Muscle oxygenation and pain in different types of temporomandibular disorders.

OBJECTIVES: Studies exploring variations in peripheral muscle oxygenation and pressure pain thresholds (PPT) of masticatory muscles in individuals with Temporomandibular Disorders (TMDs) are limited. The purpose of this study was to compare variations in peripheral oxygenation of the masseter muscle; PPT of the masseter and temporal muscles and correlate peripheral muscle oxygenation and PPT of the masseter muscle in individuals with different types of TMDs. MATERIALS AND METHODS: Cross-sectional study involving 116 participants classified into three groups: muscle group (MG, n = 32), joint group (JG, n = 30) and muscle-joint group (MJG, n = 54). Individuals aged 26.97 ± 6.93, 68.97% female, 31,03% males were included. All participants were evaluated using the Diagnostic Criteria for Temporomandibular Disorders, Near-infrared spectroscopy (NIRS) for peripheral muscle oxygenation and pressure algometer for PPT. RESULTS: There was no difference in masseter muscle oxygenation among groups. In the masseter muscle, a weakly positive correlation was observed between PPT and variation in tissue saturation index in the MG (rho = 0.365) and JG (rho = 0.317). In addition, the MJG expressed lower PPT (p = 0.004) than JG, demonstrating that MJG had more pain in this muscle. CONCLUSIONS: MJG have lower PPT in the masseter muscle. Although the PPT is dependent on the type of TMDs, the correlation between PPT and oxygenation is weak. All TMDs groups evaluated (MG, JG, MJG) showed hemodynamic similarities of the masseter muscle. CLINICAL RELEVANCE: Understanding pain thresholds and the hemodynamic behavior of the masticatory muscles contributes to a more assertive physiotherapeutic assessment in TMDs, serving as a basis for careful and individualized interventions.

Peripheral muscle oxygenation and symptoms of stress in adolescents with and without temporomandibular disorder.

OBJECTIVE: To compare peripheral muscle oxygenation levels and the prevalence of psychological stress in adolescents with and without temporomandibular disorder (TMD). METHODS: A cross-sectional study was performed with adolescents submitted into two groups: those diagnosed with TMD (DG) and control (CG). Muscle oxygenation was measured by near-infrared spectroscopy in the masseter and upper trapezius muscles. Symptoms of stress were assessed by Lipp's Stress Symptom Inventory for Adults or Child Stress Scale. A Student t-test was used for intergroup comparisons and association between categorical variables by chi-square test, phi coefficient of correlation, odds ratio, and two-way ANOVA. RESULTS: Fifty-three adolescents were evaluated and a significant reduction was observed in the oxyhemoglobin level in the masseter muscle at rest (p = 0.04) and contraction (p = 0.02). A greater total hemoglobin level was found in the upper trapezius muscle at rest in DG (p = 0.03), with a significant difference in the tissue saturation index during contraction (p = 0.05) intergroup. Individuals in the DG were 4.523 times more likely to exhibit signs and symptoms of stress than in CG. CONCLUSION: Adolescents from DG showed reduced masseter oxyhemoglobin values at rest and during contraction and showed more signs and symptoms of stress than healthy controls. In the upper trapezius, DG showed higher values of total circulating hemoglobin, essential for greater blood flow and efficient maximum voluntary contraction. CLINICAL RELEVANCE: Changes in tissue oxygenation and stress in adolescents with TMD prompted the earlier treatment of this population to prevent disease progression into adulthood.

The effectiveness of different electrical nerve stimulation protocols for treating adults with non-neurogenic overactive bladder: a systematic review and meta-analysis.

