Acute outcomes of acupuncture and dry needling over peripheral acute fatigue in untrained healthy volunteers: A randomized controlled clinical trial.

Peripheral acute fatigue (PAF) is defined as when the skeletal muscle is incapable of generating power. We aimed to investigate the acute effects of traditional Chinese acupuncture (TCA) and dry needling (DN) over PAF induced on the biceps brachii of untrained healthy volunteers. We conducted a randomized, single-blind controlled clinical trial. All volunteers (n = 45) underwent fatigue induction protocols repeated before and after treatment with TCA (TCA group; TCAg; n = 15), DN (DN group; DNg; n = 15), and rest (control group; Cg; n = 15). Assessments of PAF, skin temperature, and exercise time occur before and after each event: 1st fatigue induction (FI), treatment, and 2nd FI. We used repeated measures ANOVA adjusted with Bonferroni post hoc test to determine any change in tested variables (PAF-VAS, PAF-EMG, and skin temperature) at different time points compared to the baseline. Paired Samples t-test was used for the variable exercise times. All statistical tests considered' the significance level at p ≤ 0,05. There was no difference between groups in acute fatigue recovery (p = 0.19). All intragroup analyses were significant (p ≤ 0.05) and all volunteers show a reduction in fatigue perception after treatment (p ≤ 0,05), however, exercise time did not ameliorate after TCA or DN (p > 0.77). A single session of TCA and, DN can equally reduce fatigue, temperature, and exercise time over PAF induced on biceps brachii of untrained healthy volunteers.

Surface electromyography signal processing and evaluation on respiratory muscles of critically ill patients: A systematic review.

BACKGROUND: Surface Electromyography (sEMG) has been used to monitor respiratory muscle function and contractility in several clinical situations, however there is the lack of standardization for the analysis and processing of the signals. OBJECTIVE: To summarize the respiratory muscles most assessed by sEMG in the critical care setting and the assessment procedure details employed on those muscles regarding electrode placement, signal acquisition, and data analysis. METHODS: A systematic review of observational studies was registered on PROSPERO (number CRD42022354469). The databases included PubMed; SCOPUS; CINAHL, Web of Science and ScienceDirect. Two independent reviewers ran the quality assessment of the studies using the Newcastle-Ottawa Scale and Downs & Black checklists. RESULTS: A total of 311 participants were involved across the 16 studies, from which 62.5% (10) assessed the diaphragm muscle and 50% (8) assessed the parasternal muscle with similar electrode placement in both of them. We did not identify common patterns for the location of the electrodes in the sternocleidomastoid and anterior scalene muscles. 12/16 reported sample rate, 10/16 reported band-pass and 9/16 reported one method of cardiac-interference filtering technique. 15/16 reported Root Mean Square (RMS) or derivatives as sEMG-obtained variables. The main applicabilities were the description of muscle activation in different settings (6/16), testing of reliability and correlation to other respiratory muscles assessment techniques (7/16), and assessment of therapy response (3/16). They found sEMG feasible and useful for prognosis purposes (2/16), treatment guidance (6/16), reliable monitoring under stable conditions (3/16), and as a surrogate measure (5/16) in mechanically ventilated patients in elective or emergency invasive procedures (5/16) or in acute health conditions (11/16). CONCLUSIONS: The diaphragm and parasternal muscles were the main muscles studied in the critical care setting, and with similar electrodes placement. However, several different methods were observed for other muscles electrodes placement, sEMG signals acquisition and data analysis.

Effects of mat Pilates on older adult women with knee osteoarthritis: A randomized controlled trial.

INTRODUCTION: Osteoarthritis is the most common joint disorder in the world and its incidence is rising, and one of the most frequent causes of pain, loss of function and disability in adults. AIM: The aim of this study was to evaluate the effects of Mat Pilates on health status, pain, stiffness, and functionality of older adult women with knee osteoarthritis (KOA). METHODS: A randomized-controlled trial to preliminarily test an intervention protocol of Mat Pilates in older women with KOA on health status, pain, stiffness, and functionality. This study included 41 volunteers with age over 40 years, which mean was 52.1 ± 8.9 years, and were allocated into Mat Pilates and control groups. The protocol was developed to be performed in 60 min, twice a week; the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and the Medical Outcomes Study 36 (SF-36) were used to assess pain, to evaluate functionality and stiffness. RESULTS: The Mat Pilates group significantly improved the functional capacity assessed by SF-36 (33.12 ± 22.03 to 69.37 ± 22.43, p < 0.05), and by WOMAC (29.75 ± 6.92 to 9.75 ± 9.35, p < 0.05). The pain domain also improved in Mat Pilates group assessed by SF-36 (39.50 ± 12.89 to 71.75 ± 18.66, p < 0.05) and by WOMAC (8.00 ± 2.56 to 2.75 ± 3.01, p < 0.05). The total score of WOMAC (41.75 ± 10.39 to 14.25 ± 13.88, p < 0.05), and the general health status assessed by SF-36 (59.44 ± 18.07 to 82.75 ± 12.03, p < 0.05) only improved for Mat Pilates group. No differences were observed in outcomes for the control group in both questionnaires. CONCLUSION: Our results show that Mat Pilates protocol can improve the health status, pain, and functionality of older women with KOA.

The impact of post-COVID multicomponent rehabilitation / O impacto da reabilitação com multicomponentes no pós-COVID

Abstract Introduction Post-COVID-19 syndrome is characterized by chronic fatigue and myalgia, among other symptoms, which can limit activities of daily living. Physical therapy protocols with multicomponent exercises combine strength, resistance, balance and gait, producing sig-nificant improvements in functional mobility. Objective Evaluate whether multicomponent rehabilitation is effective in improving functional mobility and quality of life in individuals with post-COVID-19 syndrome. Methods Randomized controlled trial with 59 volunteers, divided into an intervention (IG) and control group (CG), all of whom underwent initial assessment (T0). The IG performed 24 sessions over 12 weeks and the CG did not undergo training. Functional mobility was analyzed using the 6-minute walk test (6MWT) and the Berg balance scale, while the SF-36 questionnaire assessed quality of life. Results In the 6MWT, the IG covered 464.40 + 81.26 meters (T0) and 518.60 + 82.68 meters (T4). The IG Berg scale scores were 48.00 + 4.00 (T0) and 51.90 + 4.26 (T4). In terms of quality of life, the IG obtained mean scores of 96.26 + 10.14 (T0) and 102.60 + 5.53 (T4). None of these measures was statistically significant. Conclusion Individuals who underwent the multicomponent phys-iotherapy protocol showed statistically nonsignificant increases in the variables studied.

