Publications by authors named "Karina Tamy Kasawara"

16 Publications

  • Page 1 of 1

Dietary intake profile in high-risk pregnant women according to the degree of food processing.

J Matern Fetal Neonatal Med 2020 Sep 13:1-7. Epub 2020 Sep 13.

Department of Obstetrics and Gynecology, University of Campinas, Campinas, SP, Brazil.

Background/objective: Studies that address dietary intake theme during pregnancy are generally centered on specific nutrients or on dietary patterns. However, the maternal dietary profile according to the degree of food processing is poorly understood. The purpose of the present study was to describe the dietary profile of high-risk pregnant women according to the degree of food processing.

Materials And Methods: A prospective cohort study was conducted at Prof. Dr. Jose Aristodemo Pinotti Women's Hospital (CAISM), University of Campinas, Brazil, with high-risk pregnant women in the third trimester of gestation.

Results: Data from 125 high-risk pregnant women were collected between September 2017 and April 2019. The mean total energy intake (EI) was 1778.3 ± 495.79 kcal/day and the majority of the calories was from unprocessed foods (52.42%), followed by ultra-processed foods (25.46%). The consumption of free sugar and sodium exceeded recommendations, while the consumption of fiber, calcium, folate and iron was below recommendations. The ultra-processed foods intake affects dietary patterns negatively.

Conclusion: More than 50% of the EI of high-risk pregnant women is from unprocessed or minimally processed foods, but it is insufficient for meeting dairy fiber, iron, folate and calcium recommendations.
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September 2020

Aerobic and breathing exercises improve dyspnea, exercise capacity and quality of life in idiopathic pulmonary fibrosis patients: systematic review and meta-analysis.

J Thorac Dis 2020 Mar;12(3):1041-1055

Department of Physical Therapy, University of Toronto, Toronto, Canada.

Background: Idiopathic pulmonary fibrosis (IPF) is a progressive disease associated with significant dyspnea and limited exercise capacity. This systematic review aimed to synthesize evidence of exercise interventions during pulmonary rehabilitation that aim to improve exercise capacity, dyspnea, and health-related quality of life (HRQL) in IPF patients.

Methods: Searches were performed in MEDLINE, Embase, CENTRAL, SPORTDiscus, PubMed and PEDro from inception to January 2019 using search terms for: (I) participants: 'IPF or interstitial lung disease'; (II) interventions: 'aerobic training or resistance training or respiratory muscle training'; and (III) outcomes: 'exercise capacity or dyspnea or health-related quality of life'. Two reviewers independently screened titles, abstracts and full texts to identify eligible studies. Methodological quality of studies was assessed using the Downs and Black checklist and meta-analyses were performed.

Results: Of 1,677 articles identified, 14 were included (four randomized controlled trials and 10 prospective pre-post design studies) that examined 362 patients receiving training and 95 control subjects. Exercise capacity was measured with the 6-minute walk distance, peak oxygen consumption, peak work rate, or endurance time for constant work rate cycling, which increased after exercise [aerobic exercise; aerobic and breathing exercises; aerobic and inspiratory muscle training (IMT) exercises] compared to the control groups. Dyspnea scores improved after aerobic and breathing exercises. HRQL also improved after aerobic exercise training alone or combined with breathing exercises. Aerobic training alone or combined with IMT or breathing exercises improved exercise capacity.

Conclusions: Breathing exercises appears to complement exercise training towards improved dyspnea and HRQL in patients with IPF.
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March 2020

The effect of mental tracking task on spatiotemporal gait parameters in healthy younger and middle- and older aged participants during dual tasking.

Exp Brain Res 2019 Dec 26;237(12):3123-3132. Epub 2019 Sep 26.

Department of Physical Therapy, University of Toronto, Toronto, ON, Canada.

