Analysis of the effectiveness of remote intervention of patients affected by chronic diseases: A systematic review and meta-analysis.

Objectives: The aim of the study was to verify the effectiveness of telemedicine in randomized controlled trials (RCTs) in terms of its influence on physical conditioning, quality of life, and health conditions in adults/elderly people affected by chronic diseases. Design: This was a systematic review and meta-analysis. Methods: The search covered RCTs published from 2011 to 2021 and was conducted using the PubMed, Embase, PEDro, Lilacs, and Cochrane Library databases, on volunteers of both sexes, that were rehabilitated, and/or monitored, and/or evaluated, specifically, via remote care. The extraction, quality of studies, and risk of bias were assessed using the RoB2 (risk of bias) tool, for analysis of the strength of evidence, the GRADE (Grading of Recommendations Assessment, Developing, and Evaluation) method was used, and for the preparation of meta-analysis was used at RevMan 5.4 (Review Manager) was used. Results: The database search identified 3949 potential articles for screening, 13 of which were eligible for the present systematic review, involving 1469 participants with chronic diseases (chronic obstructive pulmonary disease (COPD), asthma, heart failure, diabetes mellitus, and fibromyalgia). Through the meta-analysis, an advantage was identified for the remote intervention on physical conditioning (p = 0.001), with an estimated effect of 0.29 (0.11, 0.46) and on health conditions (p = 0.0004), -0.30 (-0.47, -0.14), while for quality of life, no significant difference was identified (p = 0.90), 0.01 (-0.13, 0.14). Conclusion: Telemedicine has clinical effectiveness for the outcome of physical conditioning and general health conditions in adults with chronic diseases when compared to usual care without face-to-face intervention.

Effect of kinesio-taping on the acute phase of the post-operative reconstruction of the anterior cruciate ligament: A randomized controlled trial.

OBJECTIVES: Evaluate the Kinesio taping (KT) effects on reducing pain and edema on postoperative (PO) after anterior cruciate ligament (ACL) reconstruction. DESIGN: Controlled and randomized clinical study. SETTINGS: Individuals of both sexes, aged 18-45, underwent ACL reconstruction were randomized into intervention (IG; n = 19) and control (CG; n = 19) groups. METHODS: Intervention consisted of KT bandage applications at hospital discharge for seven days, and on the 7th PO day, which was removed on the 14th PO. CG received specific instructions from the physiotherapy service. All volunteers were evaluations before and immediately after surgery, on the 7th and 14th PO day. Pain threshold (KgF), evaluated by algometer; edema (cm), evaluated by the perimetry measurements and volume of the lower limbs and the truncated cone test (ml) were the evaluated variables. The Student's t-test and Mann-Whitney U test were used to evaluate intergroup, analysis of variance (ANOVA) and Dunnett's test to evaluate intragroup. RESULTS: Edema reduction and increased nociceptive threshold were significant in the 7th (p < 0.001; p = 0.003) and 14th (p < 0.001; p = 0.006) PO day in IG when compared to CG patients. IG perimetry levels, on the 7th and 14th PO were similar to preoperative period (p = 0.229; p = 1.000). IG nociceptive threshold value was similar on the 14th PO to before the surgery (p = 0.987). The same pattern did not occur in CG. CONCLUSION: KT treatment reduced edema and increased nociceptive threshold in the 7th and 14th PO ACL reconstruction.

Effect of Exergaming on Quality of Life, Fatigue, and Strength and Endurance Muscle in Cancer Patients: A Randomized Crossover Trial.

Objective: To analyze the influence of exergaming (EXE) quality of life, cancer-related fatigue (CRF), electromyography, and strength and endurance muscle in a randomized crossover trial. Methods: We conducted a single-blinded, randomized, and crossover trial, which included 38 cancer volunteers undergoing chemotherapy (Age = 60.07 ± 12.10 years; body mass index = 26.79 ± 5.33 kg/m2). All volunteers were randomized into two intervention moments: EXE and without intervention (WI) and after 1-month washout period of crossing of the evaluated moments. The intervention was performed on an EXE protocol using Xbox 360 Kinect®, with the game "Your Shape Fitness Evolved 2012" two to three times per week for 20 sessions. All volunteers were assessed the CRF and quality-of-life levels through the Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F) questionnaire, the median frequency (MDF) by surface electromyography, maximal voluntary isometric contraction (MVIC), and the muscle endurance time at 80% MVIC of the dorsiflexors and plantar flexors using dynamometer. Results: In the comparison between EXE and WI moments, were observed increase in the scores for quality of life (P < 0.001), subscale fatigue (P < 0.001), in the MDF values of right lateral gastrocnemius muscles: P = 0.017, muscle endurance time (left dorsiflexion [LDF]: P < 0.001; right dorsiflexion [RDF]: P < 0.001; left plantar flexion [LPF]: P < 0.001; RPF: P = 0.039), and muscle strength (LDF: P < 0.001; RDF: P < 0.001; LPF: P = 0.002). Conclusion: The crossover study, the EXE protocol promoted improvement in cancer-related fatigue (CRF) and quality of life, increased MVIC, endurance time, and MDF values of the dorsiflexor and plantar flexor muscles of cancer volunteers undergoing chemotherapy.

