Pain mapping and characteristics in breast cancer survivors during task-oriented training: analysis at 3, 6, and 9 months.

PURPOSE: To evaluate the frequency and characteristics of trunk and upper limb pain in women diagnosed with breast cancer, in different movement planes, during task-oriented training (TOT) 3, 6, and 9 months after surgery. METHODS: A prospective cohort study with 20 women. The body pain diagram (BPD), VAS, and McGill questionnaire were used. The TOT consisted of 20 exercises based on the Disabilities of the Arm, Shoulder and Hand Questionnaire (DASH) questionnaire. BPD overlay was performed in GIMP® image editor. The chi-square test was applied to the relationship between population characteristics and pain. Freedman's ANOVA and the Cochran's Q test were used in the comparison of pain site frequencies and intensity over time. RESULTS: In total, 297 BPDs were generated, which identified the affected upper limb as the body area with the highest frequency of pain at the three moments. However, at 9 months, the unaffected upper limb presented the same frequency as the affected limb. Radiotherapy presented a statistically significant relationship (p < 0.05) with pain at 9 months. The pain was characterized as moderate at the three moments, affective at 3 and 6 months, and sensory at 9 months. CONCLUSION: The most frequent area of pain at 3 and 6 months was the affected upper limb however, at 9 months, the unaffected upper limb presented the same frequency of pain as the affected upper limb. Pain was characterized as moderate at the three evaluation moments.

Manual Therapy as Treatment for Chronic Musculoskeletal Pain in Female Breast Cancer Survivors: A Systematic Review and Meta-Analysis.

OBJECTIVE: The purpose of this systematic review was to investigate the effectiveness of manual therapy (MT) for chronic musculoskeletal pain (CMP) in the upper limbs and thorax of female breast cancer survivors and to investigate the changes in the quality of life and function of these patients. METHODS: Systematic searches were performed in the databases MEDLINE/PubMed, Cumulative Index of Nursing and Allied Health/EBSCO, Web of Science, and Physiotherapy Evidence Database, through March 2018, to identify randomized controlled trials investigating whether MT was effective to treat CMP pain in female breast cancer survivors (PROSPERO number CDR42017074175). RESULTS: The database searches retrieved 1562 titles, and after screening, 5 papers were included for full analysis. The manual therapy techniques described in the included studies involved myofascial induction, myofascial release, classic massage, ischemic compression of trigger points, and myofascial therapy. A meta-analysis, using a fixed-effects model, found that MT decreased CMP intensity (standardized mean difference: 0.32; 95% CI 0.06-0.57), but no significant difference was observed in quality of life after the MT intervention in comparison with a control condition (standardized mean difference: 0.14; 95% CI 0.17-0.46). CONCLUSION: Current evidence suggests that MT is considered effective for treating CMP in the upper limbs and thorax of female breast cancer survivors.

Prevalência dos sintomas da endometriose. : Revisão Sistemática / Prevalencia de síntomas en la endometriosis: Revisión sistemática

bjetivos: estabelecer qual a prevalência dos sintomas nas mulheres com endometriose, levando-se em consideração os dados epidemiológicos e o comprometimento dos sistemas por ela acometidos. Fonte de dados: A pesquisa foi realizada nas bases de dados: Medline (Ovid Web); Scopus e PubMed. Métodos de revisão: Foram incluídos estudos publicados a partir de 2009. Os estudos foram avaliados por dois revisores independentes que avaliaram o título, e o resumo e posteriormente cruzaram os dados, as discrepâncias foram analisadas por um terceiro revisor. Após este processo os textos completos foram analisados e os dados relevantes à pesquisa extraídos. Resultados: Os estudos revelam que os sintomas referentes ao sistema reprodutor são os mais característicos no quadro de endometriose. Mulheres de raça branca, com nível superior completo e idade média de 34 anos são as mais acometidas. E tempo de demora do diagnóstico é em torno de 5 anos. Conclusões: Os principais sintomas prevalentes encontrados nesta revisão foram a dismenorréia, a dor pélvica crônica e a dispareunia, mas sintomas secundários como a depressão também tem se tornado significativos. Eles aparecem, sobretudo nas mulheres caucasianas e em idade reprodutiva, acentuando-se perto do período menstrual, onde o estrógeno está presente em maiores quantidades, e aliviando com a gravidez e com a menopausa.

Objetivos: establecer cuál es la prevalencia de los síntomas en las mujeres con endometriosis, teniendo en cuenta la información epidemiológica y el compromiso de los sistemas que se afectan. Fuente de datos: la búsqueda se realizó en las bases de datos: Medline (Web Ovid); Scopus y PubMed. Métodos: se incluyeron estudios publicados desde 2009. Los estudios fueron evaluados por dos revisores independientes que evaluaron el título y el resumen y luego cruzaron los datos; las discrepancias fueron analizadas por un tercer revisor. Después de este proceso se analizaron los textos completos y extrajeron los datos relevantes para la investigación. Resultados: los síntomas relacionados con el sistema reproductivo son los más característicos en la endometriosis. Las más afectadas son las mujeres de raza blanca con títulos universitarios y edad promedio de 34 años. El retraso al momento del diagnóstico es de alrededor de cinco años. Conclusiones: los principales síntomas predominantes que se encuentrraron en esta revisión fueron dismenorrea, dolor pélvico crónico y dispareunia, pero los síntomas secundarios como la depresión también son importantes. Aparecen principalmente en las mujeres caucásicas en edad reproductiva, cerca de la menstruación, cuando el estrógeno está presente en cantidades más grandes y se alivian con el embarazo y la menopausia.

