Browsing by Author "Pimenta, Sara"
Now showing 1 - 10 of 12
Results Per Page
Sort Options
- ASO Visual Abstract: Effect of Preoperative Home-Based Exercise Training on Quality of Life After Lung Cancer Surgery: A Multicenter Randomized Controlled TrialPublication . Machado, Pedro; Pimenta, Sara; Garcia, Ana Luís; Nogueira, Tiago; Silva, Sónia; Santos, Claúdia Lares dos; Martins, Maria Vitória; Canha, André; Oliveiros, Bárbara; Martins, Raul A.; Cruz, Joana
- Efeito do exercício físico na qualidade de vida após a cirurgia para cancro do pulmão e cancro colorretal: Revisão sistemáticaPublication . Machado, Pedro; Pimenta, Sara; Oliveiros, Bárbara; Ferreira, José Pedro; Martins, Raúl A.; Cruz, JoanaIntrodução: O cancro colorretal (CCR) e o cancro do pulmão são atualmente dois dos tumores mais incidentes a nível global e os mais mortais. Apesar da resseção cirúrgica ser uma intervenção potencialmente curativa em pacientes com estes tumores, esta intervenção está associada a um declínio significativo na qualidade de vida relacionada com a saúde (QVRS). O exercício físico (EF) tem demonstrado um efeito benéfico na melhoria da capacidade funcional dos pacientes elegíveis para estes tipos de cirurgia oncológica, desconhecendo-se, no entanto, o seu efeito na recuperação da QVRS. Objectivo: O objetivo principal desta revisão sistemática foi avaliar a eficácia do EF na melhoria da QVRS após a cirurgia, em pacientes diagnosticados cancro do pulmão ou com CCR. Métodos: Foram incluídos estudos randomizados controlados, publicados até 21 de Março de 2021, selecionados através de pesquisa eletrónica, realizada nas bases de dados PubMed, Scopus, Web of Science, SPORTDiscus e PEDro. Os estudos elegíveis teriam de comparar o efeito de intervenções com EF, implementado no período pré-cirúrgico ou nos três primeiros meses após a cirurgia, com intervenções que não envolvessem exercício estruturado durante este período. A qualidade metodológica foi avaliada através da escala Physiotherapy Evidence Database (PEDro). Resultados: Dez estudos cumpriram com os critérios de elegibilidade e obtiveram uma pontuação ≥ 5 (0-10) na escala PEDro. Nove estudos incluíram pacientes com cancro do pulmão (n=651) e um estudo pacientes com CCR (n=93). Em pacientes com cancro do pulmão o exercício físico melhorou significativamente a dimensão física da QVRS após a cirurgia, com um efeito de magnitude elevada (SMD=0.89: 95% CI: [0.61; 1.15]; p=0.00) e reduziu significativamente os sintomas de fadiga, com um efeito de magnitude moderada SMD=-0.30: 95% CI: [-0.51;-0.08]; p=0.01). Em pacientes com CCR não se verificaram alterações significativas na QVRS nem nos sintomas de fadiga. Conclusão: O EF revela ser uma intervenção eficaz na recuperação da QVRS após a cirurgia em pacientes com cancro do pulmão, não havendo evidência do seu efeito benéfico em pacientes com CCR.
- Effect of Exercise Training on Quality of Life after Colorectal and Lung Cancer Surgery: A Meta-AnalysisPublication . Machado, Pedro; Pimenta, Sara; Oliveiros, Bárbara; Ferreira, José Pedro; Martins, Raul A.; Cruz, JoanaSurgical treatment affects health-related quality of life (HRQoL) and increases fatigue symptoms in patients with lung cancer (LC) and colorectal cancer (CRC). We aimed to systematically review the effect of exercise training on HRQoL and fatigue after LC and CRC surgery. Randomized controlled trials published before 21 March 2021, were searched in PubMed, Scopus, Web of Science, SPORTDiscus and PEDro. Eligible trials compared the effect of exercise interventions initiated preoperatively or in the first 3 months after surgery versus usual care on postoperative HRQoL and fatigue. Standardized mean differences (SMD) were pooled using random-effects models. Twelve studies with a total of 777 patients were included. In LC patients (10 studies, n = 651), exercise training in general led to a moderate improvement in the physical domain of HRQoL (0.68: 95% CI: [0.47; 0.89]) and a small reduction in fatigue levels after surgery (SMD = 0.28: 95% CI: [0.02; 0.53]), while no effects were found in other HRQoL domains. In CRC (two studies, n = 126), exercise training showed no effects on HRQoL and fatigue after surgery. Exercise training is an effective intervention to improve physical function and fatigue after LC surgery. Further studies are necessary to clarify the effects of exercise on HRQoL and fatigue after CRC surgery.
