A pilot observational study to identify reference values for the 6-minute walk test in Brazilian people with hypertension / Um estudo observacional piloto para identificar valores de referência para o teste de caminhada de 6 minutos em hipertensos brasileiros

Abstract Introduction Systemic arterial hypertension (SAH) is responsible for 9.5 million deaths in the global popu-lation. Lifestyle factors, including physical inactivity, are important modifiable risk factors in the development of SAH. Thus, physical exercise has been shown to be effective to control SAH and before the prescription, the six-minute walk test (6-MWT) has been commonly used to assess the physical capacity. Objective To propose reference values for the 6-MWT test in Brazilian people with SAH. Methods A cross-sectional observational study was conducted with 302 hypertensive subjects (62.61 + 10.93 years) admitted to a cardiac rehabilitation program. Participants were divided into different age quartiles and submitted to 6-MWT. The walking distance data was compared between the quartiles and adjusted by mul-tiple linear regression analysis. Results The hypertensive subjects walked 388.07 + 115.03 m during the 6-MWT. No significant difference between the genders was found. However, when the age quartiles were compared, for the 46-59 age group, the women walked less than the men. Intra-group comparisons showed that the distance walked in the 6-MWT decreased with the increase in age, in both men and women. Conclusion The present study provides reference values for the 6-MWT, both for Brazilian men and women of different age groups. This data may be an important parameter for future clinical studies, prevention strategies, and clinical intervention.

Resumo Introdução A hipertensão arterial sistêmica (HAS) é respon-sável por 9,5 milhões de mortes na população mundial. Con-dições do estilo de vida, incluindo a inatividade física, são importantes fatores de risco modificáveis no desenvolvimento da HAS. Desse modo, o exercício físico tem se mostrado eficaz no controle da HAS e, antes da prescrição, o teste de caminhada de seis minutos (TC6) tem sido comumente utilizado para ava-liar a capacidade física. Objetivo Propor valores de referência para o teste de TC6 em brasileiros com HAS. Métodos Realizou-se um estudo observacional transversal com 302 hipertensos (62,61 + 10,93 anos) admitidos em um programa de reabilitação cardíaca. Os participantes foram divididos em diferentes quartis de idade e submetidos ao TC6. Os dados de distância percorrida foram comparados entre os quartis e ajustados por análise de regressão linear múltipla. Resultados Os hipertensos caminharam 388,07 + 115,03 m durante o TC6. Não encontrou-se diferença significativa entre os gêneros. No entanto, quando comparados os quartis de idade, para a faixa etária de 46 a 59 anos, as mulheres caminharam menos do que os homens. As comparações intragrupo mostraram que a distância percorrida no TC6 diminuiu com o aumento da idade, tanto em homens quanto em mulheres. Conclusão O presente estudo fornece valores de referência para o TC6, tanto para homens quanto para mulheres brasileiras de diferentes faixas etárias. Esses dados podem ser um parâmetro importante para futuros estudos clínicos, estratégias de prevenção e intervenção clínica.

Effect of Exergaming on Quality of Life, Fatigue, and Strength and Endurance Muscle in Cancer Patients: A Randomized Crossover Trial.

Objective: To analyze the influence of exergaming (EXE) quality of life, cancer-related fatigue (CRF), electromyography, and strength and endurance muscle in a randomized crossover trial. Methods: We conducted a single-blinded, randomized, and crossover trial, which included 38 cancer volunteers undergoing chemotherapy (Age = 60.07 ± 12.10 years; body mass index = 26.79 ± 5.33 kg/m2). All volunteers were randomized into two intervention moments: EXE and without intervention (WI) and after 1-month washout period of crossing of the evaluated moments. The intervention was performed on an EXE protocol using Xbox 360 Kinect®, with the game "Your Shape Fitness Evolved 2012" two to three times per week for 20 sessions. All volunteers were assessed the CRF and quality-of-life levels through the Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F) questionnaire, the median frequency (MDF) by surface electromyography, maximal voluntary isometric contraction (MVIC), and the muscle endurance time at 80% MVIC of the dorsiflexors and plantar flexors using dynamometer. Results: In the comparison between EXE and WI moments, were observed increase in the scores for quality of life (P < 0.001), subscale fatigue (P < 0.001), in the MDF values of right lateral gastrocnemius muscles: P = 0.017, muscle endurance time (left dorsiflexion [LDF]: P < 0.001; right dorsiflexion [RDF]: P < 0.001; left plantar flexion [LPF]: P < 0.001; RPF: P = 0.039), and muscle strength (LDF: P < 0.001; RDF: P < 0.001; LPF: P = 0.002). Conclusion: The crossover study, the EXE protocol promoted improvement in cancer-related fatigue (CRF) and quality of life, increased MVIC, endurance time, and MDF values of the dorsiflexor and plantar flexor muscles of cancer volunteers undergoing chemotherapy.

Aquatic Exercise on Brain Activity in Type 2 Diabetic: Randomized Clinical Trial.

