Risk of unfavorable pain prognosis impacts walking physiomechanical parameters and psychophysiological workload in sufferers of chronic low back pain.

BACKGROUND: Tolerating physical tasks depends not only on task-specific characteristics but also on an individual's psychophysiological capacity to respond to the imposed load. People suffering from chronic low back pain (CLBP) may experience reduced psychophysiological capacity and are at risk for poor pain prognosis, which could lead to an increased walking workload. AIM: To investigate how the risk of unfavorable pain prognosis in CLBP can impact walking physiomechanical parameters and psychophysiological workload. METHODS: A cross-sectional observational study. The study classified 74 volunteers into four groups based on their prognosis for pain: pain-free control (CG/n = 20), low (LrG/n = 21), medium (MrG/n = 22), and high (HrG/n = 11) risk of poor prognosis for CLBP. The ground assessments identified the self-selected (SSW) and optimal (OWS) walking speeds, as well as the locomotor rehabilitation index (LRI). Treadmill assessments were conducted at two different speeds (0.83 and 1.11 m s-1, SSW and OWS) to record physiomechanical parameters. Psychophysiological workloads during walking were measured via workload impulse for the session (TRIMP), determined by variations in heart rate. RESULTS: CLBP groups exhibited slower SSW and lower LRI compared to the CG. The TRIMP was lower in the LrG. However, both MrG and HrG exhibited a comparable overload to the CG, even while walking at a lower intensity with a psychophysical demand. SSW and OWS displayed an increased TRIMP compared to fixed speeds. CONCLUSION: Psychosocial factors may affect SSW in people with CLBP but not among the risk strata. An unfavorable prognosis for pain could jeopardize the psychophysiological capacity to withstand walking demands.

Variação da velocidade de marcha e fatores clínicos associados em pessoas idosas da atenção primária à saúde: estudo longitudinal / Variation in gait speed and associated clinical factors in elderly people in primary health care: longitudinal study

Resumo: analisar a variação da velocidade da marcha e os fatores clínicos associados em pessoas idosas da Atenção Primária à Saúde, no período mínimo de dois anos. Materiais e método: estudo longitudinal prospectivo, do tipo quantitativo, subprojeto do projeto de pesquisa matriz intitulado "As variações da fragilidade física e da funcionalidade de idosos da atenção primária à saúde", desenvolvido com 389 idosos da atenção primária à saúde. As coletas de dados foram realizadas nos anos de 2019 (1ª onda) e 2022 (2ª onda), com idosos assistidos em uma Unidade Básica de Saúde de Curitiba-PR. Aplicou-se questionário com variáveis sociodemográficas e clínicas, incluindo autorrelato de agravos em saúde e história pregressa; teste Timed Up and Go para verificar o risco de queda; e avaliação do fenótipo da fragilidade física, com destaque para a velocidade da marcha. Os dados foram analisados de forma descritiva, a partir da distribuição de frequência absoluta e relativa, média e desvio padrão; bem como análise inferencial por meio de testes não paramétricos qui-quadrado, Wilcoxon Signed Rank e Exato de McNemar, para amostras pareadas, a fim de comparação entre os dois momentos (1ª e 2ª avaliação); e regressão logística para propor modelo preditivo, o qual considerou a entrada de variáveis que apresentaram p-valor =0,20 (técnica enter hierárquico), permanecendo no modelo as variáveis que apresentaram valor de p=0,05 ou que ajustassem o modelo. Considerou-se o nível de significância de 5%. O estudo recebeu parecer favorável do Comitê de Ética em Pesquisa. Resultados: a prevalência de VM reduzida na 1ª onda (n=389) foi de 20,8% (n=81). Com relação à 2ª onda (n= 128), 21 (16,4%) participantes apresentaram VM reduzida, dos quais 13 (61,9%) já dispunham dessa condição na baseline e 8 (6,25%) da amostra apresentaram redução da VM durante o seguimento (incidência). Ainda, 8 (7,5%) idosos com VM reduzida na 1ª onda apresentaram melhora desse parâmetro , indicando VM preservada na 2ª onda. Observou-se acréscimo na média de velocidade de marcha dos idosos de 0,04m/s durante o seguimento (de 1,03 m/s para 1,07m/s), no entanto, a variação não foi estatisticamente significativa (p=1,00). Os fatores clínicos, embora associados à VM reduzida na 1ª onda de avaliação, não apresentaram relação estatisticamente significativa à mudança na VM dos idosos durante o seguimento do estudo. O modelo preditivo de VM reduzida indicou que as variáveis comprometimento cognitivo sugestivo (OR:19,62; IC95%=1,93-209,92; p=0,014), força de preensão manual (OR:1,97; IC95%=1,04-3,71; p=0,036) risco de queda (OR:4,07; IC95%=2,27-7,28; p<0,001), histórico de quedas no último ano (OR:1,81; IC95%=0,99-3,26; p=0,050), problemas metabólicos (OR:1,97; IC95%=1,09-3,55; p=0,024), auditivo (OR:0,33; IC95%=0,14-0,80; p=0,013) e cardiovascular (OR:2,08; IC95%=1,02-4,26; p=0,044), aumentaram as chances de as pessoas idosas apresentarem VM reduzida. Conclusão: não houve variação significativa da VM no período investigado e os fatores clínicos se mostraram associados à VM reduzida apenas na 1ª onda de avaliação. É importante que a equipe de saúde da atenção primária desenvolva ações de acompanhamento, bem como de rastreio da velocidade da marcha e das condições clínicas relacionadas à saúde, com vistas a evitar a progressão da síndrome da fragilidade das pessoas idosas.

