RESUMO
The aim was to evaluate the effectiveness of strengthening exercises using the Swiss ball in patients with fibromyalgia through a randomized controlled trial with intention to treat analyses. A total of 60 patients with fibromyalgia met the inclusion criteria and were randomly allocated to either the Swiss ball exercise group (n=30) or a stretching group (n=30). All patients participated in 40-minute training sessions 3 times per week for 12 weeks. Pain (Visual Analogue Scale 0-100); muscle strength (One Repetition Maximum test); health status (Fibromyalgia Impact Questionnaire Revised); quality of life (Short Form-36 questionnaire) were evaluated at baseline, and after 6 and 12 weeks of training. The Swiss ball group showed a statistically significant improvement in VAS (0-100) (p<0.001), SF-36 (p<0.05) and Fibromyalgia Impact Questionnaire (p<0.001) compared with the stretching group. The results of this study proved that the treatment for fibromyalgia with strengthening exercises and the use of the Swiss ball led to improvement of pain, quality of life, muscle strength and decreased the need for medications for this disease compared to stretching exercises, without negative effects.
Assuntos
Fibromialgia , Qualidade de Vida , Terapia por Exercício , Fibromialgia/terapia , Nível de Saúde , Humanos , Força Muscular , Dor , Suíça , Resultado do TratamentoRESUMO
OBJECTIVES: To assess the effectiveness of foot orthoses with regard to pain, function, quality of life, and global perceived effect in patients with rheumatoid arthritis (RA). METHOD: A double-blind randomized controlled trial (RCT) was carried out. Eighty women with RA were randomly assigned to an experimental group (EG) or a control group (CG). The EG used an insole with metatarsal and medial arch supports and the CG used a flat insole for 6 months. Evaluations performed at baseline and after 45, 90, and 180 days by a blinded assessor were: foot pain while walking and at rest, function, quality of life, and global perceived effect with treatment. RESULTS: The groups were homogeneous for all parameters at baseline. A statistically significant improvement (p < 0.001) was found in the EG regarding pain while walking (mean difference: -2.2 for the right foot and -2.1 for the left foot) and at rest (mean difference: -0.3 for the right foot and -0.5 for the left foot) in comparison to CG. There were no differences in any other observed measures. The time of insole use correlated with foot pain and function in the EG. CONCLUSIONS: Foot orthoses with metatarsal and medial arch supports decreases pain during walking and at rest in both feet in patients with RA. Time of insole use correlated with improvements in pain and function.
Assuntos
Artrite Reumatoide/reabilitação , Órtoses do Pé , Dor/reabilitação , Satisfação do Paciente , Qualidade de Vida , Adulto , Método Duplo-Cego , Feminino , Humanos , Pessoa de Meia-Idade , CaminhadaRESUMO
Rheumatoid arthritis (RA) is an aggressive articular autoimmune disease that causes deformities and disability. The temporomandibular joint (TMJ) might be affected by this disease. Few controlled studies have evaluated bite force (BF) and oro-facial manifestations of this disease. To characterise oro-facial alterations in patients with RA, correlate these results with clinical and disease activity parameters and correlate BF with hand strength (HS). A cross-sectional study of 150 women was performed, (75 RA patients (RA group) and 75 healthy individuals (control group). The presence of articular sounds, pain on palpation of masseter, temporal and TMJ lateral pole, changes in occlusion, range of mandibular motion, measurement of BF in the incisor and molar regions and assessment of HS were evaluated. In relation to oro-facial evaluation there were statistical differences between the groups. There was correlation between BF and HS, in the RA group, this correlation was consistent in patients with natural teeth. Patients with RA had lower scores (P < 0·05) in the HAQ, DASH and OHIP-14 questionnaires than the control group. Inverse correlations were found between BF and HAQ, but not between BF and DAS-28, DASH and OHIP-14 questionnaires in the RA group. The women with RA presented more signs and symptoms in the oro-facial region and had a lower BF than the women in the control group. BF was inversely correlated with the overall function (evaluated by the HAQ) in the patients with RA, and there were correlations between BF and HS in the RA patients and in the control group.
