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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
Open Access
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
Visitas
...
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
Conteúdo relacionado
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Informação do artigo
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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