Efeitos do Tai Chi Chuan na qualidade de vida, flexibilidade e equilíbrio de idosos

Introduction: The growth of the aged population in developing countries is fast. Cognitive, motion, metabolic and social injuries are associated to aging, which are potentially able to impair the quality of life of the elder population. A physical activity that provides a mental and physical welfare besides its importance to the good aging, therefore, the Tai Chi Chuan is considered an effi cient and cheap way to improve the quality of life and to reduce the physical alterations unchained by aging. Objective: To verify the effect of the Tai Chi Chuan of the quality of life, fl exibility and balance in elderly. Methods: Nine volunteers, three men (66.33 ± 13.32 years) and six women (68.67 ± 11.34 years) participated in the study. They performed the training of Tai Chi Chuan during 12 weeks, two times per week, with duration of one hour each session. The volunteers were evaluated at the beginning of the study and after the 12 weeks of training by means of the application of the questionnaire of quality of life SF-36, a scale of balance and the test to seat and to reach was applied to evaluate the fl exibility. Results: It was observed in the Tai Chi Chuan training improvement of the balance and fl exibility; however, the quality of life did not present signifi cant difference. Conclusion: These fi ndings allow us to conclude that the Tai Chi Chuan was effi cient in the improvement of the equilibrium and the fl exibility of elder people; however, it did not modify the Quality of Life of the studied population.

Correlação entre equilíbrio, assimetria de passos e descarga de peso em indivíduos hemiparéticos

Introduction: Hemiparesis is the most common sequels after Stroke. One of the side effects of the motor skills evident in hemiparesis is the tendency to remain in asymmetric posture, with lower distribution of weight on the side hemiparetic, which ends up leading to a deficit in balance. This set of changes can cause an asymmetrical type of gait, marked by difference between the lengths of the steps these individuals. Objective: The purpose of this study was to analyze the balance, the discharge of weight in the lower limbs and asymmetry of steps in hemiparetic individuals and sees if there is correlation between those variables. Method: A group of 12 hemiparetic individuals (55,33 ± 8,92 years), both sex, who suffered from strokes participated. All subjects performed the assessment of bilateral discharge of weight, the length of the steps and balance (Berg Balance Scale). The results for the difference in the discharge of weight of the lower limbs, asymmetry of the step and the performance on the test of balance were analyzed using the Sperman Correlation Coefficient with a significance level of 5% (p ≤ 0.05). Results: We found a significant correlation between balance and asymmetry of the steps (R = -0.72 and p = 0007), however, found no significant correlation between discharge of weight on each leg and the symmetry of the steps (R =- 0.07 and p = 0, 81) and between discharge of weight and balance (R =- 0.08 and p = 0.79) in these hemiparetic individuals. Conclusion: Can be conclude that hemiparetic individuals of these study show deficits in balance, difference in weight between the discharge of the lower limbs and asymmetry of step and correlation between the asymmetry of the step and balance.

Comparação do equilíbrio e qualidade de vida entre idosos institucionalizados e não-institucionalizados

Introduction: the improvements on the health area increased the brazilians life expectative. Because of it, more people becomes elder, passing through various common processes of aging, as the balance decrease. Resulting form this the risk of fall increase, and this has a negative impact on the quality of life. As more people become elder the institutionalization tax increase. Objectives: compare the balance and quality of life between institutionalized and non-institutionalized elders; correlate the Berg Balance Scale (BBS) with the Timed Up and Go test (TUG) and with the questionnaire “The Medical Outcome Study 36 – Item Short-Form Health Survey” (SF-36). Methods: were evaluated 20 elders, ten institutionalized (GI) and ten non-institutionalized (GNI). To the balance assessment were used the BBS and the TUG, the quality of life was evaluated using the SF-36. The signifi cance level was set to 5% (p<0,05). The GraphPad Prism 5# was used to analyze the data. To identify the distribution of the data was applied the Shapiro-Wilk test. In the comparison between groups, the normal distributed data were analyzed with the Unpaired Student t test. The non-normal distributed data were analyzed with the Mann-Whitney non-parametric test. The correlations were analyzed with the Pearson (normal data) and Spearman’s (non-normal data) tests. Results: the age average for each group was 72,8±8,36 years (GI) e 67,4±3,53 years (GNI). The GNI had a better performance than the GI in the BBS (*p=0,0017) as in the TUG (*p<0,0002). There wasn’t difference between the quality of life. There was correlation between EEB and TUG (-0,8907 for the GI and -0,7180 for the GNI) and between EEB and the functional capacity domain from the SF-36 (0,7657). Conclusion: the non-institutionalized elders presented best balance. It was found good correlation between TUG and BBS. In the studied sample, to be institutionalized didn’t infl uenced the quality of life.

