Jornal Vascular Brasileiro
https://jvascbras.org/article/doi/10.1590/S1677-54492011000100005
Jornal Vascular Brasileiro
Original Article

Relação entre força muscular e capacidade funcional em pacientes com doença arterial obstrutiva periférica: um estudo piloto

Relationship between muscular strength and functional capacity in patients with peripheral occlusive arterial disease: a pilot study

Danielle Aparecida Gomes Pereira; Bruna Marques Araújo Faria; Rayssa Amaral Machado Gonçalves; Vivielle Brígida Ferreira Carvalho; Karoline Oliveira Prata; Poliana Soares Saraiva; Túlio Pinho Navarro; Inácio Cunha-Filho

Downloads: 0
Views: 969

Resumo

CONTEXTO: As informações sobre o grau de correlação entre força muscular e capacidade funcional em pacientes com doença arterial obstrutiva periférica (DAOP) são inconsistentes, além de nem sempre apresentarem protocolos que relacionem apropriadamente medidas de força muscular com desempenho. OBJETIVO: Estabelecer o nível de correlação entre força muscular e capacidade funcional em pacientes fisicamente ativos com DAOP. MÉTODOS: Doze pacientes com diagnóstico da doença e presença de claudicação intermitente participaram do estudo. Todos realizaram testes de força muscular e de caminhada. Grau de correlação entre força muscular e capacidade funcional foi avaliado pela correlação de Pearson. RESULTADOS: Dos 12 voluntários incluídos, 10 eram do sexo masculino e 2 do sexo feminino. Os participantes tinham média de idade de 63 ± 11 anos. Houve alta correlação (r = 0,872; p = 0,0001) entre distância percorrida no teste de deslocamento bidirecional progressivo (TDBP) e carga alcançada no teste de resistência máxima. Não se observou correlação entre distância percorrida no TDBP e tempo gasto para realização das cinco flexões plantares no teste de ponta de pé. CONCLUSÃO: O desempenho funcional em um grupo de pacientes com DAOP, em sua maioria fisicamente ativos, foi fortemente correlacionado com força muscular de extensores de joelho, mas não com desempenho observado funcionalmente pelo teste de ponta de pé. Futuros estudos são necessários para avaliar se força muscular de flexores plantares, mensurada de forma específica e isolada, correlaciona-se com função em pacientes com a doença.

Palavras-chave

Claudicação intermitente, força muscular, isquemia

Abstract

BACKGROUND: Information on the degree of correlation between muscular strength and functional capacity in subjects with peripheral obstructive arterial disease (POAD) is inconsistent and the available studies use protocols that do not adequately correlate measurements of muscular strength with performance. OBJECTIVE: to correlate muscular strength and functional capacity in physically active subjects with POAD. METHODS: Twelve subjects with PAOD and intermittent claudication were enrolled in the study. All subjects performed muscular strength and walking tests. Pearson's correlation was used to determine the level of association between these variables. RESULTS: Twelve subjects, 10 males and 2 females, were included in the study. The mean age was 63 ± 11 years. There was a strong correlation (r = 0.872; p = 0.0001) between the distance walked in the shuttle walk test (SWT) and the maximum load at the maximum strength test. However, there was no correlation between the distance reached in the SWT and the time spent to carry out five plantar flexions in the tiptoe test. CONCLUSION: The functional performance of a group of individuals with PAOD - most of them physically active - was strongly correlated with knee extension muscular strength, but not with performance observed at the tiptoe test. Further studies must be carried out to assess whether the muscle strength of plantar flexion, measured specifically and separately, is correlated with function in PAOD patients.

Keywords

Intermittent claudication, muscle strength, ischemia

References

McGuigan MR, Bronks R, Newton RU. Muscle fiber characteristics in patients with peripheral arterial disease. Med Sci Sports Exerc. 2001;33:2016-21.

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

Cimminiello C. PAD: Epidemiology in pathophysiology. Thrombosis Research. 2002;106:295-301.

Novo S. Classification, epidemiology, risk factors, and natural history of peripheral arterial disease. Diabetes, Obesity and Metabolism. 2002;4:S1-S6.

