Photobiomodulation therapy on expression of HSP70 protein and tissue repair in experimental acute Achilles tendinitis.

The aim of the present study was to investigate the effects of photobiomodulation (PBM) therapy on the expression of heat shock protein 70 (HSP70) and tissue repair in an experimental model of collagenase-induced Achilles tendinitis. Thirty Wistar rats (aged 12 weeks) were randomly distributed among control group (n = 8), tendinitis group (n = 11), and LED group (n = 11). Tendinitis was induced in the tendinitis and LED groups through a peritendinous injection of collagenase (100 µl). The LED group animals received the first irradiation 1 h after injury. A 630 ± 20 nm, 300-mW continuous wave light-emitting diode (LED), spot size 1 cm2, was placed in contact with the skin. One point over the tendon was irradiated for 30 s, delivering 9 J (9 J/cm2). LED irradiation was performed once daily for 7 days, with the total energy delivered being 63 J. The tendons were surgically removed and expression of the HSP70 protein was calculated using semi-quantitative analyses of immunohistochemistry (HSCORE). Number of fibroblasts and amount of collagen were measured using histological and histochemical analyses. An increase in the mean HSCORE for HSP70, in the number of fibroblasts, and in the amount of collagen were found in the LED group compared with those in the tendinitis and control group (P ≤ 0.05). PBM therapy increased the expression of the HSP70, number of fibroblasts, and amount of collagen in the acute Achilles tendinitis in rats.

Rehabilitation interventions targeting the activity and participation of patient with neuromuscular diseases: what do we know? A systematic review.

BACKGROUND: To be objective and achievable, the rehabilitation goals must be focused on the functional expectations of patients with neuromuscular disease (NMD). OBJECTIVE: Investigate rehabilitation programs that are able to modify the activity/participation of patients with NMD. Data search: Embase, BVS/Lilacs, Physiotherapy Evidence Database (PEDro), CINAHL/EBSCO, and Medline were searched in June 2021. It was last updated in March 2023. METHODS: Randomized controlled trials investigating any rehabilitation therapy for patients with NMD with an outcome encompassing the activity/participation components of the International Classification of Functioning, Disability and Health (ICF) were included. Pharmacological therapy studies were excluded. The results were synthesized according to the ICF core sets for NMD. The methodological quality and level of evidence were assessed using PEDro criteria and Grading of Recommendations Assessment, Development, and Evaluation (GRADE). This systematic review followed the PRISMA 2020 guideline and was registered at PROSPERO (CRD42020209359). RESULTS: Of a total of 1943 identified studies, 12 were included in this review with a methodological quality between regular and good. Light to moderate-intensity aerobic exercise was the most studied intervention. The mobility was assessed in all included studies. CONCLUSION: The variability of the types of NMD and the small sample size of the included studies demonstrates that there is very limited evidence of interventions focused on the activity/participation of individuals with NMD. Light to moderate-intensity aerobic exercise seems to improve the mobility, self-care, and social participation of patients with NMD, especially those with slow progression.

ANTECEDENTES: As metas de reabilitação devem ser focadas nas expectativas funcionais de pessoas com doenças neuromusculares (DNM) para que sejam objetivas e alcançáveis. OBJETIVO: Investigar programas de reabilitação capazes de modificar a atividade/participação de pessoas com DNM. Foi realizada busca nas bases de dados: Embase, BVS/Lilacs, Physiotherapy Evidence Database (PEDro), CINAHL/EBSCO e Medline em junho/2021. A última atualização foi realizada em março de 2023. MéTODOS: Foram incluídos estudos clínicos randomizados investigando qualquer terapia de reabilitação para pessoas com DNM com desfecho voltado para atividade/participação da Classificação Internacional de Funcionalidade e Saúde (CIF). Terapias farmacológicas foram excluídas. Os resultados foram sintetizados de acordo com os Core Sets da CIF para DNM. A qualidade metodológica e o nível de evidência foram avaliados usando os critérios PEDro e Grading of Recommendations Assessment, Development, and Evaluation (GRADE). Esta revisão sistemática foi registrada na PROSPERO (CRD42020209359). RESULTADOS: De 1943 estudos identificados, 12 foram incluídos com uma qualidade metodológica entre regular e boa. O exercício aeróbio de intensidade leve a moderada foi a intervenção mais estudada. A mobilidade foi avaliada em todos os estudos incluídos. CONCLUSãO: A variabilidade dos tipos de DNM e o baixo número amostral dos estudos incluídos contribuem para uma evidência muito limitada de intervenções focadas na atividade/participação de pessoas com DNM. O exercício aeróbio de baixa a moderada intensidade parece melhorar a mobilidade, autocuidado e participação de pessoas com DNM, especialmente para as DNM de progressão lenta.

