Predictive models of six-minute walking distance in adults with sickle cell anemia: Implications for rehabilitation

Marinho, Cirlene de Lima; Maioli, Maria Christina Paixão; Soares, Andréa; Bedirian, Ricardo; Melo, Pedro Lopes de; Guimarães, Fernando Silva; Ferreira, Arthur de Sá; Lopes, Agnaldo José

doi:10.1016/j.jbmt.2016.02.005

Cited by 13 publications

(21 citation statements)

References 38 publications

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“…Our results were in agreement with those of other investigators, who also noted a decrease in the 6MWD in patients with SCA (4,8). Some mechanisms have been implicated in the poor performance of patients with SCA during the 6MWT, including a low Hb level, deterioration of pulmonary function, low red blood cell deformity, presence of ACS or silent infarction, and high TRV (4,17,18).…”

Section: Discussionsupporting

confidence: 94%

“…Deterioration of lung function is a frequent finding in patients with SCA, mainly among adults (4,8–10). Our findings were similar to those of Ohara et al (8) and Delclaux et al (10), who reported that approximately 40% of adults with SCA had restrictive patterns.…”

Section: Discussionmentioning

confidence: 99%

“…In this scenario, abnormal pulmonary function tests (PFTs) are one of the first objective signs of chronic lung disease in SCA patients and may be useful for the management of these patients (9). However, the correlations of PFT parameters with clinical, cardiovascular, and radiological findings have not been strong (4,8,10,11). Recently, interest in the nitrogen single-breath washout (N 2 SBW) test has been increasing because this test is a simple and non-invasive tool that is capable of detecting heterogeneity in ventilation distribution and small airway disease when other PFTs still present parameters within normal ranges (12).…”

Section: Introductionmentioning

confidence: 96%

“…The polymerization of hemoglobin S (Hb S) within the cell is the central event that occurs in the pathophysiology of SCA; however, there is increasing evidence that nitric oxide (NO) sequestration by cell-free Hb and impaired bioavailability of NO during intravascular hemolysis also play important roles in SCA pathophysiology (1,2). Respiratory system involvement accounts for approximately 30% of all deaths in patients with SCA and mainly involves acute chest syndrome (ACS) and pulmonary hypertension (PH) (1–4). ACS is one of the most important events in patients with SCA and is a manifestation of the vaso-occlusive phenomenon that can progress to acute respiratory distress syndrome, respiratory failure, and death (3,5).…”

Section: Introductionmentioning

confidence: 99%

“…Some possible factors have been noted, including reduction of the oxygen transport capacity by Hb, pulmonary dysfunction resulting from repeated ACS episodes, cardiovascular abnormalities, osteoarticular alterations, generalized muscular weakness, and physical deconditioning (4,5,16–18). However, because deterioration of lung function is common in adults with SCA (8,9), it is of clinical interest to determine the impact of poor ventilation distribution on exercise performance in these patients.…”

Section: Introductionmentioning

confidence: 99%

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Relationship between ventilation heterogeneity and exercise intolerance in adults with sickle cell anemia

Lopes

Marinho

Alves

et al. 2017

Braz J Med Biol Res

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Sickle cell anemia (SCA) causes dysfunction of multiple organs, with pulmonary involvement as a major cause of mortality. Recently, there has been growing interest in the nitrogen single-breath washout (N2SBW) test, which is able to detect ventilation heterogeneity and small airway disease when the results of other pulmonary function tests (PFTs) are still normal. Thus, the objectives of the present study were to assess the heterogeneity in the ventilation distribution in adults with SCA and to determine the association between the ventilation distribution and the clinical, cardiovascular, and radiological findings. This cross-sectional study included 38 adults with SCA who underwent PFTs, echocardiography, computed tomography (CT), and 6-min walk test. To evaluate the ventilation heterogeneity, the patients were categorized according to the phase III slope of the N2SBW (SIIIN2). Compared with adults with lower SIIIN2 values, adults with higher SIIIN2 values showed lower hemoglobin levels (P=0.048), a history of acute chest syndrome (P=0.001), an elevated tricuspid regurgitation velocity (P=0.039), predominance of a reticular pattern in the CT (P=0.002), a shorter 6-min walking distance (6MWD) (P=0.002), and lower peripheral oxygen saturation (SpO2) after exercise (P=0.03). SIIIN2 values correlated significantly with hemoglobin (rs=-0.344; P=0.034), forced vital capacity (rs=-0.671; P<0.0001), diffusing capacity for carbon monoxide (rs=-0.376; P=0.019), 6MWD (rs=-0.554; P=0.0003), and SpO2 after exercise (P=0.040). Heterogeneity in the ventilation distribution is one of the most common pulmonary dysfunctions in adults with SCA. Moreover, relationships exist between ventilation heterogeneity, worsening of pulmonary structural damage, and reduced tolerance for exercise.

