The influence of sex and level of physical activity on maximum tolerance to mechanical pain

Abstract Background A difference in maximum tolerance to mechanical pain (MTMP) between the sexes is widely studied but there is still no consensus on whether the level of physical activity (PA) influences pain. Objectives To compare the MTMP between men and women with different levels of PA. Methods Sixty five individuals were divided in female (n = 35) and male group (n = 30). The main outcome measures were PA level and MTMP by pressure algometry. Pressure was applied three times on both sides at the following points: cervical (5th and 7th) and lumbar (3th and 5th) vertebrae; trapezius, rhomboid, gluteus, gastrocnemius, pectoralis major, tibialis anterior, and deltoid muscles, elbow, hand, knee, and ankle. Results It was observed that the PA level has little influence on the MTMP at all the assessed points and that men have greater MTMP than women. Conclusion Sex, not the PA level, influences the MTMP.

The influence of sex and level of physical activity on maximum tolerance to mechanical pain.

BACKGROUND: A difference in maximum tolerance to mechanical pain (MTMP) between the sexes is widely studied but there is still no consensus on whether the level of physical activity (PA) influences pain. OBJECTIVES: To compare the MTMP between men and women with different levels of PA. METHODS: Sixty five individuals were divided in female (n = 35) and male group (n = 30). The main outcome measures were PA level and MTMP by pressure algometry. Pressure was applied three times on both sides at the following points: cervical (5th and 7th) and lumbar (3th and 5th) vertebrae; trapezius, rhomboid, gluteus, gastrocnemius, pectoralis major, tibialis anterior, and deltoid muscles, elbow, hand, knee, and ankle. RESULTS: It was observed that the PA level has little influence on the MTMP at all the assessed points and that men have greater MTMP than women. CONCLUSION: Sex, not the PA level, influences the MTMP.

Perfil da dor lombar em trabalhadores dos restaurantes de uma universidade pública do sul do Brasil / Lower back pain profile in restaurant workers at a public university in southern Brazil

A realização das tarefas dos trabalhadores em restaurantes universitários (RUs) envolve movimentos repetitivos de coluna, levantamento de pesos excessivos e permanência na postura em pé por períodos prolongados de tempo, sendo indicada avaliação da região lombar desses trabalhadores. Assim, o objetivo deste estudo foi traçar o perfil da dor lombar em trabalhadores dos RUs de uma Universidade Pública do Sul do Brasil. Trata-se de estudo quantitativo observacional de corte transversal, no qual foram selecionados participantes de 18 a 59 anos, de ambos os sexos, que exerciam alguma função dentro dos restaurantes de uma universidade do sul do Brasil e que relataram presença dor lombar. Os participantes foram avaliados, por: questionário sociodemográfico, escala visual numérica da dor (EVN), amplitude de movimento (ADM) da coluna lombar e questionário Start Back Screening Tool Brasil (SBST). Os resultados são apresentados em frequência absoluta e relativa, correlação de Spearman, e as variáveis numéricas em média e desvio padrão ou mediana, mínimo, máximo. Foram incluídos no estudo 28 participantes sendo 71,4% mulheres, que possuíam média de idade de 36,3 (±10,8) anos. O relato de dor acima de 4 na EVN foi de 71,4% dos participantes e todos possuíam diminuição da ADM em todos os movimentos avaliados na coluna lombar. A maioria (71,4%) apresentou baixo risco para fatores psicossociais pelo SBST. O perfil dos trabalhadores de restaurantes da universidade avaliada é caracterizado por ser prioritariamente realizado por mulheres, sendo que estas trabalhadoras apresentaram quadro álgico intenso e limitação dos movimentos articulares na região lombar.

The tasks that workers in university restaurants (URs) perform involves repetitive movements of the back, lifting excessive weight, remaining in a standing posture for prolonged periods of time, and, thus, an evaluation of the lumbar region of these workers is indicated. Therefore, the objective of this study was to outline the profile of lower back pain in workers from the URs of a Public University in the South of Brazil. This is a cross-sectional, observational, quantitative study, in which participants aged 18 to 59 years, of both sexes, who performed some function within the restaurants of a university in southern Brazil and who reported the presence of lower back pain were selected. Participants were evaluated by a sociodemographic questionnaire, a visual analogue scale (VAS) for pain, a range of motion (ROM) of the lumbar spine evaluation, and the Brazilian Start Back Screening Tool (SBST) questionnaire. Results are presented as absolute and relative frequencies, with a Spearman correlation, and numerical variables as mean and standard deviation or median, minimum, and maximum. Twenty-eight participants were included in the study, 71.4% of whom were women, with a mean age of 36.3 (±10.8) years old. The report of pain above 4 in the VAS was 71.4% of the participants and all had a decrease in ROM in all movements evaluated in the lumbar spine. Most (71.4%) had low risk for psychosocial factors by SBST. The profile of restaurant workers at the evaluated university is characterized by being primarily performed by women, and these workers presented severe pain and limited joint movements in their lumbar region.

Parkinson's disease and multicomponent aquatic exercise: Effects on motor aspects, functional mobility, muscle function and aquatic motor skills.

OBJECTIVE: Analyze the effects of a multicomponent aquatic exercise program on motor aspects, functional mobility, muscle function and aquatic motor skills of people with PD. METHODS: Eighteen people with a PD diagnosis were assessed before and after a 12-week multicomponent aquatic exercise program, twice a week, with each session lasting 50 min. The terrestrial variables analyzed were motor aspects, through the Unified Parkinson Disease Rating Scale (UPDRS); functional mobility, through the Five Times Sit to Stand Test (FTSST); Peak Torque (PT) and Mean Power (MP) of hip, knee and ankle flexors and extensors, assessed using an isokinetic dynamometer. In water, aquatic motor skill levels were assessed by means of the Aquatic Functional Assessment Scale (AFAS). RESULTS: Significant improvements were found after the intervention in the following outcomes: motor aspects (p = 0.038, Δ = 5-61); MP of knee flexors at 90°/s on the most affected side (p = 0.026, Δ = 5.14), MP of knee extensors at 90°/s on the most affected side (p = 0.008, Δ = 8.69), MP of knee extensors at 120°/s on the most affected side (p = 0.005, Δ = 8.35), and AFAS in the domain of specialized therapeutic exercises (p = 0.014, Δ = 1.28). CONCLUSIONS: The completed multicomponent aquatic exercise program promoted changes in muscle function and terrestrial and aquatic functional outcomes in people with PD.

