Efeitos do treinamento muscular inspiratório de alta intensidade associado ao exercício aeróbico e resistido pós revascularização do miocárdio
Autor(a) principal: | |
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Data de Publicação: | 2017 |
Tipo de documento: | Dissertação |
Idioma: | por |
Título da fonte: | Repositório Institucional Manancial UFSM |
Texto Completo: | http://repositorio.ufsm.br/handle/1/18539 |
Resumo: | There is growing debate around the inclusion of inspiratory muscle training (IMT) to cardiac rehabilitation (CR) programs. Inspiratory muscle training has been included specifically for patients who underwent coronary artery bypass grafting (CABG). This was done not only in Phase I of CR, but also in phase II, since effects on pulmonary function and reduction in functional capacity (FC) are still present in late stages. This study had the aim of investigating the effects of the addition of high-intensity IMT to the aerobic and resistance (combined training - CT) training of patients after CABG (Phase II). A randomized clinical trial was conducted with 24 post-CABG patients randomly divided into two groups: SIMTG+CT (n=12), which performed sham IMT in association with CT, and IMTG+CT (n=12), who underwent high-intensity IMT in association with CT, for 12 weeks, twice a week. The following parameters were assessed before and after intervention: maximal FC, through cardiopulmonary exercise test (VO2 peak); submaximal FC, through the six-minute walk test (6MWT); quality of life (QoL), through the Minnesota Living with Heart Failure Questionnaire (MLHFQ); respiratory muscle strength (MIP and MEP) through manovacuometry; pulmonary function (FVC and FEV1) through spirometry; inspiratory muscle resistance (SMIP and Tlim) through manovacuometer and POWERbreathe®. Considering laboratory markers, assessment of oxidative profile was performed with advanced oxidation protein products (AOPPs); antioxidant profile through the ferric reducing method (FRAP); endothelial function through nitrite/nitrate (NOx) and inflammatory profile through high-sensitivity C-reactive protein (hsCRP). There was significant increase in VO2 peak both in SIMTG+CT (p<0.0001) and in IMTG+CT (p<0.0001). When comparing groups, a significant increase was observed in IMTG+CT (p=0.0412). Distance walked on the 6MWT significantly increased in SIMTG+CT (p<0.0001) and in IMTG+CT (p<0.0001). However, there was a significant increase in IMTG+CT in comparison to SIMTG+CT (p<0.01). Score on the MLHFQ demonstrated a significant decrease both in SIMTG+CT (p=0.0002) and in IMTG+CT (p<0.0001). In comparison between groups, a significant reduction favoring IMTG+CT was found (p<0.01). There was a significant increase of MIP in SIMTG+CT (p=0.0126) and in IMTG+CT (p<0.0001). A significant increase in IMTG+CT was observed when compared to SIMTG+CT (p<0.001). The FRAP demonstrated a significant increase both in SIMTG+CT (p=0.0016) and in IMTG+CT (p<0.0001). Between groups, a significant increase was observed favoring IMTG+CT (p=0.0069). The hsCRP demonstrated a significant decrease in SIMTG+CT (p=0.0589) and in IMTG+CT (p<0.0056). There was no significant difference between groups (p=0.3916). There was a significant intragroup increase of MEP in SIMTG+CT (p=0.0106) and in IMTG+CT (p=0.0252), and of NOx in SIMTG+CT (p=0.0015) and in IMTG+CT (p=0.0150). The IMTG+CT had significant increases in FVC (p=0.0070), in FEV1 (p=0.0022), in SMIP (p<0.0001) and in Tlim (p=0.0046). The AOPP did not present significant differences between groups. This study demonstrated for the first time that high-intensity short-length IMT can enhance the effects of CT on FC, inspiratory muscle strength, QoL and antioxidant profile. Moreover, it improved inspiratory muscle resistance and pulmonary function in post- CABG patients in the Phase II of CR. Such findings are clinically relevant in demonstrating that IMT can be a low cost and easy to insert complement to RC programs. |
