DFST - Departamento de Fisioterapia

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Aerobic exercise improves cardiac autonomic modulation in women with polycystic ovary syndrome
(Elsevier, 2016-01) Sá, Joceline Cassia Ferezini de; Costa, Eduardo Caldas; Silva, Ester da; Tamburús, Nayara Y.; Porta, Alberto; Medeiros, Leany F.; Lemos, Telma Maria Araujo Moura Lemos; Soares, Elvira M. M.; Azevedo, George Dantas de
Background: this study aimed to evaluate the effects of aerobic exercise on cardiac autonomic modulation in women with polycystic ovary syndrome (PCOS). Methods: thirty women with PCOS (25.8 ± 4.8 years old; body mass index, BMI ≥ 25 kg/m2) were divided into two groups; exercise group (n = 15) and control group (n = 15). R–R interval was recorded during 15-min at rest in the supine position. Heart rate variability (HRV) was analyzed by linear (rMSSD, SDNN, LF, HF, LFnu, HFnu, and LF/HF) and nonlinear methods (Shannon entropy, SE; symbolic analyses, 0 V%, 1 V%, 2LV%, and 2UV%) at baseline and after 16 weeks. The multivariate analysis of covariance was used to analyze the effects of exercise on HRV indexes, adjusted for changes in BMI, fasting insulin, and testosterone level. Results: the exercise group increased parasympathetic modulation (rMSSD, HF, HFnu, 2UV%; (p b 0.05)) and decreased sympathetic modulation (LF, LFnu, 0 V%; (p b 0.05)) independently of changes in BMI, fasting insulin, and testosterone level. Moreover, the exercise group decreased resting HR and systolic blood pressure (p b 0.05). All parameters remained unchanged in the control group. Conclusions: aerobic exercise increased vagal modulation and decreased sympathetic modulation in women with PCOS. This finding reinforces the recommendations for exercise during the clinical management of these patients
Aerobic training improves quality of life in women with Polycystic Ovary Syndrome
(Lippincott, Williams & Wilkins, 2018-07) Costa, Eduardo Caldas; Sá, Joceline Cássia Ferezini de; Stepto, Nigel Keith; Costa, Ingrid Bezerra Barbosa; Farias Junior, Luiz Fernando; Moreira, Simone da Nóbrega Tomaz; Soares, Elvira Maria Mafaldo; Lemos, Telma Maria Araujo Moura; Browne, Rodrigo Alberto Vieira; Azevedo, George Dantas de
Purpose: to investigate the effects of a supervised aerobic exercise training intervention on health-related quality of life (HRQL), cardiorespiratory fitness, cardiometabolic profile, and affective response in overweight/obese women with polycystic ovary syndrome (PCOS). Methods: twenty-seven overweight/obese inactive women with PCOS (body mass index, ≥ 25 kg·m−2; age 18 to 34 yr) were allocated into an exercise group (n = 14) and a control group (n = 13). Progressive aerobic exercise training was performed three times per week (~150 min·wk−1) over 16 wk. Cardiorespiratory fitness, HRQL, and cardiometabolic profile were evaluated before and after the intervention. Affective response (i.e., feeling of pleasure/displeasure) was evaluated during the exercise sessions. Results: the exercise group improved 21% ± 12% of cardiorespiratory fitness (P < 0.001) and HRQL in the following domains: physical functioning, general health, and mental health (P < 0.05). Moreover, the exercise group decreased body mass index, waist circumference, systolic and diastolic blood pressure, and total cholesterol level (P < 0.05). The affective response varied from “good” to “fairly good” (i.e., positive affective response) in an exercise intensity-dependent manner during the exercise training sessions. Conclusions: progressive aerobic exercise training improved HRQL, cardiorespiratory fitness, and cardiometabolic profile of overweight/obese women with PCOS. Moreover, the participants reported the exercise training sessions as pleasant over the intervention. These results reinforce the importance of supervised exercise training as a therapeutic approach for overweight/obese women with PCOS
Affect-regulated exercise: an alternative approach for lifestyle modification in overweight/obese women with polycystic ovary syndrome
(Taylor and Francis, 2015-09-25) Costa, Eduardo Caldas; Sá, Joceline Cássia Ferezini de; Costa, Ingrid Bezerra Barbosa; Meireles, Rodrigo da Silva Rosa Veleda; Lemos, Telma Maria Araújo Moura; Elsangedy, Hassan Mohamed; Krinski, Kleverton; Azevedo, George Dantas de