To evaluate the effect of dual tasking that combines walking with a mental tracking task on spatiotemporal gait parameters in younger and older adults. After completing the International Physical Activity Questionnaire (IPAQ), participants performed single tasks: preferred paced walk (PPW); fast paced walk (FPW); single-leg stance (SLS); spelling backwards cognitive task (CT). Thereafter, dual tasks: PPW + CT; FPW + CT; SLS + CT. Spatiotemporal gait parameters and the durations of SLS and SLS + CT were measured. Twenty younger and 20 older adults participated. The IPAQ scores were similar in both groups. Compared to the single task, stride length was shorter, stride time was longer, and stride length and time variability were higher during the PPW and FPW dual tasks in both groups. Older age was associated with shorter stride length during PPW and FPW, and longer stride time during FPW dual compared to single tasks. The older group exhibited shorter times during SLS and SLS + CT compared to younger group. Despite similar self-reported fitness, older age is associated with shorter stride length and longer stride time during FPW dual tasks as well as short times during SLS + CT, which may indicate diminished balance and posture stability.
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December 2019

Effects of quadriceps muscle neuromuscular electrical stimulation in living donor liver transplant recipients: phase-II single-blinded randomized controlled trial.

Clin Rehabil 2019 May 4;33(5):875-884. Epub 2019 Jan 4.

1 Cardiorespiratory Division, Department of Rehabilitation Medicine, Nagasaki University Hospital, Nagasaki, Japan.

Objective: To evaluate the efficacy of neuromuscular electrical stimulation on quadriceps muscle strength and thickness in liver transplantation patients.

Design: Phase-II, randomized, parallel-group, allocation-concealed, assessor-blinded, single-center controlled trial.

Setting: Inpatient rehabilitation sector.

Subjects: Patients following living donor liver transplantation.

Interventions: The quadriceps muscle stimulation and the control groups received bilateral muscle electrical stimulation on the quadriceps and tibialis anterior muscles, respectively. Neuromuscular electrical stimulation sessions in both groups were conducted for 30 minutes per session, once per day for five weekdays over four weeks by a physical therapist.

Main Measures: Quadriceps muscle strength and quadriceps muscle thickness.

Results: Neuromuscular electrical stimulation was applied to the quadriceps muscles group ( n = 23) or the tibialis anterior muscle in the control group ( n = 22). The decrease in quadriceps muscle thickness differed significantly between both groups on postoperative day 30 (median -3 vs -8, P < 0.01). The changes in predicted quadriceps strength and 6 minutes walking distance were not significantly different between groups (quadriceps strength median -12% vs -5%, P = 0.40; 6 minutes walking distance median -18 vs -21 m, P = 0.74).

Conclusion: Neuromuscular electrical stimulation of the quadriceps muscle for liver transplantation recipients was able to maintain the quadriceps muscle thickness after surgery. Future larger scale studies are needed to consider the effectiveness of neuromuscular electrical stimulation and how to incorporate this intervention in the overall strategy of the physical therapy program.
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May 2019

Interactive Video Gaming Improves Functional Balance in Poststroke Individuals: Meta-Analysis of Randomized Controlled Trials.

Eval Health Prof 2020 03 22;43(1):23-32. Epub 2018 Jul 22.

Department of Physical Therapy, University of Toronto, Toronto, Ontario, Canada.

The main objective of this study was to evaluate the effects of interactive video games on functional balance and mobility in poststroke individuals. The Health Science databases accessed included Medline via PubMed, LILACS, SciELO, and PEDro. The inclusion criteria were as follows: clinical studies evaluating the use of interactive video games as a treatment to improve functional balance and mobility in individuals poststroke and studies published in the Brazilian Portuguese, English, or Spanish language between 2005 and April 2016. PEDro Scale was used to analyze the methodological quality of the studies. The Berg Balance Scale and Timed Up and Go Test (TUGT) data were evaluated using a meta-analysis, the publication bias was assessed by funnel plots, and the heterogeneity of the studies by statistic. Eleven studies were included in the final analysis. Functional balance improved in individuals treated using interactive video games (mean difference = 2.24, 95% confidence interval [0.45, 4.04], = .01), but no improvement was observed in mobility as measured by TUGT. The studies presented low heterogeneity (24%). The mean score on the PEDro Scale was 6.2 ± 1.9. Interactive video games were effective in improving functional balance but did not influence the mobility of individuals poststroke.
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March 2020

Translation and Cultural Adaptation of the Short-Form Food Frequency Questionnaire for Pregnancy into Brazilian Portuguese.

