Occupational Health-Related Problems among Portuguese Fitness Instructors.

BACKGROUND: The fitness sector has experienced significant expansion, with fitness instructors (FIs) playing a pivotal role. Given the demands of their profession, understanding their health profile is crucial. This study's purpose is to explore the prevalence of fitness instructors' occupational health-related problems. METHODS: A questionnaire covering sociodemographic, occupational, and health-related items was administered. Statistical analyses, including Mann-Whitney U and chi-square tests, Spearman's rho correlations, and logistic regressions, were conducted. RESULTS: Fifty-nine FIs reported occupational health-related problems, with the majority occurring during instruction (66.1%), being muscular (32.2%), and knee (15.3%), the most common type and localization. Significant statistical differences were observed between injured and non-injured FIs, including sex (p = 0.012), years as an FI (p = 0.001), weekly days worked (p = 0.039), and daily hours worked (p = 0.013). Weak negative (-0.284 - -0.362) statistically significant correlations were found between health problems; weight; height; main activity; and FIs in the workplace. Logistic regressions identified significant models showing that having a sport/physical exercise background and practicing it regularly were less likely to report bursitis (OR 0.018; p = 0.020) and hip injuries (OR 0.026; p = 0.037). CONCLUSIONS: Approximately one-third of FIs reported occupational-related health problems, predominantly musculoskeletal injuries. Sociodemographic, personal, and occupational factors appear to influence the prevalence of these health problems.

Impact of Exercise Interventions on Sustained Brain Health Outcomes in Frail Older Individuals: A Comprehensive Review of Systematic Reviews.

Several systematic review studies highlight exercise's positive impact on brain health outcomes for frail individuals. This study adopts a Comprehensive Review of reviews (CRs) approach to amalgamate data from existing reviews, focusing on exercise's influence on brain health outcomes in older frail and pre-frail adults. The methodology involves a thorough search of Portuguese, Spanish, and English-indexed databases (i.e., Ebsco Health, Scielo, ERIC, LILACS, Medline, Web of Science, SportDiscus) from 1990 to 2022, with the AMSTAR-2 tool assessing evidence robustness. The search terms "physical exercise", "elderly frail", and "systematic review" were employed. Results: Out of 12 systematically reviewed studies, four presented high-quality (with metanalyses), while eight exhibit critically low quality. Positive trends emerge in specific cognitive and neuromotor aspects, yet challenges persist in psychosocial domains, complex cognitive tasks, and ADL outcomes. This study yields reasonable and promising evidence regarding exercise's influence on quality of life and depression in frail older individuals. However, the impact on biochemical markers remains inconclusive, emphasizing the need for standardized methodologies. Conclusions: The findings highlight the importance of acknowledging methodological nuances for clinicians and policymakers when translating these results into impactful interventions for aging populations. This emphasizes the necessity for a comprehensive and customized approach to exercise interventions aimed at fostering the sustainability of overall well-being in older individuals, aligning with United Nations Sustainable Development Goal 3.

The Effects of Massage Guns on Performance and Recovery: A Systematic Review.

The use of massage guns has become increasingly popular in recent years. Although their use is more and more common, both in a clinical and sports context, there is still little information to guide the practitioners. This systematic review aimed to determine the effects of massage guns in healthy and unhealthy populations as pre- and post-activity or part of a treatment. Data sources used were PubMed, PEDro, Scopus, SPORTDiscus, Web of Science and Google Scholar, and the study eligibility criteria were based on "healthy and unhealthy individuals", "massage guns", "pre-activity, post-activity or part of a treatment" and "randomized and non-randomized studies" (P.I.C.O.S.). Initially, 281 records were screened, but only 11 could be included. Ten had a moderate risk of bias and one a high risk of bias. Massage guns could be effective in improving iliopsoas, hamstrings, triceps suralis and the posterior chain muscles' flexibility. In strength, balance, acceleration, agility and explosive activities, it either did not have improvements or it even showed a decrease in performance. In the recovery-related outcomes, massage guns were shown to be cost-effective instruments for stiffness reduction, range of motion and strength improvements after a fatigue protocol. No differences were found in contraction time, rating of perceived exertion or lactate concentration. Massage guns can help to improve short-term range of motion, flexibility and recovery-related outcomes, but their use in strength, balance, acceleration, agility and explosive activities is not recommended.