Assuntos
Artrite Reumatoide/fisiopatologia , Força de Mordida , Transtornos da Articulação Temporomandibular/fisiopatologia , Adulto , Idoso , Antirreumáticos/uso terapêutico , Artrite Reumatoide/tratamento farmacológico , Estudos Transversais , Avaliação da Deficiência , Feminino , Força da Mão , Humanos , Pessoa de Meia-Idade , Medição da Dor , Qualidade de Vida , Inquéritos e QuestionáriosRESUMO
OBJECTIVE: To assess the impact of daily cane use during gait in relation to pain, function, general health and energy expenditure among patients with knee osteoarthritis. METHOD: Sixty-four patients were randomly assigned to an experimental group (EG) or control group (CG). The EG used a cane every day for 2 months, whereas the CG did not use a cane in this period. The first outcome was pain and the second were function (Lequesne and WOMAC), general health (SF-36) and energy expenditure (gas analysis during the 6-minute walk test (6MWT) with and without a cane). Evaluations were performed at baseline, 30 and 60 days. RESULTS: The groups were homogeneous for all parameters at baseline. Compared with the CG, the EG significantly improved pain (ES 0.18), function - Lequesne (ES 0.13), some domains of SF-36 (role physical, ES 0.07 and bodily pain, ES 0.08) and distance on the 6MWT with the cane (ES 0.16). At the end of the 6MWT with the cane, the EG significantly improved energy expenditure (ES 0.21), carbon dioxide production (ES 0.12) and metabolic equivalents (ES 0.15) compared with the CG. CONCLUSION: A cane can be used to diminish pain, improve function and some aspects of quality of life in patients with knee osteoarthritis. The prescription of a cane should take into account the substantial increase in energy expenditure in the first month of use, whereas energy expenditure is no longer a factor for concern by the end of the second month due to adaptation to cane use. The trial was registered in clinicaltrials.gov (NCT00698412).
Assuntos
Bengala , Metabolismo Energético , Osteoartrite do Joelho/reabilitação , Dor/prevenção & controle , Caminhada/fisiologia , Idoso , Anti-Inflamatórios não Esteroides/administração & dosagem , Bengala/estatística & dados numéricos , Dióxido de Carbono/fisiologia , Metabolismo Energético/fisiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Osteoartrite do Joelho/complicações , Osteoartrite do Joelho/tratamento farmacológico , Osteoartrite do Joelho/fisiopatologia , Consumo de Oxigênio/fisiologia , Dor/etiologia , Qualidade de VidaRESUMO
OBJECTIVE: To evaluate the efficacy of an educational program for patients with rheumatoid arthritis in relation to their knowledge about the disease and to their psychosocial and physical health status. MATERIALS AND METHODS: The study included patients with rheumatoid arthritis classified according to the American College of Rheumatology criteria without any previous participation in disease-specific educational programs. The patients were randomly assigned to an educational program intervention or a waiting list. The intervention was a 6-week educational program consisting of weekly sessions lasting 1 hour each. Evaluations by a blind assessor were made prior to intervention and after 45, 90 and 180 days. The main outcome variables were the Patient Knowledge Questionnaire and the Short-form Health Survey (SF-36) quality of life questionnaire. Secondary outcome variables were the Health Assessment Questionnaire, Visual Analogue Pain Scale, Beck Depression Inventory and State-Trait Anxiety Inventory. RESULTS: Patients in the intervention group (n=28) had significant improvement in disease-specific knowledge compared to patients in control group (n=30). There was no significant difference between the groups in terms of pain, depression, anxiety or functional capacity, but the "general health perception" subscale of SF-36 showed a significant improvement in the intervention group (p=0.041). There was a positive correlation between improvement of disease-specific knowledge and schooling. CONCLUSION: Patients who attended the educational program had significant improvement in disease-specific knowledge and general health perception. No harmful effects on their psychosocial status were noticed. The acquisition of knowledge was also found to be proportional to schooling.