Rev Bras Ginecol Obstet 2018 Jun 18;40(6):313-321. Epub 2018 May 18.

Department of Obstetrics and Gynecology, School of Medical Sciences, Universidade Estadual de Campinas, SP, Brazil.

Objective:  To translate and culturally adapt the short-form Food Frequency Questionnaire (SFFFQ) for pregnant women, which contains 24 questions, into Brazilian Portuguese.

Methods:  Description of the process of translation and cultural adaptation of the SFFFQ into Brazilian Portuguese. The present study followed the recommendation of the International Society for Pharmacoeconomics and Outcomes Research for translation and cultural adaptation with the following steps: 1) preparation; 2) first translation; 3) reconciliation; 4) back translation; 5) revision of back translation; 6) harmonization; 7) cognitive debriefing; 8) revision of debriefing results; 9) syntax and orthographic revision; and 10) final report. Five obstetricians, five dietitians and five pregnant women were interviewed to contribute with the language content of the SFFFQ.

Results:  Few changes were made to the SFFFQ compared with the original version. These changes were discussed with the research team, and differences in language were adapted to suit all regions of Brazil.

Conclusion:  The SFFFQ translated to Brazilian Portuguese can now be validated for use in the Brazilian population.
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June 2018

Effects of Kinesio Taping on breast cancer-related lymphedema: A meta-analysis in clinical trials.

Physiother Theory Pract 2018 May 8;34(5):337-345. Epub 2018 Jan 8.

b Department of Physical Therapy , Ibirapuera University , São Paulo , Brazil.

Background: Lymphedema is known as a secondary complication of breast cancer treatment, caused by reduction on lymphatic flow and lymph accumulation on interstitial space. The Kinesio Taping (KT) has become an alternative treatment for lymphedema volume reduction. The objective of the study was to evaluate the literature through a systematic review on KT effects on lymphedema related to breast cancer.

Methods: Search strategies were performed by the following keywords: "Kinesio Taping," "Athletic Tape," "Cancer," "Neoplasm," "Lymphedema," and "Mastectomy" with derivations and different combinations. The following databases were accessed: SCIELO, LILACS, MEDLINE via PubMed, and PEDro, between 2009 and 2016. Studies published in English, Portuguese, and Spanish were considered for inclusion. The studies' methodological quality was assessed by the PEDro scale.

Results: Seven studies were identified by the search strategy and eligibility. All of them showed positive effect in reducing lymphedema (perimeter or volume) before versus after treatment. However, with no effects comparing the KT versus control group or others treatments (standardized mean difference = 0.04, confidence interval 95%: -0.24; 0.33), the average score of the PEDro scale was 4.71 points.

Conclusions: KT was effective on postmastectomy lymphedema related to breast cancer; however, it is not more efficient than other treatments.
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May 2018

Body Mass Index Changes during Pregnancy and Perinatal Outcomes - A Cross-Sectional Study.

Rev Bras Ginecol Obstet 2018 Jan 18;40(1):11-19. Epub 2017 Dec 18.

Universidade Estadual de Campinas (UNICAMP), Campinas, SP, Brazil.

Objective:  To evaluate the relation between changes the body mass index (BMI) percentile, reflected in the Atalah curve, and perinatal outcomes.

Methods:  A cross-sectional study with 1,279 women was performed. Data regarding gestational weight, sociodemographic characteristics and perinatal outcomes were collected through medical charts, prenatal card and interviews in the postpartum period. Women could be classified according to the Atalah curve in the following categories: low weight, adequate weight, overweight, and obese. The BMI was calculated at the first and at the last prenatal care visits, and these values were compared.

