Palavras-chave
hydrotheraphy
quality of life
physical activity enfermedades pulmonares
hidroterapia
calidad de vida
actividad física doenças pulmonares
hidroterapia
qualidade de vida,
atividade física
Como Citar
Resumo
O objetivo foi avaliar o efeito da hidroterapia sobre o status funcional, dispneia, índice BODE e qualidade de vida em pacientes com DPOC. Foi realizado um ensaio clínico randomizado e controlado composto por 24 pacientes com DPOC que divididos de forma aleatória em dois grupos: 1) Grupo treinamento aquático (GTA), que participou de um programa de TA intervalado de intensidade moderada/alta 3x/semana, durante 8 semanas; 2) grupo controle (GC), que recebeu orientações sobre vida saudável e não realizou exercícios supervisionados. As variáveis status funcional, dispneia, índice BODE e qualidade de vida foram avaliadas antes e depois do período de intervenção. O nível de significância foi estabelecido em 5%. Os resultados mostram que o GTA apresentou melhora significativa nas atividades de vida diária (LCADL Δscore total: -10.1, p=0.01), no status funcional (PFSDQ-M, Δscore total: -16.9, p=0.01), dispneia (ΔMRC: -1.37, p=0.003), índice BODE (Δ: -1.25, p=0.048) e qualidade de vida (Δscore total: -7.4, p=0.02). Estas mudanças não foram observadas no GC. Conclui-se que o treinamento aeróbio intervalado aquático de moderada/alta intensidade promoveu melhora significativa e clinicamente relevante para a maioria dos pacientes com DPOC na qualidade de vida, nas limitações das AVD´s, dispneia e no índice preditor de mortalidade BODE.
Referências
Adolfo, J.R., Dhein, W., & Sbruzzi, G. (2019). Intensity of physical exercise and its effect on functional capacity in COPD: systematic review and meta-analysis. Jornal Brasileiro de Pneumologia, 45(6), e20180011. https://doi.org/10.1590/1806-3713/e20180011
American College of Sports Medicine Position Stand [ACSM]. (1998). The recommended quantity and quality of exercise for developing and maintaining cardiorespiratory and muscular fitness, and flexibility in healthy adults. Medicine and science in sports and exercise, 30(6), 975–991. https://doi.org/10.1097/00005768-199806000-00032
American Thoracic Society. (2002). ATS statement: guidelines for the six-minute walk test. American Journal of Respiratory and Critical Care Medicine, 166(1), 111-117. https://doi.org/10.1164/ajrccm.166.1.at1102
Anstey, K.H., & Roskell, C. (2000). Hydrotherapy: Detrimental or beneficial to the respiratory system? Physiotherapy, 86(1), 5-13. http://dx.doi.org/10.1016/S0031-9406(05)61320-X
Baltzan, M. A., Scott, A.S., Wolkove, N., Bailes. S., Bernard, S., Bourbeau, J., Maltais F. & Canadian COPD Pulmonary Rehabilitation Research Group (2011). Fatigue in COPD: prevalence and effect on outcomes in pulmonar rehabilitation. Chronic Respiratory Disease, 8(2),119-128. https://doi.org/10.1177/1479972310396737
Benzo-Iglesias, M.J., Rocamora-Pérez, P., Valverde-Martínez, M.A., Garcia-Luengo, A.V., & Lopes-Lira R. (2023). Effectiveness of water-Based exercise in patients with chronic obstructive pulmonar disease: systematic review and meta-analysis. Sensors, 23(20), 8557. https://doi.org/10.3390/s23208557
Bisca, G.W., Proença, M., Salomão, A., Hernandes, N.A., & Pitta, F. (2014). Minimal detectable change of the London chest activity of daily living scale in patients with COPD. Journal of Cardiopulmonary Rehabilitation and Prevention, 34(3), 213-216. https://doi.org/10.1097/hcr.0000000000000047
Borghi-Silva, A., Mendes, R.G., Toledo, A.C., Sampaio, L.M.M., da Silva, T.P., Kunikushita, L.N., Sousa, H.C.D, Salvini, T.F., & Costa, D. (2010). Adjuncts to physical training of patients with severe COPD: oxygen or noninvasive ventilation? American Journal of Respiratory and Critical Care Medicine, 181(7), 885-894. https://doi.org/10.1164/ajrccm-conference.2010.181.1_meetingabstracts.a6502