Assuntos
Artrite Reumatoide , Conhecimentos, Atitudes e Prática em Saúde , Educação de Pacientes como Assunto , Adulto , Estudos de Casos e Controles , Escolaridade , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Índice de Gravidade de DoençaRESUMO
OBJECTIVE: To compare the efficacy and safety of intraarticular glucocorticoid injection to its systemic use for treatment of knee synovitis in rheumatoid patients. METHODS: A randomized double-blind controlled study was conducted including 60 patients with RA. Patients were randomized to receive either a single intraarticular knee injection with triamcinolone hexacetonide 60 mg (3 ml) and xylocaine chloride 2% (1 ml) associated to a single intramuscular injection of 1 ml of xylocaine chloride 2% (IAI group) or 1 ml of xylocaine chloride 2% by intraarticular injection and a intramuscular injection of triamcinolone acetonide 60 mg (3 ml) and xylocaine chloride 2% (1 ml) (IM group). All patients were blindfolded for the procedure. Evaluations were performed at baseline and 1, 4, 8 and 12 weeks post-intervention. The following instruments were used: VAS for knee pain, as primary outcome, VAS for knee morning stiffness and edema; the ACR 20, 50 and 70% improvement criteria; knee circumference and goniometry; Likert's scale of improvement; daily use of oral glucocorticoid and NSAIDs, blood pressure and adverse effects. RESULTS: Patients in the IAI group had significantly better results for VAS for knee pain, edema and morning stiffness as well as for improvement evaluation after intervention according to the patient (p<0.001) and physician (p=0.02). CONCLUSION: Our results demonstrate that intraarticular injection with glucocorticoids is superior to its systemic use for the management of monoarticular synovitis in rheumatoid patients. The intraarticular approach showed better results in terms of local inflammatory variables and improvement evaluation by the patient and physician.
Assuntos
Artrite Reumatoide/tratamento farmacológico , Glucocorticoides/administração & dosagem , Triancinolona Acetonida/administração & dosagem , Adulto , Artrite Reumatoide/complicações , Método Duplo-Cego , Feminino , Humanos , Injeções Intra-Articulares , Injeções Intramusculares , Articulação do Joelho , Masculino , Pessoa de Meia-Idade , Medição da Dor , Amplitude de Movimento Articular , Recuperação de Função Fisiológica , Sinovite/tratamento farmacológico , Sinovite/etiologiaRESUMO
Shoulder impingement syndrome and tendonitis of the rotator cuff are the most common intrinsic causes of shoulder pain and disability. The present literature review addresses general concepts on shoulder impingement syndrome as well as progressive resistance training and different physiotherapy interventions for this condition. The aim was to review what exists in the literature regarding progressive resistance training as a therapeutic approach to shoulder impingement syndrome. The review was carried out using the Lilacs, Medline, Pubmed and Web of Knowledge databases searching for studies published between 2000 and 2008. The following keywords were used: resistance exercises, exercises with weight, resistance training, strength training, painful shoulder, shoulder impingement syndrome, exercise and the translations of these terms in Portuguese. Controlled, randomized clinical trials that assessed the use of resistance training for shoulder impingement syndrome were selected. Articles written in English and Portuguese were included. Only one article on the subject was encountered. The authors stress the need for further studies on this topic, as the method has been widely used on a number of other musculoskeletal disorders.
Assuntos
Treinamento Resistido/métodos , Síndrome de Colisão do Ombro/reabilitação , Humanos , Medição da Dor , Qualidade de Vida , Ensaios Clínicos Controlados Aleatórios como Assunto , Amplitude de Movimento Articular , Manguito Rotador/fisiopatologia , Síndrome de Colisão do Ombro/fisiopatologia , Tendinopatia/reabilitação , Resultado do TratamentoRESUMO
OBJECTIVES: To assess the accuracy of blind IA injections (IAIs) in patients with RA and determine their effectiveness. METHODS: A controlled prospective study including 96 RA patients undergoing blind IAIs in peripheral joints was carried out. Clinical evaluation was performed at baseline (T(0)), 1 (T(1)) and 4 (T(4)) weeks after IAI using the following instruments: visual analogue scale (VAS) for pain at rest and movement, VAS for oedema (range 0-10 cm) and morning stiffness. Following IAI, radiographic exam was performed in all joints for further analysis by two 'blinded' radiologists. The kappa-statistic, chi-square and analysis of variance tests were performed to determine potential differences between time-points of evaluation. Significance level was set as P < 0.05. RESULTS: A total of 232 injections were performed. Accuracy observed for the shoulder, elbow, wrist, MCP joints, knee and ankle were 82, 100, 97, 97, 100 and 77%, respectively. A statistically significant improvement was observed for all variables at both T(1) and T(4) when compared with T(0). CONCLUSIONS: Blind IAI proved safe and accurate when performed by a trained professional. Significant improvement was seen in the VAS for pain at rest and during movement, VAS for oedema and morning stiffness.
