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New approaches to evaluate patients with chronic obstructive respiratory diseases

Grant number: 16/05968-1
Support Opportunities:Regular Research Grants
Duration: September 01, 2016 - August 31, 2018
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
Associated researchers:Adriana Claudia Lunardi ; Aline Costa Lopes ; Ana Carolina Alves Caporali Pereira ; Cibele Cristine Berto Marques da Silva ; Rafaella Fagundes Xavier ; Renata Cléia Claudino Barbosa


A pulmonary rehabilitation program (PR) is defined from a proper assessment which should include at least a functional assessment. However, there is no consensus on which clinical trial evaluates properly the physical capacity of asthmatic patients. For patients with COPD, PR is much more established but it is well known that they have worse balance when compared to individuals without the disease and the maintenance of physical activity is essential for do not worsen their clinical condition. However, the predictive factors to balance disorders in COPD and to maintain their level of physical activity are poorly understood. To answer these questions, this research project includes three sub-projects. Objectives: Project I: To evaluate the effect of exercise performance, cardiovascular, respiratory and metabolic responses of normal weight and obese asthmatics in the step test; Project II: Determine which predictive factors are associated with balance disorders in patients with COPD; Project III: To evaluate the association of psychosocial factors with the level of physical activity in individuals with COPD. Methods: Project I: will be evaluated 60 adults with asthma, normal weight and obese grade II, with moderate and severe persistent asthma. All of them will be submitted to a cardiopulmonary stress test, step test and evaluation of the level of physical activity (accelerometry). The Dunnett's test will be used for multiple comparisons. The limits of agreement and accuracy for peakVO2 and the step test will be analyzed by Bland & Altman. Project II: 70 patients with COPD of both genders will be evaluated with moderate to severe disease. All them will be evaluated for postural balance (mini bestest and force platform), quadriceps muscle strength (dynamometer), level of physical activity (accelerometry), complete lung function, dyspnea (Research council scale medical modified, mMRC), quality of life (Questionnaire chronic respiratory disease, CRQ), impact of symptoms of the disease (COPD assessment test, CAT), fear of falling (Falls efficacy scale-international) and incidence of falls will be followed for 1 year. Multiple analysis models will be used to determine the predictive factors. Project III: 150 COPD of both gender will be evaluated. All them will be evaluated for the level of education, family income, current employment status, self-efficacy (General self-efficacy scale, GSE), social support (Medical outcomes study social support survey, MOS-SSS), perception of the disease (Illness perception questionnaire, IPQ-R), health factors related to quality of life (Chronic respiratory questionnaire, CRQ), level of physical activity (accelerometry). Multiple analysis models will be used to determine the predictors of physical activity. (AU)

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Scientific publications
(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)
SOUSA, ANDREY WIRGUES; BARROS CABRAL, ANNA LUCIA; SILVA, RONALDO APARECIDO; FONSECA, ALFREDO JOSE; GRINDLER, JOSE; MARTINS, MILTON ARRUDA; CARVALHO, CELSO R. F.. Physical fitness and quality of life in adolescents with asthma and fixed airflow obstruction. PEDIATRIC PULMONOLOGY, v. 56, n. 1, . (16/05968-1)
LOPES, ALINE C.; XAVIER, RAFAELLA F.; PEREIRA, ANA CAROLINA A. C.; STELMACH, RAFAEL; FERNANDES, FREDERICO L. A.; HARRISON, SAMANTHA L.; CARVALHO, CELSO R. F.. Identifying COPD patients at risk for worse symptoms, HRQoL, and self-efficacy: A cluster analysis. CHRONIC ILLNESS, v. 15, n. 2, p. 138-148, . (16/05968-1, 13/20676-9)
SOUSA, ANDREY W.; BARROS CABRAL, ANNA L.; ARRUDA MARTINS, MILTON; CARVALHO, CELSO R. F.. Risk factors for fixed airflow obstruction in children and adolescents with asthma: 4-Year follow-up. PEDIATRIC PULMONOLOGY, v. 55, n. 3, . (16/05968-1)

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