JULIA MARIA D ANDREA GREVE
Projetos de Pesquisa
Unidades Organizacionais
Departamento de Ortopediae Traumatologia, Faculdade de Medicina - Docente
Instituto de Ortopedia e Traumatologia, Hospital das Clínicas, Faculdade de Medicina - Médico
LIM/41 - Laboratório de Investigação Médica do Sistema Músculoesquelético, Hospital das Clínicas, Faculdade de Medicina - Líder
Instituto de Ortopedia e Traumatologia, Hospital das Clínicas, Faculdade de Medicina - Médico
LIM/41 - Laboratório de Investigação Médica do Sistema Músculoesquelético, Hospital das Clínicas, Faculdade de Medicina - Líder
80 resultados
Resultados de Busca
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- Prescribing and Regulating Exercise with RPE after Heart Transplant: A Pilot Study(2015) CIOLAC, Emmanuel Gomes; CASTRO, Rafael Ertner; GREVE, Julia Maria D'Andrea; BACAL, Fernando; BOCCHI, Edimar Alcides; GUIMARAES, Guilherme VeigaPurpose The objective of this study is to analyze the use of the 6-20 RPE scale for prescribing and self-regulating heated water-based exercise (HEx) and land-based exercise (LEx) in heart transplant recipients. Methods Fifteen (five females) clinically stable heart transplant recipients (time since surgery = 4.0 2.5 yr) age 46.7 11.8 yr underwent a symptom-limited maximal graded exercise test on a treadmill to determine their HR at anaerobic threshold (HRAT), respiratory compensation point (HRRCP), and maximal effort (HRmax). After a week, patients were randomized to perform 30 min of both HEx (walking inside the pool) and LEx (treadmill walking) sessions at a pace between 11 and 13 on the 6-20 RPE scale and had their HR measured every 4 min. The interval between sessions was 48-72 h. Results No significant differences between sessions were found in the average HR during HEx and LEx. Patients showed a delay in HR increase during both interventions, with the stabilization beginning after 8 min of exercise. Exercise HR was maintained between the HRAT and HRRCP (in the aerobic exercise training zone) for the most part of both HEx (72% of HR measurements) and LEx (66% of HR measurements). Only a few HR measurements stayed below HRAT (HEx = 9%, LEx = 13%) or above HRRCP (HEx = 19%, LEx = 21%) during both exercise sessions. Conclusion Exercise HR was maintained in the aerobic exercise training zone (between HRAT and HRRCP) for the most part of both sessions, suggesting that the 6-20 RPE scale may be an efficient tool for prescribing and self-regulating HEx and LEx in heart transplant recipients.
- Trunk Function Correlates Positively with Wheelchair Basketball Player Classification(2017) SANTOS, Sileno da Silva; KRISHNAN, Chandramouli; ALONSO, Angelica Castilho; GREVE, Julia Maria D'AndreaObjective: The aims of this study were (1) to identify differences in trunk muscle strength and balance among various classes of wheelchair basketball (WCB) players and (2) to determine if trunk muscle strength and balance correlate with the current observation-based classification of WCB players. Design: Isometric trunk strength and balance (limits of stability) were objectively quantified in 42 male WCB players. Principal component analysis was used to synthesize a battery of strength and balance measures into a single, composite score of trunk function. The K-means clustering algorithm was then used to generate an objective classification system by stratifying players into 4 classes based on their trunk function. Results: Results indicated that there were significant differences in trunk muscle strength and balance between various classes of WCB players (P < 0.05), such that the mean peak trunk extensor and flexor torque and limits of stability indices increased progressively according to the players' classes. There was also a significant correlation between observation-based WCB classification and principal component analysis cluster analysis-based WCB classification (rho = 0.785, P < 0.05). Conclusions: This study provides novel evidence indicating that trunk strength and balance differ among various classes of WCB players, and objective measures of trunk function correlate positively with the current observation-based WCB classification system.
