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Vol. 89. Núm. 6.
Páginas 588-594 (novembro - dezembro 2013)
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Vol. 89. Núm. 6.
Páginas 588-594 (novembro - dezembro 2013)
ARTIGO ORIGINAL
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Evaluation of functional capacity for exercise in children and adolescents with sickle cell disease through the Six Minute Walk Test
Avaliação da capacidade funcional para o exercício de crianças e adolescentes com doença falciforme pelo teste da caminhada de seis minutos
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Sandro V. Hostyna, Werther B. de Carvalhob, Cíntia Johnstonc,
Autor para correspondência
cintiajohnston@terra.com.br

Corresponding author.
, Josefina A.P. Bragad
a Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brasil
b Universidade de São Paulo, São Paulo, SP, Brasil
c Serviço de Fisioterapia Pediátrica e Neonatal, Hospital São Paulo, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brasil
d Departamento de Pediatria, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brasil
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Abstract
Objective

to evaluate lung functional capacity (FC) for physical exercise in children and adolescents with sickle cell disease (SCD) through the six-minute walk test (6MWT).

Method

a cross-sectional prospective study was performed to evaluate the FC of 46 patients with SCD through the 6MWT. The following parameters were assessed: heart rate (HR), respiratory rate (RR), peripheral pulse oxygen saturation (SpO2), peak expira- tory flow (PEF), blood pressure (systolic and diastolic), dyspnea, and leg fatigue (modi- fied Borg scale) at rest, in the end of the test, and ten minutes after the 6MWT. The total distance walked was also recorded. For statistical analysis, the parametric varia- bles were analyzed using the paired Student's t-test, analysis of variance (ANOVA), and Bonferroni multiple comparisons, with a significance level set at p ≤ 0.05.

Results

the 46 patients were aged age 9.15 ± 3.06 years, presented baseline Hb of 9.49 ± 1.67g/dL, and walked 480.89 ± 68.70 m. SCD diagnosis was as follows: group 1- HbSS (n = 20)/HbSβ0-thalassemia (n = 3) and group 2 - HbSC (n = 20)/HbSβ+-thalassemia (n = 3). Regarding total distance walked, patients in group 1 walked a shorter distance than patients in group 2 (459.39 ± 57.19 vs. 502.39 ± 73.60 m; p = 0.032). There was no statistical difference regarding PEF in the three moments of evaluation. The SpO2 in ambient air and SpO2 with O2 differed between groups 1 and 2 (p < 0.001 vs. p = 0.002), as well as the RR (p = 0.001).

Conclusion

these patients showed a lower FC for exercise than that predicted for the age range in the literature. Patients diagnosed with HbSS/Sβ0-thalassemia had a lower performance in the test than those with HbSC/Sβ+-thalassemia regarding total distance walked, RR, and SpO2 after the 6MWT.

Keywords:
Sickle cell anemia
Acute chest syndrome
Exercise
Nutritional status
Resumo
Objetivo

: avaliar a capacidade funcional pulmonar (CF) para o exercício físico de crianças e adolescentes com doença falciforme (DF) pelo teste da caminhada de seis minutos (TC6’).

Métodos

: estudo transversal prospectivo avaliando a CF pelo TC6’ de 46 pacientes com DF. Foram avaliados: frequência cardíaca (FC), frequência respiratória (FR), saturação de pulso de oxigênio (SpO2), pico de fluxo expiratório (PFE), pressão arterial (PA) sistó- lica e diastólica, dispneia e cansaço em membros inferiores (escala de Borg modificada) em repouso, ao término e 10 minutos após o TC6’ e a distância percorrida. Análise estatística: test t-Student pareado, análise de variância e comparações múltiplas de Bonferroni, significância p ≤ 0,05.

Resultados

: dos 46 pacientes, a média ± dp da idade foi 9,15 ± 3,06 anos, hemoglobina basal 9,4 ± 1,67g/dL e distância percorrida 480,89 ± 68,70 m. Diagnóstico da DF: Grupo 1– HbSS (n = 20)/HbSβ0-talassemia (n = 3); e Grupo 2 – HbSC (n = 20)/HbSβ+-talassemia (n = 3). O Grupo 1 apresentou menor distância percorrida do que o Grupo 2 (459,39 ± 57,19 vs 502,39 ± 73,60m; p = 0,032). Não houve diferença estatística em relação ao PFE. A SpO2 em ar ambiente e a SpO2 com O2 (1 L/min) após o teste foi maior no Grupo 2 (p < 0,001 e p = 0,002, respectivamente). A FR foi maior no Grupo 1 ao final do TC6’ (p < 0,001).

Conclusão

: esta amostra apresentou CF para o exercício abaixo do predito para a faixa etária na literatura. Os pacientes com HbSS/Sβ0-talassemia apresentaram desempenho inferior na distância percorrida, FR e SpO2 após o TC6’, comparativamente aos pacientes com HbSC/Sβ+-talassemia.

Palavras-chave:
Anemia falciforme
Síndrome torácica aguda
Exercício
Estado nutricional
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Como citar este artigo: Hostyn SV, de Carvalho WB, Johnston C, Braga JA. Evaluation of functional capacity for exercise in children and adolescents with sickle-cell disease through the six-minute walk test. J Pediatr (Rio J). 2013;89:588-94.

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