Efeito seletivo da hemiplegia sobre a funÃÃo pulmonar e mobilidade diafragmÃtica




The cerebrovascular diseases is the second-most cause of death in Brazil and Latin America and is a refection of an economic and social lifestyle in the modern world. The Hemiplegia, common complication of stroke, is accompanied by hypertonic tonus in the affect side compromises the motor control of the entire body. Therefore the respiratory muscles compromited muscles causes electromyographic abnormalities on the paralyzed side as well as abnormalities in breathing pattern, blood gas variables, spirometric variables and diaphragm kinematics. The aim of the present study was to assess the specific repercussion of the hemiplegia regarding lung function and movement of the domes of the diaphragm. Inspiratory capacity (with ventilometer) and diaphragmatic movement (with ultrasonography) were assessed in 20 hemiplegic patients and eight controls. The inspiratory muscles force (PImax) was assessed using a manovacuometer. For the hemiplegics patients, the MAS scale (Motor Assessment Scale) was used to assessment motor function. In right-side hemiplegia, movement was 4.97Â0.78cm and 4.20Â1.45cm for the right and left domes of the diaphragm, respectively, whereas these values were 4.42Â0.92cm and 4.66Â1.17cm in left-side hemiplegia. PImax was -48.75Â27.5 cmH2O in right-side hemiplegic patients and -74.17Â13.57 cmH2O in left-side hemiplegic patients. The forced expiratory volume in the first second (FEV1) was 0.75Â0.14 in right-side hemiplegia. The peak expiratory flow (PEF) and the mean forced expiratory flow between 25 and 75% of the forced vital capacity (FEF25-75%) were lower in both hemiplegic groups than in the control group. Thus, right-side hemiplegia exhibited greater impairment of the respiratory muscles than left-side hemiplegia due to the physiologic positioning of the domes of the diaphragm wich may be compromised for hemiplegia


biologia e fisiologia dos microorganismos diaphragmatic movement ultra-sonografia ultrasound hemiplegia hemiplegia mobilidade diafragmÃtica

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