BACKGROUND: A water-based physical exercise program is extremely important for the rehabilitation of type 2 diabetes. Little is known about its action on cerebral electrical activity. OBJECTIVE: To evaluate the effect of a water-based physical exercise protocol on electroencephalographic activity, blood glucose levels, and functional capacity, as well as their correlation, in type 2 diabetics. METHODS: Study design: Randomized Clinical Trial. Forty volunteers were randomized into two groups: control (n = 20) and study (n = 20). A water-based physical exercise program comprising 50 min sessions was conducted three times a week for five weeks. Assessments were performed at the pre- and post-intervention and follow-up phases. The qualitative data were compared using the Mann-Whitney test and Chi-Square. Quantitative data were compared using the Kruskal-Wallis, Independent t, and ANOVA mixed tests. The Spearman correlation coefficient was used to correlate the data. RESULTS: The data were similar when comparing the groups. Six-minute walk test data increased in the comparison between times (p = 0.01-PrexPos). EEG data decreased in comparison between times (prexfollow-up-p < 0.05), except AF3. EEG data decreased in the timexgroup comparison (prexfollow-up and postxfollow-up-p < 0.05). CONCLUSIONS: The water-based exercise protocol maintained electroencephalographic activity, glucose levels, and functional capacity in people with type 2 diabetes, and there was no relationship between brain electrical activity and capillary blood glucose.

The respiratory effects of a Pilates method protocol: Randomized clinical trial.

OBJECTIVES: To evaluate the respiratory effects of a Pilates method (PM) protocol in adult women. DESIGN: Single-blind randomized controlled trial. SETTINGS: Healthy women were randomized into two groups using the Random.org online tool: a Pilates group (PG) (n = 33) and a control group (CG) (n = 29). PARTICIPANTS: Sixty-two healthy women, aged 18-44 years, sedentary or irregularly active B (as defined by the international physical activity questionnaire [IPAQ]). The intervention consisted of 16 sessions of PM. protocol twice a week for the PG. The CG without intervention. MAIN OUTCOMES MEASURES: The variables evaluated were maximal inspiratory pressure (MIP), maximal expiratory pressure (MEP), peak expiratory flow (PEF), tidal volume (TV), respiratory frequency (RF), minute volume (MV), and slow vital capacity (SVC). RESULTS: The results showed significant evidence of the beneficial respiratory effects of the PM protocol when the PG was compared with the CG: increased MIP (p = 0.001), and a significant increase in TV (p = 0,047). CONCLUSION: The PM protocol used in this study may be effective for respiratory muscle strength because it improved MIP and TV. CLINICAL TRIAL REGISTRATION: https://ensaiosclinicos.gov.br/rg/RBR-5b6wc3.

Efeito da reabilitação cardíaca sobre o limiar nociceptivo aumentado de indivíduos hipertensos / Effect of cardiac rehabilitation on the nociceptive threshold increased of hypertensive subjects

Objetivos: Indivíduos hipertensos apresentam um limiar nociceptivo aumentado, o que pode contribuir para uma redução da percepção da dor. Assim, o objetivo deste estudo foi avaliar o efeito de um programa de reabilitação cardíaca (PRC) sobre limiar nociceptivo aumentados de indivíduos hipertensos. Métodos: Quarenta e um participantes foram divididos em dois grupos: grupo normotenso e grupo hipertenso. Nos dois grupos, foram avaliados a massa corporal, índice de massa corporal (IMC), circunferência abdominal, pressão arterial sistólica e diastólica, frequência cardíaca, limiar nociceptivo e a capacidade funcional pelo teste de caminhada de seis minutos (TC6). O PRC foi composto de exercícios aeróbicos em esteira com duração de 30 minutos, 3 vezes por semana, durante 7 semanas. Resultados: Após o PRC, houve uma significativa redução (p < 0,001) no limiar mecânico nociceptivo e um aumento na distância percorrida durante o TC6 (p < 0,001) no grupo composto por indivíduos hipertensos. Conclusão: Os resultados do presente estudo sugeriram que o exercício aeróbico é uma modalidade importante para normalizar o limiar nociceptivo e melhorar a capacidade funcional de indivíduos hipertensos.

Effect of aerobic exercise on functional capacity and quality of life in individuals with Parkinson's disease: A systematic review of randomized controlled trials.

OBJECTIVES: To investigate the effect of aerobic exercise (AE) on functional capacity and quality of life in individuals with Parkinson's disease (PD) in the mild to moderate stages. DATA SOURCES: Medline, Embase, Web of Science, The Cochrane Library, Lilacs and PEDro were searched from inception until January 2021 using the MeSH terms. STUDY SELECTION: Studies conducted in individuals with PD involving AE compared to a control group were included. DATA EXTRACTION: Characteristics of the studies were independently extracted by two reviewers. The PEDro scale was used to assess the methodological quality, and the level of evidence was analyzed and synthesized using the GRADE approach. DATA SYNTHESIS: Of the ten studies, 411 individuals with PD were included. The level of synthesized evidence for cardiorespiratory function was low and without effect, and very low and without effect. For gait was very low and with effect for speed and stride length and without effect for cadence. For mobility was very low and with effect. For muscle strength was very low and with effect for the lower limbs as well as without effect for the upper limbs. For postural balance was very low and without effect. For quality of life was low and without effect. CONCLUSION: Aerobic exercise was capable of promoting improvements in gait (walking speed and stride length), mobility, and lower limb muscle strength in individuals with PD in the mild to moderate stages. No significant improvement in quality of life was found due to the practice of AE.

