Sleep Quality Predicts Functional Disability in Older Adults with Low Back Pain: A Longitudinal Study.

Low back pain (LBP) and sleep quality are two very prevalent complaints in the older population. However, little is known about the prognostic relationship between sleep quality and disability in older adults with LBP. The aim of this study was to examine the association between sleep quality and disability in older adults with LBP. This was a longitudinal study over a 6-month period. Older adults with LBP in the last 12 weeks and who had preserved cognitive functions were recruited. The questionnaires used were the Pittsburgh Sleep Quality Index and the Roland Morris Disability Questionnaire. At baseline, we collected information on demographic/anthropometric variables, cognitive status, depression, daytime sleepiness, and comorbidities. Linear regression adjusted for potential covariates were performed. Poor sleep at baseline predicted higher disability after 6 months [ß = 0.30 (CI95%:0.07 to 0.55)]. Our results support the existence of an important relationship between sleep and disability in older adults with LBP.

Outcomes between different validated questionnaires to assess the level of physical activity in cardiac patients adhering to a rehabilitation program / Desfechos entre diferentes questionários validados para a avaliação do nível de atividade física em cardiopatas adeptos a um programa de reabilitação

Abstract Introduction The International Physical Activity Ques-tionnaire (IPAQ) and Baecke inventory are commonly used in cardiovascular rehabilitation routines. Thus, it is understood that investigations on the equivalence of outcomes between these two tools may be relevant to measure the magnitude of possible reproducibility and correlations between them. Objective To compare in cardiac patients the level of physical activity obtained through the IPAQ and Baecke inventory and correlate outcomes obtained with a 6-minute walk test. Methods In total, 65 heart disease patients included in a cardiovascular rehabilitation program (40 male and 25 female) were included, with a mean age of 65.8 ± 10.5 years. The data were obtained from the application of a standardized form, containing the proposed study objects, which were the IPAQ and Baecke inventory. In addition, data regarding anthropometric measurements (body mass, height, and body mass index - BMI), waist-to-hip ratio, blood pressure, and performance in the 6-minute walk test were measured. Results The main outcomes refer to the weak association between the instruments evaluated, which showed a strong relationship only between free time physical activity (r = 1), while in the other categories and when compared to the 6-minute walk test, the verified agreement was not significant. Conclusion The questionnaires are strongly equivalent only for free time physical activity, in the other categories and when compared to the 6-minute walk test, the agreement was not significant. Thus, based on the results, implementation in clinical practice considering the use of these tools with equivalence is not recommended.

Resumo Introdução O Questionário Internacional de Atividade Física (IPAQ) e o inventário de Baecke são comumente utilizados em rotinas de reabilitação cardiovascular. Assim, entende-se que investigações sobre a equiva-lência de desfechos entre essas duas ferramentas possam ser relevantes para mensurar a magnitude da possível reprodutibilidade e correlação entre tais métodos. Objetivo Comparar em cardiopatas o nível de atividade física obtido por meio do IPAQ e do Baecke e correlacionar desfechos obtidos com o teste de cami-nhada de 6 minutos (TC6). Métodos Foram incluídos no estudo 65 cardiopatias inseridos em um programa de reabilitação cardiovascular, sendo 40 do sexo masculino e 25 do sexo feminino, com idade média correspondente a 65,8 ± 10,5 anos. Os dados foram obtidos a partir de um formulário padronizado, contendo os objetos de estudo propostos (IPAQ e Baecke). Além disso, dados referentes a medidas antropométricas (massa corporal, estatura e índice de massa corpórea), relação de cintura quadril, pressão arterial e TC6 foram avaliados. Resultados Os principais desfechos se referem à fraca associação entre os instrumentos avaliados, que demonstraram relação forte somente entre atividade física de tempo livre (r = 1), sendo que nas demais categorias e quando comparadas ao TC6 a concordância verificada não apresentou significância estatística. Conclusão Os questionários se equivalem fortemente somente quando diz respeito à atividade física de tempo livre. Desta forma, não faz sentido a implementação de prática clínica que considere a utilização das ferramentas IPAQ e Baecke com equivalência, o que verificou-se não existir.