Assuntos
Antirreumáticos/administração & dosagem , Artrite Reumatoide/tratamento farmacológico , Competência Clínica , Glucocorticoides/administração & dosagem , Injeções Intra-Articulares/normas , Adulto , Anti-Inflamatórios/administração & dosagem , Anti-Inflamatórios/uso terapêutico , Antirreumáticos/uso terapêutico , Feminino , Glucocorticoides/uso terapêutico , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Índice de Gravidade de Doença , Método Simples-Cego , Resultado do Tratamento , Triancinolona Acetonida/administração & dosagem , Triancinolona Acetonida/análogos & derivados , Triancinolona Acetonida/uso terapêuticoRESUMO
OBJECTIVES: To evaluate the effectiveness of a back school program in pain, functional status, quality of life, and in anxiety and depression in patients with non-specific low back pain. METHODS: Sixty patients with low back pain were randomized to an intervention and control group. The intervention group underwent a five-weekly back school program. The control group was seen in weekly medical visits, without educative approaches. Both groups took acetaminophen as analgesic medication. All subjects were evaluated by a blind physiotherapist after randomization, 30, 60 and 120 days. Rolland-Morris, SF-36, STAI and Beck questionnaires, pain visual analogical scale and Schober's test were applied. Non-steroidal anti-inflammatory drugs (NSAID) consumption was considered co-intervention. The statistical analyses were performed using Pearson's Chi-Square analysis and Student's t-test to compare the baseline characteristics of the groups and the analysis of variance (ANOVA) with repeated measures to assess changes inter/intra groups. RESULTS: There were no significant differences in the baseline characteristics between the two groups. Fifty-five patients completed the study. The intervention group showed a significant improvement in the general health domain, assessed by SF-36, and also in the reduction of acetaminophen and NSAID intake. There was no significant difference between the groups in pain, functional status, anxiety or depression. CONCLUSION: The back school program was more effective than any educational intervention in general health status and in decreasing acetaminophen and NSAID intake. It was ineffective in the other quality of life domains, in pain, functional status, anxiety and depression.
Assuntos
Dor Lombar/terapia , Acetaminofen/uso terapêutico , Adolescente , Adulto , Idoso , Analgésicos não Narcóticos/uso terapêutico , Anti-Inflamatórios não Esteroides/uso terapêutico , Ansiedade/prevenção & controle , Depressão/prevenção & controle , Feminino , Seguimentos , Nível de Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Pacientes Desistentes do Tratamento , Educação de Pacientes como Assunto , Qualidade de Vida , Inquéritos e QuestionáriosRESUMO
OBJECTIVE: To create a Brazilian version of the Patient Knowledge Questionnaire--PKQ, an instrument for measuring the knowledge of patients with rheumatoid arthritis (RA) as regards their disease, and through the use of this instrument, also measure the knowledge of RA patients from reference hospitals in the city of São Paulo. METHODS: Two teachers of English translated the PKQ into Portuguese in order to obtain a single version, which was then translated back into English to evaluate its equivalence to the original version (back translation). The final version in Portuguese was applied to 20 patients with RA for adaptation to cultural issues, and questions not understood by 20% or more patients were subsequently modified. Inter- and intraobserver reliability and the constructive validity of the PKQ were tested. The questionnaire was then applied to 100 RA patients, selected in four outpatient clinics at reference hospitals in the city of São Paulo. RESULTS: Three of the PKQ questions were modified to adapt to cultural issues. Intraclass correlation coefficients used for the reliability and validity of the PKQ were between were between 0.62 and 0.94, therefore, statistically significant (p< 0.05). The mean PKQ score was 12.96 and the mean test application time was 10.3 minutes, for the 100 patients assessed. The lowest scores were observed in the domains of medications and joint protection/energy conservation. PKQ scores showed a positive correlation with the level of education (r=0.40) and a negative correlation with the patients' age (r= -0.32) and with HAQ (r= -0.28). CONCLUSION: The Brazilian version of the PKQ that was created and proved to be a reliable and valid instrument. Patients' knowledge of RA is poor, particularly in the domains regarding medications and joint protection/energy conservation.