Influence of an Exergaming Training Program on Reducing the Expression of IL-10 and TGF-ß in Cancer Patients.

Objective: To evaluate the effect of exergaming in the plasma levels of adipokines (interleukin [IL]-1ß, IL-6, IL-8, and tumor necrosis factor-alpha [TNF-α]), Th1 (IL-2, IL-12, and interferon gamma [IFN-γ]), Th2 (IL-4 and IL-33), Th17 (IL-17 and IL-23), and regulatory T (Treg) (IL-10 and transforming growth factor-beta [TGF-ß]) in cancer patients undergoing treatment. Materials and Methods: We conducted a quasi-experimental control clinical trial using exergaming in all groups through the Xbox 360 Kinect™. The game used in this study was called Your Shape Fitness Evolved 2012. The volunteer participants played the game two to three times per week, for a total of 20 sessions. Forty-five volunteer participants were divided into 3 groups: cancer patients undergoing chemotherapy and/or radiotherapy treatment (chemotherapy and/or radiotherapy group CRG; n = 15); cancer patients who finished chemotherapy and/or radiotherapy treatment (cancer accompaniment group CAG; n = 15); and the control group (volunteers without a cancer diagnosis CG; n = 15). In the pre- and post-training period, all volunteers submitted to blood collection procedures using the enzyme-linked immunosorbent assay (ELISA). This test was used to obtain the levels of adipokines expression (IL-1ß, IL-6, IL-8, and TNF-α) and the cytokine profiles Th1 (IL-2, IL-12, and IFN-γ), Th2 (IL-4 and IL-33), Th17 (IL-17 and IL-23), and Treg (IL-10 and TGF-ß). Results: After exergaming, the CRG showed significant reductions in proinflammatory cytokines (IL-6: P < 0.05; IL-10: P = 0.038; TGF-ß: P = 0.049) and for CAG (IL-10: P = 0.034), as well as a reduction in the expression of cytokines related to the action of T lymphocytes. Conclusion: Exergaming promoted changes in the expression of cytokine profiles IL-6, IL-10, and TGF-ß, which correlated with the action profiles of CD4+ T lymphocytes.

Effect of Exergaming on Muscle Strength, Pain, and Functionality of Shoulders in Cancer Patients.

Objective: To compare the strength of the middle deltoid muscle by means of dynamometry and the Shoulder Pain and Disability Index (SPADI) in participants in treatment for cancer after the practice of an exergaming protocol. Materials and Methods: We conducted a randomized controlled clinical trial. Thirty-eight voluntary participants were divided into two groups: cancer group (n = 19; age = 61.46 ± 8.79 years; body mass index [BMI] = 28.36 ± 4.94 kg/m3) and control group (n = 19; age = 57.62 ± 7.57 years; BMI = 28.06 ± 3.74 kg/m3), and they participated in the study. All participants performed an exergame protocol by using Xbox 360 Kinect® (Microsoft, Redmond) with the game Your Shape Fitness Evolved 2012 two to three times per week for 20 sessions. They were evaluated through the isometric dynamometer in the middle deltoid muscle and the SPADI at three moments: preintervention (EV1), after 10 sessions (EV2), and after 20 sessions (EV3). Results: The cancer group scored higher on both the disability index, in all three evaluations, and the pain index, in EV2 and EV3, when compared with the control group. There was a significant reduction in the disability score in EV2 and EV3 when compared with EV1 in the cancer group, whereas pain was lower in EV2 and EV3 when compared with EV1 in the control group. There were no significant interevaluation or intergroup differences in the maximal isometric voluntary contraction of the deltoid muscle of both upper limbs. Conclusion: At the end of the exergaming, protocol reduced the disability of the shoulder joint of the cancer group and decreased the differences between the groups for disability and pain scores, without changing isometric force.

Análise da Fadiga Relatada e das Forças Musculares Respiratória e Periférica em indivíduos com Câncer em Tratamento / Analysis of Reported Fatigue and of Respiratory and Peripheral Muscle Strength in Individuals with Cancer Undergoing Treatment / Análisis de la Fatiga Reportada e de las Fuerzas Musculares Respiratoria y Periférica en Individuos con Cáncer Sometidos a Tratamiento

