Percutaneous lumbar discectomy: a systematic review / Discectomia percutânea lombar: uma revisão sistemática

Introduction: Low back pain is a clinical condition with a multifactorial etiopathogenesis, which has a high socioeconomic impact, especially in the economically active population, as it is associated with frequent absenteeism and reduced quality of life. Through intervertebral disc degeneration, a progressive instability of the compromised region is observed, triggering a harmful positive feedback mechanism that further promotes intervertebral disc disease. Built by the interaction between the predisposing biopsychosocial components, a multidisciplinary therapeutic proposition is suggested. In persistent low back pain, treatment involves surgical procedures such as Percutaneous Lumbar Discectomy. Objectives: to evaluate the scientific evidence regarding the clinical outcomes and safety of this surgery. Method: systematic review duly registered in Prospero (CRD42022370811), based on the PICOD question, elaborated from a Boolean search in different databases for scientific articles, evaluated and selected in a paired way based on the eligibility criteria. In addition to extracting data related to the proposed objectives, the articles included were evaluated in relation to their level of evidence and strength of recommendation. Results: among the 12 articles included, it was observed that it is a clinically effective and safe procedure. In the set of evidences gathered, they are of high and moderate level of evidence with respective strength of recommendation strong/good and weak/moderate. Conclusion: Percutaneous Lumbar Discectomy promotes significant reduction of pain and increase in body functionality, in addition to preserving local musculoskeletal structures and preventing post-surgical joint instability. It is, therefore, a safe and clinically effective minimally invasive procedure for patients with herniated discs.

Introdução: a lombalgia é uma condição clínica de etiopatogenia multifatorial, que desencadeia um elevado impacto socioeconômico especialmente na população economicamente ativa, por associar-se ao absenteísmo frequente e à redução da qualidade de vida. Observa-se mediante a degeneração do disco intervertebral, uma instabilidade progressiva da região comprometida desencadeando um mecanismo de feedback positivo prejudicial que promove ainda mais a doença do disco intervertebral. Edificada pela interação entre os componentes biopsicossocial predisponentes, sugere-se uma proposição terapêutica multidisciplinar. Na dor lombar persistente o tratamento envolve procedimentos cirúrgicos como a Discectomia Percutânea Lombar. Objetivo: avaliar as evidencias científicas relativas aos desfechos clínicos e à segurança desta cirurgia. Método: revisão sistemática devidamente registrada no Prospero (CRD42022370811), fundamentada na pergunta PICOD acrônimo para Paciente, Intervenção, Comparação, Desfechos (outcomes) e Design, elaborada a partir de busca booleana em diferentes bases de dados por artigos científicos, avaliados e selecionados de forma pareado com base nos critérios de elegibilidade. Além da extração de dados relativos aos objetivos propostos, os artigos incluídos foram avaliados em relação ao respectivo nível de evidencia e força de recomendação. Resultados: dentre os 12 artigos incluídos, observou-se que se trata de um procedimento clinicamente efetivo e seguro. No conjunto de evidencias reunidas são de alto e moderado nível de evidencia com respectiva força de recomendação forte/boa e, fraca/moderada. Conclusão: a Discectomia Percutânea Lombar promove relevante redução da dor e aumento da funcionalidade corporal, além de preservar as estruturas musculoesqueléticas locais e prevenir a instabilidade articular pós-cirúrgica. Trata-se, portanto, de um procedimento minimamente invasivo seguro e clinicamente efetivo para os pacientes portadores de hérnia discal.

Effects of the Whole-Body Vibration Exercise on Sleep Disorders, Body Temperature, Body Composition, Tone, and Clinical Parameters in a Child with Down Syndrome Who Underwent Total Atrioventricular Septal Defect Surgery: A Case-Report.

BACKGROUND: The health and developmental issues of people with Down syndrome (DS) are complex and are associated with many medical, psychological, and social problems from childhood through into adulthood. DS children have an increased risk of multiorgan comorbidities, including congenital heart disease. Atrioventricular septal defect (AVSD) is a congenital heart malformation that often occurs in DS people. AIM: Physical activity and exercise are recommended for patients with cardiovascular disease and are considered to be the gold standard of cardiac rehabilitation. Whole-body vibration exercise (WBVE) is considered a form of exercises. The aim of this case report is to show the effects of WBVE on sleep disturbances, body temperature, body composition, tone, and clinical parameters in a child with DS with corrected total AVSD. The subject is a 10-year-old girl, with free-type DS, who underwent surgery to correct a total AVSD at 6 months. She underwent periodic cardiological monitoring and was released to perform any type of physical exercise, including WBVE. WBVE improved sleep quality and body composition. CONCLUSION: WBVE leads to physiological effects that benefit the DS child.

Effects of whole-body vibration exercise in patients with chronic kidney disease: a systematic review.

