Associação da educação sexual, cinesioterapia e terapia manual no tratamento de mulheres anorgásmicas: um estudo de caso / Association of sex education, kinesiotherapy and manual therapy in the treatment of anorgasmic women: a case study

O orgasmo é o ápice da excitação sexual e, quando comumente não experienciado, denomina-se anorgasmia, segunda queixa sexual mais frequente entre mulheres. A fisioterapia é um recurso que visa beneficiar a qualidade de vida das mulheres anorgásmicas por meio da prevenção, reparação de função e tratamento de quadros álgicos. O estudo teve como objetivo avaliar os efeitos da associação das técnicas de cinesioterapia aplicada à musculatura do assoalho pélvico, massagem perineal e conscientização acerca da sexualidade das participantes. Os métodos utilizados foram educação sexual, massagem perineal e cinesioterapia associada ao uso da sonda uroginecológica New PelviFit Trainer, como biofeedback visual, para promover conscientização e estimar os efeitos sobre a condição da musculatura do assoalho pélvico de mulheres com relato de anorgasmia. O resultado obtido com o protocolo da associação das técnicas terapêuticas em mulheres com disfunção orgásmica apresentou melhora da função sexual feminina, aumento da força e do estado de relaxamento da musculatura do assoalho pélvico, avaliados pelo questionário Índice de Função Sexual Feminina, quantificados por meio da escala de Oxford modificada e da escala de avaliação de flexibilidade vaginal, respectivamente. Como conclusão, a aplicação das técnicas fisioterapêuticas aliadas ao tratamento humanizado, com enfoque na conscientização das mulheres, autopercepção corporal e manutenção da função sexual, promoveu melhora da disfunção sexual orgásmica. Apesar de necessário maior embasamento científico relativo ao tema, a presente abordagem para o tratamento em questão apresentou-se promissora e pertinente à base de dados. (AU)

Orgasm is the peak of sexual excitement, when not commonly experienced, it is called anorgasmia, second most frequent sexual complaint among women. Physiotherapy is a resource that aims to improve the quality of life of anorgasmics women through prevention, function repair and pain management. The purpose of the study was to evaluate the effects of kinesiotherapy techniques applied on the pelvic floor muscles, associated with perineal massage and the participants' sexual awareness. The methods used were sexual education, perineal massage, kinesiotherapy associated with the use of the New PelviFit Trainer urogynecological probe, as a visual feedback, to promove awearness and estimate its effects on the pelvic floor muscles condition in women reporting anorgasmia. The result obtained with the protocol of association of therapeutic techniques in women with orgasmic dysfunction showed improvement in the female sexual function, assessed by the Female Sexual Function Index questionnaire, increased strength and pelvic floor muscles relaxation, quantified using the Modified Oxford scale and the vaginal flexibility assessment scale, respectively. As a conclusion, the application of physiotherapeutic techniques combined with humanized treatment, with a focus on awareness of women, body self-perception and maintenance of sexual function, promoted improvement of orgasmic sexual dysfunction. Despite the need for a greater scientific basis on the subject, the present approach to the treatment in question was promising and relevant to the database. (AU)

El término kinesiología, sus implicancias en la forma profesional y en el fondo disciplinar. Segunda parte: los matices en su desarrollo / The term kinesiology, its implications in the professional practice and disciplinary background. Second part: the nuances in its the development

Los matices que ha generado el término Kinesiología en el desarrollo disciplinar han podido justificar una importante cantidad de acciones profesionales que van desde la educación física, pasando por la investigación de laboratorio, cinética, cinemática del deporte y función ventilatoria, para culminar otorgando asistencias en el extremo de la disfunción y la inmovilidad concomitante al término de la gran mayoría de las enfermedades. Así la Kinesiología ha sido el soporte argumentativo para profesores, entrenadores, científicos y terapeutas que trabajan con el movimiento humano. No exentas de contribuir al objeto de estudio se encuentran las humanidades y las ciencias sociales que parten en la antropología y se consolidan en la biopolítica de organizaciones gremiales con carácter universal para fijar lineamientos de control. Ante la importante magnitud del campo de conocimientos acumulados, es posible sostener la evidente oportunidad de generar condiciones favorables que se encarguen de reflexionar otras soluciones inspiradas en la trascendencia de la funcionalidad y el movimiento. El denominador común de estos alcances comienza cuando la funcionalidad pasa a ser la meta epistemológica de los paradigmas al servicio del movimiento humano. En este contexto, el objetivo de esta investigación fue analizar el término Kinesiología en el contexto de los matices disciplinares para recomponer sus implicancias y determinar su posibilidad de sobrevida.

SUMMARY: The nuances that the term Kinesiology has generated in disciplinary development have upheld a significant number of professional actions, ranging from physical education to laboratory research, kinetics, sport kinematics and ventilator function. Such actions have ultimately assisted in the extreme dysfunction and immobility concomitant at the end of a vast majority of diseases. Therefore, Kinesiology has been the argumentative support for teachers, coaches, scientists and therapists working with human movement. Humanities and social sciences that commence with anthropology and are consolidated in the bio politics of global union organizations to establish control guidelines are also an important contribution to its study. Given the vast amount of knowledge in this field, there is an opportunity to generate favorable conditions that reflect on further solutions inspired by the transcendence of functionality and movement. When reflecting on these achievements, the common denominator is when functionality becomes the epistemological goal ofthe paradigms at the service of human movement. In this context, the objective of this research was to analyze the term Kinesiology in the context of disciplinary nuances to recompose its implications and to determine if it can survive as a discipline.

Razonamiento clínico en carreras de la salud: percepción de estudiantes y docentes / The perception of teachers and students about clinical reasoning in health care careers

BACKGROUND: Clinical reasoning (CR) is a training mainstay in health care careers. AIM: To describe the perception of students and teachers about the development of clinical CR in Kinesiology and Dentistry careers. MATERIAL AND METHODS: Exploratory descriptive qualitative study, with 12 informants (six teachers and six students), applying a script of questions through a semi-structured interview. A thematic inductive data analysis was carried out. RESULTS: Two hundred thirty-five meaning units, 38 codes, seven subcategories and three categories were collected. CR was reported as a basic analysis process in health care training. Its necessary elements are knowledge, a learning environment and a facilitator teacher, among others. Motivation, analysis models, variability and exposure are reported as facilitating factors for the development of CR. Teacher paternalism, resistance to change and few learning opportunities are presented as obstacles. Active strategies such as clinical cases, simulation and clinical practice are perceived as facilitators for the development of CR. Those situations where the student does not assume a leading role such as lectures and activities in large groups, are considered as obstacles. CONCLUSIONS: Both students and teachers point to CR as an analysis process that is indispensable in both careers. Exposure to variable educational experiences through active educational strategies in small groups encourages CR.

