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Silva MGS, Carvalho TL, de Azevedo Vieira JE, da Costa LR, da Silva DLO, Costa ALB, dos Anjos HPS, Lopes AJ. Evaluating performance on the Glittre-ADL test in men with long COVID 3 years after a SARS-CoV-2 infection. J Exerc Sci Fit 2024; 22:271-277. [PMID: 38601317 PMCID: PMC11002684 DOI: 10.1016/j.jesf.2024.03.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Revised: 03/08/2024] [Accepted: 03/25/2024] [Indexed: 04/12/2024] Open
Abstract
Background/objective Many COVID-19 survivors, especially those who have been hospitalized, have been suffering numerous complications that limit their activities of daily living, although changes that persist 3 years after infection are still not known. We aimed to investigate the impact of long COVID on the Glittre-ADL test (TGlittre) 3 years after acute infection in men who needed hospitalization and explore whether the performance on the TGlittre is associated with impairments in lung function, muscle strength, physical function and quality of life (QoL). Methods Cross-sectional study with 42 men with long COVID who took the TGlittre. They underwent pulmonary function tests and measurements of handgrip strength and quadriceps strength (QS). Additionally, they also completed the Saint George Respiratory Questionnaire (SGRQ) and Functional Independence Measure (FIM). Results The mean age was 52 ± 10.6 years, while the mean time after diagnosis of COVID-19 was 37 ± 3.5 months. The mean TGlittre time was 3.3 (3.1-4.1) min, which was 10% greater than the time expected for normal individuals to complete it. The TGlittre time was correlated significantly with the QS (rs = -0.397, p = 0.009), pulmonary diffusion (rs = - 0.364, p = 0.017), FIM (rs = -0.364, p = 0.017) and the "activity" domain score of the SGRQ (rs = 0.327, p = 0.034). Conclusion Functional capacity on exertion as measured by the TGlittre time is normal in most men with long COVID 3 years after hospitalization. However, this improvement in functional capacity does not seem to be reflected in muscle strength or QoL, requiring continued monitoring even after 3 years.
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Affiliation(s)
- Mayra Gomes Soares Silva
- Rehabilitation Sciences Post-Graduation Program, Augusto Motta University Center (UNISUAM), Rio de Janeiro, Brazil
| | - Thiago Lemos Carvalho
- Rehabilitation Sciences Post-Graduation Program, Augusto Motta University Center (UNISUAM), Rio de Janeiro, Brazil
| | | | | | | | | | | | - Agnaldo José Lopes
- Rehabilitation Sciences Post-Graduation Program, Augusto Motta University Center (UNISUAM), Rio de Janeiro, Brazil
- Medical Sciences Post-Graduation Program, State University of Rio de Janeiro (UERJ), Rio de Janeiro, Brazil
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Santos CE, da Fonseca Reis LF, da Silva SF, Fonseca IMPP, de Oliveira Pereira W, Pessoa LF, Villela PB, Lopes AJ. Dynamic hyperinflation on exercise and its relationship with lung mechanics at rest in adults with central obesity. Respir Physiol Neurobiol 2024; 326:104270. [PMID: 38688433 DOI: 10.1016/j.resp.2024.104270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2023] [Revised: 04/09/2024] [Accepted: 04/26/2024] [Indexed: 05/02/2024]
Abstract
This study aimed to evaluate the presence of dynamic hyperinflation (DH) during the Glittre-ADL test (TGlittre) coupled to the dynamic ventilation measurements in people with central obesity (pwCO) and to correlate it with lung mechanics at rest. Sixty-four pwCO underwent TGlittre and the following resting lung function tests: spirometry and impulse oscillometry system (IOS). On TGlittre, 22 participants presented DH at the end of the test (DH group), while 42 did not present DH (NDH group). Body mass index (BMI), waist circumference (WC), and hip circumference (HC) were higher in the DH group than in the NDH group. IOS abnormalities were more common in the DH group compared to the NDH group. TGlittre time significantly correlated with BMI, WC, waist-to-hip ratio (WHR), and neck circumference (NC). Delta inspiratory capacity correlated significantly with WC, HC, NC, and resonance frequency measured by IOS. Thus, pwCO perform worse on TGlittre, and DH is frequent in those with higher anthropometric indices and worse lung mechanics.
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Affiliation(s)
- Carlos Eduardo Santos
- Rehabilitation Sciences Postgraduate Programme, Centro Universitário Augusto Motta (UNISUAM), Rio de Janeiro, Brazil
| | - Luis Felipe da Fonseca Reis
- Rehabilitation Sciences Postgraduate Programme, Centro Universitário Augusto Motta (UNISUAM), Rio de Janeiro, Brazil
| | - Sidney Fernandes da Silva
- Rehabilitation Sciences Postgraduate Programme, Centro Universitário Augusto Motta (UNISUAM), Rio de Janeiro, Brazil
| | | | | | - Laura Franco Pessoa
- Faculty of Physiotherapy, Centro Universitário Augusto Motta (UNISUAM), Rio de Janeiro, Brazil
| | - Paolo Blanco Villela
- Postgraduate Programme in Cardiology, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
| | - Agnaldo José Lopes
- Rehabilitation Sciences Postgraduate Programme, Centro Universitário Augusto Motta (UNISUAM), Rio de Janeiro, Brazil; Postgraduate Programme in Medical Sciences, School of Medical Sciences, Universidade do Estado do Rio de Janeiro (UERJ), Rio de Janeiro, Brazil.
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Abelenda VLB, da Costa CH, Firmida MDC, Lopes AJ. Evaluating the contribution of the Glittre-ADL test in adults with cystic fibrosis. Physiother Res Int 2024; 29:e2087. [PMID: 38551092 DOI: 10.1002/pri.2087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Revised: 01/15/2024] [Accepted: 03/18/2024] [Indexed: 04/02/2024]
Abstract
BACKGROUND AND OBJECTIVES Cardiopulmonary and skeletal muscle impairment and poor physical activity are potential contributors to reduced functional capacity in cystic fibrosis (CF). The Glittre-ADL test (TGlittre) has great potential for clinical use in adult CF adults, as it meets the need for a comprehensive assessment of physical function using tasks similar to activities of daily living. This study aimed to evaluate the performance of TGlittre in CF adults compared to the 6-min walk test (6MWT) and, secondarily, to quantify the associations of their results with pulmonary function, muscle strength, and health-related quality of life (HRQoL). METHODS This cross-sectional study evaluated 34 CF adults and compared them with 34 subjects from a control group. The participants underwent the following assessments: functional capacity using TGlittre and 6MWT; spirometry; respiratory muscle strength; handgrip strength (HGS); and HRQoL using the Cystic Fibrosis Questionnaire-Revised (CFQ-R). RESULTS While CF patients showed a longer time to perform TGlittre compared to controls (134 (119-150) versus 107 (95-126) % of the predicted time p = 0.0002), no difference between these groups was observed in the 6MWT. When the second TGlittre was compared to the first TGlittre, there was a significant decrease in total time for both CF patients (p < 0.0001) and controls (p = 0.0001). TGlittre time correlated with 6MWT distance (6MWD) (rs = -0.641, p < 0.0001), HGS (rs = -0.364, p = 0.034), peripheral oxygen saturation at the end of the test (rs = -0.463, p = 0.006) and the "digestive symptoms" domain of CFQ-R (rs = 0.376, p = 0.028). TGlittre time was shorter in patients who engaged in regular physical activity (3.10 (2.49-3.39) min versus 3.28 (2.95-3.53) min, p = 0.016). CONCLUSIONS TGlittre is more effective than the 6MWT in detecting limitations during exercise. There is an important learning effect of TGlittre in adult CF patients. TGlittre time was correlated with 6MWD, HGS, oxygen saturation level, and the patient's level of physical activity.
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Affiliation(s)
- Vera Lucia Barros Abelenda
- Post-Graduation Programme in Medical Sciences, School of Medical Sciences, State University of Rio de Janeiro (UERJ), Rio de Janeiro, Brazil
| | - Cláudia Henrique da Costa
- Post-Graduation Programme in Medical Sciences, School of Medical Sciences, State University of Rio de Janeiro (UERJ), Rio de Janeiro, Brazil
- Department of Pulmonology, Piquet Carneiro Polyclinic, State University of Rio de Janeiro (UERJ), Rio de Janeiro, Brazil
| | - Mônica de Cássia Firmida
- Department of Pulmonology, Piquet Carneiro Polyclinic, State University of Rio de Janeiro (UERJ), Rio de Janeiro, Brazil
| | - Agnaldo José Lopes
- Post-Graduation Programme in Medical Sciences, School of Medical Sciences, State University of Rio de Janeiro (UERJ), Rio de Janeiro, Brazil
- Department of Pulmonology, Piquet Carneiro Polyclinic, State University of Rio de Janeiro (UERJ), Rio de Janeiro, Brazil
- Rehabilitation Sciences Post-Graduation Programme, Augusto Motta University Centre (UNISUAM), Rio de Janeiro, Brazil
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Teixeira EM, Ribeiro CO, Lopes AJ, de Melo PL. Respiratory Oscillometry and Functional Performance in Different COPD Phenotypes. Int J Chron Obstruct Pulmon Dis 2024; 19:667-682. [PMID: 38464561 PMCID: PMC10924760 DOI: 10.2147/copd.s446085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Accepted: 02/27/2024] [Indexed: 03/12/2024] Open
Abstract
Purpose Chronic obstructive pulmonary disease (COPD) phenotypes may introduce different characteristics that need to be known to improve treatment. Respiratory oscillometry provides a detailed analysis and may offer insight into the pathophysiology of COPD. In this paper, we used this method to evaluate the differences in respiratory mechanics of COPD phenotypes. Patients and Methods This study investigated a sample of 83 volunteers, being divided into control group (CG = 20), emphysema (n = 23), CB (n = 20) and asthma-COPD overlap syndrome (ACOS, n = 20). These analyses were performed before and after bronchodilator (BD) use. Functional capacity was evaluated using the Glittre‑ADL test, handgrip strength and respiratory pressures. Results Initially it was observed that oscillometry provided a detailed description of the COPD phenotypes, which was consistent with the involved pathophysiology. A correlation between oscillometry and functional capacity was observed (r=-0.541; p = 0.0001), particularly in the emphysema phenotype (r = -0.496, p = 0.031). BD response was different among the studied phenotypes. This resulted in an accurate discrimination of ACOS from CB [area under the receiver operating curve (AUC) = 0.84] and emphysema (AUC = 0.82). Conclusion These results offer evidence that oscillatory indices may enhance the comprehension and identification of COPD phenotypes, thereby potentially improving the support provided to these patients.
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Affiliation(s)
- Elayne Moura Teixeira
- Biomedical Instrumentation Laboratory, Institute of Biology and Faculty of Engineering, State University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Caroline Oliveira Ribeiro
- Biomedical Instrumentation Laboratory, Institute of Biology and Faculty of Engineering, State University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Agnaldo José Lopes
- Pulmonary Function Laboratory, Pedro Ernesto University Hospital, Faculty of Medical Sciences, State University of Rio de Janeiro, Rio de Janeiro, Brazil
- Pulmonary Rehabilitation Laboratory, Augusto Motta University Center, Rio de Janeiro, Brazil
| | - Pedro Lopes de Melo
- Biomedical Instrumentation Laboratory, Institute of Biology and Faculty of Engineering, State University of Rio de Janeiro, Rio de Janeiro, Brazil
- Laboratory of Clinical and Experimental Research in Vascular Biology - Biomedical Center, State University of Rio de Janeiro, Rio de Janeiro, Brazil
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Campos RP, Messias Oliveira JG, de Oliveira Farias I, de Souza VCV, de Alegria SG, Xavier RS, Lopes AJ. Effects of pulmonary rehabilitation on ventilation dynamics measured during exertion in patients with post-acute COVID-19 syndrome: A cross-sectional observational study. PLoS One 2024; 19:e0296707. [PMID: 38306350 PMCID: PMC10836674 DOI: 10.1371/journal.pone.0296707] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Accepted: 12/15/2023] [Indexed: 02/04/2024] Open
Abstract
BACKGROUND Pulmonary rehabilitation (PR) is recommended in people with post-acute COVID-19 syndrome (PACS), although there is a lack of studies evaluating its benefits via the most commonly used primary endpoint: the six-minute walk test (6MWT). This study evaluated the effects of PR on the dynamics of ventilation measured during the 6MWT in patients with PACS and, secondarily, evaluated the association of these findings with measures of lung function and structure. METHODS This was an observational cross-sectional study of patients with PACS, in which 33 had undergone PR (PR-PACS group) and 32 had not undergone PR (NPR-PACS group). These patients underwent Spiropalm®-equipped 6MWT with measurement of inspiratory capacity (IC) to evaluate dynamic hyperinflation (DH). In addition, they performed spirometry, impulse oscillometry (IOS) and lung ultrasound (LUS). RESULTS Spirometry was abnormal in 21.2% and 31.3% of participants in the PR-PACS and NPR-PACS groups, respectively (p = 0.36). IOS was abnormal in 28.6% and 66.7% of participants in the PR-PACS and NPR-PACS groups, respectively (p = 0.003). LUS was altered in 39.4% and 43.8% of the participants in the PR-PACS and NPR-PACS groups, respectively (p = 0.72). The 6-min walk distance (6MWD) was greater in the PR-PACS group than in the NPR-PACS group (p = 0.001]. HD was observed in 6.1% and 37.5% of participants in the PR-PACS and NPR-PACS groups, respectively, with a significant difference in ΔIC (p<0.001). The 6MWD correlated significantly with several IOS parameters and with ΔIC. CONCLUSIONS Patients with PACS undergoing PR perform better in the 6MWT, with a higher 6MWD and less HD. In these patients, IOS is able to distinguish the effects of PR that are not differentiated by spirometry or LUS. Furthermore, the better the respiratory mechanics assessed by IOS and the less DH there was, the higher the performance in the 6MWT.
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Affiliation(s)
- Renan Pereira Campos
- Rehabilitation Sciences Post-Graduation Programme, Augusto Motta University Centre (UNISUAM), Rio de Janeiro, Brazil
| | | | | | | | - Samantha Gomes de Alegria
- Pos-Graduation Programme in Medical Sciences, State University of Rio de Janeiro (UERJ), Rio de Janeiro, Brazil
| | - Rosemere Saldanha Xavier
- Local Development Post-Graduation Programme, Augusto Motta University Center (UNISUAM), Rio de Janeiro, Brazil
| | - Agnaldo José Lopes
- Rehabilitation Sciences Post-Graduation Programme, Augusto Motta University Centre (UNISUAM), Rio de Janeiro, Brazil
- Pos-Graduation Programme in Medical Sciences, State University of Rio de Janeiro (UERJ), Rio de Janeiro, Brazil
- Local Development Post-Graduation Programme, Augusto Motta University Center (UNISUAM), Rio de Janeiro, Brazil
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Dias LM, da Cruz JA, Lopes AJ. Long-term assessment of functional capacity, muscle function, lung function, and quality of life in survivors of ventilator-associated pneumonia. Heliyon 2024; 10:e23431. [PMID: 38169824 PMCID: PMC10758824 DOI: 10.1016/j.heliyon.2023.e23431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2023] [Revised: 11/27/2023] [Accepted: 12/04/2023] [Indexed: 01/05/2024] Open
Abstract
Background and objective The many patients who develop ventilator-associated pneumonia (VAP) have generated numerous VAP survivors who are not followed up in the long term. This study aimed, primarily, to evaluate the long-term functional capacity, as measured using the Glittre-ADL test (TGlittre), of VAP survivors and, secondarily, to calculate the correlations of TGlittre with muscle and lung function. Methods This cross-sectional study evaluated 30 VAP survivors 10 months after discharge from the intensive care unit. The participants underwent the following assessments: TGlittre; respiratory muscle strength; handgrip strength (HGS); spirometry; Functional Assessment of Chronic Therapy (FACIT-F); and Short Form-36 (SF-36). Results The median TGlittre time was 95 (81-130)% of predicted, and 30 % of the participants performed poorly on TGlittre. One-third of the participants had abnormal spirometry results. TGlittre time was correlated with weight (rs = -0.412, P = 0.023), body index mass (BMI, rs = -0.400, P = 0.029), forced vital capacity (FVC, rs = -0.401, P = 0.030), HGS (rs = -0.571, P = 0.0009), FACIT-F score (rs = -0.405, P = 0.026), and different SF-36 domain scores. Participants who returned to work had a shorter TGlittre time than those who did not (89 (69-104) vs. 129 (102-183)% predicted). Multiple linear regression indicated that FVC and BMI explained 39 % of TGlittre variability. Conclusion VAP survivors had suboptimal functional capacity, low lung function, and general fatigue 10 months after discharge. The longer the TGlittre time was, the worse the lung function, muscle function, general fatigue, and quality of life were and the less likely the patient was to have returned to work.
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Affiliation(s)
- Larissa Mello Dias
- Rehabilitation Sciences Post-Graduation Programme, Augusto Motta University Centre (UNISUAM), Rio de Janeiro, Brazil
- Faculty Inspirar, Curitiba, Brazil
- Worker's Hospital Complex, Curitiba, Brazil
| | | | - Agnaldo José Lopes
- Rehabilitation Sciences Post-Graduation Programme, Augusto Motta University Centre (UNISUAM), Rio de Janeiro, Brazil
- Local Development Post-Graduation Programme, Augusto Motta University Centre (UNISUAM), Rio de Janeiro, Brazil
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Vieira JEDA, Ferreira ADS, Monnerat LB, Cal MSD, Ghetti ATA, Mafort TT, Lopes AJ. Prediction models for physical function in COVID-19 survivors. J Bodyw Mov Ther 2024; 37:70-75. [PMID: 38432844 DOI: 10.1016/j.jbmt.2023.11.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Revised: 07/09/2023] [Accepted: 11/06/2023] [Indexed: 03/05/2024]
Abstract
BACKGROUND The burden of caring for patients who have survived COVID-19 will be enormous in the coming years, especially with respect to physical function. Physical function has been routinely assessed using the Post-COVID-19 Functional Status (PCFS) scale. AIM This study built prediction models for the PCFS scale using sociodemographic data, clinical findings, lung function, and muscle strength. METHOD Two hundred and one patients with post-COVID-19 syndrome (PCS) completed the PCFS scale to assess physical function. Their levels of general fatigue were also assessed using the Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F) scale, handgrip strength (HGS), and spirometry. RESULTS The number of participants who scored 0 (none), 1 (negligible), 2 (slight), 3 (moderate), and 4 (severe) on the PCFS scale was 25 (12%), 40 (20%), 39 (19%), 49 (24%), and 48 (24%), respectively. The PCFS scale was significantly correlated with the following variables: FACIT-F score (r = -0.424, P < 0.001), HGS (r = -0.339, P < 0.001), previous hospitalization (r = 0.226, P = 0.001), body mass index (r = 0.163, P = 0.021), and sex (r = -0.153, P = 0.030). The regression model with the highest coefficient of regression (R = 0.559) included the following variables: age, sex, body mass index, FACIT-F, HGS, and previous hospitalization. CONCLUSIONS Worse general fatigue and HGS are associated with more severe physical function impairments in PCS patients. Furthermore, a history of prior hospitalization results in worse physical function. Thus, prediction models for the PCFS scale that incorporate objective measures enable a better assessment of the physical function of these patients, thus helping in the selection of candidates for a program of physical reconditioning.