PURPOSE: Chronic kidney disease (CKD) is a clinical condition that promotes a decline in the overall health status of individuals affected, including parameters physical, functional, and psychosocial. This systematic review was conducted to assess effects of whole-body vibration exercise (WBVE) in individuals with CKD. MATERIALS AND METHODS: It was conducted electronic searches in Pubmed, Embase, Scopus, Web of Science databases on May 2021. Records were identified and irrelevant studies were excluded based in eligibility criteria. RESULTS: Five studies were included with a mean methodological quality score of 9, considered high quality in PEDRo scale. The studies have shown that the WBVE intervention, when applied low intensity was well tolerated, and no adverse effects; was able to improve the motor performance and strength in frail people, which could benefit the prevention of falls events. However, did not improve the quality of life, and the heart rate variability; and not altered cardiorespiratory parameters. CONCLUSIONS: WBVE intervention promotes a better response in parameters of the motor performance and muscular strength, and interaction bone-muscle. Nevertheless, more studies are needed with this intervention to improve physiological responses, and to understand your recommendation to prevent and reduce the complications and symptoms of the CKD, promoting an active life to these patients. PROTOCOL STUDY REGISTRATION: PROSPERO (CRD42020203295).IMPLICATIONS FOR REHABILITATIONChronic kidney disease (CKD) is a clinical condition that promotes a decline in the overall health status of individuals affected, including parameters physical, functional, and psychosocial.WBVE program possibility, of good acceptance, efficient as well tolerated by physically deconditioned patients who present difficulty to perform any type of exercise.WBVE protocol can promote changes in the patient with CKD lifestyle and benefits for this population because is an exercise without fatigue, impact, stress, or discomfort.

The effects of whole-body vibration on cognition: a systematic review / Os efeitos da vibração de corpo inteiro na cognição: uma revisão sistemática

Porpouse: To systematically review the mechanisms by WBV improves the ability to learn, think, memorize and all other processes involving cognition. Methods: The present study collected data from three databases using the keywords "whole-body-vibration" and "cognition". Randomized clinical trials focusing on the association of WBV and cognition were considered. The study was registered in the database of systematic reviews protocols PROSPERO. All included studies used healthy patients, exposed to WBV. The included articles were obtained regarding the risk of bias according to the Cochrane Collaboration criteria, level of evidence and strength of recommendation following the GRADE and Oxford classification. Results: Of the 89 articles published to the eligibility criteria, four were submitted to data extraction. Cognitive parameters were improved in relation to attention, memory or learning in almost all articles evaluated in this systematic review. Conclusion: Intervention with WBV would positive effects on individuals' cognitive ability, although further randomized investigations must be conducted. PROSPERO registration number: CRD42020203679

Objetivo: Revisar sistematicamente os mecanismos pelos quais a vibração de corpo inteiro (VCI) melhora a capacidade de aprender, pensar, memorizar e todos os outros processos que envolvem a cognição. Método: O presente estudo coletou dados de três bancos de dados usando as palavras-chave "vibração de corpo inteiro" e "cognição". Ensaios clínicos randomizados com foco na associação de WBV e cognição foram considerados. O estudo foi registrado no banco de dados de protocolos de revisões sistemáticas PROSPERO. Todos os estudos incluídos usaram pacientes saudáveis, expostos à VCI. Os artigos incluídos foram avaliados quanto ao risco de viés de acordo com os critérios da Colaboração Cochrane, nível de evidência e força de recomendação segundo a classificação GRADE e Oxford. Discussão e Resultados: Dos 89 artigos publicados, de acordo com os critérios de elegibilidade, quatro foram submetidos à extração de dados. Os parâmetros cognitivos, atenção, memória e aprendizagem demonstraram melhora em quase todos os artigos avaliados nesta revisão sistemática. Conclusão: A intervenção com VCI teria efeitos positivos na capacidade cognitiva dos indivíduos, embora mais ensaios clínicos randomizadas devam ser realizados para avaliação de tais parâmetros. Número de registro PROSPERO: CRD42020203679

Use of health services by the population living in contaminated areas in the region of the Santos and São Vicente estuarine system, Brazil.

Objective: To relate the socio-demographic profile with access to health services of the population living in environmentally degraded areas in an estuary region.Study design: A sectional field study of 8819 people, evaluating three contaminated areas of São Vicente.Methods: Households were divided by studied area. A structured and pre-tested questionnaire was applied to obtain the data. A probabilistic sample was used. The prevalence of each of the outcomes of interest by area was calculated. To verify the existence of an association between the outcomes of interest and other variables (qualitative), by area, a descriptive analysis and to compare percentages and a comparison test was used between two proportions, a Chi-square test and/or a Fisher's exact test and a Kruska-wallis and Dunn multiple comparison were used as well. The significance level was 5%.Results: Most residents (94%) reported the use of public health services at least once a year (p < 0.001), mainly through the Basic Health Units (BHU) (p < 0.001). Most of the studied population (65%) did not have private health insurance and their schooling was basically restricted to primary education (p < 0.001). The predominant family income (70%) in the three areas was between one and five minimum wages (p < 0.001), with a higher incidence of people receiving one to three minimum wages at the time. The demand for health services was not associated with education or income.Conclusion: The population of the regions analysed heavily rely on the Unified Health System - SUS, but there was no association between income and frequency of health services and there was also no association between education and use of health services.

Reported quality of life in countries with cases of COVID19: a systematic review.