Objectives: to establish what its the prevalence of symptoms in women with endometriosis, taking into account the epidemiological information and the commitment of the systems suffer from it. Data Source: The survey was conducted in the databases: Medline (Ovid Web); Scopus and PubMed. Review methods: We included studies published since 2009. The studies were assessed by two independent reviewers who assessed the title and the summary and then crossed the data, discrepancies were analyzed by a third reviewer. After this process the full texts were analyzed and extracted data relevant to research. Results: The studies reveal that the symptoms related to the reproductive system are the most characteristic in endometriosis frame. Whites women with college degrees and average age of 34 years are the most affected. And it delays the diagnosis time is around 5 years. Conclusions: The main prevalent symptoms found in this review were dysmenorrhea, chronic pelvic pain and dyspareunia, but secondary symptoms such as depression has also become significant. They appear mainly in Caucasian women of reproductive age, emphasizing close to the menstrual period, where the estrogen is present in larger quantities, and relieving with pregnancy and menopause.

Propuesta de puntos de corte para diferentes indicadores antropométricos en la predicción de la incontinencia urinaria en mujeres / Proposal of cut-off points for different anthropometric indicators in the prediction of urinary incontinence in women

INTRODUCCIÓN: Los episodios de pérdidas urinarias son causas de vergüenza social, disfunción sexual y bajo desempeño profesional. Objetivos: Identificar la sensibilidad y especificidad, y proponer puntos de corte de diferentes indicadores antropométricos para la predicción en mujeres de la incontinencia urinaria (IU). MÉTODOS: Fueron evaluadas 500 mujeres de la Gran Florianópolis, SC, Brasil, de un amplio rango etario, a partir del cuestionario ICIQ - SF para incontinencia urinaria. Fueron analizados los siguientes indicadores antropométricos: Circunferencia de Cintura (CC), Índice de Masa Corporal (IMC), Índice Cintura/Cadera (ICC), Razón Cintura/Estatura (RCE), Índice de Adiposidad Corporal (IAC) e Índice de Conicidad (Índice C). Para el análisis estadístico de los datos, fueron utilizadas pruebas de asociación y cálculos de sensibilidad y especificidad por medio de curvas ROC. RESULTADOS: La prevalencia de IU fue 35%. Se observaron correlaciones significativas entre los indicadores antropométricos y frecuencia e intensidad de pérdidas urinarias. La RCE fue el indicador antropométrico con mayor área sobre la curva ROC (0,618). La CC fue el indicador antropométrico con mayor sensibilidad y el Índice C, aquel con la mayor especificidad para la predicción de la IU. Mujeres con CC con 78,5 cm o más presentaron 1,24 vez más prevalencia de IU (p<0,05). Mujeres con Índice C de 1,23 puntos o más presentaron 1,23 vez más prevalencia de IU (p<0,05). CONCLUSIONES: Los indicadores antropométricos, especialmente aquellos que llevan en consideración la CC, presentaron asociaciones significativas y pueden ser usados como indicativos de IU.

BACKGROUND: The episodes of urinary incontinence may cause social embarrassment, sexual dysfunction and diminished work performance. Objectives: To identify the sensitivity, specificity and to propose cutoff points of different anthropometric indicators for the prediction of urinary incontinence (UI) in women. METHODS: 500 women from Florianópolis, SC, Brazil, from a wide age range, were assessed using the Internatinal Consultation on Incontinence Questionnaire (ICIQ - SF). The anthropometric indexes analyzed were: Waist Circumference (WC), Body Mass Index (BMI), Waist / Hip Ratio (WHR), Waist / Height Ratio (WHeR), Body Adiposity Index (IAC) and Conicity Index (Index C). For statistical analysis, association tests and calculations of sensitivity and specificity by ROC curves were used. RESULTS: The prevalence of UI was 35%. There were significant correlations between anthropometric indicators and frequency and intensity of UI. The WHeR was the index with the largest area under the ROC curve (0.618). The WC was the most sensitive index and the index C had the highest specificity. Women with WC with 78.50 cm or more exhibited 1.24 increased prevalence of UI (p < 0.05). Those women with index C of 1.23 or more showed 1.23 greater prevalence of UI (p < 0.05). CONCLUSIONS: Anthropometric indicators, especially those which take into account the WC, showed significant associations and can be used as predictors of UI.

