Análise da genotoxicidade das águas da Lagoa da Extremoz - RN

The contamination of the waters resources for wastewater from industrial, agricultural, and domestic sources is a serious environment problem, compromising its use for human consumption and agriculture. The Extremoz-RN Lake is an important freshwater source for the supply of the city of Natal, supplying a population of approximately 160,000 habitants. This aquatic body is located near an industrial pole which can be a serious risk factor for quality of its waters. The objectives of this study were examined the genotoxicity of Extremoz Lake between September of 2006 and January of 2008, by a combination of the Allium micronucleus test, piscine micronucleus test and the comet assay in erythrocytes from peripheral blood of Oreochromis niloticus. Additionally, the level of eight different heavy metals was quantified through spectrometry of atomic absorption of flame. The Allium test did not detect increase in the frequencies of micronucleus in none of the analyzed periods, however a strong cytotoxic activity was demonstrated for decrease in mitotic index in the analyses carried in April and July of 2007. Negative results had been detected in the frequencies of micronucleus in O. niloticus. A statistic significant increase was observed in the levels of DNA damage in comet assay carried in July of 2007. The results of the chemical analysis had detected increase in the levels of cadmium, chromium, copper, nickel, lead and zinc in different periods. These results demonstrated an alteration of the water s quality of the Extremoz Lake caused for the contamination for heavy metals and increase of DNA strand breaks. The use of biomonitoring program of the heavy metal and other pollutants with genotoxic potential combinated with genotoxicity assays is recommends.

Avaliação da genotoxicidade das águas sueprficiais da Barragem Engenheiro Armando Ribeiro Gonçalves, Assu/RN

Conselho Nacional de Desenvolvimento Científico e Tecnológico

Efeito in vitro da terapia fotodinâmica sobre bactérias orais em suspensão e na formação de biofilme : ensaio com azul de metileno e toluidina ativados por luz halógena

Photodynamic therapy (PDT) has been proposed as an alternative method for the treatment of biofilm-dependent oral diseases like dental caries. This therapy consists of simultaneous action of a visible light (L) and a photosensitizer (FS) in the presence of oxygen, which leads to production of different reactive oxygen species that can interact with the bacterial cell components, and promote cell death. This study aims to evaluate the antimicrobial action of PDT on oral bacteria in suspension, as well as the formation of mono and multi-species biofilms, in vitro, from a standard strain of Streptococcus mutans (ATCC 25175) and saliva samples, respectively. The dye methylene blue (MB) and toluidine blue (TB) were used at a concentration of 100 mg/ L and activated by halogen light (600 to 750 nm) from a modified hand held photopolymerizer (Ultralux ®, Dabi Atlante, Ribeirão Preto , São Paulo, Brazil.). Planktonic cultures were prepared and submitted to different experimental conditions: 1. PDT using TB 2. PDT using MB, 3. L+ FS- , 4. TB + L - ; 5. MB+ L-; 6. L- FS- (negative control) and 7. administration of 0.12% chlorhexidine digluconate (positive control) (Periogard ®, Colgate-Palmolive Company, New York, USA). The immediate and mediated action of PDT on bacterial suspensions, as well as its effect on biofilm formation were observed from the number of colony-forming units per milliliter (CFU/mL) and measures optical density (OD). The data were statistically analyzed using the Kruskal-Wallis and Mann-Whitney test for the significance level of 5%. According to the results, the PDT showed no antibacterial action on suspensions of S. mutans, regardless of the dye used. PDT with MB activated by halogen light was able to reduce 86.6% CFU/mL multi-species planktonic cultures, however, this reduction was not significant (p > 0.05). PDT showed antibacterial effect, mediate on multi-species planktonic cultures with TB (p < 0.001) and MB (p < 0.001), activated by halogen light. PDT was able to prevent the formation of multispecies biofilm, through the activation of TB by halogen light (p = 0.01). We conclude that activation of the dye toluidine blue and methylene blue, by halogen light (PDT) showed antimicrobial activity, compared to multi-species planktonic cultures prepared from saliva samples

