Dados do Trabalho

Título

Use of inspiratory muscle training in a patient with amyotrophic lateral sclerosis: a Case Report

RESUMO

Amyotrophic lateral sclerosis (ALS) is a disease of the central nervous system characterized by a progressive degeneration of upper and lower motor neurons. Respiratory muscle weakness is commonly observed in these patients, as well as a progressive reduction in lung function, leading to complications such as alveolar hypoventilation and impairment of the cough reflex. Despite the known effects of inspiratory muscle training (IMT), there are few studies on the benefits of this therapy in neuromuscular diseases. Therefore, this work aims to demonstrate the results obtained through a pulmonary rehabilitation program with IMT protocol, associated with a multidisciplinary approach in patients with ALS.

Methodology: 38 years old patient, with a clinical diagnosis of ALS for 2 years, followed in the same period in a pulmonary rehabilitation program twice a week, period: 30 to 40 min, protocol: IMT with Powerbreathe® Plus Medic in interval exercises, with load 30% of MIP; Expiratory exercises with EMST 150® load of 30cmH2O; Pulmonary hyperinflation exercises with ambu®. Non-invasive ventilation (NIV) was not used during pulmonary rehabilitation, only used once a day and during the night. Results: For a year, the patient increased inspiratory strength by 30 cmH2O, reaching MIP -140cmH2O in this period and maintained the expiratory strength without losses or gains at +110cmH2O. Regarding pulmonary function during this period, the patient showed a slight decrease in FEV1 (99 - 93%) and FVC (94 - 86%) with no pattern of pulmonary restriction or obstruction. There was an improvement in the subjective sensation of exertion, where the resting BORG reduced from 3 to 0. It is possible to conclude that IMT can be a feasible therapy and bring benefits to the patient with neuromuscular disease, however, more studies in the area are necessary.

Palavras Chave

amyotrophic lateral sclerosis