Jornal Vascular Brasileiro
https://jvascbras.org/article/doi/10.1590/S1677-54492008000200004
Jornal Vascular Brasileiro
Original Article

Confiabilidade de testes de caminhada em pacientes claudicantes: estudo piloto

Reliability of walking tests in claudicating patients: a pilot study

Inácio Teixeira da Cunha-Filho; Danielle Aparecida Gomes Pereira; André Maurício Borges de Carvalho; Leilane Campedeli; Michelle Soares; Joyce de Sousa Freitas

Downloads: 1
Views: 880

Resumo

CONTEXTO: Uma vez que a obstrução arterial periférica pode se apresentar de maneira difusa, com clínica diversa e com resultados de intervenção variados, é fundamental que a avaliação dos pacientes com doença arterial obstrutiva periférica seja feita com instrumentos que possam apresentar dados objetivos e reprodutíveis. OBJETIVO: Investigar e contrastar a confiabilidade do teste de caminhada de 6 minutos (T6M) com teste de deslocamento bidirecional progressivo (TDBP) em indivíduos claudicantes portadores de doença arterial obstrutiva periférica. MÉTODOS: Quatorze pacientes em estágio II de Fontaine participaram deste estudo piloto. Onze pacientes realizaram ambos os testes e três realizaram apenas T6M. Após familiarização, os pacientes foram avaliados em duas ocasiões distintas com intervalo máximo de 1 semana entre si. O coeficiente de correlação de intraclasse (ICC2,1) foi utilizado para avaliação da reprodutibilidade teste-reteste. RESULTADOS: A média da distância máxima de caminhada no teste e no reteste no T6M foi de 397,04±120,74 e 408,6±153,64 metros (p = 0,58), respectivamente, com ICC = 0,87 (p = 0,00005); já no TDBP, a média foi de 345±145,75 metros e, no reteste, de 345,91±127,97 (p = 0,92), com ICC = 0,99 (p = 0,00005). O tempo médio para surgimento da dor inicial, em segundos, com o T6M, foi de 172,25±88,23 (teste) e 148,58±70,36 (reteste) (p = 0,13), com ICC = 0,81 (p = 0,0004). No TDBP, o tempo médio foi de 282±141,90 (teste) e 267,14±150,58 (reteste) (p = 0,55), com ICC = 0,91 (p = 0,0008). CONCLUSÃO: Ambos os testes de caminhada são confiáveis e úteis para avaliação clínico-funcional desses pacientes. O TDBP, entretanto, gerou índices de confiabilidade mais elevados, podendo ser melhor opção para avaliação da performance desses indivíduos.

Palavras-chave

Confiabilidade dos testes, claudicação intermitente, caminhada

Abstract

BACKGROUND: Considering that peripheral arterial obstruction is a diffuse condition, manifesting as a variable clinical feature and with varied intervention outcomes, it is important to assess patients with peripheral artery occlusive disease using instruments that may provide objective and reliable data. OBJECTIVE: To investigate and compare the reliability of both the 6-minute walking test (6MWT) and the shuttle walking test (SWT) in patients with claudication secondary to peripheral artery occlusive disease. METHODS: Fourteen Fontaine stage II patients participated in the study. Eleven patients were submitted to both tests, while three patients only performed the 6MWT. After familiarization, the patients were tested on two occasions, with maximal 1-week interval between measurements. The intraclass correlation coefficient (ICC2,1) was used to check for test-retest reliability. RESULTS: Mean maximal walking distance for the 6MWT in both test and retest was 397.04±120.74 and 408.6±153.64 m (p = 0.58) respectively; ICC = 0.87 (p = 0.00005). For the SWT, mean was 345±145.75 m, and 345.91±127.97 m in the retest (p = 0.92); ICC = 0.99 (p = 0.00005). Mean times for claudication onset with the 6MWT test-retest were 172.25±88.23 and 148.58±70.36 s (p = 0.13); ICC = 0.81 (p = 0.0004); while for the SWT these values were 282±141.90 and 267.14±150.58 s (p = 0.55); ICC = 0.91 (p = 0.0008). CONCLUSION: Both walking tests are reliable and can be used for clinical and functional assessment of these patients. The SWT, however, yielded higher reliability coefficients, which suggests that it may be preferable to evaluate these individuals' performance.

Keywords

Reliability test, intermittent claudication, walking

References

Prieto AC. Doença arterial obstrutiva periférica (DAOP). .

