Aquatic therapy in congenital malformation during the use of external fixator for bone lengthening: It is possible?

OBJECTIVES: The objective of this study is to describe the rehabilitation of individuals with Congenital Malformations (CMF) during the use of an External Fixator (EF) in Aquatic Therapy (AT) and to analyze the association between diagnosis, EF type and location with rehabilitation process outcomes, surgical intervention, and adverse effects. METHODS: This retrospective study included 29 medical records from which the personal and rehabilitation data of the patient were collected. The AT used was described and the outcome variables were associated. The medical records were selected by screening the database of the CMF clinic at the AACD. The inclusion criteria were participants with CMF who used EF treated between 2011 and 2019 of both genders and without age restriction. The exclusion criteria were incomplete medical record data or not undergoing AT while using EF. The extracted data included diagnosis, gender, age, EF type and location, objective of the surgery, adverse events, surgical interventions, time of rehabilitation in AT, physiotherapeutic objectives, and rehabilitation process outcomes in AT. RESULTS: The mean age of the participants was 12.1 ± 3.99 years, with male predominance (55 %) and hemimelia cases (37 %). The most used EF was circular (51 %), located in the femur (37 %), and the main objective of surgery was bone lengthening (52 %). The most recurrent adverse effect was infection (62 %) and 76 % completed AT. There was no association between the variables analyzed. CONCLUSIONS: It was possible to describe CMF rehabilitation with EF in AT. There was no association between the variables analyzed.

Comparison of aquatic physiotherapy and therapeutic exercise in patients with chronic low back pain.

OBJECTIVE: To investigate and compare the effectiveness of aquatic physiotherapy and therapeutic exercise in the physical and functional performance of patients with chronic low back pain. METHODS: Twenty-six participants were randomized into 3 groups, namely an aquatic physiotherapy group (AG), a therapeutic exercise group (EG), and a control group (CG). The pain, disability, and quality of life were compared before and after the exercise protocols for 2 months, twice a week, on alternate days, for 60 min. For statistical analyses, the Kruskal-Wallis test was used to test the difference between the groups; the Wilcoxon test and the effect size were used for before-and-after comparisons. RESULTS: Twenty participants completed the study. There was a significant difference improvement in pain between the AG and the EG (p = 0.004), between the EG and the CG (p = 0.05), and in social role functioning between the groups (p = 0.02). No differences were observed in the other analyzed variables between the groups. Compared to the pre-treatment state, there were significant improvements in the AG in terms of pain (p = 0.02), functionality (p = 0.03), and general health status (p = 0.04). CONCLUSION: The AG group showed significant and clinical improvement in pain, disability, and quality of life. Improvements related to social aspects were found in the EG compared to the CG. The water provides a safe environment that facilitates the onset of exercise, so aquatic physiotherapy could be considered the first recommendation for patients with low back pain.

Intervención fisioterapéutica en fibromialgia / Physiotherapeutic intervention in fibromyalgia

Introducción: La fibromialgia afecta el movimiento corporal. Provoca dolor en puntos claves, causa molestias musculoesqueléticas y limita la actividad de las personas. Se ha descrito que la fisioterapia mejora de calidad de vida de estos pacientes. Objetivo: Identificar los test de evaluación y los procesos de intervención fisioterapéutica utilizados en la fibromialgia. Métodos: Se realizó una revisión de literatura en PubMed, ScientsDirect, SciELO y LILLACS, con la terminología MeSH y DeCS, entre 2017 y 2022. Resultados: La escala visual análoga y la algometría por presión son los test utilizados para el dolor. La hidroterapia, el cupping, la punción seca, el masaje sueco, los ejercicios respiratorios y los aeróbicos resultan los métodos de intervención con más uso. Conclusiones: Los procesos de intervención se deben plantear según las evaluaciones del dolor y la funcionalidad en la persona. El tratamiento fisioterapéutico de la fibromialgia debe tener un componente de ejercicio físico aérobico y fuerza para disminuir la fatiga; devolverle al músculo su funcionalidad y aumentar la capacidad aeróbica(AU)

Introduction: Fibromyalgia affects body movement. It causes pain in key points, it causes musculoskeletal discomfort and it limits the persons's activity. It has been described that physiotherapy improves the quality of life of these patients. Objective: To identify the evaluation tests and physiotherapy intervention processes used in fibromyalgia. Methods: A literature review was carried out in PubMed, ScientsDirect, Scielo and LILLACS, with the terminology MeSH and DeCS, from 2017 to 2022. Results: The visual analogue scale and pressure algometry are the tests used for pain. Hydrotherapy, cupping, dry needling, Swedish massage, breathing exercises and aerobics are the most commonly used intervention methods. Conclusions: Intervention processes should be planned according to the evaluations of pain and functionality in the person. The physiotherapy treatment of fibromyalgia must have a component of aerobic physical exercise and strength to reduce fatigue, to return the muscle to its functionality and increase aerobic capacity(AU)

Adecuación de la terapia hidrocinética en el paciente ortopédico-traumatológico: un estudio transversal / Appropriateness of hydrokinesitherapy in the orthopedic-traumatological patient: a cross sectional surve