INTRODUCTION: Considering the relevance of the quality of life (QoL) and the consequences of the 2019 new coronavirus disease (COVID-19) due to the social distancing, this systematic review aimed to summarize effects of the COVID-19 in the QoL of the studied populations. AREAS COVERED: Four databases, the methodological quality and the risk of bias in selected publications were investigated. Seven thousand and fifty-one individuals from Italy, Saudi Arabia, China, and Vietnam. Online system and printed questionnaires were used to assess the QoL, as patients affected by primary antibody deficiencies, residents, people from endemic and no endemic regions, and individuals with COVID-19. Different types of questionnaires are utilized to evaluate health-related quality of life (HRQOL). The methodological quality of three papers was good with low risk of bias and a decrease in the QoL. EXPERT OPINION: The QoL of studies populations where COVID-19 was reported, worsened. Nevertheless, considering some indicators (infant mortality, average income, life expectancy, health coverage, and average schooling years), the standard of life and subsequently the quality of life among the presented countries (China, Vietnam, Italy, and Saudi Arabia) are different. Therefore, the simple comparison of these populations and the conclusions from this comparison must be done carefully.

The use of active methodologies as teaching strategies of measuring blood pressure / O uso das metodologias ativas como estratégias de ensino da medida da pressão arterial

BACKGROUNG: Blood pressure (BP) measurement is part of the physical examination performed by students in the health field. Active methodologies may be linked to the education system, with positive contributions to knowledge about BP measurement stepsOBJECTIVE: Compare knowledge about blood pressure measurement steps, before and after an educational intervention among physiotherapy and medical studentsMETHODS: Quasi-experimental study, with a single group that will be in control of itself, before and after the intervention, carried out in the year 2020. The evaluations were based on the active methodologies: KAHOOT, theoretical evaluation, and the OSCE method for practical evaluation. An educational intervention was carried out, using the Inverted Classroom, followed by debates, using practice and simulation for better learning. In the pre and post-intervention comparison, the Wilcoxon test was used on the theoretical and practical knowledge of students regarding blood pressure measurementRESULTS: A total of 81 students, mean age 22.31 + 3.24 years. In the theoretical knowledge, from the KAHOOT, in the comparison before and after the educational intervention, a significant difference was observed in the total number of correct answers (p <0.001), except in the "patient position" step (p = 0.227). In the analysis of practical knowledge, from the checklist used in the OSCE, there was a significant improvement after the pedagogical intervention in all analyzed stages (p = 0.001CONCLUSION: educational intervention with active methodologies inverted classroom, KAHOOT, and OSCE were useful in apprehending knowledge about Blood Pressure measurement and suggests studies of broader scope

INTRODUÇÃO: A medida da pressão arterial é parte do exame físico realizado por estudantes da área da saúde. Metodologias ativas podem estar vinculadas ao sistema de ensino, com contribuições positivas para o conhecimento sobre as etapas da medida da PAOBJETIVO: Comparar o conhecimento sobre as etapas da medida da PA, pré e pós uma intervenção educativa entre estudantes de fisioterapia e medicinaMÉTODO: Estudo quase experimental, com grupo único que será controle dele mesmo, antes e depois da intervenção, realizado no ano de 2020, na Unifran. As avaliações foram baseadas nas metodologias ativas: KAHOOT, para avaliação teórica, e o método OSCE para avalição prática. Realizou-se uma intervenção educativa, com o recurso da Sala de Aula Invertida, seguida de debates, utilizando a prática e simulação para melhor aprendizado. Utilizou-se o teste de Wilcoxon, na comparação pré e pós intervenção, sobre o conhecimento teórico e prático dos estudantes referentes à medida da PARESULADOTS: 81 estudantes, idade média de 22,31+3,24 anos. No conhecimento teórico, a partir do KAHOOT, na comparação pré e pós intervenção educativa, observou-se diferença significativa no total dos itens de acertos (p<0,001), exceto na etapa "posição do paciente" (p=0,227). Na análise do conhecimento prático, a partir do checklist utilizado no OSCE, houve melhora significativa após a intervenção educativa em todas as etapas analisadas (p=0,001CONCLUSÃO: a intervenção educativa com metodologias ativas Sala de aula invertida, KAHOOT e OSCE foram efetivas na apreensão de conhecimento sobre a medida da PA e sugere estudos de maior amplitude

Development, validation and reliabilty of a questionnaire to evaluate the changes on the level of physical exercises and in daily life habits due to COVID-19 pandemic social distancing.

BACKGROUND AND AIM: Physical inactivity is expected to happen during the COVID-19 pandemic through home quarantine measures. The aim of this study was to develop, validate and perform the reliability of the questionnaire "Physical exercise (PE) level before and during social isolation (PEF-COVID19)" to evaluate the level of PE during the social distancing due to the COVID-19 pandemic and to try to identify changes in the daily life of the individuals. METHODS: This transversal study was developed to measure psychometric properties of the questionnaire PEF-COVID19. The survey was divided into 4 sections including subjects' characterization, social isolation update and physical exercise performed, pain, anxiety and stress before and during COVID-19 pandemic. After the survey construction in Portuguese language (Brazil), the survey was transferred to an online digital platform (Google® forms). The Construct, Clarity and Relevance Validation strategy was judged by a panel of experts and the validity index (VI) were calculated. The reliability was evaluated through the test-retest interrater reliability and measured through the intraclass correlation coefficient (ICC) and Kappa coefficient (KC). RESULTS: Twenty-five experts participated of the survey validity and 34 respondents from the target population participated of the test-retest reliability. The general average measures for VI were all above 0.84 and test-retest ICC and KC were 0.89 and 0.88, respectively. CONCLUSIONS: This survey was considered valid and reliable to be applied to the general population over 18 years-old to investigate the PE practice and psychological aspects during the social distancing due to the COVID-19 pandemic, a public health problem.