Assuntos
Artrite Reumatoide/psicologia , Conhecimentos, Atitudes e Prática em Saúde , Educação de Pacientes como Assunto , Inquéritos e Questionários/normas , Adolescente , Adulto , Artrite Reumatoide/fisiopatologia , Brasil , Comparação Transcultural , Feminino , Nível de Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Reprodutibilidade dos Testes , Índice de Gravidade de DoençaRESUMO
The objective of the present study was to translate, adapt and validate a Brazilian Portuguese version of the Disabilities of the Arm, Shoulder and Hand (DASH) Questionnaire. The study was carried out in two steps. The first was to translate the DASH into Portuguese and to perform cultural adaptation and the second involved the determination of the reliability and validity of the DASH for the Brazilian population. For this purpose, 65 rheumatoid arthritis patients of either sex (according to the classification criteria of the American College of Rheumatology), ranging in age from 18 to 60 years and presenting no other diseases involving the upper limbs, were interviewed. The patients were selected consecutively at the rheumatology outpatient clinic of UNIFESP. The following results were obtained: in the first step (translation and cultural adaptation), all patients answered the questions. In the second step, Spearman's correlation coefficients for interobserver evaluation ranged from 0.762 to 0.995, values considered to be highly reliable. In addition, intraclass correlation coefficients ranged from 0.97 to 0.99, also highly reliable values. Spearman's correlation coefficients and the intraclass correlation coefficients obtained during intra-observer evaluation ranged from 0.731 to 0.937 and from 0.90 to 0.96, respectively, being highly reliable values. The Ritchie Index showed a weak correlation with Brazilian DASH scores, while the visual analog scale of pain showed a good correlation with DASH score. We conclude that the Portuguese version of the DASH is a reliable instrument.
Assuntos
Artrite Reumatoide/fisiopatologia , Medição da Dor/instrumentação , Inquéritos e Questionários/normas , Extremidade Superior/fisiopatologia , Adolescente , Adulto , Brasil , Comparação Transcultural , Características Culturais , Avaliação da Deficiência , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Variações Dependentes do Observador , Reprodutibilidade dos Testes , TraduçãoRESUMO
Liver and plasma concentrations in paf-acether (paf) and related phosphocholines, i.e., lysopaf and the ether lipid 1-O-alkyl-2-acyl-sn-glycero-3-phosphocholine (AAGPC) were studied in rats following two-third hepatectomy. We report a rapid increase in hepatic content of the 3 phospholipids at early steps of the regeneration process, when hepatocytes are switching from G0 to G1 (time 2-6 h). Later on, throughout G1 and at the G1-S transition, these concentrations decreased progressively. They were back to sham-operated or intact control levels at 50 h. In the plasma of hepatectomized animals, no comparable changes were detected. However, an increase in both circulating paf and lipoprotein-bound paf concentrations was measured during the regenerating response. This report is, to our knowledge, the first one on paf level variations following 2/3 hepatectomy. In rats, partial resection of the liver was shown to initiate rapid and complex cascades of biochemical changes involving growth factors, neurotransmitters and interleukins among others. Our data are in good agreement with reported increases in both total phospholipid content and synthesis of phosphatidylcholine, a paf precursor, in the regenerating liver. At present, the possible functional significance of high paf concentrations measured over the 'priming' stage of the induced proliferative wave is suggested as a working hypothesis. However, on the one hand, the observed paf response is noteworthy in view of its cytokine-related action, i.e., stimulation of IL-6 production by different cell types (endothelial, macrophagic). On the other hand, it could represent an in vivo confirmation of previously reported in vitro paf effects inducing c-fos and c-jun expression, two members of the so-called 'cellular immediate-early gene' family.
Assuntos
Fígado/química , Fator de Ativação de Plaquetas/análise , Fator de Ativação de Plaquetas/metabolismo , Animais , Hepatectomia , Fígado/cirurgia , Regeneração Hepática/fisiologia , Masculino , Proteínas de Membrana/metabolismo , Fosfolipídeos/metabolismo , Fator de Ativação de Plaquetas/química , Ratos , Ratos WistarRESUMO
In this study, 30 percutaneous synovial knee biopsies were taken from patients with systemic lupus erythematosus (SLE) that had been diagnosed in accordance with ARA criteria. Acute articular involvement was present in 16 cases. The synovial membrane was then examined using routine histological techniques and by direct immunofluorescent methods. The most frequently observed histological picture was comprised of: a) synoviocyte hyperplasia, b) scarce inflammatory infiltrate, c) vascular proliferation, d) oedema and congestion, e) fibrinoid necrosis and intimal fibrous hyperplasia of blood vessels, g) presence of fibrin on the synovial surface and fibrin-like deposits in the chorion. It is concluded that immunofluorescence can be used in the characterization of typical cases but is not specific.