Análise do desenvolvimento neuropsicomotor de pré-termos em ambulatório multidisciplinar: um olhar da fisioterapia / Analysis of neuropsychomotor development of preterm in multidisciplinary ambulatory: a view of physiotherapy

INTRODUÇÃO: Desde a gestação até o nascimento, o desenvolvimento neuropsicomotor é influenciado por diversos fatores biopsicossociais. Tal influência pode ser ainda mais acentuada em recém-nascidos pré-termo devido a internação na Unidade de Terapia Intensiva Neonatal, por isto, bebês pré-termos estão mais susceptíveis a essas influências. OBJETIVO: Analisar sob a ótica do fisioterapeuta o desenvolvimento neuropsicomotor de pré-termos em ambulatório multidisciplinar de um hospital público. METODOLOGIA: Estudo observacional e longitudinal, ambispectivo, de 19 crianças nascidas prematuras de 0 a 12 meses de idade corrigida, sendo critério de exclusão crianças com alterações cognitivas e/ou genéticas ou não terem assinado o termo de consentimento. Os dados foram coletados por meio da análise de prontuários entre agosto de 2017 e dezembro de 2018, o desenvolvimento avaliado por meio do Teste Triagem Denver II, em dois momentos: A1 e A2, em sua admissão e retorno ao serviço após a alta da Unidade de Terapia Intensiva Neonatal e para análise da relação entre mãe e bebê foi utilizada a Avaliação Vínculo Mãe/filho apenas em A1. As estimulações eram realizadas por meio de orientações e folder educativo para os pais e responsáveis. Os dados foram analisados, por meio de média, desviopadrão, frequência absoluta e relativa, mediana, minimo e máximo e Teste de Wilcoxon para os domínios do Teste Denver II A1 em comparação a A2, utilizando o programa SPSS versão 20.0. RESULTADOS: Foram acompanhadas 19 crianças, destas 79% foram classificadas com desenvolvimento normal no A1. As crianças que apresentaram déficits no A1 (10,5%), superaram no A2. Porém, no segundo atendimento, algumas passaram a apresentar dificuldade em novas tarefas/domínio (motor, motor fino e pessoal-social), de modo que 31,5% apresentaram desenvolvimento geral anormal em A2. Foi encontrada diferença significativa (p=0,02) ao comparar as classificações gerais de Denver II nos dois momentos de avaliação. O vínculo mãe-filho foi classificado como fraco (média de 5,8 pontos). CONCLUSÃO: Observou-se que os bebês superaram os atrasos identificados na primeira avaliação, embora os resultados no Denver tiveram variações ao longo do tempo. Dessa forma, acredita-se que o perfil familiar identificado nesta pesquisa somada a abordagem multiprofissional possa ter favorecido o desenvolvimento neuropsicomotor dos bebês prematuros com até 12 meses de idade corrigida.

INTRODUCTION: From gestation to birth, neuropsychomotor development is influenced by several biopsychosocial factors. This influence can be even more accentuated in preterm newborns due to their admission to the Neonatal Intensive Care Unit, so preterm babies are more susceptible to these influences. OBJECTIVE: To analyze the neuropsychomotor development of preterm babies in a multidisciplinary outpatient clinic of a public hospital. METHODOLOGY: Observational and longitudinal, ambispective study of 19 children born prematurely from 0 to 12 months of corrected age, being exclusion criteria children with cognitive and/or genetic alterations or not having signed the consent form. The data were collected through the analysis of medical records between August 2017 and December 2018, the development evaluated through the Denver II Triage Test, in two moments: A1 and A2, on their admission and return to service after discharge from the Neonatal Intensive Care Unit and for analysis of the relationship between mother and baby the Evaluation Mother/Son bond only in A1 was used. The stimulations were carried out employing orientation and educational folder for parents and guardians. The data were analyzed by means of mean, standard deviation, absolute and relative frequency, median, minimum and maximum, and Wilcoxon Test for the domains of Denver II A1 compared to A2, using the SPSS program version 20.0. RESULTS: 19 children were accompanied, and 79% of these were classified with normal development in A1. The children who presented deficits in A1 (10.5%), surpassed in A2. However, in the second attendance, some started to present difficulties in new tasks/domains (motor, fine motor, and personal-social), so that 31.5% presented abnormal general development in A2. A significant value was found when comparing the Denver II general classification in A1 with A2 (p=0.02). The mother-child bond was classified as weak (average of 5.8 points). CONCLUSION: It was observed that babies overcame the delays identified in the first evaluation, although the results in Denver had variations over time. Thus, it is believed that the family profile identified in this research plus the multi-professional approach may have favored the neuropsychomotor development of premature babies up to 12 months of corrected age.

Perfil sociodemográfico de pais de recém-nascidos prematuros internados em um hospital público / Sociodemographic profile of parents of premature newborns admitted to a public hospital

Premature birth is unpredictable and can result from social, economic and/or health-related factors for women and newborns. This study aimed to analyze the sociodemographic profile of parents of premature newborns admitted to a Neonatal Intensive Care Unit (NICU). Furthermore, it is a descriptive, exploratory, and quantitative study, carried out from March to August 2019 in an NICU. Demographic, socioeconomic, and data related to the newborn and the pregnancy process were collected with a questionnaire containing closed and open questions, which were analyzed and compared with related studies. 31 mothers and 19 fathers participated. Most of them were young and completed high school. Almost all fathers had paying jobs, while only half of mothers worked, and not all of them contributed to social security (INSS). Fathers received 30% more than mothers, even with similar functions and working hours. 47% of the families lived with an income of up to 2 minimum wages per month. Half of the pregnancies were unplanned. Births with gestational ages (GA) ≥ 32 weeks predominated. On average, the mothers had more than 8 prenatal consultations and displayed hypertension as the most prevalent maternal risk factor. Knowing the families of newborns can support measures to promote maternal and child health.

