Pitta Fábio, Takaki Melina Y, Oliveira Natália H de, Sant'anna Thaís J P, Fontana Andréa D, Kovelis Demétria, Camillo Carlos A, Probst Vanessa S, Brunetto Antonio F
Laboratório de Pesquisa em Fisioterapia Pulmonar (LFIP), Departamento de Fisioterapia, Universidade Estadual de Londrina (UEL), Rua Robert Koch, 60 Vila Operaria, 86038-440 Londrina, Paraná, Brazil.
Respir Med. 2008 Aug;102(8):1203-7. doi: 10.1016/j.rmed.2008.03.004. Epub 2008 Jun 24.
It remains unclear how closely the physical inactivity observed in patients with Chronic Obstructive Pulmonary Disease (COPD) relates to the severity of their airflow limitation. Furthermore, it is unknown whether spirometric variables such as maximal voluntary ventilation (MVV) and inspiratory capacity (IC) reflect the level of physical activity in daily life better than the forced expiratory volume in the first second (FEV(1)), the main spirometric variable used to determine the severity of COPD. The objective of the present study was to investigate the relationship between physical activity in daily life and the severity of COPD assessed by different spirometric variables: MVV, IC and FEV(1).
Forty patients with COPD (21 men; 68+/-7 years; FEV(1) 41+/-14% predicted) were performed spirometry and assessment of the physical activity level in daily life using an accelerometer (SenseWear Armband).
MVV was significantly correlated to total energy expenditure per day, energy expenditure per day in activities demanding more than 3 metabolic equivalents (METs), number of steps per day and time spent per day in moderate and vigorous activities (0.42<or=r<or=0.52; p<0.01 for all). Correlation of these variables with IC and especially FEV(1) was more modest, borderline or not statistically significant. There was no difference in time spent in vigorous activities among patients classified according to the FEV(1)-based GOLD stages II, III and IV, differently than that observed when patients were classified in groups according to their MVV.
In COPD patients, MVV better reflects the physical activity level in daily life than FEV(1) and IC.
慢性阻塞性肺疾病(COPD)患者中观察到的身体活动不足与气流受限严重程度之间的关联程度仍不明确。此外,诸如最大自主通气量(MVV)和吸气容量(IC)等肺量计变量是否比用于确定COPD严重程度的主要肺量计变量第一秒用力呼气量(FEV₁)能更好地反映日常生活中的身体活动水平尚不清楚。本研究的目的是调查日常生活中的身体活动与通过不同肺量计变量(MVV、IC和FEV₁)评估的COPD严重程度之间的关系。
对40例COPD患者(21例男性;68±7岁;FEV₁为预测值的[41±14]%)进行了肺量测定,并使用加速度计(SenseWear臂带)评估日常生活中的身体活动水平。
MVV与每日总能量消耗、每日在需要超过3代谢当量(METs)的活动中的能量消耗、每日步数以及每日在中度和剧烈活动中花费的时间显著相关(0.42≤r≤0.52;所有p<0.01)。这些变量与IC尤其是FEV₁的相关性更适度、接近临界值或无统计学意义。根据基于FEV₁的GOLD II、III和IV期分类的患者在剧烈活动中花费的时间没有差异,这与根据MVV对患者进行分组时观察到的情况不同。
在COPD患者中,MVV比FEV₁和IC能更好地反映日常生活中的身体活动水平。