Global posture reeducation compared with segmental muscle stretching exercises in the treatment of fibromyalgia: a randomized controlled trial.

BACKGROUND: Muscle stretching exercises preserve corporal flexibility and decrease the retraction and shortening of myofascial and articular structures. These exercises are recommended for the treatment of fibromyalgia (FM). The purpose of the study was to verify and compare the effect of muscle stretching exercises on FM patients based on the global posture reeducation method against segmental muscle stretching exercises, both used in concert with an educational approach rooted in cognitive behavioral therapy. METHODS: Forty adults with FM were randomly allocated into two groups: global and segmental. The two kinds of therapies were performed in 10 individual sessions once a week. Two assessments were made: one at baseline and one at the end of therapy. The primary outcome variable was pain intensity (Visual Analog Scale). The secondary outcome variables were multidimensional pain (McGill Pain Questionnaire), the pain threshold at tender points (dolorimetry), attitudes toward chronic pain (Survey of Pain Attitudes-Brief Version), body posture (Postural Assessment Software Protocol), postural control (Modified Clinical Test of Sensory Interaction on Balance), flexibility (sit-and-reach test), the impact of FM on quality of life (Fibromyalgia Impact Questionnaire, FIQ), and self-reported perceptions and body self-care. RESULTS: At the end of treatment, there were no statistically significant differences between the groups in the outcome variables. Furthermore, the groups presented lower pain intensity (baseline vs. final; global group: 6 ± 1.8 vs. 2.2 ± 1.6 cm, p<0.01; segmental group: 6.3 ± 2.1 vs. 2.5 ± 1.7 cm, p<0.01), higher pain threshold (p ≤ 0.01), lower total FIQ score (p < 0.01), and greater postural control (p < 0.01) after treatment. CONCLUSIONS: Muscle stretching exercises based on global posture reeducation and segmental muscle stretching exercises, both used in concert with an educational approach rooted in cognitive behavioral therapy, reduced the pain intensity and impact of FM on quality of life. These exercises also improved FM patients' pain threshold at tender points, attitudes toward chronic pain, and postural control. There were no differences between global posture reeducation and segmental muscle stretching exercises. TRIAL REGISTRATION: ClinicalTrials.gov NCT02384603 . Registered on 10 March 2015.

Association of Functional Disability and Biopsychosocial Factors in Older Adults With Low Back Pain Who Live in the Amazonas State Brazil: A Cross-Sectional Study.

OBJECTIVE: The purpose of this study was to identify social and clinical factors associated with levels of functional disability (FD) in older adults with low back pain (LBP) in the city of Manaus, Amazonas, Brazil. METHODS: A cross-sectional study of 557 adults with LBP aged ≥60 years was completed. Sociodemographic and clinical features, pain intensity (Numeric Rating Scale), FD (Roland Morris Disability Questionnaire), physical activity (International Physical Activity Questionnaire-short version), body mass index, educational level, health perception, emotional level, and self-reported diseases were evaluated. Statistical analysis was used to verify the association between quantitative variables and a group; Student t test or Mann-Whitney test, and analysis of variance (normality assumption) or Kruskal-Wallis test (non-parametric), P value of less than .05. RESULTS: There were 81.3% female participants, 54.9% self-reported their race and/or skin color as brown, and 37.8% were sedentary. Pain intensity scores were 6.26 ± 2.19 in female participants and 5.82 ± 1.84 in male participants. Mean FD scores were 11.68 ± 6.08 for female participants and 9.61 ± 5.76 for males participants, although 39.7% of the total group presented with severe disability (score ≥14) and FD was associated with female sex (P = .001), physical activity (P≤ 0.001), body mass index (P≤ .001), emotional level (P < .001), and health perception (P < .001). CONCLUSION: In this group of older adults with LBP, FD was associated with female sex, level of physical activity, body mass index, emotional level, and health perception. Many factors that were identified with FD are modifiable; therefore, interventions, such as nutrition education and re-conceptualization of self-emotional and health perception, may have potential to help in preventing and reducing FD.

Effects of electroacupuncture frequencies on chronic low back pain in older adults: triple-blind, 12-months protocol for a randomized controlled trial.

