array:24 [
  "pii" => "S0873215915301276"
  "issn" => "08732159"
  "doi" => "10.1016/S0873-2159(15)30127-6"
  "estado" => "S350"
  "fechaPublicacion" => "2009-03-01"
  "aid" => "5"
  "copyright" => "Sociedade Portuguesa de Pneumologia/SPP"
  "copyrightAnyo" => "2009"
  "documento" => "simple-article"
  "crossmark" => 0
  "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/"
  "subdocumento" => "fla"
  "cita" => "Rev Port Pneumol. 2009;15:199-214"
  "abierto" => array:3 [
    "ES" => true
    "ES2" => true
    "LATM" => true
  ]
  "gratuito" => true
  "lecturas" => array:2 [
    "total" => 2665
    "formatos" => array:3 [
      "EPUB" => 221
      "HTML" => 1557
      "PDF" => 887
    ]
  ]
  "itemSiguiente" => array:19 [
    "pii" => "S0873215915301288"
    "issn" => "08732159"
    "doi" => "10.1016/S0873-2159(15)30128-8"
    "estado" => "S350"
    "fechaPublicacion" => "2009-03-01"
    "aid" => "6"
    "copyright" => "Sociedade Portuguesa de Pneumologia/SPP"
    "documento" => "simple-article"
    "crossmark" => 0
    "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/"
    "subdocumento" => "fla"
    "cita" => "Rev Port Pneumol. 2009;15:215-26"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:2 [
      "total" => 2251
      "formatos" => array:3 [
        "EPUB" => 207
        "HTML" => 1283
        "PDF" => 761
      ]
    ]
    "pt" => array:11 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Artigo Original&#47;Original Article</span>"
      "titulo" => "Estudo sobre o impacto do uso de aparelho de emiss&#227;o de press&#227;o positiva cont&#237;nua nas vias a&#233;reas superiores na hipersonia diurna em portadores da s&#237;ndroma de apneia do sono"
      "tienePdf" => "pt"
      "tieneTextoCompleto" => 0
      "tieneResumen" => array:2 [
        0 => "pt"
        1 => "en"
      ]
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "215"
          "paginaFinal" => "226"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "en" => array:1 [
          "titulo" => "Study into the use of continuous positive airway pressure in obstructive sleep apnoea-hypopnoea syndrome patients with daytime drowsiness"
        ]
      ]
      "contieneResumen" => array:2 [
        "pt" => true
        "en" => true
      ]
      "contienePdf" => array:1 [
        "pt" => true
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "Cl&#233;lia Maria Ribeiro Franco, Juliana Cestaro Bonanni, Anna Myrna Jaguaribe, Luiz Ata&#237;de"
          "autores" => array:4 [
            0 => array:2 [
              "nombre" => "Cl&#233;lia Maria Ribeiro"
              "apellidos" => "Franco"
            ]
            1 => array:2 [
              "nombre" => "Juliana Cestaro"
              "apellidos" => "Bonanni"
            ]
            2 => array:2 [
              "nombre" => "Anna Myrna"
              "apellidos" => "Jaguaribe"
            ]
            3 => array:3 [
              "nombre" => "Luiz"
              "apellidos" => "Ata&#237;de"
              "sufijo" => "Jr&#46;"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "pt"
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0873215915301288?idApp=UINPBA00004E"
    "url" => "/08732159/0000001500000002/v1_201509151524/S0873215915301288/v1_201509151524/pt/main.assets"
  ]
  "itemAnterior" => array:19 [
    "pii" => "S0873215915301264"
    "issn" => "08732159"
    "doi" => "10.1016/S0873-2159(15)30126-4"
    "estado" => "S350"
    "fechaPublicacion" => "2009-03-01"
    "aid" => "4"
    "copyright" => "Sociedade Portuguesa de Pneumologia&#47;SPP"
    "documento" => "simple-article"
    "crossmark" => 0
    "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/"
    "subdocumento" => "fla"
    "cita" => "Rev Port Pneumol. 2009;15:179-97"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:2 [
      "total" => 2270
      "formatos" => array:3 [
        "EPUB" => 228
        "HTML" => 1400
        "PDF" => 642
      ]
    ]
    "pt" => array:11 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Artigo Original&#47;Original Article</span>"
      "titulo" => "Casu&#237;stica de quatro anos de uma consulta de apoio ao fumador"
      "tienePdf" => "pt"
      "tieneTextoCompleto" => 0
      "tieneResumen" => array:2 [
        0 => "pt"
        1 => "en"
      ]
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "179"
          "paginaFinal" => "197"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "en" => array:1 [
          "titulo" => "Four years&#8217; follow up at a smoking cessation clinic"
        ]
      ]
      "contieneResumen" => array:2 [
        "pt" => true
        "en" => true
      ]
      "contienePdf" => array:1 [
        "pt" => true
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "M&#46; Aguiar, F&#46; Todo-Bom, M&#46; Felizardo, R&#46; Macedo, F&#46; Caeiro, R&#46; Sotto-Mayor, A&#46; Bugalho de Almeida"
          "autores" => array:7 [
            0 => array:2 [
              "nombre" => "M&#46;"
              "apellidos" => "Aguiar"
            ]
            1 => array:2 [
              "nombre" => "F&#46;"
              "apellidos" => "Todo-Bom"
            ]
            2 => array:2 [
              "nombre" => "M&#46;"
              "apellidos" => "Felizardo"
            ]
            3 => array:2 [
              "nombre" => "R&#46;"
              "apellidos" => "Macedo"
            ]
            4 => array:2 [
              "nombre" => "F&#46;"
              "apellidos" => "Caeiro"
            ]
            5 => array:2 [
              "nombre" => "R&#46;"
              "apellidos" => "Sotto-Mayor"
            ]
            6 => array:2 [
              "nombre" => "A&#46;"
              "apellidos" => "Bugalho de Almeida"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "pt"
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0873215915301264?idApp=UINPBA00004E"
    "url" => "/08732159/0000001500000002/v1_201509151524/S0873215915301264/v1_201509151524/pt/main.assets"
  ]
  "pt" => array:15 [
    "idiomaDefecto" => true
    "cabecera" => "<span class="elsevierStyleTextfn">Artigo Original&#47;Original Article</span>"
    "titulo" => "Influ&#234;ncia da fun&#231;&#227;o pulmonar e da for&#231;a muscular na capacidade funcional de portadores de doen&#231;a pulmonar obstrutiva cr&#243;nica"
    "tieneTextoCompleto" => 0
    "paginas" => array:1 [
      0 => array:2 [
        "paginaInicial" => "199"
        "paginaFinal" => "214"
      ]
    ]
    "autores" => array:1 [
      0 => array:4 [
        "autoresLista" => "S&#233;rgio Leite Rodrigues, C&#233;sar Augusto Melo e Silva, Tereza Lima, Carlos Alberto de Assis Viegas, Marcelo Palmeira Rodrigues, Fernanda Almeida Ribeiro"
        "autores" => array:6 [
          0 => array:3 [
            "nombre" => "S&#233;rgio Leite"
            "apellidos" => "Rodrigues"
            "referencia" => array:2 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">1</span>"
                "identificador" => "af0005"
              ]
              1 => array:2 [
                "etiqueta" => "&#42;"
                "identificador" => "cr0005"
              ]
            ]
          ]
          1 => array:3 [
            "nombre" => "C&#233;sar Augusto Melo"
            "apellidos" => "e Silva"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">2</span>"
                "identificador" => "af0010"
              ]
            ]
          ]
          2 => array:3 [
            "nombre" => "Tereza"
            "apellidos" => "Lima"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">3</span>"
                "identificador" => "af0015"
              ]
            ]
          ]
          3 => array:3 [
            "nombre" => "Carlos Alberto"
            "apellidos" => "de Assis Viegas"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">4</span>"
                "identificador" => "af0020"
              ]
            ]
          ]
          4 => array:3 [
            "nombre" => "Marcelo Palmeira"
            "apellidos" => "Rodrigues"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">5</span>"
                "identificador" => "af0025"
              ]
            ]
          ]
          5 => array:3 [
            "nombre" => "Fernanda Almeida"
            "apellidos" => "Ribeiro"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">6</span>"
                "identificador" => "af0030"
              ]
            ]
          ]
        ]
        "afiliaciones" => array:6 [
          0 => array:3 [
            "entidad" => "Mestre em Ci&#234;ncias da Sa&#250;de &#47; MSC&#44; Health Sciences&#44; Universidade de Bras&#237;lia &#8211; UnB&#44; Hospital Universit&#225;rio de Bras&#237;lia &#8211; HUB Rua L2 Norte Quadras 605 CEP 70840 - 901 Bras&#237;lia &#8211; DF Brasil"
            "etiqueta" => "1"
            "identificador" => "af0005"
          ]
          1 => array:3 [
            "entidad" => "Doutor em Ci&#234;ncias M&#233;dicas &#47; PhD&#44; Health Sciences&#44; Universidade de Bras&#237;lia &#8211; UnB&#44; Hospital Universit&#225;rio de Bras&#237;lia &#8211; HUB Rua L2 Norte Quadras 605 CEP 70840 - 901 Bras&#237;lia &#8211; DF Brasil"
            "etiqueta" => "2"
            "identificador" => "af0010"
          ]
          2 => array:3 [
            "entidad" => "Mestre em Cl&#237;nica M&#233;dica &#47; MSC&#44; Internal Medicine&#44; Universidade de Bras&#237;lia &#8211; UnB&#44; Hospital Universit&#225;rio de Bras&#237;lia &#8211; HUB Rua L2 Norte Quadras 605 CEP 70840 - 901 Bras&#237;lia &#8211; DF Brasil"
            "etiqueta" => "3"
            "identificador" => "af0015"
          ]
          3 => array:3 [
            "entidad" => "Doutor em Fisiopatologia Respirat&#243;ria &#47; PhD&#44; Respiratory Physiopathology&#44; Universidade de Bras&#237;lia &#8211; UnB&#44; Hospital Universit&#225;rio de Bras&#237;lia &#8211; HUB Rua L2 Norte Quadras 605 CEP 70840 - 901 Bras&#237;lia &#8211; DF Brasil"
            "etiqueta" => "4"
            "identificador" => "af0020"
          ]
          4 => array:3 [
            "entidad" => "Doutor em Ci&#234;ncias M&#233;dicas &#47; PhD&#44; Medical Sciences&#44; Universidade de Bras&#237;lia &#8211; UnB&#44; Hospital Universit&#225;rio de Bras&#237;lia &#8211; HUB Rua L2 Norte Quadras 605 CEP 70840 -901 Bras&#237;lia &#8211; DF Brasil"
            "etiqueta" => "5"
            "identificador" => "af0025"
          ]
          5 => array:3 [
            "entidad" => "Mestre em Ci&#234;ncias da Sa&#250;de &#47; MSC&#44; Health Sciences&#44; Universidade de Bras&#237;lia &#8211; UnB&#44; Hospital Universit&#225;rio de Bras&#237;lia &#8211; HUB Rua L2 Norte Quadras 605 CEP 70840 -901 Bras&#237;lia &#8211; DF Brasil"
            "etiqueta" => "6"