Objective: affect-regulated exercise (‘‘ARE’’) is an alternative approach to guide exercise intensity based on feeling of pleasure. The aim of this study was to analyze if overweight/obese women with polycystic ovary syndrome (PCOS) meet the American College of Sports Medicine (ACSM) recommendation regarding to exercise intensity to improve health status during a single bout of ‘‘ARE". Methods: a sample of 14 overweight/obese women with PCOS (18–34 years) performed a single bout of ‘‘ARE’’ (40 min of aerobic exercise on outdoor track). The Feeling Scale (FS) was used to guide ‘‘ARE’’ intensity/pace maintaining an affective valence between ‘‘good’’ and ‘‘very good’’ during all time. Heart rate (HR), speed, % of HR at first and second ventilatory threshold (VT1 and VT2) and time spent at moderate (64–76% of HRmax) and vigorous (77–95% of HRmax) intensity during ‘‘ARE’’ were measured with a global positioning system (GPS) device. Results: volunteers exercised at 73% (68–78%) of HRmax, 5.8 (5.2–6.2) km/h, 93.4% of HR at VT1 (89.3–98.2) and 80.5% of HR at VT2 (75.3–84.6) and spent 480% of time at moderate intensity. Conclusions: overweight/obese women with PCOS met the ACSM recommendation regarding exercise intensity to improve health status when exercised between ‘‘good’’ and ‘‘very good’’ of FS. Thus, ‘‘ARE’’ may be an interesting approach to be used in clinical practice regarding to exercise prescription and/or physical activity advice
An innovative educational strategy to addressing cultural competence in healthcare for quilombola women
(Taylor and Francis, 2019) Freitas Junior, Reginaldo Antonio de Oliveira; Santos, Carolina Araujo Damasio; Lisboa, Lilian Lira; Freitas, Ana Karla Monteiro Santana de Oliveira; Azevedo, George Dantas de
The Quilombola community is made up of descendants of enslaved Africans. These people represent an ethnic minority group within the Brazilian Black population with worse health indicators including higher rates of maternal mortality. Context: The Brazilian National Guidelines for education of health professionals state that cultural competence and education of ethnic‑racial relations need to be reinforced. Activities: An action research initiative was developed with the main goal of contributing to the development of cultural competence, interprofessional education, and collaborative work as well as improving the maternal and child indicators of the Quilombola community. An elective module for undergraduate health courses with the subject “Cultural Competence in Health Care for Quilombola Women” was implemented. Data on health‑related needs identification, students’ perceptions about interactions with the community, and competencies necessary to work with the Quilombola community were considered. Outcomes: Our educational strategy reinforces the importance of considering the processes that influence the health care of this population. The reflective capacity and communication skills emerged as the most important attitudinal and psychomotor components, respectively. Future Directions: Sustainability comes from partnerships established between the Quilombola community and the university to institutionalize educational and research strategies. This project contributes to reducing health inequities and deconstructing racism in the training of future health professionals. Conclusions: The creation of links, the building of trust between users and health staff, and the ability to reflect, with emphasis on communication, were shown as the main components of culturally competent behavior in maternal health care in the studied Quilombola population
Association between C-reactive protein and physical performance in older populations: results from the International Mobility In Aging Study (IMIAS)
(Oxford University Press (OUP), 2016-01-28) Sousa, Ana Carolina Patrício Albuquerque; Zunzunegui, Maria-Victoria; Li, Annie; Phillips, Susan P.; Guralnik, Jack M.; Guerra, Ricardo Oliveira
Background and objective: C-reactive protein (CRP) is a widely used cardiovascular risk marker, but questions remain about its role in the disability process in old age. This study examines the associations between CRP levels and physical performance in old age in different societies. Methods: data were collected during the baseline survey of IMIAS in 2012 in Kingston (Canada), Saint-Hyacinthe (Canada), Manizales (Colombia) and Natal (Brazil). Approximately 200 men and 200 women aged 65–74 were recruited at each site. CRP was assessed using a high sensitivity assay and categorised as low (<1 mg/l), moderate (1–3 mg/l), high (3–10 mg/l) and very high (≥10 mg/l). Participants were interviewed at home; blood pressure, weight and height were measured. Physical function was assessed with the Short Physical Performance Battery (SPPB) and hand grip strength. Data were analysed using descriptive statistics, bivariate analysis (χ²) and linear or logistic regression. Results: CRP was significantly associated with low hand grip strength and poor physical performance in bivariate analyses. Hand grip strength association with CRP disappeared after adjustment by socioeconomic factors and health behaviours. The odds of poor physical function was OR = 2.67 [95% CI 1.43–4.99] comparing the highest and lowest CRP categories after adjustment by relevant covariates. The three SPPB components were assessed separately. Graded associations between low CRP and faster gait speed and shorter time to rise from a chair were observed in adjusted models. Association between impaired balance and CRP was attenuated after adjustment by relevant covariates, OR = 1.15 [0.65–2.04]. Conclusions: CRP could be a possible pathway from inflammation to physical decline in older populations
