Multidisciplinary, Physical Therapy, Sports Therapy and Rehabilitation, Physiology, Immunology
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Scopus Publications
Scopus Publications
Barriers and factors associated with physical activity in patients with chronic venous insufficiency Wagner Jorge Ribeiro Domingues, Max Duarte Oliveira, Paulo Lucas da Silva e Silva, Priscilla Ribeiro dos Santos Campelo, Neivaldo José Nazaré dos Santos, Stephanie Vitória Alves dos Santos, Guilherme Arêas, Caroline Ferraz Simões Phlebology, 2026 Background Personal and environmental barriers can make it difficult to engage in physical activity. In people with chronic venous insufficiency (CVI), these barriers may exacerbate physical inactivity, but it is not known whether they are independently associated with physical activity levels in addition to clinical and sociodemographic factors. Objective To analyze the barriers and factors that are associated with the level of physical activity in patients with CVI. Methods This cross-sectional study included 97 participants, CVI patients with Clinical-Etiology-Anatomy-Pathology (CEAP) C3 to C6 (69.1% women 58.9 ± 10.7 years; 51.5% C5-C6 in CEAP classification). Personal and environmental barriers to physical activity were assessed by questionnaire. Objective time spent in physical activity was measured using a triaxial accelerometer. Sociodemographic and clinical characteristics were self-reported. Simple and multiple logistic regression was used to examine the association of age with measures of functional capacity, adjusting for sociodemographic, behavioral, clinical, and anthropometric factors. Statistical significance was accepted at p < 0.05. Results Older people with chronic venous insufficiency had greater personal barriers (lack of time and exercise-induced pain) and environmental barriers (unfavorable climate and lack of green spaces) to physical activity ( p < 0.05). After adjustment, physical activity showed a negative association with age (β = −0.022; 95% CI: −0.041 to −0.004) and the absence of a companion (β = −0.001; 95% CI: −0.002 to 0.000), and a positive association with the presence of another health condition (β = 0.001; 95% CI: 0.040 to 0.209). and anthropometrics. Conclusion Our results showed that older patients with CVI face greater personal and environmental barriers to physical activity, such as pain, lack of time, unfavorable weather, and lack of green space. In addition, older age and the absence of a companion were associated with lower levels of physical activity.
Effects of heat therapy on exercise tolerance in a rat model of heart failure with preserved ejection fraction Michael D. Belbis, Bohyun Ro, Luke E. Schepers, Kun Ho Kim, Zhen Yap, Taylor A. Schultz, Mckayla D. Tallman, Morgan F. Killam, Sara E. Hobart, Oluwapamimo J. Fafowora, Jessica N. Bray, Mitchell E. Fister, Vanessa C. C. da Silva, Hamood Ur Rehman, Binayok Sharma, Xinyue Lu, Guilherme P. T. Arêas, James F. Markworth, Kyoungrae Kim, Terence E. Ryan, Shihuan Kuang, Craig J. Goergen, Timothy P. Gavin, Bruno T. Roseguini, Daniel M. Hirai Journal of Applied Physiology, 2025 This is the first evaluation of the effects of heat therapy (HT) in heart failure with preserved ejection fraction (HFpEF). HT elicited multiple central and peripheral adaptations that impacted positively exercise tolerance in a preclinical model of HFpEF. HT adaptations included improvements in cardiac function, body composition, and skeletal muscle oxygenation (mediated partially via enhanced nitric oxide bioavailability). These novel findings indicate that HT may hold important clinical significance for the treatment of HFpEF.
Transcranial magnetic stimulation (TMS) protocol on lower limb muscle strength in healthy individuals Thiago Conceição dos Santos, Rildo Tavares dos Santos, Hudson Renatode Paula Oliveira, Felipe Mendes Barcelos Angeli, Emanuelly Augustada Silva Bispo, Ian Manhoni Bahiense, Walter Gomesda Silva Filho, Guilherme Peixoto Tinoco Areas, Fernando Zanelada Silva Arêas Methodsx, 2025 This study will investigate the effects of high-frequency Transcranial Magnetic Stimulation (TMS) on lower limb muscle strength, using an isokinetic dynamometer to measure strength changes. The research will involve 50 healthy sedentary male participants aged 18-25, randomized into active and sham groups. The protocol will integrate TMS with surface electromyography (sEMG) to assess muscle activation and enhance accuracy. The aim will be to explore whether TMS can influence peripheral neuromuscular characteristics, improving muscle performance. The protocol will involve a double-blind, randomized design and the use of an isokinetic dynamometer for precise muscle strength measurement. By employing TMS, which enhances cortical excitability, and evaluating muscle performance via controlled assessments, the study will seek to provide reliable pre- and post-intervention data. The study's sample calculation will ensure adequate statistical power and account for potential attrition, with 50 participants included. This research will have potential clinical applications, particularly for muscle rehabilitation and performance optimization. However, it will face limitations, such as a male-only sample and variability in individual responses to TMS. Despite these challenges, the study's findings could inform future therapeutic strategies for enhancing muscle strength and contribute to advancing TMS applications in both clinical and athletic settings.