Abstract: to analyze the variation in gait speed and associated clinical factors in elderly people in Primary Health Care, over a minimum period of two years. Materials and method: prospective longitudinal study, quantitative, subproject of the main research project entitled "Variations in physical frailty and functionality of elderly people in primary health care", developed with 389 elderly people in primary health care. Data collection was carried out in 2019 (1st wave) and 2022 (2nd wave), with elderly people cared for in a Basic Health Unit in Curitiba-PR. A questionnaire was applied with sociodemographic and clinical variables, including self-report of health problems and past history; Timed Up and Go test to check the risk of falling; and assessment of the physical frailty phenotype, with emphasis on gait speed. The data were analyzed descriptively, based on absolute and relative frequency distribution, mean and standard deviation; as well as inferential analysis using non-parametric chi-square tests, Wilcoxon Signed Rank and McNemar's exact tests, for paired samples, in order to compare the two moments (1st and 2nd assessment); and logistic regression to propose a predictive model, which considered the entry of variables that presented a p-value =0.20 (hierarchical enter technique), with variables that presented a p-value =0.05 or that adjusted the model remaining in the model. A significance level of 5% was considered. The study received a favorable opinion from the Research Ethics Committee. Results: the prevalence of reduced MV in the 1st wave (n=389) was 20.8% (n=81). In relation to the 2nd wave (n= 128), 21 (16.4%) participants presented reduced MV, of which 13 (61.9%) already had this condition at baseline and 8 (6.25%) of the sample presented a reduction of MV during follow-up (incidence). Furthermore, 8 (7.5%) elderly people with reduced MV in the 1st wave showed improvement in this parameter, indicating preserved MV in the 2nd wave. An increase in the elderly's average walking speed of 0.04 m/s was observed during the follow-up (from 1.03 m/s to 1.07 m/s), however, the variation was not statistically significant (p=1 ,00). Clinical factors, although associated with reduced MV in the 1st wave of evaluation, did not present a statistically significant relationship to the change in the elderly's MV during the study follow-up. The predictive model of reduced MV indicated that the variables suggestive cognitive impairment (OR:19.62; CI95%=1.93-209.92; p=0.014), handgrip strength (OR:1.97; CI95%= 1.04-3.71; p=0.036) risk of falling (OR:4.07; 95%CI=2.27-7.28; p<0.001), history of falls in the last year (OR:1.81; CI95%=0.99-3.26; p=0.050), metabolic problems (OR:1.97; CI95%=1.09-3.55; p=0.024), auditory (OR:0.33; CI95 %=0.14-0.80; p=0.013) and cardiovascular (OR:2.08; 95%CI=1.02-4.26; p=0.044), increased the chances of elderly people having reduced MV. Conclusion: there was no significant variation in MV during the period investigated and clinical factors were associated with reduced MV only in the 1st wave of evaluation. It is important that the primary care health team develops follow-up actions, as well as tracking the speed of MV. gait and healthrelated clinical conditions, with a view to preventing the progression of frailty syndrome in elderly people.

MARCH1 silencing suppresses growth of oral squamous cell carcinoma through regulation of PHLPP2.

PURPOSE: Oral squamous cell carcinoma (OSCC) is the most frequent type of oral cancer and is associated with high mortality. Membrane-associated ring-CH type finger 1 (MARCH1) is an E3 ubiquitin ligase with roles in immune regulation and cancer development. Whether MARCH1 has a specific role in OSCC, and if so through what mechanism, has not been explored. METHODS: Immunohistochemistry was performed to examine MARCH1 expression in OSCC clinical samples and adjacent paracancerous tissues. Quantitative reverse transcriptase polymerase chain reaction (qRT-PCR) and Western blot were conducted to determine mRNA expression and protein levels, respectively. Knockdown and overexpression experiments were carried out to evaluate the effects of MARCH1 on proliferation and apoptosis. To test protein-protein interaction, co-immunoprecipitation assay was performed. Finally, tumor cell grafting was utilized to test the function of MARCH in vivo. RESULTS: High MARCH1 expression in OSCC clinical samples correlated with poor patient prognosis. Functionally, MARCH1 knockdown in OSCC cells suppressed proliferation and promoted apoptosis, while MARCH1 overexpression displayed the opposite effects. We identified PH Domain And Leucine Rich Repeat Protein Phosphatase (PHLPP) 2 as an important target of MARCH1. Mechanistically, MARCH1 interacted with PHLPP2 and promoted PHLPP2 ubiquitination. Lastly, MARCH1 knockdown suppressed OSCC tumorigenicity in vivo and increased PHLPP2 protein level. CONCLUSION: Our study uncovered a function of MARCH1 in OSCC and identified PHLPP2 as an important target of MARCH1 to modulate OSCC cell proliferation and apoptosis.

