ORCID Profile
0000-0001-7648-8573
Current Organisations
State University of Londrina
,
Universidade Estadual Paulista Júlio de Mesquita Filho Faculdade de Ciências e Tecnologia
,
Universidade Pitagoras UNOPAR
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Publications
Combining functional exercises with exercise training in COPD: a randomized controlled trial
Publisher: Informa UK Limited
Date: 12-2022
DOI: 10.1080/09593985.2022.2148146
Abstract: Increasing physical activity in daily life (PADL) in chronic obstructive pulmonary disease (COPD), mainly in short-term training programs, is still a challenge. The combination of functional exercises with aerobic and resistance training may be a strategy to improve PADL and limitations in activities of daily living (ADL) in COPD. To evaluated the short- and medium-term effects of the combination of functional exercises with aerobic and resistance training. Seventy-six patients were randomized into (1) functional training group who performed resistance and aerobic and functional exercises (2) conventional training group (CTG) who performed resistance and aerobic exercise or (3) usual care group who performed respiratory physiotherapy. Patients were evaluated for PADL (activity monitor), ADL limitations (London Chest Activity of Daily Living scale [LCADL]), functional exercise capacity (6-minute walk test [6MWT]), and peripheral muscle strength before and after eight weeks. Medium-term effects were evaluated 12 weeks after the training. There were no changes or differences between groups in PADL and in 6MWT post-intervention and 12 weeks post-training. Only CTG showed a reduction in the total score on LCADL scale after the intervention and increase at follow-up (score: 20 ± 8 17 ± 6 19 ± 8, pre-intervention, post-intervention, and 12 weeks post-training, respectively, Combined aerobic and resistance training with functional exercises failed to improve PADL and ADL limitations in COPD. Eight weeks of conventional training improved ADL. This, however, was not superior to the results from the other groups and was not sustained at medium-term 12 weeks post-training.
Step Counting and Energy Expenditure Estimation in Patients With Chronic Obstructive Pulmonary Disease and Healthy Elderly: Accuracy of 2 Motion Sensors
Publisher: Elsevier BV
Date: 02-2010
DOI: 10.1016/J.APMR.2009.10.024
Abstract: To compare the accuracy of 2 motion sensors (a pedometer and a multisensor) in terms of step counting and estimation of energy expenditure (EE) in patients with chronic obstructive pulmonary disease (COPD) and in healthy elderly. In this descriptive study, all participants wore both motion sensors while performing a treadmill walking protocol at 3 different speeds corresponding to 30%, 60%, and 100% of the average speed achieved during a six-minute walk test. As criterion methods, EE was estimated by indirect calorimetry, and steps were registered by videotape. Research laboratory at a university hospital. Patients with COPD (n=30 17 men mean age +/- SD, 67+/-8 y mean forced expiratory volume in the first second [FEV(1)] predicted +/- SD, 46%+/-17% mean body mass index [BMI] +/- SD, 24+/-4 kg.m(2)) and matched healthy elderly (n=30 15 men mean age +/- SD, 68+/-7 y mean FEV(1) predicted +/- SD, 104%+/-21% mean BMI +/- SD, 25+/-3 kg.m(2)). Not applicable. Step counting and EE estimation during a treadmill walking protocol. The pedometer was accurate for step counting and EE estimation in both patients with COPD and healthy elderly at the higher speed. However, it showed significant underestimation at the 2 slower speeds in both groups. The multisensor did not detect steps accurately at any speed, although it accurately estimated EE at all speeds in healthy elderly and at the intermediate and higher speeds in patients with COPD. In both patients with COPD and healthy elderly, the multisensor showed better EE estimates during most walking speeds than the pedometer. Conversely, for step counting, accuracy is observed only with the pedometer during the higher walking speed in both groups.