Resumo Introdução A síndrome pós-COVID-19 caracteriza-se por fadiga crônica, mialgia, entre outros sintomas que podem causar limitações na realização das atividades de vida diária. Protocolos de fisioterapia com exercício de multicomponentes combinam força, resistência, equi-líbrio e marcha, e produzem melhorias significativas na mobilidade funcional. Objetivo Avaliar se a reabilitação de multicomponentes é eficaz em promover melhora na mobilidade funcional e qualidade de vida em indivíduos com síndrome pós-COVID-19. Métodos Ensaio clínico randomizado, controlado, realizado com 59 voluntários, divididos em grupo intervenção (GI) e grupo controle (GC). Todos fizeram avaliação inicial (T0); GI realizou 24 sessões durante 12 semanas e GC não realizou treinamento. A análise da mobilidade funcional foi realizada através do teste de caminhada de 6 minutos (TC6m) e da escala de equilíbrio de Berg. O questionário SF-36 avaliou a qualidade de vida. Resultados A distância percorrida no TC6m pelo GI foi de 464,40 + 81,26 metros (T0) e de 518,60 + 82,68 metros (T4). A pontuação na escala de Berg do GI foi de 48,00 + 4,00 (T0) e de 51,90 + 4,26 (T4). Na qualidade de vida, GI apresentou escore com média de 96,26 + 10,14 (T0) e 102,60 + 5,53 (T4). Nenhuma destas medidas foram estatisticamente significantes. Conclusão Os indivíduos que foram submetidos ao protocolo fisioterapêutico de multicomponentes apresentaram incrementos nas variáveis estudadas sem significância estatística.

Agreement between two methods for assessment of maximal inspiratory pressure in patients weaning from mechanical ventilation.

BACKGROUND: Respiratory muscle strength in patients with an artificial airway is commonly assessed as the maximal inspiratory pressure (MIP) and is measured using analogue or digital manometers. Recently, new electronic loading devices have been proposed to measure respiratory muscle strength. This study evaluates the agreement between the MIPs measured by a digital manometer and those according to an electronic loading device in patients being weaned from mechanical ventilation. METHODS: In this prospective study, the standard MIP was obtained using a protocol adapted from Marini, in which repetitive inspiratory efforts were performed against an occluded airway with a one-way valve and were recorded with a digital manometer for 40 seconds (MIPDM). The MIP measured using the electronic loading device (MIPELD) was obtained from repetitively tapered flow resistive inspirations sustained for at least 2 seconds during a 40-second test. The agreement between the results was verified by a Bland-Altman analysis. RESULTS: A total of 39 subjects (17 men, 55.4±17.7 years) was enrolled. Although a strong correlation between MIPDM and MIPELD (R=0.73, P<0.001) was observed, the Bland-Altman analysis showed a high bias of -47.4 (standard deviation, 22.3 cm H2O; 95% confidence interval, -54.7 to -40.2 cm H2O). CONCLUSIONS: The protocol of repetitively tapering flow resistive inspirations to measure the MIP with the electronic loading device is not in agreement with the standard protocol using one-way valve inspiratory occlusion when applied in poorly cooperative patients being weaned from mechanical ventilation.

Whole-Body Vibration Associated with Strength Training on the Lower-Limb Blood Flow and Mobility in Older Adults with Type 2 Diabetes: A Study Protocol for a Randomized Controlled Trial.

Vascular endothelium insults caused by high serum glucose levels affect the oxygen supply to tissues, via the microvascular endothelium, resulting in an increased perfusion heterogeneity. These insults may lead to the underuse of blood capillaries, while other vessels are overused and effectively overload their oxygen supply capacity, which eventually causes damages to distal parts of the peripheral nervous system. Therefore, the proprioceptive and exteroceptive feedback information will be gradually lost and contribute to a mobility reduction. This study aims to assess the efficacy of whole-body vibration (WBV) associated with strength training (ST) on lower-limb blood flow and mobility in older adults with type 2 diabetes (DM2). Methods and analyses: This is a protocol (1st version) for Pa single-blind, randomized, controlled clinical trial guided by the SPIRIT guidelines. Our sample will consist of 51 older adults with DM2 randomly allocated to three groups: low frequency WBV (16−26 Hz) associated to ST (G1), WBV sham (G2) and nonintervention control (G3). The study protocol is set for a 12-week (three times per week) schedule. Primary outcomes: skin temperature using infrared thermographic imaging (ITI); mean peripheral arterial blood flow velocity (MBF) by a handheld Doppler ultrasound (DU), and functional mobility by Timed Up and Go (TUG) test. Secondary outcomes: quasi-static posture using the DX100 BTS Smart optoelectronic system, and plantar pressure and body balance using the MPS stabilometric platform. Data will be collected and analyzed at baseline and post-intervention, considering p-value < 0.05 level of significance. The analyses will also be conducted with an intention-to-treat method and effect size. Dissemination: All results will be published in peer-reviewed journals as well as presented in conferences.

O uso da câmera termográfica no diagnóstico auxiliar do aspecto celulítico / The use of a thermographic camera in aiding the diagnosis of cellulite appearance

A celulite estética é uma disfunção caracterizada pela pele com aspecto de "casca de laranja" e tem afetado negativamente à autoestima e o convívio social de mais de 80% das mulheres pós-púberes. O conteúdo em questão cobre a escassez de estudos avaliativos na área da estética e favorece a padronização da técnica para avaliação dessa disfunção. O presente estudo teve o objetivo de verificar o uso da termografia como método auxiliar no diagnóstico de possíveis alterações circulatórias na região glútea, como em casos do aspecto celulítico e investigar a possibilidade de prevenção do seu agravamento. Trata-se de um estudo observacional, realizado com dezoito mulheres voluntárias de 18 e 35 anos, portadoras de estrias albas na região glútea, sem tratamento medicamentoso com substâncias fotossensíveis, ou em uso da isotretinoína, ou ainda em tratamento tópico específico na região de nádegas. As participantes foram divididas em 2 grupos, sendo o grupo 1 (imagens termográficas não uniforme) e grupo 2 (imagem termográfica uniforme). As avaliações do aspecto celulítico foram feitas através de fotografias convencionais, termografia e por 3 especialistas na área da fisioterapia dermatofuncional. Os resultados permitiram demonstrar que a gravidade da celulite não pode ser classificada apenas através de uma avaliação visual ou de questionários, pois, as participantes que não possuem a característica física da celulite, demonstraram na termografia, um comprometimento circulatório, que sugere um possível risco para adquirir a celulite. Portanto, esse estudo concluiu que um diagnóstico prévio através da câmera termográfica pode ajudar na prevenção dessa disfunção.