Introdução: Nos últimos anos, o tratamento do câncer evoluiu, possibilitando uma maior sobrevida ao paciente, porém os efeitos colaterais, como a diminuição da imunidade e a fadiga, influenciam o sistema respiratório e muscular. Objetivo: Analisar a fadiga e as forças musculares respiratória e periférica em voluntários com câncer em tratamento e em indivíduos saudáveis. Método: Trata-se de um estudo analítico, observacional, transversal e controlado. Os indivíduos foram distribuídos em dois grupos: um grupo de câncer em quimioterapia e/ou em radioterapia (GCA: n=98; homens=35,72%; mulheres=64,28%; idade=58,13±13,26 anos; índice de massa corporal (IMC=26,23±4,04 kg/m2; tempo de diagnóstico de câncer=27,54±9,61 meses) e um grupo controle (GC: n=86; homens=30,23%; mulheres=69,77; idade=59,24±12,87 anos; IMC=26,76±4,04 kg/m2). Para todos os indivíduos, a fadiga relatada foi avaliada, usando-se a subescala de fadiga do questionário The Functional Assessment of Cancer Therapy-Fatigue (FACT-F). A avaliação das pressões respiratórias máximas foi realizada por meio da manovacuometria e da força de preensão palmar por intermédio da dinamometria manual. Resultados: O GCA apresentou maior índice de fadiga relatada (p<0,001; f2=0,382), valores inferiores para as variáveis respiratórias (PImax: p<0,001; f2=0,441; PEmax: p<0,001; f2=0,361), força de preensão palmar esquerda (p=0,024 f2=0,182), se comparado ao GC. Conclusão: Voluntários com câncer em quimioterapia e/ou em radioterapia apresentaram maiores níveis de fadiga relatada, com reduções da força muscular respiratória e da força de preensão palmar.

Introduction: In recent years, cancer treatment has evolved, allowing longer survival for the patient, but, side effects such as a decreased immunity and fatigue influence the respiratory and muscular systems. Objective: Analyze fatigue, the respiratory and peripheral muscle strength in individuals with cancer undergoing treatment and in healthy individuals. Method: Analytical, observational, cross-sectional, and controlled study. The individuals were divided into two groups: a cancer group in chemotherapy and/or radiotherapy (GCA: n = 98; men = 35.72%; women = 64.28%; age = 58.13 ± 13.26 years; body mass index (BMI) = 26.23 ± 4.04 kg/m2; time of cancer diagnosis = 27.54 ± 9.61 months) and a control group (CG: n = 86; men = 30.23%; women = 69.77; age = 59.24 ± 12.87 years; BMI= 26.76 ± 4.04 kg/m2). For all the individuals, the reported fatigue was assessed using the fatigue subscale of The Functional Assessment of Cancer Therapy-Fatigue (FACT-F) questionnaire. The evaluation of maximal respiratory pressures was performed by manovacuometry and the palmar grip strength by manual dynamometry. Results: The GCA showed the highest reported fatigue index (p<0.001; f2=0.382), lower values for respiratory variables (PImax: p<0.001; f2=0.441; PEmax: p<0.001; f2=0.361), left palmar grip strength (p=0.024; f2=0.182), when compared to the CG. Conclusion: Volunteers with cancer in chemotherapy and/or radiotherapy presented higher levels of reported fatigue, with reductions in respiratory muscle strength and palmar grip strength.

Introducción: En los últimos años, el tratamiento oncológico ha evolucionado, permitiendo una supervivencia más larga para el paciente, pero los efectos secundarios como la disminución de la inmunidad y la fatiga influyen en los sistemas respiratorios y musculares. Objetivo: Analizar la fatiga e las fuerzas musculares respiratoria y periférica en individuos con cáncer sometidos a tratamiento y en individuos sanos. Método: Se trata de un estudio analítico, observacional, transversal y controlado. Los individuos fueran divididos en dos grupos: un grupo de cáncer bajo quimioterapia y/o radioterapia (GCA: no 98; hombres 35,72%; mujeres 64,28%; edad 58,13±13,26 años; indice de masa corporal (IMC) a 26,23±4,04 kg/m2; diagnóstico de cáncer 27,54±9,61 meses) y un grupo de control (CG: no 86; hombres 30,23%; mujeres 69,77; edad de 59,24±12,87 años; IMC 26,76±4,04 kg/m2). Para todos los voluntarios, la fatiga notificada se evaluó utilizando la subescala de fatiga del cuestionario The Functional Assessment of Cancer Therapy-Fatigue(FACT-F). La evaluación de las presiones respiratorias máximas se realizó mediante manovacuometría y fuerza de agarre palmar mediante dinamometría manual. Resultados:El GCA tuvo el índice de fatiga notificado más alto (p<0,001; f2=0,382), valores más bajos para las variables respiratorias (PImax: p<0,001; f2= 0,441; PEmax: p<0,001; f2=0,361), fuerza de agarre palmar izquierda (p=0,024; f2=0,182), en comparación con el GC. Conclusión: Voluntarios con cáncer en quimioterapia y/o radioterapia presentaron mayores niveles de fatiga reportados, con reducciones en la fuerza muscular respiratoria y fuerza de agarre palmar.

Correlation Between the Trajectory of the Center of Pressure and Thermography of Cancer Patients Undergoing Chemotherapy.

