Rates of obesity (OB) are escalating among Canadian children and youth and the obesogenic environment is likely to cause further increases. An important aspect in providing clinical care to OB children is to have accurate assessment measures, particularly of their body composition and cardiorespiratory fitness. This project entails three interrelated projects aiming to develop novel cardiorespiratory fitness and body composition measurement techniques for an OB pediatric population. The purpose of the first project was to validate a new submaximal fitness protocol specifically geared towards OB children and youth. The second objective of this thesis involved assessing cardiorespiratory efficiency utilizing the Oxygen Uptake efficiency slope. The purpose of the third project was to determine the validity of a half-body scan methodology for measuring body composition in obese children and youth. The goal of developing these novel measurement techniques is improved design and evaluation of interventions aimed at managing pediatric obesity.

Title: Comparison of the results of aerobic exercise testing while kayak paddling whith crank ergometry of upper limbs. Aims: The aim of the study was to determine the relationship between the results of aerobic execise diagnostics of 6 elite kayakers (white water slalom) when paddling of flat water with crank ergometry of upper limbs. The results obtained when paddling on flat water were also compared with results obtained when paddling in the pool with counter (bachelor thesis). Based on the results we wanted to answer the question about the possible use specific forms of stress diagnosis (spiroergometry) in routine practice of training proces. Methods: We used standardized laboratory spiroergomtry stress test at crank ergometry of upper limbs and spiroergometry stress test when paddling on flat water of the same protocol. To obtain the functional values of physiological indicators in both test we used mobile spiroergometry equipment Cortex Metamax 3B and sporttester Polar. Feedback of probands were identified based on suervey with closed questions. Results: Testing kayakers reached when paddling on flat water the average functional values: heart rate (HR) 188,5 (±8,77) beats per minute, maximal oxygen uptake (VO2max.) 56 ml.kg.min-1 (±6.31); maximum ventilation (VMAX.) 127.31 l.min-1 (±15.16);...

This diploma thesis takes interest in the issue of physical activities of children with cystic fibrosis, in possible impacts of such activities on clinical condition, in options of prescription of physical activities based on the actual clinical state of a person with cystic fibrosis, and in options of objectification of changes induced by an exercise programme. The theoretic part of this thesis summarizes the current findings about cystic fibrosis, therapy and physical activities in the context of prognosis of patients with cystic fibrosis. In experimental part, we performed examinations on few participants, who were willing to perform a home-based exercise programme. Also, we made a short exploratory questionnaire focused on the attitude of children with cystic fibrosis towards physical exercises. Methodology: We observed the evolution of maximal oxygen uptake VO2max, forced expiratory volume in 1 second (FEV1), forced vital capacity (FVC) and of the scores of 1- minute sit-to-stand test (1-MSTST). All the measurements were performed before and after 12- weeks long exercise intervention. The inclusion criteria were diagnosis of cystic fibrosis, age over 10 years, FEV1 over 60 % predicted and no present signs of an acute exacerbation. Participants were assessed by spirometry examination,...

Exercise testings are widely used to estimate current functional state of athletes and reveal their pros and cons in particular cases. The aim of the proposed research was to evaluate eligibility, validity and informativity of various methods of exercise testing for control of athletes’ physical performance. Thirty qualified athletes aged 14 to 35 years and their level of exercise performance were studied, effective method of functional testing for control of training process was developed. We justified use of exercise testing by means of RAMP-protocol cycle spiroergometry for evaluation of aerobic capacity and exercise performance in elite and amateur athletes. Practical outcome is development of effective protocols of exercise testing for adequate and reproductible estimation of aerobic capacity and exercise performance of athletes of all qualification level and specialization. / Проведение проб с дозированной физической нагрузкой позволяет объективно оценивать текущее функциональное состояние организма, выявлять недостатки и преимущества атлетов в отдельных конкретных случаях. Цель – оценить целесообразность, валидность и информативность различных методов нагрузочного тестирования для контроля физической подготовленности спортсменов. В результате исследования были изучены методики нагрузочного тестирования 30 квалифицированных спортсменов от 14 до 35 лет, оценен уровень общей физической работоспособности, разработана эффективная методика функционального тестирования для управления тренировочным процессом. Научная новизна исследования состоит в обосновании использования нагрузочного тестирования методом велоэргоспирометрии по протоколу с непрерывно возрастающей нагрузкой для оценки аэробной производительности и функциональной готовности как элитных спортсменов, так и спортсменов-любителей. Практическая значимость работы заключается в разработке эффективных протоколов нагрузочного тестирования для адекватной и воспроизводимой оценки аэробной производительности и функциональной готовности спортсменов всех уровней квалификации и специализации.