Brazil before and during COVID-19 pandemic: Impact on the practice and habits of physical exercise.

INTRODUCTION: The goal of this study was to investigate the practice and habits of physical exercise impact due to COVID-19 social isolation before and during the outbreak in Brazil and its mains macro-regions, which have social and economic disparities. METHODS: This is an observational cross-sectional study through an online questionnaire survey. A self-administered survey (PEF-COVID19) was applied in the Brazilian general population, age ≥ 18 years. T-test for independent samples and Chi-square tests were used to compare Brazil and different macro-regions, p˂0.05. RESULTS: 1,977 participants filled the survey and 1,845 were included; 80% of the included ones were in social isolation. In general, the self-related physical exercise practice before and during the COVID-19 pandemic and exercise characteristics were highly affected by the pandemic (p˂0.05). Sedentary behavior increased significantly (14.9 vs. 29.8%) and between the active ones, the frequency of PEx per week and duration of the PEx practice decreased significantly. The motivation to exercise also changed considering performance and health before and during the pandemic, respectively (10 vs. 5.6% and 72.4 vs. 79.1%). Also, the sample started to exercise less in the night and more in the afternoon, respectively (33.7 vs. 25.3% and 19.1 vs. 31.5%). CONCLUSIONS: The COVID-19 pandemic highly influenced the physical exercise practice and habits (frequency, duration, motivation, period to exercise) in Brazil and its main macro-regions. These results can be used to create measures, as home-based exercise programs, to avoid the harm of sedentary behaviors and mental health impact during and after the pandemic.

Incidence and characteristics angiographic of patients with acute myocardial / Incidência e características angiográficas de pacientes com doença miocárdica aguda

Background: Acute myocardial infarction (AMI) is defined as the death of cardiomyocytes due to prolonged ischemia, caused by thrombosis and / or vasospasm on an atherosclerotic plaque. Objective: To determine the incidence of patients with myocardial infarction undergoing primary angioplasty; characterize the anthropometric variables and identify the risk factors in this population. Methods: This was a cross-sectional, observational, retrospective study in which we collected secondary data from medical records of a hospital in a city in the state of São Paulo, where the largest number of interventions is via Public Health System, patients with a diagnosis of Myocardial Infarction, undergoing primary coronary angioplasty, from January 2011 to December 2013. Results: The total sample consisted of 437 subjects, 282 male and 155 female. In this study, there was predominance of myocardial infarction in the anterior descending artery ADA (45.51%), followed by right coronary artery RCA (38.46%), in carrying out the rescue angioplasty and stent implantation in 96.62% of cases. There was a predominance of high blood pressure as risk factors for 73.71%, followed by smoking with 41.66% of the sample. Conclusion: According to the present study data, it appears a higher prevalence of infarction occurred in the ADA, with individuals performing the rescue angioplasty procedure and the placement of the stent, and a growing incidence of drug stent placement. We observed a high incidence of risk factors, prevailing hypertension

Estratégia de monitoramento da fadiga orgânica em um grupo de idosos cardiopatas inseridos no programa de reabilitação cardíaca / Monitoring strategy of organic fatigue in a group of elderly cardiac patients entered in the cardiac rehabilitation program

Este estudo teve como objetivo identificar a ocorrência de fadiga, a qualidade do sono, e o padrão morfológico do estresse oxidativo em 11 pacientes cardiopatas submetidos à intervenção fisioterapêutica para reabilitação físico-funcional. Trata-se de um estudo observacional, longitudinal e amostra de conveniência. Os resultados mostraram que programas de reabilitação cardíaca são fundamentais para mudanças no estilo de vida e redução de novos eventos cardiovasculares. Conclui-se que idosos portadores de doença coronariana, submetidos ao programa de reabilitação cardíaca baseado na intervenção cinesioterapêutica, apresentam-se sem fadiga orgânica, com uma boa qualidade de sono, sob um estresse oxidativo com variação entre os níveis normal, leve ou moderado.

This study aimed to identify the occurrence of fatigue, sleep quality and morphology of oxidative stress in 11 patients with heart disease who underwent physical therapy intervention for physical and functional rehabilitation. This is an observational, longitudinal and convenience sample. The results showed that cardiac rehabilitation programs are fundamental to changes in lifestyle and reduction of new cardiovascular events. We conclude that elderly patients with coronary artery disease undergoing cardiac rehabilitation program based on kinesiotherapy intervention, contain no organic fatigue, with a good quality of sleep, under oxidative stress ranging between normal, mild or moderate levels.

