Fernando S Guimaraes

• PhD
• Professor (Full) at Federal University of Rio de Janeiro

Secretion management in mechanically ventilated patients is a paramount task for clinicians. A better understanding of the mechanisms of flow bias and airway dynamic compression during airway clearance therapy may enable a more effective approach for this population. Ventilator hyperinflation, expiratory rib cage compression, a PEEP-ZEEP maneuver,...

Background The Five Times Sit-to-Stand Test (FTSST) has been found reliable, safe and valid for measuring healthy adults’ lower limb muscle strength and for determining balance control, fall risk, and exercise capacity among older examinees. We believe that the FTSST has the potential to be a straightforward, low cost and valuable tool for identify...

Background: The Post-COVID-19 Functional Status (PCFS) scale was created to assess the functional status of patients after hospital discharge due to COVID-19. Objective: To perform cross-cultural adaptation of the PCFS Scale and Manual into Brazilian Portuguese and evaluate its measurement properties in patients post-COVID-19. Methods: For the...

Background This study aimed to develop prognostic models for predicting the need for invasive mechanical ventilation (IMV) in intensive care unit (ICU) patients with COVID-19 and compare their performance with the Respiratory rate-OXygenation (ROX) index. Methods A retrospective cohort study was conducted using data collected between March 2020 an...

Objective: This systematic review was designed to assess the usefulness of cough peak flow to predict the extubation outcome in subjects who passed a spontaneous breathing trial. Methods: The search covered the scientific databases MEDLINE, Lilacs, Ibecs, Cinahl, SciELO, Cochrane, Scopus, Web of Science and gray literature. The Quality Assessme...

ABSTRACT | INTRODUCTION: Hospitalization often causes mobility difficulties and hinders daily activities. Progressive mobilization of patients in intensive care units (ICUs) is safe and linked to better clinical and functional outcomes. OBJECTIVE: To assess the perception of a multidisciplinary team in the ICUs of a university hospital regarding ea...

Este estudo teve como objetivo traduzir e adaptar transculturalmente a escala, o manual explicativo e o vídeo demonstrativo da Physical Function in Critical Care (PaciFIC) para o português brasileiro, fornecendo uma ferramenta de avaliação funcional adequada para pacientes críticos durante sua trajetória hospitalar no Brasil. O estudo consistiu das...

The objective of this work was to develop a prototype application to help decision making, at the bedside, regarding the use of non-invasive mechanical ventilation in patients with worsening respiratory failure. elaboration and validation of instruments and methods. This study was carried out in two stages: development of the application prototype...

Background: Chest physiotherapy for hospitalized patients with COVID-19 has been poorly reported. Although recommendations were published to guide physiotherapists, practice might have differed depending on education and training. Objective: To analyze the differences in chest physiotherapy applied for hospitalized patients with COVID-19 between...

Background and purpose: Despite intense efforts, predicting hospital readmission risks remains an imprecise task. Growing evidence suggests that unmeasured patient-related factors, such as functional impairment, seem to be strongly associated with acute readmission and have yet to be extensively explored. We hypothesized that gait speed, hand grip...

Objective: To identify the indications for physiotherapy and to evaluate physiotherapy practices in patients with COVID-19 admitted to the ICU (on mechanical ventilation) or to the ward (spontaneously breathing). Methods: An online, 50-item survey was completed by physiotherapists who had been treating hospitalized patients with COVID-19 in Braz...

Objetivou-se caracterizar o impacto das ações de um espaço comunitário para a terceira idade na qualidade de vida e funcionalidade de idosos. Foram incluídos idosos que estivessem participando de atividades semanais recreacionais, cognitivas e físicas, ao menos duas vezes por semana em um centro comunitário de Nova Iguaçu-RJ. Os indivíduos tiveram...

Backgroud: Pulmonary rehabilitation (PR) is recognized as a multidisciplinary intervention designed to reduce symptoms, improve functional status, and prevent acute exacerbations in patients with chronic obstructive pulmonary disease (COPD). Aim: This study was aimed at evaluating the effects of a long-term PR program on the hospitalization rate...

