume in 0.5 s, forced expiratory volume in one second, peak expiratory flow, and forced expiratory flow at 25–75% of the forced vital capacity were assessed in 195 healthy children residing in the town of Sete Lagoas, state of Minas Gerais, Southeastern Brazil. The least mean squares method was used to derive the prediction equations. The level of significance was established as p < 0.05. Results Overall, 85% of the children succeeded in performing the spirometric maneuvers. In the prediction equation, height was the single predictor of the spirometric variables as follows: forced vital capacity = exponential [(−2.255) + (0.022 × height)], forced expiratory volume in 0.5 s = exponential [(−2.288) + (0.019 × height)], forced expiratory volume in one second = exponential [(−2.767) + (0.026 × height)], peak expiratory flow = exponential [(−2.908) + (0.019 × height)], and forced expiratory flow at 25–75% of the forced vital capacity = exponential [(−1.404) + (0.016 × height)]. Neither age nor weight influenced the regression equations. No significant differences in the predicted values for boys and girls were observed. Conclusion The predicted values obtained in the present study are comparable to those reported for preschoolers from both Brazil and other countries.

Resumo Objetivo Gerar equações de predição da espirometria em crianças de quatro a seis anos. Métodos Capacidade vital forçada, volume expiratório forçado em 0,5 segundo, volume expiratório forçado em um segundo, pico de fluxo expiratório e fluxo expiratório forçado com 25-75% da capacidade vital forçada foram avaliados em 195 crianças saudáveis que residem em Sete Lagoas, Estado de Minas Gerais, Sudeste do Brasil. O método dos mínimos quadrados foi usado para derivar as equações de predição. O nível de significância foi estabelecido como p < 0,05. Resultados No geral, 85% das crianças foram bem-sucedidas ao fazer as manobras espirométricas. Na equação de predição, a estatura foi a única variável preditora das variáveis espirométricas, da seguinte forma: capacidade vital forçada = exponencial [(-2,255) + (0,022 x estatura)], volume expiratório forçado em 0,5 segundo = exponencial [(-2,288) + (0,019 x estatura)], volume expiratório forçado em um segundo = exponencial [(-2,767) + (0,026 x estatura)], pico do fluxo expiratório = exponencial [(-2,908) + (0,019 x estatura)] e fluxo expiratório forçado com 25-75% da capacidade vital forçada = exponencial [(-1,404) + (0,016 x estatura)]. Nem a idade nem o peso influenciaram as equações de regressão. Não foi observada diferença significativa nos valores previstos em meninos e meninas. Conclusão Os valores previstos obtidos neste estudo são comparáveis àqueles relatados em crianças em idade pré-escolar tanto do Brasil quanto de outros países.

Fisioterapia Motora no recém-nascido prematuro em Unidade Intensiva Neonatal: uma revisão sistemática / Physical therapy for the premature newborn in neonatal intensive care unit: a systematic review

Introdução: Recém-nascidos prematuros (RNPT) apresentam maior vulnerabilidade a desfechos adversos decorrentes da própria imaturidade e da hospitalização. Dessa forma, é importante investigar as repercussões clínicas e benefícios da fisioterapia nesta população. Objetivo: Desenvolver uma revisão sistemática para verificar as repercussões clínicas e potenciais benefícios da fisioterapia motora nos RNPT internados em unidade de terapia intensiva. Métodos: As bases de dados Lilacs, Pubmed e Scopus foram consultadas. Dois revisores independentes realizaram a seleção e análise dos artigos elegíveis e avaliação do risco de viés. Resultados: Quatro artigos foram incluídos na revisão. A conduta fisioterapêutica foi considerada segura, sendo observada redução da dor, melhora da qualidade do sono, do ganho de peso e da função do sistema nervoso autônomo. Conclusões: A fisioterapia motora pode contribuir para o desenvolvimento e conforto dos RNPT sem trazer riscos. No entanto, esta revisão foi limitada pela qualidade dos dados existentes e reduzido número de estudos avaliados.

