Satisfaction and Adherence of COPD Patients to a Conventional Training Associated with Functional Exercises and to a Conventional Training Isolated: A Qualiquantitative Study.

Purpose: To verify, through quali-quantitative analysis, the satisfaction and adherence of patients with Chronic Obstructive Pulmonary Disease (COPD) to the insertion of functional circuit training into conventional training. Patients and Methods: 23 patients with COPD from a randomized clinical trial were invited to participate in a quali-quantitative analysis after the training finalization, divided into FTG (Functional Training Group) and CTG (Conventional Training Group). A total of 21 patients participated [(FTG: n=10; 65.80±7.31 years; FEV1/FVC: 56.44±12.67%) and CTG (n=11; 70.36±7.02 years; FEV1/FVC: 55.89±8.20)]. For the qualitative evaluation, focus groups were performed, using a previously developed script. Adherence was verified by the presence in the training sessions that were prescribed, and the quantitative analysis was performed using questionnaires with multiple-choice questions (evaluation of the aspects that can interfere in a training). The participants were asked to define a grade between zero and ten regarding the aspects of the training (satisfaction). Results: In both groups, there was similar adherence (p=0.965) and satisfaction (p=0.341). The qualitative analysis identified seven themes and 17 codes, representing factors related to satisfaction and negative aspects, as follows: factors associated with satisfaction: self-efficacy management, physical and psychosocial improvement, interpersonal relationships, and proposed exercises. Negative aspects: pains, comorbidities, beliefs, and personal demotivation. In the quantitative analysis, was verified that an increase in the symptoms, the distance between home and training center, and personal problems were not factors that interfered in the adherence of the participants (p<0.05). Conclusion: Similar satisfaction and adherence of patients with COPD were observed in the FTG and CTG and patients from FTG reported higher fatigue.

Resistance training using different elastic components offers similar gains on muscle strength to weight machine equipment in Individuals with COPD: A randomized controlled trial.

Purpose: To compare the effects of three modalities of resistance training, two using elastic components and one using conventional weight machine on peripheral muscle strength in Individuals with chronic obstructive pulmonary disease (COPD). Effects on exercise capacity, impact of disease on health status, body composition and daily level of physical activity were investigated as secondary endpoints.Methods: Forty-eight participants were randomly allocated (Trials Registry #RBR-6V9SJJ) into Elastic band group (Theraband®) (EBG), Elastic tubes training using Lemgruber® (ETG), and Conventional training with weight machine equipment (CG). Participants were evaluated before and after 12 weeks of training regarding peripheral muscle strength by dynamometry; impact of disease on health status via COPD Assessment Test, CAT; exercise capacity by 6-min walk test, 6MWT; body composition by bioelectrical impedance; and daily level of physical activities via accelerometry.Results: Inter-group comparison of training effects did not elucidate significant differences between the modalities in muscle strength (p ≥ .2). Likewise, all training modalities showed similar effects on CAT, body composition and daily physical activity variables with no statistical significance observed (p ≥ .15).Conclusions: Modalities of resistance training using elastic components presented similar effects on muscle strength, health status, exercise capacity, body composition and daily level of physical activity in individuals with COPD. The effects of elastic resistance were similar to conventional resistance training.

Exercise as a Peripheral Circadian Clock Resynchronizer in Vascular and Skeletal Muscle Aging.

Aging is characterized by several progressive physiological changes, including changes in the circadian rhythm. Circadian rhythms influence behavior, physiology, and metabolic processes in order to maintain homeostasis; they also influence the function of endothelial cells, smooth muscle cells, and immune cells in the vessel wall. A clock misalignment could favor vascular damage and indirectly also affect skeletal muscle function. In this review, we focus on the dysregulation of circadian rhythm due to aging and its relationship with skeletal muscle changes and vascular health as possible risk factors for the development of sarcopenia, as well as the role of physical exercise as a potential modulator of these processes.

Mucociliary Clearance of Different Respiratory Conditions: A Clinical Study.

Introduction Mucociliary clearance (MCC) is the first line of defense of the pulmonary system. Mucociliary clearance impairment may lead to increased risk of respiratory infections, lung injury, pulmonary repair problems, chronic dysfunctions and progression of respiratory diseases. Objective To characterize the MCC of active and passive smokers and individuals with chronic obstructive pulmonary disease (COPD) and compare the MCC behaviors between men and women of different age groups. Methods Patients with COPD (current smokers and ex-smokers) and apparently healthy individuals (current smokers, passive smokers and nonsmokers) were evaluated. All of the subjects underwent lung function and MCC evaluation (saccharin transport test [STT]). Smokers (with or without COPD) were questioned about the smoking history. Results A total of 418 individuals aged 16 to 82 years old, of both genders, were evaluated. The STT values of active and passive smokers were statistically higher than those of the control group ( p < 0.01). Men of the control group had lower values of STT than active smokers (9.7 ± 7.1 and 15.4 ± 10.1 minute, respectively, p < 0.01). In addition, higher MCC velocity was observed in women that are current smokers (11.7 ± 6.8 minute) compared with men (15.4 ± 10.1 minute) in this group ( p = 0.01). Among the younger age groups (< 50 years old), only passive smokers presented higher STT in relation to the control group. Conclusion Passive and active smoking are factors that influence negatively the MCC, and passive smokers may present losses of this mechanism at a younger age. Additionally, male smokers present worse MCC than male nonsmokers.

