Impedancia pulmonar como nuevo marcador de fisioterapia respiratoria en adultos con trastornos ventilatorios obstructivos
una revisión sistemática
DOI:
https://doi.org/10.11606/issn.2176-7262.v52i4p319-327Palabras clave:
Enfermedades Pulmonares Obstructivas, Resistencia de las Vías Respiratorias, Pruebas de función respiratoria, FisioterapiaResumen
Modelo del estudio: Revisión sistemática. Introducción: Los disturbios ventilatorios obstructivos (DVO) se caracterizan por causar limitaciones persistentes de las vías aéreas, aumentando la resistencia debido a la acumulación de secreciones. Objetivo: Evaluar si los recursos de fisioterapia respiratoria modifican la impedancia pulmonar evaluada por las técnicas de oscilaciones forzadas (TOF's) en adultos con DVO. Método: Se trata de una revisión sistemática conducida en las bases de datos Pubmed, Scielo, Lilacs y Pedro, utilizando la siguiente estrategia de búsqueda: Obstructive pulmonary disease OR chronic obstructive pulmonary disease OR COPD OR Bronchiectasis OR Bronchial diseases OR Cystic fibrosis OR mucoviscidosis AND impulse oscillometry OR forced oscillation techniques AND physical therapy OR physiotherapy AND Airway Resistance. Resultados: De un total de 216 artículos, sólo 3 fueron incluidos. Las muestras totalizaron 64 participantes, incluyendo adultos con fibrosis quística (FC), enfermedad pulmonar obstructiva crónica (EPOC) y bronquiectasias. Dos estudios utilizaron el flutter® y 1 realizó drenaje autógeno. La impedancia pulmonar fue evaluada en 2 investigaciones por el sistema de oscilometría de impulso (IOS) y en 1 por la TOF modificada (TOF-m). Se observó una reducción de la resistencia en varias frecuencias, siendo que las más frecuentes fueron la resistencia total (3/3), la resistencia central (2/3) y la periférica (1/3). Además, la reatancia pulmonar presentó resultados conflictivos. Conclusión: Se evidenció que los recursos fisioterapéuticos utilizados para la remoción de secreciones de las vías aéreas modifican la impedancia pulmonar evaluada por las TOF en adultos con FC, EPOC y bronquiectasias, indicando que estos métodos pueden ser instrumentos sensibles de evaluación del efecto de la fisioterapia respiratoria en adultos con DVO.
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