CLARICE TANAKA

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Departamento de Fisioterapia, Fonoaudiologia e Terapia Ocupacional, Faculdade de Medicina - Docente
LIM/54 - Laboratório de Bacteriologia, Hospital das Clínicas, Faculdade de Medicina - Líder

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  • conferenceObject
    Impact of diaphragmatic mobility in lung aeration loss in critically ill patients
    (2018) MOL, Caroline Gomes; AQUINO, Monize Karla Alves; REIS, Renato Batista; OLIVEIRA, Catherine Cely; CAMARGO, Nataly Gomes Benites De; SOUZA, Rita Ferreira De; TANAKA, Clarice
  • article 5 Citação(ões) na Scopus
    Noninvasive positive-pressure ventilation in clinical practice at a large university-affiliated Brazilian hospital
    (2012) YAMAUCHI, Liria Yuri; TRAVAGLIA, Teresa Cristina Francischetto; BERNARDES, Sidnei Ricardo Nobre; FIGUEIROA, Maise C.; TANAKA, Clarice; FU, Carolina
    OBJECTIVES: To describe noninvasive positive-pressure ventilation use in intensive care unit clinical practice, factors associated with NPPV failure and the associated prognosis. METHODS: A prospective cohort study. RESULTS: Medical disorders (59%) and elective surgery (21%) were the main causes for admission to the intensive care unit. The main indications for the initiation of noninvasive positive-pressure ventilation were the following: post-extubation, acute respiratory failure and use as an adjunctive technique to chest physiotherapy. The noninvasive positive-pressure ventilation failure group was older and had a higher Simplified Acute Physiology Score II score. The noninvasive positive-pressure ventilation failure rate was 35%. The main reasons for intubation were acute respiratory failure (55%) and a decreased level of consciousness (20%). The noninvasive positive-pressure ventilation failure group presented a shorter period of noninvasive positive-pressure ventilation use than the successful group [three (2-5) versus four (3-7) days]; they had lower levels of pH, HCO3 and base excess, and the FiO(2) level was higher. These patients also presented lower PaO2:FiO2 ratios; on the last day of support, the inspiratory positive airway pressure and expiratory positive airway pressure were higher. The failure group also had a longer average duration of stay in the intensive care unit [17 (10-26) days vs. 8 (5-14) days], as well as a higher mortality rate (9 vs. 51%). There was an association between failure and mortality, which had an odds ratio (95% CI) of 10.6 (5.93 - 19.07). The multiple logistic regression analysis using noninvasive positive pressure ventilation failure as a dependent variable found that treatment tended to fail in patients with a Simplified Acute Physiology Score II >= 34, an inspiratory positive airway pressure level >= 15 cmH2O and pH<7.40. CONCLUSION: The indications for noninvasive positive-pressure ventilation were quite varied. The failure group had a longer intensive care unit stay and higher mortality. Simplified Acute Physiology Score II >= 34, pH<7.40 and higher inspiratory positive airway pressure levels were associated with failure.
  • article
    Transcranial direct current stimulation is safe and effective in autoimmune myopathies: a randomised, double-blind, sham-controlled trial
    (2023) SOUSA, L. F. A. de; MISSE, R. G.; SANTOS, L. M. dos; TANAKA, C.; GREVE, J. M. A.; BAPTISTA, A. F.; SHINJO, S. K.
    Objective We aimed to assess the safety and efficacy of transcranial direct current stimulation (tDCS) in patients with systemic autoimmune myopathies (SAMs).Methods This prospective, randomised, sham-controlled, double-blind, study included 20 patients with SAMs allocated to receive sham or active tDCS (2mA, 20 minutes, 3 days). Electrodes were positioned with the anode over the C1 or C2, whereas the cathode was placed over the Fp2 or Fp1, respectively. The groups were evaluated in four periods with specific questionnaires and functional tests: pre-stimulation and after 30 minutes, three weeks, and eight weeks post-tDCS.Results Two patients from the sham group withdrew after the three sessions. The demographic data, type of myositis, disease duration, and disease status were comparable between the active and sham tDCS groups. After interventions, in the active tDCS group, the physical aspects of SF-36 in week eight, mean and better timed up-and-go test at each evaluation, peak torque of stimulated inferior limb extension improved significantly (p<0.05). The emotional aspect of SF-36 decreased only in the active tDCS group (p<0.001). The patients' adherence to the protocol was 100% and no serious adverse event was reported, including disease relapses.Conclusion This study evidences the safety of tDCS, as well as its potential efficacy in improving muscle strength and function in SAMs patients. More studies with a larger sample and longer tDCS sessions are necessary to corroborate the results of the present study.