The Impact of Formula Choice for the Management of Pediatric Cow's Milk Allergy on the Occurrence of Other Allergic Manifestations: The Atopic March Cohort Study.

OBJECTIVES: To compare the impact of different formulas on the occurrence of other atopic manifestations and the time of immune tolerance acquisition. STUDY DESIGN: In a 36-month prospective cohort study, the occurrence of other atopic manifestations (eczema, urticaria, asthma, and rhinoconjunctivitis) and the time of immune tolerance acquisition were comparatively evaluated in immunoglobulin E-mediated children with cow's milk allergy (CMA) treated with extensively hydrolyzed casein formula containing the probiotic L. rhamnosus GG (EHCF + LGG), rice hydrolyzed formula, soy formula, extensively hydrolyzed whey formula (EHWF), or amino acid-based formula. RESULTS: In total, 365 subjects were enrolled into the study, 73 per formula cohort. The incidence of atopic manifestations was 0.22 (Bonferroni-corrected 95% CI 0.09-0.34) in the EHCF + LGG cohort; 0.52 (0.37-0.67) in the rice hydrolyzed formula cohort; 0.58 (0.43-0.72) in the soy formula cohort; 0.51 (0.36-0.66) in the EHWF cohort; and 0.77 (0.64-0.89) in the amino acid-based formula cohort. The incidence of atopic manifestations in the rice hydrolyzed formula, soy formula, EHWF, and amino acid-based formula cohorts vs the EHCF + LGG cohort was always greater than the prespecified absolute difference of 0.25 at an alpha-level of 0.0125, with corresponding risk ratios of 2.37 (1.46-3.86, P < .001) for rice hydrolyzed formula vs EHCF + LGG; 2.62 (1.63-4.22, P < .001) for soy formula vs EHCF + LGG; 2.31 (1.42-3.77, P < .001) for EHWF vs EHCF + LGG; and 3.50 (2.23-5.49, P < .001) for amino acid-based formula vs EHCF + LGG. The 36-month immune tolerance acquisition rate was greater in the EHCF + LGG cohort. CONCLUSIONS: The use of EHCF + LGG for CMA treatment is associated with lower incidence of atopic manifestations and greater rate of immune tolerance acquisition.

Unsupervised modeling and genome-wide association identify novel features of allergic march trajectories.

BACKGROUND: The allergic march refers to the natural history of allergic conditions during infancy and childhood. However, population-level disease incidence patterns do not necessarily reflect the development of allergic disease in individuals. A better understanding of the factors that predispose to different allergic trajectories is needed. OBJECTIVE: Our aim was to determine the demographic and genetic features that are associated with the major allergic march trajectories. METHODS: Presence or absence of common allergic conditions (atopic dermatitis [AD], IgE-mediated food allergy [IgE-FA], asthma, and allergic rhinitis [AR]) was ascertained in a pediatric primary care birth cohort of 158,510 subjects. Hierarchic clustering and decision tree modeling were used to associate demographic features with allergic outcomes. Genome-wide association study was used to test for risk loci associated with specific allergic trajectories. RESULTS: We found an association between self-identified black race and progression from AD to asthma. Conversely, Asian or Pacific Islander race was associated with progression from AD to IgE-mediated food allergy, and white race was associated with progression from AD to AR. Genome-wide association study of trajectory groups identified risk loci associated with progression from AD to asthma (rs60242841) and from AD to AR (rs9565267, rs151041509, and rs78171803). Consistent with our epidemiologic associations, rs60242841 was more common in individuals of African ancestry than in individuals of European ancestry, whereas rs9565267 and rs151041509 were more common in individuals of European ancestry than in individuals of African ancestry. CONCLUSION: We have identified novel associations between race and progression along distinct allergic trajectories. Ancestral genetic differences may contribute to these associations. These results uncover important health disparities, refine the concept of the allergic march, and represent a step toward developing individualized medical approaches for these conditions.

Avaliações genéticas para altura de cernelha e funcionalidade da marcha em equinos da raça Campolina / Genetic evaluations for withers height and gait functionality in Campolina horses

