BackgroundThe Duke Activity Status Index (DASI) assesses the functional capacity of
patients with cardiovascular disease (CVD), but there is no Portuguese
version validated for CVD. ObjectivesTo translate and adapt cross-culturally the DASI for the Portuguese-Brazil
language, and to verify its psychometric properties in the assessment of
functional capacity of patients with CVD. MethodsThe DASI was translated into Portuguese, then checked by back-translation
into English and evaluated by an expert committee. The pre-test version was
first evaluated in 30 subjects. The psychometric properties and correlation
with exercise testing was performed in a second group of 67 subjects. An
exploratory factor analyses was performed in all 97 subjects to verify the
construct validity of the DASI. ResultsThe intraclass correlation coefficient for test-retest reliability was 0.87
and for the inter-rater reliability was 0.84. Cronbach's α for internal
consistency was 0.93. The concurrent validity was verified by significant
positive correlations of DASI scores with the VO2max (r = 0.51, p
< 0.001). The factor analysis yielded two factors, which explained 54% of
the total variance, with factor 1 accounting for 40% of the variance.
Application of the DASI required between one and three and a half minutes
per patient. ConclusionsThe Brazilian version of the DASI appears to be a valid, reliable, fast and
easy to administer tool to assess functional capacity among patients with
CVD.
The purpose of this study was to determine whether the improvement in muscle performance after treatment of hyperthyroidism is only a result of an increased muscle mass or if it also depends on the improvement of intrinsic contractile function. Nine patients with Graves' disease were evaluated 1) at the time of diagnosis, 2) after 1 wk of monotherapy with propranolol, and 3) after the euthyroid state had been achieved with antithyroid drugs. At each evaluation the patients were submitted, on the dominant side, to anthropometric measurements and to skeletal muscle function tests to determine the maximal static voluntary contraction (MAX) and endurance (END); "endurance" is defined as the time limit at maintaining 30% of MAX. Three movements were tested: hip flexion, ankle dorsiflexion, and handgrip. Body weight changed from 53.4 +/- 3.2 to 58.2 +/- 2.9 kg (P = 0.004) and the sum of skinfold-corrected limb circumferences changed from 90.7 +/- 3.1 to 94.4 +/- 3.1 cm (P = 0.017). MAX and END of all movements increased at the end of the study even if adjusted for the sum of skinfold-corrected limb circumferences: Hip flexion: MAX 20.60 +/- 3.32 to 31.26 +/- 5.07 g.cm-1, END 0.43 +/- 0.18 to 1.18 +/- 0.42 kg.s-1.cm-1. Ankle dorsiflexion: MAX 12.34 +/- 1.97 to 26.88 +/- 2.46 g.cm-1, END 0.97 +/- 0.28 to 2.50 +/- 0.58 kg.s-1.cm-1; Handgrip: MAX: 2.20 +/- 0.23 to 2.9 +/- 0.2 g.cm-1, END 0.13 +/- 0.01 to 0.20 +/- 0.02 kg.s-1.cm-1. In conclusion, improved muscle performance resulting from the treatment of hyperthyroidism is a consequence of an enhanced intrinsic muscle function as well as a greater muscle mass.
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