Negative neuromuscular and functional repercussion of forced swimming after axonotmesis.

Peripheral nerve injuries are cause of sensory disturbances and in functional abilities, and are associated personal and social costs. Strategies that maximize nerve regeneration and functional recovery are necessary, the exercise is an option. This study evaluated the effects of forced swimming exercise on neuromuscular histomorphometry and on functional recovery in a median nerve crush model. Sixteen Wistar rats underwent median nerve crush and were divided into control group (CG) and swimming group (SG). The forced swimming protocol started one week after the injury and was performed for 1 hr a day, 5 days per week, for 2 weeks. The rats swam with an overload of 5% and 10% of body weight in the first and second week, respectively. The functional recovery was assessed in three moments using the grasping test. On day 21, fragments of the median nerve and of the forearm flexors muscles were removed for histomorphometric analysis. The SG had functional recovery impaired (P<0.001) and presented lower myelinated fibers number, fiber and axon minimal diameter, myelin thickness and g-ratio in the proximal e distal segments of the median nerve (P<0.005) and area muscle fiber (P<0.005) than CG. Also, the SG presented a number of capillaries in the proximal segments of the median nerve greater than CG (P<0.005). The exercise protocol used in this study impaired the regeneration of the median nerve and negatively influenced the functional recovery.

The superior beneficial effects of exercise training versus hormone replacement therapy on skeletal muscle of ovariectomized rats.

Previous studies have highlighted the positive effects of Estradiol (E2) replacement therapy and physical exercise on skeletal muscle during menopause. However, the comparison effects of exercise training (ET) and estradiol replacement therapy during menopause on skeletal muscle have not been investigated to date. This study aimed to compare the effects of endurance exercise training versus E2 replacement therapy on mitochondrial density, redox status, and inflammatory biomarkers in the skeletal muscle of ovariectomized rats. Thirty female Wistar rats (12-week-old) were randomly assigned into three groups: Untrained ovariectomized rats (UN-OVX, n = 10); untrained ovariectomized rats treated with estradiol replacement therapy (E2-OVX); and, trained ovariectomized rats (TR-OVX). After ovariectomy, the E2-OVX rats were treated subcutaneously with E2 (implanted Silastic® capsule containing 360 µg of 17ß-estradiol/mL) while the TR-OVX group performed an exercise training protocol (50-70% of maximal running speed on a treadmill, 60 min/day, 5 days/week for 8 weeks). After euthanasia, the soleus muscle was processed for histological and biochemical evaluations. Only exercise prevented the reduction of maximal oxygen consumption and increased mechanical efficiency (ME). While mitochondrial muscle density, total antioxidant capacity (FRAP), catalase (CAT) activity, and interleukin 10 levels were higher in TR-OVX, only OVX-E2 presented higher CAT activity and lower interleukin 6 levels. Endurance exercise training compared with E2 replacement therapy maintains the aerobic capacity improving the ME of OVX rats. In addition, only endurance exercise training raises the skeletal muscle mitochondrial content and tends to balance the redox and inflammatory status in the skeletal muscle of OVX rats.

Photobiomodulation Therapy (Light-Emitting Diode 630 nm) Favored the Oxidative Stress and the Preservation of Articular Cartilage in an Induced Knee Osteoarthritis Model.

Objective: To evaluate the effects of photobiomodulation (PBM) therapy on oxidative stress and histological aspects of knee osteoarthritis (OA) induced by sodium monoiodoacetate in Wistar rats. Background: OA is a chronic degenerative disease. In addition to the inflammatory role, other factors, such as redox balance, appear to contribute to changes in the articular cartilage, the main articular structure affected. PBM therapy using light-emitting diode (LED) has been proposed to treat the disease by favoring anti-inflammatory effects and modulating markers of oxidative stress, acting on the degenerative process of cartilage. Methods: Twenty-seven male rats were separated into three groups: control (CG), OA (OAG), and LED treatment (LEDG). In the LED group, PBM (LED 630 nm, 300 mW, 9 J/cm2, 0.3 W/cm2, 30 sec) was applied, starting 24 h after induction, three times per week, for 8 weeks. Cartilage thickness, number of chondrocytes, enzymatic antioxidant defenses [superoxide dismutase (SOD) and catalase (CAT)], oxidative damage [thiobarbituric acid reactive substances (TBARS)], and nonenzymatic defense (ferric reducing antioxidant power) were analyzed. Results: The LEDG had higher average cartilage thickness compared with the OAG and had similar thickness to the CG. Also, the number of chondrocytes was similar to the CG. In the oxidative stress analysis, the LEDG presented antioxidant enzymatic activity (SOD and CAT) higher than the CG, and presented concentration of TBARS lower than the CG and OAG groups. Conclusions: PBM therapy was effective in recovering oxidative stress and preserving the articular cartilage aspects in a knee OA animal model.