INTRODUCTION AND HYPOTHESIS: Electrical nerve stimulation is a widely used treatment for overactive bladder but there is no consensus regarding the best placement of electrodes or protocols. We hypothesised that some non-implanted neurostimulation protocols would be more effective compared to others for treating urinary symptoms and improving quality of life among adults diagnosed with non-neurogenic overactive bladder. METHODS: A systematic review and meta-analyses of randomized clinical trials were performed in five electronic databases: PubMed/MEDLINE, Lilacs, CINAHL, Web of Science, and PEDro. The main outcome was urinary symptoms-frequency, nocturia, and urgency-and the secondary outcome quality of life. Some protocol characteristics were extracted, e.g., frequency, pulse width, intensity, intervention time, and electrode placement. RESULTS: Nine randomized controlled trials were included. Tibial neurostimulation showed better results than sacral neurostimulation for urge incontinence (mean difference = 1.25 episodes, 95% CI, 0.12-2.38, n = 73). On the pooled analysis, the different neurostimulation protocols-intravaginal, percutaneous tibial, and transcutaneous tibial nerve stimulation-demonstrated similar results for urinary frequency, nocturia, and urgency as well as quality of life. In general, effect sizes from meta-analyses were low to moderate. The best reported parameters for percutaneous tibial nerve stimulation were 20-Hz frequency and 200-µs width, once a week. CONCLUSIONS: There was evidence that tibial neurostimulation is more effective than sacral neurostimulation for urge incontinence symptoms among patients with non-neurogenic overactive bladder. Overall, there was no superiority of an electrical nerve stimulation electrode placement and protocol over others considering urinary symptoms and quality of life. Further studies with three-arm trials are necessary. This study was registered at PROSPERO: CRD4201810071.

Quality Assessment of Neonatal Pain Scales Translated and Validated to Brazilian Portuguese: A Systematic Review of Psychometric Properties.

OBJECTIVES: The objective of this systematic review was to identify and describe the psychometric properties of neonatal pain scales that were translated into Brazilian Portuguese and to verify the methodological quality of these translation, transcultural adaptations and validation. DESIGN: The present study is a systematic review. A systematic search in the literature included studies of development, validation, and transcultural adaptation of neonatal pain scales to Brazilian Portuguese. The instruments must have been developed for health care professionals to evaluate neonatal pain and stress in full-term and preterm newborns. DATA SOURCES: The search strategy was conducted in PubMed, Web of Science, Scopus, and Scielo databases following The PRISMA guidelines (Preferred Reporting Items for Systematic Reviews and Meta-Analyses). REVIEW /ANALYSIS METHODS: A total of 1,479 publications were identified and 5 fulfilled the inclusion criteria, with 4 instruments evaluated. For the methodological quality analysis of the measurement properties of the instruments the Consensus-based Standards for Health Measurement Instruments (COSMIN) Risk of Bias checklist was used. The psychometric properties verified were internal consistency, content validity, reliability, and construct validity. RESULTS: Three instruments reviewed were inadequate and one was doubtful. CONCLUSIONS: The neonatal pain scales wich were cross culturally adapted to Brazilian Portuguese were shown to be of low methodological quality based on COSMIM checklist. Caution should be considered for clinical decisions about pain management judgment coming from these instruments.

Canadian and Brazilian Percentile Ranks for the Alberta Infant Motor Scale.

Aim: To verify if there is a difference between the percentile ranks for Brazilian infants compared with norms for Canadian infants on the Alberta Infant Motor Scale (AIMS). Method: A cross-sectional study in which 322 Brazilian infants, 2 to 15 months old, were administered the AIMS. Percentile ranks were calculated using norms for Canadian infants and norms from two studies of Brazilian infants. The Friedman test compared the AIMS percentile ranks for the entire sample. For reliability analysis, the interclass correlation coefficient (ICC) was used. Bland Altman's analysis was applied to compare percentile ranks. Results: Of the 322 evaluations analyzed, there were significant differences (p<.001) between the three percentile ranks compared. The Canadian norms presented the lowest average rating. There was good reliability between the percentile ranks (ICC > 0.75) but low agreement (Bland Altman; p<.001). Conclusion: There are differences between the Brazilian and Canadian percentile ranks and between the Brazilian percentile ranks of 2014 and 2016, and these differences may influence identification of motor development.

Whole-body vibration therapy does not improve the peripheral nerve regeneration in experimental model.