  • bookPart
  • article 8 Citação(ões) na Scopus
    Caracterização eletromiográfica e ultrassonográfica da função mastigatória em indivíduos com oclusão normal
    (2012) MANGILLI, Laura Davison; SASSI, Fernanda Chiarion; SERNIK, Renato Antônio; TANAKA, Clarice; ANDRADE, Claudia Regina Furquim de
    PURPOSE: To characterize the motor control of the masseter and temporal muscles and the morphology of the masseter muscles during mastication in individuals with normal occlusion and to verify the consistency between surface electromyography (sEMG) and ultrasound (USD). METHODS: Participants were 22 adults, of both genders, with no alterations of the oral myofuntional system. The procedures performed included sEMG of the masseter (MM) and temporal (TM) muscles and USD of the MM, each during three tasks: resting condition and maximum voluntary dental clench with and without cotton rolls. RESULTS: The following statistical tests were used: Kolmogorov-Smirnov, paired t-test and Spearman correlation (significance level of 5%). The sEMG data indicated a significant difference between the MM and TM during the maximum voluntary clench with and without cotton rolls, and the TM was more active than the TM in both clenching tasks. No significant difference was observed between the sides of the face when assessed with sEMG or USD. A significant positive correlation between the exams was observed for the left maximum voluntary dental clench with and without cotton rolls, and a trend toward significance was found for the right maximum dental clench without cotton rolls. CONCLUSION: The comparison of sEMG to USD for the investigation of muscle function reveals important information about the physiology of skeletal muscles. The results of the present study suggest a correlation between sEMG and USD, i.e., between increased electrical activity and the corresponding increase in muscle thickness.
  • article
    Declínio de atividades instrumentais de vida diária associado à perda de força de preensão palmar em idosos internados em enfermaria geriátrica
    (2014) VIVEIRO, Larissa Alamino Pereira de; ALMEIDA, Andréia Silva de; MEIRA, Débora Martins; LAVOURA, Patrícia Harry; CARMO, Carolina Mendes do; SILVA, Janete Maria da; TANAKA, Clarice
    OBJECTIVE: To verify the association between the ability to perform instrumental activities of daily living (IADL) and handgrip strength in hospitalized geriatric patients without cognitive impairment. METHODS: Cross-sectional study. Elderly patients aged over 60 years of both genders admitted to geriatric patients ward were included. On the other hand, elderly with neurological, musculoskeletal and respiratory acute exacerbated diseases; individuals with medical indication of rest or use of clinical apparatus, cognitive impairment and/or delirium were excluded. Data were collected from medical records. The ability to perform IADL was assessed by Lawton Scale and the handgrip strength was measured using handheld dynamometry on the dominant upper limb. A descriptive analysis with mean and standard deviation was carried out. The Pearson correlation test was applied to verify association between the total score of Lawton Scale and handgrip strength. RESULTS: The study included 12 patients (75% women) whose mean age were 80.67±6.35 years. The mean of handgrip strength and total Lawton Scale score were 11.96±6.71 Kgf and 22.58±1.67 points, respectively. A moderate positive association between handgrip strength and Lawton Scale score (r=0.640; p=0.025) was found. CONCLUSION: The handgrip strength and IADLs were associated in this study population.
