Efeitos da reabilita????o pulmonar associada ?? fisioterapia respirat??ria vs fisioterapia respirat??ria na capacidade f??sica, for??a muscular perif??rica e qualidade de vida em pacientes com bronquiectasia: ensaio cl??nico randomizado e controlado

Detalhes bibliográficos
Autor(a) principal: Camargo, Anderson Alves de
Data de Publicação: 2015
Tipo de documento: Tese
Idioma: por
Título da fonte: Biblioteca Digital de Teses e Dissertações da Uninove
Texto Completo: http://bibliotecatede.uninove.br/handle/tede/1822
Resumo: Introduction: There is a shortage of studies evaluating the effects of respiratory physiotherapy isolated and linked to pulmonary rehabilitation in adults with bronchiectasis (BCT), and inflammatory level comparison of these patients with a control group. Aim: Study 1: To correlate the inflammatory and oxidative stress state with lung function and physical capacity, and with basal physical capacity after a pulmonary rehabilitation program associated with the respiratory physiotherapy; and Study 2: To compare the effects of a pulmonary rehabilitation program associated to respiratory physiotherapy with respiratory physiotherapy singly in physical capacity, peripheral muscle function and quality of life in patients with bronchiectasis. Methods: In the first study, 74 patients and 29 controls performed cardiopulmonary exercise test on cycle ergometer (CPET) and incremental shuttle walking test (ISWT), in addition to the assessment of the total number of steps/day (NSD) and the Pro and anti-inflammatory mediators and Pro and anti-oxidants in plasma. In the second study, 82 patients were randomized into two groups: respiratory physiotherapy (RP) and RP associated to pulmonary rehabilitation (RP+PR). Patients performed the ISWT and SWT endurance (ESWT), the maximum and submaximal CPET (sub), test of strength for the biceps brachii (BB), medium deltoids (MD) and quadriceps femoris (QF) and responded to the St. George's Respiratory Questionnaire (SGRQ) for assessment of health-related quality of life (HRQOL). NSD was obtained by pedometer and dyspnoea was measured by the Medical Research Council (MRC). Results: Study 1 ??? The level of cytokines IL1-?? and IL-6 was significantly higher compared to the control group, but for Pro markers and antioxidants no differences were found. There was significant negative correlation of VO2 with IL1-?? (r: -0.42), IL-6 (r: -0.31), thiobarbituric acid (T-BARS, r: 0.30), Carbonyl (r: -0.39) and nitrite (r: 0.32). The ISWT correlated with Catalase (r: 0.25) and total antioxidant capacity (TRAP, r: 0.23). Study 2 ??? Comparing the pre-and post-intervention intra-group effects, there was significant increase in ISWT, ESWT, CPET load, and muscle strength of DM and BB for the RP+PR group, while the endurance time in CPETsub increased both in RP+PR and RP groups; there was improvement for the RP group in all domains of SGRQ, while the RP+PR group only improved in symptoms. When comparing the effects of treatment in both groups (RP vs RP+PR), there was no statistically significant difference for any of the outcomes studied. Conclusion: Study 1 ??? Patients with BCT presented high systemic inflammation even in the stable phase of the disease, with equivalent Pro markers and antioxidants compared to the control group. Oxidative and inflammatory markers correlate with the aerobic and functional capacity. Study 2 ??? Although there was increasing exercise tolerance only at the RP+PR group, both groups showed improvement in HRQOL. Even though there wasn???t difference between interventions, it is preferable to associate RP to PR, because the latter promoted significant benefits in peripheral muscle strength and physical ability.
