Analysis of the spine posture, mobility and strength in healthy individuals with and without scapular dyskinesis / Análise da postura, mobilidade e força da coluna vertebral em indivíduos saudáveis com e sem discinese escapular

Spine posture, mobility and strength can be associated with changes in scapular movement and shoulder pain. However, these aspects have not been assessed in healthy individuals with scapular dyskinesis without shoulder and/or back pain. Objective: To analyze spine posture, mobility and strength in healthy individuals with and without scapular dyskinesis. Method: Cross-sectional study, fifty-two college-aged individuals were divided into two groups, according to scapular dyskinesis testing: a group without scapular dyskinesis (n= 19; age= 22.95±2.86 years; BMI= 22.97±3.12 kg/m²; 10 males) and another with scapular dyskinesis (n= 33; age= 22.06±2.73 years; BMI= 22.14±3.22 kg/m²; 10 males). Posture of the head and shoulders was analyzed from photographs by a postural assessment software (PAS/SAPO). Thoracic kyphosis and range of motion of the cervical and thoracolumbar spine were measured by a digital inclinometer, and the strength of the cervical and thoracolumbar spine muscles by a hand-held dynamometer. Intergroup comparison for all the variables was conducted using analysis of variance (one-way ANOVA), considering p≤0.05 as significant. Results: No intergroup difference was found for spine posture (p= 0.18-0.99), mobility (p= 0.23-0.96) and strength (p= 0.42-0.99). Conclusion: Spine posture, mobility and strength do not differ between healthy individuals with and without scapular dyskinesis. The outcomes suggest that scapular dyskinesis may be related to interpersonal variations. Future prospective studies be conducted in order to verify if these variables can change and influence the development of shoulder pain.

A postura, mobilidade e força da coluna podem estar associadas com mudanças no movimento da escápula e dor no ombro. Objetivo: Analisar a postura da coluna vertebral, mobilidade e força em indivíduos saudáveis com e sem discinese escapular. Método: Estudo transversal com cinquenta e dois indivíduos em idade universitária foram divididos em dois grupos, de acordo com o teste de discinese escapular: um grupo sem discinese escapular (n= 19; idade= 22,95±2,86 anos; IMC= 22,97±3,12 kg/m²; 10 masculino) e outro com discinese escapular (n= 33; idade= 22,06±2,73 anos; IMC= 22,14±3,22 kg/m²; 10 masculino). A postura da cabeça e dos ombros foi analisada a partir de fotografias por um software de avaliação postural (PAS/SAPO). A cifose torácica e a amplitude de movimento da coluna cervical e torácica foram medidas por um inclinômetro digital, e a força dos músculos cervical e torác lombar por um dinamômetro portátil. A comparação intergrupo para todas as variáveis foi realizada utilizando-se a análise de variância (ANOVA unidirecional), considerando p≤0,05 como significativa. Resultados: Não foi encontrada diferença entre grupos postura (p= 0,18-0,99), mobilidade (p= 0,23-0,96) e força da coluna (p= 0,42-0,99). Conclusão: Postura, mobilidade e força da coluna vertebral não diferem entre indivíduos saudáveis com e sem discinese escapular. Os resultados sugerem que a discinese escapular pode estar relacionada a variações interpessoais. Estudos prospectivos futuros devem ser conduzidos afim de verificar se essas variáveis podem modificar e influenciar o desenvolvimento da dor no ombro.

Impacts of social support on symptoms in Brazilian women with fibromyalgia.

