Avaliação da demanda cardiovascular, ventilatória e metabólica em pacientes com dpoc durante a realização do teste de atividades da vida diária de glittre

• Ano de defesa: 2013
• Autor(a) principal: Souza, Ferson Fonseca de [UNIFESP]
• Tipo de documento: Tese
• Tipo de acesso: Acesso aberto
• dARK ID: ark:/48912/001300002k6n5
• Idioma: por
• Instituição de defesa: Universidade Federal de São Paulo (UNIFESP)
• Palavras-chave em Português: activity daily living; copd; exercise test; functional capacity; atividades cotidianas; dpoc; teste de esforço; avaliação da deficiência
• Link de acesso: https://sucupira.capes.gov.br/sucupira/public/consultas/coleta/trabalhoConclusao/viewTrabalhoConclusao.jsf?popup=true&id_trabalho=112715; http://repositorio.unifesp.br/handle/11600/46133

Introduction: Chronic obstructive pulmonary disease (COPD) is characterized by a progressive worsening of lung function and symptoms, leading to difficulty in performing activities of daily living (ADLs). It was recently proposed a new test designed to evaluate the functional performance for patients with COPD, called as the Glittre activities of daily living test (Glittre ADL – test). Up to date we neither know what are the COPD patients in term of cardiovascular, ventilatory and metabolic demand to perform the Glittre ADL – test, nor how these demands correspond to the maximum values obtained to the maximal incremental test. Objective: To evaluate metabolic, ventilatory and cardiovascular responses obtained during the Glittre activities of daily living test (Glittre ADL – Test) in mild, moderate and severe COPD patients, according to the GOLD classification. Methods: Cross-sectional observational study performed in sixty-two patients who present stable COPD. Assessment: spirometry, BMI, MRC, SGRQ and LCADL questionnaires, Glittre – ADL test, six-minute walking test (6MWT) and maximal incremental test on the treadmill (IT). We analyzed the mean scores of the questionnaires, and the variables obtained before and after exercises tests: VO2 peak, VO2/VO2 peak ratio, VCO2, f, VE, VE/MVV ratio, HR, BP, VO2/FC, SpO2 and Borg dyspnea. Results: The data obtained for the three groups of COPD patients have not showed significant differences related to parameters such as age, BMI and gender. On the other hand we found statistically significant differences in mean FEV1, MRC, and VVM among groups. Patients with severe COPD showed worst quality of life and the highest dyspnea according to LCADL questionnaires. The VE/MVV ratio measured in Glittre ADL – test present distinct results of 0.46 ± 0.11, 0.68 ± 0.18, 0.92 ± 0.20 for groups of mild, moderate and severe patients, respectively. The mean VO2/VO2 peak ratio were 0.81 ± 0.1, 0.88 ± 0.2 and 0.96 ± 0.2 for same sequence of groups, with the severe COPD patients showing significantly higher ratios than the mild group (p = 0.03). The mean SpO2 values were significantly lower and dyspnea significantly higher in severe COPD patients than in the other groups. There were no statistically significant differences in other variables obtained in the Glittre ADL – test, walking distance and maximal aerobic capacity among groups. Conclusions: Patients in different stages of COPD performed the Glittre ADL – test with similar time, metabolic, ventilatory and cardiovascular demand. However, the group of most severe patients presented lower metabolic, ventilatory reserve and lower SpO2, which result in increased dyspnea to run the test.