As avaliações genéticas permitem compreender a evolução da raça e a importância dos componentes genéticos sobre a variação fenotípica das características de interesse de produção em animais. Objetivou-se, com este trabalho, estimar a tendência genética, a herdabilidade e a correlação genética para altura de cernelha e funcionalidade da marcha em equinos brasileiros da raça Campolina. A Associação Brasileira dos Criadores de Cavalo Campolina disponibilizou 107.630 dados de animais registrados desde 1951 até julho de 2016. As avaliações genéticas foram obtidas por modelo animal uni-característico, para altura de cernelha, com dados de 11.765 indivíduos, e bi-característico, para os atributos de qualidade de marcha, que são: comodidade, desenvolvimento, dissociação, estilo e regularidade, pertencentes a 2.148, 2.148, 2.145, 2.125 e 2.148 equinos, respectivamente. Incremento genético de 3,88cm foi observado para altura de cernelha ao longo dos anos, sugerindo a eficiência de seleção para porte elevado no Campolina. Não foi verificada evolução genética nos atributos de marcha, podendo indicar necessidade de melhoria nos processos de avaliação e seleção dos animais para maior comodidade e desenvoltura desse andamento. Verificou-se herdabilidade igual a 0,37 para altura de cernelha e 0,77 para dissociação, além de herdabilidades de comodidade, desenvolvimento, estilo e regularidade iguais a 0,15, 0,23, 0,22 e 0,28. Os resultados indicam que essas características podem ser utilizadas como critério de seleção para melhor qualidade de marcha. As correlações genéticas verificadas entre a medida linear e todos os atributos de marcha foram de baixa magnitude, variando entre -0,01 e 0,05. Desta forma, é sugerido que a seleção para altura na cernelha exerce baixa influência sobre os ganhos genéticos em atributos de marcha.

Genetic evaluations allow to describe the genetic evolution of a breed and to understand the importance of the genetic variability on the phenotypic variance of a production interesting trait. This study aimed to estimate genetic tendency, heritability and genetic correlation for withers height and gait functionality traits in Brazilian Campolina horses. The Brazilian Association of Campolina Horse Breeders provided 107,630 records from registered animals born from 1951 until July 2016. Genetic evaluations were obtained by uni-trait animal model, for withers height using data from 11,765 individuals, and bi-trait models for attributes of gait quality: comfort, reach, dissociation, style and regularity, belonging to 2,148, 2,148, 2,145, 2,125 and 2,148 horses, respectively. A genetic increase of 3.88cm was observed for withers height over the years, suggesting the efficiency of selection for high height in Campolina. There was no genetic evolution in the gait attributes, which may indicate the need for improvement in the evaluation and selection processes of the animals for greater comfort and range of their gait. Heritability equal to 0.37 and 0.77 was observed for withers height and dissociation. Comfort, reach, style and regularity showed heritabilities of 0.15; 0.23; 0.22 and 0.28, respectively. The results indicate that these characteristics can be used as selection criteria for better gait quality. The genetic correlations observed between the linear measurement and all gait attributes were low varying between -0.01 and 0.05. Therefore, the selection for withers height would have little influence on the genetic gains in gait attributes.

Elevated Atopic Comorbidity in Patients with Food Protein-Induced Enterocolitis.

BACKGROUND: Food protein-induced enterocolitis syndrome (FPIES) is a non-IgE-mediated food allergy. Its relationship to the major atopic manifestations (atopic dermatitis [AD], IgE-mediated food allergy [IgE-FA], allergic rhinitis [AR], asthma) is not understood. OBJECTIVE: To determine the clinical characteristics, epidemiologic features, and natural history of FPIES in relation to the major atopic manifestations. METHODS: We examined our primary care birth cohort of 158,510 pediatric patients, of whom 214 patients met 2017 FPIES diagnostic criteria. We measured the influence of FPIES on developing subsequent atopic disease. RESULTS: Pediatric FPIES incidence was between 0.17% and 0.42% depending on birth year. As in prior reports, most patients had an acute presentation (78%), and milk, soy, oat, rice, potato, and egg were common triggers. The mean age of diagnosis was 6.8 months. Atopic comorbidity was higher in patients with FPIES compared with healthy children (AD, 20.6% vs 11.7%; IgE-FA, 23.8% vs 4.0%; asthma, 26.6% vs 18.4%; AR, 28.0% vs 16.7%; P < .001 χ2). However, longitudinal analyses indicated that prior FPIES did not influence the rate of atopy development. CONCLUSIONS: The incidence of FPIES in our cohort was initially low, but is increasing. Food allergen distribution, presentation, and age of onset are similar to prior reports. Patients with FPIES have high rates of atopic comorbidity. However, longitudinal analysis does not support direct causation as the etiology of these associations. Rather it suggests a shared predisposition to both types of allergy, or associative bias effects. This work refines our understanding of the natural history of FPIES by elucidating associations between FPIES and atopy.

Restauración del patrón biomecánico de la marcha en niños cubanos / Restoration of the biomechanical pattern of walking in Cuban children

Introducción: La biomecánica en Cuba no está ajeno a la realidad internacional. Pese a las dificultades tecnológicas, los avances en materia de investigación sobre la biomecánica de la marcha humana generan mayor aporte a la medicina, hecho que reporta investigaciones de valioso impacto aplicable a la medicina física y de rehabilitación. Objetivo: Proponer la aplicación de un modelo matemático que contribuya a la recuperación del patrón biomecánico de la marcha, en la articulación de la cadera en niños con parálisis cerebral diparesia espástica. Métodos: Se realizó una exploración funcional y mecánica de dicha articulación en condiciones de normalidad, que comprendió los huesos, músculos y ligamentos, así como los movimientos que esta experimenta, y conforman el ciclo de la marcha bípeda normal. Se realizó una revisión de la parálisis cerebral (tipo diparesia espástica) desde su concepto y generalidades que describen el comportamiento de dicha patología y su manera de afectar el ciclo de la marcha normal. Resultados: El planteamiento de la ecuación que describe el movimiento tuvo sus bases en la dinámica lagrangiana, o sea, en la expresión Euler-Lagrange, y para darle funcionalidad a dicho modelo. Se realizó un estudio videográfico, el cual proporcionó los parámetros cinemáticos necesarios. Conclusiones: Parámetros cinéticos y antropométricos, dieron lugar a la obtención de las curvas de aceleración angular contra tiempo para los pacientes, estableciendo un marco comparativo de gran importancia para la toma de decisiones en el campo de acción de la medicina física y de rehabilitación, logrando mayor eficacia en la recuperación de estos pacientes o bien para el desarrollo de nuevas tecnologías(AU)