Efeito do kinesio taping® no desempenho neuromuscular do quadríceps e no equilíbrio em sujeitos submetidos à reconstrução do ligamento cruzado anterior: ensaio clínico e randomizado

Objetivo: Investigar os efeitos imediatos do Kinesio Taping® no desempenho neuromuscular do Quadríceps Femoral (QF) de indivíduos submetidos à reconstrução do Ligamento Cruzado Anterior (LCA). Metodologia: trata-se de um ensaio clínico e randomizado composto por 45 indivíduos do sexo masculino que se encontravam entre 12ª e 17ª semanas após reconstrução do LCA. Todos foram submetidos a uma avaliação inicial composta pela análise do equilíbrio postural, através da baropodometria; determinação do Senso de Posição Articular (SPA), seguidas das avaliações isocinéticas excêntricas e concêntricas a 600/s, concomitante com a captação do sinal eletromiográfico do músculo Vasto Lateral (VL). Posteriormente foram alocados de forma aleatória em Grupo Controle (GC), Grupo Placebo (GP) e Grupo Experimental (GE). Os indivíduos do GE foram submetidos ao protocolo sugerido (aplicação do Kinesio Taping® no QF do membro acometido), enquanto os do GP utilizaram a aplicação do Kinesio Taping® sem as recomendações propostas pelo método. Já os indivíduos do GC permaneceram em repouso por dez minutos, sendo todos os indivíduos submetidos a uma reavaliação de forma idêntica à primeira. Foram analisadas as seguintes variáveis: pico de torque médio, pico de torque/peso corporal, potência muscular e erro absoluto do SPA para a dinamometria; amplitude ântero-posterior e médio-lateral para a baropodometria; e a amplitude de ativação muscular (Root Means Square - RMS) por meio da eletromiografia de superfície. Resultados: Nenhuma das variáveis analisadas apresentou diferenças intergrupo ou intragrupo. Conclusão: O Kinesio Taping® não altera o desempenho neuromuscular do quadríceps femoral de indivíduos submetidos à reconstrução do LCA para nenhuma das variáveis analisadas.

Efeitos da reabilitação vestibular em idosos com vertigem posicional paroxística benigna (VPPB): ensaio clínico controlado e randomizado

