GUILHERME CARLOS BRECH
Projetos de Pesquisa
Unidades Organizacionais
LIM/41 - Laboratório de Investigação Médica do Sistema Músculoesquelético, Hospital das Clínicas, Faculdade de Medicina
6 resultados
Resultados de Busca
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- Brake response time between male drivers with and without paraplegia: Association between sociodemographic, motor and neurological characteristics(2021) SANTOS, Sileno; BRECH, Guilherme Carlos; ALONSO, Angelica Castilho; GREVE, Julia Maria D'AndreaObjective: The objective of this study was to compare the brake response time of drivers with paraplegia (who use hand control) with drivers without paraplegia (who use their feet) in a virtual driving simulator brake test. Additionally, we aimed to predict and evaluate the association of virtual brake response time with sociodemographic, motor and cognitive variables. Methods: 40 male adult drivers, with paraplegia (n = 20, mean age 38.1 +/- 3.6 years) and without paraplegia (n = 20, mean age 38.0 +/- 5.8 years), with valid driver licenses, had their brake response time evaluated in an automatic transmission car simulator. Non-disabled drivers were tested with conventional foot controls, while paraplegic drivers used hand controls. Drivers with paraplegia performed simple, choice and go/no-go reaction time tests as neuropsychological evaluations. Student's t-test was used to examine the differences of driving simulator brake response time between groups. Pearson coefficient verified the correlation of driving simulator brake response time with years of driving, length of disability, handgrip strength and neuropsychological tests of the paraplegic drivers. A regression model was developed to describe the mean of driving simulator brake response time using the backward elimination method for model adjustment selecting the explanatory variables. Results: Differences of simulator brake response time between groups were not statistically significant (non-paraplegic drivers = 0.90 seconds; paraplegic drivers = 0.92 seconds, p > 0.05). Years of driving significantly correlates with brake response time of paraplegic driver (r= -58, p = 0.009). Linear regression analyses indicated that years of schooling and years of driving (explanatory variables) explained 60.2% of driving simulator brake response time for the drivers with paraplegia. Driving simulator brake response time showed no difference between drivers with and without paraplegia. Years of driving and schooling were the main predictors of braking performance in drivers with paraplegia measured in a driving simulator.
- DYNAMIC POSTURAL BALANCE IS MEDIATED BY ANTHROPOMETRY AND BODY COMPOSITION IN OLDER WOMEN(2021) BRECH, Guilherme Carlos; FREITAS, Jessica Sillas de; GOUVEA, Marcia; MACHADO-LIMA, Adriana; BASTOS, Marta Ferreira; TAKAYAMA, Liliam; PEREIRA, Rosa Maria Rodrigues; GREVE, Julia Maria D'Andrea; ALONSO, Angelica CastilhoObjective: To investigate the relationship between anthropometry and body composition with dynamic postural balance in elderly women with low bone mineral density (BMD). Methods: 45 older women (>= 60 years), low BMD and nutritional diagnosis of low weight to overweight. For the assessment of body composition, Dual energy X-ray emission densitometry and anthropometric examination were used to measure: body mass (kg), height (cm) and BMI (k/m(2)). The assessment of dynamic postural balance was performed by the mini Balance Master Evaluation System clinical test and the computerized Balance Master (R) System test by the Sit to Stand and Step Up/Over tests. Results: There was a negative correlation between miniBESTest (r = - 0.566; p = 0.001) and time to ascend and descend step (r = - 0.393; p = 0.007) with fat mass, and positive correlation with miniBESTest (r = 0.526; p =0.001) and time to go up and down a step with muscle mass (r = 0.297; p = 0.04). As for anthropometric variables, only height showed a positive correlation (r = 0.296; p = 0.04) with the speed in the sit and stand test. Conclusion: Lean mass reduces postural oscillations; in contrast, fat mass negatively interfered with dynamic postural balance in women with low BMD. Height was related to dynamic postural balance, the taller the elderly, the worse their balance.
- Biomechanical evaluation in runners with Achilles tendinopathy(2021) ANDERE, Nathalie Ferrari Bechara; GODOY, Alexandre Leme; MOCHIZUKI, Luis; RODRIGUES, Marcelo Bordalo; FERNANDES, Tulio Diniz; SOARES-JUNIOR, Jose Maria; ALONSO, Angelica Castilho; LUNA, Natalia Mariana Silva; BRECH, Guilherme Carlos; GREVE, Julia Maria D'AndreaOBJECTIVES: To evaluate the clinical characteristics, ground reaction force (GRF), and function of the plantar muscles and dorsiflexors of the ankle in runners with and without Achilles tendinopathy (AT) and in non-runners. METHODS: Seventy-two participants (42 men, 30 women; mean age: 37.3 +/- 9.9 years) were enrolled in this cross-sectional study and divided into three groups: AT group (ATG, n=24), healthy runners' group (HRG, n=24), and non-runners' group (NRG, n=24). Both ankles were evaluated in each group. The American Orthopedic Foot and Ankle Society (AOFAS) Ankle-Hindfoot Scale was used for clinical and functional evaluation. GRF was evaluated using force plates and muscle strength was evaluated using an isokinetic dynamometer. RESULTS: The AOFAS scores were lower in the ATG. The strike impulse was higher in the ATG than in the HRG and NRG. However, GRF was similar among the groups. The ATG exhibited lower total work at 120 degrees/s speed than the HRG. The peak torque in concentric dorsiflexion was lower in the NRG than in the ATG and HRG. The peak torque and total work in concentric plantar flexion were lower in the NRG than in the ATG. The peak torque and total work in eccentric plantar flexion were lower in the NRG than in the ATG and HRG. CONCLUSION: Runners with AT showed higher strike impulse, lower muscle strength of the plantar flexors, and higher clinical and functional damage.