Comparação das variáveis hemodinâmicas durante o teste de caminhada de seis minutos e o teste de escada em adultos saudáveis

The effort test can be used to assess functional capacity, clinical hemodynamic and metabolic response at the effort, the risk of postoperative pulmonary complications and to assess the response of patients with lung diseases submitted to physiotherapy treatment. Among the stress tests we highlight the Six Minute Test Walk (6 MWT) and Stair Climbing Test (SCT), because they are easy to use and low cost. Especially the SCT is widely used in patients preoperatively. Objective: To compare the effects of six minute walk test and stair climbing test under the hemodynamic and oxygenation in healthy adults. Methods: We conducted a study with healthy subjects above 50 years. The fi rst performed was 6 MWT in quick step with encouragement, in a plan corridor of 30 meters, where the shade was determined the distance walked in 6 minutes, after 6 MWT was performed de SCT with encouragement, on a ladder in shade, consists of 44 steps, with 4 bids and bid by 11 steps, each step measured 16 cm in a total of 7.04 m of height, where the rise time was clocked. Before and after the two tests were measured respiratory rate, pulse, blood pressure and oxygen saturation. Results: We evaluated 21 patients with age 59.6 ± 5.4 years, 5 men and 16 women. The average distance covered on the 6MWT was 496.4 ± 102.2 meters and the average time in SCT 22.6 ± 5.4 seconds. The variables pulse, respiratory rate, systolic blood pressure and Borg scale presented a signifi - cant increase after the tests, however the variables oxygen saturation and diastolic blood pressure did not change signifi cantly. Conclusion: The variables pulse, respiratory rate, systolic blood pressure and Borg scale tests increased after six-minute walk test and stair climbing test but with greater signifi cance after the stair climbing test. Oxygen saturation and diastolic blood pressure did not change signifi cantly after the tests.

Comparação da flexibilidade, qualidade de vida e capacidade funcional entre idosos ativos e sedentários dos meios urbano e rural

Introduction:The regular practice of physical activity is being used as a therapeutic resource to the elderly population, with the objective of reduction of the losses provoked by the growing old process. The home place (urban or rural) is still little explored in literature about your infl uence in the physical capacity of the elderly people. Objective: The aim of this study was to value and compare the quality of life, motion and functional capacity between physically active and sedentary elderly people, residents in the urban and rural area. Methods: Sixty people with age above 60 years old were valued, 20 physically active residents in the urban area (66,5 ± 4,32 years), 20 sedentary residents in the urban area (68,8± 7,24 years), 10 physically active residents in the rural area (64,4±2,46 years) and 10 sedentary residents in the rural area (68±5,78 years). It was realized the evaluation of the fl exibility (previous fl exon of the trunk), mobility (timed up and go test), a six-minute walk test and answered a quality of life’s questionnaire SF-36. To compare the results obtained by the two groups was used the Kruskal-Wallis test, and the signifi cant presence of the test was performed post hoc Newman-Keuls. The level of signifi cance used in statistical analysis was 5% (p<0,05).Results: It was observed that the physically active elderly people obtaine better performance on the six-minutes walk test. It wasn’t found difference in the mobility among the groups. In relation to the quality of life, the elderly residents in the rural area, were better in the component Vitally. In relation to the fl exibility the elderly residents in the urban area obtained the best results. So, we can conclude that the practice of physical activity realized by the volunteers contributed to a better functional capacity, observed by the biggest distance gone through on the walk test. The rural home place positively infl uenced the vitality control, while the fl exibility was worse presented in these elderly people.

