Programa de Pós-Graduação em Ciências do Movimento Humano - PPGCMH/ICS

URI Permanente desta comunidadehttps://repositorio.ufpa.br/handle/2011/15816

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Associação de obesidade sarcopênica, indicadores de composição corporal, de variabilidade da frequência cardíaca e de esforço no teste do degrau de seis minutos com a severidade da Síndrome da Apneia Obstrutiva do Sono: Um estudo transversal
(Universidade Federal do Pará, 2025-12-19) SOUZA, Leornado Brynne Ramos de; CRISP, Alex Harley; http://lattes.cnpq.br/1187580727139009; HTTPS://ORCID.ORG/0000-0003-4683-9576; NEVES, Laura Maria Tomazi; http://lattes.cnpq.br/4235603520707156; https://orcid.org/0000-0002-3115-2571
Introduction: Obstructive sleep apnea syndrome (OSAS) is the most common sleep- related respiratory disorder in the world, with different levels of severity. The literature indicates that increased body fat can increase energy expenditure, alter heart rate variability during sleep and wakefulness and affects the severity of the syndrome. Thus, there is a greater risk of muscle catabolism, negatively influencing cellular health, measured by the phase angle in bioelectrical impedance. However, few studies have expanded the assessment of body composition in relation to sarcopenic obesity in this population. In addition, the results of current research are also conflicting when analyzing the impacts of OSAS severity on metabolic and physical performance during stress tests. Objective: To investigate the association of indicators of body composition, heart rate variability, and stress in the six-minute step test with the severity of OSAS. Methods: Cross-sectional, quantitative study that took place between December 2023 and August 2024, with a single sample of 37 people diagnosed with OSAS, age 53,7 ± 13,8 years, minimum age 28 years and maximum age 78 years, confirmed by type 1 polysomnography. Data collection was performed in two phases: a) Rest, using bioelectrical impedance (Biodynamics BIA 450, Biodynamics Corporation, Washington, USA) to collect body composition data, indirect calorimetry (Quark CPET, Cosmed, Italy) to collect resting metabolic rate and time and frequency domain variables of heart rate variability using a heart rate monitor (SmartLab, HMMGroup, Germany); b) Exercise, using the 6-minute step test with a gas analyzer (Quark CPET, Cosmed, Italy) breath by breath to assess physical and metabolic effort. To determine data normality, the Shapiro-Wilk test was used, with normal data represented by mean and standard deviation and non-normal data represented by median and interquartile range. For multivariate data analysis, principal component analysis (PCA) was used, employing the varimax rotation algorithm to create the components. The reduced value of each component was used to perform a simple linear regression analysis. Results: Thirty-seven individuals with OSAS (54.05% men), BMI 31.1 ± 5.31 kg/m2 and AHI 31.3 (11.3-61.6) were evaluated. The PCA analysis created 6 principal components (PC), which are: 1st PC: body composition; 2nd PC: cellular health; 3rd PC: physical effort; 4th PC: ventilatory reasons; 5th PC: sympathovagal stimulation; 6th PC: sympathovagal stimulation (very low frequency). The body composition indicators component (BMI, neck circumference, resting metabolic rate, body resistance, and capacitance) was associated with higher AHI (F[3,32] = 3.05; p = 0.01), with an adjusted r2 value of 0.22. Conclusion: Body composition is associated with the severity of OSAS, while the components of cellular health, physical effort, ventilatory ratios, sympathovagal stimulation, and very low frequency sympathovagal stimulation were not associated with the severity of the syndrome.