Aesthetic cellulite is a disorder characterized by the skin with an "orange peel" appearance and has negatively affected the self-esteem and social life of more than 80% of post-pubertal women. The content in question covers the scarcity of evaluative studies in the area of aesthetics and favors the standardization of a technique for evaluating this dysfunction. The present study aimed to verify the use of thermography as an auxiliary method in the diagnosis of possible circulatory alterations in the gluteal region, as in cases of cellulite appearance, and to investigate the possibility of preventing its worsening. This is an observational study, carried out with eighteen female volunteers aged between 18 and 35 years old, with striae alba in the gluteal region, without drug treatment with photosensitive substances, or using isotretinoin, or still applying any specific topical treatment on the buttocks. The participants were divided into 2 groups, which were group 1 (non-uniform thermographic images) and group 2 (uniform thermographic images). Assessments of the cellulite's appearance were performed through conventional photographs, thermography, and by 3 specialists in the field of dermatofunctional physiotherapy. The results showed that the severity of cellulite cannot be classified only through a visual assessment or questionnaires, since the participants who do not have the physical characteristic of cellulite, demonstrated through the thermography, a circulatory compromise, which suggests a possible risk in developing cellulite. Therefore, this study concluded that a previous diagnosis through a thermographic camera can help in the prevention of this dysfunction.

Perfil de idosos atendidos na fisioterapia em universidade federal entre 2009-2019: estudo retrospectivo / Profile of elderly care in physiotherapy at a federal university between 2009-2019: retrospective study

Este estudo teve como objetivo analisar perfil de idosos atendidos em laboratório de pesquisa em fisioterapia do Recife. Foi um estudo descritivo, longitudinal e retrospectivo que analisou prontuários de pacientes idosos ≥ 60 anos, datados entre 2009-2019. As variáveis coletadas foram sociodemográficas, clínicas e antropométricas, e a análise dos dados foi realizada no SPSS, versão 23.0, utilizando análise descritiva. As variáveis categóricas estão expressas em frequência absoluta e relativa, e as quantitativas em média e desvio padrão. Foram analisados dados de 187 idosos, com média de idade 68,88 ±6,47; 154 (82,4%) eram do sexo feminino; 80 (43%) eram casados e 122 (52%) residiam em Recife. Das cidades da região metropolitana, Jaboatão dos Guararapes apresentou grande concentração dessa população. Os desfechos apresentaram uma população que está acima do peso e cujo diagnóstico predominante foi osteoporose. Dentre as comorbidades frequentemente associadas estão a hipertensão arterial sistêmica, obesidade, artrose, dores articulares e diabetes. O perfil de idosos atendidos na Universidade Federal de Pernambuco foi importante para identificar as principais características dessa população, suas comorbidades e assim nortear abordagens clínicas de suporte ao Sistema Único de Saúde (SUS).

This study aimed to analyze the profile of elderly people seen in a physical therapy research laboratory in Recife. It was a descriptive, longitudinal, and retrospective study that analyzed medical records of elderly patients ≥ 60 years old, dated between 2009-2019. The variables collected were sociodemographic, clinical, and anthropometric and data analysis was performed in SPSS, version 23.0, using descriptive analysis. Categorical variables are expressed in absolute and relative frequency, and quantitative variables in mean and standard deviation. Data from 187 elderly people were analyzed, with a mean age of 68.88 ± 6.47; 154 (82.4%) were female; 80 (43%) were married and 122 (52%) lived in Recife. Of the cities in the metropolitan region, Jaboatão dos Guararapes showed a large concentration of this population. The outcomes presented a population that is overweight and whose predominant diagnosis was osteoporosis. Among the comorbidities frequently associated are systemic arterial hypertension, obesity, osteoarthritis, joint pain, and diabetes. The profile of elderly people attended at the Federal University of Pernambuco was important to identify the main characteristics of this population, their comorbidities and thus guide clinical approaches to support the Unified Health System (UHS).

Efeitos da auriculoterapia com sementes de mostarda na dor lombar crônica de profissionais de enfermagem / Efectos de la auriculoterapia con semillas de mostaza en el dolor lumbar crónico de los profesionales de enfermería / Effects of auriculotherapy with mustard seeds on chronic low back pain of nursing professionals

RESUMO Mais de 60% dos trabalhadores de enfermagem apresentam episódio de lombalgia durante um ano, provocando um impacto socioeconômico negativo, uma vez que é uma das maiores causas de faltas e afastamentos do trabalho. A auriculoterapia é uma técnica da acupuntura de baixo custo e não invasiva, que utiliza o pavilhão auricular como um microssistema do organismo humano mapeado por pontos que, estimulados, podem tratar diversas enfermidades. Sendo assim, o objetivo deste estudo foi verificar a eficácia da auriculoterapia com sementes de mostarda (Brassica juncea) na melhora da dor, na funcionalidade e na mobilidade lombar de profissionais técnicos e auxiliares de enfermagem do sexo feminino com dor lombar crônica. Foi realizado um ensaio clínico randomizado cego, dividido em dois grupos: um utilizou sementes de mostarda para acupressão nos pontos auriculares "Shen-Men", "Rim", "Simpático" e "Coluna Lombar" e o grupo placebo utilizou espuma de poliuretano de baixa densidade no lugar das sementes. Cada grupo realizou quatro sessões de auriculoterapia, uma vez por semana. Os grupos foram analisados por meio de termogramas infravermelhos e algometria por pressão para a dor, a medida dedo-chão para mobilidade e Questionário Roland-Morris para funcionalidade da coluna, com intervalo de confiança de 95%. A auriculoterapia com sementes de mostarda reduziu a temperatura média nos termogramas analisados em 0,8°C, bem como, aumentou o limiar de dor à pressão na coluna lombar das voluntárias em 0,4 Kgf, o que demonstra uma melhora significativa da dor lombar. Portanto, a auriculoterapia com sementes de mostarda mostrou-se eficaz na melhora da dor lombar.

