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De Araújo Magalhães CB, Bezerra PC, De Sousa Cardoso ME, Garcia JHP, Viana CFG, Morano MTAP, Pereira EDB. The Effect of a Comprehensive Rehabilitation Program on Respiratory Function and Functional Capacity on Patients After 1 Month to Liver Transplantation. Transplant Proc 2023; 55:178-183. [PMID: 36517285 DOI: 10.1016/j.transproceed.2022.09.034] [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: 05/12/2022] [Accepted: 09/20/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND Physical exercise is prescribed in populations with chronic diseases, but data are scarce in the liver transplantation (LT) setting. OBJECTIVE The aim of this study was to evaluate changes in forced expiratory volume in the first second, forced vital capacity, maximal inspiratory pressure, maximal expiratory pressure, 6-minute walking test (6MWT), 6-minute step test (6MST), Duke Activity Status Index, VO2 (mL/kg/min), and health-related quality of life (in patients submitted to a rehabilitation program, comprising physical exercise training, breathing techniques, and educational sessions after LT. METHODS This cohort study enrolled patients to an 8-week period of thrice weekly comprehensive supervised rehabilitation program after 1 month of LT. A nonrandomized control cohort of LT patients were selected to match the rehabilitation group based on specific demographic data and severity of disease. RESULTS The rehabilitation group, compared with the control group, showed a significant improvement in respiratory parameters (forced vital capacity [0.33L vs 0.13L,P < .01]); exercise capacity (6MWT and 6MST 71.1 vs 34.1 meters; and 30.5 vs 7.5 steps; respectively P < .01); Duke Activity Status Index scores and VO2 (21.3 vs 10.2 and 9 vs 4.3; respectively P < .01); respiratory muscle strength (maximal inspiratory pressure 21.1 vs 15.1 cmH2O and maximal expiratory pressure 21.2 vs 10.2 cmH2O; P < .01); and quality of life (SF-36 physical component summary 12.4 vs 2.9 P < .01). CONCLUSION These data suggest that improvements in physical fitness, respiratory parameters, and quality of life are achieved with a comprehensive rehabilitation program initiated early after LT.
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Affiliation(s)
| | - Patricia Carvalho Bezerra
- Centro de Transplante, Hospital Umiversitário Walter Cantídio Universidade Federal do Ceará Fortaleza, Ceará, Brazil
| | - Maria Edna De Sousa Cardoso
- Centro de Transplante, Hospital Umiversitário Walter Cantídio Universidade Federal do Ceará Fortaleza, Ceará, Brazil
| | - José Huygens P Garcia
- Centro de Transplante, Hospital Umiversitário Walter Cantídio Universidade Federal do Ceará Fortaleza, Ceará, Brazil; Departamento de Cirurgia Universidade Federal do Ceará Fortaleza, Ceará, Brazil
| | - Cyntia F G Viana
- Centro de Transplante, Hospital Umiversitário Walter Cantídio Universidade Federal do Ceará Fortaleza, Ceará, Brazil
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Zacarias LC, Câmara KJDC, Alves BM, Morano MTAP, Viana CMS, Mont'Alverne DGB, Castro SS, Leite CF. Validation of the World Health Organization Disability Assessment Schedule (WHODAS 2.0) for individuals with COPD. Disabil Rehabil 2021; 44:5663-5668. [PMID: 34261374 DOI: 10.1080/09638288.2021.1948117] [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] [Indexed: 10/20/2022]
Abstract
PURPOSE COPD fits the profile of disabling health conditions. This study aims to validate the World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) in individuals with COPD. MATERIAL AND METHODS 100 participants with COPD responded to the Brazilian 36-item version of the WHODAS 2.0, as well as the Saint George's Respiratory Questionnaire (SGRQ), and the COPD Assessment Test (CAT). Spirometric data was extracted from medical records. RESULTS The internal consistency analysis showed coefficients for all WHODAS 2.0 domains with a strong correlation (0.70-0.85) except for Life activities, which had a moderate correlation (coefficient = 0.60). In the construct analysis, the coefficients for the WHODAS and SGRQ domains presented a consistent correlation among them, varying from 0.40 to 0.69. No correlation was evidenced among the WHODAS domains and the spirometric data, highlighting that linear measures fail when associated with the functioning of an individual with COPD. Discriminative analysis revealed a capacity for the WHODAS 2.0 to distinguish among COPD different levels of clinical impact obtained from CAT excluding the Getting along domain. CONCLUSION The WHODAS 2.0 shows as a valid instrument that can sensibly assess functioning differences related to the clinical impact classification level in subjects with COPD.IMPLICATIONS FOR REHABILITATIONWHODAS 2.0 is a valid tool to assess functioning in subjects with COPD.WHODAS 2.0 is sensitive to functioning differences related to classification level and to clinical impact in individuals with COPD.As a Patient-Reported Outcome Measure (PROM), WHODAS 2.0 offers the opportunity to develop clinical patient-centered interventions, improving the health care.As a low-cost, easy-to-use tool, WHODAS can be a useful resource in the process of clinical assessment of patient functioning.