Introdução: a Vertigem Posicional Paroxística Benigna (VPPB) é uma das principais causas de tontura em idosos. O tratamento mais empregado para essa afecção é a Manobra de Reposicionamento Canalítico (MRC). Apesar de útil na resolução clínica da sintomatologia vertiginosa e do nistagmo, os pacientes podem continuar demonstrando prejuízo na estabilidade postural após serem submetidos à MRC. Outra opção não farmacológica disponível são os exercícios de Reabilitação Vestibular (RV) que podem ser direcionados à melhora do equilíbrio postural dos idosos, porém há escassez de estudos que avaliem a efetividade da RV no equilíbrio postural de idosos com VPPB. Objetivo: analisar a efetividade da Terapia de Reabilitação Vestibular associada às Manobras de Reposicionamento Canalítico em comparação às Manobras de Reposicionamento Canalítico no tratamento de idosos com Vertigem Posicional Paroxística Benigna (VPPB) crônica. Métodos: participaram do presente ensaio clínico controlado, randomizado e cego 14 idosos de ambos os sexos e idade igual ou superior a 65 anos e com diagnóstico de VPPB crônica. Os idosos foram randomizados em dois grupos, sendo sete (mediana: 69 anos, 65-78) para o grupo experimental e sete (mediana: 73 anos, 65-76) para o grupo controle. Ambos os grupos foram submetidos a Manobras de Reposicionamento Canalítico (MRC) para VPPB e somente o grupo experimental à Terapia de Reabilitação Vestibular (TRV) associada às MRC. Os efeitos da TRV foram mensurados em relação à conversão do teste de Dix-Hallpike de positivo para negativo, recorrência da VPPB, número de manobras para obter a negativação do teste de Dix-Hallpike, sintomatologia da tontura, qualidade de vida e ao equilíbrio estático e dinâmico. Os idosos foram submetidos a uma avaliação inicial (T0), em uma semana (T1), cinco (T5), nove (T9) e treze semanas (T13). Em todas as avaliações o teste de Dix-Hallpike foi realizado com o auxílio do sistema de Videonistagmoscopia (SVNC) da Contronic - Brasil, e em caso positivo, nova MRC foi empregada. As diferenças entre os grupos foram analisadas pelos testes de Mann Whitney e exato de Fisher e para elucidar as diferenças intra-grupo os testes não paramétricos de Friedman e Wilcoxon foram usados. Resultados: nenhuma diferença significativa foi encontrada na conversão do teste de Dix-Hallpike de positivo para negativo, na recorrência da VPPB e no número de manobras para a negativação do teste de Dix-Hallpike, entre os grupos ao longo do ensaio. Também não foram encontradas diferenças entre os grupos na sintomatologia da tontura, qualidade de vida e equilíbrio estático. Contudo, diferenças significativas foram observadas nos aspectos do equilíbrio dinâmico entre os grupos (p< 0,05). Na análise intra-grupo ambos os grupos obtiveram melhora em todas as medidas de desfecho, porém o grupo controle não obteve melhora no equilíbrio dinâmico. Conclusões: a TRV adicional não influenciou na conversão do teste de Dix-Hallpike de positivo para negativo, na recorrência da VPPB, no número de manobras para a negativação do teste de Dix-Hallpike, na redução da sintomatologia da tontura e na qualidade de vida dos idosos com VPPB crônica. Porém, os participantes que receberam a TRV adicional demonstraram melhores resultados no equilíbrio dinâmico do que aqueles que foram submetidos somente às MRC. Os resultados desse estudo deverão repercutir nas estratégias de reabilitação baseadas em evidências nos pacientes idosos com disfunções otoneurológicas.

Efeito tardio do kinesio taping na função do membro inferior e no desempenho neuromuscular do quadríceps femoral de mulheres saudáveis: ensaio clínico e randomizado

Introduction: Kinesio Taping (KT) has been used in healthy people to improve neuromuscular performance, however, few studies have evaluated its chronic effects, despite being suggested. Objective: To analyze the chronic effects of KT on neuromuscular performance of the quadriceps, the oscillation of the center of pressure and lower limb function in healthy women. Methods: blinded, randomized, controlled trial, composed of 60 women (mean age 21.9 ± 3.3 years and BMI 22.3 ± 2.2 kg / m2) submitted to the evaluation of oscillation of the center of pressure through the baropodometry, the lower limb function by the hop test, isokinetic knee performance, the electromyographic activity of the vastus lateralis (VL) and joint position sense of the knee (JPS). Then, participants were randomly divided into three groups of twenty: control - did not apply the KT; placebo - application of KT without tension on the quadriceps; Kinesio Taping - application of KT with tension in the same muscle group. The evaluations were conducted in five moments: prior to application of KT, immediately after the application, 24h, 48h after application and 24 hours after its removal (72h). SPSS 20.0 was used for statistical analysis. The KS test was used to verify the data normality, the Levene test for homogeneity of variances and a mixed-model ANOVA 3x5 to check intra and inter-group differences. Results: there was no difference in peak torque, the power, nor the electromyographic activity or SPA (p> 0.05) between groups. The displacement speed of center of pressure reduced immediately after the application on kinesio taping group (p <0.001), but with no differences between the groups (p = 0.28). There was a reduction in the time of peak torque among the three groups in the evaluations after KT application (p <0.001) and an increase in single hop in all groups (p <0.001), but with no differences between them. Conclusion: KT can not change, in a chronic way, the lower limb function, the oscillation of the center of pressure, the isokinetic performance, the JPS of the knee and the electromyographic activity of VL muscle in healthy women.