L’insuffisance cardiaque est une pathologie provoquant une diminution importante des capacités fonctionnelles des patients ainsi qu’une diminution drastique de la qualité de vie. L’évaluation des capacités fonctionnelles est généralement effectuée par une épreuve d’effort maximal. Cependant pour plusieurs patients, cet effort est difficile à compléter. Les objectifs de l’étude présentée dans ce mémoire sont : (1) valider trois méthodes d’évaluation de la capacité fonctionnelle et aérobie des sujets souffrant d’insuffisance cardiaque avec un complexe QRS élargi; (2) chercher à établir le profil des patients démontrant une meilleure tolérance à l’exercice malgré une consommation maximale d’oxygène identique; et (3) démontrer les conséquences de la présence et de la magnitude de l’asynchronisme cardiaque dans la capacité fonctionnelle et la tolérance à l’exercice. Tous les sujets ont été soumis à un test de marche de six minutes, un test d’endurance à charge constante sur tapis roulant et à une épreuve d’effort maximal avec mesure d’échanges gazeux à la bouche. Les résultats ont montré une association significative entre les épreuves maximale et plus spécifiquement sous-maximale. De plus, une meilleure tolérance à l’exercice serait associée significativement à une plus grande masse du ventricule gauche. Finalement, les résultats de notre étude n’ont pas montré d’effet d’un asynchronisme cardiaque sur la performance à l’effort tel qu’évalué par nos protocoles. / Heart failure is a pathology that significantly decreases functional capacity and life quality. Maximal cardiopulmonary exercise testing is usually used to evaluate the functional capacity. However, the intensity of this test is very high and difficult to complete for some patients. The objectives of the study presented in this master are: (1) to validate three different protocols that evaluate functional and aerobic capacity for patients with congestive heart failure and presenting a large QRS complex; (2) to establish the characteristics of the patients that demonstrate a better exercise tolerance despite an identical aerobic capacity; (3) to identify the consequences of the presence and the magnitude of cardiac asynchrony on the exercise tolerance and the functional capacity. All patients underwent a six minute walk test, an endurance exercise test on treadmill and also a maximal cardiopulmonary test. The results show a significant association between all tests, more importantly between submaximal tests. Also, patients with better exercise tolerance demonstrate a left ventricular mass increased compared to low exercise tolerance patients. Finally, there is no significant effect of cardiac asynchrony on exercise tolerance examined by our protocols.