Introduction: Preterm infants are more vulnerable to adverse outcomes resulting from their own immaturity and hospitalization. Thus, it is important to investigate the clinical implications and benefits of physical therapy in this population. Objective: To develop a systematic review to investigate the clinical implications and potential benefits of physical therapy in premature newborns hospitalized in the intensive care unit. Methods: Lilacs, Pubmed and Scopus databases were consulted. Two independent reviewers performed the selection of eligible studies and risk of bias assessment. Results: Four studies were included in the review. Physical therapy was considered safe, and it was possible to observe reducing pain, improvement in sleep quality, weight gain and autonomic nervous system function. Conclusion: Physical Therapy may contribute to the development and comfort of premature newborns without harms. Nevertheless, this review was limited by the existing data and by the small number of studies assessed.

Predicted normal values for maximal respiratory pressures in children / Valores preditos para as pressões respiratórias máximas em crianças

Introduction: Reference equations are used to predict normal values for maximal respiratory pressures. Objectives: To develop predictive equations for maximal respiratory pressure in children. Methods: A total of 144 healthy children, aged between 7 and 11 years, were assessed. Maximal inspiratory and expiratory pressures were assessed with a digital manovacuometer on top of residual volume and total lung capacity, respectively. Results: The variables sex, age and weight showed association with maximal inspiratory pressure, while maximal expiratory pressure, in addition to the aforementioned variables, also showed association with height. After regression analysis, only sex and age had an influence on the variability of inspiratory and expiratory pressures. Conclusions: The present study provides reference values and proposes two equation models that predict maximal respiratory pressure values among children aged between 7 and 11 years.

Introdução: Equações de referência são utilizadas para predizer valores de normalidade de pressões respiratórias máximas. Objetivo: Elaborar equações preditivas para as pressões respiratórias máximas de crianças. Métodos: Um total de144 crianças saudáveis, com idade entre 7 e 11 anos, foram avaliadas. As pressões inspiratória e expiratória máximas foram avaliadas utilizando um manovacuômetro digital a partir do volume residual e da capacidade pulmonar total, respectivamente. Resultados: As variáveis sexo, idade e peso apresentaram associação com a pressão inspiratória máxima, enquanto que a pressão expiratória máxima, além das variáveis anteriormente citadas, também mostrou associação com a altura. Após a análise de regressão, apenas o sexo e a idade permaneceram exercendo influência sobre a variabilidade das pressões inspiratória e expiratória máximas. Conclusões: Este estudo disponibiliza valores de referência e propõe dois modelos de equação que predizem o valor das pressões respiratórias máximas de crianças entre 7 e 11 anos.

Pulmonary function of children with acute leukemia in maintenance phase of chemotherapy / Função pulmonar de crianças com leucemia aguda na fase de manutenção da quimioterapia

OBJECTIVE: The aim of this study was to assess the pulmonary function of children with acute leukemia. METHODS: Cross-sectional observational analytical study that enrolled 34 children divided into groups A (17 with acute leukemia in the maintenance phase of chemotherapy) and B (17 healthy children). The groups were matched for sex, age and height. Spirometry was measured using a spirometer Microloop Viasys(r) in accordance with American Thoracic Society and European Respiratory Society guidelines. Maximal respiratory pressures were measured with an MVD300 digital manometer (Globalmed(r)). Maximal inspiratory pressures and maximal expiratory pressures were measured from residual volume and total lung capacity, respectively. RESULTS: Group A showed a significant decrease in maximal inspiratory pressures when compared to group B. No significant difference was found between the spirometric values of the two groups, nor was there any difference between maximal inspiratory pressure and maximal expiratory pressure values in group A compared to the lower limit values proposed as reference. CONCLUSION: Children with acute leukemia, myeloid or lymphoid, during the maintenance phase of chemotherapy exhibited unchanged spirometric variables and maximal expiratory pressure; However, there was a decrease in inspiratory muscle strength...

OBJETIVO: O objetivo desse estudo foi avaliar a função pulmonar de crianças com leucemia aguda. MÉTODOS: Trata-se de um estudo observacional do tipo analítico transversal com 34 crianças, divididas nos grupos A (17 crianças com leucemia aguda na fase de manutenção do tratamento quimioterápico) e B (17 crianças saudáveis). Os grupos foram pareados em relação ao sexo, idade e altura. A espirometria foi mensurada utilizando um espirômetro Microloop Viasys(r), de acordo com as recomendações da American Thoracic Society e European Respiratory Society. As pressões respiratórias máximas foram mensuradas utilizando um manovacuômetro digital MVD300 (Globalmed(r)). As pressões inspiratória máxima e expiratória máxima foram mensuradas a partir do volume residual e da capacidade pulmonar total, respectivamente. RESULTADOS: O grupo A apresentou diminuição significativa da pressão inspiratória máxima quando comparado ao grupo B. Não foram observadas diferenças entre os dados espirométricos dos dois grupos avaliados, bem como entre os valores de pressão inspiratória máxima e pressão expiratória máxima do grupo A com os limites inferiores propostos como referência. CONCLUSÃO: As crianças com leucemia aguda, linfoide ou mieloide não apresentam mudança das variáveis espirométricas e da pressão expiratória máxima durante o período de manutenção do tratamento quimioterápico; no entanto, há uma diminuição da pressão inspiratória máxima...