Results:  An increase in the BMI category according to the Atalah classification occurred in 19.9% of pregnant women, and an increase of 3.4, 5.8 and 6.4 points of BMI were found for women respectively classified in the adequate weight, overweight and obese categories at the first prenatal visit. Women with high school education presented a lower chance of increasing their BMI (odds ratio [OR] 0:47 [0.24- 0.95]). Women who evolved with an increase in the the Atalah classification were associated with cesarean section (OR 1.97-2.28), fetal macrosomia (OR 4.13-12.54) and large for gestational age newborn (OR 2.88-9.83).

Conclusion:  Pregnant women who gained enough weight to move up in their BMI classification according to the Atalah curve had a higher chance of cesarean section and macrosomia. Women classified as obese, according to the Atalah curve, at the first prenatal visit had a high chance of cesarean section and delivering a large for gestational age newborn.
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January 2018

Early menarche and teenager pregnancy as risk factors for morbid obesity among reproductive-age women: A case-control study.

Clinics (Sao Paulo) 2017 Oct;72(9):547-553

Departamento de Tocoginecologia, Faculdade de Ciências Médicas, Universidade Estadual de Campinas - UNICAMP, Campinas, SP, BR.

Objectives: The aim of this study was to evaluate potential risk factors, including non-communicable diseases, for morbid obesity in women between 20 and 49 years of age.

Methods: We performed a case-control study with 110 morbidly obese women and 110 women with adequate weight who were matched by age and with a 1:1 case to control ratio. All women were between 20 to 49 years old and non-menopausal. Possible risk factors were evaluated through a self-report questionnaire assessing socio-demographic, obstetric and gynecological characteristics, presence of non-communicable diseases and habits. Multiple logistic regression was used to estimate the odds ratio with respective confidence intervals.

Results: Menarche under 12 years old, teenage pregnancy and lower educational level were shown to be risk factors for morbid obesity among women of reproductive age. Incidences of non-communicable diseases (diabetes, hypertension, dyslipidemia, liver disease, lung disease, thyroid dysfunction, and joint pain) were increased in women with morbid obesity.

Conclusions: Early menarche, teenage pregnancy and low education level are risk factors for the occurrence of morbid obesity in women of reproductive age. Some non-communicable diseases were already more prevalent in women with morbid obesity even before 50 years of age.
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October 2017

Effects of a Knee Brace With a Patellar Hole Versus Without a Patellar Hole in Patients With Knee Osteoarthritis: A Double-Blind, Randomized Controlled Trial.

Eval Health Prof 2018 12 30;41(4):512-523. Epub 2017 Jun 30.

1 Physical Therapy Department, Santa Casa Misericórdia de São Paulo, Brazil.

The objective of this study was to observe the immediate effect of a knee brace with a patellar hole versus without a patellar hole on pain perception in patients with knee osteoarthritis. To accomplish this, a double-blind, randomized controlled trial enrolled 108 patients divided into two groups (knee brace with a patellar hole or without a patellar hole). Patients were evaluated by the Visual Analogue Scale (VAS) in order to measure their pain sensation, the Timed Up and Go (TUG) test was used to evaluate their ability to walk, and the 8-m walking test (8MWT) was used to estimate their walking speed. Both groups presented significant reduction in pain perception, higher function of the lower extremities, and greater mobility while wearing a knee brace. However, the patients who wore a knee brace without a patellar hole presented more favorable results than those who wore a knee brace with a patellar hole: a 1.6-point reduction was found versus 1.1 points in the VAS, the patients presented 0.7 s less time versus 0.4 s in the TUG, and the speed was reduced by 1.4 s versus 0.8 s in the 8MWT. Therefore, the knee brace without a patellar hole presented more favorable results when compared with the knee brace with a patellar hole.
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December 2018

Effects of physiotherapy treatment for urinary incontinence in patient with multiple sclerosis.