Caracterização das lesões desportivas em atletas de Tênis de Mesa

Introduction: The table tennis is characterized by requiring of the athletes intense body movement. The gestures performed by athletes require continuous postural changes, in cases of any sway in body structures may produce postural changes or initiate processes of injuries. Objective: The aim of this study was to characterize the table tennis lesions. Method: Were evaluated 31 athletes (26 males and fi ve females) with mean age 22.35±6.67 years. The subjects were interviewed with the Reported Morbidity Inquires retroactive to the 2009 season. It was used techniques of descriptive and analytical statistics. Results: The largest number of injuries was muscular (74.35%), on the shoulder (43.58%) during the movement of top spin (33.33%) in the specifi c training phase (64.1%) with symptomatic return to the activities (69.23%). Conclusion: The weekly training workload infl uences the number of lesions.

Associação do treinamento resistido e aeróbico em pacientes com doença pulmonar crônica

Introduction: The pulmonary rehabilitation (PR) is composed of aerobic and resisted exercises that improve the functional capacity to the exercise, life quality and decrease respiratory symptoms in subjects with chronic pulmonary disease. Objective: Assess the effects of a combined PR program in the cardiorespiratory function and peripheral muscle strength in subjects with chronic pulmonary disease. Method: Patients with chronic pulmonary disease were submitted to the PR program, which was developed on 24 sessions of 60 minutes (three times per week). The program was composed of aerobic exercises (two times per week) and resisted exercises (once a week). Before and after the PR the patients were submitted to manovacuometry in order to measure the maximum inspiratory pressure (MIP) and the maximum expiratory pressure (MEP), ventilometry, peek expiratory flow (PEF), six minute walking test (6MWT) and one maximum repetition (1RM). The data are presented in absolute frequency, percentage and mean±standard deviation. The t Student test was used to compare data before and after the PR and the ANOVA test to compare before, after and predicted distances in the 6MWT (p<0.05). Results: Seven patients were part of this study, 85.70% of women, 71.40% with pulmonary emphysema diagnosis. The mean age was 69.43±5.59 years old, the height was 1.61±0.07 m, the mean weight was 66.20±8.40 kg and the body mass index mean was 25.50±2.48 kg/m². From the variables assessed, the MEP increased from 79.71±13.69 to 84.42±12.83 cmH2O (p=0,03), the PEF increase from 255.71±66.3 to 320.00±93.63 l/min (p=0,03) and the distance in the 6MWT from 415.28±47.90 to 483,79±79,77 m (p=0,02). The load in the 1RM test in the reverse peck deck exercise (before - - 17.10±8.10kg; after – 210.40±9.00kg), knee in leg extension machine (before – 17.10±9.50kg; after – 26.40±13.10kg) and hip extensors (right before – 48.60±22.10kg; after – 62.90±19.30kg; and left before – 46.40±20.10kg; after – 62.10±18.20kg) increased significantly (p<0,05). Conclusion: After the PR program there was improvement in the expiratory muscular strength, in the lower limbs strength and in the functional capacity. Besides that, there was a reduction in the airflow obstruction of the subjects with chronic pulmonary disease.

Análise do equilíbrio e da qualidade de vida de idosos com Alzheimer e a influência na qualidade de vida do Cuidador

With the growing aging population will be an increase of chronic degenerative diseases such as dementia. Among the various forms of dementia Alzheimer’s disease (AD) is the most prevalent. In individuals with AD, there is a loss in the processing of sensory information, which may aggravate the imbalance and falls. As the disease progresses, the individual lose the ability to function independently, becoming dependent on a caregiver. This study aimed to analyze the balance of the mental state and quality of life of individuals with AD, to determine whether a correlation exists between these variables and analyze the influence on quality of life of caregivers. This study was conducted with thirty individuals (82.86 ± 9.07 years) with AD, both sexes, and their caregivers. The evaluation of the balance was accomplished by the Scale of Functional Balance of Berg (EEFB), the cognitive function for the Mini-exam of the Mental State (MEEM), and the quality of life (QV) for the scale “life Quality - Disease of Alzheimer “ (QdV - DA) that is composed for three versions: patient, caregiver and family The data were analyzed by coefficient of correlation of Spearman. The balance analyses (EEFB=32,17 ± 13,26 points) shows increased in the risk of falls in the elderly and negative correlation (R = - 0,55, p <0,01) with age and good correlation with MEEM (R=0,63 p <0,01). Already in relation of the MEEM and QV, can observed correlation between the familiar version and the MEEM ((R=0,40 p=0,02). In Relation the versions of the QV questionnaire, found significant correlation among: QdV-DA patient X caregiver (R=0,41 p=0,02), QdV-DA patient X family (R=0,40 p=0,03). In this way we can conclude that the individuals with DA, appraised in this study, present a deficit in the balance, so much related with the age as with to the cognitive decline, and the greater the cognitive decline worse the impression of caring about the QOL of their family, and still, that the worsening in the quality of the patient’s life contemplates in a worsening in the quality of your caregiver’s life.