Made available in DSpace on 2014-07-29T15:25:16Z (GMT). No. of bitstreams: 1 Tese Ana Paula Perillo Ferreira Carvalho.pdf: 2730785 bytes, checksum: 1f68b9df4f7070c902674ee992b24c24 (MD5) Previous issue date: 2011-07-04 / Introduction: Heart failure is a progressive clinical syndrome in patients that generally, present alterations in their nutritional condition and loss in the functional capacity. objectives: Evaluating the effects of creatine supplementation on functional capacity and body composition of patients with heart failure. Methodology: Prospective, randomized, double-blind study performed at the Hospital das Clínicas of Federal University of Goiás, with 33 patients over 18 years old with heart failure. The selected patients were randomized in experimental group (CRE, n=17), supplemented with creatine monohydrate and placebo group (PLA, n=16), which received maltodextrin. For both groups, the instruction about taking the supplement or the placebo were 5 g dialy during the period of six months. The patients were submitted to evaluation of functional capacity by ergospirometry and the walking test per six minutes (6-MWT), anthropometry and the food consumption, before starting suplementation and at end of sixth month.The statistical model ANCOVA was used to analyze groups and treatment forms. Results: From the variables evaluated in the ergospirometry, the volume of the peak oxygen uptake (peak VO2 ), anaerobic threshold (AT), and the oxygen pulse (O2P) did not show significant differences between the groups (p>0,05). There was no significant difference in the distance travelled concerned to 6-MWT. The volunteers in the CRE groups presented average values of muscle circumference of the arm statistically superior from the PLA group (p=0,0413). The total of the body mass, lean body mass and the fat percentage did not present significant differences between groups. As for the total caloric value and macronutrients of the diet only medium amounts of lipids in the CRE group presented statistically lower (p=0.0120) than the PLA group. Conclusion: The creatine in patients with heart failure did not cause significant improvement in the functional capacity, in spite of the skeletal muscle enhancement in the CRE group, according to (MCA). / Introdução: A insuficiência cardíaca (IC) é uma síndrome clínica progressiva na qual os pacientes, em geral, apresentam alterações no seu estado nutricional e perda da capacidade funcional. Objetivo: Avaliar os efeitos da suplementação de creatina na capacidade funcional e composição corporal de pacientes com insuficiência cardíaca. Metodologia: estudo prospectivo, randomizado, duplo cego, realizado no Hospital das Clínicas da Universidade Federal de Goiás, com 33 pacientes maiores de 18 anos com insuficiência cardíaca. Os pacientes selecionados foram randomizados em grupo experimental (CRE, n =17), suplementado com creatina monoidratada e grupo placebo (PLA, n =16), que recebeu maltodextrina. Para ambos os grupos a instrução sobre a ingestão do suplemento ou do placebo foi de 5 g diárias durante o período de seis meses. Os pacientes foram submetidos à avaliação da capacidade funcional pela ergoespirometria e por teste de caminhada de seis minutos (TC6), antropometria e de consumo alimentar, antes de iniciarem a suplementação e ao final do sexto mês. O modelo estatístico Ancova foi utilizado na análise dos grupos e nas formas de tratamento. Resultados: Das variáveis avaliadas na ergoespirometria, o volume de oxigênio pico (VO2 pico), o limiar anaeróbico (LA) e o pulso de oxigênio (PO2) não apresentaram diferenças significativas entre os grupos (p>0,05). No TC6 não houve diferença significativa na distância percorrida. Os voluntários do grupo CRE apresentaram valores médios de circunferência muscular do braço (CMB) estatisticamente superiores aos do grupo PLA (p= 0,0413). A massa corporal total, a massa corporal magra e percentual de gordura não apresentaram diferenças significativas entre os grupos. Quanto ao valor calórico total e aos macronutrientes da dieta, apenas a quantidade média de lipídios no grupo CRE apresentou-se estatisticamente inferior (p = 0,0120) ao grupo PLA. Conclusão: A creatina em pacientes com insuficiência cardíaca não promoveu melhora significativa na capacidade funcional, apesar de ter ocorrido aumento da massa muscular esquelética no grupo CRE de acordo com a CMB.