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spelling Dal Corso, SimoneStelmach, RafaelDal Corso, SimoneSampaio, Luciana Maria Malos??Lanza, Fernanda de CordobaAlbuquerque, Andr?? LuizMalaguti, Carlahttp://lattes.cnpq.br/5975974810220494Camargo, Anderson Alves de2018-06-21T18:14:35Z2015-12-16Camargo, Anderson Alves de. Efeitos da reabilita????o pulmonar associada ?? fisioterapia respirat??ria vs fisioterapia respirat??ria na capacidade f??sica, for??a muscular perif??rica e qualidade de vida em pacientes com bronquiectasia: ensaio cl??nico randomizado e controlado. 2015. 142 f. Tese( Programa de P??s-Gradua????o em Ci??ncias da Reabilita????o) - Universidade Nove de Julho, S??o Paulo.http://bibliotecatede.uninove.br/handle/tede/1822Introduction: There is a shortage of studies evaluating the effects of respiratory physiotherapy isolated and linked to pulmonary rehabilitation in adults with bronchiectasis (BCT), and inflammatory level comparison of these patients with a control group. Aim: Study 1: To correlate the inflammatory and oxidative stress state with lung function and physical capacity, and with basal physical capacity after a pulmonary rehabilitation program associated with the respiratory physiotherapy; and Study 2: To compare the effects of a pulmonary rehabilitation program associated to respiratory physiotherapy with respiratory physiotherapy singly in physical capacity, peripheral muscle function and quality of life in patients with bronchiectasis. Methods: In the first study, 74 patients and 29 controls performed cardiopulmonary exercise test on cycle ergometer (CPET) and incremental shuttle walking test (ISWT), in addition to the assessment of the total number of steps/day (NSD) and the Pro and anti-inflammatory mediators and Pro and anti-oxidants in plasma. In the second study, 82 patients were randomized into two groups: respiratory physiotherapy (RP) and RP associated to pulmonary rehabilitation (RP+PR). Patients performed the ISWT and SWT endurance (ESWT), the maximum and submaximal CPET (sub), test of strength for the biceps brachii (BB), medium deltoids (MD) and quadriceps femoris (QF) and responded to the St. George's Respiratory Questionnaire (SGRQ) for assessment of health-related quality of life (HRQOL). NSD was obtained by pedometer and dyspnoea was measured by the Medical Research Council (MRC). Results: Study 1 ??? The level of cytokines IL1-?? and IL-6 was significantly higher compared to the control group, but for Pro markers and antioxidants no differences were found. There was significant negative correlation of VO2 with IL1-?? (r: -0.42), IL-6 (r: -0.31), thiobarbituric acid (T-BARS, r: 0.30), Carbonyl (r: -0.39) and nitrite (r: 0.32). The ISWT correlated with Catalase (r: 0.25) and total antioxidant capacity (TRAP, r: 0.23). Study 2 ??? Comparing the pre-and post-intervention intra-group effects, there was significant increase in ISWT, ESWT, CPET load, and muscle strength of DM and BB for the RP+PR group, while the endurance time in CPETsub increased both in RP+PR and RP groups; there was improvement for the RP group in all domains of SGRQ, while the RP+PR group only improved in symptoms. When comparing the effects of treatment in both groups (RP vs RP+PR), there was no statistically significant difference for any of the outcomes studied. Conclusion: Study 1 ??? Patients with BCT presented high systemic inflammation even in the stable phase of the disease, with equivalent Pro markers and antioxidants compared to the control group. Oxidative and inflammatory markers correlate with the aerobic and functional capacity. Study 2 ??? Although there was increasing exercise tolerance only at the RP+PR group, both groups showed improvement in HRQOL. Even though there wasn???t difference between interventions, it is preferable to associate RP to PR, because the latter promoted significant benefits in peripheral muscle strength and physical ability.Introdu????o: H?? escassez de estudos avaliando os efeitos da fisioterapia respirat??ria (FR) isolada e associada ?? reabilita????o pulmonar (RP) em adultos com bronquiectasia (BCQ) e a compara????o do n??vel inflamat??rio destes doentes com a de um grupo controle. Objetivos: Estudo 1: