Dalavina Jonathan, Costa Ivan Peres, FarahTeixeira de Carvalho Etiene, Silva Jonathan Luiz, Silva Soraia Micaela, Malosá Sampaio Luciana Maria
Postgraduate Program in Rehabilitation Sciences, Nove de Julho University (UNINOVE), São Paulo, Brazil.
Physiother Res Int. 2025 Jul;30(3):e70090. doi: 10.1002/pri.70090.
Pulmonary Hypertension (PH) is a chronic condition that leads to progressive functional limitations, making the assessment of functional capacity essential for clinical management. This study aimed to classify PH patients based on the International Classification of Functioning, Disability, and Health (ICF) qualifiers using the Six-Minute Walk Test (6MWT) and compare this classification with the World Health Organization Functional Classification (WHO-FC).
This observational study included 33 individuals with PH. Demographic data, pulmonary function, and 6MWT results were collected. Participants were classified according to ICF qualifiers (ranging from no impairment to complete impairment) and WHO-FC. The association between classifications was tested using Fisher's exact test, considering the conceptual differences between them.
Most participants presented moderate functional impairment, with an average 6MWT distance of 431.5 ± 110 m, equivalent to 68% of the predicted value. Based on ICF qualifiers, 39% of patients had mild impairment, 42% moderate, and 18% severe impairment. However, no significant association was found between ICF qualifiers and WHO-FC, reflecting the distinct conceptual frameworks of these classifications. Unlike WHO-FC, which applies fixed cutoffs, the ICF-based classification provides a more individualized assessment by incorporating the contrast between expected and actual performance in the 6MWT.
The use of ICF qualifiers enabled a more specific evaluation of functional capacity in PH patients, complementing rather than replacing WHO-FC. This approach allows for a more individualized assessment, supporting targeted rehabilitation strategies and improving clinical decision-making in PH management.
肺动脉高压（PH）是一种导致进行性功能受限的慢性疾病，因此评估功能能力对临床管理至关重要。本研究旨在使用六分钟步行试验（6MWT），根据国际功能、残疾和健康分类（ICF）限定词对PH患者进行分类，并将该分类与世界卫生组织功能分类（WHO-FC）进行比较。
这项观察性研究纳入了33例PH患者。收集了人口统计学数据、肺功能和6MWT结果。根据ICF限定词（从无损害到完全损害）和WHO-FC对参与者进行分类。考虑到两者之间的概念差异，使用Fisher精确检验来测试分类之间的关联。
大多数参与者表现出中度功能损害，6MWT平均距离为431.5±110米，相当于预测值的68%。根据ICF限定词，39%的患者有轻度损害，42%为中度，18%为重度损害。然而，ICF限定词与WHO-FC之间未发现显著关联，这反映了这些分类的不同概念框架。与应用固定临界值的WHO-FC不同，基于ICF的分类通过纳入6MWT中预期表现与实际表现之间的对比，提供了更个性化的评估。
使用ICF限定词能够对PH患者的功能能力进行更具体的评估，是对WHO-FC的补充而非替代。这种方法允许进行更个性化的评估，支持有针对性的康复策略，并改善PH管理中的临床决策。