OBJECTIVE: The purpose of this study was to correlate potential the stabilometric parameters of baropodometry with the superficial temperature of the legs of cancer patients during and after treatment. METHODS: This study included 30 volunteers of both sexes, divided into the following groups: chemotherapy-radiotherapy group (n = 15; age = 57.13 ± 16.74 years) and cancer group without current treatment (n = 15; age = 63.29 ± 7.34 years). They were assessed for superficial temperature of the legs using infrared thermography with anterior and posterior views. Assessment of postural balance was conducted using a baropodometer, in 2 conditions-participants' open and closed eyes-to obtain the center of pressure (COP) of anteroposterior displacement, center of pressure of mediolateral displacement (COP-ML), and center of pressure of displacement area. RESULTS: When their eyes were open, the chemotherapy-radiotherapy group presented a high correlation between the displacement of the ML and the surface anterior temperature of both legs (right: r = 0.578; P = .030; left: r = 0.619; P = .018) and posterior region of the right leg (r = 0.571; P = .033), and they presented a high correlation between COP with anterior surface temperature of both legs (right: r = 0.585; P = .028; left: r = 0.540; P = .046). When patients' eyes were closed, no correlation was found between the thermography and the stabilometric parameters evaluated. CONCLUSION: During the chemotherapy-radiotherapy, cancer patients present ML and COP displacement that correlates with infrared thermography evaluation when their eyes are open.

Correlation Between the Trajectory of the Center of Pressure and Thermography of Cancer Patients Undergoing Chemotherapy.

OBJECTIVE: To correlate the potential of the stabilometric parameters of baropodometry with the superficial temperature of the legs of cancer patients during and after treatment. METHOD: This study included 30 volunteers of both sexes, divided into the following groups: chemotherapy-radiotherapy group (CRG) (n = 15; age = 57.13 ± 16.74 years) and cancer group without current treatment (n = 15; age = 63.29 ± 7.34 years). They were assessed for superficial temperature of the legs using infrared thermography with anterior and posterior views. Assessment of postural balance was conducted using a baropodometer in 2 conditions-participants' open eyes and closed eyes-to obtain the center of pressure (COP) of anteroposterior displacement, COP of mediolateral displacement, and COP of displacement area. RESULTS: When their eyes were open, the CRG participants presented a high correlation between the displacement of the ML and the surface anterior temperature of both legs (right: r = 0.578, P = .030; left: r = 0.619, P = .018) and posterior region of the right leg (r = 0.571; P = .033), and they presented a high correlation between COP with anterior surface temperature of both legs (right: r = 0.585, P = .028; left: r = 0.540, P = .046). When patients' eyes were closed, no correlation was found between the thermography and the stabilometric parameters evaluated. CONCLUSION: During the chemotherapy-radiotherapy, cancer patients present ML and COP displacement that correlates with infrared thermography evaluation when their eyes are open.

Aplicação e comparação de duas equações preditas para o teste de caminhada de seis minutos em indivíduos hipertensos / Application and comparison of two predicted equations for the six-minute walk test in hypertensive subjects

Introdução: O Teste de Caminhada de 6 minutos (TC6) tem sido utilizado especialmente para mensurar a capacidade funcional e avaliar a eficiência de diversos tratamentos cardiovasculares. Objetivo: O objetivo do presente estudo foi aplicar e comparar as equações preditas do TC6, em indivíduos hipertensos participantes de reabilitação cardiovascular (RCV). Material e métodos: A amostra foi composta por 39 pacientes de ambos os sexos (masculino: 11 e feminino: 28) com média de idade 57,5 ± 11 anos portadores de hipertensão arterial. Resultados: Após o programa de RCV foi verificado um aumento significativo (p < 0,001) da distância caminhada no TC6 quando comparada aos valores antes da RCV (514,7 ± 100,6 x 382,4 ± 116,3 m). Entretanto, não houve diferença estatística quando comparado os valores preditos das duas equações. Conclusão: A distância percorrida no TC6 foi maior após a RCV quando comparada aos valores iniciais, demostrando que a RCV produz benefícios na capacidade funcional dessa população. Além disso, os resultados sugerem que as duas equações avaliadas, tem aplicabilidade semelhante para a população de indivíduos hipertensos brasileiros.

Introduction: The 6-minute Walk Test (6MWT) has been used especially to measure functional capacity, to evaluate the efficiency of various cardiovascular treatments. Objective: The objective of the present study was to apply and compare the predicted EQ6 equations in hypertensive individuals participating in cardiovascular rehabilitation (CR). Methods: The sample consisted of 39 patients of both sexes (male: 11 and female: 28) with mean age 57.5 ± 11 years old with arterial hypertension. Results: After the CR program, was verified a significant increase (p < 0.001) in the 6MWT when compared to values before of CR (514.7 ± 100.6 x 382.4 ± 116.3 m). However, there was no statistical difference when compared to the predicted values of the two equations. Conclusion: The distance walked on the 6MWT was higher after the RCV when compared to the initial values, showing that the RCV produces benefits in the functional capacity of this population. In addition, the results suggest that the two equations evaluated have similar applicability for the population of Brazilian hypertensive individuals.

