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Sammanfattning Bakgrund: KOL är en obstruktiv lungsjukdom med luftflödesbegränsningar pga.  kronisk bronkit och emfysem. De patofysiologiska mekanismer är en progressiv inflammatorisk process som påverkar hela kroppen. De viktigaste behandlingsstrategierna är rökstopp, farmakologisk behandling samt fysisk träning.  Personer med KOL har ofta en nedsatt fysisk funktionsnivå, som inte behöver vara kopplad till sjukdomens svårighetsgrad.  De viktigaste fysioterapeutiska interventionerna för KOL är mätning av fysisk kapacitet, aerob- och muskelstärkande träning, tekniker för sekretmobilisering via motståndsandning samt undervisning i energibesparande arbetssätt. Interventionerna leder till förbättrad funktionsnivå, bromsar upp sjukdomen, minskar risken för samsjuklighet med andra icke smittsamma sjukdomar (NCD), minskar risken för execerbationer, förbättrad livskvalitet, samt minskar risken att dö för tidigt (6MWT >350 m).     God bålkontroll är central för en effektiv biomekanisk funktion i syfte att maximera kraft och minimera skaderisker. En bra bålkontroll har hos friska personer visats ha en positiv effekt på diafragmas funktion, samt att bålkontrollen påverkas av andningen vilket blir extra tydligt vid fysiskt ansträngande arbete.     Sambandet mellan bålkontroll, syrgasmättnad, fysisk funktion och självskattade symtom hos personer med KOL har enligt författarens kännedom inte studerats tidigare. Syfte: Studien syftar till att undersöka om fysisk aktivitet, med fokus på förbättrad bålstabilitet och sluten läppandning, kan förbättra syrgasmättnad, fysisk kapacitet, benmuskelstyrka, balans och självskattade symtom hos personer med KOL, stadium 2. Metod: Single subject experimental design (SSED) med AB design (baslinje undersökning – intervention) användes. Primärt utfallsmått var saturation och gångsträcka mätt med 6MWT. Sekundära utfallsmått var enbensstående balans, CS-30 samt CAT. Data på kvotskalenivå analyserades visuellt med stöd av 2-SD-bands analys och celerationslinje analys. Förändringar i CAT före och efter interventionen redovisas i procent. Resultat: Fyra personer inkluderades i studien. Resultatet visar en möjlig interventionseffekt avseende gångsträcka vid 6MWT och enbensstående balans för två av deltagarna, som vid studiestart låg under eller tangerade förväntade normalvärden i samtliga parametrar. En av dessa stabiliserades avseende lägsta värde på saturation vid 6MWT. Det fanns en effekt/möjlig effekt på förbättrad benstyrka (CS-30) för de deltagare som vid studiestart låg över förväntade normalvärden i samtliga parametrar. Självskattade lungsymtom (CAT) förbättrades hos tre av deltagarna (31–55 procent) och försämrades hon en av deltagarna (-17 procent). Konklusion: Studien visar en möjlig positiv effekt av bålstabiliserande träning på gångsträcka (6MWT), enbensstående balans, antalet uppresningar vid CS-30 samt självupplevda lungsymptom (CAT) för personer med KOL, stadium 2. Fler studier behövs för att stärka validiteten av dessa fynd. / Abstract Background: COPD is an obstructive pulmonary disease with air flow constraints due to chronic bronchitis and emphysema. The pathophysiological mechanisms are a progressive inflammatory process that affects the entire body. The main treatment strategies are smoking cessation, pharmacological treatment and physical exercise. People with COPD often have a reduced physical function level, which not need to be linked to the severity of the disease. The most important physiotherapeutic interventions for COPD are measurement of physical capacity, aerobic and muscle strength training, techniques for mobilization of sputum through resistance breathing techniques and teaching in energy-saving work methods. The interventions lead to improved functional levels, slow down the disease, reduce the risk of comorbidity with other non-communicable diseases (NCD), reduce the risk of exacerbation, improve quality of life, and reduce the risk to die prematurely (6MWT> 350m).     A well-functioning core stability is considered central to an effective biomechanical function to maximize strength and minimize risks of injury and has been shown by healthy individuals to have a positive effect on diaphragm function. It has also been shown that the ability to core-control is affected by deep breathing and especially during hard physical work.    A correlation between oxygen saturation, physical function, self-estimated symptoms and core stability in people with COPD, has to the knowledge of the author not been studied earlier.     Aim: The aim of the study was to investigate whether there are a correlation exercise together with improved core stability and pursed lip breathing, can improve oxygen saturation, physical capacity, leg muscle strength, balance and self-estimated symptoms in people with COPD in stage 2.Methodology: A single subject experimental design (SSED) with AB design (baseline survey - intervention) was used. As primary outcome saturation and walking distance measured at 6MWT were used. Secondary outcomes were CS-30, single balance and CAT. Data at nominal level were analyzed by using Two Standard Deviation Band Analysis and Celeration Line Analysis, Changes in CAT, pre- and post-intervention, was analyzed by percentage. Result: Four participants were included in the study. The result indicates a possible intervention effect regarding walking distance at 6MWT and single leg balance for two of the participants, who at study start were below or dropped below expected normal values in all parameters. One of these participants was stabilized for the lowest value of saturation at 6MWT. There was an effect/possible effect in the CS-30 for participants who at study start exceeded expected normal values in all parameters. Self-estimated symptoms (CAT) were improved in three participants (31–55 percent) and got worse in one participant (17 percent).Conclusion: The study indicates that core stability training focusing on improved motor control for stabilizing core muscles may have a positive effect on walking distance (6MWD) single leg balance, number of up rises in CS-30 and self-estimated lungsymptoms for people with COPD, stage 2. More studies are needed to validate these preliminary findings.