- Effect of Preoperative Home-Based Exercise Training on Quality of Life After Lung Cancer Surgery: A Multicenter Randomized Controlled TrialPublication . Machado, Pedro; Pimenta, Sara; Garcia, Ana Luís; Nogueira, Tiago; Silva, Sónia; Santos, Cláudia Lares dos; Martins, Maria Vitória; Canha, André; Oliveiros, Bárbara; Martins, Raul A.; Cruz, JoanaBackground. Preoperative exercise training is recommended for improvement of clinical outcomes after lung cancer (LC) surgery. However, its efectiveness in preventing postoperative decline in quality of life (QoL) remains unknown. This study investigated the efect of preoperative home-based exercise training (PHET) on QoL after LC surgery. Methods. Patients awaiting LC resection were randomized to PHET or a control group (CG). The PHET program combined aerobic and resistance exercise, with weekly telephone supervision. Primary outcome was QoL-assessed with the European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire C30 (QLQC30) at baseline, before surgery, and 1 month after surgery. The secondary outcomes were hospital length of stay and physical performance. The main analysis included a factorial repeated-measures analysis of variance. Additionally, the proportion of patients experiencing clinical deterioration from baseline to post-surgery was assessed. Results. The study included 41 patients (68.1±9.3 years; 68.3% male) in the intention-to-treat analysis (20 PHET patients, 21 CG patients). A signifcant group × time interaction was observed for global QoL (p =0.004). Betweengroup diferences in global QoL were statistically and clinically signifcant before surgery (mean diference [MD], 13.5 points; 95% confdence interval [CI], 2.4–24.6; p =0.019) and after surgery (MD, 12.4 points; 95% CI, 1.3–23.4; p=0.029), favoring PHET. Clinical deterioration of global QoL was reported by 71.4% of the CG patients compared with 30 % of the PHET patients (p =0.003). Between-group diferences in favor of PHET were found in pain and appetite loss as well as in physical, emotional and role functions after surgery (p <0.05). Compared with CG, PHET was superior in improving preoperative fve-times sit-to-stand and postoperative exercise capacity (p <0.05). No between-group diferences in other secondary outcomes were observed. Conclusion. The study showed that PHET can efectively prevent the decline in QoL after LC surgery.
- Home-Based Preoperative Exercise Training for Lung Cancer Patients Undergoing Surgery: A Feasibility TrialPublication . Machado, Pedro; Pimenta, Sara; Garcia, Ana Luís; Nogueira, Tiago; Silva, Sónia; Oliveiros, Bárbara; Martins, Raul A.; Cruz, JoanaBackground: Clinical guidelines recommend prehabilitation with exercise training to optimize recovery after lung cancer surgery. However, the lack of access to facility-based exercise programs is a major barrier to routine participation. This study aimed to assess the feasibility of a home-based exercise intervention before lung cancer resection. Methods: We conducted a prospective, two-site feasibility study, including patients scheduled for lung cancer surgery. Exercise prescription involved aerobic and resistance training with telephone-based supervision. The primary endpoint was overall feasibility (recruitment rate, retention rate, intervention adherence and acceptability). Secondary endpoints included safety and effects on health-related quality of life (HRQOL) and physical performance, evaluated at baseline, after the exercise intervention and 4–5 weeks after surgery. Results: Over three months, 15 patients were eligible, and all agreed to participate (recruitment rate: 100%). A total of 14 patients completed the exercise intervention, and 12 patients were evaluated postoperatively (retention rate: 80%). The median length of the exercise intervention was 3 weeks. Patients performed an aerobic and resistance training volume higher than prescribed (median adherence rates of 104% and 111%, respectively). A total of nine adverse events occurred during the intervention (Grade 1, n = 8; Grade 2, n = 1), the most common being shoulder pain. After the exercise intervention, significant improvements were observed in the HRQOL summary score (mean difference, 2.9; 95% confidence interval [CI], from 0.9 to 4.8; p = 0.049) and the five-times sit-to-stand test score (median difference, −1.5; 95% CI, from −2.1 to −0.9; p = 0.001). After surgery, no significant effects on HRQOL and physical performance were observed. Conclusion: A short-term preoperative home-based exercise intervention is feasible before lung cancer resection and may enhance accessibility to prehabilitation. Clinical effectiveness should be investigated in future studies.
