Biofeedback interventions for short term upper limb function following stroke: A systematic review with meta-analysis.

BACKGROUND: Biofeedback has been used by rehabilitation professionals in the treatment of poststroke function impairments. PURPOSE: Investigate the efficacy of any type of biofeedback intervention for the treatment of upper limb function in individuals following stroke. STUDY DESIGN: Systematic review of literature with meta-analysis. METHODS: Literature searches were conducted using MESH terms and text words in PubMed, Lilacs, Scielo, Scopus, PEDro, and Web of Science databases. The main outcome was improvement in upper limb's motor function and motor function in activities of daily living. We calculated the Mean Difference and Standardized Mean Difference for the assessment scales reported as primary outcome. The methodological quality of included studies was assessed using PEDro scale. The overall quality of the evidence was assessed using GRADE system. RESULTS: From 1360 articles identified, 16 were included in the review (09 in the meta-analysis). Three forest plots of hemiparesis and one of hemiplegia showed that biofeedback therapy associated with conventional therapy has a greater improvement in participants upper limb motor function when compared to isolated conventional therapy. Two forest plots of hemiparesis and one of hemiplegia showed no superiority in participants improvement for biofeedback associated with conventional therapy when compared to isolated conventional therapy. CONCLUSION: Biofeedback therapy associated with conventional therapy showed a small clinical effect when associated to conventional therapy and very low quality of evidence. Although further research with higher quality evidence is needed.

Effectiveness of Pilates and circuit-based exercise in reducing arthralgia in women during hormone therapy for breast cancer: a randomized, controlled trial.

OBJECTIVE: To investigate the effect of Pilates compared with circuit-based exercise in reducing arthralgia in women during hormone therapy for breast cancer. DESIGN: Single-blind randomized controlled trial, parallel. SETTING: University hospital of Brasilia and Brazilian Association for Assistance to People with Cancer. PARTICIPANTS: Sixty women with arthralgia were recruited. Eligibility criteria included women complaining of arthralgia during hormone therapy for breast cancer. The exclusion criteria were women with active cancer, lymphedema, limitations to physical exercise, or limitation to answer some questionnaires. MAIN OUTCOME MEASURES: Primary: Pain. Secondary: Function, flexibility, and sleep quality. Outcomes were assessed at baseline and the end of the intervention (8 weeks) by the same blinded evaluator. INTERVENTION: Sixty participants were randomly assigned 20 to each of the three groups: Pilates, circuit-based exercise, and control groups. Exercise was performed twice per week for 75 min, over a period of 8 weeks. Participants in the control group were instructed to continue their usual activities. The Kolmogorov-Smirnov test was used to verify the normality of the outcomes. Intergroup differences were calculated using Kruskal-Wallis test with post hoc Mann Whitney U testing and the parametric data between the three groups with ANOVA of repeated measures with Bonferroni post hoc. RESULTS: The Pilates group demonstrated a significant difference in pain reduction compared to the circuit group (mean difference: -1.95 points, p = 0.020). CONCLUSION: Pilates was more effective than circuit-based exercise in reducing arthralgia in women during hormone therapy for breast cancer. TRIAL REGISTRATION: http://www.ensaiosclinicos.gov.br/rg/RBR-3wsdhs/ Registered on Octob 16th 2017.

Atuação da fisioterapia no trismo secundário ao câncer de glândula salivar / Physical Therapy for trismus secondary to salivary gland cancer

Introdução: O trismo, limitação da abertura da boca, é uma das morbidades que acarreta limitações funcionais. Objetivo: Descrever o efeito da fisioterapia por meio da terapia manual e exercícios com depressores de língua na abertura máxima bucal de paciente com trismo secundário ao câncer de glândula salivar. Métodos: Relato de caso de paciente com trismo cujo tratamento consistiu em 15 atendimentos de fisioterapia por meio da terapia manual (liberação miofascial e mobilização articular) e exercícios com depressores de língua, com 40 minutos de duração cada, para ganho de abertura bucal. A abertura máxima bucal foi avaliada por meio do paquímetro e números de depressores de língua. Resultados: A paciente apresentou aumento da abertura máxima bucal entre o primeiro e o último atendimento (11,5mm - 21,2mm) e aumento na quantidade de depressores de língua utilizados (12 ­ 17,5). Conclusão: A atuação fisioterapêutica foi eficaz para o tratamento do trismo. (AU)

