REBECA BOLTES CECATTO
Projetos de Pesquisa
Unidades Organizacionais
IRLM, Hospital das Clínicas, Faculdade de Medicina - Médico
LIM/45 - Laboratório de Fisiopatologia Neurocirúrgica, Hospital das Clínicas, Faculdade de Medicina
LIM/45 - Laboratório de Fisiopatologia Neurocirúrgica, Hospital das Clínicas, Faculdade de Medicina
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conferenceObject Rehabilitation in lung cancer(2013) BRITO, C. M. M.; ALMEIDA, E. M. P. de; SAUL, M.; CECATTO, R. B.; ANDRADE, R. G.; IMAMURA, M.; BATTISTELLA, L. R.- Safety and Feasibility of Outpatient Rehabilitation in Patients With Secondary Bone Cancer: A Preliminary Study(2021) TABACOF, Laura; DELGADO, Andrew; DEWIL, Sophie; REIS, Fabiana; VELAR, Camila Molina; CORTELINE, Munique Egle Dona; CECATTO, Rebeca Boltes; PUTRINO, David; IMAMURA, Marta; BATTISTELLA, Linamara Rizzo; BRITO, Christina May Moran deBackground: Because of fear of skeletal complications, physicians often avoid referring patients with secondary bone cancer (SBC) to physical rehabilitation. However, there is little evidence on the risk of skeletal-related events (SREs) and pathological fracture (PF) during rehabilitation therapies. Objective: To determine the risk of PF following physical rehabilitation in people with SBC. Design: Single-group, single-centered interventional clinical trial. Setting: University-based outpatient rehabilitation clinic. Patients: Forty-eight patients with confirmed diagnosis of SBC were enrolled. Interventions: Participants were prescribed a multidisciplinary rehabilitation program. Participants and rehabilitation therapists were trained to detect and report symptoms that would indicate PF. Radiographs were used to confirm the presence of PF. Measurements: The primary outcomes were safety and feasibility of an outpatient rehabilitation program for patients with SBC. Safety was measured by the rate of SREs. Feasibility was measured by the ability to successfully complete the program. Secondary outcome measures included Short Form Health Survey (SF-36) and numeric rating scale (NRS) scores to assess pain intensity. Results: One PF was detected, which occurred outside of rehabilitation therapy. Two other SREs occurred, resulting in a total event rate of 11.8 for every 10 000 hours of exposure. There was a significant improvement in NRS (95% CI, 1.41-3.08, P < .001) and SF-36 measures (95% CI, 80.35-158.11, P < .001). Limitations: Twenty participants (42%) did not complete the rehabilitation program due to clinical complications or death. Conclusions: Rehabilitation interventions may not increase the risk of SREs or PF in patients with SBC. Further research is indicated to verify these findings.
- Early mobilization programme improves functional capacity after major abdominal cancer surgery: a randomized controlled trial(2017) ALMEIDA, E. P. M. de; ALMEIDA, J. P. de; LANDONI, G.; GALAS, F. R. B. G.; FUKUSHIMA, J. T.; FOMINSKIY, E.; BRITO, C. M. M. de; CAVICHIO, L. B. L.; ALMEIDA, L. A. A. de; RIBEIRO- JR., U.; OSAWA, E. A.; DIZ, M. P. E.; CECATTO, R. B.; BATTISTELLA, L. R.; HAJJAR, L. A.Background: Major abdominal oncology surgery is associated with substantial postoperative loss of functional capacity, and exercise may be an effective intervention to improve outcomes. The aim of this study was to assess efficacy, feasibility and safety of a supervised postoperative exercise programme. Methods: We performed a single-blind, parallel-arm, randomized trial in patients who underwent major abdominal oncology surgery in a tertiary university hospital. Patients were randomized to an early mobilization postoperative programme based on supervised aerobic exercise, resistance and flexibility training or to standard rehabilitation care. The primary outcome was inability to walk without human assistance at postoperative day 5 or hospital discharge. Results: A total of 108 patients were enrolled, 54 into the early mobilization programme group and 54 into the standard rehabilitation care group. The incidence of the primary outcome was nine (16.7%) and 21 (38.9%), respectively (P = 0.01), with an absolute risk reduction of 22.2% [95% confidence interval (CI) 5.9-38.6] and a number needed to treat of 5 (95% CI 3-17). All patients in the intervention group were able to follow at least partially the exercise programme, although the performance among them was rather heterogeneous. There were no differences between groups regarding clinical outcomes or complications related to the exercises. Conclusions: An early postoperative mobilization programme based on supervised exercises seems to be safe and feasible and improves functional capacity in patients undergoing major elective abdominal oncology surgery. However, its impact on clinical outcomes is still unclear.