Caracterização de medida de avaliação de força muscular expiratória: pressão expiratória nasal (SNEP)

Abstract

Introduction: the capacity of the muscles Respiratory systems produce force has been a source of study for over thirty years. Measures to quantify muscle strength inspiratory and expiratory movements are performed through volitional and non-invasive maneuvers , being widely used and accepted as an advantageous way of assessment. Muscle recruitment breathing during assessment measures is largely recorded from electromyographic (EMG) measurements using surface electrodes placed on the thorax. The assessment of the electrical activity of these muscles is part of a broad network of monitoring respiratory activity. Objective: to test the applicability of the nasal expiratory pressure test (SNEP) as a method of evaluating expiratory muscle strength, evaluate the correlation and agreement between SNEP and PEmax, compare the activation pattern of respiratory muscles and evaluate respiratory comfort during procedures. Methods: an observational analytical cross-sectional study was carried out with healthy individuals, of both sexes, between 18 and 29 years old and with a BMI between 18 and 29 kg/m2. The volunteers were evaluated for anthropometric parameters, pulmonary function through spirometry, respiratory muscle strength through manovacuometry and muscular electrical activity through surface electromyography. Results: The sample for this study was made up of 16 men and 16 women, aged approximately 23 years. The results show that men had a mean PEmax of 128.6±20.1 and SNEP of 131.6±21.8. Women obtained 107.1±33.6 and 100.8±22.8, respectively. PImax and SNIP values were 121 ± 21.6 and 87.3 ± 19.5 in men and 122.4 ± 23.1 and 93.8 ± 12.8 in women. The results also show that the SNEP and PEmax measures showed a moderate positive correlation (r=0.64), while SNIP and PImax showed a high correlation (rho =0.71). The electromyographic data indicate that the respiratory muscles were more activated during SNEP and SNIP compared to conventional measurements. Of the abdominal muscles, the internal oblique muscle showed the highest activation values. Of the cervical muscles, the scalene showed the highest activation averages. Conclusion: it can be concluded that the respiratory muscles were more recruited during SNEP and SNIP compared to conventional methods of evaluating respiratory muscles. Expiratory muscles, especially, were statistically more recruited during SNEP, and SNEP and PEmax measurements showed a moderate correlation. Therefore, despite the scattered agreement between the expiratory methods analyzed, the SNEP can be considered a complementary method for evaluating the expiratory muscles and can be widely used in clinical practice.