ESS - Escola Superior de Saúde
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Browsing ESS - Escola Superior de Saúde by Author "Abdalla, Pedro Pugliesi"
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- Feasibility, clinical efficacy, and maternal outcomes of a remote exercise program in pregnant women with obesity: The GROB randomized control pilot studyPublication . Bernardo, Diana; Bobadilla-Agouborde, Carolina; Festas, Clarinda; Carvalho, Carlos; Abdalla, Pedro Pugliesi; Amezcua-Prieto, Carmen; Naia-Entonado, Zeltia; Mesquita, Cristina; Mota, Jorge; Santos, Paula ClaraObesity is common in women of reproductive age and increases the risk during pregnancy. Exercising during this period reduces health complications. Home e-health programs are effective in overcoming exercise barriers as pregnant women use technology and the internet for health information. Methods: A single-blind randomized controlled feasibility study with pregnant women with obesity (body mass index [BMI] ≥≥30 kg/m22) was conducted in the University Hospital Center of São João between January and April 2023. Pregnant women were randomized to a control group with standard care and to an experimental group with 8-week remote exercise program using a Phoenix® biofeedback device. Feasibility outcome measures were recruitment rate (≥≥35%), loss to follow-up (≤≤15%), and program fidelity (≥≥1 session/week). Secondary outcomes were evaluated through Pregnancy Physical Activity Questionnaire, Oswestry Index on Disability, and weight assessments at baseline and at the end of the program. Results: Of the 63 eligible participants, 24 (38.1%) were successfully randomized and completed the baseline assessment. Of these, 3 (4.8%) from experimental group did not perform the initial onboarding. The control group had 8.3% of follow-up losses and for the experimental group there were no follow-up losses. Program fidelity (mean ≥≥1 session/week) was fulfilled by 66.7% of successfully randomized participants. Regarding secondary outcomes assessed between baseline and the 8th week, experimental group compared to control group had higher levels of physical activity for sports activities, a lower level of inactivity, and lower disability rates caused by low back pain. Conclusions: Based on the recruitment rate, losses to follow-up, and fidelity rate, the GROB (obesity in pregnancy) study was deemed feasible and worthy of consideration for a larger study. Moreover, the GROB study has the potential to improve maternal outcomes by reducing sedentarism and disability caused by low back pain.
- Influence of physical activity on self-esteem and anxiety during pregnancy: A longitudinal prospective studyPublication . Clara Santos, Paula; Bernardo, Diana; Abdalla, Pedro Pugliesi; Leirós-Rodríguez, Raquel; Silva, Leonardo Santos Lopes da; Mesquita, Cristina; Mota, Jorge; Machado, DalmoWomen’s pregnancy increases the odds of developing anxiety, depression, and low self-esteem. Physical activity can reduce the severity of maternal mental disorders and postpartum symptoms. The aim was to evaluate self-esteem, anxiety, and physical activity patterns among healthy pregnant women during three gestational trimesters (GTs). A longitudinal prospective study involving 248 Portuguese pregnant women, monitored for a year during all GTs, was conducted. Self-reported questionnaires were used to collect personal and obstetric data, and Rosenberg’s Self-Esteem Scale, Zung Anxiety Scale, and a Pregnancy Physical Activity Questionnaire were applied. A total of 152 women presented valid follow-up data considered for analysis. All test scores do not present normality (p < 0.001). Over the gestational trimesters, the Zung anxiety scores did not show a significant change between GTs. However, the self-esteem values reduced significantly from 1st to 2nd GT: (1st GT = 43.94 (±9.94) [95%CI: 42.37 to 45.53]; 2nd GT = 27.27 (±9.64) [95%CI: 25.74 to 28.81]; 3rd GT = 25.71 (±10.52) [95%CI: 24.04 to 27.39]; p < 0.001), remaining stable in the last GT. Moderate to vigorous (2nd GT = 73.43 (±88.69) [95%CI: 59.34 to 87.54]; 3rd GT = 65.05 (±82.65) [95%CI: 51.92 to 78.19]; p = 0.008), vigorous (1st GT = 0.45 (±3.95) [95%CI: 0.83 to 2.08]; 2nd GT = 1.63 (±3.52) [95%CI: 1.07 to 2.19]; 3rd GT = 0.81 (±2.16) [95%CI: 0.46 to 1.15]; p = 0.0475), and light (2nd GT = 101.68 (±48.77) [95%CI: 93.93 to 109.44]; 3rd GT = 98.42 (±49.05) [95%CI: 90.62 to 106.22]; p < 0.001) physical activity levels were significantly reduced throughout the GTs, but the time spent in sedentary activities did not change. In this follow-up study, it was possible to identify a critical point in the 2nd GT, when the drastic reduction in physical activity levels coincided with periods of lower self-esteem scores. However, anxiety levels do not seem to change over GTs.
- Otago exercise program plus cognitive dual-task can reduce fall risk, improve cognition and functioning in older adultsPublication . Santos, Paula Clara; Machado, Dalmo Roberto Lopes; Abdalla, Pedro Pugliesi; Santos, Claúdia Vanessa; Lopes, Sofia; Martins, Anabela Correia; Mota, Jorge; Mesquita, CristinaThe risk of falling increases with neuromusculoskeletal and cognitive changes resulting from aging. Physical exercise shows beneficial effects on the risk of falling, but the results are unknown when associated with cognitive activity dual-task (DT). 36 older adults (83.5 ± 5.7 years) participated in a quasi-experimental study, distributed in two experimental groups and a control group: 1) OEP (OEPG; n=12), 2) OEP plus DT (OEPDTG; n = 12), and a control group (CG; n=12). Older adults were evaluated at pre- and post- 12 weeks of intervention. The thresholds for the risk of falling were considered as multiparameter scores of the 10 Meter Walking Test (10MWT), evocative 10MWT, Timed Up and Go (TUG), Sit to Stand Test (STS), and The Four-Stage Balance Test (Four-Stage), and the Montreal Cognitive Assessment (MoCA), to test the cognitive impairment. At baseline, all groups were homogeneous. Post-intervention, the experimental groups presented significant functional differences, in comparison to the CG, for 10MWT (OEPDTG: p= 0.002; OEPG: p= 0.002); evocative 10MWT (OEPDTG: p=0.001; OEPG: p=0.001); TUG (OEPDTG: p=0.034); STS (OEPDTG: p<0.001; OEPG: p<0.001) and cognitive for MoCA (OEPDTG: p<0.019). Significant intra-group differences (pre-post) were observed in all intervention groups, but none in CG. The risk of falling (Four-Stage) in experimental groups (OEPDTG: 33.3%; OEPG: 41.7%) was considerably lower than CG (83.3%). Otago Exercise Program alone can reduce the risk of falling due to improved functionality, but adding the dual task also improves cognitive capacity in older adults. The clinical significance of these interventions goes beyond statistics.