Endoscopic Cubital Tunnel Release in Leprosy Neuritis of the Ulnar Nerve.

Objectives To better characterize the role of endoscopic cubital tunnel release in leprosy neuritis and determine whether there is an improvement in pain, sensitivity, and strength with the use of this minimally invasive technique. Methods A total of 44 endoscopic procedures for ulnar nerve decompression at the elbow were performed in patients who were previously diagnosed with leprosy neuritis. The inclusion criteria were surgical indication for ulnar nerve release and clinical treatment failure for 4 weeks in patients with cubital tunnel syndrome who had their ulnar nerve function, whether motor or sensitive, deteriorated progressively despite the treatment with prednisone 1 mg/kg/day and physiotherapy. For endoscopic release, the CTS Relief Kit (Linvatec. Largo, FL, USA) and a standard 4mm 30° arthroscope were used. Results The study included 39 patients, 29 (74.4%) males and 10 (25.6%) females. The age of the patients ranged from 12 to 64 years (33 ± 14.97). Five patients underwent bilateral release. The release demonstrated a statistically significant improvement in pain ( p 0.002), in sensitivity ( p < 0.001), and in strength ( p < 0.001). The best results were obtained when ulnar release was performed less than 6 months after surgery indication. None of the procedures were converted from endoscopic to open. No major complications (infection, vascular injury, and nervous injury) were reported. One patient had ulnar nerve subluxation. Conclusion The endoscopic release of the ulnar nerve at the elbow in leprosy neuritis entails true and safe benefits for the patient, such as improvement in pain, sensitivity and strength.

Swimmers with Down Syndrome Are Healthier and Physically Fit than Their Untrained Peers.

While there are positive benefits from physical activity participation for individuals with Down syndrome, little is known about the effects of swimming training. The aim of this study was to compare the body composition and physical fitness profile of competitive swimmers and moderately active (untrained) individuals with Down syndrome. The Eurofit Special test was applied to a group of competitive swimmers (n = 18) and a group of untrained individuals (n = 19), all with Down syndrome. In addition, measurements were taken to determine body composition characteristics. The results showed differences between swimmers and untrained subjects in height, sum of the four skinfolds, body fat %, fat mass index and all items of the Eurofit Special test. Swimmers with Down syndrome exhibited physical fitness levels near to the Eurofit standards, although lower fitness levels were attained by these persons when compared to athletes with intellectual disability. It can be concluded that the practice of competitive swimming seems to counteract the tendency for obesity in persons with Down syndrome and also helps to increase strength, speed and balance.

Endoscopic Cubital Tunnel Release in Leprosy Neuritis of the Ulnar Nerve / Liberação endoscópica do túnel cubital na neurite hansênica do nervo ulnar

Abstract Objectives To better characterize the role of endoscopic cubital tunnel release in leprosy neuritis and determine whether there is an improvement in pain, sensitivity, and strength with the use of this minimally invasive technique. Methods A total of 44 endoscopic procedures for ulnar nerve decompression at the elbow were performed in patients who were previously diagnosed with leprosy neuritis. The inclusion criteria were surgical indication for ulnar nerve release and clinical treatment failure for 4 weeks in patients with cubital tunnel syndrome who had their ulnar nerve function, whether motor or sensitive, deteriorated progressively despite the treatment with prednisone 1 mg/kg/day and physiotherapy. For endoscopic release, the CTS Relief Kit (Linvatec. Largo, FL, USA) and a standard 4mm 30° arthroscope were used. Results The study included 39 patients, 29 (74.4%) males and 10 (25.6%) females. The age of the patients ranged from 12 to 64 years (33 ± 14.97). Five patients underwent bilateral release. The release demonstrated a statistically significant improvement in pain (p 0.002), in sensitivity (p< 0.001), and in strength (p< 0.001). The best results were obtained when ulnar release was performed less than 6 months after surgery indication. None of the procedures were converted from endoscopic to open. No major complications (infection, vascular injury, and nervous injury) were reported. One patient had ulnar nerve subluxation. Conclusion The endoscopic release of the ulnar nerve at the elbow in leprosy neuritis entails true and safe benefits for the patient, such as improvement in pain, sensitivity and strength.

