FACISA - Mestrado em Ciências da Reabilitação
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Master Thesis Mortalidade e custos hospitalares de pacientes pós-acidente vascular cerebral no Sistema Único de Saúde: uma série temporal com análise de fatores associados(Universidade Federal do Rio Grande do Norte, 2025-07-21) Lima, Karina Kelly Gomes de; Fernandes, Aline Braga Galvão Silveira; Souza, Jane Carla de; https://orcid.org/0000-0002-8769-4273; http://lattes.cnpq.br/5997878957114840; https://orcid.org/0000-0002-7976-8009; http://lattes.cnpq.br/9406431536920693; http://lattes.cnpq.br/8423982715068151; Farias, Catharinne Angélica Carvalho de; https://orcid.org/0000-0002-4473-3041; http://lattes.cnpq.br/8874874519790126; Lucena, Larissa Coutinho de; https://orcid.org/0000-0002-1739-5737; http://lattes.cnpq.br/3705659727218619; Mata, Matheus de Sousa; http://lattes.cnpq.br/3923692125757582Introduction: Stroke is one of the leading causes of mortality and disability in Brazil, with significant clinical, social, and economic impact. Objective: To analyze hospital mortality rates and hospitalization costs due to stroke within the Brazilian Unified Health System (SUS), from 2018 to 2023, considering sociodemographic, clinical, and healthcare-related variables. Methods: This was an observational time series study with analysis of associated factors, based on secondary data extracted from the Hospital Information System (SIHSUS). Results: A total of 1,321,282 hospitalizations for stroke (ICD-10: I60–I64) were included, involving patients aged 18 years and older. The findings showed a 22% increase in hospitalizations and a 54.5% increase in total stroke-related costs over the study period, while the hospital mortality rate declined, reaching 15.3% in 2023. Mortality was statistically associated with older age, male sex, Black or Brown race/skin color, residence in rural areas and in the North and Northeast regions, longer hospital stays, intensive care unit (ICU) admission, and stroke type (especially hemorrhagic stroke). Regarding costs, higher average expenditures were observed in hospitalizations that resulted in death, ICU admissions, longer stays, and hemorrhagic stroke diagnoses. Regional differences were also significant, with the highest average costs recorded in the South and Central-West regions. Conclusion: Stroke remains a major challenge for SUS, due to its high mortality and increasing financial burden. The findings highlight inequalities in healthcare delivery and reinforce the need for public policies focused on equitable access, strengthening of care networks, and rational allocation of SUS resources.Master Thesis Efeitos do método pilates na dor, capacidade funcional, qualidade de vida e função física de pessoas com condições reumáticas: uma revisão sistemática com metanálise(Universidade Federal do Rio Grande do Norte, 2025-08-28) Nunes, Rebeca Freitas de Oliveira; Macedo, Liane de Brito; Amorim, Anita Barros Carlos de; http://lattes.cnpq.br/0429488953253871; http://lattes.cnpq.br/5451886594592429; Miyamoto, Gisela Cristiane; https://orcid.org/0000-0002-6826-4278; http://lattes.cnpq.br/2439787471228455; Silva, Hugo Jario de Almeida; https://orcid.org/0000-0003-2185-4059; http://lattes.cnpq.br/9903537909963941Introduction: rheumatic conditions are a group of diseases that can cause inflammation, joint alterations, and pain in surrounding structures. The Pilates method has been used as a tool in the rehabilitation of these patients. Objective: to evaluate the effectiveness of the Pilates method in individuals with rheumatic conditions. Methods: this study is a systematic review guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Searches were conducted in the following databases: PUBMED/Medline, CENTRAL, PEDro, Embase, and CINAHL. Only randomized controlled trials were included, comparing the Pilates method to other types of exercise, conventional physical therapy, minimal intervention, or no intervention in individuals with rheumatic conditions. The outcomes assessed were: pain, quality of life, disability, and physical function. The risk of bias in the included studies was assessed using the PEDro scale, and the certainty of evidence was evaluated according to the GRADE approach. For each outcome, treatment effects were estimated using random-effects meta-analyses for continuous variables, measured by standardized mean differences (SMD) with 95% confidence intervals (CI). Results: a total of 22 studies (n = 909) were included. Among these, 59% showed good methodological quality. Pilates method reduced pain (6 trials; 303 participants; SMD -0.85; 95% CI -1.61 to -0.10) and improved disability (10 trials; 413 participants; SMD -0.70; 95% CI -1.12 to -0.28) compared to other active therapies immediately post-intervention. Similar results were observed when compared to no intervention. No differences were found for quality of life or physical function outcomes. Conclusion: The Pilates method may help reduce pain and improve disability in individuals with rheumatic conditions when compared to other active interventions or no intervention. However, the certainty of the evidence supporting these findings is very low for pain intensity and moderate for disability. Registration: PROSPERO (CRD42024565648).Master Thesis Uso do Kinesio Taping para o manejo da dor e da diástase dos músculos reto abdominais em mulheres no pós-parto(Universidade Federal do Rio Grande do Norte, 2025-08-22) Silva, Maria Amélia Pires Soares da; Sousa, Vanessa Patrícia Soares de; Eufrásio, Laiane Santos; https://orcid.org/0000-0003-0578-7140; http://lattes.cnpq.br/3250319979361307; https://orcid.org/0000-0003-4117-3859; http://lattes.cnpq.br/6971799707627238; https://orcid.org/0000-0002-3227-8213; http://lattes.cnpq.br/8191325880491937; Barbosa, Germanna de Medeiros; https://orcid.org/0000-0002-1094-334X; http://lattes.cnpq.br/1702090920424206; Dantas, Glauko André de Figueiredo; https://orcid.org/0000-0002-4620-2877; http://lattes.cnpq.br/4433966587170692; Vera, Mariana Arias Avila; http://lattes.cnpq.br/5905617922199364Introduction: Postpartum is marked by physical and emotional changes, often associated with abdominal, pelvic, and low back pain. Kinesio Taping has been consolidated as a resource used by health professionals in the care of postpartum women. Objective: For the purposes of presenting this dissertation, two articles were developed with the following objectives: ARTICLE 01 - To evaluate the feasibility of a clinical trial with Kinesio Taping in the postpartum period, considering contact rate, eligibility, recruitment, adherence, dropout, safety, and satisfaction. ARTICLE 02 – To propose a randomized clinical trial protocol