Home-Based Indoor Physical Activity Programs for Community-Dwelling Older Adults: A Systematic Review.

CONTEXT: Home-based exercise programs are a good strategy to promote benefits to health for people who cannot visit gyms, clinics, or have limited time for physical activity outside. OBJECTIVE: To synthesize the effect of home-based indoor physical activity on psychosocial outcomes and mobility in community-dwelling older adults. DATA SOURCES: A comprehensive search was conducted in the MEDLINE, PubMed, Embase, SPORTDiscus, Cochrane Library, Scopus, and Google Scholar databases. STUDY SELECTION: A total of 11 studies (13 publications) were included involving a total of 1004 older adults. STUDY DESIGN: A systematic review of randomized controlled trials was conducted using the aforementioned 7 databases. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed. LEVEL OF EVIDENCE: Level 2. DATA EXTRACTION: Two authors independently selected studies, extracted data, and determined the risk of bias and evidence level using the Grading quality of evidence and strength of recommendations (GRADE) guidelines. We conducted a synthesis without meta-analysis (SWiM) to assess the outcome. RESULTS: There is moderately certain evidence that home-based exercise programs reduced the fear of falling. Psychosocial (mental health and quality of life) and mobility outcomes may improve after participating in the intervention inside the home. CONCLUSION: The review found very low to certain evidence that home-based exercises programs improved psychosocial outcomes (mental health and quality of life) and walking speed (mobility). Moderately certain evidence suggests that home-based exercises improved fear of falling. PROTOCOL REGISTER NUMBER: CRD42020182008.

Feasibility and effect of high-intensity training on the progression of motor symptoms in adult individuals with Parkinson's disease: A systematic review and meta-analysis.

BACKGROUND: To determine the feasibility and effect of high-intensity interval training (HIIT) in individuals with Parkinson's and their effect on symptom modification and progression. METHODS: We conducted this systematic review following the Preferred Reporting Items for systematic review and meta-analysis (PRISMA). All studies were searched in seven databases: MEDLINE (PubMed), Cochrane Central Register of Controlled Trials, Web of Science, EMBASE, SPORTDiscus, Virtual Health Library (VHL) and SCOPUS in September 2020 and updated in June 2023. The risk of bias was assessed by the Cochrane Collaboration tool and Grading of Recommendations Assessment, Development and Evaluation (GRADE) tool. We used standardized mean difference (SMD) with a 95% confidence interval (CI) and random effects models, as well as the non-parametric Cochran's Q test and I2 inconsistency test to assess heterogeneity. RESULTS: A total of 15 randomized clinical trials with 654 participants (mean age, 65.4 years). The majority of studies included high intensity training interventions versus moderate intensity, usual care, or control group. The meta-analysis comparing high-intensity exercise versus control group showed an improvement in the disease severity (MD = -4.80 [95%CI, -6.38; -3.21 high evidence certainty); maximum oxygen consumption (MD = 1.81 [95%CI, 0.36; 3.27] very low evidence certainty) and quality of life (MD = -0.54 [95%CI, -0.94; -0.13] moderate evidence certainty). The results showed that high-intensity exercise compared with moderate intensity exercise group showed a improve motor function and functional mobility measured by the TUG test (MD = -0.38 [95%CI, -0.91; 0.16] moderate evidence certainty) with moderate heterogeneity between studies. CONCLUSION: High-intensity exercise performed in both continuous and interval modes when compared with control groups may provide motor function benefits for individuals with Parkinson's disease. HIIT may be feasible, but the intensity of the exercise may influence individuals with Parkinson's disease. However, there was a lack of evidence comparing high intensity and moderate intensity for this population, as the results showed heterogeneity.

Desafios do profissional de educação física nos Núcleos Ampliados de Saúde da Família e Atenção Básica: uma revisão sistemática da literatura brasileira / Challenges of the physical education professional in the Extended Centers for Family Health and Primary Care: a systematic review of Brazilian literature