Avaliação da genotoxicidade em mulheres com síndrome dos ovários policísticos: impacto da dieta

Introduction: Polycystic Ovary Syndrome (PCOS), present in 6-12% of women of reproductive age, the criterion of Rotterdam, is characterized by hyperandrogenism, insulin resistance (IR) and its inflammatory state, exacerbated by obesity and factors associated with the increase in damage DNA. Weight loss, combined with healthy eating, acts restoring the reproductive and metabolic functions in the SOP, though its influence in reducing DNA damage in PCOS are unknown. Aim: To investigate whether there are differences between DNA damage markers and factors of cardiometabolic risk in women with PCOS and control, and evaluate the effectiveness of nutritional intervention in DNA damage markers and cardiometabolic risk markers in overweight and obese women with PCOS. Methods: the study was conducted in two studies and the participants were aged between 18 and 35 years. In the first study, a prospective case-control, were included 27 women diagnosed with PCOS and 20 controls. In the second study, clinical trial of nutritional intervention with 12-week calorie-restricted diet 500Kcal / day. The genotoxicity, DNA damage (intensity tail, tail moment and tail length) was evaluated by the comet assay. Anthropometric data, dietary intake, hormonal, biochemical and inflammatory were evaluated in different studies. Results: there was no significant difference between the DNA damage marker tail intensity (p = 0.18), tail moment (p = 0.76) and tail length (p = 0.109) in PCOS when compared to the control group. Data after nutritional intervention in PCOS women with overweight and obesity showed a decrease in DNA damage markers: tail intensity (24.35 ± 5.86 - pre-diet vs. 17.15 ± 5.04 -Post-diet) and tail moment (20.47 ± 7.85 - pre-diet vs. 14.13 ± 6.29 -post-diet) (p <0.001). Reduction of weight (3.5%) and decreased cardiometabolic markers IR and hyperandrogenism. Conclusion: women with PCOS have a worse cardiometabolic risk profile compared to control however similar genotoxicity identified by DNA damage. Nutritional intervention reduced the genotoxicity of overweight and obese women with PCOS, and reduce the factors of cardiometabolic risk.

Efeitos do Kinesio Taping® sobre os marcadores clínicos indiretos de dano muscular induzido pelo exercício excêntrico: ensaio clínico randomizado

Objective: analyze the effect of Kinesio Taping (KT) on the indirect clinical markers of muscle damage induced by eccentric exercises in the elbow flexors in healthy individuals. Materials and methods: It is a randomized controlled trial involving sixty volunteers at age group between 18 and 28 years randomly selected. The sample into three groups with twenty participants: control group (CG) – eccentric protocol without KT, KT group – eccentric with tensioned KT, placebo group – eccentric protocol KT with no tension. The evaluations took place at four moments; the first one was the basis line (AV1), after the second protocol (AV2) and the following two groups 24 (AV3) and 48 hours (AV4) after the intervention protocol. The muscle damage was induced by sixteen maximum eccentric contractions of the elbow flexors from the non-dominant limb, divided in two sets of eight repetitions, at 60º/s, with two minutes interval. The variables analyzed were: the joint amplitude in rest, the level of pain, the joint position sense (JPS) followed of isokinetic checking with electromyographic sign capitation. These data were analyzed in software SPSS 20.0. The normality was identified by Kolmogorov-Smimov examination and then, being used the ANOVA mixed model with significance of 5%. Outcomes: a decrease was observed at joint amplitude moreover, an immediate increase of pain wich increased after 24 and remained until 48 hours at all groups searched. There was not difference at the JPS. The variables peak torque, average peak torque, total work and mean power mean reduced until 48 hours after muscle lesion in all groups. Among the groups, there was no difference in EMG values and for any of the variables. Conclusion: The KT did not influence at the indirect clinical markers of muscle lesion induced by eccentric exercises in the elbow flexors in healthy people.

