Pulmonary rehabilitation: effect of new patient-centered methodologies and technologies in patients with chronic pulmonary diseases

• Grant number: 18/17788-3
• Support Opportunities: Research Projects - Thematic Grants
• Start date: November 01, 2020
• End date: October 31, 2025
• Field of knowledge: Health Sciences - Physiotherapy and Occupational Therapy
• Principal Investigator: Celso Ricardo Fernandes de Carvalho
• Grantee: Celso Ricardo Fernandes de Carvalho
• Host Institution: Faculdade de Medicina (FM). Universidade de São Paulo (USP). São Paulo , SP, Brazil
• Pesquisadores principais: Simone Dal Corso
• Associated researchers: Adriana Claudia Lunardi ; Alberto Cukier ; Anne Elizabeth Holland ; Henrique Takachi Moriya ; Kylie Hill ; Maria Notomi Sato ; Rafael Stelmach ; Regina Maria de Carvalho Pinto ; Vinícius Cavalheri de Oliveira
• Associated research grant(s): 23/00573-2 - Multi-used equipment approved in the grant 2018/17788-3: portable cardiopulmonary exercise testing, AP.EMU; 22/03774-6 - Tailoring pulmonary rehabilitation for adults with asthma, AP.R
• Associated scholarship(s): 25/00467-3 - Mobile application development to increase clinical control in people with asthma, BP.PD; 24/02190-6 - Development of an application for monitoring asthma: advancement of the technological maturity of inspirAr, BP.TT; 22/12515-4 - Effects of aerobic training on innate and acquired immunity: a randomized and controlled trial, BP.PD; + associated scholarships 23/05288-4 - Effects of elastic adhesive bandage on dyspnea, quality of life and physical activity level in patients with severe and very severe COPD: control and randomized trial, BP.TT; 23/00129-5 - Effect of the elastic tape on exercise capacity and daily physical activity level in patients with COPD severe and very severe: crossover and randomized clinical trial, BP.IC; 22/09628-1 - Effect of the elastic tape on COPD patients submitted to pulmonary rehabilitation, BP.PD; 22/09941-1 - Effect of the association of breathing and aerobics exercises with constant load on clinical control, psychosocial aspects and sleep quality of patients with moderate to severe asthma: randomized controlled clinical trial, BP.IC; 22/02135-0 - Effect of the association of aerobic and respiratory exercises on the clinical control and psychosocial aspects of patients with moderate-severe asthma, BP.TT; 22/02014-8 - The effect of new methodologies and technologies centered on patients with chronic lung diseases, BP.TT; 21/03745-3 - Effects of aerobic training versus behavioral intervention to increase physical activity in patients with Asthma: a randomized, blinded clinical trial, BP.DR; 21/04198-6 - BEHAVIORAL INTERVENTION TO INCREASE THE LEVEL OF PHYSICAL ACTIVITY IN PATIENTS WITH ASTHMA: IDENTIFICATION OF THE RESPONDING PROFILE, BP.PD - associated scholarships

Abstract

Pulmonary Rehabilitation (PR) is the most effective physical therapy intervention for clinical, psychosocial and functional improvement for patients with chronic respiratory diseases. Despite this,there is still a need for new strategies to increase patients' physical activity level as well as new methodologies and technologies to diversify treatment and improve clinical control. Objectives: The present study has 3 main objectives: i) to evaluate the effect of a new intervention in patients with moderate to severe Asthma; ii) evaluate the use of new technologies to improve thoracoabdominalmechanics, Dyspnea and physical activity level in patients with Chronic Obstructive Pulmonary Disease (COPD); iii) evaluate the role of behavioral change in patients with different chronic respiratory diseases. Methods: This thematic project is divided into three subprojects. Subproject 1 will involve the use an innovative methodology in individual with moderate to severe Asthma (association of breathing and aerobic exercise). For this, a Randomized Controlled Trial (RCT) will be performed including 54 patients with moderate to severe Asthma. The intervention will last 12 weeks, twice a week. Patients will be followed for 26 weeks for long term effect evaluation. Subproject 2 will involve an intervention performed with an elastic band placed on the chest wall of patients with severe and very severe COPD. A randomized cross-over assay will test the acute effect of the band on thoracoabdominal asynchrony via optoelectronic plethysmography and electrical impedance tomography simultaneously. Another RCTwill analyze the effect of tape for 2 weeks on Dyspnea, quality of life and level of physical activity. Subproject 3 will involve 2 RCTs and 1 bicentric study. 128 patients with 3 different diseases will be included: Asthma, COPD and bronchiectasis. Behavior change will be accomplished using cognitive behavioral therapy. Interventions aim to modify behavior to increase physical activity and/or reducephysical inactivity. Three distinct interventions will be performed considering the clinical and functional condition of the patients and the pathophysiology of each disease. The sample size calculation was performed for all RCTs. (AU)

Scientific publications

(9)

(References retrieved automatically from Web of Science and SciELO through information on FAPESP grants and their corresponding numbers as mentioned in the publications by the authors)

DE LIMA, FABIANO FRANCISCO; PINHEIRO, DAVID HALEN ARAUJO; DE CARVALHO, CELSO RICARDO FERNANDES. Physical training in adults with asthma: An integrative approach on strategies, mechanisms, and benefits. FRONTIERS IN REHABILITATION SCIENCES, v. 4, p. 10-pg., 2023-02-17. (18/17788-3, 21/03745-3, 21/04198-6)