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Made available in DSpace on 2016-06-02T20:19:27Z (GMT). No. of bitstreams: 1 6773.pdf: 1423884 bytes, checksum: 7e9d34dd271eeaddbef853357ac2a926 (MD5) Previous issue date: 2015-02-27 / Financiadora de Estudos e Projetos / This study aimed to compare neuromuscular aspects, such as antagonist co-activation during knee extension (Coext) and flexion (Coflex), functional ratio of the maximum concentric hamstring strength to the maximum eccentric quadriceps strenght for knee flexion (Icon:Qexc), knee extensor torque in concentric (PTcon_ext) and eccentric (PTexc_ext) ways, the concentric knee flexor torque (PTcon_flex) and physical function, in different knee OA degrees. It was also objective of this dissertation investigate the center of pressure (COP) behavior (amplitude and velocity of the anterior-posterior and medial-lateral displacement) during a task involving eccentric quadriceps contraction, and the correlation between center of pressure and variables related to muscle performance and physical function. These objectives comprise two studies, with different methodologies. Study I: 20 subjects with knee OA (GOA) and 20 healthy subjects (GC) performed a postural stability evaluation, standing on two force platforms (Bertec Mod) with 45 degrees of knee flexion. PTcon_flex and PTexc_ext were evaluated in a speed of 90°/s. Subjects answered Physical Function and Stiffness subscales of the questionnaire Western Ontario MacMaster Universities Osteoarthritis Index (WOMAC). Intergroup statistical analysis shown that subjects of the GOA, compared to GC, had no difference in postural control parameters, had lower Icon: Qexc (p = 0.004) and poorer selfreported physical function (p = 0.00) and stiffness (p = 0.001). Antero-posterior COP displacement was moderately and negatively correlated with the physical function subscale (ρ = -0.480, p = 0.02). Antero-posterior COP speed was moderately and negatively correlated with the physical function WOMAC subscale (ρ =-0.52, p = 0,01) and stiffness WOMAC subscale (ρ = -0.44, p = 0.03). Study II: 20 subjects with knee OA grade II (GOAII), 15 with knee OA grade III (GOAIII) and 19 healthy subjects (GC) performed isokinetic knee extension and flexion at 60 °/s, simultaneously to the electromyographic assessment of muscles quadriceps (vastus lateralis, rectus femoris, vastus) and hamstrings (biceps femoris and semitendinosus). Subjects answered Physical Function WOMAC subscale and performed functional tests 30-s chair-stand test (STS30s), 40mfast-paced walk test (Caminhada40m) and a stair-climb test (Escada). After intergroup analysis, GOAII showed higher Coflex (p = 0.001), higher Icon:Qexc (p = 0.000), Σemgflex_flex (p = 0.000), lower PTcon_ext (p = 0:02) and PTexc_ext (p = 0.008) and worse self reported physical function (p= 0.000). In GOAIII were identified greater Icon:Qexc (p = 0.000), lower PTcon_ext (p = 0.000), PTexc_ext (p = 0.000) and PTcon_flex (p = 0.04), worse self-reported Physical Function (p = 0.000) and worse performance in the functional tests: STS30s Caminhada40m e Escada (p = 0.017 p = 0.000 and p = 0.001, respectively). There was no difference between the GOAII and GOAIII for all variables (p ≥ 0.05). Together, these results suggest a neuromuscular adaptation present in individuals with knee OA, justifies the need for intervention from the early degrees of the disease and highlight the importance of taking into account different forms of assessment of physical function. / Foi objetivo desta dissertação comparar aspectos neuromusculares, como coativação do antagonista durante a extensão (Coext) e flexão (Coflex) do joelho, relação funcional de força concêntrica de isquiotibiais e excêntrica de quadríceps para flexão de joelho (Icon:Qexc), torque extensor do joelho nos modos concêntrico (PTcon_ext) e excêntrico (PTexc_ext), o torque flexor do joelho no modo concêntrico (PTcon_flex) e a função física nos diferentes graus da OA do joelho. Também foi objetivo dessa dissertação investigar o comportamento do centro de pressão (amplitude e velocidade do deslocamento ântero-posterior e médio-lateral) durante uma tarefa envolvendo contração excêntrica do quadríceps e correlaciona-lo às variáveis relacionadas ao desempenho muscular e função física. Estes objetivos compõem dois estudos, com metodologias distintas. Estudo I: 20 indivíduos com OA de joelhos (GOA) e 20 sujeitos saudáveis (GC) realizaram avaliação da estabilidade postural, em pé sobre duas plataformas de força (Bertec Mod) e flexão de joelhos de 45 graus. Também foram avaliados PTcon_flex e PTexc_ext na velocidade de 90°/s e os sujeitos responderam às seções função física e rigidez do questionário Western Ontario and MacMaster Universities Osteoarthritis Index (WOMAC). Após análise estatística intergrupo, não foi observada diferença estatística para as variáveis do controle postural entre os sujeitos com OA e o GC. No entanto, foram identificados menor PTexc_ext (p=0.01), menor Icon:Qexc (p=0.004), pior auto-relato de função física (p=0,00) e rigidez (p=0,001). A análise de correlação indicou correlação entre o controle postural e função física e rigidez. Estudo II: Vinte indivíduos com OA do joelho grau II (GOAII), 15 com OA do joelho grau III (GOAIII) e 19 saudáveis (GC) realizaram teste isocinético de extensão do joelho a 60°/s, simultaneamente à avaliação eletromiográfica dos músculos do quadríceps (vasto lateral, reto femural e vasto medial) e isquiotibiais (bíceps femural e semitendíneo). Os sujeitos responderam à seção Função Física do qustionário WOMAC e realizaram testes funcionais de sentar e levantar de uma cadeira por 30 segundos (STS30s), caminhada de 40 metros (Caminhada40m) e subida e descida de escada (Escada). Após análise intergrupo, o GOAII apresentou maior Coflex (p = 0.001), maior Icon:Qexc (p = 0.000), Ʃemgflex_flex (p = 0.000), menores PTcon_ext (p = 0.02) e PTexc_ext (p = 0.008) e pior auto-relato de função física (p = 0.000 ). No GOAIII foram identificados maior Icon:Qexc (p = 0.000), menores PTcon_ext (p = 0.000), PTexc_ext (p = 0.000) e PTcon_flex (p = 0.04), pior auto-relato de função física (p = 0.000) e pior desempenho nos testes STS30s, Caminhada40m e Escada (p = 0.017 p = 0.000 e p = 0.001, respectivamente). Não houve diferença entre o GOAII e GOAIII para nenhuma das variáveis (p ≥ 0.05). Em conjunto, os resultados sugerem uma adaptação neuromuscular presente nos indivíduos com OA do joelho, necessidade de intervenção desde os graus iniciais da doença e destacam a importância de levar em conta diferentes formas de avaliação da função física.