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Atividade física, qualidade do sono e fatores associados à capacidade para o trabalho de fisioterapeutas da linha de frente contra a COVID-19
(Universidade Federal do Pará, 2021-06-28) MORAES, William Rafael Almeida; NEVES, Laura Maria Tomazi; http://lattes.cnpq.br/4235603520707156; https://orcid.org/0000-0002-3115-2571
INTRODUCTION: The COVID-19 pandemic highlighted the importance of physical therapy for the control and prevention of pulmonary and musculoskeletal complications, with emphasis on the specialty Respiratory Physical Therapy and Physical Therapy in Intensive Care. However, the physical and mental demands required for work on the front lines, as well as the changes in lifestyle in the face of the pandemic, may have negatively interfered with the physical therapists' ability to work. OBJECTIVE: To associate the level of physical activity, sleep quality, and demographic and occupational factors with the work ability of physical therapists on the front lines against COVID-19. METHODS: Analytical, cross-sectional and quantitative study. Brazilian physiotherapists working on the front lines against COVID-19 answered an online questionnaire that grouped four instruments: a) demographic, occupational and lifestyle data; b) the International Physical Activity Questionnaire (IPAQ); c) the Pittsburgh Sleep Quality Index (PSQI); d) the Work Ability Index (ICT). Data were analyzed and presented in descriptive statistics (absolute and relative values, mean, standard deviation) and associations between the ICT results and the independent variables, giving significance when p ≤ 0.05. The statistical software R version 4.0.0 was used. RESULTS: Answers were obtained from all regions of Brazil. There was no association between work ability and physical activity level, but inadequate work ability was associated with poor sleep quality (p < 0.001) and ICT and PSQI values showed a significant negative correlation (r = - 0.340; p < 0.001). In the adjusted analysis, work ability was associated with female gender (p = 0.018) and with a clinical diagnosis of previous COVID-19 (p < 0.001). CONCLUSION: In times of pandemic, reduced work ability is associated with poor sleep quality but not with physical activity level among frontline physical therapists against COVID-19. The results warn about the potential impact of sleep on the work of professionals who deal with the health of the population, highlighting the need for occupational health support strategies for physical therapists, especially in periods of public health crisis.
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Avaliação da função neuromuscular e estresse oxidativo de pessoas com doença renal crônica no início do tratamento hemodialítico
(Universidade Federal do Pará, 2023-04-05) ALMEIDA, Clara Narcisa Silva; NEVES, Laura Maria Tomazi; http://lattes.cnpq.br/4235603520707156; https://orcid.org/0000-0002-3115-2571
Introduction: Chronic kidney disease (CKD) often evolves silently at different stages, and stage 5 is the most advanced and severe, usually requiring renal replacement therapy. As the disease progresses, the metabolic alterations resulting from reduced renal function can lead to neuromuscular disorders and reduced functional performance in this population. Objectives: To assess neuromuscular function and oxidative stress in people undergoing an unplanned transition to stage 5 CKD at the start of hemodialysis. Methods: Cross-sectional study evaluating neuromuscular function (functional capacity [1-minute sit-to-stand test], peripheral muscle strength [isometric dynamometry of lower limbs], respiratory muscle strength [manovacuometry] and neuromuscular excitability [stimulus electrodiagnostic test]) and oxidative stress [malondialdehyde] in people in unplanned transition to stage 5 CKD who started hemodialysis on an emergency basis (CKD group) compared to people without CKD (control group) and them association. Results: Twenty-four participants, 14 in the control group without CKD (42 ± 12 years) and 14 in the CKD group (53 ± 18 years), were evaluated. The CKD group compared to controls without CKD present impaired functional capacity (13.8 ± 4.9 vs 36.7 ± 9.1 repetitions, p < 0.001), on peripheral muscle strength of lower limbs (knee extenders [12.3 ± 4.6 vs 23.5 ± 9 kgf], knee flexors [11.3 ± 3.2 vs 17.8 ± 4.3 kgf], dorsiflexors [8.7 ± 2.8 vs 16.7 ± 4.3 kgf] and plantar flexors [11.2 ± 2.5 vs 16.6 ± 4.4 kgf], all p < 0.001), expiratory muscle strength (60 ± 23 vs 83 ± 27 cmH2O, p = 0.02) and neuromuscular excitability (chronaxy of the vastus lateralis, 654 ± 230 vs 415 ± 190 μs, p = 0.008; chronaxy of the tibialis anterior, 600 [500 – 1000] vs 400 [300 – 400] μs, p = 0.001),. Inspiratory muscle strength (-70 ± 33 vs -87 ± 29 cmH2O, p = 0.7) and oxidative stress (3.51 ± 1.13 vs 3.53 ± 0.92 nmol/ml, p = 0.95) showed no significant differences. In the CKD group, functional capacity was influenced only by peripheral muscle strength, while expiratory muscle strength and functional capacity demonstrated influence on peripheral muscle strength. Conclusion: People in unplanned transition to stage 5 CKD who start hemodialysis on an emergency basis have altered in neuromuscular function. The findings of this study can guide screening and monitoring strategies for neuromuscular deficiencies and rehabilitation planning.