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Section: Discussionsupporting

confidence: 94%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 96%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Relationship between ventilation heterogeneity and exercise intolerance in adults with sickle cell anemia

Lopes

Marinho

Alves

et al. 2017

Braz J Med Biol Res

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Evaluating the contribution of the Glittre‐ADL test in adults with cystic fibrosis

Abelenda,

da Costa,

Firmida

et al. 2024

Physiotherapy Res Intl

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Background and ObjectivesCardiopulmonary and skeletal muscle impairment and poor physical activity are potential contributors to reduced functional capacity in cystic fibrosis (CF). The Glittre‐ADL test (TGlittre) has great potential for clinical use in adult CF adults, as it meets the need for a comprehensive assessment of physical function using tasks similar to activities of daily living. This study aimed to evaluate the performance of TGlittre in CF adults compared to the 6‐min walk test (6MWT) and, secondarily, to quantify the associations of their results with pulmonary function, muscle strength, and health‐related quality of life (HRQoL).MethodsThis cross‐sectional study evaluated 34 CF adults and compared them with 34 subjects from a control group. The participants underwent the following assessments: functional capacity using TGlittre and 6MWT; spirometry; respiratory muscle strength; handgrip strength (HGS); and HRQoL using the Cystic Fibrosis Questionnaire‐Revised (CFQ‐R).ResultsWhile CF patients showed a longer time to perform TGlittre compared to controls (134 (119–150) versus 107 (95–126) % of the predicted time p = 0.0002), no difference between these groups was observed in the 6MWT. When the second TGlittre was compared to the first TGlittre, there was a significant decrease in total time for both CF patients (p < 0.0001) and controls (p = 0.0001). TGlittre time correlated with 6MWT distance (6MWD) (rs = −0.641, p < 0.0001), HGS (rs = −0.364, p = 0.034), peripheral oxygen saturation at the end of the test (rs = −0.463, p = 0.006) and the “digestive symptoms” domain of CFQ‐R (rs = 0.376, p = 0.028). TGlittre time was shorter in patients who engaged in regular physical activity (3.10 (2.49–3.39) min versus 3.28 (2.95–3.53) min, p = 0.016).ConclusionsTGlittre is more effective than the 6MWT in detecting limitations during exercise. There is an important learning effect of TGlittre in adult CF patients. TGlittre time was correlated with 6MWD, HGS, oxygen saturation level, and the patient's level of physical activity.

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Feasibility of whole-body gait kinematics to assess the validity of the six-minute walk test over a 10-m walkway in the elderly

Saraiva

Guimarães

Lopes

et al. 2018

Biomedical Signal Processing and Control

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Predictive models of six-minute walking distance in adults with sickle cell anemia: Implications for rehabilitation

Cited by 13 publications

References 38 publications

Relationship between ventilation heterogeneity and exercise intolerance in adults with sickle cell anemia

Relationship between ventilation heterogeneity and exercise intolerance in adults with sickle cell anemia

Evaluating the contribution of the Glittre‐ADL test in adults with cystic fibrosis

Feasibility of whole-body gait kinematics to assess the validity of the six-minute walk test over a 10-m walkway in the elderly

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