Resumo Objetivos Os objetivos deste estudo foram caracterizar melhor o papel da liberação endoscópica do túnel cubital na neurite hansênica e determinar se há melhora da dor, sensibilidade e força com esta técnica minimamente invasiva. Métodos Um total de 44 procedimentos endoscópicos para descompressão do nervo ulnar no cotovelo foram realizados em pacientes previamente diagnosticados com neurite por hanseníase. Os critérios de inclusão foram indicação cirúrgica para liberação do nervo ulnar e insucesso do tratamento clínico por 4 semanas em pacientes com síndrome do túnel cubital que sofreram deterioração progressiva da função motora ou sensitiva do nervo ulnar apesar do tratamento de 1 mg/kg/dia de prednisona e fisioterapia. A liberação endoscópica foi realizada com CTS Relief Kit (Linvatec. Largo, FL, EUA) e um artroscópio padrão de 4 mm e 30°. Resultados O estudo incluiu 39 pacientes, sendo 29 (74,4%) homens e 10 (25,6%) mulheres. A idade dos pacientes variou de 12 a 64 anos (33 ± 14,97). Cinco pacientes foram submetidos à liberação bilateral. A liberação provocou melhora estatisticamente significativa de dor (p= 0,002), sensibilidade (p <0,001) e força (p <0,001). Os melhores resultados foram obtidos quando a liberação ulnar foi realizada em menos de 6 meses após a indicação da cirurgia. Nenhum procedimento foi convertido de endoscópico para aberto. Não foram relatadas complicações maiores (infecção, lesão vascular e lesão nervosa). Um paciente apresentou subluxação do nervo ulnar. Conclusão A liberação endoscópica do nervo ulnar no cotovelo na neurite hansênica traz benefícios verdadeiros e seguros para o paciente, como melhora da dor, sensibilidade e força.

Differences in visual search behavior between expert and novice team sports athletes: A systematic review with meta-analysis.

Background: For a long time, in sports, researchers have tried to understand an expert by comparing them with novices, raising the doubts if the visual search characteristics distinguish experts from novices. Therefore, the aim of the present study was to review and conduct a meta-analysis to evaluate the differences in visual search behavior between experts and novices in team sports athletes. Methods: This systematic review with meta-analysis followed the PRISMA 2020 and Cochrane's guidelines. Healthy team athletes were included, which engaged in regular practice, from any sex or competitive level, specifically classified a priori as expert or novice in the original research (i.e., if they were classified after the experiment, based on one of the tests, the study would be excluded). We considered only research published in peer-reviewed journals, with no limitations regarding date or language. It was considered healthy team sport athletes engaged in regular practice. The scenarios could be in situ or film-based. The databases of EBSCO (Academic Search Complete, Academic Search Ultimate, APA PsycArticles, and APA PsycINFO), PubMed, Scopus, SPORTDiscus, and Web of Science were used to perform the searches. The risk of bias was calculated through the RoBANS tool. Results: From a total of 6,257 records, of which 985 were duplicates, titles and abstracts of 5,272 were screened, and 45 required full-text analysis. Of those, 23 were excluded due to not fulfilling the eligibility criteria regarding participants. In the end, 22 studies were selected, however, as two studies were part of the same trial and were analyzed conjointly. Discussion: Experts showed to be older and with more years of practice. The ability to distinguish experts from novices was not so clear regarding the variables analyzed. This could be due to the strategies chosen in each study, which were specific to each scenario, and when grouping all together, it was lost information within non-representative averages. The distinction between experts and novices was not clear, showing a lot of heterogeneity in the included studies. The expert classification itself may have been the conditioning aspect for these results, retaining the doubt and the need for more studies in the field. Systematic review registration: The protocol was pre-registered in OSF (project https://osf.io/3j4qv/, register https://osf.io/dvk2n).

Development of a Belt-actuated Robotic Platform for Early Rehabilitation.

In order to promote early rehabilitation, we proposed a system which provides full-body arm-leg training for patients in a bed-lying position. As the preliminary development, a platform for leg movement was investigated. An innovative system with four servo drives was designed and manufactured. An artificial leg frame was attached to the platform via belts. The positions of the hip and knee joints were recorded using potentiometers. Closed-loop PID position control algorithms were implemented for production of various stepping movements. Technical evaluation on a test participant showed that the platform tracked the circular trajectory of the foot in a supine-lying position with an area difference of 8.2%, and produced walking-like trajectories in the hip and knee joints in a side-lying position with a mean error of 10.6%. The mechanical structure can be resized, and the control system can be expanded, so as to produce 3-dimensional stepping movement in both arms and legs. This innovative platform combined with the closed-loop position control strategy shows the technical potential to be a promising full-body rehabilitation platform for the patients in the early post-injury stage.

