Ultrasonic therapy modulates the expression of genes related to neovascularization and inflammation in fibroblasts / Terapia ultrassônica modula a expressão de genes relacionados à neovascularização e inflamação em fibroblastos

Abstract Introduction: In the rehabilitation of musculoskeletal injuries, ultrasound is widely used in clinical practice. Objective: To evaluate the effects of pulsed ultrasonic therapy on the viability and modulation of genes involved in inflammation (IL-6) and neovascularization (VEGF) processes of L929 fibroblast cells. Methods: For irradiation with ultrasound the cells were subdivided into groups: G1 (without irradiation), G2 (0.3 W/cm2-20%) and G3 (0.6 W/cm2-20%), with periods of treatment at 24, 48 and 72 hours. The cell viability assay was analyzed by the MTT method and gene modulation was analyzed by RT-qPCR method. Results: After the comparative analysis between groups, only G2 and G3 (48-hour) presented statistically significant differences in relation to the control. In relation to the gene expression, the selection of the groups analyzed was delimited according to the comparative analysis of the values obtained by the MTT test. After the achievement of RT-qPCR, it could be observed that in G2 the amount of VEGF gene transcripts increased by 1.125-fold compared to endogenous controls, and increased 1.388-fold in G3. The IL-6 gene, on the other hand, had its transcripts reduced in both G2 (5.64x10-9) and G3 (1.91x10-6). Conclusion: Pulsed ultrasound in L929 fibroblasts showed a significant biostimulatory effect in the 48-hour period, with increased cell viability, and the same effect in the modulation of gene expression related the neovascularization and inflammation, mediating the acceleration of the tissue repair cascade.

Resumo Introdução: Na reabilitação de lesões musculoesqueléticas, o ultrassom é amplamente utilizado na prática clínica. Objetivo: Avaliar os efeitos da terapia ultrassônica pulsada sobre a viabilidade e modulação de genes envolvidos nos processos de inflamação (IL-6) e neovascularização (VEGF) de fibroblastos L929. Métodos: Para irradiação com ultrassom, as células foram subdivididas em grupos: G1 (sem irradiação), G2 (0,3 W/cm2-20%) e G3 (0,6 W/cm2-20%), com períodos de tratamento de 24, 48 e 72 horas. O ensaio de viabilidade celular foi analisado pelo método MTT e a modulação gênica pelo método RT-qPCR. Resultados: Após a análise comparativa entre os grupos, apenas G2 e G3 (48 horas) apresentaram diferenças estatisticamente significantes em relação ao controle. Em relação à expressão gênica, a seleção dos grupos analisados ​​foi delimitada de acordo com a análise comparativa dos valores obtidos pelo teste MTT. Após a obtenção do RT-qPCR, pôde-se observar que no G2 a quantidade de transcritos do gene VEGF aumentou 1,125 vezes em relação aos controles endógenos e 1,388 vezes no G3. O gene IL-6, por outro lado, teve seus transcritos reduzidos tanto no G2 (5,64x10-9) quanto no G3 (1,91x10-6). Conclusão: O ultrassom pulsado em fibroblastos L929 apresentou efeito bioestimulador significativo no período de 48 horas, com aumento da viabilidade celular, e o mesmo efeito na modulação da expressão gênica relacionou neovascularização e inflamação, mediando a aceleração da cascata de reparação de tecidos.

Comparação entre duas modalidades terapêuticas sobre o equilíbrio postural e medo de quedas em mulheres na pós-menopausa: um ensaio clínico randomizado e controlado / Comparison between two therapeutic modalities on postural balance and fear of falling in postmenopausal women: a randomized and controlled clinical trial

Resumo Objetivo: Comparar os efeitos do Pilates vs. vibração de corpo inteiro (VCI) e nenhuma intervenção sobre o equilíbrio postural e medo de quedas em mulheres na pós-menopausa. Métodos: Ensaio clínico Mono-cego, com 51 participantes randomizadas em três grupos (Pilates, VCI, ou Controle). Avaliações foram realizadas para o equilíbrio postural estático por intermédio da plataforma de força, equilíbrio postural dinâmico pelo teste Timed Up & Go e medo de quedas pela Falls Efficacy Scale-International (FES-I). Pilates e VCI foram administrados três vezes na semana, por seis meses. Resultados: Após a intervenção, nenhuma diferença (p> 0.05) foi observada para o equilíbrio postural estático, contudo, para a maior parte das variáveis, Pilates e VCI demonstraram um grande tamanho de efeito (d> 0.80) quando comparados ao grupo controle. Para o equilíbrio postural dinâmico, Pilates e VCI promoveram uma melhora significativa (p= 0.032) comparados ao grupo controle. Para o medo de quedas não houve diferença entre os grupos (p= 0.055) pós-intervenção. Conclusão: Tendo em vista a representatividade clínica evidenciada pelas medidas de tamanho de efeito, Pilates e VCI podem ser recomendados para melhora do equilíbrio postural estático e dinâmico em mulheres na pós-menopausa. Contudo, em relação ao medo de quedas, essas modalidades terapêuticas necessitam de melhor investigação.

