Testes funcionais e a relação com o índice BODE na Doença Pulmonar Obstrutiva Crônica

Abstract

Objectives: To investigate three variables of the respiratory process pulmonary ventilation ( E), oxygen consumption ( O2), and production of carbon dioxide ( CO2) during Activities of Daily Living (ADL) and functional tests of the lower limbs (LL) in individuals with Chronic Obstructive Pulmonary Disease (COPD) and Control Group; verify if the methods employed to evaluate ADL adequately reflect the functional limitation of individuals with COPD; and if there is a correlation between the variables evaluated during ADL, the performance on Lower Limb tests and peripheral muscle impairment of the Upper Limbs (UL) to the BODE Index (Body mass index; airflow Obstruction; Dyspnea and Exercise capacity) in individuals with COPD. Material and Methods: The sample was composed of 17 men from the ages of 58 to 80 years old, ten of whom had moderate to severe pulmonary obstruction composed the COPD Group (COPDG) and seven healthy men composed the Control Group (CG). All performed the ADL Test and were evaluated by ventilatory and metabolic variables; the Six Minute Walking Test in Corridor (6MWTC) by Distance Walked (DW); the Six Minute Walking Test on Treadmill (6MWTT) by DW and velocity; the Sit To Stand Test (STST) by the number of sit and stand up repetitions performed and the Hand Grip Strength Test in different postures. The COPDG was classified by the BODE Index and correlations between the tests performed and the BODE Index were found for the COPDG. Results: Intergroup analysis detected significant differences (p<0.05) in relation to ADL of lifting container to eye level ( E, CO2), combing hair, lifting containers to above shoulder level, hanging out clothes on the clothesline and sweeping the floor ( CO2) and in 6MWTC for DW, 6MWTT for velocity and STST for number of repetitions of sitting and standing from chair. The BODE Index presented a strong (r&#8805;0.66) to 6MWTT, STST and Hand Grip Strength. Conclusion: Individuals with COPD present a lower tolerance for physical effort compared to the CG during performance of the ADL and LL tests. The methods employed to evaluate the ADL did not reflect the functional limitation of the COPDG which was primarily composed of individuals with moderate obstructions. The Bode Index predictor of severity presented an association to limiting factors evaluated in the 6MWTT, STST and Hand Grip Strength Test for the COPDG; and thus suggests the possible use of these same tests to calculate physical exercise capacity in the BODE Index.