Correlacionar o estado inflamat??rio e estresse oxidativo com a fun????o pulmonar e capacidade f??sica e com a capacidade f??sica ap??s o programa de RP associado ?? FR e Estudo 2 ??? Comparar os efeitos de um programa de RP associado ?? FR com a FR isoladamente na capacidade f??sica, fun????o muscular perif??rica e qualidade de vida em pacientes com bronquiectasia. M??todo: No primeiro estudo, 74 pacientes e 29 controles realizaram o teste de exerc??cio cardiopulmonar m??ximo em cicloerg??metro (TECP) e o shuttle walking teste incremental (SWTI), al??m da avalia????o do n??mero total de passos/dia (NTP) e dos mediadores pr?? e anti-inflamat??rios e pr?? e anti-oxidantes no plasma. No segundo estudo, 82 pacientes foram randomizados em dois grupos (Grupo 1 ??? FR e Grupo 2 ??? FR associada ?? RP). Os pacientes realizaram o SWTI e o SWT endurance (SWTE), o TECP m??ximo e subm??ximo (sub), teste de for??a para o b??ceps braquial (BB), delt??ide m??dio (DM) e quadr??ceps femoral (QF) e responderam ao Saint George???s Respiratory Questionnaire (SGRQ) para avalia????o da qualidade de vida relacionada ?? sa??de (QVRS). O NTP foi obtido por ped??metro e a dispneia foi mensurada pela escala Medical Research Council (MRC). Resultados: Estudo 1 - O n??vel de citocinas IL-1?? e IL-6 foi significantemente maior em compara????o ao grupo controle, mas para os marcadores pr?? e anti-oxidantes n??o foram encontradas diferen??as. Houve correla????o negativa significante do VO2 com IL-1?? (r = -0,42), IL-6 (r = -0,31), ??cido tiobarbit??rico (T-BARS, r = 0,30), Carbonila (r = -0,39) e Nitrito (r = 0,32). O SWTI correlacionou-se com a Catalase (r = 0,25) e a capacidade anti-oxidante total (TRAP, r = 0,23). Estudo 2 ??? Ao compararmos os efeitos pr?? e p??s-interven????o intragrupo: houve aumento significante no SWTI, SWTE, carga no TECP, for??a muscular do BB e DM para o grupo FR+RP, enquanto o tempo de endurance no TECPsub aumentou tanto neste grupo quanto no grupo FR; no grupo FR houve melhora em todos os dom??nios do SGRQ, enquanto para o grupo FR+RP apenas no dom??nio sintomas. Ao comparar os efeitos do tratamento em ambos os grupos (FR vs FR+RP) n??o houve diferen??a estatisticamente significante para quaisquer dos desfechos estudados. Conclus??o: Estudo 1 - Os pacientes com BCQ apresentaram elevada inflama????o sist??mica, mesmo na fase est??vel da doen??a, com equivalentes marcadores pr?? e anti-oxidantes em rela????o ao grupo controle. Marcadores inflamat??rios e oxidativos se correlacionam com a capacidade aer??bia e funcional. Estudo 2 ??? Embora ocorreu aumento da toler??ncia ao exerc??cio apenas no grupo FR+RP, ambos os grupos demonstraram melhora da QVRS. Embora n??o tenha ocorrido diferen??a entre ambas as interven????es, ?? prefer??vel associar ?? FR a RP, pois esta ??ltima promoveu benef??cios significativos na capacidade f??sica e for??a muscular perif??rica.Submitted by Nadir Basilio (nadirsb@uninove.br) on 2018-06-21T18:14:35Z No. of bitstreams: 1 Anderson Alves de Camargo .pdf: 1030153 bytes, checksum: 6ca31fab8598bd8ac6319e473c1dac59 (MD5)Made available in DSpace on 2018-06-21T18:14:35Z (GMT). No. of bitstreams: 1 Anderson Alves de Camargo .pdf: 1030153 bytes, checksum: 6ca31fab8598bd8ac6319e473c1dac59 (MD5) Previous issue date: 2015-12-16application/pdfporUniversidade Nove de JulhoPrograma de P??s-Gradua????o em Ci??ncias da Reabilita????oUNINOVEBrasilSa??debronquiectasiareabilita????o pulmonarfisioterapia respirat??riaquestion??rio de qualidade de vidabronchiectasispulmonary rehabilitationrespiratory physiotherapyquality of life questionnaireCIENCIAS DA SAUDEEfeitos da reabilita????o pulmonar associada ?? fisioterapia respirat??ria vs fisioterapia respirat??ria na capacidade f??sica, for??a muscular perif??rica e qualidade de vida em pacientes com bronquiectasia: ensaio cl??nico randomizado e controladoEffects of pulmonary rehabilitation associated with respiratory physiotherapy vs. respiratory physiotherapy in peripheral muscle strength, physical ability and quality of life in patients with bronchiectasis: randomized and controlled clinical trialinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/doctoralThesis8765449414823306929600info:eu-repo/semantics/openAccessreponame:Biblioteca