Relação entre a progressão do escore do functional movement screen e lesão em atletas futebol / Relationship between progression of functional movement screen test and injury in athletes of football

O futebol é uma modalidade de grande exigência física com movimentos de potência e velocidade com mudança de direção. Devido à alta intensidade, ocorre uma maior predisposição às lesões. O Functional Movement Screen (FMS) é um modelo de avaliação para identificar assimetrias e desequilíbrios musculoesqueléticos. O objetivo deste trabalho foi comparar os efeitos de do is m eses de pré-temporada na progressão do escore do teste FMS e sua relação com as lesões ao longo da competição. Participaram deste estudo 28 atletas profissionais de futebol, com idade média de 25,1 ± 6,5. Foi realizado o FMS antes e após a pré-temporada e durante o período competitivo foi verificada a ocorrência de lesões. Houve uma melhora (p<0,01) dos escores do FMS da avaliação pré (15,61 ± 1,39) para a avaliação pós pré-temporada (17,29 ± 1,24) entre todo o elenco, porém, quando considerado o tamanho do efeito, os atletas que não se lesionaram tiveram um efeito maior na progressão do escore (d=1,17) do que os que se lesionaram (d=0,35). Conclui-se que os atletas que não se lesionaram durante a competição, foram os que mais progrediram no FMS durante a pré-temporada, sendo, provavelmente, a progressão do escore do s atletas mais interessante do que o atendimento ao ponto de corte sugerido pela literatura...(AU)

Football is a modality that demands high physical fitness, with intense movements and rapid direction changing. Due to the high intensity demanded, athletes are more susceptible t o in juries. The Functional Movement Screen (FMS) test it is a method to evaluate asymmetries and muscle im balance. The objective was to compared the effects of two months of preseason, on the score of the FMS t est and their relationship with the injuries resulting from the competitive period. Participated o f th is study 28 professional football players (25.1 ± 6.5 years). FMS was performed before and after the p reseason and during the competitive period the occurrence of injuries was verified. There was a significant improvement of the FMS score after the preseason (p<0.01) for the all athletes. When considering the size effect, athletes who were not injured during the competitive period had a greater effect (d=1.17) than those who injured (d=0.35). The athletes who progressed the most during the evaluation were the athletes who were exempted from injury during the competitive period. Perhaps the progression of the athlete's score was more interesting than the attendance to the cut-off point suggested by the literature...(AU)

Intradialytic exercise with blood flow restriction: Something to add to hemodialysis adequacy? Findings from a crossover study.

INTRODUCTION: Hemodialysis (HD) increases the lifespan of chronic kidney disease (CKD) patients. However, HD is only partially effective in replacing renal function. The aim of this study is to compare HD adequacy between sessions with intradialytic exercise with or without blood flow restriction (BFR) with sessions without exercise. METHODS: A crossover study including 22 adult CKD patients on HD. The patients were assigned to BFR (n = 11) or exercise alone group (n = 11). Each patient was submitted to four HD sessions (two with exercise and two control sessions). HD adequacy was assessed by equilibrated Kt/V-urea (eKT/V), single-pool Kt/V-urea (sp-Kt/V), urea and phosphorus rebound, urea reduction ratio (URR) and removal of urea and phosphorus in dialysate. FINDINGS: BFR exercise improved eKt/V and sp-Kt/V (1.32 ± 0.21 vs. 1.10 ± 0.16 for control, P < 0.001; 1.53 ± 0.26 vs. 1.27 ± 0.19 for control, P < 0.001, respectively) and URR (72.5 ± 5.4% vs. 66.1 ± 7.7% for control, P < 0.001). No difference in eKt/V, sp-Kt/V or URR could be detected between exercise alone and control HD sessions. Urea rebound was lower in BFR exercise vs. control sessions (-8.9 ± 9.1% vs. 30.7 ± 12.8%, P < 0.01) and exercise alone vs. control sessions (13.3 ± 29.0% vs. 42.4 ± 15.3%, P < 0.01). Phosphorus rebound was marginally lower in exercise vs. control sessions (14.4 ± 19.1% vs. 28.4 ± 22.1%, P = 0.18). Urea and phosphorus mass removal in dialysate were marginally higher in exercise vs. control sessions (42.2 ± 19.4 g vs. 35.7 ± 12.5 g, P = 0.24; 912.1 ± 360.9 mg vs. 778.6 ± 245.1 mg, P = 0.28). CONCLUSIONS: Intradialytic exercise with BFR was more effective than standard exercise in increasing HD adequacy.

