Respostas fisiológicas, adaptações posturais e aspectos qualitativos do teste de avd-glittre sem mochila em indivíduos com doença pulmonar obstrutiva crônica

Abstract

Background: Glittre-ADL test was developed and validated for people with Chronic Obstructive Pulmonary Disease (COPD), aiming to be more representative of activities of daily living (ADL), by proposing a set of daily tasks known as troublesome for individuals with COPD. During the test, individuals wear a backpack that simulates the weight of supplementary oxygen equipment that can be changed for the weight, if necessary, without changing the test. However, it is not common for individuals with COPD carrying oxygen equipment in backpacks. In addition, these individuals present increased risk of falls and deficits in postural stability, thus the use of the backpack may limit the performance of these individuals during the test. Objectives: To evaluate the differences in time, heart rate (HR), peripheral oxygen saturation (SpO2), perception of dyspnoea and fatigue in the legs and arms, postural adaptations between Glittre-ADL test performed with and without a backpack in individuals with COPD, and also, the perspectives of the individuals about the tests. Methods: Twenty-eight individuals with mean age 70±8 years performed, on the first day, two six minute walk tests (6MWT) were performed and on the second day, two Glittre-ADL tests with a backpack. On the third day, the accelerometer was placed in the lumbar spine of the individuals, who performed in a random order, a Glittre-ADL test with a backpack and another one without. After the tests, subjects answered to a semi-structured interview about their perceptions about the Glittre-ADL test without backpack. The paired t-test or Wilcoxon test were used to compare the variables of the Glittre-ADL test with and without the backpack. To assess learning effect between the three Glittre-ADL tests it was used ANOVA of repeated measures or Friedman and Pearson or Spearman correlation coefficient was used to verify the correlation between the Glittre-ADL test and 6MWT (α=0.05) Results: The responses of the Glittre-ADL test without backpack were similar to those of the backpack test for HR -2.46 (CI 95% -6.07 to 1.14), SpO2 0.39 (CI 95%-1.26 to 2.04), dyspnoea 0.64 (CI 95% -0.03 to 1.32), subjective perception of exertion in the legs -0.05 (CI 95% -0.48 to 0.37) and in the arms 0.07 (CI 95% -0.24 a 0.39) at the end of the test. The time to complete GlittreADL test without backpack was significantly lower 0.32 muinutes (IC95% 0.08 to 0.55). The accelerations of the trunk during the two modalities of the Glittre-ADL test did not present significant differences. From the perspective of individuals with COPD, tasks of the GlittreADL test are similar to their ADL and perform the test without the backpack resulted in less dyspnoea and fatigue in the lower and upper limbs and less movement limitation during the test. The severity of COPD did not influence the individual's perception of the removal of the backpack. Conclusion: The Glittre-ADL test without a backpack presented the same physiological responses and symptoms as the Glittre-ADL test with the backpack and the postural adjustments were not different during the two modalities of the test for the sample collected. The test seems to be an effective alternative to assess the functional capacity of individuals with COPD. Some individuals reported that performing the Glittre-ADL test without the backpack provoked less dyspnoea and fatigue in the lower and upper limbs and lower movement limitation during the test. From the perspective of individuals with COPD, this test is able to reflect the activities of daily living.