Efeitos do treinamento de caminhada em esteira sobre o equilíbrio e sintomas motores de pessoas com doença de parkinson: uma revisão da literatura / Effects of treadmill walking training on balance and motor symptoms in parkinson's disease: a literature review

A doença de Parkinson (DP) apresenta prejuízo no equilíbrio e piora de sintomas motores, os quais podem aumentar o risco de quedas. O exercício físico tem se mostrado uma estratégia eficaz para combater os sintomas e o avanço da DP. A caminhada parece ser uma das estratégias mais utilizadas dentro da reabilitação na DP. Além disso, a caminhada realizada em esteira parece ser segura e eficaz para o tratamento da DP. No entanto, para nosso conhecimento, não foi realizada uma revisão abrangente da literatura que aborde os efeitos do treinamento físico de caminhada em esteira sobre o equilíbrio e sintomas motores de indivíduos com DP. Diante disso, o objetivo do presente estudo foi comparar os efeitos do treinamento físico de caminhada em esteira sobre o equilíbrio, medido por meio da escala de equilíbrio de Berg (EEB) e sintomas motores, medido por meio da escala UPDRS-III ou UPDRS-M (Unified Parkinson's disease rating scale ­ III ou motor scale) em indivíduos com DP. Foi realizada uma busca na literatura nas bases de dados PubMed e SciELO utilizando as seguintes palavras-chave: "Parkinson disease", "Walking" e "Exercise". Um total de 11 artigos foram incluídos para leitura na íntegra. Ao fim do processo de leitura, foram incluídos oito artigos para extração dos dados. Foi observado que existem diferentes modelos de treinamento físico de caminhada em esteira, sendo que o mais utilizado é com a suspensão do peso corporal, aparecendo em cinco artigos. Além disso, um estudo investigou os efeitos da caminhada nórdica em esteira, e outros dois investigaram os efeitos da caminhada convencional em esteira com modelo de prescrição baseado na velocidade autosselecionada. Todos estudos demonstraram efeito positivo do treinamento físico de caminhada, demonstrando melhora no equilíbrio funcional e sintomas motores de indivíduos com DP quando comparados a um grupo controle. (AU)

Parkinson's disease (PD) impairs balance and worsens motor symptoms, increasing the risk of falls. Physical exercise has been shown to be an effective strategy to combat the symptoms and progress of PD. Walking seems to be one of the most used strategies within PD rehabilitation. In addition, walking on a treadmill appears to be safe and effective for the treatment of PD. However, to our knowledge, a comprehensive literature review that addresses the effects of physical walking training on the treadmill on balance and motor symptoms of individuals with PD has not been performed. Therefore, the aim of the present study was to compare the effects of physical training in treadmill walking on balance, measured using the Berg balance scale and motor symptoms, measured using the UPDRS-III or UPDRS-M scale (Unified Parkinson's disease rating scale - III or motor scale) in individuals with PD. A literature search was performed in the PubMed and SciELO databases using the following keywords: "Parkinson's disease", "Walking" and "Exercise". At the end of the selection process, eight articles were included for data extraction. It was observed that there are different models of physical training for walking on a treadmill, the most used being with the suspension of body weight, appearing in five articles. In addition, one study investigated the effects of Nordic walking on a treadmill, and two others investigated the effects of conventional walking on a treadmill with a prescription model based on self-selected speed. All studies demonstrated a positive effect of physical walking training, showing improvement in the functional balance and motor symptoms of individuals with PD when compared with control group. (AU)

A comparative study on the recruitment of shoulder stabilizing muscles and types of exercises.

The shoulder is susceptible to disturbances caused by microtraumas due to direct contact of the surrounding skeletal structures or failure of the soft parts of the rotator cuff and other muscles inserted into the glenohumeral joint. The purpose of the study was to compare the electromyographic signal in the stabilizing muscles of the shoulder during the diagonal elevation exercise as recommended by the proprioceptive neuromuscular facilitation (PNF) method and dumbbell exercise. This study is classified as Quase-experiment. Subjects were instructed to perform diagonal standard exercises and the electromyographic signal was detected from pectoralis muscles, middle and upper trapezius of dominant limb in each subject. We observed greater muscular recruitment when the PNF method was adopted in comparison with the dumbbell workouts for the trapezius upper and middle fiber muscles and for the major pectoralis (267,30 µv/181,02 µv; 235,76 µv/;164,47 µv; 299,87 µv/148,69 µv; P<0.001). The PNF method promotes a greater recruitment of the shoulder dynamic stabilizing muscles during diagonal elevation exercises. Being so, such kinesiotherapeutic technique may be effectively used in the prevention, treatment and rehabilitation of shoulder disorders.