Mucociliary Clearance of Different Respiratory Conditions: A Clinical Study

Abstract Introduction Mucociliary clearance (MCC) is the first line of defense of the pulmonary system. Mucociliary clearance impairment may lead to increased risk of respiratory infections, lung injury, pulmonary repair problems, chronic dysfunctions and progression of respiratory diseases. Objective To characterize the MCC of active and passive smokers and individuals with chronic obstructive pulmonary disease (COPD) and compare the MCC behaviors between men and women of different age groups. Methods Patients with COPD (current smokers and ex-smokers) and apparently healthy individuals (current smokers, passive smokers and nonsmokers) were evaluated. All of the subjects underwent lung function and MCC evaluation (saccharin transport test [STT]). Smokers (with or without COPD) were questioned about the smoking history. Results A total of 418 individuals aged 16 to 82 years old, of both genders, were evaluated. The STT values of active and passive smokers were statistically higher than those of the control group (p < 0.01). Men of the control group had lower values of STT than active smokers (9.7 ± 7.1 and 15.4 ± 10.1 minute, respectively, p < 0.01). In addition, higher MCC velocity was observed in women that are current smokers (11.7 ± 6.8 minute) compared with men (15.4 ± 10.1 minute) in this group (p = 0.01). Among the younger age groups (< 50 years old), only passive smokers presented higher STT in relation to the control group. Conclusion Passive and active smoking are factors that influence negatively the MCC, and passive smokers may present losses of this mechanism at a younger age. Additionally, male smokers present worse MCC than male nonsmokers.

Systemic Cytokine Profiles of CD4+ T Lymphocytes Correlate with Clinical Features and Functional Status in Stable COPD.

Aims: To evaluate the expressions of intracellular cytokines in CD4+ T lymphocytes and to investigate the correlation between biomarker expressions and clinical and functional characteristics of stable COPD patients. Patients and Methods: Peripheral blood was collected from 36 COPD patients, and the expression of cytokines (IL-8, IL-13, IL-17, IL-6, IL-2, IL-10, and TNF-α) in T lymphocytes CD4 + was investigated. In addition, lung function, dyspnea symptoms, quality of life, vital signs, body composition, level of physical activity, peripheral muscle strength, and functional capacity were assessed. Results: Individuals with greater bronchial obstruction present a higher proportion of CD4 + IL-2 + lymphocytes compared to individuals with less severe bronchial obstruction. We found a positive correlation between the expression of the cytokines IL-13, IL-17, IL-6, IL-2, IL-10, and TNF-α in CD4+ T lymphocytes. In addition, we found a positive correlation between CD4+ IL-10+ T lymphocytes and lower limb muscle strength and a negative correlation between CD4+ IL-8+ T lymphocytes and peripheral oxygen saturation and steps per day. Conclusion: Systemic CD4+IL-2+, IL-8+, and IL-10+ T lymphocytes presented a correlation with clinical characteristics and functional status in stable COPD.

Body image in COPD and its relation with physical activity levels, lung function and body composition: An observational study.

INTRODUCTION: Body image has been previously defined as the mental figure we have of the contours and shape of our body; and the feelings concerning these characteristics. A change in body perception can influence one's feelings of self-worth and compromise functional abilities. Thus, the detection of distortions in body image could be important data for clinical evaluation of subjects with COPD. OBJECTIVES: To assess the body image perception of subjects with COPD. Also, to investigate the association between body image and levels of physical activity in these subjects. MATERIALS AND METHODS: 109 subjects were recruited and divided into the COPD group and control subjects without any pulmonary conditions. For this cross-sectional study, we performed an initial evaluation and participants were evaluated regarding physical activity level, body image (silhouette scale) and determination of body mass index (BMI). Finally, we performed the evaluation of lung function (spirometry) and body composition analysis (bioelectrical impedance). RESULTS: BothCOPD and control subjects presented alterations in body image. Both groups desired significantly lower BMI and weight measures, according to the silhouette scale, demonstrating body dissatisfaction (P < .05). No differences in the level body dissatisfaction were found between Control and COPD groups (P > .05). No associations between physical activity levels and body image were observed (P > .05; r = -0.24 to 0.14). CONCLUSION: In conclusion, patients with COPD present significant body dissatisfaction, similar to control individuals. Furthermore, body image perception in COPD is related to body composition measurements but not to physical activity levels.