to investigate the effects of Kinesio Taping on pain and diastasis of the rectus abdominis muscles in postpartum women. Methods: ARTICLE 01 – A feasibility, randomized, blinded, placebocontrolled study. Participants were women aged 18 to 40 years, up to 72 hours postpartum, with term delivery, singleton pregnancy, and no recent abdominal surgeries. Participants were randomized into an intervention group (KTG = 15) or placebo group (PG = 15). During the course of the study, the following parameters were assessed: contact rate, eligibility, recruitment, adherence, dropout, safety, and participants’ satisfaction, in addition to secondary clinical outcomes regarding pain and diastasis. Descriptive statistical analysis included means, standard deviations, and confidence intervals when applicable. ARTICLE 02 – A protocol study, randomized, blinded, and placebo-controlled. A total of 90 postpartum women will be recruited and allocated into three groups: control, placebo, and intervention. Assessments will occur at three time points: baseline, post-intervention, and follow-up (30 to 45 days after the intervention). The following instruments will be used: Brief Pain Inventory, Maternal Postpartum Quality of Life Questionnaire, WHO Disability Assessment Schedule, and Global Perceived Effect Scale. The proposed statistical analysis for the data collected from this protocol includes descriptive statistics, repeated-measures factorial ANOVA, and intention-totreat analysis. Results: ARTICLE 01 – Among 88 women contacted, 84.1% were eligible and 34.1% were recruited. Adherence was 63.3%, and dropout was 36.7%. The mean discomfort with the treatments was 0.89 (KTG) and 1.85 (PG), with a high perception of safety in both groups. Despite skin reactions, satisfaction was high in both KTG and PG. According to absolute measures, a reduction in diastasis was observed in the supraumbilical region of the KTG (-1.00; 95% CI: -1.67 to -0.32), pain decreased by an average of 3.88 points (95% CI: - 5.41 to -2.33), and its interference decreased by 3.19 points (95% CI: -6.37 to 0.00). Conclusion: ARTICLE 01 – Conducting a clinical trial with KT in postpartum women is feasible, but requires strategies to minimize logistical barriers and maximize adherence.Master Thesis Efeitos da estimulação transcraniana por corrente contínua combinada com exercícios físicos sobre a dor, função física e percepção de mudança em indivíduos com osteoartrite de joelho: um ensaio clínico randomizado triplo-cego(Universidade Federal do Rio Grande do Norte, 2025-07-24) Lima, Vinícius Batista; Souza, Clécio Gabriel de; https://orcid.org/0000-0001-9005-7956; http://lattes.cnpq.br/6308219057546985; http://lattes.cnpq.br/3559301823598081; Matos, Areolino; https://orcid.org/0000-0002-3437-5105; http://lattes.cnpq.br/5013499072708263; Freitas, Rodrigo Pegado de Abreu; http://lattes.cnpq.br/3462462933163509Introduction: Knee osteoarthritis (KOA) is a degenerative and progressive joint condition that causes pain and limitation of physical function, in addition to negatively influencing functionality and quality of life. Physical exercise is described as the most effective intervention, since individuals with this condition most often present, in addition to pain, muscle weakness and balance deficit. In addition, it has been observed that individuals with KOA also present signs of central sensitization to pain. Transcranial Direct Current Stimulation (tDCS) is a non-invasive neuromodulation technique that has been investigated with the aim of promoting changes in pain perception, by changing cortical excitability. Considering that physical exercise is a robust evidence for the treatment of OA, we intend to observe whether there may be additional effects with non-invasive neuromodulation. Objective: To evaluate the effects of the combined application of tDCS with a specific physical exercise protocol for knee osteoarthritis on pain, physical function and perception of improvement. Methods: This is a triple-blind randomized clinical trial, which was carried out from August 2024 to February 2025, in the city of Santa Cruz-RN. Initially, participants were randomly distributed into two groups: active tDCS combined with physical exercises (G1) and Sham tDCS combined with physical exercises (G2). The intervention protocol took place over 5 weeks, with two sessions per week, on nonconsecutive days. The following outcomes were evaluated: primary (pain) and secondary (physical function, central sensitization, global perception of change and adherence). The evaluations occurred at three different times: before starting the protocol (T0), immediately after five weeks (T1) and seven days after the intervention protocol (T2). Results: Forty-one women with a mean age of 64.41 ± 8.93 years and a mean BMI of 30.02 ± 6.24 participated in the study. Participants had an average of six years of diagnosis of KOA and an average pain score of 6.76 at baseline. After participating in the intervention protocol, 76.6% adherence to the frequency was observed. After the exercise intervention protocol combined with tDCS, both groups obtained better results over time compared to baseline in the variables pain, NRS (p < 0.001), WOMAC physical function (p < 0.001) and BP-CSI central sensitization (p < 0.001). Regarding physical performance, there was an improvement in the sit-to-stand test (p < 0.001), 6-step climb test (p < 0.001) and 6-minute walk test (p < 0.017). However, there was no difference in the time and group interaction for any of the variables described above (p > 0.05). At the end, a significant difference was detected in the global perception of change PGIC [U = 135.5; p=0.036], for the active group, which presented higher values in relation to the Sham group. Conclusion: Transcranial Direct Current Stimulation did not promote additional effects on pain and physical function in individuals with knee osteoarthritis, when combined with physical exercises, but participants who received real stimulation reported a greater perception of improvement in symptoms.Master Thesis Qualidade da informação, compreensibilidade, acionabilidade, legibilidade, precisão, clareza e abrangência de informações online sobre tendinopatia patelar(Universidade Federal do Rio Grande do Norte, 2025-02-17) Guimarães, Lívia Madalena Ventura; Silva, Rodrigo Scattone da; https://orcid.org/0000-0002-7973-188X; http://lattes.cnpq.br/9953273388451412; http://lattes.cnpq.br/5344207128981792; Souza, Marcelo Cardoso de; https://orcid.org/0000-0002-9268-8353; http://lattes.cnpq.br/3968380924513456; Durigan, Rita de Cássia Marqueti; https://orcid.org/0000-0001-9126-3882; http://lattes.cnpq.br/0391056751283338Introduction: Patellar