Introduction: Biomechanics in Cuba is not alien to international reality. Despite the technological difficulties, advances in the field of research on the biomechanics of human walking generate greater contribution to medicine, a fact that reports research of valuable impact applicable to physical medicine and rehabilitation. Objective: To propose the application of a mathematical model that contributes to the recovery of the biomechanical pattern of gait, in the hip joint in children with cerebral palsy, spastic diparesia. Methods: A functional and mechanical exploration of the joint was performed under normal conditions, which included the bones, muscles and ligaments, as well as the movements that it undergoes, and make up the cycle of normal bipedal gait. A review of cerebral palsy (type of spastic diparesia) was made from its concept and generalities that describe the behavior of this pathology and its way of affecting the normal gait cycle. Results: The approach of the equation that describes the movement had its bases in the Lagrangian dynamics, that is, in the Euler-Lagrange expression, and to give functionality to said model. A videographic study was conducted, which provided the necessary kinematic parameters. Conclusions: Kinetic and anthropometric parameters, resulted in obtaining angular acceleration curves against time for patients, establishing a comparative framework of great importance for decision making in the field of physical medicine and rehabilitation, achieving greater efficiency in the recovery of these patients or for the development of new technologies(AU)

Velocidad de la marcha como predictor de recuperación funcional en adultos mayores hospitalizados / Gait speed as predictor of functional recovery in hospitalized elderly adults

INTRODUCCIÓN. La funcionalidad es un parámetro importante en la evaluación del paciente geriátrico, que predispone a la fragilidad, institucionalización, morbilidad, discapacidad y muerte. OBJETIVO. Determinar el papel de la velocidad de la marcha como predictor de recuperación funcional en adultos mayores hospitalizados. MATERIALES Y MÉTODOS. Estudio observacional, de corte longitudinal, prospectivo. Con un total de 167 pacientes y una muestra de 152, con criterios de inclusión: adulto mayor que requirió hospitalización, que su patología de base no les impedía la marcha, y excluidos: 13 pacientes por incapacidad para realizar la prueba de velocidad de marcha, fase final de vida o presentar deterioro cognitivo severo, 1 por fallecimiento y 1 por pérdida de datos, realizado en el Servicio de Geriatría del Hospital Quito N° 1 de la Policía Nacional, en el período Mayo a Septiembre del 2014, los datos demográficos fueron obtenidos de las Historias Clínicas Unicas, los pacientes fueron evaluados mediante las escalas de valoración geriátrica integral: Índice de Barthel, Mini-Mental Test, Escala de Tinetti; y, medición de la velocidad de la marcha en 6 metros en dos momentos; al ingreso y al alta hospitalaria. Para el análisis se utilizó el programa Microsoft Excel 2010, en la correlación bivarial, se utilizó el programa estadístico Statistical Package for Social Sciences Inc. Chicago, versión 18.0. para Windows XP. RESULTADOS. Se encontró una asociación estadísticamente significativa (p<0,05) con todas las variables del estudio. CONCLUSIÓN. La mejoría de la marcha tras la intervención hospitalaria fue de relevancia, su velocidad fue un predictor de estancia hospitalaria confiable, aquellos pacientes con velocidades de marcha bajas a su ingreso, permanecieron hospitalizados por más tiempo.

INTRODUCTION. Functionality is an important parameter in the evaluation of the geriatric patient, which predisposes to frailty, institutionalization, morbidity, disability and death. OBJECTIVE. Determine the role of gait velocity as a predictor of functional recovery in hospitalized older adults. MATERIALS AND METHODS. Observational, longitudinal, prospective study. With a total of 167 patients and a sample of 152, with inclusion criteria: older adult who required hospitalization, that his basic pathology did not prevent them from walking, and excluded: 13 patients due to inability to perform the gait speed test, final phase of life or presenting severe cognitive impairment, 1 due to death and 1 due to loss of data, performed at the Geriatrics Service of the Quito Hospital No. 1 of the National Police, in the period May to September 2014, the demographic data were obtained from the Unique Medical Records, the patients were evaluated using the comprehensive geriatric assessment scales: Barthel Index, Mini-Mental Test, Tinetti Scale; and, measurement of the speed of the march in 6 meters in two moments; upon admission and hospital discharge. For the analysis the Microsoft Excel 2010 program was used, in the bivariate correlation, the statistical program Statistical Package for Social Sciences Inc. Chicago, version 18.0 was used for Windows XP. RESULTS. A statistically significant association (p <0.05) was found with all the study variables. CONCLUSION. The improvement in gait after hospital intervention was relevant, its speed was a predictor of reliable hospital stay, those patients with low gait rates at admission, remained hospitalized for longer.

