Are visual assessments of the single-leg squat valid to be used in clinical practice? A systematic review of measurement properties based on the COSMIN guideline.

OBJECTIVE: Evaluate the discriminative and convergent validity of visual scales for the assessment of movement quality in the single-leg squat. METHODS: Searches performed in CINAHL, Cochrane, Embase, PubMed, SPORTDiscus and Web of Science databases. Studies evaluating discriminative and convergent validity of movement quality visual assessments in single-leg squats were included. The COSMIN risk of bias checklist was used to assess the risk of bias, and certainty of evidence was assessed by the GRADE modified version. RESULTS: Ten studies evaluating three different methods of visual assessment of the single-leg squat (Crossley scale; Whatman score and Medial knee displacement) were included. Very low certainty evidence suggests that the Crossley scale had sufficient discriminative validity for patient-centred outcomes. Very low to moderate certainty evidence suggests that the three visual methods of assessment of the single-leg squat had insufficient discriminative validity for surrogate outcomes and groups. None of the three methods had the convergent validity assessed. CONCLUSION: The Crossley scale exhibited sufficient discriminative validity for patient-centred outcomes, although the evidence supporting this conclusion is of very low certainty. Visual scales for the assessment of the single-leg squat movement quality should be used with caution in clinical practice as most methods had insufficient discriminative validity and no reports of convergent validity.

Residual force enhancement in human skeletal muscles: A systematic review and meta-analysis.

OBJECTIVE: We reviewed and appraised the existing evidence of in vivo manifestations of residual force enhancement in human skeletal muscles and assessed, through a meta-analysis, the effect of an immediate history of eccentric contraction on the subsequent torque capacity of voluntary and electrically evoked muscle contractions. METHODS: Our search was conducted from database inception to May 2020. Descriptive information was extracted from, and quality was assessed for, 45 studies. Meta-analyses and metaregressions were used to analyze residual torque enhancement and its dependence on the angular amplitude of the preceding eccentric contraction. RESULTS: Procedures varied across studies with regards to muscle group tested, angular stretch amplitude, randomization of contractions, time window analyzed, and verbal command. Torque capacity in isometric (constant muscle tendon unit length and joint angle) contractions preceded by an eccentric contraction was typically greater compared to purely isometric contractions, and this effect was greater for electrically evoked muscle contractions than voluntary contractions. Residual torque enhancement differed across muscle groups for the voluntary contractions, with a significant enhancement in torque observed for the adductor pollicis, ankle dorsiflexors, ankle plantar flexors, and knee extensors, but not for the elbow and knee flexors. Meta-regressions revealed that the angular amplitude of the eccentric contraction (normalized to the respective joint's full range of motion) was not associated with the residual torque enhancement observed. CONCLUSION: There is evidence of residual torque enhancement for most, but not all, muscle groups, and residual torque enhancement is greater for electrically evoked than for voluntary contractions. Contrary to our hypothesis, and contrary to generally accepted findings on isolated muscle preparations, residual torque enhancement in voluntary and electrically evoked contractions does not seem to depend on the angular amplitude of the preceding eccentric contraction.

The "Journal of Functional Morphology and Kinesiology" Journal Club Series: Highlights on Recent Papers in Corrective Exercise.

We are glad to introduce the Journal Club of Volume Five, fourth Issue. This edition is focused on relevant studies published in the last few years in the field of corrective exercise, chosen by our Editorial Board members and their colleagues. We hope to stimulate your curiosity in this field and to share a passion for sport with you, seen also from the scientific point of view. The Editorial Board members wish you an inspiring lecture.

