Effect of Systemic and Auricular Acupuncture with a 2/100 Hz Frequency and Nogier Frequency in Fibromyalgia: a Randomized Clinical Trial, Pilot Study.

Background: Fibromyalgia is a syndrome of chronic, generalized muscular pain, accompanied by sleep disturbances, fatigue and cardic autonomic dysfunction that will affect the quality of life. There is currently no gold standard treatment. There are limitations of studies with electroacupuncture in auricular acupuncture. Objectives: We evaluate the effects of systemic electroacupuncture (EA) with frequencies of 2/100 Hz associated of auricular acupuncture with a Nogier frequency (2.28, 4.56 and 9.12 Hz) for pain intensity, heart rate variability (HRV), and quality of life in fibromyalgia. Methods: Randomized clinical trial, a pilot study. Eighteen volunteers were randomized into a control group (CG, n = 9) and an experimental group (EG, n = 9). Six systemic EA sessions systemic and auricular were applied in the EG for 20 min, twice a week, for six weeks consecutive. The Numerical Pain Assessment Scale (NPRS), 2010 diagnostic criteria of the American College of Rheumatology (FDC 2010), Fibromyalgia Impact Questionnaire (FIQ) and analysis of HRV were the instruments used. The independent t-test compared to the groups was applied. Results: There was no statistically significant difference for the primary outcome for NPRS (p > 0.05). In the secondary outcome there was a significant difference in the total score and in some FIQ domains (p = 0.008) and some variables such as pain (p = 0.02) and anxiety (p = 0.006). There was no significant difference for the FDC 2010 and HRV variables (p > 0.05). Conclusion: 2/100 Hz systemic EA associated with the Nogier frequency positively influenced some quality of life variables; however, pain intensity, diagnostic criteria, and HRV variables did not change.

Evaluation of functional parameters of the foot and ankle in elderly with sarcopenia.

OBJECTIVE: With population aging, the prevalence of sarcopenia has increased. It is a pathology often neglected, with the potential to cause great damage if not diagnosed and treated. The objective of this study was to identify sarcopenic elderly people through the SARC-F score and palm grip test and to evaluate foot and ankle functionality parameters: gait speed, plantar sensitivity, and baropodometry. METHODS: This is a descriptive and cross-sectional study. The sample consisted of 20 sarcopenic elderly diagnosed through the SARC-F score and the handgrip strength test, from which demographic data were obtained, and the three functional tests related to the foot and ankle were performed. RESULTS: No individual was aware of the term sarcopenia. Regarding gait speed, 20 (100%) presented values compatible with sarcopenia (average of 0.52 m/s). Regarding plantar sensitivity, five (25%) of the patients showed changes in the exam with the detection of insensitivity. Regarding baropodometry, higher pressure values were observed in the right foot (average of 52.9±7.01%) compared to the left (average of 47.10±7.01%) and in the hindfoot (average of 55.85±16.21%) compared to the forefoot (mean 44.15±15.35%). When correlating the analyzed variables with the SARC-F scores, the only association that showed statistical significance (p<0.05) was the dynamometry on the right. CONCLUSION: The SARC-F score and the handgrip strength test are easy to apply in the screening of sarcopenia, and the functional parameters of the foot and ankle were shown to be altered in the studied group.

Evaluation of functional parameters of the foot and ankle in elderly with sarcopenia

SUMMARY OBJECTIVE: With population aging, the prevalence of sarcopenia has increased. It is a pathology often neglected, with the potential to cause great damage if not diagnosed and treated. The objective of this study was to identify sarcopenic elderly people through the SARC-F score and palm grip test and to evaluate foot and ankle functionality parameters: gait speed, plantar sensitivity, and baropodometry. METHODS: This is a descriptive and cross-sectional study. The sample consisted of 20 sarcopenic elderly diagnosed through the SARC-F score and the handgrip strength test, from which demographic data were obtained, and the three functional tests related to the foot and ankle were performed. RESULTS: No individual was aware of the term sarcopenia. Regarding gait speed, 20 (100%) presented values compatible with sarcopenia (average of 0.52 m/s). Regarding plantar sensitivity, five (25%) of the patients showed changes in the exam with the detection of insensitivity. Regarding baropodometry, higher pressure values were observed in the right foot (average of 52.9±7.01%) compared to the left (average of 47.10±7.01%) and in the hindfoot (average of 55.85±16.21%) compared to the forefoot (mean 44.15±15.35%). When correlating the analyzed variables with the SARC-F scores, the only association that showed statistical significance (p<0.05) was the dynamometry on the right. CONCLUSION: The SARC-F score and the handgrip strength test are easy to apply in the screening of sarcopenia, and the functional parameters of the foot and ankle were shown to be altered in the studied group.