OBJECTIVES: Whole-body vibration (WBV) is commonly used to improve motor function, balance and functional performance, but its effects on the body are not fully understood. The main objective was to evaluate the morphometric and functional effects of WBV in an experimental nerve regeneration model. METHODS: Wistar rats were submitted to unilateral sciatic nerve crush and treated with WBV (4-5 weeks), started at 3 or 10 days after injury. Functional performances were weekly assessed by sciatic functional index, horizontal ladder rung walking and narrow beam tests. Nerve histomorphometry analysis was assessed at the end of the protocol. RESULTS: Injured groups, sedentary and WBV started at 3 days, had similar functional deficits. WBV, regardless of the start time, did not alter the histomorphometry parameters in the regeneration process. CONCLUSIONS: The earlier therapy did not change the expected and natural recovery after the nerve lesion, but when the WBV starts later it seems to impair function parameter of recovery.

Positioning Effects for Procedural Pain Relief in NICU: Systematic Review.

OBJECTIVES: To systematically review the literature regarding the effectiveness of different positioning methods for procedural pain relief in neonates admitted to the Neonatal Intensive Care Unit (NICU). DESIGN: A systemized search of the literature was carried out by means of two independent evaluators through the systematic search of electronic index databases. DATA SOURCES: A search for relevant studies was performed in four databases (Medline, Web of Science, Scopus, and BVS-BIREME). REVIEW/ANALYSIS METHODS: Manual searches were conducted on suitable references from the included articles, and 1,941 publications were eligible for the analysis. The flowchart for the articles' selection was based on Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) criteria, and in relation to bias risks according to the Physiotherapy Evidence Database (PEDro) scale. RESULTS: Based on the inclusion criteria, only 20 publications remained. According to the PEDro scale, 75% of the studies presented good methodological quality, with scores between 6 and 8, and 5% scored ≤4 points. None of them were blinded in relation to the therapies, but all of them performed intergroup statistical comparisons. According to the results of this review, we recommend facilitated tucking by parents (FTP) in NICU of at least 30 minutes duration, starting 15 minutes before, during the painful procedure, and 15 minutes after to relieve pain and to stabilize the physiological, hormonal, and behavioral responses of the newborns. CONCLUSIONS: Positioning should be used as a nonpharmacological strategy for procedural pain relief in newborns. This review showed that facilitated tucking by parents for 30 minutes was the best position for pain relief in premature newborns during procedures in the NICU. Positioning is recommended as a nonpharmacological method for pain relief; FTP of at least 30 minutes duration should be the first positioning choice during procedures in the NICU.

Predictors for Screen Time Exposure among Children between 3 and 5 Years Old in Southern Brazil.

BACKGROUND: The use of technology is an increasingly common practice among preschoolers. Little is known about the relationship between screen time exposure (STE) and aspects related to family and the environment. AIM: The aim is to characterize STE in Brazilian children aged between 3 and 5 years. Furthermore, the objective of this study is to associate the STE of children and of their parents with sociodemographic variables. METHODS: Children aged between 3 and 5 years from southern Brazil and their parents participated in this study. To investigate STE, the researchers developed a specific questionnaire. To compare STE between age groups, the Kruskal-Wallis test was performed, followed by Dunn's post hoc test. Spearman's correlation and linear regression were used to correlate the variables. RESULTS: Children (n = 237) spend an average of 3.7 ± 0.8 h/day in front of screens. The STE of children had a moderately positive correlation with the STE of their parents (r = 0.4; p-value < 0.001). Only the variables of the children's and parents' STE had a significant and positive association. The model is significant (F = 6164, p-value < 0.001) and the residuals of the model met the necessary assumptions, with normal distribution, constant variance and without the presence of outliers. CONCLUSION: Children in southern Brazil remain in front of screens four times longer than the recommended amount of time. It was also found that the STE of parents directly influences that of their children.

Surface electromyography after lower level laser therapy application on skeletal muscles in individuals with heart failure.

The purpose of this study was to investigate the effects of low-level laser therapy (LLLT) applied before a fatigue protocol through the effects on the electrical activation in the quadriceps muscle in patients with HF. Fourteen patients with the diagnosis of heart failure (HF) were selected for this double-blind, crossover type clinical trial. These participants have attended to a familiarization, LLLT, and placebo sessions, totaling three visits. The LLLT was applied in the quadriceps muscle (850 nm, 5 J per diode). The fatigue protocol consisted of concentric and eccentric isokinetic contractions (cc/ec) until exhaustion or up to 50 cc/ec. The muscular fatigue was evaluated with surface electromyography, by the analysis of integral, median frequency, and entropy. Only one application of LLLT is not able to decrease skeletal muscle activation in patients with HF. There was no reduction of muscle fatigue among the proposed protocols. Single LLLT session has no effect on the reduction of skeletal muscle fatigue in patients with HF.

