Exercise dependence, body dismorphia, and anxiety in crossfit practitioners: A cross-sectional study.

INTRODUCTION: Physical exercise provides better body image perception and well-being. However, if practiced compulsively, it may lead to compulsion and psychobiological damage. CrossFit is a method aiming at maximum performance, and it is currently attracting many regular practitioners. OBJECTIVE: Evaluate exercise dependence prevalence, muscle dysmorphia, and trait-state anxiety in CrossFit practitioners. METHODS: One hundred fifty regular male CrossFit practitioners were evaluated and subdivided into two groups: with and without risk for exercise dependence. Trait-state anxiety and muscle dysmorphia were also assessed. Unpaired t-test compared groups, Fisher's exact test was used for associations between categorical variables (p < 0.05), while correlations were verified using Pearson's correlation coefficient. RESULTS: 122 participants were identified with no risk for exercise dependence and 28 with risk for exercise dependence. Participants presented mean age of 30.3 ± 7.05 years and had been practicing physical exercise for 8.02 ± 8.1 years, with training frequency of 5.3 ± 1.09 days per week and 107.9 ± 50.5 min per training day. Prevalence risk of exercise dependence was 18.6%, and muscle dysmorphia was significantly different between groups with (10.7%, n = 3) and without risk (6.6%, n = 8) for exercise dependence. Participants with risk for dependence chose CrossFit mainly due to appearance (32%). CONCLUSION: Prevalence risk of exercise dependence was 18.6% and satisfaction with muscle appearance may influence exercise behavior.

Fragility syndrome: determinant factors ininstitutionalized elderly / Síndrome de fragilidade: fatores determinantes em idosos institucionalizados / Síndrome de fragilidad: factores determinantes em personas institucionalizadas

The aim of the study was to evaluate the frailty syndrome in residents of a Long-Term Care Facility for the Elderly. A cross-sectional study was carried out on 24 subjects over the age of 60 years. For the screening of frailty syndrome, the criteria of the Cardiovascular Study were used, which classifies the subjects into fragile, pre-fragile and non-fragile according to five criteria: decreased handgrip strength; self-reported fatigue; decrease in walking speed; unintentional weight loss; and low level of physical activity. The average age of the population studied was 81.13 years, with 54.20% being female. Among the elderly, 83.33% were frail, 12.50% were pre-frail and 4.17% were not frail. Elderly people over 80 years old had a higher incidence of frailty when compared to those aged 60 -79 years, with 85.7% and 80%, respectively. Since 66.67% of the elderly had decreasedhandgrip muscle strength, 37.50% reported fatigue, 41.67% demonstrated decreased gait speed, 12.50% unintentional weight loss and 87.50% were physically inactive. We identified a high prevalence of DES among the elderly residing in the institution studied, thus reinforcing the importance of early screening for frailty in institutionalized elderly(AU)

O objetivo do estudo foi avaliar a síndrome de fragilidade em residentes de uma Instituição de Longa Permanência para Idosos. Foi realizado um estudo transversal em 24 sujeitos com idade superior a 60 anos. Para rastreamento da síndrome de fragilidade foram utilizados os critérios do Estudo Cardiovascular que classifica os sujeitos em frágil, pré-frágil e não frágil de acordo com cinco critérios: diminuição da força de preensão manual; auto-relato de fadiga; diminuição da velocidade de marcha; perda de peso não intencional; e baixo nível de atividade física. A idade média da população estudada foi de 81,13 anos, sendo 54,20% do sexo feminino. Entre os idosos houve 83,33% com fragilidade, 12,50% eram pré-frágeis e 4,17% não frágeis. Os idosos acima de 80 anos apresentaram incidência maior de fragilidade quando comparados aos de 60 ­79 anos, com 85,7% e 80%, respectivamente. Sendo que 66,67% dos idosos apresentaram diminuição da força muscular de preensão manual, 37,50% relataram fadiga, 41,67% demonstraram diminuição da velocidade da marcha, 12,50% perda de peso não intencional e 87,50 % eram inativos fisicamente. Identificamos alta prevalência de SF entre os idosos residentes na Instituição estudada, reforçando assim a importância do rastreamento precoce da fragilidade em idosos institucionalizados(AU)

El objetivo del estudio fue evaluar el síndrome de fragilidad en los residentes de un centro de atención a largo plazo para ancianos. Se realizó un estudio transversal en 24 sujetos mayores de 60 años. Para el cribado de síndrome de fragilidad, se utilizaron los criterios del Estudio Cardiovascular, que clasifica a los sujetos en frágiles, pre-frágiles y no frágiles de acuerdo con cinco criterios: disminución de la fuerza del mango; fatiga autoinformada; disminución de la velocidad al caminar; pérdida depeso involuntaria; y bajo nivel de actividad física. La edad promedio de la población estudiada fue de 81.13 años, con un 54.20% de mujeres. Entre los ancianos, 83.33% eran frágiles, 12.50% eran pre-frágiles y 4.17% no eran frágiles. Las personas mayores de más de 80 años tuvieron una mayor incidencia de fragilidad en comparación con las personas de 60 a 79 años, con 85.7% y 80%,respectivamente. Dado que el 66.67% de los adultos mayores había disminuido la fuerza muscular de la empuñadura, el 37.50% informó fatiga, el 41.67% demostró una disminución de la velocidad de la marcha, 12.50% de pérdida de peso no intencional y 87.50% físicamente inactivo Identificamos una alta prevalencia de DES entre los ancianos que viven en la institución estudiada, lo que refuerza la importancia de la detección temprana de la fragilidad en ancianos institucionalizados(AU)

Evidence for the efficacy of Tai Chi for treating rheumatoid arthritis: an overview of systematic reviews.