Existe correlação entre atividade elétrica muscular e cerebral após treino com terapia de contensão do membro superior e tronco em sujeitos com acidente vascular encefálico? / Is there a correlation between muscle and brain electrical activity after training with upper limb and trunk constraint-induced therapy in subjects with stroke?

Objetivo: Verificar se existe correlação entre excitabilidade central e periférica após o treino com a terapia de restrição induzida do movimento (TRIM) modificada associada a contensão de tronco para o membro superior parético após Acidente Vascular Encefálico (AVE). Métodos: Ensaio clínico controlado onde vinte e dois voluntários foram selecionados e randomizado em dois grupos: Grupo Controle (GC) e Grupo Experimental (GE). Eles foram avaliados por meio do eletroencefalograma (EEG) e da eletromiografia (EMG) de superfície. Os canais EEG analisados foram: Canal Ântero Frontal (AF3/AF4); Canal Frontal região medial (F7/F8); Canal Frontal região lateral (F3/F4); Canal Fronto Central (FC5/FC6); Região temporal (T7/T8); Região occipital (O1/O2). Os músculos analisados com EMG foram bíceps braquial, flexores e extensores de punho. As avaliações foram realizada durante a atividade, por dez minutos. O GE recebeu o treinamento com TRIM modificada uma hora por dia, duas semanas consecutivas. Resultados: O GC (pós-intervenção) apresentou correlação moderada negativa (r= -0,69; p= 0,02) do canal Fa com extensor de punho. O GE apresentou (pré-intervenção) correlação moderada negativa do canal AF (r= -0,68; p= 0,02) e FC (r= -0,71; p= 0,01) com flexor de punho. Na pós intervenção apresentou correlação positiva do canal Fa (r= 0,61; p= 0,04) com o extensor de punho. Conclusão: A TRIM modificada associada à contensão de tronco para o membro superior parético apresentou correlação positiva do canal Fa com o músculo extensor de punho e o grupo não treinado apresentou correlação negativa do canal Fa com extensor de punho.

Objective: Establish the correlation between central and peripheral excitability after training with the modified upper limb constraint-induced movement therapy (CIMT) associated with trunk constraint for patients with stroke. Methods: This study is a randomized clinical trial. Twenty-two volunteers were included and randomized into the Control (CG) and Experimental Groups (EG). They were assessed with electroencephalography (EEG) and surface electromyography (EMG). The EEG channels analyzed were antero-frontal (AF3/AF4), frontal-medial (F7/F8), frontal-lateral (F3/F4), frontal-central (FC5/FC6), temporal (T7/T8), and occipital (O1/O2). The muscles evaluated with EMG were biceps brachii, wrist flexors, and wrist extensors. The evaluations were performed simultaneously with a functional assessment for ten minutes. The EG received the modified CIMT training one hour per day for two consecutive weeks. Results: After the intervention, the CG showed a moderate negative correlation of the Fa channel with the wrist extensor (r= -0.69; p= 0.02), whereas the EG had a moderate negative correlation of the FA channel (r= -0.68; p= 0.02) and FC (r= - 0.71; p= 0.01) with wrist flexor. In the post-intervention, a positive correlation of the FA channel was found with the wrist extensor (r= 0.61; p= 0.04). Conclusion: The modified CIMT associated with the trunk constraint for the paretic upper limb showed a positive correlation between the Fa channel and the wrist extensor muscle, and the control group showed a negative correlation between the Fa channel and the wrist extensor.

Effect of Foot Reflexology on Muscle Electrical Activity, Pressure, Plantar Distribution, and Body Sway in Patients with Type 2 Diabetes Mellitus: A Pilot Randomized Controlled Trial.

