Artigos e Materiais de Revistas Científicas - LIM/54

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A coleção de Artigos e Materiais de Revistas Científicas engloba artigos originais, artigos de revisão, artigos de atualização, artigos técnicos, relatos de experiências, resenhas, ensaios, editoriais, cartas ao editor, debates, notas científicas e técnicas, depoimentos, entrevistas e pontos de vista. Consideram-se como artigos científicos originais os trabalhos redigidos para divulgação de informações e resultados sobre determinada pesquisa científica, publicados em periódico científico após avaliação por outros pesquisadores.

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Morphofunctional parameters, physical fitness and musculoskeletal symptoms in cooperative recyclers
(2023) GARCIA, R. C.; SANTOS, N. Q. dos; NASCIMENTO, D. E. do; ANTUNES, M. D.; KERBER, V. L.; BERTOLINI, S. M. M. G.
Introduction: Members of solid waste recycling cooperatives are exposed to serious conditions and complications in their everyday life, which makes them likely to present poor quality of life and unfavorable health conditions in their work environment. Objectives: To evaluate morphofunctional parameters, physical fitness, and musculoskeletal symptoms of workers at solid waste recycling cooperatives in Maringá, state of Paraná, Brazil. Methods: This was a quantitative, cross-sectional, descriptive study. Data were collected from 60 cooperative members of both sexes linked to the Popular and Solidarity Recycling Association of Maringá. Participants underwent a medical screening at the cooperative, involving anamnesis, pulmonary and cardiac auscultation, and blood pressure measurement. In a second moment, they underwent physical assessment in the laboratory, using instruments for physical tests and questionnaires. Results: There was a predominance of females in the sample (54%), with a mean age of 41.82±12.03 years, and most participants did not practice physical activity (70%). With regard to body composition, women had the highest body mass index (28.29±6.61 kg/m2); as for the variables physical and aerobic fitness, men showed better scores than women (p < 0.05). In relation to musculoskeletal symptoms, most participants complained of lower back pain (56.66%). Conclusions: Although the results for anthropometric variables are within normal standards in most cooperative members, most of them present with musculoskeletal symptoms and do not practice physical activity, which can have negative implications in their health conditions in the medium and long term.
Risk Factors for the Impairment of Ambulation in Older People Hospitalized with COVID-19: A Retrospective Cohort Study
(2023) SILVA, E. C. G. E.; SCHMITT, A. C. B.; GODOY, C. G. de; OLIVEIRA, D. B. de; TANAKA, C.; TOUFEN, C. Jr.; CARVALHO, C. R. R. de; CARVALHO, C. R. F.; FU, C.; HILL, K. D.; POMPEU, J. E.
(1) Background: Some older people hospitalized with COVID-19 have experienced reduced ambulation capacity. However, the prevalence of the impairment of ambulation capacity still needs to be established. Objective: To estimate the prevalence of, and identify the risk factors associated with, the impairment of ambulation capacity at the point of hospital discharge for older people with COVID-19. (2) Methods: A retrospective cohort study. Included are those with an age > 60 years, of either sex, hospitalized due to COVID-19. Clinical data was collected from patients’ medical records. Ambulation capacity prior to COVID-19 infection was assessed through the patients’ reports from their relatives. Multiple logistic regressions were performed to identify the risk factors associated with the impairment of ambulation at hospital discharge. (3) Results: Data for 429 older people hospitalized with COVID-19 were randomly collected from the medical records. Among the 56.4% who were discharged, 57.9% had reduced ambulation capacity. Factors associated with reduced ambulation capacity at discharge were a hospital stay longer than 20 days (Odds Ratio (OR): 3.5) and dependent ambulation capacity prior to COVID-19 (Odds Ratio (OR): 11.3). (4) Conclusion: More than half of the older people who survived following hospitalization due to COVID-19 had reduced ambulation capacity at hospital discharge. Impaired ambulation prior to the infection and a longer hospital stay were risks factors for reduced ambulation capacity.