We aimed to assess the impact of social support on symptoms in Brazilian women with FM. An observational, descriptive study enrolling 66 women who met the 1990 American College of Rheumatology (ACR) criteria. Social support was measured by the Social Support Survey (MOS-SSS), functionality was evaluated using the Fibromyalgia Impact Questionnaire (FIQ), depression was assessed using the Beck Depression Inventory (BDI), anxiety was measured using the Hamilton Anxiety Scale (HAS), affectivity was measured by Positive and Negative Affect Schedule (PANAS), and algometry was carried out to record pressure pain threshold (PPth) and tolerance (PPTo) at 18 points recommended by the ACR. Patients were divided into normal (NSS) or poor social support (PSS) groups with PSS defined as having a MOS-SSS score below the 25th percentile of the entire sample. Mann-Whitney or Unpaired t-test were used to compare intergroup variables and Fisher's for categorical variables. Analysis of covariance and Pearson correlation test were used. No differences in sociodemographic variables between PSS and NSS were found. Differences between NSS and PSS groups were observed for all four subcategories of social support and MOS-SSS total score. Significant differences between NSS and PSS on depression (p=0.007), negative affect (p=0.025) and PPTh (p=0.016) were found. Affectionate subcategory showed positive correlation between pain and positive affect in PSS. Positive social interaction subcategory showed a negative correlation between FIQ and depression state. Therefore social support appears to contribute to ameliorate mental and physical health in FM.

Impacts of social support on symptoms in Brazilian women with fibromyalgia / Impacto do apoio social sobre os sintomas de mulheres brasileiras com fibromialgia

ABSTRACT We aimed to assess the impact of social support on symptoms in Brazilian women with FM. An observational, descriptive study enrolling 66 women who met the 1990 American College of Rheumatology (ACR) criteria. Social support was measured by the Social Support Survey (MOS-SSS), functionality was evaluated using the Fibromyalgia Impact Questionnaire (FIQ), depression was assessed using the Beck Depression Inventory (BDI), anxiety was measured using the Hamilton Anxiety Scale (HAS), affectivity was measured by Positive and Negative Affect Schedule (PANAS), and algometry was carried out to record pressure pain threshold (PPth) and tolerance (PPTo) at 18 points recommended by the ACR. Patients were divided into normal (NSS) or poor social support (PSS) groups with PSS defined as having a MOS-SSS score below the 25th percentile of the entire sample. Mann-Whitney or Unpaired t-test were used to compare intergroup variables and Fisher's for categorical variables. Analysis of covariance and Pearson correlation test were used. No differences in sociodemographic variables between PSS and NSS were found. Differences between NSS and PSS groups were observed for all four subcategories of social support and MOS-SSS total score. Significant differences between NSS and PSS on depression (p = 0.007), negative affect (p = 0.025) and PPTh (p = 0.016) were found. Affectionate subcategory showed positive correlation between pain and positive affect in PSS. Positive social interaction subcategory showed a negative correlation between FIQ and depression state. Therefore social support appears to contribute to ameliorate mental and physical health in FM.

RESUMO Objetivou-se avaliar o impacto do apoio social sobre os sintomas de mulheres brasileiras com fibromialgia (FM). Trata-se de um estudo observacional descritivo que selecionou 66 mulheres que atendiam aos critérios do Colégio Americano de Reumatologia (ACR) de 1990. O apoio social foi medido com o Social Support Survey (MOS-SSS), a funcionalidade com o Questionário do Impacto da Fibromialgia (FIQ), a depressão com o Inventário de Depressão de Beck (BDI), a ansiedade com a Escala de Ansiedade de Hamilton (HAS), a afetividade com o Positive and Negative Affect Schedule (Panas) e foi feita algometria para registrar o limiar da dor à pressão (LDP) e a tolerância álgica à pressão (TAP) nos 18 pontos recomendados pelo ACR. Os pacientes foram divididos nos grupos apoio social normal (ASN) ou ruim (ASR); o ASR foi definido como uma pontuação nos MOS-SSS abaixo do percentil 25 da amostra total. Usou-se o teste de Mann-Whitney ou o teste t não pareado para comparar variáveis intergrupos e o de Fisher para as variáveis categóricas. Usaram-se a análise de covariância e o teste de correlação de Pearson. Não houve diferença nas variáveis sociodemográficas entre os grupos ASN e ASR. Observaram-se diferenças entre os grupos ASN e ASR para todas as quatro subcategorias de apoio social e pontuação total do MOS-SSS. Encontraram-se diferenças significativas entre o ASN e o ASR na depressão (p = 0,007), afeto negativo (p = 0,025) e LDP (p = 0,016). A subcategoria apoio afetivo mostrou correlação positiva entre a dor e o afeto positivo no grupo ASR. A subcategoria interação social positiva mostrou uma correlação negativa entre o FIQ e o estado de depressão. Portanto, o apoio social parece contribuir para a melhoria na saúde mental e física na FM.

