Loading...
40 results
Search Results
Now showing 1 - 10 of 40
- 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.
- Lower limb co-contraction during walking in subjects with stroke: A systematic reviewPublication . Rosa, Marlene; Marques, Alda; Demain, Sara; Metcalf, Cheryl D.The aim of this paper was to identify and synthesise existing evidence on lower limb muscle co-contraction (MCo) during walking in subjects with stroke.
- Digital technology access among patients with chronic respiratory diseasesPublication . Jácome, Cristina; Rebelo, Patrícia; Paixão, Cátia; Oliveira, Ana; Cruz, Joana; Marques, Fábio; Marques, AldaBackground: Pulmonary rehabilitation (PR) is a well-established and evidence-based intervention to manage chronic respiratory diseases (CRD), but its benefits diminish over time. Self-management can slow down this tendency and digital technologies may have a key-role in such approaches. However, few studies have evaluated the access to digital technology among patients with CRD, which is fundamental for the implementation of technology-based self-management strategies. Aims: The objective of this study was to explore if patients with CRD have access to digital technology and if they feel confident in using it. Methods: This was an exploratory cross-sectional study. Patients with CRD were recruited from community-based PR programmes between October 2017 and September 2018. Patients were surveyed regarding access to computers, smartphones, tablets, cell phones and internet. Their confidence in using these technologies was assessed using a numerical scale from 0 (not at all confident) to 10 (completely confident). Patients were considered confident when a score higher than5 was selected. Chisquare tests were used to explore if access to digital technology was related to age, sex, marital status, education or occupation. Results: 123 patients (n=76; 62% male; 67±11 [32-87] years) were included. Chronic obstructive pulmonary disease (n=73; 59%) and asthma (n=23; 19%) were the most common diagnosis. 80% of patients reported having access to digital technology: 34% reported having a computer, 44% owned a smartphone or tablet and 36% a cell phone. 81% of patients reported themselves as confident in using these technologies (median 7, interquartile range 5-8.5). About half of them (n=64; 52%) used the internet and, from these, 84% felt confident in using it (median 8, interquartile range 5-9). Patients with access to digital technology and internet were younger (p=.029 and p<.001) and with higher levels of education (p=.010 and p<.001). No further associations were found. Conclusions: Patients with CRD have access to and feel confident in using digital technologies. These results reinforce the potential of using digital technologies as a resource for the implementation of selfmanagement strategies in this population.
- Evaluating physical activity in dementia: a systematic review of outcomes to inform the development of a core outcome setPublication . Gonçalves, Ana-Carolina; Cruz, Joana; Marques, Alda; Demain, Sara; Samuel, DineshBackground: Physical activity is recommended for people living with dementia, but evidence for the positive effects of physical activity is limited by the use of heterogeneous outcomes and measurement tools. This systematic literature review aimed to summarise previously reported outcomes and identify the measurement tools used most frequently in physical activity interventions for people with dementia. Methods: Literature searches were conducted in April 2015, on Delphis and Medline. Qualitative, quantitative and mixed methods studies reporting on any type of physical activity, in any setting, across types of dementia, stages of disease progression and published from 2005 onwards were included. A content analysis approach was used to report on the frequency of reported outcomes and measurement tools. Results: The 130 included studies reported on 133 different outcome domains and 267 different measurement tools. “Functional abilities and independence” (n=69), “Global cognitive function” (n=65), “Balance” (n=43), “Global behavioural symptoms of dementia” (n=42) and “Health related quality of life” (n=40) were the most frequently reported outcome domains. “Enjoyment” was the outcome most frequently sought by patients and carers. Conclusion: The need for the development and implementation of a Core Outcome Set has been reinforced. Ahead of the completion of the Core Outcome Set, researchers and clinicians are advised to measure the impact of physical activity interventions on these frequently reported outcome domains.
