Classificação da gravidade do comprometimento funcional com base nos qualificadores da CIF: uma nova proposta para avaliar indivíduos com hipertensão pulmonar

Abstract

Introduction: Pulmonary Hypertension (PH) is a chronic condition characterized by progressive functional limitations. Assessing functional capacity is essential for the clinical management of these individuals, with the Six-Minute Walk Test (6MWT) being widely used to evaluate functional capacity and monitor disease severity and progression in this population. Objective: To assess functional capacity using the 6MWT to classify patients based on the International Classification of Functioning, Disability, and Health (ICF), rather than solely on disease symptoms, proposing an approach that considers the functional and social impact of PH. Methods: This observational study included 33 individuals diagnosed with PH. Demographic data, pulmonary function, and 6MWT results were collected. Participants were categorized according to functional impairment levels defined by the ICF and the World Health Organization Functional Class (WHO-FC). Statistical analysis included ANOVA and correlation tests to explore associations between the studied variables. Results: Most participants presented moderate functional impairment, with a mean 6MWT distance of 431.5 ± 110 meters, corresponding to 68% of the predicted value. A significant correlation was observed between the 6MWT distance and functional impairment levels defined by the ICF: 39% had mild impairment, 42% moderate, and 18% severe. However, no significant association was found between ICF qualifiers and WHO Functional Class, suggesting that other factors, such as diagnosis duration and comorbidities, may independently influence functional capacity. Conclusion: The results demonstrated that ICF qualifiers are effective in evaluating the functional capacity of PH patients using the 6MWT. Patients with greater disease severity showed poorer performance, and integrating the ICF allowed for a comprehensive analysis, including physical, functional, and social limitations. This approach supports tailored therapeutic interventions and complements the WHO Functional Class.