  • article 3 Citação(ões) na Scopus
    Balance highly influences flexibility measured by the toe-touch test
    (2018) SIQUEIRA, Cassio M.; ROSSI, Aline; SHIMAMOTO, Cristyan; TANAKA, Clarice
    Flexibility evaluation is a standard assessment in clinical and in sports settings. The Toe-touch test (TTT) is a common assessment tool to evaluate posterior muscular chain flexibility, but the test procedure implies a balance demand. The objective of the study was to verify the hypothesis that the balance demand during the TTT may affect the flexibility measured by the test. Twenty healthy, active young adults participated in the present study. Toe-touch test outcome (the linear finger to toe distance), Center of Pressure (CP) and sagittal plane joint angles were compared under two balance conditions: (1) standard TTT (ST) and (2) minimised postural demand (MPD) during ITT (using a device that restrained the participant against a forward fall). Then, ST was re-tested to verify a possible effect of motor learning on ITT outcome. Compared to ST, MPD showed an improvement of 73% in test outcome, greater flexion of the ankle, greater total body flexion, and a forward displacement of the CP. Re-test of ST showed indications of motor learning with a different balance strategy compared to the first trial in the same condition. The test outcome showed significant negative correlations with CP position in ST (weak correlation), in the re-test (strong correlation) and when the conditions were combined (moderate correlation). In conclusion, ITT outcome was highly affected by balance performance. Maximum range of motion during ST was a fraction of the range obtained when balance demand was minimized.
  • bookPart
  • article 15 Citação(ões) na Scopus
    Postural adjustment after an unexpected perturbation in children with haemophilia
    (2012) SOUZA, F. M. B. De; PEREIRA, R. P.; MINUQUE, N. P.; CARMO, C. M. Do; MELLO, M. H. M. De; VILLACA, P.; TANAKA, C.
    . Children with haemophilia often bleed inside joints and muscles, which may impair postural adjustments. These postural adjustments are necessary to control postural balance during daily activities. The inability to quickly recover postural balance could elevate the risk of bleeding. To determine whether children with haemophilia have impaired postural adjustment after an unexpected perturbation compared with healthy children. Twenty children with haemophilia comprised the haemophilic group (HG), and 20 healthy, age-paired children comprised the control group (CG). Subjects stood on a force plate, and 4% of the subjects body weight was applied via a pulley system to a belt around the subjects trunks. The centre of pressure (COP) displacement was measured after the weight was unexpectedly released to produce a controlled postural perturbation followed by postural adjustment to recover balance. The subjects postural adjustments in eight subsequent intervals of 1 s (t1t8), beginning with the moment of weight removal, were compared among intervals and between groups. The applied perturbation magnitudes were the same for both groups, and no difference was observed between the groups in t1. However, the COP displacement in t2 in the HG was significantly higher than in the CG. No differences were observed between the groups in the other intervals. Within-group analysis showed that the COP was higher in t2 than in t4 (P = 0.016), t5 (P = 0.001) and t8 (P = 0.050) in the HG. No differences were observed among intervals in the CG. Children with haemophilia demonstrated differences in postural adjustment while undergoing unexpected balance perturbations when compared with healthily children.
  • article 11 Citação(ões) na Scopus
    The effects of repetitive haemarthrosis on postural balance in children with haemophilia
    (2013) SOUZA, F. M. B.; MCLAUGHLIN, P.; PEREIRA, R. P.; MINUQUE, N. P.; MELLO, M. H. M.; SIQUEIRA, C.; VILLACA, P.; TANAKA, C.
    Sensory information from visual, vestibular and proprioceptive systems is necessary to control posture and balance. Impairment in proprioception due to repetitive joints bleeding may lead to a deficit in postural balance which, in turn, leads to high joint stress and risk of bleeding recurrence. Despite the increase in attention in this field during the past few years, the data concerning to how bleeds can affect postural control in children with haemophilia (CWH) remain scarce. This study aimed to evaluate the postural balance in CWH. Twenty CWH Haemophilia Group (HG) and 20 age-matched children Control Group (CG) were recruited to this study. A force plate was used to record centre of pressure (COP) displacement under four different postural conditions during quiet standing: eyes open on firm surface, eyes open on foam surface, eyes closed on firm surface and eyes closed on a foam surface. Variables of COP as sway area and mean velocity and in anterior-posterior (y) medio-lateral (x) direction were processed and for each variable sensory, quotients were calculated and compared between groups. No differences were found in visual and vestibular quotients variables between groups. A higher value was found in sway area variable on proprioception quotient in the HG when compared with CG (P=0.042). CWH with repetitive joint bleed on lower limbs showed differences in postural balance when compared with non-haemophiliac children. The identification of early balance impairments in CWH can help us understand better the effects of bleeds inside joints on postural control and plan a more effective preventive and rehabilitative treatment.