BACKGROUND: Low back pain (LBP) is the most frequent complaint in clinical practice. Electroacupuncture treatment may be effective; however, the supporting evidence is still limited, especially in older adults. OBJECTIVE: The current study is a randomized controlled trial that aims to evaluate the clinical efficacy of electroacupuncture in older adults with LBP. METHODS: A five-arm randomized controlled trial with patients and evaluators blinded to the group allocation. A total of 125 participants with non-specific LBP will be randomly assigned into one of five groups: three electroacupuncture groups (low, high, and alternating frequency); one control group; and one placebo group. The electroacupuncture will be applied twice a week (30 min per session) for five weeks. The primary clinical outcome measure will be pain intensity. The secondary outcomes include: quality of pain; physical functioning; perceived overall effect; emotional functionality; patient satisfaction; and psychosocial factors. Patients will be evaluated before the first session, immediately after the last, and followed up after six and 12 months to check the medium- and long-term effects. DISCUSSION: Although electroacupuncture is increasingly used to treat LBP, there is no guidance regarding the parameters used, which leads to inconsistent results. Thus, the effect of electroacupuncture (EA) on LBP remains controversial and requires more studies, especially in the older adult population. CONCLUSION: This is the first randomized controlled trial to evaluate the efficacy of different frequencies of electroacupuncture for treating chronic LBP in older adults. This study will provide evidence on the effectiveness of electroacupuncture as an alternative treatment method for LBP and will entail wider debate about an appropriate acupuncture intervention in this population. TRIAL REGISTRATION: Clinicaltrials.gov, NCT03802045. Registered on 14 January 2019.

Prevalence of low back pain in the elderly population: a systematic review.

The aim of this study was to estimate the prevalence of low-back pain (LBP) and to identify the level of functional disability in elderly individuals in different populations. From January 1985 to October 2018, a search was performed using the following databases: Embase, LILACS, SciELO, Scopus, Medline, and the Web of Science. The descriptors were low-back pain, back pain, lower-back pain, prevalence, and elderly in Portuguese and English. Two independent reviewers conducted a search for studies and evaluated their methodological quality. The search strategy returned 2186 titles, and 35 were included in this review. The studies evaluated 135,059 elderly individuals aged between 60 and 102 years, and the prevalence of LBP ranged from 21% to 75%. The levels of functional disability, as well as functional difficulties, activities of daily living, and physical capacity, were identified in 60% of the studies. This review indicated a high prevalence of LBP in elderly individuals and functional disability that affects factors important for independence. However, the studies used different methodologies, suggesting that more studies be conducted with scientific accuracy, methodological quality, and low risk of bias to contribute to the proposal of preventive actions for elderly populations.

Prevalence of low back pain in the elderly population: a systematic review

The aim of this study was to estimate the prevalence of low-back pain (LBP) and to identify the level of functional disability in elderly individuals in different populations. From January 1985 to October 2018, a search was performed using the following databases: Embase, LILACS, SciELO, Scopus, Medline, and the Web of Science. The descriptors were low-back pain, back pain, lower-back pain, prevalence, and elderly in Portuguese and English. Two independent reviewers conducted a search for studies and evaluated their methodological quality. The search strategy returned 2186 titles, and 35 were included in this review. The studies evaluated 135,059 elderly individuals aged between 60 and 102 years, and the prevalence of LBP ranged from 21% to 75%. The levels of functional disability, as well as functional difficulties, activities of daily living, and physical capacity, were identified in 60% of the studies. This review indicated a high prevalence of LBP in elderly individuals and functional disability that affects factors important for independence. However, the studies used different methodologies, suggesting that more studies be conducted with scientific accuracy, methodological quality, and low risk of bias to contribute to the proposal of preventive actions for elderly populations.

Effect of Physical Therapy in Bruxism Treatment: A Systematic Review.

