Long-term outcomes of patients affected by Guillain-Barré syndrome in Colombia after the Zika virus epidemic.

BACKGROUND: Guillain-Barré Syndrome (GBS) can lead to significant functional impairments, yet little is understood about the recovery phase and long-term consequences for patients in low- and medium-income countries. OBJECTIVE: To evaluate the functional status and identify factors influencing outcomes among patients with GBS in Colombia. METHODS: Telephone interviews were conducted with GBS patients enrolled in the Neuroviruses Emerging in the Americas Study between 2016 and 2020. The investigation encompassed access to health services and functional status assessments, utilizing the modified Rankin Scale (mRS), GBS Disability Score (GDS), Barthel Index (BI), and International Classification of Functioning (ICF). Univariate analysis, principal component analysis, linear discriminant analysis, and linear regression were employed to explore factors influencing functional status. RESULTS: Forty-five patients (mean age = 50[±22] years) with a median time from diagnosis of 28 months (IQR = 9-34) were included. Notably, 22% and 16% of patients did not receive rehabilitation services during the acute episode and post-discharge, respectively. Most patients demonstrated independence in basic daily activities (median BI = 100, IQR = 77.5-100), improvement in disability as the median mRS at follow-up was lower than at onset (1 [IQR = 0-3] vs. 4.5 [IQR = 4-5], p < 0.001), and most were able to walk without assistance (median GDS = 2, IQR = 0-2). A shorter period from disease onset to interview was associated with worse mRS (p = 0.015) and ICF (p = 0.019). Negative outcomes on GDS and ICF were linked to low socioeconomic status, ICF to the severity of weakness at onset, and BI to an older age. CONCLUSIONS: This study underscores that the functional recovery of GBS patients in Colombia is influenced not only by the natural course of the disease but also by socioeconomic factors, emphasizing the crucial role of social determinants of health.

Effect of foam rolling recovery on pain and physical capacity after resistance exercises: A randomized crossover trial.

OBJECTIVES: To compare the effects of passive recovery (PR), active recovery (AR), and recovery through self-massage with the aid of foam rolling (FRR) on pain and physical capacity in healthy volunteers after a resistance exercise (RE) session. METHODS: The sample of this randomized crossover trial comprised 37 physically healthy men who underwent three sessions of RE (squat, leg press, and leg extension), involving four sets of 10 repetitions with 80% of 10MR, with an interval of seven days between sessions. PR consisted of sitting for 20min, AR included a cycle ergometer for 20min at 50% maximum heart rate, and FRR involved 10 repetitions per target body area, followed by 1min rest. Variables of physical capacity (strength, power, agility, joint range of motion, flexibility, speed, and fatigue resistance) were assessed 1h after RE, whereas pain was assessed 24h, 48h, and 72h after RE. RESULTS: In the dominant lower limb, the percentage of strength decreased (p < 0.001) by 16.3% after RE but improved (p < 0.001) by 5.2% after AR and FRR in relation to PR. Similar results were observed in the non-dominant lower limb. Agility was enhanced (p < 0.001) by 3.6% in AR and 4.3% in FRR compared with the baseline assessment. The recoveries for the other physical variables were similar. Only FRR reduced (p < 0.001) pain at 24h (22.8%), 48h (39.2%), and 72h (59.7%) compared to PR. CONCLUSIONS: Self-massage using a foam roll reduced pain and improved agility and muscle strength during recovery after exercise. TRIAL REGISTRATION NUMBER: NCT04201977.

Longitudinal associations between stroke-related neurologic deficits and course of basic activities of daily living up to six months after stroke.

PURPOSE: To investigate the course of basic activities of daily living (ADL) from admission up to six months after the stroke and the longitudinal associations between stroke-related neurological deficits at admission to the stroke unit and course of basic ADL. MATERIALS AND METHODS: 180 individuals with a first-ever stroke were assessed at admission to the stroke unit and at follow-ups of three and six months. Stroke-related neurological deficits were assessed at admission with the National Institutes of Stroke Scale (NIHSS). Independence in basic ADL was assessed at admission and three and six months after the stroke by the Modified Barthel Index (MBI). Generalized Estimating Equations (GEE) were performed. RESULTS: Dependence in basic ADL reduced overtime, with most changes occurring over the first three months. Individuals, who had moderate/severe stroke-related neurological deficits (NIHSS ≥6) at admission, had higher chances of becoming more dependent in activities related to feeding (OR:1.27;95%CI = 1.03-1.55;p = 0.021), bathing (OR:1.30;95%CI = 1.11-1.50;p = 0.0005), dressing (OR:1.19;95%CI = 1.04-1.36;p = 0.010), transfers (OR:1.24;95%CI = 1.05-1.46;p = 0.0072), stair climbing (OR:1.46;95%CI = 1.27-1.66;p < 0.0001), and ambulation (OR:1.21;95%CI = 1.02-1.43;p < 0.0001). CONCLUSIONS: Decreases in dependence in basic ADL occurred mainly over three months after the stroke and showed different patterns for specific ADL. Baseline moderate/severe stroke-related neurological deficits were associated with poor functional status in basic ADL over the follow-up period.

Stroke survivors experience dependence in basic activities of daily living (ADL) which is reduced over six months after the stroke and showed different individual variability in patterns of recovery.Patients with moderate/severe stroke-related neurological deficits had higher chances of becoming dependent in activities related to feeding, bathing, dressing, transfers, stair climbing, and ambulation.Rehabilitation professionals should consider assessing stroke-related neurologic deficits within the first hours after stroke, with particular attention to individuals with moderate/severe impairments.

Severe traumatic brain injury and acute kidney injury patients: factors associated with in-hospital mortality and unfavorable outcomes.

