Pratiques de prise en charge de l'hypertension artérielle au Centre Hospitalier et Universitaire d' Abomey-Calavi au Bénin / NA

L'hypertension artérielle est une maladie à forte progression reste un problème de santé publique. Mais, les pratiques de sa prise en charge se heurtent à différents obstacles. Cette recherche questionne les problèmes qui caractérisent les pratiques de prise en charge de l'hypertension artérielle au Centre Hospitalier et Universitaire d'Abomey-Calavi au Bénin. Pour y parvenir, nous avons opté pour une analyse basée sur les méthodes quantitatives et qualitatives. L'échantillon est constitué de 130 personnes enquêtées. De l'analyse des résultats collectés, des difficultés éprouvées entre patients et agents de santé dans la prise en charge de l'hypertension artérielle, se caractérise par le manque de relation soignant-soigné. De même, 90% des enquêtés estiment avoir peu de ressources humaines qualifiées et du faible pouvoir d'achat des patients pour faire face aux coûts élevés du traitement de l'hypertension (86,75%). Ainsi, le manque de plateau technique et les frais de consultations spécialisées posent problèmes y compris les suivis de l'éducation hygiéno-diététique. Cet état de fait compromet les pratiques de prise en charge et les formations globales que le système soin est supposé assurer aux usagers qui le fréquentent. Ces résultats suggèrent l'urgence de formations pour le renforcement des capacités pour repérer la précarité et la réorganisation des mesures de prise en charge de l' hypertension artérielle dans le périmètre sanitaire béninois.

Arterial hypertension remains a rapidly growing public health problem. However, management practices face a number of obstacles. This research questions the problems that characterize arterial hypertension management practices at the Centre Hospitalier et Universitaire d'Abomey-Calavi in Benin. To achieve this, we opted for an analysis based on quantitative and qualitative methods. The sample consisted of 130 respondents. From the analysis of the results collected, of the difficulties experienced between patients and health workers in the management of arterial hypertension, most of those surveyed claimed to have a complexity that characterizes the training of health workers. Similarly, 90% of respondents felt that they had few non-cardiologist practitioners, and that patients had little purchasing power to meet the high costs of treating hypertension (86.75%). As a result, the cost of specialized consultations and complementary examinations poses a problem, including follow-up health and diet education. This state of affairs compromises management practices and the comprehensive training that the healthcare system is supposed to provide for its users. These results suggest the urgent need for training to identify precariousness, and the reorganization of hypertension management measures within the Beninese health perimeter.

Comparação da carga de treinamento de atletas profissionais entre modos de treinos especificos do voleibol e de força / Comparison of the training load of professional athletes between modes of volleyball specific drills and strength conditioning

RESUMO O objetivo deste estudo foi comparar a carga de treinamento em três tipos de treinamentos de uma equipe de voleibol profissional.. Participaram do estudo 28 jogadores (26,6 ± 4,7 anos; 91,5 ± 8,5 Kg; 194,1 ± 6,0 cm). Foi realizada uma análise descritiva de 29 sessões de treino técnico, 84 tecnico-tático e 75 de musculação e isoladamente das variáveis que compõem a carga de treinamento, PSE e o tempo de duração da sessão, posteriormente sendo reunidos em média e desvio padrão de acordo com tipo de treino. Para análise dos dados foi adotado o teste de Shapiro-Wilk e em seguida aplicou-se o teste Anova Two-Way com o Post Hoc de Tamhane e também foi utilizado o tamanho do efeito para análise das comparações. Os resultados demonstraram respostas significativas e grande tamanho de efeitos quando comparados técnico e técnico-tático com a musculação na carga interna de treinamento TxM (TE=1,2: grande; p= 0,002); TTxM (TE=1,3: grande; p= 0,001) e no tempo de duração da sessão TxM (TE=1,7: grande; p= 0,001); TTxM (TE=2,0: grande; p= 0,001), já a PSE da sessão apresentou apenas uma diferença sigifcativa TTxM (TE= 0,8: moderado; p= 0,001). Os estímulos de treinamentos específicos de quadra como técnico e técnico-tático promoveram maior carga interna nos atletas do que o treino de força, através principalmente pela influencia da variável tempo de duração da sessão que refletiu a carga externa.