Abstract To compare the effects of Pilates vs. whole body vibration (WBV) and no treatment controls on postural balance and fear of falling in postmenopausal women. Method: Single-blind randomized clinical trial, with 51 participants randomized into three groups (Pilates, WBV, or control). Evaluations were performed of static postural balance on a force platform, dynamic postural balance by the Timed Up & Go test, and fear of falling by the Falls Efficacy Scale-International (FES-I). Pilates and WBV were performed three times a week for six months. Results: After the intervention, no difference (p>0.05) was observed for static postural balance, however, for the majority of variables, Pilates and WBV demonstrated a large effect size (d>0.80) when compared to control. For dynamic postural balance and risk of falls, Pilates and WBV showed a significant (p=0.032) improvement compared to the control. Fear of falling did not change (p=0.055) between groups over time. Conclusion: In view of the clinical representativeness evidenced by the effect sizes, Pilates and WBV can be recommended to improve postural balance in postmenopausal women. However, in relation to fear of falling, these therapeutic modalities require further investigation.

Pilates increases the isokinetic muscular strength of the knee extensors and flexors in elderly women.

INTRODUCTION: Pilates has been shown to be effective for increasing muscle strength in older adults, however, some variables have not yet been explored. OBJECTIVE: Investigate the effects of Pilates on the isokinetic muscular strength of the knee extensors and flexors at 60°/s, in elderly women. METHOD: Thirty-two women were randomized into two groups: control group (CG, n = 16, age = 64.2 ± 0.8 years; BMI = 25.0 ± 1.2 kg/m2), and experimental group (EG, n = 16, age = 63.6 ± 1.0 years, BMI = 24.7 ± 1.3 kg/m2). Isokinetic evaluation of the knee extensor and flexor muscles was performed at 60°/s, pre- and post-intervention, considering the peak torque (N.m) and total work (J) for the right and left lower limbs. The CG participated in static stretching and the EG in Pilates sessions, twice a week for 12 weeks. RESULTS: The results demonstrated that the EG presented a significant improvement (p < 0.01) in all tests performed, when comparing the pre- and post-intervention (intragroup), with an effect size (Cohen's d) reaching 2.03 and 1.33 for the knee flexor and extensor muscles respectively. Comparing the CG and EG (intergroup), post-intervention, a significant improvement was observed (p ≤ 0.01) in favor of the EG for all variables, with an effect size (Cohen's d) reaching 1.59 and 1.15 for the knee flexor and extensor muscles respectively. CONCLUSION: The results indicated that 12 weeks of Pilates increases the isokinetic muscular strength of the knee extensors and flexors in elderly women and can be considered for this purpose when prescribing physical exercise programs.

Pilates increases isokinetic muscular strength of the elbow flexor and extensor muscles of older women: A randomized controlled clinical trial.

INTRODUCTION: The number of elderly people is growing and the practice of physical exercise, such as Pilates, contributes to increased muscular strength and functional autonomy in this population. OBJECTIVE: To verify the influence of Pilates on the isokinetic muscular strength of the elbow flexors and extensors, and on the functionality of the upper limbs, of older women. METHOD: Thirty volunteers were randomized into two groups-Pilates group (PG) and Control Group (CG). The PG exercises were performed twice weekly for 12 weeks. Evaluations were performed pre and post-intervention, for isokinetic muscular strength of the elbow flexors and extensors and functionality of the upper limbs. RESULTS: In the intra-group comparison, the PG improved strength of the elbow extensors and the functionality of the upper limbs (p < 0.05). When comparing the post-intervention moment, the PG was superior to the CG in all variables (p < 0.05), with a large effect size (d > 0.80). CONCLUSION: Pilates increases the isokinetic muscular strength of the elbow flexors and extensors, in addition to the functionality of the upper limbs, in older women.

Comparison between static stretching and the Pilates method on the flexibility of older women.