Effects of Semisupervised Exercise Training on Health Outcomes in People With Lung or Head and Neck Cancer: Protocol for a Randomized Controlled Trial
(2023) GRIGOLETTO, Isis; CAVALHERI, Vinicius; GOBBO, Luis Alberto; POZO, Karina; FILHO, Enio Rodrigues Maia; RIBEIRO, Diogo Goncalves; IELO, Nara; LIMA, Fabiano Francisco De; RAMOS, Ercy Mara Cipulo
Background: Lung or head and neck cancers are known for their high prevalence and mortality rates. Chemotherapy and radiotherapy are usually recommended as cancer treatment for these malignancies; however, they can negatively impact both the physical and mental status of patients. Hence, it is reasonable to consider resistance and aerobic exercise training to prevent these negative health outcomes. Further, several factors prevent patients from attending outpatient exercise training programs, and, therefore, a semisupervised home-based exercise training program may be seen as a well-accepted alternative.Objective: The aim of this study will be to investigate the effects of a semisupervised home-based exercise training program on physical performance, body composition, and self-reported outcomes; changes in the initial cancer treatment dose prescribed; number of hospitalizations at 3, 6, and 9 months; and 12-month survival in people with primary lung or head and neck cancer.Methods: Participants will be randomly allocated to the training group (TG) or control group (CG). The TG will undergo semisupervised home-based resistance and aerobic exercise training throughout their cancer treatment. The resistance training will be performed using elastic bands (TheraBand) twice a week. The aerobic training (ie, brisk walk) will be performed for at least 20 minutes per day outdoors. The equipment and tools used during the training sessions will be provided. This intervention will start the week before treatment commencement, will be performed throughout the duration of the treatment, and will continue for 2 weeks after treatment completion. The CG will undergo usual care (ie, cancer treatment with no formal exercise prescription). Assessments will take place 2 weeks before the beginning of the usual cancer treatment and 2 weeks after treatment completion. The measures of physical function (peripheral muscle strength, functional exercise capacity, and physical activity), body composition, and self-reported outcomes (symptoms of anxiety and depression, health-related quality of life, and symptoms related to the disease and treatment) will be collected. We will report on any change in the initial cancer treatment dose prescribed; number of hospitalizations at 3, 6, and 9 months; and 12-month survival.Results: In February 2021, the clinical trial registration was approved. Recruitment and data collection for the trial are ongoing (as of April 2023, 20 participants had already been randomized), and findings of this study are likely to be published late in 2024.Conclusions: This exercise training as a complementary treatment for patients with cancer is likely to promote positive effects on the health outcomes assessed, over and above any change in the CG, and prevent the reduction of initial cancer treatment dose prescribed. If these positive effects are shown, they will likely impact long-term outcomes such as hospitalizations and 12-month survival.Trial Registration: Brazilian Clinical Trials Registry (ReBEC) RBR-5cyvzh9; https://ensaiosclinicos.gov.br/rg/RBR-5cyvzh9.International Registered Report Identifier (IRRID): PRR1-10.2196/43547(JMIR Res Protoc 2023;12:e43547) doi: 10.2196/43547
Vibration perception among children and adolescents with Charcot-Marie-tooth disease and implications for foot posture
(2023) CARDOSO, Juliana; BAPTISTA, Cyntia Rogean de Jesus Alves de; BUZZETTI, Beatriz Parra; SARTOR, Cristina Dallemole; JR, Wilson Marques; SACCO, Isabel de Camargo Neves; MATTIELLO-SVERZUT, A. C.
Background: Alterations in vibration perception among children and adolescents with Charcot-Marie-Tooth disease might explain observed changes in foot posture. Therefore, this cross-sectional study compared the vibration perception of the lower limbs in youths with and without Charcot-Marie-Tooth disease and verified the cut-off value of the distal vibration perception for the Charcot-Marie-Tooth group. In addition, associations between dynamic plantar pressure, vibration perception and isometric muscle strength were investigated. Methods: Participants aged 9-18 (Charcot-Marie-Tooth group n = 32; Typical group n = 32) had vibration perception measured by a 128-Hz graduated tuning fork. The static and dynamic foot posture were evaluated by the Foot Posture Index and pressure distribution measuring system, respectively. For the Charcot-Marie-Tooth group, a hand-held dynamometer evaluated the isometric muscle strength of the lower limbs. Findings: Children with Charcot-Marie-Tooth disease presented impaired vibration perception at the distal phalanx of the hallux and head of the first metatarsal compared to their typically developing peers, while adolescents with Charcot-Marie-Tooth disease showed impairment in all the tested regions compared to their typically developing peers. The cut-off value for vibration perception for participants with Charcot-Marie-Tooth disease was 5.7, considering the original grade of the tuning-fork 128 Hz. Among the associations established for the Charcot-Marie-Tooth group, a greater vibration perception at the distal phalanx of the hallux was associated with a longer rearfoot contact time (beta = 31.02, p = 0.04). Interpretation: These new findings may guide the clinical evaluation and rehabilitation treatment for children and adolescents with Charcot-Marie-Tooth disease.
A non-expensive bidimensional kinematic balance assessment can detect early postural instability in people with Parkinson's disease
(2023) SANTOS, Gabriel Venas; D'ALENCAR, Matheus Silva; HELENE, Andre Frazao; ROQUE, Antonio C.; MIRANDA, Jose Garcia Vivas; PIEMONTE, Maria Elisa Pimentel
BackgroundPostural instability is a debilitating cardinal symptom of Parkinson's disease (PD). Its onset marks a pivotal milestone in PD when balance impairment results in disability in many activities of daily living. Early detection of postural instability by non-expensive tools that can be widely used in clinical practice is a key factor in the prevention of falls in widespread population and their negative consequences.ObjectiveThis study aimed to investigate the effectiveness of a two-dimensional balance assessment to identify the decline in postural control associated with PD progression.MethodsThis study recruited 55 people with PD, of which 37 were men. Eleven participants were in stage I, twenty-three in stage II, and twenty-one in stage III. According to the Hoehn and Yahr (H&Y) rating scale, three clinical balance tests (Timed Up and Go test, Balance Evaluation Systems Test, and Push and Release test) were carried out in addition to a static stance test recorded by a two-dimensional movement analysis software. Based on kinematic variables generated by the software, a Postural Instability Index (PII) was created, allowing a comparison between its results and those obtained by clinical tests.ResultsThere were differences between sociodemographic variables directly related to PD evolution. Although all tests were correlated with H&Y stages, only the PII was able to differentiate the first three stages of disease evolution (H&Y I and II: p = 0.03; H&Y I and III: p = 0.00001; H&Y II and III: p = 0.02). Other clinical tests were able to differentiate only people in the moderate PD stage (H&Y III).ConclusionBased on the PII index, it was possible to differentiate the postural control decline among the first three stages of PD evolution. This study offers a promising possibility of a low-cost, early identification of subtle changes in postural control in people with PD in clinical practice.
