CELSO RICARDO FERNANDES DE CARVALHO
Projetos de Pesquisa
Unidades Organizacionais
Departamento de Fisioterapia, Fonoaudiologia e Terapia Ocupacional, Faculdade de Medicina - Docente
LIM/20 - Laboratório de Terapêutica Experimental, Hospital das Clínicas, Faculdade de Medicina
LIM/54 - Laboratório de Bacteriologia, Hospital das Clínicas, Faculdade de Medicina - Líder
LIM/20 - Laboratório de Terapêutica Experimental, Hospital das Clínicas, Faculdade de Medicina
LIM/54 - Laboratório de Bacteriologia, Hospital das Clínicas, Faculdade de Medicina - Líder
13 resultados
Resultados de Busca
Agora exibindo 1 - 10 de 13
- Exercise effects in adults with asthma(2022) MCLOUGHLIN, R. F.; URROZ, P. D.; MCDONALD, V. M.; CARVALHO, C. R. F.; MCDONALD, V. M.Asthma is a common chronic disease, affecting over 339 million people worldwide. People with asthma present with episodes of symptoms such as shortness of breath, wheezing, coughing, and chest tightness, which can be triggered by a variety of factors. However not all asthma is the same. The severity, frequency, duration, and symptoms vary, making asthma a complex heterogeneous disease, with many triggers of symptoms. Exercise is one such trigger that induces asthma symptoms, however, despite this exercise remains important for people with asthma and can usually be performed safely in this population. Indeed, people with asthma are recommended to engage in regular physical activity. Despite this, low levels of physical activity are still being reported in those living with asthma, particularly in those with severe disease. This unnecessary avoidance of physical activity and exercise results in negative health consequences including poorer respiratory functioning, increased disease severity, and healthcare use, decreased physical and mental health, and decreased quality of life. This chapter discusses the available evidence in relation to the benefits of regular exercise training in asthma. Several physiological and psychological benefits are reported including improved asthma control, fewer asthma symptoms and exacerbations, reduced medication and healthcare use including reduced emergency department visits, improved health status, and decreased symptoms of anxiety and depression. Although there is a paucity of evidence regarding the mechanisms responsible for the beneficial effects of exercise training in asthma, a number of mechanisms have been proposed which will also be explored. Finally, based on the currently available evidence clinical practice recommendations for exercise prescribers are provided using the FITT (frequency, intensity, time, and type) principles for exercise prescription, as well important safety considerations that should be taken into account. However, more research is required to determine optimal exercise prescription principles within the asthma population. © 2022 Elsevier Inc. All rights reserved.
- Effects of a behaviour change intervention aimed at increasing physical activity on clinical control of adults with asthma: study protocol for a randomised controlled trial(2019) FREITAS, Patricia D.; XAVIER, Rafaella F.; PASSOS, Natalia F. P.; CARVALHO-PINTO, Regina M.; CUKIER, Alberto; MARTINS, Milton A.; CAVALHERI, Vinicius; HILL, Kylie; STELMACH, Rafael; CARVALHO, Celso R. F.Background: In adults with asthma, physical activity has been associated with several asthma outcomes. However, it is unclear whether changes in physical activity, measured via an accelerometer, have an effect on asthma control. The objective of the present study is, in adults with moderate-to-severe asthma, to investigate the effects of a behaviour change intervention, which aims to increase participation in physical activity, on asthma clinical control. Methods: This is a single-blind (outcome assessor), two-arm, randomised controlled trial (RCT). Fifty-five participants with moderate-to-severe asthma, receiving optimized pharmacological treatment, will be randomly assigned (computer-generated) into either a Control Group (CG) or an Intervention Group (IG). Both groups will receive usual care (pharmacological treatment) and similar educational programmes. In addition to these, participants in the IG will undergo the behaviour change intervention based on feedback, which aims to increase participation in physical activity. This intervention will be delivered over eight sessions as weekly one-on-one, face-to-face 40-min consultations. Both before and following the completion of the intervention period, data will be collected on asthma clinical control, levels of physical activity, health-related quality of life, asthma exacerbation and levels of anxiety and depression symptoms. Anthropometric measurements will also be collected. Information on comorbidities, lung function and the use of asthma medications will be extracted from the participant's medical records. Discussion: If successful, this study will demonstrate that, in adults with asthma, a behavioural change intervention which aims to increase participation in physical activity also affects asthma control.