Resumo Introdução A inserção dos profissionais de educação física na atenção básica tem relevância devido aos trabalhos relacionados à promoção da saúde, porém alguns desafios são apresentados na literatura como barreiras para a atuação profissional. Objetivo Revisar na literatura os desafios encontrados por profissionais de educação física que atuam nos Núcleos Ampliados de Saúde da Família e Atenção Básica (NASF-AB). Método Uma busca utilizando os termos "educação física" e "Núcleo de Apoio à Saúde da Família" foi realizada na base de dados LILACS e no portal SciELO. Os critérios de inclusão foram: ser artigo original, estar publicado no idioma português, ter sido publicado a partir do ano de 2008 e ter avaliado a atuação de profissionais de educação física no NASF-AB. Resultados Dos 45 estudos encontrados na busca inicial, seis atenderam os critérios de inclusão. Além desses, outros dois artigos foram identificados nas referências, resultando em oito artigos incluídos na revisão. Entre os vários desafios relatados, os mais frequentes encontrados nos estudos foram a falta de infraestrutura física e material, a distância entre a formação acadêmica e a área de saúde coletiva e a instabilidade profissional. Conclusão Embora alguns desafios relatados não dependam apenas do profissional de educação física para serem resolvidos, os achados dessa revisão fornecem importantes informações para que futuros profissionais que desejam atuar no NASF-AB possam se preparar de forma mais objetiva e consigam realizar um trabalho com eficiência e qualidade.

Abstract Background The inclusion of physical education professionals in primary care is relevant due to work related to health promotion, but some challenges are presented in the literature as barriers to professional performance. Objective This study aimed to review in the literature the challenges faced by physical education professionals who work in the extended centers for family health and primary care (NASF-AB). Method A search using the terms "physical education" and "family health support centers" was performed in the LILACS and SciELO databases. The inclusion criteria were: be an original article, be published in the Portuguese language, be published from 2008 onwards, and have assessed the role of physical education professionals in the NASF-AB. Results From 45 studies identified in the initial search, six met the inclusion criteria. In addition to these, two other articles were identified in the references, resulting in eight articles included in the review. Among the several challenges reported, the most frequent ones in the different studies were the lack of physical and material infrastructure, the distance between academic formation and the collective health area, and also professional instability. Conclusion Although some of the challenges reported do not depend solely on the physical education professional to be solved, the findings of this review already provide important information for future professionals who wish to work in NASF-AB to prepare themselves more objectively and perform an efficient and quality work.

Reproducibility of an endurance test for master swimmers

Abstract Aim: This study aimed to verify the reproducibility of an endurance test for master swimmers. Methods: Seventeen male swimmers, aged from 30 to 50 years (35.06 ± 5.36), weight (78.71 ± 13.06 kg), height (174.35 ± 0.07 cm), participated in this study. The participants underwent the Progressive Swim Test (PSwT), which corresponds to swimming progressively to exhaustion in a 25-meter pool, guided by the recording of sound signals indicating the swimming rhythm. We verified the following variables: heart rate before the test (BHR) and right after the end of the test (AHR), followed by the rate of perceived exertion (RPE) and a total of laps performed (SN - swimming number). For comparison between the three days of tests, the one-way repeated measures ANOVA with Tukey's Post-Hoc was performed. Relative reproducibility was performed by the r test and the intraclass correlation coefficient (ICC). Absolute reproducibility was determined using the coefficient of variation (CV) and the confidence interval (CI). Results: The results showed high reproducibility in (PSwT) in master swimmers in the analyzed variables of intergroup and intragroup with relative reproducibility of r > 0.60 and ICC > 0.70 and absolute reproducibility with CI 95% (lower −1.10 and upper 0.99) and CV < 10%. Most of the cases were within the limits of agreement of the Bland-Altman tests, all variables were considered a level of significance with (p <0.05). Conclusion: The Progressive Swim Test (PSwT) is a reproducible instrument in the assessment of endurance in master swimmers.

Reality and Virtual: Hemodynamic Variables and Rating of Perceived Exertion Between Dance Sessions and Active Videogame Just Dance in Women.

Objective: To analyze the hemodynamic variables and the rating of perceived exertion (RPE) between an active videogame (AVG) session and a dance session. Materials and Methods: The sample consisted of 30 university women between 18 and 30 years of age, physically active and having some kind of experience with dancing. The volunteers participated in the two sessions held on different days, the first with an active dance videogame and the other with a dance instructor, both lasting 50 minutes, with a sequence of songs and moderate intensity. For the evaluation of the two sessions, heart rate (HR), blood pressure (BP), and RPE measurements were taken before and every 10 minutes, until the time for each modality (AVG or dance) was completed. The Shapiro-Wilk and Levene test were used for normal data. For the comparison of two sessions, the two-way ANOVA test was used for repeated measures, and were considered to have a significance level of P < 0.05. Results: There were significant differences in HR [F(6, 96) = 2.606, P = 0.02, η2 P = 0.140], from 10 to 50 minutes (P < 0.01), and diastolic BP [F(6, 84) = 1.858, P = 0.10, η2 P = 0.117], as well as, in the 20th minute (P = 0.02) between Just Dance 2016® and a dance session. All the variables analyzed showed an effect size as large in the classification of the degree of magnitude. Conclusion: There are similarities between the virtual and real dance sessions regarding hemodynamic variables and RPE. Thus, AVGs, especially Just Dance®, may be a favorable option for individuals who wish to exercise at home.

