Interferential current intensity influences the hypoalgesic response in healthy subjects under mechanically-induced pain: A randomized controlled trial.

BACKGROUND: Interferential current (IFC) is a non-pharmacological therapy often used to reduce pain intensity. However, there is no scientific evidence of the biological effects of the adjustment of IFC intensity of stimulation. OBJECTIVE: To investigate whether the adjustment of IFC intensity influences pain on cutaneous sensory threshold (CST), pressure pain threshold (PPT) and pain intensity in healthy subjects under mechanically induced pain. METHODS: This is a placebo-controlled randomized trial. One hundred and two healthy university students blinded to intervention were randomized using opaque sealed envelopes to the following groups: 1) sensory IFC (n = 24); 2) fixed motor IFC (n = 26); 3) adjusted motor IFC (n = 27); and 4) placebo IFC (n = 25). After 40 minutes of stimulation or placebo, subjects were evaluated by an investigator blinded to group allocation. CST (von Frey filaments), PPT (algometry), and pain intensity (11-point numerical scale) were measured. RESULTS: Adjusted motor IFC promoted a significant reduction of CST (hand: mean difference (MD) = 2.39, confidence intervals (CI) = 1.39-3.38; and forearm: MD = 3.01, CI = 2.87-3.14) compared to placebo. Adjusted motor IFC increased PPT significantly (hand: MD = 27.59, CI = 26.80-28.37; and forearm: MD = 34, CI = 25.74-42.25) when compared to placebo. Adjusted motor IFC reduced pain intensity by 4.01 points (CI = 3.64-4.55) when compared to placebo. No adverse events were observed. CONCLUSIONS: Adjusted motor IFC intensity increased PPT and CST and also reduced pain intensity in healthy subjects under mechanically induced pain.

Is Electrical Stimulation Effective in Preventing or Treating Delayed-onset Muscle Soreness (DOMS) in Athletes and Untrained Adults? A Systematic Review With Meta-Analysis.

The effectiveness of electrical stimulation (ES) in preventing or treating delayed-onset muscle soreness (DOMS) and its effects on muscle recovery is unclear. The systematic review investigated the benefits or harms of ES on DOMS and muscle recovery. Databases (PubMed, Medline, CENTRAL, EMBASE, CINAHL, PsycINFO, PEDro, LILACS, SPORTDiscus) were searched up to March, 31st 2021 for randomized controlled trials (RCTs) of athletes or untrained adults with DOMS treated with ES and compared to placebo/sham (simulation or without ES), or control (no intervention). Data were pooled in a meta-analysis. Risk of bias (Cochrane Collaboration tool) and quality of evidence (GRADE) were analyzed. Fourteen trials (n=435) were included in this review and 12 trials (n=389) were pooled in a meta-analysis. Evidence of very low to low quality indicates that ES does not prevent or treat DOMS as well as ES does not help to promote muscle recovery immediately, 24, 48, 72, 96 hours after the intervention. Only one study monitored adverse events. There are no recommendations that support the use of ES in DOMS and muscle recovery. PERSPECTIVES: No recommendations support the use of electrical stimulation in delayed-onset muscle soreness and muscle recovery in athletes and untrained adults. This means that electrical stimulation is not fruitful for this population according those protocols used. Therefore, unlikely that further randomized controlled trials with the same approach will yield promising results.

Caracterização da qualidade microbiológica da água marítima e de mexilhões em uma fazenda marinha do município de Armação dos Búzios, RJ / Characterization of the microbiological quality of seawater and mussels in a marine farm in the county of Armação dos Búzios, RJ

O cultivo de moluscos é uma prática de grande importância devido ao alcance social e econômico para o município de Armação dos Búzios, RJ. Este trabalho tem como objetivo o monitoramento da qualidade da água de cultivo e de mexilhões em uma fazenda marinha de Armação dos Búzios, RJ. A melhor maneira de realizar um controle da qualidade da água e do produto é por meio da presença de indicadores de poluição fecal. Amostras de água e mexilhão foram coletadas em uma fazenda marinha e submetidas à análise microbiológica, através do método do Número Mais Provável. Após o monitoramento verificou-se que períodos com maior atividade turística e com maior ocorrência de chuvas apresentaram maior incidência de coliformes nas amostras, tornando-as impróprias para consumo. A não ocorrência de um monitoramento pode trazer riscos à saúde do consumidor.