Breaking barriers to rehabilitation: the role of behavior change theories in overcoming the challenge of exercise-related behavior change
(2023) KARLOH, Manuela; MATIAS, Thiago Sousa; OLIVEIRA, Joice Mara de; LIMA, Fabiano Francisco de; PINHEIRO, David Halen Araujo; BARBOSA, Graziele Besen; FURLANETTO, Karina Couto; CARVALHO, Celso R. F.
Background: Promoting exercise-related behavior change in rehabilitation is a challenge. The lack of integration between rehabilitation program prescriptions, behavior change interventions, and behavioral change theories is profound. Using behavior change theories properly is crucial for better adherence and promoting positive outcomes. Therefore, it is essential to bring theories that support the understanding of exercise-related behavioral change to the attention of rehabilitation practitioners. Objective: This masterclass article aims to provide the theoretical background of theories and strategies for exercise behavior change within the physical therapy context based on acknowledged behavioral change theoretical models. Methods: This is a narrative review that examines six behavior theories; five of them well-established, and a new (and promising) theory that has exhibited the most favorable outcomes in rehabilitation settings. The development process for this masterclass included conversations between authors, reviewing behavior theories, summarizing and discussing the theories' con-cepts and strategies for physical therapy. Results: The included theories were self-determination theory, social-cognitive theory, the trans -theoretical model, the theory of planned behavior, the health belief model, and the unifying theory of physical activity. Each theory offers a unique perspective on exercise behavior change within rehabilitation, exploring constructs such as motivation, self-efficacy, stages of change, behavioral intention, perceived threat, and the core elements of physical activity expression. Conclusion: These theoretical models provide a foundation for understanding and developing strategies for promoting exercise behavior change in rehabilitation. Knowing and using these theories is important for respecting the patient's individuality.(c) 2023 Associacao Brasileira de Pesquisa e Pos-Graduacao em Fisioterapia.
Association between illness perception and clinical control, quality of life, physical activity, and psychosocial status in subjects with moderate to severe asthma: a cluster analysis
(2023) SILVA, Simone T. Camargo; FREITAS, Patricia Duarte; LUNARDI, Adriana Claudia; XAVIER, Rafaella Fagundes; BARBOSA, Renata Cleia C.; STELMACH, Rafael; CARVALHO, Celso R. F.
Background: Illness perception (IP) is a psychosocial factor involved in several chronic diseases and is associated with relevant clinical outcomes. However, the relationship between IP and health-related quality of life (HRQoL), psychosocial status, and physical activity in daily life (PADL) in subjects with asthma is poorly understood.Objective: To identify groups of subjects with asthma based on their IPs and to assess their association with clinical control, HRQoL, psychosocial disturbances, and PADL.Methods: This cross-sectional study included 149 subjects with moderate to severe asthma. IP, anthropometric data, Asthma Control Questionnaire-7, Asthma Quality of Life Questionnaire, Hospital Anxiety and Depression Scale, PADL (accelerometry), and general self-efficacy (GSE) were assessed. Cluster analysis was performed to identify clusters with similar profiles and investigate their characteristics and differences. Pearson's correlation coefficient was used to test the associations between IP and other variables.Results: Statistical analyses identified two clusters of subjects with asthma based on IP. Cluster 1 presented worse IP in seven out of eight domains than Cluster 2. Cluster 1 had more negative consequences of the disease, worse understanding, and a high emotional representation of the disease than Cluster 2. Cluster 1 also had a greater extent of asthma symptoms, poor clinical control, worse HRQoL, and more symptoms of anxiety and depression. No difference between clusters was found for PADL or self-efficacy.Conclusion: Subjects with asthma who have worse IP have more negative symptoms, worse clinical control, HRQoL, and symptoms of anxiety and depression.
