RESUMO
BACKGROUND: We explored whether the maximum predicted walking distance, assessed with six-minute walk test (6MWT) and reflecting submaximal functional exercise capacity, is decreased among patients with pectus excavatum (PEX). METHODS: This study comprised a retrospective analysis of patients with PEX who underwent a 6MWT for the assessment of functional capacity. The maximum distance walked was recorded and compared to reference values established for different populations, including a young and healthy South American population. RESULTS: We included 43 patients with PEX who underwent 6MWT. The mean age was 17.8 ± 6.7 years. The mean maximum distance walked was significantly lower than the predicted distance (600.8 ± 67.6 metres vs. 729.8 ± 67.5 metres, p < 0.0001). Using the Enright reference equation including an older reference population, the mean negative difference was higher (PEX patients walked 190.4 ± 78.4 metres less than predicted, p < 0.0001). We also applied the Li et al. reference equation accounting for sex among other variables, detecting a decreased walked distance compared to the gender-adjusted predicted distance (PEX patients walked a mean 222.4 ± 87.4 metres less than predicted, p < 0.0001). Using the Ulrich et al. equation, PEX patients walked a mean 114.2 ± 85.1 metres less than predicted (p < 0.0001). Although of uncertain clinical relevance, there was a significant decrease in the mean oxygen saturation after exercise (baseline 97.4 ± 1.2%, vs. final 96.4 ± 2.1%, p = 0.006). CONCLUSIONS: In this study, we identified a significant reduction in the maximum walked distance among patients with PEX compared to the predicted distance, thus potentially emerging as an unsophisticated means to evaluate and quantify functional exercise capacity.
Assuntos
Tórax em Funil , Coração , Pulmão , Caminhada , Humanos , Tórax em Funil/fisiopatologia , Pulmão/fisiopatologia , Coração/fisiopatologia , Teste de Caminhada , Masculino , Feminino , Saturação de Oxigênio , Criança , Adolescente , Adulto Jovem , Adulto , Fatores de TempoRESUMO
O teste cardiopulmonar de exercício (TCPE) é utilizado para aplicações clínicas na avaliação da intolerância ao exercício não diagnosticada e na determinação da capacidade funcional. O TCPE é importante na pesquisa clínica em pacientes com apneia obstrutiva do sono (AOS), com a necessidade de mensuração da capacidade funcional e limitações físicas. O objetivo foi identificar o protocolo e ergometro mais utilizado em pacientes com AOS, se o protocolo reflete no nível de capacidade funcional e avaliar o comportamento do consumo de oxigênio de pico (VO2pico). Trata-se de uma revisão sistemática realizada de 2005 a 2017. A busca foi realizada nas bases de dados Pub-Med, LILACS, Medline e PEDro. Dos 25 estudos analisados a amostra total foi de 1124 pacientes. Os estudos que analisaram o VO2pico somaram 583 pacientes. O protocolo de rampa foi o mais utilizado, a escolha deve ser individual, considerando as características e limitações da população estudada.
Cardiopulmonary Exercise Testing (CPET) is used for clinical applications in assessing intolerance to undiagnosed exercise and in determining functional capacity. CPET is important in clinical research in patients with obstructive sleep apnea (OSA), with the need to measure functional capacity and physical limitations. The objective was to identify the protocol and ergometer most used in patients with OSA if the protocol reflects on the functional capacity level and to evaluate the behavior of peak oxygen consumption (VO2peak). It is a systematic review carried out from 2005 to 2017. The search was performed in Pub-Med, LILACS, Medline and PEDro databases. The 25 studies analyzed the total sample was 1124 patients. The studies that analyzed VO2peak totaled 583 patients. The ramp protocol was the most used, the choice must be individual, considering the characteristics and limitations of the study population.
RESUMO
Background: We aimed to investigate the effect of a priming ischemia-reperfusion (IR) model on the kinetics of pulmonary oxygen uptake (VO2) and cardiopulmonary parameters after high-intensity exercise. Our primary outcome was the overall VO2 kinetics and secondary outcomes were heart rate (HR) and O2 pulse kinetics. We hypothesized that the IR model would accelerate VO2 and cardiopulmonary kinetics during the exercise. Methods: 10 recreationally active men (25.7 ± 4.7 years; 79.3 ± 10.8 kg; 177 ± 5 cm; 44.5 ± 6.2 mL kg-1 min-1) performed a maximal incremental ramp test and four constant load sessions at the midpoint between ventilatory threshold and VO2 max on separate days: two without IR (CON) and two with IR (IR). The IR model consisted of a thigh bi-lateral occlusion for 15 min at a pressure of 250 mmHg, followed by 3 min off, before high-intensity exercise bouts. Results: There were no significant differences for any VO2 kinetics parameters (VO2 base 1.08 ± 0.08 vs. 1.12 ± 0.06 L min-1; P = 0.30; τ = 50.1 ± 7.0 vs. 47.9 ± 6.4 s; P = 0.47), as well as for HR (MRT180s 67.3 ± 6.0 vs. 71.3 ± 6.1 s; P = 0.54) and O2 pulse kinetics (MRT180s 40.9 ± 3.9 vs. 48.2 ± 5.6 s; P = 0.31) between IR and CON conditions, respectively. Conclusion: We concluded that the priming IR model used in this study had no influence on VO2, HR, and O2 pulse kinetics during high-intensity cycling exercise.
RESUMO
BACKGROUND: Aging leads to low functional capacity and this can be reversed by safe and adequate exercise prescription. OBJECTIVE: The aim of this study was to identify the anaerobic threshold (AT) obtained from the V-slope method as well as visual inspection of oxyhemoglobin ( O2Hb) and deoxyhemoglobin (HHb) curves and compare findings with the heteroscedastic (HS) method applied to carbon dioxide production ( CO2), heart rate (HR), and HHb data in healthy elderly men. A secondary aim was to assess the degree of agreement between methods for AT determination. METHOD: Fourteen healthy men (61.4±6.3 years) underwent cardiopulmonary exercise testing (CPX) on a cycle ergometer until physical exhaustion. Biological signals collected during CPX included: ventilatory and metabolic variables; spectroscopy quasi-infrared rays - NIRS; and HR through a cardio-frequency meter. RESULTS: We observed temporal equivalence and similar values of power (W), absolute oxygen consumption (O2 - mL/min), relative O2 ( mL.Kg - 1.min -1), and HR at AT by the detection methods performed. In addition, by the Bland-Altman plot, HR confirmed good agreement between the methods with biases between -1.3 and 3.5 beats per minute. CONCLUSIONS: (i) all detection methods were sensitive in identifying AT, including the HS applied to HR and (ii) the methods showed a good correlation in the identification of AT. Thus, these results support HR as valid and readily available parameter in determining AT in healthy elderly men. .