Effects of combining functional exercises with exercise training on daily physical activities and functionality in patients with COPD: a protocol for a randomized clinical trial.

INTRODUCTION: Functional training has been shown to be a viable alternative for the elderly and patients with chronic obstructive pulmonary disease (COPD). However, whether the combination of this type of training with aerobic and resistance training, commonly performed in pulmonary rehabilitation (PR) programs, induces more pronounced effects on daily physical activities and functionality remains unclear. The aims of the study will be to evaluate the short-term and sustained effects of the combination of a functional circuit program with a training program consisting of aerobic and resistance exercise. METHODS: In this randomized controlled trial, patients with COPD will be randomly assigned (1:1:1) to an 8-week training program to follow one of the three a priori defined groups: (I) resistance and aerobic and functional exercises, (II) a conventional program including only resistance and aerobic exercises, or (III) a usual care program. Patients will be evaluated before and upon completion of 8 weeks of training regarding physical activity in daily life (PADL) using an activity monitor (accelerometer), activities of daily living (London Chest Activity of Daily Living), functional exercise capacity (6-minute walk test), and muscle strength (dynamometry). Additionally, the sustained effects of the interventions will be evaluated 22 weeks after commencing the study. DISCUSSION: The inclusion of a protocol of functional physical training in the training conventionally performed by patients with COPD as an alternative to increase PADL and functionality may provide subsidies for the treatment of these patients, representing an advance and impacting on the physical training of patients with COPD. TRIAL REGISTRATION: Brazilian Clinical Trials Registry (ReBEC) ID: RBR-3zmh3r. Registered: March 7, 2018.

The perceptions of physical therapists about facilitators and challenges in the use of different tools for resistance training in COPD patients: a mixed-method study / Percepção de fisioterapeutas sobre facilitadores e barreiras no uso de diferentes ferramentas para treinamento resistido em pacientes com DPOC: estudo de método mistos / Percepción de fisioterapeutas sobre facilitadores y barreras en el uso de diferentes herramientas de entrenamiento de resistencia en pacientes con EPOC: estudio de método mixto

ABSTRACT This study sought to quantify and qualitatively analyze the perception of physical therapists about facilitators and the challenges in the use of different types of tools for resistance training in chronic obstructive pulmonary disease (COPD) patients. This was a mixed-model study with qualitative analysis developed in a rehabilitation center. Six physical therapists who performed a randomized clinical trial were interviewed. The protocol consisted of the evaluation of three types of resistance training: elastic tubes, elastic bands, and training with conventional weight machines. After completion of the randomized trial, therapists were invited to participate in a focus group to collect qualitative data. Physical therapists also answered a quantitative questionnaire containing closed questions. The main outcome measures were the opinion of physical therapists about the advantages and disadvantages in clinical practice of each of the analyzed tools. The focus group analysis resulted in eight themes: Insecurities regarding load and handling tools, implementation of home-based treatment, improvements of tools, advantages and disadvantages of tools, incidence of injuries with elastic tools, patient's preferences, and particularities of the tools. Physical therapists pointed out different challenges and facilitators for resistance training. Characteristics of the tools such as costs, portability, handling and practicality were cited as factors that influence clinical practice. In the quantitative analysis, no differences were observed when comparing the scores of each instrument. The three tools analyzed are applicable and feasible in the clinical practice of physical therapists; moreover, they present different characteristics and particularities that should be considered, such as cost, clinical applicability, portability and perception of the patient and therapists.

RESUMO O objetivo do estudo foi quantificar e analisar qualitativamente a percepção de fisioterapeutas sobre facilitadores e barreiras no uso de diferentes ferramentas para treinamento resistido em pacientes com doença pulmonar obstrutiva crônica (DPOC). O método utilizado foi desenvolvido em um centro de reabilitação. Seis fisioterapeutas que participaram como terapeutas de um ensaio clínico randomizado foram entrevistados. O protocolo consistiu na avaliação de três ferramentas para treinamento resistido: tubos elásticos, bandas elásticas e treinamento convencional com equipamentos de musculação. Depois da finalização do ensaio clínico randomizado, os fisioterapeutas foram convidados a participar de um grupo focal para análise qualitativa e responder questionário fechado para análise quantitativa. Os profissionais opinaram sobre vantagens e desvantagens de cada uma das três ferramentas na prática clínica. A análise do grupo focal resultou em oito temas: insegurança em relação à carga e manuseio das ferramentas; implementação de tratamento domiciliar; melhorias para ferramentas; vantagens e desvantagens das ferramentas; incidência de lesões com ferramentas elásticas; preferência dos pacientes; e particularidades de cada ferramenta. Fisioterapeutas apontaram diferentes barreiras e facilitadores para o treinamento resistido. Características das ferramentas - como custo, portabilidade, manuseio, praticidade e percepção do paciente e fisioterapeuta - foram citadas como fatores que influenciam a prática clínica. Na análise quantitativa, nenhuma diferença foi observada quando comparados os escores para cada instrumento. As três ferramentas são aplicáveis na prática clínica do fisioterapeuta. Adicionalmente, as características e particularidades de cada uma delas devem ser consideradas.

