Avaliação da função pulmonar em pacientes com dor lombar inespecífica
DOI:
https://doi.org/10.17267/2238-2704rpf.2023.e5364Palavras-chave:
Dor Lombar, Função Pulmonar, Músculos Respiratórios, EspirometriaResumo
INTRODUÇÃO: O diafragma é o principal músculo inspiratório e desempenha um papel essencial no controle da coluna durante o controle postural. Na dor lombar inespecífica, o músculo diafragma torna-se fraco, podendo as funções pulmonares diminuir. Até onde sabemos, há escassez de literatura a respeito do efeito da dor lombar nos parâmetros pulmonares. Assim, o estudo tem como objetivo avaliar a função pulmonar em pacientes com dor lombar inespecífica. MÉTODOS: Cento e treze pacientes com dor lombar inespecífica e 113 indivíduos normais pareados com IMC como grupo de comparação com idades entre 18 e 40 anos, dos gêneros masculino e feminino, foram recrutados por método de amostragem proposital para este estudo transversal prospectivo. O grupo de dor nas costas inespecífica incluiu participantes com diagnóstico de dor lombar inespecífica com intensidade de dor > 3 na escala VAS e duração > 3 meses. Após triagem e avaliação inicial, as características antropométricas foram registradas. Em seguida, foram registrados os testes de função pulmonar (VEF1, CVF, VEF1/CVF, PFE, CVL, VVM) em ambos os grupos. RESULTADO: O teste de Kolmogorov-Smirnov foi utilizado para avaliação da normalidade e os dados não apresentaram distribuição normal. Os dados não paramétricos foram representados como mediana e IQR (intervalo interquartil). A análise dos dados entre grupos foi realizada pelo teste U de Mann-Whitney e o tamanho do efeito foi calculado para as variáveis do estudo. P < 0,05 foi considerado estatisticamente significativo. Houve diferença significativa nos valores de função pulmonar de VEF1, VEF1/CVF, PFE, CVL, VVM. Não houve diferença significativa na idade e no IMC dos participantes de ambos os grupos. CONCLUSÃO: Existem diferenças significativas na função pulmonar em pacientes com dor lombar inespecífica.
Downloads
Referências
(1) Rasmussen-Barr E, Magnusson C, Nordin M, Skillgate E. Are respiratory disorders risk factors for troublesome low-back pain? A study of a general population cohort in Sweden. Eur Spine J. 2019;28(11):2502-9. https://doi.org/10.1007/s00586-019-06071-5
(2) Kato S, Murakami H, Demura S, Yoshioka K, Shinmura K, Yokogawa N, et al. Abdominal trunk muscle weakness and its association with chronic low back pain and risk of falling in older women. BMC Musculoskelet Disord. 2019;20(1):273. https://doi.org/10.1186/s12891-019-2655-4
(3) Kim BR, Lee HJ. Effects of proprioceptive neuromuscular facilitation-based abdominal muscle strengthening training on pulmonary function, pain, and functional disability index in chronic low back pain patients. J Exerc Rehabil. 2017;13(4):486-90. https://doi.org/10.12965/jer.1735030.515
(4) Wu A, March L, Zheng X, Huang J, Wang X, Zhao J, et al. Global low back pain prevalence and years lived with disability from 1990 to 2017: estimates from the Global Burden of Disease Study 2017. Ann Transl Med. 2020;8(6):299. https://doi.org/10.21037/atm.2020.02.175
(5) Finta R, Nagy E, Bender T. The effect of diaphragm training on lumbar stabilizer muscles: a new concept for improving segmental stability in the case of low back pain. J Pain Res. 2018;11:3031-45. https://doi.org/10.2147/jpr.s181610
(6) Maher C, Underwood M, Buchbinder R. Non-specific low back pain. Lancet. 2017;389(10070):736-47. https://doi.org/10.1016/s0140-6736(16)30970-9
(7) Mohan V, Paungmali A, Sitilerpisan P, Hashim UF, Mazlan MB, Nasuha TN. Respiratory characteristics of individuals with non-specific low back pain: A cross-sectional study. Nurs Health Sci. 2018;20(2):224-30. https://doi.org/10.1111/nhs.12406
(8) Janssens L, McConnell AK, Pijnenburg M, Claeys K Goossens N, Lysens R, et al. Inspiratory muscle training affects proprioceptive use and low back pain. Med Sci Sports Exerc. 2015;47(1):12-19. https://doi.org/10.1249/mss.0000000000000385
(9) Baruaa A, Pattnaik M, Mohanty P. Comparison of Lung Function of normal and persons with chronic low back pain and its relation with duration and severity of Chronic Low Back Pain. J Nov Physiother Rehabil. 2017;1:137-43. https://dx.doi.org/10.29328/journal.jnpr.1001015
(10) Hamaoui A, Do MC, Poupard L, Bouisset S. Does respiration perturb body balance more in chronic low back pain subjects than in healthy subjects?. Clin Biomech. 2002;17(7):548-50. https://doi.org/10.1016/s0268-0033(02)00042-6
(11) Graham BL, Steenbruggen I, Miller MR, Barjaktarevic IZ, Cooper BG, Hall GL, et al. Standardization of Spirometry 2019 Update: An Official American Thoracic Society and European Respiratory Society Technical Statement. Am J Respir Crit Care Med. 2019;200(8):e70-e88. https://doi.org/10.1164/rccm.201908-1590st
(12) Miller MR, Crapo R, Hankinson J, Brusasco V, Burgos F, Casaburi R, et al. General considerations for lung function testing. Eur Respir J. 2005;26(1):153-61. https://doi.org/10.1183/09031936.05.00034505
(13) Cohen J. Statistical power analysis for the behavioral sciences (2nd ed.). New York: Lawrence Erlbaum Associates; 1988.
