Evaluation of Knowledge Acquisition and Maintenance Using Web Pretest / Posttest in Physical Assessment Training Course / 社会薬学

Currently, pharmacists must learn the basic skills and knowledge required to conduct physical assessment (PA) in order to obtain patient information. To address this need, Kindai University Faculty of Pharmacy requires students to enroll in a training course for PA. One component of the course for 4th grade 155 students is the use of Web Test that is designed assess student performance of pharmacotherapy with PA. This paper reports on Web Test results. The 15-question Web Test is conducted on Moodle. The Web Test is administered three times (pretest, posttest (after training course) and follow-up test (two month later)). The averages for each Web Test were respectively, 9.5 ± 2.0, 12.9 ± 0.9, 11.9 ± 2.7, which indicates positive results for posttest and follow-up test (p<0.01, Tukey test). This result suggests that the PA training course is raising student awareness regarding PA.

Capacidade funcional e força muscular de indivíduos internados em uma unidade de terapia intensiva cirúrgica / Functional capacity and muscular force of individuals in a unit of intensive surgical therapy

INTRODUÇÃO: Pacientes pós-cirúrgicos podem apresentar redução da capacidade funcional e força muscular devido as complicações pós-operatórias ou do internamento hospitalar. Porém, até o momento pouco se sabe sobre o estado funcional de indivíduos internados na Unidade de Terapia Intensiva (UTI) cirúrgica. OBJETIVO: Verificar a força muscular periférica e a capacidade funcional de indivíduos no pós-operatório internados em uma UTI cirúrgica. MÉTODOS: Estudo transversal, descritivo, do qual participaram 72 pacientes admitidos na UTI cirúrgica com idade ≥18 anos, de ambos os sexos, no período pós-operatório. Os critérios de exclusão foram os casos onde os pacientes estivessem: hemodinamicamente instáveis, com desordem cognitiva ou com comunicação limitada que comprometesse a acurácia do registro de dados e aqueles que se recusaram a participar da pesquisa. A avaliação da capacidade funcional foi realizada através da medida de independência funcional, a força muscular através do Medical Research Council. RESULTADOS: A média de idade 51.2 ± 19 anos, sendo 35 (46,8%) do sexo feminino. A média da capacidade funcional foi 95,7 ± 21,3, sendo que 40 (55,6%) dos pacientes apresentaram dependência modificada (assistência de até 25% das tarefas) e 28 (38,9%) independência completa/modificada. A mediana da força muscular periférica foi 58 (48-60). A mediana do tempo de permanência na UTI foi 4 (2-7) dias. O tempo de permanência na ventilação mecânica foi de 24 horas para a maioria dos indivíduos 46 (63,9%). CONCLUSÃO: A força muscular periférica dos pacientes internados em UTI cirúrgica no pós-operatório não foi encontrada alterada. No entanto, grande parte dos pacientes apresentaram limitações funcionais. [AU]

BACKGROUND: Post-surgical patients may present functional capacity reduction and muscle strength due to postoperative complications or hospitalization. However, so far little is known about the functional status of individuals hospitalized in the Intensive Care Unit (ICU). OBJECTIVE: To verify the peripheral muscular strength and the functional capacity of an individual in the postoperative period hospitalized in a surgical ICU. METHODS: A cross-sectional, descriptive study in which 72 patients admitted to the surgical ICU, aged ≥18 years, of both sexes, participated in the postoperative period. Exclusion criteria were cases where patients were: hemodynamically unstable, with cognitive disorder or with limited communication that compromised the accuracy of the data record and those who refused to participate in the study. The functional capacity assessment was performed through functional independence measure, muscle strength through the Medical Research Council. RESULTS: The mean age was 51.2 ± 19 years, of which 35 (46.8%) were female. The mean functional capacity was 95.7 ± 21.3; 40 (55.6%) of the patients had modified dependence (up to 25% of the tasks) and 28 (38.9%) complete / modified independence. The median of peripheral muscle strength was 58 (48-60). The median length of ICU stay was 4 (2-7) days. The duration of mechanical ventilation was 24 hours for most of the individuals 46 (63.9%). CONCLUSION: The peripheral muscle strength of patients admitted to the surgical ICU postoperatively was not found to be altered. However, most patients had functional limitations. [AU]

Comparison of the Perception between Pharmacy Students and Practicing Pharmacists in the Acquisition of Physical Assessment Skills / 社会薬学