The Effects of Exercise on BDNF Levels in Adolescents: A Systematic Review with Meta-Analysis.

The aim of this study was to analyze the evidence available in the literature about the effects of exercise on brain-derived neurotrophic factor levels in adolescents. The literature searches were conducted in PubMed, Embase, Scopus, ScienceDirect, Web of Science, SportDiscus, the Cochrane Central Register of Controlled Trials (CENTRAL) and CINAHL. Randomized controlled trials and non-randomized controlled trials performed with adolescents (10-19 years) who underwent different exercise programs and who evaluated BDNF levels before and after the intervention were included. We included six studies, four RCTs and two non-RCTs in the systematic review with a total of 407 adolescents. In two randomized trials and one non-RCT, the intervention groups showed significant improvements in BDNF levels compared with the control group. The results presented in the meta-analysis indicate that despite the positive effect in favor of the intervention, there were no significant differences (standardized mean difference 0.28 ng/mL, 95% confidence interval -0.28 to 0.85; p = 0.32, I² = 0%). The results presented in our review indicate that aerobic exercise programs practiced in moderate- or high-intensity are promising strategies to increase BDNF levels in adolescents. However, further studies are required to support this finding.

Circuito de treinamento e capacidades físicas em idosos: uma revisão sistemática / Circuit training and physical capacities in older adults: a systematic review

Introdução: Um dos grandes benefícios que o exercício físico promove no envelhecimento é a preservação das capacidades funcionais. O circuito de treinamento visa melhorar controle corporal, equilíbrio muscular, diminuindo a incidência de lesões e aumentando a eficiência dos movimentos. O objetivo deste trabalho é apresentar as evidências cientificas disponíveis na literatura sobre a relação entre a aplicação do circuito de treinamento e capacidades físicas em idosos. Métodos: Os bancos de dados Bireme, Web of Science, PubMed e Science Direct foram utilizados para a seleção dos artigos publicados nos últimos cinco anos. Resultados: Apenas quatro estudos foram selecionados para a realização da revisão sistemática, preenchendo os critérios de inclusão e exclusão. Conclusão: Diante das evidências existentes em relação à intervenção baseada em circuitos de treinamento, foi observado melhora no funcionamento físico e fisiológico dos idosos.

Introduction: One of the great benefits that physical activity promotes in ageing is the preservation of functional capabilities. The training circuit aims to improve body control, muscle balance, reducing the incidence of injuries and increasing the efficiency of movements. The objective of this work is to present the scientific evidence available in the literature on the relationship between the application of the training circuit and physical capacities in older adults. Methods: the database Bireme, Web of Science, PubMed and Science Direct were used to identify the articles published in the last five years. Results: Only four studies were included to perform the systematic review, fulfilling the inclusion and exclusion criteria. Conclusion: Regular physical exercise can reduce functional declines by improving physical abilities in older adults. Given the existing evidence regarding circuit-based intervention, the training circuit improves physical and physiological functioning of older adults.

Can people self-select an exercise intensity sufficient to enhance muscular strength during weight training?: A systematic review protocol of intervention studies.

BACKGROUND: Previous studies have reported that self-selection of the training intensity can be an interesting strategy to improve adherence in aerobic exercise programs. However, its effectiveness with weight training has not been systematically reviewed and remains unclear. In this study, we will describe a systematic review protocol that aims to investigate if people are able to self-select an intensity during weight training sufficient to enhance muscular strength. METHODS: This protocol is guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols. In this study, we will search the following electronic databases: PubMed, Science Direct, Scopus, Web of Science and SPORTDiscus. Intervention studies with at least one weight training session performed at self-selected intensity, with people from both genders and all age ranges will be included. The Downs & Black checklist will be used for methodological quality assessment. Two experienced reviewers will independently perform the selection of studies, data extraction, and evaluation of the methodological quality. CONCLUSION: This will be the first systematic review describing the results of weight training intervention studies with self-selected intensity. This study will provide high-quality and reliable evidence for health professionals and may direct methodological recommendations for further studies. PROSPERO REGISTRATION NUMBER: CRD42019120323.

