Atividade física, aptidão física e qualidade de vida em pacientes portadores de cardiomiopatia chagásica
Atividade física, aptidão física e qualidade de vida em pacientes portadores de cardiomiopatia chagásica
Data
2020
Autores
Lins, Wylisson Marcelo Almeida
Journal Title
Journal ISSN
Volume Title
Publisher
Instituto Nacional de Cardiologia
Resumo
Introdução: A Doença de Chagas é uma infecção crônica com distintas
manifestações clínicas. A mais grave delas é a forma cardíaca, ocorrendo em 30%
dos casos. Nesta forma, os indivíduos podem evoluir com sintomas de insuficiência
cardíaca congestiva, podendo haver uma redução do nível de atividade fisica (AF)
desenvolvida nas atividades diárias e deterioração da qualidade de vida (QV).
Objetivo: Avaliar a contribuição da AF e da aptidão física na QV de pacientes na
fase crônica da doença de Chagas. Métodos: A amostra foi composta por pacientes
recrutados no Ambulatório de Cardiopatia Chagásica do Instituto Nacional de
Cardiologia. Foi utilizado o questionário EQ-5D-3L (Euro Quality of Life Instrument
5D 3L), para avaliar a QV e o questionário internacional de atividade física (IPAQ versão curta) para avaliar o nível de atividade física. A aptidão física foi avaliada
pelos testes de sentar-levantar em 30 segundos (TSL30s); timed up and go (TUG) e
força de preensão palmar. As variáveis demográficas, socioeconômicas e clínicas
foram obtidas através da consulta aos prontuários dos pacientes. Resultados:
Foram avaliados 63 pacientes, a maioria mulheres (68,2%), com média de idade de
67,7 ± 9,7 anos. A maior parte tinha diagnóstico de hipertensão arterial (76,2%) e
dislipidemia (65,1%), com classe funcional I (54,0%) e Fração de ejeção do
ventrículo esquerdo preservada (73,0%). O nível de AF mais frequente foi o
moderado (44,4%). A dinamometria apresentou valor de 22,7 ± 9,2kgf; no TUG a
maior parte dos pacientes apresentou alto desempenho (58,7%). No TSL30s, 53,9%
dos pacientes apresentaram desempenho moderado. O valor de QV encontrado foi
de 0,65± 0,28 pelo questionário e de 68,4±25,1 pela escala visual analógica. Foi
observada associação entre o nível de AF e QV, em que a maioria dos indivíduos
com níveis de AF moderado e alto relatou não possuir nenhum problema no domínio
mobilidade. No TSL30s, a maioria dos indivíduos com desempenho moderado/alto
referiu não ter nenhum problema nos domínios mobilidade, atividades habituais e
dor/mal-estar. O mesmo foi encontrado na associação entre o TUG e a QV, onde a
maioria dos indivíduos com moderado/alto desempenho referiu nenhum problema
nos domínios mobilidade e atividades habituais. Os indivíduos com maior força de
preensão palmar referiram nenhum problema nos domínios mobilidade e atividades
habituais. A maior parte dos indivíduos com o nível moderado/alto de AF apresentou moderado desempenho no TSL30s (p=0,012), em relação ao TUG, a maioria dos
indivíduos com nível moderado/alto de AF apresentou alto desempenho (p=0,006).
Com relação à dinamometria, os indivíduos que apresentaram maiores valores foram
os que apresentaram alto nível de AF (p<0,001). Conclusão: Observamos no
presente estudo que a AF e a aptidão física apresentam associação com a
qualidade de vida, onde os indivíduos com melhor AF e aptidão física apresentaram
os melhores escores de qualidade de vida. Sugere-se a produção de estudos futuros
para observar a aplicabilidade da AF e sua repercussão na QV em pacientes
portadores de doença de Chagas.