The expansion of home medical care and the growth in sales of OTC, coupled with Japan’s aging society and the need to reduce medical costs has broadened the role of the pharmacist to include physical assessment. In response, the Kindai University Faculty of Pharmacy, implemented the Physical Assessment Practical Training Course (PAPTC) to improve the physical assessment skills of pharmacy students and practicing pharmacists. In order to investigate pharmacy students’ and practicing pharmacists’ perceptions of PAPTC, a questionnaire using a five-part, forced- choice Lykert type scale was conducted. The results of the questionnaire were analyzed using factor analysis and cluster analysis. The total number of respondents was 456. Three hundred thirteen of the respondents were students, and 143 of the respondents were practicing pharmacists. Factor analysis revealed four factors which we titled, “Physical Assessment Skills”, “Physical Assessment Course”, “Pharmacist Jobs” and, “Knowledge Required by Pharmacist”. Subsequently, cluster analysis identified two distinct groups. Group A which constituted primarily of pharmacy students, and Group B which consisted primarily of practicing pharmacists. Each group displayed notable differences in perceptions related to PAPTC. These differences may be influenced by perceptions toward “skills” and/or “knowledge”. These findings suggest that in order to better address the motivational needs of the participants, PAPTC should be divided into two courses. One, for knowledge-based instruction, and other for skill-based practice.

Comparison of the Perception between Pharmacy Students and Practicing Pharmacists in the Acquisition of Physical Assessment Skills / 社会薬学

The expansion of home medical care and the growth in sales of OTC, coupled with Japan’s aging society and the need to reduce medical costs has broadened the role of the pharmacist to include physical assessment. In response, the Kindai University Faculty of Pharmacy, implemented the Physical Assessment Practical Training Course (PAPTC) to improve the physical assessment skills of pharmacy students and practicing pharmacists. In order to investigate pharmacy students’ and practicing pharmacists’ perceptions of PAPTC, a questionnaire using a five-part, forced- choice Lykert type scale was conducted. The results of the questionnaire were analyzed using factor analysis and cluster analysis. The total number of respondents was 456. Three hundred thirteen of the respondents were students, and 143 of the respondents were practicing pharmacists. Factor analysis revealed four factors which we titled, “Physical Assessment Skills”, “Physical Assessment Course”, “Pharmacist Jobs” and, “Knowledge Required by Pharmacist”. Subsequently, cluster analysis identified two distinct groups. Group A which constituted primarily of pharmacy students, and Group B which consisted primarily of practicing pharmacists. Each group displayed notable differences in perceptions related to PAPTC. These differences may be influenced by perceptions toward “skills” and/or “knowledge”. These findings suggest that in order to better address the motivational needs of the participants, PAPTC should be divided into two courses. One, for knowledge-based instruction, and other for skill-based practice.

Survey of Patient’s Comprehension of Home Medical Care and Pharmaceutical Intervention Using Factor Analysis / 社会薬学

Because of societal aging, Japanese pharmacists have an increasingly important role in home medical care. This is particularly true because more pharmacists are required to perform physical assessments to optimize patient treatment. However, few investigations have examined whether patients understand the role of pharmacists and the importance of home medical care. In this study, a questionnaire was provided to 260 patients aged 20-90 years to determine patients’ attitudes toward home medical care and pharmaceutical interventions. After conducting factor analysis, items related to home medical care were excluded at the stage of exploratory factor analysis, indicating that patients are not interested in home medical care. However, regarding pharmaceutical interventions, the questionnaire revealed that 42% of the patients required the pharmacists to provide information regarding the prescribed drugs during home medical care visits. Furthermore, it was demonstrated that 85% of the patients were unaware that physical assessments are also perform by pharmacists. In contrast, >50% of the patients believed that pharmacists had an important role in physical assessment interventions.

World Health Organization Wheelchair Service-Intermediate Level：Introduction and Implication for Assistive Technology Service in China / 中国康复理论与实践

World Health Organization Wheelchair Service Package-Intermediate Level focuses on the people who have severe difficul-ties in walking and moving around and also having poor postural control, as well as the children who have poor postural control and are un-able to sit upright independently. It includes step 1 referral and appointment;step 2 assessment;step 3 prescription (selection);step 4 fund-ing and ordering;step 5 product (wheelchair) preparation;step 6 fitting;step 7 user training;and step 8 maintenance, repairs and follow up. The physical assessment and postural support device of wheelchair service-intermediate level were emphasized. It is characterized as the standardized process, individual assessment and modular postural support device. It implies that it is important to make the assistive technol-ogy service system standardized, professional and modular.

