Importância do teste cardiopulmonar para a fisioterapia cardiovascular
DOI:
https://doi.org/10.33233/fb.v20i4.2411Abstract
O teste de exercício cardiopulmonar (TECP) é um método não invasivo de avaliação global da integridade dos ajustes fisiológicos no organismo humano durante a execução do exercício físico. Na prática clínica, o TECP tem sido utilizado com as mais diversas finalidades. O profissional capacitado pode utilizá-lo principalmente para avaliar a capacidade funcional dos indivíduos submetidos ao teste, mas também pode ser realizado com a finalidade diagnóstica, prognóstica e principalmente para a reabilitação, na qual a prescrição de exercícios é determinada de forma segura e individualizada. Nos últimos anos este teste tem se tornado uma importante ferramenta para os fisioterapeutas e educadores físicos para a prescrição de exercício físico. Os índices de limitação funcional mais observados são: 1) o consumo de oxigênio pico (VO2pico) ou consumo máximo de oxigênio (VO2máx); 2) limiar anaeróbico ventilatório (LAV) em níveis de exercício físico submáximo. Desta forma, o objetivo do nosso trabalho foi disseminar o conhecimento sobre o TECP entre os nossos pares e outros profissionais da saúde. Neste sentido, promovendo a possibilidade de discussão sobre a potencial inserção do TECP nos programas de reabilitação cardíaca ambulatorial de forma precisa e segura, para melhora da capacidade funcional e a qualidade de vida dos pacientes.
Palavras-chave: teste de esforço, consumo de oxigênio, desempenho físico funcional, liminar anaeróbio.
References
Powers SK. Howley ET. Fisiologia do exercÃcio: teoria e aplicação ao condicionamento e ao desempenho. Rio de Janeiro: Guanabara Koogan; 2000.
Neder JÃ, Nery LE. Fisiologia clÃnica do exercÃcio: teoria e prática. São Paulo: Artmed; 2003.
Wasserman K, Hansen JE, Sue D, Whipp BJ, Casaburi R. Principles of exercise testing and interpretation. 3ª ed. Philadelphia: Williams & Wilkins; 1999.
Balady GJ, Arena R, Sietsema K, Myers J, Coke L, Fletcher GF et al. Clinician’s guide to cardiopulmonary exercise testing in adults: a scientific statement from the American Heart Society. Circulation 2010;(122):191-225.
American College of Sports Medicine. ACSM’s guidelines for exercise testing and prescription (7th ed.). Philadelphia: Lippincott Williams & Wilkins; 2006.
Neder JÃ, Nery LE. O teste de exercÃcio cardiopulmonar. J Pneumol 2002;28(3):166-206.
Thompson PD, Arena R, Riebe D, Pescatello LS. ACSM’s new pre participation health screening recommendations from ACSM’s guidelines for exercise testing and prescription. Curr Sports Med Reports 2013;12(4):215-7. https://doi.org/10.1249/JSR.0b013e31829a68cf
Stein R. Teste cardiopulmonar de exercÃcio: noções básicas sobre o tema. Rev Soc Cardiol Rio Grand Sul 2006;9(1-4).
Meneghelo RS, Costa RV. III Diretrizes da Sociedade Brasileira de Cardiologia sobre teste ergométrico. Arq Bras Cardiol 2010;95(5):1-26.
Karvonen JJ, Kcntala E, Mustala O. The effect of training on the heart rate, a longitudinal study. Ann Med Exp Biol Fenn 1957;35(3):307-15.
Borg G. Borg's perceived exertion and pain scales. Human Kinetics, 1998.