Objective The Glittre-ADL test (GA-T) is a functional capacity test that stands out for encompassing multiple tasks similar to activities of daily living. As ventilatory efficiency is one of the variables valued in the prognosis of chronic heart failure (CHF), this study aimed to evaluate associations between functional capacity and ventilatory var...

Background A better understanding of gait kinematics during the 6-min walk test (6MWT) may facilitate the development of rehabilitation strategies for patients with chronic obstructive pulmonary disease (COPD). Aim To evaluate gait kinematics during the 6MWT in patients with COPD. Method Thirty-six patients with COPD and 19 healthy controls under...

Objectives: The purpose of this study was to compare the predictive value of three cough peak flow (CPF) maneuvers in predicting the extubation outcome in a cohort of mechanically ventilated subjects. Methods: Eighty-one mechanically ventilated subjects who succeeded in the spontaneous breathing trial were included. In a randomized order, CPF wa...

Objective To evaluate the different components of the resistance of the respiratory system, respiratory muscle strength and to investigate the occurrence of expiratory flow limitation (EFL) in patients with morbid obesity (MO) when seated. Methods The sample was composed of MO (BMI≥40 kg/m2) and non-obese individuals (NO) with a BMI between 18 a...

Objetivo avaliar os diferentes componentes da resistência do sistema respiratório e a força muscular respiratória, bem como investigar a ocorrência de limitação de fluxo expiratório (LFE) de pacientes obesos mórbidos (OM) na posição sentada. Métodos a amostra foi composta de OM (IMC ≥ 40 kg/m²) e de indivíduos não obesos (NO) com IMC entre 18 e 30...

BACKGROUND: Respiratory muscle training (RMT) has been recommended to mitigate impacts of spinal cord injuries (SCI), but the optimal dosage in terms of the frequency, intensity, time, and type (FITT principle) to promote health in SCI individuals remains unclear. OBJECTIVE: To discuss research related to the effects of RMT on pulmonary function,...

Background: In recent decades, space limitations in the clinical environment have forced health professionals to administer the six-minute walk test (6MWT) using a 20-m or even a 10-m course. However, course length and physical activity level (PAL) affect the test outcomes. Aim: To develop a reference equation for the 6MWT that takes into accoun...

Purpose: To translate and cross-culturally adapt the Functional Status Score for the Intensive Care Unit instrument to Turkish and investigate its psychometric properties. Methods: An expert committee supervised forward and backward translation. Thirteen participants reviewed the pre-final version of Turkish Functional Status Score for the Intensiv...

Objective: To evaluate whether hormonal profile, arterial function, and physical capacity are predictors of fatigue in patients with acromegaly. Subjects and methods: This is a cross-sectional study including 23 patients. The subjects underwent a Modified Fatigue Impact Scale (MFIS) assessment; serum growth hormones (GH) and IGF-1 measurements; pu...

Background: Patients who require prolonged weaning from mechanical ventilation represent a major challenge in intensive care, and the timed inspiratory effort (TIE) index has been shown to be a clinically valuable tool to predict weaning success. Objective: To evaluate whether weekly serial measurements of the TIE index can predict the success i...

Introduction: Physiotherapy has been identified in the literature as an important treatment for individuals with Parkinson’s disease (PD) to improve functional capacity. Little is discussed about the physiotherapy practice environment for this population. Objective: To assess pragmatically the effects of two physiotherapy protocols: Conventional Ph...

Societies in developed countries are aging at an unprecedented rate. Considering that aging is the most significant risk factor for many chronic lung diseases (CLDs), understanding this process may facilitate the development of new interventionist approaches. Skeletal muscle dysfunction is a serious problem in older adults with CLDs, reducing their...

Background The Functional Status Score for the Intensive Care Unit (FSS-ICU) is a valid and reliable instrument to measure physical functioning in the intensive care unit setting. Translation and cross-cultural adaptation in Chile has not been published for the FSS-ICU. Aim To translate and cross-culturally adapt all associated documents of the or...