- Motivation and physical activity in COPD: An exploratory studyPublication . Pimenta, Sara; Flora, Sofia; Silva, Cândida G.; Oliveira, Ana; Morais, Nuno; Ribeiro, José; Silva, Fernando; Caceiro, Rúben; Carreira, Bruno P.; Januário, Filipa; Andrade, Lília; Rodrigues, Fátima; Brooks, Dina; Burtin, Chris; Marques, Alda; Cruz, JoanaA key factor for the adoption of an active lifestyle is self-determined motivation; however, it is often overlooked in COPD. Understanding the motives underlying patients’ decision to be (or not) physically active will provide insight into future interventions. This study assessed the motives for patients with COPD to engage in physical activity (PA) and their association with PA behaviour. A cross-sectional study was conducted in stable patients with COPD. Motivation was assessed with the Exercise Motivation Inventory-2 (EMI-2; score 0[Not at all true for me]–5[Very true for me]; 5 dimensions) and PA with accelerometry [ActiGraph-GT3X+, 7 days; moderate to vigorous PA (MVPA), steps/day]. Spearman’s correlations (ρ) were used to assess their relationship. 60 participants were enrolled (67.2±7.7 years; 76.7% men; FEV1 49.5±19.7pp). Patients’ motives to be physically active were mostly Health, Fitness and Psychological. Correlations with PA were weak and non-significant (p>0.05) (Table 1). Patients with COPD value Health, Fitness and Psychological motives to be physically active, although these are not related to their PA behaviour. Findings highlight the complex nature of PA and the need to further explore factors influencing PA and motivation in this population.
- Motivos para a Prática de Atividade Física e Atividade Física Atual em pessoas com DPOCPublication . Pimenta, Sara; Raposo, João; Alves-Guerreiro, José; Flora, Sofia; Caceiro, Rúben; Morais, Nuno; Oliveira, Ana; Silva, Cândida G.; Valente, Carla; Andrade, L; Raínho, André; Martins, Vitória; Marques, Alda; Cruz, JoanaIntrodução e objetivos: A inatividade física está associada a um maior risco de exacerbações, hospitalizações e mortalidade em pessoas com doença pulmonar obstrutiva crónica (DPOC). A motivação é um dos fatores-chave para a adoção de um estilo de vida mais ativo. Porém, os motivos para a prática de atividade física (AF) em pessoas com DPOC têm sido pouco estudados, embora sejam relevantes para o desenvolvimento de intervenções de promoção de AF efetivas e sustentáveis. Assim, exploraram-se os motivos para o exercício que as pessoas com DPOC valorizam e a sua relação com a AF atual. Material e Métodos: Realizou-se um estudo observacional transversal em pessoas com DPOC clinicamente estáveis recrutadas em 4 hospitais e 1 centro de saúde. Os motivos para o exercício foram avaliados através do Exercise Motivation Inventory – 2 (EMI-2; 5 dimensões e 14 fatores motivacionais; valores mais altos correspondem a motivos mais valorizados). O comportamento atual de AF foi avaliado através de acelerometria [ActiGraph GT3X+; duração (min/dia) em AF ligeira e moderada-a-vigorosa (AFMV), n.