Herdy AH, Uhnlerdorf D. Reference values for cardiopulmonary exercise testing for sedentary and active men and women. Arq Bras Cardiol 2011;96(1):54-9. https://doi.org/10.1590/s0066-782x2010005000155
Guazzi M, Adams V, Conraads V, Halle M, Mezzani A, Vanhees L et al. Clinical recommendations for cardiopulmonary exercise testing data assessment in specific patient populations. Circulation 2012;126(18):2261-74. https://doi.org/10.1161/CIR.0b013e31826fb946
Piepoli MF, Corrà U, Agostoni PG, Belardinelli R, Cohen-Solal A, Hambrecht R, et al. Statement on cardiopulmonary exercise testing in chronic heart failure due to left ventricular dysfunction: recommendations for performance and interpretation Part III: Interpretation of cardiopulmonary exercise testing in chronic heart failure and future applications. Eur J Cardiovasc Prev Rehabil 2006;13(4):485-94. https://doi.org./10.1097/01.hjr.0000209812.05573.04
Piepoli MF, Corra U, Agostoni PG, Belardinelli R, Cohen-Solal A, Hambrecht R et al. Statement on cardiopulmonary exercise testing in chronic heart failure due to left ventricular dysfunction: recommendations for performance and interpretation. Part I: definition of cardiopulmonary exercise testing parameters for appropriate use in chronic heart failure. Eur J Cardiovasc Prev Rehabil 2006;13(2):150-64
Sorajja P, Allison T, Hayes C, Nishimura RA, Lam CS, Ommen SR. Prognostic utility of metabolic exercise testing in minimally symptomatic patients with obstructive hypertrophic cardiomyopathy. Am J Cardiol 2012;109(10):1494-8. https://doi.org/10.1016/j.amjcard.2012.01.363
American College of Sports Medicine. ACSM's guidelines for exercise testing and prescription. New York: Lippincott Williams & Wilkins; 2013.
Beaver WL, Wasserman K, Whipp BJ. A new method for detecting anaerobic threshold by gas exchange. J Applied Physiol 1986;60(6):2020-7. https://doi.org/10.1152/jappl.1986.60.6.2020
Pozzi LG, Melo RC, Quiterio RJ, Milan LA, Diniz CAR, Dias TCM et al. Determinação do limiar de anaerobiose de idosos saudáveis: comparação entre diferentes métodos. Rev Bras Fisioter 2006;10(3):333-8.
Stegmann H, Kindermann W, Schnabel A. Lactate kinetics and individual anaerobic threshold. Int J Sports Med 1981;2(3):160-5. https://doi.org/10.1055/s-2008-1034604
Kindermann W, Simon G, Keul J. The significance of the aerobic-anaerobic transition for the determination of work load intensities during endurance training. Eur J Appl Physiol Occup Physiol 1979;42(1):25-34.
Marães VRFS. Determinação do limiar de anaerobiose a partir da análise da frequência cardÃaca, da eletromiografia de superfÃcie e das variáveis ventilatórias e metabólicas durante exercÃcio fÃsico dinâmico [Tese]. São Carlos: Universidade Federal de São Carlos; 2004.
WASSERMAN K, Whipp BJ. Exercise physiology in health and disease. Am Rev Respir Dis 1975;112(2):219-49. https://doi.org/10.1164/arrd.1975.112.2.219
Hollenberg M, Tager IB. Oxygen uptake efficiency slope: an index of exercise performance and cardiopulmonary reserve requiring only submaximal exercise. J Am Coll Cardiol 2000;36(1):194-201. https://doi.org/10.1016/s0735-1097(00)00691-4
Davies LC, Wensel R, Georgiadou P, Cicoira M, Coats AJ, Piepoli MF et al. Enhanced prognostic value from cardiopulmonary exercise testing in chronic heart failure by non-linear analysis: oxygen uptake efficiency slope. Eur Heart J 2006;27(6):684-90. https://doi.org/10.1093/eurheartj/ehi672
Cohen-Solal A, Tabet JY, Logeart D, Bourgoin P, Tokmakova M, Dahan M. A noninvasively determined surrogate of cardiac power ('circulatory power') at peak exercise is a powerful prognostic factor in chronic heart failure. Eur Heart J 2002;23(10):806-14. https://doi.org/10.1053/euhj.2001.2966
Forman DE, Guazzi M, Myers J, Chase P, Bensimhon D, Cahalin LP et al. A novel index that enhances prognostic assessment of patients with heart failure. Circ Heart Fail 2012;5(5):621-6. https://doi.org/10.1161/CIRCHEARTFAILURE.112.968529
Jaussaud J, Blanc P, Derval N, Bordachar P, Courregelongue M, Roudaut R et al. Ventilatory response and peak circulatory power: new functional markers of response after cardiac resynchronization therapy. Arch Cardiovasc Dis 2010;103(3):184-91. https://doi.org/10.1016/j.acvd.2010.01.003
Madan N, Beachler L, Konstantinopoulos P, Worley S, Sun Z, Latson LA. Peak circulatory power as an indicator of clinical status in children after Fontan procedure. Pediatr Cardiol 2010;31(8):1203-8. https://doi.org/10.1007/s00246-010-9799-1
Torchio R, Guglielmo M, Giardino R, Ardissone F, Ciacco C, Gulotta C et al. Exercise ventilatory inefficiency and mortality in patients with chronic obstructive pulmonary disease undergoing surgery for non-small-cell lung cancer. Eur J Cardiothorac Surg 2010;38(1):14-9. https://doi.org/10.1016/j.ejcts.2010.01.032
Enright PL. The six-minute walk test. Respiratory care 2003;48(8):783-5.