RESUMEN Más del 60% de los trabajadores de enfermería tienen un episodio de dolor lumbar durante un año, causando un impacto socioeconómico negativo, ya que es una de las mayores causas de ausencias y despidos del trabajo. La auriculoterapia es una técnica de acupuntura de bajo costo y no invasiva que utiliza el pabellón auricular como un microsistema del organismo humano mapeado por puntos que, estimulados, pueden tratar diversas enfermedades. Así, el objetivo de este estudio fue verificar la eficacia de la auriculoterapia con semillas de mostaza (Brassica juncea) en la mejora del dolor, la funcionalidad y la movilidad lumbar de mujeres profesionales técnicas y auxiliares de enfermería con dolor lumbar crónico. Se realizó un ensayo clínico aleatorizado ciego, dividido en dos grupos: uno utilizó semillas de mostaza para acupresión en los puntos auriculares "Shen-Men", "Riñón", "Simpático" y "Columna Lumbar" y el grupo placebo utilizó espuma de poliuretano de baja densidad en lugar de las semillas. Cada grupo realizó cuatro sesiones de auriculoterapia una vez por semana. Los grupos se analizaron mediante termogramas infrarrojos y algometría de presión para el dolor, prueba de distancia dedos-suelo para la movilidad y Cuestionario Roland-Morris para la funcionalidad de la columna vertebral, con un intervalo de confianza del 95%. La auriculoterapia con semillas de mostaza redujo la temperatura promedio en los termogramas analizados en 0,8°C, así como aumentó el umbral de dolor a presión en la columna lumbar de las voluntarias en 0,4 Kgf, lo que demuestra una mejora significativa en el dolor lumbar. Por lo tanto, la auriculoterapia con semillas de mostaza ha demostrado ser eficaz para mejorar el dolor lumbar.

ABSTRACT More than 60% of nursing workers have an episode of low back pain for one year, causing a negative socioeconomic impact, as this is one of the major causes of absence from work. Auriculotherapy is a low-cost, non-invasive acupuncture technique that uses the auricular pavilion as a microsystem of the human organism mapped by points that when stimulated can treat several ailments. Thus, this study aims to verify the efficacy of mustard seed (Brassica juncea) auriculotherapy in alleviating pain, improving functionality and lumbar mobility of female technical professionals and nursing assistants with chronic low back pain. A blind randomized clinical trial was conducted with two groups: one group used mustard seeds for acupressure in the ear points "Shen-Men," "Kidney," "Sympathetic," and "Lumbar Spine"; the placebo group used low density polyurethane foam in place of seeds. Each group performed four auriculotherapy sessions, one per week. The groups were analyzed using infrared thermograms and pressure algometry for pain, finger-floor measurement for mobility and Roland-Morris Questionnaire for spine functionality, with a 95% confidence interval. Mustard seed auriculotherapy reduced the average temperature in the thermograms analyzed by 0.8 °C, as well as increased the pain threshold to lumbar spine pressure of the volunteers by 0.4 Kgf, which shows a significant improvement of low back pain. Therefore, mustard seed auriculotherapy was effective in alleviating low back pain.

Performance funcional, composição corporal e medo de cair em idosas com desmineralização óssea caidoras e não caidoras. Existem diferenças? / Functional performance, body composition and fear of falling in fallers and non-fallers elderly women with bone demineralization. Are there differences?

Objetivou-se comparar performance funcional, composição corporal e medo de cair em idosas com desmineralização óssea caidoras e não caidoras. Estudo transversal, analítico com 19 idosas com baixa da densidade mineral óssea (DMO), sete apresentaram osteoporose e 12 tinham osteopenia. IMC=28,9 ± 4,3kg.m-2 , idade média de 70 ± 5 anos. As idosas foram alocadas em grupos quanto à queda: Caidoras (n=9) e Não Caidoras (n=10). A avaliação da performance funcional englobou: 1) Capacidade Funcional com a bateria Senior Fitness Test (SFT); 2) Variáveis da marcha captadas com o sensor inercial Wivar® Science durante o Teste de Caminhada de 10 metros (TC10M). Composição corporal: DMO, gordura e massa magra foram analisadas através da Absortometria Radiológica de Dupla Energia (DEXA). Verificou-se o medo de cair com a Falls Efficacy Scale - Internacional ­ Brasil. Testou-se a comparação entre médias com teste t de Student e U de Mann Whitney. Quanto ao medo de cair, o escore total atingiu 28±11 pontos. Não houve diferença estatística entre as médias dos testes de capacidade funcional e marcha, exceto a simetria da marcha (p=0,017). Os grupos alcançaram resultados semelhantes de performance funcional, marcha e medo de cair. O estímulo e manutenção da função devem ser feitos como caráter preventivo no público em questão independente do evento queda ter ocorrido. A simetria da marcha pode ser uma variável complementar na avaliação de quedas em idosas com osteopenia e osteoporose.(AU)

The aim of this study was to compare functional performance, body composition and fear of falling in fallers and non-fallers elderly women with bone demineralization. This is a cross-sectional, analytical study with 19 elderly women with low bone mineral density (BMD), seven had osteoporosis and 12 had osteopenia. BMI = 28.9 ± 4.3 kg.m-2 , mean age 70 ± 5 years. The elderly were allocated by fall reported event in groups: Fallers (n = 9) and Non-fallers (n = 10). Functional performance included: 1) Functional Capacity mesuared by Senior Fitness Test (SFT) battery; 2) Walking variables captured by the inertial sensor Wivar® Science during the 10-meter Walk Test (TC10M). Body composition: BMD, fat and lean mass were mesuared by Dual Energy Radiological Absortometry (DEXA). There fear of falling was acessed by Falls Efficacy Scale - International - Brazil. The comparison between means was made with Student's t test and Mann Whitney U test. As results, the total score for fear of falling reached 28 ± 11 points. There was no statistically significant difference between the means of functional capacity and gait tests. Only gait symmetry differed between groups (p = 0.017). Both groups achieved similar results of functional performance, gait and fear of falling. The stimulus and maintenance of the function must be done as a preventive character in the public in question regardless of the event that occurred. The gait symmetry may be a complementary variable to evaluate falls in elderly women with osteopenia and osteoporosis.(AU)

Acupuncture and Dry Needling in the Reduction of Peripheral Acute Fatigue Induced in the Biceps Braquii: Protocol for a Single-blinded Randomized Controlled Clinical Trial.