- Two 6-minute Walk Tests Are Required During Hospitalisation for Acute Exacerbation of COPD(2016) OSADNIK, Christian R.; BORGES, Rodrigo C.; MCDONALD, Christine F.; CARVALHO, Celso R. F.; HOLLAND, Anne E.The 6-minute walk test (6MWT) is recommended to be performed twice to accurately assess exercise performance in stable chronic obstructive pulmonary disease (COPD) due to the presence of a learning effect. It is unknown whether a learning effect exists when the 6MWT is performed during hospitalisation for acute exacerbation of COPD (AECOPD). This study investigated whether repeat 6MWTs are necessary when conducted in inpatients with AECOPD. Pooled analysis was undertaken of data from two studies (Australia and Brazil) involving 46 participants (25 males, mean age 67.2 years, FEV1 43% predicted) admitted with AECOPD. Two 6MWTs, separated by >= 20 minutes, were performed on the day of discharge. Six-minute walk distance (6MWD; primary outcome), perceived dyspnoea (Borg scale), heart rate and oxyhaemoglobin saturation were recorded. 6MWD data from tests one (T1) and two (T2) were analysed via visual inspection of Bland-Altman plots. Factors associated with test improvement or decline were explored. Mean 6MWD difference between T1 and T2 was 6.2m, however limits of agreement were wide (-92.2 m to 104.5 m). 32 (70%) participants improved (by any distance) from T1 to T2 by a mean (+/- standard deviation) of 32m +/- 28 m. Of these, 14 (30%) improved by a distance > 30 m. Fourteen (30%) participants recorded poorer 6MWD at T2 by a mean of 52m +/- 36 m. No factors were able to identify participants who improved or declined upon repeat testing. When performed in patients admitted to hospital with AECOPD, the 6MWT needs to be conducted twice in order to better estimate 6MWD.
- Identification of asthma phenotypes based on extrapulmonary treatable traits(2021) FREITAS, Patricia Duarte; XAVIER, Rafaella Franca; MCDONALD, Vanessa Marie; GIBSON, Peter Gerard; CORDOVA-RIVERA, Laura; FURLANETTO, Karina Couto; OLIVEIRA, Joice Mara de; CARVALHO-PINTO, Regina Maria; CUKIER, Alberto; STELMACH, Rafael; CARVALHO, Celso Ricardo FernandesAsthma is a heterogeneous and complex disease, and a description of asthma phenotypes based on extrapulmonary treatable traits has not been previously reported. The objective of this study was to identify and characterise clusters based on clinical, functional, anthropometrical and psychological characteristics in participants with moderate-to-severe asthma. This was a cross-sectional multicentre study involving centres from Brazil and Australia. Participants (n=296) with moderate-to-severe asthma were consecutively recruited. Physical activity and sedentary time, clinical asthma control, anthropometric data, pulmonary function and psychological and health status were evaluated. Participants were classified by hierarchical cluster analysis and the clusters compared using ANOVA, Kruskal Wallis and Chi-squared tests. Multiple logistic and linear regression models were performed to evaluate the association between variables. We identified four clusters: 1) participants with controlled asthma who were physically active, 2) participants with uncontrolled asthma who were physically inactive and more sedentary; 3) participants with uncontrolled asthma and low physical activity, who were also obese and experienced anxiety and/or depression symptoms; and 4) participants with very uncontrolled asthma who were physically inactive, more sedentary, obese and experienced anxiety and/or depression symptoms. Higher levels of sedentary time, female sex and anxiety symptoms were associated with increased odds of exacerbation risk, while being more active showed a protective factor for hospitalisation. Asthma control was associated with sex, the occurrence of exacerbation, physical activity and health status. Physical inactivity, obesity and symptoms of anxiety and/or depression were associated with worse asthma outcomes, and closely and inextricably associated with asthma control. This cluster analysis highlights the importance of assessing extrapulmonary traits to improve personalised management and outcomes for people with moderate and severe asthma.
- Identification of Phenotypes in People with COPD: Influence of Physical Activity, Sedentary Behaviour, Body Composition and Skeletal Muscle Strength(2019) XAVIER, Rafaella F.; PEREIRA, Ana Carolina A. C.; LOPES, Aline C.; CAVALHERI, Vinicius; PINTO, Regina M. C.; CUKIER, Alberto; RAMOS, Ercy M. C.; CARVALHO, Celso R. F.Introduction People with chronic obstructive pulmonary disease (COPD) present high prevalence of physical inactivity that leads to a negative effect on health-related quality of life (HRQoL). The present study investigated COPD phenotypes according to their levels of physical activity and sedentary behaviour, as well as body composition and skeletal muscle strength. Methods This is an observational and cross-sectional study. Anthropometric data and COPD clinical control were collected and all participants underwent assessments of lung function, HRQoL, dyspnoea, levels of physical activity and sedentary behaviour, body composition and skeletal muscle strength. Participants were classified using hierarchical cluster analysis. Age, dyspnoea and obstruction (ADO) index was used to determine prognosis and calculated for each cluster. Results One hundred and fifty-two participants were included. Three distinct phenotypes were identified. Participants in phenotype 1 were more physically active, less sedentary and had better body composition and lower ADO index (p < 0.0001 for all variables). Overall, participants in phenotypes 2 and 3 were less physically active, more sedentary having a higher ADO index. However, participants in phenotype 2 were older, whereas participants in phenotype 3 had worse HRQoL, clinical control and body composition. Lung function did not differ across the three phenotypes. Conclusions Our results show that physical activity, sedentary behaviour and body composition should be considered to determine phenotypes in people with COPD and are involved in the prognosis of the disease. Less sedentary patients have better prognosis while age, body composition and clinical control seems to differentiate physically inactive patients.