Survey on Customer Satisfaction for Evaluation and Improvement of Physical Assessment Practical Training Seminar for Pharmacists / 社会薬学

<p>In the areas of home medical care and self-medication, the role of the pharmacist is growing, partly as a result of Japan’s aging society and the need to reduce medical costs. In response, the Kinki University Faculty of Pharmacy implemented a physical assessment practical training seminar in order to improve the physical assessment skills of practicing pharmacists. A series of questionnaires were conducted among pharmacists to investigate their perceptions of physical assessment practical training seminars. The results of the questionnaires were analyzed using Customer Satisfaction (CS) analysis and text mining. Based on a 5-point scale (1-low∼5-high), questionnaires revealed satisfaction for physical assessment practical training seminars was 4.6±0.6 (Ave.±S.D.). CS analysis revealed that the items “lectures” and “case seminars” had the highest level of satisfaction. However, items showing low levels of satisfaction were “auscultation of respiratory sounds” and “SBAR (Situation, Background, Assessment, Recommendation).” Results of text mining suggested a relationship between “physical assessment” and “difficult”. Analysis of the questionnaires showed a high level satisfaction with physical assessment practical training seminars, notably physical assessment practice methods. However, CS analysis and text mining indicate the finer techniques of physical assessment were difficult to acquire.</p>

Validação da bioimpedância elétrica por multifrequência em atletas / Validation of multifrequency bioelectrical impedance analysis in athletes

É reconhecida a importância de avaliar a composição corporal na população atlética. Para o efeito é preciso utilizar técnicas válidas na determinação dos principais componentes moleculares. A Densitometria Radiológica de Dupla Energia (DXA) é um método preciso e válido para avaliação decomposição corporal. No entanto, a DXA é uma técnica ainda pouco acessível em contextos não laboratoriais. Desta forma, é importante utilizar técnicas mais simples e práticas como a bioimpedância eléctrica (BIA). No entanto poucos estudos validaram a BIA especialmente de multifrequência na avaliação da composição corporal em atletas. Assim, o objetivo desta investigação é testar a validade da BIA de multifrequência (Tanita, modelo MC-180) na determinação do conteúdo mineral ósseo (CMO),massa gorda (MG) e massa isenta de gordura e osso (MIGO) em atletas. Um total de 79 atletas (35 homens) foram avaliados pela BIA e pela DXA. Comparação de médias, coeficiente de correlação de concordância, regressão múltipla, e o método Bland-Altman foram realizados. A Tanita apresentou um poder explicativo de 76 %, 72%, 95% e 73% da variabilidade total observada a partir do método de referência para a MG (kg), MG (%), MIGO e CMO, respectivamente. O coeficiente de correlação de concordância para a MIGO apresentou uma força de concordância substancial de 0.927. Observaram-selimites de concordância relativamente elevados na estimativa dos vários componentes corporais. Em conclusão, a Tanita MC-180 é uma alternativa válida especialmente na estimação da massa isenta de gordura e de osso, num grupo de atletas. Contudo, devido aos limites de concordância obtidos na determinação das vários componentes este equipamento apresenta uma validade limitada na estimação individual da composição corporal...

It is recognized the importance of assessing body composition in athletic populations.Therefore, it is necessary to use valid techniques for the determination of the main molecular components.Dual-energy X-ray absorptiometry (DXA) is a precise and valid method for assessing body composition.However, DXA is still not available at the clinical and field settings. Thus, it is important to use simpletechniques such as electrical bioimpedance analysis (BIA) but few studies validated this techniquespecifically multifrequency BIA in body composition assessment in athletes. Therefore, the aim of thisresearch is to test the validity of multifrequency BIA (Tanita, Model MC-180) in the determination ofbone mineral content (BMC), lean soft tissue (LST) and fat mass (FM) in athletes. A total of 79 eliteathletes (35 males) were assessed by DXA and BIA. Comparison of means, concordance coefficientcorrelation, multiple regression and Bland–Altman analysis were performed. Tanita explained 76%, 72%,95% and 73% of the total variability observed from the reference method for FM (kg), FM (%), LST andBMC, respectively. The concordance coefficient correlation for MIGO presented a substantial strength ofagreement of 0,927. However, relatively larger limits of agreement were found between BIA and DXA forthe several body components. These findings reveal that the Tanita MC-180 is a valid alternative,particularly in the estimation of LST, in a group of athletes. However, due to the limits of agreementobtained in the determination of the body components this equipment presents a more limited validity inthe estimation of individual body composition...