Effects of exercise on the levels of BDNF and executive function in adolescents: A protocol for systematic review and meta-analysis.

BACKOGROUND: Evidence available in the literature suggests that physical exercise increases the release of brain-derived neurotrophic factor (BDNF) in humans and may possibly be related to improvements in executive function. However, studies of this phenomenon in adolescents are still scarce. The objective of this work is to describe the protocol for a systematic review (SR) and meta-analysis of interventional studies aiming to determine the effect of physical exercise on BDNF levels and executive function in adolescents. METHODS: This protocol is guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols (PRISMA-P) and by the Cochrane Handbook of Systematic Reviews of Interventions. The databases to be searched are PubMed, EMBASE, Scopus, ScienceDirect, Web of Science, SPORTDiscus, the Cochrane Central Register of Controlled Trials (CENTRAL), and CINAHL. Interventional studies conducted on adolescents with different exercise protocols and evaluations of BDNF levels and executive function in pre- and post-intervention periods will be included in the systematic review. The characteristics of the studies, participants, and main results will be described, then the evaluation of the risk of biases and the level of evidence obtained by the protocol will be assessed. The selection of studies, data extraction, and evaluation of the methodological quality will be performed by 2 experienced reviewers independently. CONCLUSION: The systematic review will present the effects of the practice of physical exercises on the BDNF and executive function levels. The results will strengthen the interventions with the focus on the brain health of adolescents through general orientations and the evidences described shall direct future research. PROSPERO REGISTRATION NUMBER: CRD42018110683.

Physical Training and Upper-Limb Strength of People With Paraplegia: A Systematic Review.

CONTEXT: Physical training improves the strength of upper limbs, contributing directly to the performance of activities of daily life, confirming one more time that the strengthened muscle is imperative for a rapid rehabilitation. OBJECTIVE: To investigate the scientific implications of the impact of physical training on the strength of the upper limbs of people with paraplegias. EVIDENCE ACQUISITION: The search strategy with truncations and Boolean operator was defined as: (spinal cord inju* OR traumatic myelopat* OR paraplegi*) AND (physical exercise OR strength training OR resisted training) AND (upper limb* OR arm OR armrest), for all of the databases. There were included experimental and quasi-experimental studies, published in the English language and with the complete text available, with at least 1 physical exercise that worked with the strength of the upper limbs. Two independent evaluators extracted from each article data on study characteristics (publishing year, country of origin, and study design), of the subjects (gender and age), and of the disability (level of lesion and cause). EVIDENCE SYNTHESIS: Seven articles were included in the systematic revision. The procedure used the most for measuring the maximum strength was the 1-repetition maximum test, followed by the isokinetic dynamometer and Quantitative Muscle Testing System. Furthermore, the most commonly associated variables in the included studies were pain in the shoulder, cardiorespiratory capacity, and functionality, respectively. The results showed that all of the variables improved because of the training. CONCLUSIONS: The training improved the strength, the functionality, and reduced the pain in the shoulder of the people with paraplegia.

Dietary intervention and health in patients with systemic lupus erythematosus: A systematic review of the evidence.

Objective: The aim of this study was to evaluate the scientific evidence of dietary intervention, either through diet or supplementation, and its effects on the health of patients with systemic lupus erythematosus. Methods: Literature searches were conducted using Scopus, PubMed, BioMed Central and Science Direct databases. The terms used for the search were diet, nutritional support, nutrition therapy and systemic lupus erythematosus. Results: Eleven studies with interventions related to supplementation of omega-3 fatty acids, vitamin D and turmeric, as well as changes in diet composition, such as low glycaemic index diet were identified. Conclusions: The studies evidenced that omega-3 supplementation reduced inflammation, disease activity, endothelial dysfunction and oxidative stress; vitamin D supplementation increased serum levels, reduced inflammatory and hemostatic markers; turmeric supplementation reduced proteinuria, hematuria and systolic blood pressure; and low glycaemic index diet caused weight loss and reduced fatigue.

Lifestyle and sleep patterns among people living with and without HIV/AIDS.

INTRODUCTION: Negative lifestyles affect the health and quality of sleep of those living with and without HIV/AIDS. METHODS: Individuals were divided into two groups based on whether or not they were living with HIV/AIDS. RESULTS: Among the 20 participants, 95% displayed a poor lifestyle, and both groups demonstrated low-quality sleep with significant differences between groups in the early sleep variables, total sleep time, and sleep patterns. CONCLUSIONS: Both groups demonstrated similar behavior with unsatisfactory lifestyles, poor sleep quality, and irregular sleep patterns.

