Effects of aquatic physiotherapy or health education program in women with fibromyalgia: a randomized clinical trial.

Background: Different treatments have been proposed for Fibromyalgia, but only few studies have compared their effects on multiples outcomes over time. Objective: The objective of this study was to investigate the effects of aquatic physiotherapy (AP) or a health education program (HEP) in a sample of women with Fibromyalgia (FM). Methods: Forty-six women with FM, aged between 25 and 60 years old, whose BMI was less than 30, were assigned to either AP (27 women) or HEP (19 women) groups in a blind randomized clinical trial lasting eleven weeks. Pain (McGill Pain questionnaire), fatigue (Piper Fatigue Scale-Revised), functional capability (Fibromyalgia Impact questionnaire), anxiety (Beck Anxiety Inventory), depression (Beck Depression Inventory) and quality of sleep (Pittsburgh Sleep Quality Index) data were collected at baseline, after six weeks and post intervention. Two-factor mixed-model analysis of variance (ANOVAs) were used to examine the effects of the treatment on each outcome variable. Results: The AP and HEP interventions showed statistically significant within-group differences on all outcome measures except reducing the pain. Between-group differences was statistically significant only for impact of FM on the participant's life [F(1.82,80.41) = 31,99; p ≤ 0.01] indicating that patients receiving HEP experienced a greater decrease in FIQ than those treated with AP. Conclusion: The findings do not allow to affirm that one intervention is superior to the other for the treatment of people with FM. Future studies should investigate whether the combination of HEP and PA can be effective and long-lasting.

Levels of cortisol and neurotrophic factor brain-derived in Parkinson's disease.

The aim of this study was to evaluate salivary cortisol and plasma brain-derived neurotrophic factor (BDNF) in people with PD, to compare them with healthy controls and to associate them with levels of anxiety and depression. For this, 18 people with PD and 17 controls were recruited. The stage of the disease was determined by Hoehn and Yahr Disability Scale (H&Y), biomarkers levels were determined by enzyme-linked immunosorbent assay (ELISA) and anxiety and depression levels were assessed by the Hamilton Anxiety Assessment Scale (HAM-A) and Hamilton Depression Scale (HAM-D). The results show that in the PD group the median age was 68 years, the diagnosis time was 4.5 years and according to H&Y, 61.2% were in stage 2. The median values of cortisol were 972.5 pg/ml and BDNF, 215.7 pg/ml. The median HAM-A was 17 points and in HAM-D, 10. The control group had a median age of 62 years, cortisol values of 425 pg/ml and BDNF, 340.1 pg/ml. In HAM-A and HAM-D, the median was 2 points. There were no significant differences between levels of BDNF, but higher levels of cortisol were demonstrated in PD. Moreover, anxiety and depression were associated with biomarkers levels. These findings may suggest an involvement of neuroendocrine changes in the pathophysiology of the PD.

Impacto de um treinamento para o uso da Classificação Internacional de Funcionalidade, Incapacidade e Saúde / Impact of training on the use of the International Classification of Functioning, Disability and Health

O treinamento voltado para profissionais poderia ser uma abordagem simples e eficaz para aumentar o uso da Classificação Internacional de Funcionalidade, Incapacidade e Saúde (CIF) como uma ferramenta para a prática dos profissionais. Nesse caso, o treinamento pode ser crucial para seu uso correto como uma classificação, além de mostrar sua utilidade na prática clínica diária, principalmente em equipes multidisciplinares. Objetivo: O objetivo do presente estudo foi verificar o impacto de um curso de formação em CIF no conhecimento de fisioterapeutas e terapeutas ocupacionais. Métodos: Estudo experimental que utilizou questionário estruturado para avaliar o conhecimento dos profissionais sobre a CIF antes e depois de participar de um curso de treinamento. Os dados dos dois momentos foram comparados com o percentual de acertos e o teste do qui-quadrado (α = 0,05). Resultados: foram investigados 434 profissionais, com tempo de graduação de 9,3 ± 7,2 anos. Observou-se que o curso foi eficaz, pois houve maior percentual de respostas corretas no pós-curso; além disso, a análise estatística mostrou uma diferença significativa entre os dois momentos do curso na maioria das perguntas (18,91

Training aimed at professionals could be a simple and effective approach for increasing the use of International Classification of Functioning, Disability and Health (ICF) as a tool for practice by professionals. In this case, training was crucial for its correct use as a classification as well as showing its usefulness in daily clinical practice, particularly in multidisciplinary teams. Objective: The aim of the present study was to verify the impact of a training course on ICF in the knowledge of physical therapists and occupational therapists. Methods: This was an experimental study that used a structured questionnaire to evaluate the knowledge of professionals about the ICF before and after participating in a training course. Data from both moments were compared using the percentage of correct answers and the chi-square test (α=0.05). Results: 434 professionals were investigated, with graduation time of 9.3±7.2 years. It was observed that the course was effective, since there was a higher percentage of correct answers in the post course; additionally, the statistical analysis showed a significant difference between the two course moments in most of the questions (18.91