Análise da marcha em portadores de doença pulmonar obstrutiva crônica

Abstract

Fisioter Mov. 2011 abr/jun;24(2):211-9 Ribeiro A, Wayhs JHA, Machado MM, Fleig TCM, da Silva ALG. 212 ciclo de marcha. Resultados: Os dados cinemáticos encontraram-se variados; cada indivíduo apresentou peculiaridades sobrepostas aos padrões básicos. Observou-se forte correlação negativa entre cadência e PImax (p = 0,002 e r = -0,96), entre comprimento de passo e PEmax (p = 0,007 e r = -0,93). Para a qualidade de vida (SGQR), associações diretas, qualidade de vida total (QVT) e percentual da fase de apoio (p = 0,086 e r = 0,75); qualidade de vida impacto (QVI) e percentual da fase de apoio (p = 0,09 e r = 0,74). Conclusão: Avaliar a marcha do portador de DPOC possibilitou inferir objetivamente, delineando intervenções terapêuticas. Os benefícios esperados da pesquisa, tanto para o indivíduo quanto para a sociedade, é uma nova maneira de avaliar e incrementar a marcha, elemento fundamental para manutenção da independência funcional e qualidade de vida. [#] [P] Palavras-chave: DPOC. Marcha. Autonomia. Qualidade de vida. AbstractIntroduction: Knowledge about gait functional in COPD patients and the identification of the associated variables in these characteristics can support the development of specific approaches in rehabilitation with the objective to maintain the autonomy. Objective: To evaluate the gait pattern adopted by COPD patients using a bidimensional analysis. Method: Transversal delineation, study of cases, carried through with six patients of COPD, the masculine sex, 64,00 ± 8,07 years of age, index of corporal mass (IMC) 22,28 ± 2,46 kg/m2, forced expiratory volume in the first second (VEF1) 35.17 ± 25.79% predicted, vital capacity forced (CVF) 64.83 ± 17.84% predicted. For kinematic data, we used bidimensional videography Simi Motion, connected was used the camera of digital video. The registers in 60 frames for second and time of acquisition of march cycle. Results: The kinematic data had met varied, since each individual presented overlapping peculiarities the basic standards. One strong negative correlation between cadence and PImax (p = 0,002 and r = -0,96), between length of step and PEmax was observed (p = 0,007 and r = -0,93). For the quality of life (SGQR), direct associations had been found, quality of total life (QVT) and percentage of the support phase (p = 0,086 and r = 0,75), and also quality of life impact (QVI) and percentage of the support phase (p = 0,09 and r = 0,74). Conclusion: To evaluate the standard of march the DPOC carrier, made possible in them to infer objective on this, possible to delineate therapeutically interventions. The benefits waited with such research, as much for the individual as for the society, it was in a new way to evaluate and to develop the march, basic element for maintenance of functional independence and quality of life. [#] [K]

Effects of an incremental walking test in the gait of individuals with Chronic Obstructive Pulmonary Disease

“…It is believed that the increased speed can be a result of the compensatory postural pattern adopted by these individuals characterized by the anterior tilt of the trunk. The pendulum movement of the center of gravity, which characterizes the gait in the terrestrial environment, is modified in COPD, as well as in aging, causing the body to adopt differentiated angular positions to compensate for the change in the projection of the center of gravity and facilitate the increase of the muscle work, which generates the impulse of the foot and moves the body forward 8 . Ribeiro et al 8 observed correlation between gait speed and respiratory muscle strength, suggesting that the possibility of dyspnea during a physical activity leads the individual to perform the gait more quickly and with changes in step length, aiming at greater stability and less time and effort.…”

“…As a result of the ageing population, the prevalence of COPD will continue to grow in the coming decades, resulting in a large economic impact [2][3][4] . In addition to pulmonary components, systemic consequences are often observed in patients with COPD, such as weight loss, malnutrition, emotional problems, muscle weakness and physical deconditioning [2][3][4][5][6][7][8] . The ability of functional independence seems to depend on the maintenance of flexibility, muscular strength and endurance, features that, as a whole, could be considered as components of muscular fitness.…”

“…The ability of functional independence seems to depend on the maintenance of flexibility, muscular strength and endurance, features that, as a whole, could be considered as components of muscular fitness. Authors suggest that the gait is a good, if not the best indicator of the risk of loss of autonomy 8,9 . The human gait comprises a sequence of rapid and complex events, being difficult, by clinical observation, to analyze these phenomena and quantify the degree of departure from normality 10,11 .…”

“…The clinical gait analysis is of great importance to the therapeutic planning of different neuromuscular pathologies and musculoskeletal disorders, such as cerebral palsy and in the case of lower limb amputations 11 . The knowledge of the functional characteristics and the influence of stress on the gait of individuals with COPD may allow the development of specific rehabilitation strategies to maintain the autonomy and preserve independence, for as long as possible 8,9,12,17 . Studies, which have assessed the gait pattern in COPD with the methodological approach of the current research, were not found in the literature.…”

Efeitos de um programa de reabilitação nas alterações posturais e no quadro álgico de pacientes com DPOC

“…Sendo comum pacientes com DPOC possuírem estas características físicas e mais as peculiaridades da doença. Em virtude da dispneia pulmonar, estes utilizam evidentemente mais os músculos acessórios, provocando assim alteração postural maior, principalmente no tórax, consequentemente seus ombros, braços, pescoço e cabeça também tem a postura alterada podendo com o tempo também interferir e alterar os padrões locomotores aumentando assim o risco de quedas durante a marcha 9,27,[30][31][32] .…”