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Affiliation(s)
| | - Arthur de Sá Ferreira
- Rehabilitation Sciences Post-Graduation Programme, Augusto Motta University Centre (UNISUAM), Rio de Janeiro, Brazil; Local Development Post-Graduation Programme, Augusto Motta University Centre (UNISUAM), Rio de Janeiro, Brazil
| | - Laura Braga Monnerat
- Department of Pulmonology, Piquet Carneiro Policlinic, State University of Rio de Janeiro (UERJ), Rio de Janeiro, Brazil
| | - Mariana Soares da Cal
- Department of Pulmonology, Piquet Carneiro Policlinic, State University of Rio de Janeiro (UERJ), Rio de Janeiro, Brazil
| | - Angelo Thomaz Abalada Ghetti
- Department of Pulmonology, Piquet Carneiro Policlinic, State University of Rio de Janeiro (UERJ), Rio de Janeiro, Brazil
| | - Thiago Thomaz Mafort
- Department of Pulmonology, Piquet Carneiro Policlinic, State University of Rio de Janeiro (UERJ), Rio de Janeiro, Brazil; Medical Sciences Post-Graduation Programme, School of Medical Sciences, State University of Rio de Janeiro (UERJ), Rio de Janeiro, Brazil
| | - Agnaldo José Lopes
- Rehabilitation Sciences Post-Graduation Programme, Augusto Motta University Centre (UNISUAM), Rio de Janeiro, Brazil; Local Development Post-Graduation Programme, Augusto Motta University Centre (UNISUAM), Rio de Janeiro, Brazil; Department of Pulmonology, Piquet Carneiro Policlinic, State University of Rio de Janeiro (UERJ), Rio de Janeiro, Brazil; Medical Sciences Post-Graduation Programme, School of Medical Sciences, State University of Rio de Janeiro (UERJ), Rio de Janeiro, Brazil.
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Olímpio Júnior H, Camilo GB, Marques JA, Xavier RS, Santos CE, Lopes AJ. Effects of transcutaneous electrical diaphragmatic stimulation in critically ill elderly patients: a randomized controlled trial. Physiother Theory Pract 2023:1-10. [PMID: 38044840 DOI: 10.1080/09593985.2023.2289053] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Accepted: 11/25/2023] [Indexed: 12/05/2023]
Abstract
BACKGROUND Elderly patients under invasive mechanical ventilation (IMV) are more susceptible to muscle weakness. In the out-of-hospital environment, there are benefits to transcutaneous electrical diaphragmatic stimulation (TEDS), which is an easy-to-apply and low-cost technique. OBJECTIVE To evaluate the effect of TEDS on respiratory muscle strength, diaphragm thickness (DT), and IMV time in critically ill elderly patients. METHODS This was a randomized controlled trial in which patients were divided into an experimental group (EG) and a control group (CG). TEDS started 24 h after orotracheal intubation and lasted until the end of weaning. Both groups underwent the following assessments during the spontaneous breathing test after weaning from mechanical ventilation (MV): measurement of respiratory muscle strength by pressure gauge, analysis of DT by lung ultrasound, and extubation failure prevention checklist. RESULTS There were 23 participants in the EG and 21 in the CG. The median age was 66 (60-79) years. The mean values of the diaphragmatic thickening index in the EG and CG participants were 99.13 ± 26.75 and 66.88 ± 31.77, respectively (p = .001, Cohen's d = 1.094). The mean values of maximum inspiratory pressure in the EG and CG were 22.04 ± 3.41 and 19.34 ± 4.23 cmH2O, respectively (p = .005, Cohen's d = 0.698). The Tobin index and the integrative weaning index were similar between groups (p = .584 and p = .102, respectively). The duration of MV in the EG and CG was 6.28 ± 2.68 and 9.21 ± 2.76 days, respectively (p = .001, Cohen's d = -1.075). CONCLUSION Critically ill elderly patients receiving TEDS had shorter MV time, greater inspiratory muscle strength, and greater diaphragmatic contraction capacity according to their thickness fraction.
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Affiliation(s)
- Hebert Olímpio Júnior
- Postgraduate Programme in Medical Sciences, School of Medical Sciences, Universidade do Estado do Rio de Janeiro (UERJ), Rio de Janeiro, Brazil
| | - Gustavo Bittencourt Camilo
- Postgraduate Programme in Medical Sciences, School of Medical Sciences, Universidade do Estado do Rio de Janeiro (UERJ), Rio de Janeiro, Brazil
- Faculty of Medical and Health Sciences of Juiz de Fora (SUPREMA), Minas Gerais, Brazil
| | | | - Rosemere Saldanha Xavier
- Local Development Postgraduate Programme, Centro Universitario Augusto Motta (UNISUAM), Rio de Janeiro, Brazil
| | - Carlos Eduardo Santos
- Rehabilitation Sciences Postgraduate Programme, Centro Universitario Augusto Motta (UNISUAM), Rio de Janeiro, Brazil
| | - Agnaldo José Lopes
- Postgraduate Programme in Medical Sciences, School of Medical Sciences, Universidade do Estado do Rio de Janeiro (UERJ), Rio de Janeiro, Brazil
- Local Development Postgraduate Programme, Centro Universitario Augusto Motta (UNISUAM), Rio de Janeiro, Brazil
- Rehabilitation Sciences Postgraduate Programme, Centro Universitario Augusto Motta (UNISUAM), Rio de Janeiro, Brazil
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de Oliveira Saraiva NA, de Oliveira Farias I, Dos Santos BM, Xavier RS, Lopes AJ. Reply to letter to the editor: "Why 43.5% of Brazilian women with systemic sclerosis have an abnormal 6-min walk distance? The implication of parity". Clin Biomech (Bristol, Avon) 2023; 110:106134. [PMID: 37913629 DOI: 10.1016/j.clinbiomech.2023.106134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Accepted: 10/26/2023] [Indexed: 11/03/2023]
Affiliation(s)
| | | | | | - Rosemere Saldanha Xavier
- Local Development Post-Graduation Programme, Augusto Motta University Centre (UNISUAM), Rio de Janeiro, Brazil
| | - Agnaldo José Lopes
- Rehabilitation Sciences Post-Graduation Programme, Augusto Motta University Centre (UNISUAM), Rio de Janeiro, Brazil; Local Development Post-Graduation Programme, Augusto Motta University Centre (UNISUAM), Rio de Janeiro, Brazil.
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Ribeiro Moço VJ, Gulart AA, Lopes AJ, de Sá Ferreira A, da Fonseca Reis LF. Minimal-Resource Home Exercise Program Improves Activities of Daily Living, Perceived Health Status, and Shortness of Breath in Individuals with COPD Stages GOLD II to IV. COPD 2023; 20:298-306. [PMID: 37850828 DOI: 10.1080/15412555.2023.2253907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Accepted: 08/25/2023] [Indexed: 10/19/2023]
Abstract
Home exercises (HE) with minimal resources seem to be useful in individuals with COPD. The objective was to evaluate the effects of HE, on activities of daily living (ADL), dyspnea, on the health status(CAT) and quality of life (HRQoL) of individuals with COPD GOLD II to IV. Quasi-experimental study of the effects of HE, for 2 months, 3 times a week. Individuals with COPD(n = 45) were recruited, 37 started the protocol(9 did not complete it). 28 individuals (mean age 62.04 ± 5.8 years, FEV1: 44.7 ± 2.25%, FEV1/FVC 59.8 ± 6.9%) were evaluated before and after training. We observed improvements in the ADL-Glittre (4.9 ± 1.4 vs 3.9 ± 1.1 min; mean difference: -0.9 ± 0.2 min [95%CI: -1.3 to -0.2]; p = 0.008), as well as the mMRC score(2.8 ± 1.1 vs 2.07 ± 0.81; mean difference: 0.7 ± 0.3 [95%CI: -1.20.18 to -0.2]; p = 0.009), and in the CAT (25.6 ± 4.8 vs 18.9 ± 3.1; mean difference: -6.6 ± 3.4 [95%CI: -10.6 to -1.6]; p = 0.042). Analyzing the mean change before and after the intervention, a weak correlation was observed between ADL-Glittre and mMRC (r = 0.35; [95% CI 0.09; 0.56]; p = 0.009); moderate between ADL-Glittre and CAT (r = 0.52; [95% CI 0.30; 0.69]; p < 0.001) and between ADL-Glittre and SGRQ (r = 0.50; [95% CI 0 .27; 0.67]; p < 0.001). Individuals with COPD can benefit from HE performed autonomously and with minimal resources, as this proposal improves functional capacity for ADL, health perception and dyspnea.
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Affiliation(s)
| | - Aline Almeida Gulart
- Rehabilitation, Polydoro Ernani de São Thiago University Hospital (HU-UFSC), Brazilian Hospital Services Company (EBSERH), Florianópolis, Brazil
| | - Agnaldo José Lopes
- Rehabilitation Sciences Post-Graduation Programme, Augusto Motta University Centre, Rio de Janeiro, Brazil
- Graduate Program in Medical Sciences, Faculty of Medical Sciences, State University of Rio de Janeiro (UERJ), Rio de Janeiro, Brazil
| | - Arthur de Sá Ferreira
- Rehabilitation Sciences Post-Graduation Programme, Augusto Motta University Centre, Rio de Janeiro, Brazil
| | - Luis Felipe da Fonseca Reis
- Rehabilitation Sciences Post-Graduation Programme, Augusto Motta University Centre, Rio de Janeiro, Brazil
- Rehabilitation Center, Military Police of the State of Rio de Janeiro, Rio de Janeiro, Brazil
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Galhardo MM, da Cunha Chermont SLSM, de Lemos Venancio ICD, Lopes AJ, Guimaraes FS. Examining the haemodynamic repercussions of ventilator hyperinflation in elderly patients: An explanatory study. Respir Physiol Neurobiol 2023; 318:104165. [PMID: 37739150 DOI: 10.1016/j.resp.2023.104165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2023] [Revised: 09/07/2023] [Accepted: 09/18/2023] [Indexed: 09/24/2023]
Abstract
This study assessed the cardiovascular repercussions of two VHI (ventilation hyperinflation) protocols using the volume-controlled mode, one with an inspiratory pause (VHI-P) and the other without an inspiratory pause (VHI-NP), in mechanically ventilated elderly patients. The patients underwent both VHI protocols in a randomized order, and impedance cardiography was used to record cardiovascular variables. During VHI-P, the diastolic blood pressure was lower than during VHI-NP (Δ = 10%; p = 0.009). VHI-NP and VHI-P demonstrated a decrease in cardiac output (CO) during the first and third sets compared to baseline (p < 0.05; ES=0.23 and 0.29, respectively). Arterial oxygen delivery decreased simultaneously with CO compared to baseline values (p < 0.05; ES=0.22 and 0.23, respectively). Five minutes after the intervention, the systolic time ratio values were lower for VHI-P than VHI-NP (Δ = 10%; p = 0.01). Left ventricular ejection time values were consistently lower in VHI-NP compared to VHI-P (Δ = 2%; p = 0.02). In conclusion, our study shows that VHI in volume-controlled mode induces hemodynamic changes in mechanically ventilated elderly patients, albeit with a small effect size and within the normal range.
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Affiliation(s)
- Manuella Melo Galhardo
- Rehabilitation Sciences Postgraduate Programme, Augusto Motta University, Rua Dona Isabel, 94, Bonsucesso, 21032-060 Rio de Janeiro, Brazil
| | | | | | - Agnaldo José Lopes
- Rehabilitation Sciences Postgraduate Programme, Augusto Motta University, Rua Dona Isabel, 94, Bonsucesso, 21032-060 Rio de Janeiro, Brazil; Medical Sciences Postgraduate Programme, School of Medical Sciences, State University of Rio de Janeiro (UERJ), Av. Prof. Manoel de Abreu, 444, 2º andar, Vila Isabel, 20550-170 Rio de Janeiro, Brazil
| | - Fernando Silva Guimaraes
- Department of Cardiorespiratory and Musculoskeletal Physiotherapy, Faculty of Physiotherapy, Federal University of Rio de Janeiro (UFRJ), Rua Prof. Rodolpho Paulo Rocco, 255, Cidade Universitária, 21941-590, Rio de Janeiro, Brazil.
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Caldas BT, Ribeiro FCV, Pereira JS, Souza WC, Lopes AJ, de Melo PL. Oscillometry of the respiratory system in Parkinson's disease: physiological changes and diagnostic use. BMC Pulm Med 2023; 23:406. [PMID: 37884922 PMCID: PMC10605979 DOI: 10.1186/s12890-023-02716-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Accepted: 10/16/2023] [Indexed: 10/28/2023] Open
Abstract
BACKGROUND Lung function analysis in Parkinson's disease (PD) is often difficult due to the demand for adequate forced expiratory maneuvers. Respiratory oscillometry exams require onlyquiet tidal breathing and provide a detailed analysis of respiratory mechanics. We hypothesized that oscillometry would simplify the diagnosis of respiratory abnormalitiesin PD and improve our knowledge about the pathophysiological changes in these patients. MATERIALS AND METHODS This observational study includes 20 controls and 47 individuals with PD divided into three groups (Hoehn and Yahr Scale 1-1.5; H&Y scale 2-3 and PD smokers).The diagnostic accuracy was evaluated by investigating the area under the receiver operating characteristic curve (AUC). RESULTS Initial stages are related to increased peripheral resistance (Rp; p = 0.001). In more advanced stages, a restrictive pattern is added, reflected by reductions in dynamic compliance (p < 0.05) and increase in resonance frequency (Fr; p < 0.001). Smoking PD patients presented increased Rp (p < 0.001) and Fr (p < 0.01). PD does not introduce changes in the central airways. Oscillometric changes were correlated with respiratory muscle weakness (R = 0.37, p = 0.02). Rp showed adequate accuracy in the detection of early respiratory abnormalities (AUC = 0.858), while in more advanced stages, Fr showed high diagnostic accuracy (AUC = 0.948). The best parameter to identify changes in smoking patients was Rp (AUC = 0.896). CONCLUSION The initial stages of PD are related to a reduction in ventilation homogeneity associated with changes in peripheral airways. More advanced stages also include a restrictive ventilatory pattern. These changes were correlated with respiratory muscle weakness and were observed in mild and moderate stages of PD in smokers and non-smokers. Oscillometry may adequately identify respiratory changes in the early stages of PD and obtain high diagnostic accuracy in more advanced stages of the disease.
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Affiliation(s)
- Bruno Tavares Caldas
- Department of Physiological Sciences, Biomedical Instrumentation Laboratory, State University of Rio de Janeiro, Rio de Janeiro, Brazil
| | | | - João Santos Pereira
- Department of Neurology, Pedro Ernesto University Hospital, State University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Wilma Costa Souza
- Carioca Parkinson Association, Municipal Rehabilitation Center, Rio de Janeiro, Brazil
| | - Agnaldo José Lopes
- Department of Pulmonology, Respiratory Function Testing Laboratory, State University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Pedro Lopes de Melo
- Department of Physiological Sciences, Biomedical Instrumentation Laboratory, State University of Rio de Janeiro, Rio de Janeiro, Brazil.
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Bessa EJC, Ribeiro FDMC, Rodrigues RS, Henrique da Costa C, Rufino R, Pinheiro GDRC, Lopes AJ. Association between clinical, serological, functional and radiological findings and ventilatory distribution heterogeneity in patients with rheumatoid arthritis. PLoS One 2023; 18:e0291659. [PMID: 37862308 PMCID: PMC10588833 DOI: 10.1371/journal.pone.0291659] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Accepted: 09/02/2023] [Indexed: 10/22/2023] Open
Abstract
BACKGROUND In rheumatoid arthritis (RA), the involvement of the pulmonary interstitium can lead to structural changes in the small airways and alveoli, leading to reduced airflow and maldistribution of ventilation. The single-breath nitrogen washout (SBN2W) test is a measure of the ventilatory distribution heterogeneity and evaluates the small airways. This study aimed to find out which clinical, serological, functional and radiological findings are useful to identify RA patients with pathological values of the phase III slope (SIII) measured by the SBN2W test. METHODS This was a cross-sectional study in which RA patients were assessed using the Health Assessment Questionnaire-Disability Index (HAQ-DI) and the Clinical Disease Activity Index (CDAI) and underwent serological analysis of autoantibodies and inflammatory markers. In addition, they underwent pulmonary function tests (including the SBN2W test) and chest computed tomography (CT). RESULTS Of the 60 RA patients evaluated, 39 (65%) had an SIII >120% of the predicted value. There were significant correlations between SIII and age (r = 0.56, p<0.0001), HAQ-DI (r = 0.34, p = 0.008), forced vital capacity (FVC, r = -0.67, p<0.0001), total lung capacity (r = -0.46, p = 0.0002), residual volume/total lung capacity (TLC) (r = 0.44, p = 0.0004), and diffusing capacity of the lungs for carbon monoxide (r = -0.45, p = 0.0003). On CT scans, the subgroup with moderate/severe disease had a significantly higher SIII than the normal/minimal/mild subgroup (662 (267-970) vs. 152 (88-283)% predicted, p = 0.0004). In the final multiple regression model, FVC, extent of moderate/severe involvement and age were associated with SIII, explaining 59% of its variability. CONCLUSIONS In patients with RA, FVC, extent of lung involvement and age, all of which are easily obtained variables in clinical practice, identify poorly distributed ventilation. In addition, the presence of respiratory symptoms and deteriorated physical function are closely related to the distribution of ventilation in these patients.