Pain and associated symptoms: comparison between fibromyalgia and temporomandibular disorder / Dor e sintomas associados: comparação entre fibromialgia e disfunção temporomandibular

ABSTRACT BACKGROUND AND OBJECTIVES: Fibromyalgia has multivariate symptoms, also affecting temporomandibular region. This study aimed at comparing facial signs and symptoms of females with fibromyalgia and females with temporomandibular disorder. METHODS: This is a crossover study with 61 females divided in two groups: fibromyalgia group (31) and temporomandibular disorder group (30). Evaluated variables in all patients were: pain intensity in temporomandibular joint by means of visual analog scale, report of pain or discomfort during daily activities (mouth opening/closing, during meals, when talking), presence of joint noises (clicking and popping), dizziness, tinnitus, headache and mouth opening capacity. Variables were compared by unpaired t and Chi-square tests. RESULTS: Facial pain was reported by 100% of studied patients with no difference in intensity among fibromyalgia and temporomandibular disorder groups (p=0.2170). Fibromyalgia group has reported more pain during daily life activities as compared to temporomandibular disorder group (p<0.0001). With regard to joint noises, there has been more right temporomandibular joint clicking (p=0.006) in the temporomandibular disorder group. Fibromyalgia group patients have higher percentage of signs and symptoms associated to temporomandibular disorder, such as dizziness, tinnitus and headache (p<0.000). CONCLUSION: Fibromyalgia patients have clinical signs and symptoms similar to those found in temporomandibular disorder patients, being pain, discomfort during daily activities, tinnitus, hum and headache more exacerbated in the fibromyalgia group.

RESUMO JUSTIFICATIVA E OBJETIVOS: A fibromialgia apresenta sintomas multivariados acometendo também a região temporomandibular. O objetivo deste estudo foi comparar os sinais e sintomas faciais de mulheres com fibromialgia e mulheres com disfunção temporomandibular. MÉTODOS: Foi realizado um estudo de corte transversal com 61 mulheres, divididas em dois grupos: grupo fibromialgia (31) e grupo disfunção temporomandibular (30). As variáveis avaliadas em todas as pacientes foram: intensidade da dor na articulação temporomandibular por meio da escala visual analógica, relato de dor ou desconforto nas atividades diárias (abrir/fechar a boca, durante a alimentação, ao falar), presença de ruídos articulares (estalo e crepitação), tontura, zumbido, cefaleia e capacidade na abertura de boca. As variáveis foram comparadas pelos testes t não pareado e Qui-quadrado. RESULTADOS: Dor na região facial foi relatada por 100% das pacientes do estudo, não havendo diferença da intensidade entre os grupos fibromialgia e disfunção temporomandibular (p=0,2170). O grupo fibromialgia relatou maior percentual de dor nas atividades de vida diária quando comparado ao grupo disfunção temporomandibular (p<0,0001). Quanto aos ruídos articulares observou-se maior percentual para crepitação da articulação temporomandibular direita (p=0,006) do grupo disfunção temporomandibular. As pacientes do grupo fibromialgia apresentaram maior percentual dos sinais e sintomas associados à disfunção temporomandibular como tontura, zumbido e cefaleia (p<0,000). CONCLUSÃO: Pacientes com fibromialgia possuem sinais e sintomas clínicos semelhantes aos encontrados em pacientes com disfunção temporomandibular, sendo a dor, desconforto nas atividades diárias, tontura, zumbido e cefaleia mais exacerbada no grupo fibromialgia.