Dance therapy as an alternative for cardiac rehabilitation in women population: autonomic and hemodynamic acute responses - a crossover clinical trial protocol

Abstract Aim: The objective of this study is to 1. Investigate in women with cardiac risk factors the acute responses of cardiac autonomic modulation and hemodynamic parameters during and after a dance-based cardiac rehabilitation session and II. Compare these responses with a conventional exercise-based cardiac rehabilitation session. Methods: This will be a crossover-clinical trial that will enroll women with at least one cardiac risk factor. The interventions consist of one dance-based (DB) and one traditional exercise-based (EB) session of cardiac rehabilitation, both composed of initial rest, warm-up, moderate-intensity physical exercise, fast recovery evaluation in orthostatic position, and slow recovery evaluation. The main outcomes are 1. Autonomic modulation, evaluated through heart rate variability linear and non-linear methods, and II. Hemodynamic parameters (heart rate, blood pressure, peripheral oxygen saturation, and respiratory rate). All measures will be evaluated in specific moments during the initial rest, physical exercise, and recovery. Conclusion: The results will allow the safe inclusion of dance-based sessions in cardiac rehabilitation programs opening an important field of research to investigate the long-term effects on physical fitness and cardiac risk factors, as well as adherence and motivation to attend cardiac rehabilitation in the women population.

Níveis de ansiedade, depressão e estresse em funcionários de uma instituição de ensino superior pública do interior do estado de São Paulo / Anxiety, depression and stress among employees of a public higher education institution in São Paulo, Brazil

Introdução: A saúde do trabalhador ganha destaque em âmbito científico, sendo tema de pesquisas e debates internacionais, apresentando o estresse laboral como potencial agente estressor. Objetivo: Caracterizar a incidência de sintomatologia referente à ansiedade e à depressão correlacionada aos níveis socioeconômicos em servidores técnico-administrativos de uma universidade estadual do estado de São Paulo. Métodos: A amostra foi composta de 89 participantes. Os dados foram obtidos por meio do inventário de sintomas de estresse para adultos de Lipp, para detectar o nível de estresse; da escala hospitalar de ansiedade e depressão, para análise de ansiedade e depressão; e de um questionário informativo para detectar o nível educacional e sociodemográfico. Resultados: Verificou-se que 47% dos participantes apresentaram sintomas de ansiedade e 39% de depressão, não havendo relação direta com o nível socioeconômico. Além disso, observou-se que, entre os indivíduos que apresentavam ansiedade, 50% eram docentes, e, do total de indivíduos com depressão, 38,4% eram do setor administrativo. O estresse encontra-se em maior escala nas categorias ensino superior (29,6%) e pós-graduados (33,3%). Conclusões: Os achados demonstraram elevada prevalência de ansiedade e depressão em todas as classes socioeconômicas investigadas. Ademais, indivíduos de nível educacional elevado são mais estressados que os de nível educacional inferior.

Background: Occupational health is increasing in visibility within the scientific community and has become a field of international research and discussions in which occupational stress is described as a possible stressor. Objective: To analyze the relationship between anxiety and depression symptoms and socioeconomic level among technical-administrative employees of a public university in the state of São Paulo, Brazil. Methods: The sample comprised 89 participants. Data were obtained through Lipp's Inventory of Stress Symptoms for adults to identify levels of stress and the Hospital Anxiety and Depression scale. An additional questionnaire was administered to gather information on educational and socioeconomic levels. Results: About 45% of the participants exhibited symptoms of anxiety and 39% of depression, however, without direct relationship with their socioeconomic level. Among the participants with depression 50% were professors, and among those with depression 38.4% were administrative employees. Stress was more frequent among the participants who had attended higher education (29.6%) and graduate studies (33.3%). Conclusion: The study results indicate a high prevalence of anxiety and depression regardless of the socioeconomic level of the participants. Stress was more frequent among the participants with higher educational level.

Anxiety, depression and stress among employees of a public higher education institution in São Paulo, Brazil.

