ABSTRACT
QUESTION: What is the effect of a protocol targeted at the various stages of labour - with a peanut ball, positioning and pelvic mobility - on the duration of labour, pain severity, fatigue, maternal outcomes, neonatal outcomes and satisfaction in parturients without analgesia? DESIGN: A randomised trial with concealed allocation, blinding of assessors and intention-to-treat analysis. PARTICIPANTS: One hundred women in active labour. INTERVENTION: The experimental group received the protocol targeted at the various stages of labour, with a peanut ball, positioning and pelvic mobility, whilst the control group received usual care. OUTCOME MEASURES: The primary outcomes were the duration of labour and pain severity. The secondary outcomes were maternal fatigue, mode of delivery, risk of perineal laceration, severity of perineal laceration, use of synthetic oxytocin, satisfaction with delivery, Apgar scores, admission of the neonate to an intensive care unit and resuscitation of the neonate in the delivery room. In the active phase of labour, the numerical rating scale and maternal perception of childbirth fatigue questionnaire were applied; they were taken again when the parturient had 8 to 10 cm of dilation. The numerical rating scale was also applied postpartum to evaluate satisfaction with childbirth. RESULTS: The use of the protocol with a peanut ball reduced the duration of active and expulsive phases and the total duration of labour, with mean differences of 82 minutes (95% CI 41 to 125), 8 minutes (95% CI 0 to 18) and 89 minutes (95% CI 45 to 132), respectively. Maternal satisfaction was better in the experimental group: mean between-group difference on the 10-point scale was 1.1 (95% CI 0.4 to 1.8). The effects on the other outcomes were either similar between groups or unclear. CONCLUSION: A protocol with a peanut ball, positioning and pelvic mobility reduced the duration of labour and improved maternal satisfaction with childbirth. REGISTRATION: RBR-74wcnjc.
Subject(s)
Lacerations , Female , Humans , Infant, Newborn , Pregnancy , Pain Management/methodsABSTRACT
BACKGROUND: The use of unstable surfaces has been proposed to increase the neuromuscular demand. This strategy has been adopted to generate an increase in the activity of periscapular muscles due to its role in the stabilization of the scapula. However, the influence of this instability on the EMG activity remains uncertain. The aim of this study was to analyze the effects of using unstable surfaces on the EMG activity of the periscapular muscles. METHODS: A comprehensive search in the PubMed, EMBASE, SCIELO, Web of Science, SCOPUS, Cochrane and LILACS databases was undertaken from their year of inception up to December 2019. Studies which directly investigated the EMG activity of periscapular muscles in healthy individuals while performing exercises for the upper limbs in stable and unstable conditions. RESULTS: A total of 33 studies which evaluated a total of 678 healthy individuals were found according to the eligibility criteria. A meta-analysis identified that the EMG activity of the upper trapezius showed a trivial increase with the insertion of the unstable surface (P = 0.04; SMD = 0.14 [95%CI 0.00, 0.27]). No significant effects were observed on the middle trapezius (P = 0.10) and lower trapezius (P = 0.25). A decrease of the anterior serratus EMG activity with a small effect size was observed by implementing an unstable surface (P = 0.01; SMD = -0.21 [95%CI -0.36, -0.05]). CONCLUSION: The use of unstable surfaces generated a trivial increase in the upper trapezius activity, and a slight decrease in the anterior serratus activity. No effect was observed on the middle and lower trapezius.