OBJECTIVE: To verify the effect of foot reflexology on the electrical muscle activity of the lateral and medial gastrocnemius muscle, and to examine the distribution, plantar pressure, and body sway in patients with type 2 diabetes mellitus. METHODS: This pilot randomized controlled trial enrolled 17 volunteers who were clinically diagnosed with diabetes mellitus. The sample was assigned to one of two groups: the control group (CG, n = 7), who received information on foot care and health, and the intervention group (IG, n = 10), who received the application of foot reflexology on specific areas of the feet, for 10 consecutive days. There was blinding of the evaluator and the therapist. Surface electromyography (EMG) was used to assess the electrical activity of the medial and lateral gastrocnemius muscles in maximum voluntary isometric contraction (MVIC) and isotonic contraction (IC); baropodometry and stabilometry were used to analyze unloading, plantar weight distribution, and body sway. RESULTS: There was a statistically significant difference for the variables of maximum peak electrical activity of the left medial gastrocnemius (p = 0.03; effect size = 0.87 and power = 0.81) and left lateral gastrocnemius muscles (p = 0.04, effect size = 0.70 and power = 0.66) respectively, in the intragroup IC, and median frequency of the left medial gastrocnemius muscle in the intragroup MVIC (p = 0.03; effect size = 0.64 and power = 0.59), and in the variables intergroups of the total area on the right side (p = 0.04; effect size = 1.03 and power = 0.50) and forefoot area on the left side (p = 0.02; effect size = 0.51 and power = 0.16). CONCLUSIONS: We conclude that foot reflexology influenced some variables of the intergroup plantar distribution and intragroup EMG in the sample studied. There is a need for a placebo group, a larger sample and a follow-up to strengthen the findings of these experiments.

Pulsed Laser Acupuncture in the Treatment of Pain and Heart Rate Variability in Fibromyalgia Patients: A Pilot Randomized Clinical Trial.

Introduction: Laser acupuncture (LA) is a medically approved treatment for chronic pain, especially fibromyalgia. It is widely known that all pain is related to autonomic modulation, which may influence heart rate variability (HRV). There are robust studies in the literature on the effect of LA with continuous frequency on musculoskeletal pain and autonomic modulation. However, little is known about the effect of pulsed frequency on fibromyalgia. Therefore, this study aimed to evaluate whether an individualized intervention protocol applying pulsed LA would provide benefits related to pain symptoms and cardiac autonomic modulation in patients with fibromyalgia. Methods: In this pilot randomized clinical controlled trial, the sample consisted of women with fibromyalgia between the ages of 40 and 80, randomized into two groups: a control group (CG; n=10) and an experimental group (EG; n=10). EG received the intervention twice per week for 3 weeks. Statistical analysis was conducted by delta (difference between post-intervention and pre-intervention) and the Shapiro-Wilk test (normality). For comparison between the groups, the Mann-Whitney test was used. Results: The results showed a significant reduction in pain intensity as reported via the pain numerical scale (PNS; P=0.00), generalized pain index (GPI; P=0.00), and symptom severity scale (SSS; P=0.00). There was no significant difference in any HRV variable (P>0.05). Conclusion: Pulsed LA, when applied in an individualized protocol, can reduce pain intensity, as reported on the PNS, GPI, and SSS. However, no therapeutic effect was observed for HRV.

Efeito da realidade virtual no recrutamento de fibras musculares e força muscular respiratória em pacientes com doença de Parkinson - estudo piloto / Effect of virtual reality on recruitment of muscle fibers and respiratory muscle strength in patients with Parkinson's disease - pilot study

