Evidência científica sobre avaliação da musculatura respiratória e tratamento dos distúrbios respiratórios do sono em acidente vascular cerebral

Abstract

Over the past fourty years, some tests were developed to assess the resistance of respiratory muscles, especially inspiratory muscles. Devices and prototypes always sought to assess two relatively distinct aspects: fatigue and endurance. Despite its importance, previous studies using different devices or prototypes to assess respiratory muscle resistance used a small sample size, hindering interpretation of results. Additionally, the nonspecific respiratory endurance test most used, maximum voluntary ventilation (MVV), was indirectly applied in different populations (e.g., Chronic Obstructive Pulmonary Disease – [COPD]) for several years using predictive equations. However, literature lacks studies assessing the concordance of predictive equations with MVV. Significant progress has also been made in understanding sleep-disordered breathing and its consequences. Although there is evidence that positive airway pressure facilitates respiratory muscle activity and improves ventilation and disease control, its effectiveness is unknown in special populations, such as in post-stroke patients. This thesis aimed to examine methods for assessing and treating respiratory disorders in people with chronic diseases. We also evaluated the agreement of the maximum voluntary ventilation measured directly and indirectly (estimated value) in COPD patients and healthy subjects and showed the effectiveness and safety of using continuous positive nasal pressure in functionality, clinical severity of the disease, disability, daytime sleepiness, and mortality of people after stroke. The designed device has potential for innovation and can evaluate resistance of respiratory muscles (inspiratory/expiratory alone or combined) using different protocols. The systematic review is ongoing. Despite the high heterogeneity of studies, preliminary results support positive effects of nCPAP on disease severity for more than three months in patients with stroke and sleep-disordered breathing. These study aimed to evaluate, develop and examine methods of respiratory muscle assessment and treatment of respiratory disorders in healthy people or those with COPD and sleep-disordered breathing in people after stroke.