Subject(s)
Exercise , Superficial Back Muscles , Electromyography , Exercise Therapy , Humans , Muscle, Skeletal , ScapulaABSTRACT
Comparar dois diferentes métodos indiretos de estimativa do percentual de gordura corporal em adolescentes escolares. Métodos: Estudo analítico, de caráter transversal, realizado com 300 escolares entre 12 e 17 anos na cidade de Petrolina, Pernambuco, Brasil.Todos foram submetidos à avaliação antropométrica, tendo os percentuais de gordura corporal estimados por dobras cutâneas e bioimpedância elétrica (BIA) bipolar. Os testes seguiram os procedimentos recomendados e os avaliados estavam vestidos segundo recomendações. Os distintos percentuais de gordura corporal foram comparados através do teste não paramétrico de Wilcoxon e correlacionados pelo coeficiente de correlação linear de Spearman, com nível de significância de p?0,05. Resultados: A mediana (intervalo interquartil) de idade dos avaliados foi de 13,0 (13,0-15,0) anos, sendo 214 (71,3%) meninas. Os métodos comparados apresentaram forte correlação linear positiva (r=0,76; p<0,001). Porém, os 26,9% (26,5-28,2) de gordura obtidos por dobras cutâneas são estatisticamente diferentes (p<0,001) dos 22,3% (21,6-23,1) verificados por BIA. Em ambos os gêneros e em todas as idades, o percentual de gordura estimado por dobra cutânea foi maior que o estimado por BIA, entretanto, os métodos apresentam boa correlação (p<0,0001). Conclusão: Os percentuais de gorduracorporal mensurados pelo método antropométrico (dobras cutâneas) e pela bioimpedância bipolar apresentam uma correlação forte e significativa em adolescentes escolares. Nesse âmbito, BIA configura-se como opção interessante para monitorizar e avaliar as alterações no estado nutricional desta população...
To compare two different indirect methods for measuring body fat percentage in adolescent students. Methods: Analytical cross-sectional study conducted with 300 adolescent students from 12 to 17 years old in the city of Petrolina, state of Pernambuco. All patients underwent anthropometric assessment. The body fat percentage was estimated through skinfold thickness and bipolar bioelectrical impedance analysis (BIA). The tests followed recommended procedures and subjects were properly dressed for the assessment. The different body fat percentages were compared using the Wilcoxon nonparametric test and correlated by Spearman?s rank correlation coefficient with a significance level of p?0.05. Results: The median (interquartile range) age of the subjects was 13.0 (13.0?15.0) years with a total number of 214 (71.3%) girls. The compared methods showed strong positive linear correlation (r=0.76, p<0.001). However, the 26.9% (26.5?28.2) rate of fat obtained through skinfold thickness is statistically different (p<0.001) from the 22.3% (21.6?23.1) rateobtained through BIA. In both genders and at all ages the percentage of fat estimated through skinfold thickness was higher than the one estimated through BIA. However, the methods presented a good correlation (p<0.0001). Conclusion: The body fat percentage measured through anthropometric assessment (skinfold thickness) and bipolar bioelectrical impedance analysis have a strong significant correlation in adolescent students. In this context, BIA appears as an interesting option to monitor and assess changes in the nutritional status of this population...
Comparar dos distintos métodos de estimación del porcentual de grasa corporal en adolescentes escolares. Métodos: Estudio analítico de carácter trasversal realizado com 300 estudiantes entre los 12 y 17 años en la ciudad de Petrolina, Pernambuco, Brasil. Todos fueron sometidos a la evaluación antropométrica con los porcentuales de grasa corporal estimados por pliegues cutáneos y bioimpedância eléctrica (BIA) bipolar. Las pruebas siguieron los procedimientos recomendados y losevaluados estaban vestidos según las recomendaciones. Los distintos porcentuales de grasa corporal fueron comparados a través de la prueba no paramétrica de Wilcoxon y correlacionados por el coeficiente de correlación linear de Spearman con nível de significancia de p?0,05. Resultados: La mediana (intervalo intercuartil) de edad de los evaluados fue de 13,0 (13,0?15,0) años siendo 214 (71,3%) niñas. Los métodos comparados presentaron fuerte correlación linear positiva (r=0,76; p<0,001). Sin embargo, el 26,9% (26,5?28,2) de grasa obtenidos por los pliegues cutáneos son estadísticamente diferentes (p<0,001) de los 22,3% (21,6?23,1) verificados por la BIA. En ambos géneros y en todas las edades el porcentual de grasa estimado por el plieguecutáneo fue mayor que el estimado por la BIA, sin embargo, los métodos presentan buena correlación (p<0,0001). Conclusión: Los porcentuales de grasa corporal medidos por el método antropométrico (pliegues cutáneos) y por la bioimpedância bipolar presentan una correlación fuerte y significativa em adolescentes escolares. En ese ámbito, la BIA se configura como interesante opción para monitorear y evaluar las alteraciones em el estado nutricional de esa población...