Respiratory muscle strength of Brazilian adolescents: obtained and predicted values

OBJECTIVES: To compare the obtained values for maximal respiratory pressures of a sample of Brazilian adolescents with the values predicted by Wilson et al. and Domènech-Clar et al. METHODS: 156 adolescents (84 boys) aged between 12 and 17 years were assessed. Maximal respiratory pressures were assessed by a digital manometer with the adolescents in the seated position and wearing a nose clip. Maximal inspiratory and expiratory pressures were performed from residual volume and total lung capacity, respectively. Comparison of the values of maximal respiratory pressures obtained in this study with those predicted by the equations proposed by Wilson et al. and Domenèch-Clar et al., was performed by the paired Student's t test. To verify the association between these values, the Pearson's correlation test was used. RESULTS: Mean maximal inspiratory pressure was 74,66 ± 22,95 cm H2O and 103,52 ± 25,67 cm H2O for girls and boys, respectively. Mean maximal expiratory pressure was 86,23 ± 25,92 cm H2O and 120,08 ± 27,37 cm H2O for girls and boys, respectively. The values obtained by this study did not differ and also did not significantly correlate with those predicted by the equations proposed by Wilson et al., e Domènech-Claret al. CONCLUSIONS: The equations proposed by Wilson et al. and Domènech-Clar et al. were not successful in predicting the values for maximal respiratory pressures in the population studied, indicating the necessity of using in clinical practice reference values from a healthy population of the same ethnicity...(AU)

OBJETIVOS: Comparar os valores encontrados para as pressões respiratórias máximas de uma amostra de adolescentes brasileiros com os valores preditos por Wilson et al e Domènech-Clar et al. MÉTODO: Foram avaliados 156 adolescentes (84 meninos) entre 12 e 17 anos. As pressões respiratórias máximas foram avaliadas por meio de um manovacuômetro digital com os adolescentes sentados e utilizando um clipe nasal. As avaliações das pressões inspiratória e expiratória máximas foram realizadas a partir do volume residual e da capacidade pulmonar total, respectivamente. A comparação dos valores das pressões respiratórias máximas obtidos no atual estudo com os preditos pelas equações propostas por Wilson et al e Domènech-Clar et al, foi realizada pelo teste t de Student pareado. Para verificar a associação entre estes valores, foi utilizado o teste de correlação de Pearson. RESULTADOS: A média da pressão inspiratória máxima foi de 74,66 ± 22,95 cm H2O e de 103,52 ± 25,67 cm H2O para meninas e meninos, respectivamente. A média da pressão expiratória máxima foi de 86,23 ± 25,92 cm H2O e de 120,08 ± 27,37 cm H2O para meninas e meninos, respectivamente. Os valores obtidos não diferiram e também não se correlacionaram significativamente com os preditos através das equações propostas por Wilson et al., e Domènech-Clar et al. CONCLUSÕES: As equações propostas por Wilson et al. e Domènech-Clar et al., não foram capazes de predizer os valores das pressões respiratórias máximas na população estudada, indicando a necessidade de se usar na prática clínica valores de referência advindos de uma população saudável de mesma etnia...(AU)

Respiratory muscle strength of Brazilian adolescents: obtained and predicted values