tendinopathy is one of the main causes of knee pain in athletes and is characterized by degenerative changes, local pain, and functional limitations, which can impact performance and an athlete's career duration. Information about patellar tendinopathy has been frequently researched on global online search engines, highlighting the need for a better understanding of the quality of this information. Objective: To assess the comprehensibility, actionability, readability, comprehensiveness, accuracy, clarity, and quality of the content available on websites found on Google® and Bing® regarding patellar tendinopathy. Methods: This is a crosssectional observational study reported following the STROBE guidelines. Samples were collected from search engines by selecting the first 20 websites for each English search term: "Patellar Tendinopathy" and "Jumper's Knee" on each search engine, totaling 80 links collected by two independent evaluators. For content analysis, a rubric was used based on current scientific evidence. Comprehensibility and actionability were assessed using the online PEMAT questionnaire; readability was measured using the FleschKincaid grade level; and for assessing the quality of information regarding treatment options for patellar tendinopathy, the DISCERN tool was applied. Results: The overall quality of information was low (mean DISCERN score = 28.90/84), with significant inaccuracies and gaps. Regarding comprehensibility, only 37.06% of websites met the criteria suggested by PEMAT, and actionability was limited (9.05% agreement). Readability was adequate in 56.67% of the sites, indicating that almost half of the sites have issues in this domain. Conclusion: Online information about patellar tendinopathy lacks accuracy, clarity, and applicability, emphasizing the need for more reliable content aligned with scientific evidence. Users should exercise caution when seeking online information about patellar tendinopathy.Master Thesis Desenvolvimento de um checklist de fatores ambientais da Classificação Internacional de Funcionalidade, Incapacidade e Saúde para unidade de terapia intensiva neonatal(Universidade Federal do Rio Grande do Norte, 2025-02-21) Silva, Fernanda Gabrielle Mendonça; Monteiro, Karolinne Souza; Moura, Isabelly Cristina Rodrigues Regalado; http://lattes.cnpq.br/6776595559146210; http://lattes.cnpq.br/9064510807814492; http://lattes.cnpq.br/5484867452994218; Fernandes, Aline Braga Galvão Silveira; https://orcid.org/0000-0002-7976-8009; http://lattes.cnpq.br/9406431536920693; Alvarez, Carolina Daniel de Lima; https://orcid.org/0000-0002-2126-2937; http://lattes.cnpq.br/4144337339534625; Bezerra, Ingrid Fonseca Damasceno; http://lattes.cnpq.br/0679232756346017Introduction: The Neonatal Intensive Care Unit (NICU) represents an atypical environment where newborns (NBs) are exposed to various environmental stimuli through unusual sensory experiences, which can be either positive or negative. However, no specific instrument currently exists to assess or classify environmental factors related to the hospital setting in a NICU. In this context, the International Classification of Functioning, Disability, and Health (ICF) is recommended for understanding health conditions and contextual factors of the individual. Objective: To develop based on ICF environmental factors checklist for NICU. Methods: This is a qualitative study conducted through virtual focus groups and semi-structured interviews, following the guidelines of the World Health Organization (WHO) and the ICF research department for developing a CORE SET. The study was approved by the Research Ethics Committee (REC) of the Faculty of Health Sciences of Trairi (FACISA) at the Federal University of Rio Grande do Norte (UFRN), under opinion number: 6.386.729. The sample included healthcare professionals working in NICU and caregivers of NBs who were admitted to the NICU. Content analysis was performed to identify themes addressed in the discussions, which were then linked to ICF categories for the construction of the checklist. Results: Fourteen participants were included in the sample, consisting of ten professionals, predominantly women (90%), physiotherapists (50%), residents of the northeastern region (50%), with the highest qualification being a specialty in the field (80%), and four caregivers, all female, mothers of premature NBs with a college degree. The process of analyzing the themes and linking them to the ICF generated 21 categories. Conclusion: This study provides a list of relevant categories from the perspective of NICU professionals and caregivers, promoting more effective use of the classification regarding environmental factors, enhancing interventions and the management of NBs and services. It also contributes as a guide for creating assessment tools on the subject.Master Thesis Avaliação da preferência de mulheres com fibromialgia submetidas a três diferentes volumes de treinamento resistido: ensaio clínico randomizado crossover(Universidade Federal do Rio Grande do Norte, 2025-02-26) Cavalcanti, Bruno Honório; Souza, Marcelo Cardoso de; https://orcid.org/0000-0002-9268-8353; http://lattes.cnpq.br/3968380924513456; https://orcid.org/0000-0002-7180-9320; http://lattes.cnpq.br/0411207435791394; Souza, Clecio Gabriel de; Hoff, Leonardo SantosINTRODUCTION: Resistance training is part of the non-pharmacological treatment for people with fibromyalgia. However, the appropriate and/or recommended amount of exercise, despite some studies showing improvements with different resistance training volumes, is not precisely defined. Furthermore, we do not yet know if there is a preference among these individuals regarding different volumes of resistance exercise.OBJECTIVE: To assess volume preference in three different resistance training protocols in women with fibromyalgia. Secondarily, to evaluate patient expectations, pain intensity, affect, subjective perception of effort, training volume, and cadence.METHODS: A randomized, blinded, crossover clinical trial was conducted. Thirty-eight women with fibromyalgia were included. All participants underwent three resistance exercise programs with different training volumes (one set, two sets, and three sets per exercise) over a period of three weeks. The participants were assessed before the intervention (T0), before each training session (T1, T2, and T3), after each training session (T1, T2, and T3), 24 hours after each session (T1, T2, and T3), and one week after the last session (T4). RESULTS: Participants showed a preference for the two-set and three-set training protocols. No differences were found in expectations, pain intensity, affect, subjective perception of effort, training volume, or