Fisioterapia Brasil

Physical therapy in Pneumocephalus: a case report

Higor Gregore Alencar Oliveira — 2024-01-06

Pneumocephalus consists of an accumulation of air inside the intracranial cavity, which may or may not be associated with rupture of the dura mater. This has been associated with traumatic causes, accounting for up to 90% of cases and the main symptoms can occur as a result of intracranial hypertension. The objective of this report was to highlight the importance of Physical therapy in Pneumocephalus, describe the results of the intervention and discuss aggregated methods used in this atypical case. This is a case report of the physiotherapeutic approach in pneumocephalus, carried out at the Hospital Universitário do Oeste do Paraná, cataloged through analysis of the electronic medical record, physical record, laboratory tests and imaging tests. We concluded that by approaching the pneumocephalus with oxygen therapy supporting high flow, it was possible to observe the reabsorption of intracranial gas, in addition to maintaining and/or restoring the patient's functionality, making him active, through kinesiotherapy, respiratory physical therapy and early mobilization.

Limb-girdle muscular dystrophy and physical therapy: update and case report

Marco Orsini — 2024-01-06

The term limb girdle muscular dystrophy (LGMD) has been introduced to delineate a distinct form of muscular dystrophy with predominantly proximal upper and lower extremity weakness. PAS, 71 years old, male, retired, diabetic and hypertensive. He reports that the clinical picture started in mid-2010 with complaints related to atrophy of the shoulder girdle and thigh region. "When looking at myself in the mirror I started to notice that I was losing muscle in my shoulders". The beginning of the clinical picture dragged on, still with muscle shape close to normal to perform daily activities. He points out that the cervical region bothers him a lot, mainly due to the inclined position in which he is. In this clinical case, we present neurological and functional evaluations, as well as complementary exams that help in the detection of LGMD. New studies, including a larger number of patients with myopathy of the waist and limbs, are needed. We believe that the best form of rehabilitation for this group of myopathies is not to look for overuse damage and, undoubtedly, work in search of function, not primarily strength.

Effects of high frequency non-invasive ventilation in premature newborn infants: systematic review protocol

Emanuelle Tolosa dos Santos — 2024-01-06

Introduction: Premature birth is a condition, which can be induced by several factors. High Frequency non-invasive ventilation is a promising new mode of non-invasive ventilation that aims to offer adequate ventilation and oxygenation, but much has yet been discussed about its effectiveness and safety. Objective: To evaluate the effectiveness and safety of high frequency non-invasive ventilation in premature infants. Methods: To this end, we will carry out a systematic review. The study protocol was recorded on the Prosperous Platform. We will include premature newborns who used high-frequency non-invasive ventilation requiring ventilation as an initial support, after extubation or as a rescue mode (after failure of initial non-invasive therapy). The searches will be carried out in the databases: Medical Literature Analysis and Retrieval System Online (Medline) via Pubmed, Excerpta Medica dataBASE (Embase) via Elsevier, Cochrane Central Register of Controlled Trials (CENTRAL) via Cochrane Library, Latin American and Caribbean Literature in Health Sciences (LILACS) via the Virtual Health Library Portal and Physiotherapy Evidence Database We will evaluate the methodological rigor of the included studies and the certainty of the evidence of the main outcomes of the systematic review using Cochrane's Risk of Bias 2.0 tool and the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach, respectively. The selection of studies, data extraction, evaluation of the bias of the included studies and evaluation of the certainty of the evidence will be carried out by two independent researchers. Expected Results: The results of this review are expected to present a critical and up-to-date summary of the topic and facilitate safer decision-making by physiotherapists regarding the best recommendation for ventilatory support in the NICU, based on the best scientific evidence currently available.

