Efeito da reabilitação pulmonar na tolerância ao exercício de pacientes com doença pulmonar avançada em lista de espera para transplante de pulmão

Introducao: pacientes com doenca pulmonar avancada (DPA) apresentam reducao da tolerância a esforcos, dispneia e fadiga. A reabilitacao pulmonar (RP) visa a melhorar a tolerância ao exercicio, controlar sintomas, minimizar complicacoes da doenca pulmonar e melhorar a qualidade de vida. Objetivo: avaliar o efeito da RP na capacidade de exercicio, segundo a distância percorrida no teste da caminhada de seis minutos (TC6M), de pacientes com DPA em lista de espera para o transplante pulmonar. Metodologia: pacientes em lista de espera para transplante pulmonar, encaminhados a RP no Hospital das Clinicas da Universidade Federal de Minas Gerais foram submetidos, no inicio e no final da RP, ao TC6M e o grau de dispneia foi avaliado segundo a escala deBorg. Os dados foram apresentados como media e desvio-padrao dos valores absolutos e comparados usando o teste t de Student. Foram considerados estatisticamente significativos os valores de p<0,05. Resultados: entre janeiro de 2011 e dezembro 2012, 17 pacientes completaram a RP. A media de idade foi de 42±12 anos, 65% do sexo feminino, saturacao periferica de oxigenio na admissao de 83 ±17% e 35% em uso de oxigenio 24h/dia. Sete pacientes (41%) apresentavam DPOC, seis (35%) fibrose pulmonar e quatro (24%) outras DPA. Houve melhora significativa na distância percorrida no TC6M ao final da RP (314±131 m versus 427±111 m; p=0,0016), com aumento medio de 118 m. Conclusao: a RP teve impacto positivo na capacidade de exercicio dos pacientes em lista de espera para transplante de pulmao.(AU) Introduction: patients with advanced lung disease (DPA) exhibit reduced tolerance to an effort, dyspnea, and fatigue. Pulmonary rehabilitation (RP) aims to improve exercising tolerance, controlling symptoms, minimize complications in the pulmonary disease, and improve the quality of life. Objective: to evaluate the effect of RP on exercise capacity, according to the distance traveled in the six-minute walk test (TC6M), in patients with DPA on the waiting list for lung transplantation. Methodology: patients on the waiting list for lung transplantation, referred to RP in the General Hospital of the Federal University of Minas Gerais were submitted to the TC6M, at the beginning and end of RP, and the degree of dyspnea was assessed using the Borg scale. The data were presented as mean and standard deviation of absolute values and compared using the Student?s t test. The p-values < 0.05 were considered statistically significant. Results: between January of 2011 and December of 2012, 17 patients completed the RP. The average age was 42 ± 12 years, 65% were females, the peripheral oxygen saturation on admission was 83 ± 17%, and 35% used oxygen 24 hours/day. Seven patients (41%) presented DPOC, six (35%) had pulmonary fibrosis, and four (24%) other DPA. There was a significant improvement in the distance walked in the TC6M at the end of RP (314 ± 131 m versus 427 ± 111 m; p = 0.0016), with an average increase of 118 m. Conclusion: the RP had a positive impact on the exercise capacity of patients on the waiting list for lung transplantation.(AU)