Peripheral muscle training in patients with chronic obstructive pulmonary disease: novel approaches and recent advances
Publisher: Informa UK Limited
Date: 17-04-2017
DOI: 10.1080/17476348.2017.1317598
Abstract: Pulmonary rehabilitation is one of the most effective non-pharmacological management options for in iduals with chronic obstructive pulmonary disease (COPD). Exercise training is the cornerstone of pulmonary rehabilitation, however considerable variability exists regarding the way it is delivered across the world. It is widely accepted that efforts should be made to tailor specific therapeutic approaches to in iduals' needs. This applies as much to respiratory medicine as it does to respiratory rehabilitation. Areas covered: This narrative review examines the emerging literature evaluating advancements of exercise training modalities targeting peripheral muscle function in people with COPD. It aims to highlight practical considerations regarding the delivery key evidence regarding clinical effectiveness, as well as highlight some of the and evaluation of their effectiveness to inform clinical practice. Expert commentary: Although novel therapies may offer advantages over more 'traditional' training methods under specific circumstances, challenges regarding the potential impact upon clinical rehabilitation, the identification of the best candidates for such therapy and access to equipment may pose realistic barriers to their more widespread clinical implementation. Future directions regarding the ways in which these barriers could be overcome will be discussed, including identification of the key research priorities to optimize evidence-based practice in this area.
Effects of combining functional exercises with exercise training on daily physical activities and functionality in patients with COPD: a protocol for a randomized clinical trial
Publisher: Springer Science and Business Media LLC
Date: 12-2019
DOI: 10.1186/S13063-019-3780-Y
Abstract: Functional training has been shown to be a viable alternative for the elderly and patients with chronic obstructive pulmonary disease (COPD). However, whether the combination of this type of training with aerobic and resistance training, commonly performed in pulmonary rehabilitation (PR) programs, induces more pronounced effects on daily physical activities and functionality remains unclear. The aims of the study will be to evaluate the short-term and sustained effects of the combination of a functional circuit program with a training program consisting of aerobic and resistance exercise. In this randomized controlled trial, patients with COPD will be randomly assigned (1:1:1) to an 8-week training program to follow one of the three a priori defined groups: (I) resistance and aerobic and functional exercises, (II) a conventional program including only resistance and aerobic exercises, or (III) a usual care program. Patients will be evaluated before and upon completion of 8 weeks of training regarding physical activity in daily life (PADL) using an activity monitor (accelerometer), activities of daily living (London Chest Activity of Daily Living), functional exercise capacity (6-minute walk test), and muscle strength (dynamometry). Additionally, the sustained effects of the interventions will be evaluated 22 weeks after commencing the study. The inclusion of a protocol of functional physical training in the training conventionally performed by patients with COPD as an alternative to increase PADL and functionality may provide subsidies for the treatment of these patients, representing an advance and impacting on the physical training of patients with COPD. Brazilian Clinical Trials Registry (ReBEC) ID: RBR-3zmh3r . Registered: March 7, 2018.
Improvement of heart rate variability after exercise training and its predictors in COPD
Publisher: Elsevier BV
Date: 07-2011
DOI: 10.1016/J.RMED.2011.01.014
Abstract: Current literature lacks solid evidence on the improvement of heart rate variability (HRV) after exercise training in patients with COPD. We aimed to investigate changes in HRV after two exercise training programs in patients with COPD and to investigate the determinants of these eventual changes. Forty patients with COPD (FEV(1) 39 ± 13%pred) were randomized into high (n = 20) or low (n = 20) intensity exercise training (3-month duration), and had their HRV assessed by the head-up tilt test before and after either protocols. Baseline spirometry, level of daily physical activity, exercise capacity, body composition, functional status, health-related quality of life and muscle force were also assessed to investigate the determinants of improvement in HRV after the training program. There was a significant improvement in HRV only after the high-intensity protocol (pre versus post SDNN 29 ± 15 ms versus 36 ± 19 ms rMSSD 22 ± 14 ms versus 28 ± 22 ms p < 0.05 for both). Higher values of biceps brachialis strength, time spent walking in daily life and SDNN at baseline were determinants of improvement in HRV after the training program. High-intensity exercise training improves HRV at rest and during orthostatic stimulus in patients with COPD. Better baseline total HRV, muscle force and daily physical activity level are predictors of HRV improvements after the training program.
Maximum voluntary ventilation is more strongly associated with energy expenditure during simple activities of daily living than measures of airflow obstruction or respiratory muscle strength in patien
Publisher: SAGE Publications
Date: 11-2012
Abstract: This is a retrospective analysis of data in which we explored the association between energy expenditure (EE) and lung function in patients with chronic obstructive pulmonary disease (COPD). A total of 36 participants ( 20 males forced expiratory volume in 1 second (FEV 1 ) of 48 ± 15% predicted) underwent measures of indirect calorimetry whilst performing five simple activities of daily living. Maximal voluntary ventilation was the only lung function parameter associated with EE. These data highlight the limited extent to which the FEV 1 is related to the functional performance of patients with COPD.