RESUMEN El objetivo del estudio fue cuantificar y analizar cualitativamente la percepción de fisioterapeutas sobre facilitadores y barreras en el uso de diferentes herramientas de entrenamiento de resistencia en pacientes con enfermedad pulmonar obstructiva crónica (EPOC). El método utilizado fue desarrollado en un centro de rehabilitación. Seis profesionales que participaron como terapeutas en un ensayo clínico aleatorizado fueron entrevistados. El protocolo consistió en la evaluación de tres herramientas de entrenamiento de resistencia: tubos elásticos, bandas elásticas y entrenamiento convencional con equipo de entrenamiento con pesas. Después del ensayo clínico aleatorizado, se invitó a los fisioterapeutas a participar en un grupo focal para análisis cualitativo y a responder un cuestionario cerrado para análisis cuantitativo. Los profesionales opinaron sobre las ventajas y desventajas de cada una de las tres herramientas en la práctica clínica. El análisis del grupo resultó en ocho temas: falta de fiabilidad en lo referente a la carga y al manejo de las herramientas; puesta en práctica del tratamiento domiciliario; mejoras en las herramientas; ventajas y desventajas de las herramientas; incidencia de lesiones con las herramientas elásticas; preferencia de los pacientes; particularidades de cada herramienta. Los fisioterapeutas señalaron diferentes barreras y facilitadores para el entrenamiento de resistencia. Características de la herramienta - como costo, portabilidad, manejo, practicidad y percepción del paciente y del fisioterapeuta - fueron mencionadas como factores que influyen en la práctica clínica. En el análisis cuantitativo no se observaron diferencias de puntaje entre los instrumentos. Las tres herramientas son aplicables en la práctica clínica del fisioterapeuta. Además, se deben considerar las características y particularidades de cada una de ellas.

Nasal mucociliary transportability of male and female smokers / Transportabilidade mucociliar nasal de homens e mulheres tabagistas

Abstract Introduction: Female smoker's present increased susceptibility to several diseases when compared to the opposite gender. However, there are no studies showing differences in nasal mucociliary transport behavior between male and female smokers. Objective: To compare the nasal mucociliary transportability in male and female smokers and non-smokers, taking into consideration age, anthropometric data, smoking load and pulmonary function. Methods: The analysis included 139 individuals (33 men and 37 women smokers and 32 men and 37 women non-smokers). All participants answered an initial interview to obtain personal data and smoking load. Anthropometric data and carbon monoxide in the exhaled air were assessed. Individuals also performed pulmonary function test and Saccharin Transit Time test. To compare saccharin transit time values between men and women, smokers and non-smokers, stratification of all independent variables was performed (sociodemographic, smoking and respiratory variables) into two categories: below and above the median values. Results: There was no difference between men and women, smokers and non-smokers, regarding nasal mucociliary transportability. Significant differences were only observed between non-smokers. Among those with less forced vital capacity values (<97.37% of predicted), women presented mucociliary transport faster than men. Moreover, it was observed influence of BMI and COex (women smokers), FCV and FEV1 (men non-smokers) and FEF25-75% (women non-smokers) on saccharin transit time values. Conclusion: Based on the findings of this study, nasal mucociliary transport in male and female adult smokers, apparently healthy, are similar.

Resumo Introdução: Mulheres tabagistas apresentam maior susceptibilidade à diversas doenças quando comparadas ao sexo masculino. No entanto, não há estudos mostrando diferenças no comportamento do transporte mucociliar nasal entre tabagistas do sexo masculino e feminino. Objetivo: Comparar a transportabilidade mucociliar nasal em homens e mulheres fumantes e não fumantes, levando em consideração idade, dados antropométricos, carga tabágica e função pulmonar. Método: A análise incluiu 139 indivíduos (33 homens e 37 mulheres fumantes e 32 homens e 37 mulheres não fumantes). Todos os participantes responderam a uma entrevista inicial para a obtenção de dados pessoais e a carga tabágica. Dados antropométricos e monóxido de carbono no ar expirado foram avaliados. Os indivíduos também fizeram teste de função pulmonar e o teste de trânsito de sacarina. Para comparar os valores do teste de trânsito de sacarina entre homens e mulheres, fumantes e não fumantes, foi feita a estratificação de todas as variáveis independentes (variáveis sociodemográficas, tabágicas e respiratórias) em duas categorias: abaixo e acima dos valores médios. Resultados: Não houve diferenças entre homens e mulheres, fumantes e não fumantes, em relação à transportabilidade mucociliar nasal. Diferenças significativas foram observadas apenas entre não fumantes. Entre os que apresentaram valores menores de capacidade vital forçada (< 97,37% do previsto), as mulheres apresentaram transporte mucociliar mais rápido do que os homens. Além disso, observou-se influência do IMC e COex (mulheres fumantes), CVF e VEF1 (homens não fumantes) e FEF25%-75% (mulheres não fumantes) sobre os valores do teste de trânsito de sacarina. Conclusão: Com base nos achados deste estudo, o transporte mucociliar nasal em tabagistas masculinos e femininos adultos, aparentemente saudáveis, são semelhantes.