            "identificador" => "af0030"
          ]
        ]
        "correspondencia" => array:1 [
          0 => array:3 [
            "identificador" => "cr0005"
            "etiqueta" => "&#42;"
            "correspondencia" => "<span class="elsevierStyleBold">Correspond&#234;ncia&#47;<span class="elsevierStyleItalic">Correspondence to&#58;</span></span> S&#233;rgio Leite Rodrigues&#44; Rua 05 Norte Lote 02 Bloco B Apto 1304 Residencial Cedro&#44; &#193;guas Claras CEP&#58;71907-720 Bras&#237;lia &#8211; DF Brasil"
          ]
        ]
      ]
    ]
    "titulosAlternativos" => array:1 [
      "en" => array:1 [
        "titulo" => "The influence of lung function and muscular strength on the functional capacity of chronic obstructive pulmonary disease patients"
      ]
    ]
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "fechaRecibido" => "2008-08-01"
    "fechaAceptado" => "2008-11-07"
    "PalabrasClave" => array:2 [
      "pt" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Palavras-chave"
          "identificador" => "xpalclavsec570431"
          "palabras" => array:6 [
            0 => "Teste de caminhada de seis minutos"
            1 => "reabilita&#231;&#227;o pulmonar"
            2 => "for&#231;a muscular"
            3 => "hipoxemia"
            4 => "DPOC"
            5 => "sistema musculoesquel&#233;tico"
          ]
        ]
      ]
      "en" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Key-words"
          "identificador" => "xpalclavsec570432"
          "palabras" => array:6 [
            0 => "COPD"
            1 => "hypoxaemia"
            2 => "muscle strength"
            3 => "musculoskeletal system"
            4 => "pulmonary rehabilitation"
            5 => "six-minute walk test"
          ]
        ]
      ]
    ]
    "tieneResumen" => true
    "resumen" => array:2 [
      "pt" => array:2 [
        "titulo" => "Resumo"
        "resumen" => "<span id="as0005" class="elsevierStyleSection elsevierViewall"><p id="sp0005" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleBold">Objectivo&#58;</span> Determinar que vari&#225;vel entre o volume expirado for&#231;ado no primeiro segundo &#40;VEF<span class="elsevierStyleInf">1</span>&#41;&#44; a press&#227;o parcial do oxig&#233;nio no sangue arterial &#40;PaO<span class="elsevierStyleInf">2</span>&#41;&#44; a hipoxemia nocturna e a for&#231;a muscular do quadric&#237;pite femoral pode predizer a dist&#226;ncia percorrida no teste de caminhada de seis minutos &#40;TC6&#41; em doentes com DPOC&#46;</p><p id="sp0010" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleBold">Doentes e m&#233;todos&#58;</span> Um estudo observacional do tipo transversal&#44; envolvendo trinta doentes encaminhados a um programa de reabilita&#231;&#227;o pulmonar de um hospital universit&#225;rio&#46; A fun&#231;&#227;o pulmonar foi avaliada por espirometria&#44; gasometria arterial e oximetria nocturna&#46; A fun&#231;&#227;o muscular pela for&#231;a muscular do quadric&#237;pite femoral e a avalia&#231;&#227;o da capacidade funcional pelo TC6&#46;</p><p id="sp0015" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleBold">Resultados&#58;</span> A an&#225;lise de regress&#227;o bivariada mostrou que a for&#231;a do quadric&#237;pite femoral foi a &#250;nica vari&#225;vel que se mostrou estatisticamente significativa &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;002&#41; em predizer a dist&#226;ncia&#44; sendo respons&#225;vel por 38&#37; da vari&#226;ncia do TC6&#46; Para essas vari&#225;veis a rela&#231;&#227;o estabelecida estatisticamente foi que para cada quilo de for&#231;a do quadric&#237;pite femoral&#44; os doentes caminharam 5&#44;9 metros no TC6&#46;</p><p id="sp0020" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleBold">Conclus&#227;o&#58;</span> Os resultados indicam a import&#226;ncia da for&#231;a muscular do MI em testes de esfor&#231;o subm&#225;ximo&#46; Entre as vari&#225;veis estudadas&#44; apenas a for&#231;a muscular do quadric&#237;pite femoral p&#244;de predizer a dist&#226;ncia percorrida no TC6 em portadores de doen&#231;a pulmonar obstrutiva cr&#243;nica&#46;</p><p id="sp0025" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleBold">Rev Port Pneumol 2009&#59; XV &#40;2&#41;&#58; 199-214</span></p></span>"
      ]
      "en" => array:2 [
        "titulo" => "Abstract"
        "resumen" => "<span id="as0010" class="elsevierStyleSection elsevierViewall"><p id="sp0030" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleBold">Aim&#58;</span> To determine which variable &#40;forced expiratory volume in 1 second &#40;FEV<span class="elsevierStyleInf">1</span>&#41;&#44; partial pressure of oxygen in arterial blood &#40;PaO<span class="elsevierStyleInf">2</span>&#41;&#44; nocturnal hypoxaemia and muscular strength of femoral quadriceps&#41; can predict the distance walked in the six-minute walk test &#40;6MWT&#41; by COPD patients&#46;</p><p id="sp0035" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleBold">Methods&#58;</span> A cross-sectional and observational study of thirty patients referred to a pulmonary rehabilitation programme at a university hospital&#46; Lung function was evaluated by spirometry&#44; arterial blood gas analysis and nocturnal oximetry&#46; Muscle function was evaluated by quadriceps strength and functional capacity by the 6MWT&#46;</p><p id="sp0040" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleBold">Results&#58;</span> Bivariate regression analysis showed that quadriceps strength&#44; was the only variable to correlate significantly with the distance walked in the 6MWT &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;002&#41;&#44; accounting for 38&#37; of the 6MWT variance&#46; The statistical relationship established for these variables was 1<span class="elsevierStyleHsp" style=""></span>kg of quadriceps strength equalled 5&#46;9 metres walked in the 6MWT&#46;</p><p id="sp0045" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleBold">Conclusions&#58;</span> Our results showed the importance of lower limb muscle strength in submaximal exercise testing&#46; We conclude that femoral quadriceps muscle strength is the only one of the variables studied which can predict the distance COPD patients walk in the 6MWT&#46;</p><p id="sp0050" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleBold">Rev Port Pneumol 2009&#59; XV &#40;2&#41;&#58; 199-214</span></p></span>"
      ]
    ]
    "lecturaRecomendada" => array:1 [
      0 => array:3 [
        "vista" => "all"
        "titulo" => "<span class="elsevierStyleSectionTitle" id="st0025">Bibliografia&#47;Bibliography</span>"
        "seccion" => array:1 [
          0 => array:2 [
            "vista" => "all"
            "bibliografiaReferencia" => array:30 [
              0 => array:3 [
                "identificador" => "bb0005"
                "etiqueta" => "1&#46;"
                "referencia" => array:1 [
                  0 => array:2 [
                    "contribucion" => array:1 [
                      0 => array:2 [
                        "titulo" => "Idiopathic pulmonary fibrosis prognostic value of changes in physiology and six-minute-walk test"
                        "autores" => array:1 [
                          0 => array:2 [
                            "etal" => true
                            "autores" => array:6 [
                              0 => "K&#46;R&#46; Flaherty"
                              1 => "A&#46;C&#46; Andrei"
                              2 => "S&#46; Murray"
                              3 => "C&#46; Fraley"
                              4 => "T&#46;V&#46; Colby"
                              5 => "W&#46;D&#46; Travis"
                            ]
                          ]
                        ]
                      ]
                    ]
                    "host" => array:1 [
                      0 => array:2 [
                        "doi" => "10.1164/rccm.200604-488OC"
                        "Revista" => array:7 [
                          "tituloSerie" => "Am J Respir Crit Care Med"
                          "fecha" => "2006"
                          "volumen" => "174"
                          "numero" => "7"
                          "paginaInicial" => "803"
                          "paginaFinal" => "809"
                          "link" => array:1 [
                            0 => array:2 [
                              "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16825656"
                              "web" => "Medline"
                            ]
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
              1 => array:3 [
                "identificador" => "bb0010"
                "etiqueta" => "2&#46;"
                "referencia" => array:1 [
                  0 => array:2 [
                    "contribucion" => array:1 [
                      0 => array:2 [
                        "titulo" => "Physiological response to the six-minute walk test in pulmonary arterial hypertension"
                        "autores" => array:1 [
                          0 => array:2 [
                            "etal" => false
                            "autores" => array:5 [
                              0 => "G&#46; Deboeck"
                              1 => "G&#46; Niset"
                              2 => "J&#46;L&#46; Vachiery"
                              3 => "J&#46;J&#46; Moraine"
                              4 => "R&#46; Naeije"
                            ]
                          ]
                        ]
                      ]
                    ]
                    "host" => array:1 [
                      0 => array:2 [
                        "doi" => "10.1183/09031936.05.00031505"
                        "Revista" => array:7 [
                          "tituloSerie" => "Eur Respir J"
                          "fecha" => "2005"
                          "volumen" => "26"
                          "numero" => "4"
                          "paginaInicial" => "667"
                          "paginaFinal" => "672"
                          "link" => array:1 [
                            0 => array:2 [
                              "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16204599"
                              "web" => "Medline"
                            ]
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
              2 => array:3 [
                "identificador" => "bb0015"
                "etiqueta" => "3&#46;"
                "referencia" => array:1 [
                  0 => array:2 [
                    "contribucion" => array:1 [
                      0 => array:2 [
