Yield of overnight pulse oximetry in screening commercial drivers for obstructive sleep apnea.

PURPOSE: To assess the efficacy of overnight pulse oximetry in screening male commercial drivers (CDs) for obstructive sleep apnea (OSA). METHODS: Consecutive male CDs undergoing their annual scheduled occupational health visit were enrolled from ten transportation facilities. All subjects underwent a home sleep apnea test (HSAT) to determine the Respiratory Event Index (REI). Oxygen desaturation indices (ODIs) below the 3% and 4% thresholds were computed using the built-in HSAT pulse oximeter. We then assessed the association between ODI values and the presence of OSA (defined as an REI ≥ 5 events/hour) as well as moderate to severe OSA (REI ≥ 15 events/hour). RESULTS: Of 331 CDs recruited, 278 (84%) completed the study protocol and 53 subjects were excluded due to inadequate HSAT quality. The included and excluded subjects were comparable in demographics and clinical characteristics. The included CDs had a median age of 49 years (interquartile range (IQR) = 15 years) and a median body mass index of 27 kg/m2 (IQR = 5 kg/m2). One hundred ninety-nine (72%) CDs had OSA, of which 48 (17%) were with moderate OSA and 45 (16%) with severe OSA. The ODI3 and ODI4 receiving operating characteristic curve value were 0.95 for predicting OSA and 0.98-0.96 for predicting moderate to severe OSA. CONCLUSION: Overnight oxygen oximetry may be an effective means to screen CDs for OSA.

Poor performance of screening questionnaires for obstructive sleep apnea in male commercial drivers.

PURPOSE: Screening commercial drivers (CDs) for obstructive sleep apnea (OSA) reduces the risk of motor vehicle accidents. We evaluated the accuracy of standard OSA questionnaires in a cohort of CDs. STUDY DESIGN AND METHODS: We enrolled consecutive male CDs at 10 discrete transportation companies during their yearly scheduled occupational health visit. The CDs had their anthropometric measures taken; completed the Berlin, STOP, STOP-BANG, OSAS-TTI, SACS, EUROSAS, and ARES questionnaires; and underwent a home sleep apnea test (HSAT) for the determination of their respiratory events index (REI). We assessed the questionnaires' ability to predict OSA (REI ≥ 5 events/h) and moderate-to-severe OSA (REI ≥ 15 events/h). RESULTS: Among 315 CDs recruited, 243 (77%) completed the study protocol, while 72 subjects were excluded for inadequate HSAT quality. The demographics and clinical data were comparable in both the included and excluded subjects. The included CDs had a median age of 50 years (interquartile range (IQR) 25-70) and a mean body mass index of 27 ± 4 kg/m2. One hundred and seventy-one subjects (71%) had OSA, and 68 (28%) had moderate-to-severe OSA. A receiver operating characteristic curve of the questionnaires were 0.51-0.71 for predicting OSA and 0.51-0.66 for moderate-to-severe OSA. The STOP-BANG questionnaire had an unsatisfactory positive predictive value, while all of the other questionnaires had an inadequate negative predictive value. CONCLUSIONS: Standard OSA questionnaires are not suited for screening among CDs. The use of the HSAT could provide an objective evaluation of for OSA in this special population.

Static postural sway of women with and without fibromyalgia syndrome: A cross-sectional study.

BACKGROUND: There is a frequent complaint about balance problems among fibromyalgia syndrome patients; however, there are not enough studies that have shown static postural sway of women with fibromyalgia syndrome. This study aimed to compare static postural sway of women with and without fibromyalgia syndrome. METHODS: This is a cross-sectional study in which twenty-nine women with fibromyalgia syndrome and 20 without took part. A posturography evaluation was performed in six different situations (bipedal, right tandem and left tandem, with eyes opened and closed), and questionnaires for clinical depression symptoms, clinical anxiety symptoms, sleep quality, and Visual Analogue Scales for Pain and Fatigue were applied. Mann-Whitney U test was used to check differences among groups; Wilcoxon matched-pair test was used to check differences intragroup; Cohen d coefficient was used to measure effect sizes and Pearson Correlation Coefficient was used for correlations among variables. Level of significance adopted was 5%. FINDINGS: Women with fibromyalgia syndrome have presented worse postural sway than women without fibromyalgia syndrome in all situations (P<0.05), and worse scores in all questionnaires (P<0.05). In the eyes closed situations, women with fibromyalgia syndrome presented worse postural sway than women without in the same conditions. INTERPRETATION: Women with fibromyalgia syndrome have worse performance in the static posture test, more prominent in reduced support bases with eyes closed. Pain, fatigue, depression and anxiety may have directly influenced postural sway in fibromyalgia syndrome patients.

Avaliação da curvatura torácica e da presença de dor em mulheres de diferentes faixas etárias / Evaluación de la curvatura torácica y de la presencia de dolor em mujeres con diferentes rangos de edad / Evaluation of the thoracic curvature and the presence of pain in women of different age groups

Demonstrar a utilização do método flexicurva para avaliação e comparação da cifose torácica em mulheres saudáveis de diferentes faixas etárias, além de detectar se há correlação entre dor e grau de cifose torácica utilizando-se a Escala Visual Analógica (EVA). MÉTODOS: o estudo foi composto por um grupo de mulheres G1 (n=24), com média de 20,67±1,69 anos e outro grupo G2 (n=24), com média de 65,63 ±8,07 anos, que foram submetidas à avaliação da curvatura torácica, com a utilização do método flexicurva, e dor nas costas, com a EVA. RESULTADOS: foi encontrada uma diferença estatisticamente significante no ângulo de cifose torácica no grupo 2 quando comparada ao grupo 1 e uma fraca correlação entre o ângulo de cifose torácica e a classificação da dor pela escala EVA nos grupos 1 e 2. CONCLUSÃO: o grupo 1 apresentou um grau de curvatura torácica dentro da normalidade e o grupo 2 apresentou um exacerbado grau de cifose torácica, caracterizando-se como hipercifose. Entretanto, não houve correlação entre dor e grau de cifose torácica em ambos os grupos.

