Cristina Martins Coelho

Comparação entre parâmetros de pressões respiratórias máximas em indivíduos saudáveis

OBJECTIVE To investigate four parameters defining maximal respiratory pressures and to evaluate their correlations and agreements among those parameters for the determination of MIP and MEP. METHODS This was a cross-sectional study involving 49 healthy, well-nourished males and females. The mean age was 23.08 ± 2.5 years. Measurements were carried out using a pressure transducer, and the estimated values for the parameters peak pressure (Ppeak), plateau pressure (Pplateau), mean maximal pressure (Pmean), and pressure according to the area (Parea) were determined with an algorithm developed for the study. To characterize the study sample, we used descriptive statistics, followed by repeated measures ANOVA and Bonferroni post hoc test or by the Friedman test and the Wilcoxon post hoc test, as well as by Pearsons or Spearmans correlation coefficients, depending on the normality of the data. The agreement between the variables was assessed with Bland & Altman plots. RESULTS There were significant differences among all of the parameters studied for MIP (Ppeak = 95.69 ± 27.89 cmH₂O; Parea = 88.53 ± 26.45 cmH₂O⁻; Pplateau = 82.48 ± 25.11 cmH₂O⁻; Pmean = 89.01 ± 26.41 cmH₂O⁻; p < 0.05 for all) and for MEP (Ppeak = 109.98 ± 40.67 cmH₂O; Parea = 103.85 ± 36.63 cmH₂O; Pplateau = 98.93 ± 32.10 cmH₂O; Pmean = 104.43 ± 36.74 cmH₂O; p < 0.0083 for all). Poor agreement was found among almost all of the parameters. Higher pressure values resulted in larger differences between the variables. CONCLUSIONS The maximal respiratory pressure parameters evaluated do not seem to be interchangeable, and higher pressure values result in larger differences among the parameters.

Comparison of three protocols for measuring the maximal respiratory pressures

Introduction To avoid the selection of submaximal efforts during the assessment of maximal inspiratory and expiratory pressures (MIP and MEP), some reproducibility criteria have been suggested. Criteria that stand out are those proposed by the American Thoracic Society (ATS) and European Respiratory Society (ERS) and by the Brazilian Thoracic Association (BTA). However, no studies were found that compared these criteria or assessed the combination of both protocols. Objectives To assess the pressure values selected and the number of maneuvers required to achieve maximum performance using the reproducibility criteria proposed by the ATS/ERS, the BTA and the present study. Materials and method 113 healthy subjects (43.04 ± 16.94 years) from both genders were assessed according to the criteria proposed by the ATS/ERS, BTA and the present study. Descriptive statistics were used for analysis, followed by ANOVA for repeated measures and post hoc LSD or by Friedman test and post hoc Wilcoxon, according to the data distribution. Results The criterion proposed by the present study resulted in a significantly higher number of maneuvers (MIP and MEP – median and 25%-75% interquartile range: 5[5-6], 4[3-5] and 3[3-4] for the present study criterion, BTA and ATS/ERS, respectively; p < 0.01) and higher pressure values (MIP – mean and 95% confidence interval: 103[91.43-103.72], 100[97.19-108.83] and 97.6[94.06-105.95]; MEP: median and 25%-75% interquartile range: 124.2[101.4-165.9], 123.3[95.4-153.8] and 118.4[95.5-152.7]; p < 0.05). Conclusion The proposed criterion resulted in the selection of pressure values closer to the individual’s maximal capacity. This new criterion should be considered in future studies concerning MIP and MEP measurements.

Effects of an unsupervised pedometer-based physical activity program on daily steps of adults with moderate to severe asthma: a randomized controlled trial

ABSTRACT Supervised exercise has shown benefits for subjects with asthma, but little is known about the effectiveness of unsupervised physical activity on this population. We investigated the effects of a 12-week unsupervised pedometer-based physical activity program on daily steps and on clinical and psychological parameters of adults with asthma. Clinically stable adults with moderate to severe asthma were encouraged to take daily 30-minute walks and were randomized to pedometer and control groups. The pedometer group received pedometers and individualized daily step targets. Changes in daily steps (average of steps taken during six consecutive days), six-minute walk test (6MWT), health-related quality of life, asthma control and anxiety and depression levels were assessed 12 weeks after intervention and 24–28 weeks after randomization. Thirty-seven participants were recruited and 30 completed the intervention. At 12 weeks, the groups differed significantly in daily steps (adjusted average difference, 2488 steps; 95% confidence interval [CI], 803 to 4172; p = 0.005) and in the 6MWT (adjusted average difference, 21.9 m; 95% CI, 6.6 to 37.3; p = 0.006). These differences were not significant 24–28 weeks after randomization. The program was effective in increasing daily steps of adults with moderate to severe asthma 12 weeks after intervention.

Objectively measured daily-life physical activity of moderate-to-severe Brazilian asthmatic women in comparison to healthy controls: A cross-sectional study

ABSTRACT Considering the complex relationship between asthma symptoms and exercise, asthmatics are usually believed to be less active in daily life than healthy subjects. However, few studies have objectively assessed daily-life physical activity (DLPA) of asthmatic adults. Objective: To objectively assess DLPA of a sample of Brazilian asthmatic women in comparison to healthy controls, and to investigate the associations between DLPA and asthma control, health-related quality of life, anxiety and depression levels, and the Six-minute walk test (6MWT) in this population. Methods: Sixty-six women were included, 36 in the asthma group (AG) and 30 in the control group (CG). The AG was composed by clinically stable moderate-to-severe asthmatics. The CG was composed by apparently healthy volunteers. All subjects underwent DLPA assessment (considered as the average of steps taken during six consecutive days measured by a pedometer) and performed the 6MWT. Additionally, participants in the AG were assessed using the Asthma Control Questionnaire, the Asthma Quality of Life Questionnaire (AQLQ), and the Hospital Anxiety and Depression Scale. Results: There was no difference between the AG and the CG regarding DLPA (7490.3 ± 3330.2 vs 6876.4 ± 3242.1 steps respectively, p = 0.45), even after adjustment for covariates. DLPA was significantly correlated to the activity limitation domain of the AQLQ among asthmatics (r = 0.43, p < 0.01). Conclusion: Despite the association between self-perceived activity limitation and DLPA among asthmatics, there were no differences regarding DLPA between a sample of moderate-to-severe Brazilian asthmatic women and apparently healthy controls.

Interface: as danças de Ana em Lavoura arcaica

The aim of the present study was to analyse and reflect on the representations of Ana’s dances in Lavoura arcaica, literary and filmic works of Raduan Nassar e Luiz Fernando de Carvalho, respectively, using as the main theoretical reference Rudolf Von Laban. It was possible to conclude that, in the absense of verbal expression, Ana channels her desire of communication into her dances. In her first dancing manifestation, she shows marks of tradition, and in her second and last dance, the signs of rupture.