J Phys Ther Sci 2017 Jul 15;29(7):1259-1263. Epub 2017 Jul 15.

Department of Obstetrics and Gynecology, University of Campinas, Brazil.

[Purpose] The aim of the study was to evaluate the benefits of physical therapy for urinary incontinence in patients with multiple sclerosis and to verify the impact of urinary incontinence on the patient's quality of life. [Subject and Methods] A case study of a 55-year-old female patient diagnosed with multiple sclerosis and mixed urinary incontinence was conducted. Physical therapy sessions were conducted once a week, in total 15 sessions, making use of targeted functional electrical vaginal stimulation, along with active exercises for the pelvic floor muscles and electrical stimulation of the posterior tibial nerve, behavioral rehabilitation and exercise at home. [Results] After 15 physical therapy sessions, a patient diagnosed with multiple sclerosis and mixed urinary incontinence showed continued satisfactory results after five months. She showed better quality of life, higher strength of pelvic floor muscle and reduced urinary frequency without nocturia and enuresis. [Conclusion] The physical therapy protocol in this patient with multiple sclerosis and mixed urinary incontinence showed satisfactory results reducing urinary incontinence symptomatology and improving the patient's quality of life.
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July 2017

Translational studies for exercise in high-risk pregnancy: Pre-eclampsia model.

Hypertens Pregnancy 2016 Aug 9;35(3):265-79. Epub 2016 May 9.

a Department of Obstetrics and Gynecology , University of Campinas (UNICAMP) , Campinas , SP , Brazil.

Objective: Reviewed literature regarding exercise effects on pregnancy-related hypertensive disorders, analyzing basic science perspectives and clinical studies.

Methods: Scientific databases were accessed by research strategy combining Medical Subject Headings terms. Studies published between 2000 and 2015, in English, Portuguese, and Spanish language, were considered.

Results: Studies were classified into: recommendations for exercise on high-risk pregnancy; animal models for hypertension in pregnancy; exercise on hypertensive disorders in animal models and pregnant women.

Conclusion: There are several animal models to mimic hypertensive disorders in pregnancy; however, clinical studies are still needed for exercise recommendation in pregnant women with hypertensive disorders.
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August 2016

Physical Activity Patterns and Factors Related to Exercise during Pregnancy: A Cross Sectional Study.

PLoS One 2015 17;10(6):e0128953. Epub 2015 Jun 17.

Department of Obstetrics and Gynecology, Faculty Medical Sciences, University of Campinas (UNICAMP), Campinas-SP, Brazil.

Objective: To assess the physical activity levels of pregnant women and to examine the characteristics associated with the practice of exercise and the activities of daily living during pregnancy.

Methods: For this cross-sectional study, 1,279 women were recruited within 72 hours postpartum. They were interviewed about their socio-demographic data and obstetric history and were administered self-report questionnaires about exercise and daily physical activities during pregnancy. Data on the current pregnancy, labor, delivery, and newborn outcomes were collected from participants' medical records. To analyze factors related to the practice of exercise, we used the student t-test, X², and odds ratio (OR), with a corresponding 95% confident interval (CI), followed by a multiple logistic regression. The significance level was 5%.

Results: Compared to the pre-pregnancy period, the prevalence of physical activity among participants was lower throughout pregnancy (20.1%) (p = 0.01). Half of the women interrupted practicing physical exercise due to pregnancy. The lowest prevalence of exercise was observed in the first (13.6%) and third trimesters (13.4%). Less than half of women received exercise guidance during prenatal care meetings (47.4%). Walking was the most commonly reported exercise, followed by water aerobics. Factors positively associated with exercise practice were higher educational level (OR= 1.82; CI 95% 1.28-2.60), primiparity (OR=1.49; CI 95% 1.07-2.07), exercising before pregnancy (OR= 6.45; CI 95% 4.64-8.96), and exercise guidance during prenatal care (OR=2.54; CI 95% 1.80-3.57). Mildly intense exercise and domestic activities were most frequently reported among pregnant women. There were no differences in maternal and perinatal outcomes between active and sedentary pregnant women.