L’insuffisance cardiaque est une pathologie provoquant une diminution importante des capacités fonctionnelles des patients ainsi qu’une diminution drastique de la qualité de vie. L’évaluation des capacités fonctionnelles est généralement effectuée par une épreuve d’effort maximal. Cependant pour plusieurs patients, cet effort est difficile à compléter. Les objectifs de l’étude présentée dans ce mémoire sont : (1) valider trois méthodes d’évaluation de la capacité fonctionnelle et aérobie des sujets souffrant d’insuffisance cardiaque avec un complexe QRS élargi; (2) chercher à établir le profil des patients démontrant une meilleure tolérance à l’exercice malgré une consommation maximale d’oxygène identique; et (3) démontrer les conséquences de la présence et de la magnitude de l’asynchronisme cardiaque dans la capacité fonctionnelle et la tolérance à l’exercice. Tous les sujets ont été soumis à un test de marche de six minutes, un test d’endurance à charge constante sur tapis roulant et à une épreuve d’effort maximal avec mesure d’échanges gazeux à la bouche. Les résultats ont montré une association significative entre les épreuves maximale et plus spécifiquement sous-maximale. De plus, une meilleure tolérance à l’exercice serait associée significativement à une plus grande masse du ventricule gauche. Finalement, les résultats de notre étude n’ont pas montré d’effet d’un asynchronisme cardiaque sur la performance à l’effort tel qu’évalué par nos protocoles. / Heart failure is a pathology that significantly decreases functional capacity and life quality. Maximal cardiopulmonary exercise testing is usually used to evaluate the functional capacity. However, the intensity of this test is very high and difficult to complete for some patients. The objectives of the study presented in this master are: (1) to validate three different protocols that evaluate functional and aerobic capacity for patients with congestive heart failure and presenting a large QRS complex; (2) to establish the characteristics of the patients that demonstrate a better exercise tolerance despite an identical aerobic capacity; (3) to identify the consequences of the presence and the magnitude of cardiac asynchrony on the exercise tolerance and the functional capacity. All patients underwent a six minute walk test, an endurance exercise test on treadmill and also a maximal cardiopulmonary test. The results show a significant association between all tests, more importantly between submaximal tests. Also, patients with better exercise tolerance demonstrate a left ventricular mass increased compared to low exercise tolerance patients. Finally, there is no significant effect of cardiac asynchrony on exercise tolerance examined by our protocols.

Made available in DSpace on 2016-06-02T20:18:24Z (GMT). No. of bitstreams: 1 6321.pdf: 1608143 bytes, checksum: 79020037f93ef260d48c286f33c9f952 (MD5) Previous issue date: 2014-08-29 / Universidade Federal de Minas Gerais / Asthma is a chronic disease, with periods of exacerbation and worsening of airflow obstruction and may be triggered by various stimuli, including exercise, and is associated with dysfunction of the autonomic nervous system (ANS). In this context, two studies were conducted to assess adjustments of ANS in asthmatic volunteers in different situations. The first study was entitled: Increased sympathetic modulation and decreased response of the heart rate variability response in controlled asthma , was designed to evaluate the adjustments of indices of autonomic modulation of heart rate (HR) at rest in supine and seated positions and during the respiratory sinus arrhythmia maneuver (M-RSA). The assessment of 12 asthmatic volunteers included pulmonary function tests and measures of heart rate variability (HRV). The results suggest that in asthma appears to be an association of airflow obstruction with reduced total variability, and in addition, to postural change seems to be reduced adjustment of the sympathetic nervous system in asthmatic women. The second study entitled: Airway responsiveness at exercise recovery and adjustments of heart rate variability at rest and exercise in controlled asthma , evaluated the adjustments of cardiac autonomic modulation during exercise its association with the exercise induced bronchoconstriction. Sixteen asthmatics volunteers underwent constant speed exercise test, forced vital capacity maneuver before and after exercise testing and register of HR and R-R intervals. With this second study, it can conclude that in asthmatics, even with controlled disease, injury presents postural and autonomic adjustments during the year and reduced complexity of dynamical systems of HRV during exercise. / A asma é uma doença crônica, com períodos de exacerbação e piora da obstrução ao fluxo aéreo, podendo ser desencadeada por vários estímulos, incluindo o exercício, e está associada a disfunções do sistema nervoso autonômico (SNA). Nesse contexto, foram realizados dois estudos para avaliação dos ajustes do SNA em voluntários asmáticos, em diferentes situações. O primeiro estudo intitulado: Elevada modulação simpática e atenuada resposta da variabilidade da frequência cardíaca na asma controlada , teve como objetivo avaliar os ajustes dos índices de modulação autonômica da frequência cardíaca (FC) em repouso, na manobra de mudança postural e durante a manobra de acentuação da arritmia sinusal respiratória. A avaliação de 12 voluntárias asmáticas, incluiu prova de função pulmonar e medidas da variabilidade da frequência cardíaca (VFC) nas diferentes posições e durante a manobra de acentuação da arritmia sinusal respiratória. Os resultados sugerem que na asma parece haver associação da obstrução ao fluxo aéreo com reduzida variabilidade total, e além disso, frente à mudança postural parece haver reduzido ajuste do sistema nervoso simpático em mulheres asmáticas. Diante destes resultados, objetivamos avaliar a VFC também durante o exercício em voluntários asmáticos. Sendo assim, o segundo estudo intitulado: Responsividade das vias aéreas na recuperação do exercício e os ajustes da variabilidade da frequência cardíaca em repouso e durante o exercício em asmáticos controlados , avaliou os ajustes da modulação autonômica cardíaca durante o exercício e sua associação com a presença de broncoconstrição induzia pelo exercício (BIE). Dezesseis voluntários com asma foram submetidos a um teste de exercício de carga constante em esteira, manobras de capacidade vital forçada antes e após o teste de exercício e registro da FC e dos intervalos R-R. Com este segundo estudo, pode-se concluir que em asmáticos, mesmo com a doença controlada, há prejuízo nos ajustes autonômicos posturais e durante o exercício, bem como reduzida complexidade dos sistemas dinâmicos de VFC durante o exercício.

