Leda Tomiko Yamada da Silveira

@usp.br

Physiotherapist, Departamento de Fisioterapia, Fonoaudiologia e Terapia Ocupacional, Faculdade de Medicina, Universidade de Sao Paulo
Universidade de Sao Paulo

Leda Tomiko Yamada da Silveira


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https://researchid.co/lsilveir

RESEARCH, TEACHING, or OTHER INTERESTS

Physical Therapy, Sports Therapy and Rehabilitation
20

Scopus Publications

Scopus Publications

  • The relationship between the structural and functional integrity of the pelvic floor and sexual function in women with or without stress urinary incontinence: a cross-sectional study
    Débora F Porto, Andrea Dell’Aquilla, Jorge Milhem Haddad, Luciana Pistelli, Edmund Chada Baracat, et al.
    Journal of Sexual Medicine, 2026
  • Validity and reliability study of a free mobile app for assessing voiding habits
    Daniela Fantin Carro, Leda Tomiko Yamada da Silveira, Edmund Chada Baracat, Jorge Milhem Haddad, Adriana C. Lunardi, et al.
    International Journal of Medical Informatics, 2026
  • Association Between Timing of Out-of-Bed Mobilization and Functional Outcomes at Intensive Care Unit Discharge in Patients With COVID-19: An Analysis of Potential Clinical Reference Points
    Debora Stripari Schujmann, Claudia Neri Peso, Adriana Claudia Lunardi, Jose Eduardo Pompeu, Leda Tomiko Yamada da Silveira, et al.
    Physical Therapy, 2026
    Importance In patients who are critically ill, functional dependence and muscle weakness may be influenced by side effects related to the timing of out-of-bed mobilization, but there is a knowledge gap regarding the impact of exercise prescriptions in specific intensive care unit (ICU) populations. Objective The objective of this study was to determine clinical reference values for the time to start out-of-bed mobilization of patients in the ICU to avoid functional dependence and muscle weakness at ICU discharge. Design This study was a secondary analysis of a prospective multicenter cohort. Setting The settings were the ICUs of 5 Brazilian hospitals. Participants The participants were adult patients with COVID-19, an ICU stay of ≥4 days, and prior functional independence. Exposure Time for out-of-bed mobilization was the first day the patient was mobilized to higher postures, provided there were no contraindications. Main outcomes and measures Functional status (Barthel Index [BI]) and muscle strength (Medical Research Council Scale [MRC]) were assessed within 2 days of ICU discharge. Receiver operating characteristic analysis identified clinical thresholds for days to initiate out-of-bed mobilization in association with 2 levels of functional dependence and muscle weakness. Optimal cutoffs were based on sensitivity, specificity, and area under the curve (AUC). Results A total of 339 patients (58 years old [SD = 46-66 years old]; Simplified Acute Physiology Score III = 51.3 [SD = 16.5]; 36% women; 53% on mechanical ventilation) were analyzed. Days to start out-of-bed mobilization for each outcome were as follows: 3 days for a BI of <85 points (sensitivity = 67%, specificity = 65%, AUC = 0.68 [95% CI = 0.63-0.74]); 4 days for a BI of <60 points (sensitivity = 60%, specificity = 65%, AUC = 0.66 [95% CI = 0.59-0.73]); 5 days for an MRC score of <48 points (sensitivity = 54%, specificity = 73%, AUC = 0.66 [95% CI = 0.59-0.73]); and 5 days for an MRC score of <36 points (sensitivity = 69%, specificity = 67%, AUC = 0.67 [95% CI = 0.49-0.85]). Conclusions Early out-of-bed mobilization, initiated within 3 to 5 days of physiological readiness, may differentiate patients who develop functional dependence or ICU-acquired weakness at ICU discharge from those who do not. However, since discrimination ranged from 66% to 68%, with a narrow margin for worse outcomes, this recommendation should be interpreted within context. Relevance Knowing clinical reference points for days to initiate out-of-bed exercises may help minimize poor physical outcomes at ICU discharge.
  • Factors associated with functional independence at hospital discharge and 6 months post-hospitalization in intensive care unit survivors with cancer: A prospective cohort study
    Gustavo Telles da Silva, Lavinia Gomes Cavalcante, Maria Luiza Valério Dalzini, Leda Tomiko Yamada da Silveira, Débora Stripari Schujmann, et al.
    Supportive Care in Cancer, 2025
  • Intra- and Inter-Rater Reliability, Measurement Error and Criteria and Convergent Validities of the Dualpex Plus for the Vaginal Manometry of Pelvic Floor Muscles in Women With Urinary Incontinence
    Daniela Fantin Carro, Leda Tomiko Yamada da Silveira, Edmund Chada Baracat, Jorge Haddad, Adriana C. Lunardi, et al.
    Neurourology and Urodynamics, 2025