LIMA, FABIANO FRANCISCO DE; LUNARDI, ADRIANA CLAUDIA; PINHEIRO, DAVID HALEN ARAUJO; CARVALHO-PINTO, REGINA MARIA; STELMACH, RAFAEL; GIAVINA-BIANCHI, PEDRO; AGONDI, ROSANA CAMARA; CARVALHO, CELSO R. F.. Identifying the Characteristics of Responders and Nonresponders in a Behavioral Intervention to Increase Physical Activity Among Patients With Moderate to Severe Asthma: Protocol for a Prospective Pragmatic Study. JMIR RESEARCH PROTOCOLS, v. 12, p. 11-pg., 2023-01-01. (18/17788-3, 21/03745-3, 21/04198-6)

SILVA, SIMONE T. CAMARGO; FREITAS, PATRICIA DUARTE; LUNARDI, ADRIANA CLAUDIA; XAVIER, RAFAELLA FAGUNDES; BARBOSA, RENATA CLEIA C.; STELMACH, RAFAEL; CARVALHO, CELSO R. F.. Association between illness perception and clinical control, quality of life, physical activity, and psychosocial status in subjects with moderate to severe asthma: a cluster analysis. JOURNAL OF ASTHMA, v. N/A, p. 8-pg., 2022-01-25. (18/17788-3)

ITO, JULIANA TIYAKI; ALVES, LUAN HENRIQUE VASCONCELOS; OLIVEIRA, LUANA DE MENDONCA; XAVIER, RAFAELLA FAGUNDES; CARVALHO-PINTO, REGINA MARIA; TIBERIO, IOLANDA DE FATIMA LOPES CALVO; SATO, MARIA NOTOMI; CARVALHO, CELSO R. F.; LOPES, FERNANDA DEGOBBI TENORIO QUIRINO DOS SANTOS. Effect of exercise training on modulating the TH17/TREG imbalance in individuals with severe COPD: A randomized controlled trial. PULMONOLOGY, v. 31, n. 1, p. 15-pg., 2025-12-31. (18/17788-3, 19/25374-7)

KARLOH, MANUELA; MATIAS, THIAGO SOUSA; DE OLIVEIRA, JOICE MARA; DE LIMA, FABIANO FRANCISCO; PINHEIRO, DAVID HALEN ARAUJO; BARBOSA, GRAZIELE BESEN; FURLANETTO, KARINA COUTO; CARVALHO, CELSO R. F.. Breaking barriers to rehabilitation: the role of behavior change theories in overcoming the challenge of exercise-related behavior change. BRAZILIAN JOURNAL OF PHYSICAL THERAPY, v. 27, n. 6, p. 12-pg., 2023-12-05. (21/04198-6, 18/17788-3, 21/03745-3)

DAVID HALEN ARAÚJO PINHEIRO; JOÃO VICTOR HERMÓGENES DE SOUZA; ALBERTO FERNANDO OLIVEIRA JUSTO; REGINA MARIA CARVALHO-PINTO; FABIANO FRANCISCO DE LIMA; CELSO R F CARVALHO. Asthma in the Brazilian Unified Health Care System: an epidemiological analysis from 2008 to 2021. Jornal Brasileiro de Pneumologia, v. 50, n. 2, 2024-05-27. (21/03745-3, 23/00406-9, 18/17788-3, 21/04198-6, 21/14171-8)

QUEIROZ, DOUGLAS SILVA; DA SILVA, CIBELE CRISTINE BERTO MARQUES; OLIVEIRA, MARTINA RODRIGUES; AMARAL, ALEXANDRE FRANCO; CARVALHO, CARLOS ROBERTO RIBEIRO; SALGE, JOAO MARCOS; BALDI, BRUNO GUEDES; CARVALHO, CELSO R. F.. Clinical and Functional Outcomes Associated with Quality of Life in Patients with Lymphangioleiomyomatosis: A Cross-Sectional Study. Lung, v. 202, n. 6, p. 9-pg., 2024-10-14. (18/17788-3)

PINHEIRO, D. ARAUJO; DE LIMA, F.; SILVA, R.; LUNARDI, A.; DOS SANTOS, J.; CERVERA, V.; DE OLIVEIRA, Y.; CARVALHO-PINTO, R.; CARVALHO, C. R. F.. Aerobic Training Versus Behavioral Intervention to Increase Physical Activity in Patients With Asthma: A Preliminary Data From a Randomized Clinical Trial. American Journal of Respiratory and Critical Care Medicine, v. 209, p. 1-pg., 2024-05-01. (22/09941-1, 18/17788-3, 21/03745-3, 21/04198-6, 22/09628-1, 23/05288-4)

PASSOS, NATALIA FEBRINI; FREITAS, PATRICIA D.; CARVALHO-PINTO, REGINA MARIA; CUKIER, ALBERTO; CARVALHO, CELSO R. F.. Increased physical activity reduces sleep disturbances in asthma: A randomized controlled trial. Respirology, v. 28, n. 1, p. 9-pg., 2022-09-06. (18/17788-3, 18/17395-1)