Elastic tape reduces dyspnea and improves health status in the short term in nonobese COPD males: A randomized controlled trial
(2024) SANTOS, Eloise Arruda dos; PINTO, Thiago Fernandes; XAVIER, Rafaella Fagundes; STELMACH, Rafael; CARVALHO-PINTO, Regina Maria; CARVALHO, Celso Ricardo Fernandes de
Introduction and objectives: The elastic tape (ET) is a novel intervention that acutely improves exercise capacity in laboratory tests; however, its effect on a patient's daily life remains unknown. This randomized controlled trial evaluated the effects of ET on daily life physical activity (DLPA), dyspnea symptoms, health status, and health -related quality of life (HRQoL) in individuals with COPD. Methods: Fifty males with moderate to very severe COPD were randomly assigned to an intervention group (ETG, n = 25), receiving ET on the chest wall and abdomen, or a control group (CG, n = 25). The intervention was for 14 days. DLPA (accelerometry; steps per day, and sedentary time), dyspnea symptoms (transition dyspnea index, TDI; and modified Medical Research Council, mMRC), health status (COPD assessment test, CAT), and health -related quality of life (HRQoL, CRQ) were evaluated at baseline and on Day 21 after the intervention. Results: No change in the DLPA was observed in between-group comparison. CG presented a reduction in step counts after 21days (-707,p <0.05) while ETG. maintained (-114,p > 0.94). However, ET reduced dyspnea symptoms in all TDI domains (functional, task, and effort) and on the mMRC scale after 14 days compared with CG (p < 0.01). Also, the ETG improved CAT score compared to the CG, reaching minimal clinical important difference (MCID) (-4.4 score, p <0.01). The ETG also improved in most CRQ domains reaching MCID after 21 days. Conclusions: ET does not modify DLPA but reduces dyspnea and improves health status and HRQoL in nonobese males with moderate to very severe COPD in the short term. This novel and low-cost intervention improves COPD symptoms.
The impact of obesity in hospitalized patients with COVID-19: a retrospective cohort study
(2024) CARRA, Fabio Alfano; MELO, Maria Edna de; STUMPF, Matheo A. M.; CERCATO, Cintia; FERNANDES, Ariana E.; MANCINI, Marcio C.; HIROTA, Adriana; KANASIRO, Alberto Kendy; CRESCENZI, Alessandra; FERNANDES, Amanda Coelho; MIETHKE-MORAIS, Anna; BELLINTANI, Arthur Petrillo; CANASIRO, Artur Ribeiro; CARNEIRO, Barbara Vieira; ZANBON, Beatriz Keiko; PINHEIRO, Bernardo; BATISTA, Senna Nogueira; NICOLAO, Bianca Ruiz; BESEN, Bruno Adler Maccagnan Pinheiro; BISELLI, Bruno; MACEDO, Bruno Rocha De; TOLEDO, Caio Machado Gomes De; CARVALHO, Carlos Roberto Ribeiro De; MOL, Caroline Gomes; STIPANICH, Cassio; BUENO, Caue Gasparotto; GARZILLO, Cibele; TANAKA, Clarice; FORTE, Daniel Neves; JOELSONS, Daniel; ROBIRA, Daniele; COSTA, Eduardo Leite Vieira; SILVA JUNIOR, Elson Mendes Da; REGALIO, Fabiane Aliotti; SEGURA, Gabriela Cardoso; LOURO, Giulia Sefrin; MARCELINO, Gustavo Brasil; HO, Yeh-Li; FERREIRA, Isabela Argollo; GOIS, Jeison Oliveira; SILVA-JR, Joao Manoel Da; JUNIOR, Jose Otto Reusing; RIBEIRO, Julia Fray; FERREIRA, Juliana Carvalho; GALLETI, Karine Vusberg; SILVA, Katia Regina; ISENSEE, Larissa Padrao; OLIVEIRA, Larissa Santos; TANIGUCHI, Leandro Utino; LETAIF, Leila Suemi; LIMA, Ligia Trombetta; PARK, Lucas Yongsoo; NETTO, Lucas Chaves; NOBREGA, Luciana Cassimiro; HADDAD, Luciana Bertocco Paiva; HAJJAR, Ludhmila Abrahao; MALBOUISSON, Luiz Marcelo Sa; PANDOLFI, Manuela Cristina Adsuara; PARK, Marcelo; CARMONA, Maria Jose Carvalho; ANDRADE, Maria Castilho Prandini H.; SANTOS, Mariana Moreira; BATELOCHE, Matheus Pereira; SUIAMA, Mayra Akimi; OLIVEIRA, Mayron Faria de; SOUSA, Mayson Laercio; GARCIA, Michelle Louvaes; HUEMER, Natassja; MENDES, Pedro Vitale; LINS, Paulo Ricardo Gessolo; SANTOS, Pedro Gaspar Dos; MOREIRA, Pedro Ferreira Paiva; GUAZZELLI, Renata Mello; REIS, Renato Batista Dos; DALTRO-OLIVEIRA, Renato; ROEPKE, Roberta Muriel Longo; PEDRO, Rodolpho Augusto Moura; KONDO, Rodrigo; RACHED, Samia Zahi; FONSECA, Sergio Roberto Silveira Da; BORGES, Thais Sousa; FERREIRA, Thalissa; JUNIOR, Vilson Cobello; SALES, Vivian Vieira Tenorio; FERREIRA, Willaby Serafim Cassa
Background Obesity is believed to be a risk factor for COVID-19 and unfavorable outcomes, although data on this remains to be better elucidated.Objective To evaluate the impact of obesity on the endpoints of patients hospitalized due to SARS-CoV-2.Methods This retrospective cohort study evaluated patients hospitalized at a tertiary hospital (Hospital das Cl & iacute;nicas da Faculdade de Medicina da USP) from March to December 2020. Only patients positive for COVID-19 (real-time PCR or serology) were included. Data were collected from medical records and included clinical and demographic information, weight and height, SAPS-3 score, comorbidities, and patient-centered outcomes (mortality, and need for mechanical ventilation, renal replacement therapy, or vasoactive drugs). Patients were divided into categories according to their BMI (underweight, eutrophic, overweight and obesity) for comparison porpoise.Results A total of 2547 patients were included. The mean age was 60.3 years, 56.2% were men, 65.2% were white and the mean BMI was 28.1 kg/m(2). SAPS-3 score was a risk factor for all patient-centered outcomes (HR 1.032 for mortality, OR 1.03 for dialysis, OR 1.07 for vasoactive drug use, and OR 1.08 for intubation, p < 0.05). Male sex increased the risk of death (HR 1.175, p = 0.027) and dialysis (OR 1.64, p < 0.001), and underweight was protective for vasoactive drug use (OR 0.45, p = 0.027) and intubation (OR 0.31, p < 0.003).Conclusion Obesity itself was not an independent factor for worse patient-centered outcomes. Critical clinical state (indirectly evaluated by SAPS-3) appears to be the most important variable related to hard outcomes in patients infected with COVID-19.