Energy expenditure during daily activities as measured by two motion sensors in patients with COPD
Publisher: Elsevier BV
Date: 06-2011
DOI: 10.1016/J.RMED.2011.01.004
Abstract: In patients with chronic obstructive pulmonary disease (COPD), energy expenditure (EE) assessment during the performance of daily activities is not yet studied in depth. The aim of this study was to determine which daily activities are more demanding to patients with COPD and to compare the accuracy of EE estimation given by the pedometer Digiwalker SW701 (DW) and the multisensor SenseWear Armband (SAB). Thirty-six patients with COPD (20 men FEV1 48 ± 15%predicted BMI 25.7 ± 8 kg/m(2)) were submitted to a modified version of the Glittre ADL-test, which included five activities performed for 1 min each: walking on the level, walking on the level carrying a backpack, walking up/downstairs, rising/sitting in chairs and moving objects in and out of a shelf. During the protocol subjects wore both devices concomitantly, and indirect calorimetry (IC) was simultaneously performed as the criterion method to assess EE. The most demanding daily activity for in iduals with COPD was walking up/downstairs (4.9 ± 1.7 kcal versus 3.7 ± 1.4 to 4.2 ± 1.8 kcal for the other tasks p 0.05), although overestimation was found in activities involving walking. DW showed significant EE underestimation in the sum of the activities (9.6 ± 4.3 kcal p < 0.05 versus IC) and for each activity. Walking up/downstairs was the most energy-demanding daily activity for patients with COPD. Furthermore, during daily activities, the multisensor showed adequate overall estimation of energy expenditure, as opposed to the pedometer.
Effect of “add-on” interventions on exercise training in individuals with COPD: a systematic review
Publisher: European Respiratory Society (ERS)
Date: 2016
DOI: 10.1183/23120541.00078-2015
Abstract: The aim of this review was to identify the effectiveness of therapies added on to conventional exercise training to maximise exercise capacity in patients with chronic obstructive pulmonary disease (COPD). Electronic databases were searched, identifying trials comparing exercise training with exercise training plus “add-on” therapy. Outcomes included peak oxygen uptake ( V ′ O 2 peak ), work rate and incremental/endurance cycle and field walking tests. In idual trial effects on exercise capacity were extracted and collated into eight subgroups and pooled for meta-analysis. Sensitivity analyses were conducted to explore the stability of effect estimates across studies employing patient-centred designs and those deemed to be of “high” quality (PEDro score out of 10). 74 studies (2506 subjects) met review inclusion criteria. Interventions spanned a broad scope of clinical practice and were most commonly evaluated via the 6-min walking distance and V ′ O 2 peak . Meta-analysis revealed few clinically relevant and statistically significant benefits of “add-on” therapies on exercise performance compared with exercise training. Benefits favouring “add-on” therapies were observed across six different interventions (additional exercise training, noninvasive ventilation, bronchodilator therapy, growth hormone, vitamin D and nutritional supplementation). The sensitivity analyses included considerably fewer studies, but revealed minimal differences to the primary analysis. The lack of systematic benefits of “add-on” interventions is a probable reflection of methodological limitations, such as “one size fits all” eligibility criteria, that are inherent in many of the included studies of “add-on” therapies. Future clarification regarding the exact value of such therapies may only arise from adequately powered, multicentre clinical trials of tailored interventions for carefully selected COPD patient subgroups defined according to distinct clinical phenotypes.
European Respiratory Society International Congress 2018: Allied Respiratory Professionals’ report of highlighted sessions
Publisher: European Respiratory Society (ERS)
Date: 02-2019
DOI: 10.1183/23120541.00182-2018
Abstract: This article provides an overview of outstanding sessions that were supported by Assembly 9 during the recent European Respiratory Society International Congress in Paris, France. Session content was mainly targeted at allied health professionals such as respiratory physiologists, respiratory physiotherapists and respiratory nurses. Recent developments and novel findings related to pulmonary function testing, respiratory muscle function assessments and treatment, and multidimensional and multidisciplinary approaches to the assessment and management of dyspnoea were the focus of these sessions and are summarised here.