Lifestyle and sleep patterns among people living with and without HIV/AIDS

Abstract INTRODUCTION: Negative lifestyles affect the health and quality of sleep of those living with and without HIV/AIDS. METHODS: Individuals were divided into two groups based on whether or not they were living with HIV/AIDS. RESULTS: Among the 20 participants, 95% displayed a poor lifestyle, and both groups demonstrated low-quality sleep with significant differences between groups in the early sleep variables, total sleep time, and sleep patterns. CONCLUSIONS: Both groups demonstrated similar behavior with unsatisfactory lifestyles, poor sleep quality, and irregular sleep patterns.

Validation of the portuguese version of the tampa scale for kinesiophobia heart (TSK-SV heart) / Validação da versão em português da escala de tampa para cinesiofobia cardíaca (TSK-SV cardíaca) / Validación de la versión en portugués de la escala de tampa para kinesiofobia cardiaca (TSK-SV cardiaca)

ABSTRACT Introduction: It has been shown that kinesiophobia has a negative influence on the outcomes of cardiac rehabilitation and consequently is important for the clinical setting. Objective: The objective of this study was to translate, culturally adapt, and psychometrically validate the Tampa Scale for Kinesiophobia Heart (TSK-SV Heart) to Brazilian Portuguese. Methods: The Portuguese version was tested in 300 patients in cardiac rehabilitation. Test-retest reliability was assessed by intraclass correlation coefficient, internal consistency by Cronbach's alpha, and criterion validity was assessed with respect to patients' education, income, duration of cardiac rehabilitation, and sex. Results: After intraclass correlation coefficient analysis, one item was excluded. All four areas were considered internally consistent (α >0.7). Significant differences between mean total scores and income (p<0.01) supported the criterion validity. Two hundred sixty-nine (89.6%) patients had a high level of kinesiophobia (scores > 37). Conclusions: The Brazilian Portuguese version of TSK-SV Heart demonstrated sufficient reliability, consistency and validity, supporting its use in future studies.

RESUMO Introdução: Demonstrou-se que a cinesiofobia tem influência negativa sobre os resultados da reabilitação cardíaca e, consequentemente, é importante no contexto clínico. Objetivo: O objetivo deste estudo foi traduzir, fazer a adaptação cultural e validar em termos psicométricos a Escala de Tampa para Cinesiofobia Cardíaca (TSK-SV Cardíaca) para o português do Brasil. Métodos: A versão em português foi testada em 300 pacientes em reabilitação cardíaca. A confiabilidade teste-reteste foi avaliada pelo coeficiente de correlação intraclasse, a consistência interna pelo alfa de Cronbach, e a validade de critério foi avaliada no que diz respeito a educação dos pacientes, renda, duração da reabilitação cardíaca e sexo. Resultados: Após análise do coeficiente de correlação intraclasse, um item foi excluído. Todas as quatro áreas foram consideradas internamente consistentes (α > 0,7). As diferenças significativas entre os escores totais médios e de renda (p < 0,01) apoiaram a validade de critério. Duzentos e sessenta e nove (89,6%) pacientes apresentavam um alto nível de cinesiofobia (escore > 37). Conclusões: A versão em português do Brasil da TSK-SV Cardíaca demonstrou ter confiabilidade, consistência e validade suficientes, apoiando a sua utilização em estudos futuros.

RESUMEN Introducción: Se ha demostrado que la kinesiofobia tiene una influencia negativa sobre el resultado de la reha-bilitación cardiaca y, por consiguiente, es importante en el contexto clínico. Objetivo: El objetivo de este estudio fue traducir, hacer la adaptación cultural y la validación en términos psicométricos de la Escala de Tampa para Kinesio-fobia Cardiaca (TSK-SV Cardiaca) al portugués de Brasil. Métodos: La versión portuguesa se probó en 300 pacientes en rehabilitación cardiaca. Se evaluó la fiabilidad test-retest por el coeficiente de correlación intraclase, la consistencia interna mediante el alfa de Cronbach, y la validez de criterio con respecto a la educación, el ingreso, la duración de la rehabilitación cardiaca y el sexo de los pacientes. Resultados: Después del análisis de coeficientes de correlación intraclase, un elemento ha sido eliminado. Las cuatro áreas se consideraron internamente consistentes (α > 0,7). Las diferencias significativas entre las puntuaciones totales medias y el ingreso (p < 0,01) apoyaron la validez del criterio. Doscientos sesenta y nueve (89,6%) pacientes tenían un alto nivel de kinesiofobia (puntuación > 37). Conclusiones: La versión en portugués de Brasil de la TSK-SV Cardiaca ha demostrado suficiente fiabilidad, consistencia y validez, apoyando su uso en futuros estudios.