Blockchain in health information systems: a systematic review
(International Journal of Environmental Research and Public Health, 2024-11-14) Fonsêca, Aleika Lwiza Alves; Barbalho, Ingridy Marina Pierre; Fernandes, Felipe Ricardo dos Santos; Arrais Júnior, Ernano; Nagem, Danilo Alves Pinto; Cardoso, Pablo Holanda; Veras, Nícolas Vinícius Rodrigues; Farias, Fernando Lucas de Oliveira; Lindquist, Ana Raquel; Santos, João Paulo Queiroz dos; Morais, Antonio Higor Freire de; Henriques, Jorge; Lucena, Marcia Jacyntha Nunes Rodrigues; Valentim, Ricardo Alexsandro de Medeiros
Abstract: (1) Background: With the increasing digitalization of healthcare systems, data security and privacy have become crucial issues. In parallel, blockchain technology has gradually proven to be an innovative solution to address this challenge, as its ability to provide an immutable and secure record of transactions offers significant promise for healthcare information management. This systematic review aims to explore the applications of blockchain in health information systems, highlighting its advantages and challenges. (2) Methods: The publications chosen to compose this review were collected from six databases, resulting in the initial identification of 4864 studies. Of these, 73 were selected for in-depth analysis. (3) Results: The main results show that blockchain has been used mainly in electronic health records (63%). Furthermore, it was used in the Internet of Medical Things (8.2%) and for data sharing during the COVID-19 pandemic (6.8%). As advantages, greater security, privacy, and data integrity were identified, while the challenges point to the need for standardization and regulatory issues. (4) Conclusions: Despite the difficulties encountered, blockchain has significant potential to improve healthcare data management. However, more research and continued collaboration between those involved are needed to maximize its benefits
Confiabilidade do teste da caminhada de seis minutos em pacientes com miastenia gravis generalizada
(Fisioterapia e Pesquisa, 2009) Dourado Junior, Mário Emílio Teixeira; Resqueti, Vanessa Regiane; Oliveira, Georges Willeneuwe de Sousa; Andrade, Armèle Dornelas de; Casan, Pere; Fregonezi, Guilherme Augusto de Freitas; https://orcid.org/0000-0002-9462-2294
Este estudo objetivou determinar a confiabilidade do teste da caminhada de seis minutos (TC6M) como um teste de capacidade funcional em pacientes com miastenia gravis generalizada (MG). Foram selecionados 11 pacientes com MG - 5 homens, 6 mulheres - com idade de 55±9 anos, avaliados inicialmente quanto à função fulmonar, que se submeteram a três TC6M em dias diferentes. Durante e/ou após cada teste foram medidas freqüência cardíaca e saturação de oxigênio (por oxímetro portátil), sensação de dispnéia (pela escala de Borg) e distância percorrida. Nos três testes as distâncias percorridas foram 498 m, 517 m e 520 m (respectivamente 99%, 103% e 104% do valor predito). Em média, a freqüência cardíaca, dispnéia e saturação de oxigênio mostraram comportamento constante nos três testes. Foram encontradas alta confiabilidade relativa, com coeficiente de correlação interclasse maior que 0,90 entre os testes (TC6M1-TC6M2, 0,960; TC6M1-TC6M3, 0,945; e TC6M2-TC6M3, 0,970) e confiabilidade absoluta de 4%, 3,5% e 4,8%, com reprodutibilidade de 11%, 9,8% e 13,4%, respectivamente para o primeiro, segundo e terceiro testes. Os limites superiores e inferiores de concordância e o valor médio das médias das diferenças (bias) calculados pelo teste de Bland-Altman mostraram-se clinicamente aceitáveis. Conclui-se que o TC6M se mostrou seguro, confiável e reprodutível, podendo ser aplicado para avaliação e seguimento da tolerância ao exercício em pacientes com MG generalizada.
Convivendo com a asma: guia de informações e cuidados
(s.n., 2021-07-22) Santino, Thayla Amorim; Monteiro, Karolinne Souza; Barbosa, Joubert Vitor de Souto; Santos, Tácito Zaildo de Morais; Holanda, Hesli de Sousa; Leite, Sarah Joysi Almeida; Silva, Carlos Henrique Pestana; Penha, Tito Hugo Soares da; Lima, Willyenne Gomes de; Silva, Marcos Arthur Guilherme da; Menescal, Fernanda Elizabeth Pereira da Silva; Souza, Juliana Cirilo Soares de; Santana, Rebeca de Castro; Jácome, Maria Clara Almeida; Silva, Gabriel Rodrigues da; Mendonça, Karla Morganna Pereira Pinto de
O que devemos saber sobre a asma? Quais são as estratégias para alcançar um melhor controle dos sintomas e prevenir riscos futuros de exacerbações? Este e-book consiste em um guia de informações e cuidados essenciais para pessoas que convivem com asma, seus familiares e cuidadores, mas também para estudantes e profissionais de saúde que queiram compreender mais sobre a asma. Assim, este e-book foi pensado e ilustrado com a finalidade de oferecer informações essenciais com uma linguagem simples e acessível para facilitar a compreensão sobre questões pouco abordadas ou ainda pouco esclarecidas sobre a asma.
