ABSTRACT
BACKGROUND: The therapeutic effect of neuromuscular electrical stimulation (NMES) on muscle strengthening and hypertrophy depends on its dose. Patients must tolerate high doses of NMES to maximize gains in muscle function. It is unknown why some patients are able to achieve high NMES dose while others are not. Disability and psychological attributes may play a role in a patient's tolerance of NMES dose. PURPOSE: To explore if disability and psychological attributes associate with the ability to achieve high doses of NMES in patients with rheumatoid arthritis (RA). METHODS: Cross-sectional study. Forty subjects with RA participated in 2 sessions of NMES intervention to the quadriceps muscles. The highest NMES dose achieved by each subject was recorded. Dose was defined as the torque produced by the NMES as a percentage of the torque produced during a maximum voluntary isometric contraction. Subjects were then grouped in high or low NMES dose. Variables investigated in this study included disability, pain coping strategies, pain acceptance, sense of mastery or control, anxiety, and depression. Correlations were sought between these factors and NMES dose. MAIN RESULTS: In unadjusted models, disability, coping self-statements, catastrophizing, and anxiety were predictors of NMES dose. In adjusted models only disability (OR = 0.17 [95% CI: 0.04, 0.77]) and catastrophizing (OR = 0.85 [95% CI: 0.72, 0.99]) predicted NMES dose. CONCLUSION: Patients with RA with lower disability and lower catastrophising achieve higher doses of NMES. Identifying factors associated with achieving high NMES dose may guide strategies to improve effectiveness of this intervention.
ABSTRACT
OBJETIVOS: Avaliar o equilíbrio, a coordenação e a agilidade dos idosos submetidos a exercícios físicos. MÉTODOS: 61 idosos do gênero masculino, com idades entre os 60-75 anos, designados aleatoriamente para um grupo de exercícios resistidos com carga progressiva (n=39) ou para um controle submetido a exercícios sem carga (n=22). O grupo exercício resistido participou de um programa de 24 semanas, com 3 visitas por semana, em dias não consecutivos. Foram avaliados após o término do treinamento, pela Escala de Equilíbrio de Berg, do Teste de Tinetti e do Timed UP & GO. RESULTADOS: Comparando-se os dois grupos verificou-se um melhor desempenho estatisticamente significativo para o grupo experimental em relação ao controle para os testes Timed "Up & Go". (p=0,02) e para o Tinetti Total (p=0.046) e para o Tinetti marcha (p=0.029). Desta forma, não encontramos diferença na Escala de Equilíbrio de Berg e no teste de Tinetti equilíbrio. CONCLUSÃO: O programa de treinamento de força durante 24 semanas mostrou-se favorável na melhora dos desempenhos funcional e motores de idosos.
OBJECTIVES: To evaluate balance, coordination and agility of older subjects submitted to physical exercise. METHODS: 61 male older subjects, aged between 60-75 years, randomly assigned to a resisted exercises with gradual load (n=39) group or to a control group submitted to exercise without load (n=22). The resisted exercise group participated in a 24 week-program, with 3 weekly visits, in not consecutive days. After the training ending, they were evaluated through the Berg Balance Scale and the Tinetti and Timed UP & GO tests. RESULTS: Comparing the two groups, better statistical significant performance was verified for the experimental group for the Timed "Up & Go" (p=0.02), for the Total Tinetti (p=0.046) and for the Tinetti gait tests (p=0.029). Therefore, we did not find difference in the Berg Balance Scale or in the Tinetti balance test. CONCLUSION: The strength training program during 24 weeks behaved favorable in improving functional and motor performance of older subjects.