Efeito da cinesioterapia na qualidade de vida, função sexual e sintomas climatéricos em mulheres com fibromialgia / Kinesiotherapy effect on quality of life, sexual function and climacteric symptoms in women with fibromyalgia

Objetivo: Avaliar e comparar o efeito da cinesioterapia na qualidade de vida, função sexual e sintomas climatéricos em mulheres climatéricas com e sem fibromialgia. Métodos: Participaram 90 mulheres climatéricas, divididas em dois grupos: fibromialgia (47) e controle (43). As pacientes foram avaliadas nas variáveis: qualidade de vida (Utian Quality of Life [UQOL]), função sexual (questionário do quociente sexual/versão feminina [QS-F]) e intensidade dos sintomas climatérios (Índice Menopausal de Blatt-Kupperman [IMBK]). Os grupos fizeram cinesioterapia para o assoalho pélvico, composto de 20 sessões, duas vezes por semana. Análise estatística foi feita por meio dos testes t de Student pareado, análise de variância de delineamento misto e Kappa de Cohen. Resultados: Na qualidade de vida, foi observada melhoria em ambos os grupos para todos os domínios avaliados. Na análise intergrupo foi evidenciada diferença nos domínios emocional (p = 0,01), saúde (0,03) e sexual (p = 0,001) com ganhos mais expressivos para o grupo controle. Na função sexual, foi verificada melhoria nos grupos, após a intervenção; na análise intergrupo as fibromiálgicas apresentaram escores inferiores ao grupo controle (p < 0,001). Em relação aos sintomas climatéricos não houve diferença na análise intergrupo pós-intervenção (p = 0,73). Entretanto, ambos os grupos apresentaram redução significativa da sintomatologia após a intervenção (p < 0,001). Conclusões: A cinesioterapia do assoalho pélvico exerce efeito benéfico sobre os domínios da qualidade de vida, função sexual e sintomatologia climatérica em mulheres com e sem fibromialgia na fase do climatério. Entretanto, a fibromialgia parece ser fator limitante para melhores resultados em alguns aspectos avaliados .

Objective: To evaluate the effect of the kinesiotherapy in the quality of life, sexual function and menopause-related symptoms and compare in climacteric women with and without fibromyalgia (FM). Methodology: The group was composed of 90 climacteric women divided in 2 groups: FM (47) and control (43). The patients were analyzed on their quality of life (Utian Quality of Life [UQoL]), sexual function (Sexual Quotient-Female Version [SQ-F] questionnaire) and intensity of the climacteric symptoms (Blatt–Kupperman menopausal index [BKMI]). Both groups performed pelvic floor kinesiotherapy, composed of 20 sessions, twice a week. Statistical analysis was performed using Student's t-test, mixed-design analysis of variance (ANOVA) and Cohen's Kappa. Results: In the quality of life, an improvement was noticed in both groups for all domains analyzed. In the comparison between groups it was noticed a difference in the emotional (p = 0.01), health (p = 0.03) and sexual (p = 0.001) domains with considerable gains verified in the control group. Improvement was also noticed in the sexual function. In the analysis between groups, FM group showed a lower score compared to the control group (p < 0.001). With respect to the climacteric symptoms, there was no difference in the analysis between groups after the intervention (p < 0.001). Conclusions: The pelvic floor kinesiotherapy promotes a positive effect in the domains of quality of life, sexual function and climacteric symptoms in women with and without fibromyalgia in the climacteric period; however, fibromyalgia seems to be a limiting factor to achieve better results in some of the aspects evaluated. .

[Kinesiotherapy effect on quality of life, sexual function and climacteric symptoms in women with fibromyalgia]. / Efeito da cinesioterapia na qualidade de vida, função sexual e sintomas climatéricos em mulheres com fibromialgia.

