Avalia??o das vari?veis cardiovasculares, capacidade de caminhar e n?vel de atividade f?sica de obesos m?rbidos antes e depois da cirurgia bari?trica
Autor: | Lopes, Thiago Jambo Alves |
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Jazyk: | portugalština |
Rok vydání: | 2011 |
Předmět: | |
Zdroj: | Repositório Institucional da UFRNUniversidade Federal do Rio Grande do NorteUFRN. |
Druh dokumentu: | masterThesis |
Popis: | Made available in DSpace on 2014-12-17T15:16:09Z (GMT). No. of bitstreams: 1 ThiagoJAL_DISSERT.pdf: 946704 bytes, checksum: e827cc09ae18a75d76980a58fe6e619b (MD5) Previous issue date: 2010-06-25 Morbidly obese patients present an increase in heart rate, blood pressure and perceived exertion besides lower walking ability compared to normal weight people. However, little is known about how these variables are presented after bariatric surgery. Moreover, despite the distance walked during the six-minute walk (6MWT) improve after surgery is not well established if the level of physical activity influences this improvement. Objective: To evaluate cardiovascular performance, perceived effort, ability of walking and physical activity level of patients with morbid obesity before and after bariatric surgery. Methods: The cardiovascular performance, perception of effort, the ability to walk and level of physical activity were assessed in 22 patients before (BMI = 50.4 kg/m2) and after (BMI = 34.8 kg/m2) bariatric surgery through the 6MWT. The heart rate, blood pressure and perceived exertion were assessed at rest, at the end of the 6MWT and in the second minute post-test (HR recovery). The ability to walk was measured by total distance walked at the end of the test while the level of physical activity was estimated by applying the Baecke questionnaire, analyzing domains occupation, leisure and locomotion and leisure and physical activity. Results: The HR at rest and recovery decreased significantly (91.2 ? 15.8 bpm vs. 71.9 ? 9.8 bpm, 99.5 ? 15.3 bpm vs 82.5 ? 11.1 bpm, respectively), as well as all the arterial pressure and perceived exertion after surgery. The distance achieved by the patients increased by 58.4 m (p = 0.001) postoperatively. Time postoperatively had correlation with the percentage of excess weight lost (r = 0.48, p = 0.02), BMI (r =- 0.68, p = 0.001) and the Baecke (r = 0.52, p = 0.01) which did not happen with the distance walked (r = 0.37, p = 0.09). Despite weight loss, patients showed no difference in the level of physical activity in any of the areas before and after surgery. Conclusion: The cardiovascular performance, the perception of effort and ability to walk seem to improve after bariatric surgery. However, despite improvement in the ability to walk by the distance achieved in the 6MWT after weight loss, this is not reflected in an increase in physical activity level of obese patients after surgery Obesos m?rbidos apresentam aumento da freq??ncia card?aca, da press?o arterial e da percep??o do esfor?o al?m de baixa capacidade de caminhar em rela??o a pessoas eutr?ficas. No entanto, pouco se sabe como essas vari?veis se apresentam ap?s a realiza??o da cirurgia bari?trica. Al?m disso, apesar da dist?ncia percorrida no teste de caminhada de seis minutos (TC6M) melhorar ap?s a cirurgia, ainda n?o est? bem estabelecido como o n?vel de atividade f?sica influencia nesta melhora. Objetivo: Avaliar o desempenho cardiovascular, a percep??o do esfor?o, a capacidade de caminhar e o n?vel de atividade f?sica de pacientes portadores de obesidade m?rbida antes e depois da cirurgia bari?trica. M?todos: O desempenho cardiovascular, a percep??o do esfor?o, a capacidade de caminhar e o n?vel de atividade f?sica foram avaliados em 22 pacientes antes (IMC=50,4kg/m2) e ap?s (IMC=34,8kg/m2) a cirurgia bari?trica atrav?s do TC6M. A FC, a press?o arterial e a percep??o do esfor?o foram avaliados no repouso, ao final do TC6M e no segundo minuto p?s-teste (FC recupera??o). J? a capacidade de caminhar foi aferida atrav?s da dist?ncia total caminhada ao final do TC6M enquanto o n?vel de atividade f?sica foi estimado pela aplica??o do Question?rio de Baecke, analisando os dom?nios ocupa??o, lazer e locomo??o e lazer e atividade f?sica. Resultados: A FC de repouso e recupera??o diminu?ram significativamente (91,2?15,8 bpm vs 71,9?9,8 bpm; 99,5?15,3 bpm vs 82,5?11,1 bpm, respectivamente), assim como todos os valores de press?o arterial e percep??o de esfor?o ap?s a cirurgia. J? a dist?ncia atingida pelos pacientes aumentou em 58,4 m (p=0,001) no p?soperat?rio. O tempo de p?s-operat?rio obteve correla??o com o percentual de excesso de peso perdido (r=0,48;p=0,02), com o IMC (r=-0,68;p=0,001) e com o Baecke (r=0,52;p=0,01), no entanto n?o teve rela??o com a dist?ncia caminhada (r=0,37;p=0,09). Outrossim, a despeito da perda ponderal, os pacientes n?o apresentaram diferen?a no n?vel de atividade f?sica em nenhum dos dom?nios antes e depois da cirurgia. Conclus?o: O desempenho cardiovascular, a percep??o do esfor?o e a capacidade de caminhar parecem melhorar ap?s a realiza??o da cirurgia bari?trica. No entanto, apesar da xii melhora na capacidade de caminhar pela dist?ncia alcan?ada no TC6M ap?s a perda de peso, isso n?o repercutiu em aumento no n?vel de atividade f?sica dos obesos depois da cirurgia |
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