Pain level associated to socio-demographic and clinical variables in people living with human immunodeficiency virus and acquired immunodeficiency syndrome / Nível de dor associado a variáveis sócio-demográficas e clínicas em pessoas que vivem com o vírus da imunodeficiência humana e a síndrome da imunodeficiência adquirida

ABSTRACT BACKGROUND AND OBJECTIVES: Pain is a common symptom in people living with acquired immunodeficiency syndrome, being widely underreported and not treated. For this reason, there is the need for studies discussing the subject in the attempt to explain factors involved in this process and to look for adequate and effective therapies. So, this study aimed at relating pain level in people living with human immunodeficiency virus to socio-demographic and clinical variables. METHODS: This was a descriptive and cross-sectional study with 261 individuals living with the human immunodeficiency virus. Visual analog scale for pain intensity and semi-structured interview for anamnesis were applied. RESULTS: A total of 47.5% of individuals was found reporting mild pain/no pain; 24.1% with moderate pain and 28.4% with severe pain. There has been significant relationship between pain and gender (p=0.02), health status (p=0.001), health perception with regard to feeling ill or not (p=0.001) and infection stage (p=0.005). Pain was characterized as shooting (69%), piercing (55%) and burning (41%), with significant relationship with regard to pain intensity (p<0.001) and time (p<0.001). When the logistic regression model was applied, the fact of being a female has represented a risk of 7.256 (p<0.001) for moderate pain and of 5.329 (p<0.004) for severe pain. With regard to age, age groups between 21 and 30 years (0.073; p<0.046), 41 and 50 years (0.068; p<0.023) and 51 and 60 years (0.063; p<0,030) were protection factors for the presence of moderate pain. With regard to health status, this variable was a risk factor for the presence of moderate pain (8.13; p<0.038) and severe pain (11.73; p<0.005). CONCLUSION: Pain was a prevalent symptom among people living with human immunodeficiency virus.

RESUMO JUSTIFICATIVA E OBJETIVOS: A dor é um sintoma comum em pessoas que vivem com a síndrome da imunodeficiência adquirida, sendo bastante subnotificada e não tratada. Por esse motivo, existe a necessidade de estudos que discutam a temática na tentativa de esclarecer os fatores envolvidos nesse processo e buscar tratamentos adequados e eficazes. Dentro dessa perspectiva, o objetivo deste estudo foi relacionar o nível de dor em pessoas que vivem com o vírus da imunodeficiência humana, com variáveis sócio-demográficas e clínicas. MÉTODOS: Pesquisa descritiva com caráter transversal, com 261 indivíduos vivendo com o vírus da imunodeficiência humana. Foi aplicada a escala analógica visual para a intensidade da dor e entrevista semiestruturada como anamnese. RESULTADOS: Foi encontrado um total de 47,5% indivíduos referindo dor leve/sem dor; 24,1% com dor moderada e 28,4% com dor intensa. Foi encontrada relação significativa entre a dor e o sexo (p=0,02), estado de saúde (p=0,001), percepção da saúde, quanto a se sentir doente ou não (p=0,001) e o estágio da infecção (p=0,005). A dor foi caracterizada em lancinante (69%), perfurante (55%) e em queimação (41%), sendo encontrada relação significativa entre essas variáveis (p<0,001). Foi possível encontrar também uma associação significativa com relação a intensidade da dor (p<0,001) e o tempo (p<0,001). Quando aplicado o modelo de regressão logística, o fato de ser mulher representou um risco de 7,256 (p<0,001) para a dor moderada e de 5,329 (p<0,004) para dor intensa. Com relação a idade, as faixas etárias de 21 a 30 anos (0,073; p<0,046), 41 a 50 anos (0,068; p<0,023) e 51 a 60 anos (0,063; p<0,030), apresentaram-se como fator de proteção para a presença de dor moderada. Com relação ao estado de saúde, esta variável apresentou-se como fator de risco para a presença de dor moderada (8,13; p<0,038) e intensa (11,73; p<0,005). CONCLUSÃO: A dor foi um sintoma prevalente entre as pessoas que vivem com o vírus da imunodeficiência humana.