Correlation between balance, speed, and walking ability in individuals with chronic hemiparesis
(Pontifícia Universidade Católica do Paraná, 2016-03) Mendes, Luciana de Andrade; Britto, Heloisa Maria Jácome de Sousa; Moreno, Cínthia de Carvalho; Silva, Emília Márcia Gomes de Souza e; Lindquist, Ana Raquel Rodrigues
Alterations in balance and gait are frequently present in patients with hemiparesis. This study aimed at determining whether there is a correlation between static and functional balance, gait speed and walking capacity. To that end, 17 individuals with chronic hemiparesis of both sexes (58.8% men and 42.25 women), mean age of 56.3 ± 9.73 years, took part in the study. Static balance was assessed by computerized baropodometry, under two different sensory conditions: eyes open (EO) and eyes closed (EC). Functional balance was evaluated by Berg Balance Scale and walking ability by the Functional Ambulation Classification. Gait speed was assessed by kinemetry. The Kolmogorov-Smirnov test was used to verify data distribution normality. Parametric variables were correlated by Pearson's test and their non-parametric parameters by Spearman's test. Functional balance showed a positive correlation with gait speed (p=0.005; r=0.64) and walking ability (p = 0.019; r = 0.56). Anteroposterior (AP) and mediolateral (ML) alterations with EO and EC exhibited negative correlations with gait speed (EO: AP amplitude (p = 0.0049 and r = -0.48); mean ML deviation (p = 0.019 and r =-0.56)/ EC: mean AP deviation (p = 0.018 and r = -0.56) and mean ML deviation (p = 0.032 and r = -0.52); AP amplitude (p = 0.014 and r = -0.57) and ML amplitude (p = 0.032 and r = -0.52); postural instability (p = 0.019 and r = -0.55)) and walking ability (EO: mean AP deviation (p = 0.05 and r = -0.47) and AP amplitude (p = 0.024 and r = -0.54)). The results suggest correlations between static and functional balance and gait speed and walking ability, and that balance training can be an important component of gait recovery protocols
Cortisol and physical performance in older populations: findings from the International Mobility In Aging Study (IMIAS)
(Elsevier, 2017) Sousa, Ana Carolina Patrício de Albuquerque; Marchand, Alain; Garcia, Angeles; Gomez, Jose Fernando; Ylli, Alban; Guralnik, Jack M.; Zunzunegui, Maria-Victoria; Guerra, Ricardo Oliveira
Objective: To compare diurnal cortisol profiles across samples of older adults from diverse populations and to examine if differences in circadian cortisol secretion are associated with poor physical performance (SPPB<9). Methods: Data were collected during the baseline survey of the International Mobility in Aging Study conducted in 2012 in Kingston (Canada), Saint-Hyacinthe (Canada), Tirana (Albania) and Manizales (Colombia). Salivary cortisol was collected from a subsample of 309 participants instructed to collect saliva on two consecutive days, and 5 different intervals each day: upon awakening (M1), 30 min (M2) and 60 min after awakening, at 15:00 h and before bedtime (E). Cortisol was analyzed using enzyme immunoassay kits. Physical performance was measured by the Short Physical Performance Battery (SPPB). Mixed linear models were fit to assess the associations between cortisol diurnal output and physical performance, adjusting for potential confounders. Results: Kingston, Saint-Hyacinthe and Tirana residents had significantly higher cortisol values than their Manizales counterparts, with the population from Tirana showing the highest levels. Attenuated morning cortisol peak (M2) (p = 0.025), higher cortisol bed time (E) (p = 0.005), and lower M2/E ratio (p < 0.001) were found among those with SPPB<9 compared with those with good physical performance (SPPB 9). These results were not altered after adjustment by potential confounders. Conclusion: Cortisol profiles varied across four diverse populations of older adults. Circadian cortisol secretion is associated with physical performance as an attenuated morning response and higher bed time values were observed in older adults with SPPB < 9
Dor e funcionalidade na atenção básica à saúde
(ABRASCO - Associação Brasileira de Saúde Coletiva, 2011-01) Mata, Matheus de Sousa; Costa, Fabrícia Azevêdo da; Souza, Túlio Oliveira de; Mata, Ádala Nayana de Sousa; Pontes, Jaqueline Fernandes
