Influência das posições de membros superiores na configuração toracoabdominal de pacientes com doenças pulmonares intersticiais, em comparação com indivíduos saudáveis

Abstract

Interstitial lung diseases (ILD) form a heterogeneous group of restrictive lung conditions characterized by dyspnea, diminished lung volumes and intolerance to exercise, including simple activities of daily living, especially activities that involve the moving or positioning of the upper limbs. The aim of the present study was to evaluate functional capacity, lung function, respiratory mechanics and the influence of shoulder position on the thoracoabdominal configuration in patients with ILD compared to healthy controls. A cross-sectional study was conducted with 30 individuals (15 with ILD and 15 healthy controls). The participants were submitted to evaluations of physical capacity (Glitter-ADL test), spirometry, respiratory mechanics and thoracoabdominal configuration (determined using optoelectronic plethysmography) during the positioning of the upper limbs at different angles of shoulder abduction. The patients with ILD (with and without fibrosis) had lower vital capacity, forced expiratory volume in the first second and forced vital capacity than the healthy controls. Moreover, differences between groups were found for ti and ti/Ttot at rest and in all positions, with lower functional performance in the ILD group. The participants in both groups exhibited a greater contribution of the abdominal compartment for the execution of respiratory movements with the increase in the angle of shoulder abduction. The findings demonstrate that individuals with ILD have a poorer physical and functional respiratory performance than healthy individuals, but the thoracoabdominal configuration changes with the different angles of shoulder abduction similarly between these patients and healthy individuals.