BACKGROUND: Occupational health is increasing in visibility within the scientific community and has become a field of international research and discussions in which occupational stress is described as a possible stressor. OBJECTIVE: To analyze the relationship between anxiety and depression symptoms and socioeconomic level among technical-administrative employees of a public university in the state of São Paulo, Brazil. METHODS: The sample comprised 89 participants. Data were obtained through Lipp's Inventory of Stress Symptoms for adults to identify levels of stress and the Hospital Anxiety and Depression scale. An additional questionnaire was administered to gather information on educational and socioeconomic levels. RESULTS: About 45% of the participants exhibited symptoms of anxiety and 39% of depression, however, without direct relationship with their socioeconomic level. Among the participants with depression 50% were professors, and among those with depression 38.4% were administrative employees. Stress was more frequent among the participants who had attended higher education (29.6%) and graduate studies (33.3%). CONCLUSION: The study results indicate a high prevalence of anxiety and depression regardless of the socioeconomic level of the participants. Stress was more frequent among the participants with higher educational level.

INTRODUÇÃO: A saúde do trabalhador ganha destaque em âmbito científico, sendo tema de pesquisas e debates internacionais, apresentando o estresse laboral como potencial agente estressor. OBJETIVO: Caracterizar a incidência de sintomatologia referente à ansiedade e à depressão correlacionada aos níveis socioeconômicos em servidores técnico-administrativos de uma universidade estadual do estado de São Paulo. MÉTODOS: A amostra foi composta de 89 participantes. Os dados foram obtidos por meio do inventário de sintomas de estresse para adultos de Lipp, para detectar o nível de estresse; da escala hospitalar de ansiedade e depressão, para análise de ansiedade e depressão; e de um questionário informativo para detectar o nível educacional e sociodemográfico. RESULTADOS: Verificou-se que 47% dos participantes apresentaram sintomas de ansiedade e 39% de depressão, não havendo relação direta com o nível socioeconômico. Além disso, observou-se que, entre os indivíduos que apresentavam ansiedade, 50% eram docentes, e, do total de indivíduos com depressão, 38,4% eram do setor administrativo. O estresse encontra-se em maior escala nas categorias ensino superior (29,6%) e pós-graduados (33,3%). CONCLUSÕES: Os achados demonstraram elevada prevalência de ansiedade e depressão em todas as classes socioeconômicas investigadas. Ademais, indivíduos de nível educacional elevado são mais estressados que os de nível educacional inferior.

Estudo do tempo gasto com exercícios ativos realizados por hemiparéticos crônicos submetidos a Fisioterapia em Grupo no formato de Circuito de Treinamento / Study of time spent in active exercises realized by chronic hemiparetic patients submitted to Physiotherapy in Group in the format of Training Circuit

Introdução: Hemiparéticos passam pouco tempo em atividades físicas funcionais em sessões de fisioterapia convencionais. Há evidências que a Fisioterapia de Grupo em Circuito de Treinamento (FGCT) é capaz de melhorar a capacidade funcional e aumentar a quantidade de tempo gasto durante a terapia. Objetivo: O objetivo deste trabalho foi avaliar o tempo gasto com exercícios ativos realizados por hemiparéticos crônicos submetidos a FGCT e correlacionar o tempo ativo com testes funcionais. Métodologia: Para verificar a normalidade dos dados, utilizou-se o teste Shapiro-Wilk; o teste t-student foi usado para amostras pareadas, para comparar o tempo ativo e inativo, considerando significante o valor de p < 0,05. O teste de Pearson foi para avaliar as correlações do Timed-Up-and-Go (TUG) e Escala de Equilíbrio de Berg (EEB) com o tempo ativo. Resultados: O valor médio obtido no TUG foi 19,43 ± 8,65 segundos e na EEB foi 43,83 ± 11,07 pontos. O Teste de Pearson mostrou correlação entre o EEB com as Atividades de Prática Ativas (APA) (r = 0,631, p ≤ 0,01) e entre TUG e APA (r = - 0,495, p ≤ 0,01). Conclusão: Os resultados demonstraram que o tempo gasto com exercícios ativos durante uma sessão de FGCT foi maior que o tempo inativo, e houve correlação moderada entre os valores de APA com os testes EEB e TUG.

