FELIPE AUGUSTO RODRIGUES MENDES
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conferenceObject 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 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, PedroconferenceObject 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.
- Association between Maximal Aerobic Capacity and Psychosocial Factors in Adults With Moderate-to-Severe Asthma(2013) MENDES, Felipe A. R.; LUNARDI, Adriana C.; SILVA, Ronaldo A.; CUKIER, Alberto; STELMACH, Rafael; MARTINS, Milton A.; CARVALHO, Celso R. F.Background. The symptoms of asthma impair health-related quality of life (HRQoL), increase anxiety and depression and may keep subjects from engaging in physical exercise. Physical inactivity has been related to poor asthma outcomes; however, the association between physical fitness and psychosocial disorders remains poorly understood. Objective. To verify the association between aerobic capacity, HRQoL, and psychological distress in adults with moderate or severe persistent asthma who were clinically stable. Methods. Eighty-eight participants (68 females) with either moderate or severe persistent asthma (age range, 20-60 years) who were under medical treatment for at least 6 months and considered clinically stable were studied. Participants were evaluated on two non-consecutive days. On the first day, the HRQoL, depression and anxiety levels and pulmonary function were assessed. On the second day, subjects underwent cardiopulmonary exercise testing. Results. Using the agglomerative cluster approach, two clusters were identified: 21 participants (24%) were grouped in Cluster 1, and 67 (76%) were grouped in Cluster 2. Asthmatic subjects from Cluster 1 exhibited increased aerobic capacity, better HRQoL and lower depression levels than did subjects in Cluster 2 (p<.05). No difference was observed between the clusters with respect to gender, age, body mass index (BMI) or pulmonary function (p>.05). The discriminant function model exhibits good accuracy (R-2 = 0.79) and predicted 93% of the case allocations. Conclusion. Our results suggest an association between reduced exercise capacity, low HRQoL and increases in depressive symptoms in clinically stable asthmatic subjects. These results suggest the need to assess physical fitness and psychosocial distress during asthma treatment and the importance of a multidisciplinary approach.
article 9 Citação(ões) na Scopus Objective structured clinical evaluation as an assessment method for undergraduate chest physical therapy students: a cross-sectional study(2011) SILVA, Cibele C. B. M.; LUNARDI, Adriana C.; MENDES, Felipe A. R.; SOUZA, Flavia F. P.; CARVALHO, Celso R. F.Background: The Objective Structured Clinical Evaluation (OSCE) has been considered a reliable method for the evaluation of students' clinical skills in health sciences, but it has been rarely applied in the teaching of physical therapy. Objective: To assess the use of the OSCE as a tool to evaluate the abilities of undergraduate chest physical therapy students and to verify the internal consistency of the OSCE exam. Methods: Forty-seven students were evaluated using two types of exams: the traditional exam and the OSCE. Independent educators elaborated the exams. Each question (traditional) or station (OSCE) was given a score ranging from 0.0 to 2.0; being 10.0 the highest possible score of both exams. The relationship between the total score that were obtained from both exams was analyzed using Bland-Altman analysis and Pearson's correlation coefficient. The internal consistency of the OSCE stations was evaluated by four experienced chest physical therapists and it was tested using Cronbach's alpha. Results: The students average score on the OSCE ranged from 4.4 to 9.6. The internal consistency of the OSCE stations was considered good (0.7). The agreement between exams was analyzed, and it was determined that the exams are not comparable. Examiners also observed a low agreement between the two exams (r=-0.1; p=0.9). Conclusion: Our results showed that OSCE and traditional exams are not interchangeable. The OSCE exam had good internal consistency and is able to evaluate aspects that the traditional exam fails to evaluate.- Seasonal changes influence the improvement in asthma symptoms by exercise training in subjects with asthma**(2019) MENDES, Felipe A. R.; FRANCA-PINTO, Andrezza; MARTINS, Milton A.; CUKIER, Alberto; STELMACH, Rafael; GIAVINA-BIANCHI, Pedro; CARVALHO, Celso R. F.Objective: To investigate whether patients with moderate-to-severe asthma who commence an exercise training program in winter or summer show differences in exercise capacity, health-related quality of life (HRQoL) and asthma symptoms. Methods: Forty-two consecutive subjects visiting the outpatient clinic were enrolled in the 17-week rehabilitation program. One group of patients received the intervention from summer to winter (SWG, n = 21), and the other group participated from winter to summer (WSG, n = 21). Before and after the exercise training program, all patients were evaluated by cardiopulmonary exercise test, pulmonary function test, quality of life questionnaire and a daily diary that evaluated clinical asthma symptoms. Results: After the training period, both groups improved similarly in health-related quality of life (HRQoL) and aerobic capacity. The WSG patients had a greater increase that those in the SWG in asthma symptom-free days (p < 0.05). Conclusions: Our results indicate that seasonal variations affect the improvement in asthma symptoms after an exercise training program but have no effect on health-related quality of life, exercise capacity or pulmonary function.
conferenceObject The effect of acute exercise on the systemic inflammation in patients with moderate or severe asthma(2014) CARVALHO, Celso R. F.; MENDES, Felipe A. R.; FRANCA-PINTO, Andrezza; STELMACH, Rafael; CUKIER, Alberto; MARTINS, Milton