Effectiveness of proprioceptive exercises in ankle ligament injury rehabilitation in adults: a systematic review

Vitorugo dos Santos Rocha — 2024-01-06

Objective: To evaluate the effectiveness and effects of proprioceptive exercise in the rehabilitation of patients after ankle ligament injury. Method: This is a systematic review, conducted by searching for articles in electronic databases such as PubMed, Scielo, Scopus, Web of Science, Science Direct, PEDro, and Portal Regional BVS, with eligibility criteria established according to the PICOS strategy. The methodological quality and certainty of evidence were assessed using the Cochrane Collaboration Scale. Results: The electronic search resulted in 3,217 articles, with 24 duplicate articles excluded, and 3,160 excluded after title reading based on exclusion criteria, leaving 33 articles for full-text reading. After reading, 19 studies were excluded either because they were not related to the topic or did not meet inclusion criteria. Methodological evaluation using the Cochrane scale was performed on 14 studies, of which seven were confirmed eligible with an average of five scores and were thus included in this review. Overall, proprioceptive training was effective in treating patients with ankle ligament injuries. The main effects reported by the studies included improvement in ankle range of motion, functional performance, balance, and muscle function. Conclusion: This systematic review showed that proprioceptive training can be effective in the treatment of patients with ankle ligament injuries, with significant improvements, particularly in ankle range of motion, functionality, and quality of life.

Comparison between training protocols with blood flow restriction in clinical musculoskeletal rehabilitation: protocol of a systematic review

Roger Andrey Carvalho Jardim — 2024-01-06

Introduction: The training with blood flow restriction (RFS) is increasingly used in the clinical rehabilitation of musculoskeletal disorders, but there is still much uncertainty about which parameters is ideal to use regarding the restriction pressure, combination with other therapies and which groups of patients can benefit most from the technique. Objective: To compare the effectiveness and safety of different methodologies for the use of RFS in the rehabilitation of musculoskeletal disorders. Methods: A systematic review will be performed through independent searches by two reviewers of studies indexed to Medline, SPORTDiscus, Central, Lilacs, CINAHL, Embase, J-STAGE and PEDro; in addition to sources of gray literature and in the bibliographic references of the studies included in the review. The study protocol was registered on the Prospero Platform (CRD422021233488). Randomized parallel-group clinical trials that tested the efficacy or safety of RFS training in individuals aged 18 years or older for at least three weeks will be considered. Details will be extracted on the application of RFS and outcomes of pain, muscle strength and adverse events, considered as primary outcomes; in addition to functional capacity, discomfort, overall physical capacity and quality of life, composing the secondary outcomes. The risk of bias of the studies will be assessed using the PEDro scale and any disagreement during the process of selection, extraction and evaluation of the risk of bias will be decided by a third reviewer. Expected results: Expose the information available in the literature and provide clear guidance to clinicians and researchers on the prescriptions and recommendations of this technique.

Effectiveness and safety of the use of room air compared to 100% oxygen in neonates under cardiac arrest at birth

Benedita Monique Almeida Freires — 2024-01-06

Introduction: Cardiac arrest at birth represents a serious problem worldwide. The commonly recommended practice for resuscitation of asphyxiated newborns has been the use of 100% oxygen for assisted ventilation. However, there is increasing evidence that ambient air is as effective as 100% oxygen and that 100% oxygen can have adverse effects on respiratory physiology and cerebral circulation. Objective: To compare the effectiveness and safety of using room air versus 100% oxygen in the resuscitation of neonates with cardiac arrest at birth. Methods: For this purpose, we will perform a systematic review of randomized controlled trials (RCTs). We will register the study protocol in the Prospero Platform. We will include neonates of any gestational age, diagnosed with cardiac arrest or neonatal asphyxia. We will perform searches in the following databases: Medical Literature Analysis and Retrieval System Online (Medline) via Pubmed, Excerpta Medica dataBASE (Embase) via Elsevier, Cochrane Central Register of Controlled Trials (CENTRAL) via Cochrane Library, Latin American Literature and the Caribbean in Health Sciences (Lilacs) via the Virtual Health Library Portal, with no restrictions on language or year of publication. The selection of studies, data extraction, assessment of bias of included studies and assessment of certainty of evidence will be performed by two independent researchers. Expected Results: We expect to clarify the effectiveness and safety of using ambient air compared to 100% oxygen, to provide useful information for clinical decision-making, and to support future high-quality randomized clinical trials on the subject

Prospection of technological resources for physical therapy respiratory rehabilitation through game therapy