Glial fibrillary acidic protein levels are associated with global histone H4 acetylation after spinal cord injury in rats.

Emerging evidence has suggested global histone H4 acetylation status plays an important role in neural plasticity. For instance, the imbalance of this epigenetic marker has been hypothesized as a key factor for the development and progression of several neurological diseases. Likewise, astrocytic reactivity - a well-known process that markedly influences the tissue remodeling after a central nervous system injury - is crucial for tissue remodeling after spinal cord injury (SCI). However, the linkage between the above-mentioned mechanisms after SCI remains poorly understood. We sought to investigate the relation between both glial fibrillary acidic protein (GFAP) and S100 calcium-binding protein B (S100B) (astrocytic reactivity classical markers) and global histone H4 acetylation levels. Sixty-one male Wistar rats (aged ~3 months) were divided into the following groups: sham; 6 hours post-SCI; 24 hours post-SCI; 48 hours post-SCI; 72 hours post-SCI; and 7 days post-SCI. The results suggested that GFAP, but not S100B was associated with global histone H4 acetylation levels. Moreover, global histone H4 acetylation levels exhibited a complex pattern after SCI, encompassing at least three clearly defined phases (first phase: no changes in the 6, 24 and 48 hours post-SCI groups; second phase: increased levels in the 72 hours post-SCI group; and a third phase: return to levels similar to control in the 7 days post-SCI group). Overall, these findings suggest global H4 acetylation levels exhibit distinct patterns of expression during the first week post-SCI, which may be associated with GFAP levels in the perilesional tissue. Current data encourage studies using H4 acetylation as a possible biomarker for tissue remodeling after spinal cord injury.

Immediate effects of transcutaneous electrical nerve stimulation (TENS) administered during resistance exercise on pain intensity and physical performance of healthy subjects: a randomized clinical trial.

PURPOSE: Exercise-induced muscle pain is a self-limiting condition which impacts physical activity habits. Transcutaneous electrical nerve stimulation (TENS) promotes pain reduction and functional improvement in different pain conditions. We propose that applying TENS during exercise might reduce pain and improve physical performance. Thus, we aimed to investigate immediate effects of TENS applied during resistance exercise. METHODS: Healthy subjects of both sexes, irregularly active or sedentary were assigned into two groups: active (n = 24) or placebo (n = 22) TENS. The study was conducted over five moments: on day 0, subjects were recruited, on day 1 subjects performed the one-repetition maximum test (1RM); 72 h later, on day 2, 1RM was retested; 48 h later, on day 3, TENS was applied during a functional-resisted exercise protocol for upper limbs (bench press and rowing), with an intensity of 80% of 1RM; and 24 h after, on day 4, subjects were reevaluated. Assessment included pain intensity at rest and with movement, pressure pain thresholds, and muscle fatigue. RESULTS: TENS did not reduce pain intensity when compared to placebo (p > 0.05). TENS reduce PPT in the latissmus dorsi: p = 0.02 and anterior tibialis: p = 0.04 in immediate reassessment. Immediate effects of TENS were significant for fatigue perception at rest (p = 0.01) and number of maximum repetitions during exercise sets, starting from the 5th set of rowing exercise (p = 0.002). CONCLUSION: Our results show that TENS did not reduce pain perception in healthy individuals, but its use induced increased muscle action, contributing to a greater fatigue perception.

Validation of a New Placebo Interferential Current Method: A New Placebo Method of Electrostimulation.

Objective: The present study aimed to investigate if a new placebo device for interferential current (IFC) that delivers current during only the first 40 seconds of stimulation is effective at promoting adequate subject blinding. Methods: Seventy-five subjects were recruited and enrolled into three groups: active IFC, inactive placebo, and new placebo. Pressure pain threshold (PPT), cutaneous sensory threshold (CST), and pain intensity were measured before and after the intervention. After the final assessment, the subjects and the investigator who applied the current were asked about the type of stimulation administered. Results: None of the placebo forms studied resulted in significant changes to PPT, CST, or pain intensity. The subjects stimulated with active IFC at high intensities (> 17 mA) of stimulation showed higher PPT and CST and lower pain intensity than subjects stimulated at low intensities ( p < 0.03). The new placebo method blinded the investigator in 100% of cases of IFC and 60% of subjects stimulated, whereas for inactive placebo, the investigator was blinded at a rate of 0% and 34% of subjects. Conclusion: The new method of placebo IFC was effective for blinding of research investigators and most of the active IFC-treated subjects, promoting an appropriate placebo method.