Equilíbrio, autonomia e independência funcional de idosos ativos e sedentários: estudo preliminar / Balance, autonomy and functional independence of active and sedentary elderly: a preliminary study

Tanto o equilíbrio corporal (EC), quanto a autonomia funcional (AF) e o nível de independência (NIF) de 10 idosos sedentários (GI) foram avaliados e comparados aos dados correlatos em 10 idosos ativos (GII), todos do programa de saúde da família em Araxá (MG). Após assinarem o TCLE, foram submetidos aos testes de avaliação do EC, da AF e do NIF, além da identificação do IMC. Apesar do sobrepeso corporal e do NIF igual entre ambos, o EC e AF no GII foram significativamente maiores do que o GI, Concluímos que a prática de exercícios terapêuticos promove a saúde funcional no idoso.

Both the body balance (BB), as the functional autonomy (FA) and the level of functional independence (FI) of 10 sedentary elderly (GI) were evaluated and compared to related data in 10 active elderly (GII), all of the health program family in Araxá-MG), after signing the informed consent, were submitted to the evaluation tests of the EC, the AF and the NIF, besides the identification of BMI. Although body overweight and equal NIF between both the EC and AF were significantly higher in GII than in GI, we concluded that the practice of therapeutic exercise promotes functional health in the elderly.

Analysis of cardiac exams: electrocardiogram and echocardiogram use In Duchenne muscular dystrophies / Análise dos exames cardiológicos: eletrocardiograma e do ecocardiograma em Distrofia Muscular de Duchenne

Introduction Duchenne Muscular Dystrophies (DMD) is a genetic muscle disorder that causes degeneration and atrophy of skeletal muscle and heart. Objective The aim of this survey is accomplish an evaluation electrocardiographic and echocardiography in the patients bearers of Duchene Muscular Dystrophies (DMD), to observe which alterations, which the degree of cardiac compromising these patient present and the effectiveness of these exams in the evaluation cardiologic. Methods Nine patients of the sex male bearers of DMD, with medium age of 14.12 ± 4.19 years, varying of 7 to 23 years were appraised. All were submitted to the evaluation physiotherapy and the cardiologic: electrocardiogram and echocardiogram. Results The experimental conditions of the present survey we propitiate the observation of the alterations echocardiography, as well as: significant increase in the diastolic diameter of the left ventricular (LV), increase in the systolic diameter of the left atrium (LA), and significant decrease of the ejection fraction of the LV, characterizing global systolic function reduced, and of the alterations electrocardiographic suggested possible overload of RV, septum hypertrophy, blockade of left previous fascicle and overload of atrium left. Compatible alterations of hypertrophy left ventricular were not observed. Conclusion The evidences corroborate with the data described in the literature in the characterization of an important heart compromising that these patient present, like this the evaluation cardiologic, through the complemented exams of the echocardiography and electrocardiography provide important information for the prognostic, the accompaniment, and the treatment of patient bearers of DMD. .

Introdução A Distrofia Muscular de Duchenne (DMD) é uma desordem muscular de origem genética que causa degeneração e atrofia da musculatura estriada esquelética e cardíaca. Objetivo Realizar uma avaliação eletrocardiográfica e ecocardiográfica dos pacientes portadores de Distrofia Muscular de Duchenne, observando quais as alterações presentes, o grau de comprometimento cardíaco e a eficácia destes exames na avaliação cardiológica. Métodos Foram avaliados 9 pacientes do sexo masculino portadores de DMD, com idade média de 14,12 ± 4,19 anos, variando de 7 a 23 anos. Todos foram submetidos à avaliação fisioterápica e aos exames cardiológicos: eletrocardiograma e ecocardiograma. Resultados As condições experimentais do presente trabalho nos propiciam a observação de alterações ecocardiográficas, bem como: aumento significativo no diâmetro diastólico do ventrículo esquerdo, aumento do diâmetro sistólico do átrio esquerdo, e diminuição significativa da fração de ejeção do ventrículo esquerdo, caracterizando função sistólica global diminuída, e das alterações eletrocardiográficas que mostraram possível sobrecarga de ventrículo direito, hipertrofia septal, bloqueio de fascículo anterior esquerdo e sobrecarga de átrio esquerdo. Não foram observadas alterações compatíveis de hipertrofia ventricular esquerda no eletrocardiograma. Conclusão As evidências corroboram com os dados descritos na literatura na caracterização de um comprometimento cardíaco importante apresentado por estes pacientes, assim a avaliação cardiológica, através dos exames complementares de ecocardiográfica e ...