Santos Filho MAL, Rosoky RMA, Costa DFF, Ferreira CB, Wolosker N, Puech-Leão P. Comparação entre o resultado do tratamento clínico de pacientes com claudicação intermitente por obstrução femoropoplítea bilateral versus obstrução aórtica. J Vasc Bras. 2005;4:137-42.

Faxon DP, Fuster V, Libby P. Atherosclerotic Vascular Disease Conference: Writing Group III: pathophysiology. Circulation. 2004;109:2617-25.

Gardner AW, Montgomery PS, Killewich LA. Natural history of physical function in older men with intermittent claudication. J Vasc Surg. 2004;40:73-8.

McDermott MM, Greenland P, Liu K. The ankle brachial index is associated with leg function and physical activity: the Walking and Leg Circulation Study. Ann Intern Med. 2002;136:873-83.

Green S. Haemodynamic limitations and exercise performance in peripheral arterial disease. Clinical Physiology in Functional Imaging. 2002;22:81-91.

Scott-Okafor HR, Silver KKC, Parker J, Almy-Albert T, Gardner AW. Lower extremity strength deficits in peripheral arterial occlusive disease patients with intermittent claudication. Angiology. 2001;52:7-14.

McDermott MM, Mehta S, Liu K. Leg symptoms, the ankle brachial index, and walking ability in patients with peripheral arterial disease. J Gen Intern Med. 1999;14:173-81.

Regensteiner JG, Wolfel EE, Brass EP. Chronic changes in skeletal muscle histology and function in peripheral arterial disease. Circulation. 1993;87:413-421.

McDermott MM, Guralnik JM, Albay M, Bandinelli S, Miniati B, Ferrucci L. Impairments of muscles and nerves associated with peripheral arterial disease and their relationship with lower extremity functioning: the InCHIANTI Study. J Am Geriatr Soc. 2004;52:405-10.

McDermott MM, Criqui MH, Greenland Pet. Leg strength in peripheral arterial disease: Associations with disease severity and lower-extremity performance. J Vasc Surg. 2004;39:523-30.

Ritti-Dias RM, Wolosker N, de Moraes Forjaz CL. Strength training increases walking tolerance in intermittent claudication patients: randomized trial. J Vasc Surg. 2010;51:89-95.

McDermott MM, Ades P, Guralnik JM. Treadmill exercise and resistance training in patients with peripheral arterial disease with and without intermittent claudication: a randomized controlled trial. JAMA. 2009;301:165-74.

Hiatt WR, Wolfel EE, Meier RH, Regensteiner JG. Superiority of treadmill walking exercise versus strength training for patients with peripheral arterial disease: Implications for the mechanism of the training response. Circulation. 1994;90:1866-74.

Cunha-Filho IT, Pereira DAG, Carvalho AMB, Campedeli L, Sorares M, Freitas JS. Confiabilidade de testes de caminhada em pacientes claudicantes: estudo piloto. J Vasc Bras. 2008;7:106-111.

Pereira DAG, Oliveira KL, Cruz JO, Souza CG, Cunha-Filho IT. Avaliação da reprodutibilidade de testes funcionais na Doença Arterial Periférica. Revista Fisioterapia e Pesquisa. 2008;15:228-234.

Brown M, Sinacore DR, Host HH. The relationship of strength to function in the older adult. J Gerontol A Biol Sci Med Sci. 1995;50:55-9.

Mc Dermott MM, Liu K, Greenland P. Functional decline in peripheral arterial disease: Associations with the ankle brachial index and leg symptoms. JAMA. 2004;292:453-461.

Gerdle B, Hedberg B, Ãngquist KA, Fulg-Meyer AR. Isokinetic strength and endurance in peripheral arterial insufficiency with intermittent claudication. Scand J Rehabil Med. 1986;18:9-15.

Sociedade Brasileira de Angiologia e Cirurgia Vascular (SBACV)"> Sociedade Brasileira de Angiologia e Cirurgia Vascular (SBACV)">
5ddfc45d0e88251f744ce1d5 jvb Articles
Links & Downloads

J Vasc Bras

Share this page
Page Sections