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2019-10-09T20:10:44Z2019-10-09T20:10:44Z2017-08-18http://repositorio.ufsm.br/handle/1/18539There is growing debate around the inclusion of inspiratory muscle training (IMT) to cardiac rehabilitation (CR) programs. Inspiratory muscle training has been included specifically for patients who underwent coronary artery bypass grafting (CABG). This was done not only in Phase I of CR, but also in phase II, since effects on pulmonary function and reduction in functional capacity (FC) are still present in late stages. This study had the aim of investigating the effects of the addition of high-intensity IMT to the aerobic and resistance (combined training - CT) training of patients after CABG (Phase II). A randomized clinical trial was conducted with 24 post-CABG patients randomly divided into two groups: SIMTG+CT (n=12), which performed sham IMT in association with CT, and IMTG+CT (n=12), who underwent high-intensity IMT in association with CT, for 12 weeks, twice a week. The following parameters were assessed before and after intervention: maximal FC, through cardiopulmonary exercise test (VO2 peak); submaximal FC, through the six-minute walk test (6MWT); quality of life (QoL), through the Minnesota Living with Heart Failure Questionnaire (MLHFQ); respiratory muscle strength (MIP and MEP) through manovacuometry; pulmonary function (FVC and FEV1) through spirometry; inspiratory muscle resistance (SMIP and Tlim) through manovacuometer and POWERbreathe®. Considering laboratory markers, assessment of oxidative profile was performed with advanced oxidation protein products (AOPPs); antioxidant profile through the ferric reducing method (FRAP); endothelial function through nitrite/nitrate (NOx) and inflammatory profile through high-sensitivity C-reactive protein (hsCRP). There was significant increase in VO2 peak both in SIMTG+CT (p<0.0001) and in IMTG+CT (p<0.0001). When comparing groups, a significant increase was observed in IMTG+CT (p=0.0412). Distance walked on the 6MWT significantly increased in SIMTG+CT (p<0.0001) and in IMTG+CT (p<0.0001). However, there was a significant increase in IMTG+CT in comparison to SIMTG+CT (p<0.01). Score on the MLHFQ demonstrated a significant decrease both in SIMTG+CT (p=0.0002) and in IMTG+CT (p<0.0001). In comparison between groups, a significant reduction favoring IMTG+CT was found (p<0.01). There was a significant increase of MIP in SIMTG+CT (p=0.0126) and in IMTG+CT (p<0.0001). A significant increase in IMTG+CT was observed when compared to SIMTG+CT (p<0.001). The FRAP demonstrated a significant increase both in SIMTG+CT (p=0.0016) and in IMTG+CT (p<0.0001). Between groups, a significant increase was observed favoring IMTG+CT (p=0.0069). The hsCRP demonstrated a significant decrease in SIMTG+CT (p=0.0589) and in IMTG+CT (p<0.0056). There was no significant difference between groups (p=0.3916). There was a significant intragroup increase of MEP in SIMTG+CT (p=0.0106) and in IMTG+CT (p=0.0252), and of NOx in SIMTG+CT (p=0.0015) and in IMTG+CT (p=0.0150). The IMTG+CT had significant increases in FVC (p=0.0070), in FEV1 (p=0.0022), in SMIP (p<0.0001) and in Tlim (p=0.0046). The AOPP did not present significant differences between groups. This study demonstrated for the first time that high-intensity short-length IMT can enhance the effects of CT on FC, inspiratory muscle strength, QoL and antioxidant profile. Moreover, it improved inspiratory muscle resistance and pulmonary function in post- CABG patients in the Phase II of CR. Such findings are clinically relevant in demonstrating that IMT can be a low cost and easy to insert complement to RC programs.