The impact of COVID-19 severity on adult survivors: Is there a relationship between vascular reactivity and cardiorespiratory fitness? Guilherme Dionir Back, Murilo Rezende Oliveira, Guilherme Peixoto Tinoco Arêas, Patricia Faria Camargo, Cássia da Luz Goulart, Claudio Ricardo de Oliveira, José Carlos Bonjorno Junior, Flávia Rossi Caruso Bonjourno, Ross Arena, Audrey Borghi‐Silva Physiological Reports, 2025 The impact of COVID‐19 on cardiorespiratory fitness (CRF) is negative, increasing the likelihood of exertional symptoms such as fatigue and shortness of breath, and adversely affecting vascular function, impairing cardiovascular health. This study investigated endothelial function and its relationship with CRF in patients who have recovered COVID‐19. Patients were evaluated 1 month after infection, including clinical assessment, pulmonary function, endothelial function (measured by flow‐mediated dilation), and cardiopulmonary exercise testing. COVID‐19 survivors exhibited reduced exercise capacity, with poor values of peak V̇O2peak and FMD (%) according to disease severity. However, endothelial function was worse in COVID‐19 patients, regardless of severity, compared to the control group. Significant associations were observed between poorer FMD (%) and peak V̇O2, workload, circulatory power, and V̇O2peak/WR. Endothelial function was significantly associated with CRF in COVID‐19 patients according to disease severity. Strategies to improve CRF and reduce the negative impacts of endothelial function damage should be further investigated.
Functional Capacity Impairment in Long COVID After 17 Months of Severe Acute Disease Fernanda Facioli dos Reis Borges, Andrezza Cristina Barbosa Braga, Bernardo Silva Viana, Jefferson Valente, João Marcos Bemfica, Thaís Sant’Anna, Cássia da Luz Goulart, Fernando Almeida-Val, Guilherme Peixoto Tinoco Arêas International Journal of Environmental Research and Public Health, 2025 Long COVID represents a significant challenge in understanding the prolonged impact of the disease. Despite its increasing recognition, detailed insights into the long-term cardiopulmonary consequences remain sparse. This study aimed to evaluate the functional capacity of individuals with persistent symptoms after severe COVID-19 infection compared to control individuals without symptomatic COVID or mild COVID after 17 months. This is a case-control study assessing 34 individuals divided into two groups regarding functional capacity by distance in a 6-min walk test (D6MWT) associated with gas analysis, spirometry, respiratory muscle strength, and quality of life. During the 6 MWT, an important lower heart rate (HR) was observed for the COVID group (106 ± 10 bpm, difference mean: 21.3; p < 0.001), with greater exertional perception (Borg dyspnea: 4.5 [2.0–9.0], p < 0.001 and Borg fatigue: 4.0 [2.0–7.0], p = 0.01), a significant decrease in the distance covered (416 ± 94 m, difference mean: 107; p = 0.002), and a low value of O2 uptake (V˙O2) (11 ± 5.0 mL/(kg min), difference mean: 8.3; p = 0.005) and minute ventilation (22 ± 8 L/min, difference mean: 18.6; p = 0.002), in addition to very low quality of life scores. Regression analysis showed a significant association between D6MWT and Borg fatigue and Borg dyspnea at rest (p = 0.003; p = 0.009). V˙O2 and HR were also significantly associated with the outcomes of the D6MWT (p = 0.04 and p = 0.004, respectively). In conclusion, individuals who have severe COVID-19 and persist with symptoms have low functional capacity, low V˙O2, low HR behavior, and low quality of life.