                        "titulo" => "Health-related quality of life following single or bilateral lung transplantation&#46; A 7 year comparison to functional outcome"
                        "autores" => array:1 [
                          0 => array:2 [
                            "etal" => false
                            "autores" => array:5 [
                              0 => "M&#46;W&#46; Gerbase"
                              1 => "A&#46; Spiliopoulos"
                              2 => "T&#46; Rochat"
                              3 => "M&#46; Archinard"
                              4 => "L&#46;P&#46; Nicod"
                            ]
                          ]
                        ]
                      ]
                    ]
                    "host" => array:1 [
                      0 => array:2 [
                        "doi" => "10.1378/chest.128.3.1371"
                        "Revista" => array:7 [
                          "tituloSerie" => "Chest"
                          "fecha" => "2005"
                          "volumen" => "128"
                          "numero" => "3"
                          "paginaInicial" => "1371"
                          "paginaFinal" => "1378"
                          "link" => array:1 [
                            0 => array:2 [
                              "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16162731"
                              "web" => "Medline"
                            ]
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
              3 => array:3 [
                "identificador" => "bb0020"
                "etiqueta" => "4&#46;"
                "referencia" => array:1 [
                  0 => array:2 [
                    "contribucion" => array:1 [
                      0 => array:2 [
                        "titulo" => "Distance walked in the 6-minute test soon after cardiac surgery&#46; toward an efficient use in the individual patient"
                        "autores" => array:1 [
                          0 => array:2 [
                            "etal" => true
                            "autores" => array:6 [
                              0 => "C&#46; Opasich"
                              1 => "S&#46; De Feo"
                              2 => "G&#46;D&#46; Pinna"
                              3 => "G&#46; Furgi"
                              4 => "R&#46; Pedretti"
                              5 => "D&#46; Scrutinio"
                            ]
                          ]
                        ]
                      ]
                    ]
                    "host" => array:1 [
                      0 => array:2 [
                        "doi" => "10.1378/chest.126.6.1796"
                        "Revista" => array:7 [
                          "tituloSerie" => "Chest"
                          "fecha" => "2004"
                          "volumen" => "126"
                          "numero" => "6"
                          "paginaInicial" => "1796"
                          "paginaFinal" => "1801"
                          "link" => array:1 [
                            0 => array:2 [
                              "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15596676"
                              "web" => "Medline"
                            ]
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
              4 => array:3 [
                "identificador" => "bb0025"
                "etiqueta" => "5&#46;"
                "referencia" => array:1 [
                  0 => array:2 [
                    "contribucion" => array:1 [
                      0 => array:2 [
                        "titulo" => "6-minute walk work for assessment of functional capacity in patients with COPD"
                        "autores" => array:1 [
                          0 => array:2 [
                            "etal" => false
                            "autores" => array:6 [
                              0 => "R&#46; Carter"
                              1 => "D&#46;B&#46; Holiday"
                              2 => "C&#46; Nwasuruba"
                              3 => "J&#46; Stocks"
                              4 => "C&#46; Grothues"
                              5 => "B&#46; Tiep"
                            ]
                          ]
                        ]
                      ]
                    ]
                    "host" => array:1 [
                      0 => array:1 [
                        "Revista" => array:7 [
                          "tituloSerie" => "Chest"
                          "fecha" => "2003"
                          "volumen" => "123"
                          "numero" => "5"
                          "paginaInicial" => "1408"
                          "paginaFinal" => "1415"
                          "link" => array:1 [
                            0 => array:2 [
                              "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12740255"
                              "web" => "Medline"
                            ]
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
              5 => array:3 [
                "identificador" => "bb0030"
                "etiqueta" => "6&#46;"
                "referencia" => array:1 [
                  0 => array:2 [
                    "contribucion" => array:1 [
                      0 => array:2 [
                        "titulo" => "A qualitative systematic overview of the measurement properties of functional walk tests used in the cardiorespiratory domain"
                        "autores" => array:1 [
                          0 => array:2 [
                            "etal" => false
                            "autores" => array:4 [
                              0 => "S&#46; Solway"
                              1 => "D&#46; Brooks"
                              2 => "Y&#46; Lacasse"
                              3 => "S&#46; Thomas"
                            ]
                          ]
                        ]
                      ]
                    ]
                    "host" => array:1 [
                      0 => array:1 [
                        "Revista" => array:7 [
                          "tituloSerie" => "Chest"
                          "fecha" => "2001"
                          "volumen" => "119"
                          "numero" => "1"
                          "paginaInicial" => "256"
                          "paginaFinal" => "270"
                          "link" => array:1 [
                            0 => array:2 [
                              "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11157613"
                              "web" => "Medline"
                            ]
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
              6 => array:3 [
                "identificador" => "bb0035"
                "etiqueta" => "7&#46;"
                "referencia" => array:1 [
                  0 => array:2 [
                    "contribucion" => array:1 [
                      0 => array:2 [
                        "titulo" => "Global Strategy for the Diagnosis&#44; Management&#44; and Prevention of Chronic Obstructive Pulmonary Disease&#46; GOLD Executive Summary"
                        "autores" => array:1 [
                          0 => array:2 [
                            "etal" => true
                            "autores" => array:6 [
                              0 => "K&#46;F&#46; Rabe"
                              1 => "S&#46; Hurd"
                              2 => "A&#46; Anzueto"
                              3 => "P&#46;J&#46; Barnes"
                              4 => "S&#46;A&#46; Buist"
                              5 => "P&#46; Calverley"
                            ]
                          ]
                        ]
                      ]
                    ]
                    "host" => array:1 [
                      0 => array:2 [
                        "doi" => "10.1164/rccm.200703-456SO"
                        "Revista" => array:7 [
                          "tituloSerie" => "Am J Respir Crit Care Med"
                          "fecha" => "2007"
                          "volumen" => "176"
                          "numero" => "6"
                          "paginaInicial" => "532"
                          "paginaFinal" => "555"
                          "link" => array:1 [
                            0 => array:2 [
                              "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17507545"
                              "web" => "Medline"
                            ]
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
              7 => array:3 [
                "identificador" => "bb0040"
                "etiqueta" => "8&#46;"
                "referencia" => array:1 [
                  0 => array:2 [
                    "contribucion" => array:1 [
                      0 => array:2 [
                        "titulo" => "Capacidade subm&#225;xima de exerc&#237;cio em pacientes adolescentes e adultos com fibrose c&#237;stica"
                        "autores" => array:1 [
                          0 => array:2 [
                            "etal" => false
                            "autores" => array:6 [
                              0 => "B&#46; Ziegler"
                              1 => "P&#46;M&#46;E&#46; Rovedder"
                              2 => "J&#46;L&#46; Lukrafka"
                              3 => "C&#46;L&#46; Oliveira"
                              4 => "S&#46;S&#46; Menna-Barreto"
                              5 => "P&#46;T&#46;R&#46; Dalcin"
                            ]
                          ]
                        ]
                      ]
                    ]
                    "host" => array:1 [
                      0 => array:1 [
                        "Revista" => array:7 [
                          "tituloSerie" => "J Bras Pneumol"
                          "fecha" => "2007"
                          "volumen" => "33"
                          "numero" => "3"
                          "paginaInicial" => "263"
                          "paginaFinal" => "269"
                          "link" => array:1 [
                            0 => array:2 [
                              "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17906786"
                              "web" => "Medline"
                            ]
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
              8 => array:3 [
                "identificador" => "bb0045"
                "etiqueta" => "9&#46;"
                "referencia" => array:1 [
                  0 => array:2 [
                    "contribucion" => array:1 [
                      0 => array:2 [