INTRODUCTION: Flexibility decreases with advancing age and some forms of exercise, such as static stretching and Pilates, can contribute to the improvement of this physical ability. OBJECTIVE: To compare the effects of static stretching and Pilates on the flexibility of healthy older women, over the age of 60 years. METHOD: Thirty-two volunteers were randomized into two groups (Static stretching or Pilates) to perform exercises for 60 min, twice a week, for three months. Evaluations to analyze the movements of the trunk (flexion and extension), hip flexion and plantar and dorsiflexion of the ankle were performed before and after the intervention, using a fleximeter. RESULTS: The static stretching exercises improved the trunk flexion and hip flexion movements, while the Pilates improved all evaluated movements. However, over time, the groups presented differences only for the trunk extension movement. CONCLUSION: For some body segments, Pilates may be more effective for improving flexibility in older women compared to static stretching.

Relação da pressão plantar e amplitude de movimento de membros inferiores com o risco de quedas em idosas / Relación entre la presión plantar y la amplitud de los movimientos de los miembros inferiores y el riesgo de caídas en adultos mayores / Relation of plantar pressure and range of movement of the lower limbs with the risk of falls in older women

RESUMO Objetivou-se verificar a influência das variáveis de pressão plantar e amplitude de movimento (ADM) de quadril, joelho e tornozelo sobre o risco de quedas em idosas. Participaram 39 idosas, avaliando-se a Pressão Máxima e Média sobre a plataforma de baropodometria. Em seguida, realizou-se o teste Timed Up and Go (TUG) e posteriormente a avaliação da ADM de flexão de quadril e joelho e flexão plantar e dorsal de tornozelo por meio de um goniômetro. As variáveis baropodométricas (Pressão Máxima e Pressão Média) tenderam a influenciar os valores do TUG conforme valor do teste de hipótese (p=0,051), demonstrando correlação moderada (r=0,487), com destaque para a Pressão Máxima, que apresentou correlação significativa com o TUG (p<0,005). Entretanto, a ADM articular de quadril, joelho e tornozelo não apresentaram correlações significativas entre as variáveis baropodométricas e risco de quedas. Sobre a análise da associação entre o TUG, categorizado em baixo e médio risco de quedas, e as quedas, não foram observadas diferenças (p=0,475). O aumento da pressão máxima apresentou relação com o risco de quedas, mas a ADM de quadril, joelho e tornozelo não apresentaram relação sobre o risco de quedas e as variáveis baropodométricas na população investigada.

RESUMEN Se buscó evaluar la influencia de las variables de la presión plantar y la amplitud de los movimientos (ADM) de la cadera, rodilla y del tobillo en el riesgo de caídas en adultos mayores. Han participado del estudio 39 adultos mayores, de los que se evaluaron su presión máxima y media a través de la baropodometría. Además, se empleó la prueba Timed Up and Go (TUG) y la evaluación de la ADM de flexión de cadera y rodilla, y flexión plantar y dorsal del tobillo a través de un goniómetro. Las variables baropodométricas (presión máxima y media) presentaron influencias en los valores del TUG según el valor de la prueba de hipótesis (p=0,051), lo que demostró una moderada correlación (r=0,487), destacándose la presión máxima, que presentó una significativa correlación con el TUG (p<0,005). La ADM articular de la cadera, rodilla y del tobillo no ha presentado significativa correlación entre las variables baropodométricas y el riesgo de caídas. Acerca del análisis entre el TUG, caracterizado de bajo y mediano riesgo de caídas, y las caídas no se han observado diferencias (p=0,475). El aumento de la presión máxima presentó relación con el riesgo de caídas, sin embargo la ADM de la cadera, rodilla y del tobillo no presentó relaciones entre el riesgo de caídas y las variables baropodométricas evaluadas en los participantes.

ABSTRACT The aim of this study was to verify the influence of plantar pressure and range of motion of hip, knee and ankle variables with the risk of falls in older women. Thirty-nine older women participated, for which Maximum and Medium Pressure were evaluated using the baropodometry platform. Then, we performed the Timed Up and Go (TUG) test and subsequently the range of motion (ROM) evaluation of hip and knee flexion and dorsal and plantar ankle flexion through the use of a goniometer. Baropodometric variables (Maximum Pressure and Medium Pressure) showed a tendency to influence the values of the TUG according to the value of the hypothesis test (P = 0.051), demonstrating a moderate correlation (R = 0.487), with emphasis on the Maximum Pressure showing significant correlation with the TUG (P<0.005). However, the joint range of motion of hip, knee and ankle showed no significant correlations in the baropodometric variables and in the risk of falls. Concerning the analysis of the association between the TUG classified with low and medium risk of falls with the falls, no differences were found (P=0.475). The increase in maximum pressure showed a relation with the risk of falls, though the range of motion of hip, knee and ankle showed no relation to the risk of falls and the baropodometric variables in the researched population.

