Measuring Instruments
The six-minute walk test was used following the recommendations of the American Thoracic Society (ATS) and was performed in a 30-meter corridor, flat and completely free of obstacles13. Before the test, patients had a rest period of at least 10 minutes. During this period, contraindications, blood pressure data (using the Premium Aneroid sphygmomanometer and Littmann 3M® stethoscope), pulse oximetry (Pulse Oximeter - Rossmax®), dyspnea level (Borg Scale), heart rate (assessed through palpation of the radial artery and counting over a period of one minute) and respiratory (evaluation by checking the respiratory incursion over the period of one minute). The patient was instructed to walk as fast as possible, without running, going around this corridor for six minutes. During the test, phrases of encouragement were used in periods of time. At the end of the test, the examiner has the function of quantifying the meters covered within those six minutes.
During the entire protocol, the patient was monitored and, with an increase in systolic and / or diastolic blood pressure greater than 30% of baseline, heart rate below 20% of baseline, peripheral oxygen saturation <90% and increased respiratory rate above 30 forays per minute the test would be interrupted.
The Functional Independence Measurement that aims to measure what the person really accomplishes, regardless of the diagnosis, generating valid score for limitation or not. This scale assesses the patient’s ability to develop body care, sphincter control, transfer and locomotion, as well as cognitive function such as communication and memory. A score of 1 to 7 is assigned, with the lowest value corresponding to the patient totally dependent and the maximum value was that patient completely independent from the functional point of view, reaching a maximum value of 126 points when all variables were added together14.
The Medical Research Council (MRC), evaluates peripheral muscle strength through the ability to overcome the load of six muscle groups (shoulder abductors, elbow flexors, wrist extensors, hip flexors, knee extensors and ankle dorsiflexors), scoring bilaterally each group from 0 to 5, where zero represents absence of contraction and five the patient wins the maximum resistance imposed by the examiner. The minimum score for this test is 0 (quadriplegia) and can reach up to 60 points (muscle strength preserved). A value less than 48 can be suggestive of polyneuromyopathy15.