cadence between the three different training protocols. CONCLUSION: Women with fibromyalgia preferred the two-set and three-set protocols, with 50% choosing each protocol, while none preferred the one-set protocol. No differences were found in any of the secondary outcomes assessed across the three training protocols, reinforcing that the choice of two or three sets may be considered even for fibromyalgia patients who are untrained in resistance exercises.Master Thesis Determinação do ponto de corte do ICIQ- Bladder Diary para discriminar a melhora clínica de sintomas urinários femininos: estudo de acurácia diagnóstica(Universidade Federal do Rio Grande do Norte, 2025-04-28) Silva, Ana Karla Nascimento da; Correia, Grasiela Nascimento; Micussi, Maria Thereza Albuquerque Barbosa Cabral; http://lattes.cnpq.br/8878717048564522; http://lattes.cnpq.br/8982917410944873; Magalhães, Adriana Gomes; Driusso, PatriciaIntroduction: The International Consultation on Incontinence Questionnaire – Bladder Diary (ICIQ-BD) is a widely used tool to monitor and assess lower urinary tract symptoms. However, the interpretation of its results still presents challenges, especially in identifying the clinical improvement perceived by patients. Objective: This study aimed to establish cut-off points in the ICIQ-BD that indicate perceived clinical improvement in women with urinary symptoms. Methods: This is a diagnostic accuracy study that initially included 86 women with complaints of involuntary urine loss. At the end of the follow-up, 50 participants had completed all the steps and made up the final sample. Evaluations were performed using the Urinary Incontinence Diagnostic Questionnaire (QUID), the Incontinence Severity Index (ISI), the ICIQ-BD, as well as the Global Perception of Effect Scale (EPEG) and physical examination of the pelvic floor muscles (PFM) through bidigital vaginal palpation. All participants underwent an eight-week pelvic floor muscle training program. Statistical analysis was performed using the ROC (Receiver Operating Characteristic) curve to determine the cutoff points associated with the perception of clinical improvement. The McNemar test was applied to compare differences in symptom perception before and after PFM, and the paired sample t-test was applied to compare the monitoring of STUI before and after TMAP. Results: The results demonstrated moderate discrimination for the reduction of one episode of urinary incontinence (AUC = 0.783), good discriminatory capacity for the reduction of one episode of nocturia (AUC = 0.880) and excellent discrimination for the reduction of two daytime urinations (AUC = 0.911; sensitivity = 89.3%; specificity = 88.5%). Conclusion: These reductions in urinary symptoms are sufficient to indicate perceived clinical improvement, making the ICIQ-BD an objective and sensitive tool for therapeutic monitoring.Master Thesis Associação de fatores psicológicos e qualidade do sono com a dor e incapacidade em indivíduos com ombro congelado(Universidade Federal do Rio Grande do Norte, 2025-02-06) Fonseca, Romário Nóbrega Santos; Barbosa, Germanna de Medeiros; https://orcid.org/0000-0002-1094-334X; http://lattes.cnpq.br/1702090920424206; https://orcid.org/0000-0003-0642-6435; http://lattes.cnpq.br/4706618652588309; Souza, Clécio Gabriel de; Guilherme, Melina Nevoeiro HaikBACKGROUND: Frozen shoulder is a condition that cause high levels of pain and functional impairments. Psychological factors such as anxiety, depression, kinesiophobia, self-efficacy, and pain catastrophizing may be associated with pain and disability din individuals with frozen shoulder. OBJECTIVE: To analyze the association of psychological factors (anxiety, depression, kinesiophobia, pain catastrophizing, and self-efficacy) and sleep quality with pain intensity and disability in individuals with frozen shoulder. METHODS: This cross-sectional study was conducted via the Google Meet© platform, with data collected through a structured questionnaire on Google Forms©, involving individuals with frozen shoulder. Pain and disability were assessed using the Shoulder Pain and Disability Index; self-efficacy, using the Pain Self-Efficacy Scale; anxiety and depression, using the Hospital Anxiety and Depression Scale; kinesiophobia, using the Tampa Scale for Kinesiophobia-11; pain catastrophizing, using the Pain Catastrophizing Scale; and sleep quality, using the Pittsburgh Sleep Quality Index. Multiple linear regression analysis was performed. RESULTS: A total of 96 individuals with frozen shoulder were included [72 women (mean age = 53.1 ± 10.8 years; symptom duration (months) = 6.1 ± 4.2)]. Pain self-efficacy and kinesiophobia were significantly associated with disability, explaining 19.4% of the variance (f (2,93) = 12.46, p < 0.000, adjusted R² = 0.194, RMSE = 19.98). Pain self-efficacy and anxiety were significantly associated with pain intensity, explaining 21.2% of the variance (f (2,93) = 13.74, p < 0.000, adjusted R² = 0.212, RMSE = 18.7). Depression, pain catastrophizing, and sleep quality were not associated with disability or pain intensity. Kinesiophobia was not associated with pain intensity, while anxiety was not associated with disability. Kinesiophobia was not associated with pain intensity, while anxiety was not associated with disability. CONCLUSION: Self-efficacy, kinesiophobia, and sleep quality were associated with functional disability, while self-efficacy and anxiety were associated with pain. Higher levels of self-efficacy were related to lower pain and disability scores, whereas higher levels of kinesiophobia and anxiety, as well as poorer sleep quality, were associated with less favorable pain and disability outcomes.Master Thesis Tradução, adaptação transcultural e análise psicométrica do Asthma Self-Management Questionnaire para a população brasileira(Universidade Federal do Rio Grande do Norte, 2024-12-17) Lopes, Lenice Daiane da Costa; Gualdi, Lucien Peroni; http://lattes.cnpq.br/3486514016305167; http://lattes.cnpq.br/9920021821231143; Lima, Illia Nadinne Dantas Florentino; Florêncio, Rencio BentoIntroduction: Given the lack of health measurement instruments in the context of asthma selfmanagement, it is necessary to develop tools that can assist Brazilians diagnosed with asthma in managing their own health condition. Objectives: This study aimed to translate, crossculturally adapt and assess the measurement properties of the ASMQ for the Brazilian population. Methods: This is an exploratory and psychometric study approved by the CEP of UFRN, under opinion number 6.062.022. The statistical software SPSS (22.0) and JASP (16.4) were used, attributing a significance level of 5%. In this study, international