Desfechos e instrumentos de avaliação em programas de reabilitação
pulmonar para pacientes com DPOC: revisão de literatura baseada na CIF

Filipe Tadeu Sant’Anna Athayde; Raquel Rodrigues Britto; Verônica Franco Parreira

Artigo Original

Desfechos e instrumentos de avaliação em programas de reabilitação pulmonar para pacientes com DPOC: revisão de literatura baseada na CIF

Outcomes and assessment tools in pulmonary rehabilitation programs for patients with COPD: literature review based on the ICF

Filipe Tadeu Sant’Anna Athayde, Raquel Rodrigues Britto, Verônica Franco Parreira

ASSOBRAFIR Ciência, vol.1, n1, p.9-22, 2010

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Resumo

Introdução: Os pacientes com Doença Pulmonar Obstrutiva Crônica (DPOC) podem apresentar manifestações sistêmicas signifi cativas, como a disfunção muscular periférica, além de dispnéia, capacidade de exercício reduzida e morbidades associadas. Considerando a Classifi cação Internacional de Funcionalidade, Incapacidade e Saúde (CIF) e as repercussões globais da DPOC, é importante que a avaliação dos programas de reabilitação pulmonar direcionados a esses pacientes seja ampla. Objetivo: sistematizar o conhecimento acerca dos principais desfechos e instrumentos de avaliação utilizados em programas de reabilitação pulmonar para pacientes com DPOC, de acordo com o modelo da CIF, discriminando os domínios de “estrutura e função do corpo” e “atividade e participação”. Metodologia: Foi realizada uma revisão de literatura nas bases de dados MedLine, LILACS e SciELO, com os descritores: pulmonary rehabilitation, chronic obstructive pulmonary disease, COPD, dyspnoea, exercise capacity, exercise tolerance, muscle strength, health-related quality of life, physical activity, motion sensor, respiratory muscle training, maximum respiratory pressures; e seus respectivos descritores em português. Estudos adicionais foram identifi cados por meio de pesquisa manual de referências obtidas nos artigos. Resultados e Discussão: A partir do modelo teórico da CIF, foi possível discriminar os diversos desfechos e instrumentos de avaliação empregados nos estudos relativos aos efeitos dos programas de reabilitação pulmonar em seus domínios de “estrutura e função do corpo” e “atividade e participação”. Conclusões: Os desfechos e instrumentos de avaliação empregados são variados. Tradicionalmente, consistiam de aspectos exclusivamente direcionados para o domínio de “estrutura e função do corpo” do modelo de funcionalidade e incapacidade da CIF. Entretanto, mais recentemente, o domínio “atividade e participação” vem sendo abordado, o que ainda não acontece de maneira relevante com os fatores ambientais.

Palavras-chave

Fisioterapia respiratória, Doença Pulmonar Obstrutiva Crônica, Reabilitação pulmonar, Classificação Internacional de Funcionalidade.

Abstract

Introduction: Patients with Chronic Obstructive Pulmonary Disease (COPD) may have signifi cant systemic manifestations, such as peripheral muscle dysfunction, beyond dyspnea, reduced exercise capacity and associated morbidity. Considering the International Classifi cation of Functioning, Disability and Health (ICF) and the overall impact of COPD, it is important that the evaluation of pulmonary rehabilitation programs for these patients is widely used. Objective: To systematize knowledge about the main outcomes and assessment tools used in pulmonary rehabilitation programs for patients with COPD, according to the ICF model, identifying components of “structure and function of the body” and “activity and participation.” Methods: We performed a literature review on the databases Medline, LILACS and SciELO, using the key words: pulmonary rehabilitation, chronic obstructive pulmonary disease, COPD, dyspnoea, exercise capacity, exercise tolerance, muscle strength, health-related quality of life, physical activity, motion sensor, respiratory muscle training, maximum respiratory pressures; and their respective descriptors in Portuguese. Additional studies were identifi ed through manual search of references obtained in papers. Results and Discussion: From the theoretical model of ICF, it was possible to discriminate the various outcomes and assessment tools employed in studies related to the eff ects of pulmonary rehabilitation programs in components of “structure and function of the body” and “activity and participation.” Conclusions: Th e outcomes and assessment tools employed are varied. Traditionally, consisted exclusively of aspects targeted to the component “structure and function of the body” of ICF’s model of functioning and disability. However, more recently, the component of “activity and participation” has been approached, what does not still happen so relevant with the environmental factors.

Keywords

Chest physiotherapy, Chronic Obstructive Pulmonary Disease, Pulmonary rehabilitation, International Classifi cation of Functioning

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