BACKGROUND: Rheumatoid arthritis (RA) is a chronic disease with higher prevalence among women aged between 30 and 50 years and general prevalence of 1% worldwide. Interventions promoting improvement of quality of life for individuals with RA are required. Tai Chi appears to be a low-cost alternative, with studies showing positive results from this technique. However, regarding aspects of RA such as pain and sensitivity, studies remain inconclusive. OBJECTIVES: To compare the effectiveness of the Tai Chi method for treating patients diagnosed with rheumatoid arthritis, among systematic reviews. DESIGN AND SETTING: Overview of systematic reviews with Cochrane and non-Cochrane methodology. METHODS: Systematic reviews involving quasi-randomized and randomized clinical trials (RCTs) on use of Tai Chi, with no restrictions regarding the date and language of publication, were included. RESULTS: Three systematic reviews were included. The effects of Tai Chi associated with education and stretching exercises versus education and stretching were evaluated in these reviews. They showed that improvements in the variables of mood, depression and functional index were associated with use of Tai Chi. CONCLUSIONS: The findings suggest that clinical improvement was achieved, although not statistically significant with regard to pain and disease pattern, as assessed using the ACR20 measurement. Improvements relating to disability and quality of life were also seen. There was a low level of evidence and therefore caution in data analysis is recommended. The three studies included showed poor reliability for providing an accurate and complete summary of use of Tai Chi among people diagnosed with rheumatoid arthritis. PROSPERO: CRD42019125501.

Associação entre qualificação profissional de fisioterapeutas e a percepção sobre o tratamento de osteoartrite de joelho: um estudo transversal / Association between professional qualification of physical therapists and perception of knee osteoarthritis treatment: a cross-sectional study

INTRODUÇÃO: A Osteoartrite (OA) é a forma mais prevalente de artrite e requer intervenção terapêutica adequada. A Fisioterapia desempenha um importante papel no manejo desta doença. No entanto, pouco se sabe sobre as crenças e intervenções de fisioterapeutas que tratam OA no Brasil e fatores relacionados às decisões clínicas. OBJETIVO: Determinar se existe associação entre a qualificação profissional de fisioterapeutas na região Norte do Brasil e a percepção de eficiência ou ineficiência de intervenções terapêuticas para OA de joelho. MATERIAIS E MÉTODOS: Uma pesquisa transversal online foi realizada com fisioterapeutas de cinco estados do Norte do Brasil e a percepção sobre 20 intervenções foi avaliada por meio de um caso hipotético de OA de joelho. O teste qui-quadrado e regressão logística binária com nível de significância de 5% foram utilizados para a análise estatística. RESULTADOS: 370 profissionais com média de idade de 32,16 ± 6,89 responderam a pesquisa. Houve associação significativa entre qualificação e percepção de eficiência das intervenções. Fisioterapeutas apenas graduados apresentaram menos chances de reconhecer ultrassom, ondas curtas, neuroestimulação elétrica transcutânea e estimulação elétrica, crioterapia, calor, fortalecimento muscular, kinesio taping e repouso como intervenções ineficazes. O mesmo ocorreu com as intervenções ultrassom, fortalecimento muscular e kinesio taping para especialistas. CONCLUSÃO: O menor grau acadêmico leva à uma chance menor de perceber como pouco eficientes ou ineficientes algumas intervenções não recomendadas para OA de joelho.

INTRODUCTION: Osteoarthritis (OA) is the most prevalent form of arthritis, which requires appropriate therapeutic intervention. Physical therapy plays a central role in its management. However, little is known about the beliefs and interventions of physical therapists who treat OA in Brazil and factors related to clinical decisions. OBJECTIVE: To determine whether there is an association between the professional qualification of physical therapists in the North Region of Brazil and their perception of efficiency or inefficiency of therapeutic interventions for knee OA. METHODS: A cross-sectional online survey was conducted with physical therapists from five states in northern Brazil, and their perception about 20 interventions was assessed through a hypothetical case of knee OA. Statistical analyses were performed using the chi-square test and binary logistic regression with a significance level of 5%. RESULTS: 370 professionals with a mean age of 32.16 ±6.89 responded to the survey. There was a significant association between qualification and perceived efficiency of interventions. Graduated physiotherapists were less likely to recognize ultrasound, short waves, transcutaneous electrical neurostimulation and electrical stimulation, cryotherapy, heat, muscle strengthening, kinesio taping, and rest as ineffective interventions. The same occurred for ultrasound, muscle strengthening, and kinesiology tape for specialists. CONCLUSION: The lower academic degree leads to a lower chance to perceive as poorly efficient or inefficient some not recommended interventions for knee OA.

Influence of isostretching on patients with chronic low back pain. A randomized controlled trial.

Objective: This study investigated the influence of isostretching on patients with chronic low back pain. Methods: It was a randomized, controlled trial with concealed allocation, intention-to-treat analysis, and blind assessment. Fifty-four patients with chronic low back pain were randomized to an experimental group and a control group. The experimental group performed isostretching twice a week for 45 days, while the control group remained on the waiting list for physical therapy. Patients were submitted to evaluations at baseline, after 20 and 45 days of treatment with regard to pain, quality of life, functional capacity, and satisfaction. Results: The experimental group exhibited statistically significant improvements in comparison to the control group with regard to pain (p = .003), functional capacity (p = .026), patient satisfaction (p < .001), and quality of life as determined by the functional capacity (p = .012), physical aspects (p = .011) and pain (p = .006) subscales of the SF-36. The experimental group used a significantly lesser amount of pain medication than the control group (p = .03). Conclusion: Isostretching was effective in reducing pain and in improving function, patient satisfaction and some aspects of quality of life in patients with chronic low back pain.