Efeito da prática do suporte de peso corporal na função motora de crianças / Effect of the practice of body weight support in the motor function of children

Objetivo. Avaliar a influência do Suporte de Peso Corporal (SPC) sobre a função motora de crianças não deambulantes. Método. Participaram do estudo oito crianças que não apresentavam o padrão de marcha. Foi realizada a identificação do desempenho da função motora grossa por meio da Gross Motor Function Classification Measure (GMFM) e da flexibilidade por meio do Teste Flexiteste, antes e após 10 sessões e um período de retenção durante 3 meses de tratamento com SPC em esteira ergométrica. Tendo assistência de dois terapeutas que auxiliavam em pontos chaves de joelho e tornozelo simulando o padrão de marcha da criança. As sessões foram realizadas uma vez por semana, durante 30 minutos, por um período de 3 meses e o mesmo de retenção. Resultado. O GMFM apresentou aumento das pontuações obtidas pré/pós-tratamento e retenção nos itens deitar/rolar e sentar, já o item engatinhar/ajoelhar mostrou diferença significativa apenas no período pré/pós-tratamento. A variável flexibilidade apresentou diferença significativa entre o pré e pós-tratamento e no pós-tratamento com o período de retenção. Conclusão. O tratamento com SPC em esteira ergométrica pode potencializar o desempenho funcional de crianças não-deambulantes, possibilitando a evolução de sua função motora grossa e flexibilidade. (AU)

Objective: To evaluate the influence of the Body Weight Support (SPC) on the gross motor in non-ambulant children. Method: Eight children participated in the study, they did not present gait pattern (GMFCS IV and V). To access the gross motor function, the Gross Motor Function Classification Measure (GMFM) test was applied, the flexibility values were collected through flexitest. Both tests were conducted before and after 10 clinical sessions and three months after the end of the treatment. The intervention were performed on a treadmill, with the subject attached to the SPC, being accompanied by two physiotherapists that helped to maintain the gait pattern by maintaining key positions of the knees and ankles. Each session had duration of 30 minutes, once per week during three months. Results: The GMGM scores for lay down/roll and sit increased after the treatment and on the retention when compared with pre tests. The crawl/kneel score only presented difference after the end of treatment. Flexibility presented higher values for post and retention in comparison with pre tests. Conclusion: The SPC treatment during treadmill gait may potentiate the functional performance of non-ambulant children, improving the gross motor skills and flexibility. (AU)

Estudo comparativo prospectivo para a avaliação da reabilitação de usuários de próteses com amputações transtibiais / Prospective comparative study for the evaluation of prosthetic rehabilitation users with transtibial amputation

Resumo Indivíduos com amputações transtibiais apresentam dificuldades em realizar marcha e manter-se em equilíbrio, afetando diretamente a sua qualidade de vida. A utilização de próteses pode possibilitar a reabilitação do indivíduo, mas questiona-se o quão eficiente são para determinadas tarefas e como ainda podem melhorar. Objetivando avaliar as próteses para amputações transtibiais, foi realizado um estudo comparativo com dois grupos: Amputados e NÃO Amputados. Com o auxílio da tecnologia de Captura de Movimentos, realizou-se mensuração dos ângulos de equilíbrio estático, velocidade de marcha e pontuações na execução de atividades diárias. Os resultados indicam que as maiores dispersões dos ângulos de equilíbrio estático pertencem ao grupo de amputados. Em relação às médias de Velocidade de Marcha e nas pontuações das Atividades Diárias, constatou-se melhor desempenho para o grupo dos NÃO amputados. A partir disso, foi identificado ainda que as características técnicas das próteses transtibiais podem impactar na reabilitação de seus usuários.

Abstract Individuals with transtibial amputations have difficulties in performing march and stay in balance, directly affecting their quality of life. The use of prostheses can enable the rehabilitation of the individual, but we question how effective are for certain tasks and how they can still improve. To evaluate the prosthesis for transtibial amputation, a comparative study was conducted with two groups: Amputee and NOT Amputees. With the help of Motion Capture technology was held measuring the angles of static balance, walking speed and scores in the execution of daily activities. The results indicate that dispersions of larger static equilibrium angles belonging to the group amputees. In terms of average speed march and in scores of Daily Activities, there was better performance for the group of NOT amputees. From this it was also identified that the technical characteristics of transtibial prosthetic could impact rehabilitation of its members.

Association of Vitamin D With Stress Fractures: A Retrospective Cohort Study.