                        "titulo" => "The body-mass index&#44; airflow obstruction&#44; dyspnea&#44; and exercise capacity index in chronic obstructive pulmonary disease"
                        "autores" => array:1 [
                          0 => array:2 [
                            "etal" => true
                            "autores" => array:6 [
                              0 => "B&#46;R&#46; Celli"
                              1 => "C&#46;G&#46; Cote"
                              2 => "J&#46;M&#46; Marin"
                              3 => "C&#46; Casanova"
                              4 => "M&#46; Montes de Oca"
                              5 => "R&#46;A&#46; Mendez"
                            ]
                          ]
                        ]
                      ]
                    ]
                    "host" => array:1 [
                      0 => array:2 [
                        "doi" => "10.1056/NEJMoa021322"
                        "Revista" => array:7 [
                          "tituloSerie" => "N Engl J Med"
                          "fecha" => "2004"
                          "volumen" => "350"
                          "numero" => "4"
                          "paginaInicial" => "1005"
                          "paginaFinal" => "1012"
                          "link" => array:1 [
                            0 => array:2 [
                              "url" => "https://www.ncbi.nlm.nih.gov/pubmed/14999112"
                              "web" => "Medline"
                            ]
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
              9 => array:3 [
                "identificador" => "bb0050"
                "etiqueta" => "10&#46;"
                "referencia" => array:1 [
                  0 => array:2 [
                    "contribucion" => array:1 [
                      0 => array:2 [
                        "titulo" => "Functional status and survival following pulmonary rehabilitation"
                        "autores" => array:1 [
                          0 => array:2 [
                            "etal" => true
                            "autores" => array:6 [
                              0 => "J&#46;B&#46; Bowen"
                              1 => "J&#46;J&#46; Votto"
                              2 => "R&#46;S&#46; Thrall"
                              3 => "M&#46;C&#46; Haggerty"
                              4 => "R&#46; Stockdale-Woolley"
                              5 => "T&#46; Bandyopadhyay"
                            ]
                          ]
                        ]
                      ]
                    ]
                    "host" => array:1 [
                      0 => array:1 [
                        "Revista" => array:7 [
                          "tituloSerie" => "Chest"
                          "fecha" => "2000"
                          "volumen" => "118"
                          "numero" => "3"
                          "paginaInicial" => "697"
                          "paginaFinal" => "703"
                          "link" => array:1 [
                            0 => array:2 [
                              "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10988191"
                              "web" => "Medline"
                            ]
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
              10 => array:3 [
                "identificador" => "bb0055"
                "etiqueta" => "11&#46;"
                "referencia" => array:1 [
                  0 => array:2 [
                    "contribucion" => array:1 [
                      0 => array:2 [
                        "titulo" => "The 6-min walking distance&#58; long-term follow up in patients with COPD"
                        "autores" => array:1 [
                          0 => array:2 [
                            "etal" => true
                            "autores" => array:6 [
                              0 => "C&#46; Casanova"
                              1 => "C&#46;G&#46; Cote"
                              2 => "J&#46;M&#46; Marin"
                              3 => "J&#46;P&#46; De Torres"
                              4 => "A&#46; Aguirre-Jaime"
                              5 => "R&#46; Mendez"
                            ]
                          ]
                        ]
                      ]
                    ]
                    "host" => array:1 [
                      0 => array:2 [
                        "doi" => "10.1183/09031936.00071506"
                        "Revista" => array:7 [
                          "tituloSerie" => "Eur Respir J"
                          "fecha" => "2007"
                          "volumen" => "29"
                          "numero" => "3"
                          "paginaInicial" => "535"
                          "paginaFinal" => "540"
                          "link" => array:1 [
                            0 => array:2 [
                              "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17107991"
                              "web" => "Medline"
                            ]
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
              11 => array:3 [
                "identificador" => "bb0060"
                "etiqueta" => "12&#46;"
                "referencia" => array:1 [
                  0 => array:2 [
                    "contribucion" => array:1 [
                      0 => array:2 [
                        "titulo" => "Manifesta&#231;&#245;es sist&#234;micas na doen&#231;a pulmonar obstrutiva cr&#244;nica"
                        "autores" => array:1 [
                          0 => array:2 [
                            "etal" => false
                            "autores" => array:6 [
                              0 => "V&#46;Z&#46; Dourado"
                              1 => "S&#46;E&#46; Tanni"
                              2 => "S&#46;A&#46; Vale"
                              3 => "M&#46;M&#46; Faganello"
                              4 => "F&#46;F&#46; Sanchez"
                              5 => "I&#46; Godoy"
                            ]
                          ]
                        ]
                      ]
                    ]
                    "host" => array:1 [
                      0 => array:1 [
                        "Revista" => array:7 [
                          "tituloSerie" => "J Bras Pneumol"
                          "fecha" => "2006"
                          "volumen" => "32"
                          "numero" => "2"
                          "paginaInicial" => "161"
                          "paginaFinal" => "171"
                          "link" => array:1 [
                            0 => array:2 [
                              "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17273586"
                              "web" => "Medline"
                            ]
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
              12 => array:3 [
                "identificador" => "bb0065"
                "etiqueta" => "13&#46;"
                "referencia" => array:1 [
                  0 => array:2 [
                    "contribucion" => array:1 [
                      0 => array:2 [
                        "titulo" => "Metabolic and hemodynamic responses of lower limb during exercise in patients with COPD"
                        "autores" => array:1 [
                          0 => array:2 [
                            "etal" => true
                            "autores" => array:6 [
                              0 => "F&#46; Maltais"
                              1 => "J&#46; Jobin"
                              2 => "M&#46;J&#46; Sullivan"
                              3 => "S&#46; Bernard"
                              4 => "F&#46; Whitton"
                              5 => "K&#46;J&#46; Killian"
                            ]
                          ]
                        ]
                      ]
                    ]
                    "host" => array:1 [
                      0 => array:1 [
                        "Revista" => array:7 [
                          "tituloSerie" => "J Appl Physiol"
                          "fecha" => "1998"
                          "volumen" => "84"
                          "numero" => "5"
                          "paginaInicial" => "1573"
                          "paginaFinal" => "1580"
                          "link" => array:1 [
                            0 => array:2 [
                              "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9572801"
                              "web" => "Medline"
                            ]
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
              13 => array:3 [
                "identificador" => "bb0070"
                "etiqueta" => "14&#46;"
                "referencia" => array:1 [
                  0 => array:2 [
                    "contribucion" => array:1 [
                      0 => array:2 [
                        "titulo" => "Myosin heavy chain composition of skeletal muscles in young rats growing under hypobaric hypoxia conditions"
                        "autores" => array:1 [
                          0 => array:2 [
                            "etal" => false
                            "autores" => array:4 [
                              0 => "A&#46;X&#46; Bigard"
                              1 => "H&#46; Sanchez"
                              2 => "O&#46; Birot"
                              3 => "B&#46; Serrurier"
                            ]
                          ]
                        ]
                      ]
                    ]
                    "host" => array:1 [
                      0 => array:1 [
                        "Revista" => array:7 [
                          "tituloSerie" => "J Appl Physiol"
                          "fecha" => "2000"
                          "volumen" => "88"
                          "numero" => "2"
                          "paginaInicial" => "479"
                          "paginaFinal" => "486"
                          "link" => array:1 [
                            0 => array:2 [
                              "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10658014"
                              "web" => "Medline"
                            ]
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
              14 => array:3 [
                "identificador" => "bb0075"
                "etiqueta" => "15&#46;"
                "referencia" => array:1 [
                  0 => array:2 [
                    "contribucion" => array:1 [
                      0 => array:2 [