OBJECTIVES: To compare the obtained values for maximal respiratory pressures of a sample of Brazilian adolescents with the values predicted by Wilson et al. and Domènech-Clar et al. METHODS: 156 adolescents (84 boys) aged between 12 and 17 years were assessed. Maximal respiratory pressures were assessed by a digital manometer with the adolescents in the seated position and wearing a nose clip. Maximal inspiratory and expiratory pressures were performed from residual volume and total lung capacity, respectively. Comparison of the values of maximal respiratory pressures obtained in this study with those predicted by the equations proposed by Wilson et al. and Domenèch-Clar et al., was performed by the paired Student's t test. To verify the association between these values, the Pearson's correlation test was used. RESULTS: Mean maximal inspiratory pressure was 74,66 ± 22,95 cm H2O and 103,52 ± 25,67 cm H2O for girls and boys, respectively. Mean maximal expiratory pressure was 86,23 ± 25,92 cm H2O and 120,08 ± 27,37 cm H2O for girls and boys, respectively. The values obtained by this study did not differ and also did not significantly correlate with those predicted by the equations proposed by Wilson et al., e Domènech-Claret al. CONCLUSIONS: The equations proposed by Wilson et al. and Domènech-Clar et al. were not successful in predicting the values for maximal respiratory pressures in the population studied, indicating the necessity of using in clinical practice reference values from a healthy population of the same ethnicity...

OBJETIVOS: Comparar os valores encontrados para as pressões respiratórias máximas de uma amostra de adolescentes brasileiros com os valores preditos por Wilson et al e Domènech-Clar et al. MÉTODO: Foram avaliados 156 adolescentes (84 meninos) entre 12 e 17 anos. As pressões respiratórias máximas foram avaliadas por meio de um manovacuômetro digital com os adolescentes sentados e utilizando um clipe nasal. As avaliações das pressões inspiratória e expiratória máximas foram realizadas a partir do volume residual e da capacidade pulmonar total, respectivamente. A comparação dos valores das pressões respiratórias máximas obtidos no atual estudo com os preditos pelas equações propostas por Wilson et al e Domènech-Clar et al, foi realizada pelo teste t de Student pareado. Para verificar a associação entre estes valores, foi utilizado o teste de correlação de Pearson. RESULTADOS: A média da pressão inspiratória máxima foi de 74,66 ± 22,95 cm H2O e de 103,52 ± 25,67 cm H2O para meninas e meninos, respectivamente. A média da pressão expiratória máxima foi de 86,23 ± 25,92 cm H2O e de 120,08 ± 27,37 cm H2O para meninas e meninos, respectivamente. Os valores obtidos não diferiram e também não se correlacionaram significativamente com os preditos através das equações propostas por Wilson et al., e Domènech-Clar et al. CONCLUSÕES: As equações propostas por Wilson et al. e Domènech-Clar et al., não foram capazes de predizer os valores das pressões respiratórias máximas na população estudada, indicando a necessidade de se usar na prática clínica valores de referência advindos de uma população saudável de mesma etnia...

Pressões respiratórias máximas de pico e sustentada na avaliação da força muscular respiratória de crianças / Maximum peak and sustained respiratory pressures in the assessment of respiratory muscular strength in children

Comparar os valores de PImax e PEmax de pico e sustentado em uma população de crianças em idade escolar. MÉTODOS: estudo observacional descritivo de caráter transversal. Foram avaliadas 144 crianças saudáveis de 7 a 11 anos de ambos os gêneros. Foirealizada avaliação antropométrica e mensuraçãodas pressões respiratórias máximas, de pico e sustentada, através do manovacuômetro digital. A criança sorteou qual pressão respiratória iria realizar inicialmente. A medida da PImax foi realizada a partir da capacidade pulmonar total e a medida da PEmax a partir do volume residual. Os dados foram analisados através do programa SPSS 17.0 atribuindose o nível de significância de por cento. RESULTADOS: os achados obtidos foram: 78,53 ± 22,53 cmH2O para PIpico ; 91,11 ± 23,0 cmH2O para a PEpico e 72,95 ± 21,22 cmH2O e 86,25 ± 21,8 cmH2O para PIsust e PEsust, respectivamente. Osvalores obtidos através das pressões respiratórias de pico (PIpico e PEpico) foram significativamente superiores as medidas obtidas para as pressões respiratórias sustentadas (PIsust e PEsust) independentemente do gênero ou idade avaliada (p=0,001). CONCLUSÕES: a utilização de medidas de pico na avaliação das pressões respiratórias máximas, mais facilmente obtidas na prática clínica, pode comprometer a real mensuração da força muscular respiratória em crianças de 7 a 11 anos...