Effects of chronic stretching on soleus muscle of Wistar female rats / Efectos del estiramiento crónico en el músculo sóleo de ratas hembras Wistar

The purpose of this study was to evaluate the chronic effects of stretching exercise on soleus muscle histomorphology and histomorphometry of young and aged rats. Thirty-eight female rats were divided into young control group (YCG, n=10;274±50 g); young stretching group (YSG, n=8;274±12 g); aged control group (ACG, n=10;335±39 g); and aged stretching group (ASG, n=10;321±32g). A mechanical apparatus was used to stretch muscle in 4 repetitions, 60 s each, 30 s interval between repetitions in each session, 3 times a week for 3 weeks. Twenty-four hours after the last stretching session, soleus muscle was removed for micromorphology and immunostaining analysis. Data analyses were performed with one-way ANOVA, post-hoc Tukey, or Kruskal-Wallis tests for parametric and nonparametric, respectively (p≤0.05). Muscle fiber cross-sectional area (MFCSA) of ACG was lower (18 %) compared to the YCG. Stretching increased MFCSA comparing YSG to YCG (5,681.15± 1,943.61 µm2 vs 5,119.84±1,857.73 µm2, p=0.00), but decreased comparing ASG to ACG (3,919.54± 1,694.65 µm2 vs 4,172.82±1,446.08 µm2, p=0.00). More serial sarcomere numbers were found in the YSG than YCG (12,062.91±1,564.68 vs 10,070.39±1,072.38, p=0.03). Collagen I and collagen III were higher in YSG than ASG (7.44±7.18 % vs 0.07±0.09 %, p=0.04) and (14.37 %± 9.54 % vs 5.51 %±5.52 %, p=0.00), respectively. TNF-a was greater in ASG than YSG (43.42 %±40.19 % vs 1.72 ± 2.02 %, p=0.00). Epimysium was larger in the YSG compared to YCG (201.83±132.07 % vs 181.09±147.04 %, p=0.00). After 3-week stretching the soleus muscles from aged rats were smaller than their younger counter-parts. Interestingly, while stretching appeared to positively affect young soleus muscle, the opposite was detected in the muscle of the aged rats.

El propósito de este estudio fue evaluar los efectos crónicos del ejercicio de estiramiento sobre la histomorfología e histomorfometría del músculo sóleo de ratas jóvenes y envejecidas. Se dividieron 38 ratas hembras en un grupo control joven (YCG, n = 10; 274 ± 50 g); grupo de estiramiento joven (YSG, n = 8; 274 ± 12 g); grupo control de edad (ACG, n = 10; 335 ± 39 g); y grupo estiramiento envejecido (ASG, n = 10; 321 ± 32 g). Se usó un aparato mecánico para estirar el músculo en 4 repeticiones, 60 s cada una, intervalo de 30 s entre repeticiones en cada sesión, 3 veces por semana, durante 3 semanas. Veinticuatro horas después de la última sesión de estiramiento, se extrajo el músculo sóleo para análisis de micromorfología e inmunotinción. Los análisis de datos se realizaron con pruebas ANOVA de una vía, Tukey post-hoc o Kruskal-Wallis para pruebas paramétricas y no paramétricas, respectivamente (p≤0,05). El área de la sección transversal de fibra muscular (MFCSA) de GCE fue menor (18 %) en comparación con el GCJ. El estiramiento aumentó ASTFM comparando GEJ con GCJ (5.681,15 ± 1.943,61 µm2 vs 5.119,84 ± 1.857,73 µm2, p = 0,00), pero disminuyó comparando GEE con GCE (3.919,54 ± 1.694,65 µm2 vs 4.172,82 ± 1.446,08 µm2, p = 0,00). Se encontraron más sarcómeros en serie en el GEJ que en el GCJ (12.062,91 ± 1.564,68 vs 10.070,39 ± 1,072.38, p = 0,03). El colágeno I y el colágeno III fueron más numerosos en GEJ que en GEE (7,44 ± 7.18 % vs 0,07 ± 0,09 %, p = 0,04) y (14,37 % ± 9,54 % vs 5,51 % ± 5,52 %, p = 0,00), respectivamente. TNF-α fue mayor en GEE que GEJ (43,42 % ± 40,19 % vs 1,72 ± 2,02 %, p = 0,00). El epimisio fue mayor en el GEJ en comparación con el GCJ (201,83 ± 132,07 % vs 181,09 ± 147,04 %, p = 0,00). Después de 3 semanas de estiramiento, los músculos sóleo de las ratas envejecidas eran más pequeños que sus contrapartes más jóvenes. Curiosamente, si bien el estiramiento pareció afectar positivamente el músculo sóleo joven, se detectó lo contrario en el músculo de las ratas envejecidas.

Short-wave diathermy in patients with chronic low back pain: a systematic review / Diatermia por ondas curtas em pacientes com dor lombar crônica: revisão sistemática / Diatermia por ondas cortas en pacientes con dolor lumbar crónico: revisión sistemática

ABSTRACT The aim of this study was to evaluate the evidence of application of short-wave diathermy (SWD) in individuals with chronic low back pain (CLBP) and its prescription parameters. The data sources (MEDLINE, PubMed, LILACS, DARE, PsycINFO, AusportMed, SciELO, PEDro and the Cochrane Central Register of Controlled Trials) were systematically searched for articles published up to December 2017. Randomized and non-randomized clinical trial studies that investigated the effect of the application of SWD on CLBP were selected. Two independent reviewers assessed the risk of bias in studies using the Jadad and the Downs & Black scales. Five studies (731 patients) were included, all of whom presented improvements in CLBP. The majority used continuous mode SWD, with only one using pulsed mode (82 and 200 Hz). SWD produced improvements in CLBP, but there is limited evidence for its application, and a lack of standardization of the parameters used. Furthermore, the results that address this topic should be interpreted with caution due to their low methodological quality and limited number. Level of evidence II; Systematic review.

RESUMO O objetivo do presente estudo foi avaliar a evidência de aplicação da diatermia por ondas curtas (DOC) em indivíduos com dor lombar crônica (DLC) e seus parâmetros de prescrição. As fontes de dados (MEDLINE, PubMed, LILACS, DARE, PsycINFO, AusportMed, SciELO, PEDro e Cochrane Central Register of Controlled Trials) foram pesquisadas sistematicamente quanto aos artigos publicados até dezembro de 2017. Estudos de ensaios clínicos randomizados e não randomizados que investigaram o efeito da aplicação da DOC na DLC foram selecionados. Dois revisores independentes avaliaram o risco de viés em estudos usando as escalas Jadad e Downs & Black. Cinco estudos (731 pacientes) foram incluídos e todos apresentaram melhora na DLC. A maioria usou a DOC de modo contínuo, com apenas um utilizando o modo pulsado (82 e 200 Hz). A DOC apresentou melhora na DLC, no entanto, há evidências limitadas para sua aplicação e ausência de padronização dos parâmetros utilizados. Além disso, os resultados que se referem a esse tópico devem ser interpretados com cautela devido à baixa qualidade metodológica e ao número limitado de estudos. Nível de evidência II; Revisão sistemática.