Em 2004, o Instituto Nacional de Saúde Norte Americano (NIH), propôs a disponibilização de modelos inovadores (banco de itens) para avaliação de saúde, o Patient-Reported Outcomes Measurement Information System – PROMIS®, baseado em instrumentos clássicos e confiáveis de resultados relatados pelos pacientes (Patient-Reported Outcomes – PROs) existentes e inserindo métodos estatísticos avançados como a Teoria de Resposta ao Item e o Teste Adaptativo Computadorizado. Um dos domínios abordados pelo PROMIS® é o Função Física cujo banco de itens necessita, para que seja utilizado em países lusófonos sua tradução e adaptação transcultural. O objetivo do estudo foi traduzir e adaptar culturalmente o Banco de Itens Função Física do PROMIS® para a língua portuguesa. O método utilizado foi um processo de tradução e adaptação transcultural que contém oito fases determinadas pela metodologia universal proposta pelo Functional Assessment of Chronic Illness Therapy (FACIT). A sétima etapa, chamada pré-teste, contou com 50 indivíduos com idade acima de 18 anos. Os participantes responderam os itens por auto-aplicação, utilizando uma técnica do pensamento em voz alta, além de entrevista cognitiva e retrospectiva de esclarecimento. A metodologia FACIT permitiu uma versão com adaptações, desde o início do processo, assegurando equivalência semântica, conceitual, cultural e operacional do Domínio Função Física. Durante o pré-teste, dificuldades na compreensão dos itens foram relatados por 24% dos participantes, 22% deles sugeriram mudanças para melhorar a compreensão. Os itens atingiram 100% de compreensão dos termos e conceitos, em 87% dos itens. Apenas quatro itens tiveram compreensão abaixo de 80%, exigindo alterações para alcançar correspondência com o item original e entendimento pelos entrevistados após retestagem. O processo de tradução e adaptação cultural dos itens Função Física do PROMIS® para a língua portuguesa foi bem sucedido. Esta versão deve ser submetida à validação das propriedades psicométricas antes de ser disponibilizada para utilização clínica. / In 2004, the National Institutes of Health made available the Patient-Reported Outcomes Measurement Information System – PROMIS®, which is constituted of innovative item banks for health assessment. It is based on classical, reliable Patient-Reported Outcomes (PROs) and includes advanced statistical methods, such as Item Response Theory and Computerized Adaptive Test. One of PROMIS® Domain Frameworks is the Physical Function, whose item bank need to be translated and culturally adapted so it can be used in Portuguese speaking countries. This work aimed to translate and culturally adapt the PROMIS® Physical Function item bank into Portuguese. FACIT (Functional Assessment of Chronic Illness Therapy) translation methodology, which is constituted of eight stages for translation and cultural adaptation, was used. Fifty subjects above the age of 18 years participated in the pre-test (seventh stage). The questionnaire was answered by the participants (self-reported questionnaires) by using think aloud protocol, and cognitive and retrospective interviews. In FACIT methodology, adaptations can be done since the beginning of the translation and cultural adaption process, ensuring semantic, conceptual, cultural, and operational equivalences of the Physical Function Domain. During the pre-test, 24% of the subjects had difficulties understanding the items, 22% of the subjects suggested changes to improve understanding. The terms and concepts of the items were totally understood (100%) in 87% of the items. Only four items had less than 80% of understanding; for this reason, it was necessary to chance them so they could have correspondence with the original item and be understood by the subjects, after retesting. The process of translation and cultural adaptation of the PROMIS® Physical Function item bank into Portuguese was successful. This version of the assessment tool must have its psychometric properties validated before being made available for clinical use. / Dissertação (Mestrado)

Submitted by Cássia Santos (cassia.bcufg@gmail.com) on 2014-10-21T11:09:00Z No. of bitstreams: 2 Dissertacao Mestrado Final Wanessa Vieira Marques - 2014.pdf: 2424315 bytes, checksum: 43cfe85410f8246c32e9c3194794b2d6 (MD5) license_rdf: 23148 bytes, checksum: 9da0b6dfac957114c6a7714714b86306 (MD5) / Approved for entry into archive by Luciana Ferreira (lucgeral@gmail.com) on 2014-10-23T11:19:39Z (GMT) No. of bitstreams: 2 Dissertacao Mestrado Final Wanessa Vieira Marques - 2014.pdf: 2424315 bytes, checksum: 43cfe85410f8246c32e9c3194794b2d6 (MD5) license_rdf: 23148 bytes, checksum: 9da0b6dfac957114c6a7714714b86306 (MD5) / Made available in DSpace on 2014-10-23T11:19:39Z (GMT). No. of bitstreams: 2 Dissertacao Mestrado Final Wanessa Vieira Marques - 2014.pdf: 2424315 bytes, checksum: 43cfe85410f8246c32e9c3194794b2d6 (MD5) license_rdf: 23148 bytes, checksum: 9da0b6dfac957114c6a7714714b86306 (MD5) Previous issue date: 2014-04-03 / Conselho Nacional de Pesquisa e Desenvolvimento Científico e Tecnológico - CNPq / Patients with rheumatoid arthritis (RA) present higher prevalence of comorbidities. Such comorbidities are associated with different outcomes in RA patients, such as mortality risk, increase in disability, impact on RA specific treatment and higher medical costs. The purpose of this study was to assess the influence of comorbidities on the functional capacity and mobility of the affected individuals, and to identify, among the comorbidity indicators, the most appropriate to determine association between comorbidities and physical function on these patients. In a cross-sectional study we included 60 patients with RA fulfilling the American College of Rheumatology criteria (ACR, 1987) over a period of 11 months, both male and female between 43 and 80 years old. Comorbidities were assessed by means of three indicators: (i) total number of comorbidities (NCom) reported by the patients and listed on their medical records; (ii) the Charlson comorbidity index (CCI); and (iii) the functional comorbidity index (FCI). The activity of disease was evaluated by the Disease Activity Score, based on 28 joints and erythrocyte sedimentation rate value (DAS28/ESR). The participants’ functional capacity was measured using the Health Assessment Questionnaire (HAQ), and their mobility was measured using the chairrising test (CRT) and timed get up and go (TUG) test. Statistical analysis was performed using Log-Linear Stepwise multiple regression at 5% significance level. The prevalence of comorbidities in the investigated sample of patients with RA was 90% when the total number of comorbidities (NCom) was taken into consideration. In the final multiple regression model, the independent factors that influenced functional capacity (HAQ) were activity of disease (DAS28/ESR) and comorbidities, as assessed by FCI, which explained together 32.9% of the HAQ score variability (adjusted coefficient of determination [R2] = 0.329). With respect to the participants’ mobility (CRT and TUG), in the final model, only the independent factor comorbidities (FCI) exerted a significant influence on the results. The FCI scores explained 19.1% of the CRT variability (R2= 0.191) and 19.5% of the TUG variability (R2= 0.195). Among the comorbidity indicators used, the FCI was the main responsible for explain the physical function (HAQ) and mobility (CRT and TUG) variability at the final model in our sample. Comorbidities were highly prevalent in individuals with RA and exerted a negative influence on their functional capacity and mobility. FCI proved to be appropriate to determine the association between comorbidities and physical function in individuals with RA. / Pacientes com artrite reumatoide (AR) apresentam prevalência aumentada de comorbidades. A presença de comorbidades está associada a um pior desfecho clínico nesses indivíduos, tais como risco de mortalidade, comprometimento na funcionalidade, interferência no tratamento específico da AR e aumento nos custos médicos. O objetivo deste estudo foi investigar a influência das comorbidades na capacidade funcional e na mobilidade em pacientes com AR, e identificar, dentre os indicadores de comorbidade, aquele mais apropriado para determinar a associação entre comorbidades e desfecho funcional nesses indivíduos. Trata-se de um estudo transversal com a participação de 60 pacientes classificados com AR pelos critérios da American College of Rheumatology (ACR) de 1987 em um período de 11 meses, de ambos os gêneros e faixa etária entre 43 e 80 anos. As comorbidades foram avaliadas por meio de três indicadores: (i) número total de comorbidades (NCom) relatadas pelos pacientes e anotadas em prontuário médico; (ii) escore obtido no índice de comorbidade de Charlson (ICC); e escore obtido no índice de comorbidade funcional (ICF). A atividade da doença foi mensurada pelo Índice de Atividade da Doença baseado em 28 articulações e no valor do VHS (Disease Activity Score 28 – DAS28/VHS). A capacidade funcional e a mobilidade foram avaliadas por meio do escore obtido no Questionário de Avaliação da Saúde (Health Assessment Questionnaire – HAQ), no teste senta-levanta da cadeira cinco vezes (TSL) e no teste timed get up and go (TUG). A análise estatística dos dados foi realizada através de regressão múltipla Log-Linear Stepwise com nível de significância de 5%. Observou-se que a prevalência das comorbidades, analisada pelo indicador número total de comorbidades (NCom), foi de 90% em nossa amostra. No modelo final da análise múltipla os fatores determinantes da capacidade funcional (HAQ) foram a atividade da doença (DAS28/VHS) e as comorbidades, avaliadas pelo ICF, que em conjunto explicaram 32,9% da variabilidade do escore do HAQ (coeficiente de determinação [R2] ajustado = 0,329). Com relação à mobilidade (TSL e TUG), no modelo final, apenas as comorbidades (ICF) influenciaram significativamente o seu desempenho. O escore no ICF explicou 19,1% da variabilidade do TSL (R2 = 0,191)e 19,5% da variabilidade do TUG (R2 = 0,195). Dentre os indicadores de comorbidade utilizados, o indicador ICF foi o principal responsável por explicar no modelo final a variabilidade da capacidade funcional (HAQ) e da mobilidade (TSL e TUG) em nossa amostra. Conclui-se que as comorbidades são frequentes em pacientes com AR e influenciam negativamente a capacidade funcional e a mobilidade desses indivíduos. O ICF demonstrou ser um indicador de comorbidade apropriado para determinar a associação entre comorbidades e funcionalidade em pacientes com AR.

Submitted by Renata Lopes (renatasil82@gmail.com) on 2016-05-30T14:03:04Z No. of bitstreams: 1 ruiterdesouzafaria.pdf: 2324261 bytes, checksum: aefd4cf730415535baea1494d370e385 (MD5) / Approved for entry into archive by Adriana Oliveira (adriana.oliveira@ufjf.edu.br) on 2016-07-02T12:23:59Z (GMT) No. of bitstreams: 1 ruiterdesouzafaria.pdf: 2324261 bytes, checksum: aefd4cf730415535baea1494d370e385 (MD5) / Made available in DSpace on 2016-07-02T12:23:59Z (GMT). No. of bitstreams: 1 ruiterdesouzafaria.pdf: 2324261 bytes, checksum: aefd4cf730415535baea1494d370e385 (MD5) Previous issue date: 2012-05-29 / Introdução: A Doença Renal Crônica (DRC) evolui com progressiva e irreversível perda das funções renais. Suas manifestações clínicas e complicações associadas ocasionam redução da capacidade física, baixa tolerância ao exercício, comprometimento da qualidade de vida (QV) autorrelatada e, consequentemente, dificuldade para realização das atividades de vida diária. Seus distúrbios clínicos e metabólicos, característicos da uremia, já estão presentes nos pacientes desde os estágios pré-dialíticos. Porém, a literatura ainda não é clara quanto à existência e aos fatores associados às alterações na função respiratória de pacientes com DRC pré-dialítica. Objetivos: Avaliar a função respiratória, a capacidade física e a qualidade de vida autorrelatada em pacientes com DRC pré-dialítica nos estágios três, quatro e cinco de evolução da doença e comparar com voluntários saudáveis. Métodos: Realizamos um estudo transversal, em que avaliamos 38 voluntários adultos divididos em dois grupos: um grupo controle (GC) com