Aplicabilidade de testes de atividades de vida diária em indivíduos com insuficiência cardíaca

Abstract

Limitation in activities of daily living (ADL) caused by dyspnea is a common finding in patients with heart failure (HF), functional class III and IV. Specific assessment of ADL limitation could be used as a parameter of the disease progression and the therapy response. However, there is a shortage of instruments to assess ADL in this population. This study aimed to determine the applicability of the London Chest Activity of Daily Living (LCADL) and the Glittre ADL-test (T Glittre ), to evaluate functional limitations of individuals with HF functional class III and IV. Ten patients (57±9 years, 27.5±4.5kg/m 2 ) of both genders with a clinical diagnosis of HF functional class III and IV and left ventricle ejection fraction (LVEF) 34±7% participated in the study. Spirometry, body mass index (BMI), LCADL, six-minute walking test (6MWT), T Glittre , Medical Research Council Scale (MRC) and SF-36 were performed. The patients had an average score of the LCADL total from 27.7±12.1 (LCADL %total : 41.5±16.9) and time of T Glittre 6.3±4.8 minutes. A positive correlation was found between them (r = 0.88, p<0.05). LCADL %total correlated with 6MWT (r =-0.83), LVEF (r =-0.64), MRC (r =0.68) and Functional Capacity (functional capacity) of the SF-36 (r =-0.63) (p<0.05). T Glittre correlated with 6MWT (r =-0.90), LVEF (r =-0.66) and CF of the SF-36 (r =-0.69) (p<0.05). In conclusion, the LCADL scale and T Glittre have applicability in patients with HF class III and IV, demonstrating association with LVEF, distance on the 6MWT, degree of dyspnea and quality of life.

Physical Capacity, Respiratory and Peripheral Muscle Strength in Heart Failure

“…22 The assessment of activities of daily living can be performed by direct observation, by applying questionnaires or scales that are inexpensive and user-friendly, yet subjective and less accurate, or by applying submaximal tests, such as: the 6MWT, Glittre-ADL test and Shuttle Walk Test (SWT). 23 The cardiopulmonary exercise test has established a reputation as the reference standard for the objective measurement of functional capacity and stratification of heart failure patient prognosis. However, this is a high-cost technique that requires sophisticated equipment and specialized manpower, and is only found in certain centers; in addition, it requires greater patient collaboration.…”

“…25 These advantages make the Glittre-ADL an assessment tool with excellent clinical viability prospects for individuals with heart failure. 26 The Glittre-ADL test has already proven to be a user-friendly, valid and reliable tool for measuring functional status in patients with COPD; 5,26,27 applicable in the assessment of limitation in activities of daily living (ADL) in subjects with heart failure, class III and IV; 23 and able to distinguish between the functional status of healthy individuals and those with COPD. 25 It has also shown a relationship with sitting and walking time in patients with COPD, and a physiological response similar to the 6MWT, with a slight increase in oxygen consumption.…”

“…25 It has also shown a relationship with sitting and walking time in patients with COPD, and a physiological response similar to the 6MWT, with a slight increase in oxygen consumption. 27 Regarding the use of the Glittre-ADL test in patients with HF, to date, only three national studies 23,28,29 and no international studies have been found.…”

“…Valadares et al 23 conducted a study to verify the applicability of the London Chest Activity of Daily Living (LCADL) scale and the Glittre-ADL test (GlittreT) in the assessment of the functional limitation of individuals with functional class III and IV HF. Ten patients with HF (57 ± 9 years; 27.5 ± 4.5 kg/m 2 ) of both sexes, with functional class III and IV and left ventricular ejection fraction (LVEF) 34 ± 7% participated in the study.…”

Evaluation of the Glittre-ADL test as an instrument for classifying functional capacity of individuals with cardiovascular diseases

“…The time to complete the TGlittre in the present study was shorter than that reported in the literature. In a study by Valadares et al, 26 individuals with heart failure completed the test in 6.3 ± 4.8 min. In a study by Correa et al, 15 individuals with chronic obstructive pulmonary disease completed the test in 5.26 ± 2.9 min.…”