OBJECTIVE: To evaluate the effect of the kinesiotherapy in the quality of life, sexual function and menopause-related symptoms and compare in climacteric women with and without fibromyalgia (FM). METHODOLOGY: the group was composed of 90 climacteric women divided in 2 groups: FM (47) and control (43). The patients were analyzed on their quality of life (Utian Quality of Life [UQoL]), sexual function (Sexual Quotient-Female Version [SQ-F] questionnaire) and intensity of the climacteric symptoms (Blatt-Kupperman menopausal index [BKMI]). Both groups performed pelvic floor kinesiotherapy, composed of 20 sessions, twice a week. Statistical analysis was performed using Student's t-test, mixed-design analysis of variance (ANOVA) and Cohen's Kappa. RESULTS: In the quality of life, an improvement was noticed in both groups for all domains analyzed. In the comparison between groups it was noticed a difference in the emotional (p=0.01), health (p=0.03) and sexual (p=0.001) domains with considerable gains verified in the control group. Improvement was also noticed in the sexual function. In the analysis between groups, FM group showed a lower score compared to the control group (p < 0.001). With respect to the climacteric symptoms, there was no difference in the analysis between groups after the intervention (p < 0.001). CONCLUSIONS: The pelvic floor kinesiotherapy promotes a positive effect in the domains of quality of life, sexual function and climacteric symptoms in women with and without fibromyalgia in the climacteric period; however, fibromyalgia seems to be a limiting factor to achieve better results in some of the aspects evaluated.

Pressure pain endurance in women with fibromyalgia

BACKGROUND AND OBJECTIVES: Fibromyalgia syndrome is a chronic condition causing spontaneous widespread pain associated with hypersensitivity. This study aimed at investigating the pressure pain endurance in women with fibromyalgia syndrome to determine the range of painful stimulation that an individual with fibromyalgia syndrome can resist acceptably. METHODS: We conducted an observational, descriptive, crosssectional study with 60 subjects (51.23±8 years), who met the American College of Rheumatology/1990 (ACR) criteria for fibromyalgia syndrome, and 42 healthy volunteers (48.33±9 years) as the control group. Algometry was performed to record pressure pain detection threshold and pressure pain tolerance, and fibromyalgia impact questionnaire was used to determine the impact of fibromyalgia syndrome. Pressure pain endurance was calculated as the arithmetic difference between pressure pain tolerance and pressure pain detection threshold. RESULTS: A significant difference in fibromyalgia impact questionnaire (p<0.0001), pressure pain detection threshold, and pressure pain tolerance (p<0.0001) was found between both groups. Furthermore, a significant difference in pressure pain endurance (p<0.0001) for each of the 18 points identified by ACR was noted between both groups, with the highest range of physical stimulation observed in the control group. A correlation between pressure pain endurance and pressure pain detection threshold (r=0.8334; p<0.0001) and pressure pain tolerance (r=0.8387; p< 0.0001) was observed in the fibromyalgia syndrome group. CONCLUSION: Pressure pain endurance of the fibromyalgia syndrome group was extremely lower, when compared with that of healthy controls, and may be used as an additional component to measure the disturbance in pain perception and to determine the range of painful stimulation that an individual with fibromyalgia syndrome can acceptably resist. .

Chlamydia trachomatis: a major agent of respiratory infections in infants from low-income families.

OBJECTIVES: To determine the prevalence of lower respiratory tract infection (LRTI) due to Chlamydia trachomatis in newborn infants and to describe the clinical, laboratory, and radiological characteristics of the disease. METHODS: A cross-sectional study carried out over a 12-month period. All infants up to 6 months of age admitted consecutively at the Centro Pediátrico Professor Hosannah de Oliveira of the Universidade Federal da Bahia in Salvador, Brazil, and diagnosed with LRTI according to clinical and/or radiological criteria were included in the study. C. trachomatis infection was diagnosed by the enzyme-linked immunosorbent assay (ELISA) for the detection of IgM-class antibodies. The prevalence of LRTI by C. trachomatis was determined and the prevalence ratios for the infection and clinical or laboratory variables were calculated. RESULTS: One hundred and fifty-one infants were submitted to serology for C. trachomatis and 15 (9.9%) tested positive. Chlamydial infection was found only in infants under 5 months of age, mainly in those aged under 2 months. Three of the infants with C. trachomatis infection were born by cesarean section. Conjunctivitis and eosinophilia had occurred in 33.3% of the cases. Chest X rays were abnormal in 92.0% of cases. There was an association between C. trachomatis infection and the duration of hospitalization exceeding 15 days (p = 0.0398) and oxygen therapy (p = 0.0484). CONCLUSIONS: There was a high prevalence of C. trachomatis respiratory infection in the population studied. The infection was associated with a more severe form of the disease, emphasizing the importance of testing pregnant women for this infection to avoid infection in the newborn infant.

