New approaches to evaluate patients with chronic obstructive respiratory diseases

Abstract

A pulmonary rehabilitation program (PR) is defined from a proper assessment which should include at least a functional assessment. However, there is no consensus on which clinical trial evaluates properly the physical capacity of asthmatic patients. For patients with COPD, PR is much more established but it is well known that they have worse balance when compared to individuals without the disease and the maintenance of physical activity is essential for do not worsen their clinical condition. However, the predictive factors to balance disorders in COPD and to maintain their level of physical activity are poorly understood. To answer these questions, this research project includes three sub-projects. Objectives: Project I: To evaluate the effect of exercise performance, cardiovascular, respiratory and metabolic responses of normal weight and obese asthmatics in the step test; Project II: Determine which predictive factors are associated with balance disorders in patients with COPD; Project III: To evaluate the association of psychosocial factors with the level of physical activity in individuals with COPD. Methods: Project I: will be evaluated 60 adults with asthma, normal weight and obese grade II, with moderate and severe persistent asthma. All of them will be submitted to a cardiopulmonary stress test, step test and evaluation of the level of physical activity (accelerometry). The Dunnett's test will be used for multiple comparisons. The limits of agreement and accuracy for peakVO2 and the step test will be analyzed by Bland & Altman. Project II: 70 patients with COPD of both genders will be evaluated with moderate to severe disease. All them will be evaluated for postural balance (mini bestest and force platform), quadriceps muscle strength (dynamometer), level of physical activity (accelerometry), complete lung function, dyspnea (Research council scale medical modified, mMRC), quality of life (Questionnaire chronic respiratory disease, CRQ), impact of symptoms of the disease (COPD assessment test, CAT), fear of falling (Falls efficacy scale-international) and incidence of falls will be followed for 1 year. Multiple analysis models will be used to determine the predictive factors. Project III: 150 COPD of both gender will be evaluated. All them will be evaluated for the level of education, family income, current employment status, self-efficacy (General self-efficacy scale, GSE), social support (Medical outcomes study social support survey, MOS-SSS), perception of the disease (Illness perception questionnaire, IPQ-R), health factors related to quality of life (Chronic respiratory questionnaire, CRQ), level of physical activity (accelerometry). Multiple analysis models will be used to determine the predictors of physical activity. (AU)