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Affiliation(s)
- Elizabeth Jauhar Cardoso Bessa
- Postgraduate Programme in Medical Sciences, School of Medical Sciences, State University of Rio de Janeiro, Rio de Janeiro, Brazil
| | | | - Rosana Souza Rodrigues
- D’Or Institute for Research and Education, Rio de Janeiro, Brazil
- Department of Radiology, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Cláudia Henrique da Costa
- Postgraduate Programme in Medical Sciences, School of Medical Sciences, State University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Rogério Rufino
- Postgraduate Programme in Medical Sciences, School of Medical Sciences, State University of Rio de Janeiro, Rio de Janeiro, Brazil
| | | | - Agnaldo José Lopes
- Postgraduate Programme in Medical Sciences, School of Medical Sciences, State University of Rio de Janeiro, Rio de Janeiro, Brazil
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de Oliveira Saraiva NA, de Oliveira Farias I, Dos Santos BM, Xavier RS, Lopes AJ. Reference value for the 6-min walking distance in women with systemic sclerosis considering the impact of muscle strength. Clin Biomech (Bristol, Avon) 2023; 109:106094. [PMID: 37725867 DOI: 10.1016/j.clinbiomech.2023.106094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2023] [Revised: 09/02/2023] [Accepted: 09/12/2023] [Indexed: 09/21/2023]
Abstract
BACKGROUND Early triage, the search for new therapies, and closer monitoring of patients with systemic sclerosis before their lung function irreversibly deteriorates are urgent concerns. Because it is an independent predictor of systemic sclerosis-related mortality, the 6-min walk test is a potentially useful tool to evaluate outcomes, along with pulmonary function and computed tomography. This study aimed to establish a reference value for the 6-min walking distance in women with diffuse cutaneous systemic sclerosis-associated interstitial lung disease that takes into account the effects of muscle and lung function. METHODS This was a cross-sectional study in which 69 women with systemic sclerosis underwent the 6-min walk test, Health Assessment Questionnaire-Disability Index, pulmonary function, handgrip strength test, and quadriceps strength test. FINDINGS The mean 6-min walking distance was 447 ± 78 m, and 43.5% of the participants did not reach 80% of their predicted value. 6-min walking distance correlated positively with quadriceps strength (r = 0.418, P = 0.0004), forced vital capacity (r = 0.306, P = 0.011), pulmonary diffusion (r = 0.360, P = 0.002), maximum inspiratory pressure (r = 0.268, P = 0.029), and maximum expiratory pressure (r = 0.288, P = 0.019) and negatively with age (r = -0.378, P = 0.001), body mass index (r = -0.248, P = 0.039), and Health Assessment Questionnaire-Disability Index (r = -0.438, P = 0.0001). In the multiple linear regression analysis, quadriceps strength, body mass index, pulmonary diffusion, age, and maximum expiratory pressure explained 72% of the 6-min walking distance variability. INTERPRETATION Muscle function and, to a lesser extent, lung function are key contributors in determining the reference value for the 6-min walking distance in women with diffuse cutaneous systemic sclerosis-associated interstitial lung disease.
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Affiliation(s)
| | | | | | - Rosemere Saldanha Xavier
- Local Development Post-Graduation Programme, Augusto Motta University Centre (UNISUAM), Rio de Janeiro, Brazil
| | - Agnaldo José Lopes
- Rehabilitation Sciences Post-Graduation Programme, Augusto Motta University Centre (UNISUAM), Rio de Janeiro, Brazil; Local Development Post-Graduation Programme, Augusto Motta University Centre (UNISUAM), Rio de Janeiro, Brazil.
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de Oliveira Saraiva NA, de Oliveira Farias I, Mesquita dos Santos B, Xavier RS, Lopes AJ. Evaluation of cardiac autonomic control during the 6-min walk test in women with systemic sclerosis. BMC Res Notes 2023; 16:241. [PMID: 37777752 PMCID: PMC10544114 DOI: 10.1186/s13104-023-06522-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Accepted: 09/20/2023] [Indexed: 10/02/2023] Open
Abstract
OBJECTIVE To evaluate the association between sympathovagal balance and exercise performance, as measured by the 6-min walk test (6MWT), in women with systemic sclerosis (SSc) without cardiac involvement. RESULTS This was a cross-sectional study in which 69 women with SSc [median age 51 (40-63 years)] without cardiac involvement underwent the 6MWT. Throughout the 6MWT, heart rate variability (HRV) was assessed using dedicated software. METHODS The median 6-min walking distance (6MWD) was 451 (392-498) meters, and 29 (42%) participants did not achieve 80% of the predicted value for healthy adults. Desaturation during the 6MWT (SpO2 ≤ 4%) was observed in 10.1% of participants. Significant correlations were observed between the 6MWD and the following HRV parameters: number of successive normal-to-normal RR interval differences > 50 ms (rs=-0.397, P = 0.013), low-frequency range (rs=0.374, P = 0.023), high-frequency range (rs=-0.372, P = 0.023), and parasympathetic nervous system index (rs=-0.342, P = 0.045). CONCLUSION In women with SSc, there is an interrelationship of the 6MWD with both vagal withdrawal and sympathetic hyperactivation. This relationship between autonomic imbalance and worse exercise performance might increase cardiovascular risk, even in patients without apparent cardiac involvement. Control of the heart by the autonomic nervous system may be a potential target for treating patients with SSc.
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Affiliation(s)
- Nathália Alves de Oliveira Saraiva
- Post-Graduation Programme in Rehabilitation Sciences, Centro Universitário Augusto Motta (UNISUAM), Rua Dona Isabel, 94, Bonsucesso, Rio de Janeiro, 21032-060 Brazil
| | - Iasmim de Oliveira Farias
- Faculty of Physiotherapy, Centro Universitário Augusto Motta (UNISUAM), Av. Paris, 84, Bonsucesso, Rio de Janeiro, 21041-020 Brazil
| | - Brenda Mesquita dos Santos
- Faculty of Physiotherapy, Centro Universitário Augusto Motta (UNISUAM), Av. Paris, 84, Bonsucesso, Rio de Janeiro, 21041-020 Brazil
| | - Rosemere Saldanha Xavier
- Post-Graduation Programme in Local Development, Centro Universitário Augusto Motta (UNISUAM), Rua Dona Isabel, 94, Bonsucesso, Rio de Janeiro, 21032-060 Brazil
| | - Agnaldo José Lopes
- Post-Graduation Programme in Rehabilitation Sciences, Centro Universitário Augusto Motta (UNISUAM), Rua Dona Isabel, 94, Bonsucesso, Rio de Janeiro, 21032-060 Brazil
- Post-Graduation Programme in Local Development, Centro Universitário Augusto Motta (UNISUAM), Rua Dona Isabel, 94, Bonsucesso, Rio de Janeiro, 21032-060 Brazil
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16
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Tavares MAS, Myers V, Nogueira LAC, Lopes AJ. Cross-cultural adaptation of the Parental Perceptions of Children's Exposure to Tobacco Smoke instrument to the Brazilian context. BMC Res Notes 2023; 16:232. [PMID: 37752592 PMCID: PMC10523679 DOI: 10.1186/s13104-023-06513-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Accepted: 09/16/2023] [Indexed: 09/28/2023] Open
Abstract
OBJECTIVE To perform a cross-cultural adaptation of the Parental Perceptions of Children's Exposure to Tobacco Smoke (PPE) instrument to the Brazilian context. RESULTS The cross-cultural adaptation process was performed in 10 stages. Four translators, eight specialists, and 35 primary care users participated in the study. Both translations were similar. The synthesis version that was back-translated was equivalent to the original. The committee of experts scored all items in the content validity index as 3 or 4, suggesting only small changes such as changing "photo" to "image" and "service balcony" to "service area". After the completion of the first sequence of pretests, some adjustments were required by the committee of experts for the second round. The form of application of the self-administered questionnaire for the interview was changed, the Likert scale was reduced from 7 to 5 points, and the option "I don't know" was added to questions 18, 19, and 20. After these adjustments, the instrument was well accepted by the study population and presented good internal consistency (Cronbach's α score = 0.82). The PPE instrument, which assesses the perception of parents about their children's exposure to cigarette smoke, was satisfactorily translated and adapted to the Brazilian context.
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Affiliation(s)
- Maria Alice Santos Tavares
- Post-Graduation Programme in Rehabilitation Sciences, Centro Universitário Augusto Motta (UNISUAM), Bonsucesso, Rio de Janeiro, 94, 21032-060, Brazil
- Instituto Nacional do Câncer José Gomes de Alencar, Rio de Janeiro, Brazil
| | - Vicki Myers
- Department of Health Promotion, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Gertner Institute of Epidemiology & Health Policy Research, Sheba Medical Center, Ramat Gan, Israel
| | - Leandro Alberto Calazans Nogueira
- Post-Graduation Programme in Rehabilitation Sciences, Centro Universitário Augusto Motta (UNISUAM), Bonsucesso, Rio de Janeiro, 94, 21032-060, Brazil
- Physiotherapy Department, Instituto Federal do Rio de Janeiro (IFRJ), Rio de Janeiro, Brazil
| | - Agnaldo José Lopes
- Post-Graduation Programme in Rehabilitation Sciences, Centro Universitário Augusto Motta (UNISUAM), Bonsucesso, Rio de Janeiro, 94, 21032-060, Brazil.
- Post-Graduation Programme in Medical Sciences, School of Medical Sciences, Universidade do Estado do Rio de Janeiro (UERJ), Rio de Janeiro, Brazil.
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Motta CP, Olimpio da Silva DL, da Costa LR, Galhardo GF, Lopes AJ. Performance during the Glittre-ADL test between patients with and without post-tuberculosis bronchiectasis: A cross-sectional study. PLoS One 2023; 18:e0290850. [PMID: 37656719 PMCID: PMC10473510 DOI: 10.1371/journal.pone.0290850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Accepted: 08/17/2023] [Indexed: 09/03/2023] Open
Abstract
BACKGROUND Post-tuberculosis bronchiectasis (PTBB) is gaining recognition as an important chronic lung disease, representing a neglected condition with a significant burden for the individual. Recently, the Glittre-ADL test (TGlittre) has been proposed for the assessment of functional capacity, which incorporates tasks of daily living demanding the upper and lower extremities. This study used TGlittre to compare patients with PTBB to patients with non-post-tuberculosis bronchiectasis (NPTBB) and evaluate the determinants of performance during TGlittre. METHODS This is a cross-sectional study in which 32 patients with PTBB and 29 with NPTBB underwent TGlittre. In addition, they completed Short Form-36 (SF-36), handgrip strength, quadriceps muscle strength (QMS) and pulmonary function tests (PFTs). RESULTS Both PTBB and NPTBB required much more time to perform the TGlittre compared to the predicted values, although they did not differ statistically from each other [152 (124-200) vs. 145 (117-179)% predicted, p = 0.41]. Regarding the PFTs, the PTBB participants showed significantly lower values than the NPTBB participants in forced vital capacity (FVC, 60 ± 14.5 vs. 78.2 ± 22.2% predicted, p<0.001) and total lung capacity [82 (66-95) vs. 93 (82-105)% predicted, p = 0.028]. In the PTBB group, FVC (p<0.001) and QMS (p = 0.001) were the only significant independent variables to predict TGlittre time, explaining 71% of the variability in TGlittre time. In the NPTBB group, maximal expiratory pressure (p = 0.002), residual volume/TLC (p = 0.001) and QMS (p = 0.032) were the significant independent variables for predicting TGlittre time, explaining 73% of the variability in TGlittre time. CONCLUSIONS PTBB patients have lower than expected performance on TGlittre, though similar to NPTBB patients. The PTBB patients had a greater reduction in lung volume than NPTBB patients. Furthermore, the performance on TGlittre in PTBB patients is largely explained by lung volume and QMS.
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Affiliation(s)
- Cristiane Pires Motta
- Rehabilitation Sciences Post-Graduation Programme, Augusto Motta University Centre (UNISUAM), Rio de Janeiro, Brazil
| | | | | | - Giselle Faria Galhardo
- Local Development Post-Graduation Programme, Augusto Motta University Center (UNISUAM), Rio de Janeiro, Brazil
| | - Agnaldo José Lopes
- Rehabilitation Sciences Post-Graduation Programme, Augusto Motta University Centre (UNISUAM), Rio de Janeiro, Brazil
- Local Development Post-Graduation Programme, Augusto Motta University Center (UNISUAM), Rio de Janeiro, Brazil
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da Nobrega Ferreira I, de Oliveira AMC, Dos Santos BM, Lopes AJ. Feasibility of the Glittre-ADL test in the preoperative period of thoracic surgery. Physiother Theory Pract 2023:1-10. [PMID: 37427801 DOI: 10.1080/09593985.2023.2234027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/11/2023]
Abstract
BACKGROUND The Glittre-ADL test (TGlittre) broadly meets the need for an objective evaluation of physical function, using similar activities to those of daily living. OBJECTIVE To assess whether TGlittre in the preoperative assessment of patients who are candidates for thoracic surgery is associated with measures of pulmonary function, body balance, and quality of life and, secondarily, whether TGlittre may be related to postoperative complications. METHODS This study evaluated 34 patients in the preoperative period of thoracic surgery. Participants underwent the following assessments: TGlittre; pulmonary function tests; St. George's Respiratory Questionnaire; and Berg Balance Scale. For participants who underwent thoracic surgery (n = 18), the following variables were taken: surgical time; time in intensive care unit; chest drain duration; and hospital stay after surgery. RESULTS The median time to perform TGlittre tasks compared to the predicted was 137 (116-179) % predicted. There was significant correlation between TGlittre time and the diffusing capacity for carbon monoxide (rs = -0.334, p = .042). TGlittre time correlated significantly with the Berg Balance Scale (rs = -0.359, p = .036). We observed a significant correlation between TGlittre time and chest drain duration in the postoperative period (rs = 0.651, p = .003). CONCLUSION Patients in the preoperative period of thoracic surgery have a reduced functional capacity to exertion, which can be explained at least in part by worse pulmonary gas exchange and body imbalance. Furthermore, TGlittre is possibly a prognostic test for postoperative complications, especially with respect to chest tube duration.
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Affiliation(s)
- Isabelle da Nobrega Ferreira
- Rehabilitation Sciences Post-Graduation Program, Augusto Motta University Centre (UNISUAM), Rio de Janeiro, Brazil
| | | | - Brenda Mesquita Dos Santos
- Rehabilitation Sciences Post-Graduation Program, Augusto Motta University Centre (UNISUAM), Rio de Janeiro, Brazil
| | - Agnaldo José Lopes
- Rehabilitation Sciences Post-Graduation Program, Augusto Motta University Centre (UNISUAM), Rio de Janeiro, Brazil
- Post-Graduation Program in Medical Sciences, School of Medical Sciences, State University of Rio de Janeiro (UERJ), Rio de Janeiro, Brazil
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Balata MR, Ferreira AS, da Silva Sousa A, Meinertz LF, de Sá LM, Araujo VG, Papathanasiou J, Lopes AJ. Assessment of Functional Capacity in Patients with Nondialysis-Dependent Chronic Kidney Disease with the Glittre Activities of Daily Living Test. Healthcare (Basel) 2023; 11:1809. [PMID: 37372926 DOI: 10.3390/healthcare11121809] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 06/09/2023] [Accepted: 06/16/2023] [Indexed: 06/29/2023] Open
Abstract
This study evaluated the functional capacity measured by the Glittre-ADL test (TGlittre) in patients with nondialysis-dependent chronic kidney disease (NDD-CKD) and analyzed the test's associations with muscle strength, physical activity level (PAL), and quality of life. Methods: Thirty patients with NDD-CKD underwent the following evaluations: the TGlittre; the International Physical Activity Questionnaire (IPAQ); the Short Form-36 (SF-36); and handgrip strength (HGS). The absolute value and percentage of the theoretical TGlittre time were 4.3 (3.3-5.2) min and 143.3 ± 32.7%, respectively. The main difficulties in completing the TGlittre were squatting to perform shelving and manual tasks, which were reported by 20% and 16.7% of participants, respectively. The TGlittre time correlated negatively with HGS (r = -0.513, p = 0.003). The TGlittre time was significantly different between the PALs considered "sedentary", "irregularly active", and "active" (p = 0.038). There were no significant correlations between TGlittre time and the SF-36 dimensions. Patients with NDD-CKD had a reduced functional capacity to exercise with difficulties performing squatting and manual tasks. There was a relationship between TGlittre time and both HGS and PAL. Thus, the incorporation of the TGlittre in the evaluation of these patients may improve the risk stratification and individualization of therapeutic care.
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Affiliation(s)
- Mauro Ribeiro Balata
- Postgraduate Program of Rehabilitation Sciences, Centro Universitário Augusto Motta (UNISUAM), Rio de Janeiro 21032-060, RJ, Brazil
| | - Arthur Sá Ferreira
- Postgraduate Program of Rehabilitation Sciences, Centro Universitário Augusto Motta (UNISUAM), Rio de Janeiro 21032-060, RJ, Brazil
| | | | | | | | - Vinicius Guterres Araujo
- State Hospital of High Complexity Dr. Carlos Macieira, São Luís 65070-220, MA, Brazil
- Intensive Care Hospital, São Luís 65071-383, MA, Brazil
| | - Jannis Papathanasiou
- Department of Medical Imaging, Allergology & Physiotherapy, Faculty of Dental Medicine, Medical University of Plovdiv, 4002 Plovdiv, Bulgaria
- Department of Kinesitherapy, Faculty of Public Health "Prof. Dr. Tzecomir Vodenicharov, DSc.", Medical University of Sofia, 1431 Sofia, Bulgaria
| | - Agnaldo José Lopes
- Postgraduate Program of Rehabilitation Sciences, Centro Universitário Augusto Motta (UNISUAM), Rio de Janeiro 21032-060, RJ, Brazil
- Postgraduate Program of Medical Sciences, School of Medical Sciences, State University of Rio de Janeiro (UERJ), Rio de Janeiro 20550-170, RJ, Brazil
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Monnerat LB, Louzada EB, Braga VGS, da Cal MS, Lopes AJ, Mafort TT. Chocolate-Colored Pseudochylothorax in a Woman with a History of Pleuropulmonary Tuberculosis. Am J Case Rep 2023; 24:e939473. [PMID: 37317516 DOI: 10.12659/ajcr.939473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
BACKGROUND Pseudochylothorax is a rare entity, with only a few hundred case reports worldwide. It presents as a pleural effusion rich in lipids, typically with a cloudy, milky appearance. The diagnosis is made based on the levels of cholesterol and triglycerides in the pleural fluid. CASE REPORT This is the case report of a 55-year-old woman with a history of pleuropulmonary tuberculosis that was treated in childhood, with a new infection and treatment in adulthood that evolved to a left pleural effusion. Thirteen years after completing her last treatment for tuberculosis, the patient developed general fatigue and dyspnea on exertion. Computed tomography of the chest confirmed the presence of a pleural collection in the same location as in adolescence, suggesting a chronic evolution with encystation. The patient underwent ultrasound-guided diagnostic thoracentesis. The collected liquid was thick, chocolate-colored, with the following biochemical characteristics: pH, 7.3; glucose, 37.9 mg/dL; LDL, 2059.8 IU/L; total protein, 8.8 mg/dL; triglycerides, 90 mg/dL; adenosine deaminase, 56 U/L; and cholesterol, 300 mg/dL. The effusion was characterized as a pseudochylothorax. The cell count showed 631 000 leukocytes/µL, with 87.9% polymorphonuclear cells. Owing to the patient's respiratory symptoms, an evacuatory thoracentesis was performed. After the procedure, the patient's symptoms improved. CONCLUSIONS Although pseudochylothorax is a rare condition, its possibility must always be kept in mind to avoid the hazards of misdiagnosis. In addition to the 'classic' milky and machine oil appearance, a chocolate-colored appearance should also serve as a clue to the diagnosis of pseudochylothorax.
