Activity of Inspiratory Muscles With the Use of Positive Pressure in Patients With Chronic Obstructive Pulmonary Disease
Condition: Chronic Obstructive Pulmonary Disease (COPD)
MeSH terms: Lung Diseases; Lung Diseases, Obstructive; Pulmonary Disease, Chronic Obstructive; Respiratory Aspiration
Study type: Interventional

Summary: 
      The objective is to evaluate whether the use of expiratory positive airway pressure (EPAP)
      reduces the electrical activity of the sternocleidomastoid muscle and enhances the action of
      the muscle in the patient parasternal ported from Chronic Obstructive Pulmonary Disease.
      Noting also, if the set pressure level (10 or 15 cmH2O) affects this relationship.
    

Detailed description: 
      The chronic obstructive pulmonary disease (COPD) is characterized by chronic obstruction to
      airflow, which leads to respiratory muscle overload and greater activation of accessory
      muscles of respiration, especially those active in the inspiratory phase. It is believed that
      the positive expiratory pressure (EPAP) reduces respiratory work, producing less activation
      of these muscles. Thus, we evaluate the behavior of the electrical activity of inspiratory
      muscles of COPD patients in response to application of expiratory positive airway pressure
      (EPAP), and to observe the influence of pressure level in inspiratory muscle recruitment.
      This will be implemented for a clinical single blinded trial (blinded to gauge the outcome)
      developed in the Department of Pneumology, Hospital de Clinicas de Porto Alegre (HCPA). Will
      be evaluated in COPD patients with a clinical diagnosis of pathology, and of both genders and
      should be aged between 40 and 70 years. In a first day will be collected anthropometric data,
      performed the lung function test for the staging of pathology and muscle strength testing.
      These same individuals will return to evaluate the electromyographic activity of
      sternocleidomastoid (SCM), and parasternal, both from the right hemisphere. This evaluation
      will consist in the measurement during breathing at rest (control), with the implementation
      of EPAP mask 10 or 15 cmH2O (state intervention) and 10 minutes after its removal. To test
      the lung function will be assessed using a spirometer and the lung capacity compared to the
      predicted in literature. As the electrical activity of muscle, will be observed the
      percentage of activation obtained for the highest activity (% RMS). Thus, it is expected that
      the implementation of EPAP promotes reduction of the electrical activity of muscle ECM and
      leverage the action of the parasternal muscle, affected by dynamic hyperinflation. It is also
      hoped that the use of blood pressure level of 15 cmH2O, compared to 10 cmH2O, the leverage
      effect of EPAP on the muscles of interest. The surface electromyographic evaluation is a
      method of relatively inexpensive and noninvasive, and is effective in evaluating the
      electrical potential that lies on the muscle membrane. So, will describe the effect of EPAP
      on the inspiratory muscles, which will be important to guide treatment of COPD patients using
      positive airway pressure therapy.
    

Intervention name(s): Expiratory positive airway pressure (EPAP) by face mask.
Intervention type(s): Device
Intervention description(s): Implementation of the EPAP as group pressure, 10 or 15 cmH2O, for 20 minutes then evaluated the electromyographic activity of muscles and sternocleidomastoid parasternal the tenth and twentieth minutes of your application.
Other intervention name(s): PEP-mask
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Investigator)
Primary purpose: Treatment
Keywords: COPD; Electromyography; Inspiratory muscles