RESUMEN El objetivo del presente estudio fue evaluar la evidencia de la diatermia por ondas cortas (DOC) en individuos con dolor lumbar crónico (DLC) y sus parámetros de prescripción. Las fuentes de datos (MEDLINE, PubMed, LILACS, DARE, PsycINFO, AusportMed, SciELO, PEDro y Cochrane Central Register of Controlled Trials) fueron utilizadas para búsquedas sistemáticas de artículos publicados hasta diciembre de 2017. Fueron seleccionados los estudios de ensayos clínicos aleatorizados y no aleatorizados que investigaron el efecto de la aplicación de DOC en DLC. Dos revisores independientes evaluaron el riesgo de sesgo en estudios usando las escalas Jadad y Downs & Black. Fueron incluidos cinco estudios (731 pacientes) y todos presentaron mejora en DLC. La mayoría usó la DOC de modo continuo, con sólo uno usando el modo pulsado (82 y 200 Hz). La DOC produjo mejoras en DLC, sin embargo, hay evidencias limitadas para su aplicación y ausencia de estandarización de los parámetros utilizados. Además, los resultados que se refieren a ese tópico deben interpretarse con cautela debido a la baja calidad metodológica y al número limitado de estudios. Nivel de evidencia II; Revisión sistemática.

Atelectasis and lung changes in preterm neonates in the neonatal period: a blind radiological report and clinical findings. / Atelectasia e alterações pulmonares em recém-nascidos prematuros no período neonatal: laudo radiológico cego e achados clínicos.

OBJECTIVE: To determine the occurrence and characteristics of atelectasis, opacities, hypolucency and pulmonary infiltrates observed on chest X-rays of preterm infants in a neonatal intensive care unit. METHODS: This was a cross-sectional observational study. From August to December 2017, all chest radiographs of newborn infants were analyzed. The study included the chest radiographs of preterm neonates with gestational ages up to 36 weeks in the neonatal period that showed clear changes or suspected changes, which were confirmed after a radiologist's report. Radiological changes were associated with possible predisposing factors. RESULTS: During the study period, 450 radiographs were performed on preterm neonates, and 37 lung changes were identified and classified into 4 types: 12 (2.66%) changes were described as opacities, 11 (2.44%) were described as atelectasis, 10 (2.22%) were described as pulmonary infiltrate, and 4 (0.88%) were described as hypolucency. A higher occurrence of atelectasis was noted in the right lung (81.8%). Among the abnormal radiographs, 25 (67.6%) newborn infants were receiving invasive mechanical ventilation. CONCLUSION: Considering the radiological report, no significance was found for the observed changes. Atelectasis was not the most frequently observed change. The predisposing factors for these changes were extreme prematurity, low weight, male sex, a poorly positioned endotracheal tube and the use of invasive mechanical ventilation.

OBJETIVO: Verificar a ocorrência e as características de atelectasias, opacidades, hipotransparências e infiltrados pulmonares evidenciados ao raio X de tórax dos recém-nascidos prematuros, de uma unidade de terapia intensiva neonatal. MÉTODOS: Trata-se de estudo observacional transversal. No período de agosto a dezembro de 2017 foram analisadas todas as radiografias de tórax de recém-nascidos. Foram incluídas no estudo as radiografias de tórax de recém-nascidos prematuros com idade gestacional até 36 semanas, no período neonatal que apresentassem alterações evidentes na imagem ou suspeita de alterações, que fossem confirmadas após laudo do médico radiologista. As alterações radiológicas foram associadas com possíveis fatores predisponentes. RESULTADOS: No período, foram realizadas 450 radiografias nos recém-nascidos prematuros, sendo que, em 37, foram descritas quatro alterações: 12 (2,66%) descritas como opacidades, 11 (2,44%) como atelectasias, 10 (2,22%) como infiltrados pulmonares e 4 (0,88%) como hipotransparências. Observou-se maior ocorrência das atelectasias no pulmão direito (81,8%). Dentre as radiografias com alterações, 25 (67,6%) recém-nascidos estavam sob o uso da ventilação mecânica invasiva. CONCLUSÃO: Considerando o laudo radiológico, as alterações observadas têm ocorrências sem diferença estatisticamente significante. A atelectasia não foi a alteração mais encontrada. Os fatores que podem ter predisposto ao aparecimento das alterações foram a prematuridade extrema, o baixo peso, o sexo masculino, o mal posicionamento da cânula endotraqueal e o uso de ventilação mecânica invasiva.

The development of a mechanical device to stretch skeletal muscle of young and old rats.

OBJECTIVE: How much force is needed to stretch skeletal muscle is still unknown. The aim of this study was to develop a device that mechanically stretches rat muscle to compare the force (N) required to stretch the soleus muscle of young and aged rats and the tibio-tarsal angle joint at neutral and stretched positions. METHODS: Twelve female Wistar rats were divided into two groups: a young group (YG, n=6, 311±11 g) of rats 3 months old and an aged group (AG, n=6, 351±43 g) of rats 15 months old. The left soleus muscle was mechanically held in full dorsal flexion and submitted to mechanical passive stretching: 1 bout of 10 repetitions, each repetition lasted 60 seconds with an interval of 45 seconds between repetitions, performed once a day, twice a week, for 1 week. The force required during stretching was measured by a load cell, and the tibio-tarsal angle joint was measured by photometry. RESULTS: The load cell calibration showed excellent reliability, as confirmed by the intraclass correlation coefficient value of 0.93. A decrease in delta force was found in the comparison between YG and AG (0.11±0.03 N vs 0.08±0.02 N, p<0.05, repeated measures ANOVA). There was no difference between the YG and the AG in the tibio-tarsal angle at resting position (87.1±3.8° vs 87.1±3.5°, p=0.35, Kruskal Wallis) and at the end of the stretching protocol (43.9±4.4° vs 42.6±3.4°, p=0.57, Kruskal Wallis). CONCLUSION: The device presented in this study is able to monitor the force necessary to stretch hindlimb rat muscles. Aged rats required less force than young rats to stretch the soleus muscle, and there was no difference regarding the tibio-tarsal angle between the two groups.