- Effects of pilates on physical-functional performance, quality of life and mood in older adults: Systematic review and meta-analysis of randomized clinical trials(2021) METZ, Vanessa Raquel; SCAPINI, Katia Bilhar; GOMES, Amanda Lorena Dias; ANDRADE, Rodrigo Maciel; BRECH, Guilherme Carlos; ALONSO, Angelica CastilhoObjective: To systematically review the effects of pilates on physical-functional aspects and quality of life of older adults. Methods: We included randomized clinical trials whose participants were older adults, whose intervention was pilates exercises and that used a control group for comparison. The primary outcomes were balance, muscle strength, quality of life. Secondary outcomes were mood, autonomy, and flexibility. The searches were performed in the electronic databases Pubmed, Web of Science, LILACS, Cochrane Library and EMBASE, using terms from MeSH: Aged, elderly, Pilates-Based Exercises, Pilates Training, Pilates, Mat Pilates, Equipment-based Pilates, and synonyms, in May 2020. The meta-analysis, when possible, was performed using the mean and standard deviation values of the groups after the intervention period using the random effects model. Results: The search rendered 1639 studies, of which 28 articles corresponding to 24 ECRs (897 individuals) were included, most of the studies involved a female population. A meta-analysis was performed only in the balance variable, through the Berg Scale (three RCTs), where there were no significant differences between the intervention and control groups (2.06-95% CI: 1.31, 5.44, I-2: 91%), and it was evaluated by the TUG (six RCTs), which showed a reduction of 0.92 seconds in the protocol execution (95% CI: 1.67,-0.17, I-2: 62%). Conclusion: This review demon-strate that the practice of pilates by older adults may have positive effects on some of the outcomes evaluated, these results should be interpreted with caution (methodological heterogeneity and a part present high risk of bias).
- Vitamin D supplementation associated with 12-weeks multimodal training in older women with low bone mineral density: A randomized double-blind placebo-controlled trial(2021) BRECH, Guilherme Carlos; MACHADO-LIMA, Adriana; BASTOS, Marta Ferreira; BONIFACIO, Wilson de Jesus; PETERSON, Mark D.; TAKAYAMA, Liliam; PEREIRA, Rosa Maria R.; GREVE, Julia Maria D. 'Andrea; ALONSO, Angelica CastilhoObjective: To evaluate the influence of vitamin D supplementation with a multimodal exercise program on postural balance and muscle strength in older women with low bone mineral density (BMD) and vitamin D insufficiency. Methods: 12-week, randomized, double-blind, placebo-controlled clinical trial. Total of 422 subjects were screened for participation, and 46 met the inclusion criteria. Those were randomized into an experimental group (EG; n = 23) and control group (CG; n = 23). At the time of enrollment, all subjects had low BMD, vitamin D insufficiency, and were not practicing resistance exercise. Muscle strength assessments were performed by the 30-s sit to stand test; 15-steps climbing test; handgrip dynamometer and knee muscle strength using an isokinetic dynamometer at 60 degrees /sec. Postural balance was clinically evaluated by the MiniBESTest and by a force platform. Dynamic balance was assessed by standing up from a chair and walk over a step, using also a force platform. Results: In the EG, vitamin D levels increased in the post-treatment period (P < 0.001) whereas in CG levels remained unchanged (P = 0.86). Both groups improved muscular strength in the dynamometry isokinetic test: flexors PT/BW - right (P < 0.02) and left side (P < 0.04). In the dynamic postural balance during the task to step up over: the Lift Up Left was better in the CG (P = 0.01); the Moment Time left was better in the CG (P = 0.01); the Impact index left was better in the EG (P = 0.01). The Mini-BESTest - both groups improved the postural balance test (P < 0.001). Conclusion: Vitamin D supplementation associated with multimodal exercise program did not augment muscle strength adaptation or postural balance in older women with low bone mineral density and vitamin D insufficiency.
- Physical and pulmonary capacities of individuals with severe coronavirus disease after hospital discharge: A preliminary cross-sectional study based on cluster analysis(2021) ALONSO, Angelica Castilho; SILVA-SANTOS, Paulo Roberto; QUINTANA, Marilia Simoes Lopes; SILVA, Vanderlei Carneiro da; BRECH, Guilherme Carlos; BARBOSA, Lorena Goncalves; POMPEU, Jose Eduardo; SILVA, Erika Christina Gouveia e; SILVA, Elizabeth Mendes da; GODOY, Caroline Gil de; GREVE, Julia Maria D'AndreaOBJECTIVE: This study aimed to analyze the physical and pulmonary capacities of hospitalized patients with severe coronavirus disease and its correlation with the time of hospitalization and complications involved. METHODS: A total of 54 patients, aged >= 18 years of both sexes, were evaluated 2-4 months after hospital discharge in Sao Paulo, Brazil. The physical characteristics analyzed were muscle strength, balance, flexibility, and pulmonary function. The K-means cluster algorithm was used to identify patients with similar physical and pulmonary capacities, related to the time of hospitalization. RESULTS: Two clusters were derived using the K-means algorithm. Patients allocated in cluster 1 had fewer days of hospitalization, intensive care, and intubation than those in cluster 2, which reflected a better physical performance, strength, balance, and pulmonary condition, even 2-4 months after discharge. Days of hospitalization were inversely related to muscle strength, physical performance, and lung function: hand grip D (r= -0.28, p=0.04), Short Physical Performance Battery score (r= -0.28, p=0.03), and forced vital capacity (r= -0.29, p=0.03). CONCLUSION: Patients with a longer hospitalization time and complications progressed with greater loss of physical and pulmonary capacities.