Introduction: Trismus, a mouth opening amplitude limitation, is one of the morbidities that causes functional limitations. Objective: To describe the effect of physical therapy intervention utilizing manual therapy and wooden tongue depressors exercises in maximum mouth opening in a patient with trismus secondary to salivary gland cancer. Methods: Case report of a patient whose physical therapy intervention consisted in 15 sessions of manual therapy (myofascial liberation and articular mobilization) and wooden tongue depressors exercises, with 40 minutes duration each, to improve mouth opening. Maximum mouth opening was assessed with a paquimeter and number of wood tongue depressors. Results: The patient presented improvements in maximal mouth opening between the first and last assessment (11,5mm - 21,2mm) and increase in number of wood tongue depressors used. Conclusion: Physical therapy approach was an effective treatment for trismus. (AU)

Efetividade da Musicoterapia na Redução da Ansiedade de Pacientes Oncológicos: Revisão Sistemática / Effectiveness of Music Therapy in Reducing Anxiety in Cancer Patients: Systematic Review / Efectividad de la Musicoterapia en la Reducción de la Ansiedad en Pacientes con Cáncer: Revisión Sistemática

Introdução: O câncer é uma doença que envolve extenso sofrimento emocional, físico e social, o que favorece o aparecimento de diversas morbidades, incluindo ansiedade. Terapias complementares, como a musicoterapia, têm sido estudadas como alternativas para a abordagem da ansiedade. Objetivo: Revisar sistematicamente os estudos e determinar a efetividade da musicoterapia na redução da ansiedade de pacientes oncológicos. Método: A pesquisa foi realizada em seis bases de dados incluindo MEDLINE/PubMed, SciELO, Scopus, CINAHL, Cochrane e Web of Science, sem restrição de data, sexo, etnia ou tipos de câncer. Foram incluídos somente ensaios clínicos randomizados que avaliaram a ansiedade como um dos desfechos, bem como os que utilizaram a musicoterapia como intervenção e que envolveram amostra com indivíduos adultos diagnosticados com câncer. Foram excluídos os estudos em que a musicoterapia não foi realizada por um profissional especializado, não foi proposto grupo controle, não foi disponibilizado o estudo na integra, associaram pacientes com outras doenças além do câncer e incluíram no grupo experimental outra intervenção além da música. Resultado: Foram encontrados 1.909 estudos, sendo oito elegíveis. A maioria dos estudos demonstrou benefícios da musicoterapia na ansiedade. Conclusão:A musicoterapia é efetiva na redução da ansiedade de pessoas com câncer. No entanto, mais estudos com novas tecnologias e mais detalhes sobre a intervenção são necessários para a confirmação dos resultados.

Introduction: Cancer is a disease that involves extensive emotional, physical and social suffering, which favors the appearance of various morbidities, including anxiety. Complementary therapies, such as music therapy, have been studied as alternatives to an approach to anxiety. Objective: To conduct a systematic review of the literature and determine the effectiveness of music therapy to reduce anxiety of oncologic patients. Method: The research was conducted in six databases including MEDLINE/PubMed, SciELO, Scopus, CINAHL, Cochrane and Web of Science without restriction of date, gender, ethnicity or cancer types. It were included only randomized controlled trials that evaluated anxiety as one of the outcomes, as well as those using music therapy as an intervention, involving a sample with adult individuals diagnosed with cancer. The exclusion criteria were studies where music therapy was not performed by a skilled professional, without control group, studies not fully available, that associated patients with diseases other than cancer and which included in the experimental group another intervention instead of music. Result: A total of 1909 studies were found, of which eight were eligible. The majority of the studies have demonstrated benefits of music therapy for anxiety. Conclusion: Music therapy is effective in reducing the anxiety of people with cancer. However, more studies with new methodologies and further details about the intervention are necessary to confirm the results.