                        "titulo" => "Perturba&#231;&#227;o respirat&#243;ria durante o sono em doen&#231;a pulmonar obstrutiva cr&#244;nica"
                        "autores" => array:1 [
                          0 => array:2 [
                            "etal" => false
                            "autores" => array:1 [
                              0 => "A&#46;C&#46; Krieger"
                            ]
                          ]
                        ]
                      ]
                    ]
                    "host" => array:1 [
                      0 => array:1 [
                        "Revista" => array:7 [
                          "tituloSerie" => "J Bras Pneumol"
                          "fecha" => "2005"
                          "volumen" => "31"
                          "numero" => "2"
                          "paginaInicial" => "162"
                          "paginaFinal" => "172"
                          "itemHostRev" => array:3 [
                            "pii" => "S0140673601058408"
                            "estado" => "S300"
                            "issn" => "01406736"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
              15 => array:3 [
                "identificador" => "bb0080"
                "etiqueta" => "16&#46;"
                "referencia" => array:1 [
                  0 => array:2 [
                    "contribucion" => array:1 [
                      0 => array:1 [
                        "titulo" => "Lung function testing&#58; Selection of reference values and interpretative strategies&#46; American Thoracic Society"
                      ]
                    ]
                    "host" => array:1 [
                      0 => array:2 [
                        "doi" => "10.1164/ajrccm/144.5.1202"
                        "Revista" => array:7 [
                          "tituloSerie" => "Am Rev Respir Dis"
                          "fecha" => "1991"
                          "volumen" => "144"
                          "numero" => "5"
                          "paginaInicial" => "1202"
                          "paginaFinal" => "1218"
                          "link" => array:1 [
                            0 => array:2 [
                              "url" => "https://www.ncbi.nlm.nih.gov/pubmed/1952453"
                              "web" => "Medline"
                            ]
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
              16 => array:3 [
                "identificador" => "bb0085"
                "etiqueta" => "17&#46;"
                "referencia" => array:1 [
                  0 => array:2 [
                    "contribucion" => array:1 [
                      0 => array:2 [
                        "titulo" => "Changes in the normal expiration flow-volume curve with growth and aging"
                        "autores" => array:1 [
                          0 => array:2 [
                            "etal" => false
                            "autores" => array:4 [
                              0 => "R&#46;J&#46; Knudson"
                              1 => "M&#46;D&#46; Lebowitz"
                              2 => "C&#46;J&#46; Holberg"
                              3 => "B&#46; Burrows"
                            ]
                          ]
                        ]
                      ]
                    ]
                    "host" => array:1 [
                      0 => array:2 [
                        "doi" => "10.1164/arrd.1983.127.6.725"
                        "Revista" => array:7 [
                          "tituloSerie" => "Am Rev Respir Dis"
                          "fecha" => "1983"
                          "volumen" => "127"
                          "numero" => "6"
                          "paginaInicial" => "725"
                          "paginaFinal" => "734"
                          "link" => array:1 [
                            0 => array:2 [
                              "url" => "https://www.ncbi.nlm.nih.gov/pubmed/6859656"
                              "web" => "Medline"
                            ]
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
              17 => array:3 [
                "identificador" => "bb0090"
                "etiqueta" => "18&#46;"
                "referencia" => array:1 [
                  0 => array:2 [
                    "contribucion" => array:1 [
                      0 => array:2 [
                        "titulo" => "Electrophysiologic changes during exercise testing in patients with chronic obstructive respiratory disease"
                        "autores" => array:1 [
                          0 => array:2 [
                            "etal" => true
                            "autores" => array:6 [
                              0 => "N&#46; Gosselin"
                              1 => "F&#46; Durand"
                              2 => "M&#46; Poulain"
                              3 => "K&#46; Lambert"
                              4 => "F&#46; Ceugniet"
                              5 => "C&#46; Pr&#233;faut"
                            ]
                          ]
                        ]
                      ]
                    ]
                    "host" => array:1 [
                      0 => array:2 [
                        "doi" => "10.1002/mus.10286"
                        "Revista" => array:7 [
                          "tituloSerie" => "Muscle Nerve"
                          "fecha" => "2003"
                          "volumen" => "27"
                          "numero" => "2"
                          "paginaInicial" => "170"
                          "paginaFinal" => "179"
                          "link" => array:1 [
                            0 => array:2 [
                              "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12548524"
                              "web" => "Medline"
                            ]
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
              18 => array:3 [
                "identificador" => "bb0095"
                "etiqueta" => "19&#46;"
                "referencia" => array:1 [
                  0 => array:2 [
                    "contribucion" => array:1 [
                      0 => array:2 [
                        "titulo" => "ATS statement&#58; guidelines for six-minute walk test"
                        "autores" => array:1 [
                          0 => array:2 [
                            "etal" => false
                            "autores" => array:1 [
                              0 => "American Thoracic Society"
                            ]
                          ]
                        ]
                      ]
                    ]
                    "host" => array:1 [
                      0 => array:2 [
                        "doi" => "10.1164/ajrccm.166.1.at1102"
                        "Revista" => array:7 [
                          "tituloSerie" => "Am J Respir Crit Care Med"
                          "fecha" => "2002"
                          "volumen" => "166"
                          "numero" => "1"
                          "paginaInicial" => "111"
                          "paginaFinal" => "117"
                          "link" => array:1 [
                            0 => array:2 [
                              "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12091180"
                              "web" => "Medline"
                            ]
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
              19 => array:3 [
                "identificador" => "bb0100"
                "etiqueta" => "20&#46;"
                "referencia" => array:1 [
                  0 => array:2 [
                    "contribucion" => array:1 [
                      0 => array:2 [
                        "titulo" => "Relationship of upper-limb and thoracic muscle strength to 6-min walk distance in COPD patients"
                        "autores" => array:1 [
                          0 => array:2 [
                            "etal" => false
                            "autores" => array:6 [
                              0 => "V&#46;Z&#46; Dourado"
                              1 => "L&#46;C&#46;O&#46; Antunes"
                              2 => "S&#46;E&#46; Tanni"
                              3 => "S&#46;A&#46;R&#46; Paiva"
                              4 => "C&#46;R&#46; Padovani"
                              5 => "I&#46; Godoy"
                            ]
                          ]
                        ]
                      ]
                    ]
                    "host" => array:1 [
                      0 => array:2 [
                        "doi" => "10.1378/chest.129.3.551"
                        "Revista" => array:7 [
                          "tituloSerie" => "Chest"
                          "fecha" => "2006"
                          "volumen" => "129"
                          "numero" => "3"
                          "paginaInicial" => "551"
                          "paginaFinal" => "557"
                          "link" => array:1 [
                            0 => array:2 [
                              "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16537851"
                              "web" => "Medline"
                            ]
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
              20 => array:3 [
                "identificador" => "bb0105"
                "etiqueta" => "21&#46;"
                "referencia" => array:1 [
                  0 => array:2 [
                    "contribucion" => array:1 [
                      0 => array:2 [
                        "titulo" => "Estudo de correla&#231;&#227;o entre provas funcionais respirat&#243;rias e o teste de caminhada de seis minutos em pacientes portadores de doen&#231;a pulmonary obstrutiva cr&#244;nica"
                        "autores" => array:1 [
                          0 => array:2 [
                            "etal" => false
                            "autores" => array:2 [
                              0 => "S&#46;L&#46; Rodrigues"
                              1 => "C&#46;A&#46;A&#46; Viegase"
                            ]
                          ]
                        ]
                      ]
                    ]
                    "host" => array:1 [
                      0 => array:1 [
                        "Revista" => array:6 [
                          "tituloSerie" => "J Pneumol"
                          "fecha" => "2002"
                          "volumen" => "28"
                          "numero" => "6"
                          "paginaInicial" => "324"
                          "paginaFinal" => "328"
                        ]