A dor osteoarticular e a funcionalidade são elementos ligados à saúde dos indivíduos e, portanto, influenciam o modo de interação entre si e entre eles e o meio ambiente que os cerca. Contudo, não são muitos os estudos que levantam essas questões de saúde na população em geral, sobretudo quando aproximamos o olhar da atenção básica sobre elas. Este artigo tem o objetivo de fornecer dados iniciais sobre dor e funcionalidade nos indivíduos com queixa osteoarticular em uma população adscrita a uma unidade básica de saúde (UBS) e suscitar o debate sobre integralidade da atenção nesse serviço. O trabalho descritivo foi realizado na UBS (n1=64) e nos domicílios (n2=48), entre indivíduos a partir dos 20 anos de idade. Foi aplicado um instrumento de avaliação de funcionalidade e a Escala Visual Analógica de dor, e foram exploradas questões sociodemográficas. Com esses instrumentos, buscou-se avaliar o perfil dos indivíduos em relação ao seu grau de dor musculoesquelética, o grau de funcionalidade nas atividades da vida diária, idade e ocupação. Nos resultados, encontramos uma predominância do sexo feminino nos dois grupos, 84,37% e 81,25%, respectivamente. Quase metade das pessoas com dor musculoesquelética eram donas de casa, e a média de idade entre os grupos estava acima dos 55 anos
Efeito da cinesioterapia na qualidade de vida, função sexual e sintomas climatéricos em mulheres com fibromialgia
(Elsevier, 2015-05) Lisboa, Lilian Lira; Sonehara, Elisa; Oliveira, Katia Cristina Araújo Nogueira de; Andrade, Sandra Cristina de; Azevedo, George Dantas de
Objetivo: avaliar e comparar o efeito da cinesioterapia na qualidade de vida, func ̧ão sexuale sintomas climatéricos em mulheres climatéricas com e sem fibromialgia.Métodos: Participaram 90 mulheres climatéricas, divididas em dois grupos: fibromialgia (47)e controle (43). As pacientes foram avaliadas nas variáveis: qualidade de vida (Utian Qualityof Life [UQOL]), função sexual (questionário do quociente sexual/versão feminina [QS-F]) e intensidade dos sintomas climatérios (Índice Menopausal de Blatt-Kupperman [IMBK]). Os grupos fizeram cinesioterapia para o assoalho pélvico, composto de 20 sessões, duas vezes por semana. Análise estatística foi feita por meio dos testes t de Student pareado, análise de variância de delineamento misto e Kappa de Cohen. Resultados: na qualidade de vida, foi observada melhoria em ambos os grupos para todos os domínios avaliados. Na análise intergrupo foi evidenciada diferença nos domínios emocional (p = 0,01), saúde (0,03) e sexual (p = 0,001) com ganhos mais expressivos para o grupo controle. Na função sexual, foi verificada melhoria nos grupos, após a intervenção; na análise intergrupo as fibromiálgicas apresentaram escores inferiores ao grupo controle (p < 0,001).Em relação aos sintomas climatéricos não houve diferença na análise intergrupo pós-intervenção (p = 0,73). Entretanto, ambos os grupos apresentaram redução significativa das intomatologia após a intervenção (p < 0,001).Conclusões: a cinesioterapia do assoalho pélvico exerce efeito benéfico sobre os domínios da qualidade de vida, função sexual e sintomatologia climatérica em mulheres com e semfibromialgia na fase do climatério. Entretanto, a fibromialgia parece ser fator limitante para melhores resultados em alguns aspectos avaliados
Effects of a dual-task training on dynamic and static balance control of pre-frail elderly: a pilot study
(Public Library of Science, 2012) Targino, Viviane Ribeiro; Freire, Aline do Nascimento Falcão; Sousa, Ana Carolina Patrício de Albuquerque; Maciel, Nícia Farias Braga; Guerra, Ricardo Oliveira
Introduction: This quasi-experimental study is justiϐied by the need to determine the effects of an intervention strategy aimed at improving the static and dynamic balance in pre-frail elderly women. We hypothesized that dual-task training on a treadmill, compared to simple training on a treadmill,may promote statistical difference in postural control of this group. Objectives: This study aimed to verify the measures of postural control in a group of pre-frail elderly after a physical therapy intervention program based on dual-task treadmill training. Materials and methods: We selected six female pre-frail elderly subjects living in the community. The research was conducted twice a week for 45 minutes, for four weeks. The simple task training consisted only in the use of a treadmill and the dual-task training consisted on the use of a treadmill associated with visual stimuli. Only the intervention group was submitted to the dualtask training. Results: Groups showed improvements in the variables of balance in different tasks, especially on static balance. Both groups showed the most notable changes in the variables related to gait. The BBS scores and the baropodometric variables showed that the experimental group could keep all values similar or better even one month after completion of training, unlike the control group. Conclusion: The dual-task performance had no additional value in relation to the improvement of balance in general, but we observed that the effectiveness of visual stimulation seems to occur in the maintenance of short-term balance variables