Effects of photobiomodulation therapy on functional recovery, angiogenesis and redox status in denervated muscle of rats.

OBJECTIVE: To evaluate the effects of photobiomodulation therapy in redox status, angiogenesis marker - vascular endothelial growth factor - and in the functional recovery in denervated muscle. METHODS: A total of 32 female Wistar rats underwent a crush injury and were randomly divided into four groups: Light Emitting Diode Group 2 and Control Group 2 (muscle collected 2 days after injury), and Light Emitting Diode Group 21 and Control Group 21 (muscle collected 21 days afterinjury). Light Emitting Diode Group 2 and Light Emitting Diode Group 21 received two and ten light emitting diode applications (630±20nm, 9J/cm2, 300mW), respectively, and the Control Group 2 and Control Group 21 did not receive any treatment. The function was evaluated by grasping test at four moments (pre-injury, 2, 10 and 21 post-injury days). The flexor digitorum muscle was collected for analysis of immunolocalization of vascular endothelial growth factor and redox parameters. RESULTS: Functional improvement was observed at the second and tenth post-injury day in treated groups compared to control (p<0.005). The muscle tissue of treated groups presented higher immunohistochemical expression of vascular endothelial growth factor. Photobiomodulation therapy decreased the oxidative damage to lipid in Light Emitting Diode Group 2 compared to Control Group 2 (p=0.023) in the denervated muscle. CONCLUSION: Photobiomodulation therapy accelerated the functional recovery, increased angiogenesis and reduced lipid peroxidation in the denervated muscle at 2 days after injury.

Low intensity training improves redox status and reduces collagen fibers on dystrophic muscle.

Exercise therapy on skeletal muscle of muscular dystrophies has no defined parameters. The effect of low-intensity treadmill training on the oxidative stress markers and fibrosis on hindlimb muscles was investigated. Sixteen dystrophic male mdx animals were separated in trained (mdxT/n=8) and untrained (mdxNT/n=8) groups. Wild type animals (WT/n=8) were used as healthy control. The mdxT group runned at a horizontal treadmill (9 m/min, 30 min/day, 3 times/wk, 8 weeks). Gastrocnemius and tibial anterior muscles were collected for analysis of enzymatic/non-enzymatic oxidant activity, oxidative damage concentration, collagen fibers area morphometry. The mdxT group presented a lower collagen fiber area compared to mdxNT for gastrocnemius (P=0.025) and tibial anterior (P=0.000). Oxidative damage activity was higher in the mdxT group for both muscles compared to mdxNT. Catalase presented similar activity for tibial anterior (P=0.527) or gastrocnemius (P=0.323). Superoxide dismutase (P=0.003) and total antioxidant capacity (P=0.024) showed increased activity in the mdxT group at tibial anterior with no difference for gastrocnemius. Low-intensity training is considered therapeutic as it reduces collagen deposition while improving tissue redox status.

Rehabilitation interventions targeting the activity and participation of patient with neuromuscular diseases: what do we know? A systematic review / Reabilitação com foco na atividade e participação para pessoas com doenças neuromusculares: o que sabemos? Uma revisão sistemática

Abstract Background To be objective and achievable, the rehabilitation goals must be focused on the functional expectations of patients with neuromuscular disease (NMD). Objective Investigate rehabilitation programs that are able to modify the activity/participation of patients with NMD. Data search: Embase, BVS/Lilacs, Physiotherapy Evidence Database (PEDro), CINAHL/EBSCO, and Medline were searched in June 2021. It was last updated in March 2023. Methods Randomized controlled trials investigating any rehabilitation therapy for patients with NMD with an outcome encompassing the activity/participation components of the International Classification of Functioning, Disability and Health (ICF) were included. Pharmacological therapy studies were excluded. The results were synthesized according to the ICF core sets for NMD. The methodological quality and level of evidence were assessed using PEDro criteria and Grading of Recommendations Assessment, Development, and Evaluation (GRADE). This systematic review followed the PRISMA 2020 guideline and was registered at PROSPERO (CRD42020209359). Results Of a total of 1943 identified studies, 12 were included in this review with a methodological quality between regular and good. Light to moderate-intensity aerobic exercise was the most studied intervention. The mobility was assessed in all included studies. Conclusion The variability of the types of NMD and the small sample size of the included studies demonstrates that there is very limited evidence of interventions focused on the activity/participation of individuals with NMD. Light to moderate-intensity aerobic exercise seems to improve the mobility, self-care, and social participation of patients with NMD, especially those with slow progression.