Aquatic Exercise on Brain Activity in Type 2 Diabetic: Randomized Clinical Trial.

BACKGROUND: A water-based physical exercise program is extremely important for the rehabilitation of type 2 diabetes. Little is known about its action on cerebral electrical activity. OBJECTIVE: To evaluate the effect of a water-based physical exercise protocol on electroencephalographic activity, blood glucose levels, and functional capacity, as well as their correlation, in type 2 diabetics. METHODS: Study design: Randomized Clinical Trial. Forty volunteers were randomized into two groups: control (n = 20) and study (n = 20). A water-based physical exercise program comprising 50 min sessions was conducted three times a week for five weeks. Assessments were performed at the pre- and post-intervention and follow-up phases. The qualitative data were compared using the Mann-Whitney test and Chi-Square. Quantitative data were compared using the Kruskal-Wallis, Independent t, and ANOVA mixed tests. The Spearman correlation coefficient was used to correlate the data. RESULTS: The data were similar when comparing the groups. Six-minute walk test data increased in the comparison between times (p = 0.01-PrexPos). EEG data decreased in comparison between times (prexfollow-up-p < 0.05), except AF3. EEG data decreased in the timexgroup comparison (prexfollow-up and postxfollow-up-p < 0.05). CONCLUSIONS: The water-based exercise protocol maintained electroencephalographic activity, glucose levels, and functional capacity in people with type 2 diabetes, and there was no relationship between brain electrical activity and capillary blood glucose.

The respiratory effects of a Pilates method protocol: Randomized clinical trial.

OBJECTIVES: To evaluate the respiratory effects of a Pilates method (PM) protocol in adult women. DESIGN: Single-blind randomized controlled trial. SETTINGS: Healthy women were randomized into two groups using the Random.org online tool: a Pilates group (PG) (n = 33) and a control group (CG) (n = 29). PARTICIPANTS: Sixty-two healthy women, aged 18-44 years, sedentary or irregularly active B (as defined by the international physical activity questionnaire [IPAQ]). The intervention consisted of 16 sessions of PM. protocol twice a week for the PG. The CG without intervention. MAIN OUTCOMES MEASURES: The variables evaluated were maximal inspiratory pressure (MIP), maximal expiratory pressure (MEP), peak expiratory flow (PEF), tidal volume (TV), respiratory frequency (RF), minute volume (MV), and slow vital capacity (SVC). RESULTS: The results showed significant evidence of the beneficial respiratory effects of the PM protocol when the PG was compared with the CG: increased MIP (p = 0.001), and a significant increase in TV (p = 0,047). CONCLUSION: The PM protocol used in this study may be effective for respiratory muscle strength because it improved MIP and TV. CLINICAL TRIAL REGISTRATION: https://ensaiosclinicos.gov.br/rg/RBR-5b6wc3.

Effect of Ear Acupuncture plus Dry Cupping on Activities and Quality of Life in the Adults with Chronic Back Pain: a Randomized Trial.

Background: Chronic pain is a complex phenomenon that brings physical and emotional impairments negatively impacting people's quality of life. The adoption of interventions such as ear acupuncture and dry cupping can represent a treatment option for people with chronic back pain. Objectives: To investigate the effects of ear acupuncture combined with dry cupping therapy on the interference of pain with the daily activities and quality of life of adults with chronic back pain. Methods: An open-label, randomized, parallel-group controlled clinical trial. One hundred and ninety-eight adults were randomized into control (CG - ear acupuncture) or experimental (EG - ear acupuncture combined with dry cupping) groups. Interventions were performed in five sessions, once a week, lasting five weeks. Evaluations were performed before the first session, after the last session, and seven days after the second evaluation, using the Brief Pain Inventory to assess the impact of pain on daily activities and the World Health Organization Quality of Life-BREF (WHOQOL-BREF) to assess the quality of life. Results: Between the initial and final sessions, there were significant changes in daily activities , activity, work, mood, relationships, sleep, and in the physical, psychological and social relationships domains for both the control and experimental groups. Improved perception of quality of life and satisfaction with health were observed for the participants in the experimental group. Conclusion: Ear acupuncture combined with dry cupping showed better results in terms of perception of quality of life and satisfaction with health when compared to ear acupuncture by itself.

Effects of ear acupuncture combined with cupping therapy on severity and threshold of chronic back pain and physical disability: A randomized clinical trial.

Background and aim: Chronic back pain causes physical, functional, and emotional disabilities. Traditional Chinese Medicine therapies have been shown as interventions to treat chronic back pain. The present study aimed to clinically evaluate the effects of ear acupuncture combined with cupping therapy on people with chronic back pain. Experimental procedure: We conducted an open-label, randomized, parallel-group controlled clinical trial. Following the CONSORT statement recommendations, 198 participants were randomized into 'ear acupuncture' and 'ear acupuncture and cupping therapy' groups. Data were collected in three different points; before the first session (initial) with the patient, after the last session (final), and seven days after the end of the treatment (follow-up). The Brief Pain Inventory, a digital algometer, and the Rolland Morris Disability Questionnaire were used for data collection. Generalized Estimation Equation model was used to examine the association between the interventions and the primary outcome pain severity. Results: Pain severity, pressure pain threshold, and physical disability improved over time in both groups. However, for the patients being treated with both ear acupuncture and cupping therapy, significant changes were seen in pain severity, pain relief, and physical disabilities between the initial and final sessions. For the 'ear acupuncture and cupping therapy' group, significant changes were also seen for pain relief and physical disability in the follow-up session. Conclusion: Ear acupuncture combined with cupping therapy was shown to be more effective in the treatment of chronic back pain when compared to treatment using only ear acupuncture.