Respiratory muscle training decreases diaphragm DNA damage in rats with heart failure.

Respiratory muscle training (RMT) promotes beneficial effects on respiratory mechanics, heart and lung morphological changes, and hemodynamic variables in rats with heart failure (HF). However, the relation between RMT effects and diaphragm oxidative stress remains unclear. Therefore, the aim of this study was to evaluate the RMT effects on diaphragm DNA damage in HF rats. Wistar rats were allocated into 4 groups: sedentary sham (Sed-Sham, n = 8), trained sham (RMT-Sham, n = 8), sedentary HF (Sed-HF, n = 8), and trained HF (RMT-HF, n = 8). The animals underwent a RMT protocol (30 min/day, 5 days/week for 6 weeks), whereas sedentary animals did not exercise. Groups were compared by a two-way ANOVA and Tukey's post hoc tests. In rats with HF, RMT promoted reduction in pulmonary congestion (p < 0.0001) and left ventricular end diastolic pressure (p < 0.0001). Moreover, RMT produced a decrease in the diaphragm DNA damage in HF rats. This was demonstrated through the reduction in the percentage of tail DNA (p < 0.0001), tail moment (p < 0.01), and Olive tail moment (p < 0.001). These findings showed that a 6-week RMT protocol in rats with HF promoted an improvement in hemodynamic function and reduces diaphragm DNA damage.

Long-term low-level laser therapy promotes an increase in maximal oxygen uptake and exercise performance in a dose-dependent manner in Wistar rats.

The use of low-level laser therapy (LLLT) represents a new intervention modality that has been explored to enhance exercise performance. The aim of this study was to evaluate the influence of LLLT (GaAIAs-850 nm) at different doses on VO2max and on exercise performance in rats. Male Wistar rats were divided into three groups: "placebo" rats (P-LLLT, n = 10), rats at a dose of 0.315 J per treatment point of LLLT (8.7 J/cm(2)-LLLT, n = 10), and rats at a dose of 2.205 J per treatment point of LLLT (61.2 J/cm(2)-LLLT, n = 10). The LLLT was applied bilaterally at the biceps femoris, gluteus, lateral and medial gastrocnemius, iliopsoas, and adductor longus muscles. One spot in each muscle belly was applied, with a sum of 12 spots in each rat, once a day, for 10 days. All animals performed the maximal exercise test (ET) at a metabolic treadmill for rats, with simultaneous gas analysis. The distance covered was measured during ET, before and after the conclusion of the LLLT protocol. The data were compared by a repeated measures two-way ANOVA followed by the Student-Newman-Keuls post hoc tests (p < .05). The 61.2 J/cm(2)-LLLT group increased VO2basal (~40 %), VO2max (~24 %), VCO2max (~17 %), and distance covered (~34 %) after LLLT application on the skeletal muscle. No significant results were found comparing before and after conditions for the studied variables considering P-LLLT and 8.7 J/cm(2)-LLLT groups. The LLLT promoted in a dose-dependent manner an increase in oxygen consumption uptake and a performance increment of male Wistar rats.

Light-emitting diode therapy (LEDT) improves functional capacity in rats with heart failure.

