Browsing by Author "Barbosa, Marisela"
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- Community-based pulmonary rehabilitation programs in individuals with COPDPublication . Barbosa, Marisela; Andrade, Renato; Melo, Cristina; Torres, RuiCommunity-based pulmonary rehabilitation (PR) programs can be offered to patients with COPD, but the literature on its effects is still not well summarized. Our purpose was to investigate the health-, physical-, and respiratory-related effects of community-based PR in individuals with COPD as compared to control groups. The PubMed and Embase databases were searched up to May 17, 2021. We included randomized control trials that compared the effects of community-based PR as compared to control groups in individuals with COPD. The risk of bias was judged using the Cochrane Risk of Bias 2 (RoB2). Meta-analysis was performed using a random-effects model to estimate the standardized mean difference (SMD) with 95% CI of the mean changes from baseline between groups. The Grading of Recommendations Assessment, Development, and Evaluation was used to interpret certainty of results. We included 10 randomized control studies comprising a total of 9,350 participants with weighted mean age of 62.3 ± 2.38 y. The community-based interventions were based on exercise programs (resistance and/or endurance). All studies were judged as high risk and/or some concerns in one or more domains the risk of bias. All meta-analyses displayed very low certainty of evidence. The community-based PR interventions were significantly superior to control interventions in improving the St. George Respiratory Questionnaire Activity subscore (−0.40 [95% CI −0.72 to −0.08]; k = 5, n = 382) and total score (−0.73 [95% CI −1.29 to −0.18]; k = 4, n = 268) and the Chronic Respiratory Disease Questionnaire dyspnea subscore (0.36 [95% CI 0.03–0.69]; k = 6, n = 550). The mean changes from baseline were not different between the groups for all other outcomes. Community-based PR tended to result in superior health-related quality of life and symptoms than control interventions, but the findings were inconsistent across outcomes and with very low certainty of evidence. Further studies are warranted for stronger conclusions.
- Os efeitos de um programa de exercício supervisionado em indivíduos com factores de risco cardiovascular no Hospital da Santa Casa da Misericórdia de AroucaPublication . Barbosa, Marisela; Silva, Pedro; Noites, AndreiaIntrodução: Estudar os factores de risco cardiovasculares (FRCV), permitem tomar medidas preventivas em relação ao estado de saúde, contribuindo para a melhoria da qualidade de vida dos indivíduos e ajudando a prevenir a ocorrência de um evento cardiovascular. Objectivo: O principal objectivo deste estudo é comprovar se o programa de exercício físico supervisionado melhora a condição física e a capacidade funcional. Como objectivo secundário, foi analisada a correlação existente entre as diferentes variáveis, após realização do programa. Métodos: Vinte sujeitos de Arouca, constituíram a amostra do estudo, dividindo-se em grupo de controlo (n=10) e grupo experimental (n=10). Todos os indivíduos receberam informação para controlo e prevenção dos FRCV, através de palestras educacionais. Apenas o grupo experimental participou no programa de exercício, com a duração de 12 semanas / 36 sessões. Foi feito o levantamento e registo dos valores das provas de esforço (Frequência Cardíaca (FC) máxima, equivalente metabólicos (MET´s) máximos e duplo produto (DP) máximo), avaliação antropométrica (índice de massa corporal (IMC), perímetro abdominal, peso, gordura visceral, massa muscular, gordura total), FRCV (Tensão Arterial, colesterol total, colesterol HDL, triglicerídeos, proteína C reactiva) e os níveis de ansiedade e depressão antes e após o programa. Por fim, verificou-se a correlação entre as variáveis. Foi utilizada a estatística inferencial e um nível de significância de 5% (α=0,05). Resultados: Na análise comparativa intergrupo da variável diferença (MII-MI), registaram-se diminuições estatisticamente significativas da variável perímetro abdominal (p=0,02) e aumento estatisticamente significativo da variável MET´s máximo (p=0,01). As principais correlações foram encontradas entre as variáveis antropométricas: peso – gordura visceral (r2=0,824; p<0,001), peso – perímetro abdominal (r2=0,560; p=0,013), peso – IMC (r2=0,527; p=0,017), IMC – peímetro abdominal (r2=0,770; p=0,001). Conclusões: Conclui-se que o programa de exercício parece aumentar a tolerância ao esforço máximo e diminui o perímetro abdominal dos indivíduos em estudo.
- Home-based rehabilitation maintenance with or without an exercise-based pilates program in COPD patientsPublication . Barbosa, Marisela; Melo, Cristina Argel de; Torres, Rui; Melo, Cristina; Torres, RuiPilates exercise may complement pulmonary rehabilitation of Chronic Obstructive Pulmonary Disease (COPD) to improve Patient-Reported Outcome Measures (PROMs). To investigate the effects on PROMs after incorporating a six-month Pilates exercise maintenance program compared to a home-only exercise program. A total of 32 participants with COPD (GOLD B) were assigned to either the intervention group (n = 14) or the control group (n = 18). Both groups participated in a three-month pulmonary rehabilitation program. For the next six months, the intervention group engaged in a Pilates exercise program and home-based exercises, while the control group continued with home-based exercises only. Primary outcomes were evaluated at baseline, three, six, and nine months. At the nine-month follow-up, the intervention group exhibited significantly fewer activity-related impairments in the St George’s Respiratory Questionnaire Activity domain (p = 0.029) and experienced less symptoms of anxiety (p = 0.002) and depression (p = 0.014) according to the Hospital Anxiety and Depression Scale scores. Other PROMs did not show statistically significant differences between the groups. Incorporating a six-month Pilates exercise maintenance program resulted in fewer activity-related impairments and reduced anxiety and depression symptoms compared to those who followed a home-based exercise maintenance program alone.
- The effects of adding a six-month Pilates exercise program to three months of traditional community-based pulmonary rehabilitation in individuals with COPD: A prospective cohort studyPublication . Barbosa, Marisela; Melo, Cristina; Torres, RuiPilates exercise may complement traditional pulmonary rehabilitation in individuals with chronic obstructive pulmonary disease (COPD). The objective was to analyze the effects of adding a six-month Pilates exercise program to a three-month pulmonary rehabilitation for individuals with COPD. Thirty-five participants with COPD (GOLD B) were assigned to the intervention (n=14) or control (n=21) group. Both groups received an initial three months of a pulmonary rehabilitation program. The intervention group further underwent six months of pilates. Participants were evaluated at baseline and at three, six, and nine months. Lung function and strength of respiratory muscles were defined as primary outcomes. Secondary outcomes included cardiac, physical function, and exacerbation episodes. There were no consistent statistically significant differences between groups for the lung function outcomes (p<0.05). Maximal inspiratory and expiratory pressure increased significantly at three months in both groups (p<0.05). It was significantly superior in the intervention group at nine months for maximal inspiratory pressure (p=0.005) and six and nine months for maximal expiratory pressure (p=0.027 and p<0.001, respectively). Changes in muscle strength (knee extension and handgrip) were comparable between groups (p>0.05), but exercise-induced fatigue and balance were significantly superior in the intervention group at the six- and nine-month follow-ups (p<0.05). Pilates exercise programs may be implemented to augment traditional pulmonary rehabilitation with the goal of improving the strength of respiratory muscles. Adding a Pilates exercise program to pulmonary rehabilitation resulted in superior strength of respiratory muscles, higher resistance to exercise-induced fatigue, and improved balance.