OBJECTIVE: The purpose of this study was to identify the occurrence of AKI, and factors associated with in-hospital mortality and unfavorable outcomes in patients with severe traumatic brain injury (TBI) and acute kidney injury (AKI) severity. METHOD: A retrospective cohort study which analyzed data with severe TBI between 2013 and 2017. We examined demographic and clinical information, and outcome by in-hospital mortality, and the Glasgow Outcome Scale six months after TBI. We associated factors to in-hospital mortality and unfavorable outcome in severe TBI and AKI with an association test. RESULTS: A total of 219 patients were selected, 39.3% had an AKI, and several factors associated with AKI occurrence after severe TBI. Stage 2 or 3 of AKI (OR 12.489; 95% CI = 4.45-37.94) were independent risk for both outcomes in multivariable models, severity injury by the New Trauma Injury Severity Score (OR 0.97; 95% CI = 0.96-0.99) for mortality, and the New Injury Severity Score (OR1.07; 95% CI = 1.04-1.10) and Trauma and Injury Severity Score (OR = 0.98; 95% CI = 0.965-0.997) for unfavorable outcome. CONCLUSION: The findings of our study confirmed that AKI severity and severity of injury was also related to increased mortality and unfavorable outcome after severe TBI.

A comprehensive physical functional assessment of survivors of critical care unit stay due to COVID-19 / Avaliação físico-funcional abrangente de sobreviventes de internação em unidade de terapia intensiva devido à COVID-19

ABSTRACT Objective: To examine the physical function and respiratory muscle strength of patients - who recovered from critical COVID-19 - after intensive care unit discharge to the ward on Days one (D1) and seven (D7), and to investigate variables associated with functional impairment. Methods: This was a prospective cohort study of adult patients with COVID-19 who needed invasive mechanical ventilation, non-invasive ventilation or high-flow nasal cannula and were discharged from the intensive care unit to the ward. Participants were submitted to Medical Research Council sum-score, handgrip strength, maximal inspiratory pressure, maximal expiratory pressure, and short physical performance battery tests. Participants were grouped into two groups according to their need for invasive ventilation: the Invasive Mechanical Ventilation Group (IMV Group) and the Non-Invasive Mechanical Ventilation Group (Non-IMV Group). Results: Patients in the IMV Group (n = 31) were younger and had higher Sequential Organ Failure Assessment scores than those in the Non-IMV Group (n = 33). The short physical performance battery scores (range 0 - 12) on D1 and D7 were 6.1 ± 4.3 and 7.3 ± 3.8, respectively for the Non-Invasive Mechanical Ventilation Group, and 1.3 ± 2.5 and 2.6 ± 3.7, respectively for the IMV Group. The prevalence of intensive care unit-acquired weakness on D7 was 13% for the Non-IMV Group and 72% for the IMV Group. The maximal inspiratory pressure, maximal expiratory pressure, and handgrip strength increased on D7 in both groups, but the maximal expiratory pressure and handgrip strength were still weak. Only maximal inspiratory pressure was recovered (i.e., > 80% of the predicted value) in the Non-IMV Group. Female sex, and the need and duration of invasive mechanical were independently and negatively associated with the short physical performance battery score and handgrip strength. Conclusion: Patients who recovered from critical COVID-19 and who received invasive mechanical ventilation presented greater disability than those who were not invasively ventilated. However, they both showed marginal functional improvement during early recovery, regardless of the need for invasive mechanical ventilation. This might highlight the severity of disability caused by SARS-CoV-2.

RESUMO Objetivo: Examinar a função física e a força muscular respiratória de pacientes que se recuperaram da COVID-19 grave após a alta da unidade de terapia intensiva para a enfermaria nos Dias 1 e 7 e investigar as variáveis associadas ao comprometimento funcional. Métodos: Trata-se de estudo de coorte prospectivo de pacientes adultos com COVID-19 que necessitaram de ventilação mecânica invasiva, ventilação mecânica não invasiva ou cânula nasal de alto fluxo e tiveram alta da unidade de terapia intensiva para a enfermaria. Os participantes foram submetidos aos testes Medical Research Council sum-score, força de preensão manual, pressão inspiratória máxima, pressão expiratória máxima e short physical performance battery. Os participantes foram agrupados em dois grupos conforme a necessidade de ventilação mecânica invasiva: o Grupo Ventilação Mecânica Invasiva (Grupo VMI) e o Grupo Não Ventilação Mecânica Invasiva (Grupo Não VMI). Resultados: Os pacientes do Grupo VMI (n = 31) eram mais jovens e tinham pontuações do Sequential Organ Failure Assessment mais altas do que os do Grupo VMI (n = 33). As pontuações do short physical performance battery (intervalo de zero a 12) nos Dias 1 e 7 foram 6,1 ± 4,3 e 7,3 ± 3,8, respectivamente para o Grupo Não VMI, e 1,3 ± 2,5 e 2,6 ± 3,7, respectivamente para o Grupo VMI. A prevalência de fraqueza adquirida na unidade de terapia intensiva no Dia 7 foi de 13% para o Grupo Não VMI e de 72% para o Grupo VMI. A pressão inspiratória máxima, a pressão expiratória máxima e a força de preensão manual aumentaram no Dia 7 em ambos os grupos, porém a pressão expiratória máxima e a força de preensão manual ainda eram fracas. Apenas a pressão inspiratória máxima foi recuperada (ou seja, > 80% do valor previsto) no Grupo Não VMI. As variáveis sexo feminino, e necessidade e duração da ventilação mecânica invasiva foram associadas de forma independente e negativa à pontuação do short physical performance battery e à força de preensão manual. Conclusão: Os pacientes que se recuperaram da COVID-19 grave e receberam ventilação mecânica invasiva apresentaram maior incapacidade do que aqueles que não foram ventilados invasivamente. No entanto, os dois grupos de pacientes apresentaram melhora funcional marginal durante a fase inicial de recuperação, independentemente da necessidade de ventilação mecânica invasiva. Esse resultado pode evidenciar a gravidade da incapacidade causada pelo SARS-CoV-2.