Broman, G., Quintana, M., Lindberg, T., Jansson, E., & Kaijser, L. (2006). High intensity deep water training can improve aerobic power in elderly women. European Journal Applied Physiolology, 98, 117-123. https://doi.org/10.1007/s00421-006-0237-2
Camelier, A., Warken Rosa, F., Salmi, C., Nascimento, O.A, Cardoso, F., & Jardim, J.R. (2006). Avaliação da qualidade de vida pelo questionário do hospital Saint George na doença respiratória em portadores de doença pulmonar obstrutiva crônica: validação de uma nova versão para o Brasil. Jornal Brasileiro Pneumologia, 32(2), 114-122. https://doi.org/10.1590/S1806-37132006000200006
Carpes, M.F., Mayer, A.F., Simon, K.M., Jardim, J.R., & Garrod, R. (2008). Versão brasileira da escala London Chest Activity of Daily Living para uso em pacientes com doença pulmonar obstrutiva crônica. Jornal Brasileiro de Pneumologia, 34(3), 143-151. https://doi.org/10.1590/s1806-37132008000300004
Carvalho, V.O., Boccchi, E.A., & Guimarães, G.V. (2009). The borg scale as an important tool of self-monitoring and self-regulation of exercise prescription in heart failure patients during hydrotherapy. Circulation Journal, 73 (10), 1871-1876. https://doi.org/10.1253/circj.cj-09-0333
Casaburi, R. (2001). Skeletal muscle dysfunction in chronic obstructive pulmonary disease. Medicine Science Sports Exercise, 33(7), S662-S670. https://doi.org/10.1097/00005768-200107001-00004
Celli, B.R., Cote, C.G., Marin, J.N., Casanova, C., Montes de Oca, M., Mendez, R.A., Pinto Plata, V., & Cabral, H.J. (2004). The body-mass index, airflow obstruction, dyspnea, and exercise capacity index in chronic obstructive pulmonary disease. New England Journal of Medicine, 350(10), 1005-1012. https://doi.org/10.1056/nejmoa021322
Chen, H., Li, P., Li, N., Wang, Z., Wu, W., & Wang, J. (2021). Rehabilitation effects of land and water based aerobic exercise on lung function, dyspnea, and exercise capacity in patients with chronic obstructive pulmonary disease A systematic review and meta-analysis. Medicine, 100(33), e26976. https://doi.org/10.1097/md.0000000000026976
Cohen, J. (1988). Statistical Power Analysis for the Behavioral Sciences. (2nd ed.). Routledge. https://doi.org/10.4324/9780203771587
Cote, C.G., & Celli, B.R. (2005). Pulmonary rehabilitation and the BODE index in COPD. European Respiratory Journal, 26(4), 630-636. https://doi.org/10.1183/09031936.05.00045505
Craig, C.L., Marshall, A.L., Sjöström, M., Baumann, A.E., Booth, M.L., Ainsworth, B. E., Pratt, M., Ekelund, U., Yngve, A., Sallis, J., & Oja, P. (2003). International physical activity questionnaire: 12-country reliability and validity. Medicine Science Sports Exercise, 35 (8), 1381 – 1395. https://doi.org/10.1249/01.mss.0000078924.61453.fb
de Souto Araujo, Z. T., de Miranda Silva Nogueira, P.A., Alves Cabral, E.E., de Paula dos Santos, L., Soares da Silva, I., & Holanda Ferreira, G.M. (2012). Effectiveness of low-intensity aquatic exercise on COPD: A randomized clinical trial. Respiratory Medicine, 106 (11), 1535-1543. https://doi.org/10.1016/j.rmed.2012.06.022
Felcar, J.M., Probst, V.S., de Carvalho, D.R., Merli, M.F., Mesquita, R., Vidotto, L.S., Ribeiro, L.R.G. & Pitta, F. (2018). Effects of exercise training in water and on land in patients with COPD: a randomised clinical trial. Physiotherapy, 104(4), 408-416. https://doi.org/10.1016/j.physio.2017.10.009
Gallo-Silva, B., Zamunér, A.R., Cerezer-Silva, V., Gullo Ferreira, D., Sakabe, D.I., Kel de Souza, L.D., Bertholo, V.C., Ferreira Brasil, M.T., & Moreno, M.A. (2025). Data base of Benefits of hydrotherapy in patients with chronic obstructive pulmonary disease: additional results from a randomized controlled trial. Pensar en Movimiento: Revista de Ciencias del Ejercicio y la Salud, 25(1). https://doi.org/10.15517/pensarmov.v23i1.65042