Marrara KT, Marino DM, Jamami M, Oliveira Junior AD, Di Lorenzo VA. Responsiveness of the six-minute step test to a physical training program in patients with COPD. J Bras Pneumol 2012;38(5):579-87.
Pessoa BV, Arcuri JF, Labadessa IG, Costa JNF, Sentanin AC, Di Lorenzo VAP. Validity of the six-minute step test of free cadence in patients with chronic obstructive pulmonary disease. Braz J Phys Ther 2014;18(3):228-36. https://doi.org/10.1590/bjpt-rbf.2014.0041
Travensolo CF, Goessler KF, Polito MD. Correlação entre o teste de caminhada de seis minutos e o teste do degrau em idosos. Rev Bras Geriatr Gerontol 2013;16(2):375-83. https://doi.org/10.1590/S1809-98232013000200017
Monteiro DP, Brito RR, Carvalho MLV, Montemezzo D, Parreia VF. Shuttle walk test como instrumento da avaliação da capacidade funcional: uma revisão da literatura. Revista Ciência & Saúde 2014;7(2):92-7.
Pulz C, Diniz RV, Alves AN, Tebexreni AS, Carvalho AC, Paola AA, Almeida DR. Incremental shuttle and six-minute walking tests in the assessment of functional capacity in chronic heart failure. Can J Cardiol 2008;24(2):131-5. https://doi.org/10.1016/s0828-282x(08)70569-5
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(12):1019-24. https://doi.org/ 10.1136/thx.47.12.1019
Coelho CC, Aquino ES, Almeida DC, Oliveira GC, Pinto RC, Rezende IM et al. Comparative analysis and reproducibility of the modified shuttle walk test in normal children and in children with cystic fibrosis. J Bras Pneumol 2007;33(2):168-74. https://doi.org/ 10.1590/s1806-37132007000200011
Herdy AH, Ritt LEF, Stein R, Araújo CGS, Milani M, Meneghelo RS. Cardiopulmonary exercise test: background, applicability and interpretation. Arq Bras Cardiol 2016;107(5):467-81. https://doi.org/10.5935/abc.20160171
Williamson JL. The relevance of central command for neural cardiovascular control of exercise. Exp Physiol 2010;95(11):1043-8. https://doi.org/10.1113/expphysiol.2009.051870
Peterson MJ, Pieper CF, Morey MC. Accuracy of VO2 (max) prediction equations in older adults. Med Sci Sports Exerc 2003;35(1):145-9. https://doi.org/10.1249/01.MSS.0000043547.22724.0B
Bruce RA, Lovejoy FW, Pearson R, Yu PNG, Brothers GB, Velasquez T. Normal respiratory and circulatory pathways of adaptation in exercise. J Clin Invest 1949;28(6 Pt 2):1423. https://doi.org/10.1172/JCI102207
Published
Issue
Section
License
Authors are authorized for non-exclusive distribution of the version of the work published in this journal (eg, publishing in an institutional repository or as a book chapter), with acknowledgment of authorship and initial publication in this journal.