Atelectasia e alterações pulmonares em recém-nascidos prematuros no período neonatal: laudo radiológico cego e achados clínicos / Atelectasis and lung changes in preterm neonates in the neonatal period: a blind radiological report and clinical findings

RESUMO Objetivo: Verificar a ocorrência e as características de atelectasias, opacidades, hipotransparências e infiltrados pulmonares evidenciados ao raio X de tórax dos recém-nascidos prematuros, de uma unidade de terapia intensiva neonatal. Métodos: Trata-se de estudo observacional transversal. No período de agosto a dezembro de 2017 foram analisadas todas as radiografias de tórax de recém-nascidos. Foram incluídas no estudo as radiografias de tórax de recém-nascidos prematuros com idade gestacional até 36 semanas, no período neonatal que apresentassem alterações evidentes na imagem ou suspeita de alterações, que fossem confirmadas após laudo do médico radiologista. As alterações radiológicas foram associadas com possíveis fatores predisponentes. Resultados: No período, foram realizadas 450 radiografias nos recém-nascidos prematuros, sendo que, em 37, foram descritas quatro alterações: 12 (2,66%) descritas como opacidades, 11 (2,44%) como atelectasias, 10 (2,22%) como infiltrados pulmonares e 4 (0,88%) como hipotransparências. Observou-se maior ocorrência das atelectasias no pulmão direito (81,8%). Dentre as radiografias com alterações, 25 (67,6%) recém-nascidos estavam sob o uso da ventilação mecânica invasiva. Conclusão: Considerando o laudo radiológico, as alterações observadas têm ocorrências sem diferença estatisticamente significante. A atelectasia não foi a alteração mais encontrada. Os fatores que podem ter predisposto ao aparecimento das alterações foram a prematuridade extrema, o baixo peso, o sexo masculino, o mal posicionamento da cânula endotraqueal e o uso de ventilação mecânica invasiva.

ABSTRACT Objective: To determine the occurrence and characteristics of atelectasis, opacities, hypolucency and pulmonary infiltrates observed on chest X-rays of preterm infants in a neonatal intensive care unit. Methods: This was a cross-sectional observational study. From August to December 2017, all chest radiographs of newborn infants were analyzed. The study included the chest radiographs of preterm neonates with gestational ages up to 36 weeks in the neonatal period that showed clear changes or suspected changes, which were confirmed after a radiologist's report. Radiological changes were associated with possible predisposing factors. Results: During the study period, 450 radiographs were performed on preterm neonates, and 37 lung changes were identified and classified into 4 types: 12 (2.66%) changes were described as opacities, 11 (2.44%) were described as atelectasis, 10 (2.22%) were described as pulmonary infiltrate, and 4 (0.88%) were described as hypolucency. A higher occurrence of atelectasis was noted in the right lung (81.8%). Among the abnormal radiographs, 25 (67.6%) newborn infants were receiving invasive mechanical ventilation. Conclusion: Considering the radiological report, no significance was found for the observed changes. Atelectasis was not the most frequently observed change. The predisposing factors for these changes were extreme prematurity, low weight, male sex, a poorly positioned endotracheal tube and the use of invasive mechanical ventilation.

Satisfação de puérperas após intervenção fisioterapêutica em educação em saúde / Satisfaction of puerperal females after phy- siotherapy intervention in health education

O objetivo deste estudo foi avaliar a satisfação de puérperas após intervenção fisioterapêutica em educação em saúde. Estudo transversal e observacional que contou com a participação de 63 puérperas internadas em alojamento conjunto de uma maternidade. Foram realizadas atividades de educação em saúde abordando modificações e adaptações do puerpério, utilizando materiais de apoio de baixo custo, linguagem simples e exercícios preventivos. As mulheres também receberam uma cartilha educativa elaborada pelos pesquisadores. Posteriormente, foi realizada a avaliação da satisfação da puérpera em relação ao atendimento fisioterapêutico. A maioria das puérperas apresentou-se muito satisfeitas (55,5%) e satisfeitas (44,4%) com o atendimento. O esclarecimento de dúvidas foi melhor que esperado (39,6%) e como esperado (47,6%). A maioria das participantes sanou dúvidas (93,6%), afirmou que participaria novamente da atividade e recomendaria a assistência para outras mulheres (93,6%). Estratégias fisioterapêuticas de educação em saúde são satisfatórias para mulheres do puerpério imediato.

The satisfaction of puerperal females after physiotherapy intervention in health education is evaluated. Current transversal and observational study involved 63 puerperal females hospitalized in the maternity ward. Health education activities were undertaken dealing with puerperal modifications and adaptations, employing low cost material, simple diction and preventive exercises. They also received an educational handout prepared by the researchers. Puerperal satisfaction was then evaluated with regard to physiotherapy care. Most puerperal females were very satisfied (55.5%) and satisfied (44.4%) with the care. Quitting doubts was more than expected (39.6%) and as expected (47.6%). Most participants said they did not have any more doubts (93.6%) and would participate in the activity once more and would recommend it to other women (93.6%). Physiotherapy strategies in health education are satisfactory for immediate puerperal females.

The development of a mechanical device to stretch skeletal muscle of young and old rats

OBJECTIVE: How much force is needed to stretch skeletal muscle is still unknown. The aim of this study was to develop a device that mechanically stretches rat muscle to compare the force (N) required to stretch the soleus muscle of young and aged rats and the tibio-tarsal angle joint at neutral and stretched positions. METHODS: Twelve female Wistar rats were divided into two groups: a young group (YG, n=6, 311±11 g) of rats 3 months old and an aged group (AG, n=6, 351±43 g) of rats 15 months old. The left soleus muscle was mechanically held in full dorsal flexion and submitted to mechanical passive stretching: 1 bout of 10 repetitions, each repetition lasted 60 seconds with an interval of 45 seconds between repetitions, performed once a day, twice a week, for 1 week. The force required during stretching was measured by a load cell, and the tibio-tarsal angle joint was measured by photometry. RESULTS: The load cell calibration showed excellent reliability, as confirmed by the intraclass correlation coefficient value of 0.93. A decrease in delta force was found in the comparison between YG and AG (0.11±0.03 N vs 0.08±0.02 N, p<0.05, repeated measures ANOVA). There was no difference between the YG and the AG in the tibio-tarsal angle at resting position (87.1±3.8° vs 87.1±3.5°, p=0.35, Kruskal Wallis) and at the end of the stretching protocol (43.9±4.4° vs 42.6±3.4°, p=0.57, Kruskal Wallis). CONCLUSION: The device presented in this study is able to monitor the force necessary to stretch hindlimb rat muscles. Aged rats required less force than young rats to stretch the soleus muscle, and there was no difference regarding the tibio-tarsal angle between the two groups.

