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

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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

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