Digital de Teses e Dissertações da Uninoveinstname:Universidade Nove de Julho (UNINOVE)instacron:UNINOVEORIGINALAnderson Alves de Camargo .pdfAnderson Alves de Camargo .pdfapplication/pdf1030153http://localhost:8080/tede/bitstream/tede/1822/2/Anderson+Alves+de+Camargo+.pdf6ca31fab8598bd8ac6319e473c1dac59MD52LICENSElicense.txtlicense.txttext/plain; charset=utf-82165http://localhost:8080/tede/bitstream/tede/1822/1/license.txtbd3efa91386c1718a7f26a329fdcb468MD51tede/18222019-11-27 17:42:03.346oai:localhost: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Biblioteca Digital de Teses e Dissertaçõeshttp://bibliotecatede.uninove.br/PRIhttp://bibliotecatede.uninove.br/oai/requestbibliotecatede@uninove.br||bibliotecatede@uninove.bropendoar:2019-11-27T19:42:03Biblioteca Digital de Teses e Dissertações da Uninove - Universidade Nove de Julho (UNINOVE)false
dc.title.por.fl_str_mv Efeitos da reabilita????o pulmonar associada ?? fisioterapia respirat??ria vs fisioterapia respirat??ria na capacidade f??sica, for??a muscular perif??rica e qualidade de vida em pacientes com bronquiectasia: ensaio cl??nico randomizado e controlado
dc.title.alternative.eng.fl_str_mv Effects of pulmonary rehabilitation associated with respiratory physiotherapy vs. respiratory physiotherapy in peripheral muscle strength, physical ability and quality of life in patients with bronchiectasis: randomized and controlled clinical trial
title Efeitos da reabilita????o pulmonar associada ?? fisioterapia respirat??ria vs fisioterapia respirat??ria na capacidade f??sica, for??a muscular perif??rica e qualidade de vida em pacientes com bronquiectasia: ensaio cl??nico randomizado e controlado
spellingShingle Efeitos da reabilita????o pulmonar associada ?? fisioterapia respirat??ria vs fisioterapia respirat??ria na capacidade f??sica, for??a muscular perif??rica e qualidade de vida em pacientes com bronquiectasia: ensaio cl??nico randomizado e controlado
Camargo, Anderson Alves de
bronquiectasia
reabilita????o pulmonar
fisioterapia respirat??ria
question??rio de qualidade de vida
bronchiectasis
pulmonary rehabilitation
respiratory physiotherapy
quality of life questionnaire
CIENCIAS DA SAUDE
title_short Efeitos da reabilita????o pulmonar associada ?? fisioterapia respirat??ria vs fisioterapia respirat??ria na capacidade f??sica, for??a muscular perif??rica e qualidade de vida em pacientes com bronquiectasia: ensaio cl??nico randomizado e controlado
title_full Efeitos da reabilita????o pulmonar associada ?? fisioterapia respirat??ria vs fisioterapia respirat??ria na capacidade f??sica, for??a muscular perif??rica e qualidade de vida em pacientes com bronquiectasia: ensaio cl??nico randomizado e controlado
title_fullStr Efeitos da reabilita????o pulmonar associada ?? fisioterapia respirat??ria vs fisioterapia respirat??ria na capacidade f??sica, for??a muscular perif??rica e qualidade de vida em pacientes com bronquiectasia: ensaio cl??nico randomizado e controlado
title_full_unstemmed Efeitos da reabilita????o pulmonar associada ?? fisioterapia respirat??ria vs fisioterapia respirat??ria na capacidade f??sica, for??a muscular perif??rica e qualidade de vida em pacientes com bronquiectasia: ensaio cl??nico randomizado e controlado
title_sort Efeitos da reabilita????o pulmonar associada ?? fisioterapia respirat??ria vs fisioterapia respirat??ria na capacidade f??sica, for??a muscular perif??rica e qualidade de vida em pacientes com bronquiectasia: ensaio cl??nico randomizado e controlado
author Camargo, Anderson Alves de
author_facet Camargo, Anderson Alves de
author_role author
dc.contributor.advisor1.fl_str_mv Dal Corso, Simone
dc.contributor.advisor-co1.fl_str_mv Stelmach, Rafael
dc.contributor.referee1.fl_str_mv Dal Corso, Simone
dc.contributor.referee2.fl_str_mv Sampaio, Luciana Maria Malos??
dc.contributor.referee3.fl_str_mv Lanza, Fernanda de Cordoba
dc.contributor.referee4.fl_str_mv Albuquerque, Andr?? Luiz
dc.contributor.referee5.fl_str_mv Malaguti, Carla
dc.contributor.authorLattes.fl_str_mv http://lattes.cnpq.br/5975974810220494
dc.contributor.author.fl_str_mv Camargo, Anderson Alves de
contributor_str_mv Dal Corso, Simone
Stelmach, Rafael
Dal Corso, Simone
Sampaio, Luciana Maria Malos??