The present study aims to propose a protocol to verify the efficacy and acute effects of traditional Chinese acupuncture, dry needling, and the rest in peripheral acute fatigue (PAF) induced by intermittent isometric contractions of the nondominant biceps brachii (BB) of nonphysically active men in a randomized, single-blind clinical trial assessed with surface electromyography, contraction time in seconds, infrared thermal imaging, and visual analog scale applied to the PAF. These instruments will evaluate the median frequency, endurance time, temperature (°C), and perceived fatigue in BB of the volunteers. The measurements will be collected in four moments (Test 0, 01, 02, and 03) divided between the beginning and the end of two sets of exercises (Exercises 01 and 02) of intermittent isometric contractions. TRIAL IDENTIFIER: NCT03448120 in www.clinicaltrials.gov.

Inertial sensor and Timed Up and Go test in elderly women with bone demineralization: a reliability and agreement study / Sensor inercial e Timed Up and Go em idosas com desmineralização óssea: estudo de confiabilidade e concordância

The study aims to assess: 1) reliability test-retest and error measures of quantitative variables of Timed Up and Go (TUG) testing collected with the inertial sensor wireless Wiva® Science (TUGis), and 2) the agreement of TUGis and the timed method (TUGs) and between the two methods applied to elderly women with osteoporosis and osteopenia. Eighteen elderly women with bone demineralization were enrolled in this study. The time (s) for two executions of the TUG (T1 and T2) was measured with a manual stopwatch by an evaluator and with the inertial sensor at-tached to the body at the level of the L5 vertebra with remote collection. T1 and T2 were performed with an interval of 1 min. TUG's subtasks were also captured by the inertial sensor. The reliability test-retest and error variables were assessed by the intraclass correlation coefficient (ICC), standard error of measurement (SEm) and minimal detectable change (MDC). The agreement between the averages from the total time of the TUGs and TUGis and between T1 and T2 measured with the sensor and stopwatch were evaluated by the Bland-Altman method. The consistency inside of the subtasks TUGis ranged from substantial to almost complete. The SEm and MDC for TUGis were 1.27s and 2.48s, respectively. The agreement between sensor and stopwatch measurements showed low systematic error. The inertial sensor was reliable in verifying the performance of the TUG and can be a complement for assessing the risk of falls and functional mobility of elderly women with bone demineralization. However, it does not represent an improvement in the exclusive investigation of the total test time

O estudo visa avaliar: 1) confiabilidade teste-reteste e medidas de erro das variáveis quantitativas do teste Timed Up and Go (TUG) coletadas com o sensor inercial wireless Wiva® Science (TUGsi) e, 2) a concordância do TUGsi e o método cronometrado (TUGc) e entre os dois métodos aplicados em idosas com osteoporose e osteopenia. Foram recrutadas 18 idosas com desmineralização óssea. O tempo (s) de duas execuções do TUG (T1 e T2) foi mensurado com cronômetro manual por um avaliador e com o sensor inercial acoplado ao corpo em nível da vértebra L5 com coleta remota. T1 e T2 foram executadas com intervalo de 1 min. As subtarefas do TUG também foram captadas pelo sensor inercial. A confiabilidade teste-reteste e erro das variáveis foram avaliados pelo coeficiente de correlação intraclasse (CCI), erro padrão de medida (EPM) e mínima mudança detectável (MMD). A concordância entre as médias do tempo total do TUGc e TUCsi e entre T1 e T2 mensuradas com o sensor e cronômetro foram avaliadas pelo método Bland-Altman. A consistência interna das subtarefas do TUGsi variaram entre substancial a quase completa. O EPM e a MMD para o TUGsi foram de 1,27s e 2,48s, respectivamente. A concordância entre medidas do sensor e cronômetro apresentaram baixo erro sistemático. O sensor inercial foi confiável na verificação do desempenho do TUG e pode ser um complemento para avaliação de risco de quedas e mobilidade funcional de idosas com desmineralização óssea. Porém, não representa melhoria na investigação exclusiva do tempo total do teste

Prevalence and factors associated with injuries in recreational runners: a cross-sectional study / Prevalência e fatores associados às lesões em corredores amadores: um estudo transversal / Prevalencia y factores asociados a lesiones en corredores aficionados: un estudio transversal

ABSTRACT Introduction The increased number of people who choose running as a form of exercise has been associated with a higher prevalence of musculoskeletal injuries. Objectives To determine the prevalence and the factors that could be correlated with injuries among amateur runners in Recife, in the State of Pernambuco (PE), Brazil. Methods An observational, cross-sectional study, in which 300 (three hundred) amateur runners answered a social demographic questionnaire, as well as questions about training characteristics, footstrike and landing pattern, and history of running injuries. The data were analyzed by descriptive statistics, the student-t test to compare means, and the Chi-squared to compare prevalences. Results The prevalence of injuries amongst runners in Recife-PE was 58.5% (n= 175), the knee being the most commonly injured site (37.3%). In both groups - runners with and without injuries - there was a higher number of male runners, with 72.4% and 72.6% respectively. There was no difference in relation to the weekly frequency of running between the groups (p<0.63). However, runners with a history of injuries ran around 7 kmh a week more than the runners without injuries (p<0.03). A neutral footstrike (F=0.87; p=0.99) and hindfoot landing (F=4.13; p=0.90) were the most reported running patterns in both groups. It was found that wear was the main criterion used for changing running shoes in both groups (F = 8.35, p = 0.4). Conclusion There was a high prevalence of musculoskeletal injuries among amateur runners in Recife-PE. Among the factors associated with the injuries, one variable was significant: a higher weekly volume of training. Level of evidence II; Study type: Cross-sectional study.