Análise das variáveis hemodinâmicas no posicionamento gravitacional / Analysis of hemodynamic variables on gravitational positioning

INTRODUÇÃO: O sistema nervoso autônomo governa, a curto e médio prazo, as modificações necessárias para adaptação da pressão arterial e da frequência cardíaca às mudanças posturais. OBJETIVO: Analisar as variáveis hemodinâmicas em indivíduos saudáveis quando submetidos ao posicionamento gravitacional. MATERIAIS E MÉTODOS: Sessenta indivíduos saudáveis, divididos por faixa etária em três grupos: GI (n = 20), de 15 a 20 anos, GII (n = 20), de 21 a 40 anos, GIII (n = 20), de 41 a 60 anos. Todos foram submetidos ao posicionamento gravitacional e tiveram tanto a frequência cardíaca quanto a pressão arterial monitoradas durante todo o tempo de inversão. RESULTADOS: Houve diminuição significativa da frequência cardíaca e da pressão arterial sistólica após 3, 6, 9 e 12 minutos de inversão quando comparado aos valores de repouso, porém 3 minutos após o retorno à posição ortostática, essas variáveis retornaram aos valores basais. Em relação à pressão arterial diastólica, não foi verificada diminuição significativa no GI e no GII 3 minutos após a inversão, mas no GIII houve queda significativa. Após 6 minutos de inversão somente o GI apresentou queda significativa. Analisando 9 minutos após o posicionamento, somente o GIII apresentou queda significativa. Após 12 minutos de inversão, houve queda da pressão arterial diastólica somente no GIII quando comparado com os valores em repouso. Retornando à posição vertical, todos os grupos retornaram aos valores basais. CONCLUSÃO: O posicionamento gravitacional altera as variáveis hemodinâmicas, causando queda nos valores da frequência cardíaca e pressão arterial durante o período de inversão.

INTRODUCTION: The autonomic nervous system governs the short and medium term, the necessary modifications to adapt blood pressure and heart rate to changes in posture. OBJECTIVE: To analyze the hemodynamics variables in healthy individuals when subjected to positional gravity. MATERIALS AND METHODS: Sixty healthy individuals, divided in groups based on age, being GI (n = 20), from 15 to 20 years old, GII (n = 20), from 21 to 40 years old, GIII (n = 20) from 41 to 60 years old, being submitted to the position gravity through the GPS equipment and they had the cardiac frequency and blood pressure monitored throughout all the time of inversion. RESULTS: A significant reduction of heart rate and blood pressure in the rest position when compared after 3, 6, 9 and 12 minutes of inversion, however 3 minutes after return to the orthostatic position this variables came back near to the baseline. About the blood pressure diastolic, it was not observed a significant decrease in the GI and GII group in the rest position when compared after 3 minutes; however in the GIII group it was observed a significant drop. After 6 minutes of inversion only the GI group showed a significant drop. When analyzed 9 minutes after the position, only the GIII group showed a significant dro. After 12 minutes the inversion, it was also showed a blood pressure diastolic drop only in GIII group when compared to the values of the rest position. Returning to the vertical position, all groups returned to the baseline values after 3 minutes. CONCLUSION: The gravitational positioning changes the hemodynamics variables causing a drop of the values of the heart rate and the blood pressure during the inversion period.

Estresse oxidativo no plasma sanguíneo de indivíduos submetidos ao esforço físico agudo seguido de crioimersão corporal / Oxidative stress in blood plasma in persons who are submitted to cold water immersion after acute physical exercise

O objetivo deste estudo foi analisar a influência da crioimersão corporal (CIC) imediata ao esforço físico agudo no estresse oxidativo (EOx) no plasma sanguíneo. Participaram do presente estudo 12 homens, com idade média de 22±1 anos, submetidos ao teste de esforço físico intenso em esteira, seguido de CIC em um tanque com água a 10ºC durante 10 minutos contínuos. Do repouso ao final da CIC, os indivíduos foram monitorados através de alguns parâmetros como: o índice de percepção subjetiva do esforço (IPE) expresso conforme escala de Borg, frequência cardíaca (FC), pressão arterial (PA) e temperatura corporal (TC) através da temperatura timpânica. A análise morfológica do EOx plasmático foi realizada de acordo com o método denominado Morfologia Óptica do Estresse Oxidativo no Plasma (MEOP), utilizando-se gotas de sangue capilar. Observou-se uma significativa elevação (p<0,01) no grau do estresse oxidativo plasmático após a realização do esforço físico, em relação ao respectivo grau em repouso. Porém, esta elevação no grau do EOx foi significativamente reduzida (p<0,001) em função da CIC. Embora sejam necessários mais estudos científicos com o MEOP, concluiu-se que, para o presente estudo, este teste mostrou-se viável. Os dados encontrados no presente estudo sugerem que a CIC em água a 10ºC por 10 minutos imediatos ao esforço físico agudo com intensidade alta, apresenta-se como uma importante conduta fisioterapêutica para a normalização do EOx pós-esforço.

The purpose of this study was to analyze the influence of cold water immersion (CWI) following acute physical exercise on the oxidative stress in the blood plasma. Twelve men with average age of 22±1 years old, participated this study. All of them underwent the treadmill stress test followed by CWI in tank with water at 10ºC for 10 minutes. During this process, they were monitored and a set of parameters were analyzed: physical effort perception (Borg Scale), Heart Rate (HR), Blood Pressure (BP) and body heat, by measuring tympanic temperature. The morphological analysis of oxidative stress in blood plasma was done in accordance with a method known as Optical Morphology of the Oxidative Stress on Blood Plasma, which uses drops of capillary blood. A significant increase (p<0.01) in the rate of oxidative stress in plasma was noted after intense physical effort when compared with the rate of stress while at rest. However, the stress rate was significantly decreased (p<0.001) after CWI. Although further scientific studies should be carried out on the above mentioned test, may be concluded that, in the present study, the test has proven itself viable. The data found in the present study suggest that cold water immersion at 10ºC for 10 minutes following high intensity physical effort appears to be an important physical therapeutic measure towards the normalization of oxidative stress.