Mejorando la elaboración de las hipótesis iniciales para el razonamiento clínico diagnóstico en estudiantes de kinesiología: una propuesta metodológica / Improving the development of initial hypotheses for clinical diagnostic reasoning in physical therapy students: a methodological proposal

El Razonamiento Clínico es un proceso fundamental para identificar los déficits en un paciente y formular un diagnóstico kinesiológico. El objetivo de este estudio es describir parte de la metodología y sus resultados, en el marco del curso de Razonamiento Clínico de la carrera de Kinesiología en la Universidad Finis Terrae, para mejorar el proceso de formulación de hipótesis iniciales para la evaluación kinesiológica. MUESTRA : MATERIALES Y MÉTODOS Los estudiantes fueron evaluados según la cantidad, coherencia y sintaxis de estas hipótesis iniciales, además de los dominios a los que pertenecían, al inicio y al final de la intervención que consistió en 3 actividades (2 clases presenciales y un informe de actividad de campo clínico). Las clases presenciales tenían como temas la Clasificación Internacional de la Funcionalidad, Salud y Enfermedad (CIF) de la OMS, y su rol en el razonamiento clínico diagnóstico; y la importancia de las hipótesis iniciales dentro del modelo hipotético deductivo de razonamiento y cómo escribirlas, junto con el uso de una herramienta (una "Tabla Hipocrática Modificada") para sistematizar la formulación de hipótesis iniciales con respecto a déficit en estructuras corporales. El informe de campo clínico integró todo lo anterior durante la evaluación de un paciente real. RESULTADOS La evaluación final mostró un aumento significativo en la cantidad (promedio ± DS inicial 10,1 ± 8,57, final 27 ± 9,23, p < 0,001) de hipótesis planteadas y en su coherencia con respecto a la información disponible. CONCLUSIÓN La sistematización descrita para la formulación de hipótesis diagnósticas en los estudiantes de kinesiología resulta en una mayor cantidad y calidad en sus hipótesis, validando esta metodología para la enseñanza inicial del razonamiento clínico diagnóstico en kinesiología

Clinical Reasoning is a fundamental process to identify deficits in a patient and state a diagnosis. The goal of this study is to describe part of the methodology and its results, within the framework of the Clinical Reasoning course of the Kinesiology career at Finis Terrae University, implemented to improve the process of formulating initial hypotheses for kinesiological evaluation. MATERIALS AND METHODS The students were evaluated according to the quantity, coherence and syntax of these initial hypotheses, in addition to the domains to which they belonged, at the beginning and at the end of the intervention that consisted of 3 activities (2 face-to-face classes and an activity report). The face-to-face classes had as topics the International Classification of Functioning, Health and Disease (ICF), WHO, and its role in diagnostic clinical reasoning; and the importance of initial hypotheses within the hypothetical deductive model of reasoning and how to write them, together with the use of a tool (a "Modified Hippocratic Table") to methodize the formulation of initial hypotheses regarding deficits in body structures. The report integrated all of the above during the evaluation of a real patient. RESULTS The final evaluation showed a significant increase in the quantity (mean ± initial SD 10.1±8.57, final 27±9.23, p < 0.001) of hypotheses raised and in their consistency to the available information. Conclusion: The Systematization described for formulating diagnostic hypotheses in kinesiology students results in a greater quantity and quality of their hypotheses, validating this methodology for the initial teaching of diagnostic clinical reasoning in kinesiology.

Utilização da fisioterapia na reabilitação de bezerro com poliartrite e paresia neuromuscular: relato de caso / Use of physiotherapy in the rehabilitation of calves with polyarthritis and neuromuscular paresis: case report / Uso de la fisioterapia en la rehabilitación de un ternero con poliartritis y parisia neuromuscular: reporte de caso

A reabilitação animal na medicina veterinária é um campo recente, porém crescente a cada dia. Neste sentido, a fisioterapia veterinária atua trazendo inúmeros benefícios, como melhoria dos movimentos, redução da dor, edema e outras. Interfere ainda no tempo de recuperação, redução de custos para o proprietário, podendo ser hoje utilizada como um tratamento na recuperação pós-cirúrgica. Desta forma, objetivou-se relatar o uso da fisioterapia em uma bezerra com poliartrite e paresia neuromuscular. O animal apresentou um aumento de volume nas articulações cárpicas e társicas após histórico de onfalite, permanecendo em decúbito esternal por vários dias. O proprietário resolveu aplicar ferro dextrano na região glútea do animal, o que causou uma lesão de nervo isquiático. Foram instituídos protocolos medicamentosos e fisioterápicos, que culminaram no estímulo da marcha, propriocepção, além de hipertrofia muscular. Porém, em virtude de complicações resultantes de onfalite, o animal veio a óbito.(AU)

Animal rehabilitation in veterinary medicine is a recent field, but growing every day. In this sense, veterinary physiotherapy works bringing numerous benefits, such as improved movements, reduced pain, edema and others. Reducing the recovery time, reducing costs for the owner, and today it can be used as a treatment in post-surgical recovery. In this sense, the objective was to report the use of physiotherapy in a heifer with polyarthritis and neuromuscular paresis. The animal showed an increase in volume in the carpal and tarsal joints after a history of omphalitis, remaining in sternal decubitus for several days. The owner decided to apply iron dextran to the animal's gluteal region, which caused an injury to the sciatic nerve. Medicinal and physical therapy protocols were instituted, which culminated in the stimulation of gait, proprioception, in addition to muscle hypertrophy. However, due to complications resulting from omphalitis, the animal died.(AU)