Evidências para a avaliação dos pés da pessoa com diabetes mellitus / Evidence for the evaluation of the feet of people with diabetes mellitus

Objetivo: identificar os critérios de avaliação dos pés da pessoa com Diabetes Mellitus. Método: revisão integrativa com busca nas bases de dados MEDLINE, LILACS, Cochrane, SCOPUS e biblioteca virtual SciELO, com delimitação temporal entre 2011 e 2017 e amostra final de 16 artigos categorizados em anamnese, avaliação da pele e anexos, avaliação neurológica, avaliação vascular, avaliação anatômica dos pés e autocuidado. Resultados: a maioria dos artigos foi de 2013, com nível de evidência II. A categoria anamnese compreendeu questões sociodemográficas e clínicas e a categoria avaliação da pele e anexos contemplou as afecções de pele, unhas, pelos e espaços interdigitais. Na categoria avaliação neurológica, predominou o teste com monofilamento Semmes-Weinstein 10g para a avaliação da sensibilidade tátil. Na avaliação vascular, destacou-se a palpação dos pulsos pediosos e tibiaisposteriores. Na categoria avaliação anatômica dos pés, apenas dois artigos retrataram o tipo de deformidade pesquisada e em quatro estudos foram realizadas orientações de autocuidado. Conclusão: Em síntese, o estudo permitiu extrair indicadores importantes para a avaliação dos pés e observou-se consonância entre as pesquisas analisadas com o que é recomendado.(AU)

Influence of Exergaming on the Perception of Cancer-Related Fatigue.

OBJECTIVE: Exercise is recommended for cancer patients to reduce fatigue and improve quality of life. This study's aim is to evaluate the influence of an exergaming protocol on cancer-related fatigue, muscle fatigue, and muscle strength in cancer patients. MATERIALS AND METHODS: We conducted a quasi-experimental control study using exergaming in all groups through an Xbox360 Kinect™ console, two to three times per week, for 20 sessions. Three groups were created: cancer patients in chemotherapy and/or radiotherapy group (CRG; n:15), cancer patients after chemotherapy and/or radiotherapy (CAG; n:15), and a control group (CG; n:15). They were assessed for cancer-related fatigue using the fatigue subscale of the Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F) questionnaire. To assess dorsiflexor and plantar flexor muscle functioning, we used median frequency (MDF) of the surface electromyography and muscle strength using a dynamometer. The assessments were performed preintervention (EV0), after 10 sessions (EV1), and after 20 sessions (EV2). RESULTS: With an exergaming protocol, CRG and CAG showed a reduction in related fatigue compared with CG (P < 0.01). The CRG group saw an increase in maximal voluntary isometric contraction in right plantar flexor muscles and dorsiflexor muscles, as well as an increase in the MDF of both medial gastrocnemius muscles and the left tibialis anterior muscle of the CAG. For other analyses done, the differences were observed during exergaming. CONCLUSIONS: Exergaming demonstrated efficacy in reducing cancer patients' fatigue, including muscle fatigue, and increasing muscle strength in patients' legs.

Association between respiratory muscle strength and reduction of arterial blood pressure levels after aerobic training in hypertensive subjects.

[Purpose] The purpose of present study was associate the increase of respiratory muscle strength with blood pressure levels in hypertensive subjects who underwent an aerobic exercise program. [Subjects and Methods] 90 hypertensive subjects were divided in two groups: intervention and control. All participants had an interview with a physiotherapist and were evaluated by 6-minute walk test, maximal inspiratory pressure, maximal expiratory pressure, heart rate, systolic blood pressure and diastolic blood pressure, before and after the 8 weeks. In the intervention group, the subjects underwent aerobic exercise program, 2 times a week for 8 weeks [Results] After the program, the levels of blood pressure were significantly reduced and the distance walked in the 6-minute walk test and the respiratory muscle strength were increased, compared to pre intervention and control group values. However, there was no correlation between the results provided by 6-minute walk test, maximal inspiratory pressure and maximal expiratory pressure with systolic arterial blood pressure levels. Nonetheless, the distance walked correlated with respiratory muscle strength values, in the intervention group. [Conclusion] The present study demonstrated that the aerobic training was effective in reducing the arterial blood pressure in hypertensive subjects associated with an improvement of physical conditioning and respiratory muscle strength.

Pressões e volumes pulmonares em idosos institucionalizados / Pulmonary pressures and volumes in institutionalized elderly people

No envelhecimento ocorrem alterações em vários sistemas, entre eles o respiratório, que determina uma diminuição da função pulmonar. O estudo foi realizado com objetivo de investigar os volumes e pressões pulmonares em idosos institucionalizados na cidade de Tupã e avaliar suas relações com: gênero, faixa etária, tabagismo e realização de fisioterapia. Foram estudados 30 idosos de ambos os gêneros com média de idade: 73,6 ± 12,3 anos. Foram submetidos à avaliação contendo dados e antecedentes pessoais; além de testes específicos para avaliar as pressões respiratórias máximas (PImax e PEmax) por meio da manuvacuometria e para avaliar o volume minuto (Vm), volume corrente (VC) e capacidade vital (CV) por meio da ventilometria. Foi realizada análise estatística pelo teste t e correlação de Person, adotou-se nível de 5%. Foram observados valores abaixo do previsto para as variáveis de PImax (43,6 ± 30,5 cmH2O) e PEmax (45,8 ± 23,6 cmH2O). Foi observado resultado estatisticamente significante (p<0,05) na relação entre gênero com: PImax, PEmax, Vm, VC e CV; em que os homens obtiveram os melhores resultados. Na comparação entre realização de fisioterapia com as variáveis de pressão e volume se observou resultado significante (p<0,005) para pressões respiratórias máximas. Foram observadas correlações significantes entre as variáveis: Vm, VC e CV. Os resultados sugerem que os idosos estudados apresentam debilidade muscular respiratória e a realização de fisioterapia tem influência benéfica no desempenho da força muscular respiratória. A população estudada não alcançou os valores previstos pela literatura para pressões e volumes pulmonares...