Comparison of Surgical Procedures in the Treatment of Hip Periprosthetic Infection / Comparação entre procedimentos cirúrgicos no tratamento da infecção de prótese do quadril

Abstract Objective The present study aimed to compare the cure rate recovery time and Merle d'Aubigné-Postel functional (MAPF) score after single-stage surgery (C1T) or two-stage surgery (C2T) to treat prosthetic infections of the hip considering sociodemographic and clinical features of the patients. Materials and Methods The present retrospective study occurred in a single center from 2011 to 2014 with 37 studied cases including 26 treated with C1T and 11 with C2T. We compared the cure rate recovery time and MAPF score in the two groups as well as the sociodemographic and clinical features of the patients. We also considered surgical complications and the most common infectious agents. Results The C1T group had a faster functional recovery than the C2T group but there were no significant differences in the cure rate surgical complications or MAPF score. However C1T group patients were significantly younger which may have influenced the outcomes. Staphylococcus spp. was the most common infectious agent (62%). Conclusion Although C2T appears superior regarding infection cure C1T may be preferable for faster functional recovery. However it is critical to consider individual patient characteristics when choosing treatment. Further research with a larger sample size is required to confirm these results.

Resumo Objetivo Comparar a taxa de cura, o tempo de recuperação e a pontuação na escala funcional de Merle d'Aubigné-Postel (EFMA) entre a cirurgia em tempo único (C1T) e a cirurgia em dois tempos (C2T) no tratamento de infecções protéticas do quadril, considerando as características sociodemográficas e clínicas dos pacientes. Materiais e Métodos Foi realizado um estudo retrospectivo num único centro, entre 2011 e 2014, com um total de 37 casos estudados, sendo 26 tratados com C1T e 11 com C2T. Foram comparadas a taxa de cura, o tempo de recuperação e a pontuação EFMA entre os dois grupos, bem como as características sociodemográficas e clínicas dos pacientes. Foram também consideradas as complicações cirúrgicas e o agente infeccioso mais comum. Resultados O grupo C1T teve uma recuperação funcional mais rápida do que o grupo C2T, mas não houve diferenças significativas na taxa de cura, nas complicações cirúrgicas ou na pontuação EFMA. No entanto, o grupo C1T era significativamente mais jovem, o que pode ter influenciado os resultados. Staphylococcus spp. foi o agente infeccioso mais comum (62%). Conclusão Embora a C2T pareça ser superior em termos de cura de infecção, a C1T pode ser preferível para uma recuperação funcional mais rápida. No entanto, as características individuais dos pacientes devem ser consideradas na escolha do tratamento. São necessárias mais pesquisas com um tamanho de amostra maior para confirmar estes resultados.

Effects of sports training associated with nutritional intervention on athletes' post-competition recovery / Efeitos do treinamento esportivo associado à intervenção nutricional sobre a recuperação dos atletas pós-competição / Efectos del entrenamiento deportivo asociado a una intervención nutricional en la recuperación post competición de los deportistas

ABSTRACT Introduction: The athletes' physiological capacity and psychological level are raised to the limit during the competition, which is necessary for adequate recovery after the dispute. Objective: Study the effect of sports training associated with nutritional intervention on athletes' post-competition recovery. Methods: In the first two weeks of the experiment, training was done in slow aerobic exercise, aerobics, and running. Strength training and a small amount of anaerobic training were added to the training with the gradual practice of the experiment. Results: The proportion of breakfast, lunch, and dinner was 25.33%, 42.55%, and 32.12%, respectively; protein intake decreased from 34.23% to 20.13%, and the proportion of fat intake decreased from 15. 56% to 12.3%, and IgG content changed from 7.654 ± 0.283 (mmol/L) at the end to 8.586 ± 0.651 (mmol/L); IgM content changed from 3.382 ± 0.875 (g/L) at the end to 3.169 ± 1.002 (g/L). Conclusion: Athletes can effectively, through sports training and nutritional intervention, adjust body changes caused by competition while maintaining a good exercise level. Level of evidence II; Therapeutic studies - investigation of treatment outcomes.

RESUMO Introdução: A capacidade fisiológica e o nível psicológico dos atletas são elevados ao limite durante a competição, sendo necessária uma recuperação adequada após a disputa. Objetivo: Estudar o efeito do treinamento esportivo associado à intervenção nutricional para a recuperação dos atletas após a competição. Métodos: Nas duas primeiras semanas da experiência, realizou-se o treinamento na forma de exercício aeróbico lento, aeróbica e corrida. O treinamento de força e uma pequena quantidade de treinamento anaeróbico foram adicionados ao treinamento com a prática gradual do experimento. Resultados: A proporção de café da manhã, almoço e jantar foi de 25,33%, 42,55% e 32,12% respectivamente, a proporção de ingestão de proteínas diminuiu de 34,23% para 20,13%, a proporção de ingestão de gordura diminuiu de 15,56% para 12,3%, e o conteúdo de IgG mudou de 7,654 ± 0,283 (mmol/L) no final para 8,586 ± 0,651 (mmol/L); o conteúdo de IgM mudou de 3,382 ± 0,875 (g/L) no final para 3,169 ± 1,002 (g/L). Conclusão: Os atletas podem de maneira eficaz, através de treinamento esportivo e intervenção nutricional, ajustar as alterações corporais ocasionadas pela competição, mantendo um bom nível de exercício. Nível de evidência II; Estudos terapêuticos - investigação dos resultados do tratamento.