Francisco Vinicius Teles Rocha — 2024-02-26

The advancement of technology has enabled the enhancement of medical procedures and consequently improved the healing process of patients. From this, it was observed that, in view of the recent COVID-19 pandemic, respiratory rehabilitation procedures using Respiron for patients with sequelae from SARS-CoV-2 infection can have their effectiveness increased by associating them with game therapy interventions, benefiting even more patients who have associated comorbidities. In view of this fact, this study used a literature review of experimental works (in the Medline databases, via PubMed), Scientific Electronic Library Online (SciELO), Latin American and Caribbean Literature in Health Sciences (LILACS) and ScienceDirect) associated with a prospection (in the INPI and ESPACENET patent bases) to investigate the development of new technologies for respiratory rehabilitation (through game therapy), in order to analyze the trends of scientific-technological production in this area to open a field of development of a new product. With regard to the search in the database, 327 works were found, of which 91 were clinical trials, and only 5 met the selection requirements of this work after reading the title and abstract. In the patent bases, 833 patents were found, of which only 6 fit the research proposal of this work. The results found indicate that the use of game therapy in the respiratory rehabilitation process is positive and that it is a promising field of research and investment.

Health promotion in climacteric period: a physical therapy proposal

Sophia Baraldi Boscolo — 2024-01-06

Introduction: The climacteric is defined as a transitional period between a woman's reproductive and non-reproductive years, which occurs in middle age. Aim: To verify and compare the effects of the application of physical exercise protocol and tele-care in the variables;life quality, quality of sleep and sexual satisfaction in women in the climacteric period. Methods: Prospective comparative study with 20 women, aged 47-62 years, sedentary and with climacteric symptoms, divided into Face-to-Face Exercise Group (G1) and Telecare Exercise Group (G2). All received the same protocol of progressive exercises, for 12 weeks, lasting 45 minutes each session. At the beginning and end of the protocol, the participants were evaluated through the WHOQOL -bref (life quality) Female Sexual Function Index (sexual performance) and Pittsburgh Scale (sleep quality). For statistical analysis, the KS test was applied, followed by a parametric Anova test, considering p ≤ 0.005. Results: When comparing the evaluated variables, it was observed that the groups were similar before the interventions (p > 0.05). After the interventions, regarding quality of life, both groups obtained positive changes, and G1 presented statistical difference in relation to G2 (p = 0.0002), in sexual satisfaction (p ≤ 0.05) and sleep quality, only G1 showed a positive change in their domains. Conclusion: The face-to-face and online exercise protocol positively changed the quality of life, sex life and sleep quality, however the Face-to-Face Exercise Group obtained better results.

Assessment of the sexual function of women in reproductive age with self-reported dyspareunia

Danielle Deponti Cuty — 2024-01-06

Objective: To assess the sexual function of women of reproductive age with self-reported dyspareunia. Methods: This is a cross-sectional study with a quantitative approach, comprising 127 women aged 18 to 35 years. There were questionnaires on sociodemographic and clinical characteristics and the FSFI scale, in online format. Results: Most women (96.85%) were at risk of sexual dysfunction, being 80.31% since the first sexual intercourse. The lowest scores were without the satisfaction domain. There was no correlation between sexual function assessed by the FSFI and the clinical and sociodemographic characteristics of the sample, except for pain treatment, in which women who had already undergone treatment had lower scores on the FSFI. Conclusion: There is a high prevalence of sexual dysfunction and low scores without a domain of satisfaction may indicate that women with dyspareunia may be dissatisfied with their sexuality.

Influence of muscle variables on delivery route after perineal preparation in primiparous women

Leticia Rodrigues Silva — 2024-01-06

Introduction: Many pregnant women seek vaginal delivery, as a healthier and more respectful mode of delivery, and perineal massage and instrument-assisted perineal stretching techniques aim to bring better postpartum outcomes. Despite this, some deliveries may not occur as expected and conclude with interventions or surgical delivery. Objective: To analyze the influence of muscle variables on the mode of delivery of women undergoing perineal preparation. Methods: This is a secondary analysis of a clinical trial in which primiparous women with a gestational age of 33 weeks were included. Evaluations were performed before and after eight intervention sessions using perineal massage and stretching assisted by the Epi-No Delphine Plus® instrument. Perineal distensibility muscle variables were evaluated using the Epi-No Delphine Plus® equipment and the peak and mean strength of pelvic floor muscles (PFM) using the Peritron^TM vaginal manometer. After delivery, the method of delivery performed was determined by telephone contact. For statistical analysis, univariate logistic regression was performed with a significance level of 0.05. Results: Sixty-one primiparous women were included in the study (mean age: 30 years; SD: 4.8). None of the muscle variables examined were predictors for vaginal delivery (p > 0.05). Conclusion: Muscle variables did not influence the final delivery route of women undergoing perineal preparation.