Dormandy JA, Rutherford RB. Management of peripheral arterial disease (PAD): TransAtlantic inter-society consensus (TASC) working group. J Vasc Surg. 2000;31(^s1):S5-13.

Borges JL. Doença arterial obstrutiva periférica no idoso. Manual de cardiogeriatria. 2005:83-94.

Stewart KJ, Hiatt WR, Regensteiner JG, Hirsch AT. Exercise training for claudication. N Engl J Med. 2002;347:1941-51.

Gardner AW, Skinner JS, Vaughan NR, Bryant CX, Smith LK. Comparison of three progressive exercise protocols in peripheral vascular occlusive disease. Angiology. 1992;43:661-71.

Green S. Haemodynamic limitations and exercise performance in peripheral arterial disease. Clin Physiol Funct Imaging. 2002;22:81-91.

Labs KH, Nehler MR, Roessner M, Jaeger KA, Hiatt WR. Reliability of treadmill testing in peripheral arterial disease: a comparison of a constant load with a graded load treadmill protocol. Vasc Med. 1999;4:239-46.

Cachovan M, Rogatti W, Woltering F. Randomized reliability study evaluating constant-load and graded-exercise treadmill test for intermittent claudication. Angiology. 1999;50:193-200.

Solway S, Brooks D, Lacasse Y, Thomas S. A qualitative systematic overview of the measurement properties of functional walk tests used in the cardiorespiratory domain. Chest. 2001;119:256-70.

Montgomery PS, Gardner AW. The clinical utility of a six-minute walk test in peripheral arterial occlusive disease patients. J Am Geriatr Soc. 1998;46:706-11.

Singh SJ, Morgan MD, Scott S, Walters D, Hardman AE. Development of a shuttle walking test of disability in patients with chronic airways obstruction. Thorax. 1992;47:1019-24.

Walker RD, Nawaz S, Wilkinson CH, Saxton JM, Pockley AG, Wood RF. Influence of upper- and lower-limb exercise training on cardiovascular function and walking distances in patients with intermittent claudication. J Vasc Surg. 2000;31:662-9.

Gardner AW, Katzel LI, Sorkin JD. Exercise rehabilitation improves functional outcomes and peripheral circulation in patients with intermittent claudication: a randomized controlled trial. J Am Geriatr Soc. 2001;49:755-62.

Dawes HN, Barker KL, Cockburn J, Roach N, Scott O, Wade D. Borg's rating of perceived exertion scales: do the verbal anchors mean the same for different clinical groups?. Arch Phys Med Rehabil. 2005;86:912-6.

Gardner AW, Montgomery PS, Flinn WR, Katzel LI. The effect of exercise intensity on the response to exercise rehabilitation in patients with intermittent claudication. J Vasc Surg. 2005;42:702-9.

Atkins LM, Gardner AW. The relationship between lower extremity functional strength and severity of peripheral arterial disease. Angiology. 2004;55:347-55.

McDermott MM, Liu K, Greenland P. Functional decline in peripheral arterial disease: associations with the ankle brachial index and leg symptons. JAMA. 2004;292:453-61.

Zwierska I, Nawaz S, Walker RD, Wood RF, Pockley AG, Saxton JM. Treadmill versus Shuttle Walk Tests of Walking Ability in Intermittent Claudication. Med Sci Sports Exerc. 2004;36:1835-40.

Lewis ME, Newall C, Townend JN, Hill SL, Bonser RS. Incremental shuttle walk test in the assessment of patients for heart transplantation. Heart. 2001;86:183-7.

Vagaggini B, Taccola M, Severino S. Shuttle walking test and 6-minute walking test induce a similar cardiorespiratory performance in patients recovering from an acute exacerbation of chronic obstructive pulmonary disease. Respiration. 2003;70:579-84.

Onorati P, AntonuICC R, Valli G. Non-invasive evaluation of gas exchange during a shuttle walking test vs. a 6-min walking test to assess exercise tolerance in COPD patients. Eur J Appl Physiol. 2003;89:331-6.

Sociedade Brasileira de Angiologia e Cirurgia Vascular (SBACV)"> Sociedade Brasileira de Angiologia e Cirurgia Vascular (SBACV)">
5ddd6b120e882569531da3e9 jvb Articles

J Vasc Bras

Share this page
Page Sections