Introducción La Functional Status Score for the Intensive Care Unit (FSS-ICU) es un instrumento válido y confiable para medir funcionamiento físico en unida-des de cuidados intensivos. Sin embargo, la traducción y adaptación trans-cultural de la FSS-ICU en Chile no ha sido publicada. Objetivo Traducir y adaptar transculturalmente todos los document...

Background The six-minute walk test (6MWT) assesses the functional exercise capacity and its impairments due to chronic cardiorespiratory and/or musculoskeletal conditions, particularly in the elderly. The clinimetric properties and clinical utility of the 6MWT are well-described, but little is known about the gait kinematics during this test. This...

Background: Ventilator hyperinflation (VHI) is effective in improving respiratory mechanics, secretion removal, and gas exchange in mechanically ventilated subjects; however, there are no recommendations for the best ventilator settings to perform the technique. Objective: To compare six modes of VHI, concerning physiological markers of efficacy...

Chronic obstructive pulmonary disease (COPD) is a progressive and disabling disease that has been associated with aging. Several factors may potentially impair performance during exercise in elderly patients with COPD. This study was conducted to evaluate what characteristics related to lung function, peripheral muscle strength and endurance can pr...

Background: Musculoskeletal involvement and cerebrovascular disease are common in sickle cell anaemia (SCA). These changes are potentially important factors that modify the control of balance in this population. Objective: To assess balance control in adults with SCA and investigate the associations among balance, posture and muscle function. Metho...

Background: In addition to being simple and requiring minimal technology, the 6-min walk test (6MWT) has been found to be reproducible and well tolerated since its first use. However, the impact of non-anthropometric factors on functional capacity is less clear in healthy young adults because the majority experience no age-related changes in the l...

Pulmonary function tests (PFTs) traditionally used in clinical practice do not accurately predict exercise intolerance in patients with chronic obstructive pulmonary disease (COPD). The aim of this study was to assess whether the nitrogen single-breath washout (N2SBW) test explains exercise intolerance and poor quality of life in stable COPD patien...

Background Hypertension is associated with deterioration of musculoskeletal function and functional capacity. Existing prediction models for assessment of the 6-min walk test (6MWT) do not capture the disease-related functional capacity. This study developed a multivariate prediction model of the measured 6-min walked distance (6MWDM) in hypertensi...

A compressão unilateral do tórax é um recurso manual de Fisioterapia Respiratória conhecido como direcionamento de fluxo. Este procedimento é realizado em unidades de tratamento intensivo para promover a expansão do hemitórax contra lateral. O objetivo deste estudo foi caracterizar o padrão ventilatório antes, durante e após esta modalidade de inte...

Introduction: Nowadays, patients on prolonged ventilation are among the major challenges of intensive care [1]. The recent timed inspiratory effort index (TIE) has been shown to be a clinically valuable tool to predict the success of ventilatory weaning, especially for patients with difficult weaning [2]. Objective: To validate the accuracy of the...

This work aimed to evaluate the predictive utility of Support Vector Machine using variables ranked by entropy to predict the weaning outcome in a general Intensive Care Unit.

Introduction: It is well established that inspiratory muscle training (IMT) improves muscle performance in hospitalized individuals [1]. Nowadays, patients on prolonged ventilation are among the major challenges of intensive care [2,3]. In this regard, specific exercises for respiratory muscles can result in better functional performance in critica...

BACKGROUND There is a growing interest in identifying markers of pulmonary function that are predictive of peripheral muscle dysfunction in chronic obstructive pulmonary disease (COPD); however, studies of this relationship have yielded contradictory results in the literature. OBJECTIVES To evaluate the strength and endurance of the quadriceps and...

Hand grip strength (HGS) is important not only in its own right, but as an indicator of overall body strength and future outcomes as well. As we have found no studies on the HGS predictive models including Brazilian adults younger than 50 years of age, we aimed to develop a novel predictive equation using demographic and anthropometric attributes f...

