Transporte mucociliar e função autonômica de tabagistas submetidos ao esforço físico submáximo e máximo

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Lombalgia equina: diagnóstico e tratamento

Low back pain is considered a major cause of lameness and performance decay, but identify the location of the lesions and quantify the intensity of pain is difficult because often the most obvious clinical sign, in some cases, is not the pain itself, but, low athletic performance. The diagnosis and treatment of this disease are associated with a high cost and have a strong impact on the equine industry, since it results in direct economic losses. The diagnosis of low back pain is made through physical examination and additional tests, including radiography, ultrasound, thermography and blockades. Major injuries causing back pain in horses is the contact or overlap of the spinous processes, supraspinous desmitis, osteoarthritis of the articular processes, vertebral body lesions and myositis. Therapeutic measures used in the treatment of these diseases are systemic inflammatory steroid, local infiltration, acupuncture, chiropractic, physical therapy, changes in training and surgeries.

A influência da prática de atividade regular na composição corporal de pacientes com osteoartrite

Introduction: Osteoarthritis, osteoarthrosis or degenerative joint disease characterized by progressive loss of articular cartilage, pain, changes in subchondral bone, osteophyte formation and proliferation. Age, bone mineral density, joint instability, excess weight among others, are risk factors. Methods: To check the influence os physical exercise in patients with the disease were evaluated 39 patients over 50 years, both genders, with clinical and / or radiographic osteoarthritis were divided into experimental group (EG) and control group (CG). EG performed regular physical activity (aerobics) three times a week for four months, while CG was submitted to physical therapy painkiller in the same period. We analyzed demographics, BMI, basal metabolic rate and percentage of fat mass. Results: The results showed that regular physical activity reduced the body fat, but because of their characteristics and low-impact aerobics was not observed consistent benefits in muscle component. However, compared with the CG demonstrated a positive impact on other parameters of body composition.

Relação entre testes clínicos e desfechos de dor e incapacidade de pacientes com dor lombar crônica não específica submetidos ao programa de controle motor

Pós-graduação em Fisioterapia - FCT

Effects of an isostretching training protocol to increase the musculoarticular flexibility and other physiological aspetcs on the quality of life

Purpose: To apply the technique of Isostretching in a group of people over age 50 years and compare the flexibility of the posterior muscular chain before and after treatment, observing whether there was improvement in quality of life after the end of the sessions. Method: Eleven healthy and sedentary people from 51 to 74 years old participated in the study, which was conducted in Brazil. To evaluate the flexibility we applied the SF-36 questionnaire and test flexion of the spine before and after the study. Eight domains were accessed with the scores ranging form zero to one hundred. Results And Discussion:The technique was effective to gain flexibility of the posterior muscle group, which results in better quality of life for the participants. The results show that the domains related to physical health obtained the highest scores (“functional capacity”, “limitation in physical aspects” and “pain”). These aspects are strongly emphasised in a physical therapy treatment.

Resposta metabólica e inflamatória em exercício aeróbio moderado contínuo e intermitente de alta intensidade com volume equalizado

Pós-graduação em Fisioterapia - FCT

Avaliação convencional e estesiômetro: resultados controversos na avaliação sensitiva no câncer de mama

This study, clinical, prospective, randomized study was conducted from August 2004 to February 2008 in a convenience sample of 60 women who underwent breast surgery with axillary dissection, divided into two groups (n = 30). The GI (Guidance Kit with different textures, to perform at home) and GII (control). The objective was to analyze the effect of home orientation in patients after surgery for breast cancer complaining of numbness, evaluation, and the conventional esthesiometer. The surface sensitivity was assessed by monofilament Semmes-Weinstein and evaluation using conventional two test tubes with hot water (38 to 43o C) and cold (16 to 27o C), paintbrush, needle. The GI was subjected to 10 sessions and assessments in both 3 times. The M1 (pre intervention), the M2 (post-intervention) after 10 sessions of physical therapy intervention and M3 (washout) after 3 months the second time for assessment. The region targeted for evaluation and intervention was the sensory nerve dermatome intercostobrachial. In the test of Goodman (conventional assessment) there was improvement in both groups, the P1, during the thermal evaluation. The t-test of student (esthesiometer) there was improvement in P2 only in GI (p = 0.003) between points 1 and 2 while the time 3 (p = 0.121 and p = 0.733 respectively). It was concluded that there were divergent and opposite results after examining the effect of home orientation in the nerve dermatome intercostobrachial, evaluation, and the conventional esthesiometer.

