GUILHERME CARLOS BRECH
Projetos de Pesquisa
Unidades Organizacionais
LIM/41 - Laboratório de Investigação Médica do Sistema Músculoesquelético, Hospital das Clínicas, Faculdade de Medicina
8 resultados
Resultados de Busca
Agora exibindo 1 - 8 de 8
- Crash Risk Predictors in Older Drivers: A Cross-Sectional Study Based on a Driving Simulator and Machine Learning Algorithms(2023) SILVA, V. C.; DIAS, A. S.; GREVE, J. M. D.; DAVIS, C. L.; SOARES, A. L. D. S.; BRECH, G. C.; AYAMA, S.; JACOB-FILHO, W.; BUSSE, A. L.; BIASE, M. E. M. de; CANONICA, A. C.; ALONSO, A. C.The ability to drive depends on the motor, visual, and cognitive functions, which are necessary to integrate information and respond appropriately to different situations that occur in traffic. The study aimed to evaluate older drivers in a driving simulator and identify motor, cognitive and visual variables that interfere with safe driving through a cluster analysis, and identify the main predictors of traffic crashes. We analyzed the data of older drivers (n = 100, mean age of 72.5 ± 5.7 years) recruited in a hospital in São Paulo, Brazil. The assessments were divided into three domains: motor, visual, and cognitive. The K-Means algorithm was used to identify clusters of individuals with similar characteristics that may be associated with the risk of a traffic crash. The Random Forest algorithm was used to predict road crash in older drivers and identify the predictors (main risk factors) related to the outcome (number of crashes). The analysis identified two clusters, one with 59 participants and another with 41 drivers. There were no differences in the mean of crashes (1.7 vs. 1.8) and infractions (2.6 vs. 2.0) by cluster. However, the drivers allocated in Cluster 1, when compared to Cluster 2, had higher age, driving time, and braking time (p < 0.05). The random forest performed well (r = 0.98, R2 = 0.81) in predicting road crash. Advanced age and the functional reach test were the factors representing the highest risk of road crash. There were no differences in the number of crashes and infractions per cluster. However, the Random Forest model performed well in predicting the number of crashes.
- Men and women do not have the same relation between body composition and bone mineral density in Brazilian people(2017) ALONSO, A. C.; RIBEIRO, T. C.; FERREIRA, R. B.; DUARTE, R.; BRECH, G. C.; SILVA, L. X.; BOCALINI, D. S.; PETERSON, M.; MAIFRINO, L. B. M.; GREVE, J. M. D. A.Objectives: The main objective this study was to examine if lean mass and the adiposity related with BMD in a eutrophic population of Brazilian adults, in different sites and gender. Methods: A crossectional observational study, without intervention. One hundred non-obese men and women, aged 20-40 years, who did not practice regular physical activity were evaluated. Body composition analysis was conducted by dual energy X-ray absorptiometry (DXA), and multiple regression was used to examine the sex-specific association between adiposity and lean mass profiles. Results: Even after adjusting for age, sex, and BMI, total fat mass was inversely associated with total BMD (β=-4.52 g/cm2, p<0.01). Lean mass was positively associated with BMD and female groups. In our study the lean mass has a postive effect in BMD for eutrophic Brazilian adults, opposite of adiposity. Although when stratified by gender, in adults women lean mass and adiposity have positive effects on BMD, which did not happen with men. © 2017, Brazilian Society of Anatomy. All rights reserved.
- The Influence of Whey Protein on Muscle Strength, Glycemic Control and Functional Tasks in Older Adults with Type 2 Diabetes Mellitus in a Resistance Exercise Program: Randomized and Triple Blind Clinical Trial(2023) SOARES, A. L. D. S.; MACHADO-LIMA, A.; BRECH, G. C.; GREVE, J. M. D.; SANTOS, J. R. dos; INOJOSSA, T. R.; ROGERO, M. M.; SALLES, J. E. N.; SANTAREM-SOBRINHO, J. M.; DAVIS, C. L.; ALONSO, A. C.Objectives: To evaluate the effect of whey protein (WP) supplementation associated with resistance training (RT) on glycemic control, functional tasks, muscle strength, and body composition in older adults living with type 2 diabetes mellitus (T2DM). Secondly, to evaluate the safety of the protocol for renal function. Methods: The population comprised twenty-six older men living with T2DM (68.5 ± 11.5 years old). The participants were randomly assigned to the Protein Group (PG) and the Control Group (CG). The handgrip test and evolution of exercise loads, according to the Omni Resistance Exercise Scale, evaluated muscle strength. Functional tasks were assessed by force platform in three different protocols: Sit-to-Stand, Step/Quick Turn, and Step Up/Over. Body composition was evaluated by bioimpedance and glycemic control and renal function were assessed by biochemical analyses. Both groups performed RT for 12 weeks, twice a week, prioritizing large muscle groups. Protein supplementation was 20 g of whey protein isolate and the CG was supplemented with an isocaloric drink, containing 20 g of maltodextrin. Results: There was a significant difference in muscle strength, according to the evolution of the exercise loads, but it was not confirmed in the handgrip test. However, there was no significant difference between the groups, regarding performance in functional tasks, glycemic control, or body composition. Renal function showed no alteration. Conclusion: The intake of 20 g of WP in older male adults living with T2DM did not increase the effect of RT on muscle strength, functional tasks, and glycemic control. The intervention was proven safe regarding renal function.
