Effects of a low, medium, and high-intensity aquatic physiotherapy protocol on functional and biochemical parameters in individuals with knee osteoarthritis: protocol for a crossover randomized controlled trial.

Background: Knee osteoarthritis affects the performance of daily activities, independence, and quality of life. The etiopathogenesis of this condition considers the mechanisms of activation of metalloproteinase and reactive oxygen species production pathways. Metalloproteinases-3 (MMP-3) and Glutathione Peroxidase (GPx) may be responsible for cartilage destruction. Aquatic physiotherapy promotes a positive impact on the clinical picture of osteoarthritis, and this study presents an intervention protocol that aims to evaluate the effects of a single session of different aquatic physiotherapy modalities on the biochemical and functional behavior of patients with knee osteoarthritis. Methods: This will be a crossover randomized controlled trial in which 15 individuals will be submitted to three aquatic physiotherapy modalities with a minimum 15-day wash-out period in patients over 50 years old and diagnosed with OA in at least one knee, presence of pain and at least one functional dysfunction for at least 6 months, absence of physical limitation that prevents the exercise protocol from being performed, Kellgren and Lawrence ranking between I and IV, walk independently and without auxiliary device. Variations in the concentrations of MMP-3 and GPx in peripheral blood, pain, edema, and flexibility resulting from the three aquatic physiotherapeutic interventions will be evaluated both pre- and immediate post-intervention. The reference group will be submitted to the same aquatic physiotherapy protocols, however, only the biochemical parameters and the self-perception questionnaires will be evaluated. Registration: ClinicalTrials.gov ( NCT05610696, 18/01/2023).

Increased plasma levels of brain derived neurotrophic factor (BDNF) in patients with fibromyalgia.

Brain-derived neurotrophic factor (BDNF) is involved in neuronal survival and synaptic plasticity of the central and peripheral nervous system. BDNF appears to modulate nociceptive sensory inputs and pain hypersensitivity and has been studied in pathological situations, including chronic pain conditions and major depression. Increased serum BDNF levels have been recently reported in fibromyalgia (FM). In the present study, we assessed plasma BDNF levels in patients with FM and controls. Plasma BDNF was measured from 30 female patients with FM and 30 healthy age- and gender-matched volunteers using an enzyme immunoassay. FM patients showed higher levels of BDNF (FM = 167.1 +/- 171.2 pg/mL) when compared with the control group (control = 113.8 +/- 149.6 pg/mL) (P = 0.049; Mann-Whitney test). Six out of 30 controls presented superior values to the medium (15/15) of the patients with fibromyalgia (129 pg/mL) (P = 0.029, Fisher exact test). There was no correlation between plasma BDNF levels and age, disease duration, pain score, number of pain points and HAM-D score. Our results confirm previous findings of increased plasma BDNF levels in patients with FM, suggesting that BDNF may be involved in the pathophysiology of Fibromyalgia, despite high levels of depression.

Programa de hidroterapia no movimento de dorsiflexão de indivíduos hemiparéticos espásticos / Hydrotherapy program on the dorsiflexion movement in patients with spastic hemiparesis

Este trabalho foi desenvolvido com a finalidade de avaliar umprograma de hidroterapia, analisando o movimento de dorsifl exão,durante a marcha, em pacientes hemiparéticos espásticos. O presenteestudo caracterizou-se por apresentar paradigma quantitativo,abordagem pré-experimental com análise antes e depois em ummesmo grupo. Foram selecionados 7 indivíduos com hemiparesiaespástica em decorrência de AVE (Acidente Vascular Encefálico). Oscolaboradores foram submetidos a uma avaliação neurofuncional,à goniometria manual do movimento de dorsifl exão e à fi lmagemda marcha para análise posterior com a biofotogrametria computadorizada,previamente ao tratamento. Os mesmos receberam duassessões semanais de 35 minutos de hidroterapia, durante dois meses,e foram reavaliados com a goniometria manual, a fi lmagem e análiseda marcha. A análise estatística dos dados indicou diferença significante (p ≤ 0,05) no movimento de dorsifl exão após o programade fi sioterapia aquática. Sendo assim, concluímos que, mesmo emcurto período de tempo, os colaboradores da pesquisa apresentarammelhoras no movimento e no padrão motor durante a marcha coma prática de fi sioterapia aquática...

The aim of this study was to evaluate a hydrotherapy programand to analyze the dorsifl exion movement, during the gait, inspastic hemiparetic patients. Th is was a quantitative study with preexperimentalapproach and previous and post- analysis in a samegroup. A subset of seven patients with spastic hemiparesis due toa CVA (Cerebrovascular Accident) was selected. Th e patients weresubmitted to neuro-functional evaluation, manual goniometry ofdorsifl exion movement and the gait was recorded for subsequentanalysis with computerized biophotogrametry, previously to thetreatment. Th e subjects received two weekly hydrotherapy sessionsof 35 minutes, for two months, and were assessed by means of themanual goniometry, recording and analysis of the gait. Th e dataanalysis showed signifi cant diff erence (p = 0,05) in the dorsifl exionmovement after the hydrotherapy program. Th erefore, we concludedthat, even in a short period of time, the patients in this study havereported improvements in the movement and in the motor patternduring the gait, when submitted to a hydrotherapy program...