É crescente na atualidade a discussão sobre a inserção do treinamento muscular inspiratório (TMI) em programas de reabilitação cardíaca (RC). Especificamente em pacientes submetidos à cirurgia de revascularização do miocárdio (CRM), o TMI tem sido incluído, não apenas na Fase I da RC, mas também na Fase II, visto que as repercussões na função pulmonar e a redução da capacidade funcional (CF) ainda se fazem presentes tardiamente. O presente estudo teve como objetivo investigar os efeitos da adição do TMI de alta intensidade ao exercício aeróbico e resistido (treinamento combinado-TC) em pacientes pós CRM (Fase II). Trata-se de um ensaio clínico randomizado, envolvendo 24 pacientes pós CRM aleatoriamente divididos em dois grupos: GTMIS+TC (n=12), que realizou o TMI sham associado ao TC, e GTMI+TC (n=12) submetidos ao TMI de alta intensidade associado ao TC, durante 12 semanas, 2 vezes por semana. Pré e pós intervenção foram avaliadas: CF máxima através do teste cardiopulmonar de exercício (VO2 pico); CF submáxima por meio do teste de caminhada de seis minutos (TC6M); qualidade de vida (QV) pelo questionário Minnesota Living with Heart Failure Questionnaire (MLHFQ); força muscular respiratória (PImáx e PEmáx) através de manovacuometria; função pulmonar (CVF e VEF1) por meio de espirometria; resistência muscular inspiratória (PImáxS e Tlim) através do manovacuômetro e POWERbreathe®. Considerando os marcadores laboratoriais, a avaliação do perfil oxidativo ocorreu através dos produtos proteicos de oxidação avançada (AOPPs); perfil antioxidante pelo método de redução do ferro (FRAP); função endotelial por meio do nitrito/nitrato (NOx) e perfil inflamatório através da Proteína C reativa ultra-sensível (PCR-us). Houve aumento significativo no VO2 pico tanto no GTMIS+TC (p<0,0001) quanto no GTMI+TC (p<0,0001). Na comparação entre grupos, incremento significativo foi observado no GTMI+TC (p=0,0412). A distância percorrida no TC6M apresentou aumento significativo no GTMIS+TC (p<0,0001) e no GTMI+TC (p<0,0001). Entretanto, houve aumento significativo no GTMI+TC em relação ao GTMIS+TC (p<0,01). A pontuação no MLHFQ demonstrou redução significativa tanto no GTMIS+TC (p=0,0002) quanto no GTMI+TC (p<0,0001). Na comparação entre os grupos, redução significativa em favor do GTMI+TC foi encontrada (p<0,01). Houve aumento significativo da PImáx no GTMIS+TC (p=0,0126) e no GTMI+TC (p<0,0001). Incremento significativo no GTMI+TC foi observado em relação ao GTMIS+TC (p<0,001). O FRAP exibiu aumento significativo tanto no GTMIS+TC (p=0,0016) quanto no GTMI+TC (p<0,0001). Entre os grupos, aumento significativo foi observado a favor do GTMI+TC (p=0,0069). A PCR-us demonstrou redução significativa no GTMIS+TC (p=0,0589) e GTMI+TC (p=0,0056). Sem diferença significativa entre os grupos (p=0,3916). Houve aumento significativo intragrupo para PEmáx no GTMIS+TC (p=0,0106) e no GTMI+TC (p=0,0252), bem como, para o NOx no GTMIS+TC (p=0,0015) e no GTMI+TC (p=0,0150). Aumento significativo foi observado apenas no GTMI+TC na CVF (p=0,0070), no VEF1 (p=0,0022), na PImáxS (p<0,0001) e no Tlim (p=0,0046). O AOPP não apresentou diferenças significativas em nenhum dos grupos. O presente estudo demonstrou pela primeira vez que o TMI de alta intensidade, curto prazo, pode potencializar os efeitos do TC sobre a CF, força muscular inspiratória, QV e perfil antioxidante. Além disso, propiciou melhora na resistência muscular inspiratória e na função pulmonar em pacientes pós CRM inseridos na Fase II da RC. Tais achados são clinicamente relevantes ao demonstrarem que o TMI pode ser um complemento de baixo custo e fácil inserção nos programas de RC.porUniversidade Federal de