Analysis of the use of insoles in the dynamic stability of the lower limbs in recreational runners: An exploratory study.

BACKGROUND: The use of insoles, which is increasingly widespread, can promote changes in biomechanics during running. RESEARCH QUESTION: Can the use of insoles with various patterns of infracapital support influence factors related to the dynamic stability of the lower limbs during running on a treadmill in recreational runners? METHODS: This is controlled single-blind repeated measures. Static baropodometric data were collected, as well as kinematic data for the lower limbs and electromyographic data for the gluteus maximus and gluteus medius muscles, for twelve recreational runners on a treadmill using four models of insoles (neutral and with forefoot elements - infracapital bar). RESULTS: Neutral insoles were able to reduce laterolateral displacement, increase the displacement of the mass to the posterior, and increase the lateral rotation of the left knee and medial rotation of the right hip. Insoles with a 2 mm total infracapital bar were able to move the mass to the posterior, increase laterolateral displacement and activate the gluteus medius. Insoles with a 2 mm medial infracapital bar were able to increase the displacement of the mass to the posterior, increase the adduction of left hip and the medial rotation of right hip, and activate the gluteus medius. Insoles with a 4 mm medial infracapital element were able to move the body mass to the posterior and to the left, increase laterolateral displacement, increase the adduction of left hip, the medial rotation of right hip and the abduction of right knee. SIGNIFICANCE: The insoles evaluated in the present study were able to modify biomechanical variables of recreational runners related to dynamic stability during running on a treadmill and static baropodometric variables.

Relação entre dor crônica nas costas, incapacidade e qualidade de vida após auriculoacupuntura e ventosaterapia e satisfação com o tratamento: estudo transversal / Relationship between chronic back pain, disability and quality of life after auriculoacupuncture and cupping therapy and satisfaction with treatment: across-sectional study / La relación entre el dolor de espalda crónico, la discapacidad y la calidad de vida después de la acupuntura auricular y la terapia con ventosas y la satisfacción con el tratamiento: un estudio transversal

OBJETIVO: avaliar a relação da intensidade da dor, incapacidade física e qualidade devida após tratamento de auriculoacupuntura e ventosaterapia com a satisfação com o tratamento, necessidade dele para controle da dor, percepção de melhora e consumo de medicação. MÉTODO: estudo transversal conduzido com 198 pessoas com dor crônica nas costas. Foram investigadas: intensidade da dor, incapacidade física, qualidade de vida, satisfação com o tratamento, necessidade da intervenção para o controle da dor, percepção de melhora e consumo de medicação. Foi realizada correlação de Spearman a 5% de significância. RESULTADOS: Houve correlações negativas de fraca magnitude da intensidade da dor e da incapacidade física com a satisfação com o tratamento, necessidade da intervenção, percepção de melhora após o tratamento e consumo de medicamentos, e correlações positivas de fraca magnitude da percepção da qualidade de vida com a satisfação com o tratamento, necessidade da intervenção, e percepção de melhora. CONCLUSÃO: A melhora da intensidade da dor, da incapacidade física e da qualidade de vida ocasionou melhor estado geral de saúde, satisfação com o tratamento e menor consumo de medicamentos entre os participantes do estudo.

OBJECTIVE: to evaluate the relationship between pain intensity, physical disability and quality of life after auriculoacupuncture and cupping therapy with satisfaction with treatment, need for it to control pain, perception of improvement and medication consumption. METHOD: cross-sectional study conducted with 198 people with chronic back pain. The following were investigated: painintensity, physical disability, quality of life, satisfaction with treatment, need for intervention to control pain, perception of improvement and medication consumption. Spearman's correlation was performed at 5% of significance. RESULTS: There were low magnitude negative correlations of pain intensity and physical disability with treatment satisfaction, need for intervention, perception of improvement after treatment and medication consumption, and low magnitude positive correlations of quality of life perception with satisfaction with treatment, need for intervention, and perception of improvement. CONCLUSION: The improvement in pain intensity, physical disability and quality of life resulted in better general health status, satisfaction with treatment and lower consumption of medication among study participants.