Assuntos
Lúpus Eritematoso Sistêmico/patologia , Membrana Sinovial/patologia , Adolescente , Adulto , Proteínas do Sistema Complemento/imunologia , Feminino , Imunofluorescência , Humanos , Imunoglobulinas/imunologia , Lúpus Eritematoso Sistêmico/diagnóstico , Lúpus Eritematoso Sistêmico/imunologia , Masculino , Pessoa de Meia-Idade , Membrana Sinovial/imunologiaRESUMO
The purpose of the present study was to translate the Roland-Morris (RM) questionnaire into Brazilian-Portuguese and adapt and validate it. First 3 English teachers independently translated the original questionnaire into Brazilian-Portuguese and a consensus version was generated. Later, 3 other translators, blind to the original questionnaire, performed a back translation. This version was then compared with the original English questionnaire. Discrepancies were discussed and solved by a panel of 3 rheumatologists and the final Brazilian version was established (Brazil-RM). This version was then pretested on 30 chronic low back pain patients consecutively selected from the spine disorders outpatient clinic. In addition to the traditional clinical outcome measures, the Brazil-RM, a 6-point pain scale (from no pain to unbearable pain), and its numerical pain rating scale (PS) (0 to 5) and a visual analog scale (VAS) (0 to 10) were administered twice by one interviewer (1 week apart) and once by one independent interviewer. Spearman's correlation coefficient (SCC) and intraclass correlation coefficient (ICC) were computed to assess test-retest and interobserver reliability. Cross-sectional construct validity was evaluated using the SCC. In the pretesting session, all questions were well understood by the patients. The mean time of questionnaire administration was 4 min and 53 s. The SCC and ICC were 0.88 (P<0.01) and 0.94, respectively, for the test-retest reliability and 0.86 (P<0.01) and 0.95, respectively, for interobserver reliability. The correlation coefficient was 0.80 (P<0.01) between the PS and Brazil-RM score and 0.79 (P<0.01) between the VAS and Brazil-RM score. We conclude that the Brazil-RM was successfully translated and adapted for application to Brazilian patients, with satisfactory reliability and cross-sectional construct validity.
Assuntos
Avaliação da Deficiência , Dor Lombar/diagnóstico , Inquéritos e Questionários/normas , Tradução , Brasil , Estudos Transversais , Características Culturais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Reprodutibilidade dos Testes , Estatísticas não ParamétricasRESUMO
The purpose of the present study was to translate and adapt the Berg balance scale, an instrument for functional balance assessment, to Brazilian-Portuguese and to determine the reliability of scores obtained with the Brazilian adaptation. Two persons proficient in English independently translated the original scale into Brazilian-Portuguese and a consensus version was generated. Two translators performed a back translation. Discrepancies were discussed and solved by a panel. Forty patients older than 65 years and 40 therapists were included in the cultural adaptation phase. If more than 15% of therapists or patients reported difficulty in understanding an item, that item was reformulated and reapplied. The final Brazilian version was then tested on 36 elderly patients (over age 65). The average age was 72 years. Reliability of the measure was assessed twice by one physical therapist (1-week interval between assessments) and once by one independent physical therapist. Descriptive analysis was used to characterize the patients. The intraclass correlation coefficient (ICC) and Pearson's correlation coefficient were computed to assess intra- and interobserver reliability. Six questions were modified during the translation stage and cultural adaptation phase. The ICC for intra- and interobserver reliability was 0.99 (P < 0.001) and 0.98 (P < 0.001), respectively. The Pearson correlation coefficient for intra- and interobserver reliability was 0.98 (P < 0.001) and 0.97 (P < 0.001), respectively. We conclude that the Brazilian version of the Berg balance scale is a reliable instrument to be used in balance assessment of elderly Brazilian patients.