Does Intradialytic Exercise Improve Removal of Solutes by Hemodialysis? A Systematic Review and Meta-analysis.

OBJECTIVE: To describe a systematic review and meta-analysis to identify if intradialytic exercise improves the removal of solutes and the hemodialysis adequacy. DATA SOURCES: A systematic review and meta-analysis of randomized controlled trials (RCTs) were performed. The sources were MEDLINE (via PubMed), Web of Science, LILACS, and SciELO, from inception until July 2018. STUDY SELECTION: Clinical trials including patients on chronic hemodialysis submitted to the intervention of aerobic intradialytic exercise. DATA EXTRACTION: Evaluating as outcomes the removal of solutes (creatinine, phosphate, potassium) and/or adequacy parameters (Kt/V-urea). DATA SYNTHESIS: The systematic review included 23 studies (7 evaluating the effect of 1 exercise session and 16 evaluating the effect of training, lasting from 6 to 25 weeks). Eleven RCT were included in the meta-analyses. It was observed that the aerobic intradialytic exercise increased the Kt/V-urea (0.15; 95% confidence interval [95% CI], 0.08-0.21) and decreased creatinine (-1.82 mg/dL; 95% CI, -2.50 to -1.13), despite the high heterogeneity of the analysis. No differences were found in phosphorus and potassium removal. CONCLUSION: The aerobic intradialytic exercise may be suggested to improve the Kt/V-urea and the creatinine removal during the dialysis.

Respiratory training improved ventilatory function and respiratory muscle strength in patients with multiple sclerosis and lateral amyotrophic sclerosis: systematic review and meta-analysis.

BACKGROUND: Among neurodegenerative diseases, multiple sclerosis (MS) and amyotrophic lateral sclerosis (ALS) have a high rate of respiratory disability. OBJECTIVES: To analyze the effects of respiratory muscle training (RMT) on ventilatory function, muscle strength and functional capacity in patients with MS or ALS. DATA SOURCES: A systematic review and meta-analysis of randomized controlled trials (RCTs) was performed. The sources were MEDLINE, PEDro, Cochrane CENTRAL, EMBASE, and LILACS, from inception to January 2015. STUDY SELECTION/ELIGIBILITY CRITERIA: The following were included: RCTs of patients with neurodegenerative diseases (MS or lateral ALS) who used the intervention as RMT (inspiratory/expiratory), comparison with controls who had not received RMT full time or were receiving training without load, and evaluations of ventilatory function (forced vital capacity - FVC, forced expiratory volume in one second - FEV1, maximum voluntary ventilation - MVV), respiratory muscle strength (maximal expiratory pressure/maximum inspiratory pressure - MEP/MIP) and functional capacity (6-minute walk test - 6MWT). RESULTS: The review included nine papers, and a total of 194 patients. It was observed that RMT significantly increased at MIP (23.50cmH2O; 95% CI: 7.82 to 39.19), MEP (12.03cmH2O; 95% CI: 5.50 to 18.57) and FEV1 (0.27L; 95% CI: 0.12 to 0.42) compared to the control group, but did not differ in FVC (0.48L; 95% CI: -0.15 to 1.10) and distance in 6MWT (17.95m; 95% CI: -4.54 to 40.44). CONCLUSION: RMT can be an adjunctive therapy in the rehabilitation of neurodegenerative diseases improving ventilatory function and respiratory strength.

African ancestry, lung function and the effect of genetics.

African-Americans have smaller lung function compared with European-Americans. The aim of this study was to disentangle the contribution of genetics from other variables on lung function. A cohort was followed from birth to 30 years of age in Brazil. Several variables were collected: genomic analysis based on DNA; forced expiratory volume in 1 s (FEV1) and forced vital capacity (FVC) obtained by spirometry; height measured by anthropometrists; and thorax circumference evaluated by photonic scanner. Crude and adjusted linear regression models were calculated according to African ancestry. The sample comprised 2869 participants out of 3701 members of the cohort. Males with higher African ancestry by DNA analysis had a smaller FEV1 (-0.13 L, 95% CI -0.23- -0.03 L) and FVC (-0.21 L, 95% CI -0.32- -0.09 L) compared with those with less African ancestry, having accounted for height, sitting to standing height ratio and other confounders. Similar effects were seen in females. After adjustment, ancestry remained significantly associated with lung function, but the large effect of adjustment for confounding among males (but not females) does not allow us to exclude the possibility that residual confounding may still account for these findings.