Older Women Who Practiced Physical Exercises before the COVID-19 Pandemic Present Metabolic Alterations and Worsened Functional Physical Capacity after One Year of Social Isolation.

BACKGROUND: Because the consequences of the lifestyle changes in older adults associated with the social isolation imposed in response to the COVID-19 pandemic are not fully understood, here, we investigated the effects of one year of social isolation imposed by COVID-19 on the metabolic parameters and functional physical capacity of older women who regularly practiced physical exercises before the pandemic. METHODS: Systemic lipid and protein profiles, estimated creatinine clearance (ECC), and functional physical capacity (FPC) were assessed before (January-February 2020) and 12 months after social isolation in 30 older women (mean age 73.77 ± 6.22) who were engaged in a combined-exercise training program for at least 3 years before the COVID-19 pandemic. RESULTS: In this group, we observed increased plasma levels of triglycerides and creatinine, an increase in the time necessary to perform gait speed and time-up-and-go tests, and reduced muscle strength assessed by the handgrip test and ECC post-COVID-19 pandemic relative to values recorded pre-pandemic. In addition, we observed significant correlations (both negative and positive) between anthropometric, some metabolic parameters, and physical tests. CONCLUSION: One year of interruption of physical exercise practice imposed in response to the COVID-19 pandemic significantly altered some systemic metabolic parameters and worsened ECC and FPC in older women.

Vertical Jump Tests: A Safe Instrument to Improve the Accuracy of the Functional Capacity Assessment in Robust Older Women.

Age-related decreases in muscle function lead to disabilities and are associated with negative health outcomes in older people. Although several physical tests can be used to assess physical performance, muscle strength, and power, their interpretation can be hampered by the ceiling effect of some of them. The aim of this study was to assess whether vertical jump tests are safe in terms of physical integrity and whether they are useful in assessing physical performance in forty-one robust older women. The investigation entailed an assessment of anthropometric characteristics, physical functioning tests (Short Physical Performance Battery (SPPB), sit-to-up 5 times and sit-to-up 30 s, gait speed, time-up-to-go test (TUGT)), and tests evaluating muscle strength and power (handgrip, lower limb isokinetic tests, and vertical jumping tests). Significant negative correlations were found between vertical jumping tests and BMI, body fat percentage, sit-to-up 5 times and TUGT. In addition, significant positive correlations were observed between vertical jumping tests and SPPB, gait speed, handgrip, and concentric isokinetic tests of knee muscles. No adverse events in volunteers' physical integrity were reported during and after the performance of all physical tests. Thus, the study results showed that vertical jumping tests are safe and accurate for assessing physical performance and are useful for monitoring age-related loss of muscle performance in robust older women.

Hospitais universitários: limitações e riscos ocupacionais dos trabalhadores com deficiência / University hospitals: limitations and occupational risks of workers with disabilities / Hospitales universitarios: limitaciones y riesgos laborales de los trabajadores con discapacidad

Objetivo: Conhecer os riscos ocupacionais relacionados as limitações dos trabalhadores com deficiência que laboram em hospitais universitários e odontológicos de Uberlândia-MG. Métodos: Pesquisa qualitativa, exploratória e descritiva. Os dados coletados mediante entrevista, semiestruturada com questões abertas e fechadas. Resultados: 33 profissionais participaram deste estudo. A maioria mulheres 20 (60,7%), enquanto que os homens são 13 (39,3%). Quanto a deficiência limitar a sua atividade laboral, 28 (87,8%) referem não sentir essa limitação. A maioria 25 (75,7%) não sentem dificuldades sobre a sua limitação de deficiência interferir na sua atividade laboral. 12,12% dos entrevistados afirmarem que sentem suas forças diminuídas e as restrições impostas por sua deficiência afetarem sua atuação profissional. Conclusão: Observa-se que em virtude de sua deficiência, sua autodeterminação fica limitada pela vulnerabilidade, porém compreende-se que o trabalho é uma das dimensões principais na vida deste profissional, pois pode impactar na sua qualidade de vida, melhora da autoestima, ascensão profissional e pessoal e instrumento de emancipação do trabalhador. (AU)