The syndrome of heart failure (HF) promotes central and peripheral dysfunctions that result in functional capacity decrease, leading to fatigue, dyspnea, and exercise intolerance. The use of light-emitting diode therapy (LEDT) has shown good results reducing fatigue and exercise intolerance, when applied on skeletal muscles before or after exercises. Thereby, the aim of this study was to compare the effects of LEDT on functional capacity, aerobic power, and hemodynamic function in HF rats. Male Wistar rats (230-260 g) were randomly allocated into three experimental groups: Sham (n = 6), Control-HF (n = 4), and LEDT-HF (n = 6). The animals were subjected to an exercise performance test (ET) with gas analysis coupled in a metabolic chamber for rats performed two times (6 and 14 weeks after myocardial infarction). On the day after the baseline aerobic capacity test, the animals were submitted during 8 weeks to the phototherapy protocol, five times/week, 60 s of irradiation, 6 J delivered per muscle group. Statistical analysis was performed by one- and two-way ANOVAs with repeated measures and Student-Newman-Keuls post hoc tests (p ≤ 0.05). Comparing the percentage difference (Δ) between baseline and the final ET, there was no significant difference for the VO2max variable considering all groups. However, Sham and LEDT-HF groups showed higher relative values than the Control-HF group, respectively, for distance covered (27.7 and 32.5 %), time of exercise test (17.7 and 20.5 %), and speed (13.6 and 12.2 %). In conclusion, LEDT was able to increase the functional capacity evaluated by distance covered, time, and speed of exercise in rats with HF.

Whole body vibration at different exposure frequencies: infrared thermography and physiological effects.

The aim of this study was to investigate the effects of whole body vibration (WBV) on physiological parameters, cutaneous temperature, tactile sensitivity, and balance. Twenty-four healthy adults (25.3 ± 2.6 years) participated in four WBV sessions. They spent 15 minutes on a vibration platform in the vertical mode at four different frequencies (31, 35, 40, and 44 Hz) with 1 mm of amplitude. All variables were measured before and after WBV exposure. Pressure sensation in five anatomical regions and both feet was determined using Von Frey monofilaments. Postural sway was measured using a force plate. Cutaneous temperature was obtained with an infrared camera. WBV influences the discharge of the skin touch-pressure receptors, decreasing sensitivity at all measured frequencies and foot regions (P ≤ 0.05). Regarding balance, no differences were found after 20 minutes of WBV at frequencies of 31 and 35 Hz. At 40 and 44 Hz, participants showed higher anterior-posterior center of pressure (COP) velocity and length. The cutaneous temperature of the lower limbs decreased during and 10 minutes after WBV. WBV decreases touch-pressure sensitivity at all measured frequencies 10 min after exposure. This may be related to the impaired balance at higher frequencies since these variables have a role in maintaining postural stability. Vasoconstriction might explain the decreased lower limb temperature.

Submaximal Field Walking Tests Applied in the Cardiopulmonary Assessment in Congenital Heart Diseases: A Systematic Review.

INTRODUCTION: Submaximal field walking tests are easy to apply and low cost, but it is necessary to standardize their application, especially in the pediatric population. The feasibility and its use in patients with congenital heart disease have been studied. The goal of this study was to verify which are the submaximal field walking tests applied in the cardiopulmonary assessment of children and adolescents with CHD and to verify if they are being performed as recommended by the standardization protocols/guidelines. METHODS: Literature review through a search in six electronic databases, structured in PICO format, without date restrictions. Looking for studies that used submaximal field walking tests in children and adolescents with congenital heart disease aged 5 to 18 years. Methodological quality, effectiveness and safety and risk of bias were assessed. RESULTS: Five studies met the eligibility criteria with a sample of 160 individuals with congenital heart disease, and all used the six-minute walk test. Note that different methodologies and modifications are used. Only the clinical trial showed good methodological quality.Four studies had low risk of bias and one study had moderate risk. CONCLUSION: Although the six-minute walk test is the only test used as a field test found in our research, there is no standardization in the application of the test, making it difficult to compare the results. In this sense, reducing the limitations and heterogeneity in the application of the test will enable more concrete outcomes and facilitate their reproduction in clinical practice.

Jazz Dance on Menopausal Symptoms and Psychological Aspects: A Randomized Clinical Trial Pilot Study With Follow-Up.