La rehabilitación animal en medicina veterinaria es un campo reciente, pero en crecimiento cada día. En este sentido, la fisioterapia veterinaria actúa aportando numerosos beneficios, como mejora de los movimientos, reducción del dolor, edemas y otros. Disminución del tiempo de recuperación, reducción de costos para el propietario, pudiendo ser utilizado hoy en día como tratamiento en la recuperación posquirúrgica. En ese sentido, el objetivo fue reportar el uso de fisioterapia en una vaquilla con poliartritis y paresia neuromuscular. El animal presentó un aumento de volumen en las articulaciones del carpo y del tarso tras un antecedente de onfalitis, permaneciendo en decúbito esternal durante varios días. El propietario decidió aplicar hierro dextrano en la región glútea del animal, lo que provocó una lesión en el nervio ciático. Se instauraron protocolos farmacológicos y de fisioterapia, que culminaron con estimulación de la marcha, propiocepción, además de hipertrofia muscular. Sin embargo, debido a complicaciones derivadas de la onfalitis, el animal falleció.(AU)

Go tani and his influence on the kinesiology field in the brazilian scientific context / Go tani e sua influência no campo da cinesiologia no contexto científico brasileiro

ABSTRACT This study aimed to group some perspectives on Go Tani's epistemological activity in the context of Brazilian Physical Education (PE), establishing his contributions and reflections on Kinesiology for the structuring of undergraduate and graduate Physical Education in Brazil. This is a bibliographical and exploratory study, which prioritized Tani's production on the most varied platforms and the materials that circulated about Kinesiology in national and international literature. Finally, through the theoretical review, it was possible to identify that the PE field is a scenario full of disputes and that even with the transformations of paradigms that infer the legitimate alternatives in the scientific context, the relationships that are established between the different schools of PE thought have erupted in a process of mutual incomprehension that contributes to the circularity of perspectives and the maintenance of beliefs in the field.

RESUMO O presente estudo objetivou agrupar algumas perspectivas sobre a atividade epistemológica de Go Tani no contexto da Educação Física (EF) brasileira, estabelecendo suas contribuições e reflexões a partir da Cinesiologia para a estruturação da graduação e da pós-graduação em Educação Física no Brasil. Trata-se de um estudo bibliográfico e exploratório, o qual priorizou a produção de Tani nas mais variadas plataformas, bem como os materiais que circularam sobre a Cinesiologia na literatura nacional e internacional. Por fim, através da referida revisão teórica, foi possível identificar que o campo da EF é um cenário repleto de disputas e que mesmo com as transformações dos paradigmas que inferem nas alternativas legítimas no contexto científico, as relações que são estabelecidas entre as distintas escolas de pensamento da EF têm eclodido num processo de interincompreensão que contribui com a circularidade de perspectivas e a manutenção de crenças no campo.

La telerehabilitación durante la pandemia COVID-19: experiencia de las familias de niños con condiciones crónicas complejas / Telerehabilitation during the COVID-19 pandemic: experience of families of children with complex chronic conditions

La telerehabilitación ha sido una solución rápida y efectiva para la atención de pacientes durante la pandemia COVID-19. Nuestro objetivo ha sido describir la experiencia de las familias de niños con condiciones crónicas complejas (CCC) asistidos con la modalidad de telerehabilitación durante la pandemia. Materiales y métodos: Se ha realizado un estudio observacional, descriptivo y transversal de tipo encuesta online. Se encuestaron familias de niños (1 mes a 5 años de edad) con al menos una CCC que recibieron seguimiento interdisciplinario a distancia durante la pandemia de 2 o más áreas de rehabilitación (kinesiología, fonoaudiología y terapia ocupacional) pertenecientes al Servicio de Kinesiología del Hospital de Pediatría Juan P Garrahan, durante marzo a octubre de 2020. Resultados: El 88,3% de los participantes (n=43) se expresó satisfecho con la modalidad de telerehabilitación. Entre los facilitadores seleccionados por los participantes se mencionan la reducción de tiempos, mayor frecuencia de consultas, disminución de gastos por traslados y mayor comodidad, mientras que entre las barreras se destacaron: el no vínculo con profesionales, alargue en tiempos de tratamiento, problemas de conectividad. El análisis estadístico no indicó diferencias significativas entre quienes se reportaron como más satisfechos según su estrato social (alto o bajo), la disponibilidad de wifi propio, o respecto a la edad del niño. Se reportaron diferencias significativas en cuanto a la distancia al hospital (p=0.034). Conclusión: Esta forma de intervención ofreció nuevas posibilidades de atención que podrían considerarse a futuro en el seguimiento de nuestros pacientes. (AU)

Telerehabilitation has been a fast and effective solution in patient care during the COVID-19 pandemic. Our aim was to describe the experience of families of children with complex chronic conditions (CCC) treated through telerehabilitation during the pandemic. Materials and methods: An observational, descriptive, cross-sectional, online survey study was conducted. Families of children (1 month to 5 years of age) with at least one CCC who received interdisciplinary remote follow-up during the pandemic from two or more rehabilitation areas (physical therapy, speech therapy, and occupational therapy) belonging to the Department of Physical Therapy of Hospital de Pediatría Juan P Garrahan, from March to October 2020, were surveyed. Results: 88.3% of the participants (n=43) expressed satisfaction with the telerehabilitation modality. Among the facilitators selected by the participants, the following were mentioned: time saving, greater frequency of consultations, reduction of travel expenses and greater comfort, while among the barriers, the following stood out: no connection with the professionals, longer treatment times, connectivity problems. Statistical analysis did not show significant differences between those who reported being more satisfied according to socioeconomic level (high or low), availability of their own wifi connection, or age of the child. A significant difference was found for distance to the hospital (p=0.034). Conclusion: This type of intervention provided new possibilities of care that could be considered in the future follow-up of our patients (AU)

Effect of kinesio tape on scapular kinematics in subjects with scapular dyskinesis