Garrod, R., Bestall, J.C., Paul, E.A., Wedzicha, J.A., & Jomes, P.W. (2000). Development and validation of a standardized measure of activity of daily living in patients with severe COPD: the London Chest Activity of Daily Living scale (LCADL). Respiratory Medicine, 94(6), 589-596. https://doi.org/10.1053/rmed.2000.0786
Global Initiative for Chronic Obstructive Lung Disease (GOLD). (2022). Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease. https://goldcopd.org
Graef, F.I., & Kruel, F.M. (2006). Frequência cardíaca e percepção subjetiva do esforço no meio aquático: diferenças em relação ao meio terrestre e aplicações na prescrição do exercício-uma revisão. Revista Brasileira de Medicina do Esporte, 12(4), 228-232. https://doi.org/10.1590/S1517-86922006000400011
Hernandes, N.A., Wouters, E.F.M., Meijer, K., Annegarn, J., Pitta, F., & Spruit, M.A. (2011). Reproducibility of 6-minute walking test in patients with COPD. European Respiratory Journal, 38(2), 261-267. https://doi.org/10.1183/09031936.00142010
Horowitz, M.B., Littenberg, B., & Mahler, D.A. (1996). Dyspnea ratings for prescribing exercise intensity in patients with COPD. Chest, 109(5), 1169-1175. https://doi.org/10.1378/chest.109.5.1169
Janssens, M.A.T., De Peuter, S., Stans, L., Verleden, G., Troosters, T., Decramer, M., & Van den Bergh, O. (2011). Dyspnea Perception in COPD Association between anxiety, dyspnea-related fear, and dyspnea in a pulmonary rehabilitation program. Chest, 140(3), 618-625. https://doi.org/10.1378/chest.10-3257
Kim, I.S., Chung, S.H., Park, Y.J., & Kang, H.Y. (2010). The effectiveness of an aquarobic exercise program for patients with osteoarthritis. Applied Nursing Research, 25(3),181-189. https://doi.org/10.1016/j.apnr.2010.10.001
Kocks, J.W. H., Asijee, G.M., Tsiligianni, I.G., Kerstjens, H.A., & van der Molen, T. (2011). Functional status measurement in COPD: a review of available methods and their feasibility in primary care. Primary Care Respiratory Journal, 20, 269-275. https://doi.org/10.4104/pcrj.2011.00031
Kovelis, D., Oldemberg Segretti, N., Probst, V.S., Lareau. S.C., Brunetto, A.F., & Pitta, F. (2008). Validação do Modified Pulmonary Functional Status and Dyspnea Questionnaire e da escala do Medical Research Council para o uso em pacientes com doença pulmonar obstrutiva crônica no Brasil. Jornal Brasileiro de Pneumologia, 34(12), 1008-1018. https://doi.org/10.1590/s1806-37132008001200005
Lareau, S.C., Meek, P.M., & Roos, P.J. (1998). Development and Testing of a Modified Version of Pulmonary Functional Status & Dyspnea Questionnaire (PFSDQ-M). Heart & Lung, 27 (3), 159-168. https://doi.org/10.1016/s0147-9563(98)90003-6
Lotshaw, A.M., Thompson, M., Sadowsky, H.S., Hart, M.K., & Millard, M.W. (2007). Quality of life and physical performance in land and water based pulmonary rehabilitation. Journal of Cardiopulmonary Rehabilitation Prevention, 27(4), 247-251. https://doi.org/10.1097/01.hcr.0000281772.28394.30
McCarthy, B., Casey, D., Devane, D., Murphy, K., Murphy, E., & Lacasse, Y. (2015). Pulmonary rehabilitation for chronic obstructive pulmonary disease. Cochrane Database Systematic Reviews, 2015(2), CD003793. https://doi.org/10.1002/14651858.CD003793.pub3
Mc Namara, R.J, Mc Keough, Z.J., Mc Kenzie, D.K., & Alison, J.A. (2013). Water-based exercise in COPD with comorbidities: a randomised controlled trial. European Respiratory Journal, 41(6),1284-1291. https://doi.org/10.1183/09031936.00034312
Miller, M.R., Hankinson, J., Brusasco, V., Burgos, F., Casaburi, R., Coates, A., Crapo, R., Enright, P., van der Grinten, C.P.M., Gustafsson, P., Jensen, R., Johnson, D.C., Macintyre, N., McKay, R., Navajas, D., Pedersen, O.F., Pellegrino, R., Viegi, G., & Wanger, J. (2005). Standardisation of spirometry. European Respiratory Journal, 26(2), 319-338. https://doi.org/10.1183/09031936.05.00034805
