Urinary incontinence and quality of life in high-performance swimmers: An observational study.

Each day more women around the world practice high impact physical activities and this may be a risk factor for urinary incontinence (UI) in young. We verified the prevalence of UI and the impact in quality of life (QoL) in high-performance swimmers, through a cross-sectional observational study with 9 high performance swimmers and 9 sedentary women who responded the International Consultation on incontinence Questionnaire - Short Form (ICIQ-SF), participated in a functional evaluation of pelvic floor muscles with bidigital palpation and pad test. We verifed that was present in 78% of high-performance swimmers, and the quality of life was significantly worse (p =.037) when compared to sedentary women. These findings led us to conclude that presence of UI affects the quality of life, even if it is not a factor of abandonment of the sport.

Neuromuscular Electrical Stimulation in Chronic Kidney Failure: A Systematic Review and Meta-analysis.

OBJECTIVE: To systematically review the effects of neuromuscular electrical stimulation (NMES) in patients with chronic kidney failure (CKF) on hemodialysis (HD) on lower and upper limb muscle strength, functional capacity, and quality of life. DATA SOURCES: Data were obtained from MEDLINE (via PubMed), Embase, Scielo, Cochrane Central Register of Controlled Trials, and Physiotherapy Evidence Database. There were no mandatory language or publication date restrictions. STUDY SELECTION: Clinical trials that assessed the chronic effect of NMES (alone or associated with other physical therapy) on lower limb muscle strength or functional capacity of CKF patients on HD compared with control, placebo, or another intervention were selected. DATA EXTRACTION: Two independent reviewers extracted data using a predesigned data extraction form. Risk of bias was assessed with RoB 2.0 and ROBINS-I, and quality of evidence was assessed with Grading of Recommendations Assessment, Development, and Evaluation. DATA SYNTHESIS: Ten studies were included, totaling 242 patients. Randomized clinical trials showed some concerns or high risk of bias, and the nonrandomized ones showed moderate or critical risk of bias. Random-effects meta-analysis showed that NMES increases quadriceps muscle strength (standardized mean difference=1.46; 95% confidence interval [CI], 0.86-2.07; P<.0001 moderate quality of evidence), upper limb strength (mean difference [MD]=10.02kgF; 95% CI, 0.78-19.27; P=.03 low quality of evidence), and functional capacity (MD=30.11m; 95% CI, 15.57-44.65; P<.0001 moderate quality of evidence). It was impossible to quantitatively analyze quality of life data; however, NMES associated or not with exercise appears to have positive effects on them. CONCLUSIONS: NMES improves quadriceps muscle strength and the functional capacity of patients with CFK on HD. The effects on upper limb muscle strength and quality of life seem to be positive; however, the quality of evidence is very limited for these outcomes.

Effects of robotic rehabilitation using the Erigo® device on patients with neurological injury: a systematic review and meta-analysis of randomized clinical trials.

OBJECTIVE: To systematically review the effects of robotic rehabilitation with the Erigo® device on patients with neurological injury on safety, spasticity, muscle strength, functionality, gait/balance, and changes in the level of consciousness. METHODS: MEDLINE, SciELO, EMBASE, The Cochrane Library - CENTRAL and PEDro databases were consulted without the restriction of date and language. Randomized controlled trials that evaluated the robotic rehabilitation and compared it to conventional or placebo therapy, isolated or in association with other therapy, were selected. Studies in which the treatment time was less than 10 sessions were excluded. The risk of bias was assessed with the use of the RoB 2.0 tool. RESULTS: Nine studies were included, totaling 347 patients. The robotic rehabilitation performed by the Erigo® device proved to be safe for neurological patients. The meta-analysis showed an improvement for spasticity (MD = 0.29; 95% CI = -0.49 to -0.08; I2 = 0%), but there was no significant increase in muscle strength in patients with stroke (MD = 0.25; CI 95% = -0.22 to -0,71; I2 = 0%). Erigo® showed inconclusive effects on functionality, gait/balance and level of consciousness in patients with severe acquired brain injury and vegetative or minimally conscious state. All studies present some concerns for the risk of bias. CONCLUSION: Erigo® as a robotic rehabilitation strategy is safe for patients with acquired brain injury and appears to reduce spasticity in patients with stroke. The effects on muscle strength, functionality, gait and balance and level of consciousness remain uncertain and the methodological quality of the clinical trials included in this review is limited.

Erigo^® device is safe to rehabilitation of patients with neurological injury.Rehabilitation with Erigo^® device appears to reduce the spasticity of patients with stroke.New randomized clinical trials are needed to establish the effects on muscle strength, functionality, gait/balance and level of consciousness.