Chordata method combined with electrotherapy in functional recovery after brachial plexus injury: report of three clinical cases / Método Chordata combinado com eletroterapia na recuperação funcional após lesão do plexo braquial: relato de três casos clínicos

AIMS: To report three clinical cases of complex brachial plexus injury treated with an innovative physical therapy program, the Chordata Method, combined with electrotherapy. CASE DESCRIPTION: Three patients suffered a complex brachial plexus injury. They were submitted to surgery and to long-term rehabilitation with the Chordata method (including suspension and tilting exercises) combined with electrotherapy. All patients exhibited significant signs of recovery in post-treatment electroneuromyography. Moreover, improvements in muscle strength and in the range of motion of the injured upper limb were also observed, leading to better posture and gains in activities of daily living (e.g., driving a modified car, holding objects, performing household chores, and doing leisure activities). CONSLUSIONS: There was great functional recovery after the physical therapy program with the Chordata Method combined with electrotherapy, with an impact on patients' daily lives as well as on electroneuromyography findings. Randomized clinical trials are needed to confirm or refute this new non-pharmacological strategy for the treatment of brachial plexus injuries.

OBJETIVOS: Descrever três casos clínicos em que os indivíduos tiveram lesão de plexo braquial complexa, tratada com um programa inovador de fisioterapia, o Método Chordata, associado à eletroterapia. DESCRIÇÃO DOS CASOS: Três pacientes sofreram lesões complexas do plexo braquial. Os três sujeitos foram submetidos à intervenção cirúrgica e a um longo período de reabilitação com o emprego do método Chordata (envolvendo exercícios de suspensão e pendulação corporal), combinada com a eletroterapia. Todos os pacientes apresentaram sinais significativos de recuperação na eletroneuromiografia pós-tratamento. Além disso, os três também apresentaram melhora na força muscular e nas amplitudes de movimento do membro superior acometido. Observou-se melhor postura e ganhos importantes nas atividades de vida diária (tais como dirigir um carro modificado, segurar objetos, realizar tarefas domésticas e atividades de lazer). CONCLUSÕES: Os resultados revelaram uma importante recuperação funcional após o programa de fisioterapia com o Método Chordata associado à eletroterapia, com impacto na vida diária dos pacientes, bem como nos achados eletroneuromiográficos. Ensaios clínicos randomizados são necessários para confirmar ou refutar esta nova estratégia terapêutica não farmacológica nas lesões de plexo braquial.

Feldenkrais method-based exercise improves quality of life in individuals with Parkinson's disease: a controlled, randomized clinical trial.

CONTEXT: Longevity results in changes to patterns of health, with an increased prevalence of chronic diseases. Parkinson's disease (PD) is described as a progressive neurodegenerative disease related to age that influences quality of life (QoL) and leads to depression. OBJECTIVE: The study intended to assess changes in QoL and depression in older adults with PD through use of Feldenkrais method-based exercise. DESIGN: The study was a controlled, blinded, and randomized clinical trial. SETTING: The study occurred at the University Hospital of the Federal University of Sergipe in Aracaju, Sergipe, Brazil. PARTICIPANTS: Participants were 30 patients, aged between 50 and 70 y, with idiopathic PD, who signed an informed consent form and were randomly assigned to 2 groups: treatment and control. INTERVENTION: The treatment group underwent 50 sessions of an exercise program based on the Feldenkrais method. The control group received educational lectures during this period. The treatment group's 50 sessions, given 2 ×/wk on alternate days and lasting 60 min, were conducted in an appropriate room at the hospital. OUTCOME MEASURES: Two surveys, the Parkinson's Disease Quality of Life (PDQL) questionnaire and the Beck Depression Inventory (BDI), were administered before and after the sessions for both groups. RESULTS: After the exercises based on the Feldenkrais method, the treated group showed improvement in QoL scores (P = .004) as well as a reduction in the level of depression (P = .05) compared with the control group. CONCLUSION: The findings in the current study indicate that it is likely that the practice of a program based on the Feldenkrais method can contribute greatly to the QoL of patients with PD, suggesting the importance of interventions that promote wellness for this population.

Traffic-related air pollution and black carbon in sputum macrophages: a ?silent? lung disease? / Poluição do ar relacionada ao tráfego urbano e carbono preto em macrófagos de escarro: uma doença pulmonar ?silenciosa??

