Teste das argolas de seis minutos e teste de exercício de membros superiores sem apoio: valores normativos para a população brasileira

Abstract

Introduction: Chronic Obstructive Pulmonary Disease (COPD) is a progressive, systemic involvement with respiratory illness. The most common respiratory symptoms are cough and dyspnea, however individuals with this disease often report fatigue and dyspnea when performing activities of daily living (ADLs) involving the arms. COPD also be characterized by the presence of musculoskeletal dysfunction that directly affects exercise performance. In literature, it is generally agreed that exercises with upper limbs (UL) promote strength gains and function of the arms in people with COPD, reducing the symptoms during activities and improving their quality of live. Actually, several types of tests have been studied for this population to quantify muscle strength deficiency, as well as assessing the impact of this factor in physical training. Recently, a systematic review on the subject has revealed that the Unsupported Upper Limb Exercise Test (UULEX) and the Six minutes pegboard ring test (6PBRT) are the two tests that most reflect the ADLs, and therefore can be used to measure exercise and/or endurance of the arms, and function of the UL, respectively. These tests have shown to be valid and reliable for people with COPD. To date, there are still no studies that determine normative values for these two tests in the Brazilian population. Objectives: To determine normative values for the two unsupported arms tests (UULEX and 6PBRT) in healthy adults and elderly of the Brazilian population, as well as to correlate the results of the two tests with the length of the dominant arm, arm and forearm circumferences, and level of physical activity. Methods: This is a cross-sectional observational study, in which the volunteers performed the two tests of UL, twice each, in a single day. The sample consisted of men and women aged over 30 years, recruited in the community, both internal and external to UFMG. Before and after each test, values of blood pressure, heart rate, peripheral oxygen saturation, and perception of dyspnea and fatigue of arms evaluated by the Modified Borg Scale were measured. For UULEX the maximum test duration time was recorded, as well as last level and load at the end of the test. Already for 6PBRT the number of rings moved during the six minutes was noted. The volunteers completed the Human Activity Profile (HAP) questionnaire that evaluated the physical activity level, and were submitted to pulmonary function test before the execution of the two UL tests. Results: All the volunteers presented normal lung function tests, without cognitive alteration (volunteers over 60 years), and body mass index that did not characterize malnutrition. In the first study, the normative values for 6PBRT were defined by the age of the volunteers (r = 0.06, p = 0.503), so the lower limit of the 95% confidence interval was adopted with a lower limit of acceptability. The mean age of the 104 volunteers was 56.44 ± 15.72 The upper and lower scores of TA6 were: 30-39 years: 394 , 16 / 466.34, 40-49 years: 386.11 / 443.59, 50-59 years: 359.36 / 428.44, 60-69 years: 354.91 / 410.49, 70-79 years : 289.05 / 352.43, 80 years: 225.39 / 304.61 TA6 6BPRT showed a positive correlation with the level of physical activity and there was no correlation with arm and forearm length and circumference. To the UULEX, 94 subjects, aged 30 years and above, participated in the study with a mean age of 55.94 ± 14.23 For the general sample, the UULEX execution time, in seconds, was 781.40 ± 109, 04. Range of variation of the result p For UULEX (quartiles 25-75%) for each age group and sex. If the individual reaches a value above 25%, it shows normal performance. Younger individuals performed better, as did males, in all age groups. There was a positive correlation with arm length and physical activity level. Conclusion: The normative values for UULEX were based on the age and sex of the individuals, and the higher the age, the lower the performance. In addition, the male presented better performance. The normative values for 6PBRT were based on age alone, showing that the higher the age, the lower the performance of the individual in the test.