Análise da concordância entre instrumentos de avaliação de flexibilidade para os músculos isquiocrurais em idosos

Introduction : The aging is characterized by a reduction in the effectiveness of skills, among them the loss of the flexibility. The hamstring muscles may be affected by the decreased flexibility occurs when elderly can present limitation of gait, low back problems and osteomuscular. Among the techniques used to evaluate the flexibility of the hamstring muscles are the Sit and Reach Test and Computerized Photogrammetry evaluation of the popliteal angle . However, the scientific literature doesn’t provide consistent data on the correlation of these forms of evaluation. Objective: To analyze the correlation between the sit and reach test and Computerized Photogrammetry evaluation of the popliteal angle used to assess the flexibility of the hamstring muscles in elderly women. Method: This was a cross-sectional, observational study, consisting of 39 elderly, healthy. The evaluation was composed by forms with personal details and physical examination (body weight, height and body mass index), and the evaluation of tests to measure the flexibility of the hamstring muscles (Sit and reach test and Computerized Photogrammetry evaluation of the popliteal angle). The correlation of the data was done by using the Spearmam’s rank correlation coefficient, with a significance level of 5% (p<0.05). Results: The data showed a positive correlation between Sit and Reach Test Computerized Photogrammetry and the popliteal angle of the right leg (r=0.4690, p=0.0026) and the left leg (r=0.3604, p=0.0241). Conclusion: The data from this study allow conclude that the tests for assessing hamstring flexibility in elderly women, the Sit and Reach Test and Computerized Photogrammetry evaluation of the popliteal angle are complementary because it doesn’t correlate strongly.

Determinant factors for mortality of patients receiving mechanical ventilation and effects of a protocol muscle training in weaning

Introduction: Prognostic factors are used in the Intensive Care Unit (ICU) to predict morbidity and mortality , especially in patients on mechanical ventilation (MV ) . Training protocols are used in MV patients with the aim of promoting the success of the weaning process. Objective: To assess which variables determine the outcome of patients undergoing mechanical ventilation and compare the effects of two protocols for weaning. Method: Patients under MV for more than 48 hours had collected the following information: sex, age , ideal weight, height , Acute Physiology and Chronic Health Evaluation (APACHE II), risk of mortality, Glasgow Coma Scale (GCS) and index Quick and perfunctory (IRRS) breathing. Patients with unsuccessful weaning performed one of weaning protocols: Progressive T - tube or tube - T + Threshold ® IMT. Patients were compared for outcome (death or non- death in the ICU ) and the protocols through the t test or Mann-Whitney test was considered significant when P <0.05. Results: Of 128 patients evaluated 56.25% were men, the mean age was 60.05 ± 17.85 years and 40.62 % patients died, and they had higher APACHE II scores, mortality risk, time VM and IRRS GCS and the lower value (p<0.05). The age, initial and final maximal inspiratory pressure, time of weaning and duration of MV was similar between protocols. Conclusion: The study suggests that the GCS, APACHE II risk of mortality, length of MV and IRRS variables determined the evolution of MV patients in this sample. Not found differences in the variables studied when comparing the two methods of weaning.

Início de ativação muscular de estabilizadores primários e a capacidade física para avaliar estabilização lombo-pélvica