Evaluation of patients' quality of life aspects after cardiac pacemaker implantation.

OBJECTIVE: To evaluate patients' quality of life aspects after pacemaker implantation, relating it to gender, age, and implantation timespan. METHODS: A total of 107 clinically stable patients of both genders (49.5% women and 50.5% men) over 18 years old (average 69.3±12.6 years) and presenting an implantation timespan of three to 12 months (average 6.36±2.99 months) were evaluated. The evaluation included personal, clinical, and implant data as well as quality of life questionnaires (AQUAREL and SF-36). Statistical analysis was conducted using the t test and Pearson correlation, with a 5% significance level. RESULTS: The lowest SF-36 score referred to physical aspects, and the highest score referred to social aspects. In AQUAREL, the lowest score referred to dyspnea, and the highest referred to discomfort. There was a significant association between gender and quality of life in SF-36 (physical functioning and emotional aspects) and in AQUAREL (dyspnea). A negative correlation was observed between age and quality of life (functional capacity in SF-36, and discomfort in AQUAREL) in relation to implantation timespan, a correlation with vitality from SF-36. CONCLUSION: Lower quality of life scores were found in physical aspects and dyspnea; and higher scores in social aspects and discomfort. Men presented higher quality of life scores related to physical functioning, emotional aspects and dyspnea. As age increases, quality of life worsens regarding functional capacity and discomfort; and the longer the pacemaker implantation timespan, the worse quality of life when it comes to vitality. Gender, age, and implantation timespan influence quality of life; thus, these variables must be considered in strategies for improving quality of life of patients with pacemakers.

Avaliação de aspectos da qualidade de vida em pacientes pós-implante de marca-passo cardíaco / Evaluation of patients' quality of life aspects after cardiac pacemaker implantation

Objetivo: Avaliar aspectos da qualidade de vida em pacientes pós-implante de marca-passo e relacionar com gênero, idade e tempo de implante. Métodos: Foram estudados 107 indivíduos de ambos os gêneros (49,5% do sexo feminino e 50,5% do sexo masculino), tempo de implante três a 12 meses (média de 6,36±2,99 meses), estáveis clinicamente com idade acima de 18 anos (média de 69,3±12,6 anos). A avaliação constou de: dados pessoais, clínicos, do implante e questionários de qualidade de vida (AQUAREL e SF-36). Análise estatística empregou teste t e correlação de Pearson, com significância de 5%. Resultados: No SF-36, o menor escore ocorreu no domínio aspectos físicos e o maior, em aspectos sociais. No AQUAREL, o menor escore foi em dispneia e o maior em desconforto. Verificou-se associação significante entre gênero e qualidade de vida no SF-36 (capacidade funcional e aspectos emocionais) e no AQUAREL (dispneia). Observaram-se correlações negativas entre idade e qualidade de vida (capacidade funcional do SF-36 e em desconforto do AQUAREL) em relação ao tempo de implante, correlação com vitalidade do SF-36. Conclusão: Menores escores de qualidade de vida foram encontrados em aspectos físicos e dispneia; maiores em aspectos sociais e desconforto. Homens apresentaram maiores escores de qualidade de vida em capacidade funcional, aspectos emocionais e dispneia. Conforme aumenta a idade, pior é a qualidade de vida em capacidade funcional e desconforto, e, quanto maior o tempo de implante de marca-passo, pior a qualidade de vida em vitalidade. Gênero, idade e tempo de implante influenciam na qualidade de vida, dessa forma, essas variáveis devem ser consideradas nas estratégias para melhora da qualidade de vida em portadores de marca-passo. .

Objective: To evaluate patients' quality of life aspects after pacemaker implantation, relating it to gender, age, and implantation timespan. Methods: A total of 107 clinically stable patients of both genders (49.5% women and 50.5% men) over 18 years old (average 69.3±12.6 years) and presenting an implantation timespan of three to 12 months (average 6.36±2.99 months) were evaluated. The evaluation included personal, clinical, and implant data as well as quality of life questionnaires (AQUAREL and SF-36). Statistical analysis was conducted using the t test and Pearson correlation, with a 5% significance level. Results: The lowest SF-36 score referred to physical aspects, and the highest score referred to social aspects. In AQUAREL, the lowest score referred to dyspnea, and the highest referred to discomfort. There was a significant association between gender and quality of life in SF-36 (physical functioning and emotional aspects) and in AQUAREL (dyspnea). A negative correlation was observed between age and quality of life (functional capacity in SF-36, and discomfort in AQUAREL) in relation to implantation timespan, a correlation with vitality from SF-36. Conclusion: Lower quality of life scores were found in physical aspects and dyspnea; and higher scores in social aspects and discomfort. Men presented higher quality of life scores related to physical functioning, emotional aspects and dyspnea. As age increases, quality of life worsens regarding functional capacity and discomfort; and the longer the pacemaker implantation timespan, the worse quality of life when it comes to vitality. Gender, age, and implantation timespan influence quality of life; thus, these variables must be considered in strategies for improving quality of life of patients with pacemakers. .

