CAROLINA FU
Projetos de Pesquisa
Unidades Organizacionais
Departamento de Fisioterapia, Fonoaudiologia e Terapia Ocupacional, Faculdade de Medicina - Docente
LIM/54 - Laboratório de Bacteriologia, Hospital das Clínicas, Faculdade de Medicina
LIM/54 - Laboratório de Bacteriologia, Hospital das Clínicas, Faculdade de Medicina
12 resultados
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- Impact of a Progressive Mobility Program on the Functional Status, Respiratory, and Muscular Systems of ICU Patients: A Randomized and Controlled Trial*(2020) SCHUJMANN, Debora Stripari; GOMES, Tamires Teixeira; LUNARDI, Adriana Claudia; LAMANO, Murilo Zoccoler; FRAGOSO, Aretha; PIMENTEL, Mayara; PESO, Claudia Neri; ARAUJO, Priscila; FU, CarolinaObjectives: The aim was to investigate whether patients who participated in a mobility program in the ICU performed better on functional status, muscle, mobility, and respiratory assessments upon discharge than patients who received conventional physiotherapy. Design: Randomized controlled trial. Setting: Blind evaluation. Patients: Adults with previous functional independence and without contraindications for mobilization were eligible. Interventions: The intervention group participated in an early and progressive mobility program with five levels of activity. The control group underwent the conventional treatment without a preestablished routine. We evaluated functional status, level of activity, respiratory status, muscle strength, and mobility at ICU discharge. Measurements and Main Results: We analyzed 49 patients in the control group and 50 patients in the intervention group. Our data showed patients with better functional status and more functionally independent patients in the intervention group compared with those in the control group (96% vs 44%; p < 0.001). The results of the sit-to-stand and 2-minute walk tests, as well as the results of the maximum voluntary ventilation tests, also varied between the groups. The intervention group had shorter ICU stays than the control group. Higher Barthel index scores were associated with the amount of activity and participation in the protocol. The benefits to functional status remained during follow-up. Conclusions: Patients who participated in an ICU mobility program had better functional status at discharge from the ICU. The other benefits of the program included better performance in the mobility tests and improved maximum voluntary ventilation performance.
conferenceObject Association Between Days of Start Rehabilitation and Development of ICU-Acquired Weakness in Critical Ill Patients with COVID-19(2022) FRANCELIN, H.; SANTOS, D. P.; LUNARDI, A. C.; PESO, C. N.; SCHUJMANN, D. S.; FU, C.- Progressive mobility program and technology to increase the level of physical activity and its benefits in respiratory, muscular system, and functionality of ICU patients: study protocol for a randomized controlled trial(2018) SCHUJMANN, Debora Stripari; LUNARDI, Adriana Claudia; FU, CarolinaBackground: Enhanced mobility in the Intensive Care Unit (ICU) could minimize the negative effects of critical illness, such as declines in cognitive, muscular, respiratory, and functional capacity. We aim to compare the functional status at ICU discharge of patients who underwent a progressive mobilization protocol versus patients who received conventional physiotherapy. We also examine the level of physical activity in the ICU, the degree of pulmonary and muscle function, and the length of stay to analyze correlations between these variables. Methods: This is a protocol for a randomized controlled trial with blind evaluation. Ninety-six ICU patients will be recruited from a single center and randomly assigned to a control group or an intervention group. To determine the level of protocol activity the patient will receive, the patients' ability to participate actively and their muscle strength will be considered. The protocol consists of five phases, ranging from passive therapies to walking and climbing stairs. The primary outcome will be the functional status at ICU discharge, measured with the Barthel Index and the ICU Mobility Scale (IMS). Measured secondary outcomes will include the level of physical activity, maximal inspiratory and expiratory pressures, forced expiratory volume in 1 second, maximum voluntary ventilation, handgrip strength, surface electromyography of the lower limb muscles, and results of the Timed Up and Go and 2-Minute Walk tests. Evaluations will be made within 2 days of ICU discharge except for the level of activity, which will be evaluated daily. Physiological variables and activity level will be analyzed by chi-square and t tests, according to the intention-to-treat paradigm. Discussion: Mobility and exercise in the ICU should be undertaken with intensity, quantity, duration, and frequency adjusted according to the patients' status. The results of this study may contribute to new knowledge of early mobility in the ICU, activity level, and varying benefits in critical patients, directing new approaches to physiotherapeutic interventions in these patients.
- Functional Recovery Groups in Critically III COVI D-19 Patients and Their Associated Factors: From ICU to Hospital Discharge(2022) SCHUJMANN, Debora Stripari; LUNARDI, Adriana Claudia; PESO, Claudia Neri; POMPEU, Jose Eduardo; ANNONI, Raquel; MIURA, Mieko Claudia; CENSO, Caroline Maschio de; TANIGUCHI, Luzia Noriko Takahashi; REGENGA, Marisa de Moraes; CAMPOS, Elaine Cristina de; RIGHETTI, Renato Fraga; YAMAGUTI, Wellington Pereira; BRITO, Christina May Moran de; LOURENCO, Adriana; AGUERA, Sabrina Castaldi; TANAKA, Clarice; FU, CarolinaOBJECTIVES: To analyze functional recovery groups of critically ill COVID-19 survivors during their hospital stay and to identify the associated factors. DESIGN: Prospective observational multicenter study. SETTING: Demographic, clinical, and therapeutic variables were collected, and physical and functional status were evaluated. The Barthel index was evaluated at three time points: 15 days before hospitalization, at ICU discharge, and at hospital discharge from the ward. PATIENTS: Patients with functional independence before COVID-19 diagnosis were recruited from four hospitals and followed up until hospital discharge. MEASUREMENTS AND MAIN RESULTS: Three groups of functional recovery were described for 328 patients: functional independence (n = 144; 44%), which included patients who preserved their functional status during hospitalization; recovered functionality = 109; 33.2%), which included patients who showed dependence at ICU discharge but recovered their independence by hospital discharge; and functional dependency (n = 75; 22.8%), which included patients who were dependent at ICU discharge and had not recovered their functional status at hospital discharge. The factors associated with becoming functionally dependent at ICU discharge were time to out-of-bed patient mobilization (odds ratio [OR], 1.20; 95% CI, 1.11-1.29), age (OR, 1.02; 95% CI, 1.01-1.04), hyperglycemia (OR, 2.52; 95% CI, 1.56-4.07), and Simplified Acute Physiology Score (OR, 1.022; 95% CI, 1.01-1.04). Recovery to baseline independence during ward stays was associated with ICU length of stay (OR, 0.97; 95% CI, 0.94-0.99) and muscle strength (Medical Research Council test) at ICU discharge (OR, 1.13; 95% CI, 1.08-1.18). CONCLUSIONS: Age, hyperglycemia, and time for patient mobilization out of bed were independent factors associated with becoming physically dependent after their ICU stay. Recovery of physical function at hospital discharge was associated with muscle strength at ICU discharge and length of ICU stay.