RESUMEN Introducción: La capacidad fisiológica y el nivel psicológico de los atletas se elevan al límite durante la competición, siendo necesaria una adecuada recuperación tras la disputa. Objetivo: Estudiar el efecto del entrenamiento deportivo asociado a la intervención nutricional para la recuperación de los deportistas tras la competición. Métodos: En las dos primeras semanas del experimento, el entrenamiento se realizó en forma de ejercicio aeróbico lento, aeróbic y carrera. El entrenamiento de fuerza y una pequeña cantidad de entrenamiento anaeróbico se añadieron al entrenamiento con la práctica gradual del experimento. Resultados: La proporción de desayuno, comida y cena fue del 25,33%, 42,55% y 32,12% respectivamente, la proporción de ingesta de proteínas descendió del 34,23% al 20,13%, la proporción de ingesta de grasas descendió del 15. 56% a 12,3%, y el contenido de IgG pasó de 7,654 ± 0,283 (mmol/L) al final a 8,586 ± 0,651 (mmol/L); el contenido de IgM pasó de 3,382 ± 0,875 (g/L) al final a 3,169 ± 1,002 (g/L). Conclusión: Los atletas pueden ajustar eficazmente, mediante el entrenamiento deportivo y la intervención nutricional, los cambios corporales provocados por la competición, manteniendo un buen nivel de ejercicio. Nivel de evidencia II; Estudios terapéuticos - investigación de los resultados del tratamiento.

Fatigue and the recovery ways in athlete runners / Fadiga e suas vias de recuperação em corredores esportistas / La fatiga y sus vías de recuperación en corredores deportistas

ABSTRACT Introduction: With the continuous development of running, great changes have occurred in training media, equipment, and training concepts. Running fatigue and recovery have increasingly become the direction of research by scientists worldwide. Objective: In this paper, the mechanism, causes, and measures of biological recovery in athletes during training are discussed. Method: The effects of different interventions on athletes' recovery after training were analyzed through protocoled experiments. Effective methods of fatigue recovery were presented. The study compared the variables of the sprinter's morning heart rate, blood pressure, body temperature, CK, BUN, RPE, and other indicators to understand the recovery of middle and long-distance runners after training. Results: Recovery measures are effective when combined with exercise training based on the fatigue mechanism. Conclusion: Subjective sensory, physiological, and biochemical indicators are used to judge the intensity of fatigue in exercise training, and the fatigue recovery phase of exercise training is an important item to consider during training activities. Level of evidence II; Therapeutic studies - investigation of treatment outcomes.

RESUMO Introdução: Com o desenvolvimento contínuo da corrida, grandes mudanças ocorreram nos meios de treinamento, nos equipamentos e conceitos de treinamento. A fadiga e a recuperação da corrida têm se tornado cada vez mais a direção da pesquisa de cientistas em todo o mundo. Objetivo: Neste artigo, são discutidos o mecanismo, as causas e suas medidas de recuperação biológica nos atletas durante o treinamento. Método: Através de experimentos protocolados, foram analisados os efeitos de diferentes intervenções sobre a recuperação dos atletas após o treinamento. Métodos eficazes de recuperação da fadiga foram apresentados. O estudo comparou as variáveis da frequência cardíaca matinal do velocista, pressão arterial, temperatura corporal, CK, BUN, RPE e outros indicadores para entender a recuperação dos corredores de média e longa distância após o treinamento. Resultados: As medidas de recuperação são efetivas quando combinadas ao treinamento de exercício baseado no mecanismo de fadiga. Conclusão: Os indicadores sensoriais subjetivos, fisiológicos e bioquímicos são usados para julgar a intensidade da fadiga no treinamento físico, sendo a fase de recuperação da fadiga do treinamento físico um item importante a ser considerado durante as atividades de treinamento. Nível de evidência II; Estudos terapêuticos - investigação dos resultados do tratamento.

RESUMEN Introducción: Con el continuo desarrollo de las carreras, se han producido grandes cambios en los medios de entrenamiento, el equipamiento y los conceptos de entrenamiento. La fatiga y la recuperación en la carrera se han convertido cada vez más en objeto de investigación por parte de científicos de todo el mundo. Objetivo: En este artículo, se discute el mecanismo, las causas y las medidas de la recuperación biológica en los atletas durante el entrenamiento. Método: Mediante experimentos protocolizados, se analizaron los efectos de diferentes intervenciones en la recuperación de los atletas después del entrenamiento. Se presentaron métodos eficaces de recuperación de la fatiga. El estudio comparó las variables de la frecuencia cardíaca matutina de los velocistas, la presión arterial, la temperatura corporal, la CK, el BUN, el RPE y otros indicadores para comprender la recuperación de los corredores de media y larga distancia después del entrenamiento. Resultados: Las medidas de recuperación son eficaces cuando se combinan con el entrenamiento del ejercicio basado en el mecanismo de la fatiga. Conclusión: Los indicadores subjetivos sensoriales, fisiológicos y bioquímicos se utilizan para juzgar la intensidad de la fatiga en el entrenamiento con ejercicios, y la fase de recuperación de la fatiga del entrenamiento con ejercicios es un elemento importante que debe tenerse en cuenta durante las actividades de entrenamiento. Nivel de evidencia II; Estudios terapéuticos - investigación de los resultados del tratamiento.