Vitamin D is an essential, fat-soluble nutrient that is a key modulator of bone health. Despite the gaining popularity throughout published medical studies, no consensus has been reached regarding a serum vitamin D level that will guarantee adequate skeletal health in a patient with an increased functional demand. The purpose of the present investigation was to examine the serum concentrations of vitamin D in patients with confirmed stress fractures. A total of 124 patients were included in our retrospective cohort study. Of the 124 patients, 53 had vitamin D levels measured within 3 months of diagnosis. An association was seen in patients with a stress fracture and vitamin D level measured, as 44 (83.02%) of the 53 patients had a serum 25-hydroxyvitamin D level <40 ng/mL. Although an association was seen at our institution in patients with stress fractures and a serum vitamin D concentration <40 ng/mL, a larger and prospective investigation is warranted to further understand the effect of vitamin D level and stress fracture prevention in an active, nonmilitary population.

Desempenho da marcha de idosos praticantes de psicomotricidade / Walking performance of elderly practitioners of psychomotricity / Desempeño de la marcha de ancianos practicantes de la psicomotricidad

Estudo quase experimental realizado com quinze idosos, desenvolvido na Clínica Escola de Fisioterapia da Universidade Federal da Paraíba, em 2011. Objetivou-se avaliar o desempenho da marcha de idosos praticantes de atividades psicomotoras. Foi realizada uma entrevista estruturada centrada em dados sociais, clínicos e funcionais, com o intuito de poder correlacionar diversas informações que sustentassem o objetivo do estudo. A média no desempenho cognitivo foi de 19,4, na primeira avaliação e de 23,2, na segunda. A média no desempenho de atividades relacionadas à marcha foi de 11,6, na primeira avaliação, e de 15,5, na segunda, logo após a prática de atividades psicomotoras. Constatou-se uma melhora significativa no desempenho das atividades relacionadas à marcha, com irregularidades que persistiram na altura e na continuidade do passo, bem como no desvio da linha média.

Quasi-experimental study conducted with fifteen elderlies, developed at the Physiotherapy Clinical School, Federal University of Paraíba, in 2011. The study aimed to evaluate the performance of gait in elderly practitioners of psychomotor activities. It was conducted a structured interview focusing on social, clinical and functional data, in order to be able to correlate various information which supported the aim of the study. The average cognitive performance was 19.4 at the first assessment and 23.2 in the second. The average performance of activities related to the gait was 11.6 at the first assessment, and 15.5 in the second, after the practice of psychomotor activities. It was found a significant improvement in the performance of activities related to the gait, with irregularities persisting in height and continuity of the step, as well as in the midline deviation.

Estudio casi experimental realizado con quince ancianos, desarrollado en la Clínica Escuela de Fisioterapia de la Universidad Federal de Paraíba, en 2011. Objetivó-se evaluar el desempeño de la marcha de ancianos practicantes de actividades psicomotoras. Con el fin de correlacionar informaciones diversas para apoyo al objetivo del estudio, se llevó a cabo una encuesta estructurada centrada en datos sociales, clínicos y funcionales. El rendimiento cognitivo promedio fue de 19,4 en la primera evaluación y 23,2 en el segundo. El rendimiento promedio de las actividades relacionadas con la marcha fue de 11,6 en la primera evaluación, y 15,5 en la segunda, después de la práctica de actividades psicomotoras. Se percibió una mejora significativa en el desempeño de actividades relacionadas con la marcha, persistiendo irregularidades en la altura y en la continuidad del paso, y en el desplazamiento de la línea media.

Análise da marcha em portadores de doença pulmonar obstrutiva crônica / Analysis of the march in patients with chronic obstructive pulmonary disease

Introdução: O conhecimento da marcha nos portadores de Doença Pulmonar Obstrutiva Crônica (DPOC)e a identificação de variáveis podem promover o desenvolvimento de estratégias de reabilitação, com vistaà manutenção e preservação da autonomia. Objetivo: Avaliar o padrão de marcha do portador de DPOC,a partir da análise bidimensional com o software Simi Motion®. Método: Delineamento transversal, estudode casos, com seis portadores de DPOC, sexo masculino, 64,00 ± 8,07 anos, IMC 22,28 ± 2,46 kg/m2, volume expiratório forçado no primeiro segundo (VEF1) 35,17 ± 25,79 por ciento predito, capacidade vitalforçada (CVF) 64,83 ± 17,84 por ciento predito. Para dados cinemáticos utilizou-se videografia bidimensional, SimiMotion®, acoplado à câmera de vídeo digital. Registros em 60 frames por segundo e tempo de aquisição de ciclo de marcha. Resultados: Os dados cinemáticos encontraram-se variados; cada indivíduo apresentoupeculiaridades sobrepostas aos padrões básicos. Observou-se forte correlação negativa entre cadência e PImax (p = 0,002 e r = - 0,96), entre comprimento de passo e PEmax (p = 0,007 e r = - 0,93). Para a qualidadede vida (SGQR), associações diretas, qualidade de vida total (QVT) e percentual da fase de apoio (p= 0,086 e r = 0,75); qualidade de vida impacto (QVI) e percentual da fase de apoio (p = 0,09 e r = 0,74).Conclusão: Avaliar a marcha do portador de DPOC possibilitou inferir objetivamente, delineando intervençõesterapêuticas. Os benefícios esperados da pesquisa, tanto para o indivíduo quanto para a sociedade, é uma nova maneira de avaliar e incrementar a marcha, elemento fundamental para manutenção da independência funcional e qualidade de vid.