Scapular dyskinesis is an abnormality in scapula static or dynamic position. There are several techniques for scapular dyskinesis conservative treatment, including Kinesio Tape application, which is used to promote and support scapula joint alignment, decrease pain and improve local muscle control. The study aim to investigate the effect of kinesio tape on scapular kinematics in subjects with scapular dyskinesis. Fourteen subjects with scapular dyskinesis performed flexion and scaption movements in two conditions: (1) without load and (2) holding a dumbbell. A scapular tape was applied over the lower trapezius (Y shaped) muscle with a 20% tension. Kinematic data were captured with 10 infrared cameras and analyzed based on Euler angles, peak values of upward rotation, internal rotation, and posterior tilt angles. To compare the situations with and without kinesio tape the repeated measures two-way ANOVAs (α = 0.05) was performed using SPSS software. Scapular tape increase upward rotation and posterior tilt during flexion of the shoulder. No interaction (Load x KT) was found during flexion, suggesting that KT effect in the peak values is the same, regardless the load condition. Scapular tape decreases internal rotation during scaption and a significant interaction was found between load x KT, suggesting the effect of using KT could depend the load u sed during this movement. The results suggest that kinesio tape may can be use as assistant to increase upward rotation, posterior tilt and decrease internal rotation in scapular dyskinesis subjects. (AU)

Rehabilitación de un paciente con fractura femoral distal izquierda con pérdida de sustancia ósea, fractura patelar y tibial izquierda: a propósito de un caso / Rehabilitation of a patient with a left distal femoral fracture with loss of bone substance, a left patellar and tibial fracture: about a case

La rehabilitación de un paciente con fractura es progresivos y secuenciales para la mejora del foco de fractura, en especial en este tipo de fracturas con pérdida de sustancia ósea ya que suelen ser agresivas y de difícil resolución, por tanto, el tratamiento ortopédico es cuidadoso y complejo como la recuperación es prolongada sujeta a varios pasos según la progresión del paciente. El objetivo de este artículo es la de describir la secuencia de pasos en la rehabilitación de este tipo de fracturas, ya que no hay un manual claro para el manejo en rehabilitación de casos similares. El seguimiento y recuperación de este caso dura 8 meses dividida en 3 etapas de rehabilitación en un total de 122 sesiones, teniendo 4 evaluaciones en base a los tres parámetros de evaluación de ingreso: dolor, movimiento, postura y fuerza muscular, mejorando progresivamente estos aspectos.

The rehabilitation of a fractured patient is progressive and sequential for the improvement of the fracture focus, especially in this type of fractures with loss of bone substance since they are usually aggressive and difficult to resolve, so orthopedic treatment is careful and complex. as the recovery is prolonged subject to several steps depending on the patient's progression. The objective of this article is to describe the sequence of steps in the rehabilitation of this type of fractures, since there is no clear manual for the management in rehabilitation of similar cases. The follow-up and recovery of this case lasts 8 months divided into 3 stages of rehabilitation in a total of 122 sessions, having 4 evaluations based on the three parameters of admission assessment: pain, movement, posture and muscular strength, progressively improving these aspects.

Estrategias de enseñanza y aprendizaje de docentes y estudiantes de primer año de la carrera de kinesiología de la Universidad Finis Terrae / Learning strategies for first-year teachers and students of the physical therapy program at Universersity Finis Terrae

Las estrategias de aprendizaje explican el curso y organización del pensamiento, destacando tres momentos claves en su utilización: antes, donde se incluyen las condiciones para que ocurra el aprendizaje; durante, donde se llevan a cabo los procesos; y después, que presentan los resultados de esta secuencia. Para determinar cuáles son las estrategias que utilizan los estudiantes de primer año de Kinesiología se aplicó a 75 estudiantes el instrumento ACRA abreviado, que consiste en un cuestionario autoadministrado de 44 preguntas de escala Likert, Por otro lado, para conocer las estrategias que los docentes necesitan y exigen a sus estudiantes se realizó una encuesta estructurada validada por juicio de expertos a 5 profesores encargados de asignatura. Los resultados en los estudiantes destacan que la codificación es el proceso que presenta mayor debilidad y en los docentes destaca que, si bien se les exigen determinadas estrategias a los estudiantes, los docentes declaran no saber cómo enseñarlas. Esto contribuye a la persistencia de la brecha que los estudiantes traen desde la educación media en las estrategias de codificación y evidencia la necesidad de capacitación de los docentes.

The learning strategies explain the course and organization of thought, highlighting three key moments on their use: before, where the conditions for learning occurs are included; during, where the processes are carried out; and later, presenting the results of this sequence. To determine which are the strategies used for first-year Kinesiology students, the abbreviated ACRA instrument was applied to 75 students, which consists of a self-administrated questionnaire of 44 Likert Scale questions, and to know the strategies that teachers need that students have, a structured survey validated by expert's judgment was carried out to 5 teachers in charge of a course. The results in the students highlight that coding is the process that presents the greatest weakness and, in the teachers, although students are required to have certain strategies, the teachers declare that they do not know how to teach those. This contributes to the persistence of the gap that students bring from high school in coding strategies and shows the need for training in pedagogical tools for university teachers.

Opinión de estudiantes de kinesiología relacionado con precauciones estándar, vista de enfermería / Opinion of kinesiology students related to standard precautions, nursing view

INTRODUCCIÓN: Las precauciones estándar corresponden a un grupo de prácticas de prevención de infecciones que se aplican en la atención a todos los pacientes, tiene como objetivo prevenir la transmisión cruzada de microorganismos entre pacientes. OBJETIVO: Develar la opinión de las/os estudiantes de Kinesiología de la Universidad Mayor-Temuco con relación a las Precauciones Estándar. METODOLOGÍA: Estudio cualitativo, descriptivo y exploratorio, estudio intrínseco de caso, la muestra no probabilística, intencionada: 12 sujetos estudiante de kinesiología 2018; criterio de inclusión: haber aprobado la asignatura de Cuidados Básicos del Enfermo; recogida de datos: entrevistas en profundidad, se utilizaron notas de campo y se manejó el método de comparación constante, además esquema de la reducción progresiva. RESULTADOS: Para la categoría de significado de precauciones estándar surge medida de protección y seguridad para usuario y tratante; para precauciones estándar utilizadas en prácticas clínicas emerge las subcategorías de elementos y técnicas de barrera en forma análoga nace como categoría aplicabilidad de precauciones estándar de ella se desprenden campos clínicos, eventos clínicos del usuario y técnicas y procedimientos; para la categoría factores facilitadores: docente y estudiantes; en tanto factores obstaculizadores: curriculum. CONCLUSIONES: En los estudiantes existe un conocimiento deficiente y conceptos aislados sobre PE, utilizan principalmente guantes y lavado de manos; menor grado uso de mascarilla y pechera. Destaca positivamente conocimiento docente; factores obstaculizadores: aspectos teóricos deficientes curriculares; considerar modificaciones curriculares en aspectos conceptuales y procedimentales.

