A abordagem da funcionalidade na avaliação da reabilitação pulmonar em pacientes com doença pulmonar obstrutiva crônica

Abstract

Introduction: Pulmonary rehabilitation (PR) is a key intervention for the treatment of Chronic Obstructive Pulmonary Disease (COPD). However, the relationship between the evaluation domains and the components of the International Classification of Functioning, Disability and Health (ICF) is unclear. Objective: To analyze the main instruments used in modern PR assessment in patients with COPD in order to investigate whether they reflect the ICF components. Methods: A systematic review was conducted to identify documents such as clinical practice guides, statements or guidelines for the management of COPD or implementation of PR. Then, the content of these documents was investigated to identify the instruments recommended for assessment of the essential domains of modern PR. Finally, the relationship between the concepts present in these instruments and the ICF components was investigated. Results: Six documents were found (4 for COPD and 2 for RP). From these, 4 instruments were identified for the exercise capacity (EC) domain, 4 for quality of life (QoL), 3 for dyspnea, 1 for nutritional status, and no document cited instruments for occupational status. All ICF components were present, but in different instruments. The QL instruments were the ones that reflected more ICF components. Conclusion: The instruments used for the evaluation of COPD patients in RP include all ICF components. The QL instruments are the most comprehensive. However, it is still unclear whether all relevant categories of each component are represented.