Balance assessment in HTLV-1 associated myelopathy or tropical spastic paraparesis
(2020) PATRICIO, Naiane Araujo; RIOS, Monica Andrade; BARBOSA, Patricia Carvalho; RIBEIRO, Jessica Ramos; VIDAL, Diogo Guedes; SA, Katia Nunes; BAPTISTA, Abrahao Fontes
Introduction: A good rating of the device in people with HTLV-1 in this population is essential for accuracy in prescribing data (walking). Thus, this study aimed to analyze the counterpart assessment methods that are best suited to patients with human T-cell lymphotropic virus (HTLV)-1 associated myelopathy or tropical spastic paraparesis (HAM/TSP). Methods: This cross-sectional study related stabilometric and kinematic variables of postural oscillations with Berg's balance scale (BBS) and Timed Up and Go (TUG) in subjects with HAM/1'SP compared to asymptomatic subjects. To assess the posterior and lateral postural projection, baropodornetry and the Footwork (R) system was used, and the CVMob system was applied to kinematic parameters. The means comparison tests and correlations were applied with an alpha of 5%. Results: Thirty-nine subjects (predominantly female) made up the sample. There was an increase in barodopometric oscillations, in the total oscillation area (p = 0.004), in the anteroposterior oscillation in the left (p = 0.015) and right views (p = 0.036), and in the lateral oscillation (p = 0.039) in the HAM/TSP group. Moderate correlations were found between oscillation baropodometry and the angular variation of the ankle, as well as with the BBS in the three angles and the TUG for lateral oscillation (p = 0.406). Conclusions: Each method has advantages and disadvantages, including cost accuracy. The best resources available at no additional cost for outpatient to use are the kinematic evaluation using a simple smartphone camera and free analysis software, and the TUG.
Effects of a foot-ankle muscle strengthening program on pain and function in individuals with knee osteoarthritis: a randomized controlled trial
(2023) DANTASA, Glauko A. F.; SACCOC, Isabel C. N.; V, Angelica Ferraria; MATIASC, Alessandra B.; WATARIC, Ricky; OLIVEIRAA, Larissa V. M.; MARCONA, Thaina R.; FATOREA, Jose A.; POTT-JUNIOR, Henrique; SALVINIA, Tania F.
Background: Foot-ankle exercises could improve pain and function of individuals with KOA and need to be tested.Objective: To investigate whether an 8-week foot-ankle muscle strengthening program is effective for individuals with KOA to reduce pain and improve function. Methods: In this randomized controlled trial, individuals diagnosed with clinical and radiographic KOA were randomized into the intervention (supervised foot-ankle strengthening exercise program three times a week for 8 weeks) or control (usual care and recommendations of the healthcare team) group. Effectiveness was assessed by changes in clinical and functional outcomes between baseline and 8 weeks with pain as the primary outcome. ANCOVA tests using the intervention group as a reference and sex, body mass index, and baseline values as covariates assessed between-group differences.Results: The intervention group showed lower pain scores (-4.4 units; 95%CI =-7.5,-1.1), better function (-7.1 units; 95%CI =-12.7,-1.4), higher total functional score (-11.9 units; 95%CI =-20.7,-3.1), with confidence intervals indicating a potential for the differences to be clinically meaningful, and better scores for the 30-s chair stand test (2.7 repetitions; 95%CI = 1.1, 4.1), with a confidence interval indicating a moderate clinically meaningful difference, compared to the controls. Conclusion: The 8-week foot-ankle exercise program showed positive, and potentially clinically meaningful, effects on knee pain and physical function among individuals with KOA, when com-pared to usual care. Trial registration: NCT04154059. https://clinicaltrials.gov/ct2/show/NCT04154059 (c) 2023 Associacao Brasileira de Pesquisa e Pos-Graduacao em Fisioterapia.