Absorção, acúmulo e exportação de macronutrientes no milho doce cultivado em condições de campo / Absorption, accumulation and export of macronutrients in sweet corn cultivated under field conditions

O milho doce é uma hortaliça voltada para o processamento industrial, é ainda pouco difundido para o consumo in natura no Brasil, talvez pelo restrito número de cultivares adaptadas ao clima tropical. Os estudos sobre as práticas de manejo mais adequadas, incluindo a dinâmica de absorção de nutrientes pela cultura, ainda são inexistentes. Portanto, neste trabalho, objetivou-se determinar a absorção, o acúmulo e a exportação de nutrientes no milho doce cultivado em condições de campo. Utilizou-se o híbrido simples Tropical, em delineamento inteiramente casualizado, sendo o experimento constituído por nove épocas de coleta (9, 18, 27, 36, 45, 54, 63, 72 e 81 dias após a emergência) com quatro repetições. As plantas amostradas em cada época (tratamento) foram cortadas no nível do solo para avaliação da parte aérea e divididas em planta e espigas, que foram utilizadas para a determinação da absorção de nutrientes pela parte vegetativa e sua redistribuição para a espiga. Foram calculadas as taxas de absorção diária dos macronutrientes, bem como as porcentagens de acúmulo de nitrogênio, fósforo, potássio, cálcio, magnésio e enxofre. O padrão de acúmulo de macronutrientes seguiu o acúmulo de matéria seca pelas plantas. A ordem decrescente de acúmulo de macronutrientes na parte aérea foi: K > N > Mg > P > Ca > S. Para a maioria dos nutrientes, o intervalo de máxima absorção foi de 18 a 27 dias após a emergência.

Sweet Corn is a vegetable addressed to industrial processing not widely consumed in natura in Brazil, possibly due to the restricted number of varieties adapted to the Brazilian tropical climate. Studies on the most appropriate management practices, which include the dynamics of nutrient absorption by the culture, are still nonexistent. Thus, the objective of this work was to determine the absorption, accumulation and export of nutrients in sweet corn under field conditions. Simple tropical hybrid was used, on an entirely randomized design comprised of nine treatments (9, 18, 27, 36, 45, 54, 63, 72 and 81 days after emergence) with four replicates. The plants were sampled in every treatment and cut to the soil surface for shoot (plant and ear) evaluation. Both parts were used to determine the absorption of nutrients by the plant and their transmigration to the ear. Daily nutrient absorption rates, as well as the accumulation percentages of nitrogen, phosphorus, potassium, calcium, magnesium and sulfur were evaluated. The pattern of macronutrient accumulation followed the dry matter accumulation of the plants. The decreasing order of macronutrient accumulation at the shoot was: K > N > Mg > P > Ca > S. Most nutrients had a maximum absorption interval around 18 to 27 days after emergence.

Marcha atópica / Atopic march

Objetivo: Rever a literatura a respeito do conceito de marcha atópica, suas bases teóricas e evidências clínicas. Tal conhecimento é importante no entendimento e aplicação dos princípios de prevenção primária e secundária das doenças atópicas. Fontes dos dados: Pesquisa bibliográfica em base eletrônica de dados, limitando a busca a artigos publicados nos últimos 15 anos, referentes a pesquisas ou estudos clínicos em seres humanos e estudos experimentais, escritos em português ou inglês. Referências a livros pertinentes ao tema também foram incluídas. Foram selecionados os artigos mais citados e com metodologia e discussão melhor estruturados dentro do tema dermatite atópica / marcha atópica. Síntese dos dados: O conceito de marcha atópica é uma tentativa de se explicar a inter-relação entre as doenças atópicas, assim como as características da história natural de cada uma delas. Tal conceito baseia-se em estudos clínicos que demonstraram que, em cerca de 50% dos indivíduos predispostos, as doenças atópicas ocorrem de forma seqüencial, sendo a dermatite atópica considerada como o primeiro passo desta marcha. Conclusões: A partir de dados coletados em estudos sobre prevalência de doenças atópicas e os possíveis fatores determinantes envolvidos no desenvolvimento das mesmas, princípios de prevenção primária e secundária podem ser recomendados e implementados.

Objective: To review the literature on atopic march concept, its theoretical basis and clinicai evidences. This knowledge is important to understand and to apply the principies of primary and secondary atopic diseases prevention. Data sources: A bibliographic search was done in electronic database, limited to articles published in the last 15 years, related to human research or experimental research, written in Portuguese or English. Some book relevant references were also included. The articles about atopic dermatitis and atopic march were selected according to the number of citation and the better methodology and discussion. Data synthesis: The atopic march concept is a trial to explain the relationship between the atopic diseases and the natural evolution of each one. Clinicai researches have demons¬trated that in something about 50% of predisposed individual, the atopic diseases occurred in a sequence way, being the atopic dermatitis the first step in this marcho Conclusions: Principies of primary e secondary prevention can be recommended and implemented after review the data collected in studies about prevalence of atopic diseases and the factors involved in the development of such diseases.