FELIPE AUGUSTO RODRIGUES MENDES
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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 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.
- 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- 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.
- 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 Effect of aerobic exercise training on bronchial hyperresponsiveness, airway inflammation and health related quality of life in asthmatic patients: A pilot study(2012) PINTO, Andrezza; MENDES, Felipe; AGONDI, Rosana; SARAIVA-ROMANHOLO, Beatriz; STELMACH, Rafael; CUKIER, Alberto; MARTINS, Milton; KALIL, Jorge; CARVALHO, Celso; GIAVINA-BIANCHI, Pedro