- INTERSET STRETCHING VS. TRADITIONAL STRENGTH TRAINING: EFFECTS ON MUSCLE STRENGTH AND SIZE IN UNTRAINED INDIVIDUALS(2019) EVANGELISTA, Alexandre L.; SOUZA, Eduardo O. De; MOREIRA, Daniella C. B.; ALONSO, Angelica Castilho; TEIXEIRA, Caue Vasquez La Scala; WADHI, Tanuj; RAUCH, Jacob; BOCALINI, Danilo S.; PEREIRA, Paulo Eduardo De Assis; GREVE, Julia Maria D'AndreaThis study compared the effects of 8 weeks of traditional strength training (TST) and interset stretching (ISS) combined with TST on muscular adaptations. Twenty-nine sedentary, healthy adults were randomly assigned to either the TST (n = 17; 28.0 +/- 6.4 years) or ISS (n = 12; 26.8 +/- 6.1 years) group. Both groups performed 6 strength exercises encompassing the whole body (bench press, elbow extension, seated rows, biceps curl, knee extension, and knee flexion) performing 4 sets of 8-12 repetition maximum (RM) with a 90-second rest between sets. However, the ISS group performed static passive stretching, at maximum amplitude, for 30 seconds between sets. Both groups performed training sessions twice a week on nonconsecutive days. Muscle strength (i.e., 1RM) and hypertrophy (i.e., muscle thickness [MT] by ultrasonography) were measured at pre-test and after 8 weeks of training. Both groups increased 1RM bench press (p <= 0.0001): ISS (23.4%, CIdiff: 4.3 kg-11.1 kg) and TST (22.2%, CIdiff: 5.2 kg-10.9 kg) and 1RM knee extension (p <= 0.0001): ISS (25.5%, CIdiff: 5.6 kg-15.0 kg) and TST (20.6%, CIdiff: 4.4 kg-12.3 kg). Both groups increased MT of biceps brachii (BIMT), triceps brachii (TRMT), and rectus femoris (RFMT) (p <= 0.0001). BIMT: ISS (7.2%, CIdiff: 1.14-3.5 mm) and TST (4.7%, CIdiff: 0.52.5 mm), TRMT: ISS (12.3%, CIdiff: 1.1-4.4 mm) and TST (7.1%, CIdiff: 0.3-3.1 mm), and RFMT: ISS (12.4%, CIdiff: 1.1-2.9 mm) and TST (9.1%, CIdiff: 0.7-2.2 mm). For vastus lateralis muscle thickness (VLMT) and sum of the 4 muscle thickness sites (Sigma MT), there was a significant group by time interaction (p <= 0.02) in which ISS increased VLMT and Sigma MT to a greater extent than TST. Vastus lateralis muscle thickness: ISS (17.0%, CIdiff: 1.5-3.1 mm) and TST (7.3%, CIdiff: 0.7-2.1 mm), and Sigma MT: ISS (10.5%, CIdiff: 6.5-9.0 mm) and TST (6.7%, CIdiff: 3.9-8.3 mm). Although our findings might suggest a benefit of adding ISS into TST for optimizing muscle hypertrophy, our data are not sufficient enough to conclude that ISS is superior to TST for inducing muscle hypertrophic adaptations. More studies are warranted to elucidate the effects of ISS compared with TST protocols on skeletal muscle. However, our findings support that adding ISS to regular TST regimens does not compromise muscular adaptations during the early phase of training (<8 weeks) in untrained individuals.
- Alcohol and drug involvement in motorcycle driver injuries in the city of Sao Paulo, Brazil: Analysis of crash culpability and other associated factors(2016) CARVALHO, Heraclito Barbosa de; ANDREUCCETTI, Gabriel; REZENDE, Marcelo Rosa; BERNINI, Celso; SILVA, Jorge Santos; LEYTON, Vilma; GREVE, Julia Maria D'AndreaBackground: Earlier studies have already identified that a greater proportion of injured drivers are under the effects of illicit drugs than alcohol in Brazil, but the crash risk attributable to each substance is still unknown. Methods: Injured motorcycle drivers who were involved in traffic accidents in the West Zone of the city of Sao Paulo were recruited for a cross-sectional study based on crash culpability analysis. Alcohol and drug positivity among drivers was evaluated according to their responsibility for the crash. Culpability ratios were generated based on the proportion of drivers who were deemed culpable in relation to those considered not culpable according to the use of drugs and alcohol. Results: Of the 273 drivers recruited, 10.6% tested positive for alcohol. Among those who were also tested for drugs (n=232), 20.3% had consumed either alcohol and/or other drugs, 15.5% of whom were positive only for drugs other than alcohol, specifically cannabis and cocaine. Drivers who tested positive for alcohol were significantly less likely to possess a valid driver's license and to report driving professionally, whereas those who had consumed only drugs were more likely to drive professionally. The culpability ratio estimated for alcohol-positive drivers was three times higher than that for alcohol-free drivers, showing a superior ratio than drivers who had consumed only drugs other than alcohol, who presented a 1.7 times higher culpability ratio than drug-free drivers. Conclusion: Substance use was overrepresented among culpable motorcycle drivers, with alcohol showing a greater contribution to crash culpability than other drugs.