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Affiliation(s)
- Laura Braga Monnerat
- Department of Pneumology, University Hospital Pedro Ernesto, State University of Rio de Janeiro (UERJ), Rio de Janeiro, RJ, Brazil
| | - Elisa Barbosa Louzada
- Department of Pneumology, University Hospital Pedro Ernesto, State University of Rio de Janeiro (UERJ), Rio de Janeiro, RJ, Brazil
| | - Vanessa Godinho Souza Braga
- Department of Pneumology, University Hospital Pedro Ernesto, State University of Rio de Janeiro (UERJ), Rio de Janeiro, RJ, Brazil
| | - Mariana Soares da Cal
- Department of Pneumology, University Hospital Pedro Ernesto, State University of Rio de Janeiro (UERJ), Rio de Janeiro, RJ, Brazil
| | - Agnaldo José Lopes
- Department of Pneumology, University Hospital Pedro Ernesto, State University of Rio de Janeiro (UERJ), Rio de Janeiro, RJ, Brazil
- Post-Graduation Programme in Medical Sciences, School of Medical Sciences, State University of Rio de Janeiro (UERJ), Rio de Janeiro, RJ, Brazil
- Rehabilitation Sciences Post-Graduation Program, Augusto Motta University Centre (UNISUAM), Rio de Janeiro, RJ, Brazil
| | - Thiago Thomaz Mafort
- Department of Pneumology, University Hospital Pedro Ernesto, State University of Rio de Janeiro (UERJ), Rio de Janeiro, RJ, Brazil
- Post-Graduation Programme in Medical Sciences, School of Medical Sciences, State University of Rio de Janeiro (UERJ), Rio de Janeiro, RJ, Brazil
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21
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Oliveira JGM, Campos RP, Azevedo BLPA, de Alegria SG, Litrento PF, Mafort TT, Lopes AJ. Ventilation dynamics using a portable device coupled to the six-minute walk test in people with long-COVID syndrome: a preliminary study. BMC Res Notes 2023; 16:99. [PMID: 37291610 DOI: 10.1186/s13104-023-06374-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Accepted: 06/01/2023] [Indexed: 06/10/2023] Open
Abstract
OBJECTIVE To investigated the dynamic ventilatory responses and their influence on functional exercise capacity in patients with long-COVID-19 syndrome (LCS). RESULTS Sixteen LCS patients were subjected to resting lung function (spirometry and respiratory oscillometry-RO) and cardiopulmonary performance to exercise (Spiropalm®-equipped six-minute walk test-6MWT and cardiopulmonary exercise test-CPX). At rest, spirometry showed a normal, restrictive and obstructive pattern in 87.5%, 6.25% and 6.25% of participants, respectively. At rest, RO showed increased resonance frequency, increased integrated low-frequency reactance and increased difference between resistance at 4-20 Hz (R4-R20) in 43.7%, 50%, and 31.2% of participants, respectively. The median of six-minute walking distance (DTC6) was 434 (386-478) m, which corresponds to a value of 83% (78-97%) of predicted. Dynamic hyperinflation (DH) and reduced breathing reserve (BR) were detected in 62.5% and 12.5% of participants, respectively. At CPX, the median peak oxygen uptake (VO2peak) was 19 (14-37) ml/kg/min. There was a significant correlation of 6MWD with both R4-R20 (rs=-0.499, P = 0.039) and VO2peak (rs=0.628, P = 0.009). Our results indicate that DH and low BR are contributors to poor exercise performance, which is associated with peripheral airway disease. These are promising results considering that they were achieved with simple, portable ventilatory and metabolic systems.
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Affiliation(s)
- Jéssica Gabriela Messias Oliveira
- Department of Pulmonology, Universidade do Estado do Rio de Janeiro (UERJ), Policlínica Piquet Carneiro, Avenida Mal. Rondon, 381, São Francisco Xavier, Rio de Janeiro, 20950-003, Brazil
| | - Renan Pereira Campos
- Post-Graduation Programme in Rehabilitation Sciences, Centro Universitário Augusto Motta (UNISUAM), Rua Dona Isabel, 94, Bonsucesso, Rio de Janeiro, 21032-060, Brazil
| | - Beatriz Luiza Pinheiro Alves Azevedo
- Department of Pulmonology, Universidade do Estado do Rio de Janeiro (UERJ), Policlínica Piquet Carneiro, Avenida Mal. Rondon, 381, São Francisco Xavier, Rio de Janeiro, 20950-003, Brazil
| | - Samantha Gomes de Alegria
- Department of Pulmonology, Universidade do Estado do Rio de Janeiro (UERJ), Policlínica Piquet Carneiro, Avenida Mal. Rondon, 381, São Francisco Xavier, Rio de Janeiro, 20950-003, Brazil
- Post-Graduation Programme in Medical Sciences, School of Medical Sciences, Universidade do Estado do Rio de Janeiro (UERJ), Boulevard 28 de Setembro, 77, Vila Isabel, Rio de Janeiro, 20551-030, Brazil
| | - Patrícia Frascari Litrento
- Department of Pulmonology, Universidade do Estado do Rio de Janeiro (UERJ), Policlínica Piquet Carneiro, Avenida Mal. Rondon, 381, São Francisco Xavier, Rio de Janeiro, 20950-003, Brazil
| | - Thiago Thomaz Mafort
- Department of Pulmonology, Universidade do Estado do Rio de Janeiro (UERJ), Policlínica Piquet Carneiro, Avenida Mal. Rondon, 381, São Francisco Xavier, Rio de Janeiro, 20950-003, Brazil
- Post-Graduation Programme in Medical Sciences, School of Medical Sciences, Universidade do Estado do Rio de Janeiro (UERJ), Boulevard 28 de Setembro, 77, Vila Isabel, Rio de Janeiro, 20551-030, Brazil
| | - Agnaldo José Lopes
- Department of Pulmonology, Universidade do Estado do Rio de Janeiro (UERJ), Policlínica Piquet Carneiro, Avenida Mal. Rondon, 381, São Francisco Xavier, Rio de Janeiro, 20950-003, Brazil.
- Post-Graduation Programme in Rehabilitation Sciences, Centro Universitário Augusto Motta (UNISUAM), Rua Dona Isabel, 94, Bonsucesso, Rio de Janeiro, 21032-060, Brazil.
- Post-Graduation Programme in Medical Sciences, School of Medical Sciences, Universidade do Estado do Rio de Janeiro (UERJ), Boulevard 28 de Setembro, 77, Vila Isabel, Rio de Janeiro, 20551-030, Brazil.
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22
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Deucher RADO, Reis LFDF, Papathanasiou JV, Azevedo BLPA, Oliveira JGM, da Silva MM, de Sales RC, Dos Santos BP, Ferreira ADS, Lopes AJ. Estimating cardiopulmonary fitness with a new sampling technology in patients with rheumatoid arthritis-associated interstitial lung disease. Physiother Res Int 2023:e2005. [PMID: 37022592 DOI: 10.1002/pri.2005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Accepted: 03/14/2023] [Indexed: 04/07/2023]
Abstract
BACKGROUND AND OBJECTIVES Although peak oxygen uptake (VO2peak ) is one of the most important measures in clinical practice, the high cost and time consumption have led to the search for simpler devices and the development of the estimating cardiopulmonary fitness (eCPF) equation. Since the lungs are one of the sites most affected by rheumatoid arthritis (RA), this study aimed to create a predictive equation for VO2peak obtained by simple sampling technology in women with RA-associated interstitial lung disease (RA-ILD). METHODS This cross-sectional study evaluated 47 women with RA-ILD. The participants underwent the following evaluations: computed tomography (CT); evaluation of disease activity through the Clinical Disease Activity Index (CDAI); measurement of physical function using the Health Assessment Questionnaire disability index (HAQ-DI); pulmonary function testing, including spirometry, diffusing capacity for carbon monoxide (DlCO ), nitrogen single-breath washout (N2 SBW) test, and impulse oscillometry; and cardiopulmonary exercise testing (CPET) using FitMate™. RESULTS VO2peak was correlated with age (r = -0.550, p < 0.0001), rheumatoid factor (r = -0.443, p = 0.002), anti-cyclic citrullinated peptide antibodies (r = -0.410, p = 0.004), CDAI (r = -0.462, p = 0.001), HAD-DI (r = -0.486, p = 0.0005), forced vital capacity (r = 0.491, p = 0.0004), DlCO (r = 0.621, p < 0.0001), phase III slope of N2 SBW (r = -0.647, p < 0.0001), resonance frequency (Fres , r = -0.717, p < 0.0001), integrated low-frequency reactance (r = -0.535, p = 0.0001), and the inhomogeneity of respiratory system resistance between 4 and 20 Hz (r = -0.631, p < 0.0001). In the CT examination, patients with extensive ILD had significantly lower VO2peak than patients with limited ILD (p < 0.0001). In the stepwise forward regression analysis, Fres , DlCO and age explained 61% of the VO2peak variability. CONCLUSIONS As assessed by CPET, women with RA-ILD show reduced cardiopulmonary fitness, which can be explained at least in part by the presence of small airway disease, deterioration of pulmonary gas exchange, and advanced age. These associations of pulmonary variables with eCPF may be clinically important and support the use of the eCPF equation to improve patient outcomes.
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Affiliation(s)
| | - Luis Felipe da Fonseca Reis
- Rehabilitation Sciences Post-Graduation Programme, Augusto Motta University Centre (UNISUAM), Rio de Janeiro, Brazil
| | - Jannis Vasileios Papathanasiou
- Faculty of Dental Medicine, Department of Medical Imaging, Allergology & Physiotherapy, Medical University of Plovdiv, Plovdiv, Bulgaria
- Faculty of Public Health "Prof. Dr. Tzecomir Vodenicharov, DSc.", Department of Kinesiotherapy, Medical University of Sofia, Sofia, Bulgaria
| | | | | | - Matheus Mello da Silva
- Rehabilitation Sciences Post-Graduation Programme, Augusto Motta University Centre (UNISUAM), Rio de Janeiro, Brazil
| | - Rayanne Costa de Sales
- Rehabilitation Sciences Post-Graduation Programme, Augusto Motta University Centre (UNISUAM), Rio de Janeiro, Brazil
| | - Beatriz Pereira Dos Santos
- Rehabilitation Sciences Post-Graduation Programme, Augusto Motta University Centre (UNISUAM), Rio de Janeiro, Brazil
| | - Arthur de Sá Ferreira
- Rehabilitation Sciences Post-Graduation Programme, Augusto Motta University Centre (UNISUAM), Rio de Janeiro, Brazil
| | - Agnaldo José Lopes
- Rehabilitation Sciences Post-Graduation Programme, Augusto Motta University Centre (UNISUAM), Rio de Janeiro, Brazil
- Department of Pulmonology, Piquet Carneiro Polyclinic, State University of Rio de Janeiro (UERJ), Rio de Janeiro, Brazil
- Post-Graduation Programme in Medical Sciences, School of Medical Sciences, State University of Rio de Janeiro (UERJ), Rio de Janeiro, Brazil
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23
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Parisotto G, Reis LFF, Junior MS, Papathanasiou J, Lopes AJ, Ferreira AS. Association of Multiple Cardiovascular Risk Factors with Musculoskeletal Function in Acute Coronary Syndrome Ward Inpatients. Healthcare (Basel) 2023; 11:healthcare11070954. [PMID: 37046881 PMCID: PMC10093940 DOI: 10.3390/healthcare11070954] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 03/21/2023] [Accepted: 03/24/2023] [Indexed: 03/29/2023] Open
Abstract
This study explored the association of multiple risk factors with musculoskeletal function in adults hospitalized for acute coronary syndrome. Sixty-nine inpatients (55 ± 6 years; 67% male) admitted to the cardiology ward within <12 h were assessed regarding stress, smoking, alcoholism, hypertension, diabetes mellitus, and obesity. The musculoskeletal function was assessed by predicted values of handgrip strength of the dominant hand (HGS-D%) and maximal inspiratory and expiratory pressures (MIP% and MEP%, respectively). After adjustment by age and sex, drinking habits showed the strongest linear association with the total number of cardiovascular disease risk factors [standardized ß, p-value] (ß = 0.110, p < 0.001), followed by smoking load (ß = 0.028, p = 0.009). Associations were also observed for HGS-D% with mean blood pressure (ß = 0.019 [0.001; 0.037], p = 0.048); MIP% with mean blood pressure (ß = 0.025 [0.006; 0.043], p = 0.013); and MEP% with drinking habits (ß = 0.009 [0.002; 0.016], p = 0.013) and body mass index (ß = 0.008 [0.000; 0.015], p = 0.035). Peripheral and respiratory muscle strength must be interpreted in the context of its association with cardiovascular disease risk factors in adults hospitalized for acute coronary syndrome.
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Affiliation(s)
- Gabriel Parisotto
- Postgraduate Program of Rehabilitation Sciences, Augusto Motta University Center/UNISUAM, Rio de Janeiro 21032-060, Brazil; (G.P.); (L.F.F.R.); (A.J.L.)
| | - Luis Felipe Fonseca Reis
- Postgraduate Program of Rehabilitation Sciences, Augusto Motta University Center/UNISUAM, Rio de Janeiro 21032-060, Brazil; (G.P.); (L.F.F.R.); (A.J.L.)
| | | | - Jannis Papathanasiou
- Department of Medical Imaging, Allergology & Physiotherapy, Faculty of Dental Medicine, Medical University of Plovdiv, 4002 Plovdiv, Bulgaria;
- Department of Kinesitherapy, Faculty of Public Health, Medical University of Sofia, 1431 Sofia, Bulgaria
| | - Agnaldo José Lopes
- Postgraduate Program of Rehabilitation Sciences, Augusto Motta University Center/UNISUAM, Rio de Janeiro 21032-060, Brazil; (G.P.); (L.F.F.R.); (A.J.L.)
| | - Arthur Sá Ferreira
- Postgraduate Program of Rehabilitation Sciences, Augusto Motta University Center/UNISUAM, Rio de Janeiro 21032-060, Brazil; (G.P.); (L.F.F.R.); (A.J.L.)
- Correspondence: ; Tel.: +55-2138-829-797 (ext. 2012)
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24
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de Oliveira JPA, Costa ACT, Lopes AJ, de Sá Ferreira A, Reis LFDF. Factors associated with mortality in mechanically ventilated patients with severe acute respiratory syndrome due to COVID-19 evolution. Crit Care Sci 2023; 35:19-30. [PMID: 37712726 PMCID: PMC10275312 DOI: 10.5935/2965-2774.20230203-en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Accepted: 12/01/2022] [Indexed: 09/16/2023]
Abstract
OBJECTIVES To evaluate the factors associated with mortality in mechanically ventilated patients with acute respiratory distress syndrome due to COVID-19. METHODS This was a retrospective, multicenter cohort study that included 425 mechanically ventilated adult patients with COVID-19 admitted to 4 intensive care units. Clinical data comprising the SOFA score, laboratory data and mechanical characteristics of the respiratory system were collected in a standardized way immediately after the start of invasive mechanical ventilation. The risk factors for death were analyzed using Cox regression to estimate the risk ratios and their respective 95%CIs. RESULTS Body mass index (RR 1.17; 95%CI 1.11 - 1.20; p < 0.001), SOFA score (RR 1.39; 95%CI 1.31 - 1.49; p < 0.001) and driving pressure (RR 1.24; 95%CI 1.21 - 1.29; p < 0.001) were considered independent factors associated with mortality in mechanically ventilated patients with acute respiratory distress syndrome due to COVID-19. Respiratory system compliance (RR 0.92; 95%CI 0.90 - 0.93; p < 0.001) was associated with lower mortality. The comparative analysis of the survival curves indicated that patients with respiratory system compliance (< 30mL/cmH2O), a higher SOFA score (> 5 points) and higher driving pressure (> 14cmH2O) were more significantly associated with the outcome of death at 28 days and 60 days. CONCLUSION Patients with a body mass index > 32kg/m2, respiratory system compliance < 30mL/cmH2O, driving pressure > 14cmH2O and SOFA score > 5.8 immediately after the initiation of invasive ventilatory support had worse outcomes, and independent risk factors were associated with higher mortality in this population.
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Affiliation(s)
| | | | - Agnaldo José Lopes
- Postgraduate Program in Rehabilitation Sciences, Centro
Universitário Augusto Motta - Rio de Janeiro (RJ), Brazil
| | - Arthur de Sá Ferreira
- Postgraduate Program in Rehabilitation Sciences, Centro
Universitário Augusto Motta - Rio de Janeiro (RJ), Brazil
| | - Luis Felipe da Fonseca Reis
- Postgraduate Program in Rehabilitation Sciences, Centro
Universitário Augusto Motta - Rio de Janeiro (RJ), Brazil
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25
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de Azevedo Vieira JE, Mafort TT, Monnerat LB, da Cal MS, Ghetti ATA, Lopes AJ. Assessment of short- and long-term functionality and quality of life in patients with post-acute COVID-19 syndrome. J Back Musculoskelet Rehabil 2023; 36:541-550. [PMID: 36776041 DOI: 10.3233/bmr-220308] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/10/2023]
Abstract
BACKGROUND Although the number of new cases of coronavirus 2019 (COVID-19) has been drastically reduced worldwide, patients who demonstrate long-term symptoms need more attention from health systems, as these symptoms can negatively affect functionality and quality of life. OBJECTIVE To evaluate muscle function and quality of life at 3, 6, 9 and 12 months in patients with post-acute COVID-19 syndrome and to assess their associations with general fatigue and lung function. METHODS This observational and longitudinal study evaluated patients with post-acute COVID-19 syndrome. Participants were subjected to the following evaluations: Short Form-36; handgrip strength; Functional Assessment of Chronic Illness Therapy-Fatigue scale; and spirometry. RESULTS Among the 350 participants who were evaluated in the third month, 74.6%, 61.4% and 45.4% reported general fatigue, dyspnoea and cough, respectively. In the comparisons between the third month and the sixth month, there were significant increases in Functional Assessment of Chronic Illness Therapy-Fatigue scale, pulmonary function and several Short Form-36 domains. In the comparisons between the sixth month and the ninth month, there was a significant increase only in the social functioning domain of the Short Form-36. In the comparisons between the ninth month and the twelfth month, there was an increase only in some Short Form-36 domains. Significant correlations were observed between the Short Form-36 domains with Functional Assessment of Chronic Illness Therapy-Fatigue scale, handgrip strength and pulmonary function. CONCLUSION In patients with post-acute COVID-19 syndrome, there was a progressive improvement in quality of life, general fatigue and pulmonary function during the 12 months of follow-up, with this improvement being more pronounced in the first 6 months. There was a relationship between functionality and quality of life in these patients.