ABSTRACT Introduction: Hydrokinesitherapy is a rehabilitation method used for the treatment of different types of orthopedic, neurological, respiratory problems, etc. However, the existing literature presents not so much evidence regarding the greater efficacy of water treatment compared to dry treatment in patients with post-traumatic outcomes. Objective: Through the administration of a questionnaire, we tried to investigate the rehabilitation experience of hydrokinetic therapists (trained with the so-called Sequential and Preparatory Approach) in order to understand hydrokinesitherapy areas and methods of proper application based on experts' opinion. Methods: A cross-sectional study was carried out in 2020 by administering a questionnaire to physiotherapists trained in hydrokinesitherapy according to the Sequential and Preparatory Approach method, with the aim to investigate their opinion on the use of hydrokinesitherapy in patients with various orthopedic-traumatological problems. Microsoft FORMS® platform was used for the administration of the questionnaire. Results: Sixty-two users participated in the study. From their answers emerged that the use of hydrokinesitherapy is not recommended for the treatment of post-traumatic hypersensitization of peri-lesional tissues (hypersensitive scars; general hypersensitization) and neuropathic syndromes (of the upper and lower limbs). Conclusions: The data obtained from administering the questionnaire were not sufficient to create a specific path to define the appropriateness of hydrokinesitherapy for some orthopedic-traumatological problems but could be considered a good starting point on which to build future developments through further studies.

RESUMEN Introducción: La terapia hidrocinética es un método rehabilitador utilizado para el tratamiento de diferentes tipos de problemas ortopédicos, neurológicos, respiratorios, entre otros. Sin embargo, en la literatura existente no abundan evidencias en cuanto a la mayor eficacia del tratamiento con agua en comparación con el tratamiento seco en pacientes con resultados traumáticos. Objetivo: A través de un cuestionario, se intentó investigar la experiencia de rehabilitación de los terapeutas hidrocinéticos (entrenados con el llamado Enfoque Secuencial y Preparatorio) para comprender las áreas de la terapia hidrocinética y los métodos de aplicación adecuados con base en la opinión de expertos. Métodos: Se realizó un estudio transversal en el año 2020 mediante la administración de un cuestionario a fisioterapeutas formados en la terapia hidrocinética según el método de Abordaje Secuencial y Preparatorio, con el objetivo de averiguar su opinión sobre el uso de la terapia hidrocinética en pacientes con diversos problemas ortopédico-traumatológicos. Se utilizó la plataforma Microsoft FORMS® para la administración del cuestionario. Resultados: Sesenta y dos usuarios participaron en el estudio. De sus respuestas surgió que no se recomienda el uso de la terapia hidrocinética para el tratamiento de la hipersensibilización postraumática de los tejidos perilesionales (cicatrices hipersensibles; hipersensibilización general) y síndromes neuropáticos (de miembros superiores e inferiores). Conclusiones: Los datos obtenidos del cuestionario no fueron suficientes para crear una ruta específica que defina la idoneidad de la terapia hidrocinética para algunos problemas ortopédicos-traumatológicos, pero podría considerarse un buen punto de partida para construir futuros desarrollos a través de estudios adicionales.

Impact of deep water running in interval training (DWR-IT) on body composition, functional capacity, and quality of life in overweight adults: study protocol for a randomized controlled trial.

BACKGROUND: Interval training in deep water running (DWR-IT) is a training method to improve cardiovascular fitness, functional health, and quality of life and to help control body weight. Its main advantages are the reduction of joint overload and a low risk of musculoskeletal injuries. The aim of the study is to investigate the influence of DWR-IT on functional capacity, body composition, and quality of life of overweight middle-aged adults. METHODS: This is a randomized controlled, two-arm, open, parallel clinical trial with overweight adults. Volunteers will be allocated to a water group (WG), which will be submitted to the intervention, or a control group, which will not be subjected to any kind of intervention. The evaluation will be composed of anamnesis, electrical bioimpedance, six-minute walk test (6MWT), questionnaire on the Impact of Weight on Quality of Life-lite (IWQOL-LITE), Pittsburgh Sleep Quality Index, Epworth Sleepiness Scale, chair stand test, arm curl test, and food frequency questionnaire. The DWR-IT will last for 12 weeks, systematically increasing the intensity and training volume. DISCUSSION: The objective of this clinical trial is to evaluate the effect of DWR-IT on overweight adults. The study is guided through practice based on scientific evidence for the use of training and aquatic rehabilitation. It is expected that after 12 weeks of aquatic intervention there will be a decrease in body fat by about 10%, evaluated by electrical bioimpedance, an increase of about 25% of cardiorespiratory endurance, evaluated by 6MWT, and an improvement of about 25% of physical function domains, self-esteem, distress in public places, and work, analyzed by IWQOL-LITE in the WG. TRIAL REGISTRATION: The study protocol was published in the Brazilian Registry of Clinical Trials (ReBEC) on June 16, 2016. Registration number: RBR-6dmh7d.

[Effectiveness of Watsu therapy in patients with juvenile idiopathic arthritis. A parallel, randomized, controlled and single-blind clinical trial]. / Efectividad de la terapia Watsu en pacientes con artritis idiopática juvenil. Un ensayo clínico controlado paralelo, aleatorio y simple ciego.