Objective: To know the occupational risks related to the limitations of workers with disabilities who work in university and dental hospitals in Uberlândia-MG. Methods: Qualitative, exploratory and descriptive research. The data collected through semiestruture interviews with open and closed questions. Results: 33 professionals participated in this study. Most women are 20 (60.7%), while men are 13 (39.3%). As for the disability to limit their work activity, 28 (87.8%) reported not feeling this limitation. Most (75.7%) do not feel difficulties about their disability limitations interfering with their work activity. 12.12% of the interviewees affirm that they feel their strengths are diminished and the restrictions imposed by their disability affecttheir professional performance. Conclusion: It is observed that due to his disability his self-determination is limited by vulnerability, but it is understood that work is one of the main dimensions in the life of this professional, as it can impact his quality of life, improveself este em professional and personal and instrument of mancipation of the subject. (AU)

Objetivo: Conocer los riesgos laborales relacionados con las limitaciones de los trabajadores con discapacidad que laboran en hospitales universitarios y odontológicos de Uberlândia-MG. Métodos: Investigación cualitativa, exploratoria y descriptiva. Datos recolectados a través de entrevistas semiestructuradas con preguntas abiertas y cerradas. Resultados: 33 profesionales participaron en este estudio. Mayoría de las mujeres 20 (60,7%), mientras que los hombres son 13 (39,3%). En cuanto a la discapacidad que limita su actividad laboral, 28 (87,8%) refirieron no sentir esta limitación. La mayoría 25 (75,7%) no siente dificultades por su limitación de discapacidad interfiriendo con su actividad laboral. El 12,12% de los encuestados dice sentir que su fuerza disminuye y las restricciones impuestas por su discapacidad afectan su desempeño profesional. Conclusión: Se observa que debido a su discapacidad, su autodeterminación está limitada por la vulnerabilidad, pero se entiende que el trabajo es una de las principales dimensiones en la vida de este profesional, ya que puede impactar su calidad de vida, mejorar la autoestima, promoción profesional y personal e instrumento de emancipación del sujeto (AU)

Impact of soil water regimes and partial root-zone drying in field-grown papaya in semi-arid conditions.

This study aimed to evaluate in the papaya Tainung genotype, the effects of partial root-zone drying (PRD) technique on soil water regimes by using different frequencies of shifting irrigation-side of plant row and the effects of PRD technique on (1) crop agronomic performance, (2) titratable fruit acidity (TA), (3) total soluble solids (TSS), and TSS/TA ratio. Also, we analyze the spatial dynamic of papaya condition using normalized difference vegetation index (NDVI) from different satellite images. The study was conducted in the semi-arid region of Bahia (BA) and Minas Gerais (MG), Brazil. The combination of 100% (Full irrigation-FU), 50%, and 35% in the irrigation depth (WID) and frequencies of shifting plant-row side irrigation of 0 (Fixed Irrigation-FX), 7, 14, and 21 days were applied. Nine treatments were studied in BA and five in MG. The water available in the soil was reduced to 44% for frequencies of shifting plant-row side irrigation of 7 days, 50% for 14 days, and 85% for 21 days, compared to the soil water availability at field capacity. Partial water deficit in the soil through the PRD technique did not significantly reduce the total root length, effective root depth, and root effective horizontal distance of the papaya Tainung genotype. However, PRD treatments showed leaf abscission, which resulted in reduced leaf area and NDVI values, especially in the MG experiment. Papaya yield and fruit quality were not affected. However, except for PRD 21 35%, irrigation water depth reduced to 50 and 35% under PRD increased crop water productivity (CWP) in papaya plants. Thus, the PRD technique may save 35% of WID using the alternation of lateral shift irrigation of crop row every 7 days under water scarcity in semi-arid regions. The NDVI index was important to compare the papaya canopy vigor between the experimental areas studied. We also confirmed the potential of NDVI to monitor the vigor of papaya canopy, since we could notice the sensibility of NDVI to identify water stress in papaya in higher vapor pressure deficit (VPD) conditions occurred in October 2016 and January 2017 in Bom Jesus da Lapa-BA. Therefore, the PRD strategy can be a useful tool to save water in papaya cultivation under semi-arid conditions.

Preliminary development and technical evaluation of a belt-actuated robotic rehabilitation platform.