Prevalence and associated factors of back pain in adults from southern Brazil: a population-based study.

OBJECTIVES: To identify the prevalence of spinal pain and possible prognostic factors in a representative sample of Pelotas, RS, Brazil. METHODS: Cross-sectional study evaluated 972 adults aged between 20 and 69 years, of both sexes, residents in a urban area. The questionnaire included socio-economic, demographics, behavioral and health-related questions. Spinal pain was defined as any pain or discomfort in the spine somewhere in the last 12 months, either in the cervical, thoracic or lumbar area. RESULTS: The prevalence of spinal pain was 63.1% (95% CI 60.0 to 66.1) being lower back the most prevalent condition (40%). Female gender 1.24 (1.12 to 1.37) and poor health status(p<0.001) were the variables that remained associated with the presence of spinal pain in the final model. CONCLUSIONS: The prevalence of back pain is important as it is associated with activity limitation and with health care utilization.

Prevalência de dor nas costas e fatores associados em adultos do sul do Brasil: estudo de base populacional / Prevalence and associated factors of back pain in adults from southern Brazil: a population-based study

OBJETIVOS: Determinar a prevalência de dor nas costas e fatores associados em uma amostra representativa da cidade de Pelotas, RS, Brasil. MÉTODOS: Estudo transversal que avaliou 972 adultos com idade entre 20 e 69 anos, de ambos os sexos, moradores da zona urbana do município. O questionário aplicado incluiu questões socioeconômicas, demográficas, comportamentais e de saúde. Dor nas costas foi definida como qualquer dor ou desconforto em algum local das costas nos últimos 12 meses, seja na região cervical, torácica ou lombar. RESULTADOS: A prevalência de dor nas costas foi de 63,1 por cento (IC95 por cento 60,0 a 66,1), sendo a região lombar a mais referenciada (40 por cento). Sexo feminino 1,24 (1,12 a 1,37) e percepção ruim de saúde (p<0,001) foram as variáveis que permaneceram associadas à presença de dor nas costas no modelo final. CONCLUSÕES: A prevalência de dor nas costas encontrada é importante e causa limitação e aumento na procura por serviços de saúde.

OBJECTIVES: To identify the prevalence of spinal pain and possible prognostic factors in a representative sample of Pelotas, RS, Brazil. METHODS: Cross-sectional study evaluated 972 adults aged between 20 and 69 years, of both sexes, residents in a urban area. The questionnaire included socio-economic, demographics, behavioral and health-related questions. Spinal pain was defined as any pain or discomfort in the spine somewhere in the last 12 months, either in the cervical, thoracic or lumbar area. RESULTS: The prevalence of spinal pain was 63.1 percent (95 percent CI 60.0 to 66.1) being lower back the most prevalent condition (40 percent). Female gender 1.24 (1.12 to 1.37) and poor health status(p<0.001) were the variables that remained associated with the presence of spinal pain in the final model. CONCLUSIONS: The prevalence of back pain is important as it is associated with activity limitation and with health care utilization.

Eletromiografia de laringe / Laryngeal electromyography

Introdução: As disfunções laríngeas e imobilidade de pregas vocais são cada vez mais documentadas em nossa prática diária; porém, o diagnóstico diferencial entre imobilidade por limitação mecânica e distúrbios neuromotores é difícil. A eletromiografia de laringe é um método fundamental no diagnóstico objetivo do estado neuromuscular e da função laríngea, determinando prognóstico e influenciando decisivamente no tratamento. Forma do estudo: C1ínico prospectivo. Objetivo: Com o objetivo de avaliar as vantagens e desvantagens da eletromiografia de laringe em nosso meio, e mostrar a experiência do serviço nos distúrbios laríngeos, apresentamos cinco pacientes submetidos à eletromiografia de laringe por via percutânea, a técnica utilizada, os resultados obtidos e a conduta. Conclusão: Observamos que a eletromiografia de laringe é método de exame viável, de baixo custo, de realização ambulatorial, com mínimo desconforto e sem complicações associadas