OBJECTIVE: The aim of this literature review was to examine the effect of physical therapy in bruxism treatment. METHODS: The data sources used were Medline, Excerpta Medica Database, Cumulative Index of Nursing and Allied Health Literature, Physiotherapy Evidence Database, SPORTDiscus, Scientific Electronic Library Online, Web of Science, Cochrane Library, Scopus, and Literatura Latino-Americana e do Caribe em Ciências da Saúde. We included randomized and nonrandomized and controlled and noncontrolled clinical trials and interventions focused on physical therapy as treatment for sleep bruxism or awake bruxism. Two reviewers independently screened the records, examined full-text reports for compliance with the eligibility criteria, and extracted data. RESULTS: The present review found 1296 articles. We excluded 766 duplicated articles and 461 irrelevant articles and selected 69 titles to read. Forty-five of these were excluded, leading to a total of 24 that met the eligibility criteria and were included in our analysis. The articles were grouped into 7 treatment methods used in physical therapy. The treatment methods were electrotherapeutic (14 articles), cognitive-behavioral therapy (3 articles), therapeutic exercises (2 articles), acupuncture (2 articles), postural awareness (1 article), muscular relaxation (1 article), and massage (1 article). Results and conclusions, methodological quality, and quality of evidence of each study were reported. CONCLUSIONS: These results suggest very low-quality evidence that diverse methods used in physical therapy improve muscle pain and activity, mouth opening, oral health, anxiety, stress, depression, temporomandibular disorder, and head posture in individuals with bruxism. This finding is mainly a result of the poor methodological quality of most of the studies.

As invisibilidades da história: Athayde Ribeiro da Silva e a psicologiado esporte no Brasil / Invisibilities in history: Athayde Ribeiro da Silva and sport psychology in Brazil

O futebol chegou ao Brasil como esporte das elites e começou a se popularizar durante o governo de Getúlio Vargas, que o utilizou, juntamente com o samba, para a afirmação da identidade nacional. Neste processo, profissionalizou-se e conferiu novo status ao jogador: o de trabalhador. Esta transformação possibilitou que a Psicologia começasse a atuar junto ao esporte, com técnicas de recrutamento e seleção profissional, bem como realizando psicodiagnóstico. Um importante personagem nesta trajetória foi Athayde Ribeiro da Silva, indicado para trabalhar com a seleção brasileira de futebol em 1962 e1966. Embora com uma vasta atuação acadêmica e profissional, Ribeiro da Silva permanece incógnito para a história da Psicologia do Esporte. O intuito deste artigo é,portanto, apresentar sua trajetória, demonstrar sua relevância para o campo e contribuir,assim, com novos dados para os profissionais da área.(AU)

Soccer arrived in Brazil as a sport of the elite and started to become popular during the government of Getulio Vargas, who used it, as well as samba, for the affirmation of national identity. In this process, soccer was professionalized and gave the player a new status: he became a worker. This transformation enabled psychology to begin to work with sports, using technical recruiting and professional selection as well as performing psychological diagnosis. An important persona in this trajectory was Athayde Ribeiro da Silva, appointed to work with the Brazilian national soccer team in 1962 and 1966. Despite a wide academic and professional performance, Ribeiro da Silva remains unknown for the History of Sport Psychology. The purpose of this article is, therefore, to present his trajectory, demonstrating his relevance to the field and thus contributing with new data to the psychologists who work with sports.(AU)

As invisibilidades da história: Athayde Ribeiro da Silva e a psicologia do esporte no Brasil / Invisibilities in history: Athayde Ribeiro da Silva and sport psychology in Brazil

O futebol chegou ao Brasil como esporte das elites e começou a se popularizar durante o governo de Getúlio Vargas, que o utilizou, juntamente com o samba, para a afirmação da identidade nacional. Neste processo, profissionalizou-se e conferiu novo status ao jogador: o de trabalhador. Esta transformação possibilitou que a Psicologia começasse a atuar junto ao esporte, com técnicas de recrutamento e seleção profissional, bem como realizando psicodiagnóstico. Um importante personagem nesta trajetória foi Athayde Ribeiro da Silva, indicado para trabalhar com a seleção brasileira de futebol em 1962 e 1966. Embora com uma vasta atuação acadêmica e profissional, Ribeiro da Silva permanece incógnito para a história da Psicologia do Esporte. O intuito deste artigo é, portanto, apresentar sua trajetória, demonstrar sua relevância para o campo e contribuir, assim, com novos dados para os profissionais da área.(AU)

Soccer arrived in Brazil as a sport of the elite and started to become popular during the government of Getulio Vargas, who used it, as well as samba, for the affirmation of national identity. In this process, soccer was professionalized and gave the player a new status: he became a worker. This transformation enabled psychology to begin to work with sports, using technical recruiting and professional selection as well as performing psychological diagnosis. An important persona in this trajectory was Athayde Ribeiro da Silva, appointed to work with the Brazilian national soccer team in 1962 and 1966. Despite a wide academic and professional performance, Ribeiro da Silva remains unknown for the History of Sport Psychology. The purpose of this article is, therefore, to present his trajectory, demonstrating his relevance to the field and thus contributing with new data to the psychologists who work with sports.(AU)