    ObjectiveTo test the Intra‐ and inter‐rater reliability, measurement error and criteria and convergent validities of the Dualpex Plus (DP) for vaginal manometry in women with urinary incontinence (UI).DesignThis is a clinimetric properties study.SettingUniversity Hospital in Brazil.PopulationOne hundred and two women with UI.MethodsVaginal manometry was performed with DP and Peritron (Pr), in a random order. Intra‐rater reliability was tested within a 1‐week interval; inter‐rater reliability was tested on the same day by two different evaluators. Perception of contraction and comfort with each device were assessed and compared with Chi‐square or paired t tests. Reliability was evaluated by intraclass correlation coefficient (ICC) with a 95% confidence interval (CI). Criteria (with Pr) and convergent (with Oxford score) validities were evaluated by Pearson's correlation. The standard error of measurement (SEM) and the minimum detectable change were also calculated.Main Outcome MeasuresIntra‐ and inter‐rater reliability, measurement error and criteria and convergent validities of the Dualpex Plus.ResultsDP showed substantial inter‐rater and excellent intra‐rater reliability (ICC = 0.85; 95% CI 0.76–0.91 and 0.90; 95% CI 0.86–0.93, respectively); strong and positive criteria validity (r = 0.83; p < 0.001) and convergent validity (r = 0.45; p < 0.001). Pressure values for pelvic floor muscle contraction were different between DP and Pr [17.61 ± 12.22 vs. 34.91 ± 21.22 cmH2O; p < 0.001]. SEM was doubtful (19%) and the minimum detectable change was 0.152 cmH2O. DP was more comfortable than Pr and perception of contraction was higher for Pr.ConclusionDualpex Plus showed adequate clinimetric properties. Measurement error was considered doubtful. DP was more comfortable than Pr and perception of contraction was higher for Pr.
  • Workload of physiotherapy procedures in the adult intensive care unit: a descriptive study in a Brazilian teaching hospital
    Alexandra Siqueira Colombo, Leda Tomiko Yamada da Silveira, Carolina Fu
    Physiotherapy Theory and Practice, 2025
    BACKGROUND Physiotherapy techniques applied in intensive care units (ICU) aim to counteract functional decline and manage acute respiratory conditions. Treatment strategies vary depending on factors such as diagnosis, disease severity, and costs. Staffing resources and workload impact the duration and frequency of interventions. Understanding the workload of procedures may enhance patient care quality. OBJECTIVE To determine the frequency, duration, and workload of physiotherapy procedures applied to adult ICU patients. Secondarily, we analyzed the time spent per shift on teaching-related and non-procedure-related activities. METHODS Longitudinal panel study conducted in a 12-bed university hospital. Physiotherapy sessions applied to adult ICU patients were included. The list of procedures was derived using the Delphi method. The investigator followed physiotherapists to measure the duration of procedures and calculate a workload index for each (determined as duration x frequency). Duration of teaching-related and non-procedure-related tasks was also recorded. RESULTS A total of 339 physiotherapy sessions were analyzed across 79 shifts, involving 181 patients and 19 physiotherapists. Procedures with the highest workload index were: out-of-bed mobilization, patient positioning, passive limb mobilization, active exercises, artificial airway suctioning, and equipment management. Time distribution across the shifts was as follows: direct patient care 40% (SD 12%), non-procedure-related activities 20% (SD 6%), and teaching-related activities 10% (range: 4%-19%). CONCLUSION The procedures with the highest workload index were those directly related to rehabilitation, such as mobilization and exercises, and those not specific to patient condition, like positioning and equipment management. Physiotherapists spent most of their time in direct patient care, followed by indirect care activities and teaching.
  • Relationship Between the PERFECT Scheme, Vaginal Manometry, and Transperineal Ultrasound in Women With and Without Stress Urinary Incontinence: A Cross-Sectional Study
    Débora Franções Porto, Andrea Dell’Aquilla, Leda Tomiko Yamada da Silveira, Luciana Pistelli, Jorge Milhem Haddad, et al.
    International Urogynecology Journal, 2025
  • Predictive Factors for Physiotherapy Session Length at an Adult Intensive Care Unit: A Longitudinal Panel Study
    Leda Tomiko Yamada da Silveira, Maria Teresa Politi, Bruno Leonel Ferreyro, Altay Alves Lino de Souza, Alexandra Siqueira Colombo, et al.
    Archives of Physical Medicine and Rehabilitation, 2024
  • Adherence to low tidal volume in the transition to spontaneous ventilation in patients with acute respiratory failure in intensive care units in Latin America (SPIRAL): a study protocol
    Fabia Diniz-Silva, Bruno Valle Pinheiro, Luis Felipe Reyes, Alexandre Biasi Cavalcanti, Belinda Figueredo, et al.
    Critical Care Science, 2024