RESUMO Introdução O evidente aumento do número de pessoas que escolhem a corrida como forma de exercitar o corpo tem sido associado à maior prevalência de lesões musculoesqueléticas. Objetivos Verificar a prevalência e os fatores que possam estar associados às lesões em corredores amadores da cidade de Recife-PE. Métodos Estudo observacional do tipo transversal, no qual 300 corredores amadores responderam a um questionário sociodemográfico, além de questões sobre características do treinamento, tipo de pisada e aterrissagem e histórico de lesões relacionadas à corrida. Os dados foram analisados pela estatística descritiva; para a comparação entre médias, foi usado o Teste t de Student e para a comparação de prevalências, o teste do qui-quadrado. Resultados A prevalência de lesões em corredores amadores de Recife-PE foi de 58,5% (n = 175), sendo o joelho a região mais acometida (37,3%). Nos grupos corredores com lesão e sem lesão, a maioria dos participantes era do sexo masculino, respectivamente, 72,4% e 72,6%. Não houve diferença quanto à frequência semanal de treinamento entre os grupos (p < 0,63). Ao contrário, os corredores com histórico de lesão treinaram em média 7 quilômetros/semana a mais do que os corredores sem lesões (p < 0,03). O tipo de pisada neutra (F = 0,87; p = 0,99) e a aterrissagem com retropé (F = 4,13; p = 0,90) foram os mais referidos pelos corredores em ambos os grupos. Foi verificado que o desgaste foi o principal critério utilizado para trocar de tênis em ambos os grupos (F = 8,35; p = 0,4). Conclusões Houve alta prevalência de lesões musculoesqueléticas em corredores amadores de Recife-PE. Entre os fatores associados às lesões, uma variável mostrou-se significante: maior volume de treino semanal. Nível de Evidência: II; Tipo de Estudo: Transversal.

RESUMEN Introducción El evidente aumento en el número de personas que eligen la carrera como forma de ejercitar el cuerpo ha sido asociado con una mayor prevalencia de lesiones musculoesqueléticas. Objetivos Verificar la prevalencia y los factores que pueden estar asociados con lesiones en corredores aficionados en la ciudad de Recife-PE. Métodos Estudio transversal observacional, en el que 300 corredores aficionados respondieron un cuestionario sociodemográfico, además de cuestiones sobre características del entrenamiento, tipo de pisada y aterrizaje e historial de lesiones relacionadas con la carrera. Los datos se analizaron mediante estadística descriptiva; para la comparación entre promedios, se utilizó el test t de Student y para la comparación de prevalencia, la prueba de chi-cuadrado. Resultados La prevalencia de lesiones en corredores aficionados en Recife-PE fue de 58,5% (n = 175), siendo la rodilla la región más afectada (37,3%). En los grupos de corredores lesionados y no lesionados, la mayoría de los participantes eran del sexo masculino, respectivamente, 72,4% y 72,6%. No hubo diferencias con respecto a la frecuencia de entrenamiento semanal entre los grupos (p < 0,63). Por el contrario, los corredores con historial de lesiones entrenaron un promedio de 7 kilómetros/semana más que los corredores sin lesiones (p < 0,03). El tipo de pisada neutra (F = 0,87; p = 0,99) y el aterrizaje con retropié (F = 4,13; p = 0,90) fueron los más indicados por los corredores en ambos grupos. Se encontró que el desgaste fue el principal criterio utilizado para cambiar de zapatillas en ambos grupos (F = 8,35, p = 0,4). Conclusiones Hubo una alta prevalencia de lesiones musculoesqueléticas en corredores aficionados en Recife-PE. Entre los factores asociados con las lesiones, se encontró una variable significativa: el mayor volumen de entrenamiento semanal. Nivel de evidencia II; Tipo de Estudio: Transversal.

Functionality and quality of life of patients with unilateral lymphedema of a lower limb: a cross-sectional study.

BACKGROUND: Lymphedema of the lower limbs is a chronic disease caused by damage to the lymphatic system that influences people's mobility, functionality, and quality of life. Questionnaires and physical test are very practical, easy to apply, and low cost methods that provide important data for evaluation of these patients. OBJECTIVES: To evaluate the influence of unilateral lower limb lymphedema on functionality and quality of life, correlating 3 assessment tools. METHODS: This was a descriptive study investigating 25 patients of both sexes with unilateral lymphedema in a lower limb. Limb volume was assessed using circumferential tape measurements, the Medical Outcomes Study Short Form-36 Health Survey (SF-36) was used to assess quality of life, the Lymphoedema Functioning, Disability and Health Questionnaire for Lower Limb Lymphoedema (Lymph-ICF-LL) was used to assess physical, mental, and social skills related to lymphedema, and the Timed Up and Go (TUG) test was used for functional assessment. RESULTS: Lymphedema was present throughout the affected lower limb of participants. The domains most affected by lymphedema were physical aspects (25.0 ± 31.4) and emotional aspects (36.0 ± 42.9) from the SF-36 and the mobility domain (6.0 ± 2.6) from the Lymph -ICF-LL. Patients performed the TUG in 9.88 ± 1.98 seconds. The TUG was correlated with the questionnaires and the questionnaires were correlated with each other. CONCLUSIONS: People with unilateral lower limb lymphedema exhibited negative impacts on quality of life and functionality, as evaluated by questionnaires, which were correlated with each other. TUG performance was within normal limits, but results correlated with the questionnaires used.