INTRODUCTION: Juvenile idiopathic arthritis (JIA) is a rheumatologic disease in children under 16 years old, which causes early physical disability. The use of hydrotherapy Watsu in these patients is propo sed. OBJECTIVE: To evaluate the effectiveness of Watsu compared to conventional hydrotherapy on health-related quality of life (HRQoL), functional health status, pain, and ranges of joint motion in patients with acute or subacute JIA. PATIENTS AND METHOD: Randomized (1:1) single-blind parallel controlled clinical trial in 46 patients with acute and subacute JIA between 8-18 years old. Pediatric Quality of Life Inventory 4.0 (PedsQL4.0), Childhood Health Assessment Questionnaire (CHAQ), and 10-joints Global range of motion score (GROMS) assessments were used at the beginning, post treatment, and after three months of follow-up. Patients were randomly assigned to the Watsu group (n = 24) and to the conventional hydrotherapy group (n = 22), participating in 10 sessions of 45 mi nutes once a week. RESULTS: Watsu therapy showed statistically significant improvements in physical functioning-HRQoL (p = 0.041), disability index (p = 0.015), distress index (p = 0.015), and functio nal health status-CHAQ (p = 0.013) after treatment compared to conventional hydrotherapy. Con clusions: Watsu therapy improved HRQoL, pain sensation, and functional health status compared to conventional hydrotherapy. Methodological adaptations are required in future studies to improve the external validity of these results.

Protocolo de Durán modificado en rehabilitación precoz de lesiones tendinosas flexoras de la mano / Modified Duran protocol in early rehabilitation of flexor tendon injuries of the hand

OBJETIVOS: conocer la efectividad del Protocolo de Durán Modificado en las Lesiones Tendinosas Flexoras de la Mano determinando el grado de discapacidad funcional en pacientes atendidos por el Servicio de Medicina Física y Rehabilitación del Hospital de Clínicas en el periodo agosto ­ diciembre de 2016. MATERIAL Y MÉTODOS: se incluyeron dos grupos paralelos: al primer grupo (9 pacientes) se aplicó el protocolo de Durán Modificado y al segundo (9 pacientes) el tratamiento rehabilitador convencional. La valoración de la funcionalidad fue a través de la fórmula de Strickland, el sistema de Bruck Gramcko y la Distancia Pulpejo-Palma. Se realizó en 36 sesiones de 30 minutos aproximadamente para cada modalidad terapéutica con la correspondiente evaluación al finalizar los 3 meses de terapia. RESULTADOS: los que realizaron el protocolo de Durán Modificado finalizaron el tratamiento con una funcionalidad excelente en 4 casos, bueno en 3 y regular en 2 según la fórmula de Strickland. Según el sistema de Buck Gramcko la funcionalidad fue excelente para 5 pacientes y regular para 4. Y finalmente con la evaluación de la distancia pulpejo - palma se determinó que 4 pacientes obtuvieron un rango excelente, 4 bueno y 1 regular. CONCLUSIONES: la aplicación del protocolo de Durán modificado como rehabilitación precoz en pacientes con lesiones tendinosas flexoras de la mano es de mayor efectividad que el tratamiento rehabilitador convencional siendo una herramienta que puede ser aplicada de manera temprana en pacientes postoperados por esta afección

OBJECTIVES: to determine the effectiveness of the Modified Duran Protocol on flexor tendon injuries of the hand determining the degree of functional disability in patients treated by the Department of Physical Medicine and Rehabilitation at the Hospital de Clinicas during term August - December 2016.MATERIAL AND METHODS: we included two parallel groups: The Duran Modified protocol was applied on the first group (9 patients) and the Conventional Rehabilitation (9 patients) Treatment on the second. The assessment of the functionality was carried out with the formula Stricklan, Bruck Gramcko System and Pulpejo-Palma Distance. It was conducted in 36 sessions of approximately 30 minutes for each treatment modality with the corresponding evaluation at the end of 3 months of therapy. RESULTS: those who carried out the Modified Duran protocol completed treatment with excellent functionality in 4 cases, good in 3 and fair in 2 according to the formula Strickland. According Gramcko Buck system functionality was excellent for 5 patients and Fair for 4. Finally the evaluation of the pulpejo - palm distance showed that four patients had an excellent range, 4 good and 1 fair. CONCLUSIONS: the application the Modified Duran protocol as immediate rehabilitation in patients with flexor tendon injuries of the hand is more effective than conventional rehabilitation treatment being a tool that can be applied early in patients after surgery for this injury

Efectividad de la terapia Watsu en pacientes con artritis idiopática juvenil: un ensayo clínico controlado paralelo, aleatorio y simple ciego / Effectiveness of Watsu therapy in patients with juvenile idiopathic arthritis: a parallel, randomized, controlled and single-blind clinical trial