Introducción: El cáncer es una enfermedad que implica extensión emocional, física y social, lo que favorece la aparición de diversas morbilidades, incluida la ansiedad. Las terapias complementarias, como la musicoterapia, se han estudiado como alternativas al enfoque de la ansiedad. Objetivo: Revisar la literatura sobre la efectividad de la musicoterapia para el tratamiento de pacientes con trastornos de ansiedad y cáncer. Método:La investigación se realizó en seis bases de datos, incluyendo MEDLINE/PubMed, SciELO, Scopus, CINAHL, Cochrane y Web of Science, sin restricciones de fecha, género, etnia o tipos de cáncer. Se incluyeron solo ensayos controlados aleatorios de estudios que evaluaron la ansiedad como uno de los resultados, así como el uso de la musicoterapia como una intervención y la participación de una muestra con individuos adultos diagnosticados con cáncer. Los estudios en los que la musicoterapia no fue realizada por un profesional especializado, no se propuso un grupo de control, no se disponía de un estudio completo, se asociaron pacientes con enfermedades distintas al cáncer y se incluyó otra intervención además de la música en el grupo experimental. Resultados: Se encontraron 1.909 estudios, de los cuales ocho fueron elegibles. La mayoría de los estudios han demostrado los beneficios de la musicoterapia en la ansiedad. Conclusión: Esta revisión sistemática concluyó que la musicoterapia es efectiva para reducir la ansiedad de las personas con cáncer. Sin embargo, se necesitan más estudios con nuevas tecnologías y más detalles sobre la intervención para confirmar los resultados.

Aumento da fadiga e redução da qualidade de vida após tratamento de câncer do colo do útero / Increased fatigue and reduced quality of life after treatment of cervical cancer

Introdução: o câncer do colo do útero (CCU) acarreta prejuízos físicos e emocionais, sendo um grande problema de saúde pública. Objetivo: avaliar fadiga, capacidade funcional e qualidade de vida antes e após o tratamento com quimiorradioterapia para o CCU. Métodos: a avaliação de fadiga e qualidade de vida foi realizada por meio dos questionários: Inventário Breve de Fadiga (BFI) e Functional Assessment of Chronic Therapy ­ Cervix Cancer (FACT-Cx), respectivamente, já a capacidade funcional por mensuração direta pelo Teste do degrau (TD6). Participaram 11 mulheres com CCU. O Graphpad Prism® foi utilizado para estatística. Resultados: após a quimiorradioterapia houve aumento significativo da fadiga (de 2,80 para 4,83), redução significativa da qualidade de vida (de 107,8 para 88,1) e redução da capacidade funcional (de 91 degraus para 82 degraus). Conclusão: aumento da fadiga e redução da qualidade de vida foram observados uma semana após a realização de quimiorradioterapia para o CCU.

Introduction: cervical cancer (CC) causes physical and emotional damage and is a major public health problem. Objective: to evaluate fatigue, functional capacity and quality of life before and after treatment with chemoradiotherapy for CC. Method: the evaluation of fatigue and quality of life were performed through questionnaires the Brief Fatigue Inventory (BFI) and Functional Assessment of Chronic Therapy (FACT-Cx), respectively, and the functional capacity by direct measurement by the Test of the step (TD6). Eleven women participated with CC. Graphpad Prism® was used for statistics. Results: after chemoradiotherapy, there was a significant increase in fatigue (from 2.80 to 4.83), a significant reduction in quality of life (from 107.8 to 88.1) and reduction in functional capacity (from 91 steps to 82 steps). Conclusion: increased fatigue and reduced quality of life were observed one week after the completion of chemoradiotherapy for CC.