ABSTRACT The aim of this study was to compare the training load in three types of training of a professional volleyball team. Participants were 28 players (26.6 ± 4.7 years, 91.5 ± 8.5 kg; 194.1 ± 6.0 cm). A descriptive analysis of 29 technical training sessions, 84 technical-tactical training sessions and 75 training sessions, and of the variables that compose the training load, PSE and the duration of the session were performed, and were then collected on average and standard deviation according to with type of training. To analyze the data, the Shapiro-Wilk test was adopted, and then the Anova Two-Way test was applied with Tamhane's Post Hoc and the effect size was also used for analysis of the comparisons. The results demonstrated significant responses and a large effect size when compared to technical and tactical-to- strength training (T = 1.2: large; p = 0.002); TTxM (TE = 1.3: large, p = 0.001) and the duration of the session / external load in the TxM training (TE = 1.7: large; p = 0.001); TTxM (TE = 2.0: large, p = 0.001), whereas the PSE of the session showed only a sigifcant difference TTxM (TE = 0.8: moderate; p = 0.001). The stimuli of specific training of court as technician and technician-tactician promoted greater internal load in the athletes than the strength training, mainly through the influence of the variable time of the session that reflected to external load.

The Persisted Effects of Low-Frequency Repetitive Transcranial Magnetic Stimulation to Augment Task-Specific Induced Hand Recovery Following Subacute Stroke: Extended Study

OBJECTIVE: To examine the long-term effects of the low-frequency repetitive transcranial magnetic stimulation (LFrTMS) combined with task-specific training on paretic hand function following subacute stroke. METHODS: Sixteen participants were randomly selected and grouped into two: the experimental group (real LFrTMS) and the control group (sham LF-rTMS). All the 16 participants were then taken through a 1-hour taskspecific training of the paretic hand. The corticospinal excitability (motor evoke potential [MEP] amplitude) of the non-lesioned hemisphere, and the paretic hand performance (Wolf Motor Function Test total movement time [WMFT-TMT]) were evaluated at baseline, after the LF-rTMS, immediately after task-specific training, 1 and 2 weeks after the training. RESULTS: Groups comparisons showed a significant difference in the MEP after LF-rTMS and after the training. Compared to the baseline, the MEP of the experimental group significantly decreased after LF-rTMS and after the training and that effect was maintained for 2 weeks. Group comparisons showed significant difference in WMFT-TMT after the training. Only in the experimental group, the WMFT-TMT of the can lifting item significantly reduced compared to the baseline and the effect was sustained for 2 weeks. CONCLUSION: The results of this study established that the improvement in paretic hand after task-specific training was enhanced by LF-rTMS and it persisted for at least 2 weeks.

Treinamento específico do membro superior de hemiparéticos poracidente vascular encefálico / Specific training of the upper extremity of hemiparectic patients after stroke

Contextualização: A reabilitação do membro superior depacientes hemiparéticos por Acidente Vascular Encefálico(AVE) é um grande desafio. O treinamento específico (TE) detarefas tem se mostrado bastante útil quando associado à Fisioterapiaconvencional. Objetivo: Avaliar os efeitos do TE dealcance e preensão do membro superior de hemiparéticospor AVE. Métodos: Estudo pré- experimental (pré e pós-teste)com 10 pacientes crônicos com idade média de 62,8 anos(±3,9). Os parâmetros de avaliação foram a motricidade damão através da Escala de Movimentos da Mão (EMM), a forçade preensão pela Dinamometria (Din), a destreza do membrosuperior pelos testes de Caixa e Blocos (CB) e dos 9 Pinos eBuracos (9PB), a espasticidade pela Escala de Ashworth Modificada(EAM) e a independência funcional pelo Índice deBarthel (IB). A TE era realizar o movimento de alcance e preensãode garrafas de diferentes tamanhos com o membrosuperior afetado em diferentes combinações de posições,num total máximo de 54 repetições por sessão. Foram realizadasem média 20 sessões com frequência de 2 x/semana.Resultados: Os resultados mostraram que houve melhoraestatisticamente significativa em todos os parâmetros avaliados.Conclusão: O tratamento através da tarefa específicamelhora o desempenho na função do membro superior, sendouma boa opção nos programas de reabilitação do membrosuperior de pacientes hemipar éticos por AVE.

Background: The rehabilitation of the upper limb inhemiparetic patients after stroke is a major challenge.Specific training (ST) task has proven very useful whencombined with conventional physiotherapy. Objective:To evaluate the effects of ST reaching and grasping ofthe upper limb of hemiparetic stroke. Methods: A pre--experimental (pre-and post-test) with 10 chronic patientswith a mean age of 62.8 years (± 3.9). The evaluationparameters were hand movements across the HandMovement Scale (HMS), grip strength by dynamometry(Din), the dexterity of the upper limb by the tests of Boxand Blocks (BB) and 9-Pin and Holes (9PH), spasticityby Modified Ashworth Scale (MAS) and functional independenceby the Barthel Index (BI). The ST was performingthe movement of reaching and grasping bottlesof different sizes with the affected upper limb in differentcombinations of positions for a total maximum of54 repetitions per session. A mean of 20 sessions wasapplied with a frequency of twice/ week. Results: Theresults showed statistically significant improvement inall parameters. Conclusion: Treatment by specific taskimproves performance on upper limb function, being agood choice in rehabilitation programs of hemipareticpatients by stroke.