Hip morphology and its relationship with hip strength, mobility and lower limb biomechanics: a systematic review in adults / Relação da morfologia do quadril com força, mobilidade e biomecânica dos membros inferiores: uma revisão sistemática em adultos

Abstract This systematic review (PROSPERO registration n.43640) aimed to summarise and determine the quality of evidence relating hip bone morphology to (i) hip strength, (ii) mobility and (iii) lower limb biomechanics during functional activities. A standardized search on MEDLINE/PubMed, Web of Science, ScienceDirect and Scopus resulted in 17 papers that met inclusion criteria: i) original investigations with a minimal sample of n=10, ii) studies on humans and iii) presence of at least one quantitative hip morphological parameter and one hip functional (i.e. strength and mobility) and/or one lower limb biomechanical parameter. Risk of bias was assessed using the Quality Assessment of Diagnostic Accuracy Studies tool with adaptations. Sixteen out of the 17 included studies showed high risk of bias. We observed that primary evidence pointed to the influence of hip morphology on hip mobility in the transverse plane. Specifically, positive correlations between femoral anteversion angle and range of internal hip rotation in physical examination were observed. Regarding biomechanical parameters, no clear evidence of association between hip morphology, and kinematic and kinetic parameters were found. Our results point to a field that is currently under explored and future studies with low risk of bias addressing these relationships are required.

Resumo Essa revisão sistemática (PROSPERO registro no 43640) tem por objetivo sintetizar e determinar a qualidade da evidência que relaciona morfologia do quadril à (i) força do quadril, (ii) mobilidade e (iii) biomecânica dos membros inferiores durante atividades funcionais. Uma busca padronizada no MEDLINE/PubMed, Web of Science, ScienceDirect e Scopus resultou em 17 artigos em acordo com os critérios de inclusão: i) estudos originais com amostra mínima de n=10; ii) estudos em humanos e iii) presença de no mínimo um parâmetro quantitativo da morfologia do quadril e um parâmetro funcional do quadril (ex.: mobilidade e força) e/ou um parâmetro biomecânico do membro inferior. A avaliação do risco de viés foi realizada através da ferramenta Quality Assessment of Diagnostic Accuracy Studies (QUADAS) com adaptações. Dezesseis dos 17 estudos incluídos apresentaram alto risco de viés. Observamos que a evidência primária aponta para influência da morfologia do quadril em sua mobilidade no plano transverso. Foram observadas, especificamente, correlações positivas entre o ângulo de anteversão femoral e a mobilidade de rotação interna do quadril durante o exame físico. Em relação aos parâmetros biomecânicos, não foram encontradas evidências claras sobre associação entre morfologia do quadril e parâmetros cinemáticos e cinéticos. Nossos resultados apontam para um campo atualmente subexplorado e investigações futuras com baixo risco de viés que avaliem essas relações são necessárias.

Prediction of ground reaction forces while walking in water.

Despite being a key concept in rehabilitation, controlling weight-bearing load while walking, following lower limb injury is very hard to achieve. Walking in water provides an opportunity to prescribe load for people who have pain, weakness or weight bearing restrictions related to stages of healing. The aim of this experimental study was to evaluate and validate regression models for predicting ground reaction forces while walking in water. One hundred and thirty seven individuals (24±5 years, 1.71±0.08 m and 68.7±12.5 kg) were randomly assigned to a regression group (n = 113) and a validation group (n = 24). Trials were performed at a randomly assigned water depth (0.75 to 1.35 m), and at a self-selected speed. Independent variables were: immersion ratio, velocity, body mass, and waist, thigh and leg circumferences. Stepwise regression was used for the prediction of ground reaction forces and validation included agreement and consistency statistical analyses. Data from a force plate were compared with predicted data from the created model in the validation group. Body mass, immersion ratio, and velocity independently predicted 95% of the vertical and resultant ground reaction force variability, while, together, velocity and thigh circumference explained 81% of antero-posterior ground reaction force variability. When tested against the data measured in validation samples, the models output resulted in statistically similar values, intraclass correlation coefficients ranging from 0.88 to 0.90 and standard errors of measurement, 11.8 to 42.3 N. The models introduced in this study showed good predictive performance in our evaluation procedures and may be considered valid in the prediction of vertical, antero-posterior and resultant ground reaction forces while walking in water. All predictive variables can be easily determined in clinical practice. Future studies should focus on the validation of these models in specific populations.