Electromyographic analysis of constraint-induced movement therapy effects in patients after stroke in chronic course.

[Purpose] The purpose is to analyze the effects of Constraint-induced Movement Therapy in post stroke patients in chronic course. [Subjects and Methods] This is a Quasi-experiment study and the adopted protocol consisted of a three-hour therapy for ten consecutive working days applied to a constraint intact upper limb. Surface Electromyography, Motor Activity Log, Wolf Motor Function Test and Functional Independence Measure were used for evaluating the experiment. [Results] The individuals showed reduction in the degree of spasticity, confirmed by Surface Electromyography. In relation to Motor Activity Log this study showed an increase in amount and in quality of the paretic upper limb movement. The Wolf Motor Function Test showed reduction in the average time to perform the tasks and a functional improvement was identified through the Functional Independence Measure. [Conclusion] Constraint Induced Movement Therapy proved to be a relevant method to improve motor function in chronic hemiparesis post stroke reducing the spasticity, maximizing and improving the use of committed upper limb.

Tai Chi Chuan for Cardiac Rehabilitation in Patients with Coronary Arterial Disease / Tai Chi Chuan como Reabilitação Cardíaca na Doença Arterial Coronária: Revisão Sistemática

Background: Several studies have shown that Tai Chi Chuan can improve cardiac function in patients with heart disease. Objective: To conduct a systematic review of the literature to assess the effects of Tai Chi Chuan on cardiac rehabilitation for patients with coronary artery disease. Methods: We performed a search for studies published in English, Portuguese and Spanish in the following databases: MEDLINE, EMBASE, LILACS and Cochrane Register of Controlled Trials. Data were extracted in a standardized manner by three independent investigators, who were responsible for assessing the methodological quality of the manuscripts. Results: The initial search found 201 studies that, after review of titles and abstracts, resulted in a selection of 12 manuscripts. They were fully analyzed and of these, nine were excluded. As a final result, three randomized controlled trials remained. The studies analyzed in this systematic review included patients with a confirmed diagnosis of coronary artery disease, all were clinically stable and able to exercise. The three experiments had a control group that practiced structured exercise training or received counseling for exercise. Follow-up ranged from 2 to 12 months. Conclusion: Preliminary evidence suggests that Tai Chi Chuan can be an unconventional form of cardiac rehabilitation, being an adjunctive therapy in the treatment of patients with stable coronary artery disease. However, the methodological quality of the included articles and the small sample sizes clearly indicate that new randomized controlled trials are needed in this regard. .

Fundamento: Alguns estudos têm mostrado que o Tai Chi Chuan pode melhorar a função cardiorrespiratória de pacientes com doenças cardíacas. Objetivo: Realizar uma revisão sistemática da literatura para avaliar os efeitos do Tai Chi Chuan na reabilitação cardíaca de pacientes com doença arterial coronária. Métodos: Foi realizada uma pesquisa nas seguintes bases de dados: MEDLINE, EMBASE, LILACS e Registro Cochrane de Ensaios Controlados. Foram feitas buscas por estudos publicados em inglês, português e espanhol. Os dados foram extraídos de forma padronizada, por três investigadores independentes, que foram responsáveis pela avaliação da qualidade metodológica dos manuscritos. Resultados: A busca inicial detectou 201 estudos que, após revisão de títulos e resumos, resultou na seleção de 12 manuscritos. Os mesmos foram analisados na íntegra e, destes, nove foram excluídos. Ao final, restaram três ensaios clínicos randomizados. Os estudos incluídos nessa revisão sistemática foram compostos por amostra de pacientes com diagnóstico comprovado de doença arterial coronária, todos estáveis clinicamente e capazes de se exercitar. Os três experimentos contaram com a presença de um grupo controle praticante de qualquer categoria de treinamento físico estruturado ou receberam aconselhamento para exercício físico. O tempo de acompanhamento variou de 2 a 12 meses. Conclusão: Evidências preliminares sugerem que o Tai Chi Chuan possa ser uma forma não convencional de reabilitação cardíaca, podendo ser terapêutica adjuvante no tratamento de pacientes com doença arterial coronária estável. No entanto, a qualidade metodológica dos artigos incluídos e as amostras de tamanho reduzido ...

