ABSTRACT
AbstractObjective The objective of this review was to evaluate the evidence of the influence of therapeutic modalities on postural balance in patients with knee osteoarthritis (OA).Methods A search for published papers on therapeutic modalities was conducted using the Pubmed, Medline, Lilacs and SciELO databases. The keywords “knee” and “balance” in combination with “osteoarthritis” were used as the search strategy. Randomized controlled clinical trials published in the last 10 years in either English or Portuguese were selected. The PEDro scale was applied to assess the quality of the selected clinical trials.Results A total of 46 studies of patients with knee OA were found, of which seven were analyzed in full and 39 were excluded because they did not meet the inclusion criteria. Of the seven studies reviewed, six were considered to have a high methodological quality on the PEDro scale. Several therapeutic modalities were found (physical exercise, hydrotherapy, electrotherapy and manual therapy), and postural balance improved in only three studies.Conclusion The studies included in this systematic review had a high methodological quality, so it can be concluded that the therapeutic modalities used in those studies improved postural balance in patients with knee OA.
ResumoObjetivo O objetivo desta revisão foi fornecer evidências da influência das modalidades terapêuticas no equilíbrio postural em pacientes com osteoartrite de joelho.Métodos A busca de publicações sobre as modalidades terapêuticas foi realizada nas bases de dados Pubmed, Medline, Lilacs e SciELO. Foram utilizadas como estratégia de busca as palavras-chave “knee” e “balance”, em combinação com “osteoarthritis”. Foram selecionados ensaios clínicos aleatórios e controlados dos últimos dez anos, em língua inglesa e portuguesa. Para verificar a qualidade dos ensaios clínicos selecionados, foi aplicada a Escala PEDro.Resultados Foram encontrados 46 estudos com pacientes com OA de joelho, sendo que, 7 estudos foram analisados na integra e 39 estudos foram excluídos por não se adequarem ao tema proposto. Dos sete estudos avaliados, seis foram considerados de alta qualidade metodológica na Escala de PEDro. Foram encontradas diversas modalidades terapêuticas (exercício físico, hidroterapia, eletroterapia e terapias manuais), porém em apenas três estudos houve melhora no equilíbrio postural.Conclusão Tendo em vista que os estudos incluídos na presente revisão sistemática têm uma alta qualidade metodológica, pode-se concluir que as modalidades terapêuticas utilizadas pelos estudos melhoraram o equilíbrio postural de pacientes com OA de joelho.
ABSTRACT
OBJECTIVE: To assess the effect of passive body heating on the sleep patterns of patients with fibromyalgia. METHODS: Six menopausal women diagnosed with fibromyalgia according to the criteria determined by the American College of Rheumatology were included. All women underwent passive immersion in a warm bath at a temperature of 36 ±1 °C for 15 sessions of 30 minutes each over a period of three weeks. Their sleep patterns were assessed by polysomnography at the following time-points: pre-intervention (baseline), the first day of the intervention (acute), the last day of the intervention (chronic), and three weeks after the end of the intervention (follow-up). Core body temperature was evaluated by a thermistor pill during the baseline, acute, chronic, and follow-up periods. The impact of this treatment on fibromyalgia was assessed via a specific questionnaire termed the Fibromyalgia Impact Questionnaire. RESULTS: Sleep latency, rapid eye movement sleep latency and slow wave sleep were significantly reduced in the chronic and acute conditions compared with baseline. Sleep efficiency was significantly increased during the chronic condition, and the awakening index was reduced at the chronic and follow-up time points relative to the baseline values. No significant differences were observed in total sleep time, time in sleep stages 1 or 2 or rapid eye movement sleep percentage. The core body temperature and Fibromyalgia Impact Questionnaire responses did not significantly change over the course of the study. CONCLUSION: Passive body heating had a positive effect on the sleep patterns of women with fibromyalgia.
Subject(s)
Female , Humans , Middle Aged , Balneology/methods , Body Temperature/physiology , Fibromyalgia/therapy , Sleep/physiology , Fibromyalgia/physiopathology , Hyperthermia, Induced/methods , Immersion , Polysomnography , Quality of Life , Statistics, Nonparametric , Surveys and Questionnaires , Sleep, REM/physiology , Time Factors , Treatment OutcomeABSTRACT
O objetivo foi identificar o nível de atividade física e sua relação com sonolência excessiva diurna e qualidade de sono em 15 mulheres com fibromialgia, com idade média de 58±7 anos. Foi utilizado o Questionário Internacional de Atividade Física, o Índice de Qualidade de Sono de Pittsburgh e a Escala de Sonolência de Epworth. O programa SPSS Statistics versão 17 foi utilizado para as analises estatísticas e o valor para significância foi de α ≤ 0,05. Os resultados evidenciaram que 33,3% das pacientes classificaram-se inativas e 66,7% minimamente ativas. Observou-se sonolência excessiva diurna em 60% das pacientes. A qualidade ruim de sono foi observada em 55,6% das pacientes minimamente ativas e em 60% das inativas. O tempo médio para adormecer foi 34,3 minutos, a eficiência do sono foi 81% e o tempo total de sono foi 5,9 horas. O baixo nível de atividade física parece ser um dos fatores capazes de piorar a qualidade do sono de mulheres com fibromialgia.
The objective was to identify the level of physical activity and its relation to excessive daytime sleepiness and sleep quality in 15 women with fibromyalgia and mean age 58 ± 7 years. We used the International Physical Activity Questionnaire, the Sleep Quality Index in Pittsburgh and Epworth Sleepiness Scale. We used SPSS Statistics Version 17 and the value for significance was α ≤ 0.05. The results showed that 33,3% of patients rated themselves inactive and 66,7% minimally active. We observed excessive daytime sleepiness in 60% of patients. The poor quality of sleep was observed in 55,6% of patients in minimally active and 60% of inactive. The average time was 34,3 minutes to fall asleep, sleep efficiency was 81% and total sleep time was 5,9 hours. The low level of physical activity seems to be one of the factors that can worsen sleep quality in women with fibromyalgia.