Biomechanical analysis of the contact phase in drop jumps performed in water and on dry land / Análise biomecânica da fase de contato no salto em profundidade no solo e na água

Abstract Plyometric training in the aquatic environment has been used as way of reducing loads through the action of buoyancy. However, little is known about the biomechanical characteristics of plyometric exercises in water, which can assist in the prescription of training in this environment. This study aimed to analyze the vertical component of the ground reaction force and contact duration of drop jumps (DJ) performed on land and at hip level water immersion. Participants were 22 male athletes (19.1 ± 3.7 years), who performed three maximum DJs in water and on dry land. Peak force and duration of braking and propulsion sub-phases of the DJ contact were analyzed with the use of two underwater force platforms, a 2-D waterproofed electrogoniometer, acquisition systems ADS2000-IP and TeleMyo 2400TG2, and a signal synchronizer. The effect of immersion was investigated through comparison tests for dependent samples (p <0.05). In water, the following results were observed: (a) reduction of 41.8% (p <0.001, d = 2.24) and 23.8% (p <0.001, d = 1.50) of peak forces during braking and propulsion sub-phases respectively; and (b) increase of 41.8% in the braking (p <0.001, d = 1.41) and 12.3% in the propulsion contact times (p = 0.006, d = 0.75). The aquatic environment can be an alternative when one aims to reduce the load during the DJ contact; however, the longer duration increasing of contact sub-phases in water at hip immersion may compromise the proper functioning of the stretch-shortening cycle in water.

Resumo O treinamento pliométrico em ambiente aquático tem sido proposto porque reduz as cargas proporcionada pela ação do empuxo. Entretanto, pouco se sabe sobre as características biomecânicas dos exercícios pliométricos na água, as quais podem auxiliar na prescrição do treinamento neste ambiente. Este estudo teve por objetivo analisar a força vertical de reação do solo e a duração do contato do salto em profundidade (SP) realizado no solo e na água. Participaram da pesquisa 22 atletas do sexo masculino (19,1±3,7 anos), os quais executaram três SPs máximos no solo e na água (imersão do quadril). Analisou-se o pico de força e a duração das subfases de frenagem e propulsão do contato do SP com o uso de duas plataformas de força subaquáticas, um eletrogoniômetro 2-D impermeabilizado, os sistemas de aquisição ADS2000-IP e TeleMyo 2400TG2, e um sincronizador de sinais. O efeito do ambiente foi investigado através de testes de comparação para amostras dependentes (p<0,05). Na água, observou-se (a) uma redução de 41,8% (p<0,001; d=2,24) e de 23,8% (p<0,001; d=1,50) do pico de força durante as subfases de frenagem e propulsão, respectivamente; e (b) um aumento de 41,8% na duração da frenagem (p<0,001; d=1,41) e de 12,3% na duração da propulsão (p=0,006; d=0,75) do contato. O ambiente aquático pode ser uma alternativa quando se tem o objetivo de reduzir a carga durante o contato do SP; entretanto, o aumento da duração das subfases do contato pode comprometer o funcionamento adequado do ciclo alongamento-encurtamento na água.

Validity and reliability of an instrumented leg-extension machine for measuring isometric muscle strength of the knee extensors.