Made available in DSpace on 2016-06-02T20:18:24Z (GMT). No. of bitstreams: 1 6556.pdf: 2232464 bytes, checksum: d84f3d538456b42ad0ec52f81c1f7771 (MD5) Previous issue date: 2015-02-11 / Financiadora de Estudos e Projetos / This thesis consisted of two studies described below. The Study 1 aimed to investigate if expiratory flow limitation (EFL) present at moderate intensity exercise in subjects following myocardial infarction (MI) (as shown in a previous study conducted in our laboratory) already manifests in those with stable coronary artery disease (CAD). Forty-one men aged 40-65 years were allocated into four different groups: 1) stable coronary artery disease (SCADG) (n=9), 2) recent myocardial infarction (RMIG) (n=8), 3) late myocardial infarction group (LMIG) (n=12), and 4) health control group (CG) (n=12). Two cardiopulmonary exercise testing (CPX) at constant workload (moderate and high intensity) were applied and EFL was evaluated by exercise flow-volume loops. We observed that during moderate intensity exercise the RMIG and LMIG presented with a significantly higher number of subjects with EFL compared to the CG, while no significant difference was observed among groups at high intensity exercise. Regarding the degree of expiratory flow limitation, the RMIG and LMIG showed significantly higher values at moderate intensity exercise when compared to the CG. At high intensity exercise, significantly higher values for the degree of expiratory flow limitation were observed only in the LMIG compared to the CG. We concluded that an EFL was only present in MI groups (recent and late) during moderate intensity exercise; whereas at high intensity exercise all groups presented EFL. Thus, EFL observed at moderate intensity exercise in both MI groups may be linked to the consequences of event and not to CAD. Following, the Study II aimed to investigate the indexes of circulatory (CP) and ventilatory power (VP) in CAD patients. Eighty-seven men were studied aged 40-65 years, being 42 subjects in the CAD group and 45 in the CG. CPX was performed on a treadmill and the following measures were obtained: 1) peak oxygen consumption (VO2), 2) peak heart rate (HR), 3) peak blood pressure (BP), 4) peak rate-pressure product (peak systolic BP x peak HR), 5) peak oxygen pulse = (peak VO2/peak HR), 6) the oxygen uptake efficiency (OUES), 7) the carbon dioxide production efficiency (VE/VCO2 slope), 8) CP (peak VO2 x peak systolic BP) and 9) VP (peak systolic BP/VE/VCO2 slope). The CAD group had significantly lower values for peak VO2, peak HR, peak systolic BP, peak rate-pressure product, peak oxygen pulse, the OUES, CP and VP and significantly higher values for peak diastolic BP and the VE/VCO2 slope compared to the CG. Furthermore, a stepwise regression analysis showed that CP was influenced by the group and VP was influenced both by group and by number of vessels with stenosis after treatment. Given the findings, we concluded that the indices of CP and VP were lower in men with CAD compared to CG. Thus, both studies brought important findings related to the responses of the cardiovascular, pulmonary and musculoskeletal systems of patients with CAD during physical exercise, bringing many contributions to clinical practice and assisting in the prescription of exercise