Amateur surfing on the south coast of são paulo: lifestyle and work as factors for practice engagement / O surfe amador no litoral sul de são paulo: estilo de vida e trabalho como fatores de aderência à prática

ABSTRACT The present study addresses correlations between lifestyle and engagement in physical activity, in addition to discussing the conditions that make it possible for amateurs to continue with a complex practice such as surfing for a long time. To this end, we interviewed eleven surfers with more than ten years of uninterrupted practice on the south coast of São Paulo. Using content analysis, it was possible to find that their permanence is less influenced by matters of gender, age and marital status (usually prioritized in the literature on the topic) than by employment conditions. It is argued that engagement in surfing is linked to the lifestyle and ideals of youth, while the conditions that lead amateurs to keep this practice involve family and employment relationships, the stability of which provides security to routine and modulates the games between social and nature times. Thus, mature surfers narrate a way of living that values prudent attitudes as a means for re-signifying surfing in their lives, pointing to a transformation of the surf culture. It is considered that the relationships between permanence in practice and job stability are worth investigating in further studies.

RESUMO No presente estudo, tratamos das relações entre estilo de vida e aderência à atividade física e discutimos as condições que possibilitam a longa permanência de amadores numa prática complexa como o surfe. Para tanto, entrevistamos onze surfistas com mais de dez anos de prática ininterrupta no litoral sul de São Paulo. Por meio de uma análise de conteúdo, foi possível constatar que a sua permanência é menos influenciada por questões de gênero, idade e estado civil (geralmente priorizada na literatura sobre o tema) do que condições empregatícias. Discute-se que adesão ao surfe é vinculada ao estilo de vida e aos ideais de juventude, ao passo que as condições de continuidade da prática dos amadores envolvem a família e os vínculos de emprego, cuja estabilidade dá segurança à rotina e modula os jogos entre os tempos sociais e da natureza. Assim, os surfistas maduros narram um modo de viver que valoriza atitudes prudentes como uma forma de ressignificação do surfe em suas vidas, apontando para uma transformação da cultura do surfe. Considera-se que as relações entre permanência na prática e estabilidade do emprego merecem ser investigadas em estudos futuros.

The impact of a low-calorie, low-glycemic diet on systemic lupus erythematosus: a systematic review

Abstract Background: Diet plays a critical role in Systemic Lupus Erythematosus (SLE) patients, impacting on the microbiota composition and, consequently, on the immune response. The objective was to analyze and verify the diet effect on SLE patients. Methods: This is a systematic review performed at the Evidences-based Health Lab, Escola Superior em Ciências da Saúde, Brasília (DF), Brazil. In March, 2021, five databases, and grey literature, through JSTOR, Open Grey, and Google Scholar were searched. Randomized Clinical Trials in which SLE patients with calorie restricted, low glycemic index or other diet involving the joint adequacy of these aspects, compared with placebo or different types of diet, were included. Results: It was identified in the databases 758 articles; 132 were duplicated; 616 references were screened, and 604 were excluded. After reading the title and abstract, 12 articles were included for full-text reading. After the full-text reading, three studies were included for quantitative analysis. The diet improved the quality of life at 6 (MD 16.30; 5.91;26.69) and 12 weeks (MD 14.60; 0.88;28.32). The GRADE was used to evaluate the quality of evidence. Conclusion: There is low evidence that the diet has a positive impact on the quality of life of SLE patients. Trial registration PROSPERO—CRD4202012208.

Força muscular de membros inferiores em mulheres com artrite reumatoide e mulheres sem a doença: há diferença? / Fuerza muscular de los miembros inferiores entre las mujeres con artritis reumatoide y las mujeres sin esta enfermedad: ¿habrá diferencias? / Lower-limb muscle strength in women with rheumatoid arthritis and women without the disease: is there a difference?

RESUMO A artrite reumatoide (AR) é uma doença inflamatória sistêmica, crônica, que acomete preferencialmente a membrana sinovial das articulações. Dentre as qualidades de aptidão física que podem ser reduzidas em indivíduos com AR merece destaque a força muscular, que está diretamente relacionada à capacidade de realização de todas as atividades da vida diária, desde as mais simples até as mais complexas. O objetivo deste estudo foi avaliar a força muscular de membros inferiores de mulheres com AR. Métodos: 17 voluntárias com AR (das classes funcionais I, II e III) e 17 sem a doença, com idade média de 54,7+6,63 anos, foram submetidas ao teste de uma repetição máxima para avaliar a força muscular de flexores e extensores de joelho e de abdutores e adutores de quadril. Utilizou-se o teste τ para analisar os dados, sendo considerados estatisticamente significativos os níveis de α <0,05. Em todas as avaliações o grupo de mulheres com AR apresentou valores inferiores quando comparados ao grupo sem a doença. No entanto não houve diferenças estatisticamente significativas entre os grupos. Os níveis descritivos obtidos da comparação entre a força muscular dos grupos foram: para extensores de joelho, p=0,224; flexores de joelho, p=0,467; abdutores de quadril, p=0,190; e adutores de quadril, p=0,127. A força muscular de membros inferiores não difere entre mulheres com AR (das classes funcionais I, II e III) e mulheres sem a doença.