Effect of a telerehabilitation exercise program versus a digital booklet with self-care for patients with chronic non-specific neck pain: a protocol of a randomized controlled trial assessor-blinded, 3 months follow-up
(2023) BARBOSA, Juliene Correa; COMACHIO, Josielli; MARQUES, Amelia Pasqual; SARAGIOTTO, Bruno Tirotti; MAGALHAES, Mauricio Oliveira
BackgroundNeck pain is the fourth worldwide leading cause of disability and represents 22% of musculoskeletal disorders. Conservative intervention has been strongly recommended to treat chronic neck pain and Telerehabilitation is the alternative for the treatment of musculoskeletal conditions. There is a lack of high-quality research on the effects of telerehabilitation in patients with neck pain and functional disability. Therefore, this study aims to evaluate the effect of a telerehabilitation exercise program versus a digital booklet only with self-care information in individuals with non-specific chronic neck pain.MethodsThis is a prospectively registered, assessor-blinded, two-arm randomized controlled trial comparing a telerehabilitation exercise program versus a digital booklet with self-care information. Seventy patients will be recruited with non-specific chronic neck pain. Follow-ups will be conducted post-treatment, 6 weeks, and 3 months after randomization. The primary outcome will be disability at post-treatment (6 weeks) measured using neck pain disability. Secondary outcomes will be pain intensity levels, global perceived effect, self-efficacy, quality of life, kinesiophobia, and adherence to treatment. In our hypothesis, patients allocated to the intervention group experience outcomes that are similar to those of those assigned to the self-care digital booklet. Our hypothesis can then be approved or disapproved based on the results of the study.DiscussionThis randomized clinical trial will provide reliable information on the use of telerehabilitation to treat patients with chronic non-specific neck pain.Trial registrationThe study was prospectively registered at the Brazilian Registry of Clinical Trials (number: RBR-10h7khvk). Registered on 16 September 2022.
A web-based educational therapy intervention associated with physical exercise to promote health in fibromyalgia in Brazil: the Amigos De Fibro (Fibro Friends) study protocol
(2023) ANTUNES, Mateus Dias; LOURES, Felipe Cayres Nogueira da Rocha; SOUZA, Ingred Merllin Batista de; CRUZ, Ariela Torres; JANUARIO, Priscila de Oliveira; PINHEIRO, Mara Maria Lisboa Santana; SCHMITT, Ana Carolina Basso; FRUTOS-BERNAL, Elisa; MARTIN-NOGUERAS, Ana Maria; MARQUES, Amelia Pasqual
Background Health education is one of the main items to enable health promotion to patients with fibromyalgia. The objective of the study ""Amigos de Fibro (Fibro Friends)"" is to evaluate the impact of an educational intervention associated with physical exercise based on the web in promoting health and quality of life of patients with fibromyalgia in Brazil.Methods A study with a randomized controlled trial approach will be carried out. The sample will consist of 24 participants, divided into two groups, with 12 individuals each. The experimental group will participate in meetings with lectures, debates, conversation rounds and exercises by a multidisciplinary team. Physical exercises will also be performed in an online environment. On the other hand, the control group will receive an e-book of education and self-care. Primary outcomes will be quality of life. The secondary outcomes will be sociodemographic and health profile, pain intensity, sleep quality, self-care agency, usage and costs of health and social care services, viability of the program and program participation. In addition, a qualitative evaluation process will be carried out with the participants. After the intervention, the data of both groups will be collected again, as well as after 3, 6, and 12 months to verify the effect and the maintenance of the intervention.Discussion The results will provide data for studies to consider the use of this tool in the future by professionals working in the field of rheumatology.
Integrative assessment of cerebral blood regulation in COPD patients
(2024) CORRE, Daniel I.; DE-LIMA-OLIVEIRA, Marcelo; NOGUEIRA, Ricardo C.; CARVALHO-PINTO, Regina M.; BOR-SENG-SHU, Edson; PANERAI, Ronney B.; CARVALHO, Celso R. F.; SALINET, Angela S. M.
Cerebrovascular responses were compared between COPD and non-COPD participants. The association between COPD severity and cognitive function was also investigated. Cerebral blood velocity in the middle cerebral artery, blood pressure, and end-tidal CO2 were recorded at rest, followed by a brain activation paradigm, and an inhaled gas mixture (5% CO2) to assess cerebral autoregulation (CA), neurovascular coupling (NVC) and cerebrovascular reactivity to carbon dioxide (CVRCO2), respectively. Pulmonary function, blood gas analysis (COPD) and cognitive function (MoCA test) were also performed. No difference in baseline (systemic and cerebral parameters) and CA was found between 20 severe COPD and 21 non-COPD. Reduced NVC and CVRCO2 test were found in the COPD group. Lower pulmonary function was positively correlated with CA, NVC and CVRCO2 in COPD patients. Cognitive impairment (MoCA<26) was associated with lower NVC responses (COPD and non-COPD) and lower pulmonary function (COPD). Both mechanisms, CVRCO2 and NVC, were lower in COPD patients. Moreover, disease severity and cognitive impaired were associated with worse cerebrovascular regulation.