Effects of air stacking maneuver on cough peak flow and chest wall compartmental volumes of subjects with amyotrophic lateral sclerosis
(Elsevier, 2017) Dourado Junior, Mário Emílio Teixeira; Sarmento, Antonio; Resqueti, Vanessa Resqueti; Saturnino, Lailane; Aliverti, Andrea; Fregonezi, Guilherme; Andrade, Armele Dornelas de; https://orcid.org/0000-0002-9462-2294
Objectives To assess the acute effects of air stacking on cough peak flow (CPF) and chest wall compartmental volumes of persons with amyotrophic lateral sclerosis (ALS) versus healthy subjects positioned at 45° body inclination. Design Cross-sectional study with a matched-pair design. Setting University hospital. Participants Persons (N=24) with ALS (n=12) and age-matched healthy subjects (n=12). Main Outcomes Measures CPF, chest wall compartmental inspiratory capacity, chest wall vital capacity, chest wall tidal volume and operational volumes, breathing pattern, and percentage of contribution of the compartments to the inspired volume were measured by optoelectronic plethysmography. Results Compared with healthy subjects, significantly lower CPF (P=.007), chest wall compartmental inspiratory capacity (P<.001), chest wall vital capacity (P<.001), and chest wall tidal volume (P<.001) were found in subjects with ALS. Immediately after air stacking, CPF (P<.001) and chest wall compartmental inspiratory capacity (P<.001) significantly increased in both groups, with values returning to basal only in healthy subjects. After air stacking, the abdominal compartment (P=.004) was determined to be responsible for the inspired volume in subjects with ALS. Significantly higher chest wall vital capacity (P=.05) was observed in subjects with ALS 5 minutes after air stacking, with the rib cage compartment (P=.049) being responsible for volume change. No differences were found in chest wall vital capacity and compartmental volumes of healthy subjects. Chest wall tidal volume (P<.001) significantly increased during the protocol in the healthy subjects, mainly because of end-inspiratory (P<.001) and abdominal volumes (P=.008). No significant differences were observed in percentage of contribution of the compartments to the inspired volume and end-expiratory volume of both groups. No significant differences were found in chest wall tidal volume, operational volume, and breathing pattern in persons with ALS. Conclusions Air stacking is effective in increasing CPF, chest wall compartmental inspiratory capacity, and chest wall vital capacity of persons with ALS with no hyperinflation. Differences in compartmental volume contributions are probably because of lung and chest wall physiological changes.
Effects of positioning on cough peak flow and muscular electromyographic activation in duchenne muscular dystrophy
(Respiratory Care, 2020) Dourado Junior, Mário Emílio Teixeira; Marques, Layana; Santos, Ilsa Priscila; Marcelino, Ana Aline; Fonseca, Jessica Danielle Medeiros da; Aliverti, Andrea; Sarmento, Antonio; Resqueti, Vanessa Regiane; Fregonezi, Guilherme Augusto de Freitas; https://orcid.org/0000-0002-9462-2294
Advanced stages of Duchenne muscular dystrophy (DMD) result in muscle weakness and the inability to generate an effective cough. Several factors influence the effectiveness of cough in patients with DMD. The aim of this study was to assess whether differences in positioning affect cough peak flow (CPF) and muscular electromyographic activation in subjects with DMD compared with paired healthy subjects. METHODS: Optoelectronic plethysmography and surface electromyography were used to assess chest wall volumes, chest wall inspiratory capacity, CPF, breathing pattern, and electromyographic activity of sternocleidomastoid, scalene, rectus abdominis, and external oblique muscles during inspiratory and expiratory cough phases in the supine position, supine position with headrest raised at 45 , and sitting with back support at 80 in 12 subjects with DMD and 12 healthy subjects. RESULTS: Subjects with DMD had lower CPF (P < .01) in comparison to control subjects in all positions; the DMD group also exhibited lower CPF (P 5 .045) in the supine position versus 80 . Moreover, the relative volume contributions of the rib cage and abdominal compartments to tidal volume modified significantly with posture. The electromyographic activity during inspiratory and expiratory cough phases was lower in subjects with DMD compared to healthy subjects for all evaluated muscles (P < .05), but no significant differences were observed with posture change. CONCLUSIONS: In subjects with DMD, posture influenced CPF and the relative contribution of the rib cage and abdominal compartments to tidal volume. However, muscular electromyographic activation was not influenced by posture in subjects with DMD and healthy subjects.
