ABSTRACT
Abstract Regular physical exercise tends to benefit people with fibromyalgia syndrome (FMS). The effects have been observed regarding aerobic power and strength; however, results concerning flexibility have been controversial. In general, studies have evaluated specific joints or tests involving only a single body movement. The aim of this study was to compare the flexibility profile of FMS and asymptomatic women using a more comprehensive test protocol regarding the number of movements and joints involved. The sample consisted of 30 women divided into two groups: asymptomatic (n = 15; mean age: 50.2 ± 8.2 years; mean weight: 63.0 ± 9.6 kg; mean height: 157 ± 6 cm) and fibromyalgia (n = 15; mean age: 47.3 ± 9.4 years; mean weight: 61.9 ± 12.2 kg; mean height: 159 ± 7 cm). Flexibility was measured using the Flexitest, which was evaluated by the global index of flexibility (Flexindex), and the five indices of variability of joint mobility: intermovement (IVIM), interjoint (IVIA), flexion-extension (IVFE), between segment (IVES) and distal-proximal (IVDP). All of the indices were calculated based on the results of the 20 movements of the Flexitest. There was no difference between groups (44.4 ± 3.7 vs. 45.7 ± 4.1 points, for asymptomatic and fibromyalgia, respectively; p = 0.379; 95% confidence interval (CI): -4.2 to 1.6). Most of the sample (83%) showed an average level of flexibility based on reference values for gender and age. Only IVIM showed a significant difference between the groups. Asymptomatic and fibromyalgic women have similar overall levels of flexibility but with different profiles.
Resumo Exercícios físicos em mulheres com síndrome de fibromialgia (SFM) têm apresentado efeitos na força e potência aeróbica, contudo, os resultados acerca da flexibilidade têm sido controversos. Além disso, os estudos têm avaliado articulações específicas ou testes que envolvam apenas um único movimento corporal. Objetivou-se comparar o perfil de flexibilidade global de mulheres acometidas pela SFM e assintomáticas a partir de um protocolo de teste mais abrangente quanto ao número de movimentos e articulações envolvidas. Participaram da pesquisa 30 mulheres divididas em dois grupos: assintomáticas (n = 15; 50,2 ± 8,2 anos; 63,0 ± 9,6 kg; 157 ± 6 cm) e fibromiálgicas (n = 15; 47,3 ± 9,4 anos; 61,9 ± 12,2 kg; 159 ± 7 cm). A flexibilidade medida pelo Flexiteste foi avaliada pelo índice global de flexibilidade (flexíndice) e pelos cinco índices de variabilidade da mobilidade articular: intermovimentos (IVIM), intra-articulação (IVIA), flexão-extensão (IVFE), entre segmentos (IVES) e distal-proximal (IVDP). Todos os índices foram calculados com base nos resultados dos 20 movimentos do flexiteste. Não houve diferença no flexíndice entre os grupos (44,4 ± 3,7 vs 45,7 ± 4,1 pontos, para assintomáticas e fibromiálgicas respectivamente; p=0,379; IC95% = -4,2 a 1,6). A maioria da amostra (83%) apresentou nível de flexibilidade considerado na média da população para o gênero feminino e para cada faixa etária específica. Entre os índices de variabilidade da mobilidade articular apenas o IVIM apresentou diferença significativa. Mulheres assintomáticas e fibromiálgicas apresentam níveis globais de flexibilidade similares, mas com perfis diferentes.
ABSTRACT
Diarrhea is an important cause of hospitalization among infants. There are many complex factors that influence hospital use: socioeconomic and cultural characteristics, access, medical needs, and supply. The objective was to measure hospitalization rates from diarrhea among infants in Rio de Janeiro in 1996 and the association with demographic, geographical, and clinical data comparing differentials between public/university and private/philanthropic hospital care under the Unified National Health System (SUS). The authors used data from the Hospital Information System. Private/philanthropic hospitals admitted approximately four times more children than public/university hospitals. Analysis shows that variation in age, length of hospital stay, and use of pediatric intensive care may reflect differences in physicians' practice styles. This may in turn influence the respective health care unit's capacity to prevent death associated with diarrhea. The authors conclude that it is necessary to continue the analysis of hospital utilization under the SUS due to implications for the cost and quality of pediatric care.