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Avalia??o das vari?veis cardiovasculares, capacidade de caminhar e n?vel de atividade f?sica de obesos m?rbidos antes e depois da cirurgia bari?tricaLopes, Thiago Jambo Alves 25 June 2010 (has links)
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Previous issue date: 2010-06-25 / Morbidly obese patients present an increase in heart rate, blood
pressure and perceived exertion besides lower walking ability compared to normal
weight people. However, little is known about how these variables are presented
after bariatric surgery. Moreover, despite the distance walked during the six-minute
walk (6MWT) improve after surgery is not well established if the level of physical
activity influences this improvement. Objective: To evaluate cardiovascular
performance, perceived effort, ability of walking and physical activity level of patients
with morbid obesity before and after bariatric surgery. Methods: The cardiovascular
performance, perception of effort, the ability to walk and level of physical activity were
assessed in 22 patients before (BMI = 50.4 kg/m2) and after (BMI = 34.8 kg/m2)
bariatric surgery through the 6MWT. The heart rate, blood pressure and perceived
exertion were assessed at rest, at the end of the 6MWT and in the second minute
post-test (HR recovery). The ability to walk was measured by total distance walked at
the end of the test while the level of physical activity was estimated by applying the
Baecke questionnaire, analyzing domains occupation, leisure and locomotion and
leisure and physical activity. Results: The HR at rest and recovery decreased
significantly (91.2 ? 15.8 bpm vs. 71.9 ? 9.8 bpm, 99.5 ? 15.3 bpm vs 82.5 ? 11.1
bpm, respectively), as well as all the arterial pressure and perceived exertion after
surgery. The distance achieved by the patients increased by 58.4 m (p = 0.001)
postoperatively. Time postoperatively had correlation with the percentage of excess
weight lost (r = 0.48, p = 0.02), BMI (r =- 0.68, p = 0.001) and the Baecke (r = 0.52, p
= 0.01) which did not happen with the distance walked (r = 0.37, p = 0.09). Despite
weight loss, patients showed no difference in the level of physical activity in any of
the areas before and after surgery. Conclusion: The cardiovascular performance, the
perception of effort and ability to walk seem to improve after bariatric surgery.
However, despite improvement in the ability to walk by the distance achieved in the
6MWT after weight loss, this is not reflected in an increase in physical activity level of
obese patients after surgery / Obesos m?rbidos apresentam aumento da freq??ncia card?aca,
da press?o arterial e da percep??o do esfor?o al?m de baixa capacidade de
caminhar em rela??o a pessoas eutr?ficas. No entanto, pouco se sabe como
essas vari?veis se apresentam ap?s a realiza??o da cirurgia bari?trica. Al?m
disso, apesar da dist?ncia percorrida no teste de caminhada de seis minutos
(TC6M) melhorar ap?s a cirurgia, ainda n?o est? bem estabelecido como o
n?vel de atividade f?sica influencia nesta melhora. Objetivo: Avaliar o
desempenho cardiovascular, a percep??o do esfor?o, a capacidade de
caminhar e o n?vel de atividade f?sica de pacientes portadores de obesidade
m?rbida antes e depois da cirurgia bari?trica. M?todos: O desempenho
cardiovascular, a percep??o do esfor?o, a capacidade de caminhar e o n?vel
de atividade f?sica foram avaliados em 22 pacientes antes (IMC=50,4kg/m2) e
ap?s (IMC=34,8kg/m2) a cirurgia bari?trica atrav?s do TC6M. A FC, a press?o
arterial e a percep??o do esfor?o foram avaliados no repouso, ao final do
TC6M e no segundo minuto p?s-teste (FC recupera??o). J? a capacidade de
caminhar foi aferida atrav?s da dist?ncia total caminhada ao final do TC6M
enquanto o n?vel de atividade f?sica foi estimado pela aplica??o do
Question?rio de Baecke, analisando os dom?nios ocupa??o, lazer e
locomo??o e lazer e atividade f?sica. Resultados: A FC de repouso e
recupera??o diminu?ram significativamente (91,2?15,8 bpm vs 71,9?9,8 bpm;
99,5?15,3 bpm vs 82,5?11,1 bpm, respectivamente), assim como todos os
valores de press?o arterial e percep??o de esfor?o ap?s a cirurgia. J? a
dist?ncia atingida pelos pacientes aumentou em 58,4 m (p=0,001) no p?soperat?rio.
O tempo de p?s-operat?rio obteve correla??o com o percentual de
excesso de peso perdido (r=0,48;p=0,02), com o IMC (r=-0,68;p=0,001) e com
o Baecke (r=0,52;p=0,01), no entanto n?o teve rela??o com a dist?ncia
caminhada (r=0,37;p=0,09). Outrossim, a despeito da perda ponderal, os
pacientes n?o apresentaram diferen?a no n?vel de atividade f?sica em nenhum
dos dom?nios antes e depois da cirurgia. Conclus?o: O desempenho
cardiovascular, a percep??o do esfor?o e a capacidade de caminhar parecem
melhorar ap?s a realiza??o da cirurgia bari?trica. No entanto, apesar da
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melhora na capacidade de caminhar pela dist?ncia alcan?ada no TC6M ap?s
a perda de peso, isso n?o repercutiu em aumento no n?vel de atividade f?sica
dos obesos depois da cirurgia
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