Fatores associados à marcha de pacientes adultos hospitalizados com insuficiência cardíaca

Abstract

Introduction–Monitoring walking performance has been considered useful for clinically estimating the functional capacity of patients with heart failure. The evaluation of kinematic gait parameters can help to stratify different levels of functional impairment. Objective –To analyze factors associated with gait in adult patients hospitalized with heart failure. Methods –This is a cross-sectional observational study. Participants diagnosed with HF, between 18 and 60 years old, of both sexes, with functional classification II and III and who were authorized to walk as prescribed in the medical records were included. Demographic and clinical data were collected from the electronic medical record. The 10-meter gait speed test extracted the spatiotemporal parameters of gait. The BTS G-Walk device (BTS Bioengineering – Free4act – ACC0774N, Italy) was used to analyze gait. The T-Student test was applied to compare the significant differences between gait speed and its determinants with the independent variables. Pearson and Spearman correlation were performed between the studied data. Crude (univariate) and adjusted (multivariate) binary logistic regression analyzes were used. Gait speed ≤0.8m/s was the dependent variable. Epidemiological, clinical and spatio-temporal variables of walking were the independent variables. Results –Thirty (30) participants were included in the study. Women walked significantly slower than men, as did those with functional class III. Participants who used beta-blockers had significantly longer stride length compared to those who did not use them. Gait speed ≤0.8 m/s was associated with stride length ≤ 1.14 meters and cadence ≤ 45.8 steps/minute. Conclusion –Female participants, functional class III, without the use of beta-blockers and with preserved LVEF had worse gait performance. The main factors associated with walking speed were shorter stride length and shorter cadence.