Introduction: Chagas disease is a chronic infection with a variety of clinical manifestations. The more severe is the cardiac form, occurring in 30% of patients. In this form, individuals can present heart failure symptoms, which can result in a reduction in physical activity (PA) level in daily activities and Health related quality of life (HRQoL). Objective: To evaluate the contribution of PA and physical fitness in HRQoL in chronic Chagas disease patients. Methods: Patients from the Chagas cardiomiopathy outpatient clinic at Instituto Nacional de Cardiologia were included. Were used the Euro Quality of Life Instrument 5D 3L (EQ-5D-3L) to evaluate HRQoL, and the International Physical Activity Questionnaire Short version (IPAQ short) to evaluate the level of PA. Physical fitness was evaluated by the 30-s Chair Stand Test (30sCST), timed up and go test (TUG) and hand grip by dynamometry. Demographic, socioeconomic and clinical variables were obtained by consulting the patients medical records. Results: 63 patients were evaluated, the majority women (68.2%), average age 67.7±9.7 years. The more prevalent comorbidities were hypertension (76.2%) and dyslipidemia (65.1%), with functional class I (54%) and preserved ejection fraction (73%). PA intermediate level was the most frequent (44.4%). Dynamometry performance was 22.5±9.2kgf. High performance in TUG test was the most frequent result (58.7%). 53.9% displayed moderate performance in 30sCST. HRQol value was 0.65±0.28 according to the questionnaire, and 68.4±25.1 by analog visual scale. There was an association between PA and HRQoL levels and most patients with moderate/high PA referring no problems in mobility domain. Considering mobility, habitual activities and pain/feeling ill, individuals with moderate/high performance in 30sCST referred no problems. The same was found in the association between TUG and HRQoL, which most individuals with moderate/high performance referred no problems in mobility and habitual activities domains. The majority of individuals with moderate/high PA displayed intermediate performance in the 30sCST test (p=0,012). The majority of individuals with moderate/high level of PA displayed high performance in TUG (p=0,006). In hand dynamometry, most individuals with the higher values displayed high level PA (p<0,001). Conclusion: Therefore, we did observe in the present study that PA and physical fitness are associated with quality of life, where individuals with higher PA and physical fitness had the best quality of life scores. We sugest future studies observe the contribution of PA its impact on QOL of chronic Chagas disease patients.
Introduction: Chagas disease is a chronic infection with a variety of clinical manifestations. The more severe is the cardiac form, occurring in 30% of patients. In this form, individuals can present heart failure symptoms, which can result in a reduction in physical activity (PA) level in daily activities and Health related quality of life (HRQoL). Objective: To evaluate the contribution of PA and physical fitness in HRQoL in chronic Chagas disease patients. Methods: Patients from the Chagas cardiomiopathy outpatient clinic at Instituto Nacional de Cardiologia were included. Were used the Euro Quality of Life Instrument 5D 3L (EQ-5D-3L) to evaluate HRQoL, and the International Physical Activity Questionnaire Short version (IPAQ short) to evaluate the level of PA. Physical fitness was evaluated by the 30-s Chair Stand Test (30sCST), timed up and go test (TUG) and hand grip by dynamometry. Demographic, socioeconomic and clinical variables were obtained by consulting the patients medical records. Results: 63 patients were evaluated, the majority women (68.2%), average age 67.7±9.7 years. The more prevalent comorbidities were hypertension (76.2%) and dyslipidemia (65.1%), with functional class I (54%) and preserved ejection fraction (73%). PA intermediate level was the most frequent (44.4%). Dynamometry performance was 22.5±9.2kgf. High performance in TUG test was the most frequent result (58.7%). 53.9% displayed moderate performance in 30sCST. HRQol value was 0.65±0.28 according to the questionnaire, and 68.4±25.1 by analog visual scale. There was an association between PA and HRQoL levels and most patients with moderate/high PA referring no problems in mobility domain. Considering mobility, habitual activities and pain/feeling ill, individuals with moderate/high performance in 30sCST referred no problems. The same was found in the association between TUG and HRQoL, which most individuals with moderate/high performance referred no problems in mobility and habitual activities domains. The majority of individuals with moderate/high PA displayed intermediate performance in the 30sCST test (p=0,012). The majority of individuals with moderate/high level of PA displayed high performance in TUG (p=0,006). In hand dynamometry, most individuals with the higher values displayed high level PA (p<0,001). Conclusion: Therefore, we did observe in the present study that PA and physical fitness are associated with quality of life, where individuals with higher PA and physical fitness had the best quality of life scores. We sugest future studies observe the contribution of PA its impact on QOL of chronic Chagas disease patients.
Description
Palavras-chave
Doença de Chagas, Atividade física, Aptidão física, Qualidade de Vida Relacionada à Saúde, Cardiology, Chagas Disease, Motor Activity, Physical Fitness, Quality of Life, Cardiologia
Citação
Lins WMA. Atividade física, aptidão física e qualidade de vida em pacientes portadores de cardiomiopatia chagásica. Dissertação [Mestrado Profissional em Ciências Cardiovasculares]. Instituto Nacional de Cardiologia; 2020.