Impairments in ankle range of motion, dorsi and plantar flexors muscle strength and gait speed in patients with chronic venous disorders: A systematic review and meta-analysis.

OBJECTIVE: To verify the differences in ankle range of motion (ROM), muscle strength of dorsi and plantar flexors, and gait speed among healthy subjects, and patients with chronic venous disorders (CVD) with and without venous leg ulcer. METHODS: A systematic review and meta-analysis (http://osf.io/b7n3k) were conducted following a search of MEDLINE, Web of Science, CINAHL, LILACS, Scopus, and EMBASE databases. RESULTS: Eight papers were included. The ankle ROM was significantly lower both in dorsiflexion and plantar flexion in patients with venous leg ulcer when compared to healthy individuals and CVD patients without venous leg ulcer. The muscle strength of the plantar flexors and gait speed were reduced in CVD patients when compared to healthy ones. CONCLUSION: Impaired muscle strength and gait speed can be detected in CVD patients compared to healthy individuals, and ankle ROM tends to be reduced in CVD patients even in the absence of venous leg ulcers.

The prognostic value of the Incremental Shuttle Walk Test in Chagas cardiomyopathy.

PURPOSE: To verify the value of the Incremental Shuttle Walk Test (ISWT) distance to identify patients with Chagas cardiomyopathy (ChC) at risk of adverse cardiovascular events. METHODS: Fifty-two patients with ChC (51 ± 6 years) were evaluated by ISWT, echocardiography, Cardiopulmonary Exercise Testing, and Human Activity Profile (HAP) Questionnaire. Patients were prospectively followed for 44 ± 10 months. The combined endpoint was cardiac death/heart transplant/stroke. The prognostic value of ISWT was verified by the Cox regression, and the ISWT was adjusted for age, sex, left ventricular ejection fraction (LVEF), and minute ventilation/carbon dioxide production relationship (VE/VCO2 slope). RESULTS: At the final follow-up, 11 patients (21%) had experienced the endpoint event. When adjusted for age, sex, LVEF, and VE/VCO2 slope, only ISWT distance (HR 0.99, 95% confidence interval (CI): 0.98-0.99; p = 0.026) and VE/VCO2 slope (HR 0.93, 95% CI: 0.87-0.99; p = 0.044) remained as independent predictors of adverse cardiovascular events in patients with ChC. The optimal cutoff point for identifying poor prognosis was the ISWT distance less than 440 m (AUC = 0.72). There was a significant difference (p = 0.032) in the number of events between the groups with low ISWT distance (≤440 m) and high (>440 m) ISWT distance. CONCLUSIONS: The ISWT is a valuable tool with potential value in the prognostic evaluation of patients with ChC.Implications for rehabilitationPatients with Chagas cardiomyopathy showed functional impairment since the early stages of heart disease.The Incremental Shuttle Walk Test (ISWT) can be a valuable and inexpensive tool in the risk stratification of the patients.The ISWT distance is an independent predictor of adverse cardiovascular event.The ISWT distance of 440m is the optimal cut-off point in the identification of patients at risk for adverse cardiovascular events.

Determinants of minute ventilation-carbon dioxide production relationship in Chagas cardiomyopathy.

INTRODUCTION: The minute ventilation-carbon dioxide production relationship (VE/VCO2 slope) is among the main prognostic factors of Chagas cardiomyopathy whose determinants remain unknown. METHODS: Seventy-eight patients with Chagas cardiomyopathy were evaluated using clinical assessment, cardiopulmonary exercise test, echocardiography, and International Physical Activity Questionnaire. RESULTS: Age, functional class, International Physical Activity Questionnaire score, and dilated cardiomyopathy with systolic dysfunction were independent determinants of VE/VCO2 slope, and these variables explained 63% of its variance. CONCLUSIONS: The VE/VCO2 slope was related to age, functional class, physical activity level, and dilated cardiomyopathy with systolic dysfunction in patients with Chagas cardiomyopathy.

Determinants of minute ventilation-carbon dioxide production relationship in Chagas cardiomyopathy

Abstract INTRODUCTION: The minute ventilation-carbon dioxide production relationship (VE/VCO2 slope) is among the main prognostic factors of Chagas cardiomyopathy whose determinants remain unknown. METHODS: Seventy-eight patients with Chagas cardiomyopathy were evaluated using clinical assessment, cardiopulmonary exercise test, echocardiography, and International Physical Activity Questionnaire. RESULTS: Age, functional class, International Physical Activity Questionnaire score, and dilated cardiomyopathy with systolic dysfunction were independent determinants of VE/VCO2 slope, and these variables explained 63% of its variance. CONCLUSIONS: The VE/VCO2 slope was related to age, functional class, physical activity level, and dilated cardiomyopathy with systolic dysfunction in patients with Chagas cardiomyopathy.

Existe associação entre a curvatura lombar, incapacidade e recrutamento dos músculos abdominais com a dor lombar de enfermeiros / Is there association between the degree of lumbar curvature, disability, and the recruitment of abdominal muscles with low back pain in nurses

Dentre as profissões da área da saúde, a enfermagem, em particular, tem sido especialmente afetada por distúrbios musculo esqueléticos como episódios de dor lombar. Alteração no recrutamento dos músculos abdominais e o grau de lordose lombar estão associados à instabilidade segmentar. Objetivo: Avaliar a associação entre a dor lombar e o recrutamento dos músculos abdominais com grau de lordose lombar nos enfermeiros e técnicos de enfermagem do Hospital Paulo de Tarso Geriatria e Reabilitação. Método: Participaram desse estudo 37 enfermeiros, os quais foram submetidos à aplicação de dois questionários e dois testes específicos. Resultados: Durante a realização deste trabalho, foi verificado que as variáveis explicativas correspondem a 37,1% que estão relacionados com a variável resposta, apresentando-se como um modelo estatisticamente significativo (R2 = 0,371; F = 4,723; P = 0,004). Conclusão: De acordo com os resultados obtidos neste trabalho, é necessário o aprofundamento das discussões para investigar a natureza multidimensional da dor lombar e desenvolver estratégias para potencializar as intervenções utilizadas no tratamento e prevenção desta patologia.

Among the professions of health, nursing, in particular, has been especial/y affected by musculoskeletal disorders as back pain. Changes in recruitment of abdominal muscles and the degree of lumbar lordosis are associated with segmental instability. Objective: To evaluate the association between pain and the recruitment of abdominal muscles with a degree of lumbar lordosis in nurses and nursing technicians of Paulo de Tarso Geriatrics and Rehabilitation Hospital. Method: The sample was composed by 37 nurses, which were submitted to two questionnaires and two specific tests. Results: During this work it was found that the explanatory variables account for 37.1% that are related to the response variable, presenting itself as a statistical/y significant model (R2=0.371, F=4.723, p=0.004). Conclusion: According to the results obtained in this work, it is necessary to deepen the discussions in order to investigate the multidimensional nature of pain and develop strategies to improve the interventions used in prevention and treatment of this pathology.