FELIPE AUGUSTO RODRIGUES MENDES
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- Musculoskeletal Dysfunction and Pain in Adults with Asthma(2011) LUNARDI, Adriana Claudia; MARQUES, Cibele Cristine Berto; MENDES, Felipe Augusto Rodrigues; MARQUES, Amelia Pasqual; STELMACH, Rafael; CARVALHO, Celso Ricardo FernandesBackground. The mechanical alterations related to the overload of respiratory muscles observed in adults with persistent asthma might lead to the development of chronic alterations in posture, musculoskeletal dysfunction and pain; however, these changes remain poorly understood. Objective. This study aimed to assess postural alignment, muscle shortening and chronic pain in adults with persistent asthma. Methods. This cross-sectional and controlled study enrolled 30 patients with mild (n = 17) and severe ( n = 13) persistent asthma. Fifteen non-asthmatic volunteers were also assessed. Asthma was classified by the Global Initiative for Asthma (GINA) guidelines. Postural alignment and muscle shortening were evaluated by head and shoulder positions, chest wall mobility, and posterior ( trunk and lower limb) muscle flexibility. In addition, the measures used were previously tested for their reproducibility. Pain complaints were also assessed. Results. In comparison with non-asthmatic subjects, patients with mild or severe persistent asthma held their head and shoulders more forward and had lower chest wall expansion, decreased shoulder internal rotation, and decreased thoracic spine flexibility. Chronic lower thoracic, cervical, and shoulder pain was significantly increased in patients with mild or severe asthma compared with non-asthmatic subjects (p < 0.05). Conclusion. Adults with persistent asthma have musculoskeletal dysfunction and chronic pain that is independent of the severity of their disease but that might be related to their age at the onset of disease symptoms.
conferenceObject Aerobic exercise training cannot be prescribed based on predictive heart rate equations in moderate or severe asthmatic patients(2012) MENDES, Felipe; TEIXEIRA, Renata; PINTO, Andrezza; STELMACH, Rafael; CUKIER, Alberto; MARTINS, Milton; CARVALHO, CelsoconferenceObject Aerobic training decreases bronchial hyperresponsiveness, serum chemokines and symptoms in asthmatic patients: Randomized controlled trial(2013) MENDES, Felipe; FRANCA-PINTO, Andrezza; CUKIER, Alberto; STELMACH, Rafael; AGONDI, Rosana; MARTINS, Milton A.; KALIL, Jorge; GIAVINA-BIANCHI, Pedro; CARVALHO, Celso R. F.conferenceObject Screening for allergy in elite marathon runners(2013) TEIXEIRA, Renata Nakata; MENDES, Felipe Augusto Rodrigues; MARTINS, Milton Arruda; CARVALHO, Celso Ricardo FernandesconferenceObject Aerobic training decrease bronchial hyperresponsiveness and systemic inflammation in patients with moderate or severe asthma: A randomized controlled trial(2014) CARVALHO, Celso R. F.; FRANCA-PINTO, Andrezza; MENDES, Felipe A. R.; STELMACH, Rafael; CUKIER, Alberto; AGONDI, Rosana C.; MARTINS, Milton A.; SARAIVA-ROMANHOLO, Beatriz M.; KALIL, Jorge; GIAVINA-BIANCHI, Pedroarticle 7 Citação(ões) na Scopus Analysis of cardiovascular system responses to forced vital capacity in COPD(2011) MENDES, Felipe A. R.; MORENO, Isadora L.; DURAND, Marina T.; PASTRE, Carlos M.; RAMOS, Ercy M. C.; VANDERLEI, Luiz C. M.Background: The forced vital capacity (FVC) test is routinely performed to evaluate pulmonary function in patients with chronic obstructive pulmonary disease (COPD). However, the influence of the FVC maneuver on the cardiovascular system of patients with COPD is poorly understood. Objectives: To analyze the behavior of heart rate (HR), blood pressure (BP) and heart rate variability (HRV) during the FVC test in COPD patients. Methods: Nineteen men with COPD (72 +/- 7 years, GOLD stage I=3, II=5, III=7 and IV=4 patients) performed the FVC test while having their HR monitored. HRV was assessed in time (rMSSD) and frequency domains (LF, HF and LF/HF) at rest, before and after the best FVC maneuver. BP was measured at rest, immediately before and at the end of the test, as well as 10 minutes after the end of the test. Results: At the beginning of the FVC maneuver, HR decreased (p < 0.001) and then increased gradually until the end of the test (p < 0.001). After the end of maneuver, HR continued to increase until it reached a peak (p < 0.001), and then it fell quickly to below at-rest values (p < 0.001) prior to returning to baseline. The BP and HRV indices did not change during the assessment. Conclusion: The PVC test influences the behavior of COPD patient HR without changing autonomic control or BP.conferenceObject Aerobic training promotes benefits in patients with moderate and severe asthma independent of seasonal variation(2013) FRANCA-PINTO, Andrezza; MENDES, Felipe A. R.; CUKIER, Alberto; STELMACH, Rafael; MARTINS, Milton