Utilização da CIF como um instrumento de avaliação da capacidade funcional de indivíduos com Doença Pulmonar Intersticial

Abstract

Introduction: Functional capacity (FC) and quality of life in patients with chronic diseases are widely evaluated and monitored; such changes caused due to circulatory restriction of pulmonary mechanics and impairment of gas exchange due to the course of interstitial lung disease (IPD). Functional and clinical tests used to evaluate and monitor the aggravation of these limitations in this population; therefore, it does not allow the characterization of the functional profile of these individuals. Objective: Evaluate the functionality based on International Classification of Functioning (ICF) model, thus allowing the characterization and categorization of the functional profile of these individuals. Method: Individuals with lung disease were recruited in this descriptive and exploratory cross-sectional study. Participated in this study 25 patients with ILD according to current guidelines of the American Thoracic Society (ATS) and European Respiratory Society (ERS) and with stable clinical condition for three months. Tests were performed in 3 days of visits, and field tests, spirometry, bioimpedance and ICF qualifiers. Results: Study 1: considering the data obtained from the ISWT, a positive association was observed in pulmonary function (FVC, FEV1) and respiratory muscle strength (MIP and MEP). The same was not observed when considering the data obtained by the 6MWT, which presented a negative association of moderate magnitude (r= -0,52; p= 0,007). Study 2: In relation to SWTI, noticed that there was a statistically significant difference in the score of all SGRQ domains, compared to other level of severity. No problem versus severe problem (DM=2618,33; CI 95%: 396,05/4840,60; p<0,015) and moderate problem versus serious problem (DM=2133,52; CI 95%: 360,76/3906,28; p<0,013), in SGRQ symptom score when compared to moderate problem versus severe problem (DM=930,24; CI 95%: 66,50/1793,99; p<0,03) and SGRQ impact score when compared to any problem versus severe problem (DM=1178,16; CI95%: 102,79/2253,54;P<0,026). There was no statistical difference in the other variables. Conclusion: Study 1: The characterization based on the ICF classification and the use of field tests showed a positive association in ISWT, pulmonary function and respiratory muscle strength. The 6MWT and SGRQ were negatively associated, not being a good marker. Study 2: The ICF qualifiers were useful for categorizing SWTI and 6MWT allowing classifying the functional capacity of individuals with different severity levels.