                      ]
                    ]
                  ]
                ]
              ]
              21 => array:3 [
                "identificador" => "bb0110"
                "etiqueta" => "22&#46;"
                "referencia" => array:1 [
                  0 => array:2 [
                    "contribucion" => array:1 [
                      0 => array:2 [
                        "titulo" => "Inspiratory capacity&#44; dynamic hyperinflation&#44; breathlessness&#44; and exercise performance during the 6-minute-walk test in chronic obstructive pulmonary disease"
                        "autores" => array:1 [
                          0 => array:2 [
                            "etal" => false
                            "autores" => array:6 [
                              0 => "J&#46;M&#46; Marin"
                              1 => "S&#46;J&#46; Carrizo"
                              2 => "M&#46; Gascon"
                              3 => "A&#46; Sanchez"
                              4 => "B&#46;A&#46; Gallego"
                              5 => "B&#46;R&#46; Celli"
                            ]
                          ]
                        ]
                      ]
                    ]
                    "host" => array:1 [
                      0 => array:2 [
                        "doi" => "10.1164/ajrccm.163.6.2003172"
                        "Revista" => array:7 [
                          "tituloSerie" => "Am J Respir Crit Care Med"
                          "fecha" => "2001"
                          "volumen" => "163"
                          "numero" => "6"
                          "paginaInicial" => "1395"
                          "paginaFinal" => "1399"
                          "link" => array:1 [
                            0 => array:2 [
                              "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11371407"
                              "web" => "Medline"
                            ]
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
              22 => array:3 [
                "identificador" => "bb0115"
                "etiqueta" => "23&#46;"
                "referencia" => array:1 [
                  0 => array:2 [
                    "contribucion" => array:1 [
                      0 => array:2 [
                        "titulo" => "Hypoxaemia enhances peripheral muscle oxidative stress in chronic obstructive pulmonary disease"
                        "autores" => array:1 [
                          0 => array:2 [
                            "etal" => true
                            "autores" => array:6 [
                              0 => "C&#46; Koechlin"
                              1 => "F&#46; Maltais"
                              2 => "D&#46; Saey"
                              3 => "A&#46; Michaud"
                              4 => "P&#46; LeBlanc"
                              5 => "M&#46; Hayot"
                            ]
                          ]
                        ]
                      ]
                    ]
                    "host" => array:1 [
                      0 => array:2 [
                        "doi" => "10.1136/thx.2004.037531"
                        "Revista" => array:7 [
                          "tituloSerie" => "Thorax"
                          "fecha" => "2005"
                          "volumen" => "60"
                          "numero" => "10"
                          "paginaInicial" => "834"
                          "paginaFinal" => "841"
                          "link" => array:1 [
                            0 => array:2 [
                              "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15964914"
                              "web" => "Medline"
                            ]
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
              23 => array:3 [
                "identificador" => "bb0120"
                "etiqueta" => "24&#46;"
                "referencia" => array:1 [
                  0 => array:2 [
                    "contribucion" => array:1 [
                      0 => array:2 [
                        "titulo" => "Oxygen desaturation during sleep and exercise in patients with severe chronic obstructive pulmonary disease"
                        "autores" => array:1 [
                          0 => array:2 [
                            "etal" => false
                            "autores" => array:5 [
                              0 => "E&#46; Mulloy"
                              1 => "M&#46; Fitzpatrick"
                              2 => "S&#46; Bourke"
                              3 => "A&#46; O&#8217;Regan"
                              4 => "W&#46;T&#46; McNicholas"
                            ]
                          ]
                        ]
                      ]
                    ]
                    "host" => array:1 [
                      0 => array:1 [
                        "Revista" => array:7 [
                          "tituloSerie" => "Respir Med"
                          "fecha" => "1995"
                          "volumen" => "89"
                          "numero" => "3"
                          "paginaInicial" => "193"
                          "paginaFinal" => "198"
                          "link" => array:1 [
                            0 => array:2 [
                              "url" => "https://www.ncbi.nlm.nih.gov/pubmed/7746912"
                              "web" => "Medline"
                            ]
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
              24 => array:3 [
                "identificador" => "bb0125"
                "etiqueta" => "25&#46;"
                "referencia" => array:1 [
                  0 => array:2 [
                    "contribucion" => array:1 [
                      0 => array:2 [
                        "titulo" => "Pulmonary rehabilitation joint ACCP&#47;AACVPR evidence-based clinical practice guidelines"
                        "autores" => array:1 [
                          0 => array:2 [
                            "etal" => true
                            "autores" => array:6 [
                              0 => "A&#46;L&#46; Ries"
                              1 => "G&#46;S&#46; Bauldoff"
                              2 => "B&#46;W&#46; Carlin"
                              3 => "R&#46; Casaburi"
                              4 => "C&#46;F&#46; Emery"
                              5 => "D&#46;A&#46; Mahler"
                            ]
                          ]
                        ]
                      ]
                    ]
                    "host" => array:1 [
                      0 => array:2 [
                        "doi" => "10.1378/chest.06-2418"
                        "Revista" => array:7 [
                          "tituloSerie" => "Chest"
                          "fecha" => "2007"
                          "volumen" => "131"
                          "numero" => "5"
                          "paginaInicial" => "4S"
                          "paginaFinal" => "42S"
                          "link" => array:1 [
                            0 => array:2 [
                              "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17494825"
                              "web" => "Medline"
                            ]
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
              25 => array:3 [
                "identificador" => "bb0130"
                "etiqueta" => "26&#46;"
                "referencia" => array:1 [
                  0 => array:2 [
                    "contribucion" => array:1 [
                      0 => array:2 [
                        "titulo" => "Mid-arm muscle area is a better predictor of mortality than body mass index in COPD"
                        "autores" => array:1 [
                          0 => array:2 [
                            "etal" => false
                            "autores" => array:6 [
                              0 => "J&#46;J&#46; Soler-Catalu&#241;a"
                              1 => "L&#46; S&#225;nchez-S&#225;nchez"
                              2 => "M&#46;A&#46; Mart&#237;nez-Garc&#237;a"
                              3 => "P&#46;R&#46; S&#225;nchez"
                              4 => "E&#46; Salcedo"
                              5 => "M&#46; Navarro"
                            ]
                          ]
                        ]
                      ]
                    ]
                    "host" => array:1 [
                      0 => array:2 [
                        "doi" => "10.1378/chest.128.4.2108"
                        "Revista" => array:7 [
                          "tituloSerie" => "Chest"
                          "fecha" => "2005"
                          "volumen" => "128"
                          "numero" => "4"
                          "paginaInicial" => "2108"
                          "paginaFinal" => "2115"
                          "link" => array:1 [
                            0 => array:2 [
                              "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16236862"
                              "web" => "Medline"
                            ]
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
              26 => array:3 [
                "identificador" => "bb0135"
                "etiqueta" => "27&#46;"
                "referencia" => array:1 [
                  0 => array:2 [
                    "contribucion" => array:1 [
                      0 => array:2 [
                        "titulo" => "Peripheral muscle weakness in patients with chronic obstructive pulmonary disease"
                        "autores" => array:1 [
                          0 => array:2 [
                            "etal" => true
                            "autores" => array:6 [
                              0 => "S&#46; Bernard"
                              1 => "P&#46; Leblanc"
                              2 => "F&#46; Whittom"
                              3 => "J&#46; Jobin"
                              4 => "R&#46; Belleau"
                              5 => "C&#46; B&#233;rub&#233;"
                            ]
                          ]
                        ]
                      ]
                    ]
                    "host" => array:1 [
                      0 => array:2 [
                        "doi" => "10.1164/ajrccm.158.2.9711023"
                        "Revista" => array:8 [
                          "tituloSerie" => "Am J Respir Crit Care Med"
                          "fecha" => "1998"
                          "volumen" => "158"
                          "numero" => "2"
                          "paginaInicial" => "629"