OBJETIVOS: evaluar la relación de la intensidad del dolor, la discapacidad física y la calidad de vida después de la acupuntura auricular y la terapia con ventosas con la satisfacción con el tratamiento, la necesidad del mismo para controlar el dolor, la percepción de mejoría y el consumo de medicamentos. MÉTODO:estudio transversal realizado con 198 personas con dolor de espalda crónico. Se investigó: la intensidad del dolor, la discapacidad física, la calidad de vida, la satisfacción con el tratamiento, la necesidad de intervención para el control del dolor, la percepción de mejoría y el consumo de medicamentos. Se realizó la correlación de Spearman al 5% de significancia. RESULTADOS: Hubo correlaciones negativas de baja magnitud de la intensidad del dolor y de la discapacidad física con la satisfacción con el tratamiento, necesidad de intervención, percepción de mejoría después del tratamiento y consumo de medicamentos, y correlacion espositivas de baja magnitud de la percepción de la calidad de vida con la satisfacción con el tratamiento, necesidad de intervención y percepción de mejora. CONCLUSIÓN: La mejora en la intensidad del dolor, la discapacidad física y la calidad de vida llevaron aun mejor estado general de salud, satisfacción con el tratamiento y menor consumo de medicamentos entre los participantes del estudio.

Physical and emotional factors associated with the severity of chronic back pain in adults: a cross-sectional study / Factores físicos y emocionales asociados a la gravedad del dolor crónico en adultos: un estudio transversal / Fatores físicos e emocionais associados à severidade da dor crônica nas costas em adultos: estudo transversal

ABSTRACT Objective: determining the multidimensional factors associated with the severity of chronic back pain is essential to design appropriate interventions. The objective of this study was to assess the physical and emotional factors associated with the severity of chronic back pain in adults. Method: a descriptive, analytical and cross-sectional study, carried out between November 2017 and December 2018 in Family Health Strategies, with 198 adults with chronic back pain. Pain severity, assessed by the Brief Pain Inventory, was considered the outcome variable; and the pain interference in daily activities (Brief Pain Inventory), physical disability (Roland Morris Disability Questionnaire), quality of life (World Health Organization Quality of Life-Brief) and pain threshold (digital algometer) variables were considered explanatory. A Multivariate Multiple Linear Regression analysis, using the stepwise method with 5% significance, was preformed to establish an explanatory model of pain severity. Results: the mean age was 48.03 years old (standard deviation: 12.41). Most of the participants were women, married and worked. The variables that had a significant and joint impact on pain severity were pain interference in daily activities (parameter: 0.196; p-value<0.001) and in mood (parameter: 0.054; p-value=0.039) and physical domain of quality of life (parameter: -0.032; p-value<0.001). Conclusion: physical factors (pain interference in daily activities and physical domain of quality of life) and emotional factors (pain interference in mood) play an important role in the severity of chronic back pain, which reinforces its multidimensional character.

RESUMEN Objetivo: determinar los factores multidimensionales asociados a la gravedad del dolor de espalda crónico es esencial para diseñar intervenciones apropiadas. El objetivo de este estudio fue evaluar los factores físicos y emocionales asociados a la gravedad del dolor de espalda crónico en adultos. Método: estudio descriptivo y analítico, de corte transversal, realizado entre noviembre de 2017 y diciembre de 2018, en unidades de la Estrategia de Salud Familiar, con 198 adultos que sufren dolor de espalda crónico. La gravedad del dolor, evaluada por medio del Brief Pain Inventory, se consideró como variable de resultado; y las variables interferencia del dolor en las actividades cotidianas (Brief Pain Inventory), discapacidad física (Cuestionario de Discapacidad de Roland Morris), calidad de vida (World Health Organization Quality of Life-Brief) y umbral de dolor (algómetro digital) se consideraron como variables explicativas. Se realizó un análisis multivariado de Regresión Lineal Múltiple, usando el método stepwise con 5% de significancia, para establecer el modelo explicativo de la gravedad del dolor. Resultados: la media de edad fue de 48,03 años (desviación estándar: 12,41). La mayoría de los participantes fueron mujeres, casadas y con alguna actividad laboral. Las variables que ejercieron un impacto sobre la gravedad del dolor en forma significativa y conjunta fueron las siguientes: interferencia del dolor en las actividades cotidianas (parámetro: 0,196; valor p<0,001) y en el estado de ánimo (parámetro: 0,054; valor p=0,039) y el dominio físico de la calidad de vida (parámetro: -0,032; valor p<0,001). Conclusión: los factores físicos (interferencia del dolor en las actividades cotidianas y el dominio físico de la calidad de vida) y emocionales (interferencia del dolor en el estado de ánimo) desempeñan un rol importante en la gravedad del dolor de espalda crónico, lo que refuerza su carácter multidimensional.