Evaluation of the types of urinary incontinence in a Nucleus of Voiding Dysfunction in Rio de Janeiro

Lilian Castro Ponzoni — 2024-01-06

Urinary incontinence (UI) in adult women is a very common problem. Its prevalence can be underestimated, as some patients do not inform health professionals about this problem because they believe it to be a condition typical of aging.⁽¹⁾ Women have a higher prevalence (32.9%) of UI compared to men (6.2%) due to anatomical differences in the pelvis and lower urinary tract, in addition to the interference of hormonal factors, pregnancies and deliveries that challenge the forces and musculoskeletal stability of pélvis.⁽³⁾ Knowing in detail the types of UI of patients seeking treatment at the Nucleus of Mictional Dysfunction (NDM) Feminine Urology (UF) of the Piquet Carneiro Polyclinic (PPC) of State University of Rio de Janeiro (UERJ) is the principle to be able to offer a quality service for individuals and for the Public Health System. The medical records of 869 patients who sought care at the NDM/UF, during the period from August 2016 to August 2019, were analyzed. CONCLUSION: our study showed a high prevalence of Mixed Urinary Incontinence (MUI) in relation to the other two types, the use of the electronic medical records and telemonitoring by all medical professionals, nurses and physiotherapists, is a tool that can increase the effectiveness of the NDM/UF, expanding service and significantly reducing waiting lines, we consider the increase in physical space to be relevant for face-to-face care by the pelvic physiotherapy team, so that we can reduce the length of stay of patients in the waiting list, with a consequent improvement in their quality of life.

The dance in labor: systematic review

Taís da Cunha Schneider — 2024-01-06

Introduction: Dance in the transpartum used with the aim of bringing beneficial effects to pregnant women in this physiological process. The use of this practice appears as an alternative of pharmacological method in order to avoid complications, pain, fear, in addition to bringing comfort and satisfaction to the parturients. Objective: To systematically review the studies published in the last 10 years about the performance and effects of dance in labor. Methods: Systematic literature review conducted through a digital bibliographic search in articles like clinical trials and randomized studies, in the period between 2011 and 2021, in the complete electronic databases PubMed, BVS Scielo and Science Direct. Results: 4 articles applicable to the eligibility criteria were included. The population studied was women aged between 18 and 35, who are parturient, that show the effects related to dance in the transpartum. There was no great variability in the resources used and the studies positive and similar results. Conclusion: Dancing proved to be beneficial for parturients in the studies analyzed during labor in terms of comfort, satisfaction and in reducing the perception of fear and trauma during childbirth. However, more research is needed, given the moderate methodological scores and the scarcity of important studies.

Comparison of neurological assessment and general movements of infants at risk at different time points