Chronic obstructive pulmonary disease (COPD) is an independent risk factor for osteoporosis. Oral glucocorticoids are deleterious to bone; however, the impact of inhaled glucocorticoids (ICS) remains unclear. Our objective was to determine whether ICS contribute to osteoporosis and fragility fractures. Sixty-one COPD patients, 35 current users of I...

Background: Subjects with spinal cord injuries (SCI) have impaired autonomic cardiac regulation and increased risk of cardiovascular disease. In face of the insufficient research data on the autonomic control of physically active subjects with SCI, this study aimed at describing the chronotropic response, as well as the heart rate recovery behavio...

Background: Impaired functional status is a common complication of critical illness. Thus, the use of appropriate outcome measures is necessary to examine functional ability in this setting. The physical dimension of functional status is related to the quality and quantity of daily activities that a person can perform with the mobility of the whole...

Background Individuals with systemic sclerosis have muscle functions with varying degrees of muscle weakness and atrophy, which in turn can have a negative impact on functional and health-related quality of life. This study aimed to evaluate peripheral muscle performance using isokinetic dynamometry of the knee in women with systemic sclerosis and...

Background Systemic sclerosis (SSc) is a multisystem disease affecting the skin, respiratory system and skeletal muscles. In SSc patients, hand function disability is the major factor limiting daily activities. Aim To evaluate the association of physical function with handgrip strength and pulmonary function in SSc patients. A further aim was to a...

Objective The aim of the present study was to translate and cross-culturally adapt the Functional Status Score for the intensive care unit (FSS-ICU) into Brazilian Portuguese. Methods This study consisted of the following steps: translation (performed by two independent translators), synthesis of the initial translation, back-translation (by two i...

Abstract Objectives: To compare the results of the 6-Minute Walk Test (6MWT) with those estimated using national and foreign predictive equations of the six-minute walked distance (6MWD) in Brazilian elderly women. Methods: Fifty healthy elderly women (72 ± 5 years, 29.4 ± 4.7 kg/m2) performed the 6-Minute Walk Test. Results: Predicted distances...

AIM To investigate the factors associated with the functional progress of hospitalized patients following an intensive care admission. METHODS Retrospective study including data from a cohort of 198 hospitalized patients following an intensive care admission and not requiring mechanical ventilation in a single tertiary referral hospital. A general...

Advances in the knowledge of acromegaly are leading to an increase in the survival rate of acromegalic subjects. This study was conducted to evaluate balance control, risk of falls, and peripheral muscle function in the acromegalic elderly. Seventeen elderly subjects with acromegaly (67 (63-73) years) and twenty paired control subjects were evaluat...

Purpose: To evaluate the effects of demographics and hormonal variations on knee muscle performance in patients with acromegaly and develop explanatory models of peripheral muscle function in these individuals. Methods: This was a cross-sectional study in which 53 acromegalics and 27 healthy subjects underwent knee isokinetic dynamometry to eval...

BACKGROUND Individuals with acromegaly (IwA) may have alterations in skeletal muscles. Isokinetic testing is the standard method to assess muscle performance through objective, reliable, and reproducible measures. OBJECTIVES To assess knee muscles performance of IwA with active and controlled disease and to correlate the findings with hormone leve...

Method: A search for papers was made in the databases Bireme, Scielo and Pubmed with the following keywords: post polio syndrome, cardiorespiratory and rehabilitation in English, French and Spanish languages. Although we targeted only seek current studies on the topic in question, only the relevant (double-blind, randomized-controlled and consensu...

Introduction: Although impaired pulmonary function and respiratory sleep disorders are described as responsible for increased mortality in acrome- galic patients, little is known about the tracheal abnormalities in this group of patients. Thus, the objectives of this study were to describe the tracheal structural abnormalities and correlate these c...

Background: Sickle cell anemia (SCA) is characterized by a broad spectrum of abnormalities that affect most body organs and systems. To date, there is few data on the influence of these patients' clinical characteristics on the functional exercise capacity. Aim: To investigate the effect of the clinical complications on the functional exercise c...

