Autor(es): Nascimento, Marcia Helena Machado
Data: 2018
Origem: Oasisbr
Assunto(s): cardiopatias cong??nitas; crian??as; qualidade de vida; capacidade funcional; congenital heart disease; children; quality of life; functional capacity; CIENCIAS DA SAUDE
Submitted by Nadir Basilio (nadirsb@uninove.br) on 2018-07-20T20:26:04Z No. of bitstreams: 1 Marcia Helena Machado Nascimento.pdf: 4734214 bytes, checksum: d3e07e20873861d014bba8270609ff30 (MD5)
Made available in DSpace on 2018-07-20T20:26:04Z (GMT). No. of bitstreams: 1 Marcia Helena Machado Nascimento.pdf: 4734214 bytes, checksum: d3e07e20873861d014bba8270609ff30 (MD5) Previous issue date: 2018-03-05
Introduction: The Modified Shuttle Test (MST) is useful to assess the functional capacity of children with Congenital Heart Disease (CHD) due to its incremental characteristic and for being externally cadenced. Objective: To assess functional capacity and quality of life in children with CHD pre and post surgery. Methods: A transversal (Study I) and longitudinal study (Study II), that took place in a public hospital (heart disease group ??? GCard) and in a high school (control group ??? GC). In Study I the participants were children with CHD (n=32, 6-12 years old) vs control group (healthy children, n=32). In Study II, children with acyanotic congenital heart, age 6-12 years old, were assessed before hemodynamic or surgery procedures (pre-procedure, n=32), up to 15 days after hospital discharge (post-procedure 15, n=21), and up to 30 days after hospital discharge (post-procedure 30, n=27). Both studies assessed lung function, used the pediatric quality of life inventory (PedsQL4.0) and the Modified Shuttle Test (MST). Heart rate (HR), blood pressure (BP) and oxygen saturation were assessed during rest, during the test, at peak exercise, and in the recovering time. We considered HR x BPsystolic as the Double Product. Results: In Study I, the distance achieved was higher in the GC group when compared to the GCard group (644,6 ?? 160,7m, p <0,001). At peak exercise we observed statically significant differences in the variables heart rate (bpm and %prev), SpO2, desaturation at peak exercise, and distance achieved, where these variables were lower in the heart disease group in comparison to the control group, p<0,05. PedsQL4.0 was worse in the GCard, and there was significant correlation between distance achieved and the dominance over the physical activity (r = 0,95,p <0,001). Study II showed that functional capacity was reduced in the pre-procedure (69,1 ?? 17,5%prev), with significant worsening in the post-procedure 15 (55,7 ?? 18,0%prev), and recovery in the post-procedure 30 (78,9 ?? 12,8), p<0,05. The double product was not statistically different during the assessed periods of time, although, when correcting this variable with the distance achieved, we found that the children in the post-procedure 15 (23 ??? 39, median=31) had significant higher values when compared to the post-procedure (19 ??? 29, median=25), p<0,05. There was significant correlation between distance achieved and the psychosocial domain of the children age 8 to 12 years old (PedsQL 8-12) in the post-procedure 15 (r=0,70, p=0,002). The distance achieved was correlated to the item physical activity (5 -7 years old) in the post-procedure 15 (r=0,90, p=0,03). Conclusion: Children with congenital heart disease has reduced functional capacity and quality of life. Additionally, the surgery to correct the disease increses the functional capacity and quality of life after 30 days of the procedure.
Introdu????o: O shuttle teste modificado (STM) ?? ??til para avaliar a capacidade funcional de crian??as com cardiopatia cong??nita (CC) por ter caracter??stica incremental e ser cadenciado externamente. Objetivo: Avaliar a capacidade funcional e a qualidade de vida de crian??as com CC no pr??-operat??rio e ap??s procedimento cir??rgico. M??todo: estudo transversal (Estudo I) e longitudinal (Estudo II), realizado no hospital p??blico (grupo cardiopatia -GCard) e na escola de ensino m??dio (grupo controle- GC). Participaram do Estudo I crian??as CC (n = 32, 6-12 anos) vs grupo controle (crian??as saud??veis, n = 32). Estudo II, crian??as com doen??a card??aca cong??nita acian??tica de 6 a 12 anos no pr??-procedimento hemodin??mico ou cir??rgico (pr??, n=32), at?? 15 dias de alta hospitalar (p??s 15, n=21), e 30 dias de alta hospitalar (p??s 30, n=27). Em ambos estudos foram avaliadas a fun????o pulmonar, qualidade de vida (PedsQL4.0) e shuttle teste modificado. A frequ??ncia card??aca (FC), a press??o arterial (PA) e a satura????o de oxig??nio foram avaliadas em repouso, no decorrer do teste, no pico do exerc??cio e na recupera????o do teste. Resultados: No estudo I, a dist??ncia percorrida foi maior no GC (829,6 ?? 129,0 m) comparado ao GCard (644,6 ?? 160,7m), p <0,001. No pico do exerc??cio no STM foram observadas diferen??as estatisticamente significativas nas vari??veis frequ??ncia card??aca, SpO2, dessatura????o no pico, dist??ncia percorrida, sendo essas menores no grupo cardiopata em rela????o ao controle, p<0,05. O PedsQL 4.0 foi pior no GCard, e houve correla????o significante entre a dist??ncia percorrida e o dom??nio da atividade f??sica (r = 0,95, p<0,001). No estudo II, a capacidade funcional estava reduzida (69,1?? 17,5%prev) no pr??; com piora significante no p??s 15 (55,7 ?? 18,0%prev) e melhora da ap??s 30 dias de alta (78,9 ?? 12,8), p<0,05. O duplo produto (PAS x FC) n??o foi estatisticamente diferente no pr??, p??s 15 e p??s 30, entretanto, ao corrigir essa vari??vel pela dist??ncia percorrida, notam-se que os pacientes no p??s 15 tiveram valores 31 (23 ??? 39mmHg/bpm) significantemente maiores comparado ao pr??-operat??rio 25 (19 ??? 29mmHg/bpm), p<0,05. Correla????o significante entre a dist??ncia percorrida e o dom??nio psicossopcial das crian??as entre 8-12 anos (PedsQL 8-12) na fase p??s 15 (r=0,70, p=0,002). A dist??ncia percorrida correlacionou-se com o dom??nio atividade crian??a (5 -7 anos) na fase p??s 15 (r=0,90, p=0,03). Conclus??o: Crian??as com cardiopatia cong??nita apresentam redu????o na capacidade funcional e da qualidade de vida. A corre????o do defeito anat??mico no cora????o resulta em melhora da capacidade funcional e na qualidade de vida desses pacientes ap??s 30 dias de cirurgia.
