Mapa de Evidência: aplicação clínica das Práticas Corporais / Mapa de evidencia: aplicación clínica de Prácticas Corporales / Evidence Map: clinical application of Body Practices

O mapa apresenta visão geral das evidências sobre os efeitos das Práticas Mente e Corpo da Medicina Tradicional Chinesa para diversas condições clínicas e de saúde das pessoas. A partir de uma ampla busca bibliográfica de estudos publicados e não publicados, entre 1989 e 2019, foram incluídas no Mapa 180 revisões sistemáticas, que foram avaliadas, caracterizadas e categorizadas pelo Grupo de Pesquisa em Promoção da Saúde e Práticas Integrativas e Complementares (GPPIC/Unifesp).

El mapa proporciona una visión general de la evidencia sobre los efectos de las Prácticas Mente y Cuerpo de la Medicina Tradicional China para diversas afecciones clínicas y de salud de las personas. A partir de una amplia búsqueda bibliográfica de estudios publicados y no publicados, entre 1989 y 2019, se incluyeron 180 revisiones sistemáticas en el Mapa, que fueron evaluadas, caracterizadas y clasificadas por el Grupo de Investigación sobre Promoción de la Salud y Prácticas Integrativas y Complementarias (GPPIC / Unifesp).

The map provides an overview of the evidence on the effects of the Mind and Body Practices of Traditional Chinese Medicine for various clinical and health conditions of people. From a wide bibliographic search of published and unpublished studies, between 1989 and 2019, 180 systematic reviews were included in the Map, which were evaluated, characterized and categorized by the Research Group on Health Promotion and Integrative and Complementary Practices (GPPIC / Unifesp).

El arte de interpretar y el cambio psíquico / The art of interpreting and psychic change

El artículo quiere poner de manifiesto la importancia en psicoanálisis de una comunicación que va más allá de las palabras, en la que la escucha de paciente y analista se amplía para dar cabida a un diálogo cuyos significados trascienden las palabras. Asimismo, pretende reflexionar y cuestionar la relación entre el contenido de la interpretación y el cambio psíquico del paciente. En este sentido subraya la importancia de la energía pulsional de la transferencia, tanto del paciente como del analista y de la mente continente del analista, como los dos elementos fundamentales para que la interpretación promueva el insight necesario que conlleve al cambio psíquico. La palabra interpretación del analista se nutrirá de la energía pulsional de la transferencia y la contratransferencia, y el diálogo psicoanalítico donde tiene lugar la interpretación estará siempre sostenido por la mente, continente mental del analista (AU)

The article seeks to reveal the importance in psychoanalysis of a form of communication that goes beyond words, in which the listening of analyst and patient is broadened to accommodate a dialogue whose meanings transcend words. In addition, it aims to reflect upon and question the relationship between the content of the interpretation and the patients psychic change. In this respect it underscores the importance of the drive energy of transference, both patient´s and analysis, and of the containing mind of the analyst, as the two crucial elements for interpretation to foster the insight required to lead to psychic change. The word-interpretation of the analyst is nourished by the drive energy of transference and countertransference, and the psychoanalytic dialogue where interpretation takes place will always be sustained by the mind, the analyst´s mental container (AU)

RESPeRATE: the role of paced breathing in hypertension treatment.

Despite a good adherence to lifestyle modifications and antihypertensive drugs, hypertension remains resistant in more than one-third of patients, thus creating the need for additional strategies, including non-pharmacologic approaches. Slow and deep breathing ("paced breathing") associated in the past with meditation has a direct antihypertensive effect by increasing baroreflex sensitivity. With the method of guiding the pace of breathing, a US Food and Drug Administration-certified device, RESPeRATE, may offer an easy, efficient, inexpensive, and noninvasive option for treating hypertension. Multiple studies showed a significant reduction of blood pressure when RESPeRATE was evaluated in a home and office setting. In conclusion, this review outlines the pathophysiologic background of paced respiration, describes RESPeRATE clinical trials, and presents briefly other guided breathing alternatives.

The mirror therapy program enhances upper-limb motor recovery and motor function in acute stroke patients.

OBJECTIVE: The purpose of this study was to evaluate the effects of the mirror therapy program on upper-limb motor recovery and motor function in patients with acute stroke. DESIGN: Twenty-six patients who had an acute stroke within 6 mos of study commencement were assigned to the experimental group (n = 13) or the control group (n = 13). Both experimental and control group members participated in a standard rehabilitation program, but only the experimental group members additionally participated in mirror therapy program, for 25 mins twice a day, five times a week, for 4 wks. The Fugl-Meyer Assessment, Brunnstrom motor recovery stage, and Manual Function Test were used to assess changes in upper-limb motor recovery and motor function after intervention. RESULTS: In upper-limb motor recovery, the scores of Fugl-Meyer Assessment (by shoulder/elbow/forearm items, 9.54 vs. 4.61; wrist items, 2.76 vs. 1.07; hand items, 4.43 vs. 1.46, respectively) and Brunnstrom stages for upper limb and hand (by 1.77 vs. 0.69 and 1.92 vs. 0.50, respectively) were improved more in the experimental group than in the control group (P < 0.05). In upper-limb motor function, the Manual Function Test score (by shoulder item, 5.00 vs. 2.23; hand item, 5.07 vs. 0.46, respectively) was significantly increased in the experimental group compared with the control group (P < 0.01). No significant differences were found between the groups for the coordination items in Fugl-Meyer Assessment. CONCLUSIONS: This study confirms that mirror therapy program is an effective intervention for upper-limb motor recovery and motor function improvement in acute stroke patients. Additional research on mirror therapy program components, intensity, application time, and duration could result in it being used as a standardized form of hand rehabilitation in clinics and homes.

Treating hypertension in type II diabetic patients with device-guided breathing: a randomized controlled trial.

The objective of the study was to evaluate the efficacy of device-guided breathing to lower blood pressure (BP) in hypertensive type II diabetic patients. A randomized controlled trial was carried out in four urban family practice clinics in Israel. Non-insulin-dependent diabetic, hypertensive patients with uncontrolled BP, receiving antihypertensive therapy or those non-medicated were enrolled. Baseline characteristics of the 66 patients who completed the study (33 intervention and 33 control) were: 62% men, age 62+/-8 years (mean+/-s.d.); body mass index 29+/-5 kg/m2; systolic BP 148+/-11 mm Hg and diastolic BP 81+/-9 mm Hg. The intervention group used a device (RESPeRATE), which interactively guides the user towards slow and regular breathing by synchronizing respiration voluntarily to musical tones for 15 min daily for an 8-week period. The control group continued with their regular treatment. BP was measured in the clinic at baseline, after 4 weeks and at 8 weeks. Medication was unchanged for 4 weeks prior to and during the study period. The main outcome measure was the office BP change from baseline to the end of the 8-week period. BP was reduced in the treatment group (mean+/-s.e.) systolic -10.0+/-1.8 mm Hg and diastolic -3.6+/-1.3 mm Hg (P<0.0001 and P<0.01), but not in the controls +1.6+/-2.1 and -1.0+/-1.4 mm Hg P>0.4 and P>0.4, respectively. Test for between group difference P<0.0001 and P=0.08. The subjects were highly compliant with the treatment, performing 75% of the requested exercise sessions. Greater BP reduction was observed with increased compliance with device usage (P=0.01 and P=0.001). It is concluded that self-treatment with device-guided breathing at home for 8 weeks by non-insulin-dependent diabetic patients was associated with a substantial reduction in office systolic BP.