                          "paginaFinal" => "634"
                          "link" => array:1 [
                            0 => array:2 [
                              "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9700144"
                              "web" => "Medline"
                            ]
                          ]
                          "itemHostRev" => array:3 [
                            "pii" => "S0016508500976194"
                            "estado" => "S300"
                            "issn" => "00165085"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
              27 => array:3 [
                "identificador" => "bb0140"
                "etiqueta" => "28&#46;"
                "referencia" => array:1 [
                  0 => array:2 [
                    "contribucion" => array:1 [
                      0 => array:2 [
                        "titulo" => "Endurance and strength training in patients with COPD"
                        "autores" => array:1 [
                          0 => array:2 [
                            "etal" => false
                            "autores" => array:5 [
                              0 => "M&#46;J&#46; Mador"
                              1 => "E&#46; Bozkanat"
                              2 => "A&#46; Aggarwal"
                              3 => "M&#46; Shaffer"
                              4 => "T&#46;J&#46; Kufel"
                            ]
                          ]
                        ]
                      ]
                    ]
                    "host" => array:1 [
                      0 => array:1 [
                        "Revista" => array:7 [
                          "tituloSerie" => "Chest"
                          "fecha" => "2004"
                          "volumen" => "125"
                          "numero" => "6"
                          "paginaInicial" => "2036"
                          "paginaFinal" => "2045"
                          "link" => array:1 [
                            0 => array:2 [
                              "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15189919"
                              "web" => "Medline"
                            ]
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
              28 => array:3 [
                "identificador" => "bb0145"
                "etiqueta" => "29&#46;"
                "referencia" => array:1 [
                  0 => array:2 [
                    "contribucion" => array:1 [
                      0 => array:2 [
                        "titulo" => "Skeletal muscle strength and endurance in patients with mild COPD and the effects of weight training"
                        "autores" => array:1 [
                          0 => array:2 [
                            "etal" => false
                            "autores" => array:4 [
                              0 => "C&#46;J&#46; Clark"
                              1 => "L&#46;M&#46; Cochrane"
                              2 => "E&#46; Mackay"
                              3 => "B&#46; Paton"
                            ]
                          ]
                        ]
                      ]
                    ]
                    "host" => array:1 [
                      0 => array:1 [
                        "Revista" => array:7 [
                          "tituloSerie" => "Eur Respir J"
                          "fecha" => "2000"
                          "volumen" => "15"
                          "numero" => "1"
                          "paginaInicial" => "92"
                          "paginaFinal" => "97"
                          "link" => array:1 [
                            0 => array:2 [
                              "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10678627"
                              "web" => "Medline"
                            ]
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
              29 => array:3 [
                "identificador" => "bb0150"
                "etiqueta" => "30&#46;"
                "referencia" => array:1 [
                  0 => array:2 [
                    "contribucion" => array:1 [
                      0 => array:2 [
                        "titulo" => "Resistance versus endurance training in patients with COPD and peripheral muscle weakness"
                        "autores" => array:1 [
                          0 => array:2 [
                            "etal" => false
                            "autores" => array:5 [
                              0 => "M&#46;A&#46; Spruit"
                              1 => "R&#46; Gosselink"
                              2 => "T&#46; Troosters"
                              3 => "K&#46; De Paepe"
                              4 => "M&#46; Decramer"
                            ]
                          ]
                        ]
                      ]
                    ]
                    "host" => array:1 [
                      0 => array:1 [
                        "Revista" => array:7 [
                          "tituloSerie" => "Eur Respir J"
                          "fecha" => "2002"
                          "volumen" => "19"
                          "numero" => "6"
                          "paginaInicial" => "1072"
                          "paginaFinal" => "1078"
                          "link" => array:1 [
                            0 => array:2 [
                              "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12108859"
                              "web" => "Medline"
                            ]
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
          ]
        ]
      ]
    ]
  ]
  "idiomaDefecto" => "pt"
  "url" => "/08732159/0000001500000002/v1_201509151524/S0873215915301276/v1_201509151524/pt/main.assets"
  "Apartado" => array:4 [
    "identificador" => "9575"
    "tipo" => "SECCION"
    "pt" => array:2 [
      "titulo" => "Artigos originais"
      "idiomaDefecto" => true
    ]
    "idiomaDefecto" => "pt"
  ]
  "PDF" => "https://static.elsevier.es/multimedia/08732159/0000001500000002/v1_201509151524/S0873215915301276/v1_201509151524/pt/main.pdf?idApp=UINPBA00004E&text.app=https://journalpulmonology.org/"
  "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0873215915301276?idApp=UINPBA00004E"
]
Share
Journal Information
Vol. 15. Issue 2.
Pages 199-214 (March - April 2009)
Share
Share
Download PDF
More article options
Vol. 15. Issue 2.
Pages 199-214 (March - April 2009)
Artigo Original/Original Article
Open Access
Influência da função pulmonar e da força muscular na capacidade funcional de portadores de doença pulmonar obstrutiva crónica
The influence of lung function and muscular strength on the functional capacity of chronic obstructive pulmonary disease patients
Visits
6473
Sérgio Leite Rodrigues1,*, César Augusto Melo e Silva2, Tereza Lima3, Carlos Alberto de Assis Viegas4, Marcelo Palmeira Rodrigues5, Fernanda Almeida Ribeiro6
1 Mestre em Ciências da Saúde / MSC, Health Sciences, Universidade de Brasília – UnB, Hospital Universitário de Brasília – HUB Rua L2 Norte Quadras 605 CEP 70840 - 901 Brasília – DF Brasil
2 Doutor em Ciências Médicas / PhD, Health Sciences, Universidade de Brasília – UnB, Hospital Universitário de Brasília – HUB Rua L2 Norte Quadras 605 CEP 70840 - 901 Brasília – DF Brasil
3 Mestre em Clínica Médica / MSC, Internal Medicine, Universidade de Brasília – UnB, Hospital Universitário de Brasília – HUB Rua L2 Norte Quadras 605 CEP 70840 - 901 Brasília – DF Brasil
4 Doutor em Fisiopatologia Respiratória / PhD, Respiratory Physiopathology, Universidade de Brasília – UnB, Hospital Universitário de Brasília – HUB Rua L2 Norte Quadras 605 CEP 70840 - 901 Brasília – DF Brasil
5 Doutor em Ciências Médicas / PhD, Medical Sciences, Universidade de Brasília – UnB, Hospital Universitário de Brasília – HUB Rua L2 Norte Quadras 605 CEP 70840 -901 Brasília – DF Brasil
6 Mestre em Ciências da Saúde / MSC, Health Sciences, Universidade de Brasília – UnB, Hospital Universitário de Brasília – HUB Rua L2 Norte Quadras 605 CEP 70840 -901 Brasília – DF Brasil
This item has received

Under a Creative Commons license
Article information
Resumo

Objectivo: Determinar que variável entre o volume expirado forçado no primeiro segundo (VEF1), a pressão parcial do oxigénio no sangue arterial (PaO2), a hipoxemia nocturna e a força muscular do quadricípite femoral pode predizer a distância percorrida no teste de caminhada de seis minutos (TC6) em doentes com DPOC.

Doentes e métodos: Um estudo observacional do tipo transversal, envolvendo trinta doentes encaminhados a um programa de reabilitação pulmonar de um hospital universitário. A função pulmonar foi avaliada por espirometria, gasometria arterial e oximetria nocturna. A função muscular pela força muscular do quadricípite femoral e a avaliação da capacidade funcional pelo TC6.

Resultados: A análise de regressão bivariada mostrou que a força do quadricípite femoral foi a única variável que se mostrou estatisticamente significativa (p=0,002) em predizer a distância, sendo responsável por 38% da variância do TC6. Para essas variáveis a relação estabelecida estatisticamente foi que para cada quilo de força do quadricípite femoral, os doentes caminharam 5,9 metros no TC6.

Conclusão: Os resultados indicam a importância da força muscular do MI em testes de esforço submáximo. Entre as variáveis estudadas, apenas a força muscular do quadricípite femoral pôde predizer a distância percorrida no TC6 em portadores de doença pulmonar obstrutiva crónica.

Rev Port Pneumol 2009; XV (2): 199-214

Palavras-chave:
Teste de caminhada de seis minutos
reabilitação pulmonar
força muscular
hipoxemia
DPOC
sistema musculoesquelético
Abstract

Aim: To determine which variable (forced expiratory volume in 1 second (FEV1), partial pressure of oxygen in arterial blood (PaO2), nocturnal hypoxaemia and muscular strength of femoral quadriceps) can predict the distance walked in the six-minute walk test (6MWT) by COPD patients.

Methods: A cross-sectional and observational study of thirty patients referred to a pulmonary rehabilitation programme at a university hospital. Lung function was evaluated by spirometry, arterial blood gas analysis and nocturnal oximetry. Muscle function was evaluated by quadriceps strength and functional capacity by the 6MWT.

Results: Bivariate regression analysis showed that quadriceps strength, was the only variable to correlate significantly with the distance walked in the 6MWT (p=0.002), accounting for 38% of the 6MWT variance. The statistical relationship established for these variables was 1kg of quadriceps strength equalled 5.9 metres walked in the 6MWT.