- Fatores associados com o declínio funcional em uma unidade de terapia intensiva: estudo prospectivo sobre o nível de atividade física e os fatores clínicos(2021) SCHUJMANN, Débora Stripari; GOMES, Tamires Teixeira; LUNARDI, Adriana Cláudia; FU, CarolinaABSTRACT Objective: To identify the factors associated with functional status decline in intensive care unit patients. Methods: In this prospective study, patients in an intensive care unit aged 18 years or older without neurological disease or contraindications to mobilization were included. The exclusion criteria were patients who spent fewer than 4 days in the intensive care unit or died during the study period. Accelerometry was used to assess the physical activity level of patients. We recorded age, SAPS 3, days on mechanical ventilation, drugs used, comorbidities, and functional status after intensive care unit discharge. After intensive care unit discharge, the patients were assigned to a dependent group or an independent group according to their Barthel index. Logistic regression and the odds ratio were used in the analyses. Results: Sixty-three out of 112 included patients were assigned to the dependent group. The median Charlson comorbidity index was 3 (2 - 4). The mean SAPS 3 score was 53 ± 11. The patients spent 94 ± 4% of the time spent in inactivity and 4.8 ± 3.7% in light activities. The odds ratio showed that age (OR = 1.08; 95%CI 1.04 - 1.13) and time spent in inactivity (OR = 1.38; 95%CI 1.14 - 1.67) were factors associated with functional status decline. Time spent in light activity was associated with a better functional status (OR = 0.73; 95%CI 0.60 - 0.89). Conclusions: Age and time spent in inactivity during intensive care unit stay are associated with functional status decline. On the other hand, performing light activities seems to preserve the functional status of patients.
conferenceObject Mobility And Clinical Characteristics As Predictor And Protective Factors Of Functional Decline In The Intensive Care Unit(2016) SCHUJMANN, D. S.; GOMES, T. T.; LUNARDI, A. C.; FU, C.conferenceObject Physical Function Trajectories in of Critically Ill Patients by COVID-19 and Risk Factors: From ICU to Hospital Discharge(2022) FU, C.; LUNARDI, A. C.; PESO, C. N.; POMPEO, J. E.; CARVALHO, C. R. F.; SCHMITT, A. C. B.; SILVA, E. C. G.; TANAKA, C.; SCHUJMANN, D. S.conferenceObject Prospective Analysis Of Levels Of Activity And Functional Decline In Intensive Care Unit(2016) GOMES, T. T.; SCHUJMANN, D. S.; LUNARDI, A. C.; FU, C.- Effect of therapeutic Swedish massage on anxiety level and vital signs of Intensive Care Unit patients(2017) SILVA, Tatiana Alves da; SCHUJMANN, Debora Stripari; SILVEIRA, Leda Tomiko Yamada da; CAROMANO, Fatima Aparecida; FU, CarolinaObjective: To evaluate how Swedish massage affects the level of anxiety and vital signs of Intensive Care Unit (ICU) patients. Methods: Quasi-experimental study. Inclusion criteria: ICU patients, 18-50 years old, cooperative, respiratory and hemodynamic stable, not under invasive mechanical ventilation. Exclusion criteria: allergic to massage oil, vascular or orthopedic post-operative, skin lesions, thrombosis, fractures. A 30-min Swedish massage was applied once. Variables: arterial pressure, heart rate, respiratory rate, S-STAI questionnaire. Timing of evaluation: pre-massage, immediately post-massage, 30 min post-massage. Comparison: T-test, corrected by Bonferroni method, level of significance of 5%, confidence interval of 95%. Results: 48 patients included, 30 (62.5%) female, mean age 55.46 (15.70) years old. Mean S-STAI pre-massage: 42.51 (9.48); immediately post-massage: 29.34 (6.37); 30 min post-massage: 32.62 (8.56), p < 0.001 for all comparison. Mean vital signs achieved statistical significance between pre-massage and immediately post-massage. Conclusion: Swedish massage reduced anxiety of ICU patients immediately and 30 min post-massage. Vital signs were reduced immediately post-massage.
- Concerns With the Accuracy of Activities of Daily Living Score at ICU Discharge Reply(2020) SCHUJMANN, Debora Stripari; GOMES, Tamires Teixeira; LUNARDI, Adriana Claudia; LAMANO, Murilo Zoccoler; FRAGOSO, Aretha; PIMENTEL, Mayara; PESO, Claudia Neri; ARAUJO, Priscila; FU, Carolina