Comparison of Quality of Life in Breast Cancer Survivors with and without Persistent Depressive Symptoms: A 12-Month Follow-Up Study.

Although breast cancer treatments reduce mortality, their adverse effects can increase depression which impacts one's quality of life (QoL). Physical activity (PA) seems to improve the QoL of breast cancer survivors (BCS). However, an unanswered question is the influence of PA on the QoL in BCS with depressive symptoms. Thus, we analyzed the influence of PA on the QoL in BCS with persistent depressive symptoms during 12 months of follow-up. The sample included 70 female BCS. Depression and QoL domains (i.e., functional capacity, physical limitations, body pain, general health status, vitality, social and emotional aspects, and mental health) were assessed at baseline and follow-up periods by the Hospital Anxiety and Depression Scale and SF-36, respectively. Habitual PA was assessed by Baecke's questionnaire. Our results indicate a prevalence of 17.1% of depressive symptoms. Non-depressives BCS improved their physical limitations and general health status domains over time, but there were no observed differences in depressive BCS. BCS with persistent depressive symptoms (baseline and follow-up) showed worse QoL scores than non-depressives in all domains, regardless of confounding factors. When adjusted for PA, the difference between BCS depressives and non-depressives lost its significance in the functional capacity domain. In conclusion, habitual PA practice positively influenced the functional capacity domain of the QoL in BCS.

Association Between Different Domains of Physical Activity and Body Adiposity Indicators in Breast Cancer Survivors.

BACKGROUND: To analyze the relationship between different physical activity (PA) domains and adiposity indicators in breast cancer survivors. METHODS: This is a cross-sectional study, composed of 115 breast cancer (BC) survivors. Measurements of weight, height, waist circumference (WC), and hip circumference were objectively collected, as well as the analysis of body fat percentage through bioelectrical impedance analysis. The PA level was assessed by the Baecke questionnaire including domains related to occupational activity, leisure-time activity, and transportation, while the time spent in sedentary behavior was assessed through self-reported screen-time. Socioeconomic status was assessed through the Brazilian criteria for economic classification and considered as a covariate. RESULTS: BC survivors with higher PA levels in leisure-time activity/sport presented reductions in body fat percentage (ß = 1.13%; CI = -2.06; -0.21), BMI (ß = 0.80 kg/m²; CI = -1.50; -0.11), WC (ß = 1.89 cm; CI = -3.54; -0.23), and waist-to-height ratio (ß = 0.13 cm; CI = -0.23; -0.02). Similar values were observed in PA during transportation and in total. There was no correlation between PA at work and adiposity indicators. CONCLUSION: Different PA domains were inversely related to body adiposity in BC survivors.

Relationship of anxiety and depression symptoms with the different domains of physical activity in breast cancer survivors.

Background Physical activity (PA) has shown benefits in the mental health of breast cancer (BC) survivors. However, it is unclear if different domains of PA are related to the emotional well-being of this population. The objective of this study was to verify the relationship between different domains of PA [occupational, exercise/sport participation and leisure time/commuting] with symptoms of anxiety and depression in BC survivors. Methods It is a cross-sectional study, composed of 128 women breast cancer survivor, in which the socioeconomic class was evaluated through the questionnaire of the Brazilian Association of Research Companies (ABEP), PA level was evaluated through the Baecke questionnaire, and, symptoms of anxiety and depression were evaluated through the Hospital Anxiety and Depression Scale (HADS). Results It was verified that occupational PA related to anxiety (B = 1.44 [95% CI: 0.11; 2.76]) and leisure time/commuting PA was negatively related to depression (B=-0.99 [95% CI: -1.64;-0.34]), even after adjustment of analysis by age, marital status, and socioeconomic status. There was no correlation between exercise/sport participation with scores of anxiety and depression in BC survivors. Physical activity at leisure time/commuting was negatively related with depression in BC survivors with mastectomy (B=-1.20 [95% CI:-1.92; -0.47). Limitations The difficulty of recruiting the studied population and the absence of subsidy for participation in the study are factors to be considerate. Conclusions Occupational PA may not to be indicated in the management of emotional disorders in BC survivors; however, leisure time/commuting may be recommended to contribute to the mental well-being of this population.

Vasculopathy associated with peripheral neuropathy in gait parameters of diabetic people

Abstract Diabetic peripheral neuropathy (DPN) is a common complication of diabetes mellitus when glycemic levels are poorly controlled. Sometimes DPN is accompanied by vasculopathy (DPV), which can worsen the clinical prognosis. The aim of this study was to analyze the gait parameters of nondiabetic individuals and diabetic individuals with DPN with or without DPV. METHOD The study included 68 individuals (50 to 65 years old) divided into three groups: people without diabetes mellitus (n = 33), diabetic patients with DPN (n = 18), and diabetic patients with both DPN and DVP (n = 17). The participants underwent a gait evaluation using electronic baropodometry to obtain the single and double support, velocity, and pressure-time integral. RESULTS The pressure-time integral, velocity, and single support variables were lower, and the double support and double support/single support ratio were higher in the diabetic neuropathy and vasculopathy group. The velocity was lower the greater the degree of impairment of the diabetic foot. Some correlations were identified with velocity. CONCLUSION In diabetic individuals, there was a significant worsening of the gait parameters analyzed according to increasing degree of clinical impairment.

The relationship between post-operative time and cardiac autonomic modulation in breast cancer survivors.