RESUMO Objetivo: determinar os fatores multidimensionais associados à severidade da dor crônica nas costas é essencial para traçar intervenções apropriadas. O objetivo deste estudo consistiu em avaliar os fatores físicos e emocionais associados à severidade da dor crônica nas costas em adultos. Método: estudo descritivo analítico, de corte transversal, realizado entre novembro de 2017 e dezembro de 2018, em Estratégias de Saúde da Família, com 198 adultos com dor crônica nas costas. A severidade da dor, avaliada pelo Brief Pain Inventory, foi considera variável de desfecho; as variáveis interferência da dor nas atividades cotidianas (Brief Pain Inventory), incapacidade física (Questionário de Incapacidade de Rolland Morris), qualidade de vida (World Health Organization Quality of Life-Brief) e limiar de dor (algômetro digital) foram consideradas variáveis explicativas. Análise multivariada de Regressão Linear Múltipla, usando o método stepwise com 5% de significância, foi conduzida para estabelecer modelo explicativo da severidade da dor. Resultados: a média de idade foi de 48,03 anos (desvio padrão: 12,41). A maioria eram mulheres, casadas e que trabalhavam. As variáveis que tiveram impacto na severidade da dor de forma significativa e conjunta foram interferência da dor nas atividades cotidianas (parâmetro: 0,196; valor p<0,001) e no humor (parâmetro: 0,054; valor p=0,039) e domínio físico da qualidade de vida (parâmetro: -0,032; valor p<0,001). Conclusão: fatores físicos (interferência da dor nas atividades cotidianas e domínio físico da qualidade de vida) e emocionais (interferência da dor no humor) desempenham importante papel na severidade da dor crônica nas costas, o que reforça o seu caráter multidimensional.

Analysis of the Muscular Activity, Peak Torque in the Lower Limbs, and Static Balance after Virtual Rehabilitation in Women with Fibromyalgia: A Randomized Controlled Study.

Objective: To analyze the effect of the exergaming on muscular activity at rest and on maximum voluntary isometric contraction by electromyography (EMG) at peak torque, widespread pressure hyperalgesia identified using a tender point count, and static balance in fibromyalgia. Materials and Methods: Thirty-five women were divided into two groups: Wii™ (virtual rehabilitation, n = 16) and control (stretching exercises, n = 19), through simple randomization. The volunteers were evaluated by means of EMG, dynamometry by load cell, baropodometry, and algometry before interventions and reevaluated after the 10th and 20th sessions. The subjects participated fully in three 1-hour treatment sessions per week of 20 sessions. Results: The Wii group showed significant benefits for the peak torque of dorsiflexion movement after 20 sessions and for movement plantarflexion after 10 sessions. The control group showed bilateral improvement in muscular activity in the tibialis anterior muscle after 20 sessions. Both groups showed a significant decrease in tender point count, suggesting improved hyperalgesia after 10 sessions and 20 sessions. No significant improvement was found in static baropodometry in the two evaluated groups. Conclusion: Exergaming have the potential to increase the peak torque for dorsiflexion and plantarflexion movement in women with fibromyalgia. It also produces a decrease in tender point count equal to that with flexibility exercises and does not produce changes in the static balance.

A intervenção "Ensino do cuidado com os pés" para pessoas com diabetes: ensaio clínico randomizado

Introdução: pessoas com diabetes possuem risco aumentado para o desenvolvimento de morbidades nos membros inferiores, o que está relacionado a amputações. Objetivo: analisar o efeito da intervenção "Ensino do Cuidado com os Pés", realizada por meio de visitas domiciliares, na integridade tissular, no conhecimento sobre as atividades de autocuidado e na intenção de cuidar dos pés. Método: ensaio clínico paralelo, de mascaramento único e randomizado com taxa de alocação de 1:1, desenvolvido com pessoas com Diabetes tipo 2. O desfecho primário está relacionado a avaliação da integridade tissular e o secundário, ao conhecimento sobre as atividades de autocuidado e à intenção em realizar cuidados com os pés. Resultados: Participaram do estudo 72 pessoas, divididas em grupo controle e tratado. O grupo controle apresentou diferença significativa (p=<0,05) nos indicadores de pele e anexo, circulação, sensibilidade, conhecimento e intenção de cuidar dos pés. Conclusão: "Ensino do Cuidado com os Pés" é uma estratégia que pode influenciar os indicadores de comprometimento dos pés. nº 20376013.2.0000.5142

Validation study of a software for proprioceptive evaluation / Estudo de validação de um programa de computador para avaliação proprioceptiva

Objective: To validate the PhisioPlay software for proprioceptive evaluation of the shoulder joint based on the data obtained by isokinetic dynamometry equipment. Methods: Thirty-one individuals constituted a single group for proprioceptive evaluation of both shoulder joints by means of joint position sense (JPS). The testing protocol of PhisioPlay consisted of the abduction movement of the shoulder to the target angles of 45° and 90° and the maintenance of these positions for 30 seconds. In the isokinetic dynamometer, the test was performed using its proprioceptive evaluation protocol for the same movement, target angles, and maintenance time established for the previous test. Results: For the 90° variables, statistical analysis pointed to agreement for the dominant limb in relation to the mean angulation and the absolute difference and for the non-dominant limb in relation to the absolute difference. The results of mean comparisons of the absolute differences via the Wilcoxon Test corroborate the literature regarding the behavior of the JPS considering joint amplitude, lateral dominance, and greater or lesser torque affecting the joint. Reliability and sensitivity measures also strengthen the conclusions. Conclusion: The results point to the construct validity of the PhisioPlay software for evaluating the JPS of the shoulder joint at 45° and 90° and suggest that the JPS is more influenced by the angle of the joint during the motor task than by the lateral dominance.