Chlamydia trachomatis: um importante agente de infecções respiratórias em lactentes de famílias de baixa renda / Chlamydia trachomatis: a major agent of respiratory infections in infants from low-income families

OBJETIVOS: Determinar a prevalência de infecção do trato respiratório inferior (ITRI) por Chlamydia trachomatis em lactentes internados e descrever as características clínicas, laboratoriais e radiológicas da doença. MÉTODOS: Este foi um estudo do tipo corte transversal, realizado durante um período de 12 meses. Foram incluídos todos os lactentes de até 6 meses internados consecutivamente no Centro Pediátrico Professor Hosannah de Oliveira da Universidade Federal da Bahia, em Salvador, BA, com diagnóstico clínico ou clínico-radiológico de ITRI. O diagnóstico de infecção por C. trachomatis foi realizado através da pesquisa de anticorpos da classe IgM, utilizando-se o ensaio imunoenzimático (ELISA). A prevalência de ITRI por C. trachomatis foi determinada, e foram calculadas as razões de prevalência para essa infecção e variáveis clínicas e laboratoriais. RESULTADOS: Cento e cinquenta e um lactentes realizaram sorologia para C. trachomatis, das quais 15 (9,9%) foram positivas. A infecção por C. trachomatis ocorreu unicamente entre os menores de 5 meses, principalmente naqueles menores de 2 meses. Três crianças com infecção por C. trachomatis nasceram de parto cesáreo. Conjuntivite e eosinofilia ocorreram em 33,3% dos casos. As radiografias de tórax se mostraram alteradas em 92% dos casos. Demonstrou-se associação da infecção por C. trachomatis com duração de internação superior a 15 dias (p = 0,0398) e com oxigenoterapia (p = 0,0484). CONCLUSÕES: Houve alta prevalência de ITRI por C. trachomatis na população estudada. A infecção por esta bactéria foi associada a uma forma mais grave da doença, demonstrando a importância de se investigar essa infecção na gestante de forma a evitar o adoecimento de recém-nascidos.

OBJECTIVES: To determine the prevalence of lower respiratory tract infection (LRTI) due to Chlamydia trachomatis in newborn infants and to describe the clinical, laboratory, and radiological characteristics of the disease. METHODS: A cross-sectional study carried out over a 12-month period. All infants up to 6 months of age admitted consecutively at the Centro Pediátrico Professor Hosannah de Oliveira of the Universidade Federal da Bahia in Salvador, Brazil, and diagnosed with LRTI according to clinical and/or radiological criteria were included in the study. C. trachomatis infection was diagnosed by the enzyme-linked immunosorbent assay (ELISA) for the detection of IgM-class antibodies. The prevalence of LRTI by C. trachomatis was determined and the prevalence ratios for the infection and clinical or laboratory variables were calculated. RESULTS: One hundred and fifty-one infants were submitted to serology for C. trachomatis and 15 (9.9%) tested positive. Chlamydial infection was found only in infants under 5 months of age, mainly in those aged under 2 months. Three of the infants with C. trachomatis infection were born by cesarean section. Conjunctivitis and eosinophilia had occurred in 33.3% of the cases. Chest X rays were abnormal in 92.0% of cases. There was an association between C. trachomatis infection and the duration of hospitalization exceeding 15 days (p = 0.0398) and oxygen therapy (p = 0.0484). CONCLUSIONS: There was a high prevalence of C. trachomatis respiratory infection in the population studied. The infection was associated with a more severe form of the disease, emphasizing the importance of testing pregnant women for this infection to avoid infection in the newborn infant.