Lanza, Fernanda de Cordoba
Albuquerque, Andr?? Luiz
Malaguti, Carla
dc.subject.por.fl_str_mv bronquiectasia
reabilita????o pulmonar
fisioterapia respirat??ria
question??rio de qualidade de vida
topic bronquiectasia
reabilita????o pulmonar
fisioterapia respirat??ria
question??rio de qualidade de vida
bronchiectasis
pulmonary rehabilitation
respiratory physiotherapy
quality of life questionnaire
CIENCIAS DA SAUDE
dc.subject.eng.fl_str_mv bronchiectasis
pulmonary rehabilitation
respiratory physiotherapy
quality of life questionnaire
dc.subject.cnpq.fl_str_mv CIENCIAS DA SAUDE
description Introduction: There is a shortage of studies evaluating the effects of respiratory physiotherapy isolated and linked to pulmonary rehabilitation in adults with bronchiectasis (BCT), and inflammatory level comparison of these patients with a control group. Aim: Study 1: To correlate the inflammatory and oxidative stress state with lung function and physical capacity, and with basal physical capacity after a pulmonary rehabilitation program associated with the respiratory physiotherapy; and Study 2: To compare the effects of a pulmonary rehabilitation program associated to respiratory physiotherapy with respiratory physiotherapy singly in physical capacity, peripheral muscle function and quality of life in patients with bronchiectasis. Methods: In the first study, 74 patients and 29 controls performed cardiopulmonary exercise test on cycle ergometer (CPET) and incremental shuttle walking test (ISWT), in addition to the assessment of the total number of steps/day (NSD) and the Pro and anti-inflammatory mediators and Pro and anti-oxidants in plasma. In the second study, 82 patients were randomized into two groups: respiratory physiotherapy (RP) and RP associated to pulmonary rehabilitation (RP+PR). Patients performed the ISWT and SWT endurance (ESWT), the maximum and submaximal CPET (sub), test of strength for the biceps brachii (BB), medium deltoids (MD) and quadriceps femoris (QF) and responded to the St. George's Respiratory Questionnaire (SGRQ) for assessment of health-related quality of life (HRQOL). NSD was obtained by pedometer and dyspnoea was measured by the Medical Research Council (MRC). Results: Study 1 ??? The level of cytokines IL1-?? and IL-6 was significantly higher compared to the control group, but for Pro markers and antioxidants no differences were found. There was significant negative correlation of VO2 with IL1-?? (r: -0.42), IL-6 (r: -0.31), thiobarbituric acid (T-BARS, r: 0.30), Carbonyl (r: -0.39) and nitrite (r: 0.32). The ISWT correlated with Catalase (r: 0.25) and total antioxidant capacity (TRAP, r: 0.23). Study 2 ??? Comparing the pre-and post-intervention intra-group effects, there was significant increase in ISWT, ESWT, CPET load, and muscle strength of DM and BB for the RP+PR group, while the endurance time in CPETsub increased both in RP+PR and RP groups; there was improvement for the RP group in all domains of SGRQ, while the RP+PR group only improved in symptoms. When comparing the effects of treatment in both groups (RP vs RP+PR), there was no statistically significant difference for any of the outcomes studied. Conclusion: Study 1 ??? Patients with BCT presented high systemic inflammation even in the stable phase of the disease, with equivalent Pro markers and antioxidants compared to the control group. Oxidative and inflammatory markers correlate with the aerobic and functional capacity. Study 2 ??? Although there was increasing exercise tolerance only at the RP+PR group, both groups showed improvement in HRQOL. Even though there wasn???t difference between interventions, it is preferable to associate RP to PR, because the latter promoted significant benefits in peripheral muscle strength and physical ability.
publishDate 2015
dc.date.issued.fl_str_mv 2015-12-16
dc.date.accessioned.fl_str_mv 2018-06-21T18:14:35Z
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
dc.type.driver.fl_str_mv info:eu-repo/semantics/doctoralThesis
format doctoralThesis
status_str publishedVersion
dc.identifier.citation.fl_str_mv Camargo, Anderson Alves de. Efeitos da reabilita????o pulmonar associada ?? fisioterapia respirat??ria vs fisioterapia respirat??ria na capacidade f??sica, for??a muscular perif??rica e qualidade de vida em pacientes com bronquiectasia: ensaio cl??nico randomizado e controlado. 2015. 142 f. Tese( Programa de P??s-Gradua????o em Ci??ncias da Reabilita????o) - Universidade Nove de Julho, S??o Paulo.
dc.identifier.uri.fl_str_mv http://bibliotecatede.uninove.br/handle/tede/1822
identifier_str_mv Camargo, Anderson Alves de. Efeitos da reabilita????o pulmonar associada ?? fisioterapia respirat??ria vs fisioterapia respirat??ria na capacidade f??sica, for??a muscular perif??rica e qualidade de vida em pacientes com bronquiectasia: ensaio cl??nico randomizado e controlado. 2015. 142 f. Tese( Programa de P??s-Gradua????o em Ci??ncias da Reabilita????o) - Universidade Nove de Julho, S??o Paulo.
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