RESUMEN La artritis reumatoide (AR) es una enfermedad inflamatoria sistémica, crónica, que afecta específicamente a la membrana sinovial de las articulaciones. Entre las cualidades de aptitud física que pueden reducirse en individuos con AR, se señala la fuerza muscular, que está directamente relacionada con la capacidad para realizar todas las actividades de la vida diaria, desde las más simples hasta las más complejas. Este estudio propone evaluar la fuerza muscular de los miembros inferiores de mujeres con AR. Métodos: Se sometieron a 17 voluntarias con AR (de categorías funcionales I, II y III) y a 17 sin la enfermedad -con un promedio de edad de 54,7+6,63 años- a la prueba de repetición máxima para que se evalúe la fuerza muscular de los flexores y los extensores de rodilla, así como los extensores y abductores de cadera. Se utilizó la prueba τ para analizar los datos, siendo considerados estadísticamente significativos los niveles de α <0,05. En todas las evaluaciones, el grupo de mujeres con AR presentó valores más bajos en comparación con el grupo sin la enfermedad. Sin embargo, no hubo ninguna diferencia estadísticamente significativa entre los grupos. Los niveles descriptivos obtenidos de la comparación entre la fuerza muscular de los grupos fueron: los extensores de rodilla, p=0,224; los flexores de rodilla, p=0,467; los abductores de cadera, p=,190; y los aductores de cadera, p=0,127. La fuerza muscular de los miembros inferiores no difirió entre las mujeres con AR (de categorías funcionales I, II y III) y las mujeres sin esta enfermedad.

ABSTRACT Rheumatoid arthritis (RA) is a systemic inflammatory disease, which is chronic and affects the joints' synovial membrane. Among the physical aptitude qualities that can be impaired in individuals with RA, muscle strength deserves attention. It is directly associated with the capacity of performing all activities of daily living, from the simplest to the most complex. The aim of this study was to assess the muscle strength of the lower limbs of women with RA. Seventeen volunteers with RA (I, II and III functional classes) and 17 women without the disease, with mean age corresponding to 54.7+6.63 years, underwent the one-maximum repetition test to assess knee flexors and extensors, hip abductors and adductors. We used Student's T test to analyze the data, considering significant p values < 0.05. In all assessments, the group of women with RA showed lower values when compared with women without the disease. However, there were no statistically significant differences between the groups. The descriptive levels obtained from the comparison between the groups' muscle strength were: knee extensors, p=0.224; knee flexors, p=0.467; hip abductors, p=0.190 and hip adductors, p=0.127. The muscle strength of the lower limbs does not differ between women with RA (I, II and III functional classes) and women without the disease.

Nível de atividade física e risco de quedas em idosos institucionalizados / Level of physical activity and risk of falls in the institutionalized elderly

INTRODUÇÃO: O envelhecimento se caracteriza pelo declínio progressivo de todos os processos fisiológicos, o que acarreta em alterações de todos os órgãos e sistemas, gerando perda de força muscular e déficit de equilíbrio. Esses processos podem ser agravados se o indivíduo for inativo fisicamente. OBJETIVO: avaliar o nível de atividade física e risco de quedas em idosos institucionalizados. MÉTODOS: Trata-se de um estudo quantitativo transversal, realizado com os 24 idosos residentes em uma ILPI, na cidade de São Paulo. Para a avaliação do equilíbrio foi utilizada a Escala de Equilíbrio de Berg e a avaliação do nível de atividade física, realizada por meio do IPAQ. RESULTADOS: a frequência de quedas nos últimos 3 meses foi de 16,66% e para o último ano de 20,83%. Idosos com tempo de institucionalização menor que 5 anos apresentam maior risco de quedas do que os idosos com maior tempo de institucionalização. Em relação à deambulação observamos que 41,66% dos homens deambulavam, índice este superior ao sexo feminino. Quanto ao equilíbrio, foi observado que 83,33% do total dos idosos apresentavam déficit de equilíbrio, sendo destes 50% com 80 anos ou mais. Em relação ao IPAQ, 87,5% dos idosos foram classificados como sedentários. CONCLUSÃO: A partir deste estudo foi possível concluir que, idosos residentes nessa ILPI apresentam alto índice de risco de quedas, sendo este risco maior em idosos do sexo feminino e idosos institucionalizados a menos de 5 anos. Houve alta taxa de sedentarismo e foi maior em indivíduos com idade superior a 80 anos. [AU]

INTRODUCTION: Aging is characterized by the progressive decline of all physiological processes, which results in alterations of all organs and systems, generating loss of muscular strength and deficit of balance. These processes can be aggravated if the individual is physically inactive. OBJECTIVE: to evaluate the level of physical activity and risk of falls in institutionalized elderly. METHODS: This is a cross-sectional quantitative study performed with the 24 elderly people living in an ILPI, in the city of São Paulo. In order to evaluate the balance, the Berg Balance Scale and the assessment of the physical activity level, using the IPAQ, were used. RESULTS: the frequency of falls in the last 3 months was 16.66% and for the last year 20.83%. Older people with institutionalization time of less than 5 years present a higher risk of falls than older people with longer institutionalization time. Regarding walking, we observed that 41.66% of the men wandered, which is higher than the female sex. Regarding the balance, it was observed that 83.33% of the total of the elderly presented balance deficit, being of these 50% with 80 years or more. In relation to the IPAQ, 87.5% of the elderly were classified as sedentary. CONCLUSION: Based on this study, it was possible to conclude that, elderly people living in this ILPI have a high risk of falls, and this risk is higher in elderly women and institutionalized elderly individuals less than 5 years of age. There was a high rate of sedentary lifestyle and it was higher in individuals older than 80 years. [AU]

Acute effect of a resistance exercise session on markers of cartilage breakdown and inflammation in women with rheumatoid arthritis.

