Compara??o entre os n?veis de sarcopenia e a for?a da musculatura respirat?ria em idosas comunit?rias

T?tulo que consta em todos os documentos que comp?em o trabalho: "N?veis de sarcopenia e for?a da musculatura respirat?ria em idosas comunit?rias".T?tulo retirado da folha de aprova??o.Introdu??o: A sarcopenia ? uma s?ndrome geri?trica caracterizada pela perda da massa muscular, diminui??o da for?a muscular e funcionalidade, contribuindo para desfechos adversos na saude do idoso. Falta consenso quanto aos seus crit?rios diagn?sticos.. A redu??o da for?a muscular encontrada em idosos pode n?o estar limitada ? musculatura apendicular, podendo coexistir um decl?nio da for?a da musculatura respirat?ria (FMR) e, este ?ltimo, pode comprometer a fun??o pulmonar, j? que a FMR apresenta um elevado valor progn?stico, embora pouco explorada na sarcopenia. Objetivos: Avaliar e categorizar idosas comunit?rias quanto aos n?veis de sarcopenia e verificar a sua associa??o com altera??es da FMR respirat?ria avaliada atrav?s das medidas de for?a das musculaturas ins e expirat?rias (MIP e MEP). Metodologia: Trata-se de um estudo explorat?rio, descritivo, observacional do tipo transversal, Participaram mulheres idosas com 65 anos ou mais, sem distin??o de ra?a e/ou classe social. A Sarcopenia foi diagnosticada por meio do ?ndice de Massa Muscular Esquel?tica (SMI) dado pela Massa Muscular Apendicular Esquel?tica/Altura2 (ASM/h2), obtido pelo DXA, considerando-se como ponto de corte SMI<5,77kg/m2, e tamb?m pelo desempenho nos testes de for?a de preens?o palmar (FPP<15) e Short Physical Performance Battery (SPPB?8). Deste modo foi poss?vel classificar e distribuir as idosas em 4 grupos: NS ? N?o Sarcop?nicas, PS ? Pr?-Sarcop?nicas, SA ? Sarcop?nicas e SG ? Sarcop?nicas-Graves. Para a avalia??o da FMR, tanto a MIP quanto a MEP foram avaliadas por meio do manovacu?metro anal?gico. Realizou-se an?lise descritiva (m?dia?desvio padr?o) para a caracteriza??o da amostra; testou-se a normalidade via Shapiro-Wilk, para as compara??es realizou-se ANOVA com post hoc de Tukey ou Kruskal-Walis e, utilizou-se o teste Man-Whitney, considerando-se significativo o valor de p?0,05. O Odds Ratio foi usado para verificar a raz?o de chances da idosa apresentar decl?nio da FMR. A correla??o dos dados foi feita com os testes de Pearson ou Spearman. Resultados: Ap?s a avalia??o das participantes e obedecidos os crit?rios de exclus?o, foram inclu?das 156 idosas com m?dia de 74,32?7,24 anos, sendo que as mais velhas estavam no SG (80,88?6,01 anos) e todos os grupos se diferiram entre si. A preval?ncia global de sarcopenia foi de 16,7% (n=26); NS 73,70% (n=115); 9,60% (n=15) PS; 11,55% (n=18) SA e 5,15% (n=8) SG. As idosas do grupo SG apresentavam 15,6 vezes mais chances de decl?nio respirat?rio na MIP se comparadas ?s do NS. J? na MEP o simples fato de ser sarcop?nica aumentou em 17,91vezes as chances de se ter comprometimento respirat?rio. A medida da FPP se correlacionou positivamente com SMI (p<0,0001, r2=0,46); com a MIP (p<0,0001, r2=0,36) e com a MEP (p<0,0001, r2=0,43). Conclus?o: Idosas comunit?rias sarcop?nicas graves eram as mais velhas, apresentavam menor IMC, piores desempenhos nos testes de FPP, SPPB, MIP e MEP. A correla??o positiva observada entre a FPP e o SMI e a FMR (MIP e MEP), sugere que a medida da FPP poderia ser usada na pr?tica cl?nica tanto para o rastreio de sarcopenia, quanto para a detec??o do decl?nio da FMR.Funda??o de Amparo ? Pesquisa do estado de Minas Gerais (FAPEMIG)Disserta??o (Mestrado Profissional) ? Programa de P?s-Gradua??o em Reabilita??o e Desempenho Funcional, Universidade Federal dos Vales do Jequitinhonha e Mucuri, 2018.Introduction: Sarcopenia is a geriatric syndrome characterized by loss of muscle mass, decreasing muscle strength and functionality, contributing to adverse health outcomes in the elderly. There is a lack of consensus regarding their diagnostic criteria, but it is used laboratories exams such as measuring muscle mass through Dual Energy X-ray Absorption (DXA), beyond as clinics avaliations, among them, measures of muscular strength, such as Hand Grip Strength (HGS) and performance avaliations, such as the Short Physical Performance Battery (SPPB). A reduction in muscle strength found in the elderly may not be limited to the appendicular muscles, and a decline in respiratory muscle strength (FMR) may coexist, and the latter may compromise lung function, since an FMR has a high prognostic value, although rarely explored in sarcopenia. Objectives: To assess and categorize community-dwelling elders regarding sarcopenia levels and to verify their association with changes in respiratory FMR assessed by the ins and expiratory muscle strength measurements (MIP and MEP). Methodology: This is an exploratory, descriptive, observational cross-sectional study. Elderly women aged 65 years and over, without distinction of race and / or social class, participated. Sarcopenia was diagnosed by means of the Skeletal Muscle Mass Index (SMI) given by the Skeletal Appendicular Muscle Mass / Height2 (ASM / h2), obtained by the DXA, considering as an SMI cut-off point <5.77kg / m2, and also performance in palmar grip strength tests (FPP <15) and Short Physical Performance Battery (SPPB?8). In this way it was possible to classify and distribute the elderly in 4 groups: NS - Non Sarcopenic, PS - Pre - Sarcopenic, SA - Sarcopenic and SG - Sarcopenic - Graves. For the evaluation of the FMR, both the IPM and the MEP were evaluated by means of the analog manovacuometer. A descriptive analysis (mean ? standard deviation) was performed to characterize the sample; normality was tested via Shapiro-Wilk, ANOVA with post hoc of Tukey or Kruskal-Walis was used for the comparisons, and the Man-Whitney test was used, the value of p?0.05 being considered significant. The Odds Ratio was used to verify the odds ratio of the elderly woman presenting FMR decline. The correlation of the data was made with the Pearson or Spearman tests. Results: After the evaluation of the participants and obeying the exclusion criteria, 156 elderly women with a mean of 74.32 ? 7.24 years were included, the oldest being in the SG (80.88 ? 6.01 years) and all the groups differed from each other. The overall prevalence of sarcopenia was 16.7% (n = 26); NS 73.70% (n = 115); 9.60% (n = 15) PS; 11.55% (n = 18) SA and 5.15% (n = 8) SG. The elderly of the SG group presented 15.6 times more chances of respiratory decline in the MIP when compared to the NS. In MEP, the simple fact of being sarcopenic increased in 17.91 times the chances of having respiratory compromise. The PPF measurement correlated positively with SMI (p <0.0001, r2 = 0.46); with MIP (p <0.0001, r2 = 0.36) and with MEP (p