Level of pain and quality of life of people living with HIV/AIDS pain and quality of life in HIV/AIDS.

The aim of this descriptive study was to correlate the level of pain with the quality of life in 261 people living with HIV/AIDS. Mild pain/no pain was reported by 47.5% of subjects, 24.1% reported moderate pain, and 28.4% reported severe pain; pain levels were correlated with gender (p = 0.02), health status (p < 0.001), perception (p < 0.001), and stage of infection (p = 0.005). Being female represented a risk factor for moderate (p < 0.001) and intense pain (p = 0.004). Poor health represented a risk for moderate (p < 0.038) and intense pain (p = 0.005). Being young was a factor of protection for moderate pain (21-30 years, p = 0.046; 41-50 years, p = 0.023; and 51-60 years, p < 0.030). The low quality of life averages was identified and correlated with pain in all evaluated domains (p < 0.001). The risk factors for moderate and severe pain were a low level of independence (p = 0.004) and compromised social relations (p = 0.029), respectively. Psychological control behaved as a protection factor for moderate pain (p = 0.011), and bad physical domain proved to be a protection factor for severe pain (p = 0.007). The level of pain is a negative impact on the quality of life of people with HIV/AIDS.

Reflexões sobre o emprego da osteopatia nas políticas públicas de saúde no Brasil / Reflections on the use of osteopathy in public health policies in Brazil

The National Policy on Integrative and Complementary Practices was regulated by the Ministry of Health as a part of health changes in Brazil. The COFFITO was in charge to regulate the practice of osteopathy by trained physiotherapists. The aim of this review was a reflection about osteopathy integrated to public health policies. This is a literature review which the descriptors: osteopathy, musculoskeletal disorders, physical therapy, holistic therapies, complementary therapies and public policies. We concluded that osteopathy added to the techniques applied in the treatment of musculoskeletal disorders and orthopedic disorders showed satisfactory therapeutic effects to individuals. Its effects arise on physical, social and economic aspects, justifying their participation in the public health policies in Brazil, since these results are in line with the concept of health adopted by WHO, which substantiates the existence of SUS. The Brazilian political structure of health seems to be interesting alternative to the practice of osteopathy with the low income population, although there is lack of knowledge by population and health professionals.(AU)

A Política Nacional de Práticas Integrativas e Complementares foi regulamentada pelo Ministério da Saúde em continuidade às mudanças sobre a saúde no Brasil. A esta política pública se soma o COFFITO ao regulamentar a prática da osteopatia por fisioterapeutas capacitados. Objetiva-se então fazer uma reflexão sobre a osteopatia integrada às políticas públicas de saúde. Trata-se de uma revisão a partir de levantamento literário e em periódicos online com os descritores: osteopatia, disfunções osteomioarticulares, fisioterapia, terapias holísticas, terapias complementares e políticas públicas. Concluiu-se que a osteopatia compõe o quadro de técnicas aplicadas no tratamento de disfunções musculoesqueléticas e transtornos de ordem ortopédica apresentando efeitos terapêuticos satisfatórios aos indivíduos. Seus efeitos decorrem sobre aspectos físicos, sociais e econômicos, justificando a sua participação nas políticas públicas de saúde no Brasil, uma vez que estes resultados se encontram em consonância com o conceito de saúde adotado pela OMS, o qual fundamenta a existência do SUS. A estrutura política da saúde no Brasil parece ser alternativa interessante para a prática da osteopatia junto à população de baixa renda, embora haja escassez de conhecimento tanto por parte da população quanto pelos profissionais de saúde. (AU)

[Clinical and epidemiological profile of patients with leprosy-related reactions]. / Perfil clínico e epidemiológico de pacientes em reação hansênica.

OBJECTIVE: To identify the clinical and epidemiological profile of patients under treatment for leprosy-related reactions. METHOD: This is a descriptive, cross-sectional and quantitative study, conducted from October 2013 to April 2014 with 61 individuals in a reference center in the Brazilian northeast region. The statistical test used considered a significance level of 0,05. RESULTS: Most individuals were males (57.38%), with low family income (50.82%) and incomplete elementary education (75.41%). In the moment of leprosy diagnosis, 52.45% of patients presented some degree of physical disability established. There was significant association between the observed clinic form and the moment of manifestation of leprosy reactions (p= 0.034). The residual analysis indicated that pure neural leprosy is associated to a manifestation of reactions before treatment and dimorphous leprosy was associated to manifestations during treatment. CONCLUSION: The disclosure of the clinical picture of pure neural leprosy and early detection of cases strongly contribute to the promotion of population health enabling the fulfillment of the goal of eradicating leprosy.