BACKGROUND: the standard precautions correspond to a group of infection prevention practices that are applied in the care of all patients, it aims to prevent the cross-transmission of microoganisms between patiens. OBJETIVE: to reveal the opinion of Kinesiology students at the Universidad Mayor-Temuco regarding standard precautions. METHODOLOGY: Qualitative, descriptive, and exploratory study, intrinsic case study, non-probabilistic sample, intentional: 12 subjects, kinesiology student of the year 2018; For data collection, in-depth interviews were used, field notes and the constant comparison method were used, in addition to the progressive reduction scheme. RESULTS: 173 units of meaning emerge, for the category of meaning of standard precautions, protection and security measure for user and trafficker arises; For standard precautions used in clinical practices, the subcategories of barrier elements and techniques emerge, the most mentioned, in an analogous way, the applicability of standard precautions is born as a category of clinical fields, clinical events of the user and techniques and procedures; for the category facilitating factors: teacher and student are the least mentioned; as impeding factors: curriculum. CONCLUSIONS: There is a deficient knowledge and isolated concepts about SP, mainly use gloves and hand washing; less degree the use of masks and scrubs. It is positively highlighted teacher's knowledge, and some of the hindering factors are the lack of theoretical aspects of the curriculum and the consideration for curriculum modifications to compensate conceptual and procedural aspects.

Aprendizaje interprofesional en los internados de las carreras de la salud del Hospital Josefina Martínez / Interprofessional learning of interns at Josefina Martínez Hospital

Introducción: las dinámicas de atención en salud requieren que los profesionales que componen el equipo de salud trabajen en for-ma colaborativa. Sin embargo, durante su formación, las oportunidades de aprendizaje con otras disciplinas son escasas. Se reportan los resultados del primer proyecto para promover el aprendizaje interprofesional en los internos que rotan por el Hospital Josefina Martínez. Método: de marzo a julio 2018, se realizó un taller constituido por dos sesiones, en cada rotación de internado. Participaron internos de cinco carreras en forma conjunta (kinesiología, odontología, nutrición, fonoaudiología y terapia ocupacional). Se adaptó la encuesta de disposición al aprendizaje interprofesional, para ser aplicada antes y después de cada taller. Se calcularon las medianas, rangos intercuartílicos (Q1; Q3y se compararon los puntajes mediante test de Wilcoxon. Resultados: hubo una disposición positiva inicial al aprendizaje interprofesional, con mejoría significativa después de los talleres en todas las dimensiones de la encuesta: Trabajo en equipo y colaboración (<0,001), trabajo centrado en el paciente (<0,001), y sentido de identidad profesional (<0,05). La diferencia del puntaje global de la encuesta también fue significativa (<0,001). Conclusiones: se demostró un cambio favorable y significativo en las respuestas de los internos después de los talleres, en todas las dimensiones de la encuesta. En los comentarios, destacaron la relevancia de aprender con estudiantes de otras carreras, describiendo que aumentó su conocimiento sobre éstas y reforzando el impacto que dicha integración tiene en mejorar la atención y resolución de problemas en salud.

Background: The dynamics of health care require that the health professionals work collaboratively; however, during their training, learning opportunities with other disciplines are infrequent. The results of the first project to promote interprofessional learning in the clinical internship at Hospital Josefina Martínez are reported. Methods: From March to July 2018, two workshops for each internship rotation were carried. Students from fivecareers participated together (Kinesiology, Dentistry, Nutrition, Speech Therapy, and Occupa-tional Therapy). The readiness to interprofessional scale survey was adapted, to be applied before and after each workshop. Medians, interquartile range (Q1; Q3) were calculated, and the Wilcoxon test was used to compare the results. Results: There was an initial po-sitive readiness for interprofessional learning, with a significant improvement in all the dimensions of the survey, after the workshops: Teamwork and collaboration (<.001), patient-centered care (<.001), and sense of professional identity (<.05). The differences from the overall survey were also significant (<0.001). Conclusions: A favorable change was demonstrated in the responses of the students after the workshops, overalland in all the dimensions of the survey. In the comments, the students highlighted the relevance of learning with students from other careers, describing that it increased their knowledge about different professions and strengthening the impact that this integration has in improving attention and resolving health problems.

Evaluación para el aprendizaje: diseño e implementación de un mini-CEX en el internado profesional de la carrera de kinesiología / Assessment for learning: design and implementation of the Mini-CEX to the physiotherapy clerkship

Introducción: la evaluación kinesiológica contempla la realización de una rigurosa historia clínica y examen físico que orientan a establecer un diagnóstico, un pronóstico funcional, y es la base del plan de intervención. Esta competencia requiere de experiencia y razonamiento clínico para la toma de buenas decisiones terapéuticas. Los resultados históricos de las evaluaciones de aprendizajes del internado, concluyen que esta competencia tiene bajo nivel de desempeño, por lo que se deben mejorar las estrategias utilizadas para su aprendizaje durante el internado. El mini-CEX, es un instrumento de evaluación para el aprendizaje, que promueve la observación y feedback en el sitio de trabajo. Objetivo: diseñar e implementar un instrumento de evaluación para el aprendizaje de la evaluación kinesiológica durante el internado profesional de la Carrera de Kinesiología de la PUC. Método: estudio prospectivo, utilizando la me-todología de investigación acción, diseñado en 4 etapas. Resultados: se obtuvo un instrumento de evaluación para el aprendizaje, el mini-CEX, adaptado a las necesidades del internado profesional de kinesiología. El estudio piloto reportó buena aceptación entre estu-diantes y docentes. La percepción de los internos es que son más observados y que las destrezas asociadas a la evaluación kinesiológica mejoraron luego del estudio. Conclusiones: el instrumento reportó un tiempo de aplicación bajo (35 min.), lo que beneficiaría instancias de observación directa y feedback dentro de los internados. Es necesaria una aplicación a gran escala, que contribuya a determinar su validez y confiabilidad. Se requiere una capacitación formal a los docentes evaluadores y ajustar la escala.