Caroline Silveira Morinel — 2024-01-06

Background: Brain development is a constant interaction between genetic, biological, and environmental factors. Its maturation process is extremely sensitive, and if it does not occur in sync, brain damage can occur in the immature brain, triggering a set of permanent movement and posture disorders. Thus, early diagnosis of developmental changes is essential for intervention to begin as soon as possible, optimizing results, improving functional skills, and reducing the damage to the future life of these babies, and serve as a basis for the actions of professional teams dedicated to stimulation and monitoring of child development. Objectives: To compare the neurological assessment and general movements of infants at risk at 40, 52, and 64 weeks of gestational age (GA). Methods: Infants at risk born in a reference maternal and child hospital were assessed for their neuromotor behavior using the "Hammersmith Neonatal Neurological Examination (HNNE)", "Hammersmith Infant Neurological Examination (HINE)" and "General Movements Assessment (GMA)" scales at 40, 52, and 64 weeks gestational age. Data will be correlated and analyzed descriptively. Results: 33 infants at risk were assessed at 40, 52 and 64 weeks, i.e., up to six months of corrected age. Male gender (75.8%), a cesarean delivery (51.5%), and white race (60.6%) predominated. The Median Apgar score was nine, mean of five prenatal visits, and a mean GA of 35.8 weeks. Prematurity and congenital syphilis were the main diagnoses found. 30.3% of the patients underwent neuroimaging exams, especially brain ultrasounds, with normal results. There was a predominance of "altered evaluation" in HNNE and HINE at the three evaluative moments for term babies, especially for babies with congenital syphilis, and "adequate" for premature babies. In the GMA evaluation and regarding the presence of fidgety, there was a higher frequency of the "suboptimal" classification and most presented fidgety. In the longitudinal comparison between the three moments assessed using the HNNE/HINE scales, it was found that there was a significant difference between the first and the third evaluative moment (p = 0.029), where babies improved their classification. There were positive associations of results between the HNNE/HINE scales with scores in different variables. Conclusion: Infants at risk had altered scores on neurological assessments, indicating developmental delay. Children at risk or with delayed neurological development may present restrictions in activities and participation with compromised quality of life and even school learning. Therefore, it is extremely important to include standardized scales during neonatal screening in the routine of the Neonatal Intermediate Care Unit (NICU), as they are highly reliable and low-cost, so that early identification of neurological changes can be enabled, and thus intervene early, enhancing development.

Neuromuscular activation of the rectus abdominis in hundred, plank and crunch exercises: A surface electromyographic comparison

André de Aguiar Santos Filho — 2024-01-06

Introduction: The rectus abdominis muscle has among its functions to stabilize and flex the trunk. There are several static and dynamic exercises that can condition it for sports performance or rehabilitation. Objective: To compare the neuromuscular activation of the rectus abdominis between hundred, plank and crunch exercises by surface electromyography. Methods: Cross-sectional study with female students from a public university, 18 to 30 years old. Evaluated by surface electromyography, equipment Miotool 400, software MiotecSuite, unipolar surface electrodes positioned bilaterally in the upper portions of the rectus abdominis muscle, considering values of the square root of the mean normalized by dynamic peak in crunch exercise and maximum voluntary isometric contraction in hundred and plank. Results: We evaluated 34 female students, mean age of 20.47 years, where the exercise hundred evidenced significant difference (p = 0.0146) between the activation of the muscle belly of the rectus abdominis, revealing greater activation in the left in relation to the right; the exercise plank was the one that revealed the greatest discrepancy between the muscle bellies. The plank exercise revealed the greatest discrepancy between the muscle bellies (p = 0.0001), exposing a high activation of the left abdomen in comparison to the right; the crunch exercise showed no significant difference between the muscle bellies (p = 0.1834), with less activation between the exercises. Conclusion: The abdominal crunch exercise proved to be an isotonic exercise that recruited fewer motor units, suggesting greater effectiveness when performing the task fully.

Knowledge of physiotherapy students about the therapeutic management of patients with non-specific chronic low back pain

Cássia Nelcy Marcolino de Araújo — 2024-01-06

Introduction: Nonspecific chronic low back pain is a dynamic, progressive and multifaceted painful process that can determine changes in the functional capacity of individuals, which makes it important that academics involved in their therapeutic management have adequate knowledge to provide quality care. Objective: To characterize the knowledge of physiotherapy students from a private higher education institution on the therapeutic management of patients with chronic nonspecific low back pain. Methods: This is an observational, cross-sectional, descriptive study with a quantitative approach developed with physiotherapy students from Faculdades Nova Esperança based on a semi-structured instrument covering sociodemographic data and 12 questions related to their knowledge on the subject, which was classified as adequate when the percentage of correct answers was greater than or equal to 70% and inadequate when it was less than 70%. Quantitative data were coded in Microsoft Excel and analyzed using descriptive statistics techniques. Results: There was a predominance of females (79.4%), mean age of 24.8 years, single marital status (89.7%), attending the 5th semester of graduation (38.5%) and participating in internships extracurricular activities, improvement courses or events in the research area (74.3%). A total of 84.6% of the participants answered 8 or more questions correctly, having knowledge classified as adequate. In all items there were more than 75% correct answers, except for 1, 5 and 6 which obtained only 12.8%, 7.6% and 48.7% correct answers, respectively. Conclusion: Academics have adequate knowledge about the therapeutic management of patients with chronic nonspecific low back pain, indicating their preparation to work in the job market.