Effects of respiratory muscle training on respiratory muscle strength and heart rate variability in myotonic dystrophy patients type 1
(Journal of Respiratory and CardioVascular Physical Therapy, 2012) Dourado Junior, Mário Emílio Teixeira; Araújo, Thayse Lucena; Resqueti, Vanessa Regiane; Lima, Illia Nadinne Dantas Florentino; Fregonezi, Guilherme; https://orcid.org/0000-0002-9462-2294
Introduction: Myotonic dystrophy (MD) is a multisystemic neuromuscular disease responsible for causing progressive respiratory muscle weakness. Respiratory muscle training (MRT) has been shown to be effective in several diseases; however, its effects on respiratory and cardiac functions in MD are still inconsistent. Objective: Assess the effects of MRT on respiratory muscle strength and heart rate variability in patients with type 1 myotonic dystrophy. Methods: The sample was composed of 6 individuals of both sexes. The following was assessed: respiratory muscle strength, before and after training (sessions 1-4) and heart rate variability before and after sessions 2 and 3. The group submitted to MRT used the Threshold IMT device, adapted for inspiratory and expiratory training, three times a week, once at an outpatient facility and twice at home. Results were expressed as median and interquartile ranges for pulmonary function variables, and the Friedman and Wilcoxon tests were applied to compare heart rate variability. Results: respiratory muscle strength significantly improved expiratory and inspiratory muscles (33% and 20%, respectively), considering training sessions 1-4. With respect to variability, there was a 102% increase in sympathetic activity, reflected by low frequency and 194% increase in vagal tonus, represented by high frequency. Conclusions: Preliminary study results demonstrate that a partial home-based respiratory muscle-training program is feasible, in addition to improving strength and heart rate variability in patients with MD.
Effects of treadmill inclination on the gait of individuals with chronic hemiparesis
(Elsevier, 2011-10-01) Mendes, Luciana de Andrade; Moreno, Cinthia de Carvalho; Lindquist, Ana Raquel
Objective: To analyze the effects of electric treadmill inclination on the gait of individuals with chronic hemiparesis. Design Descriptive, observational study Setting Laboratory for human movement analyses of UFRN. Participants Individuals (N=18) with a mean age of 55.3±9.3 years and a lesion time of 36±22.8 months. Interventions Not applicable. Main Outcome Measures Subjects were assessed for functional independence (FIM) and balance (Berg Balance Scale). Spatial-temporal variables were observed as well as the angular variation of the hip, knee, and ankle in the sagittal plane, while the individuals walked on the treadmill at 3 different inclinations (0%, 5%, and 10%). Results: There was an increase in stance time between 0% and 5% (0.83±0.21 vs 0.87±0.20; P=.011) and 0% and 10% (0.83±0.21 vs 0.88±0.23; P=.021). The other spatial-temporal variables did not change. During initial contact there was an increase in the hip, knee, and ankle flexion angle. An increase in hip amplitude was also observed between 0% and 10% (37.83±5.23 vs 41.12±5.63; P<.001) and 5% and 10% (38.80±5.96 vs 41.12±5.63; P=.002) and in knee amplitude between 0% and 10% (47.51±15.07 vs 50.30±12.82; P=.040), as well as decreased hip extension and increased dorsiflexion. Conclusions: Treadmill inclination promoted angular alterations such as an increase in hip, knee, and ankle angle during initial contact and the swing phase and an increase in the amplitude of movement of the hip and knee, as well as an increase in stance time of the paretic lower limb
Força muscular respiratória e perfil postural e nutricional em crianças com doenças neuromusculares
(Fisioterapia em Movimento, 2012) Dourado Junior, Mário Emílio Teixeira; Pontes, Jaqueline Fernandes; Ferreira, Gardenia Maria Holanda; Fregonezi, Guilherme; Evangelista, Karine Cavalcanti Maurício de Sena; https://orcid.org/0000-0002-9462-2294
