Programa de pós-graduação 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 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.