The use of participation assessment and contextual factors for extended analysis of child neurodevelopment

Camila Santos Barros — 2024-01-06

Objective: To investigate the use of participation and contextual factors assessment instruments to enable expanded analysis of neurodevelopment in at-risk children. Methods: Cross-sectional study, composed of preterm children aged between three and 42 months. Those with congenital malformations, genetic syndromes and exposure to congenital infections were excluded. The instruments Alberta Infant Motor Scale (AIMS), Denver Test II, Child Engagement in Daily Life (CEDL), Affordances in the Home Environment for Motor Development (AHEMD) and a structured questionnaire developed by the researchers were used for assessment. Results: Sample of 29 children with higher prevalence of alterations in fine (34.5%) and gross (24.1%) motor domains; regarding participation, 58.6% almost never played outdoors with other children and 75.9% almost never went on entertainment outings, regarding contextual factors, low provision of fine (46.4%) and gross (57.1%) motor skills materials in homes. Conclusion: Children with neurodevelopment classified as questionable had changes in the domains of participation and contextual factors, indicating the importance of a more detailed assessment. The use of instruments to analyze these domains contributed to a better understanding of neurodevelopment.

Effect of breath stacking in mechanically ventilated patients admitted to the Intensive Care Unit

Thays Roberta Pessoa de Freitas — 2024-01-06

Objective: To compare two methods of the Breath Stacking maneuver, using a mechanical ventilator and a manual resuscitator, in patients on mechanical ventilation admitted to the intensive care unit. Method: This is a non-randomized clinical study consisting of 32 patients. The subjects were initially submitted to the breath stacking technique with a mechanical ventilator, occluding the expiratory branch of the circuit for 20 seconds. The technique was performed six consecutive times with a two-minute interval between maneuvers. After 24 hours, the second breath stacking technique was performed with a manual resuscitator, with 20 seconds of insufflations with the valve closed, being performed 10 consecutive times with 1-minute pauses between applications. Results: It was observed that the breath stacking maneuver, when analyzing hemodynamic variables, did not show significant changes after applying the techniques, therefore, it was safe without changing vital signs. In the analysis of pulmonary variables: respiratory rate, peripheral oxygen saturation, tidal volume and static compliance, there were no significant variations after application of the techniques. In the variables: peak pressure (p-0.02) and driving pressure (p-0.03), it can be seen that peak pressure and driving pressure were better in both others, however, in the breath group stacking with a mechanical ventilator, there was a superiority of the technique compared to breath stacking with a manual resuscitator. Conclusion: The breath stacking technique with a mechanical ventilator compared to breath stacking with a manual resuscitator was more effective in lung expansion, being a safe and effective maneuver in the respiratory mechanics of patients on invasive mechanical ventilation.

Prevalence of musculoskeletal conditions and associated factors with joint pain in individuals with Chikungunya in Amapá, Brazil: a cross-sectional study

Cecília Emily Costa dos Santos — 2024-01-06

Introduction: Chikungunya fever is an infectious disease caused by the Chikungunya virus (CHIKV), with joint pain being the most common symptom in these cases. The disease often presents with musculoskeletal dysfunctions (MS) that can sometimes be debilitating. In Brazil, since 2014, cases have been identified, with high infection rates. In the state of Amapá, in the far north of the country, there have been no studies that profile the infected population and their clinical and musculoskeletal manifestations post-Chikungunya infection. Objective: To identify the prevalence of musculoskeletal manifestations and factors associated with joint pain in individuals with Chikungunya fever in the state of Amapá, Brazil. Methods: A cross-sectional and retrospective study analyzed data from the SINAN NET system of the Ministry of Health (MH) from 869 individuals infected with CHIKV. Sociodemographic and clinical data from diagnosed individuals were used. Data correctly filled out in accordance with the MH identification and notification form were included in the study, while incompletely filled forms were excluded. Descriptive and inferential analyses were performed, with a significance level of 5% (p < 0.05) and a 95% confidence interval (CI). Results: Muscle pain (75.4%) and back pain (57.3%) were the most prevalent musculoskeletal conditions. The results indicate a positive and direct association between joint pain and arthritis (OR=2.56/CI = 1.90–3.46); fever (OR: 2.42; CI: 1.27–4.60); back pain (OR: 4.34; CI: 3.26–5.80); myalgia (OR: 4.89; CI: 3.43 – 6.98); headache (OR: 3.69; CI: 2.45–5.55); and rash (OR: 1.89; CI: 1.44–2.48). Conclusion: In the analyzed sample, it was observed that muscle pain and back pain were even more prevalent than joint pain. The presence of these two musculoskeletal complaints is still strongly associated with complaints of joint pain in these individuals. These findings may alert healthcare professionals to a more rigorous monitoring of individuals with multiple musculoskeletal conditions after CHIK, with the aim of preventing the possible chronicity of joint complaints.