As doenças neuromusculares infantis são crônicas, degenerativas e determinam alterações funcionais, musculares e nutricionais. OBJETIVOS: Avaliar sistematicamente a força muscular respiratória e o perfil postural e nutricional de crianças com doenças neuromusculares em seguimento multidisciplinar institucional. MATERIAIS E MÉTODOS: Foram estudados pacientes com diferentes doenças neuromusculares por meio da verificação da força muscular respiratória, da avaliação nutricional de massa muscular, do índice de massa corpórea e da porcentagem (%) de gordura corporal, além de avaliação postural e dos padrões de movimento. RESULTADOS: Foram avaliados 41 sujeitos. As crianças do sexo masculino predominaram na população em estudo, sendo 82,9% dela (n = 34), e os outros 17,1% (n = 7) eram do sexo feminino. A média de idade encontrada foi de 9,65 ± 3,11 anos. O principal diagnóstico encontrado foi Distrofia Muscular de Duchenne, 43,9% (n = 18), seguido de Atrofia Muscular Espinhal, 9,75% (n = 4), Distrofia Congênita, 7,31% (n = 3), Distrofia Muscular de Cinturas, Polineuropatia e Miopatia Congênita, todos com 4,9% (n = 2), além de Distrofia Muscular Progressiva, Miastenia Grávis, Charcoot Marie Toot, Emery Dreifuss, encontrados em 2,43% (n = 1). Foi verificada uma diminuição da força muscular respiratória (PImáx = 81 ± 24,3 cmH2O, 91% predito e PEmáx = 70 ± 29,6 cmH2O, 72% predito), mais evidente nos músculos expiratórios. A Hiperlordose lombar foi encontrada em 26 pacientes (64%) e 9 pacientes (22%) já haviam perdido a capacidade de deambular. Em relação ao perfil nutricional, 90% dos pacientes (n = 30) mostraram uma alta incidência de perda de reserva muscular e 52% deles (n = 13) apresentaram a porcentagem de gordura corporal abaixo do aceitável. CONCLUSÃO: A avaliação multidisciplinar das doenças neuromusculares pediátricas podem auxiliar no estabelecimento de tratamento precoce da Fisioterapia para melhorar a qualidade de vida dos pacientes e cuidadores.
Frailty syndrome and associated factors in community-dwelling elderly in Northeast Brazil
(Elsevier, 2011-09-17) Sousa, Ana Carolina Patrício de Albuquerque; Dias, Rosângela Correa; Maciel, Álvaro Campos Cavalcanti; Guerra, Ricardo Oliveira
Introduction: Frailty syndrome in the elderly, characterized by decreased physiological reserves, is associated with increased risk of disability and high vulnerability to morbidity and mortality. This study is part of a multicenter project on Frailty in Elderly Brazilians (REDE FIBRA). Aims: To investigate characteristics, prevalence and associated factors related to frailty. Methodology: A total of 391 randomly selected elderly patients aged 65 years were interviewed. Data collection was performed using a multidimensional questionnaire containing information about sociodemographic and clinical variables. Fried’s phenotype was used to characterize the frail elderly. Data were analyzed using descriptive statistics, bivariate analysis (x2) and binary logistic regression. Results: The prevalence of frailty was 17.1%. In the final multivariate analysis model, the following factors associated with frailty were obtained: advanced chronological age (p < 0.001), presence of comorbidity (p < 0.035), dependence in basic (p < 0.010) and instrumental (p < 0.003) activities of daily living and negative perception of health status (p < 0030). Conclusion: The factors associated with frailty suggest a predictive model that helps in understanding the syndrome, guiding actions that minimize adverse effects in the aging process
Impactos da covid-19 no trabalho colaborativo na atenção primária à saúde
(2023) Almeida Júnior, José Jailson de; Xavier, Pedro Bezerra; Silva, Ísis de Siqueira; Magalhães, Adriana Gomes; Guedes, Dimitri Taurino
O estudo tem como tema o impacto da pandemia no trabalho colaborativo na Atenção Primária à Saúde. O objetivo é analisar os impactos da pandemia da COVID-19 no trabalho colaborativo na Atenção Primária à Saúde. Trata-se de um estudo exploratório, descritivo de abordagem qualitativa, tendo como campo de investigações as Unidades Básicas de Saúde da Família do município de Campina Grande, Paraíba. A amostra do estudo foi composta por profissionais de saúde vinculados à Estratégia Saúde da Família. Entre as equipes selecionadas, foram entrevistados 31 participantes. Os resultados evidenciam que a pandemia da COVID-19 causou impactos significativos em diversas ações de saúde, especialmente aquelas relacionadas às interações em grupos, como prevenção e vigilância em saúde. A dinâmica do trabalho das equipes foi alterada, diante da necessidade de reorganização das atividades, afetando diretamente o trabalho interprofissional e as práticas colaborativas em saúde. Os achados deste estudo também apontaram que antes do advento da pandemia, o trabalho interprofissional já estava sofrendo modificações, influenciado principalmente pelo cenário político. Conclui-se que há a necessidade da reorganização dos papéis de cada membro da equipe da APS, para alcançar o domínio e a execução das práticas colaborativas, fundamentais para promover o cuidado em sua integralidade. Esses resultados são relevantes, e poderão contribuir para as decisões futuras acerca da temática, este estudo revela ações, que foram prejudicadas durante a pandemia, e que necessitam de maior atenção e fortalecimento no atual momento

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