To demonstrate the use of the flexicurve method for evaluation and comparison of thoracic kyphosis in healthy women of different ages, and to observe if there is a correlation between degree of pain and thoracic kyphosis using the Visual Analog Scale (VAS). METHODS: the study was composed by a group of young G1 (n = 24) and another group G2 (n = 24) which were submitted for evaluation of thoracic curvature (using the flexicurve method) and back pain (using VAS). RESULTS: found a statistically significant difference in the angle of thoracic kyphosis in group 2 compared to group 1 and a weak correlation between the angle of thoracic kyphosis and pain classification of the VAS - in groups 1 and 2. CONCLUSION: the group 1 showed a normal degree of thoracic curvature and the group and group 2 showed a exacerbated degree of thoracic kyphosis, characterizing themselves as hiperkyphosis. However, there was no correlation between degree of pain and thoracic kyphosis in both groups.

Demostrar la utilización de este método flexicurva para la evaluación y la comparación de cifosis torácica en mujeres sanas de diferentes edades, y si hay correlación entre el grado de dolor y la cifosis torácica mediante una Escala Analógica Visual (EVA). MÉTODOS: el estudio se compone de un grupo de mujeres G1 (n = 24), con un promedio de 20,67 ± 1,69 años y otro grupo G2 (n = 24), con un promedio de 65,63 ± 8,07 años, que fueron presentados para la evaluación de pecho curvatura (utilizando el método flexicurva) y dolor de espalda (usando la EVA). RESULTADOS: se encontró una diferencia estadísticamente significante en el ángulo de cifosis torácica en el grupo 2 en comparación con el grupo 1 y una correlación débil entre el ángulo de cifosis y la clasificación del dolor en el pecho de la Escala Analógica Visual de los grupos 1 y 2. CONCLUSIÓN: el grupo 1 mostraron un grado de curvatura de pecho dentro del rango normal, Grupo 2 ha exacerbado un cierto grado de cifosis torácica, que caracterizan a sí mismo como hipercifose. Sin embargo, no hubo correlación entre el grado de dolor y la cifosis torácica en ambos grupos.

Body balance evaluation in osteoporotic elderly women.

SUMMARY: Osteoporotic Brazilian women balance was evaluated by timed up and go test (TUG) and to the Berg balance scale (BBS). In the BBS, women with and without osteoporosis had normal range scores, even with history of fall. In the TUG test, women with osteoporosis were slower, but in the normal parameter. Results suggest that the references values of these tests are not appropriate for Brazilians. PURPOSES: The purposes of this study were to evaluate balance and functional mobility in women with osteoporosis and without osteoporosis and to verify if the history of falls has association to the TUG and to the BBS, both largely used in the clinical practice. MATERIALS AND METHODS: Forty-five women were divided into three groups: group 1, young women with normal body mineral density (BMD); group 2, elderly with normal BMD; and group 3, elderly with osteoporosis. BBS and TUG were performed, and the history of falls was collected. RESULTS: BBS and TUG showed differences in the scores obtained for young women compared with both elderly with and without osteoporosis. In the TUG test, there were differences between elderly with and without osteoporosis. The fall's history did not present correlations either for TUG or BBS. CONCLUSIONS: Although the results showed that all women were within the normal range for BBS and TUG, the results suggest that the reference values for TUG and BBS are not appropriate for Brazilian population.

Traumatismo raqui-medular infantil / Spinal cord injury in children

A lesão medular infantil apresenta um índice de incid~encia menor comparado ao adulto, entretanto, a compreensão dos porblemas secundários que podem ocorrer após a lesão e suas formas de prevenção é de extrema importância para evitar que a criança fique debilitada em plena fase de crescimento e desenvolvimento. A compreensão das diferenças entre a lesão medular em adultos e e crianças ajudará o fisioterapeuta a ser mais efetivo em seu trabalho, a fim de estimular o maior grau possível de independência da criança. O objetivo desta revisão da literatura é elucidar os problemas ocorridos pelo traumatismo raqui-medular infantil e comoa Fisioterapia deve atuar para beneficiar o desenvolvimento e o aumento da independência das crianças, melhorando a qualidade de vida a curto e a longo prazos. Para a realização do levantamento bibliográfico, foram consultadas as bases de dados Pubmed, Scielo, Lilacs e Medline, referentes às publicações dos últimos 17 anos. Os estudos mostraram que a fisioterapia auxilia na manutenção ou melhora da integridade artticular, óssea e da pele, da função intestinal e vesical, normalização do tõnus, melhora do condicionamento cardiorrespiratórios, aumento d aindependência e da capacidade de realização das atividades da vida diária, afim de resultar em uma vida adulta mais produtiva e satisfatória na sociedade