Banca de DEFESA: ZENIA TRINDADE DE SOUTO ARAUJO

Uma banca de DEFESA de DOUTORADO foi cadastrada pelo programa.
STUDENT : ZENIA TRINDADE DE SOUTO ARAUJO
DATE: 30/11/2021
TIME: 08:00
LOCAL: videoconferência
TITLE:

Pulmonary Rehabilitation in COPD: Overview of Cochrane Reviews and Validation of a Physical Activity Assessment Instrument.

KEY WORDS:

 

COPD; Rehabilitation; Exercise; Evidence-Based Practice.

PAGES: 150
BIG AREA: Ciências da Saúde
AREA: Fisioterapia e Terapia Ocupacional
SUMMARY:

Chronic Obstructive Pulmonary Disease (COPD) is a major public health problem that is caused by exposure to harmful gases, genetic changes or changes in lung development, in addition to the accelerated aging process. Thus, it may be associated with chronic diseases, increasing morbidity and contributing to the incapacity and mortality of these associates. For this Doctoral thesis two studies were carried out, objectives were: 1) Systematically assess as evidence from the Cochrane trial reviews to summarize the evidence on the effectiveness and safety of rehabilitation capacities for people with COPD and highlight current gaps in knowledge; 2) Translate, cross-culturally adapt and assess the psychometric properties of the Rapid Assessment of Physical Activity (RAPA) instrument. Study 1 is an overview of systematic reviews of randomized clinical trials published in the Cochrane Database of Systematic Reviews. We searched that database until August 2020 to identify how reviews assess the effectiveness of pulmonary rehabilitation (PR) actions in COPD. The risk of bias was assessed using the risk of bias tool in systematic reviews (ROBIS). Methodological quality was analyzed using the Multiple Systematic Review Assessment (R-AMSTAR), and a quality of evidence included in the analyzes was assessed using the GRADE framework. Overall, we included 13 publications published in the Cochrane Library, comprising 245 randomized controlled trials, with a total of 19,148 participants. Included reviews evaluated a wide range of RP interventions alone or associated with another intervention in stable disease and acuteness, including: RP / exercise training; physical activity counseling; self-management; pharmacological treatment; nutritional supplementation; oxygen therapy; Non-invasive conditions; inspiratory muscle training; telerehabilitation; active mind-body movement therapies (AMBMT); neuromuscular electrical stimulation (NMES) and Tai Chi. We assessed all reviews as being of high to moderate methodological quality, based on the R-AMSTAR criteria. High-quality evidence suggested that PR after exacerbation improved quality of life and functional capacity. Moderate to high quality evidence suggested that integrated disease management (IDM) functions, aquatic exercise compared to no exercise improved quality of life and functional capacity, respectively. Moderate-quality evidence suggested that after high-intensity interval exercise training, IDM improved functional capacity. Poor quality evidence suggested that there is little or no difference with telerehabilitation, no difference when comparing aquatic and terrestrial physical training, oxygen supplementation during exercise, comparing continuous and interval training for the quality of life outcome. Evidence does not show the difference in risk for mortality with the techniques: NMES, IDM, RP after a COPD exacerbation. A small improvement in dyspnea was reported in the MMSS training group when compared to no training or sham training. No review reported cost-effectiveness as an outcome. No adverse events were observed in the following procedures: telerehabilitation, NMES, IDM, NIV during exercise, Tai Chi and exercise. We have summarized a wide range of PR interventions, mostly in individual studies. Future studies should focus on determining which components of lung recovery are optimal, the type and intensity of associated actions, and cost-effectiveness are needed to fill current knowledge gaps. Study 2 involves the process of cross-cultural adaptation and adaptation, through translation, reverse translation, review by a multidisciplinary committee of 5 experts and 2 members of the target population. The analysis of the psychometric properties of validity and reliability is being developed by our research group and will be exhibited as a master's dissertation.

BANKING MEMBERS:
Externa à Instituição - BRENDA NAZARÉ GOMES ANDRIOLO - UEPA
Externa à Instituição - IVANIZIA SOARES DA SILVA - UFRN
Interna - 2291421 - KARLA MORGANNA PEREIRA PINTO DE MENDONCA
Externa ao Programa - 2966742 - KAROLINNE SOUZA MONTEIRO
Presidente - 1632408 - PATRICIA ANGELICA DE MIRANDA SILVA NOGUEIRA