Awareness Survey to Create a Seminar Program Effective for Pharmacist Practice of Physical Assessments / 社会薬学

Seminars on physical assessment (PA) are being held at a wide variety of universities and medical institutions. However, the current situation shows that the number of pharmacists practicing PA at medical sites is still very small. We therefore conducted a questionnaire survey, targeting all 70 individuals who took part in a PA seminar carried out in 2013 at Daiichi University of Pharmacy, to investigate the reasons for pharmacists being unable to practice PA at present, and then we studied the types of seminars that would be needed for them to practice PA in the future. The results showed that 91% of pharmacists, currently working in a pharmacy, who took part in the seminar and 100% of hospital pharmacists hoped to practice PA, if possible, although they had no immediate plans for implementing PA. Of those who participated in the current seminar, only 10% felt that they could practice PA immediately after taking the seminar just once, although the degrees of their understanding of the seminar content and mastering of the techniques were high. Our findings suggested additional training and studies to be necessary in order for the participating pharmacists to practice PA.

Programas de avaliação em academias de ginástica: o que se faz? / Assessment programs in gyms: what usually do?

Objetivou-se analisar o processo estrutural dos programas de avaliação em Academias de Ginástica no município de Maceió-AL. Esse estudo foi do tipo transversal, sendo a amostra constituída por 58 academias. Aplicou-se um questionário com os responsáveis pela avaliação física, contendo as variáveis da rotina de avaliação nas respectivas academias: anamnese, medidas fisiológicas (pressão arterial sistêmica), avaliação postural, aptidão física relacionada a saúde e emissão de laudos. Na análise dos dados utilizou-se o teste de comparação entre duas proporções, Qui-quadrado de heterogeneidade ou o Teste Exato de Fisher. Foi estabelecido nível de significância de 5%. A maior parte das academias exigia a obrigatoriedade da avaliação física na matrícula (p=0,005) o que não se observou quanto à reavaliação p(=0,079); os indicadores presentes na anamnese quanto as morbidades auto referidas, ingestão de medicamentos, tabagismo e atividade física estiveram presentes na rotina de avaliação. Além disso, a mensuração da pressão arterial sistêmica, avaliação postural e composição corporal apresentou presença significativa na rotina do programa de avaliação. Nas academias cuja avaliação era obrigatória, a reavaliação também foi; o objetivo da clientela estava na saúde; a avaliação do componente da aptidão física flexibilidade foi negligenciado. De modo geral, os indicadores presentes no processo de avaliação das academias podem ser mais bem estruturados para que possam apresentar um melhor perfil da população usuária desse serviço.

The objective of this study was to analyze the structural process of physical assessment of Fitness Centers from Maceió-AL. In this cross-sectional study, 58 Fitness Centers were evaluated. A self-reported questionnaire with information about physical assessment was answered by Physical Education professionals. Comparison Test between two proportions, Chi-square Test and Fisher's exact Test was used to identify associated variables with physical assessment of Fitness Centers. Most of the gyms demanded the mandatory physical assessment on enrollment (p=0.005) which was not observed for the reassessment (p=0.079); the indicators present in anamnesis as the self-morbidities, medication intake, smoking and physical activity were present in the routine evaluation. Furthermore, measurement of systemic blood pressure, postural and body composition assessment had a significant presence in the routine evaluation program. In the gyms whose assessment was required, the revaluation was also; the goal of the clientele was in health; the assessment of the flexibility was neglected. In general, the indicators present in the process of physical assessment of Fitness Centers should be reorganized so that they can be used effectively.

Protocolo para avaliação física em portadores de síndrome de fibromialgia / Protocol for physical assessment in patients with fibromyalgia syndrome

Introdução: A síndrome da fibromialgia (SFM) é uma doença crônica que provoca dor e fadiga e apresenta impacto negativo na qualidade de vida. O exercício auxilia na manutenção da aptidão física e influencia diretamente na melhoria da qualidade de vida. Objetivo: Elaborar um protocolo para avaliação física relacionada à saúde de portadores da SFM com testes que sejam viáveis e apropriados para esse público. Método: Foi feita uma revisão da literatura de forma exploratória e analítica, para determinar os testes usados pela comunidade científica. Com isso, fez-se um levantamento bibliográfico por meio do banco de dados das bibliotecas virtuais PubMed, Bireme, Banco de Teses e Dissertações da Capes e Biblioteca Digital Brasileira de Teses e Dissertações publicados entre 1992 e 2012. Resultados: Demonstraram uma variedade de testes, em que se destacaram, em número de citações, os seguintes: Índice de Massa Corporal (IMC) e Bioimpedância; Caminhada de 6 minutos; Força de preensão manual (dinamômetro), 1 RM [Repetição Máxima]); Sentar e alcançar e Flexibilidade de ombro; Levantar e ir - Foot Up and Go e Equilíbrio do flamingo. Conclusão: Estes são os testes que devem compor o protocolo para avaliação física de portadores de SFM. Ressalte-se que esse protocolo é de fácil utilização. .