Fatigue and physical recovery in basketball under covid-19 / Fadiga e recuperação física no basquetebol em meio a covid-19 / Fatiga y recuperación física en baloncesto en el marco de covid-19

ABSTRACT Introduction: A new research direction to strengthen basketball, improve physical function and enhance the immunity of athletes during the epidemic situation of COVID-19 is requested. Objective: Explore the specific methods of basketball fatigue and physical recovery under the outlook of COVID-19. Methods: 36 college volunteers without significant differences in height, weight, or age were randomly selected for the research. Divided into two groups, the intervention mode of the experimental group was vibration foam roller intervention, while the control group adopted the traditional walking and stretching method. The subjective assessment data of lactic acid change and exercise fatigue were collected and analyzed. Results: One hour after exercise, the rate, and decrease of lactic acid in the experimental group were statistically higher. Before the beginning of the experiment, the subjective assessment of fatigue in the control group was (16.031 ± 2.4438) points, and that in the experimental group was (16.139 ± 2.7043) points. After the end of the ninth week, the subjective assessment of fatigue in the control group was (14.646 ± 2.7453) points, while in the experimental group, it was (11.576 ± 3.2552). Conclusion: The vibrating foam roller massage method can recover athletes from muscle fatigue more efficiently while respecting the limitations imposed by the epidemic situation. Level of evidence II; Therapeutic studies - investigation of treatment outcomes.

RESUMO Introdução: Uma nova direção de pesquisa para fortalecer o basquetebol, melhorar o nível da função física e aumentar a imunidade dos atletas sob a situação epidêmica da COVID-19 é requisitada. Objetivo: Explorar os métodos específicos de fadiga do basquetebol e recuperação física sob o panorama da COVID-19. Métodos: Foram selecionados aleatoriamente 36 universitários voluntários sem diferenças significativas de altura, peso ou idade para a pesquisa. Divididos em dois grupos, o modo de intervenção do grupo experimental foi a intervenção com rolo de espuma vibratória, enquanto o grupo de controle adotou o método tradicional de caminhada e alongamento. Os dados da avaliação subjetiva da mudança do ácido lático e da fadiga do exercício foram coletados e analisados. Resultados: Em uma hora após o exercício, a taxa e a diminuição do ácido láctico no grupo experimental foram estatisticamente superiores. Antes do início do experimento, a avaliação subjetiva da fadiga no grupo controle foi de (16.031 ± 2.4438) pontos, e a do grupo experimental foi de (16.139 ± 2.7043) pontos. Após o final da nona semana, a avaliação subjetiva da fadiga no grupo controle foi de (14.646 ± 2.7453) pontos, enquanto no experimental foi de (11.576 ± 3.2552) pontos. Conclusão: O método de massagem por rolo de espuma vibratória pode recuperar os atletas da fadiga muscular de forma mais eficiente, respeitando as limitações impostas pela situação epidêmica. Nível de evidência II; Estudos terapêuticos - investigação dos resultados do tratamento.

RESUMEN Introducción: Se solicita una nueva dirección de investigación para fortalecer el baloncesto, mejorar el nivel de la función física y aumentar la inmunidad de los atletas bajo la situación epidémica de COVID-19. Objetivo: Explorar los métodos específicos de fatiga y recuperación física en baloncesto bajo la perspectiva de COVID-19. Métodos: Para la investigación se seleccionaron aleatoriamente 36 estudiantes universitarios voluntarios sin diferencias significativas de estatura, peso o edad. Divididos en dos grupos, el modo de intervención del grupo experimental fue la intervención con rodillo de espuma vibratoria, mientras que el grupo de control adoptó el método tradicional de caminar y estirar. Se recogieron y analizaron los datos de la evaluación subjetiva del cambio del ácido láctico y la fatiga del ejercicio. Resultados: Una hora después del ejercicio, la tasa y la disminución de ácido láctico en el grupo experimental fueron estadísticamente superiores. Antes del inicio del experimento, la evaluación subjetiva de la fatiga en el grupo de control fue de (16,031 ± 2,4438) puntos, y la del grupo experimental fue de (16,139 ± 2,7043) puntos. Al final de la novena semana, la evaluación subjetiva de la fatiga en el grupo de control fue de (14,646 ± 2,7453) puntos, mientras que en el grupo experimental fue de (11,576 ± 3,2552) puntos. Conclusión: El método de masaje con rodillo de espuma vibratorio puede recuperar a los deportistas de la fatiga muscular de forma más eficaz, respetando las limitaciones impuestas por la situación epidémica. Nivel de evidencia II; Estudios terapéuticos - investigación de los resultados del tratamiento.

Impact of renal recovery on in-hospital and post-discharge mortality / Impacto de la recuperación renal en la mortalidad intra y poshospitalaria / Impacto da recuperação renal na mortalidade intra e pós alta hospitalar

ABSTRACT Objective: To verify the impact of renal recovery on mortality in non-critically ill patients with acute kidney injury. Method: A prospective cohort study was carried out in a public hospital in the Federal District with patients with acute kidney injury admitted to a non-critical care unit. Renal recovery was assessed based on the ratio of serum creatinine to baseline creatinine and the patient was followed up for 6 months. Mortality was assessed during hospitalization and after discharge. Results: Of the 90 patients with hospital-acquired kidney injury, renal recovery was identified in 34.1% to 75% of cases, depending on the time of assessment, considering a follow-up period of up to 6 months. Recovery of renal function during follow-up had an impact on in-hospital mortality [95% CI 0.15 (0.003 - 0.73; p = 0019). Conclusion: Recovery of renal function has been shown to be a protective factor for mortality in patients admitted to the non-critical care unit. Early identification of kidney damage and monitoring of physiological and laboratory variables proved to be fundamental in identifying the severity of the disease and reducing mortality.