Funcionalidade e qualidade de vida em indivíduos com linfedema unilateral em membro inferior: um estudo transversal / Functionality and quality of life of patients with unilateral lymphedema of a lower limb: a cross-sectional study

O linfedema de membros inferiores é uma doença crônica decorrente de dano no sistema linfático que influencia a mobilidade, a funcionalidade e a qualidade de vida dos indivíduos. Questionários e o teste físico são métodos bastante práticos, de fácil aplicação e baixo custo, que fornecem dados importantes para a avaliação desses pacientes. Objetivos Avaliar a influência do linfedema unilateral de membro inferior na funcionalidade e na qualidade de vida, correlacionando três ferramentas de avaliação. Métodos Estudo descritivo com 25 indivíduos com linfedema unilateral em membro inferior, de ambos os sexos. Foi avaliada a perimetria e foram aplicados The Medical Outcome Study Short Form-36 Health Survey (SF-36) para avaliação da qualidade de vida, Lymphoedema Functioning, Disability and Health Questionnaire for Lower Limb Lymphoedema (Lymph-ICF-LL) para estudo das habilidades físicas, mentais e sociais relacionadas ao linfedema e o Timed Up and Go (TUG) para avaliação da funcionalidade. Resultados Houve a presença de linfedema em todo o membro inferior dos participantes. Os domínios mais prejudicados pelo linfedema foram os aspectos físicos (25,0 ± 31,4) e emocionais (36,0 ± 42,9) no SF-36 e o domínio mobilidade (6,0 ± 2,6) no Lymph-ICF-LL. O TUG foi realizado em 9,88 ± 1,98 s. Houve correlação entre o TUG e os questionários e entre os dois questionários utilizados. Conclusões Indivíduos com linfedema unilateral em membro inferior apresentam um impacto negativo na qualidade de vida e na funcionalidade avaliadas através de questionários, que correlacionam entre si. Não foi encontrada alteração no TUG, mas houve correlação entre ele e os questionários utilizados

Lymphedema of the lower limbs is a chronic disease caused by damage to the lymphatic system that influences people's mobility, functionality, and quality of life. Questionnaires and physical test are very practical, easy to apply, and low cost methods that provide important data for evaluation of these patients. Objectives To evaluate the influence of unilateral lower limb lymphedema on functionality and quality of life, correlating 3 assessment tools. Methods This was a descriptive study investigating 25 patients of both sexes with unilateral lymphedema in a lower limb. Limb volume was assessed using circumferential tape measurements, the Medical Outcomes Study Short Form-36 Health Survey (SF-36) was used to assess quality of life, the Lymphoedema Functioning, Disability and Health Questionnaire for Lower Limb Lymphoedema (Lymph-ICF-LL) was used to assess physical, mental, and social skills related to lymphedema, and the Timed Up and Go (TUG) test was used for functional assessment. Results Lymphedema was present throughout the affected lower limb of participants. The domains most affected by lymphedema were physical aspects (25.0 ± 31.4) and emotional aspects (36.0 ± 42.9) from the SF-36 and the mobility domain (6.0 ± 2.6) from the Lymph -ICF-LL. Patients performed the TUG in 9.88 ± 1.98 seconds. The TUG was correlated with the questionnaires and the questionnaires were correlated with each other. Conclusions People with unilateral lower limb lymphedema exhibited negative impacts on quality of life and functionality, as evaluated by questionnaires, which were correlated with each other. TUG performance was within normal limits, but results correlated with the questionnaires used

Desempenho Motor e Quedas: um Estudo Comparativo entre Idosos Cadastrados no Programa Saúde da Família, no Município de Vitória de Santo Antão-PE / Motor Performance and Falls: a comparative study among elderly registered in the family health program, in Vitória de Santo Antão-PE

Analisar a relação entre o risco de quedas e o desempenho das habilidades motoras de idosos, cadastrados no Programa Saúde da Família - PSF, zona urbana, do Município de Vitória de Santo Antão, Região da Zona da Mata do Estado de Pernambuco. Material e Métodos: Estudo do tipo epidemiológico, transversal de campo do tipo descritivo-analítico, observacional e de inquéritos. Participaram desta pesquisa 235 idosos com idade superior ou igual a 60 anos, do gênero masculino e feminino, residentes em Vitória- -PE. O medo de cair foi avaliado por meio da escala de eficácia de quedas FES-I (Falls efficacyscale-International). Para a análise do desempenho motor foram utilizados quatro testes motores: Time Up&Go, Índice de Tinetti, Alcance Funcional e o Apoio Unipodal, avaliados por tempo e equilíbrio. As associações foram verificadas segundo a correlação de Spearman. Resultados: Os dados do presente estudo apontam para uma ocorrência maior de quedas entre o gênero feminino do que no masculino. Os idosos que relataram quedas recorrentes no último ano apresentaram maior comprometimento funcional, independentemente, do sexo. A associação entre a pontuação na FES-I e o número de quedas no ano anterior foi estatisticamente significativa (r=0,602; p=0,005). Conclusão: Os resultados da presente pesquisa apontaram uma associação entre quedas e a capacidade funcional independente do sexo. (AU)

Objective: To analyze the relation between the risk of falls and elderly's motor skills performance (registered in programa de saúde da famíia ­ family health program ­ in the urban area of Vitória de Santo Antão, in Zona da Mata, in Pernambuco state). Material and Methods: Epidemiological, transversal, descriptive and analytical field study, being observational and survey-like. 235 elderly residents, both male and female (60 year old or so), residents in Vitória-PE participated in this research. Fear of falling and falls occurrence were evaluated by FES-I (falls efficacy scale-International). Four motor tests were used to analyze motor performance: Time Up&Go, Tinetti´s Index, Functional Reach and Unipodal Support, evaluated for time and balance. The associations were verified according to Spearman´s correlation. Results: The data of this current study indicate a higher occurrence of falls among women. Elders who reported recurrent falls in the previous year presented a bigger functional difficulty, regardless of their genre, compared to the ones that reported only one fall in the previous year and the ones that reported none. The association between FES-I score and the number of falls in the previous year was statistically significant (r=0,602; p=0,005). Conclusion: The results of the current survey showed an association between falls and functional ability, regardless the genre. (AU)

Perfil das lesões das vítimas de acidentes de motocicletas atendidas em hospital público / Profile of motorcycle accident injuries injury at a public hospital