nove sujeitos saudáveis e um grupo experimental com 29 pacientes com DRC pré-dialítica estágios três, quatro e cinco (G3, G4 e G5 respectivamente) pertencentes ao Serviço de Nefrologia do Hospital Universitário da Universidade Federal de Juiz de Fora (HU-UFJF), provenientes do Programa de Prevenção às Doenças Renais do Núcleo Interdisciplinar de Estudos, Pesquisas e Tratamento em Nefrologia da Universidade Federal de Juiz de Fora e Fundação IMEPEN (PREVENRIM – NIEPEN/UFJF). Critérios de inclusão: pacientes adultos, de ambos os sexos, pertencentes aos estágios três, quatro e cinco da DRC, que concordaram em participar do estudo através da assinatura do termo de consentimento livre e esclarecido. Os critérios de não inclusão foram pacientes com: idade superior 65 anos, doenças pulmonares previamente diagnosticadas, tabagistas, ex-tabagistas que fumaram acima 20 anos/maço e/ou que interromperam o hábito de fumar a menos de dez anos, alterações cognitivas e osteomioarticulares que comprometiam a realização dos testes, angina instável, infecção ativa nos últimos três meses, hipertensão arterial descontrolada (pressão arterial sistólica ≥ 200 mmHg e/ou pressão arterial diastólica ≥ 120 mmHg), em uso de medicamentos que influenciam a função da musculatura respiratória, como esteroides ou ciclosporina e que não concordaram em participar. Para formação do grupo controle, foram selecionados indivíduos saudáveis pareados por idade, sexo e índice de massa corpórea (IMC), respeitando os mesmos critérios de não inclusão. Todos os voluntários foram avaliados segundo o protocolo a seguir: Primeira Visita- Avaliação Médica e Fisioterapêutica; coleta de duas amostras de sangue, uma para análise de dados laboratoriais e outra para estocagem de soro; realização do Teste de Caminhada de Seis Minutos; Manovacuometria; e aplicação do Questionário de Qualidade de Vida Autorrelatada SF-36. Segunda Visita: Avaliação Espirométrica- Terceira Visita: Teste Cardiopulmonar de Exercício. Além disso, foram retirados dos prontuários dados referentes à avaliação nutricional. Análise estatística: Os dados foram expressos como média e desvio-padrão ou percentagem conforme a característica da variável. Para comparação entre os estágios, foi utilizada a ANOVA, Kruskal-Wallis ou teste do qui-quadrado. Para avaliar a associação entre as variáveis, foi utilizada a correlação de Pearson ou Spearman, conforme a característica da variável. Considerado significante um p < 0,05. Utilizado o Software estatístico SPSS 13.0 Resultados: Quando comparados aos indivíduos controle, não houve diferença entre os pacientes com DRC com relação à idade, sexo e IMC. A causa mais comum de DRC foi nefroesclerose hipertensiva (34,4%), seguida de glomerulonefrite crônica (20,6%) e doença renal diabética (17,2%). As comorbidades mais prevalentes foram hipertensão arterial (96,5%), dislipidemia (68,9%) e diabetes mellitus (24,1%). Houve diferença estatisticamente significante em variáveis laboratoriais como PTHi (GC = 71,2 ± 29,8pg/mL, G3 = 77,0 ± 24,9pg/mL, G4 = 114,2 ± 52,2pg/mL, G5 = 337,2 ± 283,0pg/mL e p = 0,004) e hemoglobina (GC = 15,0 ± 1,8g/dL, G3 = 13,7 ±1,4g/dL, G4 = 12,3 ± 1,3g/dL, G5 = 12,3 ± 1,6g/dL com p = 0,003). A Função Pulmonar não apresentou diferença estatisticamente significativa entre os grupos nos parâmetros espirométricos, porém, na manovacuometria, a pressão inspiratória máxima (PImáx) demonstrou diferença estatisticamente significativa em valores absolutos (GC = 95,0 ± 17,6cmH2O, G3 = 61,0 ± 26,8cmH2O, G4 = 60,5 ± 14,6cmH2O, G5 = 66,1 ± 25,3cmH2O, com p = 0,024). Igualmente, a maioria das variáveis estudadas relacionadas à capacidade física avaliada pelo Teste Cardiopulmonar de Exercício, como a potência relativa máxima (GC = 4,9 ± 1,3W/Kg, G3 = 3,7 ± 0,9W/Kg, G4 = 3,0 ± 1,2W/Kg, G5 = 3,2 ± 1,0W/Kg, com p = 0,007), e o consumo de oxigênio (VO2pico) (GC = 85,4 ± 18,2 %, G3 = 75,8 ± 18,3 %, G4 = 65,9 ± 16,0 %, G5 = 63,4 ± 16,0%, com p = 0,038) e à capacidade funcional medida através da distância percorrida no Teste de Caminhada de Seis Minutos (TC6M) (GC = 90,5 ± 7,6%, G3 = 93,9 ± 7,5%, G4 = 83,4 ± 9,5%, G5 = 83,0 ± 8,9%, com p = 0,017) apresentaram diferenças estatisticamente significantes. Além disso, a taxa de filtração glomerular (TFG) associou-se a variáveis laboratoriais (hemoglobina, r = 0,596 e p = < 0,0001), da função pulmonar (VEF1 (%) r = 0,349 e p = 0,020; PImáx (cmH2O) (r = 0,415 e p = 0,015) e da capacidade física (VO2pico (mL/kg.mim) r = 0,430 e p = 0,008) e funcional (TC6M (m) r = 0,556 e p = < 0,0001). Avaliando a qualidade de vida (QV) através do SF-36, observamos um declínio da mesma, nos domínios capacidade funcional (p = 0,003), aspectos físicos (p = 0,012), estado geral da saúde (p = 0,008), aspectos sociais (p = 0,002), com a progressão do estágio da DRC. A QV esteve associada a variáveis relacionadas à função pulmonar e ao teste cardiopulmonar de exercício. Vale ressaltar que houve uma importante correlação entre o domínio capacidade funcional avaliado pelo SF-36 e a distância percorrida no TC6M (r = 0,766 e p < 0,0001) e o VO2pico em valores absolutos no TCPE (r = 0,688 e p < 0,0001). Conclusão: Pacientes com DRC pré-dialítica apresentaram alterações na função respiratória e na capacidade física e funcional e a associação destes parâmetros com a TFG sugere que a progressão da doença agrava estas funções. Além disso, ocorreu uma piora da QV associada à piora da TFG e associação entre QV e capacidade funcional avaliada pelo teste de caminhada de 6 minutos e capacidade física avaliada pelo TCPE, indicando que a avaliação subjetiva realizada pelo questionário de QV reflete a avaliação objetiva avalida pelo TC6M e pelo TCPE e que podemos sugerir este instrumento como rastreio para avaliação de capacidade funcional/física em pacientes com DRC pré-dialítica. / Introduction: Chronic Kidney Disease (CKD) evolves with progressive and irreversible loss of kidney function. Its clinical manifestations and complications cause reduction in physical capacity, low exercise tolerance, reduced quality of life (QOL) self-reported and therefore difficult