Investigando em História da Psicologia: contribuições metodológicas / Investigating the history of psychology: methodological contributions

Este artigo tem por objetivo apresentar discussões metodológicas acerca da pesquisa em História da Psicologia. Utiliza como eixo norteador da compreensão de história as perspectivas teóricas e metodológicas da Nova História. Esta, em sua crítica à história tradicional, propõe a análise das condições de construção dos fatos. Uma de suas consequências foi a ampliação do campo do documento histórico, com a utilização de outras fontes que não os textos oficiais. Na História da Psicologia, essa ampliação significou a preocupação com o caráter científico das pesquisas históricas e a reflexão sobre os modos de pensar e fazer Psicologia, considerando o contexto e as vozes daqueles que ajudaram a construi-la enquanto conhecimento e prática profissional. No caso do Brasil, diferentes iniciativas e laboratórios têm reafirmado a importância do debate sobre a organização sistemática e análise cuidadosa do material de pesquisa. Aqui são referidos brevemente alguns exemplos de investigação para demonstração deste tipo de proposta.

This article aims to present methodological discussions about the research on the History of Psychology. Here it is used as a guiding axis in the comprehension of history, methodological and theoretical perspectives of the New History. In its critical to the traditional history, the New History proposes the analysis of the conditions of construction of the narratives about the facts. One of its consequences was the expansion of the historical document field, with the utilization of other sources, different than official texts. In the History of Psychology, that expansion meant the concern about the scientific type of historical researches and the considerations about the ways of thinking and making Psychology, considering the context and the voices of those who helped to build it as knowledge and professional practice. In the case of Brazil, different initiatives and laboratories have reaffirmed the importance of the debate about the systematic organization and the careful analysis of the research material. Some examples are referred here, so as to demonstrate this kind of proposal.

A imagem da infância nas teses da faculdade de medicina do Rio de Janeiro (1832-1930) / The image of children in the theses of the medical college of Rio de janeiro (1832-1930)

Este trabalho procura analisar historicamente o conceito de infância no Brasil e como a representação infantil passou de um papel secundário no sistema colonial a foco das preocupações no século XIX, através da atuação dos médicos higienistas. A partir da análise das teses de doutoramento da Faculdade de Medicina do Rio de Janeiro que discorrem sobre a criança, produzidas no período de 1832 a 1930, procuramos investigar de que maneira a construção e disciplina do corpo infantil se refletem no desenvolvimento de uma ciência psicológica. Neste percurso, deparamo-nos com discussões sobre temas que englobam não apenas o corpo, mas também a compreensão da alma infantil, sob a influência do paradigma científico e das teorias evolucionistas vigentes à época. Além disso, associada à imagem infantil, também encontramos a importância da mulher - enquanto mãe e ama - como mantenedora da família, constituindo uma nova moldagem também da figura feminina (AU)

A imagem da infância nas teses da faculdade de medicina do Rio de Janeiro - (1832-1930) / The image of children in the theses of the medical college of Rio de Janeiro (1832-1930)

Este trabalho procura analisar historicamente o conceito de infância no Brasil e como a representação infantil passou de um papel secundário no sistema colonial a foco das preocupações no século XIX, através da atuação dos médicos higienistas. A partir da análise das teses de doutoramento da Faculdade de Medicina do Rio de Janeiro que discorrem sobre a criança, produzidas no período de 1832 a 1930, procuramos investigar de que maneira a construção e disciplina do corpo infantil se refletem no desenvolvimento de uma ciência psicológica. Neste percurso, deparamo-nos com discussões sobre temas que englobam não apenas o corpo, mas também a compreensão da alma infantil, sob a influência do paradigma científico e das teorias evolucionistas vigentes à época. Além disso, associada à imagem infantil, também encontramos a importância da mulher - enquanto mãe e ama - como mantenedora da família, constituindo uma nova moldagem também da figura feminina.