A.; KALIL, Jorge; CARVALHO, Celso R. F.; GIAVINA-BIANCHI, Pedro- Aerobic training decreases bronchial hyperresponsiveness and systemic inflammation in patients with moderate or severe asthma: a randomised controlled trial(2015) FRANCA-PINTO, Andrezza; MENDES, Felipe A. R.; CARVALHO-PINTO, Regina Maria de; AGONDI, Rosana Camara; CUKIER, Alberto; STELMACH, Rafael; SARAIVA-ROMANHOLO, Beatriz M.; KALIL, Jorge; MARTINS, Milton A.; GIAVINA-BIANCHI, Pedro; CARVALHO, Celso R. F.Background The benefits of aerobic training for the main features of asthma, such as bronchial hyperresponsiveness (BHR) and inflammation, are poorly understood. We investigated the effects of aerobic training on BHR (primary outcome), serum inflammatory cytokines (secondary outcome), clinical control and asthma quality of life (Asthma Quality of Life Questionnaire (AQLQ)) (tertiary outcomes). Methods Fifty-eight patients were randomly assigned to either the control group (CG) or the aerobic training group (TG). Patients in the CG (educational programme+breathing exercises (sham)) and the TG (same as the CG+aerobic training) were followed for 3 months. BHR, serum cytokine, clinical control, AQLQ, induced sputum and fractional exhaled nitric oxide (FeNO) were evaluated before and after the intervention. Results After 12 weeks, 43 patients (21 CG/22 TG) completed the study and were analysed. The TG improved in BHR by 1 doubling dose (dd) (95% CI 0.3 to 1.7 dd), and they experienced reduced interleukin 6 (IL-6) and monocyte chemoattractant protein 1 (MCP-1) and improved AQLQ and asthma exacerbation (p<0.05). No effects were seen for IL-5, IL-8, IL-10, sputum cellularity, FeNO or Asthma Control Questionnaire 7 (ACQ-7; p>0.05). A within-group difference was found in the ACQ-6 for patients with non-well-controlled asthma and in sputum eosinophil and FeNO in patients in the TG who had worse airway inflammation. Conclusions Aerobic training reduced BHR and serum proinflammatory cytokines and improved quality of life and asthma exacerbation in patients with moderate or severe asthma. These results suggest that adding exercise as an adjunct therapy to pharmacological treatment could improve the main features of asthma.
- Effects of Aerobic Training on Airway Inflammation in Asthmatic Patients(2011) MENDES, Felipe Augusto Rodrigues; ALMEIDA, Francine Maria; CUKIER, Alberto; STELMACH, Rafael; JACOB-FILHO, Wilson; MARTINS, Milton A.; CARVALHO, Celso Ricardo FernandesMENDES, F. A. R., F. M. ALMEIDA, A. CUKIER, R. STELMACH, W. JACOB-FILHO, M. A. MARTINS, and C. R. F. CARVALHO. Effects of Aerobic Training on Airway Inflammation in Asthmatic Patients. Med. Sci. Sports Exerc., Vol. 43, No. 2, pp. 197-203, 2011. Purpose: There is evidence suggesting that physical activity has anti-inflammatory effects in many chronic diseases; however, the role of exercise in airway inflammation in asthma is poorly understood. We aimed to evaluate the effects of an aerobic training program on eosinophil inflammation (primary aim) and nitric oxide (secondary aim) in patients with moderate or severe persistent asthma. Methods: Sixty-eight patients randomly assigned to either control (CG) or aerobic training (TG) groups were studied during the period between medical consultations. Patients in the CG (educational program + breathing exercises; N = 34) and TG (educational program + breathing exercises + aerobic training; N = 34) were examined twice a week during a 3-month period. Before and after the intervention, patients underwent induced sputum, fractional exhaled nitric oxide (FeNO), pulmonary function, and cardiopulmonary exercise testing. Asthma symptom-free days were quantified monthly, and asthma exacerbation was monitored during 3 months of intervention. Results: At 3 months, decreases in the total and eosinophil cell counts in induced sputum (P = 0.004) and in the levels of FeNO (P = 0.009) were observed after intervention only in the TG. The number of asthma symptom-free days and (V) over dotO(2max) also significantly improved (P < 0.001), and lower asthma exacerbation occurred in the TG (P < 0.01). In addition, the TG presented a strong positive relationship between baseline FeNO and eosinophil counts as well as their improvement after training (r = 0.77 and r = 0.9, respectively). Conclusions: Aerobic training reduces sputum eosinophil and FeNO in patients with moderate or severe asthma, and these benefits were more significant in subjects with higher levels of inflammation. These results suggest that aerobic training might be useful as an adjuvant therapy in asthmatic patients under optimized medical treatment.
conferenceObject Physical training for asthmatics: Which patients obtain most clinical benefits?(2012) MENDES, Felipe; PINTO, Andrezza; SARAIVA-ROMANHOLO, Beatriz; STELMACH, Rafael; CUKIER, Alberto; GIAVINA-BIANCHI, Pedro; MARTINS, Milton; CARVALHO, Celso