Conclusion: The findings indicate that promoting physical activity remains a priority in public health policy, and women of childbearing age, especially those planning a pregnancy, should be encouraged to adopt an exercise routine or maintain an active lifestyle during pregnancy in order to avoid sedentary- and obesity-associated risks.
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March 2016

Maternal and Perinatal Outcomes of Exercise in Pregnant Women with Chronic Hypertension and/or Previous Preeclampsia: A Randomized Controlled Trial.

ISRN Obstet Gynecol 2013 12;2013:857047. Epub 2013 Aug 12.

101 Alexander Fleming Avenue, Cidade Universitária Zeferino Vaz, 13083-881 Campinas, SP, Brazil.

Objectives. To evaluate the association between physical exercise supervised in pregnant women with chronic hypertension and/or previous preeclampsia and maternal and neonatal outcomes. Method. Randomized controlled trial, which included 116 pregnant women with chronic hypertension and/or previous preeclampsia, considered risk of preeclampsia development. They were divided into two groups: study group that performed physical exercise with a stationary bicycle once a week, for 30 minutes; the intensity was controlled (heart rate 20% above resting values), under professional supervision and a control group that was not engaged in any physical exercise. The data was retrieved from medical charts. Significance level assumed was 5%. Results. Women from study group performed 9.24 ± 7.03 of physical exercise sessions. There were no differences between groups comparing type of delivery and maternal outcomes, including maternal morbidity and hospitalization in intensive unit care, and neonatal outcomes, including birth weight, adequacy of weight to gestational age, prematurity, Apgar scale at first and fifth minutes, hospitalization in intensive unit care, and neonatal morbidity. Conclusions. Physical exercise using a stationary bicycle in pregnant women with chronic hypertension and/or previous preeclampsia, once a week, under professional supervision, did not interfere in the delivery method and did not produce maternal and neonatal risks of the occurrence of morbidity. This trial is registered with NCT01395342.
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September 2013

Exercise and physical activity in the prevention of pre-eclampsia: systematic review.

Acta Obstet Gynecol Scand 2012 Oct 24;91(10):1147-57. Epub 2012 Jul 24.

Department of Obstetrics and Gynecology, University of Campinas (UNICAMP), Campinas, Brazil.

Exercise and physical activity have been studied and suggested as a way to reduce or minimize the effects of pre-eclampsia. Our aim was to evaluate the association between exercise and/or physical activity and occurrence of pre-eclampsia. We conducted electronic searches without year of publication and language limitations. This was a systematic review designed according to PRISMA. Different databases accessed were as follows: PubMed®; Latin-American and Caribbean Literature in Health Sciences (LILACS); Scientific Electronic Library On-line (SciELO); Physiotherapy Evidence Database (PEDro); and ISI web of Knowledge(SM) . The Medical Subject Headings (MeSH) were as follows: ("exercise" OR "motor activity" OR "physical activity") AND ("pre-eclampsia" OR "eclampsia" OR "hypertension, pregnancy-induced"). Inclusion criteria were studies conducted in adults who were engaged in some physical activity. The selection and methodological evaluation were carried out by two independent reviewers. Risk assessment was made by the odds ratio (OR) and incidence of pre-eclampsia in the population who performed physical activity/exercise. A total of 231 articles were found, 214 of which were excluded based on title and full-text, so that 17 remained. Comparison of six case-control studies showed that physical activity had a protective effect on the development of pre-eclampsia [OR 0.77, 95% confidence interval (CI) 0.64-0.91, p < 0.01]. The 10 prospective cohort studies showed no significant difference (OR 0.99, 95% CI 0.93-1.05, p= 0.81). The only randomized clinical trial showed a protective effect on the development of pre-eclampsia in the stretching group (OR 6.34, 95% CI 0.72-55.37, p= 0.09). This systematic review indicates a trend toward a protective effect of physical activity in the prevention of pre-eclampsia.
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October 2012