This paper has the purpose to analyze historically the concept of childhood in Brazil. How the representation of children went from a secondary role during the colonization system to focus of concern in the 19th Century, through the performance of Hygienist Doctors. In order to do so, we studied all the Theses of the Medical College of Rio de Janeiro, produced from 1832 to 1930 regarding children. By this study, we intended to search how the construction and discipline of the children's body are reflected in the development of a Psychological Science. Throughout the study, we found discussions on themes that involve not only the body, but also the comprehension of a child's soul, the predominance of a scientific paradigm and of evolutionist theories which were in effect at the time. Moreover, associated to the image of children, we also found the importance of women - while mother and wet-nurse - as a family keeper, composing a new model for the feminine figure.

Medicina legal nas teses da Faculdade de Medicina do Rio de Janeiro (1830-1930): o encontro entre medicina e direito, uma das condições de emergência da psicologia jurídica / Forensic medicine in the theses of the Medical School in Rio de Janeiro (1830-1930): the encounter between medicine and law, one of the conditions to the emergence of juridical psychology

Sabendo-se que a Psiquiatria no Brasil constituiu-se a partir da Medicina Legal, o artigo analisa as teses de Medicina Legal da Faculdade de Medicina do Rio de Janeiro, defendidas nos anos de 1832-1930. Durante esse período as teses eram obrigatórias para a obtenção do título de Doutor em Medicina, isto é, para a conclusão do curso médico. Apresentam-se as principais idéias psiquiátricas européias – notadamente Pinel, Morel e Lombroso – e seu desdobramento nas teses. Acrescenta-se também o pensamento nelas presente acerca do papel social dos médicos. O início do Manicômio Judiciário no Brasil é apresentado rapidamente, indicando-se em seguida a gênese do campo da Psicologia Jurídica, vista então como forma instrumental de auxílio ao psiquiatra na determinação das características não só do réu ou criminoso, mas também da criança e do doente (AU)

Medicina legal nas teses da Faculdade de Medicina do Rio de Janeiro (1830-1930): o encontro entre medicina e direito, uma das condições de emergência da psicologia jurídica / Forensic medicine in the theses of the Medical School in Rio de Janeiro (1830-1930): the encounter between medicine and law, one of the conditions to the emergence of juridical psychology

Sabendo-se que a Psiquiatria no Brasil constituiu-se a partir da Medicina Legal, o artigo analisa as teses de Medicina Legal da Faculdade de Medicina do Rio de Janeiro, defendidas nos anos de 1832-1930. Durante esse período as teses eram obrigatórias para a obtenção do título de Doutor em Medicina, isto é, para a conclusão do curso médico. Apresentam-se as principais idéias psiquiátricas européias – notadamente Pinel, Morel e Lombroso – e seu desdobramento nas teses. Acrescenta-se também o pensamento nelas presente acerca do papel social dos médicos. O início do Manicômio Judiciário no Brasil é apresentado rapidamente, indicando-se em seguida a gênese do campo da Psicologia Jurídica, vista então como forma instrumental de auxílio ao psiquiatra na determinação das características não só do réu ou criminoso, mas também da criança e do doente

Miocardiopatia hipertrófica / Hypertrophic cardiomyopathy

Neste estudo, os autores fazem uma revisäo bibliográfica sobre miocardiopatia hipertrófica, dando ênfase aos mais recentes avanços sobre o tema, principalmente no que se refere ao prognóstico e manejo dos pacientes

Adaptaçäo fisiológica do recém-nascido / Physiologic adaptation of the newborn

O nascimento é, sem dúvida, um dos momentos mais importantes, curiosos e decisivos do ser humano, o início de uma vida e todos os fenômenos que estäo implicados na transiçäo do estágio fetal para o recém-nascido. É sobre as modificaçöes pulmonares, cardiovasculares, renais, digestivas e metabólicas desta transiçäo que os autores fazem uma breve revisäo, permitindo ao leitor melhor conhecer o recém-nascido e as patologias decorrentes de alteraçöes nas funçöes descritas

Hipertensäo arterial na infância / Hypertension in children

Esta revisäo bibliográfica visa discutir a imortância da aferiçäo precoce e continuada da pressäo arterial na infância como medida de prevençäo e diagnóstico da hipertensäo arterial. Sugere critérios diagnósticos para se considerar uma criança portadora de níveis tensionais elevados e discute possíveis causas desta alteaçäão, ressaltando a importância de serem detectadas patologias e identificados fatores de risco