ABSTRACT
Non-specific low back pain is a common complaint frequently presented by patients and this complex clinical condition has challenged the biomedical model. The Biopsychosocial (BPS) model is recognized as an option for better guidance and patient management. However, physiotherapy training is based on the biomedical perspective, added to which, in clinical practice the applicability of the BPS model is a challenge for many professionals. In this article, we explore the feelings, beliefs, and attitudes of newly trained physiotherapists about using the BPS model to treat people with non-specific low back pain. It also aims to understand to what extent these physiotherapists are willing and prepared to use this model. Method: A qualitative phenomenological research was carried out in the Brazilian federal capital. A set of criteria was used to select 10 physiotherapists. The data were collected through semi-structured interviews and analyzed using five steps: familiarization, identification, indexation, mapping, and interpretation. Results: We identified one theme and three categories. The theme 'a practitioner physiotherapist can consider BPS aspects, but it is not necessary in his/her role to approach them' explains a shared belief about the use of BPS. The theme is better understood when looking at the three categories that explore and exemplify key elements of the theme: (i) understanding the BPS model and its relation to non-specific low back pain; (ii) the role of practitioner physiotherapists regarding the BPS model; and (iii) barriers: from undergraduate training to clinical settings.
Subject(s)
Attitude of Health Personnel , Low Back Pain/therapy , Physical Therapists/psychology , Adult , Brazil , Female , Humans , Interviews as Topic , Male , Physical Therapy ModalitiesABSTRACT
ABSTRACT BACKGROUND AND OBJECTIVES: During the undergraduate course students have the opportunity to learn and understand health promotion and prevention, quality of life and other concepts, but they rarely learn about health education, let alone pain. Knowing that there are gaps in the training of health professionals regarding pain, and in the use of pedagogical methodologies that encourage the active construction of knowledge, the objective of this study was to provide an experience about the process of understanding pain neuroscience education from an instrument and the role-playing technique in the academic environment of Physiotherapy students. CASE REPORTS: During a Basic Complexity class, Physiotherapy students from the Ceilândia campus of the University of Brasília were invited to provide care to a fictitious population and develop explanations and lessons about pain and its processes in the human body using the WHOQOL-Bref questionnaire to evaluate the quality of life of the individual and target the care accordingly. CONCLUSION: The experience provided by the simulation of clinical cases was important for the analysis and discussion of challenging issues such as psychological, social and behavioral factors in the health education process in multi and interdisciplinary interventions.
RESUMO JUSTIFICATIVA E OBJETIVOS: Durante a graduação, os acadêmicos têm a oportunidade de aprender e compreender sobre promoção e prevenção de saúde, qualidade de vida, entre outros conceitos, mas raramente a educação em saúde é colocada nas salas de aula, em especial o entendimento da dor. Sabendo que há lacunas na formação de profissionais de saúde relacionadas ao conhecimento da dor e à utilização de metodologias pedagógicas que incentivem a construção ativa do conhecimento, o objetivo deste estudo promoveu um relato de experiência sobre o processo de entendimento e educação em neurociência da dor, por meio de um instrumento e da técnica de dramatização na vivência acadêmica de estudantes de Fisioterapia. RELATO DOS CASOS: Durante a realização de uma aula de Básica Complexidade, alunos do curso de Fisioterapia da Universidade de Brasília - Campus Ceilândia, foram convidados a vivenciarem um atendimento à uma população fictícia e desenvolverem explicações e ensinamentos sobre a dor e seus processos no corpo humano, utilizando o instrumento WHOQOL-Bref para avaliar a qualidade de vida do indivíduo e direcionar o seu atendimento. CONCLUSÃO: A experiência vivenciada por meio de simulações de casos clínicos na disciplina foi importante para a análise e discussão de questões desafiadoras como fatores psicológicos, sociais, e comportamentais no processo de educação em saúde em intervenções multi e interdisciplinar.