- The variability of isokinetic ankle strength is different in healthy older men and women(2022) BERSOTTI, Felipe Marrese; MOCHIZUKI, Luis; BRECH, Guilherme Carlos; SOARES, Andre Luiz de Seixas; SOARES-JUNIOR, Jose Maria; BARACAT, Edmund Chada; GREVE, Julia Maria D. 'Andrea; ALONSO, Angelica CastilhoContext: In the elderly, weak lower limb muscles impair functional tasks' performance. Objective: To evaluate the healthy elderly's ankle dorsiflexion and plantarflexion maximum torque and its variability in two sets of 5 RM isokinetics evaluation. Method: 50 women (68.0 +/- 4.6 years old) and 50 men (72.7 +/- 8.5 years old) did two sets of ankle plantar flexor and dorsiflexor isokinetic tests at 30 degrees/s. Peak torque, total work, and coefficient of variation were analyzed. Results: Men did the strongest plantarflexion torque (p < 0.05) and dorsiflexion torque (p < 0.05); their highest peak torque occurred at set 2 (p < 0.05), while the largest plantarflexion torque variability (p < 0.05), dorsiflexion torque variability (p < 0.05), and the largest plantarflexion torque variability occurred at set 1 (p < 0.05). Men did the highest plantarflexion and dorsiflexion total work (p < 0.05) at set 2 (p < 0.05). Conclusion: Older men are stronger than older women. The torque variability, in men, was higher during the first set, suggesting an adaptation to the isokinetics evaluation. Clinicians and researchers should consider that different muscles might need different numbers of sets and trials to measure their maximal muscle strength.
- Effect of concurrent training in unilateral transtibial amputees using Paralympic athletes as a control group(2023) GRECCO, Marcus Vinicius; BRECH, Guilherme Carlos; SOARES-JUNIOR, Jose Maria; BARACAT, Edmund Chada; GREVE, Julia Maria D'Andrea; SILVA, Paulo Roberto SantosContext: Transtibial Amputation (TA) predisposes to a sedentary lifestyle.Objectives: To evaluate the efficiency of a short-term (8-week) Concurrent Training (CT) program in Unilateral Transtibial Amputees (UTA) and to compare it with the physical condition of a group of Paralympic athletes in preparation for the Rio de Janeiro Paralympics.Design: This was a longitudinal, prospective and controlled trial study.Methods: Thirty-four male subjects with UTA and using prostheses for six months or more were selected for this study. They were divided into two groups: Group 1 (G1) -17 non-athlete and untrained UTA and Group 2 (G2) -17 paralympic athletes with active UTA in the training phase. G1 was evaluated before and after eight weeks of CT and G2 made a single evaluation for control. All were submitted to anamnesis, clinical evaluation (blood pres-sure, electrocardiogram, and heart rate) and cardiopulmonary exercise testing on a lower limb cycle ergometer, and isokinetic knee dynamometry. The CT of G1 included resistance exercise and aerobic interval training on a stationary bicycle and G2 followed the training of the Paralympic teams.Results: Patients were retested by the same methods after CT. The two most important central dependent variables (maximal oxygen uptake and muscular strength) increased by 22% and knee extensor and flexor strength by 106% and 97%, respectively.Conclusion: After eight weeks of CT, there was an improvement in general functional condition, muscle strength, and cardiorespiratory performance improving protection against chronic diseases and quality of life.
- The eight-week concurrent training effect on functional capacity in person living with unilateral transtibial amputation: A randomized controlled trial(2023) GRECCO, Marcus Vinicius; BRECH, Guilherme Carlos; CAMARGO, Cristina Pires; SANTOS-SILVA, Paulo Roberto; GREVA, Julia Maria D'AndreaIntroduction: The main causes of amputation include vascular diseases, trauma, cancer, and congenital limb abnormalities. The person with transtibial amputation (TA) is affected by a greater cardiorespiratory, metabolic, and muscular load to walk and perform daily activities. The sedentary lifestyle contributes to the process of chronic non-communicable diseases. The purpose of the study was to compare the effects of eight-week concurrent training (CT) for dependent variables as muscle strength, cardiorespiratory fitness, agility, and postural balance in persons with unilateral TA.Methods: A eight-week, randomized, controlled trial. Thirty-one people using prostheses for three or more months were selected. They were randomly divided into two groups: Experimental Group (EG; n = 17) -concurrent training and Control group (CG; n = 14) -no training. All patients were evaluated at the baseline and after eight weeks by the functional performance, isokinetic knee evaluation, static and dynamic posturography and cardiopulmonary test. Results: The patients showed improvements in all measures after training (size effect >0.80).Conclusion: The main limitations are the sample size, related to the socioeconomic status and availability training and no comparison to other types of training. Eight weeks of CT was effective and favorably modified the dependent variables in TA patients. Therefore, CT is a good option to improve functional performance after the regular rehabilitation program discharge and decreases the metabolic and func-tional deficits of these patients.(c) 2022 Elsevier Ltd. All rights reserved.