To analyze the short-term (one month intervention and post-intervention) and long-term (six-month follow-up) effects of Jazz Dance on menopausal symptoms (somatic, psychological and urogenital), in addition to the psychological aspects in specific (anxiety, depression, mood, stress, and aging perspective), compared to the control group of menopausal women. Randomized clinical trial with early postmenopausal women divided into two groups: Jazz Dance Intervention Group (GIDJ) (n = 23), and control group (CG) (n = 24). The physical exercise group received interventions of two weekly sessions of 60 minutes each, for 16 weeks. The control group received monthly calls, educational lectures, and maintained their usual activities during the intervention period. Assessments with all participants occurred at baseline, after the 1st month, after the interventions, and at the six-month follow-up. The evaluations are assessed by questionnaires and include menopausal symptoms (Menopause Rating Scale), depressive and anxiety symptoms (Anxiety and Depression Scale), stress (Perceived Stress Scale), mood (Brunel Mood Scale), and aging perspective (Sheppard Inventory). There was a significant improvement in GIDJ outcomes post-intervention, such as menopausal symptoms (p = .001), psychological aspects (anxiety (p = <.001), depression (p = .016) and stress (p = .030)); in the integrity domain (p = .011) for the aging perspective, and in the confusion (p = .028) and vigor (p = .044) domains for mood. Furthermore, the CG showed significant improvements in the happiness domain at one month of intervention (p = .043) from the perspective of aging. Jazz Dance is effective in treating symptoms of menopause, depression, anxiety and stress, especially with an intervention of at least 16 weeks duration.

Peripheral muscle oxygenation, pain, and disability indices in individuals with and without nonspecific neck pain, before and after myofascial reorganization®: A double-blind randomized controlled trial.

To investigate whether myofascial reorganization® in the trapezius muscle (MRT) improves peripheral muscle oxygenation and pain tolerance and decreases neck disability index (NDI) scores in individuals with and without nonspecific neck pain (NP) using a double-blind randomized controlled trial. Seventy-five subjects were equally and randomly assigned to three groups: the intervention groups (experimental [EG] and sham sSG]) and the control group (CG). Several inclusion criteria were applied to the intervention groups: male or female, aged 18-32 years, self-reported NP in the last 3 months without a defined cause; at least "soft" pain in session 1 of the NDI, and at least a score of 1 on the Visual Analogue Scale (VAS). The CG was required to have NDI and VAS scores of 0 at recruitment. Intervention: The EG underwent MRT for 10 min, once a week for 6 weeks. Patients with NP in the SG underwent classical massage for the same duration and frequency. Patients in the CG had no pain and underwent no intervention. Data collection was performed using the NDI Questionnaire, a pressure algometer for pain evaluation, and near-infrared spectroscopy for muscle oxygenation measurements. It was registered as NCT03882515 at ClinicalTrials.gov. The NDI score in both the EG (p<0.001) and SG (p<0.001) decreased after 6 weeks of intervention compared to the CG. The CG demonstrated a lower basal tissue saturation (TSI) index than the EG (p<0.001) and SG (p = 0.02). The EG demonstrated higher oxyhemoglobin values than the SG (p<0.001) and CG (p = 0.03). The CG had higher pain tolerance than the EG (p = 0.01) and SG (p<0.001) post-intervention. MRT increased trapezius muscle oxygenation after 6 weeks of intervention.

The Influence of Physical Exercises on the Flexibility of Older Individuals with Knee Osteoarthritis: A Systematic Review.

Background: Flexibility is a component of functional capacity and is relevant in maintaining the musculature and structures adjacent to the joints. Then, the improvement of the flexibility must be a critical goal in the rehabilitation programs. By improving flexibility in knee osteoarthritis (KOA) individuals, the pain is relieved, the risk of injury is reduced, and the need for surgical interventions is delayed. We aimed to summarize the available literature on the influence of different physical exercise modalities on flexibility in older KOA individuals. Methods: This study followed the PRISMA statement and registered in PROSPERO (CRD42020195786). Seven databases (MEDLINE/PubMed; PEDro; CINAHL; Scopus; Web of Science; Embase; and SPORTDiscus) were screened for papers published prior to Sep 6, 2022. The PEDro scale, Cochrane collaborations, and ROBINS-I tools were used to evaluate the methodological quality and risk of bias. Results: Ten studies (including 438 participants diagnosed with KOA) fulfilled the eligibility criteria, and nine concluded that flexibility was improved after a physical exercise program. Conclusion: Despite the modality, physical exercise improves flexibility in older KOA individuals, improving the functional capacity. Health professionals engaged in KOA rehabilitation should use physical exercise as a strategy to improve the flexibility of this population.

Effects of Whole-Body Vibration Exercises on Muscle Responses and on Risk of Falls in Elderly Individuals: A Systematic Review.