guidelines were used as a guide for the preparation and execution of the eight stages of the study. For the translation phase of the instrument, the Delphi Technique was used, through the Multidisciplinary Committee of Experts. And, for the cross-cultural adaptation, a pre-test stage was carried out, through a questionnaire applied to subjects similar to the eligibility criteria. In the psychometric analysis of the tool, the properties of the construct were measured using the ASMQ-Brazil, ACT and AQLQ(S). The content validity and reliability of the instrument were also analyzed. Results: An IVC > 0.80 was found for all items and adequate internal consistency (α = 0.762). In addition, the KMO test had a result of 0.756 and Bartlett's sphericity test found a χ² (chi-square) value of 257.903 with 120 degrees of freedom and significance of p < 0.001, which indicates adequate data adjustment. Finally, this study found mean values for the raw score of 8.98 ± 2.95 points and for the transformed score of 56.17 ± 18.45 points. Correlation tests demonstrated a very weak correlation with no statistical significance between ASMQ-Brazil and ACT (r = 0.043 and p = 0.704) and between ASMQ-Brazil and AQLQ(S) (r = 0.043 and p = 0.704), respectively. Conclusion: ASMQ-Brazil is a valid, reliable and accessible health measurement instrument for assessing asthma self-management in the Brazilian population.Master Thesis Efeito do dry neendlig na dor muscular de início tardio em mulheres saudáveis: ensaio controlado randomizado e cego(Universidade Federal do Rio Grande do Norte, 2024-12-18) Viana, Joelmir Lisboa; Lins, Caio Alano de Almeida; https://orcid.org/0000-0001-6424-3114; http://lattes.cnpq.br/1378037748813246; http://lattes.cnpq.br/8463795325407399; Nascimento, José Diego Sales do; Macedo, Liane de BritoIntroduction: Delayed Onset Muscle Soreness (DOMS) likely occurs due to unfamiliar exercises or excessive sets or loads. Strategies to accelerate recovery should be implemented so that the individual can return to performing exercises efficiently as soon as possible. In the scientific and clinical field, the use of Dry Needling (DN) has gained prominence, although its effects on DOMS are still underexplored. Objective: To investigate the effect of DN on DOMS administered immediately after an eccentric exercise protocol on the biceps brachii in healthy women. Methods: This is a randomized, controlled, and blinded clinical trial, composed of forty women. All participants were initially assessed with measurements of pain perception (numerical pain scale and algometry), dynamometry, and treatment expectations. They then performed an exercise protocol on an isokinetic dynamometer, consisting of 2 sets of 6 eccentric contractions at 60°/s for the elbow flexors. After the protocol, participants received an intervention according to the group to which they were randomly assigned: the DN group, where dry needling was applied, and the sham group (SG), where needle penetration was simulated. Finally, re-evaluations were conducted immediately and 48 hours after the intervention protocol, except for the Numerical Pain Scale (NPS), which was also assessed at 24 and 72 hours post-exercise. The analysis focused on pain perception (NPS and pain threshold), peak torque normalized by body weight, average peak torque, power, and work. Statistical analysis included Kolmogorov-Smirnov and Levene tests and mixed ANOVA. The Bonferroni post-hoc test was applied to identify differences when a significant F value was found. Statistical significance was set at 5% with a 95% confidence interval. Results: No significant differences were observed between the groups for pain sensation at any time point. No differences were found between groups for the other secondary outcomes. Conclusion: Dry needling treatment was not effective in reducing pain sensation, pain threshold, or muscle performance in the participants.Master Thesis Correlação entre a manometria e dinamometria dos músculos do assoalho pélvico em mulheres no período da menacme e climatério(Universidade Federal do Rio Grande do Norte, 2024-09-13) Silva, Tárcila Aurita Medeiros Bastos; Magalhães, Adriana Gomes; https://orcid.org/0000-0002-0279-5930; http://lattes.cnpq.br/5918222264099117; http://lattes.cnpq.br/9030287737539308; Correia, Grasiela Nascimento; Nascimento Júnior, Leonildo Santos do; Micussi, Maria Thereza Albuquerque Barbosa CabralIntroduction: Pelvic floor dysfunctions are a global health problem that encompasses several disorders. The combination of risk factors, anatomical alterations, and weakening of the pelvic floor components can lead to the appearance of pathological symptoms associated with changes in its function. In this sense, the evaluation of the pelvic floor muscles (PFM) is of utmost importance, with sensitive and accurate resources, in order to assess muscle function, mainly before and after a PFM training program. Objective: to evaluate the correlation between PFM function and strength through vaginal manometry and dynamometry. Methodology: Cross-sectional observational study, carried out from May/2023 to July/2024, composed of 91 women in the reproductive and non-reproductive period, recruited at the Januário Cicco Maternity School (MEJC) of the Federal University of Rio Grande do Norte (UFRN), Natal/RN/Brazil. Data collection was performed by applying a questionnaire on sociodemographic and clinical data, followed by functional assessment of the PFM using palpation, manometry and vaginal dynamometry. Descriptive statistics were used to characterize the data. Pearson's correlation test was used to verify the correlations between vaginal manometry and vaginal dynamometry. Receiver Operating Characteristic (ROC) analysis was used to establish the sensitivity and specificity of the PFM functional tests. Results: The analysis of the correlation between the manometry and dynamometry results was positive, moderate and significant (r = 0.4; p = 0.01). The ROC curve of the dynamometry showed an area under the curve of 66%, which was considered statistically significant (95% CI: 0.53- 0.78; p = 0.024). The established cut-off point was 0.5141, with a sensitivity of 70.6% and a specificity of 52.6%. Conclusion: The correlation between manometry and vaginal dynamometry was moderate, demonstrating vaginal dynamometry as a powerful assessment tool.Master Thesis Fatores preditores da incapacidade de pacientes pós-acidente vascular cerebral: um estudo transversal baseado na classificação internacional de funcionalidade, incapacidade e saúde(Universidade Federal do Rio Grande do Norte, 2024-10-18) Santos, Raweny Thayna Gomes dos; Fernandes, Aline Braga Galvão