Prevalence of sport injuries during the 53th Regional Games in Franca (SP), Brazil / Prevalência de lesões esportivas durante os 53os Jogos Regionais em Franca (SP), Brasil

The purpose of this study was to perform a survey about the prevalence, type and location of the injuries occurred in athletes of different modalities during the 53th Regional Games held in 2009. A total of 182 injured athletes being treated at the physical therapy clinic were included. Physical Therapy evaluation was performed to determine the anatomic location and type of injury, as well the sport modality. The results showed that mean age, height, weight and BMI were 23 years (±5.9), 1.73 m (±0.11), 71 kg (±14.22) and 24 kg/m2 (±4) respectively. Proportionality to the number of athletes, handball athletes presented with higher number of injuries (4.25%), followed by indoor soccer players (3.7%), basketball (2.48%), volleyball (1.72%) and soccer (1.63%). The most common type of injury were sprains with 29.7% of cases (n=54) and mostly from soccer players; followed by contracture – 26.9% (n=49), mostly from basketball players; and contusion –25.8% (n=47), mostly from handball and indoor soccer players. The type of injury showed a significant association with the sports modality (p=0.0016). The lower limbs accounted for 71.4% of all injuries including knee (23.1%), ankle (18.1%), thigh (17.0%), leg (10.4%) and spine (9.9%). Preventive actions to avoid athletes' injury should be implemented in order to reduce the number of injuries in sports competitions such as in the Regional Games.

O objetivo do presente estudo foi investigar a prevalência, tipo e localização anatômica das lesões nos atletas durante os 53os Jogos Regionais de 2009. No total, 182 atletas participaram do estudo. A avaliação fisioterápica incluiu dados como local e tipo de lesão e modalidade esportiva. Os resultados mostraram que a média de idade, altura, peso e IMC foram respectivamente 23 anos (±5,9), 1,73 m (±0,11), 71 kg (±14,22) e 24 kg/m2 (±4). Proporcionalmente ao número de atletas, o handball foi a modalidade esportiva que apresentou maior número de lesões (4,25%), seguidos pelos atletas de futsal (3,70%), de basquete (2,48%), de voleibol (1,72%) e de futebol (1,63%). O tipo de lesão mais comum foi entorse com 29,7% dos casos (n=54), ocorridos com maior frequência em jogadores de futebol; seguido de contratura – 26,9% (n=49), ocorridos com maior frequência em jogadores de basquete; e contusão – 25,8% (n=47), ocorridos com maior frequência em jogadores de handball e futsal. O tipo de lesão mostrou significativa associação com o tipo de esporte praticado pelo atleta (p=0,0016). Os membros inferiores representaram 71,4% de todas as lesões, sendo o joelho o local mais acometido, com 23,1% dos casos, seguido do tornozelo – 18,1%, coxa – 17%, perna – 10,4% e coluna vertebral – 9,9%. Programas de prevenção para os atletas devem ser desenvolvidos e implantados a fim de reduzir o número de lesões em competições esportivas como os Jogos Regionais.

The effects of high-intensity resistance exercise on the blood lipid profile and liver function in hypercholesterolemic hamsters.

It is well established that atherogenic dyslipidemia, characterized by high levels of triglycerides (TG), total cholesterol (TC), and low-density lipoprotein (LDL) cholesterol and low levels of high-density lipoprotein (HDL) cholesterol, constitutes important risk factors for cardiovascular disease. Regular exercise has been associated with a reduced risk for metabolic diseases. However, studies supporting the concept that resistance exercise is a modifier of blood lipid parameters are often contradictory. The aim of this study was to investigate the effects of high-intensity resistance exercise on the serum levels of TG, TC, HDL and non-HDL cholesterol, glucose, and the liver function enzymes alanine aminotransferase (ALT, EC 2.6.1.2) and aspartate aminotransferase (AST, EC 2.6.1.1) in golden Syrian hamsters (Mesocricetus auratus (Waterhouse, 1839)) fed a hypercholesterolemic diet. Sedentary groups (S) and exercise groups (E) were fed a standard diet (SS and ES) or a cholesterol-enriched diet (standard plus 1% cholesterol, SC and EC). Resistance exercise was performed by jumps in the water, carrying a load strapped to the chest, representing 10 maximum repetitions (10 RM, 30 s rest, five days per week for five weeks). Mean blood sample comparisons were made by ANOVA + Tukey or ANOVA + Kruskal-Wallis tests (p < 0.05) to compare parametric and nonparametric samples, respectively. There were no differences in blood lipids between the standard diet groups (SS and ES) (p > 0.05). However, the EC group increased the glucose, non-HDL, and TC levels in comparison with the ES group. Moreover, the EC group increased the TG levels versus the SC group (p < 0.05). In addition, the ALT levels were increased only by diet treatment. These findings indicated that high-intensity resistance exercise contributed to dyslipidemia in hamsters fed a hypercholesterolemic diet, whereas liver function enzymes did not differ in regards to the exercise protocol.