Heart Rate Variability and Disease Characteristics in Patients with COPD
Publisher: Springer Science and Business Media LLC
Date: 25-09-2008
DOI: 10.1007/S00408-008-9105-7
Abstract: Heart rate variability (HRV) is reduced in patients with chronic obstructive pulmonary disease (COPD). However, the relationships among HRV and characteristics of COPD are unknown. The aim of this study was to characterize HRV in patients with COPD and to verify the correlation of HRV measured during rest with disease severity and pulmonary, muscular, and functional impairment. Thirty-one patients with COPD (16 male 66 +/- 8 years BMI = 24 +/- 6 kg/m(2) FEV(1) = 46 +/- 16% predicted) without severe cardiac dysfunction were included. HRV assessment was performed by the head-up tilt test (HUTT), and the main variables used for analysis were SDNN index, LF/HF ratio, and R-R intervals. Other tests included spirometry, bioelectrical impedance, cardiopulmonary exercise test, 6-minute walk test, respiratory and peripheral muscle force, health-related quality of life and functional status questionnaires, and objective quantification of physical activity level in daily life with the DynaPort and SenseWear armband activity monitors, besides calculation of the BODE index. There was a statistical difference in all variables of HRV between the HUTT positions (lying and standing). There was no correlation of HRV with BODE index or FEV(1). Out of the BODE index, just the BMI was correlated with SDNN and R-R intervals (r = 0.44 p < 0.05 and r = 0.37 p < 0.05, respectively). There was correlation between HRV reduction and a lower level of physical activity in daily life, besides worse health-related quality of life, functional status, and respiratory and peripheral muscle force. Cardiac autonomic function of patients with COPD is not related to disease severity but mainly to the level of physical activity in daily life.
Effects of downhill walking in pulmonary rehabilitation for patients with COPD: a randomised controlled trial
Publisher: European Respiratory Society (ERS)
Date: 22-05-2020
DOI: 10.1183/13993003.00639-2020
Abstract: The development of contractile muscle fatigue (CMF) affects training responses in patients with chronic obstructive pulmonary disease (COPD). Downhill walking induces CMF with lower dyspnoea and fatigue than level walking. This study compared the effect of pulmonary rehabilitation (PR) comprising downhill walking training (DT) to PR comprising level walking (conventional training (CT)) in patients with COPD. In this randomised controlled trial, 35 patients (62±8 years forced expiratory volume in 1 s (FEV 1 ) 50±17% predicted) were randomised to DT or CT. Exercise tolerance (6-minute walk test distance (6MWD) primary outcome), muscle function, symptoms, quality-of-life and physical activity levels were assessed before and after PR. Absolute training changes and the proportion of patients exceeding the 30 m 6MWD minimally important difference (MID) were compared between groups. Quadriceps muscle biopsies were collected after PR in a subset of patients to examine physiological responses to long-term eccentric training. No between-group differences were observed in absolute 6MWD improvement (mean 6MWD change 77±46 m DT versus 56±47 m CT p=0.45), however 94% of patients in DT exceeded the 6MWD MID compared to 65% in CT (p=0.03). Patients in DT tended to have larger improvements than CT in other outcomes. Muscle biopsy analyses did not differ between groups. PR incorporating downhill walking confers similar magnitudes of effects to PR with conventional walking across clinical outcomes in patients with COPD, however, offers a more reliable stimulus to maximise the achievement of clinically relevant gains in functional exercise tolerance in people with COPD.
Author Response to Wewege et al
Publisher: Oxford University Press (OUP)
Date: 13-10-2020
DOI: 10.1093/PTJ/PZAA186
Effects of 2 Exercise Training Programs on Physical Activity in Daily Life in Patients With COPD
Publisher: Daedalus Enterprises
Date: 11-2011
Abstract: The effects of different exercise training programs on the level of physical activity in daily life in patients with COPD remain to be investigated. In patients with COPD we compared the effects of 2 exercise/training regimens (a high-intensity whole-body endurance-and-strength program, and a low-intensity calisthenics-and-breathing-exercises program) on physical activity in daily life, exercise capacity, muscle force, health-related quality of life, and functional status. We randomized 40 patients with COPD to perform either endurance-and-strength training (no. = 20, mean ± SD FEV(1) 40 ± 13% of predicted) at 60-75% of maximum capacity, or calisthenics-and-breathing-exercises training (no. = 20, mean ± SD FEV(1) 39 ± 14% of predicted). Both groups underwent 3 sessions per week for 12 weeks. Before and after the training programs the patients underwent activity monitoring with motion sensors, incremental cycle-ergometry, 6-min walk test, and peripheral-muscle-force test, and responded to questionnaires on health-related quality of life and functional status (activities of daily living, pulmonary functional status, and dyspnea). Time spent active and energy expenditure in daily life were not significantly altered in either group. Exercise capacity and muscle force significantly improved only in the endurance-and-strength group. Health-related quality of life and functional status improved significantly in both groups. Neither training program significantly improved time spent active or energy expenditure in daily life. The training regimens similarly improved quality of life and functional status. Exercise capacity and muscle force significantly improved only in the high-intensity endurance-and-strength group.