Correlation between quality of life, functional class and age in patients with cardiac pacemaker.

OBJECTIVE: To evaluate whether there is a correlation between quality of life and functional class in early heart pacemaker in patients, and its relationship with age. METHODS: 107 patients of both sexes (49.5% female/50.5% male) were investigated, average implant time of 6.36 months (±2.99), and average age of 69.3 years (±12.6). To assess the FC, a scale suggested by Goldman was used; for QoL the AQUAREL questionnaire was used, associated with SF-36. Statistical analysis was conducted using Spearman's correlation with 5% significance. RESULTS: Negative correlations were observed between QoL and FC: AQUAREL in the three domains, chest discomfort (r=-0.197, P=0.042), dyspnea (r=-0.508, P=0.000), arrhythmia (r=-0.271, P=0.005), and the SF-36 in the eight domains. Regarding age, there was a negative correlation with the SF36 Functional Capacity (r=-0.338, P=0.000) and no correlation was found with AQUAREL. Positive correlation (r=0.237, P=0.014) was observed between age and FC. CONCLUSION: In this study we found a significant negative correlation between QoL and FC, indicating that patients in this sample who belong to a better FC demonstrated better QoL. The older the patient, QoL is worse in functional capacity and FC. It is suggested that age and FC influence QoL, and the functional classification scales may be established as one of the assessment tools and reflect QoL in patients with pacemakers.

Correlação entre a qualidade de vida, classe funcional e idade em portadores de marca-passo cardíaco / Correlation between quality of life, functional class and age in patients with cardiac pacemaker

OBJETIVO: Avaliar se existe correlação entre qualidade de vida e classe funcional em pacientes no pós-implante de marca-passo cardíaco, e sua relação com idade. MÉTODOS: Investigados 107 pacientes de ambos os sexos (49,5% do sexo feminino e 50,5% do sexo masculino), tempo médio de implante 6,36º ±2,99 meses e média de idade 69,3º ±12,6 anos. Para avaliação da classe funcional, foi utilizada escala proposta por Goldman e para qualidade de vida, questionário AQUAREL associado ao SF-36. Realizada análise estatística pela correlação de Spearman, com significância de 5%. RESULTADOS: Foram observadas correlações negativas entre qualidade de vida e classe funcional: AQUAREL nos três domínios, desconforto no peito (r=-0,197, P=0,042), dispneia (r=-0,508, P =0,000), arritmia (r=-0,271, P=0,005) e, no SF-36 nos oito domínios. Em relação à idade, correlação negativa com Capacidade Funcional do SF-36 (r=-0,338, P=0,000) e não se observou correlação com AQUAREL. Entre idade e classe funcional observou-se correlação positiva (r=0,237, P=0,014). CONCLUSÃO: Neste estudo, encontrou-se correlação negativa entre qualidade de vida e classe funcional, evidenciando nesta amostra que os pacientes pertencentes a melhor classe funcional apresentaram melhor qualidade de vida. Conforme maior idade, pior a qualidade de vida em Capacidade Funcional e em classe funcional. Sugere-se, que idade e classe funcional influenciam qualidade de vida e as escalas de classificação funcional podem constituir um dos instrumentos que integram a avaliação e refletem a qualidade de vida em portadores de marca-passo.

OBJECTIVE: To evaluate whether there is a correlation between quality of life and functional class in early heart pacemaker in patients, and its relationship with age. METHODS: 107 patients of both sexes (49.5% female/50.5% male) were investigated, average implant time of 6.36 months (±2.99), and average age of 69.3 years (±12.6). To assess the FC, a scale suggested by Goldman was used; for QoL the AQUAREL questionnaire was used, associated with SF-36. Statistical analysis was conducted using Spearman's correlation with 5% significance. RESULTS: Negative correlations were observed between QoL and FC: AQUAREL in the three domains, chest discomfort (r=-0.197, P=0.042), dyspnea (r=-0.508, P=0.000), arrhythmia (r=-0.271, P=0.005), and the SF-36 in the eight domains. Regarding age, there was a negative correlation with the SF36 Functional Capacity (r=-0.338, P=0.000) and no correlation was found with AQUAREL. Positive correlation (r=0.237, P=0.014) was observed between age and FC. CONCLUSION: In this study we found a significant negative correlation between QoL and FC, indicating that patients in this sample who belong to a better FC demonstrated better QoL. The older the patient, QoL is worse in functional capacity and FC. It is suggested that age and FC influence QoL, and the functional classification scales may be established as one of the assessment tools and reflect QoL in patients with pacemakers.