Nasal mucociliary transportability of male and female smokers.

INTRODUCTION: Female smoker's present increased susceptibility to several diseases when compared to the opposite gender. However, there are no studies showing differences in nasal mucociliary transport behavior between male and female smokers. OBJECTIVE: To compare the nasal mucociliary transportability in male and female smokers and non-smokers, taking into consideration age, anthropometric data, smoking load and pulmonary function. METHODS: The analysis included 139 individuals (33 men and 37 women smokers and 32 men and 37 women non-smokers). All participants answered an initial interview to obtain personal data and smoking load. Anthropometric data and carbon monoxide in the exhaled air were assessed. Individuals also performed pulmonary function test and Saccharin Transit Time test. To compare saccharin transit time values between men and women, smokers and non-smokers, stratification of all independent variables was performed (sociodemographic, smoking and respiratory variables) into two categories: below and above the median values. RESULTS: There was no difference between men and women, smokers and non-smokers, regarding nasal mucociliary transportability. Significant differences were only observed between non-smokers. Among those with less forced vital capacity values (<97.37% of predicted), women presented mucociliary transport faster than men. Moreover, it was observed influence of BMI and COex (women smokers), FCV and FEV1 (men non-smokers) and FEF25-75% (women non-smokers) on saccharin transit time values. CONCLUSION: Based on the findings of this study, nasal mucociliary transport in male and female adult smokers, apparently healthy, are similar.

Critical Velocity Determined by a Non-Exhaustive Method in Subjects With COPD.

BACKGROUND: Exercise training is an effective and low-cost tool for COPD rehabilitation. Thus, validating a non-exhaustive method to determine a patient's anaerobic threshold would be a very interesting tool in practical settings. We aimed to test the reproducibility of critical velocity values determined in a non-exhaustive manner (CVNE) and tolerance for exercise performed at this physiological marker in subjects with COPD. METHODS: Twelve subjects with COPD were evaluated in this cross-sectional study. The study was divided into 2 phases: Phase A consisted of reproducibility of CVNE for subjects with COPD, and Phase B determined the tolerance for exercise tests performed at this physiological marker. RESULTS: The proposed protocol for determining CVNE presented fair reproducibility according to blood lactate concentrations (intraclass correlation coefficient = 0.58). However, we cannot consider that the tests were reproducible due to the wide CI (0.03-0.85). Furthermore, moderate and strong correlations were observed between the CVNE determined by lactate concentration, by oxygen consumption (V̇O2 ) (r = 0.66), and by heart rate (r = 0.88). However, a high limit of agreement was observed ±1.45 km/h and ±1.55 km/h, respectively. In the tolerance for exercise test, none of the subjects presented lactate destabilization, whereas 3 tests were interrupted by oxygen saturation decline and 1 test was interrupted by hemodynamic instability. CONCLUSIONS: Although most of the subjects presented good tolerance for exercise at CVNE, fair levels of reproducibility were observed in subjects with COPD, even using lactate. Thus, the use of CVNE determined through double 3-min efforts should be considered with caution.

Qualidade de vida de tabagistas e sua correlação com a carga tabagística / Calidad de vida de los consumidores de tabaco y su correlación con la carga de tabacos / Quality of life of smokers and its correlation with smoke load

RESUMO O tabagismo é considerado uma doença crônica e uma das principais causas de mortes evitáveis no mundo. A qualidade de vida é uma importante medida de impacto na saúde e em sua relação com os níveis de dependência de nicotina e de carga tabagística, os quais ainda não estão totalmente esclarecidos. Avaliou-se a qualidade de vida de tabagistas e sua correlação com a carga tabagística e com o nível de dependência nicotínica. Foram inclusos, neste estudo, tabagistas de ambos os sexos e sem doenças clínicas diagnosticadas. Posteriormente, foi realizada avaliação da qualidade de vida e nível de dependência nicotínica por meio de questionários. A amostra foi constituída por 48 indivíduos. Houve correlação negativa entre a vitalidade e a quantidade de anos em que estes indivíduos fumaram (p=0,009; r=-0,27), assim como o estado geral de saúde e anos/maço (p=0,02; r=-0,23) e quantidade de cigarros consumidos por dia atualmente (p=0,006; r=-0,29). É possível observar correlação negativa entre capacidade funcional e a pontuação do questionário de Fagerström (p=0,004; r=-0,3). Concluiu-se que a carga tabagística e o grau de dependência de nicotina apresentaram relação com piores índices de qualidade de vida da população tabagista.

