Influência da massa magra corporal nas repercussões cardiopulmonares durante o teste de caminhada de seis minutos em pacientes com DPOC

Abstract

activities of daily living and is associated with lower survival in COPD patients.(2) Various etiologies, including sedentary lifestyle, hypoxemia, IntroductionWorldwide, COPD is one of the leading causes of death and physical incapacity.( AbstractObjective: Although lean body mass (LBM) has been associated with mortality in patients with COPD, its influence on functional limitation is not clear. The objective of this study was to analyze the cardiopulmonary variables in COPD patients with or without LBM depletion, prior to and after the six-minute walk test (6MWT). Methods: We evaluated COPD patients, 32 with LBM depletion and 36 without. All patients underwent clinical evaluation, spirometry, evaluation of body mass composition and 6MWT, as well as completing questionnaires related to quality of life and perception of dyspnea. Results: No significant differences in the severity of airway obstruction, perception of dyspnea and quality of life scores were found between the groups. The distance covered on the 6MWT was similar in COPD patients with and without LBM depletion (470.3 ± 68.5 m vs. 448.2 ± 89.2 m). However, patients with LBM depletion presented significantly greater differences between baseline and final values in terms of heart rate and Borg scale index for lower limb fatigue. There was a significant positive correlation between distance covered on the 6MWT and FEV 1 (r = 0.381, p = 0.01).Conclusions: In the patients studied, functional exercise tolerance and quality of life were unaffected by LBM depletion. However, the patients with LBM depletion presented more pronounced lower limb fatigue during the 6MWT, which underscores the importance of the evaluation and treatment of systemic manifestations in COPD patients.Keywords: Body mass index; Pulmonary disease, chronic obstructive; Exercise tolerance. ResumoObjetivo: A massa magra corporal (MMC) tem sido associada à mortalidade em pacientes com DPOC, mas seu impacto na limitação funcional é pouco conhecido. O objetivo deste trabalho foi analisar as variáveis cardiopulmonares em pacientes com DPOC, com ou sem depleção da MMC, antes e após a realização do teste de caminhada de seis minutos (TC6). Métodos: Foram avaliados pacientes com DPOC, 36 sem depleção de MMC e 32 com depleção de MMC. Todos os pacientes foram submetidos à avaliação clínica, espirometria, avaliação da composição da massa corpórea e TC6 e responderam a questionários de qualidade de vida e de percepção de dispnéia. Resultados: Não foram observadas diferenças significativas na gravidade de obstrução das vias aéreas, na percepção da dispnéia e na qualidade de vida entre os grupos. A distância percorrida no TC6 foi similar nos pacientes com DPOC com e sem depleção de MMC (470,3 ± 68,5 m vs. 448,2 ± 89,2 m). Entretanto, durante a realização do teste, os pacientes com depleção de MMC apresentaram aumento significativamente maior na diferença entre os valores final e basal da frequência cardíaca e do índice da escala de Borg para cansaço dos membros inferiores. A distância percorrida no TC6...

Systematic review of the association between exercise tests and patient-reported outcomes in patients with chronic obstructive pulmonary disease

“…In total, 13 study publications reported correlations between the SGRQ total score (SGRQ total ) and one or more exercise test outcomes ( Table 2 , Figure 2 ). 37 , 41 – 43 , 45 , 46 , 49 , 50 , 52 , 53 , 55 , 59 , 60 Of these, correlations between outcomes from the SGRQ total and distance covered in the 6MWT were most commonly reported. These correlations were typically significant, with six articles reporting weak negative Pearson’s correlations of −0.26, 37 −0.26 ( P <0.01), 59 −0.37 ( P <0.05), 41 −0.37 ( P =0.0228), 49 −0.39 ( P <0.01), 53 and −0.39 ( P =0.01), 60 demonstrating that as distance covered in the 6MWT increases, SGRQ total scores decrease, indicating better health status.…”

“… 50 Three papers noted nonsignificant associations between the 6MWT and SGRQ total . 46 , 52 , 55 Limited data were available for other exercise tests, with moderate correlations given for the ISWT ( r =−0.55 45 , ρ =−0.55 43 ), weak–moderate correlations for the ICET ( r =−0.29 to −0.23, 37 , 41 ρ =−0.49 to −0.36, 50 depending on the outcome measure obtained [VO 2 or W max ]), and moderate Spearman’s correlations ( ρ =−0.54 50 and −0.58 43 ) for the ECET and TT, respectively.…”

Assessment of body composition, functional capacity and pulmonary function in patients with Chronic Obstructive Pulmonary Disease

“…With regard to body composition, even though Pelegrino et al 15 stated that the reduced muscle mass is correlated to worse physical performance in relation to the presented fatigue, not being directly related to the reduced coursed distance in field tests, findings from other studies in literature showed up to 60% variation in the 12-minute walk test 16 , and positive significant correlation between muscle mass and the result of the 6-minute walk test 17 . With these findings, with our results we could confirm the correlation between muscle mass and the distance coursed also in ISWT, besides the correlation between pulmonary function and bone mass, which was not explored in that context in literature.…”

A review of cardiopulmonary research in Brazilian medical journals: clinical, surgical and epidemiological data

“…The circulatory response to a 50-meter walk in acute coronary syndrome was presented by Dias et al3 Furtado et al reported on blood pressure measurements during aerobic exercise in cardiac rehabilitation,4 whereas Oliveira et al reported on the effect of the walk test on the length of hospital stay for cardiac surgery patients 5. The relationships between fitness, waist circumference and hypertension in elderly Brazilian women were investigated by Krause et al6 Pelegrino et al studied the influence of lean body mass on cardiopulmonary repercussions during the six-minute walk test in patients with chronic obstructive pulmonary disease (COPD) 7…”

“…Ferreira et al analyzed respiratory rehabilitation in COPD in the transition from exercise training to real life 44. Pelegrino et al examined the influence of lean body mass on cardiopulmonary repercussions during the six-minute walk test in patients with COPD 7. Ziegler et al looked at predictors of oxygen desaturation during the six-minute walk test in patients with cystic fibrosis 45.…”