BACKGROUND/OBJECTIVES: Breast cancer survivors present autonomic dysfunction when evaluated by their heart rate variability (HRV). The purpose of this study is to investigate the relationship between post-operative time and cardiac autonomic modulation in breast cancer survivors and compare these values to those of women without cancer. METHODS: This is a cross-sectional study consisting of 45 women from 35 to 70years old. These women were divided into two after breast cancer groups (BCG1 and BCG2) and a control group (CG). Group BCG1 consisted of women who had undergone breast cancer surgery within the last 18months and BCG2 those whose postoperative periods were more than 18months. The control group was formed by cancer-free women. HRV indices were used in the time and the frequency domain and geometric indexes. RESULTS: The indices in millisecond, RMSSD (BCG1=19.83; BCG2=14.99; CG=31.46), SD1 (BCG1=14.03; BCG2=10.61; CG=22.27), SD2 (BCG1=39.17; BCG2=35.28; CG=61.16), SDNN (BCG1=29.58; BCG2=26.12; CG=46.36) and HF in milliseconds squared (BCG1=194.2; BCG2=91.07; CG=449.4) showed statistically significant reductions in the breast cancer groups compared to the CG (p≤0.0001). Lower SD1 index values were observed when comparing BCG2 to BCG1. CONCLUSIONS: Breast cancer survivors regardless of their postoperative period exhibited a decrease in overall variability and both sympathetic and parasympathetic activity when compared to women without the disease. The group with the longer postoperative period manifested more pronounced autonomic modulation changes.

Immediate effect of basic body awareness therapy on heart rate variability.

OBJECTIVE: To determine the immediate effect of a Basic Body Awareness Therapy (BAT) session on measures of heart rate variability (HRV) in healthy young people. METHODS: 13 healthy young subjects of both genders, who showed no illnesses related to the autonomic nervous system (ANS) underwent an ANS evaluation before and after conducting a session of BAT. The assessment of ANS activity was conducted through the HR with the aid of Nerve-Express(®) software. The BAT session lasted for 50 min and was performed by one investigator (blinded to the assessment procedures). RESULTS: After BAT session significant improvement was found in the sympathetic and parasympathetic modulation (p < 0.05), and the general estimate of heart rate variability (p < 0.04). CONCLUSION: BAT was found to be an effective, easy to apply and inexpensive therapeutic technique, able to change ANS in order to improve HR which may suggest better health conditions for participating individuals.

Implementation of physiotherapeutic shares in the prevention of diabetes complications in a Family Health Strategy / Implementação de ações fisioterapêuticas na prevenção de complicações do diabetes na Estratégia de Saúde da Família

Introduction In the Family Health Strategy (FHS), the treatment of Diabetes Mellitus (DM) includes education and lifestyle change strategies. Physiotherapists have a key role in this health setting. Objectives To implement actions of evaluation and guidelines for patients with type 2 DM who attend a Family Health Strategy (FHS), regarding diabetic foot and the practice of regular physical exercise in the control and prevention of the complications of Diabetes Mellitus. Methods 17 individuals from an FHS were evaluated, with the following procedures: clinical and anthropometric parameters, inspection, a questionnaire on diabetic neuropathy, tests of vibratory and tactile sensitivity, muscle function, range of motion, functional analysis, questions about exercise practice and guidance regarding controlling blood glucose and foot care. Results Deformities, dry skin, calluses, dehydration, ulceration, cracking and brittle nails were found. Peripheral neuropathy was not observed; tactile sensitivity was altered in the heel region and the vibratory sense was absent in 5% of individuals. A decrease in functionality of ankle movements was verified. Of the participants, 76% were sedentary, 24% knew about the benefits of practicing regular exercise, 25% had undergone a medical evaluation prior to performing physical exercise and, of these, 25% were supervised by a qualified professional. Discussion The implementation of physiotherapy actions in diabetics from an FHS was important for highlighting the presence of risk factors for diabetic complications. Conclusions Individuals attending the FHS need more information and programs for the prevention of diabetic complications. .

Introdução Na Estratégia da Saúde da Família (ESF) o tratamento do Diabetes Mellitus (DM) inclui estratégias de educação e modificação do estilo de vida. Os fisioterapeutas vêm desenvolvendo papel fundamental nesse novo cenário de saúde. Objetivos Implementar ações de avaliação e orientações para pacientes com DM tipo 2, quanto ao pé diabético e à prática regular de exercícios físicos no controle e na prevenção de complicações do DM, os quais frequentam uma Estratégia de Saúde da Família (ESF). Métodos Foram avaliados 17 indivíduos de uma ESF, com os seguintes procedimentos: verificação de parâmetros clínicos e antropométricos, inspeção, questionário sobre neuropatia diabética, teste da sensibilidade tátil e vibratória, função muscular, amplitude de movimento, análise funcional, questionamentos sobre realização de exercícios, orientações sobre sua prática no controle glicêmico e orientações quanto aos cuidados com os pés. Resultados Foram encontradas deformidades, pele ressecada, calos, desidratação, ulceração, rachaduras e unhas quebradiças. A investigação sobre neuropatia periférica não indicou sua presença; a sensibilidade tátil estava alterada principalmente na região do calcanhar e a sensibilidade vibratória estava ausente em 5% dos indivíduos. Verificou-se diminuição na funcionalidade em movimentos de tornozelo. Dos participantes, 76% eram sedentários e 24% conheciam os benefícios da prática regular de exercícios físicos; 25% dos indivíduos passaram por avaliação médica antes de realizar exercício físico, que era supervisionado por profissional habilitado em 25% dos casos. Discussão A implementação de ações fisioterapêuticas nos diabéticos de uma EFS foi importante para destacar a presença de fatores de risco para complicações do diabetes. Conclusões Os indivíduos da ESF necessitam de mais informações e programas para a prevenção de complicações do DM e apresentam alterações predisponentes a amputações e outras complicações. .