Efeitos do exercício de alongamento em pessoas com síndrome de Down / Effects of stretching exercise in people with Down syndrome

Introdução: Estratégias de esquema corporal são comumente utilizadas para minimizar disfunções musculoesqueléticas decorrentes da Síndrome de Down (SD). Dessa forma, posturas adotadas nessas estratégias promovem o alongamento muscular, entretanto não são claros os efeitos do exercício de alongamento neste público. Objetivo: Verificar as evidências a respeito dos efeitos dos exercícios de alongamento muscular em pessoas com SD. Material e métodos: Foi realizada revisão sistemática com 3 avaliadores independentes, nas bases de dados: Bireme, Pubmed, Pedro e Cinahl. Com os descritores: "alongamento", "exercício de alongamento", "Síndrome de Down", "flexibilidade" e "amplitude de movimento" combinados, e em inglês e português. Os critérios de inclusão foram a presença dos descritores no título e a relação com o tema, artigos publicados até julho de 2017. Foram excluídos títulos repetidos, títulos cujo resumo não se relacionava com a SD e artigos que não tratavam sobre flexibilidade ou alongamento na SD. Resultados: Foram encontrados 372 artigos, sendo selecionados 9 artigos de acordo com o título para leitura dos resumos. Após leitura dos resumos, apenas 5 artigos foram selecionados para análise na íntegra. Conclusão: Não há evidências suficientes na literatura que indiquem os efeitos do exercício de alongamento muscular em pessoas com SD. (AU)

Introduction: Body scoring strategies are commonly used to minimize musculoskeletal dysfunctions resulting from Down Syndrome (DS). Thus, postures adopted in these strategies promote muscle stretching; however, the effects of the stretching exercise in this public are not clear. Objective: To verify the evidence regarding the effects of muscle stretching exercises in people with DS. Methods: A systematic review was carried out with 3 independent evaluators, in the databases: Bireme, Pubmed, Pedro and Cinahl. With the descriptors: "stretching", "stretching exercise", "down syndrome", "flexibility", "range of motion" combined, in English and Portuguese. The inclusion criteria were the presence of the descriptors in the title and the relation with the theme, articles published until July 2017. We excluded repeated titles, titles whose summary was not related to DS, and articles that did not relate flexibility or stretching in DS. Results: A total of 372 articles were found, and 9 articles were selected according to the title for the reading of the abstracts. After reading the abstracts, only 5 articles were selected for analysis in their entirety. Conclusion: There is insufficient evidence in the literature to indicate the effects of muscle stretching exercise in people with DS. (AU)

Effects of resistive exercise and stretching on the soleus muscle of ovariectomized rats / Efeitos do exercício resistido e alongamento no músculo sóleo de ratas ovariectomizadas / Efectos del ejercicio resistido y estiramiento en el músculo sóleo de ratas ovariectomizadas

ABSTRACT This study analyzed the effects of resistive exercise and/or stretching in the muscle morphology of ovariectomized rats. Seventy-five female Wistar rats (218±22g) were divided into 8 groups: Control (CONTROL, n=5); Ovariectomy/Hysterectomy (OH, n=10): ovariectomized/hysterectomized and then waited 8 weeks for the onset of osteopenia. Stretching (STRET, n=10): manual stretching of the soleus muscle (10 repetitions of 60s), twice weekly; Ovariectomy/Hysterectomy and Stretching (OH+STRET, n=10); Progressive Loading (PL, n=10): 4 sets of 10 repetitions, initial load 50% of body weight, increasing weekly until 70%, three times a week. Progressive Loading and Stretching (PL+STRET, n=10); Ovariectomy/Hysterectomy and Progressive loading exercise (OH+PL, n=10); Ovariectomy/Hysterectomy, Progressive Loading and Stretching (OH+PL+STRET, n=10). Stretching and/or progressive loading were performed for 6 weeks. After 14 weeks, the female rats were euthanized to remove the soleus muscle. The following variables were assessed: body weight; muscle weight and length; number and length of sarcomeres and the muscle fiber cross-sectional area (MFCSA). Comparisons between the groups were performed with ANOVA one-way post hoc Tukey or Kruskall-Wallis (p<0.05). The body and muscle weights of ovariectomized rats submitted to exercise were higher than the intact ones. The OH and OH+PL+STRET increased the muscle length and the serial sarcomere number. OH presented the smallest MFCSA compared to all groups. Ovariectomy/hysterectomy induced sarcopenia, but the exercise's protocols were enough to prevent the loss of MFCSA. The increase in body weight associated to resistive training and stretching enhanced sarcomerogenesis of ovariectomized rats.

RESUMO O estudo analisou os efeitos do exercício resistido e/ou alongamento na morfologia muscular de ratas ovariectomizadas. Setenta e cinco ratas Wistar (218±22g) foram divididas em 8 grupos: Controle (CONTROLE, n=5); Ovariectomia/histerectomia (OH, n=10): foram submetidas à ovariectomia/histerectomia e aguardaram oito semanas para instalação de osteopenia; Alongamento (ALONG, n=10): alongamento manual do músculo sóleo (10 repetições de 60s), duas vezes por semana; Ovariectomia/histerectomia e Alongamento (OH+ALONG, n=10); Exercício Resistido (ER, n=10): 4 séries de 10 repetições, carga inicial de 50% do peso corporal, aumentando semanalmente até 70%, três vezes por semana; Exercício Resistido e Alongamento (ER+ALONG, n=10); Ovariectomia/histerectomia e Exercício Resistido (OH+PL, n=10); Ovariectomia/histerectomia, Exercício Resistido e Alongamento (OH+ER+Along, n=10). Alongamento e/ou Exercicio Resistido foram realizados durante 6 semanas. Após 14 semanas, as ratas foram submetidas à ortotanásia para remoção do sóleo. As seguintes variáveis foram avaliadas: peso corporal; peso e comprimento muscular; número e comprimento dos sarcômeros e área da secção transversa das fibras musculares (ASTFM). Comparação entre grupos foi realizada com ANOVA one way post hoc Tukey ou Kruskall-Wallis (p <0,05). O peso corporal e muscular das ratas submetidas aos exercícios foram maiores do que as intactas. O OH e OH+ER+ALONG aumentaram o comprimento e o número de sarcômeros. O OH apresentou menor ASTFM em comparação com todos os grupos. Ovariectomia/histerectomia induziu sarcopenia, mas os protocolos de exercícios foram suficientes para evitar a perda de ASTFM. O aumento do peso corporal associado ao exercício resistido e alongamento induziu sarcomerogenese nas ratas ovarectomizadas.