Introduction: Fibromyalgia syndrome (FMS) is a chronic disease that causes pain and fatigue, presenting a negative impact on quality of life. Exercise helps maintaining physical fitness and influences directly on the improvement of quality of life. Objective: Develop a protocol for health-related physical fitness assessment of patients with FMS with tests that are feasible and appropriate for this population. Method: An exploratory and analytical literature review was performed, seeking to determine the tests used by the scientific community. With this in mind, we performed a literature revision through the use of virtual libraries databases: PubMed, Bireme, Banco de Teses e Dissertações da Capes and Biblioteca Digital Brasileira de Teses e Dissertações, published in between 1992-2012. Results: A variety of tests was found; the following, by number of citations, stood out: Body Mass Index (BMI) and bioimpedance; 6-minute walk; handgrip strength (dynamometer, 1RM [Repetition Maximum]); Sit and reach and Shoulder flexibility; Foot Up and Go, and Flamingo balance. Conclusion: These are the tests that should make up the protocol for the physical evaluation of FMS patients, emphasizing their ease of use. .

Pharmacy Education Necessary for Pharmacists who has Completed their Vital Signs Training / 社会薬学

A number of pharmaceutical colleges have adopted a training program for the vital signs in their 6 year-education curriculum. However, few hospitals or pharmacies carry out vital signs monitoring or physical assessment at present, and graduate pharmacists cannot utilize the techniques that they are skilled in fully. In this study, in order to clarify the situation for implementing vital sign monitoring by pharmacist and what is necessary for pharmacy education, we carried out a web survey for two months, from October 4th to December 3rd, 2012, targeting 1026 pharmacists who attended the vital signs training program hosted by The Japanese Association of Home Care Pharmacies. The Survey item were; (1) basic information of a respondent; (2) situation of homecare conducted by pharmacists; (3) seminar attendance status; (4) vital signs monitoring status after the seminar; (5) hope for future pharmacy education. From the result of the survey, it became clear that over 40% of pharmacists had a chance to perform vital sign monitoring, leading to proper use of medicines. In total, 183 responses to the questions concerning future pharmacy education were obtained from 135 pharmacists and were classified into 11 categories. A request for “a purpose and the significance” was the most common. In the education of pharmacy schools, it is thought that having lectures from on-site pharmacists with an abundance of experience in cases will be effective.

Carga para a aplicação de testes de 1-RM em exercícios de membros superiores em mulheres jovens treinadas e não treinadas / Load to the application of 1-RM tests in upper limbs of young women trained and untrained / Cargo por el uso de las pruebas de 1-RM en el miembro superior de las mujeres jóvenes entrenados y no entrenados

O objetivo do estudo foi propor valores de referência para a aplicação dos testes de 1-RM em mulheres jovens treinadas e não treinadas. 90 mulheres, de 18 a 31 anos, agrupadas em: 43 Treinadas (GT) e 47 Não Treinadas (GNT) foram submetidas aos testes de 1-RM nos seguintes exercícios: supino reto, desenvolvimento, rosca direta e tríceps testa. O GT apresentou maiores valores em relação ao GNT, em termos absolutos e relativos: supino reto (GT = 36,44 kg/0,63 e GNT = 27,34 kg/0,46), desenvolvimento (GT = 27,93 kg/0,49 e GNT = 22,70 kg/0,38), rosca direta (GT = 21,63 kg/0,37 e GNT = 15,57 kg/0,26) e tríceps testa (GT = 18,09 kg/0,31 e GNT = 12,55 kg/0,21). Os valores encontrados no estudo podem ser utilizados como referências de cargas para a aplicação dos testes de 1-RM.

The purpose of this study was to propose reference values to application of the 1-RM tests in young women trained and untrained. 90 women, 18-31 years, grouped into: 43 Trained (GT) and 47 Untrained (GNT) were submitted to 1-RM tests in the following exercises: bench press, shoulder press, biceps curl and lying triceps extension. GT showed higher values than GNT in absolute and relative terms: bench press (GT = 36.44 kg/0.63 and GNT = 27.34 kg/0.46), shoulder press (GT = 27.93 kg/0.49 and GNT = 22.70 kg/0.38), biceps curl (GT = 21.63 kg/0.37 and GNT = 15.57 kg/0.26) and lying triceps extension (GT = 18.09 kg/0.31 and GNT = 12.55 kg/0.21). The values found in this study can be used as references of load to application of 1-RM tests.