training. / Esta tese constou de 2 estudos descritos a seguir. O Estudo I teve como objetivo verificar se a limitação ao fluxo expiratório (LFE) presente na moderada intensidade do exercício em sujeitos com infarto do miocárdio (IM) (conforme mostrado em estudo prévio realizado em nosso laboratório) já está presente naqueles com doença arterial coronariana (DAC) estável. Quarenta e um homens com idade entre 40 e 65 anos foram alocados em quatro diferentes grupos: 1) DAC estável (GDAC) (n=9), 2) IM recente (GIMR) (n=8), 3) IM tardio (GIMT) (n=12) e, 4) grupo controle saudável (GC) (n=12). Dois testes de exercício cardiopulmonar (TECP) em carga constante (moderada e alta intensidade) foram aplicados e a LFE foi avaliada por meio da alça fluxo-volume corrente durante o exercício. Nós observamos que durante a moderada intensidade do exercício somente os GIMR e GIMT apresentaram número significativamente maior de sujeitos com LFE comparados ao GC, enquanto nenhuma diferença significativa foi observada entre os grupos na alta intensidade do exercício. Em relação ao grau de LFE, tanto o GIMR como o GIMT apresentaram significativamente maiores valores de LFE na moderada intensidade do exercício comparado ao GC, e na alta intensidade do exercício foi observado maior grau de LFE somente para o GIMT em relação ao GC. Concluímos que a LFE esteve presente somente nos grupos com IM (recente e tardio) durante a moderada intensidade do exercício; já na alta intensidade do exercício todos os grupos apresentaram LFE. Diante do exposto, a LFE observada na moderada intensidade do exercício em ambos os grupos com IM pode estar relacionada às consequências do evento e não à DAC. Na sequência, o Estudo II objetivou investigar os índices da potência circulatória (PC) e ventilatória (PV) em pacientes com DAC comparados a indivíduos saudáveis. Para isso foram estudados oitenta e sete homens com idade entre 45 a 65 anos, sendo 42 sujeitos no grupo DAC e 45 no GC. Um TECP foi realizado em esteira e as seguintes variáveis foram obtidas: 1) consumo de oxigênio (VO2) pico, 2) frequência cardíaca (FC) pico, pressão arterial (PA) pico, duplo produto pico (PA sistólica pico x FC pico), 5) pulso de oxigênio pico (VO2 pico dividido pela FC pico), 6) eficiência ventilatória para o consumo de oxigênio (OUES), 7) eficiência ventilatória para a produção de dióxido de carbono (VE/VCO2 slope), 8) PC (VO2 pico x PA sistólica pico) e 9) PV (PA sistólica pico dividido pelo VE/VCO2 slope). O grupo DAC apresentou significativamente menores valores no pico do exercício de VO2, FC, PA sistólica, duplo produto, pulso de oxigênio, OUES, PC e PV e, significativamente maiores valores de PA diastólica e VE/VCO2 slope em relação ao GC. Além disso, uma análise de regressão pelo método stepwise mostrou que a PC foi influenciada pelo grupo e a PV tanto pelo grupo quanto pelo número de vasos com estenose pós tratamento. Diante dos achados, nós concluímos que os índices da PC e PV foram menores em homens com DAC comparados ao GC. Desta forma, ambos os estudos trouxeram importantes achados relacionados às respostas dos sistemas cardiovascular, pulmonar e musculoesquelético de pacientes com DAC durante o exercício físico, trazendo contribuições para a prática clínica e auxiliando na prescrição do treinamento físico.