Efeitos do Kinesio Taping® sobre os marcadores clínicos indiretos de dano muscular induzido pelo exercício excêntrico: ensaio clínico randomizado

Objective: analyze the effect of Kinesio Taping (KT) on the indirect clinical markers of muscle damage induced by eccentric exercises in the elbow flexors in healthy individuals. Materials and methods: It is a randomized controlled trial involving sixty volunteers at age group between 18 and 28 years randomly selected. The sample into three groups with twenty participants: control group (CG) – eccentric protocol without KT, KT group – eccentric with tensioned KT, placebo group – eccentric protocol KT with no tension. The evaluations took place at four moments; the first one was the basis line (AV1), after the second protocol (AV2) and the following two groups 24 (AV3) and 48 hours (AV4) after the intervention protocol. The muscle damage was induced by sixteen maximum eccentric contractions of the elbow flexors from the non-dominant limb, divided in two sets of eight repetitions, at 60º/s, with two minutes interval. The variables analyzed were: the joint amplitude in rest, the level of pain, the joint position sense (JPS) followed of isokinetic checking with electromyographic sign capitation. These data were analyzed in software SPSS 20.0. The normality was identified by Kolmogorov-Smimov examination and then, being used the ANOVA mixed model with significance of 5%. Outcomes: a decrease was observed at joint amplitude moreover, an immediate increase of pain wich increased after 24 and remained until 48 hours at all groups searched. There was not difference at the JPS. The variables peak torque, average peak torque, total work and mean power mean reduced until 48 hours after muscle lesion in all groups. Among the groups, there was no difference in EMG values and for any of the variables. Conclusion: The KT did not influence at the indirect clinical markers of muscle lesion induced by eccentric exercises in the elbow flexors in healthy people.

Efeitos dos exercícios aeróbio contínuo e intervalado na variabilidade da frequência cardíaca em adultos jovens saudáveis. Ensaio clínico aleatório

The high-intensity interval exercise has been described as an option for increasing physical activity and its use also being suggested in the therapeutic management of many conditions such as diabetes mellitus and heart failure. However, the knowledge of its physiological effects and parameters that can assure greater safety for interval exercise prescription; especially its effect on short- and medium-term (24 hours after exercise) exercise recovery, need to be clarified. This study objective was to evaluate the effect of continuous and interval aerobic exercise on the cardiac autonomic control immediate and medium term (24 hours), by assessing heart rate variability (HRV). The present study is a randomized crossover clinical trial in which healthy young individuals with low level of physical activity had the VFC 24 hours measured by a heart rate sensor and portable accelerometer (3D eMotion HRV, Kuopio, Finland) before and after continuous aerobic exercise (60-70% HR max, 21 min.) and interval exercise (cycle 1 min. 80-90% HR max, 2 min. at 50-60% HR max, duration 21 min.). HRV was measured in the time and frequency domain and the sympathovagal balance determined by the ratio LF / HF. Nonlinear evaluation was calculated by Shannon entropy. The data demonstrated delayed heart rate recovery immediate after exercise and lower HR after 24 hours compared to pre intervention values, especially in the interval exercise group. There was a tendency to higher predominance and representatives index values of sympathetic stimulation during the day in interval exercise group; however, without statistical significance. The study results help to clarify the effects of interval exercise on the 24 hours following interval exercise, setting parameters for prescription and for further evaluation of groups with metabolic and cardiovascular diseases.

Efeitos imediatos da plataforma vibratória no desempenho neuromuscular do quadríceps femoral, após reconstrução do LCA: ensaio controlado, randomizado e cego