CONTEXT: Isometric muscle strength of knee extensors has been assessed for estimating performance, evaluating progress during physical training, and investigating the relationship between isometric and dynamic/functional performance. OBJECTIVE: To assess the validity and reliability of an adapted leg-extension machine for measuring isometric knee extensor force. DESIGN: Validity (concurrent approach) and reliability (test and test-retest approach) study. SETTING: University laboratory. PARTICIPANTS: 70 healthy men and women aged between 20 and 30 y (39 in the validity study and 31 in the reliability study). MAIN OUTCOME MEASURE: Intraclass correlation coefficient (ICC) values calculated for the maximum voluntary isometric torque of knee extensors at 30°, 60°, and 90°, measured with the prototype and with an isokinetic dynamometer (ICC2,1, validity study) and measured with the prototype in test and retest sessions, scheduled from 48 h to 72 h apart (ICC1,1, reliability study). RESULTS: In the validity analysis, the prototype showed good agreement for measurements at 30° (ICC2,1 = .75, SEM = 18.2 Nm) and excellent agreement for measurements at 60° (ICC2,1 = .93, SEM = 9.6 Nm) and at 90° (ICC2,1 = .94, SEM = 8.9 Nm). Regarding the reliability analysis, between-days' ICC1,1 were good to excellent, ranging from .88 to .93. Standard error of measurement and minimal detectable difference based on test-retest ranged from 11.7 Nm to 18.1 Nm and 32.5 Nm to 50.1 Nm, respectively, for the 3 analyzed knee angles. CONCLUSIONS: The analysis of validity and repeatability of the prototype for measuring isometric muscle strength has shown to be good or excellent, depending on the knee joint angle analyzed. The new instrument, which presents a relative low cost and easiness of transportation when compared with an isokinetic dynamometer, is valid and provides consistent data concerning isometric strength of knee extensors and, for this reason, can be used for practical, clinical, and research purposes.

In vivo vastus lateralis force-velocity relationship at the fascicle and muscle tendon unit level.

The force velocity relationship of in vivo human muscle fibers has often been derived from the torque-angular speed relationship during maximal voluntary isokinetic contractions. However, the assumption of a close association between joint performance and muscle mechanics is questionable. We aimed to determine the relationship between knee extension angular speeds, vastus lateralis fascicle and muscle tendon unit (MTU) shortening speeds, and maximal knee extensor force for the entire range of knee joint movement, for the isokinetic range, and for the ranges before, after and at peak torque occurrence, with different commonly used pre-loading conditions. Higher peak forces were observed when knee extensions were preceded by a pre-load, despite the similarity in fascicle shortening speeds. For the entire and the isokinetic range, MTU always shortened faster than fascicles, and this difference increased as joint speed increased. Interestingly, fascicle shortening velocities were greater before compared to after peak torque occurrence while the opposite happened at the MTU level. Assuming a close relationship between joint and fascicle dynamics results in an overestimation of muscle contractile component shortening velocity or force production at peak torque. The force velocity relationships obtained in vivo depend crucially on the test conditions, and the movement range used for analysis.

Ground reaction forces in shallow water running are affected by immersion level, running speed and gender.

OBJECTIVES: To analyze the effect of depth of immersion, running speed and gender on ground reaction forces during water running. DESIGN: Controlled laboratory study. METHODS: Twenty adults (ten male and ten female) participated by running at two levels of immersion (hip and chest) and two speed conditions (slow and fast). Data were collected using an underwater force platform. The following variables were analyzed: vertical force peak (Fy), loading rate (LR) and anterior force peak (Fx anterior). Three-factor mixed ANOVA was used to analyze data. RESULTS: Significant effects of immersion level, speed and gender on Fy were observed, without interaction between factors. Fy was greater when females ran fast at the hip level. There was a significant increase in LR with a reduction in the level of immersion regardless of the speed and gender. No effect of speed or gender on LR was observed. Regarding Fx anterior, significant interaction between speed and immersion level was found: in the slow condition, participants presented greater values at chest immersion, whereas, during the fast running condition, greater values were observed at hip level. The effect of gender was only significant during fast water running, with Fx anterior being greater in the men group. Increasing speed raised Fx anterior significantly irrespective of the level of immersion and gender. CONCLUSIONS: The magnitude of ground reaction forces during shallow water running are affected by immersion level, running speed and gender and, for this reason, these factors should be taken into account during exercise prescription.