Resumo Antecedentes As metas de reabilitação devem ser focadas nas expectativas funcionais de pessoas com doenças neuromusculares (DNM) para que sejam objetivas e alcançáveis. Objetivo Investigar programas de reabilitação capazes de modificar a atividade/participação de pessoas com DNM. Foi realizada busca nas bases de dados: Embase, BVS/Lilacs, Physiotherapy Evidence Database (PEDro), CINAHL/EBSCO e Medline em junho/2021. A última atualização foi realizada em março de 2023. Métodos Foram incluídos estudos clínicos randomizados investigando qualquer terapia de reabilitação para pessoas com DNM com desfecho voltado para atividade/participação da Classificação Internacional de Funcionalidade e Saúde (CIF). Terapias farmacológicas foram excluídas. Os resultados foram sintetizados de acordo com os Core Sets da CIF para DNM. A qualidade metodológica e o nível de evidência foram avaliados usando os critérios PEDro e Grading of Recommendations Assessment, Development, and Evaluation (GRADE). Esta revisão sistemática foi registrada na PROSPERO (CRD42020209359). Resultados De 1943 estudos identificados, 12 foram incluídos com uma qualidade metodológica entre regular e boa. O exercício aeróbio de intensidade leve a moderada foi a intervenção mais estudada. A mobilidade foi avaliada em todos os estudos incluídos. Conclusão A variabilidade dos tipos de DNM e o baixo número amostral dos estudos incluídos contribuem para uma evidência muito limitada de intervenções focadas na atividade/participação de pessoas com DNM. O exercício aeróbio de baixa a moderada intensidade parece melhorar a mobilidade, autocuidado e participação de pessoas com DNM, especialmente para as DNM de progressão lenta.

Effects of photobiomodulation therapy on functional recovery, angiogenesis and redox status in denervated muscle of rats / Efeitos da terapia de fotobiomodulação na recuperação funcional, na angiogênese e no estado redox em músculo desnervado de ratos

ABSTRACT Objective: To evaluate the effects of photobiomodulation therapy in redox status, angiogenesis marker - vascular endothelial growth factor - and in the functional recovery in denervated muscle. Methods: A total of 32 female Wistar rats underwent a crush injury and were randomly divided into four groups: Light Emitting Diode Group 2 and Control Group 2 (muscle collected 2 days after injury), and Light Emitting Diode Group 21 and Control Group 21 (muscle collected 21 days afterinjury). Light Emitting Diode Group 2 and Light Emitting Diode Group 21 received two and ten light emitting diode applications (630±20nm, 9J/cm2, 300mW), respectively, and the Control Group 2 and Control Group 21 did not receive any treatment. The function was evaluated by grasping test at four moments (pre-injury, 2, 10 and 21 post-injury days). The flexor digitorum muscle was collected for analysis of immunolocalization of vascular endothelial growth factor and redox parameters. Results: Functional improvement was observed at the second and tenth post-injury day in treated groups compared to control (p<0.005). The muscle tissue of treated groups presented higher immunohistochemical expression of vascular endothelial growth factor. Photobiomodulation therapy decreased the oxidative damage to lipid in Light Emitting Diode Group 2 compared to Control Group 2 (p=0.023) in the denervated muscle. Conclusion: Photobiomodulation therapy accelerated the functional recovery, increased angiogenesis and reduced lipid peroxidation in the denervated muscle at 2 days after injury.

