Effectiveness of the Pilates Method in the Treatment of Chronic Mechanical Neck Pain: A Randomized Controlled Trial.

OBJECTIVE: To assess the effectiveness of the Pilates method on pain, function, quality of life, and consumption of pain medication in patients with mechanical neck pain. DESIGN: The design was a randomized controlled trial, with a blinded assessor and intention-to-treat analysis. SETTING: The study took place in the outpatient clinic of the rheumatology department, referral center. PARTICIPANTS: Patients (N=64) with chronic mechanical neck pain were randomly allocated to 2 groups: the Pilates group (PG) and a control group (CG). INTERVENTIONS: The PG attended 2 sessions of Pilates per week, for 12 weeks. The protocol included Pilates exercises performed on a mat and on equipment and was adapted depending on the physical fitness of each participant; the repetitions varied from 6 to 12, respecting patient reports of fatigue and pain, using a single series for each exercise. The CG received only the standard pharmacological treatment. Both groups were instructed to use acetaminophen 750 mg if necessary. Patients were evaluated at baseline after 45, 90, and 180 days. MAIN OUTCOME MEASURES: We used the Numerical Pain Scale for pain, the Neck Disability Index for function, and the SF-36 questionnaire for quality of life. RESULTS: The groups were homogeneous at baseline, the only exception being body mass index (BMI), with the PG showing higher BMI. Regarding the assessment between groups over time, statistical differences were identified for pain (P<.001), function (P<.001) and the SF-36 (functional capacity, P=.019; pain, P<.001; general health, P=.022; vitality, P<.001; mental health, P=.012) with the PG consistently achieving better results. Drug consumption was lower in PG patients (P=.037). CONCLUSIONS: This trial demonstrated the effectiveness of the Pilates method for the treatment of chronic mechanical neck pain, resulting in improvement of pain, function, quality of life, and reduction of the use of analgesics.

A resistance exercise program improves functional capacity of patients with psoriatic arthritis: a randomized controlled trial.

The objective of this study is to assess the effectiveness of resistance training in patients with psoriatic arthritis (PsA). The study is a randomized controlled trial with 41 patients aged between 18 and 65 years with diagnosis of psoriatic arthritis (PsA). The patients were randomized into the following: intervention group (IG) and control group (CG). The IG underwent resistance exercise twice a week, for 12 weeks. The CG remained with the conventional drug therapy. The outcome measurements were the following: BASFI and HAQ-S for functional capacity, one maximum repetition test (1RM) for muscle strength, SF-36 questionnaire for general quality of life, and BASDAI and DAS-28 for disease activity. The evaluations were done by a blinded evaluator at baseline (T0) after 6 (T6) and 12 weeks (T12). At baseline, the groups were homogeneous regarding clinical and demographic characteristics. The IG significantly improved functional capacity measured by HAQ-S and disease activity measured by BASDAI, compared to CG, at week 12. Regarding quality of life, the IG improved the domains "pain" and "general health status" compared to CG (p < 0.05). There was improvement in muscular strength in almost all exercises in IG, except in the exercise for biceps. However, there were statistical differences between groups only on exercise "leg extension" in IG compared to CG. Resistance training is effective in improving functional capacity, disease activity, and quality of life of patients with psoriatic arthritis. The clinical improvements were not coupled to significant changes in muscular strength.

Public-private partnerships and physical activity: a matter of health promotion and chronic disease prevention / Parcerias públic-privadas e atividade física: promoção da saúde e prevenção de doenças crônicas

Public­private partnerships are joint initiatives between the public and private sectors with a specific focus and a defined level of action. Several international reports have shown good results of public­private partnerships using physical activity interventions associated with public health policies and strategies. Among these reports, we highlight those that focus on the prevention of chronic diseases such as cardiovascular disease, diabetes, asthma, and obesity using physical activity as the main tool. This article discusses the conceptual framework behind these partnerships, addressing their possible effectiveness and feasibility. We debate important factors in the success of these partnerships, as well as possible benefits to the public and private entities involved and to the target populations of these interventions. (AU)