Tai Chi Chuan for cardiac rehabilitation in patients with coronary arterial disease.

BACKGROUND: Several studies have shown that Tai Chi Chuan can improve cardiac function in patients with heart disease. OBJECTIVE: To conduct a systematic review of the literature to assess the effects of Tai Chi Chuan on cardiac rehabilitation for patients with coronary artery disease. METHODS: We performed a search for studies published in English, Portuguese and Spanish in the following databases: MEDLINE, EMBASE, LILACS and Cochrane Register of Controlled Trials. Data were extracted in a standardized manner by three independent investigators, who were responsible for assessing the methodological quality of the manuscripts. RESULTS: The initial search found 201 studies that, after review of titles and abstracts, resulted in a selection of 12 manuscripts. They were fully analyzed and of these, nine were excluded. As a final result, three randomized controlled trials remained. The studies analyzed in this systematic review included patients with a confirmed diagnosis of coronary artery disease, all were clinically stable and able to exercise. The three experiments had a control group that practiced structured exercise training or received counseling for exercise. Follow-up ranged from 2 to 12 months. CONCLUSION: Preliminary evidence suggests that Tai Chi Chuan can be an unconventional form of cardiac rehabilitation, being an adjunctive therapy in the treatment of patients with stable coronary artery disease. However, the methodological quality of the included articles and the small sample sizes clearly indicate that new randomized controlled trials are needed in this regard.

Comparison of the electrical activity in upper trapezius and wrist extensor muscles during two typewriting conditions / Comparação da atividade elétrica dos músculos trapézio superior e extensores do punho em duas condições de digitação

Introduction The proper use of the position of the arm and wrist while typing may reduce muscle overload and prevent musculoskeletal disorders.Objective To evaluate the electromyographic activity of upper trapezius and wrist extensor muscles during two typewriting conditions.Materials and methods : Six healthy females (Xage = 42 years,SD= 10), (Xheight = 1.65m, SD = 0.05) and (Xweight = 71kg, SD = 16) participated in this study. The task was performed with a newly developed arm support and without the support. A perceived exertion scale was used with all subjects. An ANOVA with repeated measures was used to verify differences in perceived exertion and root mean square (RMS).Results There were no statistically significant differences for the RMS between the typewriting tasks. The condition without arm support presented a significantly greater mean velocity and amount of words typed (P= 0.02; P= 0.03) and there was a significant difference in perceived exertion during the condition without arm support (P= 0.03). Electromyographic activity did not present differences.Conclusion The muscle electrical activity was not altered regardless the arm support and occurred the improvement of the perceived exertion after 10 minutes of typing without support. Long-term studies are needed.

Introdução O uso adequado da posição do braço e do punho durante a digitação pode reduzir a sobrecarga muscular e prevenir doenças musculoesqueléticas.Objetivo Avaliar a atividade eletromiográfica dos músculos trapézio superior e extensores do punho durante duas condições de digitação.Materiais e métodos Seis mulheres sadias (X idade = 42 anos, DP = 10), (Xaltura = 1,65m, DP = 0,05) e (Xmassa = 71 kg, DP = 16) participaram deste estudo. A tarefa foi realizada com e sem um apoio de braço. Uma escala de percepção de esforço foi aplicada para todos participantes. ANOVA de medidas repetidas foi utilizada para verificar diferenças na percepção de esforço e root mean square (RMS) para a atividade eletromiográfica.Resultados Não houve diferença estatisticamente significante para o RMS entre as tarefas de digitação. A condição sem apoio de braço apresentou maior média de velocidade e quantidade de palavras digitadas (P = 0,02; P = 0,03) e houve uma diferença significante na percepção de esforço durante a condição sem apoio de braço (P = 0,03). A atividade eletromiográfica não apresentou diferença.Conclusão A atividade elétrica muscular não se alterou independente do apoio e ocorreu a melhora do esforço percebido após 10 minutos de digitação sem apoio. Estudos em longo prazo são necessários.