Introduction: Hemiparetic patients spent little time in functional physical activities of conventional physiotherapy. There are evidences that the Physiotherapy of Group in Training Circuit (PGTC) is able to better the functional capacity and increase the quantity of time spent during the therapy. Objective: The objective of this work was to evaluate the time spent with active exercises realized by chronic hemiparetic patients submitted to PGTC, to correlating active time with functional tests. Methodology: It was verified the normality of the data with the Shapiro-Wilk test; the t-student test to paired samples, comparing active and inactive time, being significant the value of p < 0,05. The Pearson test was to evaluate the correlations of Timed-Up-and-Go (TUG) and Berg Balance Scale (BBS) with the active time. Results: The average value obtained in the TUG was 19,43 ± 8,65 seconds and in the BBS was 43,83 ± 11,07 points. Pearson test shows correlations between the BBS with the Active Practical Activities (APA) (r = 0,631, p ≤ 0,01) and between the TUG and the APA (r = -0,495, p ≤ 0,01). Conclusion: Results demonstrated that the time spent with active exercises during one session of PGTC was larger than the inactive time, and there was moderated correlation between the values of APA with the BBS and TUG tests.

Como determinar a velocidade inicial da esteira no treinamento aeróbio de hemiparéticos crônicos? / How to determine the initial treadmill speed for the aerobic training of chronic hemiparetics?

Objetivo: Investigar os critérios para estabelecer a velocidade inicial da esteira e viabilizar um treinamento motor funcional ou cardiorrespiratório em hemiparéticos crônicos. Métodos: Foram recrutados 15 hemiparéticos crônicos determinados pelo Lower Extremity Motor Coordination Test (LEMOCOT) e submetidos à avaliação da marcha pelo Time up and go (TUG), Teste de Esforço Máximo (TES) e Teste de velocidade de marcha de 10 metros (TV10M). Resultados: A análise dos valores do LEMOCOT demonstrou uma média de 26,87 ± 9,76 acertos nos alvos no lado não parético e 15,40 ± 8,46 no lado parético. No TUG verificou-se a velocidade média de 0,37 ± 0,14 m/s e no TV10M 0,63 ± 0,23 m/s. No TES a velocidade média foi 0,60 ± 0,25 m/s. Houve correlação forte e significante entre os valores de TUG, TV10M e TEX. Conclusão: O TES e TV10M são testes adequados para serem utilizados como critério de elegibilidade da velocidade inicial para treinos aeróbios, todavia o TES é capaz de revelar o tempo em que o paciente consegue manter a marcha. O TUG não revelou ser um bom instrumento para estabelecer a velocidade inicial do treinamento

Objective: To investigate the criteria for establishing the initial treadmill speed and create a functional or cardiorespiratory motor training for hemiparetic individuals. Methods: Fifteen chronic hemiparetic individuals were recruited and qualified by the Lower Extremity Motor Coordination Test (LEMOCOT) and submitted to gait evaluation through the Timed Up and Go (TUG), Stress Test (ST), and the 10-Meter Walk Test (10MWT). Results: The analysis of the LEMOCOT results showed a mean of 26.87 ± 9.76 target hits for the non-paretic side and 15.40 ± 8.46 for the paretic side. In the TUG, the average speed of 0.37 ± 0.14 m/s was found and in the 10MWT, 0.63 ± 0.23 m/s. In the ST the average speed was 0.60 ± 0.25 m/s. There was strong and significant correlation between the TUG, 10MWT, and ST values. Conclusion: The ST and 10MWT are suitable tests to be used as eligibility criteria for the initial speed of aerobic trainings, however the ST is able to reveal the time for which the patient is able to maintain the gait. The TUG did not prove to be a good instrument to establish the initial training speed

Histology and renal lipoperoxidation in rats exercised on a treadmill and submitted to water restriction / Histología y lipoperoxidación renal en ratas ejercitadas sobre una caminadora y sometidas a restricción de agua