[Purpose] This study aimed to evaluate the impact of lung function and peripheral muscle function on the six-minute walking distance (6MWD) in systemic sclerosis (SS) patients and, thereby, to develop an explanatory model of functional exercise capacity for these individuals. [Methods] In a cross-sectional study, 31 SS patients underwent pulmonary...

Background: Morbid obesity is directly related to deterioration in cardiorespiratory capacity, including changes in cardiovascular autonomic modulation. Objective: This study aimed to assess the cardiovascular autonomic function in morbidly obese individuals. Methods: Cross-sectional study, including two groups of participants: Group I, compos...

Amyotrophic lateral sclerosis is a progressive neuromuscular disease, resulting in respiratory muscle weakness, reduced pulmonary volumes, ineffective cough, secretion retention, and respiratory failure. Measures as vital capacity, maximal inspiratory and expiratory pressures, sniff nasal inspiratory pressure, cough peak flow and pulse oximetry are...

Complaints of peripheral muscle weakness are quite common in patients with systemic sclerosis (SSc). It is likely that the muscle impairments may reduce the patients' exercise performance, which in turn may decrease their functional capacity and exert a direct impact on their quality of life. To assess the peripheral and respiratory muscle strength...

[Purpose] The six-minute walk test (6MWT) is increasingly being used as an important tool for analyzing functional capacity in patients with multisystem disorders. The aim of this study was to evaluate the effect of body composition, peripheral muscle function, and pulmonary function on the six-minute walk distance (6MWD) in acromegalic patients. [...

Introduction Decrease in muscle mass and increase in body fat are important changes that occur with aging. Strength decline and worse resistance to fatigue can lead to a decreased functional autonomy of the elderly. Objective The present study aimed to verify the existence of a relationship between body composition, muscle strength, lower limbs fa...

Background: No studies have described and evaluated the association between hemodynamics, physical limitations and quality of life in patients with pulmonary hypertension (PH) without concomitant cardiovascular or respiratory disease. Objective: To describe the hemodynamic profile, quality of life and physical capacity of patients with PH from gro...

As there are few studies on the impact of respiratory and functional status on the quality of life domains in adults with cystic fibrosis, this study aimed to evaluate the association between respiratory function, functional capacity and quality of life in these subjects. This is a cross-sectional study, where adults with clinical and laboratorial...

Visual interpretation of electromyograms is common, but its accuracy is unknown. This study compared the accuracy curves of inexperienced observers in detecting muscular contractions from variable, simulated surface electromyogram signals. Accuracy was assessed both without feedback (unsupervised practice) and with feedback (supervised practice) to...

Background: Bronchiectasis develops along the natural course of several respiratory and systemic conditions and induces significant changes in the morphofunctional structure of airways. Our objective was to assess the impact of various causes of bronchiectasis on clinical data, pulmonary function tests, and high-resolution computed tomography (HRC...

Background: The aim of this study was to evaluate the performance of the recently described timed inspiratory effort (TIE) index in comparison with 4 other previously reported indices as to the weaning outcome in patients with neurologic or neuromuscular disorders. Methods: This observational prospective study included subjects undergoing weanin...

In Reply : We thank Dr Marti and his colleagues for their comments on our study. The different methods used to investigate the clinical and physiological repercussions of airway clearance techniques make comparison between studies difficult. Animal studies like those from Unoki et al[1][1],[2][2]

Chest physical therapy techniques are essential in order to reduce the frequency of recurrent pulmonary infections that progressively affect lung function in cystic fibrosis patients. Recently, ELTGOL (L'Expiration Lente Totale Glotte Ouverte en décubitus Latéral) emerged as an inexpensive and easy to perform therapeutic option. The aim of this stu...

Acromegaly is a chronic debilitating disease that presents with multiple systemic manifestations, including changes in body composition, joint abnormalities, muscular impairment and visual disturbances. This study aimed to assess posture and body balance in acromegalic patients and to establish the correlation between these measures. Twenty-eight a...