Effects of cold water immersion on variables of balance in healthy subjects with open and closed eyes / Efeito da crioimersão nas variáveis de equilíbrio em indivíduos saudáveis com olhos abertos e fechados

AbstractIntroduction Cryotherapy is the use of cold as therapeutic approach. Although often used, its impact on the postural balance is not well-known.Objectives To analyze the effects of cold water immersion in the postural balance on single-leg balance in healthy subjects through the variables of center-of-pressure, velocity anteroposterior and medial-lateral oscillations, comparing conditions open and closed eyes in the moments before, immediately, 20 and 40 minutes after cold water immersion.Material and methods Cross-sectional study with 30 male subjects, cold water immersion at 5 °C during 15 minutes assessed in a force platform, protocol of 3 trials of 30 seconds each with 10 seconds of rest, the average of the 3 trials was used for analysis. The software GraphPad Prisma 5.0 was used for statistical analysis, with the ANOVA test for repeated measures and comparisons with test of Friedman and post-test of Dunn.Results It was observed improvement of the balance by the results of the following variables: in the condition Open Eyes (OE) it was observed significant difference only in the velocity anteroposterior (AP) in the moment before immersion when compared to the 40-minute moment. Significant differences were observed in the condition Closed Eyes (CE) in the following comparisons: in the Center-of-Pressure (COP) only at the immediate moment when compared to the 40-minute moment; in the velocity AP in the moment before when compared to the 40-minute moment, in the immediate moment when compared to the 20-minute and 40-minute moments; and in the medial-lateral velocity (Vel-ML) in two comparisons: in the moment before immersion when compared to the 20-minute and 40-minute moments after cryotherapy. Results show safety in performing activities after cryotherapy.Conclusion Improvement of the postural balance after cold water immersion on the predetermined conditions of this study.

ResumoIntrodução A crioterapia consiste na utilização local do frio como abordagem terapêutica. Embora frequentemente utilizada, seu impacto no equilíbrio corporal é pouco explorado.Objetivos Analisar a influência da crioimersão no equilíbrio estático em apoio unipodal em indivíduos saudáveis por meio de variáveis do centro de pressão, oscilações da velocidade anteroposterior e médio-lateral, comparando condições olhos abertos e fechados nos momentos prévios, imediatamente, 20 e 40 minutos após crioimersão.Materiais e métodos Estudo transversal realizado com 30 sujeitos do gênero masculino: crioimersão a 5 °C durante 15 minutos; avaliação na plataforma de força, protocolo de 3 tentativas de 30 segundos cada, com 10 segundos de descanso; média das 3 medidas foi adotada para análise. Utilizou-se o programa GraphPad Prisma 5.0, ANOVA de medidas repetidas e comparações com teste de Friedman e pós-teste de Dunn.Resultados Verificou-se melhora do equilíbrio por meio dos resultados das seguintes variáveis analisadas: na condição Olhos Abertos (OA) observou-se diferença significativa apenas na velocidade anteroposterior (Vel-AP) no tempo pré-imersão comparado com 40 minutos. Com Olhos Fechados (OF) observou-se diferenças significativas nas seguintes comparações: no Centro-de-Pressão (COP) apenas no momento imediato comparado com 40 minutos; na velocidade AP no momento pré-comparado com o tempo de 40 minutos e no momento imediato comparado com 20 e 40 minutos após; e na velocidade médio-lateral (Vel-ML) no tempo pré-imersão comparado com 20 e 40 minutos após. Os resultados demonstram segurança na realização de atividades após crioterapia.Conclusão Verificou-se melhora do equilíbrio postural após crioimersão nas condições predeterminadas neste estudo.

O significado da prática do método Pilates para as praticantes / The significance of the Pilates method practice for the practitioners

Foi objetivo do presente estudo verificar as características de mulheres praticantes de Pilates e a opinião destas, quanto a particularidades do método. A pesquisa caracterizou-se como não experimental e descritiva, sendo realizada em 10 diferentes estabelecimentos, de três cidades do norte do Paraná, com 45 mulheres, na faixa etária entre 14 e 73 anos (34,5±10,60), praticantes de Pilates há no mínimo seis meses. Uma entrevista semiestruturada com perguntas abertas e fechadas foi realizada. Para análise foram criadas categorias, de forma a agrupar as respostas por afinidade. Foi possível observar que a maioria das praticantes, procuraram a técnica por apresentarem condições patológicas (40%), e encontraram no método tranquilidade, prazer e identificação (42,23%). Aproximadamente 98% declararam não pensar em parar de praticar Pilates, por perceberem mudanças corporais ao longo do tempo. A maior parte relatou conseguir realizar os movimentos com contração dos estabilizadores da coluna (84,44%), correta respiração (91,11%), com concentração (88,88%), além de realizar os movimentos de forma precisa, controlada e com fluidez (91,11%). Concluiu-se que o método Pilates, tem sido procurado principalmente em casos de reabilitação e possibilita às praticantes, prazer e tranquilidade, não oferecendo dificuldades para o aprendizado dos seis princípios básicos.(AU)