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Affiliation(s)
| | - Thiago Thomaz Mafort
- Post-Graduation Programme in Medical Sciences, School of Medical Sciences, State University of Rio de Janeiro (UERJ), Rio de Janeiro, Brazil.,Department of Pulmonology, Piquet Carneiro Policlinic, State University of Rio de Janeiro (UERJ), Rio de Janeiro, Brazil
| | - Laura Braga Monnerat
- Department of Pulmonology, Piquet Carneiro Policlinic, State University of Rio de Janeiro (UERJ), Rio de Janeiro, Brazil
| | - Mariana Soares da Cal
- Department of Pulmonology, Piquet Carneiro Policlinic, State University of Rio de Janeiro (UERJ), Rio de Janeiro, Brazil
| | - Angelo Thomaz Abalada Ghetti
- Department of Pulmonology, Piquet Carneiro Policlinic, State University of Rio de Janeiro (UERJ), Rio de Janeiro, Brazil
| | - Agnaldo José Lopes
- Rehabilitation Sciences Post-Graduation Programme, Augusto Motta University Centre (UNISUAM), Rio de Janeiro, Brazil.,Post-Graduation Programme in Medical Sciences, School of Medical Sciences, State University of Rio de Janeiro (UERJ), Rio de Janeiro, Brazil.,Department of Pulmonology, Piquet Carneiro Policlinic, State University of Rio de Janeiro (UERJ), Rio de Janeiro, Brazil
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26
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Gomes SMR, Brito ACDS, Manfro WFP, Ribeiro-Alves M, Ribeiro RSDA, da Cal MS, Lisboa VDC, Abreu DPBD, Castilho LDR, Porto LCDMS, Mafort TT, Lopes AJ, da Silva SAG, Dutra PML, Rodrigues LS. High levels of pro-inflammatory SARS-CoV-2-specific biomarkers revealed by in vitro whole blood cytokine release assay (CRA) in recovered and long-COVID-19 patients. PLoS One 2023; 18:e0283983. [PMID: 37018291 PMCID: PMC10075475 DOI: 10.1371/journal.pone.0283983] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Accepted: 03/21/2023] [Indexed: 04/06/2023] Open
Abstract
BACKGROUND Cytokines induced by SARS-CoV-2 infection play a crucial role in the pathophysiology of COVID-19 and hyperinflammatory responses have been associated with poor clinical outcomes, with progression to severe conditions or long-term subacute complications named as long-COVID-19. METHODS In this cross-sectional study, we aimed to evaluate a set of antigen-specific inflammatory cytokines in blood from recovered COVID-19 individuals or who suffered a post-acute phase of SARS-CoV-2 infection compared to healthy individuals with no history of COVID-19 exposition or infection. Interferon-gamma (IFN-γ), IFN-γ-induced protein 10 (IP-10), tumor necrosis factor (TNF), IL-1β, IL-2, IL-4, IL-6, IL-8, IL-10, IL-12, and IL-17A were quantified by multiplex cytometric bead assay and enzyme-linked immunosorbent assay after stimulation of whole blood with recombinant Spike protein from SARS-CoV-2. Additionally, all participants have evaluated for anti-(S) protein-specific IgG antibodies. Clinical specimens were collected within two months of COVID-19 diagnosis. RESULTS A total of 47 individuals were enrolled in the study, a median age of 43 years (IQR = 14.5), grouped into healthy individuals with no history of infection or exposure to SARS-CoV-2 (unexposed group; N = 21); and patients from the Health Complex of the Rio de Janeiro State University (UERJ), Brazil, who were SARS-CoV-2 positive by RT-PCR (COVID-19 group)-categorized as recovered COVID-19 (N = 11) or long-COVID-19 (N = 15). All COVID-19 patients presented at least one signal or symptom during the first two weeks of infection. Six patients were hospitalized and required invasive mechanical ventilation. Our results showed that COVID-19 patients had significantly higher levels of IFN-γ, TNF, IL-1β, IL-2, IL-6, IL-8, and IP-10 than the unexposed group. The long-COVID-19 group has presented significantly high levels of IL-1β and IL-6 compared to unexposed individuals, but not from recovered COVID-19. A principal-component analysis demonstrated 84.3% of the total variance of inflammatory-SARS-CoV-2 response in the first two components, and it was possible to stratify IL-6, TNF, IL-1β, IL-10, and IL-2 as the top-five cytokines which are candidates to discriminate COVID-19 group (including long-COVID-19 subgroup) and healthy unexposed individuals. CONCLUSION We revealed important S protein-specific differential biomarkers in individuals affected by COVID-19, bringing new insights into the inflammatory status or SARS-CoV-2 exposition determination.
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Affiliation(s)
- Shayane Martins Rodrigues Gomes
- Department of Microbiology, Parasitology and Immunology, Medical Science Faculty (FCM), Rio de Janeiro State University (UERJ), Rio de Janeiro, RJ, Brazil
| | - Andréia Carolinne de Souza Brito
- Department of Microbiology, Parasitology and Immunology, Medical Science Faculty (FCM), Rio de Janeiro State University (UERJ), Rio de Janeiro, RJ, Brazil
| | - Wânia Ferraz Pereira Manfro
- Department of Microbiology, Parasitology and Immunology, Medical Science Faculty (FCM), Rio de Janeiro State University (UERJ), Rio de Janeiro, RJ, Brazil
| | - Marcelo Ribeiro-Alves
- Laboratory of Clinical Research on STD/AIDS, National Institute of Infectology Evandro Chagas, Oswaldo Cruz Foundation (FIOCRUZ), Rio de Janeiro, RJ, Brazil
| | | | - Mariana Soares da Cal
- Pulmonary and Tisiology Department, Pedro Ernesto University Hospital (HUPE), Policlínica Piquet Carneiro (PPC)/UERJ, Rio de Janeiro, RJ, Brazil
| | - Vinicius da Cunha Lisboa
- Laboratory of Immunopathology, Department of General Pathology and Laboratories, FCM, UERJ, Rio de Janeiro, RJ, Brazil
| | - Daniel Paiva Barros de Abreu
- Chemical Engineering Program, Cell Culture Engineering Lab (COPPE), Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brazil
| | - Leda Dos Reis Castilho
- Chemical Engineering Program, Cell Culture Engineering Lab (COPPE), Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brazil
| | - Luís Cristóvão de Moares Sobrino Porto
- Histocompatibility and Cryopreservation Laboratory, Department of Histology and Embryology Institute of Biology Roberto Alcantara Gomes, UERJ, Rio de Janeiro, RJ, Brazil
| | - Thiago Thomáz Mafort
- Pulmonary and Tisiology Department, Pedro Ernesto University Hospital (HUPE), Policlínica Piquet Carneiro (PPC)/UERJ, Rio de Janeiro, RJ, Brazil
| | - Agnaldo José Lopes
- Pulmonary and Tisiology Department, Pedro Ernesto University Hospital (HUPE), Policlínica Piquet Carneiro (PPC)/UERJ, Rio de Janeiro, RJ, Brazil
| | - Silvia Amaral Gonçalves da Silva
- Department of Microbiology, Parasitology and Immunology, Medical Science Faculty (FCM), Rio de Janeiro State University (UERJ), Rio de Janeiro, RJ, Brazil
| | - Patrícia Maria Lourenço Dutra
- Department of Microbiology, Parasitology and Immunology, Medical Science Faculty (FCM), Rio de Janeiro State University (UERJ), Rio de Janeiro, RJ, Brazil
| | - Luciana Silva Rodrigues
- Laboratory of Immunopathology, Department of General Pathology and Laboratories, FCM, UERJ, Rio de Janeiro, RJ, Brazil
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Mateus SP, Ribeiro-Alves M, Salles REB, Costa W, da Costa CH, Lopes AJ, Bártholo TP, Mafort TT, Tura BR, Rufino R. Mortality and comorbidities in patients with bronchiectasis over a 3-year follow-up. Medicine (Baltimore) 2022; 101:e32537. [PMID: 36596005 PMCID: PMC9803512 DOI: 10.1097/md.0000000000032537] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
To identify the risk factors associated with all-cause mortality in patients with noncystic fibrosis bronchiectasis (NCFB). This prospective cohort study included 120 adult patients with NCFB, who were regularly treated at a specialized outpatient clinic of a university hospital between January 2017 and June 2020. All patients were diagnosed using high-resolution computed tomography. Demographic and clinical data, pulmonary function tests, and the Euro-quality-of-life 5-domain 3-level questionnaire were analyzed. The factors associated with death were determined using the Cox proportional hazards model. The all-cause mortality rate at 41 months was 10.8%. Adjusted multivariate analysis showed that the main contributing predictors for mortality were female sex, smoking, diabetes, chronic obstructive pulmonary disease, emergency visits, use of antibiotics due to exacerbation, secretion color change, exacerbation, predicted forced expiratory volume in 1 second, predicted forced vital capacity, lack of respiratory physiotherapy, absence of vaccination against pneumococci, and mobility domain. Multiple factors contribute to unfavorable outcomes in patients with NCFB, and early recognition of these factors may improve care management.
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Affiliation(s)
- Simone Paulo Mateus
- Department of Chest Diseases, -Rio de Janeiro State University, Pulmonology Service, Rio de Janeiro, Brazil
| | | | | | - Walter Costa
- Department of Chest Diseases, -Rio de Janeiro State University, Pulmonology Service, Rio de Janeiro, Brazil
| | - Claudia Henrique da Costa
- Department of Chest Diseases, -Rio de Janeiro State University, Pulmonology Service, Rio de Janeiro, Brazil
| | - Agnaldo José Lopes
- Department of Chest Diseases, -Rio de Janeiro State University, Pulmonology Service, Rio de Janeiro, Brazil
| | - Thiago Prudente Bártholo
- Department of Chest Diseases, -Rio de Janeiro State University, Pulmonology Service, Rio de Janeiro, Brazil
| | - Thiago Thomaz Mafort
- Department of Chest Diseases, -Rio de Janeiro State University, Pulmonology Service, Rio de Janeiro, Brazil
| | | | - Rogério Rufino
- Department of Chest Diseases, -Rio de Janeiro State University, Pulmonology Service, Rio de Janeiro, Brazil
- * Correspondence: Rogério Rufino, Department of Chest Diseases, -Rio de Janeiro State University, Pulmonology Service, Rio de Janeiro, Brazil (e-mail: )
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de Oliveira TCP, Gardel DG, Ghetti ATA, Lopes AJ. The Glittre-ADL test in non-hospitalized patients with post-COVID-19 syndrome and its relationship with muscle strength and lung function. Clin Biomech (Bristol, Avon) 2022; 100:105797. [PMID: 36244099 PMCID: PMC9554320 DOI: 10.1016/j.clinbiomech.2022.105797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Revised: 09/30/2022] [Accepted: 10/07/2022] [Indexed: 02/07/2023]
Abstract
BACKGROUND Patients with post-acute COVID-19 syndrome tend to have limitations in performing activities of daily living, which may negatively impact performance during the Glittre-ADL test. This study aimed to verify if the Glittre-ADL test is associated with measures of pulmonary function, muscle function, and health-related quality of life in the assessment of non-hospitalized patients with sequelae of COVID-19, and also to identify the predictor variables related to the Glittre-ADL test in order to create a predictive model. METHODS Cross-sectional study with 37 women with post-acute COVID-19 syndrome who underwent Glittre-ADL test. They performed pulmonary function tests and measurements of handgrip strength and quadriceps strength. Additionally, they completed the Post-COVID-19 Functional Status scale and the Short Form-36 questionnaire. FINDINGS The mean value of Glittre-ADL test time was 4.8 ± 1.1 min, which was 163.7 ± 39.7% of the predicted. The Glittre-ADL test time showed correlation with diffusing capacity for carbon monoxide (r = -0.671, P < 0.0001), forced vital capacity (r = -0.588, P = 0.0001), maximum inspiratory pressure (r = -0.391, P = 0.015), handgrip strength (r = -0.453, P = 0.005), quadriceps strength (r = -0.591, P = 0.0001), and various dimensions of the Short Form-36 questionnaire. In the regression analysis, diffusing capacity for carbon monoxide, quadriceps strength, and forced vital capacity explained 64% of the Glittre-ADL test time variability. INTERPRETATION In patients with post-acute COVID-19 syndrome, lung function and quadriceps strength strongly affect the time to perform Glittre-ADL test multiple tasks.
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Affiliation(s)
| | - Damara Guedes Gardel
- Faculty of Physiotherapy, Augusto Motta University Centre (UNISUAM), Rio de Janeiro, Brazil
| | | | - Agnaldo José Lopes
- Rehabilitation Sciences Post-Graduation Programme, Augusto Motta University Centre (UNISUAM), Rio de Janeiro, Brazil; School of Medical Sciences, State University of Rio de Janeiro (UERJ), Rio de Janeiro, Brazil; Medical Sciences Post-Graduation Programme, State University of Rio de Janeiro (UERJ), Rio de Janeiro, Brazil.
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de Alegria SG, Azevedo BLPA, Oliveira JGM, da Silva MM, Gardel DG, Mafort TT, Lopes AJ. Home-based rehabilitation improves functional capacity and quality of life in women with systemic sclerosis: A preliminary study. J Back Musculoskelet Rehabil 2022; 36:455-463. [PMID: 36155500 DOI: 10.3233/bmr-220077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Recent initiatives, such as earlier diagnosis and treatment, have enhanced the survival of patients with systemic sclerosis (SSc). Despite these initiatives, there is extreme variability in rehabilitation strategies for these patients. In 2006, the Glittre-ADL test (TGlittre) was developed to evaluate functional capacity using multiple tasks similar to the activities of daily living (ADLs). OBJECTIVES To evaluate the impact of therapist-oriented home rehabilitation (TOHR) on functional capacity using TGlittre and to examine the effects of TOHR on physical function, hand function, and quality of life (QoL) among women with SSc. METHODS This quasi-experimental and longitudinal study included 12 women with SSc who underwent TOHR 3 times per week for 12 weeks. Before and after TOHR, functional capacity was assessed using TGlittre, physical function was examined by the Health Assessment Questionnaire Disability Index (HAQ-DI), hand function was evaluated using the Cochin Hand Functional Scale (CHFS) and handgrip strength (HGS), and QoL was evaluated using the Short Form-36 Health Survey Questionnaire (SF-36). RESULTS When comparing the pre- and post-TOHR values of TGlittre, a significant reduction was found in total time (p= 0.002) and manual time (p= 0.010). There was a nonsignificant decrease in HAQ-DI scores between pre- and post-TOHR (p= 0.07). Regarding hand function, there was a significant reduction in the CHFS between pre- and post-TOHR (p= 0.036), although no significant difference was observed in HGS between pre- and post-TOHR (p= 0.08). Regarding QoL, there was an increase in all SF-36 categories, although physical function was the only category that was significantly increased (p= 0.008). CONCLUSION After TOHR, patients with SSc are able to more quickly perform TGlittre tasks when considering both total and manual times. TOHR also positively affects manual skills and QoL.
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Affiliation(s)
- Samantha Gomes de Alegria
- Post-Graduation Programme in Medical Sciences, State University of Rio de Janeiro (UERJ), Rio de Janeiro, Brazil
| | | | | | - Matheus Mello da Silva
- Faculty of Physiotherapy, Augusto Motta University Centre (UNISUAM), Rio de Janeiro, Brazil
| | - Damara Guedes Gardel
- Faculty of Physiotherapy, Augusto Motta University Centre (UNISUAM), Rio de Janeiro, Brazil
| | - Thiago Thomaz Mafort
- Post-Graduation Programme in Medical Sciences, State University of Rio de Janeiro (UERJ), Rio de Janeiro, Brazil
| | - Agnaldo José Lopes
- Post-Graduation Programme in Medical Sciences, State University of Rio de Janeiro (UERJ), Rio de Janeiro, Brazil.,Post-Graduation Programme in Rehabilitation Sciences, Augusto Motta University Centre (UNISUAM), Rio de Janeiro, Brazil
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de Sousa KCA, Gardel DG, Lopes AJ. Postural balance and its association with functionality and quality of life in non-hospitalized patients with post-acute COVID-19 syndrome. Physiother Res Int 2022; 27:e1967. [PMID: 35842844 PMCID: PMC9349853 DOI: 10.1002/pri.1967] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Revised: 06/09/2022] [Accepted: 07/02/2022] [Indexed: 11/25/2022]
Abstract
Background and Objectives The neuromuscular system is responsible for performing adequate muscle activities to maintain postural balance. Since COVID‐19 can cause damage to this system, long‐term sequelae might alter control of postural stability. This study aimed to evaluate the postural balance of patients with post‐acute COVID‐19 syndrome (PCS) who were not hospitalized and to evaluate the correlations of changes in postural balance with general fatigue, muscle strength, and quality of life (QoL). Methods This was a cross‐sectional study in which 40 patients with PCS and 40 controls underwent balance assessment through the Berg Balance Scale (BBS) and Tinetti Balance Scale (TBS). They were evaluated for general fatigue by the Functional Assessment of Chronic Illness Therapy‐Fatigue (FACIT‐F) scale, handgrip strength (HGS), and quality of life (QoL) by the Short Form‐36 (SF‐36). Results When compared to controls, patients with PCS had lower BBS and TBS scores (p = 0.001 for both). The FACIT‐F score was lower in PCS patients (p = 0.0001). HGS was slightly lower in the PCS patients, but not statistically significant (p = 0.09). Regarding QoL, PCS patients showed worse evaluations in five dimensions of the SF‐36 (physical functioning, physical role limitations, bodily pain, general health perceptions, and mental health). Both the BBS and TBS scores had statistically significant positive correlations with the FACIT‐F score, HGS, and two SF‐36 dimensions (physical role limitations and emotional role limitations). Conclusions Patients with PCS show worse postural balance than controls, which is associated with general fatigue, lower HGS, and poor QoL. Postural balance assessment should be considered in the follow‐up and rehabilitation of PCS.
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Affiliation(s)
| | - Damara Guedes Gardel
- Rehabilitation Sciences Post-Graduation Program, Augusto Motta University Centre (UNISUAM), Rio de Janeiro, Brazil
| | - Agnaldo José Lopes
- Rehabilitation Sciences Post-Graduation Program, Augusto Motta University Centre (UNISUAM), Rio de Janeiro, Brazil.,Medical Sciences Post-Graduation Program, School of Medical Sciences, State University of Rio de Janeiro (UERJ), Rio de Janeiro, Brazil
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Silva CA, Lopes AJ, Papathanasiou J, Reis LFF, Ferreira AS. Association of Functional Characteristics and Physiotherapy with COVID-19 Mortality in Intensive Care Unit in Inpatients with Cardiovascular Diseases. Medicina (Kaunas) 2022; 58:medicina58060823. [PMID: 35744086 PMCID: PMC9229782 DOI: 10.3390/medicina58060823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Revised: 05/30/2022] [Accepted: 06/17/2022] [Indexed: 11/26/2022]
Abstract
Background and Objectives: To estimate the association between admission functional outcomes and exposure to physiotherapy interventions with mortality rate in intensive care unit (ICU) inpatients with cardiovascular diseases and new coronavirus disease (COVID-19). Materials and Methods: Retrospective cohort including 100 ICU inpatients (mean (standard deviation), age 75 (16) years) split into COVID-19+ or COVID-19−. The association of in-ICU death with admission functional outcomes and physiotherapy interventions was investigated using univariable and multivariable regression models. Results: In total, 42 (42%) patients tested positive for COVID-19. In-ICU mortality rate was 37%, being higher for the COVID-19+ group (odds ratio, OR (95% CI): 3.15 (1.37−7.47), p = 0.008). In-ICU death was associated with lower admission ICU Mobility Scale score (0.81 (0.71−0.91), p = 0.001). Restricted mobility (24.90 (6.77−161.94), p < 0.001) and passive kinesiotherapy (30.67 (9.49−139.52), p < 0.001) were associated with in-ICU death, whereas active kinesiotherapy (0.13 (0.05−0.32), p < 0.001), standing (0.12 (0.05−0.30), p < 0.001), or walking (0.10 (0.03−0.27), p < 0.001) were associated with in-ICU discharge. Conclusions: In-ICU mortality was higher for inpatients with cardiovascular diseases who had COVID-19+, were exposed to invasive mechanical ventilation, or presented with low admission mobility scores. Restricted mobility or passive kinesiotherapy were associated with in-ICU death, whereas active mobilizations (kinesiotherapy, standing, or walking) were associated with in-ICU discharge in this population.