RESUMO Objetivo: Avaliar os efeitos da terapia de fotobiomodulação no estado redox, no marcador de angiogênese - fator de crescimento endotelial vascular - e na recuperação funcional do músculo desnervado. Métodos: Um total de 32 ratas Wistar foi submetido a uma lesão por esmagamento e dividido aleatoriamente em quatro grupos: Grupo Diodo Emissor de Luz 2 e Grupo Controle 2 (músculo coletado 2 dias após a lesão), além do Grupo Diodo Emissor de Luz 21 e do Grupo Controle 21 (músculo coletado 21 dias após a lesão). Grupo Diodo Emissor de Luz 2 e Grupo Diodo Emissor de Luz 21 receberam duas e dez aplicações de diodo emissor de luz (630±20nm, 9J/cm2e 300mW), respectivamente, e Grupo Controle 2 e Grupo Controle 21 não receberam tratamento. A função foi avaliada pelo teste de preensão em quatro momentos (pré-lesão, 2, 10 e 21 dias após a lesão). O músculo flexor dos dedos foi coletado para análise dos parâmetros redox e da imunolocalização do fator de crescimento endotelial vascular. Resultados: Houve melhora funcional no segundo e décimo dia pós-lesão nos grupos tratados em comparação aos controles (p<0,005). O tecido muscular dos grupos tratados apresentou maior expressão imuno-histoquímica do fator de crescimento endotelial vascular. A terapia de fotobiomodulação diminuiu o dano oxidativo aos lipídeos no Grupo Diodo Emissor de Luz 2 comparado ao Grupo Controle 2 (p=0,023) no músculo desnervado. Conclusão: A terapia de fotobiomodulação acelerou a recuperação funcional, aumentou a angiogênese e reduziu a peroxidação lipídica no músculo desnervado 2 dias após a lesão.

Pessoas com Deficiências Motoras, Conhecimento e Usufruto dos seus Direitos Fundamentais / People With Motor Disabilities, Knowledge And Use of Their Fundamental Rights

RESUMO: Existe, no Brasil, vasta legislação que evoca os direitos das pessoas com deficiência. No entanto, há carência de estudos sobre a real ciência dessas pessoas acerca de seus direitos. Compreender essa temática permitirá, dessa maneira, a formulação de propostas de intervenções futuras no sentido do efetivo acesso dessas pessoas ao usufruto de seus direitos fundamentais. Assim sendo, o objetivo deste artigo foi verificar se as pessoas com deficiência motora têm consciência e usufruem de seus direitos. Para isso, traçou-se um estudo transversal descritivo com uma amostra de conveniência composta por 39 pessoas com deficiência física. Como resultados, verificou-se que o grupo foi formado por adultos que deambulam, são desfavorecidos socioeconomicamente e de maioria feminina. A maioria parou de trabalhar após o evento/doença, recebe algum benefício do Governo e saem pouco de casa, exceto para tratamento de saúde. A acessibilidade em locais externos foi apontada como dificuldade pela maioria. O grupo demonstrou conhecer pouco sobre os seus direitos específicos, usufruindo daqueles mais propagados, como: benefícios previdenciários e atendimento prioritário. Dessa forma, é importante não apenas aprovação de leis, mas a educação de parte da sociedade, inclusive das próprias pessoas com deficiência, acerca dos seus direitos para que elas possam usufruir deles.

ABSTRACT: In Brazil, there is a large number of legislation that evoke the rights of people with disabilities. However, there are few studies about the awareness of this population about their rights. Thus, understanding this theme will allow the formulation of proposals for future interventions in the sense of the effective access of these people to take advantage of their fundamental rights. Therefore, the purpose of this paper is to verify if people with motor disability are aware and take advantage of their rights. For this, a descriptive cross-sectional study was drawn up with a convenience sample composed of 39 people with physical disabilities. The participants answered a questionnaire about awareness and use of the rights of the person with disability. As a result, it was verified that the group was comprised of mainly female adults who can move around and are socioeconomically disadvantaged. Most of them stopped working after an event/illness, receive some benefit from the Government and practically do not leave home, except for health treatment. Accessibility in and around external places, was identified as a difficulty for the majority of the participants. The group demonstrated to know little about their specific rights, and they take advantage from the most propagated ones, such as: social security benefits and priority service. Thus, it is important not just to approve laws, but also to educate part of society including the people with disabilities about their rights, so they can benefit from them.