Effects of aerobic exercise on patients with pre-dialysis chronic kidney disease: a systematic review of randomized controlled trials.

PURPOSE: Reviewing systematically the randomized controlled trials (RCTs) that evaluated aerobic exercisealone vs. usual care in exercise tolerance, functional capacity, and quality of life (QoL) in patients withpre-dialysis. METHODS: Searches in the MEDLINE, Cochrane CENTRAL, EMBASE, PEDro, and LILACS databases untilFebruary 2021 included RCTs that evaluated the effects of aerobic exercise on peak VO2, functional capacity,lower limb muscle strength, and QoL. The random effect meta-analysis model was used andreported as mean difference (MD) and 95% confidence interval (CI), risk of bias through RoB2.0 and thequality of evidence by GRADE. RESULTS: 10 RCTs, with 365 patients. Aerobic exercise increased 2.07 ml/kg/min (95% CI = 1.16 to 2.98; I2= 24%, QoE moderate) at peak VO2; 77.78m (95% CI= 33.27 to 122.30; I2= 44.5%, QoE moderate) in the 6MWT and 7.65 repetitions (95% CI= 5.73 to 9.58; I2= 0 %; QoE moderate) in STS-30 versus usual care. In QoL, studies reported improvements in the questionnaire scores.Eu.2 = 24%, QoE moderado) no pico de VO2; 77,78 m (IC95% = 33,27-122,30; Eu.2 = 44,5%, QoE moderado) nas repetições 6MWT e 7,65 (IC95% = 5,73-9,58; Eu.2 = 0%; QoE moderado) em STS-30". CONCLUSION: Aerobic exercise increases VO2 peak, functional capacity and lower limb muscle strength in patients with pre-dialysis. Effects on QoL appear to be beneficial.IMPLICATIONS FOR REHABILITATIONAerobic exercise should be encouraged in the rehabilitation of patients at any stage of chronic kidney disease.Aerobic exercise promotes improved exercise tolerance, functional capacity, and muscle strength of the lower limbs.There is some evidence to show it is beneficial to improve the quality of life.

A Telerehabilitation Program for Maintaining Functional Capacity in Patients With Chronic Lung Diseases During a Period of COVID-19 Social Isolation: Quasi-Experimental Retrospective Study.

BACKGROUND: Pulmonary diseases represent a great cause of disability and mortality in the world, and given the progression of these pathologies, pulmonary rehabilitation programs have proven to be effective for people with chronic respiratory diseases. During the COVID-19 pandemic, telerehabilitation has become an alternative for patients with such diseases. OBJECTIVE: The aim of this study was to compare the outcomes (ie, functional capacity and quality of life) of telerehabilitation to those of usual care among patients who previously participated in face-to-face pulmonary rehabilitation programs. METHODS: We conducted a quasi-experimental retrospective study from April 2020 to August 2021. A total of 32 patients with chronic lung diseases were included and divided into the control and intervention groups. The intervention group performed telerehabilitation synchronously twice per week and was supervised by a physical therapist during breathing, strengthening, and aerobic exercises. Changes in the degree of dyspnea and leg discomfort were assessed based on changes in Borg scale scores. The control group did not perform any activities during the period of social isolation. Functional capacity was assessed with the 6-minute walk test, and quality of life was assessed with the Medical Outcomes Study 36-item Short Form Health Survey. RESULTS: The telerehabilitation group's mean 6-minute walk distance decreased by 39 m, while that of the control group decreased by 120 m. There was a difference of 81 m between the groups' mean 6-minute walk distances (P=.02). In relation to the quality of life, telerehabilitation was shown to improve the following two domains: social functioning and mental health. CONCLUSIONS: Telerehabilitation programs for patients with chronic lung diseases can ease the deleterious effects of disease progression, be used to maintain functional capacity, and improve aspects of quality of life.

Reduced venous endothelial responsiveness after oral lipid overload in healthy volunteers.