º passos/dia]. Foram usadas medidas de estatística descritiva e correlação de Spearman para avaliar a relação entre os dados do EMI-2 e de acelerometria. Resultados: Foram incluídos 79 participantes (67,4±8,2 anos; 82,3% homens; 43,3% GOLD 3). O fator motivacional mais pontuado foi “manter-se saudável” (mediana [Q1-Q3] 4,7 [3,3–5]) e o que obteve um menor valor foi o “reconhecimento social” (0,8 [0–2,8]). Relativamente às dimensões, os “Motivos de Saúde” 4,1 [3,1–4,7] foram os mais valorizados. Em média, os participantes realizaram 5365,1±3239,1 passos/dia, despenderam 133,6±72,5 min/dia em AF ligeira e 30,5±25,6 min/dia em AFMV. As correlações entre a AF e os fatores e dimensões motivacionais do EMI-2 não apresentaram significância estatística (ρ≤0,194, p>0,05). Conclusões: Embora as pessoas com DPOC valorizem motivos relacionados com a dimensão “saúde”, nenhum dos fatores motivacionais se correlacionou fortemente com a AF atual. Os resultados realçam a natureza multifatorial e complexa da AF e a necessidade de explorar a relação de outros fatores na motivação e AF desta população.
- Perfil de atividade física de pessoas com Doença Pulmonar Obstrutiva Crónica (DPOC) em PortugalPublication . Raposo, João; Pimenta, Sara; Alves-Guerreiro, José; Flora, Sofia; Caceiro, Rúben; Morais, Nuno; Oliveira, Ana; Silva, Cândida G.; Ribeiro, José; Silva, Fernando; Januário, Filipa; Carreira, Bruno P.; Rodrigues, Fátima; Marques, Alda; Cruz, JoanaIntrodução e objetivos: A participação em atividade física (AF) regular está associada a um menor risco de mortalidade e melhor qualidade de vida relacionada com a saúde. Apesar de se saber que as pessoas com Doença Pulmonar Obstrutiva Crónica (DPOC) apresentam níveis baixos de AF quando comparadas com indivíduos saudáveis da mesma idade e sexo, desconhece-se ainda a caracterização diária dos níveis de AF destas pessoas em Portugal. Este estudo teve como objetivos caracterizar o perfil de AF de pessoas com DPOC portuguesas e explorar a sua relação com características clínicas. Material e Métodos: Foi realizado um estudo observacional transversal em pessoas com DPOC clinicamente estáveis, nas regiões Centro e Lisboa e Vale do Tejo. Foram recolhidos dados sociodemográficos, antropométricos, função pulmonar [Volume Expiratório Forçado no 1º segundo (FEV1)], sintomas e exacerbações (GOLD ABCD), dispneia (modified Medical Research Council), tolerância ao exercício (teste de marcha dos 6-min) e estado de saúde (COPD Assessment Test). A AF foi avaliada através de acelerometria (ActiGraph GT3X+) durante 7 dias e consistiu em: tempo despendido em AF Moderada a Vigorosa (AFMV) e em AF Total (min/dia), e número de passos/dia. Realizou-se estatística descritiva e correlações de Spearman (ρ) entre as variáveis de AF e as medidas clínicas. Resultados: Os participantes (n=102, 82 do sexo masculino, FEV1=48±19%previsto) apresentaram uma mediana [Q1–Q3] de 20 [9–41] min/dia em AFMV, 144 [100–208] min em AF Total e realizaram 4438 [2821–6944] passos/dia. Apenas 24% dos participantes atingiram ≥7000 passos/dia e 41% os ≥30 min/dia de AFMV recomendados na literatura. O tempo despendido em AFMV e o n.º de passos/dia apresentaram correlações moderadas com a dispneia (ρ=-0.401 e ρ=0.537, respetivamente; p<0.001) e com a tolerância ao exercício (ρ=0.560 e ρ=0.525, respetivamente; p<0.001). O tempo em AFMV apresentou ainda correlação com os graus ABCD (ρ=-0.430, p<0.001). Conclusões: A maioria das pessoas com DPOC é fisicamente inativa. Os sintomas, exacerbações e tolerância ao esforço estão associados à AF nesta população e devem ser considerados em intervenções de promoção de AF.
