SciELO - Scientific Electronic Library Online

 
vol.12 issue3Traumatic diaphragmatic hernias: Retrospective analysisAdenocarcinoma do pulmão: Aplicação da classificação WHO 1999/2004 à casuística do Serviço de Anatomia Patológica do Hospital da Universidade de Coimbra author indexsubject indexarticles search
Home Pagealphabetic serial listing  

Services on Demand

Journal

Article

Indicators

Related links

  • Have no similar articlesSimilars in SciELO

Share


Revista Portuguesa de Pneumologia

Print version ISSN 0873-2159

Rev Port Pneumol vol.12 no.3 Lisboa May 2006

 

O trabalho de caminhada dos seis minutos não se correlaciona com o grau de obstrução do fluxo aéreo em doentes portadores de Doença Pulmonar Obstrutiva Crónica (DPOC)*

 

Six-minute walk work is not correlated to the degree of airflow obstruction in patients with Chronic Obstructive Pulmonary Disease (COPD) *

 

 

Paulo José Zimermann Teixeira 1,2*

Cássia Cínara Costa 1 **

Danilo Cortozi Berton 2 ***

Greice Versa 2 ****

Otávio Bertoletti 1**

Dáversom Bordin Canterle 1 **

 

 

Resumo

Introdução: No teste de caminhada dos seis minutos, o principal parâmetro é a distância percorrida. Não se considera o peso corporal, embora se conheça a sua influência na capacidade de exercício. Por outro lado, existem evidências de que o grau de obstrução não se correlaciona com a distância caminhada.

Objectivo: Verificar se existe correlação entre o grau de obstrução do fluxo aéreo e o trabalho de caminhar obtido a partir do produto distância x x peso (DxP).

Materiais e métodos: Foram estudados 60 doentes portadores de doença pulmonar obstrutiva crónica. As variáveis fisiológicas e funcionais foram correlacionadas com a distância percorrida e com o produto distância/peso.

Resultados: Não se encontraram correlações entre o trabalho de caminhar e o grau de obstrução ao fluxo aéreo, nem com os volumes pulmonares. Encontrou-se correlação positiva e significativa da distância com a  difusão de monóxido de carbono (DLCO) (r=0,6; p<0,01) e com a SatO2 final (r= 0,3; p<0,05). A correlação da distância foi negativa e significativa com a D da escala Borg (r= - 0,3; p<0,05). O trabalho de caminhar correlacionou-se de maneira positiva e significativa com a DLCO (r= 0,7; p<0,01) e de maneira negativa e significativa com a escala de Borg inicial (r= - 0,3; p<0,01) e  final   (r= -0,4;p<0,05).

Conclusões: Não existe correlação entre o grau de obstrução ao fluxo aéreo e o trabalho de caminhar na população estudada. A DLCO foi o único parâmetro funcional respiratório que se correla­cionou significativamente com a distância e com o trabalho de caminhar.

Palavras-chave: DPOC, trabalho de caminhada, teste dos seis minutos, capacidade de exercício.

 

 Abstract

Introduction: The six-minute walking test distance, despite being considered the main parameter, does not consider body weight which is known to influence exercise capacity. A body of evidence shows the degree of airflow obstruction does not correlate to walking distance and the body weight affects the work/energy required to perform the walk.

Objective: To verify if the degree of airflow obstruction correlates to six-minute walk work obtained by weight – walking distance product.

Patient and methods: A total of 60 patients with chronic obstructive pulmonary disease were eva­luated. The physiological and functional variables were correlated to distance and body weight – walking distance product (WxW).

Results: There were no correlations between six-minute walk work and the degree of airflow obstruction. A positive and significant correlation were observed between the distance and Carbon Monoxide Diffusing Capacity (DLCO) (r=0.6; p<0.01) and between the distance and final SatO 2 (r= 0.3 ; p <0.05). Correlation between distance and Borg scale was negative and significant (r= –0.3; p<0.05). The six-minute walk work was positive and significantly correlated to DLCO (r= 0.7; p<0.01) and  negative but significantly correlated to Borg scale in the initial (r= - 0.3; p<0.01) and final of the test (r= -0.4; p<0.05).

Conclusion: Based on this data, there was no correlation between the degree of airflow obstruction and six-minute walk work test. The DLCO was the only respiratory functional parameter significantly correlated to the distance and to the six-minute walk work.

Key-words: COPD, six-minute walking test, six-minute work walk, exercise capacity.

 

 

Texto completo disponível apenas em PDF.

Full text only available in PDF format.

 

 

Bibliografia/Bibliography

1. Barnes PJ. Chronic Obstructive Pulmonary Disease. New Engl J Med 2000; 343:269-280.        [ Links ]

2. Pawels RA, Buist AS, Calverley PMA, Jenkins CR, Hurd SS. Global strategy for the diagnosis, management, and prevention of chronic obstrutctive pulmonary disease: NHLBI/WHO Global Initiative for Chronic Obstructive Lung Disease (GOLD) Workshop summary. Available at http://www.goldcopd.com.

3. Marin JM, Carrizo SJ, Gascon M, Sanchez A, Gallego B; Celli B. Inspiratory capacity, dynamic hyperinsuflation, breathless and exercise performace during the 6-minutes-walk test in chronic obstructive pulmonary disease. Am J Respir Crit Care Med 2001; 1395-9.