Introduction: Due to the high incidence of low back pain without apparent cause, different approaches to evaluate the lumbar instability has been proposed, such as surface electromyography to determine pre-activation and the ability of lumbar stabilization through functional physical assessment. In this context, the objective of this study was to evaluate the early activation of the primary stabilizing muscles in subjects without low back pain, with different physical abilities function (CFF). Method: Study participants were 20 subjects with 19.8 ± 1.4 years, 55.7 ± 8.8 kilos, 1.66 ± 0.08 m, of both sexes. The subjects underwent six Tests Physical Function (TFF) and the Test of Fast Moving Flexion Arm (TMRFB) to capture the electromyographic activity of the lumbar multifidus muscles (LM) and internal oblique - lower fibers (HI). Were assigned weights for each functional test and the result of the physical capacity of the final functional subject ranged from 0 to 100%. In the analysis of TMRB was considered the onset time of activation between the ML and HI. Results: Regarding TFF 2 (10%) subjects were considered to have normal physical capacity, 6 (30%) with good physical ability and 12 (60%) with regular physical capacity or poor. As for TMRFB average values of initiation of muscle activation in 75% of subjects were within the limits to characterize the condition of pre-muscle activation. Conclusion:The results obtained in the TFF were low compared with the CFF of asymptomatic subjects evaluated. This fact does not mean that the condition of stabilization of the subject is appropriate. However, the results obtained in the electromyographic examination to suggest that 25% of asymptomatic subjects tested did not have a proper condition of lumbar stabilization.

Algoritmo de control anticipatorio assisted-as-needed para neurorrehabilitación funcional de extremidad superior

Los dispositivos robóticos se están convirtiendo en una alternativa muy extendida a las terapias de neurorrehabilitación funcional tradicionales al ofrecer una práctica más intensiva sin incrementar el tiempo empleado en la supervisión por parte de los terapeutas especialistas. Por ello, este trabajo de investigación propone un algoritmo de control anticipatorio que, bajo el paradigma 'assisted-as-needed', proporcione a una ortesis robótica las capacidades de actuación necesarias para comportarse tal y como lo haría un terapeuta que proporciona una sesión de terapia manual. Dicho algoritmo de control ha sido validado mediante un simulador robótico obteniéndose resultados que demuestran su eficacia.

Introdução de medidas centradas no doente para avaliação de resultados em saúde

A introdução na rotina da prática clínica de medidas de avaliação de resultados centradas no paciente permite a identificação de problemas físicos e psicológicos, a monitorização da evolução e impacto provocado no estado de saúde e possibilita a adequação dos cuidados e verificação da sua efetividade. Objetivos: Avaliar estado de saúde e mudanças ocorridas após processo de cuidados de fisioterapia. Material e métodos: Efetuou‐se um estudo de desenho longitudinal e preditivo em 511 indivíduos utilizadores do Serviço de Fisioterapia do Hospital da Misericórdia da Mealhada, avaliados no início e no fim do tratamento. Do protocolo constava a medida de estado de saúde MOS SF‐36 e o índice de saúde SF-6D. Resultados: Observaram-se melhorias significativas do estado de saúde dos indivíduos entre o início e o fim do tratamento. Houve grande variabilidade de tratamentos realizados com predominância dos agentes físicos, terapia manual e terapia pelo movimento. Não se encontraram fatores preditivos para as mudanças de estado de saúde ocorridas. Conclusões: A criação de um sistema de recolha de dados reportados pelo paciente é necessário para a melhoria dos cuidados, bem como a sustentação dos mesmos na prática baseada na evidência.

Aplicação do método POLD® na redução da sintomatologia álgica da lombociatalgia

Projeto de Graduação apresentado à Universidade Fernando Pessoa como parte dos requisitos para obtenção do grau de Licenciado em Fisioterapia

Literature review and update of lower limb neural mobilization

Summarize the available literature descriptions of neural mobilization (NM) techniques and neural provocation tests (NPT) for the Lower Limb (LL). Compilation of data was performed in May 2016 using MEDLINE data base, Google Scholar and the library of the European University of Madrid. After application of inclusion/exclusion criterions 5 books and 14 journal publications where found to be of interest and used during data extraction.Results: a list of 8 different LLNM techniques are applied in a rhythmic alternating oscillatory cycle fashion, starting in the initial position from where the therapist proceeds to move the limb in order to achieve a final position. LL NPTs are useful tools for differential diagnose and selecting the proper LLNM procedure. There is no consensus about the time frame of repetition intervals or amount of tensile strength during NPT never the less it is found to normally be performed at a rate of 2-4 seconds per complete cycle of movement, during 1-5 minutes, 3-5 times a week. LLNM treatment techniques all thou increasingly popular in clinical practice are found to be frugally described and lack proper standardization in regards to therapeutic dosification.