Introduction: The physiotherapy clinical assessment competence includes the performance of a rigorous clinical history and physical examination that guides the establishment of a diagnosis and a functional prognosis, and is the basis of the intervention plan. This competence requires experience and clinical reasoning to make good therapeutic decisions. The historical global clerkship assessments conclude that this competency has a low level of performance, so the strategies used for its learning the clerkship must be improved. The mini-CEX is an assessment for learning, which promotes observation and feedback in the workplace. Objective: To design and im-plement an assessment for learning mini-CEX to the Physiotherapy PUC clerkship. Method: Prospective study, using an action research methodology, designed in 4 stages. Results: The main result was the mini-CEX, adapted to the Physiotherapy clerkship needs. The pilot study reported good acceptance among students and teachers. In addition, clerks' perception is that they feel more observed and that the skills associated with the physiotherapy assessment improved after its implementation.

Efeito imediato da MWM de Mulligan em pacientes com dor no ombro / MWM Mulligan immediate effect on shoulder pain patients

Introdução: a dor no ombro leva a limitações e incapacidades entre adultos e idosos, merecendo atenção do fisioterapeuta. Objetivo: Avaliar o efeito imediato da técnica de Mulligan em pacientes com dor no ombro. Metodologia: trata-se de resultados preliminares de um ensaio clínico realizado entre julho de 2018 a julho de 2019. Pacientes com dor no ombro (n=44), de ambos os sexos, foram randomizados e submetidos a dois protocolos de tratamento: exercícios terapêuticos (n=22) e MWM de Mulligan (n=22), atendidos na Clínica Escola de Fisioterapia da UFBA. Todos os participantes responderam a um questionário clínico e sociodemográfico e realizaram avaliação da dor pela escala visual analógica (EVA) e algometria. Os pacientes foram tratados por dois fisioterapeutas experientes na área e, depois, foram reavaliados imediatamente. Resultados: mulheres predominaram, a média de idade foi de 56 anos no grupo Mulligan e 57 no grupo exercícios terapêuticos. Síndrome do manguito rotador predominou: 19 (86,4%) no grupo Mulligan e 15 (68%) no grupo exercícios. O ombro mais acometido foi o direito no Grupo Mulligan, (17 (77,3%); já no grupo exercícios, foi o esquerdo com 12 (55%). A cor negra foi a mais autorrelatada pelos pacientes, e poucos tinham o ensino superior completo. No grupo Mulligan, as ocupações mais informadas foram dona de casa, seguida de aposentados e autônomos. No grupo exercícios, não houve dona de casa, e sim mais aposentados e autônomos. Os dois grupos mostraram ser mais sedentários. Não houve diferença da dor pela EVA entre os grupos, antes e após o tratamento (p=0.79, p=0.56, respectivamente). Já a intensidade da dor mensurada pela algometria, tanto antes do tratamento (p=0.008) quanto depois do tratamento (p=0.04), foi diferente entre os grupos, com predomínio de melhora no grupo Exercícios. Conclusão: a MWM não foi mais eficaz que os exercícios terapêuticos na redução da dor do ombro, sendo que o exercício apresentou mais eficácia quando medido através da EVA e sem melhora significativa ao ser mensurada pela algometria após aplicação de uma única sessão de tratamento.

Introduction: shoulder pain leads to limitations and disabilities among adults and the elderly deserving attention from the physiotherapist. Objective: to evaluate the immediate effect of the Mulligan technique in patients with shoulder pain. Methodology: these are preliminary results of a clinical trial conducted from July 2018 to July 2019. Patients (n=44) with shoulder pain of both sexes were randomized and submitted to two treatment protocols: therapeutic exercises (n = 22) and Mulligan's MWM (n = 22) attended at the UFBA School of Physiotherapy Clinic. All participants answered a clinical and sociodemographic questionnaire and underwent pain assessment by visual analog scale (VAS) and algometry. The patients were treated by two experienced physiotherapists and then reassessed immediately. Results: women predominated, the average age was 56 years in the Mulligan group and 57 in the therapeutic exercises group. Rotator cuff syndrome predominated, 19 (86.4%) in the Mulligan group and 15 (68%) in the exercise group. The most affected shoulder was the right shoulder in the Mulligan Group (17 (77.3%), while in the exercise group was the left shoulder with 12 (55%).The black color was the most self-reported by the patients and few patients had higher education. In the Mulligan group the most informed occupations were housewife followed by retirees and self-employed. In the exercise group we had no housewife but more retired and self-employed. The two groups were more sedentary. There was no difference in VAS pain between the groups before and after treatment (p = 0.79, p = 0.56, respectively), while pain intensity measured by algometry both before treatment (p = 0.008) and after treatment (p = 0.04) was different between Conclusion: Mulligan's MWM was not more effective than exercise in reducing shoulder pain, and exercise was more effective when measured by VAS and without significant improvement when measured by algometry after applying a single treatment session.

Razonamiento clínico en kinesiología mediante aprendizaje basado en casos / Clinical reasoning in kinesiology by case-based learning

Introducción: En cursos clínicos con gran número de estudiantes, las experiencias clínicas con pacientes reales son limitadas, dificul-tando el logro de objetivos de aprendizaje. La didáctica aprendizaje basado en casos (ABC) promueve el pensamiento crítico y trabajo coolaborativo, aspectos esenciales para desarrollar competencias profesionales. El objetivo de este estudio fue reportar si la incorpo-ración de la metodología ABC en una asignatura clínica curricular promueve el razonamiento clínico en la formación en kinesiología. Metodología: En la asignatura curricular "evaluación cardiorrespiratoria en kinesiología", 10 grupos de 7 estudiantes desarrollaron casos clínicos de temas disciplinares seleccionados bajo criterio de jueces por expertos del área, y lo presentaron al resto de sus compañeros. Un académico guió la reflexión del tema tratado en el ABC, fomentando la discusión entre los estudiantes. Al finalizar la asignatura se evaluó la percepción de la didáctica educativa mediante encuesta y logro de objetivos de aprendizaje con indicadores académicos. Resultados: Los estudiantes reportaron gran satisfacción con la metodología, mayor preparación para actividades de campo clínico y mejoras en sus habilidades comunicacionales. El promedio obtenido en las interrogaciones y en las actividades clínicas fue superior a versiones previas de la asignatura, aumentando el porcentaje de aprobación y satisfacción con el curso. Conclusión: La incorporación de la didáctica de ABC fomentó el razonamiento clínico, reflexión y habilidades comunicacionales mejorando el rendimiento académico y promoviendo competencias profesionales. Como producto final se elaboró un libro de descarga libre con los temas tratados en los ABC, titulado: "Identificando problemas kinesiológicos: aprendizaje basado en casos".