AIM: To assess the acute effect of resistance exercise (RE) on circulating biomarkers of cartilage breakdown and inflammation in women with rheumatoid arthritis (RA). METHODS: Thirty-four volunteers (17 with and 17 without RA), participated in a 25 min RE session (knee extension, knee flexion, hip abduction and hip adduction) with one set of 12 repetitions at 50% of one repetition maximum (1RM) and one set of eight repetitions at 75% of 1RM. Blood samples were collected 30 and 5 min before, immediately after and 1, 2 and 24 h after the session. We used analysis of variance for repeated-measures with Bonferroni adjustments to assess differences between groups over time. RESULTS: In both groups we found significant changes in interleukin (IL)-1 beta (P = 0.045), IL-1 receptor antagonist (IL-1ra) (P < 0.001), IL-10 (P = 0.004), IL-6 (P < 0.001) and cartilage oligomeric matrix protein (COMP) P < 0.001) in response to exercise, but no changes in tumor necrosis factor-alpha and C-reactive protein levels. We found no differences in the responses of the two groups to the session, except for COMP levels, which are more sensitive to exercise and rest effects in RA patients. CONCLUSION: Women with and without RA have similar changes in response to a RE session in levels of inflammation biomarkers, but not of cartilage breakdown. IL-10 and IL-1ra increased after the RE session, indicating that RE may have an acute anti-inflammatory effect. Additional studies are necessary to clarify if repeated RE sessions can have long-term anti-inflammatory effects and the possible clinical repercussions of this cartilage breakdown characteristic in response to exercise in RA patients.

Neuropsychological assessment of patients with fibromyalgia / Avaliação neuropsicológica de pacientes com fibromialgia / Evaluación neuropsicológica de los pacientes con fibromialgia

The aim of the present study was to investigate associations among symptoms of depression, anxiety, pain perception and cognitive impairment in patients with a diagnosis of fibromyalgia. We evaluated 32 women volunteers with a diagnosis of fibromyalgia based on the criteria of the ACR. The control group was matched to the patient group for age, schooling and income. The volunteers were submitted to a neuropsychological battery focused on Memory, Attention, Executive Functions, Perceived Pain, Anxiety and Depression. Anxiety was more relevant than depression in the group of women with fibromyalgia, the perception of pain was very high and cognitive impairment was more evident in executive functions, especially planning and inhibitory control. Memory and attention were more impaired in the fibromyalgia group, especially on tasks that require executive functions. Patients with fibromyalgia seem to be less efficient in tasks related to executive functions.

O escopo desse artigo é a investigação das associações entre sintomas de depressão, ansiedade, percepção da dor e déficits cognitivos em pacientes com diagnostico de fibromialgia. Avaliamos 32 mulheres com diagnósticos de fibromialgia segundo a ACR. O grupo controle foi equiparado em termos de idade, escolaridade e renda. Todas as voluntárias foram submetidas a uma bateria neuropsicológica focada em Memoria, Atenção, Funções Executivas, Dor Percebia, Ansiedade e Depressão. Ansiedade foi mais relevante que depressão para o grupo de mulheres com fibromialgia, ao mesmo tempo os níveis de dor foram mais altos e os prejuízos cognitivos mais evidentes foram relacionados às funções executivas, principalmente controle inibitório e planejamento. Memória e atenção estavam mais prejudicadas no grupo fibromialgia, principalmente naquelas tarefas que requisitam mais das funções executivas. Pacientes com fibromialgia parecem menos eficazes em tarefas relacionadas às funções executivas.

Investigar las asociaciones entre los síntomas de depresión, ansiedad, percepción del dolor y deterioro cognitivo en pacientes con diagnóstico de fibromialgia. Se evaluó a 32 mujeres voluntarias con un diagnóstico de fibromialgia según la ACR. El grupo de control fue emparejado con el grupo de pacientes por edad, escolaridad e ingresos. Los voluntarios fueron sometidos a una batería neuropsicológica enfocada en Memoria, Atención, Funciones Ejecutivas, Dolor Percibido, Ansiedad y Depresión. La ansiedad fue más relevante que la depresión en el grupo de mujeres con fibromialgia, la percepción del dolor fue muy alta y el deterioro cognitivo fue más evidente en las funciones ejecutivas, especialmente en la planificación y el control inhibitorio. La memoria y la atención estaban más afectadas en el grupo fibromialgia, especialmente en las tareas que requieren funciones ejecutivas. Las pacientes con fibromialgia parecen ser menos eficientes en tareas relacionadas con las funciones ejecutivas.

Static, dynamic balance and functional performance in subjects with and without plantar fasciitis / Equilíbrio estático, dinâmico e desempenho funcional em indivíduos com e sem fasciíte plantar

Abstract Introduction: Plantar fasciitis (PF) is characterized by non-inflammatory degeneration and pain under the heel, and is one of the most common foot complaints. The compensations and adjustments made to decrease the discomfort caused by the disease are clinical findings and can be a factor that contributes to impaired balance and decreased functional performance. Objective: To compare functional performance as well as static and dynamic balance among subjects with and without PF. Methods: The sample consisted of 124 subjects of both sexes aged 20-60 years. Participants were divided into two groups: a bilateral PF group (PFG; n = 62) and a control group (CG, n = 62). The following outcomes were analyzed: static and dynamic balance (using functional tests) and functional performance (using a questionnaire). We used Student's t test for independent samples to compare variables between the groups. The alpha error was set at 0.05. Results: Subjects with PF showed greater impairment in their overall dynamic balance performance (p < 0.001) than the control group, except for left posteromedial movement (p = 0.19). The CG showed showed better functional performance (p < 0.001) than the PF group. There was no difference between groups for the variable static balance on stable (p = 0.160) and unstable surfaces (p = 0.085). Conclusion: Subjects with PF displayed smaller reach distances in the overall Star Excursion Balance Test (SEBT), demonstrating a deficit in dynamic balance and functional performance when compared with healthy subjects.