Physical effort stimulates an increase in oxygen consumption in tissues, generating toxic chemical species derived from oxygen (ROS), which are considered the initiators of the lipid peroxidation process (LPO), the major mechanism of cellular injury. As the essential mechanism for maintaining the electrolyte balance depends on an effective kidney function, oxidative stress in this organ can be a key factor in the development and persistence of hypertension. This study aimed to determine the kidney changes induced by a combination of fluid restriction and exercise in rats. The study consisted of 24 male Wistar rats of 90 days of age, divided into four groups, two of which were submitted to water restriction and exercise on a treadmill.Twenty-four hours after the last training session, the animals were euthanized and the left kidney was removed.The upper part of the kidney was used for the histological procedures and the lower part for the quantification of membrane lipoperoxides.Analysis of variance was applied after testing the normality of data, and the comparison between groups was performed using the Bonferroni test, adopting a significance of p<0.05. The restriction had an influence on body weight; kidney weight; proximal tubule maximum diameter; and area, perimeter and diameter of glomeruli, whereas the exercise affected the weight and the minimum diameter of the proximal tubule. According to the TBARS (thiobarbituric acid reactive substances) method, there was a difference between the G1 (control) and G3 (sedentary with water restriction) and between the G2 (exercised with water) and G4 (exercised with water restriction) compared to G1. The treadmill exercise combined with the water restriction promoted structural changes in the glomeruli and promoted oxidative stress, although neither variable corroborated for the potentiating of lipid peroxidation.

El esfuerzo físico estimula un aumento en el consumo de oxígeno en los tejidos, generando variedades químicas tóxicas derivadas de oxígeno (ROS), que son considerados iniciadores del proceso de peroxidación lipídica (LPO), principal mecanismo de lesión celular. Como el mecanismo esencial para mantener el equilibrio de los electrolitos depende de una función renal eficaz, el estrés oxidativo en este órgano puede ser un factor clave en el desarrollo y persistencia de la hipertensión. Este estudio tuvo como objetivo determinar los cambios renales en ratas, inducidos por una combinación de restricción de líquidos y ejercicio. Esta investigación se realizó en 24 ratas Wistar machos de 90 días de edad, divididos en cuatro grupos, dos de los cuales fueron sometidos a restricción de agua, mientras que los dos grupos restantes fueron ejercitados en una caminadora. Veinticuatro horas después de la última sesión de entrenamiento, los animales fueron sacrificados y se realizó la extracción del riñón izquierdo. La parte superior del riñón se usó para los procedimientos histológicos y la parte inferior para la cuantificación de peróxidos lipídicos en la membrana. El análisis de varianza se aplicó después de probar la normalidad de los datos, y la comparación entre grupos se realizó mediante la prueba de Bonferroni, adoptando una significación de p<0,05. La restricción hídrica tuvo influencia sobre: el peso corporal, peso de los riñones, diámetro máximo del túbulo proximal, y área, perímetro y diámetro de los glomérulos. Mientras que el ejercicio afectó el peso y el diámetro mínimo del túbulo proximal de las ratas. Según el método SRAT (sustancias reactivas al ácido tiobarbitúrico), existió una diferencia entre el G1 (control) y G3 (sedentarismo con restricción de agua) y entre el G2 (ejercicio con agua) y G4 (ejercicio con restricción de agua) en comparación con G1. El ejercicio rodante combinado con la restricción de agua promovió cambios estructurales en los glomérulos y estimuló el desarrollo de estrés oxidativo, aunque ninguna variable fue corroborada para establecer la potenciación de la peroxidación lipídica.

Influence of cardiac rehabilitation in Primigravida with spontaneous coronary artery dissection during postpartum.

BACKGROUND: The physical exercise consists of trainable physical abilities such as strength and endurance. It can be inferred that the individual cardiac patient is dependent on it as an associated therapy to the drug treatment for a rapid and lasting improvement of their overall clinical status. CASE PRESENTATION: The patient - with Spontaneous Coronary Artery Dissection Postpartum period - was subjected to 21 sessions of cardiac rehabilitation. A physical evaluation was performed, before and after the treatment period, for data collection: anthropometric values, flexibility, aerobic capacity and strength of grip. CONCLUSION: The patient had a positive response in aerobic capacity, flexibility and grip strength and the anthropometric values were kept in short term rehabilitation.