BACKGROUND: To provide effective rehabilitation in the early post-injury stage, a novel robotic rehabilitation platform is proposed, which provides full-body arm-leg rehabilitation via belt actuation to severely disabled patients who are restricted to bed rest. OBJECTIVE: To design and technically evaluate the preliminary development of the rehabilitation platform, with focus on the generation of various leg movements. METHODS: Two computer models were developed by importing the components from SolidWorks into Simscape Multibody in MATLAB. This allowed simulation of various stepping movements in supine-lying and side-lying positions. Two belt-actuated test rigs were manufactured and automatic control programs were developed in TIA Portal. Finally, the functionality of the test rigs was technically evaluated. RESULTS: Computer simulation yielded target positions for the generation of various stepping movements in the experimental platforms. The control system enabled the two-drive test rig to provide three modes of stepping in a supine position. In addition, the four-drive test rig produced walking-like stepping in a side-lying position. CONCLUSIONS: This work confirmed the feasibility of the mechanical development and control system of the test rigs, which are deemed applicable for further development of the overall novel robotic rehabilitation platform.

The Outcomes of Switching from Short- to Long-Term Intravitreal Corticosteroid Implant Therapy in Patients with Diabetic Macular Edema.

BACKGROUND: First-line treatment for diabetic macular edema (DME) is usually with antivascular endothelial growth factor agents, followed by intravitreal corticosteroids as a second-line treatment option. Long-term corticosteroids may offer quality of life and effectiveness benefits over short-term implants. OBJECTIVES: To evaluate outcomes of patients with persistent or recurrent DME who switched from a short-term (dexamethasone) to a long-term (fluocinolone acetonide, FAc) corticosteroid intravitreal implant in a real-world setting. METHODS: This is a retrospective study in 9 Portuguese centers. An FAc intravitreal implant was administered according to product labeling. Effectiveness outcomes were mean change in visual acuity (VA; ETDRS letters), central retinal thickness (CRT; µm), and macular volume (MV; mm3). The safety outcome was mean change in intraocular pressure (IOP; mm Hg). All were analyzed at months 1 and 3, and then quarterly until month 24 after implantation. RESULTS: Forty-four eyes from 36 patients were analyzed. Mean duration of DME was 3.3 ± 1.9 years, and mean follow-up was 8 months. From baseline following FAc implantation, VA increased significantly at months 1 and 6 (mean +6.82 and +13.02 letters, respectively; p = 0.005), and last observation carried forward (LOCF; mean +8.3 letters; p = 0.002). CRT improved significantly at months 1 and 6 (mean -71.81 and -170.77 µm, respectively; p = 0.001), and LOCF (mean -121.46 µm; p = 0.001). MV was consistently, but not significantly, decreased from baseline to LOCF (mean -0.69 mm3; p = 0.062). The mean change in IOP was -0.25 and +0.88 mm Hg at months 1 and 6, respectively (p = 0.268), and +1.86 mm Hg at LOCF (p = 0.036). Increases were controlled with topical medication in most cases. CONCLUSIONS: The FAc intravitreal implant is effective in patients previously treated with short-term corticosteroid implants. Thus, after a suboptimal response to antiangiogenics or a short-term corticosteroid, a single FAc implant may be considered an effective and tolerable treatment that can improve long-term outcomes for patients with sight-threatening DME.

The Portuguese Experience with Ocriplasmin in Clinical Practice.

AIM: Evaluate the real-life experience with ocriplasmin on vitreomacular traction (VMT) release and full-thickness macular hole (FTMH) closure in Portugal. METHODS: Multicentric, retrospective study of 83 eyes of 78 patients who were treated with intravitreal ocriplasmin for VMT with and without FTMH. Primary outcomes were VMT release and FTMH closure. Secondary outcomes included visual acuity changes and structural features on spectral-domain ocular coherence tomography. RESULTS: VMT resolved in 47 of the 83 eyes (56.6%) and 6 of the 12 FTMH were closed (50.0%). Mean best-corrected visual acuity (BCVA) improved from 65.1 at baseline to 70.8 ETDRS letters at the end of follow-up (p < 0.0001) with a mean follow-up of 138.8 days. Improvement in BCVA was significantly better in eyes with VMT release (p = 0.021). Approximately 73% of patients had normal ellipsoid zone integrity at the end of follow-up, 87% had no neurosensorial detachment and 40% had no intra- or subretinal fluid. CONCLUSION: VMT release and FTMH closure were achieved in more than half of the treated eyes and were correlated with significant BCVA improvements and favorable baseline characteristics. In fact, if a careful patient selection is carried out, VMT resolution with ocriplasmin can be optimized, tailoring the best approach to each patient.