INTRODUCCIÓN: La artritis idiopática juvenil (AIJ), es una enfermedad reumatológica en menores de 16 años, que produce discapacidad física temprana. Se propone el uso de hidroterapia Watsu en estos pacientes. OBJETIVO: Evaluar la efectividad del Watsu en comparación a hidroterapia convencional en la calidad de vida relacionada con la salud (CVRS), estado de salud funcional, dolor y rangos articulares de movimiento en pacientes con AIJ aguda o subaguda. PACIENTES Y MÉTODO: Ensayo clínico controlado paralelo, con asignación 1:1, aleatorio y simple ciego, en 46 pacientes con AIJ en fase aguda y subaguda entre 8-18 años de edad. Se utilizaron las evaluaciones Pediatric Quality of Life Inventory 4.0 (PedsQL4.0), Childhood Health Assessment Questionnaire (CHAQ) y 10 joints-Global range of motion score (GROMS) al inicio, posterior al tratamiento y a los 3 meses de seguimiento. Los pacientes se asignaron aleatoriamente al grupo Watsu (n = 24) y al grupo hidroterapia convencional (n = 22), participando de 10 sesiones de 45 minutos, con frecuencia de una vez por semana. RESULTADOS: La terapia Watsu presentó mejoras estadísticamente significativas en funcionamiento ñsico-CVRS (p = 0,041), índice de discapacidad (p = 0,015), índice de malestar (p = 0,015) y estado de salud funcional-CHAQ (p = 0,013) posterior al tratamiento en comparación a la hidroterapia convencional. CONCLUSIONES: La terapia Watsu mejoró la CVRS, sensación de dolor y estado de salud funcional en comparación a la hidroterapia convencional. Se requiere de adaptaciones metodológicas en futuros estudios para mejorar la validez externa de estos resultados.

INTRODUCTION: Juvenile idiopathic arthritis (JIA) is a rheumatologic disease in children under 16 years old, which causes early physical disability. The use of hydrotherapy Watsu in these patients is proposed. OBJECTIVE: To evaluate the effectiveness of Watsu compared to conventional hydrotherapy on health-related quality of life (HRQoL), functional health status, pain, and ranges of joint motion in patients with acute or subacute JIA. PATIENTS AND METHOD: Randomized (1:1) single-blind parallel controlled clinical trial in 46 patients with acute and subacute JIA between 8-18 years old. Pediatric Quality of Life Inventory 4.0 (PedsQL4.0), Childhood Health Assessment Questionnaire (CHAQ), and 10-joints Global range of motion score (GROMS) assessments were used at the beginning, post treatment, and after three months of follow-up. Patients were randomly assigned to the Watsu group (n = 24) and to the conventional hydrotherapy group (n = 22), participating in 10 sessions of 45 mi nutes once a week. RESULTS: Watsu therapy showed statistically significant improvements in physical functioning-HRQoL (p = 0.041), disability index (p = 0.015), distress index (p = 0.015), and functio nal health status-CHAQ (p = 0.013) after treatment compared to conventional hydrotherapy. CONCLUSIONS: Watsu therapy improved HRQoL, pain sensation, and functional health status compared to conventional hydrotherapy. Methodological adaptations are required in future studies to improve the external validity of these results.

Hypotensive Effect of Heated Water-based Exercise in Older Individuals with Hypertension.

Blood pressure (BP) and hemodynamic response to heated water-based (HEx) vs. land-based exercise (LEx) were assessed in 15 (6 men) older hypertensives (age 66.4±4.9 yr) under pharmacological treatment. Participants were randomly assigned to perform 30 min of moderate-intensity HEx (walking inside the pool), LEx (walking on a treadmill) and non-exercise control (CON) intervention. Resting BP, arterial stiffness, endothelial reactivity and heart rate variability (HRV) were measured before, immediately after, and 45 min after interventions. 24-h ambulatory BP monitoring was performed after interventions. Resting systolic (but not diastolic) BP reduced 9.9±3.1 mmHg (P<0.01) 45 min after HEx only. 24-h systolic and diastolic, daytime diastolic and nightime systolic BP were lower (P<0.05) after HEx than both LEx and CON. Daytime systolic BP was also lower (P<0.05) after HEx than CON. Nighttime diastolic was not different between interventions. HEx-induced ambulatory BP reduction ranged 4.5±1.3 mmHg (24-h diastolic BP) to 9.5±3.0 mmHg (nighttime systolic BP), and persisted for 18/11 h in systolic/diastolic BP, when compared with CON. No significant changes in arterial stiffness, endothelial reactivity and HRV were found during any intervention. These results suggest that HEx may have important implications for managing BP in older hypertensive under pharmacological treatment.

Hidroterapia em esteira aquática no ganho de massa muscular em cães com displasia coxofemoral: relato de caso / Hydrotherapy in aquatic treadmill in the gain of muscle mass in dogs with hip dysplasia: case report / Hidroterapia en cinta caminadora acuática para la mejora de la masa muscular en perros con displasia de cadera: relato de caso

A hidroterapia é uma das principais técnicas para auxiliar no tratamento das afecções osteomusculares em cães. Dentre as afecções ortopédicas, a displasia coxofemoral é a enfermidade articular de maior incidência em cães. O presente estudo teve como objetivo a análise dos efeitos da esteira aquática no ganho de massa muscular em membros pélvicos em um animal acometido por displasia coxofemoral. Para avaliação do ganho de massa muscular, foram utilizadas a escalas de claudicação, avaliação por perimetria e avaliação do movimento em flexão e extensão dos membros pélvicos pela goniometria. Após 4 semanas de tratamento, constatou-se melhora no padrão do passo, ganho de 3 cm em média em cada coxa do animal, de 15 graus na amplitude de movimento da coxofemoral direita, e de 5 graus na articulação esquerda.(AU)