Prevalência de dor osteomuscular em profissionais de enfermagem de equipes de cirurgia em um hospital universitário / Prevalence of musculoskeletal pain among surgical nursing teams

Dentre as profissões da área da saúde, a enfermagem, em particular, tem sido afetada pelos distúrbios musculoesqueléticos produzindo alterações na vida desses trabalhadores, impossibilitando-os de realizarem atividades cotidianas e laborais. Objetivo: Investigar a prevalência de dor osteomuscular e a associação com a qualidade de vida em profissionais de enfermagem que atuam em equipes de cirurgia no Hospital de Clínicas de Porto Alegre. Método: Estudo transversal realizado entre março de 2011 ejaneiro de 2012, em um hospital universitário terciário do sul do Brasil. Foram avaliados 110 trabalhadores de enfermagem das equipes de cirurgia. Foram excluídos os trabalhadores em licença saúde, fériasou outro tipo de afastamento durante o período de coleta dos dados. A dor osteomuscular foi avaliada através do questionário Nórdico de Sintomas Osteomusculares e a qualidade de vida foi avaliada atravésdo questionário Medical Outcomes Study 36 - Item Short-Form Survey (SF-36). As relações entre dor osteomuscular e qualidade de vida foram analisadas através do Teste U de Mann-Whitney, utilizandonível de significância de 95%. Resultados: A prevalência de dor osteomuscular encontrada neste estudo foi de 91,81%. Com relação às regiões anatômicas, considerou-se as queixas de dor osteomuscular retroativo há doze meses, onde o predomínio foi de dor no pescoço (56%) e ombros (56%). Quando consideramos afastamento por dor osteomuscular encontramos a prevalência de dor lombar (34%). O grupo que não relatou dor osteomuscular apresentou melhores índices de qualidade de vida nos domínios de capacidade funcional, aspectos físicos, dor, vitalidade, aspectos sociais e saúde mental. Conclusão: A dor osteomuscular apresenta maior prevalência nas regiões do pescoço e ombros. Além disso, o maior número de afastamentos ocorre por prevalência de dor lombar entre os trabalhadores de enfermagem das equipes de cirurgia. A dor influenciou na qualidade de vida afetando seis dos domínios avaliados

Among the health professions, nursing, in particular, has been affected by musculoskeletal disorders. The WMSD produce changes in the lives of these workers, impossible of them held daily activities andlabour. Objective: Investigating the prevalence of musculoskeletal pain and associated with the quality of life in nursing professionals who work in surgery teams. Method: Cross-sectional study conductedbetween March 2011 and January 2012 in a tertiary university hospital in southern Brazil. We evaluated 110 workers nursing teams. It was excluded workers on sick leave, vacation or other absence duringthe period of data collection. The musculoskeletal pain was assessed using the Nordic Musculoskeletal symptoms questionnaire the quality of life was assessed by the Medical Outcomes Study 36 - Item Short-Form Survey (SF-36). The relationship between musculoskeletal pain and quality of life were analyzed by the U of Mann-Whitney test, using a significance level of 95%. Results: The prevalence of musculoskeletal pain found in this study was 91.81%. With respect to anatomic regions, it was consideredthe complaints of musculoskeletal pain retroactive twelve months ago, where there was the predominance of neck pain (56%) and shoulders (56%). When we consider sick leaving for musculoskeletal painwe found the prevalence of low back pain (34%). The group who reported no musculoskeletal pain showed better indices of quality of life in the areas of physical functioning, physical aspect, bodily pain,vitality, social and mental health aspect. Conclusion: the higher prevalence of musculoskeletal pain in the neck and shoulder regions. Moreover, the largest number of sick leaves occurs because of the prevalenceof low back pain among nursing staff of the surgical teams. The pain influenced the quality of life affecting six of the areas assessed.