El objetivo del estudio fue proponer puntos de referencia para la aplicación de las pruebas de 1RM en mujeres jóvenes entrenados y no entrenados. 90 mujeres, 18-31 años, agrupados en: 43 entrenados (GT) y 47 no entrenados (GNT), se probaron para las pruebas de 1RM en los siguientes ejercicios: prensa de banca, prensa de hombros, curl con barra y extensión de tríceps. GT mostró valores más altos en comparación con el GNT en términos absolutos y relativos: prensa de banca (GT = 36,44 kg/0,63 y GNT = 27,34 kg/0,46), prensa de hombros (GT = 27,93 kg/0,49 y GNT = 22,70 kg/0,38), curl con barra (GT = 21,63 kg/0,37 y GNT = 15,57 kg/0,26) y extensión de tríceps (GT = 18,09 kg/0,31 y GNT = 12,55 kg/0,21). Los valores encontrados en el estudio pueden ser utilizados como referencia de cargo para la aplicación de las pruebas de 1RM.

Efeitos do treinamento em rugby em cadeira de rodas em atletas de elite com lesão da medula espinhal / Effects of wheelchair rugby training on elite athletes with spinal cord injury

O treinamento físico é capaz de proporcionar melhoras dos componentes fisiológicos, metabólicos e neuromusculares em indivíduos com LME cervical, dessa forma, o objetivo do estudo foi de analisar a influência do treinamento de rúgbi em cadeira de rodas nos aspectos fisiológicos e na capacidade funcional dos indivíduos com Lesão da Medula Espinhal. Foram avaliados sete atletas de RCR do sexo masculino com LME cervical (média do grupo de 28,57±6,52anos e tempo de lesão de 7±4,96 anos). Os sujeitos realizaram o Teste de Campo de corrida 12 minutos adaptado em dois momentos distintos, o primeiro antes de realizar a prática esportiva e o segundo momento, após intervenções do treinamento do RCR. Foram observadas diferenças significativas entre as médias da amostra referentes aos valores de Consumo Máximo de Oxigênio (VO2max), número de voltas realizadas (Voltas) e distância percorrida (D) (p?0.05), que inicialmente eram de 10,09 ± 6,91 ml(kg.min)-1, 15 ± 4,95voltas e 1151,3 ± 373,4 metros, respectivamente. Enquanto que, os valores obtidos no final do programa foram de 18,23 ± 8,21 ml(kg.min)-1, 21,14 ± 5,92 voltas e 1592,5 ± 446,5 metros. Conclui-se que a prática de forma regular no RCR gera adaptações e melhoras sobre os componentes fisiológicos e neuromusculares em atletas com LME.

Physical training is able to provide improved on physiological, metabolic and neuromuscular components in individuals with cervical SCI. Thus, the aim of this study was to analyze the influence of wheelchair rugby (WR) training on the physiological and functional capacity of individuals with spinal cord injury. A total of seven male athletes with cervical SCI (group average of 28.57 ± 6.52 years old and 7 ± 4.96 years injury time). The athletes performed the 12-minute adapted running Field Test at two different times; the first before practicing the sport and the second time after the WR training interventions. Significant differences were observed among the sample means regarding Maximum Oxygen Consumption (VO2max), number of laps (Laps) performed and distance (D) (p ? 0.05), which initially were 10.09 ± 6.91ml (kg.min) -1, 15 ± 4.95laps and 1151.3 ± 373.4m, respectively. The values obtained at the end of the program were 18.23 ± 8.21 ml(kg.min)-1, 21.14 ± 5.92laps and 1592.5 ± 446.5m. It can be concluded that regular practice in WR generates adaptations and improvements on the physiological and neuromuscular components in athletes with SCI.

Making of the Condition Change Scenario Programs Aiming at Problem-based Learning using a Patient Simulator and Enforcement of the Workshop / 社会薬学

We developed a program to generate scenarios of pathological changes for problem-based learning (PBL) in a physical assessment workshop using the patient simulator, "Physiko^®”. With these programs, PBL-style case experiencing also became possible by actually performing physical assessment on “Physiko^®” using a stethoscope while presenting information such as the patient background. The results of a survey conducted during the physical assessment workshop showed that participants were significantly interested in simulation-based education. However, the results also revealed a lack of understanding of technical terms used in physical assessment, suggesting the need to urgently facilitate not only the acquisition of basic skills to monitor vital signs but also that of symptomatology knowledge in order to understand technical terms and pathological characteristics.

