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Kawakami, Débora Mayumi de Oliveira; Colucci, Maria Gabriela; Araújo, Gustavo Henrique Guimarães; Pires di Lorenzo, Valéria Amorim; Mendes, Renata Gonçalves
Revista brasileira de fisioterapia (São Carlos (São Paulo, Brazil)), April 2024, 2024-04-00, Volume: 28Journal Article
Chronic obstructive pulmonary disease (COPD) is characterized by a persistent respiratory disorder due to airflow limitation. COPD is considered a debilitating disease in which the symptomatology and muscle and functional damage affect the performance of physical activity and the quality of life of individuals. In these, periods of exacerbation of the disease can be frequent, with increased symptoms and even the need for hospitalization, which accentuates physical deconditioning, loss of strength and muscle mass. In this context, rehabilitation strategies should be designed and knowing the level of self-determination and symptomatology after COPD exacerbation can be useful for clinical decision. The objective of the study was to evaluate the existence of a correlation between self-determination, self-efficacy for physical activity and symptomatology in patients hospitalized for COPD exacerbation. This is a cross-sectional study. Nine individuals hospitalized for COPD exacerbation were evaluated. At the time of pre-hospital discharge, they were asked about self-determination (Behavioral Regulation in Exercise - Questionnaire 2 BREQ-2), self-efficacy (The COPD Self-Efficacy Scale) and symptomatology (COPD Assessment Test™ CAT and Medical Research Council mMRC dyspnoea). The BREQ-2 questionnaire was scored by domains (amotivation, introjected regulation, identified regulation, external regulation, and intrinsic motivation) and relative autonomic index, The COPD Self-Efficacy Scale was also scored by domains (negative effects, intense emotional arousal, physical exertion, time/environment, and behavioral risk factors). The sample consisted of nine patients, 5 (55.6%) males and 4 (44.4%) females, aged 67±9 years old and hospital stay of 7.44±5 days. A positive correlation was found between the physical exertion domain of The COPD Self-Efficacy Scale and the relative autonomic index and introjected regulation of BREQ-2 (r= 0.83; p<0.01/ r= 0.86; p< 0.01, respectively). Furthermore, a negative correlation was found between the CAT and the BREQ-2 amotivation domain (r= -0.80; p<0.01) and a positive correlation between the mMRC and the BREQ-2 external regulation domain (r=0.64; p=0.05). In patients hospitalized for COPD exacerbation, there is an association between the motivational level to perform physical activity and COPD symptomatology. The greater symptomatology was associated with greater external regulation for performing physical activity, as well as being more self-determined for the practice of physical activity and with more self-efficacy for managing dyspnea when performing physical exertion. These results, even if determined by external reward, demonstrate susceptibility to changes in behavior related to the practice of physical activity.
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