4. Fishman A, Martinez F, Naunheim K, Piantadosi S, Wise R, Ries A, Weinmann G, Wood DE; National Emphysema Treatment Trial Research Group. A randomized trial comparing lung-volume-reduction surgery with medical therapy for severe emphysema. N Engl J Med. 2003;348(21):2059-73.

5. Rabinovich RA, Valaró J., Roca J. Evaluación de la tolerância al ejercicio em pacientes com EPOC. Prueba de marcha de 6 minutos. Arch Bronconeumol 2004; 40(2):80-5.

6. Bauerle O, Chrusch CA, Younes M. Mechanisms by which COPD affects exercise tolerance. Am J Respir Crit Care Med 1998; 157:57-68.

7. ATS Statement: Guidelines for the six-minute walk test. Am J Respir Crit Care Med 2002; 166:111-117.

8. Chuang M-L, Lin I-F and Wasserman K. The body weight-walking distance product as related to lung function, anaerobic threshold and peak VO2 in CPOD patients. Respir Med 2001; 95,618-626.

9. Carter R, Holiday DB, Nwasuruba C, Stocks J, Grothues C and Tiep B. 6-Minute Walk Work Capacity in Patients With COPD. Chest 2003; 123:1408-1415.

10. Knudson RJ, Lebowitz MD, Holdberg CJ, Burrows B. Changes in the normal maximal expiratory flow-volume curve with growth and aging. Am Rev Respir Dis 1983; 127:725-734.

11. Gaensler EA, Smith AA. Attachment for automated single breath diffusion capacity measurement. Chest 1973; 63:136-145.

12.Goldman P, Becklake MR. Respiratory function tests: normal values at median altitudes and the prediction of normal results. Am Rev Tuberc 1959; 79:457-467.

13. Killian KH, Campbell EJM, Summers E and Jones NL. Relationship between pulmonary impairment, exercise capacity and intensity of dyspneia. Eur Respir J 1993; 6 (Suppl 7): 571S.

14. Fink G, Moshe S, Goshen J, Klainman E, Lebzelter J, Spitzer S and Kramer MR. Functional Evaluation in Patients with Chronic Obstructive Pulmonary Disease: Pulmonary Function Test versus Cardiopulmonary Exercise Test. J Occup Environ Med 2002; 44: 54-58.

15. Mac Gavin CR, Artvinli M, Naoe H, McHardy. Dyspnoea, disability, and distance walked: comparison of estimates of exercise performance in respiratory disease. Br Med J 1978; 2:241-243.

16. Mak VE, Bugler JR, Roberts CM, Spiro SG. Effect of arterial oxygen desaturation on six minute walk distance, perceived effort, and perceived breathlessness in patients with airflow limitation. Thorax 1993; 48: 33-38.

17. Carter R, Nicotra B, Huber G. Differing effects of airway obstruction on physical work capacity and ventilation in men and women with COPD. Chest 1994; 106:1730-39.

18. ODonnel DE, Revill SM and Webb KA. Dynamic Hyperinflation and exercise Intolerance in Chronic Obstructive Pulmonary Disease. AM J Respir Crit Care Med 2001; 164:770-777.

19. Troosters T, Vialro J, Rabinovich R, Casas A, Barberá JA, Rodriguez-Roisin R et al. Physiological responses to the 6-min walk test in patients with chronic obstructive pulmonary disease. Eur Respir J 2002; 20: 546-9.

20. Casas A, Vilaro J, Rabinovich RA, Mayer Af, Valera JL, Bertoni E et al. Encouraged six minute walking test reflects "maximal" sustainable exercise performance in COPD patients. Eur Resp J 2002; 20: 285S.

* Professor do Centro Universitário Feevale de Novo Hamburgo/ Médico pneumologista do Pavilhão Pereira Filho/ Professor do Programa de Pós Graduação em Ciências Pneumológicas da Universidade Federal do Rio Grande do Sul/Professor at the Centro Universitário Feevale of Novo Hamburgo/ Pulmonologist at Pavilhão Pereira Filho/ Professor on the Pulmonology Sciences Post Graduate Programme at the Universidade Federal do Rio Grande do Sul

** Professores do Curso de Fisioterapia do Centro Universitário Feevale de Novo Hamburgo/Professors on the Physiotherapy Course at the Centro Universitário Feevale of Novo Hamburgo

*** Médico residente em Pneumologia do Pavilhão Pereira Filho – Santa Casa de Porto Alegre/Resident doctor in Pulmonology at the Pavilhão Pereira Filho – Santa Casa de Porto Alegre

**** Fisioterapeuta do Centro de Reabilitação Pulmonar do Pavilhão Pereira Filho – Santa Casa de Porto Alegre/Physiotherapist at the Pulmonary Rehabilitation Centre of the Pavilhão Pereira Filho – Santa Casa de Porto Alegre

Trabalho realizado no Programa de Reabilitação Pulmonar do/Study undertaken as part of the Pulmonary Rehabilitation Programme of 1,2

1 Centro Universitário Feevale, Novo Hamburgo - Rio Grande do Sul - Brasil

2 Pavilhão Pereira Filho - Santa Casa do Porto Alegre - Rio Grande do Sul - Brasil

 

Correspondência: Paulo José Zimermann Teixeira

Centro Universitário Feevale - Campus II

RS 239, 2755 - Novo Hamburgo - RS - Brasil

CEP 93352-000 - Telefone:+55(51)586 8800

e-mail: paulojzt@feevale.br

 

 

Recebido para publicação/received for publication: 05.09.05

Aceite para publicação/accepted for publication: 06.03.21