Background: This systematic review was conducted to assess the effects of whole-body vibration (WBV) exercises on muscles responses and on risk of falls in elderly individuals. Methods: Searches were conducted in MEDLINE/PubMed, Physiotherapy Evidence Database (PEDro), Web of Science, CINAHL and Scopus databases in Feb 2023 to identify studies with the potential to be included according to the eligibility criteria. Relevant data from included studies were extracted. The methodological quality was evaluated for each study included by PEDro scale, risk of bias (Cochrane Collaboration's tool), and the level of evidence by National Health and Medical Research Council (NHMRC). Results: Six randomized clinical trial (RCT) were included. In respect of the level of evidence, all studies were classified as Level II (NHMRC) and regarding to the methodological quality (PEDro scale), four studies were considered 'high' and two were 'fair'. Two publications presented low risk of bias, three with high risk of bias and one unclear. All the selected studies reported positive effects and improvements on risk of falls and muscle response after WBV exercise. Conclusion: WBV exercise may contribute to reduce the risk of falls and improve muscle responses in the elderly individuals.

Trigger point dry needling increases masseter muscle oxygenation in patients with temporomandibular disorder.

BACKGROUND: Temporomandibular disorder (TMD) is an umbrella term encompassing various clinical complaints involving the temporomandibular joints, masticatory muscles, and/or associated orofacial structures. Myogenous TMDs are the most frequent cause of chronic orofacial pain. Musculoskeletal pain is commonly associated with myofascial trigger points (MTPs), for which dry needling (DN) is a routine treatment. OBJECTIVE: To investigate muscle oxygenation and pain immediately after DN application on an MTP in the masseter muscle of patients with myogenous TMDs. METHODOLOGY: Masseter muscle oxygen tissue saturation indices (TSI%) were assessed by near-infrared spectroscopy (NIRS) pre- and post-interventions by a randomized, controlled, double-blind, crossover DN/Sham clinical trial (primary outcome). Pain was investigated by the visual analog scale (VAS). In total, 32 individuals aged from 18 to 37 years who were diagnosed with myogenous TMD and myofascial trigger points in their masseter muscles participated in this study. Relative deltas for the studied variables were calculated. Data normality was tested using the Shapiro-Wilk test. According to their distribution, data were analyzed by two-way ANOVA and the Student's t-, and Mann-Whitney tests. Statistical analyses were performed using Prism® 5.0 (GraphPad, USA). RESULTS: We found a significant difference (2,108% vs. 0,142%) between masseter muscle TSI% deltas after the DN and Sham interventions, respectively (n=24). We only evaluated women since men refused to follow NIRS procedures. Pain increased immediately after DN (n=32, 8 men), in comparison to Sham delta VAS. CONCLUSION: These findings show an increase in tissue oxygen saturation in the evaluated sample immediately after the DN intervention on the MTP of patients' masseter muscle. Pain may have increased immediately after DN due to the needling procedure.

Does premature birth affect Brazilian parents' practices related to infant positioning?

OBJECTIVE: To verify whether the time spent in prone, supine, or seated positions differed between term and preterm infants; and to determine whether a single verbal guidance session for parents changed the time spent in different positions, and, consequently, the motor development scores, after one month in preterm infants. METHODS: Sixty-one infants from a full-term and preterm group from Brazil were included. Motor development was assessed by the Alberta Infant Motor Scale (AIMS) and the parents registered the time spent in each position on a 24-hour schedule. A month after verbal guidance, a second assessment was performed only on the preterm infants. RESULTS: The positioning times awake determined for the full-term and preterm parents were similar. Preterm infants spent more time in the prone sleeping position (2.1 vs. 0.8 h; p=0.037) than full-term infants. The AIMS percentile scores did not differ significantly between the groups. For preterm infants, the time spent in all positions did not change during the second assessment (n=18). CONCLUSIONS: The fact that some parents position their infants in the prone posture during sleeping periods reinforce the importance of parental education approaches for sudden infant death syndrome (SIDS) prevention during the first months of life. The verbal guidance provided to parents of preterm infants did not influence the AIMS percentile and time spent in various positions but increased preterm parents' confidence in placing their infants in a prone position to play.