Teste da caminhada de seis minutos na doença respiratória crônica: simples de realizar, nem sempre fácil de interpretar

Reliability of the five-repetition sit-to-stand test in patients with chronic obstructive pulmonary disease on domiciliary oxygen therapy

Objectives: To evaluate the reliability and learning effect of the five-repetition sit-to-stand test (5STSt) in severe and very severe chronic obstructive pulmonary disease (COPD) patients on domiciliary oxygen therapy compare the results with those of COPD patients not on such therapy. Methods: Twenty-eight COPD patients were included in the domiciliary oxygen therapy group (DOTG) and 17 in the control group (CG). The participants of the groups were paired by age, sex, body mass index, and lung function. The groups performed two 5STSt (5STSt₁ and 5STSt₂). Results: In total, 96% of the patients in the DOTG performed better on the second 5STSt (5STSt₂) (17.1 ± 4.63s), with an average reduction of 3.87 ± 3.50 s (p < 0.001) and a learning effect of 18.4%. In the CG, 82.3% of patients had better performance on the 5STSt₂ (15.06 ± 3.45 s), with an average reduction of 1.38 ± 2.51 s (p = 0.035) and a learning effect of 8.39%. The 5STSt had an ICC of 0.79 (95%CI: 0.02-0.93; p < 0.001) in the DOTG and of 0.89 (95%CI: 0.65-0.96; p < 0.001) in the CG. Conclusion: The 5STSt is reliable in patients with severe and very severe COPD on domiciliary oxygen therapy, with learning effect of nearly 18% in the DOTG. Thus, performing two tests is recommended to achieve the patient´s best performance in this population.

Reproducibility of Ventilatory Parameters, Dynamic Hyperinflation, and Performance in the Glittre-ADL Test in COPD Patients

BACKGROUND

This study aimed to investigate the reproducibility of the ventilatory parameters and dynamic hyperinflation (DH) induced by the Glittre ADL-test (TGlittre) in chronic obstructive pulmonary disease (COPD) patients.

METHODS

Twenty-three patients with COPD underwent anthropometry, spirometry, TGlittre (TGlittre1 and TGlittre2) and pre- and post-test slow vital capacity. During the tests the ventilatory response was evaluated.

RESULTS

Regarding the TGlittre reproducibility, 87% of patients had a better performance in TGlittre2, and reduced on average 0.34 minute ± 0.62 (p = 0.01) from TGlittre1 time to TGlittre2, showing a learning effect of 6.34%. The difference average between tests was correlated with the time spent in TGlittre1 (r = -0.52; p < 0.05). The TGlittre time was statistically reproducible (intraclass correlation coefficient = 0.97; p < 0.001). Final ventilation parameters and their variations presented low-to-high reproducibility, except respiratory rate. The DH was similar (p > 0.05) in both tests, with low reproducibility in percentage, while in liters it was not reproducible.

CONCLUSIONS

The TGlittre time and ventilatory parameters are reproducible, while DH is variable in COPD patients. A 6-7% learning effect was shown, and it is recommended to perform two tests.

Functional capacity after pediatric liver transplantation: a pilot study

The prospective cross-sectional study investigated the 6MWT performance in pediatric group of liver transplant recipients (6-17 yr, median post-transplantation time of 22 months) and compared to the normal values obtained in healthy children as well as evaluated the reproducibility of the 6MWT. We analyzed the relationship between walked distance and the 6MWw, distance walked × body weight) with the anthropometric, clinical, and pulmonary functions. In post-transplanted group, the average walked distance was significantly shorter compared with control (687 ± 80 m vs. 511 ± 72 m, p < 0.001). The calculated ICC coefficient confirmed the reproducibility among tests. The Pearson correlation revealed that only walked distance in the 6MWT was moderately correlated with tidal volume. Conversely, the 6MWw was significantly correlated with age, weight, height, BMI, FVC, PEF rate, and volume expiratory. According to multiple regression analysis, age, VE and FVC factors explained 80% of the variance in the 6MWw. In conclusion, the pediatric liver transplant recipients' performance in the 6MWT is significantly lower than the values for healthy children of the same age. Notably, the 6MWw may provide relevant information, constituting an additional parameter in the determination of functional capacity.

On the functional capacity and quality of life of patients with acromegaly: are they candidates for rehabilitation programs?

[Purpose] This study compared patients having active acromegaly with those having controlled acromegaly in terms of peripheral muscle strength, body composition, and functional capacity. We also examined the associations between these measures. [Methods] A total of 14 patients with active acromegaly, 12 patients with controlled acromegaly, and 12 healthy controls were subjected to isometric dynamometry, surface electromyography, electrical bioimpedance, and a six-minute walk test. [Results] The active acromegaly group exhibited significantly more fat-free mass than the control group. With respect to the peripheral muscle performance, the controlled acromegaly group presented a significantly lower electromyographic median frequency than the control group. The quadriceps maximum strength was significantly lower in the controlled acromegaly group than in the control group. The fat-free mass was significantly correlated with the quadriceps maximum strength. The global scores of the Acromegaly Quality of Life Questionnaire were significantly correlated with the six-minute walk distance. [Conclusion] Patients with acromegaly have more fat-free mass, less peripheral muscle strength, and greater fatigability than healthy control subjects. These findings depend on the degree of hormonal control. In acromegalic patients, peripheral muscle strength is related to body composition, and functional capacity is correlated with quality of life.