to perform activities of daily living. Their clinical and metabolic disturbances characteristic of uremia, are already present in patients from the pre-dialysis stage. However, the literature is unclear as to the existence and the factors associated with changes in lung function in patients with pre-dialysis CKD. Objectives: To evaluate the respiratory function, physical capacity and self-reported quality of life in patients with pre-dialysis CKD stages three, four and five of the disease and compare them with healthy volunteers. Methods: We conducted a cross-sectional study that evaluated 38 adult volunteers divided into two groups: a control group (CG) with nine healthy subjects and a group with 29 patients with pre-dialysis CKD stages three, four and five (G3, G4 and G5, respectively) belonging to the Department of Nephrology, University Hospital, Federal University of Juiz de Fora (HU-UFJF), from the Program for the Prevention of Kidney Diseases, the Center for Interdisciplinary Studies, Research and Treatment in Nephrology, Federal University of Juiz de Fora and IMEPEN Foundation (PREVENRIM - NIEPEN / UFJF). Inclusion criteria: adult patients, belonging to stages three, four and five CKD, who agreed to participate by signing an informed consent. The exclusion criteria were patients with age over 65 years, previously diagnosed pulmonary disease, smokers, former smokers who smoked above 20 pack / years and / or who stopped smoking less than ten years, cognitive and musculoskeletal that compromised the testing, unstable angina, active infection in the last three months, uncontrolled hypertension (systolic blood pressure ≥ 200 mmHg and / or diastolic blood pressure ≥ 120 mmHg), using drugs that affect the function of the respiratory muscles, as cyclosporine and steroids or not agreed to participate. To form the control group, we selected healthy individuals matched for age, sex and body mass index (BMI), respecting the same criteria for inclusion. All volunteers were evaluated according to the following protocol: First Visit-Medical Evaluation and Physical Therapy; collection of two blood samples, one for analysis of laboratory data and one for storage of serum; completion of Six-Minutes Walk Test; Manovacuometry; and implementation of the Quality of Life Questionnaire Short Form-36 self-reported. Second Visit: spirometric evaluation. Third Visit: Cardiopulmonary Exercise Test. In addition, records were removed from the data on nutritional assessment. Statistical analysis Data were expressed as mean and standard deviation or percentage as the characteristic variable. For comparison between stages, we used ANOVA, Kruskal-Wallis test or chi-square test. To evaluate the association between variables, we used the Pearson correlation or Spearman, as the characteristic variable. Considered significant at p <0.05. Used the statistical software SPSS 13.0 Results: Compared with control subjects, there was no difference between patients with CKD with respect to age, sex and BMI. The most common cause of CKD were hypertensive nephrosclerosis (34.4%), followed by chronic glomerulonephritis (20.6%) and diabetic kidney disease (17.2%). The most prevalent comorbidities were hypertension (96.5%), dyslipidemia (68.9%) and diabetes mellitus (24.1%). There were significant differences in laboratory variables and iPTH (CG = 71.2 ± 29.8 pg / mL, G3 = 77.0 ± 24.9 pg / mL, G4 = 114.2 ± 52.2 pg / mL, G5 = 337, 2 ± 283.0 pg / mL, p = 0.004) and hemoglobin (CG = 15.0 ± 1.8 g / dL, G3 = 13.7 ± 1.4 g / dL, G4 = 12.3 ± 1.3 g / dL, G5 = 12.3 ± 1.6 g / dL, p = 0.003). Pulmonary Function showed no statistically significant difference between groups in spirometric parameters, but in the manometer, maximal inspiratory pressure (MIP) showed statistically significant difference in absolute values (GC = 95.0 ± 17.6 cmH2O, G3 = 61.0 ± 26.8 cmH2O, G4 = 60.5 ± 14.6 cmH2O, G5 = 66.1 ± 25.3 cmH2O, p = 0.024). Moreover, most of the variables related to physical capacity measured by cardiopulmonary exercise testing, as the relative power output (GC = 4.9 ± 1.3 W / kg, G3 = 3.7 ± 0.9 W / kg, G4 = 3.0 ± 1.2 W / kg, G5 = 3.2 ± 1.0 W / kg, p = 0.007), and oxygen consumption (VO2peak) (GC = 85.4 ± 18.2%, G3 = 75 , 18.3 ± 8%, G4 = 65.9 ± 16.0%, G5 = 63.4 ± 16.0%, p = 0.038) and functional capacity measured by distance walked in the Six Minutes Walk Test (6MWT) (GC = 90.5 ± 7.6%, G3 = 93.9 ± 7.5%, G4 = 83.4 ± 9.5%, G5 = 83.0 ± 8.9%, p = 0.017) showed statistically significant differences. In addition, glomerular filtration rate (GFR) was associated with laboratory variables (hemoglobin, r = 0.596 and p = <0.0001), pulmonary function (FEV1 (%) r = 0.349 and p = 0.020; PImax (cmH2O) (r = 0.415 and p = 0.015) and physical capacity (peak VO2 (ml / kg.mim) r = 0.430 and p = 0.008) and functional (6MWT (m) r = 0.556 and p = <0.0001). Evaluating the quality of life (QOL) by SF-36, we observed a decline of the same in functional capacity (p = 0.003), physical (p = 0.012), general health (p = 0.008), social functioning (p = 0.002), with the progression of CKD stage. QOL was associated with variables related to pulmonary function and cardiopulmonary exercise testing. It is noteworthy that there was a significant correlation between the physical functioning domain assessed by the SF-36 and the walking distance in the 6MWT (r = 0.766 and p <0.0001) and VO2peak in absolute values in CPET (r = 0.688 and p <0.0001). Conclusion: Patients with CKD pre-dialysis had abnormal lung function and physical capacity and functional parameters and their association with GFR suggests that the progression of the disease aggravates these functions. Moreover, there was a worsening of QOL associated with worsening GFR and the association between QOL and functional capacity evaluated by the 6-minute walk and exercise capacity assessed by CPET, indicating that the assessment performed by subjective QOL questionnaire reflects the objective evaluation assessment the 6MWT and the CPET and we can suggest this as a screening instrument for assessing functional / physical in patients with pre-dialysis CKD.