Santa MariaCentro de Ciências da SaúdePrograma de Pós-Graduação em Reabilitação FuncionalUFSMBrasilCiências da SaúdeAttribution-NonCommercial-NoDerivatives 4.0 Internationalhttp://creativecommons.org/licenses/by-nc-nd/4.0/info:eu-repo/semantics/openAccessCapacidade funcionalExercício físicoReabilitação cardíacaCirurgia de revascularização do miocárdioTreinamento muscular inspiratórioFunctional capacityExerciseCardiac rehabilitationCoronary artery bypass graftingInspiratory muscle trainingCNPQ::CIENCIAS DA SAUDE::FISIOTERAPIA E TERAPIA OCUPACIONALEfeitos do treinamento muscular inspiratório de alta intensidade associado ao exercício aeróbico e resistido pós revascularização do miocárdioEffects of high-intensity inspiratory muscle training in association with aerobic and resistance exercise after myocardial revascularizationinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/masterThesisPereira, Marisa Bastoshttp://lattes.cnpq.br/4068842399123210Albuquerque, Isabella Martins dehttp://lattes.cnpq.br/5579735303815692Dal Lago, Pedrohttp://lattes.cnpq.br/9299796177039282Puntel, Gustavo Orionehttp://lattes.cnpq.br/0319301096075015http://lattes.cnpq.br/2644450723580402Santos, Tamires Daros dos4008000000086007e553312-93f9-4c2c-af4c-12fe77a7127d36457c9f-443c-4d7d-b501-3f40f0521a299b210aa7-3c33-43a1-97ad-25348a3734287d7fc233-745b-4caa-bb2c-1c0bc912d1389833072d-6444-4c3b-b41b-e9c278dcd5c5reponame:Repositório Institucional Manancial UFSMinstname:Universidade Federal de Santa Maria (UFSM)instacron:UFSMCC-LICENSElicense_rdflicense_rdfapplication/rdf+xml; charset=utf-8805http://repositorio.ufsm.br/bitstream/1/18539/2/license_rdf4460e5956bc1d1639be9ae6146a50347MD52LICENSElicense.txtlicense.txttext/plain; charset=utf-816http://repositorio.ufsm.br/bitstream/1/18539/3/license.txtf8fcb28efb1c8cf0dc096bec902bf4c4MD53ORIGINALDIS_PPGRF_2017_SANTOS_TAMIRES.pdfDIS_PPGRF_2017_SANTOS_TAMIRES.pdfDissertação de Mestradoapplication/pdf3480401http://repositorio.ufsm.br/bitstream/1/18539/1/DIS_PPGRF_2017_SANTOS_TAMIRES.pdf9e1cfbd3b0d83daadcb16cfcc964dbdcMD51TEXTDIS_PPGRF_2017_SANTOS_TAMIRES.pdf.txtDIS_PPGRF_2017_SANTOS_TAMIRES.pdf.txtExtracted texttext/plain283345http://repositorio.ufsm.br/bitstream/1/18539/4/DIS_PPGRF_2017_SANTOS_TAMIRES.pdf.txtdc5a65c3d0f7920a7b48a4da6f9399e3MD54THUMBNAILDIS_PPGRF_2017_SANTOS_TAMIRES.pdf.jpgDIS_PPGRF_2017_SANTOS_TAMIRES.pdf.jpgIM Thumbnailimage/jpeg4421http://repositorio.ufsm.br/bitstream/1/18539/5/DIS_PPGRF_2017_SANTOS_TAMIRES.pdf.jpgaf45728dc0c9777b345ebbb2065657a2MD551/185392019-10-10 03:02:04.461oai:repositorio.ufsm.br:1/18539Q3JlYXRpdmUgQ29tbW9ucw==Repositório Institucionalhttp://repositorio.ufsm.br/PUBhttp://repositorio.ufsm.br/oai/requestouvidoria@ufsm.bropendoar:39132019-10-10T06:02:04Repositório Institucional Manancial UFSM - Universidade Federal de Santa Maria (UFSM)false |
dc.title.por.fl_str_mv |
Efeitos do treinamento muscular inspiratório de alta intensidade associado ao exercício aeróbico e resistido pós revascularização do miocárdio |
dc.title.alternative.eng.fl_str_mv |
Effects of high-intensity inspiratory muscle training in association with aerobic and resistance exercise after myocardial revascularization |
title |
Efeitos do treinamento muscular inspiratório de alta intensidade associado ao exercício aeróbico e resistido pós revascularização do miocárdio |
spellingShingle |
Efeitos do treinamento muscular inspiratório de alta intensidade associado ao exercício aeróbico e resistido pós revascularização do miocárdio Santos, Tamires Daros dos Capacidade funcional Exercício físico Reabilitação cardíaca Cirurgia de revascularização do miocárdio Treinamento muscular inspiratório Functional capacity Exercise Cardiac rehabilitation Coronary artery bypass grafting Inspiratory muscle training CNPQ::CIENCIAS DA SAUDE::FISIOTERAPIA E TERAPIA OCUPACIONAL |