Perfil clínico e epidemiológico de pacientes em reação hansênica / Perfil clínico y epidemiológico de pacientes con reacción de lepra / Clinical and epidemiological profile of patients with leprosy-related reactions

RESUMO Objetivo Identificar o perfil clínico e epidemiológico de pacientes em tratamento para reações hansênicas. Método Estudo quantitativo, descritivo, transversal, realizado entre outubro de 2013 e abril de 2014, com 61 usuários, em um centro de referência de um estado nordestino. Os testes estatísticos utilizados consideraram um nível de significância de 0,05. Resultados Predominou o sexo masculino (57,38%), com baixa renda familiar (50,82%) e ensino fundamental incompleto (75,41%). No diagnóstico, 52,45% já apresentava algum grau de incapacidade física. Houve associações entre a forma clínica e o momento de manifestação das reações (p= 0,034). A análise de resíduos apontou que a forma neural pura associa-se às reações antes do tratamento e a dimorfa associa-se às reações durante o tratamento. Conclusão A divulgação do quadro clínico da forma neural pura e a detecção precoce dos casos contribuiriam fortemente para a promoção da saúde da população, possibilitando o cumprimento do objetivo de erradicar a Hanseníase.

RESUMEN Objetivo Identificar el perfil clínico y epidemiológico de pacientes en tratamiento para las reacciones leprosas. Método Estudio descriptivo, transversal y cuantitativo, efectuado entre octubre de 2013 y abril de 2014, con 61 usuarios en un centro de referencia para la lepra ubicado en la región Nordeste de Brasil. La prueba estadística utilizada considerando un nivel de significación de 0,05. Resultados Predominaron las personas del sexo masculino (57,38%), con ingreso familiar de hasta un salario mínimo (50,82%) y enseñanza primaria incompleta (75,41%). En el momento del diagnóstico, 52,45% de los pacientes ya presentaban algún grado de discapacidad física instalada. Había asociaciones entre forma y tiempo de la manifestación de las reacciones (p = 0,034) clínica. El análisis de residuos señaló que la forma neural pura está asociada a una manifestación de reacciones antes del tratamiento y que la forma dimorfa de la lepra estuvo asociada a manifestaciones durante el tratamiento. Conclusión La divulgación del cuadro clínico de la forma neuronal pura y la detección temprana de los casos contribuyen fuertemente a la promoción de la salud de la población que permite el cumplimiento de la meta de erradicar la lepra.

ABSTRACT Objective To identify the clinical and epidemiological profile of patients under treatment for leprosy-related reactions. Method This is a descriptive, cross-sectional and quantitative study, conducted from October 2013 to April 2014 with 61 individuals in a reference center in the Brazilian northeast region. The statistical test used considered a significance level of 0,05. Results Most individuals were males (57.38%), with low family income (50.82%) and incomplete elementary education (75.41%). In the moment of leprosy diagnosis, 52.45% of patients presented some degree of physical disability established. There was significant association between the observed clinic form and the moment of manifestation of leprosy reactions (p= 0.034). The residual analysis indicated that pure neural leprosy is associated to a manifestation of reactions before treatment and dimorphous leprosy was associated to manifestations during treatment. Conclusion The disclosure of the clinical picture of pure neural leprosy and early detection of cases strongly contribute to the promotion of population health enabling the fulfillment of the goal of eradicating leprosy.

[Obesity in adolescents and public policies on nutrition]. / Obesidade em adolescentes e as políticas públicas de nutrição.

In recent years, obesity has become a major public health problem and its prevalence is increasing at an alarming pace. Moreover, this problem has affected children and adolescents in marked fashion. Considering this situation, public policies on nutrition were created as strategies to attempt to combat/control the high Brazilian obesity indices. The scope of this study was to conduct a historical analysis of the advances in Brazilian public policies related to nutrition/food and the practice of physical exercise to control obesity among adolescents. In this respect, a review was conducted of the literature in the PubMed and SciELO electronic databases that addresses Brazilian public policies on nutrition in the control of obesity. Official documents of the Ministry of Health, scientific articles, journals and the recommendations of the World Health Organization were also used in the research. The results revealed that public policies on nutrition practiced in Brazil have been implemented in an incipient manner when directed at adolescents with respect to the obesity factor. Therefore, a broader vision seeking policies that attempt to control obesity in adolescents is of paramount importance.