Introduction: In clinical courses with a large number of students, clinical experiences with real patients are limited, difficult to achieve the learning objectives. The 'Case-Based Learning' (CBL), like educational methodology, promotes critical thinking and improve collaborative work, which are essential aspects of the development of professional skills. The objective of this study was to report how the incorporation of the CBL methodology in a clinical course promoted the clinical reasoning in kinesiology students. Methodology: In the curriculum subject ten groups of seven students analyzed different clinical cases and presented them to their classmates. The CBL topics were selected by academic experts, who also guided and encouraged the discussion among the students. An online survey at the end of the course assessed perceptions students participated in this methodology. The final academic indicators assessed the learning objectives of the course achieved by students that participated with this methodology. Results: The students reported high satisfaction with the CBL methodology. They showed better preparation for clinical experiences and an improvement in their communication skills. The final marks obtained in the interrogations and the clinical practice activities were higher than in previous years. There was an increase in academic approval and student satisfaction with the course. Conclusion: The incorporation of the CBL methodology enhanced clinical reasoning, reflection, and communication skills, improving academic performance, and promoting professional skills. The topics covered in the CBLs conformed a free download book, entitled: «Identifying kinesiology problems: case-based learning.

Accuracy of the Applied Kinesiology Muscle Strength Test for Sacroiliac Dysfunction / Acurácia do teste de força muscular da cinesiologia aplicada para disfunção sacroilíaca

Abstract Objective To investigate the accuracy of the applied kinesiology muscle strength test for sacroiliac dysfunction and compared it with four validated orthopedic tests. Methods This is a cross-sectional accuracy survey developed at a private practice in the city of Manaus, Brazil, during February 2017. The sample consisted of 20 individuals, with a median age of 33.5 years. Four tests were applied: distraction, thigh thrust, compression and sacral thrust, and the diagnosis was confirmed when three of these tests were positive. Soon after, the applied kinesiology test was applied to the piriformis muscle. Results The prevalence of sacroiliac joint dysfunction was of 45%; the thigh thrust test had the highest specificity, and the sacral thrust test had the highest sensitivity. The applied kinesiology test presented good results (sensitivity: 0.89; specificity: 0.82; positive predictive value: 0.80; negative predictive value: 0.82; accuracy: 0.85; and area under the receiver operating characteristic [ROC] curve: 0.85). Conclusion The applied kinesiology muscle strength test, which has great clinical feasibility, showed good accuracy in diagnosing sacroiliac joint dysfunction and greater discriminatory power for the existing dysfunction in comparison to other tests.

Resumo Objetivo Investigar a acurácia do teste de força muscular da cinesiologia aplicada para disfunção sacroilíaca, comparando-o com quatro testes ortopédicos validados. Métodos Trata-se de uma pesquisa transversal de acurácia desenvolvida em uma clínica particular da cidade de Manaus no mês de fevereiro de 2017. A amostra teve 20 indivíduos, com mediana de idade 33,5 anos. Foram aplicados quatro testes: distração, thigh thrust, compressão e thrust sacral, e o diagnóstico foi confirmado quando três destes testes deram positivo. Logo após, foi aplicado o teste da cinesiologia aplicada para o músculo piriforme. Resultados A prevalência de disfunção da articulação sacroilíaca observada foi de 45%, tendo o teste thigh thrust alta especificidade, e o teste thrust sacral, alta sensibilidade. O teste da cinesiologia aplicada obteve bons resultados (sensibilidade: 0,89; especificidade: 0,82; valor preditivo positivo: 0,80; valor preditivo negativo: 0,82; acurácia: 0,85; área abaixo da curva de característica de operação do receptor [COR]: 0,85). Conclusão O teste de força muscular da cinesiologia aplicada, de grande viabilidade clínica, mostrou ter boa acurácia no diagnóstico da disfunção da articulação sacroilíaca, e maior poder discriminatório da disfunção existente, em comparação aos demais testes.

Cinesioterapia aplicada a entorse de tornozelo: estudo de qualidade metodológica / Kinesiotherapy applied to ankle sprain: methodological quality study

Introdução: A entorse é definida como uma lesão ligamentar cujo trauma é causado por estiramento ou por ruptura das faixas fibrosas que constituem a estrutura ligamentar, acometendo o complexo articular de tornozelo e pé causado por movimentos bruscos de inversão e eversão. Objetivo: Identificar e analisar através da escala PEDro os ensaios clínicos sobre a aplicação da cinesioterapia como tratamento para indivíduos com entorse de tornozelo. Métodos: Trata-se de uma revisão de literatura na qual foram incluídos estudos do tipo ensaio clínico randomizado e não randomizado, referentes aos anos de 2009 a 2019, que usassem exercícios fisioterapêuticos em seu protocolo. A qualidade metodológica dos estudos foi avaliada com base na escala PEDro. Resultados: Os estudos selecionados utilizaram protocolos fisioterapêuticos contendo exercícios terapêuticos isolados e combinados associados ao treinamento de propriocepção para tratamento de curto a longo prazo da entorse de tornozelo. Conclusão: Para pacientes com entorse de tornozelo, o tratamento deve ser baseado na combinação de diferentes métodos fisioterapêuticos para a obtenção do efeito terapêutico positivo na fase aguda e crônica da lesão. (AU)

Introduction: Sprain is defined as a ligament injury whose trauma is caused by stretching or rupture of the fibrous bands that constitute the ligamentous structure, affecting the ankle and foot joint complex, caused by sudden inversion and eversion movements. Objective: To identify and analyze through the PEDro scale clinical trials on the application of kinesiotherapy as a treatment for individuals with ankle sprains. Methods: This is a literature review that included studies of the randomized and nonrandomized clinical trial, referring to the years 2009 to 2019, that used physical therapy exercises in its protocol. The methodological quality of the studies was assessed based on the PEDro scale. Results: The selected studies used physical therapy protocols containing isolated and combined therapeutic exercises associated with proprioception training for short-term long-term treatment of ankle sprains. Conclusion: For patients with ankle sprains, treatment should be based on the combination of different physical therapy methods to obtain a positive therapeutic effect in the acute and chronic phase of the injury. (AU)