RESUMEN Objetivo: Verificar el impacto de la recuperación renal en la mortalidad en pacientes no críticos con lesión renal aguda. Método: Cohorte prospectiva, realizada en un hospital público del Distrito Federal con pacientes con daño renal agudo ingresados en una unidad de cuidados no críticos. La recuperación renal se evaluó según la relación entre la creatinina sérica y la creatinina inicial y se siguió al paciente durante 6 meses. La mortalidad se evaluó durante la hospitalización y después del alta hospitalaria. Resultados: De los 90 pacientes con daño renal intrahospitalario, se identificó recuperación renal entre el 34,1% y el 75% de los casos, dependiendo del momento de la evaluación, considerando un período de seguimiento de hasta 6 meses. La recuperación de la función renal durante el seguimiento tuvo impacto en la mortalidad hospitalaria [IC 95% 0,15 (0,003 - 0,73; p = 0019). Conclusión: La recuperación de la función renal demostró ser un factor protector de la mortalidad en pacientes ingresados en la unidad de cuidados no críticos. La identificación temprana de la lesión renal y el seguimiento de variables fisiológicas y de laboratorio resultaron esenciales para identificar la gravedad de la enfermedad y reducir la mortalidad.

RESUMO Objetivo: Verificar o impacto da recuperação renal na mortalidade de pacientes não críticos com injúria renal aguda. Método: Coorte prospectiva, realizado em um hospital público do Distrito Federal com pacientes diagnosticados com injúria renal aguda internados em uma unidade de cuidados não críticos. A recuperação renal foi avaliada a partir da razão da creatinina sérica em relação à creatinina basal e o paciente foi acompanhado por 6 meses. A mortalidade foi avaliada durante internação e após alta hospitalar. Resultados: Dos 90 pacientes com injúria renal adquirida no hospital, identificou-se a recuperação renal em 34,1% a 75% dos casos, a depender do momento de avaliação, considerando o período de acompanhamento de até 6 meses. A recuperação da função renal durante o acompanhamento impactou na mortalidade intra-hospitalar [IC 95% 0,15 (0,003-0,73; p = 0019). Conclusão: A recuperação da função renal demonstrou-se como um fator protetor para mortalidade em pacientes internados na unidade de cuidados não críticos. A identificação precoce da injúria renal e o monitoramento de variáveis fisiológicas e laboratoriais mostraram-se fundamentais para identificação da gravidade da doença e redução da mortalidade.

Study on the characteristics of lower limb muscle motor organization among athletes with traumatic knee injuries / Estudo sobre as características de organização motora muscular do membro inferior entre atletas com lesões traumáticas no joelho / Estudio sobre las características de la organización motriz de los músculos de las extremidades inferiores en atletas con lesiones traumáticas de rodilla

ABSTRACT Introduction Traumatic injury to the knee joints and their adjacent muscles is common among athletes, and their organizational characteristics require thorough analysis. Objective Investigate the motor organization of muscles in the lower limbs of athletes with traumatic knee injuries. Methods A systematic survey of the peculiarities of motor organization in the muscles of physically healthy athletes was preceded by an analytical survey of the peculiarities of this organization among athletes with traumatic knee injuries interested in medical treatment to restore the functional condition of the knee joints and perform active sports activities. Results The characteristics of muscle motor organization in traumatic injuries and their recovery methods were determined, as well as the formation of a sequential understanding of the recovery process of knee joint injuries for athletes representing various sports. Conclusion The results of this scientific study and the conclusions formulated based on them are of great importance for athletes concerned with restoring functional status after knee joint injuries sustained during the competition and in the training process. Evidence level II; Therapeutic studies - outcomes research.

RESUMO Introdução A lesão traumática nas articulações do joelho e seus músculos adjacentes é comum entre atletas e suas características organizacionais exigem uma análise minuciosa. Objetivo Investigar a organização motora dos músculos nos membros inferiores de atletas com lesões traumáticas no joelho. Métodos Uma pesquisa sistemática sobre as peculiaridades da organização motora na musculatura de atletas fisicamente saudáveis foi precedida a uma pesquisa analítica das peculiaridades desta organização entre atletas com lesões traumáticas no joelho, interessados no tratamento médico a fim de restaurar a condição funcional das articulações do joelho e realizar atividades esportivas ativas. Resultados Foram determinadas as características de organização motora muscular nas lesões traumáticas e seus métodos de recuperação, bem como a formação de uma compreensão sequencial no processo de recuperação das lesões das articulações do joelho para os atletas que representam diversos esportes. Conclusão Os resultados deste estudo científico e as conclusões formuladas com base neles são de grande importância para atletas preocupados com o restauro do estado funcional após as lesões nas articulações do joelho sofridas durante o período de competição e no processo de treinamento. Evidência nível II; Estudos terapêuticos - pesquisa de resultados.

RESUMEN Introducción Las lesiones traumáticas de las articulaciones de la rodilla y sus músculos adyacentes son frecuentes entre los deportistas y sus características organizativas requieren un análisis exhaustivo. Objetivo Investigar la organización motora de los músculos de las extremidades inferiores de atletas con lesiones traumáticas de rodilla. Métodos Una investigación sistemática sobre las peculiaridades de la organización motora en los músculos de los atletas físicamente sanos fue precedida por una investigación analítica de las peculiaridades de esta organización entre los atletas con lesiones traumáticas de la rodilla, interesados en el tratamiento médico para restaurar la condición funcional de las articulaciones de la rodilla y realizar actividades deportivas activas. Resultados Se determinaron las características de la organización motora del músculo en las lesiones traumáticas y sus métodos de recuperación, así como la formación de una comprensión secuencial en el proceso de recuperación de las lesiones de la articulación de la rodilla para los atletas que representan varios deportes. Conclusión Los resultados de este estudio científico y las conclusiones formuladas a partir de ellos son de gran importancia para los deportistas preocupados por el restablecimiento del estado funcional tras las lesiones de la articulación de la rodilla sufridas durante el periodo de competición y en el proceso de entrenamiento. Nivel de evidencia II; Estudios terapéuticos - investigación de resultados.