conferenceObject Proteins Or Carbohydrates Influence On Strength And Functionality After Exercising In Elderly Type Ii Diabetics.(2020) SOARES, Andre Luiz de Seixas; MACHADO-LIMA, Adriana L.; GREVE, Julia M.; BECKER, Ricardo A.; INOJOSA, Thiago R.; ARAUJO, Grazzyelle S.; MARCOLINO, Bruna A.; MATOS, Daiane A.; RODRIGUES, Joselma; SILVA, Keren R. da; ALONSO, Angelica C.- Predictors of quality of life of individuals living in Brazil with spinal cord injury/disease(2023) CHRISTOFI, Alice A. S. N.; TATE, Denise G.; WITTER, Carla; ALONSO, Angelica Castilho; GREVE, Julia Maria D'AndreaStudy designA cross-sectional, descriptive study.ObjectivesTo investigate the demographic, clinical behavioral, and rehabilitation predictors of the quality of life (QoL) of people with spinal cord injury/disease (SCI/D) in a middle-income country.MethodNinety-five participants living in the community were evaluated with the following instruments: World Health Organization Quality of Life - Bref; International SCI Core DataSet; Clinical Interview; Spinal Cord Secondary Conditions Scale and Patient Health Questionnaire; Numerical Pain Intensity Scale; Short-Form 12 Health Survey - Item 8 (how much pain hinders activities); Patient Health Questionnaire 2, Numerical Fatigue Scale. Data were analyzed via Spearman correlation, univariate analysis, and multiple regression to explain the effects associated with quality-of-life predictors.ResultsThe main factors that decreased quality of life were fatigue (by 11.5%), depression (by 5.5-12.8%), pain (by 1.3 in total life quality, in the physical domain by 8.6-9.6%), sores (15.6% in the physical domain only). The practice of sports increased the total quality of life by 14.4%, in the physical domain by 11.9%, in the psychological domain by 17.2%, and in the social domain by 23.7%.ConclusionsFatigue, risk of depression, pain, and the presence of sores are predictors of poor quality of life, and sports are a predictor of a better quality of life, for people with spinal cord injury. Multidisciplinary rehabilitation, in addition to policies, to increase accessibility and social inclusion, and incentives or subsidies for the practice of sports could improve QoL following SCI/D.
article Transcranial direct current stimulation is safe and effective in autoimmune myopathies: a randomised, double-blind, sham-controlled trial(2023) SOUSA, L. F. A. de; MISSE, R. G.; SANTOS, L. M. dos; TANAKA, C.; GREVE, J. M. A.; BAPTISTA, A. F.; SHINJO, S. K.Objective We aimed to assess the safety and efficacy of transcranial direct current stimulation (tDCS) in patients with systemic autoimmune myopathies (SAMs).Methods This prospective, randomised, sham-controlled, double-blind, study included 20 patients with SAMs allocated to receive sham or active tDCS (2mA, 20 minutes, 3 days). Electrodes were positioned with the anode over the C1 or C2, whereas the cathode was placed over the Fp2 or Fp1, respectively. The groups were evaluated in four periods with specific questionnaires and functional tests: pre-stimulation and after 30 minutes, three weeks, and eight weeks post-tDCS.Results Two patients from the sham group withdrew after the three sessions. The demographic data, type of myositis, disease duration, and disease status were comparable between the active and sham tDCS groups. After interventions, in the active tDCS group, the physical aspects of SF-36 in week eight, mean and better timed up-and-go test at each evaluation, peak torque of stimulated inferior limb extension improved significantly (p<0.05). The emotional aspect of SF-36 decreased only in the active tDCS group (p<0.001). The patients' adherence to the protocol was 100% and no serious adverse event was reported, including disease relapses.Conclusion This study evidences the safety of tDCS, as well as its potential efficacy in improving muscle strength and function in SAMs patients. More studies with a larger sample and longer tDCS sessions are necessary to corroborate the results of the present study.