Silveira; https://orcid.org/0000-0002-7976-8009; http://lattes.cnpq.br/9406431536920693; http://lattes.cnpq.br/6126246188956527; Cacho, Enio Walker Azevedo; Castro, Shamyr Sulyvan deIntroduction: Stroke causes global complications that impact the lives of survivors. Therefore, it is necessary to evaluate these patients more thoroughly, considering all components and the perspective of the International Classification of Functioning (ICF). Objective: To evaluate the predictors of disability in post-stroke patients considering the ICF model. Material and methods: This is a cross-sectional study that evaluated 60 post-stroke patients of both sexes aged 18 years and older. Patients were evaluated using specific forms and questionnaires on various areas of their lives that are related to functioning and disability, namely: WHODAS, Motricity Index, Hospital Anxiety and Depression Scale, Pittsgurgh Sleep Quality, International Consultation on Incontinence Questionnaire and International Physical Activity Questionnaire. Results: The study included 60 individuals with a mean age of 68,0 ± 12,0 years. The majority are male (56,7%), unemployed (81,7%) and with ischemic stroke (66,7%). In the multiple linear regression, in general, it was seen that the level of physical activity, the presence of depressive symptoms, the use of orthoses, the decrease in limb strength, the amount of medication used, poor sleep quality, the presence of urinary incontinence and the habit of not leaving the house were predictive factors of general disability and its specific domains. Conclusion: It is concluded that the analysis of disability in post-stroke patients, based on the ICF biopsychosocial model, allowed the identification of important predictors, such as low level of physical activity, depressive symptoms, use of orthosis, reduced limb strength, greater use of medications, poor sleep quality, urinary incontinence and the habit of not leaving the house.Master Thesis Confiabilidade intra e inter-examinador do mini-exame do estado mental para a população pós-acidente vascular cerebral(Universidade Federal do Rio Grande do Norte, 2024-09-30) Medeiros, Ana Loyse de Souza; Cacho, Roberta de Oliveira; https://orcid.org/0000-0002-0440-8594; http://lattes.cnpq.br/9802587696943482; http://lattes.cnpq.br/1465152528862285; Cacho, Enio Walker Azevedo; Alves, Marcus Vinicius Costa; Almeida, Kelson James Silva deIntroduction: Cognitive deficits are among the most impactful consequences of stroke, substantially diminishing the quality of life for those affected. The Mini-Mental State Examination (MMSE) is widely employed to screen cognitive status in post-stroke populations; however, psychometric data specific to the Brazilian-translated version in this group remain unavailable. Objective: This study aimed to evaluate the intra- and inter-examiner reliability of the MMSE for post-stroke individuals in Brazil. Methods: Thirty post-stroke participants were recruited via non-probabilistic sampling and assessed in-person using the MMSE by a trained examiner (E1). For inter-examiner reliability, two additional examiners (E2 and E3) independently scored the assessment via video recordings. To assess intra-examiner reliability, E1’s in-person scoring was compared to a second evaluation conducted by the same examiner through video 7 days later. Intraclass Correlation Coefficients (ICC) were used to analyze interand intra-examiner reliability, employing ICC2,1 and ICC3,1 models, respectively. Results: Excellent inter-examiner reliability was observed for the total MMSE score, with ICC values of 0.96 (E1 and E2), 0.98 (E1 and E3), and 0.97 (E2 and E3). Sub-item analysis indicated high reliability, except for visuospatial ability, classified as fair with ICC scores of 0.73 (E1 and E2) and 0.73 (E2 and E3). Intra-examiner reliability was also excellent, with an ICC of 0.99. Conclusion: The Brazilian MMSE version exhibited excellent inter- and intra-examiner reliability in the post-stroke population, except for the visuospatial ability sub-item. Caution is advised when administering this test to post-stroke patients, as careful adaptation may be required to accurately assess cognitive abilities.Master Thesis Efeito da técnica Low Pressure Fitness (LPF)® sobre a diástase do reto abdominal em mulheres no pós-parto: resultados preliminares de um ensaio clínico randomizado cego(Universidade Federal do Rio Grande do Norte, 2024-09-04) Nunes, Ana Beatriz da Fonseca; Sousa, Vanessa Patrícia Soares de; Lins, Caio Alano de Almeida; https://orcid.org/0000-0001-6424-3114; http://lattes.cnpq.br/1378037748813246; https://orcid.org/0000-0003-4117-3859; http://lattes.cnpq.br/6971799707627238; https://orcid.org/0000-0002-1817-6042; http://lattes.cnpq.br/6590389222992165; Barbosa, Germanna de Medeiros; Varella, Larissa Ramalho DantasIntroduction: Diastasis of the Rectus Abdominis Muscle (DRAM) is an excessive separation between the bellies of the rectus abdominis muscle. Persistent DRAM, aside from being an aesthetic concern, has negative effects on functionality, trunk endurance, and quality of life in postpartum women. Abdominal exercise is generally recommended as an important physiotherapeutic intervention for women with DRAM, and one alternative treatment is the Low Pressure Fitness (LPF®) technique. Objectives: To describe the preliminary results of the effects of LPF® on abdominal diastasis, pelvic floor muscle function, trunk endurance, pain, functionality, quality of life, perception of global effect, and expectations in postpartum women with DRAM undergoing treatment. Methods: This is a descriptive study of a randomized, controlled, blinded clinical trial with concealed allocation and intention-to-treat analysis, conducted from January to July 2024. Women with DRAM, starting at 12 weeks postpartum and presenting a rectus abdominis separation >2cm and ≥2 finger-widths above, below, or at the navel, were recruited. After giving consent, the women were randomly allocated into two groups: control (CG, kinesitherapy) and experimental (EG, Low Pressure Fitness (LPF®)). All participants underwent an 8-week intervention, with assessments at baseline, after 8 sessions, and after 16 sessions. Both groups attended in-person sessions twice a week, lasting 30 to 45 minutes, and were instructed to perform daily home exercises. The CG (n=5) performed a set of kinesitherapy exercises including abdominal crunch, posterior pelvic tilt, Russian twist, and Pelvic Floor Muscle Training (PFMT), while the EG (n=5) performed exercises from the LPF® method with posture variations. SPSS® software (version 21.0) was used for data analysis. To describe the results of this preliminary study, descriptive statistical tests were used (mean, standard