To compare peak and sustained values of PImax and PEmax in a sample of schoolaged children. METHODS: a descriptive observational crosssection analysis. 144 healthy boys and girls between the ages of 7 and 11 were evaluated. An anthropometric assessment was performed and measurements of peak and sustained respiratory muscle strength with the use of a digital manometer. The child chose at random what initial respiratory pressure to hold. The measurement of PImax was taken from total lung capacity and the measurement of PEmax from residual volume. Data was analyzed using SPSS 17.0 and was attributed a significance level of 5 percent. RESULTS: the following findings were produced bythe study: 78.53 ± 22.53 cmH2O for PIpeak and 72.95 ± 21.22 cmH2O and 86.25 ± 21.8 cmH2O for PIsust and PEsust respectively. The values obtained throughpeak respiratory pressures (PIpeak and PEpeak) were significantly higher than the measurements obtained for sustained respiratory pressures (PIsust and PEsust)regardless of gender or age assessment (p=0.001). CONCLUSIONS: the use of measures in assessing peak maximum respiratory pressure, more easily obtained in clinical practice, may undermine the real measurements of respiratory muscle strength in children between 7 and 11 years of age...

Analysis of the rate of perceived exertion in the assessment of maximal respiratory pressures in children and adolescents / Análise do índice de percepção de esforço na avaliação das pressões respiratórias máximas em crianças e adolescentes

OBJECTIVE: To analyze the rate of perceived exertion in assessing maximal respiratory pressures in children and adolescents. METHODS: We evaluated 144 healthy children and adolescents from seven to eleven years old, 63 boys and 81 girls, students from public and private schools. The instrument used was a digital manovacuometer MVD300 (Globalmed, Porto Alegre-RS, Brazil). A maximum of nine maneuvers were carried out, with one minute rest between each maneuver and five minutes between the measurement of maximal inspiratory and expiratory pressures. The rate of perceived effort was determined by Borg scale and was used at four different moments: before measuring maximal inspiratory and expiratory pressures, previously drawn; immediately after the first measurement; after five minutes of rest and immediately after the last assessment. RESULTS: The children and adolescents' perceived exertion before, immediately after and five minutes after assessment was 7.8 ± 1.8, 9.6 ± 2.5 and 8.5 ± 2.3, respectively. There was a significant increase after measuring maximal inspiratory and expiratory pressures (p < 0.001). The amount of effort decreased significantly with five minutes of rest after maximal respiratory pressures (p < 0.05). The perceived exertion was similar for children and adolescents who underwent up to five or more maneuvers. CONCLUSION: The assessment of maximal respiratory pressures in children and adolescents proved to be a safe method regarding perceived exertion. It is suggested that the analysis of the rate of perceived exertion may be a common practice during the evaluation of respiratory muscle strength.(AU)

OBJETIVO: Analisar o índice de percepção de esforço na avaliação das pressões respiratórias máximas de crianças e adolescentes. MÉTODO: Foram avaliadas 144 crianças e adolescentes saudáveis, de sete a onze anos, sendo 63 meninos e 81 meninas, estudantes das redes pública e privada. O instrumento utilizado foi o manovacuômetro digital MVD300 (Globalmed, Porto Alegre - RS, Brasil). Foram realizadas no máximo nove manobras, com um minuto de descanso entre cada manobra e cinco minutos entre a medição das pressões inspiratórias e expiratórias máximas. A sensação de esforço percebido foi determinada através da escala de Borg e foi utilizada em quatro momentos: antes das medições das pressões respiratórias máximas, previamente sorteadas; imediatamente após a primeira medição sorteada; após cinco minutos de descanso e imediatamente após a última avaliação. RESULTADOS: O esforço percebido das crianças e adolescentes antes, imediatamente após e cinco minutos após a manovacuometria foi de 7,8±1,8; 9,6±2,5 e 8,5±2,3, respectivamente. Houve aumento significativo após a mensuração das pressões inspiratórias e expiratórias máximas (p < 0,001). A quantidade de esforço diminuiu significativamente após cinco minutos de descanso da realização das pressões respiratórias máximas (p< 0,05). A percepção de esforço foi semelhante para as crianças e adolescentes que realizaram até cinco ou mais manobras. CONCLUSÃO: A avaliação das pressões respiratórias máximas, em crianças e adolescentes, mostrou-se um método seguro quanto à percepção de esforço. Sugere-se que a análise do índice de esforço percebido possa ser prática frequente durante a avaliação da força muscular respiratória.(AU)