Translation, cross-cultural adaptation, and measurement properties of the Brazilian-Portuguese version of the idiopathic pulmonary fibrosis-specific version of the Saint George's Respiratory Questionn
Publisher: Elsevier BV
Date: 11-2021
DOI: 10.1016/J.BJPT.2021.06.008
Abstract: The idiopathic pulmonary fibrosis-specific version of the St George's Respiratory Questionnaire (SGRQ-I) is a valid tool to assess health-related quality of life in patients with interstitial lung diseases (ILDs). To translate and cross-culturally adapt the SGRQ-I to Brazilian-Portuguese, and to assess its measurement properties. Phase one consisted of the translation and cross-cultural adaptation of the questionnaire. In phase two, intra- and inter-assessor reliability (intraclass correlation coefficient [ICC]), internal consistency (Cronbach's α), minimal detectable change (MDC), ceiling/floor effects, convergent validity (correlation with SF-36 questionnaire), and discriminative validity (according to clinical characteristics) were investigated. No significant adaptations were needed during the translation process of the SGRQ-I. In phase two, 30 patients with ILD were included (15 men age 59 ± 10 years Forced Vital Capacity 73 [61-80]%predicted). The total score on the SGRQ-I presented excellent intra-assessor (ICC: 0.93 95%CI: 0.85, 0.97]) and inter-assessor (ICC: 0.88 95%CI: 0.77, 0.94) agreement. Internal consistency was considered adequate for the domains impact, activity, and total score (0.79<α<0.88) but not for symptoms (α=0.43). MDC was 12.8 points and ceiling/floor effects were found in only 3% of patients. No discriminative validity was observed, but there was adequate convergent validity. The results provide preliminary evidence of adequate measurement properties and validity of the Brazilian-Portuguese version of the SGRQ-I for patients with ILDs.
Estimation of Maximal Work Rate Based on the 6-Minute Walk Test and Fat-Free Mass in Chronic Obstructive Pulmonary Disease
Publisher: Elsevier BV
Date: 10-2010
DOI: 10.1016/J.APMR.2010.07.002
Abstract: To propose a predictive equation of the maximal work rate (Wmax) in patients with chronic obstructive pulmonary disease (COPD) based on the product of 6-minute walking test (6MWT) and fat-free mass (FFM) and to compare it with a previously proposed equation based on the product of 6MWT and body weight (BW). Descriptive (cross-sectional) study. University-based rehabilitation center. Patients with COPD (N=53 30 men forced expiratory volume in 1 second, 45%±15% predicted). Not applicable. Three Wmax were produced: Wmax_real (obtained from the maximal cycle ergometry test), Wmax_BW (estimated from the product of 6MWT and BW), previously proposed by Hill et al. (Arch Phys Med Rehabil 2008 89(9):1782-7) and Wmax_FFM (estimated from the product of 6MWT and FFM). The equation derived from a regression model to estimate Wmax_FFM was as follows: -27.9717+3.7792*(6MWT*FFM). Wmax_real correlated better with Wmax_FFM (r=.64) than with Wmax_BW (r=.54). There was no difference between Wmax_FFM (median [interquartile range], 41 [29-50] W) and Wmax_real (40 [20-50] W, P=.88), whereas Wmax_BW (60 [52-69] W) significantly overestimated Wmax_real (P<.0001). In patients with COPD, Wmax is better estimated by an equation including the product of 6MWT and FFM than by a previously proposed equation including the product of 6MWT and body weight.
Related Organisations
Universidade Estadual Paulista Júlio De Mesquita Filho Faculdade De Ciências E Tecnologia
Location: Brazil
Universidade Estadual Paulista Júlio De Mesquita Filho
Location: Brazil
Related Funding Activities
No related grants have been discovered for Carlos Augusto Camillo.