Effect of moderate running on sports injury rehabilitation / Efeito da corrida moderada na reabilitação de lesões esportivas / Efecto de la corrida moderada en la rehabilitación de lesiones deportivas

ABSTRACT Introduction Running has become one of the most popular sports and fitness methods for low cost, convenience, and easy adherence. This has made the characteristics and rules of running-related sports injuries a key research issue in sports medicine and public health. Objective Evaluate the effects of moderate running on sports injuries rehabilitation. Methods This paper uses mathematical statistics to study some groups that have been running for a long time (n=369). The causes of sports injuries analyses and risks are performed by questionnaire. Results Relaxation after exercise is a protective factor for sports injuries. The time of maintenance of the running habit and the previous sport's history are factors influencing the risk for a sport's injury. Conclusion Amateur runners have a high rate of running injuries. The knee is the area with the highest injury incidence. Weight-loss running increases the risk of injury. An individually moderate running training plan can reduce the risk of running injuries. Evidence level II; Therapeutic Studies - Investigating the results.

RESUMO Introdução A corrida tornou-se um dos esportes e métodos de aptidão física mais populares devido ao seu baixo custo, conveniência e fácil adesão. Isso fez com que as características e regras das lesões esportivas relacionadas à corrida tornaram-se uma questão-chave de pesquisa em medicina esportiva e saúde pública. Objetivo Avaliar os efeitos da corrida moderada sobre a reabilitação de lesões esportivas. Métodos Este artigo utiliza a estatística matemática para estudar alguns grupos que já praticam corrida há muito tempo (n=369). A análise das causas de lesões e riscos desportivos é feita por questionário. Resultados O relaxamento após o exercício é um fator de proteção para lesões esportivas. O tempo de manutenção do hábito da corrida bem como o histórico esportivo pregresso são fatores que influenciam no risco para uma lesão esportiva. Conclusão Corredores amadores têm uma alta taxa de lesões na corrida. O joelho é a área de maior incidência das lesões. Correr para perder peso aumenta o risco de lesões. Um plano de treinamento de corrida moderado planejado individualmente pode reduzir os riscos das lesões durante as corridas. Nível de evidência II; Estudos terapêuticos - Investigação de resultados.

RESUMEN Introducción La corrida se ha convertido en uno de los deportes y métodos de acondicionamiento físico más populares debido a su bajo coste, comodidad y fácil adherencia. Esto ha hecho que las características y las reglas de las lesiones deportivas relacionadas con la corrida sean un tema de investigación clave en la medicina deportiva y la salud pública. Objetivo Evaluar los efectos de la corrida moderada en la rehabilitación de las lesiones deportivas. Métodos Este trabajo utiliza la estadística matemática para estudiar algunos grupos que llevan mucho tiempo corriendo (n=369). El análisis de las causas de las lesiones deportivas y los riesgos se realiza mediante un cuestionario. Resultados La relajación después del ejercicio es un factor de protección para las lesiones deportivas. El tiempo de mantenimiento del hábito de correr, así como el historial deportivo previo son factores que influyen en el riesgo de sufrir una lesión deportiva. Conclusión Los corredores aficionados tienen un alto índice de lesiones al correr. La rodilla es la zona de mayor incidencia de lesiones. Correr para perder peso aumenta el riesgo de lesiones. Un plan de entrenamiento moderado para correr, planificado individualmente, puede reducir el riesgo de lesiones al correr. Nivel de evidencia II; Estudios terapéuticos - Investigación de resultados.

Long-Term Outcomes in Severe Traumatic Brain Injury and Associated Factors: A Prospective Cohort Study.

OBJECTIVE: The presence of focal lesion (FL) after a severe traumatic brain injury is an important factor in determining morbidity and mortality. Despite this relevance, few studies show the pattern of recovery of patients with severe traumatic brain injury (TBI) with FL within one year. The objective of this study was to identify the pattern of recovery, independence to perform activities of daily living (ADL), and factors associated with mortality and unfavorable outcome at six and twelve months after severe TBI with FL. METHODOLOGY: This is a prospective cohort, with data collected at admission, hospital discharge, three, six, and twelve months after TBI. RESULTS: The study included 131 adults with a mean age of 34.08 years. At twelve months, 39% of the participants died, 80% were functionally independent by the Glasgow Outcome Scale Extended, 79% by the Disability Rating Scale, 79% were independent for performing ADLs by the Katz Index, and 53.9% by the Lawton Scale. Report of alcohol intake, sedation time, length of stay in intensive care (ICU LOS), Glasgow Coma Scale, trauma severity indices, hyperglycemia, blood glucose, and infection were associated with death. At six and twelve months, tachypnea, age, ICU LOS, trauma severity indices, respiratory rate, multiple radiographic injuries, and cardiac rate were associated with dependence. CONCLUSIONS: Patients have satisfactory functional recovery up to twelve months after trauma, with an accentuated improvement in the first three months. Clinical and sociodemographic variables were associated with post-trauma outcomes. Almost all victims of severe TBI with focal lesions evolved to death or independence.

AVALIAÇÃo MUSCULO-ARTICULAR DOS EFEITOS DA HIDROTERAPIA NA RECUPERAÇÃo PÓS-TREINO EM JOGADORES DE BASQUETEBOL / Musculoarticular evaluation of the hydrotherapy effects on basketball players post-training recovery / Evaluación musculo-articular de los efectos de la hidroterapia en la recuperación post-entrenamiento en jugadores de baloncesto

ABSTRACT Objective: To evaluate the effects of hydrotherapy on post-training recovery of basketball players. Methods: 60 basketball players from the sports representative team were divided equally into test and control group for evaluation according to the Partridge method. The experimental group received hydrotherapy for 15 minutes after intense winter training. Pain degrees in joint flexion and extension, adduction, external rotation, and internal rotation were evaluated. Results: The HL value of blood immediately after 800m hydrotherapy swimming was not significantly different between the experimental group and the control group by t-test (P>0.05). Before treatment, there was no significant difference in the Partridge score between the two groups (P<0.01). The improvement of the Partridge score in the two groups of patients was significantly reduced after treatment (P<0.01), and the improvement of the experimental group was significantly better than that of the control group (P<0.01). Before treatment, there was no significant difference between the two groups (P<0.01). After treatment, it was significantly reduced (P<0.01), but the experimental group's improvement was significantly better than the control group (P<0.01). Conclusion: The method of introducing hydrotherapy as post-workout swimming has a significant effect on relieving swelling of the brachial and quadriceps muscles. However, intense swimming may affect the effect of muscle recovery. Level of evidence II; Therapeutic studies - investigation of treatment results.