- Identification of asthma phenotypes based on extrapulmonary treatable traits(2020) FREITAS, Patricia Duarte; XAVIER, Rafaella Fagundes; MCDONALD, Vanessa M.; GIBSON, Peter G.; CORDOVA-RIVERA, Laura; FURLANETTO, Karina C.; OLIVEIRA, Joice M. De; CARVALHO-PINTO, Regina M.; CUKIER, Alberto; STELMACH, Rafael; CARVALHO, Celso R. F.
- Preoperative 6-min walking distance does not predict pulmonary complications in upper abdominal surgery(2012) PAISANI, Denise M.; FIORE JR., Julio F.; LUNARDI, Adriana C.; COLLUCI, Daniela B. B.; SANTORO, Ilka Lopes; CARVALHO, Celso R. F.; CHIAVEGATO, Luciana Dias; FARESIN, Sonia MariaBackground and objective: Field exercise tests have been increasingly used for pulmonary risk assessment. The 6-min walking distance (6MWD) is a field test commonly employed in clinical practice; however, there is limited evidence supporting its use as a risk assessment method in abdominal surgery. The aim was to assess if the 6MWD can predict the development of post-operative pulmonary complications (PPCs) in patients having upper abdominal surgery (UAS). Methods: This prospective cohort study included 137 consecutive subjects undergoing elective UAS. Subjects performed the 6MWD on the day prior to surgery, and their performance were compared with predicted values of 6MWD (p6MWD) using a previously validated formula. PPCs (including pneumonia, tracheobronchitis, atelectasis with clinical repercussions, bronchospasm and acute respiratory failure) were assessed daily by a pulmonologist blinded to the 6MWD results. 6MWD and p6MWD were compared between subjects who developed PPC (PPC group) and those who did not (no PPC group) using Student's t-test. Results: Ten subjects experienced PPC (7.2%) and no significant difference was observed between the 6MWD obtained in the PPC group and no PPC group (466.0 +/- 97.0 m vs 485.3 +/- 107.1 m; P = 0.57, respectively). There was also no significant difference observed between groups for the p6MWD (100.7 +/- 29.1% vs 90.6 -/+ 20.9%; P > 0.05). Conclusions: The results of the present study suggest that the 6-min walking test is not a useful tool to identify subjects with increased risk of developing PPC following UAS.
- Effects of a behaviour change intervention aimed at increasing physical activity on clinical control of adults with asthma: an RCT(2019) FREITAS, Patricia Duarte; PASSOS, Natalia F. P.; CARVALHO-PINTO, Regina M.; CUKIER, Alberto; CAVALHERI, Vinicius; HILL, Kylie; STELMACH, Rafael; CARVALHO, Celso R. F.
- Protocol for Functional Assessment of Adults and Older Adults after Hospitalization for COVID-19(2021) GODOY, Caroline Gil de; SILVA, Erika Christina Gouveia e; OLIVEIRA, Danielle Brancolini de; GAMBETA, Amislaine Cristina; SILVA, Elizabeth Mendes da; CAMPOS, Camila Machado de; SCHMITT, Ana Carolina Basso; CARVALHO, Celso R. F.; FU, Carolina; TANAKA, Clarice; NAKAGAWA, Naomi Kondo; TOUFEN JUNIOR, Carlos; CARVALHO, Carlos Roberto Ribeiro de; HILL, Keith; POMPEU, Jose Eduardo
- Risk Factors for the Impairment of Ambulation in Older People Hospitalized with COVID-19: A Retrospective Cohort Study(2023) SILVA, E. C. G. E.; SCHMITT, A. C. B.; GODOY, C. G. de; OLIVEIRA, D. B. de; TANAKA, C.; TOUFEN, C. Jr.; CARVALHO, C. R. R. de; CARVALHO, C. R. F.; FU, C.; HILL, K. D.; POMPEU, J. E.(1) Background: Some older people hospitalized with COVID-19 have experienced reduced ambulation capacity. However, the prevalence of the impairment of ambulation capacity still needs to be established. Objective: To estimate the prevalence of, and identify the risk factors associated with, the impairment of ambulation capacity at the point of hospital discharge for older people with COVID-19. (2) Methods: A retrospective cohort study. Included are those with an age > 60 years, of either sex, hospitalized due to COVID-19. Clinical data was collected from patients’ medical records. Ambulation capacity prior to COVID-19 infection was assessed through the patients’ reports from their relatives. Multiple logistic regressions were performed to identify the risk factors associated with the impairment of ambulation at hospital discharge. (3) Results: Data for 429 older people hospitalized with COVID-19 were randomly collected from the medical records. Among the 56.4% who were discharged, 57.9% had reduced ambulation capacity. Factors associated with reduced ambulation capacity at discharge were a hospital stay longer than 20 days (Odds Ratio (OR): 3.5) and dependent ambulation capacity prior to COVID-19 (Odds Ratio (OR): 11.3). (4) Conclusion: More than half of the older people who survived following hospitalization due to COVID-19 had reduced ambulation capacity at hospital discharge. Impaired ambulation prior to the infection and a longer hospital stay were risks factors for reduced ambulation capacity.