Comparação do nível de atividade física na vida diária entre pacientes portadores da Doença Pulmonar Obstrutiva Crônica (DPOC) com e sem atividade profissional
Comparison of physical activity level in daily life between patients with Chronic Obstructive Pulmonary Disease with and without professional activity
Thaís Jordão Perez Sant’Anna, Andréa Daiane Fontana, Natália Helena de Oliveira, Vanessa Suziani Probst, Antonio Fernando Brunetto, Fábio de Oliveira Pitta
Resumo
Introdução: Estudos sugerem que portadores da Doença Pulmonar Obstrutiva Crônica (DPOC) apresentam sintomas que podem limitar a capacidade de trabalhar. A literatura internacional sugere que o vínculo empregatício está relacionado com o nível de atividade física e a qualidade de vida destes pacientes, evidenciando o fato de que a aposentadoria leva à redução destas variáveis. Porém, esses estudos foram realizados em populações internacionais e não se sabe se seus resultados se aplicam aos pacientes brasileiros, que apresentam características sócio-econômicas diferentes de populações européias e americanas. Objetivos: Comparar o nível de atividade física na vida diária (AFVD) em portadores de DPOC brasileiros com e sem atividade profissional e avaliar o impacto desta atividade em vários aspectos da doença. Métodos: Neste estudo transversal, 35 pacientes com DPOC (12H, 67±8 anos, VEF1 46±16%pred.) tiveram o nível de AFVD avaliado objetivamente por 2 monitores de atividade física: DynaPort (McRoberts, Holanda) e Sensewear Armband (BodyMedia, EUA). Também foram realizados espirometria, teste da caminhada de 6 minutos (TC6min), avaliação da composição corporal, força muscular e qualidade de vida, além de uma entrevista composta por questões sobre grau de escolaridade, status socioeconômico, presença de comorbidades e histórico de trabalho, entre outras. Baseado nos dados obtidos na entrevista, os pacientes foram divididos em 2 grupos: com e sem atividade profissional. Resultados: Não houve diferença no nível de AFVD entre os grupos (p>0.05 para todas as variáveis dos monitores). O grupo com atividade profissional apresentou maior TC6min, força de bíceps braquial, tríceps braquial e preensão palmar (p≤0.05 para todos) e tendência a maior força de quadríceps (p=0.09). Conclusão: Pacientes brasileiros com DPOC que mantêm atividade profissional não são mais ativos na vida diária do que pacientes que não trabalham, apesar de apresentarem melhor condicionamento físico.
Palavras-chave
Abstract
Introduction: Different studies suggest that people with Chronic Obstructive Pulmonary Disease (COPD) present symptoms that can restrict work capacity. International literature shows that employment is related to physical activity level and quality of life in these patients, suggesting that retirement leads to reduction of these outcomes. Nevertheless, these studies were performed in international samples and it is not certain whether their results are reproduced in Brazilian COPD patients. Objectives: To compare the level of physical activity in daily life (PADL) in Brazilian patients with COPD with and without professional activity and to analyze the impact of this activity in different aspects of disease. Methods: In this cross-sectional study, 35 patients with COPD (12 men, 67±8 years, FEV1 46±16% predicted) had PADL objectively measured with 2 activity monitors: DynaPort (McRoberts, The Netherlands) and Sensewear Armband (BodyMedia, Unites States of America). Patients also performed spirometry, six-minute walking test (6MWT), assessment of body composition, muscle strength and quality of life, besides an interview with questions about education level, socioeconomic status, comorbidity presence, work history, etc. According to data collected from this interview, patients were divided in 2 groups: with and without professional activity. Results: There was no difference in PADL level between the two groups (p>0.05 for all monitor variables). The group with professional activity showed better 6MWT, braquial biceps and triceps strength, handgrip force (p≤0.05 for all), besides a trend for better quadriceps force (p=0.09). Conclusion: Brazilian patients with COPD with professional activity are not more active in daily life when compared to patients without professional activity, although they have better physical conditioning.
Keywords
Referências
1. Global Initiative for Chronic Obstructive Lung Disease. Global Strategy for the Diagnosis, Management and Prevention of Chronic Obstructive Pulmonary Disease. NHLBI/WHO workshop report [Internet]. Bethesda: National Heart, Lung and Blood Institute; 2001 Mar. [cited 2005 Jan 6]. Available from: http://www.goldcopd.com/download.asp?intId=194.
2. De Smedt M, van den Berg JK. Indicators disability and social participation in Europe. Brussels: European Comission Eurostat; 2001:30. Erikssen G. Physical fitness and changes in mortality: the survival of the fittest. Sports Med. 2001; 31: 571-576.