Introdução: A Doença de Parkinson compromete a mobilidade da caixa torácica, acarretando limitação progressiva da ventilação, devido ao padrão de flexão e rigidez e fraqueza muscular. A realidade virtual propicia interação em tempo real com atividades e ambientes tridimensionais. Objetivo: Avaliar o efeito da realidade virtual no recrutamento de fibras e forças musculares respiratória e postural em pacientes com doença de Parkinson. Métodos: Estudo clínico, piloto, prospectivo, com alocação por conveniência. Dez indivíduos foram selecionados e alocados em grupo estudo (GE n=5) constituídos por idosos com DP e grupo controle (GC n=5) formado por idosos na mesma faixa etária, sem condições clínicas neurológicas e respiratórias. As variáveis mensuradas foram: independência funcional, desempenho motor, força muscular respiratória, recrutamento de fibras musculares respiratórias e posturais, e qualidade de vida. Foram realizadas 16 sessões com realidade virtual. Resultados: As Pressões Inspiratória máxima (PImáx) e Expiratória máxima (PEmáx) melhoraram em alguns momentos da intervenção. O recrutamento de fibras musculares em esternocleidomastóideo diminuiu e o recrutamento de fibras musculares no diafragma aumentou. Conclusão: A PImáx e a PEmáx melhoraram em alguns momentos do tratamento, e houve diminuição do recrutamento de fibras musculares dos músculos respiratórios acessórios nos pacientes com DP. (AU)

Introduction: Parkinson's disease commits the mobility of the rib cage, causing progressive ventilation limitation due to bending and stiffness. Virtual reality provides real-time interaction with activities and three-dimensional environments. Objective: To evaluate the effect of virtual reality on the recruitment of muscle fibers and respiratory and postural muscle strength in patients with Parkinson's disease. Methods: Clinical, pilot, prospective study, with allocation by convenience. Ten individuals were selected and allocated to a study group (EG n = 5) consisting of elderly people with Parkinson and a control group (CG n = 5) formed by elderly people in the same age group, without neurological and respiratory conditions. The measured variables were functional independence, motor performance, respiratory muscle strength, recruitment of respiratory and postural muscle fibers, and quality of life. 16 sessions were held with virtual reality. Results: The maximum inspiratory pressures (MIP) and maximum expiratory pressures (MEP) improved in some moments of the intervention. The recruitment of muscle fibers in the sternocleidomastoid decreased and the recruitment of muscle fibers in the diaphragm increased. Conclusion: MIP and MEP improved in some moments of treatment, and there was a decrease in the recruitment of muscle fibers from accessory respiratory muscles in patients with PD. (AU)

Existe associação entre α -amilase salivar, escala hospitalar de ansiedade e depressão e autorrelato em estudantes com sintomas de ansiedade? / Is there an association between salivary α -amylase, hospital scale of anxiety and depression and self-report in students with anxiety symptoms?

Objetivo: Verificar se existe associação entre a α-amilase salivar, a escala hospitalar de ansiedade e a depressão e autorrelato de estudantes universitários com sintomas da ansiedade. Métodos: Estudo observacional, realizado com 67 estudantes de uma universidade pública. Para a coleta de dados, foram utilizada a Escala Hospitalar de Ansiedade e Depressão, o autorrelato de ansiedade e a aferição da α-amilase salivar por meio do dispositivo Cocoro Meter®. Os dados foram analisados por meio do teste de qui-quadrado. Resultados: Não houve associação entre α-amilase salivar e a Escala Hospitalar de Ansiedade e Depressão (p=0,51), nem entre a α-amilase salivar e o autor- relato de ansiedade (p=0,51), o que indica que o biomarcador não produz resposta dessas duas variáveis ao mensurar a ansiedade. Conclusão: O biomarcador α-amilase salivar não possui a mesma capacidade em mensurar a ansiedade quando associado com à Escala Hospitalar de Ansiedade de Depressão e ao autorrelato em estudantes universitários com sintomas de ansiedade.

Objective: Verifying if there is an association between the salivary α-amylase biomarker, the hospital scale of anxiety and depression, and a self-report of university students with anxiety symptoms. Methods: An observational study carried out with 67 students from a public university. For the data collection, the Hospital Anxiety and Depression Scale, the self-reported anxiety, and the salivary α-amylase measurement were carried out with the Cocoro Meter® device. The data were analyzed by using the chi-square test. Results: There is no association between salivary α-amylase and the Hospital Anxiety and Depression Scale (p = 0.51), and neither between the salivary α-amylase and the self-reported anxiety (p = 0.51), which indicates that the biomarker does not produce any response of these two variables when measuring anxiety. Conclusion: The salivary α-amylase biomarker does not have the same ability to measure anxiety when associated with the Hospital Anxiety and Depression Scale and with the self-report in university students with anxiety symptoms.