Objetivo: Validar do software PhisioPlay para avaliação proprioceptiva da articulação do ombro realizando movimento de abdução a 45º e 90º utilizando os dados obtidos por um equipamento de dinamometria isocinética. Métodos: Trinta e um indivíduos compuseram um único grupo de avaliação da propriocepção pelo senso de posição articular (SPA) do ombro. O protocolo de teste no PhisioPlay consistiu no movimento de abdução do ombro para o ângulo alvo de 45° e 90° e sua manutenção por 30 segundos. No dinamômetro isocinético o teste foi realizado utilizando seu protocolo de avaliação proprioceptiva para o mesmo movimento, ângulos alvo e tempo de manutenção no ângulo alvo estabelecidos para o teste anterior. Resultados: Para as variáveis de 90° foi observada concordância moderada para o membro dominante em relação à angulação média e à diferença absoluta, e para o membro não dominante em relação à diferença absoluta. O teste de Wilcoxon ao comparar os valores dos erros absolutos em relação ao ângulo alvo obtidos pelo PhisioPlay corroboram com a literatura sobre o comportamento do SPA observando amplitude articular, lateralidade e maior ou menor torque incidindo sobre a articulação. Medidas de confiabilidade e sensibilidade também reforçaram este comportamento. Conclusão: Os resultados apontam para validade de construto do software PhisioPlay para a avaliação do SPA da articulação do ombro a 45° e 90° e sugerem que o SPA é mais influenciado pela angulação da articulação durante a tarefa motora do que pela dominância lateral.

Reliability of the PhysioPlay™ device for assessing the reaction time of cancer patients / Confiabilidade do dispositivo PhysioPlay™ para avaliar o tempo de reação de pacientes com câncer

Objective: To determine the intra-evaluator and inter-evaluator reliability of the Physioplay-Kinect interaction and Trigno device for assessing the reaction time (RT) of cancer volunteers undergoing treatment. Methods: 46 cancer volunteers who underwent treatment modalities participated and were allocated into three groups: Chemotherapy Group (CG), Radiotherapy Group (RG), and Chemotherapy-Radiotherapy Group (CRG). The RT for all volunteers was assessed using the PhysioPlay™ and Trigno device. Results: In the intra-evaluator analysis, excellent levels of reliability (Physioplay: ICC> 0.99; Trigno 8: ICC>0.92) were observed in all groups. In the inter-evaluator analysis, excellent levels of reliability were observed in the CG (Physioplay: ICC= 0.98; Trigno 8: ICC= 0.98); excellent (Physioplay: ICC= 0.98) and good (Trigno 8: ICC= 0.44) levels in the RG; good (Physioplay: ICC= 0.49) and reasonable (Trigno 8: ICC= 0.29) levels in the CRG. Conclusion: The PhysioPlay™ and Trigno device proved to be reliable for assessing the RT of cancer volunteers undergoing treatment

Objetivo: Determinar a confiabilidade intra-avaliador e inter-avaliador da interação Physioplay-Kinect e do dispositivo Trigno para avaliar o tempo de reação (TR) de voluntários com câncer em tratamento. Métodos: 46 voluntários com câncer em tratamento participaram do estudo e foram distribuídos em três grupos: Grupo de Quimioterapia (GQ), Grupo de Radioterapia (GR), e Grupo de Quimioterapia-Radioterapia (GQR). O TR para todos os voluntários foi avaliado utilizando o dispositivo PhysioPlay™ e Trigno. Resultados: Na análise intra-avaliador, foram observados excelentes níveis de confiabilidade (Physioplay: ICC> 0,99; Trigno 8: ICC>0,92) em todos os grupos. Na análise inter-avaliador, foram observados excelentes níveis de confiabilidade no GQ (Physioplay: ICC= 0,98; Trigno 8: ICC= 0,98); excelente (Physioplay: ICC= 0,98) e bom (Trigno 8: ICC= 0,44) níveis no GR; bons (Physioplay: ICC= 0,49) e razoáveis (Trigno 8: ICC= 0,29) níveis no GQR. Conclusão: Os dispositivos PhysioPlay™ e Trigno provaram ser confiáveis para avaliar o TR de voluntários com câncer em tratamento

The effect of operative groups on diabetic foot self-care education: a randomized clinical trial. / Efeito do grupo operativo no ensino do autocuidado com os pés de diabéticos: ensaio clínico randomizado.

OBJECTIVE: To evaluate the effect of operative groups on teaching self-care for diabetic foot prevention. METHOD: Controlled, blinded clinical trial with volunteers presenting type 2 Diabetes Mellitus, randomized into treatment (55 subjects) and control (54 subjects) groups. The treatment group received the educational intervention "Teaching foot self-care", whereas the control group was simply evaluated. Feet evaluation was conducted before and after the intervention, as well as 15 days later in a follow-up. The intervention was conducted through an operative group and developed with orientation via writing, explained through dialogue and role-playing. The following tests were used: Shapiro-Wilk, Chi-squared, t-test, Mann-Whitney, McNemar, and paired Wilcoxon. RESULTS: One-hundred and nine volunteers took part in this study. Their sociodemographic variables were homogeneous. In an analysis between groups, an improvement was observed after the educational intervention regarding most variables related to skin annexes, blood flow, foot sensitivity, and foot pressure. Improved scores for risk of diabetic foot in the treatment group were observed. CONCLUSION: The educational intervention through operative group was efficient, for it encouraged self-care and reduced potential risk of diabetic foot. Brazilian Registry of Clinical Trials (Registro Brasileiro de Ensaios Clínicos): RBR- 753 Kcg.

