Influência da função pulmonar e da força muscular na capacidade funcional de portadores de doença pulmonar obstrutiva crónica

 

Sérgio Leite Rodrigues 1

César Augusto Melo e Silva 2

Tereza Lima 3

Carlos Alberto de Assis Viegas 4

Marcelo Palmeira Rodrigues 5

Fernanda Almeida Ribeiro 6

 

 

Resumo

Objectivo: Determinar que variável entre o volume expirado forçado no primeiro segundo (VEF1), a pressão parcial do oxigénio no sangue arterial (PaO2), a hipoxemia nocturna e a força muscular do quadricípite femoral pode predizer a distância percorrida no teste de caminhada de seis minutos (TC6) em doentes com DPOC.

Doentes e métodos: Um estudo observacional do tipo transversal, envolvendo trinta doentes encaminhados a um programa de reabilitação pulmonar de um hospital universitário. A função pulmonar foi avaliada por espirometria, gasometria arterial e oximetria nocturna. A função muscular pela força muscular do quadricípite femoral e a avaliação da capacidade funcional pelo TC6.

Resultados: A análise de regressão bivariada mostrou que a força do quadricípite femoral foi a única variável que se mostrou estatisticamente significativa (p = 0,002) em predizer a distância, sendo responsável por 38% da variância do TC6. Para essas variáveis a relação estabelecida estatisticamente foi que para cada quilo de força do quadricípite femoral, os doentes caminharam 5,9 metros no TC6.

Conclusão: Os resultados indicam a importância da força muscular do MI em testes de esforço submáximo. Entre as variáveis estudadas, apenas a força muscular do quadricípite femoral pôde predizer a distância percorrida no TC6 em portadores de doença pulmonar obstrutiva crónica.

Palavras -chave: Teste de caminhada de seis minutos, reabilitação pulmonar, força muscular, hipoxemia, DPOC, sistema musculoesquelético.

 

 

The influence of lung function and muscular strength on the functional capacity of chronic obstructive pulmonary disease patients

Abstract

Aim: To determine which variable (forced expiratory volume in 1 second (FEV1), partial pressure of oxygen in arterial blood (PaO2), nocturnal hypoxaemia and muscular strength of femoral quadriceps) can predict the distance walked in the six-minute walk test (6MWT) by COPD patients.

Methods: A cross-sectional and observational study of thirty patients referred to a pulmonary rehabilitation programme at a university hospital. Lung function was evaluated by spirometry, arterial blood gas analysis and nocturnal oximetry. Muscle function was evaluated by quadriceps strength and functional capacity by the 6MWT.

Results: Bivariate regression analysis showed that quadriceps strength, was the only variable to correlate significantly with the distance walked in the 6MWT (p=0.002), accounting for 38% of the 6MWT variance. The statistical relationship established for these variables was 1kg of quadriceps strength equalled 5.9 metres walked in the 6MWT.

Conclusions: Our results showed the importance of lower limb muscle strength in submaximal exercise testing. We conclude that femoral quadriceps muscle strength is the only one of the variables studied which can predict the distance COPD patients walk in the 6MWT.

Key-words: COPD, hypoxaemia, muscle strength, musculoskeletal system, pulmonary rehabilitation, six-minute walk test.

 

 

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1 Mestre em Ciências da Saúde / MSC, Health Sciences

2 Doutor em Ciências Médicas / PhD, Health Sciences

3 Mestre em Clínica Médica / MSC, Internal Medicine

4 Doutor em Fisiopatologia Respiratória / PhD, Respiratory Physiopathology

5 Doutor em Ciências Médicas / PhD, Medical Sciences

6 Mestre em Ciências da Saúde / MSC, Health Sciences

Universidade de Brasília – UnB

 

Correspondência/Correspondence to:

Sérgio Leite Rodrigues

Rua 05 Norte Lote 02 Bloco B Apto 1304 Residencial Cedro, Águas Claras CEP:71907 -720 Brasília – DF Brasil

 

Trabalho realizado no Serviço de Pneumologia do Hospital Universitário de Brasília e no Centro de Fisioterapia e Reabilitação do Hospital Universitário de Brasília / Work undertaken at the Pulmonology Unit, Hospital Universitário de Brasília, and the Physiotherapy and Rehabilitation Centre, Hospital Universitário de Brasília

Hospital Universitário de Brasília – HUB

Rua L2 Norte Quadras 605 CEP 70840 -901 Brasília – DF Brasil

Chefe do Serviço de Pneumologia / Head of Pulmonology: Dra.Verônica Amado

Chefe do Centro de Fisioterapia e Reabilitação / Head of Physiotherapy and Rehabilitation: Sérgio Leite Rodrigues

 

Recebido para publicação/received for publication: 08.08.01

Aceite para publicação/accepted for publication: 08.11.07