ABSTRACT
The goal of this work is to study the behavior of electromyographic variables during the menstrual cycle. Ten female volunteers (24.0 ± 2.8 years of age) performed fatiguing isometric contractions, and electromyographic signals were measured on the biceps brachii in four phases of the menstrual cycle. Adaptations of classical algorithms were used for the estimation of the root mean square (RMS) value, absolute rectified value (ARV), mean frequency (MNF), median frequency (MDF), and conduction velocity (CV). The CV estimator had a higher (p = 0.002) rate of decrease at the end of the follicular phase and at the end of the luteal phase. The MDF (p = 0.002) and MNF (p = 0.004) estimators had a higher rate of decrease at the beginning of the follicular phase and at the end of the luteal phase. No significant differences between phases of the menstrual cycle were detected with the ARV and RMS estimators (p > 0.05). These results suggest that the behavior of the muscles in women presents different characteristics during different phases of the menstrual cycle. In particular, women were more susceptible to fatigue at the end of the luteal phase.
Subject(s)
Electromyography/methods , Menstrual Cycle/physiology , Electric Conductivity , Electrodes , Female , Humans , Muscle Fatigue/physiology , Young AdultABSTRACT
Este trabalho analisa o efeito da estimulação elétrica neuromuscular de baixa freqüência (50Hz) e de média freqüência (2000Hz modulada a 50Hz) na freqüência mediana. Foram analisados o efeito de dois protocolos nos músculos flexores do punho de 12 voluntários na faixa etária 18 a 29 anos, através da estimulação neuromuscular (EENM) no período de 30 minutos. Após o posicionamento do voluntário, foi realizado três contrações isométricas voluntárias máximas antes da EENM para aquisição do sinal eletromiográfico. Posteriormente foram eletroestimulados no período de 30 minutos, sendo que a cada 10 minutos foram realizadas aquisições do sinal eletromiográfico. Após 15 minutos e 24 horas da aplicação, os voluntários foram submetidos a aquisição do sinal eletromiográfico. Os resultados revelaram que houve diferença estatística significante (p<0,002226) para os valores da freqüência mediana dos músculos flexores do punho no grupo 1 (1G MF) n=6 e grupo 2 (2G BF), n=6, antes (0), a cada 10 minutos durante a EENM e 15 minutos e 24 horas após a EENM. O grupo estimulado com BF gerou maior fadiga muscular que o MF, sendo mais evidente no período de 20 a 30 minutos de EENM. A EENM com corrente de MF mostrou-se mais vantajosa que a EENM de BF. Portanto, o tempo ideal foi 20 minutos para a EENM MF e cuidados adicionais devem ser tomados para protocolos mais demorados.
This work analyzes the immediate effect of the neuromuscular electrical stimulation with low frequency (50Hz) and medium frequency (2000Hz modulated 50Hz) in the median frequency. We analyze the effects two protocols in the wrist flexor muscles, in twelve voluntaries between eighteen to twenty-nine years old, through of the neuromuscular electrical stimulation (EENM), in the thirty minutes of period. Median frequency analyzed during three maximum voluntaries contractions, before of the EENM for each acquisition of the electromyography signal. After fifteen minutes and twenty four hours of the electrical stimulation, the voluntaries were engaged in the others acquisition of the electromyographyc signal. There was significant statistics different (p< 0,002226) in the numbers of the median frequency (Fmed) of the wrist flexors muscles in the group one (1G-MF,n=6) and group two (2G-BF, n=6), before of electrical stimulation and for each temn minutes during a electrical stimulation and after fifteen and twenty four hours of the electrical stimulation. The groups electroestimulated with low frequency indicated larger muscle fatigue, in the period between twenty until thirty minutes of the electrical stimulation. The group medium frequency indicated more advantages. Therefore the results allow to conclude the ideal time is twenty minutes to EENM and additional cautions to programs more delayed.