RESUMEN El estudio analizó los efectos del ejercicio resistido y/o estiramiento en la morfología muscular de ratas ovarectomizadas. Se dividió setenta y cinco ratas Wistar (218±22g) en 8 grupos: Control (CONTROL, n=5); ovariectomía/histerectomía (OH, n=10): fueron sometidas a ovariectomía/histerectomía y esperaron ocho semanas para la instalación de osteopenia; Estiramiento (ESTIR, n=10): estiramiento manual del músculo sóleo (10 repeticiones de 60s), dos veces por semana; ovariectomía/histerectomía y estiramiento (OH + ESTIR, n=10), ejercicio resistido (ER, n=10): 4 series de 10 repeticiones, carga inicial de 50% del peso corporal, aumentando semanalmente hasta 70%, tres veces por semana; Ejercicio resistido y estiramiento (ER+ESTIR, n=10); ovariectomía/histerectomía y ejercicio resistido (OH + PL, n=10); ovariectomía/histerectomía, ejercicio resistido y estiramiento (OH + ER + ESTIR, n=10). Se realizó estiramiento y/o ejercicio resistido durante 6 semanas. Después de 14 semanas, las ratas fueron sometidas a ortotanasia para la remoción del sóleo. Las siguientes variables fueron evaluadas: peso corporal; peso y longitud muscular; número y longitud de los sarcómeros y área de la sección trasversa de las fibras musculares (ASTFM). Se realizó una comparación entre grupos con ANOVA one way post hoc Tukey o Kruskall-Wallis (p <0,05). El peso corporal y muscular de las ratas sometidas a los ejercicios fue mayor que el de las intactas. El OH y OH+ER+ESTIR aumentaron la longitud y el número de los sarcómeros. El OH presentó menor ASTFM en comparación con todos los grupos. Ovariectomía/histerectomía indujo sarcopenia, más los protocolos de ejercicios fueron suficientes para evitar la pérdida de ASTFM. El aumento del peso corporal asociado al ejercicio resistido y estiramiento indujo sarcomerogénesis en las ratas sometidas a ovariectomía.

Profile of injures prevalence in athletes who participated in SESC Triathlon Caiobá-2011.

OBJECTIVE: To identify the prevalence of injuries occurred during training and/or competition in triathlon athletes at SESC Triathlon Caiobá-2011. METHODS: One hundred and ninety athletes participated in the study (153 males and 37 females). RESULTS: Athletes reported time of practice between 3 to 6 years (20%), training frequency of 5 days per week (48%), at least one injury during trainings (76%). The prevalence of injuries according to the sports category was: running (79%), cycling (16%) and swimming (5%). The most injured region during training (39%) and competition (46%) was the calf. Female athletes reported 92% of injuries during running training and 35% of those injuries were on ankle and foot. During competition only two athletes reported injuries. Muscle injury was the most prevalent (54%) among male athletes, followed by tendon (19%), ligament (17%) and bone (9%) injuries. Among female athletes prevalent injuries were: 32% muscle, 32% bone, 32% tendon and only 4% ligament injuries. CONCLUSION: Skeletal muscle injuries were the most commom lesions during running training, however, male athletes reported mostly calf injuries, while female had mostly ankle and foot injuries. Level of Evidence III. Study of Non-Consecutive Patients; Without Consistently Applied Reference ''Gold'' Standard.

Perfil da prevalência de lesões em atletas participantes do SESC TRIATHLON CAIOBÁ-2011 / Profile of injures prevalence in athletes who participated in SESC TRIATHLON CAIOBÁ-2011

Identificar a prevalência de lesões ocorridas durante treinos e/ou competições em triatletas no SESC Triatlhon Caiobá, Matinhos, PR,Brasil em 2011. Métodos: Participaram do estudo 190 triatletas (153 dosexo masculino e 37 do sexo feminino). Resultados: Os triatletas apresentaramtempo de prática entre 3 e 6 anos (20%); frequência de treinosde 5 dias por semana (48%); e sofreram ao menos uma lesão duranteos treinos (76%). A prevalência de lesões de acordo com a modalidadepraticada foi a seguinte: corrida (79%), ciclismo (16%) e natação (5%).A panturrilha foi a região mais acometida em treinos (39%) e em competições(46%). Entre as atletas, 92% das lesões aconteceram durantetreinos de corrida no tornozelo e pé (35%). Em competições, apenasdois atletas relataram lesões. Lesões musculares foram prevalentes em54% entre os atletas, seguida das lesões tendíneas (19%), ligamentares(17%) e ósseas (9%). Entre as mulheres, as lesões prevalentes foram:32% musculares, 32% ósseas, 32% tendíneas, e apenas 4% ligamentares.Conclusão: A prevalência foi de lesões musculares ocorridasdurante treinos de corrida, sendo que homens tiveram predomínio delesões na panturrilha e mulheres no tornozelo e/ou pé. Nível de EvidênciaIII, Estudo de Pacientes Não Consecutivos; Sem Padrãode Referência “Ouro” Aplicado Uniformemente...

To identify the prevalence of injuries occurred during trainingand/or competition in triathlon athletes at SESC Triatlhon Caiobá,Matinhos, PR, Brasil in 2011. Methods: One hundred and ninety athletesparticipated in the study (153 males and 37 females). Results:Athletes reported time of practice between 3 to 6 years (20%), trainingfrequency of 5 days per week (48%), at least one injury duringtrainings (76%). The prevalence of injuries according to the sportscategory was: running (79%), cycling (16%) and swimming (5%).The most injured region during training (39%) and competition (46%)was the calf. Female athletes reported 92% of injuries during runningtraining and 35% of those injuries were on ankle and foot. Duringcompetition only two athletes reported injuries. Muscle injury wasthe most prevalent (54%) among male athletes, followed by tendon(19%), ligament (17%) and bone (9%) injuries. Among female athletesprevalent injuries were: 32% muscle, 32% bone, 32% tendon and only4% ligament injuries. Conclusion: Skeletal muscle injuries were themost prevalent lesions during running training, however, male athletesreported mostly calf injuries, while female had mostly ankle/foot injuries.Level of Evidence III. Study of Non-Consecutive Patients;Without Consistently Applied Reference ‘‘Gold’’ Standard...

