Efeito do Treinamento Físico Supervisionado sobre o Conhecimento da Doença, Nível de Atividade Física e Qualidade de Vida de Pacientes com Doença Pulmonar Obstrutiva Crônica

Abstract

Physical training and education are central elements of Pulmonary Rehabilitation (PR), essential for the treatment of patients with chronic obstructive pulmonary disease (COPD). The PR optimizes the level of independence and tolerance to the exercise, with consequent improvement of the quality of life. However, it is not clear whether the opportunity to perform physical training in isolation is capable of improving the level of daily physical activity and the patient's knowledge about his illness. The objectives of this study were: to compare knowledge about the disease, the level of daily physical activity and quality of life in COPD patients submitted and not submitted to supervised physical training (SPT); to identify predictive factors of knowledge about the disease and to verify the correlation between questionnaire and pedometer in the evaluation of the level of daily physical activity in the individuals studied. This is a case control study, using information collected through the application of the Beck Depression Inventory, Medical Research Council, Human Activity Profile (HAP), Bristol Knowledge Questionnaire on COPD and the use of a pedometer in patients with COPD. To analyze the data, the participants were divided into two groups: Case (individuals submitted to SPT); Control (individuals not submitted to SPT). In the statistical analysis, the Kolmogorov-Smirnov test, the Chi-square test and the univariate General Linear Test (GLM) were used. Linear regression test was used to analyze the effect of predictive factors for disease knowledge. The significance level adopted was p≤0.05. Seventy individuals completed the study. The mean knowledge score on the disease was 48.00 ± 10.00 in the case group and 48.56 ± 9.00 in the control group (p = 0.80). The average steps of the two groups were 5235.42 ± 4106.57 and 4886.24 ± 3765.75 (p = 0.71), respectively. Regarding quality of life, the mean score in the control group was 8.24 ± 3.75 and in the case group, 8.49 ± 4.82 (p = 0.81). There was a moderate positive correlation between the mean number of steps / day with the two PAH scores in the total sample: Maximum Activity Score - EMA (r = 0.43, p <0.001) and Adjusted Activity Score - EAA (r = 0.52, p <0.001). In the case group, there was also a positive correlation between EMA and AAS with mean number of steps / day (r = 0.56, p <0.001 and r = 0.68, p <0.001, respectively). In the control group, only the AAS obtained a significant positive correlation with the mean number of steps (r = 0.36, p = 0.03). The study showed that knowledge about the disease, daily physical activity level and quality of life did not differ between the groups of individuals with COPD who were submitted to and not submitted to SPT. Smoking burden and level of physical activity were the predictors of knowledge about the disease in these individuals. A moderate correlation was observed between the HAP questionnaire and the pedometer in the evaluation of the level of daily physical activity.