Learning challenges in Physical Therapy, Speech-Language-Hearing Sciences, and Occupational Therapy undergraduate programs during the COVID-19 pandemic
(2023) SAMELLI, Alessandra Giannella; MATAS, Carla Gentile; NAKAGAWA, Naomi Kondo; SILVA, Talita Naiara Rossi da; JOAO, Silvia Maria Amado
Purpose: COVID-19 posed numerous challenges to educational programs that had to quickly adapt to remote online learning (ROL) to ensure the continuity of health professional training over the pandemic. We aimed to assess the students' and professors' perceptions of the teaching-learning process in the Physical Therapy, Speech-Language-Hearing Sciences, and Occupational Therapy undergraduate programs at a Brazilian public university. Methods: We used an electronic self-reported questionnaire with multiple-choice questions on a Likert scale ranged 1-5; higher the score, higher the level of agreement/importance/satisfaction. Results: Most of undergraduate students and teachers had previous experience using information and communication technologies, and 85% stated their preference for in-person learning. Students expressed their appreciation for more active learning methodologies with clear objectives, accessible content, and visualization of abstract concepts. Regarding benefits and barriers, some similar perceptions were observed between students and teachers with ROL favoring time management, benefits in the teaching-learning process, satisfaction and motivation with the course content, and low attendance rates to general academic activities due to absent or poor access to technological resources. Conclusion: ROL is an alternative learning mode when the in-person classes cannot be carried out, as in the case of the COVID-19 pandemic. ROL is believed to be unfit to replace in-person learning, although it can complement the traditional classroom-based education in a hybrid model, respecting the nature of each program in the field of health that requires in-person practical training.
Comparison of disability level between Early and Late Onset Parkinson's Disease using WHODAS 2
(2023) NASCIMENTO, Isaira Almeida Pereira da Silva; NOBREGA, Katia Cirilo Costa; SOUZA, Bruno Rafael Antunes; BARONE, Isabela Carneiro; CHECCHIO, Giovanna; PONCIANO, Vitoria Pereira; PAULA, Clara Greif Cerveira de; POSSANI, Arieni Nunes; PENHA, Natalia Cardoso; HELENE, Andre Frazao; ROQUE, Antonio Carlos; SAVICA, Rodolfo; PIEMONTE, Maria Elisa Pimentel
Background: Parkinson's disease (PD) is a degenerative neurological disorder that usually affects people over the age of 60. However, 10%-20% of patients have an early onset of PD (EOPD).Objectives: To compare disability levels according to the World Health Organization Disability Assessment Schedule 2.0 (WHODAS-2) between people with EOPD and those with late-onset PD (LOPD).Methods: We conducted a cross-sectional study with 95 EOPD patients (mean-age 44.51 +/- 4.63, H&Y 1.93 +/- 0.93) and 255 LOPD patients (mean-age 63.01 +/- 7.99, H&Y 2.02 +/- 0.95). Demographic information, clinical characteristics, cognitive evaluation by Telephone-Montreal-Cognitive-Assessment (T-MoCA), functionality self-evaluation by WHODAS-2 and the Unified-Parkinson's-Disease-Rating-Scale (MDS-UPDRS), parts I and II, were documented for each patient by an individual remote interview.Results: Analysis showed a statistically significant difference between EOPD and LOPD in two domains of WHODAS-2 only: cognition (Z-adjusted = 2.60; p-value adjusted <0.009) and activities of daily living related to work/school (Z-adjusted = 2.34; p-value adjusted <0.01). T-MoCA scores confirmed more impaired cognition capacity in LOPD (Z-adjusted = 2.42; p-value adjusted <0.01). The two groups had no significant differences in levodopa daily dosage, Hoehn and Yahr (H&Y) stages, disease time duration, and MDS-UPDRS I and II scores.Conclusion: People living with EOPD face similar disability levels as those with LOPD, except for cognition, where LOPD patients exhibited higher levels of disability than EOPD and for work activities where the EOPD exhibited higher levels of disability than LODP. These results highlight the challenges faced by people with EOPD in interacting with society and living with the disease for a longer time. The WHODAS-2 can be a useful tool to assess disability and tailor interventions for people with PD of different age groups.
Wearable-based assessment of anticipatory postural adjustments during step initiation in patients with knee osteoarthritis
(2023) OLIVEIRA, Luana Karine Resende; MARQUES, Amelia Pasqual; IGARASHI, Yuzo; ANDRADE, Karen Flaviane Assis; SOUZA, Givago Silva; CALLEGARI, Bianca
Older adults with moderate to severe knee osteoarthritis (KOA) exhibit adaptive strategy for initiating walking, known as anticipatory postural adjustments (APAs). While video motion kinematics has been the traditional way of measuring APAs, it can be difficult to transport and install, making it impractical for medical settings. Inertial sensors have become a more popular method for evaluating APAs, but no prior research has used accelerometers to measure gait initiation in individuals with KOA. The study aimed to assess the validity and reliability of a wearable accelerometer device for measuring APAs older adults with and without KOA. 25 individuals with KOA and 10 healthy individuals underwent evaluation using a wearable commercially available accelerometer (MetamotionC) and a video motion capture system. Reflective markers were placed on the lumbar vertebra and calcaneus. Participants were asked to initiate a step, and the researchers measured the APA(latency) and APA(amplitude) of each subject. APA(latency) showed an very large to almost perfect correlation in both groups (CG:r = 0.82; p = 0.003 and KOA r = 0.98; p < 0.00001) between the instruments, while APA(amplitude) had a moderate to very large correlation (CG: r = 0.65; p = 0.04and KOA: r = 0.80; p < 0.00001). Overall, the measurements showed fair to high reliability for intraclass correlation for video and accelerometer variables. Significant group effect was found for both variables: APA(latency) (F-1,F- 66 = 7.3; p = 0.008) and APA(amplitude) (F-1,F-66 = 9.5; p = 0.00). The wearable tri-axial accelerometer is a valid and reliable for assessing APAs during gait initiation in individuals with KOA, and this population exhibits lower APAs when initiating a step.