Modulação autonômica cardíaca de mulheres pós cirurgia de câncer de mama

Pós-graduação em Fisioterapia - FCT

Concepção de um dispositivo fisioterápico: parapodium mecanizado

This paper presents a proposal to redesign a physical therapy device for patients with quadriplegia, called parapodium. With the help of the Association of Parents and Exceptional Friends of Guaratinguetá, it was possible to know the currently used device and from this it was conceived changes, allowing the increase of freedom of its central portion, in the down and across positions with mechanical drive . This adaptation is to introduce improvements in the routine of physical therapy professionals and reduce ergonomic problems resulting from repetitive strain during the transfer of patients to the parapodium. In addition to providing greater security for patients who require the use of this equipment. The proposed device comprises: wheel, gearbox and brake systems used for actuation, allowing a degree of turning of the rear post, along an axis which is fixed to the gearbox and the rear structure that permits posterior movement. The mechanism allows the rear post rotate from 0 ° to 90 °. The estimated cost to make the proposal is lower than the marketed parapodiuns, reaching the device's functional expectations

Concepção de um dispositivo fisioterápico: parapodium mecanizado

This paper presents a proposal to redesign a physical therapy device for patients with quadriplegia, called parapodium. With the help of the Association of Parents and Exceptional Friends of Guaratinguetá, it was possible to know the currently used device and from this it was conceived changes, allowing the increase of freedom of its central portion, in the down and across positions with mechanical drive . This adaptation is to introduce improvements in the routine of physical therapy professionals and reduce ergonomic problems resulting from repetitive strain during the transfer of patients to the parapodium. In addition to providing greater security for patients who require the use of this equipment. The proposed device comprises: wheel, gearbox and brake systems used for actuation, allowing a degree of turning of the rear post, along an axis which is fixed to the gearbox and the rear structure that permits posterior movement. The mechanism allows the rear post rotate from 0 ° to 90 °. The estimated cost to make the proposal is lower than the marketed parapodiuns, reaching the device's functional expectations

Do muscle strengthening exercises improve performance in the 6-minute walk test in postmenopausal women?

Background: Walking speed seems to be related to aerobic capacity, lower limb strength, and functional mobility, however it is not clear whether there is a direct relationship between improvement in muscle strength and gait performance in early postmenopausal women. Objective: To evaluate the effect of muscle strengthening exercises on the performance of the 6-minute walk test in women within 5 years of menopause. Methods: The women were randomized into control group (n=31), which performed no exercise, and exercise group (n=27), which performed muscle strengthening exercises. The exercises were performed twice a week for 3 months. The exercise protocol consisted of warm-up, stretching, and strengthening of the quadriceps, hamstring, calf, tibialis anterior, gluteus maximus, and abdominal muscles, followed by relaxation. Muscular strength training started with 60% of 1MR (2 series of 10-15 repetitions), reaching 85% until the end of the 3-month period (4 series of 6 repetitions each). Results: The between-group comparisons pre- and post-intervention did not show any difference in distance walked, heart rate or blood pressure (p>0.05), but showed differences in muscle strength post-intervention, with the exercise group showing greater strength (p<0.05). In the within-group comparison, there were differences in final heart rate and quadriceps and hamstring strength pre- and post-intervention in the exercise group (p<0.05). Conclusion: The results suggest that muscle strengthening of the lower limbs did not improve performance in the 6-minute walk test in this population of postmenopausal women. Trial registration ACTRN12609001053213.

Low pressure support changes the rapid shallow breathing index (RSBI) in critically ill patients on mechanical ventilation

Background: The rapid shallow breathing index (RSBI) is the most widely used index within intensive care units as a predictor of the outcome of weaning, but differences in measurement techniques have generated doubts about its predictive value. Objective: To investigate the influence of low levels of pressure support (PS) on the RSBI value of ill patients. Method: Prospective study including 30 patients on mechanical ventilation (MV) for 72 hours or more, ready for extubation. Prior to extubation, the RSBI was measured with the patient connected to the ventilator (Drager (TM) Evita XL) and receiving pressure support ventilation (PSV) and 5 cmH(2)O of positive end expiratory pressure or PEEP (RSBI_MIN) and then disconnected from the VM and connected to a Wright spirometer in which respiratory rate and exhaled tidal volume were recorded for 1 min (RSBI_ESP). Patients were divided into groups according to the outcome: successful extubation group (SG) and failed extubation group (FG). Results: Of the 30 patients, 11 (37%) failed the extubation process. In the within-group comparison (RSBI_MIN versus RSBI_ESP), the values for RSBI_MIN were lower in both groups: SG (34.79 +/- 4.67 and 60.95 +/- 24.64) and FG (38.64 +/- 12.31 and 80.09 +/- 20.71; p<0.05). In the between-group comparison, there was no difference in RSBI_MIN (34.79 +/- 14.67 and 38.64 +/- 12.31), however RSBI_ESP was higher in patients with extubation failure: SG (60.95 +/- 24.64) and FG (80.09 +/- 20.71; p<0.05). Conclusion: In critically ill patients on MV for more than 72h, low levels of PS overestimate the RSBI, and the index needs to be measured with the patient breathing spontaneously without the aid of pressure support.

