RESUMO
BACKGROUND AND OBJECTIVES: Although peak oxygen uptake (VO2peak ) is one of the most important measures in clinical practice, the high cost and time consumption have led to the search for simpler devices and the development of the estimating cardiopulmonary fitness (eCPF) equation. Since the lungs are one of the sites most affected by rheumatoid arthritis (RA), this study aimed to create a predictive equation for VO2peak obtained by simple sampling technology in women with RA-associated interstitial lung disease (RA-ILD). METHODS: This cross-sectional study evaluated 47 women with RA-ILD. The participants underwent the following evaluations: computed tomography (CT); evaluation of disease activity through the Clinical Disease Activity Index (CDAI); measurement of physical function using the Health Assessment Questionnaire disability index (HAQ-DI); pulmonary function testing, including spirometry, diffusing capacity for carbon monoxide (DlCO ), nitrogen single-breath washout (N2 SBW) test, and impulse oscillometry; and cardiopulmonary exercise testing (CPET) using FitMate™. RESULTS: VO2peak was correlated with age (r = -0.550, p < 0.0001), rheumatoid factor (r = -0.443, p = 0.002), anti-cyclic citrullinated peptide antibodies (r = -0.410, p = 0.004), CDAI (r = -0.462, p = 0.001), HAD-DI (r = -0.486, p = 0.0005), forced vital capacity (r = 0.491, p = 0.0004), DlCO (r = 0.621, p < 0.0001), phase III slope of N2 SBW (r = -0.647, p < 0.0001), resonance frequency (Fres , r = -0.717, p < 0.0001), integrated low-frequency reactance (r = -0.535, p = 0.0001), and the inhomogeneity of respiratory system resistance between 4 and 20 Hz (r = -0.631, p < 0.0001). In the CT examination, patients with extensive ILD had significantly lower VO2peak than patients with limited ILD (p < 0.0001). In the stepwise forward regression analysis, Fres , DlCO and age explained 61% of the VO2peak variability. CONCLUSIONS: As assessed by CPET, women with RA-ILD show reduced cardiopulmonary fitness, which can be explained at least in part by the presence of small airway disease, deterioration of pulmonary gas exchange, and advanced age. These associations of pulmonary variables with eCPF may be clinically important and support the use of the eCPF equation to improve patient outcomes.
RESUMO
BACKGROUND: Recent initiatives, such as earlier diagnosis and treatment, have enhanced the survival of patients with systemic sclerosis (SSc). Despite these initiatives, there is extreme variability in rehabilitation strategies for these patients. In 2006, the Glittre-ADL test (TGlittre) was developed to evaluate functional capacity using multiple tasks similar to the activities of daily living (ADLs). OBJECTIVES: To evaluate the impact of therapist-oriented home rehabilitation (TOHR) on functional capacity using TGlittre and to examine the effects of TOHR on physical function, hand function, and quality of life (QoL) among women with SSc. METHODS: This quasi-experimental and longitudinal study included 12 women with SSc who underwent TOHR 3 times per week for 12 weeks. Before and after TOHR, functional capacity was assessed using TGlittre, physical function was examined by the Health Assessment Questionnaire Disability Index (HAQ-DI), hand function was evaluated using the Cochin Hand Functional Scale (CHFS) and handgrip strength (HGS), and QoL was evaluated using the Short Form-36 Health Survey Questionnaire (SF-36). RESULTS: When comparing the pre- and post-TOHR values of TGlittre, a significant reduction was found in total time (p= 0.002) and manual time (p= 0.010). There was a nonsignificant decrease in HAQ-DI scores between pre- and post-TOHR (p= 0.07). Regarding hand function, there was a significant reduction in the CHFS between pre- and post-TOHR (p= 0.036), although no significant difference was observed in HGS between pre- and post-TOHR (p= 0.08). Regarding QoL, there was an increase in all SF-36 categories, although physical function was the only category that was significantly increased (p= 0.008). CONCLUSION: After TOHR, patients with SSc are able to more quickly perform TGlittre tasks when considering both total and manual times. TOHR also positively affects manual skills and QoL.