Front Crawl Sprint Performance: A Cluster Analysis of Biomechanics, Energetics, Coordinative, and Anthropometric Determinants in Young Swimmers.

The aim of this study was to evaluate the determinants of front crawl sprint performance of young swimmers using a cluster analysis. 103 swimmers, aged 11- to 13-years old, performed 25-m front crawl swimming at 50-m pace, recorded by two underwater cameras. Swimmers analysis included biomechanics, energetics, coordinative, and anthropometric characteristics. The organization of subjects in meaningful clusters, originated three groups (1.52 ± 0.16, 1.47 ± 0.17 and 1.40 ± 0.15 m/s, for Clusters 1, 2 and 3, respectively) with differences in velocity between Cluster 1 and 2 compared with Cluster 3 (p = .003). Anthropometric variables were the most determinants for clusters solution. Stroke length and stroke index were also considered relevant. In addition, differences between Cluster 1 and the others were also found for critical velocity, stroke rate and intracycle velocity variation (p < .05). It can be concluded that anthropometrics, technique and energetics (swimming efficiency) are determinant domains to young swimmers sprint performance.

Programa de apoio ao aleitamento materno exclusivo para mães trabalhadoras da iniciativa privada / Program to support exclusive breastfeeding for mothers working in the private sector

Objetivos: descrever a repercussão de um programa de incentivo ao aleitamento materno exclusivo (AME) denominado Curso Casal Gestante (CCG), realizado durante o pré-natal com seguimento de seis meses pós parto. Método: estudo de coorte retrospectivo, quantitativo, descritivo e comparativo, realizado em empresa privada, com 28 mães que tiveram seus partos em janeiro de 2012, acompanhadas durante os seis mesesseguintes, tendo 14 delas participado do CCG, recebendo orientações prévias sobre AM. Foram coletadas informações sobre índices de AME no primeiro, segundo, quarto e sexto mês pós-parto e as principais dificuldades durante a amamentação. Os dados foram avaliados por estatística descritiva e pelo teste não paramétrico qui-quadrado (x2) de comparação de proporções. Resultados: ao final do sexto mês de acompanhamento pós-parto, 18 mães (64,3%) permaneceram em AME, 13 (46,4%) não fizeram uso de mamadeira, 15 (53,6%) não ofereceram bico/chupeta. Das 14 mães que participaram do CCG recebendo orientações sobre AM, 13 (93%) permaneceram em AME até o sexto mês de vida do recém-nascido. Conclusões: o curso CCG mostrou-se estratégia complementar na manutenção do AME em até dois terços das mães, até o sexto mês pós-natal, e capaz de reduzir as principais dificuldades com amamentação.

Objectives: to describe the impact of a program to encourage exclusive breastfeeding (AME) named Expectant Couple Course (GCC), conducted during the prenatal period and followed-up to six months postpartum. Method: this was a retrospective cohort, quantitative, descriptive, and comparative study conducted in the private sector with 28 mothers who had their babies in January 2012, followed-up in the following six months; 14 participated in the CCG and received preliminary guidelines about AM. Information about AME indexes on the first, second, fourth and sixth months postpartum and the main difficulties while breastfeeding were collected. The data were evaluated by descriptive statistics and the nonparametric Chi-square test (x2) for comparison of proportions. Results: the end of the sixth month postpartum follow-up, 18 (64.3%) mothers remained in AME, 13 (46.4%) did not use bottle-feeding, 15 (53.6%) did not offer a pacifier. Out of the 14 mothers who participated in the CCG receiving guidance on AM, 13 (93%) remained in AME until the sixth month of the newborn life. Conclusions: the GCC course proved to be a complementary strategy for maintaining AME in up to two- -thirds of mothers, until the sixth postpartum month, and capable of reducing the main difficulties in breastfeeding.

Reliability of Concentric, Eccentric and Isometric Knee Extension and Flexion when using the REV9000 Isokinetic Dynamometer.

