Impacto isolado e associado das aptidões cardiorrespiratória e neuromuscular nos níveis de atividade física de pacientes com doença arterial periférica: um estudo observacional longitudinal

Abstract

Introduction: Peripheral arterial disease (PAD) is the result of the chronic atherosclerotic process. Patients with DAP perform 36% less physical activity compared to individuals without the disease, thus presenting low cardiorespiratory and neuromuscular fitness. The impact of these low fitness alone is already in the literature, but there are no studies that point out the consequences of these combined components in the level of physical activity. Objective: To verify the impact of low neuromuscular fitness and low cardiorespiratory fitness on the level of physical activity of patients with PAD Method: The project involves two studies, one cross-sectional and the other longitudinal. Both studies, patients used accelerometer for seven days to measure the level of physical activity. Neuromuscular fitness was evaluated through the sit to stand test and cardiorespiratory fitness was assessed by the six-minute walk test. With the data, the patients were categorized into three groups for the cross-sectional study (n=187): low neuromuscular fitness and low cardiorespiratory fitness, two components (2C), low neuromuscular fitness or low cardiorespiratory fitness, one component (1C) and high neuromuscular fitness and high cardiorespiratory fitness, no component (NC). For the longitudinal study (n=53) the groups were separated into high cardiorespiratory and/or neuromuscular fitness (NNC) and low cardiorespiratory and neuromuscular fitness (LNC). In the longitudinal study, the measurements performed in the cross-sectional study were reevaluated after two years and the changes in neuromuscular and cardiorespiratory fitness from baseline to follow-up were calculated. Results: Cross-sectional study: Patients in group 1C and 2C spend less time in low-light, moderate and vigorous physical activity compared to the NC group (low-light physical activity: NC:2026 ± 711 minutes/week vs 1C:1778 ± 583 minutes/week, vs 2C: 1659 ± 600 minutes/week, p=.016; moderate physical activity: NC:2316 ± 840 minutes/week vs. 1C:1972 ± 665 minutes/week, vs. 2C: 1849 ± 747 minutes/week, p=.005; vigorous physical activity: NC:132 ± 125 minutes/week vs. 1C: 68 ± 77 minutes/week, vs 2C: 74 ± 105 minutes/week, p=.<001). Longitudinal study: Both groups maintained the level of physical activity (Sedentary behavior: Year 0: NNC: 2666 ± 1239 minutes/week vs. CNL: 3779 ± 649 minutes/week, Year 2: NNC: 3124 ± 1222 minutes/week vs. LNC: 3512 ± 1920 minutes/week; group p=.009; Light physical activity: Year 0: NNC: 1649 ± 799 minutes/week vs. LNC: 1175 ± 410 minutes/week, Year 2: NNC: 1519 ± 729 minutes/week vs. LNC: 1061 ± 596 minutes/week; group p=.004; Moderate-vigorous physical activity: Year 0: NNC: 107 ± 125 minutes/week vs. LNC: 54 ± 45 minutes/week, Year 2: NNC: 70 ± 100 minutes/week vs. LNC: 3512 ± 1920 minutes/week; group p=.029; Step count: Year 0: NNC: 31984 ± 17524 minutes/week vs. LNC: 23659 ± 10419 minutes/week, Year 2: NNC: 27839 ± 17019 minutes/week vs. LNC: 15909 ± 9425 minutes/week; group p=.004). Conclusion: Low cardiorespiratory and/or neuromuscular fitness are associated with a reduction in the level of physical activity of patients with DAP, however, these conditions are not associated with greater reductions over time