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Estratificação de risco de fragilidade, incapacidade e avaliação de distúrbios de sono na pessoa idosa residente da comunidade: estudo transversal
(Universidade Federal do Pará, 2023-10-30) RIBEIRO, Breno Caldas; CARNEIRO, Saul Rassy; http://lattes.cnpq.br/9162153771863939; https://orcid.org/0000-0002-6825-0239; NEVES, Laura Maria Tomazi; http://lattes.cnpq.br/4235603520707156; https://orcid.org/0000-0002-3115-2571
Background: Fragility is considered a state of vulnerability to health stressors, rendering elderly individuals susceptible to disability, hospitalization, and mortality. Recent studies have indicated an increase in the prevalence of frailty risk among older adults with sleep disturbances. Given that frailty is a dynamic condition with the potential for reversal, it is imperative to screen for possible modifiable factors to prevent, mitigate, or interrupt the frailty process. Consequently, there is a need for the stratification of frailty and an investigation into the potential associations between sleep quality, excessive daytime sleepiness, and the risk of sleep disorders in older adults. Objective: To stratify the risk of frailty and disability and investigate potential associations with sleep quality, excessive daytime sleepiness, and the risk of Obstructive Sleep Apnea (OSA) in community-dwelling older adults. Methods: This study employs a quantitative cross-sectional design, adhering to the recommendations of The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE). The research involves the stratification of frailty and disability using the Frail Non-disable Questionnaire (FiND) and the FRAIL Scale, along with the evaluation of excessive daytime sleepiness, sleep quality, and the risk of OSA through the Epworth Sleepiness Scale (ESE), Pittsburgh Sleep Quality Index (PSQI), and STOP-BANG questionnaire, respectively. Data normality was assessed using the Kolmogorov-Smirnov test. For binomial categorical comparisons, the Binomial Test was employed, while the Proportions Test was utilized for multiple comparisons. Correlation analysis was conducted using Spearman's Correlation Test. Results: A total of 109 older adults (61% females, p = 0.02) were evaluated, with a median age of 68, from the capital city (86%), self-identified as mixed race (68%), and in a state of preobesity (36%). According to FiND, 26% of participants were deemed frail and 32% were considered incapable. In contrast, according to the FRAIL Scale, 33% were pre-frail and 25% were frail. In addition, most patients had poor sleep quality (80%, p = 0.010), moderate risk of obstructive sleep apnea (49%, p < 0.010) and absence of excessive daytime sleepiness (62%, p < 0.010). There was a weak relationship between frailty and disability with poor sleep quality (rho = 0.39; p < 0.001) and risk of obstructive sleep apnea (rho = 0.26; p = 0.000). No relationship was observed between frailty and disability and excessive daytime sleepiness (rho = 0.04; p = 0.660). A weak relationship with sleep quality (rho = 0.33; p < 0.001) and the risk of obstructive sleep apnea (rho = 0.27; p = 0.001) was also observed in the analysis of correlation with frailty, but no relationship was found with excessive daytime sleepiness (rho = 0.05; p = 0.590). Conclusion: This study showed a weak relationship between the risk of frailty 8 and disability with sleep quality and the risk of obstructive apnea, but no relationship was observed with excessive daytime sleepiness.

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