Hydrotherapy is one of the main techniques to assist in the treatment of orthopedic, neurological and endocrinological conditions. Among the orthopedic conditions, the hip dysplasia is the one with the highest incidence in the hip joint in dogs. The present study aimed to analyze the effects of the aquatic treadmill on the muscule mass gain in pelvic limbs. For this evaluation, claudication scales, perimetry muscle mass evaluation menses assessment of the movement in flexion and extension of the pelvic limbs by goniometry were used. There was improvement in the pattern of the step, gain of 3 cm in average in each thigh of the animal, 15 degrees in the range of movement of the right hip, and 5 degrees in the left.(AU)

La hidroterapiaesuna de las principales técnicas para auxiliar el tratamiento de las afecciones osteomusculares en perros. Entre las afecciones ortopédicas, la displasia de cadera es la enfermedad articular de mayor incidencia en los perros. El presente estudio tuvo como objetivo el análisis de los efectos de la cinta caminadora acuática en el aumento de masa muscular en miembros pélvicos de un animal acometido por displasia de cadera. Para la evaluación del aumento de la masa muscular, se utilizaron la escala de claudicación, evaluación por perimetría y evaluación del movimiento en flexión y extensión de los miembros pélvicos por la goniometría. Después de 4 semanas de tratamiento, se constató una mejora en el patrón del paso, con el aumento pro medio de 3 cm en cada muslo del animal, de 15 grados en el rango de movimiento de la cadera derecha, y de 5 grados en la izquierda.(AU)

Hidroterapia em esteira aquática no ganho de massa muscular em cães com displasia coxofemoral: relato de caso / Hydrotherapy in aquatic treadmill in the gain of muscle mass in dogs with hip dysplasia: case report / Hidroterapia en cinta caminadora acuática para la mejora de la masa muscular en perros con displasia de cadera: relato de caso

A hidroterapia é uma das principais técnicas para auxiliar no tratamento das afecções osteomusculares em cães. Dentre as afecções ortopédicas, a displasia coxofemoral é a enfermidade articular de maior incidência em cães. O presente estudo teve como objetivo a análise dos efeitos da esteira aquática no ganho de massa muscular em membros pélvicos em um animal acometido por displasia coxofemoral. Para avaliação do ganho de massa muscular, foram utilizadas a escalas de claudicação, avaliação por perimetria e avaliação do movimento em flexão e extensão dos membros pélvicos pela goniometria. Após 4 semanas de tratamento, constatou-se melhora no padrão do passo, ganho de 3 cm em média em cada coxa do animal, de 15 graus na amplitude de movimento da coxofemoral direita, e de 5 graus na articulação esquerda.

Hydrotherapy is one of the main techniques to assist in the treatment of orthopedic, neurological and endocrinological conditions. Among the orthopedic conditions, the hip dysplasia is the one with the highest incidence in the hip joint in dogs. The present study aimed to analyze the effects of the aquatic treadmill on the muscule mass gain in pelvic limbs. For this evaluation, claudication scales, perimetry muscle mass evaluation menses assessment of the movement in flexion and extension of the pelvic limbs by goniometry were used. There was improvement in the pattern of the step, gain of 3 cm in average in each thigh of the animal, 15 degrees in the range of movement of the right hip, and 5 degrees in the left.

La hidroterapiaesuna de las principales técnicas para auxiliar el tratamiento de las afecciones osteomusculares en perros. Entre las afecciones ortopédicas, la displasia de cadera es la enfermedad articular de mayor incidencia en los perros. El presente estudio tuvo como objetivo el análisis de los efectos de la cinta caminadora acuática en el aumento de masa muscular en miembros pélvicos de un animal acometido por displasia de cadera. Para la evaluación del aumento de la masa muscular, se utilizaron la escala de claudicación, evaluación por perimetría y evaluación del movimiento en flexión y extensión de los miembros pélvicos por la goniometría. Después de 4 semanas de tratamiento, se constató una mejora en el patrón del paso, con el aumento pro medio de 3 cm en cada muslo del animal, de 15 grados en el rango de movimiento de la cadera derecha, y de 5 grados en la izquierda.

Efectos de la hipoterapia en niños con lesión del sistema nervioso central: estudio de casos / Effects of hippotherapy in children with central nervous system injury: study of cases

Introducción la hipoterapia está constituida como coadyuvante en los procesos de intervención fisioterapéutica, definida como un procedimiento alternativo de tratamiento utilizado por los especialistas dedicados a la atención al niño en condición de discapacidad. Objetivo: Determinar los efectos de la técnica de hipoterapia en los niños con lesión del sistema nervioso central. Pacientes y Métodos: Se realizó un estudio de casos de tipo descriptivo con cuatro niños con lesión del Sistema Nervioso Central. Se valoraron antes y después de la aplicación de la hipoterapia con el fin de establecer los efectos de la técnica. Resultados y conclusiones: se encontró una influencia positiva de la hipoterapia en la movilidad articular, flexibilidad, aptitud postural y reacciones de equilibrio de los participantes.