Effects of kinesiotherapy in ischemic lesion and reperfusion in rats.

OBJECTIVE: To investigate the effect of kinesiotherapy on the functionality of the pelvic limb of rats after ischemic and reperfusion injury. METHODS: 10 rats were divided into two groups, GI (control) and GII (kinesiotherapy). All the animals underwent ischemia for a period of three hours, followed by tissue reperfusion. In Group GII, non-resistive systemic kinesiotherapy was performed (swimming) in three weekly sessions of 50 minutes, over a period of four weeks, while the GI animals remained at rest. Functional analysis of motor behavior was evaluated weekly. The animals were then sacrificed, and the soleus and gastrocnemius muscles and the sciatic nerve removed for histopathological analysis. RESULTS: There was a significant recovery of motor behavior with kinesiotherapeutic treatment during the four weeks of treatment. However, the histological examination of the tissues showed no morphological changes of cell injury and repair. CONCLUSION: It was not possible to affirm that the exercise was effective in cell repair, because neither of the groups (control and experimental) showed any histological difference. On the other hand, systemic kinesiotherapy showed a beneficial effect on functional rehabilitation after ischemia and reperfusion. Level of evidence III, Case-Control Study .

Efeito da cinesioterapia na lesão isquêmica e reperfusão em ratos / Effects of kinesiotherapy in ischemic lesion and reperfusion in rats

OBJETIVO: Verificar o efeito da cinesioterapia na funcionalidade do membro pélvico de ratos após lesão isquêmica e reperfusão. MÉTODOS: Foram utilizados 10 ratos, divididos em dois grupos, GI (controle) e GII (cinesioterapia). Todos os animais foram submetidos à isquemia por um período de três horas, seguido de reperfusão tecidual. No Grupo GII foi realizado cinesioterapia sistêmica (natação) não resistida em três sessões semanais de 50 minutos durante quatro semanas, enquanto que no grupo GI os animais permaneceram em repouso. A análise funcional do comportamento motor foi realizada semanalmente. Posteriormente, os animais foram mortos e retirados os músculos sóleo, gastrocnêmio e nervo ciático para análise histopatológica. RESULTADOS: Houve uma recuperação significativa do comportamento motor com o tratamento cinesioterapêutico ao longo das quatro semanas de tratamento. No entanto, na avaliação histológica os tecidos não mostraram alterações morfológicas de lesão e reparação celular. CONCLUSÃO: Não foi possível afirmar que o exercício mostrou-se eficiente na reparação celular, pois, tanto no grupo controle como no experimental, não apresentou diferença histológica. Por outro lado, a cinesioterapia sistêmica apresentou um efeito benéfico na reabilitação funcional após isquemia e reperfusão. Nível de Evidência III, Estudo Caso-Controle.

OBJECTIVE: To investigate the effect of kinesiotherapy on the functionality of the pelvic limb of rats after ischemic and reperfusion injury. METHODS: 10 rats were divided into two groups, GI (control) and GII (kinesiotherapy). All the animals underwent ischemia for a period of three hours, followed by tissue reperfusion. In Group GII, non-resistive systemic kinesiotherapy was performed (swimming) in three weekly sessions of 50 minutes, over a period of four weeks, while the GI animals remained at rest. Functional analysis of motor behavior was evaluated weekly. The animals were then sacrificed, and the soleus, gastrocnemius and sciatic nerve removed for histopathological analysis. RESULTS: There was a significant recovery of motor behavior with kinesiotherapeutic treatment during the four weeks of treatment. However, the histological tissues showed no morphological changes of cell injury and repair. CONCLUSION: It was not possible to affirm that the exercise was effective in cell repair, because neither of the groups (control and experimental) showed any histological difference. On the other hand, systemic kinesiotherapy showed a beneficial effect on functional rehabilitation after ischemia and reperfusion. Level of evidence III, Case-Control Study.

Treinamento de resistência elástica em programa de reabilitação cardiovascular / Elastic resistance training in a cardiovascular rehabilitation program

Fundamentos: A inserção de treinamento resistido em programa de reabilitação cardiovascular ainda é assunto novo que necessita de vários estudos. Objetivo: Comparar as respostas de frequência cardíaca (FC) e de pressão arterial(PA) em repouso, decorrentes do treinamento aeróbio e de resistência elástica realizados em diferentes momentos. Métodos: Foram estudados 9 indivíduos do sexo masculino, cardiopatas, incluídos em programa de reabilitação cardiovascular, com idade média de 63 + ou menos 5,05 anos. Todos foram submetidos a um total de 12 sessões de exercícios aeróbios na bicicleta ergométrica, três vezes por semana, durante 50 minutos, intensidade 60 por cento da frequência cardíaca máxima. A frequência cardíaca e a pressão arterial foram mensuradas durante todo o período de treinamento. Após as 12 sessões de treinamento aeróbio, os indivíduos foram submetidos à avaliação de força inicial para dar inicio ao treinamento...