Introdução:A motocicleta vem se destacando como o meio de transporte mais envolvido nos acidentes de trânsito, levando a altos índices de morbimortalidade. Objetivo: Caracterizar as vítimas e as lesões decorrentes de trauma por acidente de motocicleta atendidas em um hospital público. Metodologia:Estudo de caráter transversal do tipo descritivo com uma amostra de 53 internos por acidente de motocicleta no Hospital Estadual de Emergência e Trauma Senador Humberto Lucena. Resultados:Constatou-se que o gênero masculino foi o mais recorrente (88,7%), assim como a faixa etária dos 15 aos 35 anos (69,8%), solteiros (52,9%), ativos (77,3%), com segundo grau completo (50,9%) e renda familiar per caput <1 salário mínimo (73,6%). As fraturas (77,4%) e as lesões de superfície externa (69,8%) foram as mais frequentes. Os índices de gravidade das lesões (ISS) mais encontrados foram do tipo leve (79,2%), seguido do moderado (15,1%) e grave (5,7%). A região do corpo mais atingida foi membros/cintura pélvica (43,4%), porém a maior média de gravidade das lesões foi na região de cabeça/pescoço (2,9±1,0). Conclusão: A redução da morbimortalidade de acidentados de motocicleta depende da adoção de medidas preventivas baseadas no perfil das vítimas. (AU)

Introduction: Motorcycles have been highlighted as the most means of transportation involved in traffic accidents, leading to high morbidity and mortality rates. The objective was to characterize the victims and injuries resulting from motorcycle accident trauma treated at a public hospital. Methodology: A descriptive cross-sectional study with a sample of 53 hospitalized patients due to motorcycle accidents at Senator Humberto Lucena State Emergency and Trauma Hospital. Results: It was found that the male gender was the most recurrent (88.7%), as well as the age group from 15 to 35 years (69.8%), single (52.9%), active (77.3%), with high school degree (50 , 9%) and per capita family income of <1 minimum wage (73.6%). Fractures (77.4%) and external surface injuries (69.8%) were the most frequent. The most common injury severity indexes (ISS) were mild (79.2%), followed by moderate (15.1%) and severe (5.7%). The most affected body region was pelvic limbs / waist (43.4%), but the highest mean severity of injuries was in the head / neck region (2.9 ± 1.0). Conclusion: The reduction of motorcycle accident morbidity and mortality depends on the adoption of preventive measures based on the profile of the victims.(AU)

Pain threshold, sleep quality and anxiety levels in individuals with temporomandibular disorders / Limiar de dor, qualidade do sono e níveis de ansiedade em indivíduos com disfunção temporomandibular

ABSTRACT Purpose: to evaluate the pressure pain threshold, sleep quality and anxiety levels of individuals with different types of chronic temporomandibular disorders (TMD). Methods: a controlled, observational and cross-sectional study. TMD diagnosis followed the Research Diagnostic Criteria and the volunteers were divided into three groups: A-Muscular Disorder (n = 15), B- Articular Disorder (n = 10) and C- Control Group (n = 15). Evaluation was performed using the Pittsburg Sleep Quality Index, Visual Analog Scale, Algometry and Hospital Anxiety and Depression Scale. The significance level for all tests was 5%. Results: lower threshold of pain was seen in the masticatory and cervical musculature within groups A and B. However, when TMD groups were compared to the control group, only a statistically significant difference in the pain threshold of the masticatory muscle and the trapezius muscle was found. Groups A and B presented poor sleep quality, showing a statistical difference when compared to the control group. Additionally, it was observed that patients in the groups with TMD presented anxiety, while those in the control group, did not present it. Conclusion: individuals presented with TMD show lower levels of pain threshold, sleep quality and anxiety, as compared to healthy subjects. These results do not depend on the type of disorder presented.

RESUMO Objetivo: avaliar o limiar de dor, qualidade do sono e níveis de ansiedade em iindivíduos com diferentes tipos de disfunções temporomandibulares. Métodos: estudo controlado, observacional transversal. Foi utilizado o Research Diagnostic Criteria e os voluntários foram divididos em três grupos: Grupo A-disfunção muscular (n=15), Grupo B-disfunção articular (n=10) e Grupo C- controle (n=15). Foi utilizado o Pittsburg Sleep Quality Index (PSQI), Escala Visual Analógica da Dor (EVA), Algometria e Hospital Anxiety and Depression Scale - HADS). O nível de significância para todos os testes foi de 5%. Resultados: menor limiar de dor da musculatura mastigatória e cervical nos grupos A e B, mas quando comparados ao grupo controle só houve diferença estatística na algometria da musculatura mastigatória e do trapézio (p<0,05). Os grupos A e B apresentaram qualidade do sono pobre, mostrando diferença estatística com o grupo controle (p<0,05). Apenas os grupos A e B apresentaram ansiedade. Entre os grupos A e B não houve diferença estatística em relação ao limiar de dor, qualidade do sono e ansiedade. Conclusão: menores níveis de limiar de dor e redução da qualidade do sono e ansiedade ocorreram em indivíduos com Disfunção temporomandibular quando comparado aos sadios. Esses resultados independem do tipo de disfunção apresentada.

Evidence of an inverse correlation between serotonergic activity and spreading depression propagation in the rat cortex.

Various neurological and psychiatric diseases lead to alterations in cortical serotonergic activity as one of their underlying processes. However, the electrophysiological implication of changes in serotonergic activity remains a matter of investigation. In this study, we investigated whether brain serotonergic activity influences the excitability-related phenomenon known as cortical spreading depression (CSD). CSD parameters (propagation velocity, and amplitude and duration of the DC-shift) was evaluated in rats that received two treatments that increased cortical serotonergic activity, electrical stimulation of the raphe nuclei and subcutaneous injection of a selective serotonin reuptake inhibitor, sumatriptan. A third group of rats was tested on a low-tryptophan diet rat model of serotonin depletion. Control rats for these three groups received, respectively, sham raphe stimulation, saline injection, and a tryptophan-supplemented diet. Compared to controls, electrical stimulation of the raphe nuclei and sumatriptan administration decelerated CSD and increased the duration of the negative DC-shift of CSD, whereas the low-tryptophan diet was associated with significantly accelerated CSD propagation and shortened DC-shift of CSD (p<0.05). We concluded that serotonergic neurons are very important for stabilizing the delicate equilibrium between excitatory and inhibitory neuronal influences that determines cortical excitability and CSD propagation. Our pharmacological, electrophysiological and dietary data suggest that cortical serotonergic activity negatively modulates CSD propagation in the rat cortex. Reduced central serotonergic activity, as can be observed in several neurological and psychiatric diseases, may constitute a pathological factor for increased sensitivity to CSD.