RESUMEN El tabaquismo es considerado una enfermedad crónica y una de las principales causas de muertes evitables en el mundo. La cualidad de vida es una importante medida de impacto en la salud y en su relación con los niveles de dependencia de nicotina y de carga de tabacos, los cuales todavía no están totalmente aclarados. Se evaluó la cualidad de vida de consumidores de tabaco y su correlación con la carga de tabacos y con el nivel de dependencia nicotínica. Fueron inclusos, en este estudio, consumidores de tabacos de ambos sexos y sin enfermedades clínicas diagnosticadas. Posteriormente, fue realizada la evaluación de la cualidad de vida y el nivel de dependencia nicotínica por medio de cuestionarios. La muestra fue constituida por 48 individuos. Hubo correlación negativa entre la vitalidad y la cuantidad de años en que estos individuos fumaron (p=0,009; r=-0,27), así como el estado general de salud y años/cajetilla (p=0,02; r=-0,23) y la cuantidad de cigarrillos consumidos al día actualmente (p=0,006; r=-0,29). Es posible observar correlación negativa entre la capacidad funcional y el puntaje del cuestionario de Fagerström (p=0,004; r=-0,3). Se concluyó que la carga de tabacos y el grado de dependencia de nicotina presentaron relación con los peores índices de cualidad de vida de la población consumidora de tabacos.

ABSTRACT Smoking is considered a chronic disease and one of the leading causes of preventable death in the world. The quality of life is an important measure of health impact and its correlation with nicotine dependence levels and smoking is unclear. We evaluated the quality of life of smokers and its correlation with smoke load and the nicotine dependence level. Smokers of both sexes and with no diagnosis of clinical diseases were included in this study. We evaluated their quality of life and level of nicotine dependence through questionnaires. The sample consisted of 48 individuals, 27 women and 21 men. There was a negative correlation between vitality and the amount of years these individuals have smoked (p=0.009;r=-0.27), as well as the general health condition and pack/years (p=0.02; r=-0.23), and the current amount of cigarettes consumed per day (p=0.006;r=-0.29). We can also observe a negative correlation between functional capacity and the Fagerström questionnaire score (p=0.004;r=-0.3). We concluded that the smoke load and the nicotine dependence levels were related to worse quality of life indices of the smoking population.

Relações entre atividade física, tabagismo, transportabilidade mucociliar nasal e função pulmonar / Relationships between physical activity, smoking, nasal mucociliary transportability and pulmonary function

OBJETIVOS: Comparar indivíduos tabagistas e não tabagistas, ativos e insuficientemente ativos fisicamente, quanto à transportabilidade mucociliar nasal e à função pulmonar. MÉTODOS: Estudo de delineamento transversal. Os voluntários responderam a uma entrevista para obtenção de dados pessoais, informação sobre hábitos tabagísticos e nível de atividade física. Após, eles foram avaliados quanto aos dados antropométricos, transporte mucociliar nasal (pelo teste do tempo de trânsito da sacarina) e função pulmonar (pela mensuração do volume expiratório forçado no primeiro segundo e da capacidade vital forçada). Foram utilizados a análise de variância para investigação entre os grupos e a análise de covariância (ajustada por fatores de confusão) para investigação de cofatores sobre o tempo de trânsito de sacarina. Foram adotados o nível de significância de 5% e o intervalo de confiança de 95%. RESULTADOS: Foram selecionados 139 indivíduos, alocados em quatro grupos, de acordo com o hábito tabagístico e o nível de atividade física: 45 tabagistas insuficientemente ativos fisicamente; 25 tabagistas ativos fisicamente; 31 não tabagistas insuficientemente ativos; e 38 não tabagistas ativos fisicamente. As médias de idade e os índices de massa corporal não apresentaram diferenças estatisticamente significativas entre os quatro grupos. No teste do tempo de trânsito da sacarina os indivíduos não fumantes fisicamente ativos apresentaram um tempo de 8,73 minutos, enquanto nos insuficientemente ativos o tempo foi de 13,0 minutos (p=0,0409). Os fumantes fisicamente ativos apresentaram menores valores de volume expiratório forçado no primeiro segundo em comparação aos insuficientemente ativos (escore z em relação aos valores preditos -1,01 e -0,55, respectivamente; p=0,0207). CONCLUSÕES: Nesta amostra de indivíduos adultos, sadios, de ambos os sexos, a prática de atividade física foi benéfica para a transportabilidade mucociliar nasal, porém somente nos indivíduos que nunca fumaram. Por outro lado, os tabagistas fisicamente ativos apresentaram menores valores de função pulmonar quando comparados aos tabagistas insuficientemente ativos, sugerindo que os exercícios ísicos possam provocar prejuízos adicionais à função pulmonar se o indivíduo não modificar o hábito de fumar.