Resumo Introdução: A fasciíte plantar (FP) caracteriza-se por uma degeneração não inflamatória e dor na parte inferior do calcanhar, sendo uma das queixas mais comuns na região do pé. As compensações e as adaptações para diminuir o desconforto da doença é um achado clínico e atua como um fator que pode contribuir para o comprometimento no equilíbrio e no desempenho funcional. Objetivo: comparar os equilíbrios estático, dinâmico e o desempenho funcional entre indivíduos com e sem a FP. Métodos: participaram da pesquisa 124 voluntários distribuídos em dois grupos: grupo fasciíte plantar bilateral (GFP; n = 62) e grupo controle (GC; n = 62) de ambos os sexos, na faixa etária de 20 a 60 anos. Os desfechos analisados foram o equilíbrio estático, equilíbrio dinâmico por meio dos testes funcionais e o desempenho funcional por um questionário. Os resultados foram analisados utilizando o teste t de Student de amostras independentes para comparar as variáveis entre os grupos. O erro alfa considerado foi p < 0,05. Resultados: Indivíduos com FP apresentaram maior comprometimento durante o teste de equilíbrio dinâmico total (p < 0,001), exceto no movimento póstero-medial esquerdo (p = 0,19). O GC apresentou melhor desempenho funcional (p < 0,001) e não houve diferença entre os grupos para a variável equilíbrio estático nas superfícies estável (p = 0,160) e instável (p = 0,085). Conclusão: Indivíduos com FP obtiveram menores alcances no SEBT total, apresentando déficit de equilíbrio dinâmico e comprometimento no desempenho funcional quando comparados com os participantes saudáveis.

Aspectos psicológicos da síndrome da fibromialgia juvenil: revisão de literatura / Psychological aspects of juvenile fibromyalgia syndrome: a literature review

Resumo A síndrome da fibromialgia juvenil (SFJ) é uma condição dolorosa não inflamatória crônica que ocorre principalmente em meninas entre nove e 15 anos. Pode ser caracterizada por dores generalizadas e constantes em várias regiões do corpo, distúrbios do sono, fadiga diurna e estado de humor alterado. Fatores psicológicos e biológicos concomitantes resultaram na diminuição da capacidade de lidar com a dor. A qualidade de vida das crianças que sofrem de dores crônicas, e a de seus cuidadores, é severamente prejudicada e a ocorrência de sintomas de ansiedade e depressão é mais comum nessa população. Este estudo objetivou fazer uma revisão sistemática da literatura dos fatores psicossociais relacionados com a SFJ. Os achados revelam uma percepção divergente entre pacientes e parentes em relação aos efeitos da condição. As mães dos pacientes tendem a classificar a doença com uma gravidade maior do que os próprios pacientes. Os pacientes com fibromialgia parecem compartilhar os mesmos traços de personalidade e parece existir um tipo de ambiente familiar favorável à ocorrência da doença. As implicações psicológicas e funcionais devem ser tratadas com métodos que ajudem pacientes e parentes a modificar suas estratégias de enfrentamento dos problemas cotidianos, a aliviar as consequências disfuncionais da dor e da fadiga e a diminuir o risco de catastrofização.

Abstract Juvenile fibromyalgia syndrome (JFMS) is a non-inflammatory chronic pain condition that occurs mainly in girls aged 9–15 years. JFMS is characterized by constant widespread pain in different parts of the body, poor sleep quality, daytime sleepiness and an altered mood. Concomitant psychological and organic factors result in a diminished capacity to cope with pain. The quality of life of individuals with chronic pain and their caregivers is severely restricted and the occurrence of symptoms of anxiety and depression is common in this population. The aim of the present study was to perform a systematic review of the literature on psychosocial factors related to JFMS. The findings reveal differences in opinion between patients and family members regarding the effect of the condition, as mothers tend to classify JFMS as more severe than the patients themselves. Individuals with JFMS seem to share the same personality traits and there seems to be a type of family environment that is favorable to the occurrence of this condition. Psychological and functional aspects should be treated with methods that can help patients and family members alter their coping strategies regarding day-to-day problems, attenuate the dysfunctional consequences of pain and fatigue and diminish the risk of catastrophizing that individuals submitted to constant pain develop in relation to their surrounding environment.

Maus-tratos a idosos: perfil das vítimas, vínculo com o agressor e atuação dos profissionais / Ill-treament of the elderly: profile of the victims, bond with the aggressor and work of professionals

O envelhecimento populacional vem aumentando nos últimos anos e, associado a isso, tem-se o aumento das doenças crônicas, dependência e os maus-tratos aos idosos. O objetivo deste estudo foi identificar quais as causas de maus-tratos em idosos, onde ocorrem e quais as pessoas responsáveis por esses maus-tratos e a atuação dos profissionais em relação a isso. Trata-se de estudo qualitativo e de revisão de literatura baseada em publicações nacionais e internacionais publicadas num recorte temporal de 13 (treze) anos. Os dados apontam que, as vítimas que mais sofrem com maus-tratos/ violência são as mulheres, a violência física é a mais relatada, seguida da violência psicológica, a pessoa que mais pratica os tipos de maus-tratos/violência contra o idoso são os fi lhos seguidos pelos demais membros da família, o local onde mais ocorrem os abusos é no domicílio e os profissionais de saúde precisam de qualificação para identificar maus-tratos/violência no idoso. Conclui-se que a avaliação dos riscos relacionados aos maus-tratos contra os idosos é imprescindível, pois através dessa avaliação a assistência adequada poderá ser prestada. (AU)