Aims: To describe two case reports with significant black carbon deposition in sputum macrophages in healthy young adults from an urban city, showing mild airway obstruction in lung function tests. The role of black carbon deposition by air pollution in the airways and the development of indolent chronic lung disease in populations living in larger cities is not clear and may be a potential world health problem.Cases description: We report two cases of voluntary adults living in a South American large city who have undergone clinical examination, lung function and analysis of inflammation and black carbon deposition in macrophages from induced sputum. Two Caucasian, previously healthy, nonsmokers, male adults, living in the same city of southern Brazil, with no respiratory symptoms presented with normal physical exams, but with lung function demonstrating mild obstructive lung disorder, with no bronchodilator response. In particular, one of the subjects works daily in delivery services as a motorcycle driver. Induced sputum of both patients showed no signs of cellular inflammation. However, a large number of black carbon content was detected inside macrophages of the sputum sample in both patients.Conclusions: In summary, significant daily air pollution exposure may play a role in long-term silent disease in adults, potentially leading to clinically relevant chronic lung diseases later in life, particularly in populations of urbanized large cities from developing countries. The development of better, more directly and less invasive, methods for air pollution exposure are required, along with longitudinal studies, in order to measure the real impact of air pollution in chronic lung diseases of susceptible populations.

Objetivos: descrever dois casos com importante deposição de carbono preto em macrófagos de escarro induzido em adultos jovens saudáveis de uma cidade urbana, mostrando obstrução leve no teste de função pulmonar. A deposição de carbono preto pela poluição do ar nas vias aéreas e no desenvolvimento de doença pulmonar crônica ?silenciosa? em populações que vivem em grandes cidades não é clara e pode ser um potencial problema de saúde mundial.Descrição dos casos: relatamos dois casos de adultos voluntários que vivem em uma grande cidade sul-americana, que se submeteram a exame clínico, função pulmonar e análise de inflamação e deposição de carbono preto em macrófagos de escarro induzido. Os indivíduos eram caucasianos, previamente saudáveis, não-fumantes, adultos, do sexo masculino, moradores da mesma cidade do sul do Brasil, e sem sintomas respiratórios. Apresentaram exames físicos normais, mas com função pulmonar demonstrando doença pulmonar obstrutiva leve, sem resposta ao broncodilatador. Em particular, um dos sujeitos trabalha diariamente em serviços de entrega como motoboy. No exame de escarro ambos não apresentaram sinais de inflamação celular, mas foi detectado um elevado número de carbono preto no interior dos macrófagos.Conclusões: a exposição contínua à poluição do ar pode desempenhar um papel no desenvolvimento de doenças pulmonares crônicas em longo prazo. O desenvolvimento de um exame melhor, mais direto e menos invasivo para análise da exposição à poluição do ar, juntamente com estudos longitudinais, permitirá medir o real impacto da poluição na etiopatogenia das doenças pulmonares crônicas em populações suscetíveis.

Dance therapy in patients with chronic heart failure: a systematic review and a meta-analysis.

OBJECTIVE: To see whether dance therapy was more effective than conventional exercise in exercise capacity and health-related quality of life (HRQOL) in patients with chronic heart failure. DESIGN AND METHODS: Systematic review and meta-analysis. We searched MEDLINE, Cochrane Controlled Trials Register, EMBASE, SPORT Scielo, CINAHL (from the earliest date available to August 2013) for randomized controlled trials (RCTs), examining effects of dance therapy versus exercise and/or dance therapy versus control on exercise capacity (VO2peak), and quality-of-life (QOL) in chronic heart failure. Two reviewers selected studies independently. Weighted mean differences (WMDs) and 95% confidence intervals (CIs) were calculated, and heterogeneity was assessed using the I(2) test. RESULTS: Two studies met the study criteria (62 dance therapy patients, 60 exercise patients and 61 controls patients). The results suggested that dance therapy compared with control had a positive impact on peak VO2 and HRQOL. Dance therapy resulted in improvement in: peak VO2 peak weighted mean difference (4.86 95% CI: 2.81 to 6.91) and global HRQOL standardized mean differences (2.09 95% CI: 1.65 to 2.54). Non-significant difference in VO2 peak and HRQOL for participants in the exercise group compared with dance therapy. No serious adverse events were reported. CONCLUSIONS: Dance therapy may improve peak VO2 and HRQOL in patients with chronic heart failure (CHF) and could be considered for inclusion in cardiac rehabilitation programmes.