Efeitos da cinesioterapia ativa resistida no tratamento fisioterapêutico para portadoras da síndrome da fibromialgia: revisão narrativa / Efects of active resisted kinesiotherapy in physiotherapeutic treatment for patients with fibromyalgia syndrome: narrative review

Analisar os resultados sobre a aplicabilidade da utilização da cinesioterapia resistida no tratamento fisioterapêutico para portadoras da Síndrome da Fibromialgia. A presente pesquisa tratou-se de uma revisão de literatura do tipo narrativa. Cujos dados foram extraídos de artigos científicos publicados nos idiomas inglês e português no período de 2010 a 2020, nas bases de dados Pubmed, Scielo, Lilacs e PEDro mediante os seguintes descritores em português: fisioterapia, fibromialgia, terapia por exercício, exercício de resistência e mulheres. E em inglês: fibromyalgia, Physical Therapy Modalities, Exercise Therapy, Women, Resistance Training. Um total de 18 artigos foram previamente selecionados e após a aplicação dos critérios de elegibilidade 6 publicações foram incluídas.A intervenção fisioterapêutica além de promover o controle dos sintomas adequa as capacidades físicas utilizando diversos recursos como a cinesioterapia ativa resistida em que diversos estudos demostraram a efetividade e influência na qualidade de vida com resultados satisfatórios. Com estes achados, pode-se concluir que a cinesioterapia ativa resistida mostra-se eficaz para melhorar os sintomas e a qualidade de vida do portador de fibromialgia

To analyze the results on the applicability of the use of resisted kinesiotherapy in physiotherapeutic treatment for patients with Fibromyalgia Syndrome. The present research was a narrative-type literature review. Whose data were extracted from scientific articles published in English and Portuguese between 2010 and 2020, in the databases Pubmed, Scielo, Lilacs and PEDro using the following descriptors in Portuguese: Physiotherapy, fibromyalgia, exercise therapy, resistance exercise and women. And in English: fibromyalgia, Physical Therapy Modalities, Exercise Therapy, Women, Resistance Training. A total of 18 articles were previously selected and after the application of the eligibility criteria 6 publications were included. The physical therapy intervention, in addition to promoting symptom control, adapts physical capacities using several resources such as active resisted kinesiotherapy, in which several studies have demonstrated the effectiveness and influence on quality of life with satisfactory results. With these findings, it can be concluded that active resisted kinesiotherapy is effective in improving symptoms and quality of life for patients with fibromyalgia

Implementación de la Telekinesiología como una opción de tratamiento domiciliario, a propósito de un caso / Telekinesiology implementation as an option of home treatment, a case report

Paciente con secuela neurológica severa es dado de alta al domicilio, siendo dependiente total para AVD (Actividades de la Vida Diaria), traqueostomizado y sin posibilidad de comenzar con rehabilitación psicofísica por su contexto socioeconómico. OBJETIVO: El objetivo, es mostrar como la implementación de un programa vía Telemedicina, puede ser efectivo en pacientes seleccionados, cuando el contexto socioeconómico limita la posibilidad de continuar con su correspondiente rehabilitación. METODOLOGÍA: En consenso interdisciplinario, se creó un programa de seguimiento, evaluación y tratamiento vía Telemedicina, donde se programó un encuentro semanal, de manera virtual de 30-40 minutos durante 3 meses hasta cumplir el objetivo de decanular. RESULTADOS: Mediante este programa se logró capacitar e instruir a la familia para cuidado y el manejo domiciliario, y se logró el seguimiento sin eventos adversos. CONCLUSIONES: El programa de telekinesiología parece cumplir con el objetivo de acercar el hospital y la atención kinésica a pacientes seleccionados y a su familia, brindando una solución para la pronta rehabilitación.

Patient with a severe neurological sequela is discharged home, being totally dependent on DLA (Daily Life Activities), tracheostomized and unable to start with psychophysical rehabilitation due to its socioeconomic context. OBJECTIVE: The objective is to show how the implementation of a program via Telemedicine can be effective in selected patients, when patient´s recovery is limited due to its socioeconomic context. METHODS: By interdisciplinary consensus, a evaluation, monitorization and treatment program was created, and patient was followed-up via Telemedicine. We scheduled a virtual meeting weekly 30-40 min. for the time of 3 months to achieve the goal of decannulation. RESULTS: Through this program, the family was trained and instructed for home care and patient management, and follow-up was achieved without adverse events. CONCLUSIONS: The Telekinesiology program seems to accomplish the objective of bringing the hospital and physiotherapist care to selected patients and their family, providing a solution for prompt rehabilitation.

Fichas clínicas simuladas en kinesiología / Simulated clinical records in kinesiology

Introducción: la normativa actual de docencia clínica regula el desarrollo de actividades curriculares disminuyendo el tiempo de con-tacto estudiante-paciente, requiriendo entre otras destrezas del estudiante la lectura eficiente de información clínica. La simulación permite desarrollar competencias clínicas en los estudiantes de ciencias de la salud. El objetivo de este estudio es describir la experiencia de talleres de fichas clínicas simuladas (FCS) en estudiantes curriculares y reportar indicadores de logro de objetivos de aprendizaje relacionados al reconocimiento de las partes de la ficha clínica e identificación y extracción de información relevante. Metodología: en una asignatura de carácter mínimo previo al encuentro de estudiantes con pacientes reales, se desarrollaron cuatro talleres de FCS en grupo pequeño. Un académico guió la actividad consistente en responder cuestionarios de ubicación de información presente en las FCS. Al finalizar la asignatura, se evaluó la percepción de la didáctica educativa y logro de objetivos de aprendizaje en tutores clínicos y estudiantes mediante encuesta. Resultados: los estudiantes reportaron alta satisfacción con la metodología, facilidad para extraer información relevante y mayor tiempo de contacto clínico con pacientes reales. Los tutores clínicos informaron que los estudiantes logran reconocer las partes de la ficha clínica. Ambos consideran que el tiempo ideal para lectura de ficha clínica es de 10 a 20 minutos.Conclusión: la incorporación de talleres de fichas clínicas simuladas desarrolló habilidades clínicas de reconocimiento de las partes que componen la ficha clínica, optimizando el tiempo necesario para identificar y extraer información relevante a diferentes escenarios clínicos.