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Affiliation(s)
- Chiara Andrade Silva
- Postgraduate Program of Rehabilitation Sciences, Centro Universitário Augusto Motta/UNISUAM, Rio de Janeiro 20080-003, Brazil; (C.A.S.); (A.J.L.); (L.F.F.R.)
| | - Agnaldo José Lopes
- Postgraduate Program of Rehabilitation Sciences, Centro Universitário Augusto Motta/UNISUAM, Rio de Janeiro 20080-003, Brazil; (C.A.S.); (A.J.L.); (L.F.F.R.)
| | - Jannis Papathanasiou
- Department of Medical Imaging, Allergology & Physiotherapy, Faculty of Dental Medicine, Medical University of Plovdiv, 4002 Plovdiv, Bulgaria;
- Department of Kinesitherapy, Faculty of Public Health “Prof. Dr. Tzecomir Vodenicharov, DSc.”, Medical University of Sofia, 1431 Sofia, Bulgaria
| | - Luis Felipe Fonseca Reis
- Postgraduate Program of Rehabilitation Sciences, Centro Universitário Augusto Motta/UNISUAM, Rio de Janeiro 20080-003, Brazil; (C.A.S.); (A.J.L.); (L.F.F.R.)
| | - Arthur Sá Ferreira
- Postgraduate Program of Rehabilitation Sciences, Centro Universitário Augusto Motta/UNISUAM, Rio de Janeiro 20080-003, Brazil; (C.A.S.); (A.J.L.); (L.F.F.R.)
- Correspondence: ; Tel.: +5521-38829797 (ext. 2012)
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de Alegria SG, Litrento PF, de Oliveira Farias I, Mafort TT, Lopes AJ. Can home rehabilitation impact impulse oscillometry and lung ultrasound findings in patients with scleroderma-associated interstitial lung disease? A pilot study. BMC Res Notes 2022; 15:176. [PMID: 35570301 PMCID: PMC9107596 DOI: 10.1186/s13104-022-06064-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2022] [Accepted: 05/05/2022] [Indexed: 12/02/2022] Open
Abstract
Objective Exercise has been demonstrated to be beneficial for improving physical capacity and quality of life in people with scleroderma, although knowledge of its impact on the respiratory system is limited. This study evaluated the impact of therapist-oriented home rehabilitation (TOHR) on impulse oscillometry (IOS) and lung ultrasound (LUS) findings in patients with scleroderma-associated interstitial lung disease (ILD). Results Twelve women with scleroderma underwent spirometry, IOS, and LUS before and after performing TOHR. Regarding spirometry, a normal pattern and restrictive damage were observed in five (41.7%) and seven (58.3%) participants pre-TOHR and post-TOHR, respectively. For IOS, an abnormal result was detected in nine (75%) pre-TOHR participants and six (50%) post-TOHR participants. Heterogeneity of resistance between 4–20 Hz (R4-R20) > 20% of the predicted value was observed in eight (66.7%) pre-TOHR participants and three (25%) post-TOHR participants (P = 0.031). An abnormal LUS result was observed in nine (75%) participants both pre-TOHR and post-TOHR. The main change observed was B-lines > 2, which was noted in nine (75%) participants both pre-TOHR and post-TOHR. Our findings suggest that TOHR for women with scleroderma-associated ILD improves the resistance and reactance measured by IOS, including small airway disease. Trial Registration ClinicalTrials.gov ID: NCT05041868 Registered on: 13th September 2021.
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Noguera CAL, Lopes AJ, Mathias Filho I, Higa C, Nunes RA, Lima CET, Saito EH. The importance of endobag use with incision-protective devices in VATS lung resection: a preliminary study. BMC Res Notes 2022; 15:158. [PMID: 35538583 PMCID: PMC9092789 DOI: 10.1186/s13104-022-06047-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Accepted: 04/24/2022] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVE The advent of new techniques such as video-assisted thoracoscopic surgery (VATS) for the removal of lung segments leads to compression of the surgical specimen, with the possible dissemination of neoplastic cells. The sheer volume of surgeries performed using these techniques has caused many institutions to stop removing the surgical specimen using an endobag, even when retractors/protectors are used in the instrumentalization incision. This study aimed to collect data from patients undergoing lung resection by VATS and analyze the cytopathological results of the collected material. RESULTS A total of 47 endobag fluid samples were collected from patients who underwent VATS. The surgical specimen was subjected to histopathological analysis, and all patients underwent pathological TNM staging. In the cytopathological analyses, only 2 (4.3%) specimens of endobag fluid aspirate were positive for neoplastic cells. In these two cases, the tumors were peripheral, both with diagnoses of moderately differentiated adenocarcinoma and with classifications of T1bN0M0 and T3N0M0. These results indicate that although there is a low incidence of tumor cells in endobag fluid, it is always better to perform surgery using all available protective measures to avoid tumor implantation in the thoracic cavity to the greatest extent possible.
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Affiliation(s)
- Carlos Andrés Latorre Noguera
- Pedro Ernesto University Hospital, State University of Rio de Janeiro (UERJ), Boulevard 28 de Setembro, 77, Vila Isabel, Rio de Janeiro, 20551-030, Brazil
| | - Agnaldo José Lopes
- Pedro Ernesto University Hospital, State University of Rio de Janeiro (UERJ), Boulevard 28 de Setembro, 77, Vila Isabel, Rio de Janeiro, 20551-030, Brazil. .,Medical Sciences Post-Graduation Program, School of Medical Sciences, State University of Rio de Janeiro (UERJ), Av. Prof. Manoel de Abreu, 444, 2º andar, Vila Isabel, Rio de Janeiro, 20550-170, Brazil.
| | - Ivan Mathias Filho
- Pedro Ernesto University Hospital, State University of Rio de Janeiro (UERJ), Boulevard 28 de Setembro, 77, Vila Isabel, Rio de Janeiro, 20551-030, Brazil.,Hospital Quinta D'Or, Rua Almirante Baltazar, 435, São Cristóvão, Rio de Janeiro, 20941-150, Brazil
| | - Claudio Higa
- Pedro Ernesto University Hospital, State University of Rio de Janeiro (UERJ), Boulevard 28 de Setembro, 77, Vila Isabel, Rio de Janeiro, 20551-030, Brazil
| | - Rodolfo Acatauassú Nunes
- Pedro Ernesto University Hospital, State University of Rio de Janeiro (UERJ), Boulevard 28 de Setembro, 77, Vila Isabel, Rio de Janeiro, 20551-030, Brazil.,Medical Sciences Post-Graduation Program, School of Medical Sciences, State University of Rio de Janeiro (UERJ), Av. Prof. Manoel de Abreu, 444, 2º andar, Vila Isabel, Rio de Janeiro, 20550-170, Brazil
| | - Carlos Eduardo Teixeira Lima
- Pedro Ernesto University Hospital, State University of Rio de Janeiro (UERJ), Boulevard 28 de Setembro, 77, Vila Isabel, Rio de Janeiro, 20551-030, Brazil
| | - Eduardo Haruo Saito
- Pedro Ernesto University Hospital, State University of Rio de Janeiro (UERJ), Boulevard 28 de Setembro, 77, Vila Isabel, Rio de Janeiro, 20551-030, Brazil.,Medical Sciences Post-Graduation Program, School of Medical Sciences, State University of Rio de Janeiro (UERJ), Av. Prof. Manoel de Abreu, 444, 2º andar, Vila Isabel, Rio de Janeiro, 20550-170, Brazil.,Hospital Quinta D'Or, Rua Almirante Baltazar, 435, São Cristóvão, Rio de Janeiro, 20941-150, Brazil
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Ribeiro CO, Lopes AJ, de Melo PL. Respiratory Oscillometry in Chronic Obstructive Pulmonary Disease: Association with Functional Capacity as Evaluated by Adl Glittre Test and Hand Grip Strength Test. Int J Chron Obstruct Pulmon Dis 2022; 17:1017-1030. [PMID: 35547780 PMCID: PMC9081189 DOI: 10.2147/copd.s353912] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Accepted: 04/03/2022] [Indexed: 11/23/2022] Open
Abstract
Purpose Respiratory oscillometry has emerged as a powerful method for detecting respiratory abnormalities in COPD. However, this method has not been widely introduced into clinical practice. This limitation arises, at least in part, because the clinical meaning of the oscillometric parameters is not clear. In this paper, we evaluated the association of oscillometry with functional capacity and its ability to predict abnormal functional capacity in COPD. Patients and Methods This cross-sectional study investigated a control group formed by 30 healthy subjects and 30 outpatients with COPD. The subjects were classified by the Glittre‑ADL test and handgrip strength according to the functional capacity. Results This study has shown initially that subjects with abnormal functional capacity had a higher value for resistance (p < 0.05), reactance area (Ax, p < 0.01), impedance modulus (Z4, p < 0.05), and reduced dynamic compliance (Cdyn, p < 0.05) when compared with subjects with normal functional capacity. This resulted in significant and consistent correlations among resistive oscillometric parameters (R=−0.43), Cdyn (R=−0.40), Ax (R = 0.42), and Z4 (R = 0.41) with exercise performance. Additionally, the effects of exercise limitation in COPD were adequately predicted, as evaluated by the area under the curve (AUC) obtained by receiver operating characteristic analysis. The best parameters for this task were R4-R20 (AUC = 0.779) and Ax (AUC = 0.752). Conclusion Respiratory oscillometry provides information related to functional capacity in COPD. This method is also able to predict low exercise tolerance in these patients. These findings elucidate the physiological and clinical meaning of the oscillometric parameters, improving the interpretation of these parameters in COPD patients.
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Affiliation(s)
- Caroline Oliveira Ribeiro
- Biomedical Instrumentation Laboratory, Institute of Biology and Faculty of Engineering, State University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Agnaldo José Lopes
- Pulmonary Function Laboratory, State University of Rio de Janeiro, Rio de Janeiro, Brazil
- Pulmonary Rehabilitation Laboratory, Augusto Motta University Center, Rio de Janeiro, Brazil
| | - Pedro Lopes de Melo
- Biomedical Instrumentation Laboratory, Institute of Biology and Faculty of Engineering, State University of Rio de Janeiro, Rio de Janeiro, Brazil
- Correspondence: Pedro Lopes de Melo, Rua São Francisco Xavier 524, Pavilhão Haroldo Lisboa da Cunha, Sala 104, Maracanã, Rio de Janeiro, 20550-013, Brazil, Tel +55-21-2334-0705, Email
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Mateus SP, Salles REB, Costa W, Costa CHD, Lopes AJ, Tura BR, Rufino R. Follow-up of a cohort of patients with noncystic fibrosis bronchiectasis for 1 year. Rev Assoc Med Bras (1992) 2022; 68:329-336. [PMID: 35442359 DOI: 10.1590/1806-9282.20210710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Accepted: 01/01/2022] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE The objective of this study was to evaluate the quality of life of patients with noncystic fibrosis bronchiectasis during a 1-year follow-up by using the EuroQol - 5 Dimensions - 3 Levels (EQ-5D-3L) questionnaire. METHODS A cohort study was conducted with 100 patients with noncystic fibrosis bronchiectasis and followed up with face-to-face visits or by telephone contact every 3 months for 1 year. All patients were recruited from a single referral center for bronchiectasis. At the time of recruiting and at the end of 1 year, the EQ-5D-3L questionnaire was applied to evaluate the patients' quality of life. Variables, such as exacerbation, emergency care, comorbidities, hemoptysis, colonization, and hospitalization, were assessed. RESULTS Of the 100 patients, 99 completed the study and 72% were women. There were no marked limitations in the mobility and self-care domains during the follow-up. At the end of the follow-up, 32 patients were extremely anxious or depressed. The quality of life assessed by using EQ-5D-3L had an initial mean score of 0.545 and of 0.589 after 1 year, which was statistically significant (p=0.011). CONCLUSION Patients with noncystic fibrosis bronchiectasis have a poor quality of life, and the EQ-5D-3L questionnaire may be a tool for monitoring patients with bronchiectasis.
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Affiliation(s)
- Simone Paulo Mateus
- Universidade do Estado do Rio de Janeiro, Pulmonology Service, Department of Chest Diseases - Rio de Janeiro (RJ), Brazil
| | - Raquel Esteves Brandão Salles
- Universidade do Estado do Rio de Janeiro, Pulmonology Service, Department of Chest Diseases - Rio de Janeiro (RJ), Brazil
| | - Walter Costa
- Universidade do Estado do Rio de Janeiro, Pulmonology Service, Department of Chest Diseases - Rio de Janeiro (RJ), Brazil
| | - Claudia Henrique da Costa
- Universidade do Estado do Rio de Janeiro, Pulmonology Service, Department of Chest Diseases - Rio de Janeiro (RJ), Brazil
| | - Agnaldo José Lopes
- Universidade do Estado do Rio de Janeiro, Pulmonology Service, Department of Chest Diseases - Rio de Janeiro (RJ), Brazil
| | | | - Rogério Rufino
- Universidade do Estado do Rio de Janeiro, Pulmonology Service, Department of Chest Diseases - Rio de Janeiro (RJ), Brazil
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Willuweit MGA, Lopes AJ, Ferreira AS. Development of a multivariable prediction model of functional exercise capacity in liver transplant recipients. Journal of Liver Transplantation 2022. [DOI: 10.1016/j.liver.2021.100067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Assis ACB, Lopes AJ. Functional exercise capacity in rheumatoid arthritis unrelated to lung injury: A comparison of women with and without rheumatoid disease. J Back Musculoskelet Rehabil 2022; 35:449-458. [PMID: 34275888 DOI: 10.3233/bmr-210056] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Rheumatoid arthritis (RA) mainly affects the joints of the upper and lower limbs, so evaluating functional exercise capacity in individuals with RA via dynamic tests of the locomotor system is essential. OBJECTIVES To compare functional exercise capacity using the Glittre-activities of daily living (ADL) test (G-AT) in women with and without RA in the absence of RA pulmonary disease (RA-PD) and to correlate the findings with hand functioning, physical functioning, handgrip strength (HGS), and quadriceps strength (QS). METHODS This cross-sectional pilot study evaluated 35 women with RA and 25 healthy controls by assessing hand functioning using the Cochin Hand Functional Scale (CHFS), physical functioning with the Health Assessment Questionnaire Disability Index (HAQ-DI), muscle functioning using HGS and QS, and G-AT results. RESULTS Compared to the women in the control group, the women with RA presented higher scores for the CHFS (p< 0.0001) and HAQ-DI (p< 0.0001) and lower HGS (p< 0.0001) and QS (p= 0.013) values. The median G-AT time was higher in the RA patients than in the healthy controls [300 (295-420) vs. 180 (155-203) s], p< 0.0001), and the greatest difficulty reported by patients after the G-AT was squatting to perform the shelving tasks. G-AT time was positively correlated with the HAQ-DI (rs= 0.668, p< 0.0001) and CHFS (rs= 0.586, p= 0.0007) and negatively correlated with QS (rs=-0.429, p= 0.037). There was no significant correlation between the G-AT time and HGS. CONCLUSIONS Women with RA take longer to perform G-AT tasks. Moreover, G-AT time was associated with hand functioning, physical functioning and QS, but not with HGS.
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Affiliation(s)
- Ana Carolina Brandão Assis
- Rehabilitation Sciences Post-Graduation Programme, Augusto Motta University Centre (UNISUAM), Rio de Janeiro, Brazil
| | - Agnaldo José Lopes
- Rehabilitation Sciences Post-Graduation Programme, Augusto Motta University Centre (UNISUAM), Rio de Janeiro, Brazil.,Medical Sciences Post-Graduation Programme, School of Medical Sciences, State University of Rio de Janeiro (UERJ), Rio de Janeiro, Brazil
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Vilela VS, Vanhaecke A, da Silva BRA, da Costa CH, Lopes AJ, Rufino R, Cutolo M, Smith V. Is There a Link Between Nailfold Videocapillaroscopy and Pulmonary Function Tests in Systemic Sclerosis Patients?: A 24-Month Follow-up Monocentric Study. J Clin Rheumatol 2022; 28:26-32. [PMID: 34741001 DOI: 10.1097/rhu.0000000000001798] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND/OBJECTIVE The aim of this study was to explore the associations between nailfold videocapillaroscopy (NVC) and pulmonary function tests (PFTs) in systemic sclerosis (SSc) patients. METHODS This was a longitudinal study with follow-up of unselected Brazilian SSc patients. Baseline clinical examination, serological workup, high-resolution chest tomography, and NVC were performed. Pulmonary function test was performed at baseline and after 24 months. Pulmonary function test worsening over time was defined as either a ΔFVC decline ≥10% or a ΔFVC decline ≥5% and <9%, combined with a ΔDLCO decline ≥15%, at 24 months. The NVC parameters were quantitatively (capillary density number, dimension, morphology, and hemorrhages) and qualitatively (NVC pattern) evaluated according to the consented standardized definitions of the EULAR Study Group on Microcirculation in Rheumatic Diseases. RESULTS Seventy-nine patients were included. Fifty-nine were rated to have a scleroderma pattern (6 "early"/16 "active"/37 "late"). The mean FVC and DLCO were 76.8% and 67.2% at baseline and 73.8% and 64.3% at 24 months, respectively. After multivariate analysis, we found that a reduced baseline FVC was associated with reduced capillary density (odds ratio [OR], 11; 95% confidence interval [CI], 1.5-90.7; p = 0.03) and a reduced baseline DLCO associated with the late scleroderma pattern (OR, 6.75; 95% CI, 1.09-42; p = 0.03). No association between worsening of PFT over time and NVC was found. CONCLUSIONS The association between NVC and PFTs might corroborate the link between microangiopathy and interstitial lung disease in patients with SSc. This finding might strengthen the idea of incorporating NVC as a tool to predict progressive interstitial lung disease in these patients in the future.