Low intensity training provokes adaptations on muscle fibrosis of a muscular dystrophy model / El entrenamiento de baja intensidad provoca adaptaciones en la fibrosis muscular de un modelo de distrofia muscular

Duchenne muscular dystrophy (DMD) is a genetic neuromuscular disorder with progressive clinical signs until death, around the second decade of life. Mdx is the most used animal model to pre-clinical studies of DMD. Parameters of exercise on this muscular disease are still unknown. This research aimed to investigate if the low intensity treadmill training would exacerbate the markers of muscle injury, fibrosis, and the composition of the extracellular matrix by type I and III collagens of the mdx model. Dystrophic 11-week-old male mice were separated in exercised (mdxE, n=8) and sedentary (mdxC, n=8) groups. Wild-type mice were used as control (WT, n=8). Exercised group underwent a LIT protocol (9 m/min, 30min, 3days/week, 60 days) on a horizontal treadmill. Gastrocnemius muscle was collected at day 60 and processed to morphological and morphometric analyzes. Sedentary mdx animals presented inflammatory infiltrate and necrotic fibers. Histochemical analysis revealed that the perimysium of the mdxC group is organized into thick and clustered collagen fibers, which generates a larger area of intramuscular collagen fibers for these animals. Histomorphometry attested that fraction area of collagen fibers of mdxC group was higher than mdxE group (p=0.04) and mdxE group values similar to WT group (p=1.00). Centrally located nuclei fibers and the variance coefficient (VC) of minimal Feret's diameter was similar in mdxE and mdxC groups (p=1.00) and both groups presented higher mean values than WT group (p<0.00). Immunohistochemistry revealed the presence of type I collagen mainly in the mdxC group. LIT protocol had not exacerbated muscle injuries resulting from the dystrophindeficiency membrane fragility at the same time that had reduced the intramuscular collagen deposition. LIT had positively influenced these markers of dystrophic muscle injury on gastrocnemius muscle of mdx model.

La distrofia muscular de Duchenne (DMD) es un trastorno neuromuscular genético con signos clínicos progresivos hasta la muerte, alrededor de la segunda década de la vida. Mdx es el modelo animal más utilizado para estudios preclínicos de DMD. Los parámetros del ejercicio en esta enfermedad muscular aún se desconocen. Esta investigación tuvo como objetivo investigar si el entrenamiento de cinta de baja intensidad exacerbaría los marcadores de lesión muscular, fibrosis y la composición de la matriz extracelular por colágenos tipo I y III del modelo mdx. Ratones machos de 11 semanas de edad con distrofia se separaron en grupos ejercitados (mdxE, n = 8) y sedentarios (mdxC, n = 8). Se usaron ratones de tipo salvaje como control (WT, n = 8). El grupo sometido a ejercicio se sometió a un protocolo LIT (9 m / min, 30 min, 3 días / semana, 60 días) en una cinta de trotar horizontal. El músculo gastrocnemio se retiró el día 60 y se procesó para realizar análisis morfológicos y morfométricos. Los animales sedentarios mdx presentaron infiltrado inflamatorio y fibras necróticas. El análisis histoquímico reveló que el perimisio del grupo mdxC está organizado en fibras de colágeno gruesas y agrupadas, lo que genera una mayor área de fibras de colágeno intramusculares para estos animales. La histomorfometría indicó que el área de fracción de las fibras de colágeno del grupo mdxC era más alta que el grupo mdxE (p = 0,04) y los valores del grupo mdxE eran similares al grupo WT (p = 1,00). Las fibras de los núcleos ubicados centralmente y el coeficiente de varianza (VC) del diámetro mínimo de Feret fueron similares en los grupos mdxE y mdxC (p = 1,00) y ambos grupos presentaron valores medios más altos que el grupo WT (p <0,00). La inmunohistoquímica reveló la presencia de colágeno tipo I principalmente en el grupo mdxC. El protocolo LIT no había agravado las lesiones musculares resultantes de la fragilidad de la membrana con deficiencia de distrofina al mismo tiempo que había reducido la deposición intramuscular de colágeno. LIT ha influido positivamente en estos marcadores de lesión muscular distrófica en el músculo gastrocnemio del modelo mdx.

Evolução funcional da distrofia muscular do tipo Cinturas em indivíduos de uma mesma família / Functional evolution of Girdle Muscular Dystrophy in individuals of the same family