- The ABCD assessment tool: relationship with the clinical outcomes of patients with COPDPublication . Marques, Alda; Miranda, Sara; Paixão, Cátia; Valente, Carla; Andrade, Lília; Cruz, Joana; Jácome, Cristina; Machado, AnaThe ABCD assessment tool for patients with chronic obstructive pulmonary disease (COPD) has recently been revised. Few studies have evaluated patients’ clinical characteristics based on this classification, although it may be important to adjust interventions to patients’ specific needs. This study explored the distribution of the most used clinical outcomes in patients with COPD across ABCD groups. A cross sectional study was conducted. Patients with COPD were recruited from routine pulmonology appointments and primary care centres in Portugal. Assessments included a spirometric test, quadriceps muscle strength (QMS) with handheld dynamometer, inspiratory muscle strength with the maximal inspiratory pressure (MIP), functional performance with the 1-minute sit-to-stand test (1-min STS) and health-related quality of life with the Saint George Respiratory Questionnaire (SGRQ). Patients were classified into ABCD groups based on the modified British Medical Research Council dyspnoea questionnaire and history of exacerbations in the previous year. One-way ANOVA and Bonferroni corrections for multiple comparisons were used to explore differences between groups. Three hundred and twenty-nine patients with COPD (253 (77%) male, 67±10 years old, forced expiratory volume in one second 60±25 % of predicted, forced vital capacity 81±23 % of predicted, body mass index 28±16 kg/m2; 73 (22%) GOLD I, 133 (40%) GOLD II, 90 (27%) GOLD III, 33 (10%) GOLD IV) participated. Group A was the most prevalent (131; 40%), followed by groups B (95; 29%), D (70; 21%) and C (33; 10%). Patients from groups B and D, which are the most symptomatic, presented the worst results for all outcomes (Figure 1). Patients from ABCD groups present different clinical characteristics. The ABCD classification appears to be important to discriminate patients with worst outcomes, hence it may be useful to personalise treatments according to patients’ needs and clinical characteristics.
- Cardiorespiratory physiotherapy as a career choice-perspective of students and physiotherapists in PortugalPublication . Marques, Alda; Oliveira, Ana; Machado, Ana; Jácome, Cristina; Cruz, Joana; Pinho, Tânia; Hall, Andreia; Alvelos, Helena; Brooks, DinaWe investigated Portuguese physiotherapy students' and physiotherapists' (1) perceptions of cardiorespiratory physiotherapy (CRP); (2) factors that influenced their decision to pursue a career in CRP; and (3) suggestions to develop CRP. Online surveys were disseminated to final year students and physiotherapists. A number of 189 students (mean age 23 [SD 6] years; 78% ♀) and 375 physiotherapists (mean age 31 [SD 8] years; 78% ♀) participated. Students' opinions about CRP were positively influenced by lecturers (n = 112, 69%), clinical experiences (n = 110, 68%), and scientific evidence (n = 93, 57%). Only 13% of students were "extremely interested" in specializing in CRP. Interest in the area and clinical exposure were the main factors influencing students to pursue a career in CRP. A percentage of 15 of responding physiotherapists were working in CRP. Their decision to pursue a CRP career was most influenced by their interest in the area (n = 37, 67%) and opportunity to work in acute settings (n = 31; 56%). Main suggestions to develop CRP were (1) include placements in CRP; (2) emphasize health promotion within the curriculum; and (3) develop CRP skills in broader contexts and training. Strategies focusing on changing the curriculum, increasing exposure to CRP, providing good mentorship, developing health promotion activities, and creating postgraduate courses may increase the attractiveness for CRP.
- What Motivates Patients with COPD to Be Physically Active? A Cross-Sectional StudyPublication . Pimenta, Sara; Silva, Cândida G.; Flora, Sofia; Hipólito, Nádia; Burtin, Chris; Oliveira, Ana; Morais, Nuno; Brites-Pereira, Marcelo; Carreira, Bruno P.; Januário, Filipa; Andrade, Lília; Martins, Vitória; Rodrigues, Fátima; Brooks, Dina; Marques, Alda; Cruz, JoanaMotivation can be broadly defined as what moves people to act. Low motivation is a frequently reported factor for the reduced physical activity (PA) levels observed in patients with chronic obstructive pulmonary disease (COPD). This study assessed patients’ motives to be physically active, according to three pulmonary rehabilitation (PR) participation groups (Never PR, Previous PR and Current PR) and explored whether these motives were related to the PA levels and clinical characteristics. The motives to be physically active were assessed with the Exercise Motivation Inventory-2 (EMI-2, 14 motivational factors, five dimensions) and PA with accelerometry (PA groups: <5000 steps/day vs. ≥5000 steps/day). The clinical variables included symptoms, impact of the disease, exercise capacity and comorbidities. Ninety-two patients (67.4 ± 8.1 years, 82.6% male, forced expiratory volume in 1s (FEV1) 48.3 ± 18.9% predicted; 30.4% Never PR, 51% Previous PR and 18.5% Current PR) participated. The motivational dimensions related to health/fitness presented the highest scores (3.8 ± 1.1; 3.4 ± 1.3). The motives to be active were not significantly different between PA groups (p > 0.05) but having less symptoms and ≥two comorbidities were associated with higher scores in psychological/health and body-related motives, respectively (p < 0.05). The findings may encourage health professionals to actively explore with patients their motives to be physically active to individualise PA promotion.