Contexte : Les différences de fonctionnement physique entre les hommes et les femmes ne sont pas bien comprises. Les chercheurs ont porté attention aux différences biologiques entre les hommes et les femmes mais ne se sont pas concentrés sur les différences de fonctionnement physique et de mobilité qui pourraient être reliées au sexe et au genre. En particulier, les effets de la masculinité et de la féminité sur le fonctionnement physique des personnes âgées n’ont pas été examinés. Objectifs : L’objectif principal de cette recherche est d’évaluer l’association entre fonctionnement physique et rôles de genre. Pour atteindre cet objectif, nous avons examiné : 1) la validité de la version courte (12 items) de l’Inventaire des rôles sexués de Bem (IRSB) ; 2) les associations transversales et longitudinales entre l’IRSB et des indicateurs de mobilité et de performance physique, et finalement 3) les variables jouant un rôle de médiation entre l’IRSB et la performance physique. Méthodes : Les données de l’étude internationale sur la mobilité au cours du vieillissement (IMIAS) recueillies en 2012 et 2014 ont été utilisées dans cette recherche. Cette étude s’est déroulée dans 5 villes : Saint-Hyacinthe (Québec) and Kingston (Ontario) au Canada, Tirana (Albanie), Manizales (Colombie) et Natal (Brésil), avec un échantillon approximatif à chaque site de 200 hommes et 200 femmes âgés de 65 à 74 ans vivant dans la communauté (N=2004). Deux aspects du fonctionnement physique ont été examinés dans cette thèse : la mobilité et la performance physique. La mobilité a été mesurée par deux questions sur la difficulté à marcher un Km et à monter un étage d’escaliers. La performance physique a été objectivée par le Short Physical Performance Battery (SPPB). Cette batterie inclut des mesures de la marche, de l’équilibre et de la force musculaire et elle mesure le temps requis pour exécuter trois tests : marcher quatre mètres, se tenir début en position de tandem et se lever d’une chaise cinq fois. Pour la validation psychométrique de l’instrument IRSB, des analyses factorielles exploratoires et confirmatoires ont été réalisées. Pour les études d’associations transversales, des analyses de régression de Poisson ont permis l’estimation des ratios de prévalence pour les incapacités de mobilité et la mauvaise performance physique, comparant les rôles masculins, féminins et indifférenciés. Pour l’étude de l’incidence de la mauvaise performance physique, les estimations de risque relatif ont été obtenues à l’aide de la régression de Poisson. L’étude des variables de médiation entre les rôles de genre et la performance physique a inclus le tabagisme, l’inactivité physique, la consommation d’alcool, l’index de masse corporelle élevé, le nombre de maladies chroniques et la dépression. Finalement, une méta-analyse a été effectuée pour examiner l’homogénéité des associations entre les rôles de genre et la performance physique dans les cinq sites de recherche. Résultats : Les résultats des analyses factorielles pour l’instrument de mesure IRSB ont révélé qu’une solution à deux facteurs (instrumentalité-expression) donne une validité conceptuelle satisfaisante, ainsi qu’un ajustement aux données supérieur par rapport à une solution à trois facteurs. La solution à deux facteurs permet d’assigner un score de masculinité et un score de féminité à chaque participant et de classifier les personnes âgées dans quatre catégories selon leur typologie de rôle de genre : masculin, féminin, androgyne et indifférencié. En ce qui concerne les associations avec les indicateurs de mobilité et de fonctionnement physique, les rôles féminins et indifférenciés sont des facteurs indépendants associés à la prévalence des incapacités dans la mobilité et à la mauvaise performance après ajustement avec des variables de confusion potentielle. Les rôles féminins et indifférenciés sont des facteurs de risque associés à une détérioration plus rapide du fonctionnement des extrémités inferieures. Nous avons rapporté une incidence de mauvaise performance physique plus élevée pour ceux qui adoptent un rôle féminin (IRR ajusté=2.36, intervalle de confiance de 95% 1.55-3.60) ou le rôle indifférencié (IRR ajusté=2.19, 95% Intervalle de confiance de 95% 1.45-3.30) comparé au rôle androgyne. Le score de masculinité est associé à la performance physique, alors que le score de féminité ne l’est pas. Une augmentation d’une unité sur le score de masculinité est associée à une incidence de mauvais fonctionnement physique plus faible (IRR ajusté=0.76, 95% intervalle de confiance de 95% 0.67-0.87). Les rôles de genre agissent sur les comportements de santé (tabagisme et inactivité physique), sur l’index de masse corporelle et sur les maladies chroniques et la dépression, tous des facteurs de risque pour la performance physique. Les effets des rôles de genre ne sont que partiellement expliqués par ces facteurs de médiation et un effet direct des rôles de genre sur le fonctionnement physique reste toujours significatif. Conclusion : Les rôles de genre sont présents dans tous les cinq sites de recherche. La mobilité et la performance physique des personnes âgées sont associées au type de rôle de genre avec un possible effet protecteur pour les personnes androgynes, indépendamment du fait qu’ils soient un homme ou une femme. Les rôles de genre semblent influencer les comportements de santé et les risques de développer une maladie chronique et de souffrir de dépression, ce qui peut avoir des effets sur la fonction physique au cours du vieillissement. Cette étude est la première sur le sujet et nos résultats devraient être confirmés par des études futures avant d’être traduits en interventions concrètes de santé publique. / Background: Gender differences in mobility disability among older adults are not well understood. Studies have focused on the biological differences between men and women, but not on the mobility differences due to interrelationships of sex and gender. The associations between masculinity, and femininity on physical function in old age have never been examined. Objective: The main objective of this dissertation is to study the relationships between physical function and gender roles in old age. To accomplish this objective, I have: 1) assessed the psychometric properties and construct validity of the 12-items short form Bem Sex Roles Inventory (BSRI), 2) examined the cross-sectional associations between BSRI and mobility and physical performance, and 3) examined mediating pathways between BSRI and physical performance. Methods: A total of 2004 community-dwelling older adults from the International Mobility in Aging Study (IMIAS) aged 65 to 74 years were recruited in Natal (Brazil), Manizales (Colombia), Tirana (Albania), Kingston (Ontario, Canada), and Saint-Hyacinthe (Quebec, Canada). Two aspects of mobility loss will be assessed in this dissertation: first, Mobility disability is a self-reported measure of the difficulty to walk half a mile or climb one flight of stairs without assistance. Second, poor physical function or performance of the lower extremities which is assessed by an objective tool and defined as inability to perform physical action in the manner considered normal in the short physical performance battery (SPPB). This battery includes three timed tests of lower extremity function: a hierarchical test of standing balance, a four-meter walk, and five repetitive chair stands. To assess the validity of BSRI in old age as a measure of gender roles. The psychometric properties of the 12- items short form BSRI were assessed by means of exploratory (EFA) and confirmatory factor analysis (CFA). To assess the cross-sectional associations between gender roles and both measures of mobility loss, I used Poisson regression analysis to estimate prevalence rate ratios of gender role types using the androgynous type as reference category. To calculate the incidence of poor physical performance after two years of follow up, Poisson regression was conducted for the estimation of relative risks. Body mass index, smoking, alcohol consumption, physical activity, chronic diseases, and depression were tested as potential mediators in the pathway between gender roles and physical performance in old age. Finally, taking account the possible differences in associations between countries, I have conducted a meta-analysis to estimate overall effects of masculinity and femininity scores on physical performance based on five distinct studies representing each research site of IMIAS. Results: The results of Exploratory Factor Analysis revealed a three-factor model. This model was further confirmed by CFA and compared with the original two-factor structure model. CFA results revealed that a two-factor solution (instrumentality-expressiveness) has satisfactory construct validity and superior fit to data compared to the three-factor solution. These factor analysis findings allowed to calculate scores of masculinity and femininity and classify participants into four categories according to gender roles: Masculine, feminine, androgynous and undifferentiated. Feminine and undifferentiated gender roles are independent risk factors associated with the prevalence of mobility disability and low physical performance in older adults. Consistent with cross sectional analysis, higher incidence of poor physical performance was observed among participants endorsing the feminine role or the undifferentiated role compared to the androgynous role. Higher masculinity but not femininity scores predicted good physical performance two years later. Gender roles predicted poor physical performance through statistically significant direct and indirect pathways. Cumulative smoking, BMI, physical activity, multimorbidity, and depression were serial mediators explaining the indirect effect of gender roles on physical performance. These intermediate behavioral and pathological pathways only partially mediated the observed associations. None of the potential serial mediators in the present study could completely account for the association between gender roles and physical performance. Conclusions: Traditional gender roles are existent in the five research sites of IMIAS. Gender roles influence physical function in old age with a possible protective effect of androgyny in old age independent of biological sex. Gender roles influence health behaviors which in turn contribute to chronic conditions and faster decline of lower extremities physical function. This study adds to the scant literature on this topic and the findings obtained from this dissertation need to be confirmed by future longitudinal studies for the appropriate translation into public health actions.