deviation, absolute and relative frequencies). Confidence intervals of 95% (CI95%) were presented. Results: Ten women were included in the study, with a mean age of 31.00±5.35 years (age range of 25 to 39 years). The mean postpartum period, in weeks, was 30.80±13.21 for the experimental group (EG) and 31.40±6.91 for the control group (CG). In absolute terms, both groups showed a decrease in the average diastasis after 8 weeks of intervention. Conclusion: The preliminary results of this study suggest that both Low Pressure Fitness (LPF®) and conventional kinesiotherapy appear to promote reductions in abdominal diastasis in postpartum women after eight weeks of intervention. However, further studies with larger sample sizes and inferential analyses are needed to corroborate or refute the findings of this preliminary study.Master Thesis Efeitos de um protocolo de estimulação transcraniana por corrente contínua combinada com exercícios baseados no método Pilates no tratamento da dor lombar crônica: ensaio controlado randomizado(Universidade Federal do Rio Grande do Norte, 2024-09-23) Silva, Aleilson Abner Câmara da; Macedo, Liane de Brito; Souza, Clecio Gabriel de; https://orcid.org/0000-0001-9005-7956; http://lattes.cnpq.br/6308219057546985; http://lattes.cnpq.br/0429488953253871; https://orcid.org/0009-0000-9220-7401; http://lattes.cnpq.br/4203466841195146; Hazime, Fuad Ahmad; Nascimento, José Diego Sales do; Freitas, Rodrigo Pegado de AbreuIntroduction: chronic low back pain (CLBP) is a multifactorial condition that significantly impacts functionality and quality of life. Transcranial Direct Current Stimulation (tDCS) is a non-invasive neuromodulation technique that modulates cortical excitability, influencing pain perception. It has been explored as a promising approach for treating chronic pain, although there is still no consensus regarding its effectiveness for CLBP. On the other hand, physical exercises, such as Pilates, are already widely recommended to reduce pain and improve functionality in these patients. Objective: To investigate the effects tDCS combined with Pilates-based exercises in individuals with CLBP. Methodology: A double-blind randomized controlled trial was conducted with 36 participants randomly assigned into two groups: active tDCS + Pilates (ATP) and sham tDCS + Pilates (STP). Pain intensity, disability, pressure pain threshold, and quality of life were assessed before and after four weeks of intervention, as well as one month after the end of the treatment. We recorded the change in the patient's global impression after the first and last day of intervention. Results: There were no statistically significant differences between the groups for all analyzed variables (p > 0.05). Despite this, both groups showed improvements over time compared to baseline in pain (p < 0.001), disability (p < 0.001), pressure pain threshold at L5 (p = 0.005), and in the SF-36 domains: functional capacity (p = 0.003), social aspects (p = 0.045), general health (p = 0.006), and emotional aspects (p = 0.009). Conclusion: Transcranial Direct Current Stimulation did not promote additive effects when combined with Pilates-based exercises in individuals with chronic low back pain.Master Thesis Estimulação transcraniana por corrente contínua combinada com exercícios adiciona efeitos positivos sobre a dor, incapacidade e percepção de mudança em indivíduos com tendinopatia crônica de manguito rotador com sensibilização central(Universidade Federal do Rio Grande do Norte, 2024-08-31) Silva, César Augusto Medeiros; Souza, Clécio Gabriel de; https://orcid.org/0000-0001-9005-7956; http://lattes.cnpq.br/6308219057546985; https://orcid.org/0000-0002-0915-1759; http://lattes.cnpq.br/6704544572244284; Silva, Rodrigo Scattone da; Hazime, Fuad AhmadIntroduction: Pain is one of the main symptoms affecting individuals with chronic shoulder tendinopathy. Physical exercise is the primary approach to managing this symptom, which aims to restore movement patterns, optimize scapular kinematics, and provide greater local muscle strength and endurance. Pain neuromodulation techniques such as Transcranial Direct Current Stimulation (tDCS) may constitute complementary non-pharmacological options to promote pain relief, based on central modulation and changes in cortical excitability. Objective: To evaluate the effects of tDCS combined with a protocol of specific exercises for the shoulder in individuals with chronic shoulder tendinopathy. Methods: This is a triple-blind randomized clinical trial. It was approved by the ethics and research committee (opinion number: 6,821,408). Initially, participants were randomly assigned to two groups: active tDCS combined with physical exercise (G1) and sham tDCS combined with physical exercise (G2). The interventions were carried out over a period of 4 weeks, with two sessions per week, on nonconsecutive days. The following outcomes were assessed: primary (pain) and secondary (disability, physical function, adherence and global perception of change). Assessments were made at three different times: before (T0), immediately after (T1) and seven days after the interventions (T2). Results: Forty individuals with a mean age of 44.75±12.95 years participated in the study. A significant difference and a clinically important change in pain were found between the groups at T1 (p=0.001) and T2 (p=0.001). A significant difference in disability was observed at T1 (p=0.003) and T2 (p=0.001), as well as an important clinical change at T2 in the individuals. Regarding the global perception of change, a significant difference (U=132; p=0.018) was detected between the means when comparing G1 (U=478) and G2 (U=342). When comparing the percentage of adherence to the protocol of both groups, there was no difference between them (p=0.054). Conclusion: We can conclude from this study that the use of tDCS combined with a specific exercise protocol added positive effects on subjective variables such as pain, disability and global perception of change in individuals with chronic shoulder tendinopathy.Master Thesis Avaliação da informação online sobre tendinopatia de aquiles: um estudo transversal sobre a abrangência, compreensibilidade, aplicabilidade, legibilidade, precisão, clareza e qualidade da informação(Universidade Federal do Rio Grande do Norte, 2024-04-26) Vasconcelos, Joelly Gomes; Silva, Rodrigo Scattone da; Silva, Danilo de Oliveira; https://orcid.org/0000-0002-7973-188X; http://lattes.cnpq.br/9953273388451412; http://lattes.cnpq.br/2612681250404102; Souza, Marcelo Cardoso de; Durigan, Rita de Cássia MarquetiIntroduction: The assessment of general online information about musculoskeletal conditions indicates that most