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Estimulação eléctrica neuromuscular transcutânea e seu impacto na doença pulmonar obstructiva crónica
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Resumo(s)
A Doença Pulmonar Obstructiva Crónica (DPOC) é a quarta principal causa de morte nos países desenvolvidos. As exacerbações agudas constituem a causa mais comum de mortalidade e morbilidade, com grande impacto na qualidade de vida dos indivíduos. A DPOC é, ainda, responsável por uma grande despesa financeira no sector da saúde, constituindo, por todos estes aspectos, um importante problema de saúde pública. As manifestações da doença não se restringem somente à componente pulmonar havendo um comprometimento sistémico. A disfunção muscular periférica é uma importante consequência da DPOC e que se associa a pior qualidade de vida, maior número de exacerbações e mortalidade. O exercício terapêutico é dos componentes mais importantes do programa de reabilitação respiratória (PRR). Porém, os doentes que apresentam dispneia em repouso, exacerbações repetidas e atrofia muscular associada podem não tolerar esta modalidade terapêutica pelas suas exigências em termos de sobrecarga ventilatória, cardiocirculatória e muscular. Dado o seu reduzido impacto sobre a função respiratória, a estimulação eléctrica neuromuscular transcutânea (TENS) poderá constituir uma alternativa terapêutica promissora nestas sub-populações de doentes. O seu benefício terapêutico advém sobretudo dos ganhos ao nível da força muscular, capacidade de exercício e qualidade de vida.
Chronic Obstructive Pulmonary Disease (COPD) is the fourth leading cause of death in developed countries. Acute exacerbations are the most common cause of mortality and morbidity, having a huge impact on patients’ quality of life. Besides that, COPD is also responsible for high financial expenses in the health sector, representing as a consequence of all these factors, an important public health issue. Disease manifestations are not restricted to pulmonary sintomatology, there is also a systemic compromise. Peripheral muscle dysfunction is an important consequence of COPD which is associated with poor quality of life and an higher number of exacerbations and mortality rate. Exercise training is one of the most important components of the Pulmonary Rehabilitation Program (PRP). However, patients with dyspnoea at rest, repeated exacerbation episodes and muscular atrophy may not sustain this therapeutic modality because of its ventilatory, cardiocirculatory and muscular requirements. Given its little impact on pulmonary function, Neuromuscular Transcutaneous Electrical Stimulation (NMES) might constitute a promising therapeutic intervention. Its clinical importance arises from the increased muscle strength, function capacity and health status that have been showed to result from this technique.
Chronic Obstructive Pulmonary Disease (COPD) is the fourth leading cause of death in developed countries. Acute exacerbations are the most common cause of mortality and morbidity, having a huge impact on patients’ quality of life. Besides that, COPD is also responsible for high financial expenses in the health sector, representing as a consequence of all these factors, an important public health issue. Disease manifestations are not restricted to pulmonary sintomatology, there is also a systemic compromise. Peripheral muscle dysfunction is an important consequence of COPD which is associated with poor quality of life and an higher number of exacerbations and mortality rate. Exercise training is one of the most important components of the Pulmonary Rehabilitation Program (PRP). However, patients with dyspnoea at rest, repeated exacerbation episodes and muscular atrophy may not sustain this therapeutic modality because of its ventilatory, cardiocirculatory and muscular requirements. Given its little impact on pulmonary function, Neuromuscular Transcutaneous Electrical Stimulation (NMES) might constitute a promising therapeutic intervention. Its clinical importance arises from the increased muscle strength, function capacity and health status that have been showed to result from this technique.
Descrição
Trabalho Final do Curso de Mestrado Integrado em Medicina, Faculdade de Medicina, Universidade de Lisboa, 2016
Palavras-chave
Doença pulmonar obstrutiva crónica (DPOC) Estimulação eléctrica neuromuscular Disfunção muscular Intolerância ao exercício Reabilitação respiratória