Objective: to investigate the immediate effect of the vibrating platform on the neuromuscular performance of the quadriceps femoris and on the postural oscillation of subjects submitted to Anterior Cruciate Ligament (ACL) reconstruction. Materials and methods: this study is a randomized and blind clinical trial. Forty-four male volunteers (average age of 27,4 ±6,2 IMC of 26,85± 3,8 Kg/m² and post surgery timeframe of 17± 1,4 weeks) were randomized into two groups: OFF platform (n=22, protocol of exercise over the vibrating platform off) and ON platform (n=22 protocol of exercise over the vibrating platform on, 50Hz frequency and 4mm of amplitude). All volunteers were submitted to assessment the isokinetic evaluation of the quadriceps femoris (isometric and isokinetic at 60°/s) and of the electromyography activity of the muscles Vasto Lateralis (VL) and Vasto Medialis (VM), besides the postural oscillation (baropodometry) in two distinct moments: before and immediately after the intervention protocol. The data was analyzed through the SPSS 20.0 software, with a 5% significance level. To verify the homogeneity of the groups it was used an ANOVA one way, and a ANOVA mixed model to compare the intra and inter groups. Results: it was observed differences between the pre and the post, to latero lateral velocity, isometric torque peak and total work in comparison with intragroup. However, it wasn’t verified any difference in comparing the intergroup in the preevaluation and in the post-evaluation protocol over the vibrating platform. Conclusion: the use of the vibrating platform doesn’t change as an immediate manner the isokinetic performance of the quadriceps femoris, the electromyography activity of the VL and the VM, also doesn’t interfere with the postural oscillation of individuals that were submitted to the ACL reconstruction.

Eficiência mastigatória e qualidade das próteses totais confeccionadas pelas técnicas tradicionais e simplificada: um ensaio clínico

Traditional methods for dentures fabrication require a wide clinical and laboratory procedures; however, there is no scientific evidence that these methods can produce better results when compared with simplified methods. Aim: To evaluate the effectiveness of a simplified methods for denture fabrication, comparing it to the traditional one through masticatory efficiency and prosthesis quality. Method: A randomized controlled trial was conducted with 50 patients, 25 rehabilitated with prosthesis produced by traditional technique and 25 rehabilitated by a simplified technique. The masticatory efficiency was evaluated by colorimetric method, using chewing capsules. The quality of prosthesis was obtained using a reliable and reproducible instrument. Statistical analysis of the masticatory efficiency and quality of the prosthesis was obtained by the Mann-Whitney test. Results: 39 patients completed the study, 18 on traditional group and 21 on simplified group. There was no difference between groups for the masticatory efficiency (p = 0.835) and the quality of the prosthesis (p = 0672). The evaluation of the overall quality of the prosthesis according to oral conditions, demonstrated significant difference on the height of the mandibular ridges (p = 0.010) and mandibular muscle attachments (p = 0.039). Conclusion: Complete dentures fabricated by simplified method were considered effective from the point of view of masticatory efficiency and quality of prosthetics, with results similar to those made by the traditional method.

Eficiência mastigatória e qualidade das próteses totais confeccionadas pelas técnicas tradicionais e simplificada: um ensaio clínico

Traditional methods for dentures fabrication require a wide clinical and laboratory procedures; however, there is no scientific evidence that these methods can produce better results when compared with simplified methods. Aim: To evaluate the effectiveness of a simplified methods for denture fabrication, comparing it to the traditional one through masticatory efficiency and prosthesis quality. Method: A randomized controlled trial was conducted with 50 patients, 25 rehabilitated with prosthesis produced by traditional technique and 25 rehabilitated by a simplified technique. The masticatory efficiency was evaluated by colorimetric method, using chewing capsules. The quality of prosthesis was obtained using a reliable and reproducible instrument. Statistical analysis of the masticatory efficiency and quality of the prosthesis was obtained by the Mann-Whitney test. Results: 39 patients completed the study, 18 on traditional group and 21 on simplified group. There was no difference between groups for the masticatory efficiency (p = 0.835) and the quality of the prosthesis (p = 0672). The evaluation of the overall quality of the prosthesis according to oral conditions, demonstrated significant difference on the height of the mandibular ridges (p = 0.010) and mandibular muscle attachments (p = 0.039). Conclusion: Complete dentures fabricated by simplified method were considered effective from the point of view of masticatory efficiency and quality of prosthetics, with results similar to those made by the traditional method.

