Title:	Estudo da variabilidade da frequência cardíaca e do nível funcional de amputados transfemorais
Authors:	Almeida, Camila Cadena de
Orientador(es)::	Marães, Vera Regina Fernandes da Silva
Assunto::	Amputados Sistema nervoso autônomo Frequência cardíaca
Issue Date:	26-Jan-2016
Data de defesa::	31-Jul-2015
Citation:	ALMEIDA, Camila Cadena de. Estudo da variabilidade da frequência cardíaca e do nível funcional de amputados transfemorais. 2015. 101 f. Dissertação (Mestrado em Engenharia Biomédica)—Universidade de Brasília, Brasília, 2015.
Abstract:	A multidisciplinary team is a determining factor in the prognosis of individuals who suffered significant member loss. The surgical procedure directly affects the transfemoral amputees routine, causing several changes. The aim of this study was to analyze in the linear perspective and the nonlinear heart rate variability (HRV) during three different rest positions, during exercise and correlate its main indexes with functional measures. We studied seven patients with transfemoral amputation with mean age of 31.7 ± 7.53 years, body mass index (BMI) of 23.74 ± 3.58 kg / m2, amputation time of 6.21 ± 2.7 years and six minute walking test (6MWT) distance of 322.29 ± 61,74m. Initially, they underwent evaluation by the International Physical Activity Questionnaire (IPAQ) in its short version, a functional assessment questionnaire for amputees (AMF) was investigated and the existence of metabolic risk through correlation measures. Later data of HRV were collected and stored using a heart monitor (POLAR- S800) during supine position, sitting, standing for 10 minutes and during the 6MWT. Under the linear perspective, the RMSSD and pNN50 rates, global indicators of the activity of the parasympathetic system, were used in the time domain and the Low frequency components (LF), high frequency (HF) and LF / HF ratio corresponding to the frequency domain, respectively indicating the sympathetic activity, parasympathetic and their relation. The nonlinear variables selected were the SD1 and SD2 used as indices representing parasympathetic instant and long-term, respectively, and the indices α1 and α2, indicators of the cardiovascular system normality, also instantaneous and long-term and the value of approximate entropy (ApEn) indicator system organization level. For comparative statistic analysis we used Wilcoxon test, correlation coefficient Spearman and Pearson Chi-Square test for nonparametric variables using SPSS (SPSS (Statistical Package for Social Sciences, Chicago, IL, USA) version 18 and the HRV data collected were collected using the Polar ProTrainer 5® program and analyzed using the Kubius program (HRV Kubios 2.1 release). Subjects were considered predominant active with traumatic amputation without metabolic risk and did not seem to present problems related to the use of the prosthesis, the non-amputated member, the residual limb (stump) and locomotion. Regarding the HRV, volunteers have a healthy cardiovascular system due to the values α1 and α2 near one and sympathetic predominance in all resting positions with a slight increase during exercise. Comparing the resting positions, a greater parasympathetic activity in lying and sitting positions relative to stand up and sympathetic predominance in the standing position and sitting when compared to supine. In comparing the resting conditions and exercise, the parasympathetic component to the long-term was lower during the 6MWT. There were no correlations between variables "time of amputation", "distance", "age" and "mobility score." By correlating the types of HRV analysis, strong correlations were found between rMSSD indexes, AF, BF SD1 and SD2 with the values as well as between the cardiac system normality indicators α1 and α2 with the sympathetic markers. The standing position has produced significant changes in the autonomic control of the volunteers when compared to lying position. Exhibiting similar behavior to individuals without amputation, where the parasympathetic system dominates at the lying position and decreases when standing. Such behavior was observed in linear and non-linear context. We also observed strong correlations between the two types of analysis, highlighting the rMSSD, HF and LF indexes. The components in the frequency domain also appear to influence the organization of the system and the parasympathetic activity seems to be related to cardiovascular health of the individual.
metadata.dc.description.unidade:	Faculdade de Ciências e Tecnologias em Engenharia (FCTE) – Campus UnB Gama
Description:	Dissertação (mestrado)—Universidade de Brasília, Faculdade Gama, Programa de Pós-Graduação em Engenharia Biomédica, 2015.
metadata.dc.description.ppg:	Programa de Pós-Graduação em Engenharia Biomédica
Licença::	A concessão da licença deste item refere-se ao termo de autorização impresso assinado pelo autor com as seguintes condições: Na qualidade de titular dos direitos de autor da publicação, autorizo a Universidade de Brasília e o IBICT a disponibilizar por meio dos sites www.bce.unb.br, www.ibict.br, http://hercules.vtls.com/cgi-bin/ndltd/chameleon?lng=pt&skin=ndltd sem ressarcimento dos direitos autorais, de acordo com a Lei nº 9610/98, o texto integral da obra disponibilizada, conforme permissões assinaladas, para fins de leitura, impressão e/ou download, a título de divulgação da produção científica brasileira, a partir desta data.
DOI:	http://dx.doi.org/10.26512/2015.07.D.19364
Appears in Collections:	Teses, dissertações e produtos pós-doutorado

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