title_short |
Efeitos do treinamento muscular inspiratório de alta intensidade associado ao exercício aeróbico e resistido pós revascularização do miocárdio |
title_full |
Efeitos do treinamento muscular inspiratório de alta intensidade associado ao exercício aeróbico e resistido pós revascularização do miocárdio |
title_fullStr |
Efeitos do treinamento muscular inspiratório de alta intensidade associado ao exercício aeróbico e resistido pós revascularização do miocárdio |
title_full_unstemmed |
Efeitos do treinamento muscular inspiratório de alta intensidade associado ao exercício aeróbico e resistido pós revascularização do miocárdio |
title_sort |
Efeitos do treinamento muscular inspiratório de alta intensidade associado ao exercício aeróbico e resistido pós revascularização do miocárdio |
author |
Santos, Tamires Daros dos |
author_facet |
Santos, Tamires Daros dos |
author_role |
author |
dc.contributor.advisor1.fl_str_mv |
Pereira, Marisa Bastos |
dc.contributor.advisor1Lattes.fl_str_mv |
http://lattes.cnpq.br/4068842399123210 |
dc.contributor.advisor-co1.fl_str_mv |
Albuquerque, Isabella Martins de |
dc.contributor.advisor-co1Lattes.fl_str_mv |
http://lattes.cnpq.br/5579735303815692 |
dc.contributor.referee1.fl_str_mv |
Dal Lago, Pedro |
dc.contributor.referee1Lattes.fl_str_mv |
http://lattes.cnpq.br/9299796177039282 |
dc.contributor.referee2.fl_str_mv |
Puntel, Gustavo Orione |
dc.contributor.referee2Lattes.fl_str_mv |
http://lattes.cnpq.br/0319301096075015 |
dc.contributor.authorLattes.fl_str_mv |
http://lattes.cnpq.br/2644450723580402 |
dc.contributor.author.fl_str_mv |
Santos, Tamires Daros dos |
contributor_str_mv |
Pereira, Marisa Bastos Albuquerque, Isabella Martins de Dal Lago, Pedro Puntel, Gustavo Orione |
dc.subject.por.fl_str_mv |
Capacidade funcional Exercício físico Reabilitação cardíaca Cirurgia de revascularização do miocárdio Treinamento muscular inspiratório |
topic |
Capacidade funcional Exercício físico Reabilitação cardíaca Cirurgia de revascularização do miocárdio Treinamento muscular inspiratório Functional capacity Exercise Cardiac rehabilitation Coronary artery bypass grafting Inspiratory muscle training CNPQ::CIENCIAS DA SAUDE::FISIOTERAPIA E TERAPIA OCUPACIONAL |
dc.subject.eng.fl_str_mv |
Functional capacity Exercise Cardiac rehabilitation Coronary artery bypass grafting Inspiratory muscle training |
dc.subject.cnpq.fl_str_mv |
CNPQ::CIENCIAS DA SAUDE::FISIOTERAPIA E TERAPIA OCUPACIONAL |
description |
There is growing debate around the inclusion of inspiratory muscle training (IMT) to cardiac rehabilitation (CR) programs. Inspiratory muscle training has been included specifically for patients who underwent coronary artery bypass grafting (CABG). This was done not only in Phase I of CR, but also in phase II, since effects on pulmonary function and reduction in functional capacity (FC) are still present in late stages. This study had the aim of investigating the effects of the addition of high-intensity IMT to the aerobic and resistance (combined training - CT) training of patients after CABG (Phase II). A randomized clinical trial was conducted with 24 post-CABG patients randomly divided into two groups: SIMTG+CT (n=12), which performed sham IMT in association with CT, and IMTG+CT (n=12), who underwent high-intensity IMT in association with CT, for 12 weeks, twice a week. The following parameters were assessed before and after intervention: maximal FC, through cardiopulmonary exercise test (VO2 peak); submaximal FC, through the six-minute walk test (6MWT); quality of life (QoL), through the Minnesota Living with Heart Failure Questionnaire (MLHFQ); respiratory muscle strength (MIP and MEP) through manovacuometry; pulmonary function (FVC and