Conclusions: Our results showed the importance of lower limb muscle strength in submaximal exercise testing. We conclude that femoral quadriceps muscle strength is the only one of the variables studied which can predict the distance COPD patients walk in the 6MWT.

Rev Port Pneumol 2009; XV (2): 199-214

Key-words:
COPD
hypoxaemia
muscle strength
musculoskeletal system
pulmonary rehabilitation
six-minute walk test
Full text is only aviable in PDF
Bibliografia/Bibliography
[1.]
K.R. Flaherty, A.C. Andrei, S. Murray, C. Fraley, T.V. Colby, W.D. Travis, et al.
Idiopathic pulmonary fibrosis prognostic value of changes in physiology and six-minute-walk test.
Am J Respir Crit Care Med, 174 (2006), pp. 803-809
[2.]
G. Deboeck, G. Niset, J.L. Vachiery, J.J. Moraine, R. Naeije.
Physiological response to the six-minute walk test in pulmonary arterial hypertension.
Eur Respir J, 26 (2005), pp. 667-672
[3.]
M.W. Gerbase, A. Spiliopoulos, T. Rochat, M. Archinard, L.P. Nicod.
Health-related quality of life following single or bilateral lung transplantation. A 7 year comparison to functional outcome.
Chest, 128 (2005), pp. 1371-1378
[4.]
C. Opasich, S. De Feo, G.D. Pinna, G. Furgi, R. Pedretti, D. Scrutinio, et al.
Distance walked in the 6-minute test soon after cardiac surgery. toward an efficient use in the individual patient.
Chest, 126 (2004), pp. 1796-1801
[5.]
R. Carter, D.B. Holiday, C. Nwasuruba, J. Stocks, C. Grothues, B. Tiep.
6-minute walk work for assessment of functional capacity in patients with COPD.
Chest, 123 (2003), pp. 1408-1415
[6.]
S. Solway, D. Brooks, Y. Lacasse, S. Thomas.
A qualitative systematic overview of the measurement properties of functional walk tests used in the cardiorespiratory domain.
Chest, 119 (2001), pp. 256-270
[7.]
K.F. Rabe, S. Hurd, A. Anzueto, P.J. Barnes, S.A. Buist, P. Calverley, et al.
Global Strategy for the Diagnosis, Management, and Prevention of Chronic Obstructive Pulmonary Disease. GOLD Executive Summary.
Am J Respir Crit Care Med, 176 (2007), pp. 532-555
[8.]
B. Ziegler, P.M.E. Rovedder, J.L. Lukrafka, C.L. Oliveira, S.S. Menna-Barreto, P.T.R. Dalcin.
Capacidade submáxima de exercício em pacientes adolescentes e adultos com fibrose cística.
J Bras Pneumol, 33 (2007), pp. 263-269
[9.]
B.R. Celli, C.G. Cote, J.M. Marin, C. Casanova, M. Montes de Oca, R.A. Mendez, et al.
The body-mass index, airflow obstruction, dyspnea, and exercise capacity index in chronic obstructive pulmonary disease.
N Engl J Med, 350 (2004), pp. 1005-1012
[10.]
J.B. Bowen, J.J. Votto, R.S. Thrall, M.C. Haggerty, R. Stockdale-Woolley, T. Bandyopadhyay, et al.
Functional status and survival following pulmonary rehabilitation.
Chest, 118 (2000), pp. 697-703
[11.]
C. Casanova, C.G. Cote, J.M. Marin, J.P. De Torres, A. Aguirre-Jaime, R. Mendez, et al.
The 6-min walking distance: long-term follow up in patients with COPD.
Eur Respir J, 29 (2007), pp. 535-540
[12.]
V.Z. Dourado, S.E. Tanni, S.A. Vale, M.M. Faganello, F.F. Sanchez, I. Godoy.
Manifestações sistêmicas na doença pulmonar obstrutiva crônica.
J Bras Pneumol, 32 (2006), pp. 161-171
[13.]
F. Maltais, J. Jobin, M.J. Sullivan, S. Bernard, F. Whitton, K.J. Killian, et al.
Metabolic and hemodynamic responses of lower limb during exercise in patients with COPD.
J Appl Physiol, 84 (1998), pp. 1573-1580
[14.]
A.X. Bigard, H. Sanchez, O. Birot, B. Serrurier.
Myosin heavy chain composition of skeletal muscles in young rats growing under hypobaric hypoxia conditions.
J Appl Physiol, 88 (2000), pp. 479-486
[15.]
A.C. Krieger.
Perturbação respiratória durante o sono em doença pulmonar obstrutiva crônica.
J Bras Pneumol, 31 (2005), pp. 162-172
[16.]
Lung function testing: Selection of reference values and interpretative strategies. American Thoracic Society.
Am Rev Respir Dis, 144 (1991), pp. 1202-1218
[17.]
R.J. Knudson, M.D. Lebowitz, C.J. Holberg, B. Burrows.
Changes in the normal expiration flow-volume curve with growth and aging.
Am Rev Respir Dis, 127 (1983), pp. 725-734
[18.]
N. Gosselin, F. Durand, M. Poulain, K. Lambert, F. Ceugniet, C. Préfaut, et al.
Electrophysiologic changes during exercise testing in patients with chronic obstructive respiratory disease.
Muscle Nerve, 27 (2003), pp. 170-179
[19.]
American Thoracic Society.
ATS statement: guidelines for six-minute walk test.
Am J Respir Crit Care Med, 166 (2002), pp. 111-117
[20.]
V.Z. Dourado, L.C.O. Antunes, S.E. Tanni, S.A.R. Paiva, C.R. Padovani, I. Godoy.
Relationship of upper-limb and thoracic muscle strength to 6-min walk distance in COPD patients.
Chest, 129 (2006), pp. 551-557
[21.]
S.L. Rodrigues, C.A.A. Viegase.
Estudo de correlação entre provas funcionais respiratórias e o teste de caminhada de seis minutos em pacientes portadores de doença pulmonary obstrutiva crônica.
J Pneumol, 28 (2002), pp. 324-328
[22.]
J.M. Marin, S.J. Carrizo, M. Gascon, A. Sanchez, B.A. Gallego, B.R. Celli.
Inspiratory capacity, dynamic hyperinflation, breathlessness, and exercise performance during the 6-minute-walk test in chronic obstructive pulmonary disease.
Am J Respir Crit Care Med, 163 (2001), pp. 1395-1399
[23.]
C. Koechlin, F. Maltais, D. Saey, A. Michaud, P. LeBlanc, M. Hayot, et al.
Hypoxaemia enhances peripheral muscle oxidative stress in chronic obstructive pulmonary disease.
Thorax, 60 (2005), pp. 834-841
[24.]
E. Mulloy, M. Fitzpatrick, S. Bourke, A. O’Regan, W.T. McNicholas.
Oxygen desaturation during sleep and exercise in patients with severe chronic obstructive pulmonary disease.
Respir Med, 89 (1995), pp. 193-198
[25.]
A.L. Ries, G.S. Bauldoff, B.W. Carlin, R. Casaburi, C.F. Emery, D.A. Mahler, et al.
Pulmonary rehabilitation joint ACCP/AACVPR evidence-based clinical practice guidelines.
Chest, 131 (2007), pp. 4S-42S
[26.]
J.J. Soler-Cataluña, L. Sánchez-Sánchez, M.A. Martínez-García, P.R. Sánchez, E. Salcedo, M. Navarro.
Mid-arm muscle area is a better predictor of mortality than body mass index in COPD.
Chest, 128 (2005), pp. 2108-2115
[27.]
S. Bernard, P. Leblanc, F. Whittom, J. Jobin, R. Belleau, C. Bérubé, et al.
Peripheral muscle weakness in patients with chronic obstructive pulmonary disease.
Am J Respir Crit Care Med, 158 (1998), pp. 629-634
[28.]
M.J. Mador, E. Bozkanat, A. Aggarwal, M. Shaffer, T.J. Kufel.
Endurance and strength training in patients with COPD.
Chest, 125 (2004), pp. 2036-2045
[29.]
C.J. Clark, L.M. Cochrane, E. Mackay, B. Paton.
Skeletal muscle strength and endurance in patients with mild COPD and the effects of weight training.
Eur Respir J, 15 (2000), pp. 92-97
[30.]
M.A. Spruit, R. Gosselink, T. Troosters, K. De Paepe, M. Decramer.
Resistance versus endurance training in patients with COPD and peripheral muscle weakness.
Eur Respir J, 19 (2002), pp. 1072-1078
Copyright © 2009. Sociedade Portuguesa de Pneumologia/SPP
Download PDF
Pulmonology
Article options
Tools

Are you a health professional able to prescribe or dispense drugs?