Efeitos do treino de marcha em esteira com adição de carga ao membro inferior não parético de indivíduos com acidente vascular cerebral: ensaio clínico controlado e randomizado

Introduction: Gait after stroke is characterized by a significant asymmetry between the lower limbs, with predominant use of the non-paretic lower limb (NPLL) over using the paretic lower limb. Accordingly, it has been suggested that adding load/weight to the NPLL as a form of restricting the movement of this limb may favor the use of the paretic limb, reducing interlimb asymmetry. However, few studies have been conducted up to this moment, which only investigated the immediate effects of this practice. Objectives: 1) Investigating whether there is an influence of adding load to the NPLL during treadmill training on cardiovascular parameters and on gait performance of individuals with stroke, compared to treadmill training without load addition; 2) Analyzing the effects of treadmill training with and without load added to the NPLL on kinematic parameters of each lower limb during gait; 3) Analyzing the effects of treadmill training with and without load added to the NPLL on measurements of functional mobility and postural balance of these patients. Materials and Methods: This is a randomized single blinded clinical trial involving 38 subjects, with a mean age of 56.5 years, at the subacute post-stroke phase (with mean time since stroke of 4.5 months). Participants were randomly assigned into an experimental group (EG) or control group (CG). EG (n= 19) was submitted to gait training on a treadmill with the addition of load to the NPLL by ankle weights equivalent to 5% of body weight. CG (n= 19) was only submitted to gait training on a treadmill. Behavioral strategies which included home exercises were also applied to both groups. The interventions occurred daily for two consecutive weeks (Day 1 to Day 9), being of 30 minutes duration each. Outcome measures: postural balance (Berg Functional Balance Scale – BBS), functional mobility (Timed Up and Go – TUG; kinematic variables of 180° turning) and kinematic gait variables were assessed at baseline (Day 0), after four training sessions (Day 4), after nine training sessions (Day 9), and 40 days after completion of training (Follow-up). Cardiovascular parameters (mean arterial pressure and heart rate) were evaluated at four moments within each training session. Analysis of variance (ANOVA) was used to compare outcomes between EG and CG in the course of the study (Day 0, Day 4, Day 9 and Follow-up). Unpaired t-tests allowed for intergroup comparison at each training session. 5% significance was used for all tests. Results: 1) Cardiovascular parameters (systemic arterial pressure, heart rate and derivated variables) did not change after the interventions and there were no differences between groups within each training session. There was an improvement in gait performance, with increased speed and distance covered, with no statistically significant difference between groups. 2) After the interventions, patients had increased paretic and non-paretic step lengths, in addition to exhibiting greater hip and knee joint excursion on both lower limbs. The gains were observed in the EG and CG, with no statistical difference between the groups and (mostly) maintained at follow-up. 3) After the interventions, patients showed better postural balance (higher scores on BBS) and functional mobility (reduced time spent on the TUG test and better performance on the 180° turning). All gains were observed in the EG and CG, with no statistically significant difference between groups and were maintained at follow-up. Conclusions: The addition of load to the NPLL did not affect cardiovascular parameters in patients with subacute stroke, similar to treadmill training without load, thus seemingly a safe training to be applied to these patients. However, the use of the load did not bring any additional benefits to gait training. The gait training program (nine training sessions on a treadmill + strategies and exercises for paretic limb stimulation) was useful for improving gait performance and kinematics, functional mobility and postural balance, and its use is suggested to promote the optimization of these outcomes in the subacute phase after stroke.

Promoção da saúde e trabalho: um ensaio analítico

CAVALCANTE,Cleonice Andréa Alves, NÓBREGA, Jussara Azevedo Bezerra da, ENDERS,Bertha Cruz, MEDERIROS, Soraya Maria de. Promoção da saúde e trabalho: um ensaio analítico. Revista Eletrônica de Enfermagem. v.10,n.1 p.241-248.2008. Disponível em :.