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Affiliation(s)
- Laíla Cândida Zacarias
- Graduate Program in Cardiovascular Sciences, Federal University of Ceara, Fortaleza, Brazil
| | | | | | | | | | | | - Shamyr Sulyvan Castro
- Master Program in Physiotherapy and Functioning, Federal University of Ceara, Fortaleza, Brazil
| | - Camila Ferreira Leite
- Graduate Program in Cardiovascular Sciences, Federal University of Ceara, Fortaleza, Brazil.,Master Program in Physiotherapy and Functioning, Federal University of Ceara, Fortaleza, Brazil
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Araújo AS, Nogueira IC, Gomes Neto A, de Medeiros IL, Morano MTAP, da Silva GPF, Santos FA, De Moraes Filho MO, Pereira EDB. The impact of lung cancer resection surgery on fibrinogen and C-reactive protein and their relationship with patients outcomes: A prospective follow up study. Cancer Biomark 2015; 16:47-53. [PMID: 26484610 DOI: 10.3233/cbm-150539] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [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: 11/15/2022]
Abstract
BACKGROUND Major thoracic surgery is characterized by release of inflammatory markers.The objective of this study was to assess the preoperative and postoperative systemic inflammatory markers of patients undergoing lung cancer resection. METHODS This is a prospective follow up study conducted with 48 patients submitted to lung cancer resection.All patients were assessed before and 1 month after surgery through measurement of fibrinogen and C-reative protein(CRP), pulmonary function tests, 6- minute Walk Test (6 MWT), maximal inspiratory pressure (PImax) and maximal expiratory pressure (PEmax), anxiety and depression scale and karnofsky performance status scale. RESULTS Both fibrinogen and CRP were higher 1 month after surgery, although only the change in CRP was statistically significant (p= 0.03). The following functional parameters: 6 MWT, PImax, PEmax, FEV1(%) and FVC(%) decreased after surgery with p ≤ 0.001 for all the parameters. Anxiety and depression improved and Karnofsky decrease after surgery (p= 0.03, p= 0.01 and p= 0.02; respectively). Change in CRP score following lung resection correlated significantly with changes in fibrinogen (r= 0.40; p= 0.003), change in Karnofsky scale (r= -0.50; p< 0.001) and a borderline significant trend with the 6 MWT (r= -0.28; p= 0.05). With the exception of video-assisted thoracoscopic surgery (VATS), who had a significantly lower fibrinogen level 1 month after surgery compared with thoracotomy (p= 0.01), no significant differences in fibrinogen or CRP were noted in other subgroups of patients considered at increased risk for higher levels of inflammation compared with lower risk counterparts. CONCLUSION Lung cancer resection surgery was associated with increased level of CRP, 1 month after surgery, and correlated directly with change in fibrinogen and inversely with measurement of performance status. VATS provided lower level of fibrinogen after surgery.
