RESUMO
The complete safety and efficacy of endoscopic cyclophotocoagulation (ECP) remain unclear in the literature and, to our knowledge, there are no current meta-analyses on phaco-ECP versus phacoemulsification alone to date. Thus, we conducted a systematic review and meta-analysis comparing these two strategies through studies, assessing the effectiveness and safety of outcomes in a population with glaucoma. The protocol for this systematic review was registered in the PROSPERO International Prospective Register of Systematic Reviews (CRD42023482376). We systematically searched PubMed, Embase, and Web of Science from inception to December 2023. A random-effects model was used for all analyses due to heterogeneity. Review Manager 5.3 (Cochrane Centre, The Cochrane Collaboration, Denmark) was used for statistical analysis. Finally, nine studies were included in this comprehensive review and a total of 5389 eyes were analyzed in our study. In comparison to the ECP and phacoemulsification group, those receiving phacoemulsification alone showed better results in best-corrected visual acuity (MD 0.09; CI 95% 0.03 to 0.16; I²=0%), but worse outcomes in intraocular pressure (IOP) (MD -1.49; 95% CI -2.29 to -0.68; I²=29%) and use medications (MD -0.75; 95% CI -0.94 to -0.56; I²=0%) in the last visit. Complication rates, both general and serious, were significantly different between the groups, indicating the potential impact of combined procedures on patient outcomes. Thus, combining ECP with phacoemulsification for glaucoma treatment showed sustained IOP reduction and decreased medication dependence. However, higher complication rates suggest careful consideration of risks. More extensive research with larger trials and longer follow-ups is needed to validate findings and address limitations, providing valuable insights into this treatment approach.
RESUMO
INTRODUÇÃO: As evidências sobre a melhora da capacidade funcional utilizando o Método Pilates não são contundentes. Uma possibilidade de melhorar o efeito de uma sessão de Pilates sobre a capacidade cardiorrespiratória de seus praticantes é utilizar a resistência de fluxo inspiratório (RFI) de forma concomitante. Esse efeito pode ser visualizado através da determinação do limiar glicêmico (LG), técnica utilizada como marcador de intensidade do exercício. OBJETIVO: Testar a hipótese de que a utilização de RFI em uma sessão de pilates antecipa o LG. MÉTODOS: Estudo crossover de corte transversal. Foram avaliados 26 indivíduos de ambos os sexos, sendo 10 do sexo masculino, sadios e com idade entre 20 e 40 anos. Os voluntários foram randomizados para dois protocolos: Protocolo RFI 11 movimentos do Método Pilates com RFI utilizando 20% da pressão inspiratória máxima; e Protocolo sem RFI (SRFI) 11 movimentos do Método Pilates sem RFI. Os dois protocolos foram realizados no mesmo dia, sendo um pela manhã e outro à tarde, conforme randomização feita por sorteio aleatório simples. No repouso e ao final de cada movimento coletas de sangue capilar foram realizadas para dosagem da glicemia e construção da curva glicêmica. O LG foi determinado no menor ponto da curva. RESULTADOS: O LG foi antecipado no protocolo que utilizou RFI, ou seja, no protocolo com RFI o LG foi visualizado no sexto exercício, enquanto no protocolo SRFI o LG foi visualizado no nono exercício (p<0,05). CONCLUSÃO: A RFI antecipou o LG, o que sugere que a RFI aumenta a intensidade de uma sessão de pilates. Isso aventa a hipótese de que a RFI pode proporcionar a médio e longo prazo benefícios adicionais aos praticantes do Método Pilates.
INTRODUCTION: The evidence on the improvement of functional capacity using the Pilates Method is not conclusive. One possibility to improve the effect of a Pilates session on the cardiorespiratory capacity of its practitioners is to use the inspiratory flow resistance (IFR) concomitantly. This effect can be visualized by determining the glycemic threshold (GT), a technique used as an exercise intensity marker. OBJECTIVE: To test the hypothesis that the use of IFR in a Pilates session anticipates GT. METHODS: Cross-sectional crossover study. A total of 26 individuals of both genders were evaluated, 10 of whom were male, healthy, and aged between 20 and 40 years. The volunteers were randomized to two protocols: Protocol IFR - Eleven movements of the Pilates method with IFR using 20% of the maximum inspiratory pressure, and Protocol no IFR (NIFR) - Eleven movements of the Pilates method without IFR. The two protocols were performed on the same day, one in the morning and the other in the afternoon, according to randomization by simple random draw. At rest and at the end of each movement, capillary blood collections were performed to measure blood glucose and construct the glycemic curve. GT was determined at the smallest point on the curve. RESULTS: The GT was anticipated in the protocol that used IFR; that is, in the protocol with IFR, the GT was visualized in the sixth exercise, while in the NIFR protocol, the GT was visualized in the ninth exercise (p<0.05). CONCLUSION: IFR anticipated GT, which suggests that IFR increases the intensity of a Pilates session. This suggests the hypothesis that IFR can provide additional medium and long-term benefits to Pilates method practitioners.