Population aging has increased in recent years and associated with this, there is the increase in chronic diseases, addiction and mistreatment of the elderly. The objective of this study was to identify the causes of ill-treatment in the elderly, where they occur and what the people responsible for this abuse and the work of professionals in this regard. This is a qualitative study and literature review based on national and international publications published in a time frame of thirteen (13) years. The data indicate that the victims who suffer most from abuse / violence are women, physical violence is the most reported, followed by psychological violence, the person who most practical types of abuse / violence against the elderly are the children followed by other family members, where most abuses occur is in the home and health professionals need skills to identify abuse / violence in the elderly. It is concluded that the risk assessment related to mistreatment of the elderly is essential, because through this assessment appropriate assistance can be provided. (AU)

Maus-tratos a idosos: perfil das vítimas, vínculo com o agressor e atuação dos profissionais / Ill-treament of the elderly: profile of the victims, bond with the aggressor and work of professionals

O envelhecimento populacional vem aumentando nos últimos anos e, associado a isso, tem-se o aumento das doenças crônicas, dependência e os maus-tratos aos idosos. O objetivo deste estudo foi identificar quais as causas de maus-tratos em idosos, onde ocorrem e quais as pessoas responsáveis por esses maus-tratos e a atuação dos profissionais em relação a isso. Trata-se de estudo qualitativo e de revisão de literatura baseada em publicações nacionais e internacionais publicadas num recorte temporal de 13 (treze) anos. Os dados apontam que, as vítimas que mais sofrem com maus-tratos/ violência são as mulheres, a violência física é a mais relatada, seguida da violência psicológica, a pessoa que mais pratica os tipos de maus-tratos/violência contra o idoso são os fi lhos seguidos pelos demais membros da família, o local onde mais ocorrem os abusos é no domicílio e os profissionais de saúde precisam de qualificação para identificar maus-tratos/violência no idoso. Conclui-se que a avaliação dos riscos relacionados aos maus-tratos contra os idosos é imprescindível, pois através dessa avaliação a assistência adequada poderá ser prestada.

Population aging has increased in recent years and associated with this, there is the increase in chronic diseases, addiction and mistreatment of the elderly. The objective of this study was to identify the causes of ill-treatment in the elderly, where they occur and what the people responsible for this abuse and the work of professionals in this regard. This is a qualitative study and literature review based on national and international publications published in a time frame of thirteen (13) years. The data indicate that the victims who suffer most from abuse / violence are women, physical violence is the most reported, followed by psychological violence, the person who most practical types of abuse / violence against the elderly are the children followed by other family members, where most abuses occur is in the home and health professionals need skills to identify abuse / violence in the elderly. It is concluded that the risk assessment related to mistreatment of the elderly is essential, because through this assessment appropriate assistance can be provided.

Spine school for patients with low back pain: interdisciplinary approach / Escola de coluna para pacientes com lombalgia: abordagem interdisciplinar / Escuela de columna para pacientes com dolor lumbar: enfoque interdisciplinario

To analyze and evaluate an interdisciplinary educational treatment - Spine School.

Analisar e avaliar um tratamento educativo interdisciplinar - Escola da Coluna.

Analizar y evaluar un tratamiento educativo interdisciplinario - Escuela de la Columna.

Effect of a muscle stretching program using the global postural reeducation method for patients with chronic low back pain: A randomized controlled trial.

OBJECTIVES: To assess the effect of a muscle stretching program using the global postural reeducation (GPR) method for patients with chronic low back pain. METHODS: A randomized, controlled, clinical trial with a single blinded examiner and intention-to-treat analysis was conducted. Sixty-one patients with chronic low back pain were randomly allocated to either the GPR group or a control group. Patients in the GPR group underwent one weekly 60-minute session of GPR for a period of 12 weeks. The control group remained on the waiting list under drug treatment, with no physical intervention. The following parameters were evaluated: pain (VAS), function capacity (Roland-Morris Questionnaire [RMQ]), quality of life (SF-36) and depressive symptoms (Beck Inventory). The evaluations were performed by a single blinded examiner at baseline, three and six months after the initial evaluation. RESULTS: The GPR group demonstrated statistical improvements (P<0.05) in the VAS and RMQ as well as the pain, emotional aspects, limitation in physical functioning, vitality and mental health subscales of the SF-36 immediately after the intervention (three months), which were maintained through to the six-month evaluation. DISCUSSIONS: Based on the findings, a stretching program using the GPR method showed effective at improving pain, function, some quality of life aspects (emotional, limitations in physical functioning, vitality and mental health) and had no effect on depressive symptoms in patients with chronic low back pain.

Progressive resistance exercise in women with osteoarthritis of the knee: a randomized controlled trial.

OBJECTIVE: To determine the effect of a progressive resistance exercise (PRE) program on women with osteoarthritis (OA) of the knee. METHODS: Eligible subjects included women aged 40 to 70 years with pain between 3 and 8 on a 10-cm pain scale. Among the 144 subjects screened, 60 met the eligibility criteria and were randomized to the experimental group (EG) or control group (CG). Subjects in the EG participated in a 12-week PRE program twice a week and CG remained on a waiting list for physical therapy. The PRE program consisted of strengthening exercises for knee extensors, knee flexors, hip abductors and hip adductors, all performed with 50% and 70% of the one-repetition maximum (1RM) using machines with free weights. Resistance was reevaluated every two weeks. Assessments of pain, muscle strength, walking distance, function and quality of life were performed at baseline, six weeks and 12 weeks by a blinded assessor. RESULTS: Twenty-nine female subjects were randomly assigned to the EG and 31 were randomly assigned to the CG. Repeated-measures ANOVA revealed significantly better results in the EG pain (from 7.0±1.3 to 4.3±3.1 in the EG and from 7.0±1.2 to 6.6±1.5 in the CG - p<0.001), function (p<0.001), some domains of quality of life (physical function: p=0.002; physical role limitation: p=0.002; and pain: p=0.044) and muscle strength (extensors: p<0.001; flexors: p=0.002; and abductors: p<0.001). CONCLUSION: The PRE program was effective in reducing pain and improving function, some quality of life domains and strength in women with OA of the knee.