3. Rijken PM, Spreeuwenberg. Baanders AN et al. Patienten panel chronisch zieken [Panel of Chronically Ill Patients]. Utrecht: Nederlands Institituut voor Onderzoek naar de Eerstelijns Gezondheidszorg, 2001.
4. Yelin E, Katz P, Balmes J, Trupin L, Earnest G, Eisner M, et al. Work life of persons with asthma, rhinitis, and COPD: a study using a national, population-based sample. J Occup Med Toxicol. 2006 Feb 2;1:2.
5. Kremer AM, Pal TM, van Keimpema AR. Employment and disability for work in patients with COPD: a cross-sectional study among Dutch patients. Int Arch Occup Environ Health. 2006 Oct;80(1):78-86.
6. Orbon KH, Schermer TR, van der Gulden JW, Chavannes NH, Akkermans RP, Schayck OP, et al. Employment status and quality of life in patients with chronic pulmonary disease. Int Arch Occup Environ Health. 2005 Jul;78(6):467-74.
7. Slingerland AS, van Lenthe FJ, Jukema JW, Kamphuis CB, Looman C, Giskes K, et al. Aging, retirement, and changes in physical activity: prospective cohort findings from the GLOBE study. Am J Epidemiol. 2007 Jun 15;165(12):1356-63.
8. Pitta F, Troosters T, Probst VS, Spruit MA, Decramer M, Gosselink R. Quantifying physical activity in daily life with questionnaires and motion sensors in COPD. Eur Respir J. 2006 May;27(5):1040-55.
9. Brooks D, Solway S, Gibbons WJ. ATS statement on six-minute walk test. Am J Respir Crit Care Med. 2003 May 1;167(9):1287.
10. Camelier A, Rosa FW, Salmi C, Nascimento OA, Cardoso F, Jardim JR. Using the Saint George’s Respiratory Questionnaire to evaluate quality of life in patients with chronic obstructive pulmonary disease: validating a new version for use in Brazil. J Bras Pneumol. 2006 Mar-Apr; 32(2),114-22. Portuguese.
11. Standards for the diagnosis and care of patients with chronic obstructive pulmonary disease. American Thoracic Society. Am J Respir Crit Care Med. 1995 Nov;152(5 Pt 2):S77-121.
12. Knudson RJ, Slatin RC, Lebowitz MD, Burrows B. The maximal expiratory flow-volume curve. Normal standards, variability, and effects of age. Am Rev Respir Dis. 1976 May;113(5):587-600.
13. Troosters T, Gosselink R, Decramer M. Six minute walking distance in healthy elderly subjects. Eur Respir J. 1999 Aug;14(2):270-4.
14. Lukaski HC. Methods for the assessment of human body composition: traditional and new. Am J Clin Nutr. 1987 Oct;46(4):537-56.
15. Kyle UG, Pichard C, Rochat T, Slosman DO, Fitting JW, Thiebaud D. New bioelectrical impedance formula for patients with respiratory insufficiency: comparison to dual-energy X-ray absorptiometry. Eur Respir J. 1998 Oct;12(4):960-6.
16. Erikssen G. Physical fitness and changes in mortality: the survival of the fittest. Sports Med. 2001;31(8):571-6.
17. Oga T, Nishimura K, Tsukino M, Sato S, Hajiro T. Analysis of the factors related to mortality in chronic obstructive pulmonary disease: role of exercise capacity and health status. Am J Respir Crit Care Med. 2003 Feb 15;167(4):544-9.
18. Yohannes AM, Baldwin RC, Connolly M. Mortality predictors in disabling chronic obstructive pulmonary disease in old age. Age Ageing. 2002 Mar;31(2):137-40.
19. American College of Sports Medicine Position Stand. The recommended quantity and quality of exercise for developing and maintaining cardiorespiratory and muscular fitness, and flexibility in healthy adults. Med Sci Sports Exerc. 1998 Jun;30(6):975-91.
20. Pitta F, Troosters T, Spruit MA, Probst VS, Decramer M, Gosselink R. Characteristics of physical activities in daily life in chronic obstructive pulmonary disease. Am J Respir Crit Care Med. 2005 May 1;171(9):972-7.
21. Pitta F, Troosters T, Probst VS, Spruit MA, Decramer M, Gosselink R. Physical activity and hospitalization for exacerbation of COPD. Chest. 2006 Mar;129(3):536-44.
22. Pitta F, Troosters T, Probst VS, Lucas S, Decramer M, Gosselink R. Potential consequences for stable chronic obstructive pulmonary disease patients who do not get the recommended minimum daily amount of physical activity. J Bras Pneumol. 2006 Jul-Aug;32(4):301-8.
23. Pitta F, Troosters T, Spruit MA, Decramer M, Gosselink R. Activity monitoring for assessment of physical activities in daily life in patients with COPD. Arch Phys Med Rehabil. 2005 Oct;86(10):1979-85.
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