Introduction: Hippotherapy is constituted as an adjuvant in the processes of physiotherapeutic intervention, defined as an alternative treatment procedure used by specialists dedicated to the care of children with disabilities. Objective: To determine the effects of the hippotherapy technique in children with central nervous system injury. Patients and methods: A descriptive case study was conducted with four children with Central Nervous System injury. They were assessed before and after the application of hippotherapy in order to establish the effects of the technique. Results and conclusions: a positive influence of hippotherapy on joint mobility, flexibility, postural aptitude and equilibrium reactions was found.

Avaliação clínica e bioquímica de cães submetidos a dois métodos de hidroterapia / Clinical and biochemical evaluation of dogs submitted to two methods of hydrotherapy

Avaliou-se a resposta dos parâmetros fisiológicos de frequência cardíaca (FC) e respiratória (FR), temperatura retal (TR) e a atividade sérica das enzimas creatina quinase (CK) e lactato desidrogenase (LDH) em cães adultos hígidos, machos e fêmeas, sob duas modalidades de hidroterapia. Dez cães foram distribuídos em dois grupos de cinco animais, denominados de grupo I (caminhada em esteira aquática) e grupo II (natação) e submetidos a duas sessões por semana com duração inicial de 10 minutos, acrescida de cinco minutos por sessão até 30 minutos, durante nove semanas. As avaliações foram realizadas antes, imediatamente depois e quatro horas após o exercício em todas as sessões para as variáveis de FC, FR e TR e nos dias um, sete, 28 e 60 para CK e LDH. Não houve diferença (P>0,05) quando comparados os valores médios dos parâmetros fisiológicos de frequência cardíaca e respiratória e de temperatura retal. Os níveis de CK e LDH não se elevaram após a hidroterapia nos diferentes tempos e dias avaliados. Dessa forma, foi possível concluir que as sessões de natação e de caminhada em esteira aquática não causaram alterações nos parâmetros fisiológicos de frequência cardíaca e respiratória, temperatura retal e nos níveis sanguíneos de creatina quinase (CK) e lactato desidrogenase (LDH) no protocolo proposto.(AU)

The physiological parameters of heart rate (HR), respiratory rate (RR), rectal temperature (TR), and serum activity of creatine kinase (CK) and lactate dehydrogenase (LDH) enzymes were determined in healthy dogs, male and female, under two hydrotherapy modalities. Ten dogs were distributed in two groups of five animals, named Group I (underwater treadmill walk) and Group II (swimming), submitted to two sessions per week with initial duration of 10 minutes, plus 5 minutes per session up to 30 minutes, during 9 weeks. The evaluations were performed before, immediately after and 4 hours after exercise in all sessions for the HR, RR and TR variables and on days one, seven, 28 and 60 for CK and LDH. There was no difference (P> 0.05) when comparing the mean values of physiological parameters of heart and respiratory rate and rectal temperature. CK and LDH levels did not rise after hydrotherapy at different times and days evaluated. So, it was possible to conclude that swimming sessions and underwater treadmill walking did not cause alterations in the physiological parameters of heart and respiratory rate, rectal temperature, and the blood levels of creatine kinase (CK) and lactate dehydrogenase (LDH) in the proposed protocol.(AU)

Avaliação clínica e bioquímica de cães submetidos a dois métodos de hidroterapia / Clinical and biochemical evaluation of dogs submitted to two methods of hydrotherapy

Avaliou-se a resposta dos parâmetros fisiológicos de frequência cardíaca (FC) e respiratória (FR), temperatura retal (TR) e a atividade sérica das enzimas creatina quinase (CK) e lactato desidrogenase (LDH) em cães adultos hígidos, machos e fêmeas, sob duas modalidades de hidroterapia. Dez cães foram distribuídos em dois grupos de cinco animais, denominados de grupo I (caminhada em esteira aquática) e grupo II (natação) e submetidos a duas sessões por semana com duração inicial de 10 minutos, acrescida de cinco minutos por sessão até 30 minutos, durante nove semanas. As avaliações foram realizadas antes, imediatamente depois e quatro horas após o exercício em todas as sessões para as variáveis de FC, FR e TR e nos dias um, sete, 28 e 60 para CK e LDH. Não houve diferença (P>0,05) quando comparados os valores médios dos parâmetros fisiológicos de frequência cardíaca e respiratória e de temperatura retal. Os níveis de CK e LDH não se elevaram após a hidroterapia nos diferentes tempos e dias avaliados. Dessa forma, foi possível concluir que as sessões de natação e de caminhada em esteira aquática não causaram alterações nos parâmetros fisiológicos de frequência cardíaca e respiratória, temperatura retal e nos níveis sanguíneos de creatina quinase (CK) e lactato desidrogenase (LDH) no protocolo proposto.(AU)