Moga, A.M., de Marchie, M., Saey, D., & Spahija, J. (2012). Mechanisms of non-pharmacologic adjunct therapies used during exercise in COPD. Respiratory Medicine, 106(5), 614-626. https://doi.org/10.1016/j.rmed.2012.01.006
Nici, L., Donner, C., Wouters, E., Zuwallack, R., Ambrosino, N., Bourbeau, J., Carone, M., Celli, B., Engelen, M., Fahy, B., Garvey, C., Goldstein, R., Gosselink, R., Lareau, S., MacIntyre, N, Maltais, F., Morgan, M., O´Donnell, D., Prefault, C., Reardon, J., Rochester, C., Schols, A., Singh, S., & Troosters, T. (2006). American Throracic Society/ European Respiratory Society Statement on Pulmonary Rehabilitation. American Journal of Respiratory Critical Care Medicine, 173(12), 1390-1413. https://doi.org/10.1164/rccm.200508-1211st
Pereira, C.A., Sato, T., & Rodrigues, S.C. (2007). Novos valores de referência para espirometria forçada em brasileiros adultos de raça branca. Jornal Brasileiro de Pneumologia, 33 (4), 397-406. https://doi.org/10.1590/s1806-37132007000400008
Probst, V.S., Kovelis, D., Hernandes, N.A., Camillo, C.A., Cavalheri, V., & Pitta, F. (2011). Effects of 2 Exercise Training Programs on Physical Activity in Daily Life in Patients With COPD. Respiratory Care, 56(11), 1799-1807. https://doi.org/10.4187/respcare.01110
Regueiro, E.M.G., Burtin, C., Baten, P., Langer, D., Van Remoortel, H., Pires Di Lorenzo, V.A., Costa, D., Janssens, W., Decramer, M., Gosselink, R., & Troosters, T. (2013). The minimal important difference of the pulmonary functional and dyspnea questionnaire in patients with severe chronic obstructive pulmonary disease. Respiratory Research, 14(58). https://doi.org/10.1186/1465-9921-14-58
Resende, S.M., & Rassi, C.M. (2008). Efeitos da hidroterapia na recuperação do equilíbrio e prevenção de quedas em idosas. Revista Brasileira de Fisioterapia, 12(1), 57-63. https://doi.org/10.1590/S1413-35552008000100011
Ritchie, A.I., & Wedzicha, J.A. (2020). Definitions, causes, pathogenesis, and consequences of chronic obstructive pulmonary disease exacerbations. Clinics in Chest Medicine, 41(3),421-438. https://doi.org/10.1016/j.ccm.2020.06.007
Schünemann, H.J., Griffith, L., Jaeschke, R., Goldstein, R., Stubbing, D., & Guyatt, G.H. (2003). Evaluation of the minimal important difference for the feeling thermometer and the St. George’s Respiratory Questionnaire in patients with chronic airflow obstruction, Journal of Clinical Epidemiology, 56(12),1170-1176. https://doi.org/10.1016/S0895-4356(03)00115-X
Van Herck, M., Antons, J., Vercoulen, J., Goërtz, Y., Ebadi, Z, Burtin, C., Janssen, D., Thong, M., Otker, J., Coors, A., Sprangers., M., Muris, J., Wouters, E., Prins, J., Spruit, M., & Peters, J. (2019). Pulmonary rehabilitation reduces subjective fatigue in COPD: a responder analysis. European Respiratory Journal, 54(63), PA573. https://doi.org/10.1183/13993003.congress-2019.PA573
Vogiatzis, I., Nanas, S., & Roussos, C. (2002). Interval training as an alternative modality to continuous exercise in patients with COPD. European Respiratory Journal, 20(1),12-19. https://doi.org/10.1183/09031936.02.01152001
Wadell, K., Sundelin, G., Henriksson-Larsén, K., & Lundgren, R. (2004). High intensity physical group training in water—an effective training modality for patients with COPD. Respiratory Medicine, 98(5),428-438. https://doi.org/10.1016/j.rmed.2003.11.010
Zampogna, E., Ferriero, G., Visca, D., Patrini, M., Negrini, S., & Arienti, C. (2023). An overview of Cochrane systematic reviews for pulmonar rehabilitation interventions in people with chronic obstructive pulmonary disease: a mapping synthesis. Panminerva Medica, 65(2), 234-243. https://doi.org/10.23736/s0031-0808.22.04757-7
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Copyright (c) 2025 Bruna Gallo-Silva, Antonio Roberto Zamunér, Viviane Cerezer-Silva, Danilo Gullo Ferreira, Daniel Iwai Sakabe, Luana Daniele Kel de Souza, Vanessa Cristina Bertholo, Mayara Thaysa Ferreira Brasil, Marlene Aparecida Moreno