AIMS: To compare smokers and non-smokers, physically active and insufficiently active, on mucociliary transportability and lung function. METHODS: Cross-sectional study. The volunteers were interviewed to obtain personal data, information on smoking habits and level of physical activity. Then, they were evaluated for anthropometric data, nasal mucociliary transport (by saccharin transit time test) and lung function (by measuring forced expiratory volume in the first second and forced vital capacity). Analysis of variance was used for investigation between the groups and analysis of covariance (adjusted for confounding factors) to investigate cofactors on the transit time of saccharin. The significance level of 5% and the 95% confidence interval were adopted. RESULTS: A total of 139 individuals were selected and assigned to four groups, according to the smoking habits and the level of physical activity: 45 smokers who were not physically active; 25 physically active smokers; 31 non-smokers who were not physically active; and 38 physically active non-smokers. The mean age and body mass index did not present statistically significant differences between the four roups. In the saccharin transit time test, physically active non-smokers presented a time of 8.73 minutes, while in the insufficiently active, the time was 13.0 minutes (p=0.0409). Physically active smokers presented lower values of forced expiratory volume in the first second compared to those who were not physically active (z score in relation to predicted values -1.01 and -0.55, respectively; p=0.0207). CONCLUSIONS: In this sample of healthy adults of both sexes, the practice of physical activity was beneficial for nasal mucociliary transportability, but only in individuals who never smoked. On the other hand, physically active smokers presented lower values of lung function when compared to insufficiently active smokers, suggesting that physical exercises may cause additional lung function impairment if the individual does not change the smoking habit.

Características sociodemográficas e padrão de consumo tabagístico de fumantes que procuram atendimento em programas de cessação / Socio-demographic characteristics and smoking pattern of smokers seeking care in cessation programs

Conhecer as características de tabagistas é fundamental para estruturar adequadamente os programas de cessaçãotabagística, de forma a atender as necessidades específicas dessa população. Analisar características sóciodemográficase o padrão de consumo tabagístico de fumantes que procuram atendimento em programas de cessação. Foi realizadaanálise retrospectiva de 38 meses dos dados da avaliação inicial de tabagistas que buscaram o Programa de Orientaçãoe Conscientização Antitabagismo da UNESP-Presidente Prudente. A amostra foi constituída de 209 mulheres e 150homens com idade de 48,16±12 anos; 34% cursaram ensino médio completo ou superior incompleto; 38,44%apresentaram nível elevado de dependência e 72,15% se apresentaram na fase motivacional de contemplação. Nestetrabalho foram evidenciadas algumas características de tabagistas que procuram atendimento especializado paraa cessação tabagística. Esses achados facilitarão a abordagem por profissionais que trabalham com essa temática,permitindo melhor direcionamento no tratamento e consequentemente aumento na taxa de sucesso na cessaçãotabagística dessa população(AU)

Knowing the characteristics of smokers is essential to adequately structure tobacco cessation programs in order to meetthe specific needs of this population. To analyze socio-demographic characteristics and the smoking pattern of smokersseeking care in cessation programs. A 38-month retrospective analysis of data from the initial evaluation of smokerswho sought the Anti-Smoking Counseling and Orientation Program of UNESP-Presidente Prudente was conducted.The sample consisted of 209 women and 150 men aged 48.16 ± 12 years; 34% did not complete high school oruniversity, 38.44% presented a high level of dependence, and 72.15% presented themselves in the motivational phaseof contemplation. In this study, some characteristics of smokers seeking specialized care for smoking cessation wereevidenced. These findings will facilitate the approach by professionals who work with this theme, allowing for bettertargeting in the treatment and consequently an increase in the smoking cessation success rate of this population(AU)

Características sociodemográficas e padrão de consumo tabagístico de fumantes que procuram atendimento em programas de cessação / Socio-demographic characteristics and smoking pattern of smokers seeking care in cessation programs

Conhecer as características de tabagistas é fundamental para estruturar adequadamente os programas de cessaçãotabagística, de forma a atender as necessidades específicas dessa população. Analisar características sóciodemográficase o padrão de consumo tabagístico de fumantes que procuram atendimento em programas de cessação. Foi realizadaanálise retrospectiva de 38 meses dos dados da avaliação inicial de tabagistas que buscaram o Programa de Orientaçãoe Conscientização Antitabagismo da UNESP-Presidente Prudente. A amostra foi constituída de 209 mulheres e 150homens com idade de 48,16±12 anos; 34% cursaram ensino médio completo ou superior incompleto; 38,44%apresentaram nível elevado de dependência e 72,15% se apresentaram na fase motivacional de contemplação. Nestetrabalho foram evidenciadas algumas características de tabagistas que procuram atendimento especializado paraa cessação tabagística. Esses achados facilitarão a abordagem por profissionais que trabalham com essa temática,permitindo melhor direcionamento no tratamento e consequentemente aumento na taxa de sucesso na cessaçãotabagística dessa população

