Fatores que influenciam a capacidade física de pacientes com doença pulmonar obstrutiva crônica

Abstract

Este estudo objetivou identificar fatores que influenciam a capacidade física, avaliada por meio da distância percorrida no teste de caminhada de seis minutos (TC6'), de pacientes com doença pulmonar obstrutiva crônica (DPOC). Os fatores testados foram idade, grau de obstrução das vias aéreas (pelo volume expiratório forçado no primeiro segundo (VEF1), resistência da musculatura respiratória (pela ventilação voluntária máxima (VVM) e capacidade máxima ao esforço (medida pela distância percorrida no teste cardiopulmonar limitado por sintomas, TCP). Dezoito pacientes do sexo masculino, com idade média de 69,6±8,4anos e diagnóstico de DPOC classes II e III, foram submetidos ao TC6', ao TCP e à espiromeria. Foram encontradas correlações significativas moderadas entre a distância percorrida no TC6' e o VEF1 (r=0,62), a VVM (r=0,50), e a distância percorrida no TCP (r=0,67), não havendo correlação com a idade. Conclui-se que o grau de obstrução das vias aéreas, a resistência da musculatura respiratória e a capacidade máxima ao esforço influenciam a capacidade física dos pacientes com DPOC classes II e III ao executar uma atividade cotidiana como a caminhada.

COPD patients' oxygen uptake and heart rate on-kinetics at cycle-ergometer: correlation with their predictors of severity

“…Moderate negative correlations were found between VO 2 τ and MRT and FEV 1 , suggesting that the slowing of VO 2 on-kinetics is reflected by the level of airway obstruction, although the same cannot be said regarding HR on-kinetics. FEV 1 is one of the variables composing the BODE index and has been considered a key prognostic marker of mortality in COPD 39 , although studies show that FEV 1 alone does not represent systemic manifestations of the disease 40,41 . The COPD patients' VO 2 and HR τ and MRT showed moderate negative correlation with distance traveled (m) and predicted (%) at 6MWT.…”

Decreased respiratory performance of children and adolescents with myelomeningocele who use a wheelchair – preliminary data

“…Their values can bring important inferences about the relationship of the respiratory system to exercise capacity, since it is better related to physical exertion than FEV 1 . Inadequate ventilation may compromise oxygen supply to the peripheral muscles, leading to impairment during physical exercises and daily living activities (12).…”

Effects of upper limb resistance exercise on aerobic capacity, muscle strength, and quality of life in COPD patients: a randomized controlled trial

“…17,18 Thus, it can be inferred that there was clinical improvement in the subjective symptoms of these patients in terms of reduced fatigue, dyspnea, and the effort to perform daily activities, as well as better aerobic capacity, lower mortality, and higher survival. 19 Studies have shown that compromised peripheral muscle strength promotes physical limitation in patients with chronic obstructive pulmonary disease with worse respiratory muscle dysfunction. 20 Lack of physical conditioning leads to muscle atrophy with reduced muscle strength, reduction in oxidative metabolism, muscle capillarization, and muscle fiber change (lower proportion of type I fibers and increase in type IIb fibers) in patients with chronic obstructive pulmonary disease, 21 affecting the upper limbs with increased fatigue.…”

“…17,18 Thus, it can be inferred that there was clinical improvement in the subjective symptoms of these patients in terms of reduced fatigue, dyspnea, and the effort to perform daily activities, as well as better aerobic capacity, lower mortality, and higher survival. 19…”