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Affiliation(s)
| | - Ingrid Correia Nogueira
- Universidade Federal do Ceará - UFC, Fortaleza, Brazil.,Hospital de Messejana Dr. Carlos Alberto Studart Gomes, Fortaleza, Brazil
| | - Antero Gomes Neto
- Universidade Federal do Ceará - UFC, Fortaleza, Brazil.,Hospital de Messejana Dr. Carlos Alberto Studart Gomes, Fortaleza, Brazil
| | | | - Maria Tereza Aguiar Pessoa Morano
- Universidade Federal do Ceará - UFC, Fortaleza, Brazil.,Hospital de Messejana Dr. Carlos Alberto Studart Gomes, Fortaleza, Brazil.,Universidade de Fortaleza - UNIFOR, Fortaleza, Brazil
| | | | | | | | - Eanes Delgado Barros Pereira
- Universidade Federal do Ceará - UFC, Fortaleza, Brazil.,Hospital de Messejana Dr. Carlos Alberto Studart Gomes, Fortaleza, Brazil
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de Sousa Pinto JM, de Castro do Vale CK, de Lima Rodrigues DL, Barbosa de Freitas J, Maia Júnior J, Souza Araújo A, Aguiar Pessoa Morano MT. Pulmonary rehabilitation programs in lung transplant: a literature review. RBPS 2015. [DOI: 10.5020/18061230.2015.p443] [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] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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Morano MTAP, Mesquita R, Da Silva GPF, Araújo AS, Pinto JMDS, Neto AG, Viana CMS, De Moraes Filho MO, Pereira EDB. Comparison of the effects of pulmonary rehabilitation with chest physical therapy on the levels of fibrinogen and albumin in patients with lung cancer awaiting lung resection: a randomized clinical trial. BMC Pulm Med 2014; 14:121. [PMID: 25065540 PMCID: PMC4120009 DOI: 10.1186/1471-2466-14-121] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [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: 02/14/2014] [Accepted: 07/17/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Systemic inflammation plays an important role in the initiation, promotion, and progression of lung carcinogenesis. In patients with non-small cell lung cancer (NSCLC), fibrinogen levels correlate with neoplasia. Here we compared the effects of pulmonary rehabilitation (PR) with chest physical therapy (CPT) on fibrinogen and albumin levels in patients with LC and previous inflammatory lung disease awaiting lung resection. METHODS We conducted a randomized clinical trial with 24 patients who were randomly assigned to Pulmonary Rehabilitation (PR) and Chest Physical Therapy (CPT) groups. Each group underwent training 5 days weekly for 4 weeks. All patients were assessed before and after four weeks of training through clinical assessment, measurement of fibrinogen and albumin levels, spirometry, 6-minute Walk Test (6MWT), quality of life survey, and anxiety and depression scale. PR involved strength and endurance training, and CPT involved lung expansion techniques. Both groups attended educational classes. RESULTS A mixed between-within subjects analysis of variance (ANOVA) revealed a significant interaction between time (before and after intervention) and group (PR vs. CPT) on fibrinogen levels (F(1, 22)=0.57, p<0.0001) and a significant main effect of time (F(1, 22)=0.68, p=0.004). Changes in albumin levels were not statistically significant relative to the interaction effect between time and group (F(1, 22)=0.96, p=0.37) nor the main effects of time (F(1, 22)=1.00, p=1.00) and group (F(1, 22 )=0.59, p=0.45). A mixed between-within subjects ANOVA revealed significant interaction effects between time and group for the peak work rate of the unsupported upper limb exercise (F(1, 22)=0.77, p=0.02), endurance time (F(1, 22)=0.60, p=0.001), levels of anxiety (F(1, 22)=0.60, p=0.002) and depression (F(1, 22)=0.74, p=0.02), and the SF-36 physical component summary (F(1, 22)=0.83, p=0.07). CONCLUSION PR reduced serum fibrinogen levels, improved functional parameters, and quality of life of patients with LC and inflammatory lung disease awaiting lung resection. TRIAL REGISTRATION Current Controlled Trials RBR-3nm5bv.