Knowing the characteristics of smokers is essential to adequately structure tobacco cessation programs in order to meetthe specific needs of this population. To analyze socio-demographic characteristics and the smoking pattern of smokersseeking care in cessation programs. A 38-month retrospective analysis of data from the initial evaluation of smokerswho sought the Anti-Smoking Counseling and Orientation Program of UNESP-Presidente Prudente was conducted.The sample consisted of 209 women and 150 men aged 48.16 ± 12 years; 34% did not complete high school oruniversity, 38.44% presented a high level of dependence, and 72.15% presented themselves in the motivational phaseof contemplation. In this study, some characteristics of smokers seeking specialized care for smoking cessation wereevidenced. These findings will facilitate the approach by professionals who work with this theme, allowing for bettertargeting in the treatment and consequently an increase in the smoking cessation success rate of this population

The quality of clinical practice guidelines for chronic respiratory diseases and the reliability of the AGREE II: an observational study.

OBJECTIVES: To survey the quality of evidence-based clinical practice guidelines for chronic respiratory diseases relevant to physiotherapy practice using the Appraisal of Guidelines for Research and Evaluation version II instrument (AGREE II) and to evaluate the inter-rater reliability of AGREE II. DESIGN: Observational survey. PROCEDURES: Guidelines indexed in the Physiotherapy Evidence Database (PEDro) on chronic respiratory diseases were evaluated by four assessors using AGREE II. MAIN OUTCOME MEASURES: The six domains and two global items of AGREE II. RESULTS: Thirty-three guidelines were evaluated (58% were published in the last 5 years and 36% were for chronic obstructive pulmonary disease). The domains with the highest scores were scope and purpose (79%, SD 10%) and clarity of presentation (79%, SD 10%). The domain with the lowest score was applicability (37%, SD 23%). Mean overall quality was five out of seven (SD 1). Intraclass correlation coefficients ranged from 0.66 to 0.93 for the six domains and first global item, suggesting good to excellent reliability. The second global item had very poor reliability (Kappa 0.097). CONCLUSION: The quality of evidence-based clinical practice guidelines for chronic respiratory diseases relevant to physiotherapy could be improved, particularly in consideration with applicability. The number of assessors for AGREE II could be reduced because of the good inter-rater reliability.

Integridade respiratória é prejudicada em tabagistas passivos adultos expostos em ambiente domiciliar / Respiratory integrity is impaired in adults passive smokers exposed in household environment

Objetivo: Analisar a integridade respiratória de adultos tabagistas passivos expostos em ambiente domiciliar. Métodos: Avaliaram-se 56 voluntários, divididos em grupo de tabagistas passivos (GTP; n=29), composto por familiares de tabagistas, e grupo controle (GC; n=27). Foi realizada avaliação inicial que constava de dados pessoais, antropométricos, pressão arterial (PA), frequência cardíaca, saturação periférica de oxigênio, frequência respiratória. Em seguida, foi aplicado um questionário de afecções respiratórias, mensurado o nível de monóxido de carbono no ar exalado e realizada espirometria. Resultados: Valores de PA mais elevados no GTP foram observados. O GTP apresentou menores valores espirométricos nos índices volume expiratório forçado no primeiro segundo (p<0,0342) e capacidade vital forçada (p<0,0291). Com relação à intensidade dos sintomas, pôde-se observar diferença significativa no sintoma relacionado à coceira no nariz, no qual o GTP relatou maior intensidade (p<0,002). Maior intensidade também foi relatada no GTP no sintoma de respirar com mais dificuldade em lugares que tenham muita poeira ou quando o clima muda (p<0,0001). Conclusão: Tabagistas passivos apresentam prejuízo em sua integridade respiratória caracterizado por maior intensidade de sintomas respiratórios e alterações de função pulmonar.

Objective: To analyze the respiratory integrity of adult passive smokers exposed in home environment. Methods: A total of 56 volunteers, divided into passive smokers group (GPS; n = 29) composed of family members of smokers and a control group (CG; n = 27) with no history of exposure. Initial evaluation was performed which consisted of personal data, anthropometric, blood pressure (BP), heart rate, peripheral oxygen saturation, respiratory rate. Then a questionnaire was administered to respiratory diseases, measured the carbon monoxide level in exhaled air and spirometry was performed. Results: Higher BP values were observed in the GPS. The GPS showed lower spirometric values in forced expiratory volume in one second (p <0.0342) and forced vital capacity (p <0.0291). Regarding the intensity of the symptoms we observed significant difference in the symptom related to itchy nose, in which the GPS reported higher intensity (p <0.002). Higher intensity was also reported in the GPS symptom in breathing more difficult in places that have a lot of dust or when the weather changes symptom (p <0.0001). Conclusion: Passive smokers presented impairment in their respiratory health characterized by a greater intensity of respiratory symptoms and alterations in lung function.