Predição da força de reação do solo durante a corrida na água / Prediction of ground reaction force during water immersion running

Este estudo visou desenvolver um modelo para a predição da força de reação do solo na corrida subaquática. Participaram 20 sujeitos (9 homens e 11 mulheres), que realizaram corrida subaquática em dois níveis de imersão e três velocidades. Para cada sujeito foram coletadas seis passagens válidas em cada condição, com autilização de uma plataforma subaquática de força. O modelo para predição da força foi construído por regressão linear múltipla. Foram consideradas variáveis dependentes a componente vertical e a componente ântero-posterior da força de reação do solo. As variáveis imersão, sexo, velocidade, massa corporal, densidade corporal e percentual de gordura foram consideradas independentes. Permaneceu no modelo final de regressão para a componente vertical a velocidade (p<0,001), enquanto no modelo da componente ântero-posterior permaneceram a velocidade, a imersão e a massa corporal (todas com p<0,001). O modelo preditivo para a componente ântero-posterior da força de reação do solo pode ser considerado satisfatório (o coeficiente de determinação ajustado foi 0,79). Entretanto, o modelo para a componente vertical não pode ser recomendado para a predição dessa variável durante a corrida na água (coeficiente encontrado 0,18). Ressalva-se que o modelo preditivo criado aplica-se a sujeitos com características semelhantes(idade e medidas antropométricas) às dos participantes do estudo.

This study aimed at developing a model to predict ground reaction force during deep-water running. A total of 20 subjects ((9 men, 11 women) ran in water at two immersion levels and three different speeds. Each subject performed six valid trials in each condition, data being captured by an underwater force plate. The force prediction model was build by multiple linear regression. Dependent variables were the vertical and anteroposterior components of the ground reaction force; independent variables were runners’ immersion, sex, speed, body mass, bodydensity, and percentage of fat. At the final regression model for the vertical component, only speed remained (p<0.001), while for the anteroposterior component, speed, immersion, and body mass were maintained (all at p<0.001). The obtained model for the anteroposterior component of ground reaction forcemay be found satisfactory, as adjusted determination coefficient was 0.79. However,the prediction model for the vertical component cannot be recommended forprediction during deep-water running, since that coefficient was 0.18. It must be noted that the proposed prediction model applies to subjects provided that they have similar characteristics to those who took part in this study.

Força de reação do solo durante a marcha de crianças em ambiente aquático / Ground reaction force during childrens' gait in an aquatic environment

O objetivo desta pesquisa foi analisar parâmetros biomecânicos da marcha de crianças de 7 a 12 anos em ambiente aquático. Analisaram-se características dinamométricas, a fim de verificar o comportamento das mesmas no ambiente mais utilizado para a educação da marcha de indivíduos com as mais diversas patologias. Para a realização do estudo foram utilizadas plataformas de força subaquáticas para aquisição da componente vertical da força de reação do solo (FRS). Após as coletas de dados, as informações dinamométricas foram armazenadas e processadas pelo programa SAD32®, versão 3.0. Foi realizada estatística descritiva para os resultados encontrados. Há uma redução de até 62% da carga corporal da criança em relação ao ambiente terrestre. Sugere-se um aprofundamento nos dados encontrados e o estudo de outras variáveis que também influenciam na marcha subaquática, para que a vida de crianças que necessitam de recuperação funcional possa ser melhorada.

