Trainability and reversibility in physical fitness among elderly persons taking part in an intervention program

Assessment of detraining through a six-minute walk test in patients with heart disease

BACKGROUND

Detraining can partially or completely reduce training-induced metabolic adaptations. However, the duration for which the rehabilitation effects persist after detraining, especially in patients with heart disease, remains unclear.

OBJECTIVES

To evaluate the principle of reversibility/detraining in patients with heart disease via the 6-minute walk test (6MWT) after a period of rest.

DESIGN AND SETTING

A retrospective cohort study developed at the Rehabilitation Center of the Universidade Federal do Triângulo Mineiro in Uberaba/MG, Brazil.

METHODS

This clinical, retrospective longitudinal study involved 20 patients with heart disease who underwent 5 months of supervised cardiac rehabilitation (CR). The mean age of participants was 64.05 ± 9.25 years. The initial rehabilitation was followed by an interruption period and rehabilitation for another 5 months. Functional capacity was assessed using the 6MWT.

RESULTS

In the specific analysis of the distance covered, values of P = 0.03 and P = 0.01 were obtained on comparing post-training (669.64 ± 58.80 meters) with post-detraining (640.82 ± 101.23 meters) and post-detraining with post-retraining (650.82 ± 96.28 meters), respectively. No significant difference was observed for the comparison between training and retraining (P = 0.83).

CONCLUSION

Cardiovascular rehabilitation positively stimulates functional capacity, whereas detraining significantly reduces it. The 6MWT is effective in measuring changes in physical capacity.

Assessment instruments of functioning in Brazilian elderly and the ICF: a systematic review

Abstract Introduction: Under the new conceptual model described by the International Classification of Functioning Disability and Health (ICF) for a biopsychosocial health analysis, it is necessary to consider that it is not arising only from biological conditions, but also environmental, social, cultural and politics involved in this process. Objective: To review the publications that had the Brazilians elderly functioning as outcome by analyzing the instruments used and to verify its consistency with the ICF model. Methods: A systematic review of the Brazilian literature on elderly was performed in SciELO, PubMed, Scopus, and Lilacs databases. Publications starting in 2001, in English, Portuguese or Spanish, studies with experimental design or intervention, having the Brazilian elderly as the only subject. For evaluating the quality of the papers, the Downs and Black checklist were used. Results: From 3070 items first found in the research, 29 articles remained for this study. Of these, 25 instruments were used to measure the eldery functioning. The frequency of the ICF domains were: health condition (0.28%), body structure and function (1.71%), activity (82.34%), participation (3.42%), environmental factors (12.25%) and personal factors (0%). Conclusion: Despite the ICF be much discussed today, it was possible to detect remaining gaps in the studies about the subject. The results of this study indicate that the conceptual model has not being fully and equitably used when it comes to the eldery functioning.