(14) Portney LG, Watkins MP. Foundations of clinical research applications to practice (3rd ed.). New Jersey: Prentice Hall Health; 2009.
(15) Memoalia J, Anjum B, Singh N, Gupta M. Decline in Pulmonary Function Tests after Menopause. J Menopausal Med. 2018;24(1):34-40. https://doi.org/10.6118/jmm.2018.24.1.34
(16) Shah SG, Choezom T, Prabu Raja G. Comparison of respiratory parameters in participants with and without chronic low back pain. J Bodyw Mov Ther. 2019;23(4):894-900. https://doi.org/10.1016/j.jbmt.2019.03.008
(17) Soundararajan LRA, Irani A, Borade N, Palekar TJ, Thankappan MS, Alshammari QT. Clinical Evaluation of the Peak Expiratory Flow Rate in Patients with Chronic Low Back Pain: A cross-sectional study. J Clin Diagnostic Res. 2021;15(11):YC01-YC03. https://doi.org/10.7860/JCDR/2021/50259.15623
(18) Perrin C, Unterborn JN, Ambrosio CD, Hill NS. Pulmonary complications of chronic neuromuscular diseases and their management. Muscle Nerve. 2004;29(1):5-27. https://doi.org/10.1002/mus.10487
(19) Dimitriadis Z, Kapreli E, Strimpakos N, Oldham J. Pulmonary function of patients with chronic neck pain: a spirometry study. Respir Care. 2014;59(4):543-49. https://doi.org/10.4187/respcare.01828
(20) Janssens L, Brumagne S, McConnell AK, Hermans G, Troosters T, Gayan-Ramirez G. Greater diaphragm fatigability in individuals with recurrent low back pain. Respir Physiol Neurobiol. 2013;188(2):119-23. https://doi.org/10.1016/j.resp.2013.05.028
(21) Rathinaraj L, Irani A, Sharma SK, Borada NG, Sreeja MT. Forced Expiratory Volume in the first second [FEV1] in patients with chronic low back pain. J Res Med Dent Sci [Internet]. 2017;5(1):27-32. Available from: https://www.jrmds.in/abstract/forced-expiratory-volume-in-the-first-second-fev1-in-patients-with-chronic-low-back-pain-1483.html
(22) Kim E, Lee H. The effects of deep abdominal muscle strengthening exercises on respiratory function and lumbar stability. J Phys Ther Sci. 2013;25(6):663-5. https://doi.org/10.1589%2Fjpts.25.663
(23) Kaneko H, Satou H, Maruyama H. Reliability of Lateral Abdominal Muscles Thickness Measurement Using Ultrasonography. Rigakuryoho Kagaku. 2005;20(3):197-201. http://dx.doi.org/10.1589/rika.20.197
(24) Teixeira-Salmela LF, Parreira VF, Britto RR, Brant TC, Inácio EP, Alcântara TO, et al. Respiratory pressures and thoracoabdominal motion in community-dwelling chronic stroke survivors. Arch Phys Med Rehabil. 2005;86(10):1974-8. https://doi.org/10.1016/j.apmr.2005.03.035
(25) Key J, Clift A, Condie F, Harley C. A model of movement dysfunction provides a classification system guiding diagnosis and therapeutic care in spinal pain and related musculoskeletal syndromes: a paradigm shift-Part 1. J Bodyw Mov Ther. 2008;12(1):7-21. https://doi.org/10.1016/j.jbmt.2007.04.005
(26) Kapreli E, Vourazanis E, Strimpakos N. Neck pain causes respiratory dysfunction. Med Hypotheses. 2008;70(5):1009-13. https://doi.org/10.1016/j.mehy.2007.07.050
(27) Sharma G, Goodwin J. Effect of aging on respiratory system physiology and immunology. Clin Interv Aging. 2006;1(3):253-60. https://doi.org/10.2147%2Fciia.2006.1.3.253
(28) Lee SH, Yim SJ, Kim HC. Aging of the respiratory system. Kosin Med J. 2016;31(1):11-18. https://doi.org/10.7180/kmj.2016.31.1.11
(29) Zakaria R, Harif N, Al-Rahbi B, Aziz CBA, Ahmad AH. Gender Differences and Obesity Influence on Pulmonary Function Parameters. Oman Med J. 2019;34(1):44-8. https://doi.org/10.5001/omj.2019.07
(30) Kaur P, Vaish H. Prevalence of work-related musculoskeletal disorders in women cultivators. J Physiother Res. 2022;12:e4236. http://dx.doi.org/10.17267/2238-2704rpf.2022.e4236
(31) Hong JY, Song KS, Cho JH, Lee JH, Kim NH. An Updated Overview of Low Back Pain Management. Asian Spine J. 2022;16(6):968-82. https://doi.org/10.31616/asj.2021.0371
(32) Vaish H, Saha S. Letter to the Editor: An Updated Overview of Low Back Pain Management. Asian Spine J. 2022;16(6):1034-5. https://doi.org/10.31616%2Fasj.2022.0399.r1
Downloads
Publicado
Edição
Seção
Licença
Copyright (c) 2023 Bafi Uddin, Hina Vaish
Este trabalho está licenciado sob uma licença Creative Commons Attribution 4.0 International License.
Esta obra está licenciada com uma Licença Creative Commons Atribuição 4.0 Internacional.