FEV1) through spirometry; inspiratory muscle resistance (SMIP and Tlim) through manovacuometer and POWERbreathe®. Considering laboratory markers, assessment of oxidative profile was performed with advanced oxidation protein products (AOPPs); antioxidant profile through the ferric reducing method (FRAP); endothelial function through nitrite/nitrate (NOx) and inflammatory profile through high-sensitivity C-reactive protein (hsCRP). There was significant increase in VO2 peak both in SIMTG+CT (p<0.0001) and in IMTG+CT (p<0.0001). When comparing groups, a significant increase was observed in IMTG+CT (p=0.0412). Distance walked on the 6MWT significantly increased in SIMTG+CT (p<0.0001) and in IMTG+CT (p<0.0001). However, there was a significant increase in IMTG+CT in comparison to SIMTG+CT (p<0.01). Score on the MLHFQ demonstrated a significant decrease both in SIMTG+CT (p=0.0002) and in IMTG+CT (p<0.0001). In comparison between groups, a significant reduction favoring IMTG+CT was found (p<0.01). There was a significant increase of MIP in SIMTG+CT (p=0.0126) and in IMTG+CT (p<0.0001). A significant increase in IMTG+CT was observed when compared to SIMTG+CT (p<0.001). The FRAP demonstrated a significant increase both in SIMTG+CT (p=0.0016) and in IMTG+CT (p<0.0001). Between groups, a significant increase was observed favoring IMTG+CT (p=0.0069). The hsCRP demonstrated a significant decrease in SIMTG+CT (p=0.0589) and in IMTG+CT (p<0.0056). There was no significant difference between groups (p=0.3916). There was a significant intragroup increase of MEP in SIMTG+CT (p=0.0106) and in IMTG+CT (p=0.0252), and of NOx in SIMTG+CT (p=0.0015) and in IMTG+CT (p=0.0150). The IMTG+CT had significant increases in FVC (p=0.0070), in FEV1 (p=0.0022), in SMIP (p<0.0001) and in Tlim (p=0.0046). The AOPP did not present significant differences between groups. This study demonstrated for the first time that high-intensity short-length IMT can enhance the effects of CT on FC, inspiratory muscle strength, QoL and antioxidant profile. Moreover, it improved inspiratory muscle resistance and pulmonary function in post- CABG patients in the Phase II of CR. Such findings are clinically relevant in demonstrating that IMT can be a low cost and easy to insert complement to RC programs. |
publishDate |
2017 |
dc.date.issued.fl_str_mv |
2017-08-18 |
dc.date.accessioned.fl_str_mv |
2019-10-09T20:10:44Z |
dc.date.available.fl_str_mv |
2019-10-09T20:10:44Z |
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info:eu-repo/semantics/masterThesis |
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http://repositorio.ufsm.br/handle/1/18539 |
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http://repositorio.ufsm.br/handle/1/18539 |
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400800000008 |
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600 |
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Attribution-NonCommercial-NoDerivatives 4.0 International http://creativecommons.org/licenses/by-nc-nd/4.0/ info:eu-repo/semantics/openAccess |
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Attribution-NonCommercial-NoDerivatives 4.0 International http://creativecommons.org/licenses/by-nc-nd/4.0/ |
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openAccess |
dc.publisher.none.fl_str_mv |
Universidade Federal de Santa Maria Centro de Ciências da Saúde |
dc.publisher.program.fl_str_mv |
Programa de Pós-Graduação em Reabilitação Funcional |
dc.publisher.initials.fl_str_mv |
UFSM |
dc.publisher.country.fl_str_mv |
Brasil |
dc.publisher.department.fl_str_mv |
Ciências da Saúde |
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Universidade Federal de Santa Maria Centro de Ciências da Saúde |
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