websites often present inaccurate or misleading information compared to the best available scientific evidence. Achilles tendinopathy is a highly relevant topic researched by sports physiotherapists and patients. However, the accuracy and quality of online information about Achilles tendinopathy are unknown. Objective: To evaluate the comprehensiveness, comprehensibility, applicability, readability, accuracy, clarity, and overall quality of online information about Achilles tendinopathy. Methods: Two investigators conducted searches using keywords for Achilles tendinopathy on Google® and Bing®. The first 20 websites for each term from each search engine were examined, totaling 80 websites per reviewer. Each eligible website was evaluated for comprehensiveness (rubric); comprehensibility and applicability (PEMAT); readability (Flesch-Kincaid reading level); accuracy, clarity (rubric), and quality of information on treatment options (DISCERN) by two investigators. Results: Out of the 160 Uniform Resource Locators (URLs) collected, 29 websites were included in the analyses. Only 6.9% of the websites provided accurate and clear information about exercise therapy and patient education for Achilles tendinopathy. The average score for the quality of information on treatment options was 39.3, rated as "fair." For comprehensibility and applicability, the average scores were 82.7% and 51.7%, respectively. Only 51.7% of the websites were within the recommended readability levels (4th to 7th-grade education). Conclusion: Few websites presented accurate and clear information about the management of Achilles tendinopathy. There was substantial variation in comprehensiveness, comprehensibility, applicability, and readability. Relying on websites as a source of information about Achilles tendinopathy may be inadequate, and users should exercise caution when doing so.Master Thesis Efeito da cinesioterapia pélvica sobre a função sexual em mulheres com endometriose: protocolo para um ensaio clínico randomizado(Universidade Federal do Rio Grande do Norte, 2024-07-05) Matias, Thawan da Luz; Sousa, Vanessa Patrícia Soares de; Micussi, Maria Thereza Albuquerque Barbosa Cabral; https://orcid.org/0000-0003-4140-5568; http://lattes.cnpq.br/2360845979410206; https://orcid.org/0000-0003-4117-3859; http://lattes.cnpq.br/6971799707627238; http://lattes.cnpq.br/2574226435754163; Barbosa, Germanna de Medeiros; Viana, Elizabel de Souza Ramalho; Oliveira, Maria Clara Eugênia deIntroduction: Endometriosis is a chronic and progressive disease, characterized by the growth of endometrial tissue outside the uterine cavity, which can cause various symptoms in patients with this disease. Changes in the sexual function of these women are one of them. Objectives: To evaluate the effects of pelvic kinesiotherapy on sexual function, functionality, intensity of chronic pelvic pain, quality of life and strength parameters of the Pelvic Floor Muscles (PFM) in women with endometriosis. Methods: Randomized clinical trial, including women aged between 18 and 40 years old, sexually active and not undergoing any other type of treatment for changes in sexual function related to endometriosis. The 64 participants will be randomized into 2 groups: Control Group (CG=32, will follow the pharmacological treatment prescribed by the responsible doctor) and Experimental Group (GE=32, will participate in a pelvic kinesiotherapy program and pharmacological treatment). A self-assessment questionnaire will be applied, Female Sexual Function Index (FSFI), World Health Organization Disability Assessment Schedule (WHODAS), Visual Analogue Scale (VAS), McGill Pain Questionnaire, The World Health Organization Quality of Life (WHOQOL-BREF) and PERFECT at 3 moments (before the intervention, 4 and 8 weeks after intervention). For data analysis, analysis of variance (ANOVA - 2 groups x 3 measurement moments) and intention-to-treat analysis will be used. A p<0.05 will be adopted. Final considerations: Based on the physiological plausibility of pelvic kinesiotherapy in other chronic disease conditions and the scarcity of studies on this resource in the treatment of sexual dysfunctions in women with endometriosis, it is necessary to investigate the topic.Master Thesis Análise temporal dos custos hospitalares por doenças respiratórias no Brasil(Universidade Federal do Rio Grande do Norte, 2024-07-23) Santos, Maryelli Laynara Barbosa de Aquino; Lima, Illia Nadinne Dantas Florentino; http://lattes.cnpq.br/9427677288797166; http://lattes.cnpq.br/1680050354185189; Bernardes Neto, Saint Clair Gomes; Fernandes, Ana Tereza do Nascimento Sales FigueiredoIntroduction: Respiratory diseases (RD) affect individuals in all age groups. These diseases have a negative impact on patients' quality of life and cause costly costs to health services. These diseases can cause deaths if not managed appropriately. The information made available by DATASUS about RD can be used to facilitate professional decision-making, as well as to outline approach and treatment goals and favor the creation of public policies aimed at this population. Aim: To evaluate the financial costs of hospital admissions in the Brazilian population caused by respiratory diseases between 1998 and 2021. Methods: This is a descriptive, longitudinal and quantitative study, with data duly registered in the Hospital Information System of the Unified System of Health (SIH/SUS), referring to the costs generated by respiratory diseases in Brazil, including individuals aged 0 to 80 years. The following variables were extracted: total value, average value, average length of stay, and deaths; these were correlated with region, gender, age group, and morbidity list. The data were analyzed using the GraphPad Prism software version 5.0 and the significance level was set at 5%. Results: 34,749,023 hospitalizations were observed, representing a total of R$23,653,000,000.00 reais and an average of R$760.62 reais per hospital admission in the trained period. The age group between 20 and 80 years old had higher rates related to the number of internationals. Regarding the morbidity list, pneumonia emerged with the highest costs to the public healthcare system - R$11,415,000,000.00. The Southeast region exhibited the highest financial burden (R$9,192,000,000.00), the highest mortality rate (n= 907,434 - 49%), and the longest average hospital stay (5.9 days). Conclusion: Respiratory diseases, despite representing a public health problem, causes a major financial impact on the SUS. It's important to highlight the priority of strategy plans and actions to combat these diseases, especially pneumonia, for men and in the Southeast region, can reduce inequalities in public health.