- Heart rate response to exercise and cardiorespiratory fitness of young women at high familial risk for hypertension: effects of interval vs continuous training(2011) CIOLAC, Emmanuel G.; BOCCHI, Edimar A.; GREVE, Julia M. D.; GUIMARAES, Guilherme V.Exercise training is an effective intervention for treating and preventing hypertension, but its effects on heart rate (HR) response to exercise and cardiorespiratory fitness (CRF) of non-hypertensive offspring of hypertensive parents (FH+) has not been studied. We compared the effects of three times per week equal-volume high-intensity aerobic interval (AIT) and continuous moderate-intensity exercise (CME) on HR response to exercise and CRF of FH+. Forty-four young FH+ women (25.0 +/- 4.4 years) randomized to control (CON; n = 12), AIT (80-90% of VO2MAX; n = 16), or CME (50-60% of VO2MAX; n = 16) performed a graded exercise test (GXT) before and after 16 weeks of follow-up to evaluate HR response to exercise and several parameters of CRF. Resting, maximal, and reserve HR did not change after the follow-up in all groups. HR recovery (difference between HRMAX and HR at 1 minute of GXT recovery phase) improved only after AIT (11.8 +/- 4.9 vs. 20.6 +/- 5.8 bpm, p < 0.01). Both exercise programmes were effective for improving CRF parameters, but AIT was more effective than CME for improving oxygen consumption at the respiratory compensation point (VO2RCP; 22.1% vs. 8.8%, p = 0.008) and maximal effort (VO2MAX; 15.8% vs. 8.0%, p = 0.036), as well as tolerance time (TT) to reach anaerobic threshold (TTAT; 62.0 vs. 37.7, p = 0.048), TTRCP (49.3 vs. 32.9, p = 0.032), and TTMAX (38.9 vs. 29.2, p = 0.042). Exercise intensity was an important factor in improving HR recovery and CRF of FH+women. These findings may have important implications for designing exercise-training programmes for the prevention of an inherited hypertensive disorder.
- Muscle strength, postural balance, and cognition are associated with braking time during driving in older adults(2016) ALONSO, Angelica C.; PETERSON, Mark D.; BUSSE, Alexandre L.; JACOB-FILHO, Wilson; BORGES, Mauricio T. A.; SERRA, Marcos M.; LUNA, Natalia M. S.; MARCHETTI, Paulo H.; GREVE, Julia M. D. A.Background: Despite the well-known declines in driving performance with advancing age, there is little understanding of the specific factors that predict changes in key determinants such as braking time. Objectives: The aims of this study were to determine the extent to which age, muscle strength, cognition and postural balance are associated with braking performance in middle-aged and older adults. Methods: Male and female middle-aged adults (n = 62, age = 39.3 +/- 7.1 years) and older adults (n = 102, age = 70.4 +/- 5.8 years) were evaluated for braking performance, as well as in several motor and cognitive performance tasks. The motor evaluation included isokinetic ankle plantar flexor muscle strength, handgrip strength, and postural balance with and without a cognitive task. The cognitive assessment included the Mini Mental State Examination. Braking performance was measured using a driving simulator. Results: Older adults exhibited 17% slower braking time, lower strength, and poorer performance in the postural balance (p < 0.001). For both older and middle-aged adults, significant correlates of braking time included performance in the postural balance tests, muscle strength, and cognitive function. However, after full model adjustment, only postural balance and cognitive function were significantly associated. Conclusion: Muscle strength, postural balance, and cognition are associated with braking time, and may affect the safety of and driving performance in older adults. These findings may help to inform specific targeted interventions that could preserve driving performance during aging.
conferenceObject FOUR-YEAR FOLLOW-UP OF A TWO DAY EDUCATIONAL PROGRAM ABOUT OA IN BRAZIL(2020) SILVA, J. Da; REZENDE, M. De; OCAMPOS, G.; SPADA, T.; FRANCISCO, L.; SANTOS, H. Dos; FARIAS, F.; SILVA, C. Da; CERNIGOY, C.; GREVE, J.; CIOLAC, E.