Physical activity levels in patients with chronic venous insufficiency Wagner Jorge Ribeiro Domingues, Antonio Henrique Germano-Soares, Gabriel Grizzo Cucato, Lenon Corrêa de Souza, Emely Kércia Santiago de Souza Brandão, Emmina Lima da Cruz de Souza, Thiago Renan da Silva e Silva, Guilherme Peixoto Tinoco Arêas, Cleinaldo Costa, Priscilla Ribeiro dos Santos Campelo, Neivaldo José Nazaré dos Santos, Gustavo Oliveira da Silva, Caroline Ferraz Simões Phlebology, 2025 Background Increasing the levels of physical activity (PA) is widely recommended for people with chronic venous insufficiency (CVI). However, studies investigating the patterns of PA and adherence to PA guidelines using objective measures are lacking. Objective The primary aim was to examine the patterns of PA and adherence to PA guidelines among patients with CVI. A secondary aim was to identify whether adherence to PA recommendations differed according to patients’ sociodemographic and clinical characteristics. Methods This cross-sectional study included 96 patients with CVI with Clinical-Etiology-Anatomy-Pathology (CEAP) C3 to C6 (69.1% women 59 ± 11 years; 51.5% C5-C6 on CEAP classification). Objective time spent in PA was measured by a triaxial accelerometer. To examine adherence to PA guidelines, patients were grouped as meeting (or) the recommendations if they had at least 150 min/week of moderate to vigorous PA. Sociodemographic and clinic characteristics were obtained by self-report. Binary logistic regression was employed to examine whether sociodemographic and clinical characteristics were associated with adherence to PA guidelines. T-tests were employed to compare PA levels at different intensities according to patients’ age. Results Patients spent an average of 311.4 ± 91.5 min/week, 42.1 ± 28.0 min/week, and 19.8 ± 17.8 min/week in low-light PA, high-light PA, and moderate-to-vigorous PA, respectively. The proportion of patients meeting PA recommendations was 36.2%, and older patients had lower odds (OR = 0.94; 95%CI: 0.89 to 0.99). Additional analysis reinforced that by showing lower time in high-light PA (51.2 ± 30.0 min/day vs. 31.9 ± 21.8 min/day; p = .001) and moderate-to-vigorous PA (24.3 ± 15.8 min/day vs. 14.8 ± 18.8 min/day; p = .012) among older patients than their peers younger. Conclusion Our findings showed that 36,2% of CVI patients met PA recommendations, with lower odds found among older patients. Public health interventions to enhance PA engagement among CVI patients should prioritize those who are older.
Feasibility randomized controlled trial of transcranial direct current stimulation (tDCS) to reduce falls in Parkinson's disease Jader Vinicius Silva Rocha, Marcela Barçante, Tiffany Holz Pereira, Juliana Cristina de Souza, Augusto Boening, Guilherme Peixoto Tinoco Areas, Lucas Rodrigues Nascimento, Fernando Zanela da Silva Areas Pm and R, 2025 Background Parkinson's disease (PD) significantly impairs mobility and increases the risk of falls. Objective To evaluate the feasibility and safety of a randomized controlled trial protocol investigating the effects of transcranial direct current stimulation (tDCS) combined with gait training. Methods Twenty‐five individuals with PD were assessed for eligibility to participate in either active tDCS walking training (experimental group) or sham tDCS walking training (control group) for 4 weeks, consisting of 12 30‐minute sessions. Results Of the 25 individuals assessed, 11 met the eligibility criteria (44%), and 9 were enrolled in the study (36% of eligible, 22.5% of total). Adherence to the intervention was high (88.9%), and no serious adverse events were reported. Conclusion The protocol was found to be safe and feasible, though methodological adjustments, particularly in eligibility criteria and logistical procedures, are recommended to improve future implementation. These findings support the feasibility of conducting a full‐scale randomized controlled trial to evaluate the combined effects of tDCS and gait training in individuals with PD.