Características biomecânicas dos pés no período gravídico-puerperal: estudo de caso / Biomechanical characteristics of feet during pregnancy and puerperium: a case study

Objetivos: Avaliar as variações antropométricas e a distribuição de pressão plantar dos pés durante o ciclo gravídico-puerperal de uma paciente.Descrição do caso: Este estudo descritivo-exploratório analisou uma gestante por meio de oito avaliações, seis durante a gestação (na 26ª, 28ª, 30ª, 32ª, 34ª e 36ª semana da gestação) e duas no puerpério (10º e 50º dia após o parto). Foram avaliadas seis variáveis antropométricas dos pés e tornozelos. Por meio do escaneamento dos pés, obteve-se indiretamente o ângulo da impressão plantar. O Sistema Pedar-Mobile (Novel GmbH), avaliou o índice do arco plantar e o pico de pressão máxima plantar tanto estático como dinâmico. Durante o período gestacional o comprimento e o perímetro do mediopé direito apresentaram-se maiores do que o esquerdo. Ocorreu diminuição do ângulo plantar com a evolução da gestação. A variação do índice do arco plantar na tarefa estática mostrou variação mínima em todo o período avaliado, enquanto na dinâmica demonstrou diminuição progressiva dos valores durante a gestação e aumento no período puerperal. As médias dos picos de pressão plantar na tarefa dinâmica foram mais elevadas durante o período gestacional em comparação ao puerpério.Conclusões: Estes dados mostram alterações nas características biomecânicas dos pés no ciclo gravídico-puerperal, ressaltando aumento na perimetria e diminuição do arco plantar.

Aims: To evaluate anthropometric variations and distribution of plantar pressure during pregnancy and puerperium. Case description: In this descriptive exploratory study, a pregnant woman was submitted to eight assessments, six of them during pregnancy (at 26, 28, 30, 32, 34, and 36 weeks of gestation) and two in the postpartum period (at 10 and 50 days postpartum). Six foot and ankle anthropometric parameters were assessed. The footprint angle was indirectly obtained by scanning electron microscopy. The Pedar-Mobile (Novel GmbH) system assessed the plantar arch index and maximum peak plantar pressure both statically and dynamically. The right mid-foot length and circumference were larger than those of the left mid-foot during the gestational period. Footprint angle decreased as the gestational period progressed. The plantar arch index in static footprints varied slightly throughout the study period, but it progressively decreased during pregnancy and increased in the postpartum period. The average peak plantar pressure in dynamic footprints was higher during pregnancy than in the postpartum period.Conclusions: These data reveal changes in the biomechanics of feet during pregnancy and puerperium, indicating an increase in circumference measurement and a reduction in plantar arch.

Características posturais de idosos praticantes de atividade física / Postural characteristics of elderly who practice physical activities

Objetivos: Os objetivos deste estudo foram caracterizar e descrever a postura de idosos praticantes de atividade física.Métodos: Foram estudados idosos com idade entre 60 e 80 anos, do Grupo de Estudos da Terceira Idade da Universidade do Estado de Santa Catarina, que praticavam atividade física por pelo menos dois dias na semana. Os dados foram obtidos por fotogrametria computadorizada com o Software para Avaliação Postural (SAPO) nas vistas laterais, anterior e posterior. Foi realizada estatística descritiva por meio de média e desvio padrão.Resultados: A amostra foi composta por 40 idosos, sendo 34 mulheres e seis homens. As características posturais encontradas na vista anterior foram rotação da cabeça, elevação de ombros, escápula e pelve e rotação interna dos membros inferiores; na vista posterior foi valgismo de retropé, tanto direito quanto esquerdo; e, na vista lateral, foram anteriorização da cabeça, inclinação do tronco para trás, extensão de quadril, anteversão pélvica e joelhos fletidos.Conclusões: Algumas características posturais observadas nos idosos ativos foram semelhantes àquelas encontradas no envelhecimento normal. No entanto, a inclinação do tronco para trás e a extensão do quadril diferiram da postura flexora típica dos idosos. Acreditamos que estas características sejam consequência dos exercícios físicos que promovem o fortalecimento da musculatura extensora, importante para a manutenção da postura correta...

Aims: The purposes of this study were to characterize and to describe the posture of elderly who practice physical activities.Methods: Elderly participants of the Third Age Study Group at the Santa Catarina State University, between 60 and 80 years old, who practiced physical activity for at least two days a week, were studied. Data were obtained through computerized photogrammetry using the Postural Assessment Software (PAS/SAPO) in anterior, posterior and side views. Descriptive statistics were performed by using the mean and standard deviation.Results: The sample consisted of 40 subjects, 34 women and six men. Postural characteristics in the anterior view were head rotation, lifting shoulders, scapula and pelvis, and internal rotation of the lower limbs; in the posterior view were right and left valgus hindfoot; and, in the side view, were the head forward, backward inclination of the trunk, hip extension, pelvic anteversion and flexed knees.Conclusions: Some postural features observed in seniors engaged in physical activity were similar to those found in normal aging. However, inclination of trunk backward and extension of the hip differed from the typical flexor posture of the elderly. We believe that these features are a consequence of physical exercises that promote the strengthening of the extensor muscles, important for maintaining the correct posture...