The aim of this study was to investigate endothelial venous function, inflammatory markers, and systemic oxidative stress after an oral lipid overload (OLO). We studied 18 healthy adults (9 men; age, 29.2 +/- 0.9 years; body mass index, 22.3 +/- 0.4 kg/m(2)). Blood samples were collected in the fasting state and 3, 4, and 5 hour after the OLO (1000 kcal, 58% fat) for metabolic variables, oxidative stress, inflammatory markers, adiponectin, and resistin. Changes in vein diameter to phenylephrine, acetylcholine, and sodium nitroprusside (dorsal hand vein technique) were measured before and after the OLO. Oral lipid overload increased triglycerides (61 +/- 6 vs 134 +/- 17 mg/dL, P < .001), insulin (7.2 +/- 0.8 vs 10.7 +/- 1.3 muU/mL, P < .05), and resistin (5.38 +/- 0.5 vs 6.81 +/- 0.7 ng/mL, P < .05) and reduced antioxidant capacity (plasma total antioxidant capacity: 186.7 +/- 56 vs 161.8 +/- 50 U Trolox per microliter plasma, P < .01), vascular reactivity (171.3 +/- 85 vs 894.4 +/- 301 ng/mL, P < .001), and maximum acetylcholine venodilation (105.9% +/- 9% vs 61.0% +/- 7%, P < .05). No changes were observed for sodium nitroprusside. Post-OLO triglycerides were positively correlated with phenylephrine dose (rho = 0.38, P < .05) and resistin (rho = 0.43, P < .01) and negatively correlated with the maximum acetylcholine venodilation (rho = -0.36, P < .05). In conclusion, an OLO impaired venoconstriction responsiveness in healthy subjects, probably because of a reduction in the antioxidant capacity.

Influence Diagram As a Support Tool for Clinical Decisions In Cardiopulmonary And Metabolic Rehabilitation.

An influence diagram (ID) is a method of graphical representation of uncertain knowledge, which can be employed to support decisions in health care using probabilistic reasoning. We aimed to describe the development of an ID to support the decision-making process in phase II at Cardiopulmonary and Metabolic Rehabilitation Program (CPMR). The development of the ID was carried out through the identification of relevant variables and their possible values, as well as the identification of details of each variable, in order to find a network structure that appropriately connects the nodes that represent the variables, with arcs linking acyclic graphs, and to build the graph using specialized knowledge and the conditional probability table for each node in the graph. In spite of the complexity of the interactions, the model obtained with the ID seems to contribute in the decision-making process in phase II CPMR, providing a second opinion to the health pratictioner and helping in diagnostic, therapeutic and decision-making processes, since it is useful in situations with non-linear modeling or with absent or uncertain information.

Treinamento (Entrenamiento) muscular inspiratório para o controle (el control) autonômico de indivíduos saudáveis (sanos) / Inspiratory muscle training in autonomic control in healthy individuals

Verificar o efeito (el efecto) agudo de diferentes sobrecargas de treinamento (entrenamiento) muscular inspiratório (TMI) sobre a (la) modulação autonômica cardiovascular em indivíduos saudáveis.Métodos: Ensaio (Ensayo) clínico randomizado cruzado. Foram (Fueron) incluídos voluntários saudáveis (sanos) entre 18 e 35 anos. A variabilidade da (de la) frequência cardíaca (VFC) foi analisada antes e após o (y después del) TMI a os (a los) 10 minutos, 60 minutos e 24 horas (agudo, subagudo e tardio, respectivamente). A força (La fuerza) muscular inspiratória foi avaliada (fue evaluada) através da (de la)medida de pressão inspiratória máxima (PImáx) com a utilização do (del) manovacuômetro digital MVD300 (Microhard System®, Globalmed, Porto Alegre, Brasil). O TMI foi realizado à 30% e 60% da PImáx ajustados no (en el) dispositivo pressórico linear Power breathe®. Resultados: Foram avaliados dezenove (diecinueve) indivíduos (47% homens, 25 ± 5 anos). Na (En la) fase aguda apenas com 60% da PImá houve redução (hubo una reducción) significativa da variabilidade dos (de los) intervalos RR e no (y enel) componente de alta frequência (HFnu), en quanto que o (mientras que el) componente de baixa(baja) frequência (LFnu) e o balanço (y el equilibrio) autonômico (LF/HF) aumentaram significativamente.Na (En la) fase subaguda, o mesmo comportamento foi observado para HFnu, LFnu, LF/HF. Quando comparadas as (Cuando se compararon las) sobrecargas, houve (hubo) aumento significativo na (en la) magnitude do efeito a 60% PImáx para NN50, LF/HF, LFnu, HFnu na fase aguda, bem como, para (así como para) RR, NN50, LFnu e HFnu na fase subaguda (p < 0.05). Conclusão: Agudamente, o efeito doTMI à 60% da PImáx foi maior deslocando a (fue más grande, desplazando la) modulação autonômicado sistema cardiovascular em indivíduos saudáveis para um predomínio simpático...