Influence of an Exergaming Training Program on Reducing the Expression of IL-10 and TGF-ß in Cancer Patients.

Objective: To evaluate the effect of exergaming in the plasma levels of adipokines (interleukin [IL]-1ß, IL-6, IL-8, and tumor necrosis factor-alpha [TNF-α]), Th1 (IL-2, IL-12, and interferon gamma [IFN-γ]), Th2 (IL-4 and IL-33), Th17 (IL-17 and IL-23), and regulatory T (Treg) (IL-10 and transforming growth factor-beta [TGF-ß]) in cancer patients undergoing treatment. Materials and Methods: We conducted a quasi-experimental control clinical trial using exergaming in all groups through the Xbox 360 Kinect™. The game used in this study was called Your Shape Fitness Evolved 2012. The volunteer participants played the game two to three times per week, for a total of 20 sessions. Forty-five volunteer participants were divided into 3 groups: cancer patients undergoing chemotherapy and/or radiotherapy treatment (chemotherapy and/or radiotherapy group CRG; n = 15); cancer patients who finished chemotherapy and/or radiotherapy treatment (cancer accompaniment group CAG; n = 15); and the control group (volunteers without a cancer diagnosis CG; n = 15). In the pre- and post-training period, all volunteers submitted to blood collection procedures using the enzyme-linked immunosorbent assay (ELISA). This test was used to obtain the levels of adipokines expression (IL-1ß, IL-6, IL-8, and TNF-α) and the cytokine profiles Th1 (IL-2, IL-12, and IFN-γ), Th2 (IL-4 and IL-33), Th17 (IL-17 and IL-23), and Treg (IL-10 and TGF-ß). Results: After exergaming, the CRG showed significant reductions in proinflammatory cytokines (IL-6: P < 0.05; IL-10: P = 0.038; TGF-ß: P = 0.049) and for CAG (IL-10: P = 0.034), as well as a reduction in the expression of cytokines related to the action of T lymphocytes. Conclusion: Exergaming promoted changes in the expression of cytokine profiles IL-6, IL-10, and TGF-ß, which correlated with the action profiles of CD4+ T lymphocytes.

Effects of Exergames in Women with Fibromyalgia: A Randomized Controlled Study.

Objective: Evaluation of the effects of exergames in women with fibromyalgia on the impact of the disease-pain threshold and physical variables-compared to performing stretching exercises. Materials and Methods: Thirty-five women were enrolled in the study and divided by simple randomization into two treatment groups: the control group (n = 19) and the Wii™ (exergames) group (n = 16). Participants were evaluated using the fibromyalgia impact questionnaire (FIQ), algometry, step tests, cardiopulmonary parameters, and fatigue in the lower limbs. The participants underwent treatments for a period of 7 weeks with three 1-hour sessions weekly and were reevaluated after the 10th and the 20th sessions. Results: The exergames group showed significant reduction of their fibromyalgia symptoms, as demonstrated by lower FIQ scores in the key domains on questions regarding missed work, pain, fatigue, problems resting, stiffness, anxiety, and depression. Significant improvements were observed in mean algometric values in the cervical region, the second chondrocostal junction, the lateral epicondyle, left medial knee border, left occipital region, trapezius, supraspinatus, gluteal muscles, and the greater trochanter. Improved cardiovascular adaptation was reflected by decreased systolic blood pressure, reduction in fatigue of the lower limbs assessed by the CR10 Borg scale, and improved exercise capacity assessed by a step test. Conclusion: Exergames have the potential to increase exercise capacity, decrease the impact of fibromyalgia, promote cardiovascular adaptation, reduce fatigue of lower limbs, and improve the pain threshold in women with fibromyalgia.

Effect of Exergaming on Muscle Strength, Pain, and Functionality of Shoulders in Cancer Patients.

Objective: To compare the strength of the middle deltoid muscle by means of dynamometry and the Shoulder Pain and Disability Index (SPADI) in participants in treatment for cancer after the practice of an exergaming protocol. Materials and Methods: We conducted a randomized controlled clinical trial. Thirty-eight voluntary participants were divided into two groups: cancer group (n = 19; age = 61.46 ± 8.79 years; body mass index [BMI] = 28.36 ± 4.94 kg/m3) and control group (n = 19; age = 57.62 ± 7.57 years; BMI = 28.06 ± 3.74 kg/m3), and they participated in the study. All participants performed an exergame protocol by using Xbox 360 Kinect® (Microsoft, Redmond) with the game Your Shape Fitness Evolved 2012 two to three times per week for 20 sessions. They were evaluated through the isometric dynamometer in the middle deltoid muscle and the SPADI at three moments: preintervention (EV1), after 10 sessions (EV2), and after 20 sessions (EV3). Results: The cancer group scored higher on both the disability index, in all three evaluations, and the pain index, in EV2 and EV3, when compared with the control group. There was a significant reduction in the disability score in EV2 and EV3 when compared with EV1 in the cancer group, whereas pain was lower in EV2 and EV3 when compared with EV1 in the control group. There were no significant interevaluation or intergroup differences in the maximal isometric voluntary contraction of the deltoid muscle of both upper limbs. Conclusion: At the end of the exergaming, protocol reduced the disability of the shoulder joint of the cancer group and decreased the differences between the groups for disability and pain scores, without changing isometric force.