Força de reação do solo como subsídio para prescrição de exercícios aquáticos: estudo de caso / Ground reaction force as a subsidy for prescribing aquatic exercises: case study

OBJETIVO: Comparar a componente vertical da força de reação do solo nos exercícios de caminhada, corrida com deslocamento, corrida estacionária e salto vertical, realizados em ambiente aquático em diferentes níveis de imersão. MÉTODO: Participou deste estudo de caso um sujeito do sexo masculino (27 anos, 1,80 m e 84,3 kg). Utilizou-se para a coleta de dados uma plataforma subaquática de força posicionada no fundo de uma piscina térmica. O sujeito realizou 30 tentativas válidas de cada exercício, imerso nos níveis do processo xifoide e do quadril. Os dados foram analisados com a utilização da estatística descritiva, teste "t" de Student para amostras pareadas e ANOVA, para medidas repetidas (p < 0,05). RESULTADOS: Os valores máximos da força para os níveis do processo xifoide e do quadril (em por cento do peso corporal do sujeito) foram de, respectivamente: 39 por cento e 48 por cento para a caminhada; 138 por cento e 156 por cento para a corrida com deslocamento; 139 por cento e 202 por cento para a corrida estacionária; 194 por cento e 195 por cento para a propulsão no salto; e 222 por cento e 387 por cento, para a aterrissagem no salto. CONCLUSÃO: Ao variar o tipo de exercício podemos realizar um aumento de carga gradual, desde a caminhada no nível do processo xifoide até o salto no nível do quadril. Para tanto, deve ser analisado o objetivo do trabalho a ser realizado para a escolha do exercício correto, com o aumento da carga sendo realizado não somente pela diminuição do nível de imersão, como também pelo tipo e pela velocidade/cadência do exercício executado.

OBJECTIVE: To compare the vertical component of the ground reaction force in the exercises of walking, running, stationary running and vertical jump in the water, performed in different levels of immersion. METHODS: This case study was conducted with one subject (male, 27 years, 1,80 m and 84,3 kg). An underwater force plate was used for data collection, placed at the bottom of a thermal swimming pool. The subject performed 30 valid passages for each exercise in two immersion levels: xiphoid process and hip. Data were analyzed through descriptive statistics, Student's "t" test for paired samples and ANOVA for repeated measures (p < 0,05). RESULTS: The maximum values of force in the xiphoid process and hip levels (in percent of body weight) were, respectively: 39 percent and 48 percent for walking; 138 percent and 156 percent for running; 139 percent and 202 percent for stationary running; 194 percent and 195 percent for the propulsion phase of jumping; and 222 percent and 387 percent for the landing phase of jumping. CONCLUSION: When varying the type of exercise we can gradually increase the load, from walking in the xiphoid process immersion level to jumping in the hip immersion level. In order to choose the correct exercise we have to consider the objectives of the treatment/training program, increasing the load not only by decreasing the immersion level but also by the choice of the exercise type and the velocity/ rhythm of execution.

Alongamento balístico versus sustentar e relaxar: comparação do ganho imediato e após 24 horas / Ballistic versus hold-relax stretching: comparison of immediate

Dentre os métodos de alongamento mais utilizados na prática clínica, encontram-se os métodos balístico e facilitação neuromuscular proprioceptiva (FNP) através da técnica de sustentar-relaxar. Poucos estudos analisaram por quanto tempo as alterações na amplitude de movimento (ADM) decorrentes da intervenção permanecem ou compararam a efetividade de dois tipos de carga sobre este tempo. Sendo assim, o objetivo deste estudo foi comparar qual método de alongamento aplicado à musculatura isquiotibial, dentre balístico e FNP do tipo sustentar-relaxar, é mais eficaz no ganho de ADM e na manutenção deste após 24 horas. Participaram do estudo 19 adultos jovens saudáveis. A avaliação da ADM foi realizada através da foto grametria antes, imediatamente após e 24 horas após a intervenção. Os métodos de alongamento foram aplicados de forma randomizada em uma sessão. Através dos resultados foi possível verificar que ambas as técnicas foram capazes de aumentar a ADM imediatamente após a aplicação (p = 0,001 para o balístico e p = 0,001 para o sustentar-relaxar) e manter por 24 horas após a aplicação (p = 0,023 para o balístico e p = 0,022 para o sustentar-relaxar). No entanto, na comparação entre os métodos, não houve diferença no ganho de ADM obtido. Confirma-se, portanto, a equivalente efetividade de ambos os métodos na obtenção e manutenção do ganho de ADM.