Changes in FDB and soleus muscle activity after a train of stimuli during upright stance

Background: Evidence of self-sustained muscle activation following a brief electrical stimulation has been reported in the literature for certain muscles. Objectives: This report shows that the foot muscle (Flexor Digitorum Brevis - FDB) shows a self-sustained increase in muscle activity during upright stance in some subjects following a train of stimuli to the tibial nerve. Methods: Healthy subjects were requested to stand upright and surface EMG electrodes were placed on the FDB, Soleus and Tibialis Anterior muscles. After background muscle activity (BGA) acquisition, a 50 Hz train of stimuli was applied to the tibial nerve at the popliteal fossa. The root mean square values (RMS) of the BGA and the post-stimulus muscle activation were computed. Results: There was a 13.8% average increase in the FDB muscle EMG amplitude with respect to BGA after the stimulation was turned off. The corresponding post-stimulus Soleus EMG activity decreased by an average of 9.2%. We hypothesize that the sustained contraction observed in the FDB following stimulus may be evidence of persistent inward currents (PIC) generated in FDB spinal motoneurons. The post-stimulus decrease in soleus activity may have occurred due to the action of inhibitory interneurons caused by the PICs, which were triggered by the stimulus train. Conclusions: These sustained post-stimulation changes in postural muscle activity, found in different levels in different subjects, may be part of a set of possible responses that contribute to overall postural control.

Postural adjustment after an unexpected perturbation in children with haemophilia

. Children with haemophilia often bleed inside joints and muscles, which may impair postural adjustments. These postural adjustments are necessary to control postural balance during daily activities. The inability to quickly recover postural balance could elevate the risk of bleeding. To determine whether children with haemophilia have impaired postural adjustment after an unexpected perturbation compared with healthy children. Twenty children with haemophilia comprised the haemophilic group (HG), and 20 healthy, age-paired children comprised the control group (CG). Subjects stood on a force plate, and 4% of the subjects body weight was applied via a pulley system to a belt around the subjects trunks. The centre of pressure (COP) displacement was measured after the weight was unexpectedly released to produce a controlled postural perturbation followed by postural adjustment to recover balance. The subjects postural adjustments in eight subsequent intervals of 1 s (t1t8), beginning with the moment of weight removal, were compared among intervals and between groups. The applied perturbation magnitudes were the same for both groups, and no difference was observed between the groups in t1. However, the COP displacement in t2 in the HG was significantly higher than in the CG. No differences were observed between the groups in the other intervals. Within-group analysis showed that the COP was higher in t2 than in t4 (P = 0.016), t5 (P = 0.001) and t8 (P = 0.050) in the HG. No differences were observed among intervals in the CG. Children with haemophilia demonstrated differences in postural adjustment while undergoing unexpected balance perturbations when compared with healthily children.

Avaliação dos exercícios proprioceptivos no tratamento dos distúrbios do manguito rotador em profissionais de enfermagem: um estudo clínico controlado e randomizado

CONTEXTUALIZAÇÃO: A dor no ombro em profissionais de enfermagem pode acarretar limitação das atividades diárias e ocupacionais e interferir na qualidade de vida. OBJETIVO: Comparar o efeito da aplicação de dois programas fisioterapêuticos diferenciados pelos exercícios de propriocepção em trabalhadores de enfermagem com desordem do manguito rotador, segundo indicadores de qualidade de vida, satisfação no trabalho e intensidade da dor. MÉTODO: Trata-se de um estudo experimental, randomizado, prospectivo, comparativo, com análise quantitativa dos dados. A coleta de dados foi realizada no período de junho de 2010 a julho de 2011, por meio de um questionário sociodemográfico e profissional, questionário Western Ontario Rotador Cuff Index (WORC), Escala de Satisfação no Trabalho (Occupational Stress Indicator) e Escala Visual Numérica (EVN) para intensidade da dor. Após randomização, os sujeitos foram alocados em dois grupos. No Grupo 1 (controle), foram aplicados exercícios de alongamento, fortalecimento e crioterapia. No Grupo 2 (experimental), foram realizados os mesmos exercícios que no Grupo 1 acrescidos de exercícios proprioceptivos. Os dados foram analisados por meio do Statistical Package for the Social Science, versão 16.0 para Windows. RESULTADOS: Após os tratamentos fisioterapêuticos, houve melhora significativa da dor nos sujeitos dos dois grupos e da qualidade de vida nos trabalhadores do Grupo 2. Não houve alteração dos indicadores de satisfação no trabalho nos dois grupos. CONCLUSÕES: Os exercícios proprioceptivos foram importantes no tratamento dos distúrbios osteomusculares. No entanto, os resultados não permitiram inferir a melhor efetividade deles em relação ao outro tratamento, pois não houve diferença significativa entre os grupos. Ensaio clínico registrado no ClinicalTrials.gov NCT01465932.