- Relationship between fatigue, physical activity and health-related factors in COPDPublication . Vieira, Ana; Dias, Diana; Miguel, Eunice; Matos, Telma; Flora, Sofia; Silva, Cândida G.; Morais, Nuno; Oliveira, Ana; Caceiro, Rúben; Silva, Fernando; Ribeiro, José; Silva, Sónia; Martins, Vitória; Valente, Carla; Burtin, Chris; Brooks, Dina; Marques, Alda; Cruz, JoanaFatigue is highly prevalent in COPD and may be associated with reduced physical activity (PA) and poor outcomes. This study explored the relationship between fatigue, objectively measured PA and health-related factors in people with COPD. Fatigue was assessed with the Checklist of Individual Strength (CIS20) and CIS20-Subjective Fatigue (CIS20-SF) and PA with Actigraph GT3X monitors (moderate-to-vigorous PA, MVPA; total PA; steps/day). Dyspnoea (modified Medical Research Council, mMRC), exercise tolerance (6-min walk distance, 6MWD), lung function (spirometry) and GOLD A-D were collected. Spearman (ρ) and Pearson (r) correlations and multiple regressions were performed. Variables entered the model if correlation≥0.2. 54 patients participated (68±7 years; 82% men) and 69% reported fatigue (CIS20-SF≥27). Fatigue was significantly correlated with MVPA, steps/day, mMRC, 6MWD, GOLD A-D and FEV1pp (Table 1). In regression models for CIS20 (p=.001; r2=.61) and CIS20-SF (p=.003; r2=.56), dyspnoea was the only significant variable. People with higher scores of fatigue present lower PA levels, although the relationship is weak. Dyspnoea appears to have the largest influence on fatigue.
- 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.
- Is the international physical activity questionnaire (IPAQ-sf) valid to assess physical activity in patients with COPD? Comparison with accelerometer dataPublication . Cruz, Joana; Jácome, Cristina; Marques, AldaIntroduction: The International Physical Activity Questionnaire short form (IPAQ-sf) is primarily designed for physical activity (PA) surveillance, presenting good psychometric properties in people with an age range of 15-69 years. However, studies conducted in older people have shown conflicting results, suggesting that it may not be adequate for this population. Therefore, the use of the IPAQ-sf for the assessment of PA in patients with chronic conditions such as chronic obstructive pulmonary disease (COPD), in which patients are frequently older, remains unclear. Objective: To preliminary evaluate the validity and test-retest reliability of the IPAQ-sf in patients with COPD. Methods: This exploratory cross-sectional study included 10 patients with COPD (71.6±7.3 years old, 7 male, FEV1 77.2±20.7%predicted). Participants completed the IPAQ-sf on two occasions separated by 1 week and wore an accelerometer (Actigraph GT3X+) for 7 consecutive days. The following statistical analyses were conducted: 1) Pearson’s correlation coefficient (r) to assess correlations between the results obtained from the IPAQ-sf (PA in METs-min/week; sitting time in min/day) and the accelerometer (PA: total moderate-to-vigorous physical activity [MVPA] per week and recommended MVPA per week – i.e., MVPA conducted in bouts of at least 10-min as internationally recommended1; sedentary time in min/day); 2) percentage of agreement (%agreement) and Cohen’s kappa to assess the agreement between categorical scores obtained from the two measures (i.e., ‘sufficiently’ and ‘insufficiently’ active patients); 3) Intraclass Correlation Coefficient (ICC2,1) and 95% limits of agreement (LoA) to assess test-retest reliability and agreement. Results: Significant correlations were found between IPAQ-sf METs-min/week and total MVPA (r=0.729, p=0.017), but not between METs-min/week and recommended MVPA (r=0.346, p=0.327) or between IPAQ-sf sitting time and accelerometer-based sedentary time (r=-0.383, p=0.308). Agreement between the IPAQ-sf and accelerometer-based data in identifying ‘sufficiently’ and ‘insufficiently’ active patients was low (total MVPA: kappa=-0.538, %agreement=20%; recommended MVPA: kappa=-0.087, %agreement=50%). Test-retest reliability of the IPAQ-sf was poor to moderate (PA: ICC2,1=0.439 [-0.267→0.838]; sedentary time: ICC2,1=0.511 [-0.178→0.864]) and the agreement was low (PA: LoA: -10361→4548 METs-min/week; sedentary time: LoA: -194→148 min/day). Conclusions: Findings suggest that the IPAQ-sf has limited validity and reliability in the assessment of PA in patients with COPD. Further research with a larger sample is needed to support these findings. 1American College of Sports Medicine (ACSM) (2011). Med Sci Sports Exerc, 43(7), 1334-59.