Indiana University-Purdue University Indianapolis (IUPUI) / Background: Persons with Mild Cognitive Impairment (PwMCI) battle progressive disengagement from personally meaningful activities that results in functional decline. Little is known about PwMCI experience of engaging in meaningful activities and relationships among MCI stage, confidence, depressive symptoms, and function. Daily Engagement of Meaningful Activity (DEMA) is a multicomponent, family-focused, tailored intervention designed to benefit PwMCI and their caregivers by facilitating goal identification, preserve engagement, and support adjustments to cognitive and functional changes. Objectives: The aims of this secondary analysis were to: (i) describe PwMCI experience of engagement in DEMA, (ii) evaluate for potential relationship among MCI stage, confidence, depressive symptoms, activity type, activity performance, physical function and (iii) evaluate ability of select outcomes to predict change in depressive symptoms and physical function, (iv) determine difference between participants when sub-grouped by ICF level. Methods: Mixed methodology was used to conduct a secondary analysis from the parent study. The parent study used a two-group randomized trial involving PwMCI and informal caregivers participating in the Indiana Alzheimer Disease Center DEMA program. Quantitative analysis (dyads: DEMA N=20, Information Support N = 20) examined outcomes at baseline, posttest and follow-up. Analysis employed: (i) Colaizzi's Method of empirical phenomenology to describe PwMCI experience of engagement in activity intervention related to perceptions of changes in confidence, activity performance, and physical function; (ii) Pearson's and Spearman's correlation to ascertain relationship; (iii) Linear regression to model the relationship between explanatory and dependent variables; (iv) Independent t-test to determine significant difference in activities and physical function. Results: Qualitative themes confirm improved awareness, adjustment, problem-solving, confidence and optimized function. Significant correlations were found at baseline and posttest for MCI stage, depressive symptoms, activity type and physical function. At posttest, change in self-rated performance predicted change in depressive symptoms. Additionally, those who engaged in activity at the ICF level of participation demonstrated a significant increase in confidence and physical function. Conclusion: Qualitative themes and quantitative results clearly indicate the positive impact of DEMA. Future research should employ a larger, randomized controlled longitudinal trial to ascertain DEMA impact on physical function, reduction of participation restriction and improved QOL.

La chirurgie est le traitement principal du cancer colorectal (CCR). Une durée d'hospitalisation prolongée peut augmenter le risque de complications et d'inactivité physique, entraînant un déclin de la fonction physique. L'objectif de cette étude est de déterminer si la celle-ci peut prédire l’hospitalisation prolongée chez les patients atteints de CCR. Un total de 459 patients provenant de 7 cohortes a été analysé. Une régression logistique a été utilisée pour déterminer le risque d'hospitalisation prolongée (>3 jours) et une courbe ROC a été tracée pour établir la sensibilité/spécificité. Les variables sélectionnées comprenaient l'âge, le sexe, l'IMC, la présence de comorbidités, le statut ASA, le site tumoral, l'approche chirurgicale, la force de préhension, le test Timed-Up and Go, le test assis-debout de 30 secondes, le test de flexion des coudes de 30 secondes, le test de marche de 6 minutes (6MWT), le questionnaire CHAMPS et le SF-36. Les résultats démontrent que les patients atteints d'une tumeur rectale ont un risque 2,7 fois plus élevé d'appartenir au groupe d'hospitalisation prolongée que ceux atteints d'une tumeur du côlon (O.R. 2,7 ; C.I. 1,3-5,7, p=0,01). Pour chaque augmentation de 20 mètres dans le 6MWT, il y a une diminution de 9% du risque d'être dans le groupe d'hospitalisation prolongée (C.I. 1.03-1.17, p=0.00). Un seuil de 431 m peut prédire 70% des patients dans le groupe d'hospitalisation prolongée (AUC 0,71, C.I. 0,63-0,78, p=0,00). L'utilisation du 6MWT comme outil de dépistage de l'hospitalisation prolongée devrait être intégrée dans le parcours chirurgical préopératoire. / Surgery is the primary treatment for colorectal cancer. A prolonged Length of Stay (pLOS) can increase risk of complications and physical inactivity, leading to a decline in physical function. While promising results were seen from preoperative exercise training and post-operative functional recovery, the predictive potential of preoperative physical function has not yet been investigated. The objective of this study is to determine if preoperative physical function can predict pLOS in patients with for colorectal cancer. A total of 459 patients from 7 cohorts were analyzed. Logistic regression was used to determine risk of pLOS (>3 days), and ROC curve was plotted to establish sensitivity/specificity. Selected variables included age, sex, BMI, comorbidity, ASA status, tumor site, surgical approach, handgrip strength, Timed-Up and Go, 30-second Sit-to-Stand, 30-second Arm Curl Test, 6-Minute-Walking Test (6MWT), CHAMPS Physical Activity Questionnaire for Older Adult and 36-Item Short Form Survey. The results showed that patients with rectal tumor are 2.7x more at risk to be in the pLOS group compared to those with colon tumor (O.R. 2.7; C.I. 1.3-5.7, p=0.01). For every increment of 20 meters in 6MWT, there is a decreased risk of 9% of being in pLOS group (C.I. 1.03-1.17, p=0.00). A cut-off of 431m can predict 70% of patients in pLOS group (AUC 0.71 C.I 0.63-0.78, p=0.00). Tumor site (rectal) and 6MWT were significant predictors of pLOS. Using the 6MWT as a screening tool for pLOS with cut-off of 431 m should be implemented in the preoperative surgical pathway.