The aim of this study was to verify the characteristics of women who practice Pilates and their view, as regards the particularities of the method. The research was characterized as nonexperimental and descriptive, being held in 10 different venues, three cities in Northern Paraná, with 45 women, aged between 14 and 73 years (34.5 ± 10.60), practitioners of Pilates for at least six months. A semi-structured interview with open and closed questions was performed. Categories were created for the analysis in order to group responses by affinity. It was observed that most practitioners, searched for the Pilates due to pathological conditions (40%), and found in the method tranquility, pleasure and identification (42.23%). Approximately 98% reported they were not thinking in stopping to practice Pilates for perceiving bodily changes over time. Most reported ability to perform movements with the contraction of spinal stabilizers (84.44%), proper breathing (91.11%) and concentration (88.88%), and to perform the movements in a precise form, controlled and with fluidity (91.11%). It was concluded that the Pilates method has been searched mainly in cases of rehabilitation and enables the practitioners, pleasure and tranquility, offering no difficulties in the learning of the six basic principles.(AU)

Effects of Pilates on muscle strength, postural balance and quality of life of older adults: a randomized, controlled, clinical trial.

[Purpose] The aim of the present study was to determine the effects of Pilates on lower leg strength, postural balance and the health-related quality of life (HRQoL) of older adults. [Subjects and Methods] Thirty-two older adults were randomly allocated either to the experimental group (EG, n = 16; mean age, 63.62 ± 1.02 years), which performed two sessions of Pilates per week for 12 weeks, or to the control group (CG, n = 16; mean age, 64.21 ± 0.80), which performed two sessions of static stretching per week for 12 weeks. The following evaluations were performed before and after the interventions: isokinetic torque of knee extensors and flexors at 300°/s, the Timed Up and Go (TUG) test, the Berg Balance Scale, and the Health Survey assessment (SF-36). [Results] In the intra-group analysis, the EG demonstrated significant improvement in all variables. In the inter-group analysis, the EG demonstrated significant improvement in most variables. [Conclusion] Pilates exercises led to significant improvement in isokinetic torque of the knee extensors and flexors, postural balance and aspects of the health-related quality of life of older adults.

Efeitos do Pilates na resistência muscular, flexibilidade e equilíbrio de mulheres jovens / Effects of Pilates on muscular endurance, flexibility and balance in young women

Introdução: O método Pilates tem possibilitado melhora da resistência muscular, flexibilidade e equilíbrio, no entanto, pouco se sabe sobre os efeitos na população jovem e em curtos períodos de treinamento. Objetivo: Verificar os efeitos do Pilates em mulheres jovens, sobre a resistência muscular do tronco, flexibilidade e equilíbrio. Métodos: Participaram da pesquisa dez voluntárias, com média de 22,5±1,80 anos. Avaliações pré- e pós-intervenção foram realizadas para resistência muscular dos flexores e extensores do tronco; flexibilidade do quadril em flexão e do tronco em flexão e extensão; e equilíbrio postural estático por meio de uma plataforma de força. As intervenções ocorreram com oito sessões de Pilates ao longo de quatro semanas. Resultados: Foi possível identificar melhora significativa (P<0,05) em todos os testes relacionados à resistência muscular e flexibilidade. Conclusão: Quatro semanas de intervenção com Pilates foi capaz de proporcionar melhora da resistência muscular do tronco e flexibilidade de mulheres jovens.

Introduction: The Pilates method has enabled improvement in muscle strength, flexibility and balance, however, little is known about the effects on young people and in short periods of training. Objective: To investigate the effects of Pilates in young women, on the trunk muscle endurance, flexibility and balance. Methods: Participants were ten volunteers, with a mean of 22.5±1.80 years. Pre- and post-intervention were performed for muscle strength of the trunk flexors and extensors; flexibility in flexion of the hip and trunk flexion and extension; and static postural balance through a force platform. The interventions occurred with eight Pilates sessions over four weeks. Results: It was possible to identify a significant improvement (P<0.05) in all tests related to muscle strength and flexibility. Conclusion: Four weeks of intervention with Pilates was able to provide improved muscle strength and flexibility of the trunk of young women.