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Affiliation(s)
- Verônica Silva Vilela
- From the Department of Rheumatology, University Hospital Pedro Ernesto, State University of Rio de Janeiro, Rio de Janeiro, Brazil
| | | | - Bruno Rangel Antunes da Silva
- Department of Thorax Diseases, University Hospital Pedro Ernesto, State University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Cláudia Henrique da Costa
- Department of Thorax Diseases, University Hospital Pedro Ernesto, State University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Agnaldo José Lopes
- Department of Thorax Diseases, University Hospital Pedro Ernesto, State University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Rogério Rufino
- Department of Thorax Diseases, University Hospital Pedro Ernesto, State University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Maurizio Cutolo
- Research Laboratory and Academic Division of Clinical Rheumatology, Department of Internal Medicine, University of Genoa, IRCCS San Martino Polyclinic Hospital, Genoa, Italy
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Lopes AJ, Litrento PF, Provenzano BC, Carneiro AS, Monnerat LB, da Cal MS, Ghetti ATA, Mafort TT. Small airway dysfunction on impulse oscillometry and pathological signs on lung ultrasound are frequent in post-COVID-19 patients with persistent respiratory symptoms. PLoS One 2021; 16:e0260679. [PMID: 34843598 PMCID: PMC8629296 DOI: 10.1371/journal.pone.0260679] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Accepted: 11/12/2021] [Indexed: 11/23/2022] Open
Abstract
Background Thousands of people worldwide are suffering the consequences of coronavirus disease-2019 (COVID-19), and impulse oscillometry (IOS) and lung ultrasound (LUS) might be important tools for the follow-up of this population. Our objective was to prospectively evaluate abnormalities detected using these two methods in a cohort of COVID-19 survivors with respiratory symptoms. Methods In this follow-up study, 59 patients underwent clinical evaluations, spirometry, IOS and LUS in the 2nd (M1) and 5th (M2) months after diagnostic confirmation of COVID-19 by real-time reverse transcriptase–polymerase chain reaction. Aeration scores were obtained from the LUS exams based on the following findings: B-lines >2, coalescent B-lines, and subpleural consolidations. Results Fifty-nine (100%) participants had cough and/or dyspnea at M1, which decreased to 38 (64.4%) at M2 (p = 0.0001). Spirometry was abnormal in 26 (44.1%) and 20 (33.9%) participants at M1 and M2, respectively, although without statistical significance (p = 0.10). Normal examination, restrictive patterns, and obstructive patterns were observed in 33 (55.9%), 18 (30.5%), and 8 (13.6%) participants, respectively, at M1 and in 39 (66.1%), 13 (22%), and 7 (11.9%) participants at M2 (p = 0.14). Regarding IOS, considering changes in resistive and reactive parameters, abnormal exams were detected in 52 (88.1%) and 42 (71.2%) participants at M1 and M2, respectively (p = 0.002). Heterogeneity of resistance between 4 and 20 Hz >20% was observed in 38 (64.4%) and 33 (55.9%) participants at M1 and M2, respectively (p = 0.30). Abnormal LUS was observed in 46 (78%) and 36 (61%) participants at M1 and M2, respectively (p = 0.002), with a reduction in aeration scores between M1 and M2 [5 (2–8) vs. 3 (0–6) points, p<0.0001]. Conclusions IOS and LUS abnormalities are frequent in the first 5 months post-COVID-19 infection; however, when prospectively evaluated, significant improvement is evident in the parameters measured by these two methods.
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Affiliation(s)
- Agnaldo José Lopes
- Department of Pulmonology, Piquet Carneiro Policlinic, State University of Rio de Janeiro (UERJ), Rio de Janeiro, Brazil
- Medical Sciences Post-Graduation Programme, School of Medical Sciences, State University of Rio de Janeiro (UERJ), Rio de Janeiro, Brazil
- Rehabilitation Sciences Post-Graduation Programme, Augusto Motta University Center (UNISUAM), Rio de Janeiro/RJ, Brazil
- * E-mail:
| | - Patrícia Frascari Litrento
- Department of Pulmonology, Piquet Carneiro Policlinic, State University of Rio de Janeiro (UERJ), Rio de Janeiro, Brazil
| | - Bruna Cuoco Provenzano
- Department of Pulmonology, Piquet Carneiro Policlinic, State University of Rio de Janeiro (UERJ), Rio de Janeiro, Brazil
| | - Alícia Sales Carneiro
- Department of Pulmonology, Piquet Carneiro Policlinic, State University of Rio de Janeiro (UERJ), Rio de Janeiro, Brazil
| | - Laura Braga Monnerat
- Department of Pulmonology, Piquet Carneiro Policlinic, State University of Rio de Janeiro (UERJ), Rio de Janeiro, Brazil
| | - Mariana Soares da Cal
- Department of Pulmonology, Piquet Carneiro Policlinic, State University of Rio de Janeiro (UERJ), Rio de Janeiro, Brazil
| | - Angelo Thomaz Abalada Ghetti
- Department of Pulmonology, Piquet Carneiro Policlinic, State University of Rio de Janeiro (UERJ), Rio de Janeiro, Brazil
| | - Thiago Thomaz Mafort
- Department of Pulmonology, Piquet Carneiro Policlinic, State University of Rio de Janeiro (UERJ), Rio de Janeiro, Brazil
- Medical Sciences Post-Graduation Programme, School of Medical Sciences, State University of Rio de Janeiro (UERJ), Rio de Janeiro, Brazil
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Almeida CHSD, Reis LFDF, Nascimento LPADS, Soares AR, Maioli MCP, Lopes AJ. Therapist-oriented home rehabilitation for adults with sickle cell anemia: effects on muscle strength, functional capacity, and quality of life. ACTA ACUST UNITED AC 2021; 26:612-619. [PMID: 34411499 DOI: 10.1080/16078454.2021.1965736] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVES Considering the advances in functional rehabilitation in recent decades, therapist-oriented home rehabilitation (TOHR) has been increasingly used in the field of physical therapy because it increases patient compliance and reduces health system costs. The objective of this study was to investigate the effects of TOHR on functional capacity, muscle strength, and quality of life (QoL) in adults with sickle cell anemia (SCA). METHODS Forty adults with SCA underwent manually guided TOHR for 12 weeks. Before and at the end of training, the following variables were assessed in the participants: distance covered in the 6-min walk test (6MWD); maximal inspiratory pressure (MIP); maximal expiratory pressure (MEP); handgrip strength (HGS); quadriceps strength (QS); and QoL using the Short Form-36 physical component summary (SF-36PCS) and the Short Form-36 mental component summary (SF-36MCS). RESULTS After TOHR, significant increases were observed in the mean values for the 6MWD, MIP, MEP, HGS, QS, and SF-36PCS and SF-36MCS scores. The relative delta between the pre- and post-TOHR 6MWDs correlated significantly with the relative deltas of MIP (rs = 0.640, p < 0.0001), MEP (rs = 0.587, p < 0.0001), HGS (rs = 0.360, p = 0.022), and QS (rs = 0.351, p = 0.026). When the participants were separated according to their use of hydroxyurea, significant increases were observed in the relative deltas of the 6MWD, MIP and MEP values. CONCLUSIONS This study shows that TOHR can potentially increase functional capacity, muscle strength, and QoL in adults with SCA. Furthermore, there appears to be a relationship between 6MWD gains and muscle strength gains with TOHR.Trial registration: ClinicalTrials.gov identifier: NCT04705792.
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Affiliation(s)
| | - Luis Felipe da Fonseca Reis
- Programa de Pós-Graduação em Ciências da Reabilitação, Centro Universitário Augusto Motta (UNISUAM), Rio de Janeiro, RJ, Brasil
| | | | - Andrea Ribeiro Soares
- Programa de Pós-Graduação em Ciências Médicas, Faculdade de Ciências Médicas, Universidade do Estado do Rio de Janeiro (UERJ), Rio de Janeiro, RJ, Brasil.,Disciplina de Hematologia, Faculdade de Ciências Médicas, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brasil
| | - Maria Christina Paixão Maioli
- Programa de Pós-Graduação em Ciências Médicas, Faculdade de Ciências Médicas, Universidade do Estado do Rio de Janeiro (UERJ), Rio de Janeiro, RJ, Brasil.,Disciplina de Hematologia, Faculdade de Ciências Médicas, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brasil
| | - Agnaldo José Lopes
- Programa de Pós-Graduação em Ciências da Reabilitação, Centro Universitário Augusto Motta (UNISUAM), Rio de Janeiro, RJ, Brasil.,Programa de Pós-Graduação em Ciências Médicas, Faculdade de Ciências Médicas, Universidade do Estado do Rio de Janeiro (UERJ), Rio de Janeiro, RJ, Brasil
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Carneiro AS, Mafort TT, Lopes AJ. A 34-Year-Old Woman from Brazil with Pulmonary Lymphangioleiomyomatosis Diagnosed by Raised Serum Vascular Endothelial Growth Factor-D (VEGF-D) Levels and Lung Cysts on Computed Tomography Imaging Presenting with COVID-19 Pneumonia. Am J Case Rep 2021; 22:e932660. [PMID: 34330886 PMCID: PMC8340921 DOI: 10.12659/ajcr.932660] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Patient: Female, 34-year-old Final Diagnosis: COVID-19 • lymphangioleiomyomatosis Symptoms: Dyspnea • fever • hypoxemia • myalgia Medication: Sirolimus Clinical Procedure: — Specialty: Pulmonology
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Affiliation(s)
- Alícia Sales Carneiro
- Department of Pneumology, Pedro Ernesto University Hospital, State University of Rio de Janeiro (UERJ), Rio de Janeiro, RJ, Brazil
| | - Thiago Thomaz Mafort
- Department of Pneumology, Pedro Ernesto University Hospital, State University of Rio de Janeiro (UERJ), Rio de Janeiro, RJ, Brazil.,Medical Sciences Postgraduate Program, School of Medical Sciences, State University of Rio de Janeiro (UERJ), Rio de Janeiro, RJ, Brazil
| | - Agnaldo José Lopes
- Department of Pneumology, Pedro Ernesto University Hospital, State University of Rio de Janeiro (UERJ), Rio de Janeiro, RJ, Brazil.,Medical Sciences Postgraduate Program, School of Medical Sciences, State University of Rio de Janeiro (UERJ), Rio de Janeiro, RJ, Brazil.,Rehabilitation Sciences Postgraduate Program, Augusto Motta University Centre (UNISUAM), Rio de Janeiro, RJ, Brazil
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Vilela VS, Dias MM, Salgado ÂA, da Silva BRA, Lopes AJ, Bessa EJC, Bruno LP, da Costa CH, Levy RA, Rufino R. Pulmonary hypertension in systemic sclerosis: diagnosis by systematic screening and prognosis after three years follow-up. BMC Pulm Med 2021; 21:251. [PMID: 34325685 PMCID: PMC8323291 DOI: 10.1186/s12890-021-01618-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Accepted: 07/26/2021] [Indexed: 12/25/2022] Open
Abstract
Background Systemic sclerosis (SSc) is a rare disease, and the presence of pulmonary hypertension can be a determining factor in prognosis. The aim of this study was to evaluate the diagnosis, profile, and prognosis of systemic sclerosis pulmonary hypertension (SSc-PH) diagnosed by systematic screening in a Brazilian population.
Methods A cohort of SSc patients underwent systematic screening for SSc-PH. Patients were referred for right heart catheterization (RHC) according to transthoracic echocardiogram or a combination of diagnostic tools. The clinical, immunological, and hemodynamic features and prognosis after 3 years were evaluated.
Results Twenty patients underwent RHC. SSc pulmonary arterial hypertension (SSc-PAH) was the most common group of SSc-PH. These patients had long disease duration, high urate levels and highly elevated mean pulmonary arterial pressure (mPAP) and peripheral vascular resistance (PVR) on hemodynamics. Patients with mPAP > 20– < 25 mmHg had hemodynamic features of intermediate disease. Patients with SSc-PH associated to interstitial lung disease (SSc-ILD-PH) had signs of vasculopathy on hemodynamics. In patients with no-SSc-PH, the survival at 1, 2, and 3 years was 96%, 92% and 92%, respectively and in patients with SSc-PH it was 86.7%, 60% and 53.3%, respectively. Conclusions Patients identified with SSc-PAH and SSc-ILD-PH in our screening had severe clinical and hemodynamic features. Mortality remains high in SSc-PH but was more related to Bo-PAH and SSc-ILD-PH, while in SSc-PAH, the prognosis was better. Trial registration: Current Controlled Trials ISRCTN 72968188, July 8th, 2021. Retrospectively registered. Supplementary Information The online version contains supplementary material available at 10.1186/s12890-021-01618-z.
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Affiliation(s)
- Verônica Silva Vilela
- Rheumatology Discipline, State University of Rio de Janeiro, Hospital Universitário Pedro Ernesto, Third Floor, Boulevard 28 de Setembro 77, Rio de Janeiro, 20551-031, Brazil
| | - Marcio Macri Dias
- Cardiology Discipline, Thorax Diseases Department, State University of Rio de Janeiro, Hospital Universitário Pedro Ernesto, Third Floor, Boulevard 28 de Setembro 77, Rio de Janeiro, 20551-031, Brazil
| | - Ângelo Antunes Salgado
- Cardiology Discipline, Thorax Diseases Department, State University of Rio de Janeiro, Hospital Universitário Pedro Ernesto, Third Floor, Boulevard 28 de Setembro 77, Rio de Janeiro, 20551-031, Brazil
| | - Bruno Rangel Antunes da Silva
- Cardiology Discipline, Thorax Diseases Department, State University of Rio de Janeiro, Hospital Universitário Pedro Ernesto, Third Floor, Boulevard 28 de Setembro 77, Rio de Janeiro, 20551-031, Brazil
| | - Agnaldo José Lopes
- Cardiology Discipline, Thorax Diseases Department, State University of Rio de Janeiro, Hospital Universitário Pedro Ernesto, Third Floor, Boulevard 28 de Setembro 77, Rio de Janeiro, 20551-031, Brazil
| | - Elizabeth Jauhar Cardoso Bessa
- Cardiology Discipline, Thorax Diseases Department, State University of Rio de Janeiro, Hospital Universitário Pedro Ernesto, Third Floor, Boulevard 28 de Setembro 77, Rio de Janeiro, 20551-031, Brazil
| | - Leonardo Palermo Bruno
- Cardiology Discipline, Thorax Diseases Department, State University of Rio de Janeiro, Hospital Universitário Pedro Ernesto, Third Floor, Boulevard 28 de Setembro 77, Rio de Janeiro, 20551-031, Brazil
| | - Cláudia Henrique da Costa
- Cardiology Discipline, Thorax Diseases Department, State University of Rio de Janeiro, Hospital Universitário Pedro Ernesto, Third Floor, Boulevard 28 de Setembro 77, Rio de Janeiro, 20551-031, Brazil
| | - Roger Abramino Levy
- Rheumatology Discipline, State University of Rio de Janeiro, Hospital Universitário Pedro Ernesto, Third Floor, Boulevard 28 de Setembro 77, Rio de Janeiro, 20551-031, Brazil.,Immunology and Specialty Medicine, GSK, 1250 Collegville Rd, Collegeville, PA, 19426, USA
| | - Rogério Rufino
- Cardiology Discipline, Thorax Diseases Department, State University of Rio de Janeiro, Hospital Universitário Pedro Ernesto, Third Floor, Boulevard 28 de Setembro 77, Rio de Janeiro, 20551-031, Brazil.
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de Alegria SG, Kasuki L, Gadelha M, Lopes AJ. The Glittre Activities of Daily Living Test in patients with acromegaly: Associations with hand function and health-related quality of life. J Back Musculoskelet Rehabil 2021; 34:441-451. [PMID: 33492273 DOI: 10.3233/bmr-200089] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Musculoskeletal disorders in acromegaly compromise upper and lower limb activity. Corresponding changes can be better assessed by a functional capacity test incorporating multitasking, such as the Glittre Activities of Daily Living Test (GA-T). OBJECTIVES To evaluate functional capacity in adults with acromegaly using the GA-T and to correlate functional capacity with hand function and health-related quality of life. METHODS The GA-T was applied to 36 patients with acromegaly and an equal number of healthy individuals. Additionally, participants completed the Acromegaly Quality of Life (AcroQoL) questionnaire and underwent a chronic pain assessment using a map of the human body, a hand function evaluation using the Cochin Hand Functional Scale (CHFS), and a handgrip strength test. RESULTS Relative to the comparison group, patients with acromegaly required more time to perform the GA-T, showed worse hand function, and reported that squatting to accomplish shelving tasks was the major difficulty. GA-T time was correlated with the AcroQoL global score, handgrip strength, and the CHFS (rs=-0.487, p= 0.002; rs=-0.369, p= 0.026; rs= 0.538, p= 0.0007, respectively). CONCLUSIONS Patients with acromegaly exhibited a reduced functional capacity as assessed by the GA-T. Additionally, an association was identified between the total GA-T time and both hand function and quality of life.
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Affiliation(s)
| | - Leandro Kasuki
- Neuroendocrinology Research Centre/Endocrinology Section, Medical School and Clementino Fraga Filho University Hospital, Federal University of the Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil.,Neuroendocrine Unit, Paulo Niemeyer State Brain Institute, Secretary of State for Health of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Monica Gadelha
- Neuroendocrinology Research Centre/Endocrinology Section, Medical School and Clementino Fraga Filho University Hospital, Federal University of the Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil.,Neuroendocrine Unit, Paulo Niemeyer State Brain Institute, Secretary of State for Health of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Agnaldo José Lopes
- Rehabilitation Sciences, Augusto Motta University Center (UNISUAM), Rio de Janeiro, Brazil.,School of Medical Sciences, State University of Rio de Janeiro (UERJ), Rio de Janeiro, Brazil
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Lopes AJ, Mafort TT, da Costa CH, Rufino R, de Cássia Firmida M, Kirk KM, Cobo CG, da Costa HDSB, da Cruz CMBQ, Mogami R. Comparison Between Lung Ultrasound and Computed Tomographic Findings in Patients With COVID-19 Pneumonia. J Ultrasound Med 2021; 40:1391-1399. [PMID: 32996607 PMCID: PMC7537266 DOI: 10.1002/jum.15521] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Revised: 08/22/2020] [Accepted: 09/11/2020] [Indexed: 05/02/2023]
Abstract
OBJECTIVES The aim of this study was to describe findings from lung ultrasound (LUS) and computed tomography (CT) in health professionals with coronavirus disease 2019 pneumonia and to evaluate the associations of the findings of both tests. METHODS This cross-sectional observational study evaluated 45 health professionals who were initially seen in screening tents and had a diagnosis of coronavirus disease 2019 as confirmed by a reverse transcription polymerase chain reaction and lung involvement diagnosed by LUS. Subsequently, these individuals were admitted to the hospital, where chest CT was performed. Aeration scores were obtained for the LUS examinations based on the following findings: more than 2 B-lines, coalescent B-lines, and subpleural consolidations. A subjective assessment of the extent of lung disease on CT was performed on the basis of the percentage of lung parenchyma involvement as follows: 25% or less, 25% to 50%, and greater than 50%. RESULTS Regarding LUS signs, more than 2 B-lines, coalescent B-lines, and subpleural consolidations were present in 73.3%, 68.2%, and 24.4% of cases, respectively. The main findings on CT were ground glass opacities, a crazy-paving pattern, and consolidations (66.7%, 20%, and 20% of cases); 17.8% of cases had examinations without abnormalities. Patients with more than 2 B-lines on LUS had more ground glass opacity areas on CT (P = .0007), whereas patients with subpleural consolidations on LUS had more consolidations on CT (P < .0001). In addition, patients with higher LUS aeration scores had more extensive disease on CT (P < .0001). CONCLUSIONS Lung ultrasound can detect lung injury even in the presence of normal CT results. There are associations between the abnormalities detected by both methods, and a relationship also exists between LUS aeration scores and the disease extent on CT.
