Cristiane Golias Gonçalves

Postural balance and physical activity in daily life (PADL) in physically independent older adults with different levels of aerobic exercise capacity

Balance impairs with aging and may cause mobility limitations and functional decline. We aimed to evaluate postural balance and PADL in physically independent older adults with different levels of exercise capacity. One hundred fifty seven physically independent individuals, aged 60 years or older were evaluated. Postural balance assessment was performed during one-legged stance test using a force-platform and maximum exercise capacity with the incremental shuttle walking test (ISWT). PADL was assessed subjectively by the modified Baecke questionnaire and objectively using a pedometer. Based on the performance achieved in the ISWT, according to the percentage of the predicted value, the older adults were separated into 3 groups: low performance group (LP group, ISWT < 80% predicted, n = 32, 19 women), normal performance group (NP group, 80 ≤ ISWT ≤ 100% predicted, n = 30, 22 women) and high performance group (HP group, ISWT > 100% predicted, n = 95, 67 women). The HP group showed better postural balance when compared to LP groups (p < 0.001) and also higher levels of PADL measured with pedometer (p < 0.001). There was a modest correlation (r = 0.45) between exercise capacity and PADL in the LP group and a weak correlation between exercise capacity and balance (r = -28) in the HP group. Physically independent older adults with more preserved exercise capacity have better postural balance and higher levels of PADL in comparison to those older adults who show a poorer condition in terms of exercise capacity.

Comportamento da função pulmonar, força muscular respiratória e qualidade de vida em pacientes submetidos às toracotomias eletivas

OBJECTIVE To evaluate pre-and postoperative pulmonary function, respiratory muscle strength and quality of life in patients submitted to elective thoracotomy. METHODS We selected 19 patients undergoing elective thoracotomy to assess the following parameters: forced vital capacity (FVC), forced expiratory volume in one second (FEV1), maximal inspiratory pressure (MIP), maximal expiratory pressure (MEP) and quality of life through implementation of the SF-36. The examinations were performed preoperatively and in the second, 10th, 15th, 30th and 60th days postoperatively. We conduced data normality analyzes were made with the Shapiro-Wilk test, descriptive analysis of the study variables, as well as analysis of variance with multiple comparisons using ANOVA and Friedman, p-value <0.05 . RESULTS There was a significant decrease in spirometric levels and in maximal respiratory pressures in the second postoperative day. FVC returned to preoperative values between the 15th and 30th postoperative days, whereas FEV1, between the 10th and 15th. MIP and MEP returned to preoperative values between the 10th and 15th postoperative days. There was a decrease in quality of life as for functional capacity and physical aspects, which returned to preoperative values within two months after surgery. CONCLUSION There was significant reduction in lung function and respiratory muscle strength, which returned to baseline within 30 days after surgery. There was a decrease in quality of life that persisted for up to 60 days after the operation.

Efeito de um programa de exercícios direcionados à mobilidade torácica na DPOC

BACKGROUND: Chronic Obstructive Pulmonary Disease produces mechanical changes in chest wall and this physical disability reduces the daily life activities and quality of life levels. OBJECTIVES: To assess the effects of an exercise program for Thoracopulmonary Complex Re-Adaptation in the chest wall mobility, exercise capacity and quality of life in COPD patients. MATERIALS AND METHODS: Thirteen COPD patients were studied. Spirometry, Six Minutes Walk Test, Thoracic Mobility and Quality of Life by Saint George Respiratory Questionnaire (SGRQ) were the variables. The exercise program was created based on physical exercises that aim at increasing the thoracic mobility and a better exercise tolerance, as well as improving the subjective response related to quality of life. RESULTS: After a 12-week program, it was observed a significant improvement in chest wall mobility in lower chest region (xiphoid level mobility: from 3 ± 2 cm to 7 ± 4 cm; p = 0.01) and in the abdominal region (umbilical level mobility: from 2 ± 1 cm to 6 ± 4 cm; p = 0.01). There was a statistically significant improvement of exercise capacity (walk distance: from 391 ± 117 m to 442 ± 124 m; p = 0.04). In quality of life assessment by SGRQ, there was a tendency of improving in three domains (symptom: from 37 ± 22 to 26 ± 21; activity: from 64 ± 15 to 62 ± 19; and impacts: from 42 ± 16 to 38 ± 16), but with no statistic significances. CONCLUSION: Respiratory exercises aimed at increasing the chest wall mobility improve abdominal and lower chest expansibility and exercise tolerance.