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Silva GPFD, Morano MTAP, Viana CMS, Magalhães CBDA, Pereira EDB. Portuguese-language version of the COPD Assessment Test: validation for use in Brazil. J Bras Pneumol 2014; 39:402-8. [PMID: 24068260 PMCID: PMC4075870 DOI: 10.1590/s1806-37132013000400002] [Citation(s) in RCA: 54] [Impact Index Per Article: 5.4] [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: 01/22/2013] [Accepted: 05/07/2013] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To validate a Portuguese-language version of the COPD assessment test (CAT) for use in Brazil and to assess the reproducibility of this version. METHODS This was multicenter study involving patients with stable COPD at two teaching hospitals in the city of Fortaleza, Brazil. Two independent observers (twice in one day) administered the Portuguese-language version of the CAT to 50 patients with COPD. One of those observers again administered the scale to the same patients one week later. At baseline, the patients were submitted to pulmonary function testing and the six-minute walk test (6MWT), as well as completing the previously validated Portuguese-language versions of the Saint George's Respiratory Questionnaire (SGRQ), modified Medical Research Council (MMRC) dyspnea scale, and hospital anxiety and depression scale (HADS). RESULTS Inter-rater and intra-rater reliability was excellent (intraclass correlation coefficient [ICC] = 0.96; 95% CI: 0.93-0.97; p < 0.001; and ICC = 0.98; 95% CI: 0.96-0.98; p < 0.001, respectively). Bland Altman plots showed good test-retest reliability. The CAT total score correlated significantly with spirometry results, 6MWT distance, SGRQ scores, MMRC dyspnea scale scores, and HADS-depression scores. CONCLUSIONS The Portuguese-language version of the CAT is a valid, reproducible, and reliable instrument for evaluating patients with COPD in Brazil.
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de Sousa Pinto JM, Martín-Nogueras AM, Morano MTAP, Macêdo TEPM, Arenillas JIC, Troosters T. Chronic obstructive pulmonary disease patients' experience with pulmonary rehabilitation: a systematic review of qualitative research. Chron Respir Dis 2014; 10:141-57. [PMID: 23897930 DOI: 10.1177/1479972313493796] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [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: 11/15/2022] Open
Abstract
The aim of this study was to give an in-depth consideration of the chronic obstructive pulmonary disease (COPD) patients' subjective view of the impact of pulmonary rehabilitation (PR) on their lives. A systematic review in PubMed, Embase, CINAHL and PsychInfo databases yielded 3306 articles, of which 387 were duplicates, 263 remained after screening abstract and title; of them, 4 were excluded (editorial or due to lacking of full text) remaining a total of 259 for full text reading. Among these, eight studies met the inclusion criteria and were finally included. The meta-ethnography approach synthesized an understanding of the studies, which focused on constructing interpretations and developed a 'line-of-argument' synthesis. The psychosocial support of PR contributes to the patients' strength and desire for participation and the health education leads to illness-perception learning. Both psychosocial support and health education develop patients' empowerment, while PR promotes opportunities to health transitions. The empowerment experienced by the patients in taking advantage of these opportunities leads to positive impacts over time. If they do not exploit these occasions, negative impacts arise in their life, which make the treatment assistance or follow-up more difficult. The COPD patients' feedback revealed that PR promotes a better 'way of life', well-being and important behavioural changes towards health promotion.
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Mesquita RBD, Morano MTAP, Landim FLP, Collares PMC, Pinto JMDS. Rede de apoio social e saúde de idosos pneumopatas crônicos. Ciênc saúde coletiva 2012; 17:1125-33. [DOI: 10.1590/s1413-81232012000500006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2010] [Accepted: 09/06/2010] [Indexed: 11/21/2022] Open
Abstract
Esse estudo objetivou analisar características estruturais da rede de apoio social de idosos pneumopatas crônicos, traçando relações com a manutenção/recuperação da saúde. Utilizou-se dos pressupostos da metodologia de Análise de Redes Sociais (ARS), focando o conceito de apoio social e suas dimensões. Na coleta dos dados, foram empregados questionário e entrevista semiestruturada, aplicados a 16 idosos assistidos por um hospital público de Fortaleza-CE. Os dados quantitativos foram processados com auxílio dos softwares UCINET 6.123, NetDraw 2.38 e Microsoft Excel. Na analise qualitativa, o corpus constituiu material submetido a interpretações apoiadas em referencial teórico pertinente e atual. Cada informante trazia para a rede uma média de 10,37 indivíduos. Dentre os três tipos de apoio social, houve predominância daquele de informação com procedência nos profissionais de saúde. Ainda se observou a importância da reciprocidade no fornecimento/recebimento de apoio social, o qual funciona com a participação dos profissionais de saúde e da família. Conclui-se que a rede do idoso pneumopata crônico é pouco coesa, restringindo-se à rede pessoal de cada um, e que, mesmo assim, os informantes reconhecem e estão satisfeitos com o apoio social proporcionado por ela.
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