Validação de um protocolo de auriculoterapia com laser para dor crônica na coluna vertebral / Validación de un protocolo de auriculoterapia láser para el dolor crónico en la columna vertebral / Validation of a laser auriculotherapy protocol for chronic spinal pain

RESUMO Objetivo: validar um protocolo de auriculoterapia com laser para dor crônica na coluna vertebral. Método: estudo metodológico realizado a partir de uma revisão sistemática, baseada no PRISMA Statement; validação de conteúdo por 21 experts e validação clínica do protocolo desenvolvido em pessoas com dor. Resultados: a partir da análise de 13 artigos foi observado o efeito positivo da acupuntura no alívio da dor e foi possível construir o seguinte protocolo: auriculoterapia com laser, em cinco sessões, com a proporção de uma sessão por semana, aplicação bilateral com alternância do pavilhão auricular nos pontos Shenmen, rim, simpático, bexiga, fígado, subcórtex e vértebras cervical, torácica e/ ou lombar, dependendo do local da dor. A avaliação desse conteúdo assumindo nível de concordância de 80% interavaliadores resultou em aprovação de todos os itens do protocolo. Na avaliação clínica, ao ser administrado em pessoas com dor na coluna vertebral, o protocolo desenvolvido demonstrou reduzir a média de dor, aumentar o limiar de tolerância e diminuir o impacto da dor nas atividades de vida diária. Conclusão: a acupuntura auricular, realizada com laser de baixa potência infravermelho no protocolo estudado, provou ser capaz de tratar com efetividade a dor crônica na coluna vertebral.

RESUMEN Objetivo: validar un protocolo de auriculoterapia láser para el dolor crónico en la columna vertebral. Método: estudio metodológico realizado a partir de una revisión sistemática, en base a la declaración PRISMA; validación de contenido por 21 expertos y validación clínica del protocolo de tratamiento en personas con dolor. Resultados: del análisis de 13 artículos se observó el efecto positivo de la acupuntura en el alivio del dolor y se pudo construir el siguiente protocolo: auriculoterapia láser, en cinco sesiones, con una sesión por semana, aplicación bilateral con alternancia de pabellón auricular en los puntos Shen Men, Riñón, Nervio simpático, Vejiga, Hígado, Subcórtex y vértebras cervicales, torácicas y / o lumbares, dependiendo de la localización del dolor. La evaluación de este contenido, asumiendo un nivel de acuerdo del 80% entre evaluadores, resultó en la aprobación de todos los ítems del protocolo. En la evaluación clínica, cuando se administró a personas con dolor en la columna, el protocolo de tratamiento demostró reducir el promedio de dolor, aumentar el umbral de tolerancia y disminuir el impacto del dolor en las actividades de la vida diaria. Conclusión: la acupuntura auricular, realizada con láser infrarrojo de baja potencia en el protocolo estudiado, demostró ser capaz de tratar eficazmente el dolor crónico de columna vertebral.

ABSTRACT Objective: to validate a laser auriculotherapy protocol for chronic spinal pain. Method: methodological study carried from a systematic review based on the PRISMA Statement; content validation carried out by 21 specialists and pilot test with clinical validation of the protocol developed in people with pain. Results: from the analysis of 13 articles, a positive effect of acupuncture on pain relief was noted and it was possible to develop the following protocol: laser auriculotherapy, in 5 sessions, with the proportion of one session a week, bilateral application with alternation of the auricular pavilion at Shenmen points, Kidney, Sympathetic Nervous System, Urinary Bladder, Liver, Subcortex and Cervical, Thoracic and/or Lumbar Vertebrae, depending on the location of the pain. The evaluation of this content, assuming a level of agreement of 80% interobserver, resulted in the approval of all items in the protocol. In the clinical evaluation, when it was administered in people with spinal pain, the protocol developed showed a reduction in the pain average, an improvement in the tolerance threshold and a reduction in the pain impact on daily activities. Conclusion: the auricular acupuncture, carried out using an infrared low-level laser, in the studied protocol, proved to be capable of effectively treating chronic spinal pain.

Intercessory Prayer on Spiritual Distress, Spiritual Coping, Anxiety, Depression and Salivary Amylase in Breast Cancer Patients During Radiotherapy: Randomized Clinical Trial.

The goal of this study was to assess the effect of intercessory prayer in the psychological, spiritual and biological scores of breast cancer patients who are undergoing radiotherapy. Double-blind RCT comprising a sample of 31 participants (15 in the Control Group and 16 in the Intervention Group). Data collection was performed in three time points (T0, T1 and T2). Significant changes have been identified in the intra-group analysis, concerning the decrease in spiritual distress score; negative religious/spiritual coping prevailed, while the total religious/spiritual coping increased between the posttest T2 to T0. Intercessory prayer was effective in religious and spiritual scores.