Investigation of stress, anxiety and depression in women with fibromyalgia: a comparative study.

INTRODUCTION: Depression has emerged as the most prevalent mental disorder in patients with fibromyalgia. Stress, whose stages are alarm, resistance, near-exhaustion and exhaustion, constitutes a physical reaction to a threatening situation. OBJECTIVE: To investigate the levels of stress, anxiety and depression in women with fibromyalgia, comparing them with those of healthy women. PATIENTS AND METHODS: Participants were 50 women, 25 with a diagnosis of fibromyalgia according to the criteria of the American College of Rheumatology, and 25 without this diagnosis, matched for age. Instruments used: Lipp Inventory of Stress Symptoms for Adults (LISS), State-Trait Anxiety Inventory (STAI) and Beck Depression Inventory (BDI). RESULTS: The mean age was 49.36 years for the group with fibromyalgia (FM) and 49.20 years for the group without fibromyalgia (non-FM). FM showed a higher incidence of stress (96%) compared with non-FM (5%). The resistance phase was predominant in both groups, FM (42%) and non-FM (100%). In FM there was distribution of the four stages (alarm, resistance, near-exhaustion and exhaustion). The differences between phases in the analyzed groups were significant (p < 0.001). FM showed predominance of psychological symptoms (54%); non-FM did show the same frequency of psychological and physical/psychological (40%) symptoms. Symptoms of state and trait anxiety and of depression in FM were significantly higher, when compared with non-FM (p < 0.01). CONCLUSION: Stress index (96%), trait anxiety (over 50) and clinically relevant depression (greater than 20) in FM were relevant. The understanding of the emotional variables involved in fibromyalgia is important to define the therapeutic strategy.

Investigacao do estresse, ansiedade e depressao em mulheres com fibromialgia: um estudo comparativo / Investigation of stress, anxiety and depression in women with fibromyalgia: a comparative study

Introdução: A depressão tem se apresentado como o transtorno mental mais prevalente em pacientes com fibromialgia. O estresse, cujas fases são alarme, resistência, quase-exaustão e exaustão, constitui importante reação do organismo frente a uma situação ameaçadora. Objetivo: Investigar os índices de estresse, ansiedade e depressão em mulheres com fibromialgia, comparando-os com os de mulheres saudáveis. Pacientes e métodos: Participaram 50 mulheres, 25 com o diagnóstico de fibromialgia, segundo os critérios do American College of Rheumatology, e 25 sem o diagnóstico, pareadas por idade. Instrumentos utilizados: Inventário de Sintomas de Stress para Adultos de Lipp (ISSL), Inventário de Ansiedade Traço-Estado (IDATE) e Inventário de Depressão Beck (BDI). Resultados: Idade média de 49,36 anos para o grupo com fibromialgia (FM) e 49,20 anos para o grupo sem fibromialgia (não FM). O FM apresentou maior incidência de estresse (96%) quando comparado com o não FM (5%). A fase de resistência foi predominante nos dois grupos, FM (42%) e não FM (100%). No FM verificou-se distribuição nas quatro fases (alerta, resistência, quase-exaustão e exaustão). As diferenças entre as fases nos grupos analisados foram significativas (p<0,001). O FM apresentou predominância de sintomas psicológicos (54%), o não FM apresentou a mesma frequência de sintomas psicológico e físico/psicológico (40%). Os sintomas de ansiedade estado e traço e depressão do FM foram significativamente superiores, quando comparados com o não FM (p<0,01). Conclusão: Constatou-se índice de estresse (96%), traço de ansiedade (superior a 50) e depressão clinicamente (superior a 20) relevantes no FM. O entendimento das variáveis ...

Introduction: Depression has emerged as the most prevalent mental disorder in patients with fibromyalgia. Stress, whose stages are alarm, resistance, near-exhaustion and exhaustion, constitutes a physical reaction to a threatening situation. Objective: To investigate the levels of stress, anxiety and depression in women with fibromyalgia, comparing them with those of healthy women. Patients and methods: Participants were 50 women, 25 with a diagnosis of fibromyalgia according to the criteria of the American College of Rheumatology, and 25 without this diagnosis, matched for age. Instruments used: Lipp Inventory of Stress Symptoms for Adults (LISS), State-Trait Anxiety Inventory (STAI) and Beck Depression Inventory (BDI). Results: The mean age was 49.36 years for the group with fibromyalgia (FM) and 49.20 years for the group without fibromyalgia (non-FM). FM showed a higher incidence of stress (96%) compared with non-FM (5%). The resistance phase was predominant in both groups, FM (42%) and non-FM (100%). In FM there was distribution of the four stages (alarm, resistance, near-exhaustion and exhaustion). The differences between phases in the analyzed groups were significant (p < 0.001). FM showed predominance of psychological symptoms (54%); non-FM did show the same frequency of psychological and physical/psychological (40%) symptoms. Symptoms of state and trait anxiety and of depression in FM were significantly higher, when compared with non-FM (p < 0.01). Conclusion: Stress index (96%), trait anxiety (over 50) and clinically relevant depression (greater than 20) in FM were relevant. The understanding of the emotional variables involved in fibromyalgia is important to define the therapeutic strategy. .