    Objective: Patients with acute respiratory failure often require mechanical ventilation to reduce the work of breathing and improve gas exchange; however, this may exacerbate lung injury. Protective ventilation strategies, characterized by low tidal volumes (≤ 8mL/kg of predicted body weight) and limited plateau pressure below 30cmH2O, have shown improved outcomes in patients with acute respiratory distress syndrome. However, in the transition to spontaneous ventilation, it can be challenging to maintain tidal volume within protective levels, and it is unclear whether low tidal volumes during spontaneous ventilation impact patient outcomes. We developed a study protocol to estimate the prevalence of low tidal volume ventilation in the first 24 hours of spontaneous ventilation in patients with hypoxemic acute respiratory failure and its association with ventilator-free days and survival. Methods: We designed a multicenter, multinational, cohort study with a 28-day follow-up that will include patients with acute respiratory failure, defined as a partial oxygen pressure/fraction of inspired oxygen ratio < 300mmHg, in transition to spontaneous ventilation in intensive care units in Latin America. Results: We plan to include 422 patients in ten countries. The primary outcomes are the prevalence of low tidal volume in the first 24 hours of spontaneous ventilation and ventilator-free days on day 28. The secondary outcomes are intensive care unit and hospital mortality, incidence of asynchrony and return to controlled ventilation and sedation. Conclusion: In this study, we will assess the prevalence of low tidal volume during spontaneous ventilation and its association with clinical outcomes, which can inform clinical practice and future clinical trials.
  • Mixed-effects model: A useful statistical tool for longitudinal and cluster studies
    Leda Tomiko Yamada da Silveira1, 2, 3, Juliana Carvalho Ferreira1, 4, et al.
    Jornal Brasileiro De Pneumologia, 2023
    1. Methods in Epidemiologic, Clinical, and Operations Research-MECOR-program, American Thoracic Society/Asociación Latinoamericana del Tórax, Montevideo, Uruguay. 2. Departamento de Fisioterapia, Fonoaudiologia e Terapia Ocupacional, Faculdade de Medicina, Universidade de São Paulo, São Paulo (SP) Brasil. 3. Hospital Universitário, Universidade de São Paulo, São Paulo (SP) Brasil. 4. Divisão de Pneumologia, Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo (SP) Brasil. 5. Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles (CA) USA. PRACTICAL SCENARIO
  • Content and functionality features of voiding diary applications for mobile devices in Brazil: a descriptive analysis
    Natalie Alves Vaccari, Leda Tomiko Yamada da Silveira, Maria Augusta Tezelli Bortolini, Jorge Milhem Haddad, Edmund Chada Baracat, et al.
    International Urogynecology Journal, 2020
  • Decline in functional status after intensive care unit discharge is associated with ICU readmission: a prospective cohort study
    Leda Tomiko Yamada da Silveira, Janete Maria da Silva, Clarice Tanaka, Carolina Fu
    Physiotherapy United Kingdom, 2019
  • Recruitment maneuver might be an option for patients with hypoxemia and atelectasis
    Mieko Claudia Miura, Carlos Roberto Ribeiro de Carvalho, Leda Tomiko Yamada da Silveira, Marisa de Moraes Regenga, Lucas Petri Damiani, et al.
    Journal of Thoracic and Cardiovascular Surgery, 2019
  • The effects of recruitment maneuver during noninvasive ventilation after coronary bypass grafting: A randomized trial
    Mieko Claudia Miura, Carlos Roberto Ribeiro de Carvalho, Leda Tomiko Yamada da Silveira, Marisa de Moraes Regenga, Lucas Petri Damiani, et al.
    Journal of Thoracic and Cardiovascular Surgery, 2018
  • Assessing functional status after intensive care unit stay: the Barthel Index and the Katz Index
    Leda Tomiko Yamada da Silveira, Janete Maria da Silva, Júlia Maria Pavan Soler, Carolina Yea Ling Sun, Clarice Tanaka, et al.
    International Journal for Quality in Health Care, 2018
  • Effect of therapeutic Swedish massage on anxiety level and vital signs of Intensive Care Unit patients
    Tatiana Alves da Silva, Debora Stripari Schujmann, Leda Tomiko Yamada da Silveira, Fátima Aparecida Caromano, Carolina Fu
    Journal of Bodywork and Movement Therapies, 2017
  • Quality of life of critically ill patients in a developing country: A prospective longitudinal study
    José Marcelo e Souza Mafra, Janete Maria da Silva, Leda Tomiko Yamada da Silveira, Carolina Fu, Clarice Tanaka
    Journal of Physical Therapy Science, 2016
  • Reply to: Noninvasive positive pressure ventilation after extubation: Features and outcomes in clinical practice
    Liria Yuri Yamauchi, Maise Figueiroa, Leda Tomiko Yamada da Silveira, Teresa Cristina Francischetto Travaglia, Sidnei Bernardes, et al.
    Revista Brasileira De Terapia Intensiva, 2016
  • Noninvasive positive pressure ventilation after extubation: Features and outcomes in clinical practice
    Liria Yuri Yamauchi, Maise Figueiroa, Leda Tomiko Yamada da Silveira, Teresa Cristina Francischetto Travaglia, Sidnei Bernardes, et al.
    Revista Brasileira De Terapia Intensiva, 2015
  • Implementing a clinical assessment protocol for sensory and skeletal function in diabetic neuropathy patients at a University Hospital in Brazil
    Isabel de Camargo Neves Sacco, Silvia Maria Amado João, Denise Alignani, Daniela Kinoshita Ota, Cristina Dallemole Sartor, et al.
    Sao Paulo Medical Journal, 2005