Although pursed-lip breathing (PLB) has been advocated to reduce respiratory rate and improve oxygen saturation in patients with chronic obstructive pulmonary disease (COPD) at rest, the evidence of its effects on dynamic hyperinflation (DH) and exercise tolerance is scarce. To evaluate the effect of PLB on exercise tolerance, breathing pattern, dy...

This study investigated the association between hemodynamic variables and the 6-minute walk distance (6MWD) in adults with and without hypertension and explored the role of hemodynamic variables as predictors of 6MWD. Patients undergoing antihypertensive medication therapy (n=41) and sex-matched healthy subjects (n=41) were evaluated for their clin...

[Purpose] Balance deficits are increasingly recognized in chronic obstructive pulmonary disease, but little is known regarding this issue in asthma. Our primary aim was to assess the correlation between postural balance and pulmonary function in adults with asthma. Secondarily, we aimed to correlate balance with functional capacity and body mass in...

Background: In addition to pulmonary involvement, adults with cystic fibrosis (CF) are at higher risk of developing skeletal muscle dysfunction, nutritional depletion, and bone and joint disease. Objective: This study aimed to assess the correlation between posture, balance, and peripheral muscle function in adults with CF. Methods: A cross-se...

Background In systemic sclerosis (SS), pulmonary involvement is currently the leading cause of mortality. Joint impairments limit the range of motion (ROM), which may reduce the functional capacity of these patients. Aim To assess the correlation between the functional capacity, joints mobility, and pulmonary function parameters in adults with SS....

This study aimed to investigate the association between respiratory mechanics and autonomic modulation in morbidly obese patients. We evaluated 10 morbidly obese subjects (BMI=52.9±11.2kg/m(2)), aged 23-58 years. Assessment of respiratory mechanics was done by the forced oscillation technique (FOT), and cardiovascular autonomic function was recorde...

Despite the gradual improvement in treatment procedures and cure rates of acromegaly, a steady increase in the mortality rate due to respiratory disease has been documented in recent decades. In this study, our objectives were to describe the abnormalities in lung structure and function that occur in acromegalic patients and to correlate these chan...

Background: Despite the gradual improvement in treatment procedures and cure rates of acromegaly, a steady increase in the mortality rate due to respiratory disease has been documented in recent decades. In this study, our objectives were to describe the abnormalities in lung structure and function that occur in acromegalic patients and to correlat...

Asthma may cause systemic repercussions due to its severity and the effects of treatment. Our objective was to compare posture, balance, functional capacity, and quality of life (QOL) according to the severity of disease, as assessed by pulmonary function levels. This cross-sectional study evaluated fifty individuals with asthma. We compared two gr...

[Purpose] This study compared patients having active acromegaly with those having controlled acromegaly in terms of peripheral muscle strength, body composition, and functional capacity. We also examined the associations between these measures. [Methods] A total of 14 patients with active acromegaly, 12 patients with controlled acromegaly, and 12 h...

Expiratory rib cage compression (ERCC) has been empirically used by the physiotherapists with the rationale of improving expiratory flows and, therefore, the airway clearance in mechanically ventilated patients. This study aimed at evaluating the acute mechanical effects and sputum clearance of an ERCC protocol in ventilated patients with pulmonary...

Cystic fibrosis (CF) is a hereditary condition in which lung disease affects all patients. In addition to pulmonary involvement, the multisystemic components of CF cause significant physical limitations. However, the impact of lung function on balance control in CF has not been studied. To assess body balance in adults with CF and to test its possi...

Aim Asthma may result in postural disorders due to increased activity of accessory respiratory muscles and hyperinflation. Our primary objective was to assess the correlation between pulmonary function and posture in adult patients with asthma. Secondarily, we aimed to study the correlation between body composition and body posture in this group of...

INTRODUCTION: The shape-varying format of surface electromyograms introduces errors in the detection of contraction events.OBJECTIVE: To investigate the accuracy and learning curves of inexperienced observers to detect the quantity of contraction events in surface electromyograms.MATERIALS AND METHODS: Six observers performed manual segmentation in...