Physical assessment training to change the opinions of pharmacy students about physical assessment / 医学教育

Introduction: Physical assessment training is included in many 6-year training programs for pharmacists.<br>Method: To clarify the effects of this training for developing the professional abilities of pharmacists and for increasing the students’ motivation for learning, we investigated changes in students’ attitudes before and after physical assessment training by means of a questionnaire, whose free descriptions were evaluated with a text-mining approach.<br>Results: After training, the percentage of students who believed they needed to acquire the knowledge and skills of physical assessment increased significantly. Furthermore, the motivation for learning increased.<br>Discussion: We believe that physical assessment training makes students aware of the importance of the contribution of physical assessment to drug therapy and increases students’ motivation for learning.

Teste de força/resistência de membros superiores: análise metodológica e dados normativos / Strength/resistance test of the superior members: methodological analysis and normative data

INTRODUÇÃO: A força e a resistência muscular são componentes da aptidão física importantes para a saúde e alto rendimento. Os testes de flexão de braços, puxada em suspensão na barra e puxada em suspensão na barra modificada, utilizam o próprio peso corporal e avaliam as capacidades motoras relacionadas à aptidão física, saúde e ao desempenho atlético, no sentido de mensurar a força e resistência muscular dos membros superiores em ambos os sexos e ampla faixa etária. OBJETIVOS: O objetivo deste estudo foi buscar na literatura os aspectos metodológicos relacionados à validade, fidedignidade, objetividade e procedimentos específicos utilizados nos testes: flexão de braços, puxada suspensão na barra e puxada em suspensão na barra modificada, fazendo, dessa forma, um levantamento dos indicadores de rendimento desses testes em atletas de alto nível de diferentes modalidades. CONCLUSÃO: Os testes de flexão de braços, puxada em suspensão na barra e puxada em suspensão na barra modificada são eficientes, confiáveis, de fácil aplicação e são ferramentas que empregam baixo custo, além de requererem pouco treinamento do avaliador. Entretanto, devemos chamar a atenção quanto à padronização e as recomendações metodológicas para suas aplicações, para que possam ser utilizados com segurança na reabilitação e no desempenho atlético.

INTRODUCTION: The strength and muscular endurance are important components of physical fitness for health and high performance. The tests of push-up, pull-up and modified pull-up, using own body weight and evaluate motor skills related to physical fitness, health and athletic performance, to measure the strength and muscular endurance upper limbs in both sexes and a wide age range. OBJECTIVES: The aim of this study was to search the literature methodological issues related to validity, reliability, objectivity and specific procedures used in tests: push-up, pull-up and modified pull-up, by doing so, a survey of indicators yield of these tests in elite athletes of different modalities. CONCLUSION: The tests of push-up, pull-up and modified pull-up are efficient, reliable, easy to apply and are tools that employ low cost, and require little training for evaluators. However, as we draw attention to the standardization and methodological recommendations for your applications so they can be safely used in rehabilitation and athletic performance.

Counter movement e squat jump: análise metodológica e dados normativos em atletas / Counter movement and jump squat: methodological analysis and normative data in athletes

Diferentes modalidades esportivas utilizam a força explosiva de componente vertical como fator determinante do rendimento, entre estas se destaca principalmente o futebol, voleibol e basquetebol. A potência dos membros inferiores é exigida nestas modalidades específicas onde o nível de força gerado pode ser o diferencial no rendimento do atleta. Assim, o counter movement jump e squat jump ou saltos com contramovimento e sem contramovimento, respectivamente, são procedimentos de controle usuais para treinadores, preparadores físicos e fisioterapeutas para determinar a capacidade física de um atleta, para medir o resultado de um programa de formação, e como uma medida funcional de preparação de um atleta para retornar ao esporte após uma lesão. O presente estudo reuniu informações a partir da literatura disponível sobre os principais aspectos metodológicos envolvidos na mensuração da força explosiva de membros inferiores utilizando o counter movement jump e squat jump, identificando os aspectos relacionados à validade, fidedignidade, objetividade, indicações para os mais variados desportos, recomendações metodológicas para sua aplicação e possíveis erros. Assim, oferece ao leitor um levantamento de estudos para compor uma base de dados com valores de referência em diferentes modalidades esportivas.

Different sports modalities use the explosive force with vertical component as a determinant of performance and among these, football, volleyball and basketball stand out. The potency of the lower limbs is required in these specific modalities where the level of strength generated can be the differential in the athlete's performance. Thereby, the counter movement jump and squat jump are the usual control procedures for coaches, athletic trainers and physiotherapists to determine the athlete's physical capacity, to measure the result of a training program, and as a functional measure of an athlete preparation to return to sport after an injury. This study collected information from the available literature about the main methodological aspects involved in the measurement of the explosive strength of lower limbs using the counter movement jump and squat jump, identifying the aspects related to validity, reliability, objectivity, indications for several sports, methodological recommendations for its application and possible errors. Thus, it offers to the reader a survey of studies to compose a database with reference values in different sports modalities.

