Banca de DEFESA: LARISSA FERNANDA ESTEVAM DO NASCIMENTO

Uma banca de DEFESA de DOUTORADO foi cadastrada pelo programa.
STUDENT : LARISSA FERNANDA ESTEVAM DO NASCIMENTO
DATE: 28/08/2024
TIME: 08:30
LOCAL: Hibrido
TITLE:

Critical Evaluation of the Psychometric Properties of Exercise Capacity
Tests in Post-COVID-19 Patients: Implications for Rehabilitation and
Clinical Intervention

KEY WORDS:

Post-Covid-19, physical capacity, exercise test, 6-minute walk test.

PAGES: 60
BIG AREA: Ciências da Saúde
AREA: Fisioterapia e Terapia Ocupacional
SUMMARY:

COVID-19 is an infectious disease that induces various systemic
manifestations during its acute stage, potentially resulting in severe acute
respiratory syndrome in many cases. In the subsequent phase, known as
post-COVID-19, it is widely recognized that some patients experience reduced
exercise tolerance and quality of life. During the COVID-19 pandemic,
significant progress was made in understanding the repercussions of these
manifestations on the cardiopulmonary and musculoskeletal systems, from
functional limitations to optimized strategies for clinical identification and
intervention. Exercise capacity assessment has proven essential for identifying
functional deterioration and planning the rehabilitation process in
post-COVID-19 survivors. However, the psychometric properties of the tests
used have not been sufficiently investigated, highlighting the need for studies
to validate these tools to ensure more effective and personalized interventions.
Therefore, the general objective of this thesis is to evaluate the psychometric
properties of exercise capacity tests used in post-COVID-19 patients and synthesize evidence on the effectiveness of these tests for rehabilitation and clinical intervention.

Methods: This thesis was conducted in two stages. The first stage involved
registering the systematic review (SR) protocol, followed by conducting the
systematic review itself. The SR protocol focuses on the psychometric
properties (validity, reliability [internal consistency and measurement error],
learning effects, test repetition, familiarity, responsiveness, and interpretability)
of physical performance tests such as cardiopulmonary exercise tests (CEPT),
including the 6-minute walk test (6MWT), incremental shuttle walk test (ISWT),
endurance shuttle walk test (ESWT), sit-to-stand test (STST), short physical
performance battery (SPPB), and the step test (ST) in post-COVID-19
patients. This protocol was developed following the Preferred Reporting Items
for Systematic Review and Meta-Analysis Protocols (PRISMA-P) guidelines; it
was registered on the PROSPERO platform (CRD42021242334) and
published in the journal BMJ Open. During the second phase, the actual SR
execution, studies involving post-COVID-19 patients evaluated only by the
6MWT were included. Searches were conducted in the following databases:
PubMed/MEDLINE, EMBASE, SciELO, Cochrane Library, CINAHL, and Web
of Science. The research included randomized clinical trials (RCTs),
quasi-RCTs, and observational studies conducted in hospital, rehabilitation
center, and outpatient clinic settings, published in English, with no date
restriction, involving adult post-COVID-19 patients over 18 years old with a
confirmed diagnosis of COVID-19. All evaluation stages were conducted by
two independent researchers, and in cases of disagreement, a third evaluator
was consulted. The risk of bias was analyzed using COSMIN and the certainty
of the evidence assessment was determined by the modified GRADE. Results:
A total of 8,890 articles were identified, and only 20 articles included for the
psychometric property's analysis. The psychometric properties evaluated were
validity and responsiveness, with one study assessing construct validity, 12
studies assessing validity compared to subgroups, and 15 studies evaluating
responsiveness, including one study comparing subgroups and 14 pre- and
post-intervention studies. For validity, only 6 studies confirmed the hypothesis,
with an overall insufficient rating and very low evidence quality. For
responsiveness, the overall rating was classified as insufficient and low-quality
evidence. Conclusions: It can be inferred that the 6MWT has potential for
evaluating functional capacity in post-COVID-19 patients, but current evidence
on its validity and responsiveness is limited. Only a few studies have
confirmed its validity and responsiveness, with the majority presenting
low-quality evidence. Robust future studies are necessary to validate the
6MWT, aiming for more effective and personalized interventions in
post-COVID-19 rehabilitation.

COMMITTEE MEMBERS:
Interna - 2211023 - ILLIA NADINNE DANTAS FLORENTINO LIMA
Externa à Instituição - KAREN DE MEDEIROS PONDOFE
Externa ao Programa - 2682800 - LUCIANA DE ANDRADE MENDES - nullExterno à Instituição - MATIAS OTTO-YANES
Interna - 2682777 - ROBERTA DE OLIVEIRA CACHO