A Distrofia Muscular de Cinturas (DMC) possui herança autossômica dominante ou recessiva e caracteriza-se por paresia progressiva que induz à deterioração funcional e dificuldades no desempenho de atividades cotidianas. O objetivo do presente estudo foi analisar a evolução funcional de indivíduos com diagnóstico de DMC de uma mesma família. Nove indivíduos foram avaliados por um questionário para identificação do parentesco, idade de inicio dos primeiros sintomas e queixas principais, e pelas Escalas de Vignos (EV) e Hammersmith (EMFH). O projeto foi aprovado pelo CEP/UFVJM, protocolo nº061/12. A idade média foi de 33 ± 8.1 anos, com seis indivíduos sendo do sexo masculino, a idade de aparecimento dos primeiros sintomas foi aos 9± 2,83 anos e os sintomas iniciais mais frequentes foram dificuldade de correr, quedas e marcha equina. Os sujeitos pontuaram 4, 6 e 7 na EV e no exame físico verificou-se acometimento principalmente dos membros inferiores. Foi encontrado correlação negativa entre idade dos sujeitos e escore na EMFH (r2=-0,839) e entre pontuação na EV e EMFH (r2 =-0,819), e correlação positiva entre EV e uso de dispositivos (r2=0,866). Nossos achados sugerem que a mesma patologia diagnosticada em indivíduos de uma mesma família apresenta repercussões funcionais diferentes. O aspecto ambiente deve ser levado em consideração ao avaliar a funcionalidade desses indivíduos uma vez que, independente do diagnóstico em comum, da idade, e limitações físicas, os indivíduos apresentaram adaptações particulares com objetivo de manutenção do seu deslocamento de acordo com as características do ambiente em que vive.(AU)

Limb Girdle Muscular Dystrophy (LGMD) is an autosomal-dominant or recessive hereditary disease. Progressive muscular weakness leads to functional damage and difficulty to perform activities of daily life. The present study aimed to analyze the functional evolution of LGMD individuals of the same family. Nine individuals were assessed using a questionnaire (to identify their relationship, age of onset of the first signs of the disease and main complaints) and by Vignos and Hammersmith Scales. Projetct was aproved by Ethics Committee of UFVJM, protocol nº061/12. Mean age was 33±8.1 years old, six male, mean age of onset of the first signs was 9± 2,83 years old and the most frequent signs were difficulty to run, falls and gait with ankle on plantar flexion. Subjects scored 4, 6 and 7 on Vignos Scale and on physical exam, lower limbs were the most affected. Negative correlation between age and Hammermith scale (r 2=-0,839), Vignos and Hammersmith Scale (r2=-0,819) were found. Positive correlation between Vignos Scale and use of assistive devices (r2=0,866). Our finds suggest that the same disease in individuals of the same family leads to different functional impairment. The environmental aspect should be considered when assessing functionality of individuals with LGMD once although they present the same diagnosis, they present particular adaptations with the aim of maintain displacement according to characteristics of the environment where they live.(AU)

Análise das dosagens e concentrações séricas da ciclosporina A em cães da raça Golden Retriever normais ou afetados pela distrofia muscular / Analyses of dosages and blood concentration of cyclosporin A on norrmal Golden Retriever dogs or Golden Retriever with muscular dystrophy

A distrofia muscular dos cães Golden Retriever (GRMD), uma miopatia degenerativa causada pela ausência da distrofina é geneticamente homóloga à distrofia muscular de Duchenne que acomete humanos, portanto, estes cães são considerados modelos experimentais para estudos em terapia celular. Seu sucesso depende da imunossupressão adequada. A ciclosporina A (CsA) é indicada para tal e a monitorização de suas concentrações sangüíneas e efeitos adversos são essenciais para viabilizar a terapia. Foram estudados cães GRMD, e normais da mesma raça, submetidos a terapia com CsA, associada, nos GRMD, ao transplante de células tronco. Foram avaliados as concentrações sangüíneas do fármaco através de amostras coletadas a cada dois ou três dias e analisadas pelo método do imunoensaio por fluorescência (FPIA). Como resultado observamos que as concentrações de CsA oscilaram muito, em seis dos oito animais. Concluímos que as doses variam individualmente sendo de maior importância avaliar a concentração do fármaco no sangue e sua viabilização no uso da terapia celular

The muscular dystrophy of Golden Retriever (GRMD) is a degenerative miopaty caused by the absence of dystrophy and it is genetically homologue of the Duchenne muscular dystrophy in humans, so, these dogs are considerably experimental models for studies on cellular therapy. Their successful depends of the adequate immunosuppression. Cyclosporin A (CsA) is indicated for that and the monitoring of the blood concentration and adverse effects are essential to viabilise the therapy. It was studied GRMD dogs, and normal dogs from the same breed, submitted for therapy with CsA, associated, on GRMD, of cell transplantation. It was evaluated blood concentration of the drug, between two or tree days using the method of FPIA. In our results we found that the CsA blood concentrations oscillated too much on six than eight of our animals. We concluded that the doses varieties Braz. J. vet. Res. anim. Sci., São Paulo, v. 45, n. 2, p. 131-137, 2008 individually and the correct dosage as to important as the evaluation of the blood concentration of the drug and became viable for cell therapy