Perfil da aptidão física dos praticantes de Le Parkour / Physical fitness profile of Le Parkour practitioners

O objetivo deste estudo foi avaliar a aptidão física dos praticantes do Le Parkour na cidade de Curitiba-PR. Participaram do estudo 13 sujeitos (19,46 ± 2,82 anos) do sexo masculino, praticantes da atividade há mais de seis meses. Foram realizadas medidas antropométricas e testes de aptidão física (teste de corrida vai-e-vem de 20 metros, de abdominal em um minuto, flexão e extensão dos braços, impulsão vertical e horizontal, sentar-e-alcançar e teste de Wingate). Os resultados foram analisados através de estatística descritiva (média e desvio padrão), sendo classificados com base em tabelas de referência para cada teste. Após avaliar o VO2máx, 53,85 por cento dos praticantes estavam com valores considerados "baixa aptidão" e 46,15 por cento apresentaram uma aptidão cardiorrespiratória adequada. Na força/resistência abdominal, 46,15 por cento dos sujeitos foram classificados como "baixa aptidão" e 53,85 por cento como "faixa recomendável". A potência de pico e a potência média foram consideradas como "regular" em todos os indivíduos. O índice de fadiga foi igual ou superior em 54 por cento dos sujeitos. A flexibilidade foi avaliada como "baixa aptidão" em 69,23 por cento da amostra. Na avaliação da força/resistência de membros superiores, observou-se que 84,62 por cento estavam na "faixa recomendável". A partir dos resultados encontrados neste estudo, sugere-se que o Le Parkour, por ser uma atividade acíclica com ênfase em saltos e atividades de força nos braços, ocasionou melhores valores nos testes de impulsão horizontal, vertical e força de membros superiores. Entretanto, as demais variáveis avaliadas estavam abaixo da média, o que deve ser considerado na prescrição de exercícios e no acompanhamento dos indivíduos durante a prática da atividade. Sugerem-se novos estudos com amostras maiores e controle de treinamento dos praticantes de Le Parkour.

The aim of this study was to evaluate physical fitness of Le Parkour practitioners in the city of Curitiba-PR. 13 male subjects (19.46 ± 2.82 years) who have been practicing the activity for more than six months participated in the study. Anthropometry and tests of physical fitness (back-and-forth 20-meter running, 1-minute abdominal, flexion and extension of the arms, vertical and horizontal push, sit-and-reach test and Wingate) were performed. The results were analyzed using descriptive statistics (mean and standard deviation) and are classified based on the reference tables for each test. After evaluating the VO2max, 53.85 percent of the practitioners were considered "low fitness" and 46.15 percent presented adequate cardiorespiratory fitness. Regarding strength /abdominal resistance, 46.15 percent of subjects were classified as "low fitness" and 53.85 percent as "recommended range". The peak power and average power were considered as "regular" in all subjects. The fatigue index was greater than or equal in 54 percent of subjects. Flexibility was assessed as "low fitness" in 69.23 percent of the sample. Assessment of strength / endurance of upper limbs presented 84.62 percent in the "recommended range". The results from this study suggest that Le Parkour, as an acyclic activity with emphasis on jumping and activities of strength in arms, led best values on tests of dynamic horizontal, vertical and strength of upper limbs. Meanwhile the other variables were below average, which should be considered in the prescription of exercises and the monitoring of individuals during the activity's practice. Further studies with larger samples and training control Le Parkour practitioners are suggested.

Subjective perception and analysis of physical assessment technique in clinical nurses / 中国实用护理杂志

Objective To understand the subjective perception and influential factors of physical assessment technique in clinical nurses. Methods Using self-designed physical assessment skills questionnaire to investigate nurses in the six provinces of China, 1115 questionnaires were valid. Results There were 11 items in this questionnaire. The first four were: physical assessment is an essential skill of nurses (88.1%),the importance of continuous learning (84.8%), lack of maturity assessment tools (79.8%), heavy workload,lack of time (60.8%). The result of multiple regression analysis (stepwise) showed that hospital-level and regional were the main factors affecting the subjective perception. Conclusions The development of physical assessment reies mainly on rational allocation of human resources structure, establishing the physical assessment framework, and make sure different departments have their own characteristics and the importance of continuing education.