Human bocavirus in very young infants hospitalized with acute respiratory infection in northeast Brazil.

A cross-sectional study was carried out over a period of 12 months to investigate the occurrence of human bocavirus (HBoV) infection in infants hospitalized for respiratory infections in a teaching hospital in Salvador, Brazil, and to describe the clinical manifestations of this infection. Nasopharyngeal aspirates were collected from the children and immunofluorescence and polymerase chain reaction were performed to investigate the presence of respiratory viruses. HBoV was detected in 4 out of 66 patients. Two of the HBoV-positive infants were co-infected with other viruses. The principal clinical findings in HBoV-positive children were: nasal obstruction, catarrh, cough, fever and dyspnea. This study revealed HBoV infection in children aged <2 months, suggesting that the infection may occur at a very early age.

Thalassotherapy for fibromyalgia: a randomized controlled trial comparing aquatic exercises in sea water and water pool.

The aim of this study was to evaluate the effectiveness of aerobic exercise in water pool compared with aerobic exercise performed in sea by women with fibromyalgia (FM). A total of 46 patients were randomly allocated into two groups: pool group (23 patients) and sea group (23 patients) that performed the same aerobic exercise program. Patients were evaluated baseline and after 12 weeks using: VAS, number of tender points, FIQ, SF-36, PSQI, and BDI. Both groups improved significantly in post-treatment for all the evaluated variables. There were no significant differences between two groups, except for BDI (F=2.418, P<0.0001). Aerobic exercise program performed in water (pool or sea) was effective for patients with FM. However, sea water exercises have been shown to bring more advantages related to emotional aspects. Then, exercise performed sea water (thalassotherapy) is an option for effective treatment with low cost for patients with FM.

Benefícios da talassoterapia e balneoterapia na fibromialgia / Benefits of thalassotherapy and balneotherapy for fibromyalgia

Talassoterapia e balneoterapia são modalidades terapêuticas utilizadas há vários anos em outras regiões do mundo na prevenção e no tratamento de diversas enfermidades, incluindo doenças reumáticas. No entanto, só recentemente têm sido descritas na literatura em fibromialgia (FM), contribuindo para a redução da dor e de outros sintomas da doença e melhorando a qualidade de vida dos pacientes. Nesta revisão são relatados os principais estudos que avaliam a talassoterapia e/ou a balneoterapia como abordagem terapêutica na FM, abordando aspectos a serem investigados no intuito de estabelecer o valor dessa forma de tratamento. Os autores ainda destacam a necessidade da realização de estudos no Brasil, utilizando principalmente a talassoterapia, uma vez que o baixo custo, aliado ao fácil acesso de boa parte das pessoas ao litoral, podem beneficiar pacientes com FM.

Thalassotherapy and balneotherapy are therapeutic strategies commonly used in other countries for the prevention and treatment of several diseases, including rheumatic diseases. However, only in the recent years its use in the treatment of fibromyalgia (FM) has been reported. The potential beneficial effects include the reduction of pain and other related symptoms of FM, thus improving the quality of life. The authors revise studies focusing on thalassotherapy and/or balneotherapy in the treatment of FM, discussing their benefits and methodological biases that still preclude a more precise evaluation on the efficacy of these methods. Finally, the authors emphasize the need for such studies in Brazil, mainly thalassotherapy, since the low cost and good accessibility to sea, might well provide benefit to our patients.

Escola de Coluna: revisão histórica e sua aplicacão na lombalgia crônica / Back School: historical revision and its application in chronic low back pain

A "Escola de Coluna" vem sendo utilizada como forma de prevencão e tratamento das algias da coluna desde sua criacão, em 1969, mas estudos sobre sua eficácia na literatura ainda são controversos. Neste artigo, os autores fazem uma revisão histórica sobre a implantacão e difusão da "Escola de Coluna" no mundo e no Brasil, as diversas modificacões e adaptacões ocorridas ao longo dos anos onde tem sido utilizada e, finalmente, apresentam os estudos que discutem sua eficácia em pacientes com lombalgia crônica.