Efeitos da ciclosporina a sobre a função renal de cães da raça Golden Retriever normais ou afetados pela distrofia muscular / Effect of cyclosporin A on renal functions of normal Golden Retriever dogs or Golden Retriever with muscular dystrophy

A distrofia muscular dos cães Golden Retriever (GRMD), uma miopatia degenerativa causada pela ausência da distrofina, é geneticamente homóloga à distrofia muscular de Duchenne que acomete humanos, portanto, estes cães são considerados modelos experimentais para estudos em terapia celular. Seu sucesso depende da imunossupressão adequada. A ciclosporina A é indicada para tal e a monitorização de suas concentrações sangüíneas e efeitos adversos são essenciais para viabilizar a terapia. Foram estudados cães GRMD e normais da mesma raça, submetidos à terapia com CsA, associada, nos GRMD, ao transplante de células tronco. Foram avaliados os possíveis efeitos do fármaco sobre a função renal, sendo consideradas as manifestações clínicas, urinálise, testes de função glomerular, e concentrações séricas de uréia, creatinina, sódio e potássio. Como resultado houve aumento discreto na uréia sérica de ambos os grupos; cilindrúria e proteinúria e aumento da densidade urinária no grupo dos GRMD. Concluímos que a CsA pode causar lesão aguda de túbulos renais, principalmente em GRMDs; os mesmos também reagem de modo distinto com relação à homeostase de íons e função renal. Entretanto, diagnóstico precoce e tratamento podem prevenir o agravamento das lesões e desenvolvimento de insuficiência renal.

The muscular dystrophy of Golden Retriever is a degenerative miopaty caused by the absence of dystrophy and it is genetically homologue of the Duchenne muscular dystrophy in humans, so, these dogs are considerably experimental models for studies on cellular therapy. Their successful depends of the adequate immunosuppression. Cyclosporin A is indicated for that and the monitoring of blood concentration and adverse effects are essential to viabilise the therapy. It was studied GRMD dogs, and normal dogs from the same breed, submitted for therapy with CsA, associated, on GRMD, of cell transplantation. It was evaluated the possible effects of the drug on renal functions. It has been considerate the clinic manifestations, urinalisis, testis of glomerular function and blood concentrations of urea, cretinine, sodium and potassium. In our results we found a discrete increase of blood urea on booth groups; increased levels of urine's cylinders and protein and also increase of urinary density on GRMD group. CsA therapy could make acute lesions on renal tubules, especially on GRMD. These dogs also have different reactions than normal dogs on relation of ions homeostasis and renal function. However, earlier diagnosis and adequate treatment could prevent the development of renal diseases.

Análise da eficácia do estágio supervisionado em fisioterapia na formação profissional: uma visão do egresso / Analysis of the efficiency of the supervisioned apprenticeship in physiotherapy for the formation of the professional: the view of the newly graduate

Segundo as Diretrizes Curriculares de 2002, os cursos de graduação em Fisioterapia devem garantir uma sólida formação básica, para começar a preparar o futuro profissional a enfrentar os desafios das rápidas transformações da sociedade, do mercado de trabalho e das condições de exercício profissional. O objetivo do presente trabalho foi analisar a eficiência do Estágio Supervisionado do Curso de Graduação em Fisioterapia na formação do profissional Fisioterapeuta a partir da visão do ex–aluno. Participaram deste estudo 28 profissionais Fisioterapeutas graduados em 2002 pela UNIPAR. Todos os indivíduos responderam a um questionário constando de quatorze questões objetivas com espaço para comentários. Os dados foram tabulados para posterior análise. A maioria dos entrevistados afirmaram estar atuando na área de fisioterapia (85 por cento) dos quais 54,5 por cento em uma área específica, sendo a mais freqüente a Ortopedia e Traumatologia. Todos os entrevistados julgaram a prática curricular supervisionada do último ano como importante para sua formação e 85,7 por cento afirmaram sentirem-se aptos para atuar a partir da prática curricular, demonstrando que os objetivos do estágio supervisionado vem sendo cumpridos. Conclui-se que o estágio supervisionado é de extrema importância para a formação do profissional Fisioterapeuta e que a maioria está apto para atuar imediatamente após a conclusão do curso, apesar de sentir a necessidade de uma formação continuada. O ambiente de estágio foi considerado adequado e a duração pequena, apesar do mesmo estar de acordo com a legislação corrente. Sugere-se que sejam avaliadas as possibilidades de inclusão de novas áreas emergentes na atuação