Parcerias público-privadas são iniciativas organizadas em conjunto por entidades dos setores público e privado, com foco específico e nível de atuação definido. Diversos relatos internacionais demonstram bons resultados das parcerias público-privadas que usam intervenções de atividade física associadas a estratégias ou a políticas de saúde pública. Dentre estas, destacam-se aqueles que focam a prevenção de doenças crônicas, como doenças cardiovasculares, diabetes, asma e obesidade. Este artigo discute os aspectos conceituais que embasam essas parcerias, abordando os fatores que justificam sua eficácia e viabilidade. São debatidos os fatores de sucesso e os possíveis benefícios destas parcerias às entidades envolvidas, sejam elas públicas ou privadas, bem como para a população-alvo destas parcerias. (AU)

Exercício físico e fibromialgia / Physical exercise and fibromyalgia

A síndrome da fibromialgia é uma doença reumática não inflamatória que acomete principalmente as mulheres, sendo que 93% dos atingidos são de etnia branca. A síndrome da fibromialgia pode ser classificada como primária, quando não há relação com outra patologia, ou secundária, quando esta se encontra associada com alguma patologia. O paciente fibromiálgico precisa receber tratamento multidisciplinar, ou seja, áreas distintas devem trabalhar em conjunto para que haja uma melhora nos sintomas. Dentre os sintomas observados na fibromialgia, o mais comum é a dor crônica e difusa. A literatura apresenta referências que apontam os efeitos e benefícios do exercício físico como forma de tratamento não-medicamentoso para os portadores da síndrome da fibromialgia. Dentre os exercícios físicos estão a atividade aeróbica, alongamentos e treinamento de força, entre outros. O objetivo desta revisão é apresentar as formas pelas quais o exercício físico pode ser útil ao paciente fibromiálgico, sobretudo no que tange a melhora dos seus sintomas(AU)

Fibromyalgic syndrome is a non-inflammatory rheumatic disease which affects primarily Caucasian women. Fibromyalgic syndrome can be classified as primary, when there is no other associated pathology; or secondary, when it is diagnosed related to some other pathology. The fibromyalgic patient needs to receive multidisciplinary treatment and different areas should work together to promote the improvement of symptoms. The most common classical symptom of this disease is the chronic and diffuse pain. The specialized literature presents several works that point out the effects and benefits of physical exercise as a non-pharmacological treatment for patients with fibromyalgic syndrome. Aerobic activity, stretching and strength training are among the physical exercises. Thus, this review aimed to highlight the several ways physical exercise can be useful to the fibromyalgic patient, especially concerning the improvement of symptoms(AU)

Exercício físico e fibromialgia / Physical exercise and fibromyalgia

A síndrome da fibromialgia é uma doença reumática não inflamatória que acomete principalmente as mulheres, sendo que 93% dos atingidos são de etnia branca. A síndrome da fibromialgia pode ser classificada como primária, quando não há relação com outra patologia, ou secundária, quando esta se encontra associada com alguma patologia. O paciente fibromiálgico precisa receber tratamento multidisciplinar, ou seja, áreas distintas devem trabalhar em conjunto para que haja uma melhora nos sintomas. Dentre os sintomas observados na fibromialgia, o mais comum é a dor crônica e difusa. A literatura apresenta referências que apontam os efeitos e benefícios do exercício físico como forma de tratamento não-medicamentoso para os portadores da síndrome da fibromialgia. Dentre os exercícios físicos estão a atividade aeróbica, alongamentos e treinamento de força, entre outros. O objetivo desta revisão é apresentar as formas pelas quais o exercício físico pode ser útil ao paciente fibromiálgico, sobretudo no que tange a melhora dos seus sintomas

Fibromyalgic syndrome is a non-inflammatory rheumatic disease which affects primarily Caucasian women. Fibromyalgic syndrome can be classified as primary, when there is no other associated pathology; or secondary, when it is diagnosed related to some other pathology. The fibromyalgic patient needs to receive multidisciplinary treatment and different areas should work together to promote the improvement of symptoms. The most common classical symptom of this disease is the chronic and diffuse pain. The specialized literature presents several works that point out the effects and benefits of physical exercise as a non-pharmacological treatment for patients with fibromyalgic syndrome. Aerobic activity, stretching and strength training are among the physical exercises. Thus, this review aimed to highlight the several ways physical exercise can be useful to the fibromyalgic patient, especially concerning the improvement of symptoms