Identifying the Characteristics of Responders and Nonresponders in a Behavioral Intervention to Increase Physical Activity Among Patients With Moderate to Severe Asthma: Protocol for a Prospective Pragmatic Study
(2023) LIMA, Fabiano Francisco de; LUNARDI, Adriana Claudia; PINHEIRO, David Halen Araujo; CARVALHO-PINTO, Regina Maria; STELMACH, Rafael; GIAVINA-BIANCHI, Pedro; AGONDI, Rosana Camara; CARVALHO, Celso R. F.
Background: Previous research has suggested that most adults improve their asthma control after a short-term behavioral intervention program to increase physical activity in daily life (PADL). However, the characteristics of individuals who respond and do not respond to this intervention and the medium-term response remain unknown.Objective: This study aims to (1) identify the characteristics of adult responders and nonresponders with asthma to a behavioral intervention to increase physical activity and (2) evaluate the functional and clinical benefits in the medium term.Methods: This prospective pragmatic study will include adults with moderate to severe asthma who enroll in a behavioral intervention. All individuals will receive an educational program and an 8-week intervention to increase PADL (1 time/wk; up to 90 min/session). The educational program will be conducted in a class setting through group discussions and video presentations. Behavioral interventions will be based on the transtheoretical model using counseling, incentives, and individual feedback aiming to increase participation in physical activity. Motivational interviewing and guidelines for overcoming barriers will be used to stimulate individuals to reach their goals. Pre-and postintervention assessments will include the following: PADL (triaxial accelerometry), body composition (octopolar bioimpedance), barriers to PADL (questionnaire), clinical asthma control (Asthma Control Questionnaire), quality of life (Asthma Quality of Life Questionnaire), anxiety and depression levels (Hospital Anxiety and Depression Scale), and exacerbations. ""Responders"" to the intervention will be defined as those who demonstrate an increase in the number of daily steps (& GE;2500). Results: In December 2021, the clinical trial registration was approved. Recruitment and data collection for the trial is ongoing, and the results of this study are likely to be published in late 2024. Conclusions: The intervention will likely promote different effects according to the clinical characteristics of the individuals, including asthma control, age, anxiety and depression levels, obesity, and several comorbidities. Identifying individuals who respond or do not respond to behavioral interventions to increase PADL will help clinicians prescribe specific interventions to adults with asthma.Trial Registration: ClinicalTrials.gov NCT05159076; https://clinicaltrials.gov/ct2/show/NCT05159076International Registered Report Identifier (IRRID): DERR1-10.2196/49032
Time perception and pain: Can a temporal illusion reduce the intensity of pain?
(2023) MAIA, Vanessa S. Z.; SILVA, Catarina Movio; OLIVEIRA, Inaeh de Paula; OLIVEIRA, Victoria Regina da Silva; DALE, Camila Squarzoni; BAPTISTA, Abrahao Fontes; CAETANO, Marcelo S. S.
It is commonly known-and previous studies have indicated-that time appears to last longer during unpleasant situations. This study examined whether a reciprocal statement can be made-that is, whether changes in the perception of time can influence our judgment (or rating) of a negative event. We used a temporal illusion method (Pomares et al. Pain 152, 230-234, 2011) to induce distortions in the perception of time. Two stimuli were presented for a constant time: a full clock, which stayed on the screen until its clock hand completed a full rotation (360 degrees); and a short clock, in which the clock hand moved just three-quarters of the way (270 degrees), thus suggesting a reduced interval duration. However, both stimuli were shown for the same amount of time. We specifically investigated (a) whether we could induce a temporal illusion with this simple visual manipulation, and (b) whether this illusion could change participants' ratings of a painful stimulus. In Experiment I (n = 22), to answer (a) above, participants were asked to reproduce the duration in which the different clocks were presented. In Experiment II (n = 30), a painful thermal stimulation was applied on participants' hands while the clocks were shown. Participants were asked to rate the perceived intensity of their pain, and to reproduce its duration. Results showed that, for both experiments, participants reproduced a longer interval after watching the full clock compared with the short clock, confirming that the clock manipulation was able to induce a temporal illusion. Furthermore, the second experiment showed that participants rated the thermal stimuli as less painful when delivered with the short clock than with the full clock. These findings suggest that temporal distortions can modulate the experience of pain.
Human peripheral blood age-associated (CD11c+Tbet+) B cells: No association with age
(2023) PINTO, Thalyta Nery Carvalho; SILVA, Cibele Cristine Berto Marques da; PINTO, Regina Maria Carvalho; DUARTE, Alberto Jose da Silva; BENARD, Gil; FERNANDES, Juliana Ruiz

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