Functional capacity assessment in individuals in preoperative thoracic surgery through the AVD-Glittre test

Abstract

Introduction: Thoracic surgery may be one of the options for the curative treatment of diseases such as lung cancer and thymus tumours. Patients in the postoperative period of thoracic surgery may present with dyspnea on exertion and reduced activity tolerance, compromising their functionality and quality of life (QoL). Functional scales and tests are available to measure functional capacity (FC) and, for this, it is necessary to use an instrument that assesses FC globally. The AVD-Glittre test (TGlittre) has been validated to assess FC in patients with chronic obstructive pulmonary disease (COPD) and has since been used in different populations. This test has great potential for clinical use in the preoperative period of thoracic surgery with surgical risk assessment. It meets the need for an objective evaluation of physical function broadly, using tasks similar to activities of daily living (ADL). Objective: The present study aimed to evaluate the association of TGlittre with measures of pulmonary function, body balance and QoL in the preoperative period of thoracic surgery and, secondarily, to evaluate the ability of TGlittre to predict postoperative complications. Methods: This is a cross-sectional study carried out at Hospital Universitário Pedro Ernesto (HUPE) between March and December 2021, with patients over 18 years of age and a proposal for thoracic surgery. Study participants underwent the TGlittre to assess FC, pulmonary function tests (PFT), St. George's Respiratory Questionnaire to assess QoL and Berg Balance Scale (BSE) for body balance analysis. Results: This study evaluated 34 patients in the preoperative period of thoracic surgery, of which 23 (67.6%) were women, with a mean age of 56.5 ± 12.4 years. The median time to perform TGlittre tasks about predicted was 137 (116–179) % predicted. There was a significant correlation between the TGlittre team and carbon monoxide diffusing capacity (rs = -0.334, p = 0.042), although there were no significant correlations with other measures of pulmonary function. TGlittre time correlated significantly with BSE (rs = -0.359, p = 0.036). A significant correlation was also observed between TGlittre time and the duration of chest drainage in the postoperative period (rs = 0.651, p = 0.003). Conclusion: In conclusion, patients in the preoperative period of thoracic surgery spend much more time performing TGlittre tasks than expected. There is a relationship between TGlittre time and pulmonary diffusion and balance control. Furthermore, there is a relationship between the TGlittre time and the duration of chest drainage. The use of TGlittre during preoperative thoracic risk stratification may provide relevant information in the search for personalized treatment for patients with a proposal for thoracic surgery.