- Phenotyping Adopters of Mobile Applications Among Patients With COPD: A Cross-Sectional StudyPublication . Flora, Sofia; Hipólito, Nádia; Brooks, Dina; Marques, Alda; Morais, Nuno; Silva, Cândida; Silva, Fernando; Ribeiro, José; Caceiro, Rúben; Carreira, Bruno; Burtin, Chris; Pimenta, Sara; Cruz, Joana; Oliveira, AnaEffectiveness of technology-based interventions to improve physical activity (PA) in people with COPD is controversial. Mixed results may be due to participants' characteristics influencing their use of and engagement with mobile health apps. This study compared demographic, clinical, physical and PA characteristics of patients with COPD using and not using mobile apps in daily life. Patients with COPD who used smartphones were asked about their sociodemographic and clinic characteristics, PA habits and use of mobile apps (general and PA-related). Participants performed a six-minute walk test (6MWT), gait speed test and wore an accelerometer for 7 days. Data were compared between participants using (App Users) and not using (Non-App Users) mobile apps. A sub-analysis was conducted comparing characteristics of PA–App Users and Non-Users. 59 participants were enrolled (73% Male; 66.3 ± 8.3 yrs; FEV1 48.7 ± 18.4% predicted): 59% were App Users and 25% were PA-App Users. Significant differences between App Users and Non-App Users were found for age (64.2 ± 8.9 vs. 69.2 ± 6.3yrs), 6MWT (462.9 ± 91.7 vs. 414.9 ± 82.3 m), Gait Speed (Median 1.5 [Q1–Q3: 1.4–1.8] vs. 2.0 [1.0–1.5]m/s), Time in Vigorous PA (0.6 [0.2–2.8] vs. 0.14 [0.1–0.7]min) and Self-Reported PA (4.0 [1.0–4.0] vs. 1.0 [0.0–4.0] Points). Differences between PA–App Users and Non-Users were found in time in sedentary behavior (764.1 [641.8–819.8] vs. 672.2 [581.2–749.4] min) and self-reported PA (4.0 [2.0–6.0] vs. 2.0 [0.0–4.0] points). People with COPD using mobile apps were younger and had higher physical capacity than their peers not using mobile apps. PA-App Users spent more time in sedentary behaviors than Non-Users although self-reporting more time in PA.
- Role of digital health in pulmonary rehabilitation and beyond – shaping the futurePublication . Pimenta, Sara; Hansen, Henrik; Demeyer, Heleen; Slevin, Patrick; Cruz, JoanaPulmonary rehabilitation (PR) is a cost-effective intervention with well-known benefits on exercise capacity, symptoms and quality of life in patients with chronic respiratory diseases. Despite the compelling evidence of its benefits, PR implementation is still suboptimal, and maintenance of PR benefits is challenging. To overcome these pitfalls, there has been a growing interest to develop novel models for PR delivery. Digital health is a promising solution, as it has the potential to address some of the most reported barriers to PR uptake and adherence (such as accessibility issues), help maintain the positive results following a PR programme, and/or promote patients’ adherence to a more active lifestyle through physical activity (tele-)coaching. Despite the accelerated use of digital health to deliver PR during the COVID-19 pandemic, there are still several factors that contribute to the resistance in the adoption of digital health, such as the lack of evidence on its effectiveness, low acceptability by patients and healthcare professionals, concerns about implementation and maintenance costs, inequalities in access to the internet and technological devices, and data protection issues. Nevertheless, the trend towards reducing technology costs and the higher availability of digital devices, as well as the greater ease and simplicity of use of devices, enhance the opportunities for future development of digitally enabled PR interventions. This narrative review aimed to examine the current evidence on the role of digital health in the context of PR, including strengths and weaknesses, and to determine possible threats and opportunities, as well as areas for future work.