Análise histomorfométrica do músculo sóleo de ratos submetidos ao modelo animal de parkinsonismo induzido pelo MPTP / Histomorphometrical analysis of rats' soleus muscle submitted to animal model of MPTP-induced parkinsonism

INTRODUÇÃO: Modelos experimentais da Doença de Parkinson (DP) que reproduzem a desnervação dopaminérgica têm sido desenvolvidos para estudar a patofisiologia desta doença e analisar a eficácia de novas terapêuticas. Dentre os sinais cardinais da DP temos a rigidez muscular, estudos sugerem que mudanças intrínsecas nas propriedades mecânicas do músculo podem ser responsáveis pelo aumento dessa alteração tônica. OBJETIVO: Analisar a morfologia geral e a histomorfometria do músculo sóleo de ratos Wistar induzidos ao Parkinsonismo por 1-metil-4-fenil-1,2,3,6-tetrahidropiridina (MPTP). MATERIAIS E MÉTODOS: Utilizaram-se 24 ratos Wistar machos, com idade de 13 semanas e peso de 279 ± 13 g, divididos em quatro grupos: 1- controle-controle (n = 6): sham tratados com benserazida + salina; 2 - controle-L-DOPA (n = 6): sham tratados com benserazida + L-DOPA; 3 - MPTP- controle (n = 6): lesão na substância negra (SNc) por MPTP tratados com benserazida + salina; 4 - MPTP-L-DOPA (n = 6): lesão na SNc por MPTP tratados com benserazida + L-DOPA. Esses animais foram submetidos a eutanásia 35 dias após os procedimentos experimentais. Foram analisados: peso corporal, peso muscular, morfologia geral do músculo com microscopia de luz e mensuração da área de secção transversa das fibras musculares. Realizaram-se comparações com o teste t pareado entre o peso corporal inicial e final. A ANOVA post-hoc Tukey foi usada para comparações entre os grupos, sendo considerado significativo p ≤ 0,05. RESULTADOS: Não foram encontradas diferenças estatisticamente significativas nas variáveis analisadas. CONCLUSÃO: Os dados analisados não excluem a possibilidade de alterações ocorrerem no interior dessas células, nos tipos de fibras musculares ou em longo prazo.

INTRODUCTION: Animal models for Parkinson's disease (PD) which mimetize dopaminergic degeneration of nervous cells have been developed to study the pathology of this disease and to analyze the efficiency of new therapies. One of the cardinal signs of PD have muscle stiffness, studies suggest that intrinsic changes in mechanical properties of muscle may be responsible for the increase of this amendment tonic. OBJECTIVE: To analyze the morphology and histomorphometry of soleus muscle of rats PD-induced by 1-methyl-4-phenyl-1,2,3,6-tetrahydropiridine (MPTP). MATERIALS AND METHODS: We used 24 male Wistar rats, with the age of 13 weeks and 279 ± 13 g weight, divided into four groups: 1- control-control (n = 6): sham treated with benserazidasalina; 2 - control-L-DOPA (n = 6): sham treated with benserazida + L-DOPA; 3 - MPTP-control (n = 6): injury in substantia nigra (SNc) by MPTP treated with benserazidasalina; 4 - MPTP-L-DOPA (n = 6): CNS injury by MPTP treated with benserazida + L-DOPA. These animals were euthanized 35 days after the experimental procedures. It was analyzed: body weight, muscle weight, General muscle morphology with light microscopy and measurement of the cross-sectional area of muscle fibers. Comparisons between initial and final body weight were developed with the paired T-test. The Tukey post-hoc ANOVA was used for comparisons between groups, being considered significant p ≤ 0.05. RESULTS: No statistically significant differences were found in the analyzed variables. CONCLUSION: The data analyzed do not exclude the possibility of occurrence of changes in the interior of these cells, in the types of muscle fibers or long term.

Viabilidade da terapia virtual na reabilitação de pacientes com doença de Parkinson: estudo-piloto / Feasibility of virtual therapy in rehabilitation of Parkinson's disease patients: pilot study

INTRODUCTION: Among Parkinson's disease (PD) motor disabilities, postural and balance alterations are important parameters to physical therapists who need to choose specific, targeted therapies for their patients. Among many therapy options, virtual therapy is studied as to whether it can be a viable rehabilitation method. OBJECTIVE: To verify the applicability of virtual rehabilitation in PD patients for the improvement of their balance and quality of life. MATERIAL AND METHODS: Six volunteers, diagnosed to be in Stages II and III of PD (Hoehn and Yahr Scale), were recruited for this study. Patients (65 ± 13 years old) participated in activities involving Wii Fit, for a total of twelve interventions, twice per week. Clinical and qualitative methods were used for the data collection for the initial and final evaluations: Borg's Scale, Berg Functional Balance Scale, Time Up and Go, anterior and lateral functional reach and Nottingham's Scale were performed during the study. Penguin Slide, Ski Slalom, Soccer Heading and Table Tilt were the Wii games selected as a form of virtual therapy. RESULTS: The collected data were analyzed using the Wilcoxon test. Motor skill, functional capacities and quality of life were analyzed as variables of the patients' balance. Statistically significant differences were found in the following tests: Borg's Scale (p = 0.0464), Berg Functional Balance Scale (p = 0.0277), lateral functional reach to the right (p = 0.0431*) and lateral functional reach to the left (p = 0.0277). CONCLUSION: It is believed that exercises with virtual reality therapy can be a useful tool to improve the balance in PD patients.

INTRODUÇÃO: Dentre as incapacidades motoras da Doença de Parkinson (DP), as alterações posturais e de equilíbrio são parâmetros importantes para fisioterapeutas que necessitam escolher terapias específicas e direcionadas a seus pacientes. Dentre muitas opções de terapia para essa condição, a terapia virtual é estudada como um método viável para reabilitação. OBJETIVO: Verificar a aplicabilidade da reabilitação virtual em pacientes com DP para a melhora de seu equilíbrio e da qualidade de vida. MATERIAL E MÉTODOS: Seis voluntários, diagnosticados como portadores da DP nas fases II e III (escala de Hoehn e Yahr), foram recrutados para este estudo. Os pacientes (de 65 ± 13 anos) participaram de atividades envolvendo o Wii Fit, em um total de doze intervenções, duas vezes por semana. Métodos clínicos e qualitativos foram utilizados na coleta de dados para as avaliações iniciais e finais: escala de Borg, escala de equilíbrio funcional de Berg, time Up and Go, reação funcional anterior e lateral e escala de Nottingham foram aplicadas durante o estudo. Penguin Slide, Slalom Ski, Futebol e Inclinação da Mesa foram os jogos de Wii selecionados como forma de terapia virtual. RESULTADOS: Os dados coletados foram analisados utilizando o teste de Wilcoxon. Habilidade motora, capacidade funcional e qualidade de vida foram analisadas como variáveis de equilíbrio dos pacientes. Foram encontradas diferenças estatisticamente significativas nos seguintes testes: escala de Borg (p = 0.0464), escala de equilíbrio funcional de Berg (p = 0.0277), alcance lateral funcional à direita (p = 0.0431) e alcance lateral funcional à esquerda (p = 0.0277). CONCLUSÃO: Estima-se que os exercícios com terapia de realidade virtual podem ser uma ferramenta útil para melhorar o equilíbrio em pacientes com DP.