Influence of a mobilization protocol in COPD patients after myocardial revascularization

Ingrid Ribeiro de Ribeiro — 2024-01-06

Background: The Chronic Obstrutive Pulmonary Disease (COPD) compromises the cardiac function, which may lead to a surgical necessity such as the myocardial revascularization (MR), and consequent pulmonary complications. Objective: To identify the influence of mobilization in the postoperative of MR on pulmonary complications and functional capacity in COPD patients. Methods: 69 patients with COPD II or III, >21 years old, divided into 2 groups. Preoperatively, control group (CG) and experimental group (EG) received orientations. Postoperatively, CG underwent respiratory physiotherapy and EG, respiratory and mobilization. The evaluation was pre-surgical and at hospital discharge through the 6-minute-walk test. Data tested for normality by the Kolmogoroy-Smirnov test. For the moment, two-way ANOVA was applied for the repeated samples. For the analysis of pulmonary complications, it was used the Chi-square test. In all analyses, the IBM SPSS version 21 software was adopted, with a significance level of 5%. Results: In the preoperative period, CG and EG showed no difference on the distance walked (p = 0.39), while postoperatively, yes (p = 0.00). Regarding the occurrence of pulmonary complications, CG was more compromised (p = 0.015). Conclusion: Postoperative mobilization of MR in COPD patients provided an increase in functional capacity and reduction in pulmonary complications.

Acute cardiovascular responses and changes in autonomic modulation in an inspiratory muscle training session: a pilot study

Thaisa Sarmento dos Santos — 2024-01-06

Introduction: Inspiratory muscle training (IMT) has been used in healthy individuals to improve physical performance. However, cardiovascular responses from IMT have not yet been well elucidated. Objective: To describe the acute cardiovascular responses and changes in autonomic modulation resulting from a moderate-intensity inspiratory muscle training session. Methods: This is an observational and cross-sectional study conducted with a convenience sample composed of young adult individuals. The study consisted of a protocol lasting 25 minutes, with ten minutes of rest (pre-IMT), 5 minutes of IMT and a ten-minute recovery period (post-IMT), with verification of heart rate (HR), systolic (SBP), diastolic (DBP) and mean (DBP) blood pressure, double product (SD) and subjective sensation of exertion (Borg). The IMT was performed using a digital device with a load of 50% of the maximal inspiratory pressure (MIP). The assessment of cardiovascular autonomic modulation was performed by analyzing the heart rate variability (HRV) in the time (DT) and frequency (DF) domains. For data analysis and comparison between pre-IMT, IMT and post-IMT periods, double-entry ANOVA was used for measurements and adopted as significance when P < 0.05. Results: 17 individuals with a mean age of 26.40 ± 6.11 years participated in the study, 13 (77%) were female. During the performance of the IMT, it can be observed that the individuals reached on average 46% of the maximum HR. Regarding the hemodynamic variables, significant differences were observed when comparing the periods before IMT vs. IMR for HR, SBP, DBP, MBP, SD and Borg (p < 0.05), and significance between the periods IMT vs. post IMT for HR, SBP, MBP and SD variables (p < 0.05). Significance was also verified between pre-IMT vs. post IMT only for the subjective sensation of effort. Regarding HRV, significant differences were observed between pre-IMT vs. IMT in the DT for RR intervals, and between the periods IMT vs. post IMT in DF for the low frequency and high frequency components (p < 0.05). Conclusion: An IMT session with 50% of MIP is able to promote important increases in cardiovascular variables with increased blood pressure and heart rate and subjective sensation of exertion, as well as reduced parasympathetic activity.