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Affiliation(s)
- Agnaldo José Lopes
- Postgraduation Program in Medical SciencesSchool of Medical Sciences, State University of Rio de JaneiroRio de JaneiroBrazil
- Rehabilitation Sciences Postgraduation ProgramAugusto Motta University CenterRio de JaneiroBrazil
- Department of PulmonologyPiquet Carneiro Policlinic, State University of Rio de JaneiroRio de JaneiroBrazil
| | - Thiago Thomaz Mafort
- Postgraduation Program in Medical SciencesSchool of Medical Sciences, State University of Rio de JaneiroRio de JaneiroBrazil
- Department of PulmonologyPiquet Carneiro Policlinic, State University of Rio de JaneiroRio de JaneiroBrazil
| | - Cláudia Henrique da Costa
- Postgraduation Program in Medical SciencesSchool of Medical Sciences, State University of Rio de JaneiroRio de JaneiroBrazil
- Department of PulmonologyPiquet Carneiro Policlinic, State University of Rio de JaneiroRio de JaneiroBrazil
| | - Rogério Rufino
- Postgraduation Program in Medical SciencesSchool of Medical Sciences, State University of Rio de JaneiroRio de JaneiroBrazil
- Department of PulmonologyPiquet Carneiro Policlinic, State University of Rio de JaneiroRio de JaneiroBrazil
| | - Mônica de Cássia Firmida
- Postgraduation Program in Medical SciencesSchool of Medical Sciences, State University of Rio de JaneiroRio de JaneiroBrazil
- Department of PulmonologyPiquet Carneiro Policlinic, State University of Rio de JaneiroRio de JaneiroBrazil
| | - Kennedy Martins Kirk
- Postgraduation Program in Medical SciencesSchool of Medical Sciences, State University of Rio de JaneiroRio de JaneiroBrazil
- Department of PulmonologyPiquet Carneiro Policlinic, State University of Rio de JaneiroRio de JaneiroBrazil
| | - Carolina Gianella Cobo
- Department of RadiologyPedro Ernesto University Hospital, State University of Rio de JaneiroRio de JaneiroBrazil
| | | | | | - Roberto Mogami
- Postgraduation Program in Medical SciencesSchool of Medical Sciences, State University of Rio de JaneiroRio de JaneiroBrazil
- Department of RadiologyPedro Ernesto University Hospital, State University of Rio de JaneiroRio de JaneiroBrazil
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Provenzano BC, Bartholo T, Ribeiro-Alves M, Santos APGD, Mafort TT, Castro MCSD, Oliveira JGPD, Bruno LP, Lopes AJ, Costa CHD, Rufino R. The impact of healthcare-associated infections on COVID-19 mortality: a cohort study from a Brazilian public hospital. Rev Assoc Med Bras (1992) 2021; 67:997-1002. [DOI: 10.1590/1806-9282.20210433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Accepted: 05/30/2021] [Indexed: 11/21/2022] Open
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Mafort TT, Rufino R, da Costa CH, da Cal MS, Monnerat LB, Litrento PF, Parra LLZ, Marinho ADSEDS, Lopes AJ. One-month outcomes of patients with SARS-CoV-2 infection and their relationships with lung ultrasound signs. Ultrasound J 2021; 13:19. [PMID: 33835273 PMCID: PMC8033556 DOI: 10.1186/s13089-021-00223-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Accepted: 03/30/2021] [Indexed: 12/13/2022] Open
Abstract
Background The role of lung ultrasound (LUS) in evaluating the mid- and long-term prognoses of patients with COVID-19 pneumonia is not yet known. The objectives of this study were to evaluate associations between LUS signs at the time of screening and clinical outcomes 1 month after LUS and to assess LUS signs at the time of presentation with known risk factors for COVID-19 pneumonia. Methods This was a retrospective study of data prospectively collected 1 month after LUS screening of 447 adult patients diagnosed with COVID-19 pneumonia. Sonographic examination was performed in screening tents with the participants seated. The LUS signs (B-lines > 2, coalescent B-lines, and subpleural consolidations) were captured in six areas of each hemithorax and a LUS aeration score was calculated; in addition, the categories of disease probability based on patterns of LUS findings (high-probability, intermediate-probability, alternate, and low-probability patterns) were evaluated. The LUS signs at patients’ initial evaluation were related to the following outcomes: symptomatology, the need for hospitalization or invasive mechanical ventilation (IMV), and COVID-19-related death. Results According to the evaluations performed 1 month after LUS screening, 36 patients were hospitalised, eight of whom required intensive care unit (ICU) admission and three of whom died. The presence of coalescent B-lines was associated with the need for hospitalization (p = 0.008). The presence of subpleural consolidations was associated with dyspnoea (p < 0.0001), cough (p = 0.003), the need for hospitalization (p < 0.0001), the need for ICU admission (p < 0.0001), and death (p = 0.002). A higher aeration score was associated with dyspnoea (p < 0.0001), the need for hospitalization (p < 0.0001), the need for ICU admission (p < 0.0001), and death (p = 0.003). In addition, patients with a high-probability LUS pattern had a higher aeration score (p < 0.0001) and more dyspnoea (p = 0.024) and more often required hospitalization (p < 0.0001) and ICU admission (p = 0.031). Conclusions In patients with COVID-19 pneumonia, LUS signs were related to respiratory symptoms 1 month after LUS screening. Strong relationships were identified between LUS signs and the need for hospitalization and death.
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Affiliation(s)
- Thiago Thomaz Mafort
- Department of Pulmonology, Piquet Carneiro Policlinic, State University of Rio de Janeiro, Av. Mal. Rondon, 381, São Francisco Xavier, Rio de Janeiro, 20950-003, Brazil.,Postgraduate Programme in Medical Sciences, School of Medical Sciences, State University of Rio de Janeiro, Av. Prof. Manuel de Abreu, 444, 2° andar, Vila Isabel, Rio de Janeiro, 20550-170, Brazil
| | - Rogério Rufino
- Department of Pulmonology, Piquet Carneiro Policlinic, State University of Rio de Janeiro, Av. Mal. Rondon, 381, São Francisco Xavier, Rio de Janeiro, 20950-003, Brazil.,Postgraduate Programme in Medical Sciences, School of Medical Sciences, State University of Rio de Janeiro, Av. Prof. Manuel de Abreu, 444, 2° andar, Vila Isabel, Rio de Janeiro, 20550-170, Brazil
| | - Claudia Henrique da Costa
- Department of Pulmonology, Piquet Carneiro Policlinic, State University of Rio de Janeiro, Av. Mal. Rondon, 381, São Francisco Xavier, Rio de Janeiro, 20950-003, Brazil.,Postgraduate Programme in Medical Sciences, School of Medical Sciences, State University of Rio de Janeiro, Av. Prof. Manuel de Abreu, 444, 2° andar, Vila Isabel, Rio de Janeiro, 20550-170, Brazil
| | - Mariana Soares da Cal
- Department of Pulmonology, Piquet Carneiro Policlinic, State University of Rio de Janeiro, Av. Mal. Rondon, 381, São Francisco Xavier, Rio de Janeiro, 20950-003, Brazil
| | - Laura Braga Monnerat
- Department of Pulmonology, Piquet Carneiro Policlinic, State University of Rio de Janeiro, Av. Mal. Rondon, 381, São Francisco Xavier, Rio de Janeiro, 20950-003, Brazil
| | - Patrícia Frascari Litrento
- Department of Pulmonology, Piquet Carneiro Policlinic, State University of Rio de Janeiro, Av. Mal. Rondon, 381, São Francisco Xavier, Rio de Janeiro, 20950-003, Brazil
| | - Laura Lizeth Zuluaga Parra
- Department of Pulmonology, Piquet Carneiro Policlinic, State University of Rio de Janeiro, Av. Mal. Rondon, 381, São Francisco Xavier, Rio de Janeiro, 20950-003, Brazil
| | - Arthur de Sá Earp de Souza Marinho
- Department of Pulmonology, Piquet Carneiro Policlinic, State University of Rio de Janeiro, Av. Mal. Rondon, 381, São Francisco Xavier, Rio de Janeiro, 20950-003, Brazil
| | - Agnaldo José Lopes
- Department of Pulmonology, Piquet Carneiro Policlinic, State University of Rio de Janeiro, Av. Mal. Rondon, 381, São Francisco Xavier, Rio de Janeiro, 20950-003, Brazil. .,Postgraduate Programme in Medical Sciences, School of Medical Sciences, State University of Rio de Janeiro, Av. Prof. Manuel de Abreu, 444, 2° andar, Vila Isabel, Rio de Janeiro, 20550-170, Brazil. .,Rehabilitation Sciences Post-Graduation Programme, Augusto Motta University Centre (UNISUAM), Rua Dona Isabel, 94, Bonsucesso, Rio de Janeiro, 21032-060, Brazil.
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Palugan MJA, Assis ACB, Bessa EJC, Ferreira AS, Lopes AJ. Predictors of functional capacity as measured by the Glittre activities of daily living test in women with rheumatoid arthritis. ACTA ACUST UNITED AC 2021; 54:e10040. [PMID: 33729387 PMCID: PMC7959171 DOI: 10.1590/1414-431x202010040] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2020] [Accepted: 12/18/2020] [Indexed: 08/19/2023]
Abstract
Although pulmonary involvement is the most common extra-articular manifestation of rheumatoid arthritis (RA), traditional pulmonary function tests (PFTs) do not show a good correlation with the field tests usually performed in these patients. In recent decades, measurement of ventilation distribution heterogeneity through the nitrogen single-breath washout (N2SBW) test and evaluation of functional capacity during exercise using the Glittre activities of daily living test (GA-T) have been increasingly used. Therefore, the objective of this study was to evaluate predictors of GA-T outcomes in women with RA considering demographic, anthropometric, clinical, functional variables, and chest computed tomography (CT) findings. Forty-three women with RA underwent the GA-T, the N2SBW test, spirometry, measurement of the diffusing capacity for carbon monoxide (DLco), measurement of respiratory muscle strength, and evaluation of physical function of the lower and upper limbs through the Health Assessment Questionnaire Disability Index (HAQ-DI). Chest CT scans were analyzed retrospectively. The GA-T time showed significant correlations with the DLco (rs=-0.397, P=0.008), forced vital capacity/DLco (rs=0.307, P=0.044), phase III slope of the N2SBW test (SIIIN2, rs=0.644, P<0.0001), and the HAQ-DI (rs=0.482, P=0.001). Disease extent as assessed by chest CT was associated with the GA-T time. On multiple regression analysis, the SIIIN2 and HAQ-DI were the only predictors of the GA-T time, explaining 40% of its variability. Thus, ventilation distribution heterogeneity and worse physical function substantially explain the variability in GA-T time in women with RA and varying extents of disease on chest CT.
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Affiliation(s)
- M J A Palugan
- Programa de Pós-Graduação em Ciências da Reabilitação, Centro Universitário Augusto Motta, Rio de Janeiro, RJ, Brasil
| | - A C B Assis
- Programa de Pós-Graduação em Ciências da Reabilitação, Centro Universitário Augusto Motta, Rio de Janeiro, RJ, Brasil
| | - E J C Bessa
- Programa de Pós-Graduação em Ciências Médicas, Faculdade de Ciências Médicas, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brasil
| | - A S Ferreira
- Programa de Pós-Graduação em Ciências da Reabilitação, Centro Universitário Augusto Motta, Rio de Janeiro, RJ, Brasil
| | - A J Lopes
- Programa de Pós-Graduação em Ciências da Reabilitação, Centro Universitário Augusto Motta, Rio de Janeiro, RJ, Brasil.,Programa de Pós-Graduação em Ciências Médicas, Faculdade de Ciências Médicas, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brasil
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48
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Olímpio Júnior H, Lopes AJ, Guimarães FS, da Cunha Chermont SLSM, de Menezes SLS. Association between ventilatory efficiency, oxygen uptake, and Glittre-ADL test results in patients with chronic heart failure: a preliminary study. BMC Res Notes 2021; 14:62. [PMID: 33593417 PMCID: PMC7885201 DOI: 10.1186/s13104-021-05479-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Accepted: 02/05/2021] [Indexed: 11/24/2022] Open
Abstract
Objective The Glittre-ADL test (GA-T) is a functional capacity test that stands out for encompassing multiple tasks similar to activities of daily living. As ventilatory efficiency is one of the variables valued in the prognosis of chronic heart failure (CHF), this study aimed to evaluate associations between functional capacity and ventilatory variables in patients with CHF during the GA-T. Results Eight patients with CHF and New York Heart Association (NYHA) functional classification II–III underwent the GA-T coupled with metabolic gas analysis to obtain data by means of telemetry. The median total GA-T time was 00:04:39 (00:03:29–00:05:53). Borg dyspnoea scale scores before and after the GA-T were 2 (0–9) and 3 (1–10), respectively (P = 0.011). The relationship between the regression slope relating minute ventilation to carbon dioxide output (VE/VCO2 slope) was correlated with the total GA-T time (rs = 0.714, P = 0.047) and Borg dyspnoea score (rs = 0.761, P = 0.028). The other ventilatory variables showed no significant correlations. Our results suggest that the total GA-T time can be applied to estimate the ventilatory efficiency of patients with CHF. Future studies may use the GA-T in conjunction with other functional capacity tests to guide the treatment plan and evaluate the prognosis.
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Affiliation(s)
- Hebert Olímpio Júnior
- Medical Sciences Post-Graduation Programme, School of Medical Sciences, State University of Rio de Janeiro (UERJ), Av. Prof. Manoel de Abreu, 444, 2º andar, Vila Isabel, Rio de Janeiro, 20550-170, Brazil
| | - Agnaldo José Lopes
- Medical Sciences Post-Graduation Programme, School of Medical Sciences, State University of Rio de Janeiro (UERJ), Av. Prof. Manoel de Abreu, 444, 2º andar, Vila Isabel, Rio de Janeiro, 20550-170, Brazil. .,Rehabilitation Sciences Post-Graduation Programme, Augusto Motta University Center (UNISUAM), Rua Dona Isabel, 94, Rio de Janeiro, Bonsucesso, 21032-060, Brazil.
| | - Fernando Silva Guimarães
- Department of Physiotherapy, Federal University of Rio de Janeiro (UFRJ), Rua Prof. Rodolpho Paulo Rocco, Cidade Universitária, Rio de Janeiro, 25521941-590, Brazil
| | | | - Sara Lúcia Silveira de Menezes
- Department of Physiotherapy, Federal University of Rio de Janeiro (UFRJ), Rua Prof. Rodolpho Paulo Rocco, Cidade Universitária, Rio de Janeiro, 25521941-590, Brazil
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Castro P, Ferreira ADS, Lopes AJ, Paula TD, Costa RMR, Cunha FA, Vigário PDS. Validity of the Polar V800 heart rate monitor for assessing cardiac autonomic control in individuals with spinal cord injury. Motriz: rev educ fis 2021. [DOI: 10.1590/s1980-65742021003221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Affiliation(s)
| | | | | | | | | | - Felipe A. Cunha
- Universidade do Estado do Rio de Janeiro, Brazil; Universidade do Estado do Rio de Janeiro, Brazil
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50
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Luchesa CA, Mafort TT, Rodrigues da Silva R, Paro IC, Micheli de Souza F, Lopes AJ. Reference Value for the Distance Walked in the Six-Minute Walk Test in Obese Brazilian Men in the Preoperative Period of Bariatric Surgery. J Obes 2021; 2021:9577412. [PMID: 34306749 PMCID: PMC8282397 DOI: 10.1155/2021/9577412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Revised: 06/24/2021] [Accepted: 06/29/2021] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Obesity has several effects on the mechanics of the rib cage that may impair the exercise performance of obese individuals and therefore impact the assessment of surgical risk. This study aimed to establish a reference value for the 6-minute walk distance (6 MWD) in obese Brazilian men in the preoperative period of bariatric surgery that considers the effect of lung function. METHODS This was a cross-sectional study in which 104 obese men underwent the six-minute walk test (6 MWT) before bariatric surgery. They also underwent the spirometry test and respiratory muscle strength measurement before the 6 MWT. RESULTS The 6 MWD was correlated with age (r = -0.388, p=0.0005), weight (r = -0.365, p=0.0007), height (r = 0.285, p=0.022), body mass index (BMI) (r = -0.543, p < 0.0001), forced vital capacity (FVC) (r = 0.472, p < 0.0001), peak expiratory flow (r = 0.253, p=0.031), and maximal inspiratory pressure (r = 0.313, p=0.017). In the stepwise forward regression analysis, BMI, FVC, and age were the only variables that independently predicted the 6 MWD and explained 40% of its variability. The reference equation proposed for obese Brazilian men is 6 MWD (m) = 570.5 - (3.984 × BMIkg/m2) + (1.093 × FVC%predicted) - (0.836 × ageyrs). CONCLUSION In this sample of obese Brazilian men, lung function contributed to poor performance in the 6 MWT. In these individuals, BMI, FVC, and age were the variables that composed the reference equation for the 6 MWD. Thus, in several clinical settings, such as in the evaluation before bariatric surgery, pulmonary function data are important to determine the reference value for the 6 MWD.
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Affiliation(s)
- Cesar Antonio Luchesa
- Rehabilitation Sciences Postgraduation Program, Augusto Motta University Centre (UNISUAM), RJ, Brazil
- Rehabilitation Center, University Center Fundação Assis Gurgacz (FAG), Cascavel, PR, Brazil
| | - Thiago Thomaz Mafort
- Medical Sciences Post-Graduation Program, School of Medical Sciences, State University of Rio de Janeiro (UERJ), RJ, Brazil
| | | | - Isabela Cristina Paro
- Rehabilitation Center, University Center Fundação Assis Gurgacz (FAG), Cascavel, PR, Brazil
| | | | - Agnaldo José Lopes
- Rehabilitation Sciences Postgraduation Program, Augusto Motta University Centre (UNISUAM), RJ, Brazil
- Medical Sciences Post-Graduation Program, School of Medical Sciences, State University of Rio de Janeiro (UERJ), RJ, Brazil
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