The physiological parameters of heart rate (HR), respiratory rate (RR), rectal temperature (TR), and serum activity of creatine kinase (CK) and lactate dehydrogenase (LDH) enzymes were determined in healthy dogs, male and female, under two hydrotherapy modalities. Ten dogs were distributed in two groups of five animals, named Group I (underwater treadmill walk) and Group II (swimming), submitted to two sessions per week with initial duration of 10 minutes, plus 5 minutes per session up to 30 minutes, during 9 weeks. The evaluations were performed before, immediately after and 4 hours after exercise in all sessions for the HR, RR and TR variables and on days one, seven, 28 and 60 for CK and LDH. There was no difference (P> 0.05) when comparing the mean values of physiological parameters of heart and respiratory rate and rectal temperature. CK and LDH levels did not rise after hydrotherapy at different times and days evaluated. So, it was possible to conclude that swimming sessions and underwater treadmill walking did not cause alterations in the physiological parameters of heart and respiratory rate, rectal temperature, and the blood levels of creatine kinase (CK) and lactate dehydrogenase (LDH) in the proposed protocol.(AU)

Effect of aquatic physical therapy on pain perception, functional capacity and quality of life in older people with knee osteoarthritis: study protocol for a randomized controlled trial.

BACKGROUND: Aquatic therapy promotes short-term benefits for patients with knee osteoarthritis (OA), and it may be the first therapeutic option for this pathological condition. The objective of this study was to investigate the effects of an aquatic therapy program on pain intensity, functional ability, and quality of life in older people with knee OA. METHODS/DESIGN: This is a parallel, two-arm, open, randomized controlled clinical trial with older people with knee OA. Volunteers will be allocated to an aquatic intervention group (WG), subjected to the intervention, or to a control group, not be subjected to any kind of intervention. Data collection pre- and postintervention will be composed of the evaluation of the perception of pain by visual analogue scale with application of nociceptive stimuli in four anatomical points of the knee, functional fitness tests, and application of the World Health Organization Quality of Life Scale abbreviated version and Western Ontario and McMaster Universities Osteoarthritis Index. The program will last 12 weeks, consisting of aerobic and functional exercises in the form of circuit training. DISCUSSION: The objective of this clinical trial is to evaluate the effect of aquatic therapy in elderly patients with knee OA. The study is guided by practice-based scientific evidence for the use of aquatic rehabilitation exercises. It is expected that the WG volunteers will show reduced pain intensity, increased flexibility, and improved functional capacity and quality of life. It is believed that the desired results can be attributed to physical and physiological effects of immersion in warm water associated with the exercise protocol proposed. The data will be published after completion of the study. TRIAL REGISTRATION: Brazilian Registry of Clinical Trials (ReBEC) registration number: RBR-78h48d . Registered on 19 August 2015.

Efeito da hidroterapia no condicionamento cardiovascular e na qualidade de vida de pacientes após acidente vascular encefálico / Effects of hydrotherapy on the endurance and quality of life in stroke survivors

Introdução: os efeitos do treinamento cardiovascular são potencializados quando realizados na piscina terapêutica devido às propriedades físicas da água. Objetivo: avaliar os efeitos de um protocolo de hidroterapia na qualidade de vida e no condicionamento cardiovascular de pacientes pós-AVE. Métodos: dez pacientes foram divididos nos grupos: controle (exposto ao protocolo de exercícios no solo) e experimental (submetidos a 10 sessões de hidroterapia). As medidas para frequência cardíaca e respiratória, o número de voltas, saturação de oxigênio durante o teste de caminhada de seis minutos e qualidade de vida segundo a escala EQVE-AVE, foram avaliadas antes e após o programa de atividades. Resultados: houve um aumento expressivo da quantidade de voltas [12,80 ± 2,78 (p=0,01) ] em ambos os grupos e dos escores para a qualidade de vida [196,20±42,92 (p=0,046) ] apenas no grupo experimental em relação a condição inicial. Conclusão: o protocolo de hidroterapia promoveu os mesmos efeitos do treinamento no solo sobre o condicionamento cardiovascular, no entanto, aumentou os escores para qualidade de vida. (AU)

Introduction: Cardiovascular training programs effects are extended when performed in the therapeutic pool due to physical properties of the water. Objective: To evaluate the effects of a hydrotherapy protocol on the quality of life and endurance in stroke survivors. Methods: ten stroke survivors were divided into two groups: control (exposed to a floor exercise protocol) and experimental (underwent to 10 sessions of hydrotherapy). Heart and respiratory rate and oxygen saturation were assessed during the six-minute walk test. Additionally, the number of turns and stroke specific quality of life scale (SS-QOL) were assessed before and after the exercise protocols. Results: there was a significant increase in the number of turns [12.80 ± 2.78 (p = 0.01)] in both groups and in the quality of life scores [196.20 ± 42.92 (p = 0.046)] only after hydrotherapy protocol when compared to the baseline condition. Conclusion: the hydrotherapy protocol promoted the same benefits of the floor exercise's protocol on the endurance, however, it increased the quality of life scores. (AU)

Jumping in aquatic environment after sciatic nerve compression: nociceptive evaluation and morphological characteristics of the soleus muscle of Wistar rats.