Ballistic and proprioceptive neuromuscular facilitation (PNF)through hold-relax technique are amongst the most used stretchingmethods in the clinical practice. Few studies have explored for howlong alterations in range of movement (ROM) dependent upon thestretching intervention have lasted or compared the effi cacy of diff erenttypes of stretching within a given load on this time. Th erefore,the aim of this study was to compare ballistic and PNF hold-relaxstretching and their eff ects in the hamstrings musculature related to ROM gain and its maintenance after 24 hours. 19 healthy young adults participated on the study. The ROM evaluation was carriedout through photogrammetry before, immediately after and after 24 hours the intervention. The stretching methods were randomly assigned in one session. It was possible to verify, through the results, that both techniques improved ROM immediately after intervention(p = 0,001 for ballistic and p = 0,001 for hold-relax) and theeff ects were maintained after 24 hours intervention (p = 0,023 forballistic and p = 0,022 for hold-relax). However, when comparingboth methods, no difference was found about the ROM gained. It has been then confi rmed the equal efficacy of both methods forimprovement and maintenance of ROM.

Fisioterapia respiratória e motora no pós-operatório imediato de gastroplastia - relato de caso / Practice physiotherapeutic in the immediate postoperative period of gastroplasty - a case study

O objetivo deste trabalho foi relatar a atuação fisioterapêutica no pós-operatório imediato de gastroplastia de Fobi-Capella. Para isso, foram realizadas duas avaliações, uma antes e outra após o tratamento. As avaliações englobaram: anamnese, exame físico geral, cirtometria e o teste da distância percorrida durante seis minutos. A conduta fisioterapêutica foi realizada em quatro sessões e baseou-se em manobras de higienização brônquica, reexpansão pulmonar, exercícios respiratórios, treino de padrão respiratório diafragmático e fisioterapia motora. A paciente relatada evoluiu de forma satisfatória no pós-operatório, evidenciando-se a importância da Fisioterapia para a recuperação motora e respiratória. Essa evolução foi principalmente constatada por meio da melhora da expansibilidade torácica ? aumento de três centímetros na expansibilidade diafragmática e de dois centímetros na altura do processo xifóide; do padrão respiratório, o qual passou de uma predominância apical para um padrão misto e por intermédio da capacidade física geral, verificada por meio do aumento expressivo da distância percorrida no teste de caminhada de 6 minutos (111,25 metros para 262,15 metros). Considera-se, portanto, a fisioterapia importante no pós-operatório de pacientes submetidos a gastroplastia, propiciando, junto a uma equipe multidiscplinar, uma melhor recuperação desses pacientes.

This study aimed to report the physiotherapeutic intervention in the immediate postoperative period of gastroplasty by Fobi-Capella. In order to do this, there were two evaluations, one before and one after treatment. Evaluations included: history, general physical examination, cirtometry and the six minutes walk test. There were four sessions of physiotherapeutic intervention which were based on maneuvers for the removal of respiratory secretion, re-lung, breathing exercises, training of diaphragmatic breathing pattern and physiotherapy needs. The patient reported growing satisfactorily in the postoperative period, which highlights the importance of physiotherapy to restore motor and breathing capacities. This was demonstrated in this study mainly by the chest expansion improvement (a three centimeter rise in diaphragmatic mobility and a two centimeter rise in mobility at the xiphoid process level), the breathing pattern (which changed from an apical breathing pattern to a pattern characterized mainly by the diaphragmatic expansion) and also demonstrated by the general physical capacity progress which was verified through the expressive increase in the distance walked during the six-minute-walk-test (111,25 meters to 262,15 meters). Therefore, it is concluded that the physiotherapeutic intervention is important in the gastroplasty immediate post-operative period, as it can provide, with a multidisciplinary group, a better recovery for these patients.