Impact of Respiratory Support During Hospitalization on Functional Outcomes in Long COVID: A Post-Hoc Analysis of a Prospective Cohort Study Camila Miriam Suemi Sato Barros do Amaral, Jefferson Valente, Cássia da Luz Goulart, Bernardo Maia da Silva, Alexandre Silva Neto, Nadia Cubas-Vega, Anna Gabriela Rezende, Eduardo Fernandes, Mayla Gabriela Silva Borba, Vanderson Sampaio, Wuelton Monteiro, Gisely Cardoso de Melo, Marcus Lacerda, Guilherme Peixoto Tinoco Arêas, Fernando Almeida-Val International Journal of Environmental Research and Public Health, 2025
Low handgrip strength is associated with worse functional outcomes in long COVID Camila Miriam Suemi Sato Barros do Amaral, Cássia da Luz Goulart, Bernardo Maia da Silva, Jefferson Valente, Anna Gabriela Rezende, Eduardo Fernandes, Nadia Cubas-Vega, Mayla Gabriela Silva Borba, Vanderson Sampaio, Wuelton Monteiro, Gisely Cardoso de Melo, Marcus Lacerda, Guilherme Peixoto Tinoco Arêas, Fernando Almeida-Val Scientific Reports, 2024
Sex-Based Differences in Pulmonary Function and Cardiopulmonary Response 30 Months Post-COVID-19: A Brazilian Multicentric Study Cássia da Luz Goulart, Guilherme Peixoto Tinoco Arêas, Mauricio Milani, Fernanda Facioli dos Reis Borges, Juliana Ribeiro Magalhães, Guilherme Dionir Back, Audrey Borghi-Silva, Luciano Fonseca Lemos Oliveira, André Ribeiro de Paula, Carolina Coimbra Marinho, Déborah Pereira Prado, Celso Nascimento de Almeida, Cristiane Maria Carvalho Costa Dias, Vinícius Afonso Gomes, Luiz Eduardo Fonteles Ritt, Leandro Tolfo Franzoni, Ricardo Stein, Mansueto Gomes Neto, Gerson Cipriano Junior, Fernando Almeida-Val International Journal of Environmental Research and Public Health, 2024
Exploring Prehospital Data for Pandemic Preparedness: A Western Brazilian Amazon Case Study on COVID-19 Eduardo Fernandes, Bernardo Maia da Silva, Cássia da Luz Goulart, Jefferson Valente, Nádia Cubas-Vega, Camila Sato, Anna Gabriela Rezende, Taynna Vernalha Rocha Almeida, Robson Luís Oliveira de Amorim, Jorge Luis Salinas, Wuelton Marcelo Monteiro, Guilherme Peixoto Tinoco Arêas, Fernando Almeida-Val International Journal of Environmental Research and Public Health, 2024
Sequelae and mortality in patients with HIV/AIDS and Progressive Multifocal Leukoencephalopathy: Systematic review and case series in the Brazilian Amazon Jefferson Valente, Paola López Del-Tejo, Nadia Carolina Cubas-Vega, Maria Gabriela de Almeida Rodrigues, Francisco Railson Bispo de Barros, Márcia Araújo Alexandre, Guilherme Peixoto Tinoco Arêas, Michele Bastos, Sérgio Damasceno Pinto, Camila Miriam S. S. Barros, Eveny Perlize Marinho, Sabrina Mello, Ewerton Ferreira, Valderjane Aprigio, Rossiclea Lins Monte, Vanderson Sampaio, Marcus Lacerda, Djane Clarys Baia-da-Silva, Fernando Val Frontiers in Tropical Diseases, 2023
Short-Course of Methylprednisolone Improves Respiratory Functional Parameters After 120 Days in Hospitalized COVID-19 Patients (Metcovid Trial): A Randomized Clinical Trial Camila Miriam Suemi Sato Barros, Raissa Soares Freire, Elisângela Frota, Anna Gabriela Rezende Santos, Maria Eduarda Leão de Farias, Maria Gabriela Almeida Rodrigues, Bernardo Maia da Silva, Christiane Maria Prado Jeronimo, R. A. C. Netto, Mayla Gabriela Silva Borba, D. Baía-da-Silva, J. D. Brito-Sousa, M. Xavier, Marcia Almeida Araújo-Alexandre, V. Sampaio, G. Melo, G. Arêas, L. Hajjar, W. Monteiro, F. Gomes Naveca, Fábio Trindade Maranhão Costa, F. Val, M. Lacerda, Adria Adriana Ferreira Alexandre Aline Sales Amanda Carv de Lemos Vasconcelos Praia Marins de Oliveira Trin Frontiers in Medicine, 2021
COPD assessment test and FEV 1 : Do they predict oxygen uptake in COPD? Luiz Carlos Soares Carvalho Jr, Renata Trimer, Guilherme Arêas, Flávia Caruso, Katiany Zangrando, Soraia Jürgensen, José Carlos Bonjorno-Jr., Cláudio Oliveira, Ramona Cabiddu, Renata Mendes, Audrey Borghi-Silva International Journal of Copd, 2018