The aim of this study was to assess the reliability of isokinetic and ISO knee extensor and flexor muscle strength when using the REV9000 (Technogym) isokinetic dynamometer. Moreover, the reliability of several strength imbalance indices and bilateral ratios were also examined. Twenty-four physically active healthy subjects (age 23±3 years) underwent three testing sessions, two on the same day and a third, 7 days later. All sessions proceeded in the same order: five concentric contractions at 60ºs-1 followed by an isometric contraction (5 seconds) and five eccentric contractions (60ºs-1). The results of this study showed a high reproducibility in eccentric (0.95-0.97), concentric (0.95-0.96) and isometric (0.93-0.96), isokinetic strength for knee extensor and flexor muscles, thus indicating that the REV9000 isokinetic dynamometer can be used in future sports performance studies. A low-to-moderate reliability was found in the isokinetic strength bilateral ratios while the Hamstring:Quadricep concentric ratio showed moderate reliability. The highest reliability (>0.90) was observed in the dynamic control ratio (Hamstring eccentric:Quadricep concentric) which consequently confirms that it is a more valid indicator for imbalanced reciprocal parameters and can be used in rehabilitation and sports medicine.

Iniciação desportiva, actividades prévias e especialização no treino de futsal em Portugal / Sport initiation, early sport involvement and specialization in futsal training in Portugal

O presente estudo pretende analisar e caracterizar a preparação desportiva em longo prazo dos melhores jogadores de futsal portugueses. Para alcançar este objetivo foram realizados dois estudos distintos. O estudo 1 permitiu averiguar o percurso desportivo de jogadores séniores proveniente de diferentes níveis competitivos, elite (n=60), intermédio (n=160) e regional (151). Por sua vez, o estudo 2 comparou o envolvimento desportivo inicial dos melhores jogadores portugueses (n=24), com aquele desenvolvido por jogadores mais jovens, selecionados para representar as equipas distritais (n=270) e contemplou, adicionalmente, uma análise entre sexos. Todos os participantes preencheram um questionário previamente validado, que fornece informações de carácter retrospectivo sobre as atividades desportivas experiências ao longo da sua carreira. Os resultados demonstraram que os melhores jogadores se distinguem dos jogadores de níveis competitivos inferiores pela dedicação mais precoce ao treino desportivo e especificamente ao futsal, facto que é reforçado tanto pelo acréscimo progressivo do volume de treino semanal como na duração das épocas desportivas. Estes aspectos emergem como fatores discriminantes neste processo, não deixando de referenciar o contributo da prática diversificada no percurso dos melhores jogadores portugueses de futsal.

The present study aimed to analyze and characterize the long-term athlete development in the elite Portuguese futsal players. There were performed two different studies to achieve this goal. The first one allowed to ascertain the route of seniors sports players from different competitive levels, elite (n=60), medium (N=160) and regional (n=151). The second study has compared the early involvement of the elite senior Portuguese players (n=24), with the study developed with young players, selected to represent the district teams (n=270) and also included a comparison between genders. All the participants completed a previous validated questionnaire, which provides retrospective information about the sport activities experienced throughout his career. The results showed that the elite players are distinguished from lower level competitive players for their earlier dedication to the sports training and specifically to futsal, which is reinforced by the progressive increase in volume of weekly training as in the durations of seasons. These aspects emerge as discriminating factors in this process, whilst the early practice diversifications contribution to the course of the elite Portuguese futsal players.

Evaluation of an instrument for screening patients at risk for chronic kidney disease: testing SCORED (Screening for Occult Renal Disease) in a Portuguese population.

Prevalence of chronic kidney disease (CKD) is increasing and CKD has a long asymptomatic phase suitable for screening. SCORED (Screening for Occult Renal Disease) is a prescreening test which has compared favorably with KEEP. We report the results of SCORED testing in subjects attending a World Kidney Day event. After SCORED, subjects were tested for creatinine, urinary albumin and creatinine, and renal ultrasound. Eighty-eight subjects participated (32 men; mean age 59.7 ± 14.8 years; 58% hypertensive and 15.9% diabetics) of which 60 had a high score for kidney disease. Thirty-eight of 47 (80.8%) subjects that were further evaluated had a high-risk score. All subjects with CKD had a high score (100% sensitivity). SCORED showed low specificity (24.3%), but a high negative predictive value (100%). Including albuminuria in the definition of CKD increased the positive predictive value to 43.6%. In conclusion, SCORED is good for prescreening subjects for CKD in a European population as it captures all patients with CKD. Moreover, in subjects with low risk, the probability of CKD is low. SCORED is useful in alerting the general population and the medical community about the risk factors of CKD.