OBJECTIVE: To evaluate the effect of jumping in aquatic environment on nociception and in the soleus muscle of trained and not trained Wistar rats, in the treatment of compressive neuropathy of the sciatic nerve. METHODS: Twenty-five Wistar rats were distributed into five groups: Control, Lesion, Trained + Lesion, Lesion + Exercise, and Trained + Lesion + Exercise. The training was jumping exercise in water environment for 20 days prior to injury, and treatment after the injury. Nociception was evaluated in two occasions, before injury and seven after injury. On the last day of the experiment, the right soleus muscles were collected, processed and analyzed as to morphology and morphometry. RESULTS: In the assessment of nociception in the injury site, the Control Group had higher average than the rest, and the Lesion Group was larger than the Trained + Lesion and Lesion + Exercise Groups. The Control Group showed higher nociceptive threshold in paw, compared to the others. In the morphometric analysis, in relation to Control Group, all the injured groups showed decreased muscle fiber area, and in the Lesion Group was lower than in the Lesion + Exercise Group and Trained + Lesion Group. Considering the diameter of the muscle fiber, the Control Group had a higher average than the Trained + Lesion Group and the Trained + Lesion + Exercise Group; and the Lesion Group showed an average lower than the Trained + Lesion and Lesion + Exercise Groups. CONCLUSION: Resistance exercise produced increased nociception. When performed prior or after nerve damage, it proved effective in avoiding hypotrophy. The combination of the two protocols led to decrease in diameter and area of the muscle fiber. OBJETIVO: Avaliar os efeitos do salto em meio aquático, na nocicepção e no músculo sóleo, em ratos Wistar treinados e não treinados, no tratamento de neuropatia compressiva do nervo isquiático. MÉTODOS: Foram distribuídos em cinco grupos 25 ratos Wistar: Controle, Lesão, Treinado + Lesão, Lesão + Exercício e Treinado + Lesão + Exercício. O treino foi com exercício de salto em meio aquático durante 20 dias, prévio à lesão, e o tratamento ocorreu após a lesão. Foram realizadas avaliações da nocicepção, sendo uma pré-lesão e sete pós-lesão. No último dia de experimento, os músculos sóleos direitos foram coletados, processados e analisados por meio de morfologia e morfometria. RESULTADOS: Na avaliação da nocicepção no local da lesão, o Grupo Controle apresentou média maior que os demais, e o Grupo Lesão foi maior que os Grupos Treinado + Lesão e Lesão + Exercício. O Grupo Controle apresentou limiar nociceptivo na pata maior com relação aos demais. Nas análises morfométricas, em relação ao Grupo Controle, todos os grupos lesionados apresentaram diminuição da área da fibra muscular; o Grupo Lesão apresentou-se menor que os Grupos Treinado + Lesão e Lesão + Exercício. No diâmetro da fibra muscular, o Grupo Controle apresentou média maior que os Grupos Treinado + Lesão e Treinado + Lesão + Exercício, e o Grupo Lesão apresentou média menor que os Grupos Treinado + Lesão e Lesão + Exercício. CONCLUSÃO: O exercício físico resistido produziu aumento da nocicepção. Quando realizado previamente ou após a lesão nervosa, mostrou-se eficaz em evitar a hipotrofia. A associação dos dois protocolos levou à diminuição do diâmetro e da área da fibra muscular.

Oxygen uptake and body composition after aquatic physical training in women with fibromyalgia: a randomized controlled trial.

BACKGROUND: Aquatic physical training (APT) has been strongly recommended to improve symptoms in fibromyalgia syndrome (FMS). However, its effects on body composition and whether lean body mass (LBM) directly influences the aerobic functional capacity of this population are still not clear. AIM: To investigate whether APT can help improve body composition and increase the aerobic functional capacity in women with FMS, and whether oxygen uptake (VO2) related to LBM can better quantify the functional capacity of this population. DESIGN: Randomized controlled trial. SETTING: The Federal University of São Carlos, São Paulo, Brazil. POPULATION: Fifty-four women with FMS were randomly assigned to trained group (TG, N.=27) or control group (CG, N.=27). METHODS: All women underwent cardiopulmonary exercise test (CPET) to assess oxygen consumption at ventilatory anaerobic threshold (VAT) and at peak exercise, and also to assess body composition. The TG was submitted to APT program, held twice a week for 16 weeks. The exercise intensity was adapted throughout the sessions in order to keep heart rate and ratings of perceived exertion achieved at VAT. RESULTS: After APT, body composition was not significantly different between groups (TG and CG). In VAT only TG showed increased VO2 related to LBM, since in peak CPET, VO2 in absolute units, VO2 related to total body mass (TBM), VO2 related to LBM and power showed significant differences. Significant difference between VO2 related to TBM and VO2 related to baseline LBM and after 16 weeks of follow-up, both in VAT as in peak CPET in both groups. Significant difference between VO2 related to TBM and VO2 related to LBM at VAT and at peak CPET in both groups at baseline and after 16 weeks of follow-up was observed. CONCLUSIONS: APT with standardized intensities did not cause significant changes in body composition, but was effective in promoting increased VO2 at peak CPET in women with FMS. However, VO2 related to LBM more accurately reflected changes in aerobic functional capacity at VAT level after to APT. CLINICAL REHABILITATION IMPACT: APT with standardized intensities at VAT level is of great interest, since VAT reflects better aerobic functional capacity of patients with FMS than maximum VO2.