Made available in DSpace on 2016-06-02T20:19:26Z (GMT). No. of bitstreams: 1 6645.pdf: 2027088 bytes, checksum: 18fe5648e0835cf1cfcbef303f079520 (MD5) Previous issue date: 2015-02-27 / Universidade Federal de Sao Carlos / In chronic obstructive pulmonary disease (COPD), functional and structural impairment of lung function can negatively impact heart rate variability (HRV); in addition, a reduced exercise capacity is an important independent prognostic marker in COPD patients. However, 1) if the degree of lung impairment negatively impacts HRV responses and 2) whether the injury of the autonomic control may be associated with reduced exercise capacity in patients with COPD remain unclear. Thus, two studies were conducted in order to verify if functional status at rest and during exercise would be related to autonomic impairment in COPD patients. In the first study, entitled "Relationship between linear and nonlinear dynamics of heart rate and impairment of lung function in COPD patients," we investigated whether the impairment static lung volumes and lung diffusion capacity (DL) would be related to HRV indices in moderate-to-severe COPD. Sixteen patients with COPD underwent pulmonary function tests (spirometry, plethysmography and lung diffusion capacity for carbon monoxide - DLCO). The RR interval was registered in the supine, standing and seated positions and during a respiratory sinus arrhythmia maneuver (M-RSA). Our results suggest that responses of HRV indices were more prominent during M-RSA in moderate-to-severe COPD. Moreover, greater lung function impairment was related to poorer heart rate dynamics. Finally, impaired DLCO is related to an altered parasympathetic response in these patients. The second study, entitled "Are linear and nonlinear heart rate dynamics in submaximal exercise related to cardiorespiratory responses during maximal exercise in patients with COPD?", we inquired whether there is a relationship between HRV responses and exercise capacity in patients with COPD. Fifteen patients underwent incremental cardiopulmonary exercise testing and six-minute walk test (6MWT). The RR interval was registered at rest (standing position) and during 6MWT. Our results showed that HRV responses at rest and during simple field tests may reflect functional impairment of COPD patients, providing important information about both ventilatory and hemodynamic inefficiency in these patients. / Em pacientes com doença pulmonar obstrutiva crônica (DPOC), as alterações funcionais e estruturais do pulmão podem impactar negativamente na variabilidade da frequência cardíaca (VFC). Além disso, a reduzida capacidade de exercício se traduz como um marcador prognóstico nesses pacientes. No entanto, ainda não estão esclarecidos 1) se o grau de comprometimento pulmonar tem impacto negativo sobre as respostas da VFC, frente a diferentes estímulos autonômicos, e 2) se o prejuízo no controle autonômico pode estar relacionado à reduzida capacidade de exercício nos pacientes com DPOC. Sendo assim, dois estudos foram realizados com o intuito de relacionar as alterações funcionais, no repouso e no exercício, com o grau de prejuízo autonômico em pacientes com DPOC. O primeiro estudo, cujo título é Correlação entre as dinâmicas linear e não linear da frequência cardíaca e o comprometimento da função pulmonar em pacientes com DPOC , teve como objetivo investigar se o comprometimento nos volumes pulmonares estáticos e na difusão pulmonar estaria relacionado aos índices da VFC em repouso e em resposta às mudanças posturais. Dezesseis pacientes com diagnóstico de DPOC foram submetidos à prova de função pulmonar (espirometria, pletismografia e capacidade de difusão pulmonar ao monóxido de carbono DCO) e à coleta da VFC nas posturas supino, ortostatismo e sentado e durante a manobra de arritmia sinusal respiratória (M-ASR). Nossos resultados sugerem que as respostas da VFC frente a um estímulo vagal (M-ASR) são mais evidentes. Ainda, quanto maior o comprometimento da função pulmonar pior a dinâmica da frequência cardíaca. Por fim, a redução da DCO está relacionada à alterada resposta vagal nos pacientes com DPOC. O segundo estudo, intitulado Os índices da dinâmica linear e não linear na frequência cardíaca no exercício submáximo estão relacionados com as respostas cardiorrespiratórias ao exercício máximo em pacientes com DPOC? teve por objetivo avaliar se existe relação entre as respostas da VFC e a capacidade de exercício em pacientes com DPOC. Quinze pacientes foram submetidos aos testes de exercício cardiopulmonar incremental e de caminhada de seis minutos (TC6). A coleta da VFC feita em repouso (ortostatismo) e durante o TC6. Os resultados mostraram que as respostas da VFC no repouso e em testes simples de campo podem inferir o prejuízo funcional de pacientes com DPOC, fornecendo informações importantes acerca das limitações ventilatória e hemodinâmica destes pacientes.