- Adaptation to the driving simulator and prediction of the braking time performance, with and without distraction, in older adults and middle-aged adults(2023) CANONICA, Alexandra Carolina; ALONSO, Angelica Castilho; BRECH, Guilherme Carlos; PETERSON, Mark; LUNA, Natalia Mariana Silva; BUSSE, Alexandre Leopold; JACOB-FILHO, Wilson; ROSA, Juliana Leme; SOARES-JUNIOR, Jose Maria; BARACAT, Edmund Chada; GREVE, Julia Maria D'AandreaContext: Many studies show the importance of evaluating the adaptation time of subjects in a virtual driving environment, looking forwards to a response as closest as a possible real vehicle. Objectives: This study aimed to identify and analyze the adaptation to the driving simulator in older adults and middle-aged adults with and without a distraction, and a secondary aim was to identify predictors of safe performance for older adults' drives.Design: Male and female middle-aged adults (n = 62, age = 30.3 +/- 7.1 years) and older adults (n = 102, age = 70.4 +/- 5.8 years) were evaluated for braking time performance in a driving simulator; cognition performance assessment included the Mini-Mental State Examination; motor evaluation included ankle flexor muscle strength with the isokinetic dynamometer and handgrip strength; the postural balance was evaluated with Timed Up and Go test, with and without a cognitive distraction task.Results: Older adults (men and women) and middle-aged adult women require more time to adapt to the driving simulator. The distractor increases the adaptation time for all groups. The main predictors of braking time for older women are age, muscle strength, and postural balance associated with distraction, and for older men, muscle strength.Conclusions: Age, sex, and distractor interfere in the adaptation of the virtual task of driving in a simulator. The evaluation model developed with multi-domains demonstrated the ability to predict which skills are related to braking time with and without the presence of the distractor.
- Quality of life and socio-demographic factors associated with nutritional risk in Brazilian community-dwelling individuals aged 80 and over: cluster analysis and ensemble methods(2024) BRECH, Guilherme Carlos; SILVA, Vanderlei Carneiro da; ALONSO, Angelica Castilho; MACHADO-LIMA, Adriana; SILVA, Daiane Fuga da; MICILLO, Glaucia Pegorari; BASTOS, Marta Ferreira; AQUINO, Rita de Cassia deIntroductionThe aim of the present study was to use cluster analysis and ensemble methods to evaluate the association between quality of life, socio-demographic factors to predict nutritional risk in community-dwelling Brazilians aged 80 and over.MethodsThis cross-sectional study included 104 individuals, both sexes, from different community locations. Firstly, the participants answered the sociodemographic questionnaire, and were sampled for anthropometric data. Subsequently, the Mini-Mental State Examination (MMSE) was applied, and Mini Nutritional Assessment Questionnaire (MAN) was used to evaluate their nutritional status. Finally, quality of life (QoL) was assessed by a brief version of World Health Organizations' Quality of Life (WHOQOL-BREF) questionnaire and its older adults' version (WHOQOL-OLD).ResultsThe K-means algorithm was used to identify clusters of individuals regarding quality-of-life characteristics. In addition, Random Forest (RF) and eXtreme Gradient Boosting (XGBoost) algorithms were used to predict nutritional risk. Four major clusters were derived. Although there was a higher proportion of individuals aged 80 and over with nutritional risk in cluster 2 and a lower proportion in cluster 3, there was no statistically significant association. Cluster 1 showed the highest scores for psychological, social, and environmental domains, while cluster 4 exhibited the worst scores for the social and environmental domains of WHOQOL-BREF and for autonomy, past, present, and future activities, and intimacy of WHOQOL-OLD.ConclusionHandgrip, household income, and MMSE were the most important predictors of nutritional. On the other hand, sex, self-reported health, and number of teeth showed the lowest levels of influence in the construction of models to evaluate nutritional risk. Taken together, there was no association between clusters based on quality-of-life domains and nutritional risk, however, predictive models can be used as a complementary tool to evaluate nutritional risk in individuals aged 80 and over.