Assuntos
Atividades Cotidianas , Avaliação da Deficiência , Avaliação Geriátrica/métodos , Equilíbrio Postural , Inquéritos e Questionários/normas , Idoso , Brasil , Características Culturais , Feminino , Humanos , Masculino , Variações Dependentes do Observador , Reprodutibilidade dos Testes , TraduçãoRESUMO
UNLABELLED: Repetitive strain injuries are a common diagnostic label for musculoskeletal pain occurring at the workplace. Although many individuals present with diffuse pain, the diagnosis of fibromyalgia in this setting is rare. Our objective was to establish the point prevalence of the fibromyalgia syndrome in a population of assembly line workers in São Paulo, Brazil. METHODS: Thirty-four workers with repetitive strain injury diagnoses were studied and compared with 49 workers, paired by age, sex, and labor function. All individuals were studied by a comprehensive clinical protocol. Diagnosis of fibromyalgia syndrome was established when the 1990 American College of Rheumatology criteria for this syndrome were met. RESULTS: Among the 34 workers with the diagnosis of repetitive strain injuries, 58.8% fulfilled the American College of Rheumatology criteria for fibromyalgia syndrome, while only 10.4% of the controls met the same criteria. CONCLUSIONS: Fibromyalgia syndrome was largely involved in the symptoms of patients with repetitive strain injuries, as opposed to coworkers with non-repetitive strain injuries. So, instead of the repetitive strain injuries label, many of these cases should be called fibromyalgic patients.
Assuntos
Transtornos Traumáticos Cumulativos/complicações , Fibromialgia/complicações , Metalurgia , Doenças Profissionais/etiologia , Adulto , Brasil/epidemiologia , Transtornos Traumáticos Cumulativos/epidemiologia , Transtornos Traumáticos Cumulativos/fisiopatologia , Feminino , Fibromialgia/epidemiologia , Fibromialgia/fisiopatologia , Humanos , Masculino , Pessoa de Meia-Idade , Doenças Profissionais/epidemiologia , Doenças Profissionais/fisiopatologia , Ocupações , Licença Médica/estatística & dados numéricos , Transtornos do Sono-Vigília/epidemiologia , Transtornos do Sono-Vigília/etiologiaRESUMO
The electroencephalogram (EEG) is often used for the diagnosis of diseases and functional disturbances in the brain. In this paper, new algorithms developed for the automatic detection of transients in EEG are described. The single spike, and spike and wave bursts, both of which are abnormal phenomena associated with epileptic activity are considered. The algorithms for detecting these transients were tested using real EEG data. The transient detection is enhanced by two classification algorithms: patient-independent analysis and patient-dependent analysis. In the patient-independent analysis, multiple reference templates are generated from a patient population and for the patient-dependent analysis, the spikes from the patient's own EEG recording is used as reference. The description of the algorithms and their performances are presented.
Assuntos
Algoritmos , Eletroencefalografia , Processamento de Sinais Assistido por Computador , Epilepsia/diagnóstico , Humanos , Design de SoftwareAssuntos
Artrite Reumatoide/tratamento farmacológico , Glucocorticoides/administração & dosagem , Injeções Intra-Articulares/métodos , Articulação do Punho/diagnóstico por imagem , Adulto , Artrite Reumatoide/diagnóstico por imagem , Método Duplo-Cego , Feminino , Seguimentos , Glucocorticoides/uso terapêutico , Humanos , Masculino , Pessoa de Meia-Idade , Resultado do Tratamento , UltrassonografiaRESUMO
PURPOSE: The aim of the present study was to assess the immediate impact of cane use on energy expenditure during gait in patients with knee OA analyzing VO(2). METHODS: An observational, cross-sectional study was carried out on 64 symptomatic patients with a diagnosis of knee OA. The assessment of energy expenditure was performed through an analysis of expired gases using the portable K4 apparatus (Cosmed, Model K4 b2, Italy) during the six-min walk test (6MWT). Two tests were performed with a cane and two without a cane on two different days within a seven-day period. RESULTS: The patients walked farther on the test without the cane (p<0.001). Oxygen expenditure (VO(2)) and the O(2) cost of walking at the end of the 6MWT increased approximately 50% and 80% during cane-assisted gait when compared to gait without the use of a cane (p<0.001). Pain (Borg scale) decreased approximately 20% at the end of the 6MWT with cane-assisted gait in comparison to gait without a cane (p<0.001). CONCLUSION: Cane use causes an immediate increase in energy expenditure (VO(2)) during gait and O(2) cost of walking and an immediate decrease of pain during gait. It is necessary to do a more prolonged follow up in order to assess the impact of daily cane use on energy expenditure among these patients and determine whether adaptation occurs. Furthermore, it is necessary to study whether daily cane use has a positive impact on important parameters in these patients, such as pain, function and quality of life.