RESUMO Objetivo: Avaliar os efeitos da hidroterapia sobre a recuperação pós-treinamento dos jogadores de basquete. Método: 60 jogadores de basquetebol da equipe de representantes esportivos foram divididos igualmente em grupo teste e controle para avaliação de acordo com o método Partridge. O grupo experimental recebeu hidroterapia por 15 minutos após o treino intenso de inverno. Foram avaliados os graus de dor em flexão e extensão das articulações, adução, rotação externa e rotação interna. Resultados: O valor de HL do sangue imediatamente após a natação hidroterápica de 800m não foi significativamente diferente entre o grupo experimental e o grupo controle por teste t (P>0,05). Antes do tratamento, não houve diferença significativa na pontuação de Partridge entre os dois grupos (P<0,01). A melhora da pontuação de Partridge nos dois grupos de pacientes foi significativamente reduzida após o tratamento (P<0,01), e o desenvolvimento do grupo experimental foi significativamente melhor que a do grupo controle (P<0,01). Antes do tratamento, não houve diferença significativa entre os dois grupos (P<0,01). Após o tratamento, foi significativamente reduzido (P<0.01), mas o desenvolvimento do grupo experimental foi significativamente melhor que a do grupo controle (P<0.01). Conclusão: O método de introduzir a hidroterapia como natação pós-treino tem um efeito significativo no alívio do inchaço dos músculos braquial e quadríceps. No entanto, a natação intensa pode afetar o efeito de recuperação muscular. Nível de evidência II; Estudos terapêuticos - investigação de resultados de tratamento.

RESUMEN Objetivo: Evaluar los efectos de la hidroterapia en la recuperación post-entrenamiento de los jugadores de baloncesto. Método: 60 jugadores de baloncesto del equipo de representación deportiva fueron divididos equitativamente en grupo de prueba y grupo de control para su evaluación según el método Partridge. El grupo experimental recibió hidroterapia durante 15 minutos después de un entrenamiento invernal intenso. Se evaluaron los grados de dolor en la flexión y extensión de la articulación, la aducción, la rotación externa y la rotación interna. Resultados: EL valor de HL de la sangre inmediatamente después de 800 m de natación con hidroterapia no fue significativamente diferente entre el grupo experimental y el grupo de control mediante la prueba t (P>0,05). Antes del tratamiento, no hubo diferencias significativas en la puntuación Partridge entre los dos grupos (P<0,01). La mejora de la puntuación Partridge en ambos grupos de pacientes se redujo significativamente después del tratamiento (P<0,01), y la mejora del grupo experimental fue significativamente mejor que la del grupo de control (P<0,01). Antes del tratamiento, no hubo diferencias significativas entre los dos grupos (P<0,01). Después del tratamiento, se redujo significativamente (P<0,01), pero el desarrollo del grupo experimental fue significativamente mejor que la del grupo de control (P<0,01). Conclusión: El método de introducción de la hidroterapia como natación post-entrenamiento tiene un efecto significativo en el alivio de la hinchazón de los músculos braquiales y del cuádriceps. Sin embargo, la natación intensa puede perjudicar el efecto de recuperación muscular. Nivel de evidencia II; Estudios terapéuticos - investigación de resultados de tratamiento.

Perfil da fisioterapia na reabilitação de indivíduos com doença de Alzheimer: um estudo transversal / Perfil de la fisioterapia en la rehabilitación de personas con enfermedad de Alzheimer: un estudio transversal / Profile of physical therapy in the rehabilitation of individuals with Alzheimer's disease: a cross-sectional study

RESUMO O estudo analisou o perfil de atuação dos fisioterapeutas do Rio de Janeiro (RJ) e do Rio Grande do Sul (RS) no manejo da pessoa com doença de Alzheimer (DA). Foram obtidas 256 respostas a um questionário enviado via endereço eletrônico dos Conselhos Regionais de Fisioterapia e Terapia Ocupacional das regiões 2 (RJ) e 5 (RS) - CREFITOS 2 e 5 -, entre março e dezembro de 2020. O questionário tinha 36 perguntas fechadas, cujas variáveis foram agrupadas em: (1) caracterização da amostra; (2) dados específicos sobre a profissão de fisioterapeuta; e (3) questões relacionadas à DA. Neste artigo serão analisadas apenas as questões relacionadas à DA. Todas as questões eram de múltipla escolha, com 2 até 15 opções de resposta. A maioria dos respondentes (88,3%) já atendeu paciente com DA, mas 50,8% fariam uma revisão de literatura para atender novamente esses pacientes. O principal objetivo relatado no manejo do indivíduo com DA foi "retardar a progressão das perdas motoras". As condutas foram significativamente diferentes conforme a fase da doença (p<0,001). Mais de 85% citaram como benefício que a fisioterapia "retarda a dependência física". Este estudo deixa evidente a necessidade de mais pesquisas que abordem especificamente as fases intermediária e avançada da DA, pois, até o momento, a literatura se mostra inconclusiva e com pouca evidência em relação à fisioterapia no manejo dessas pessoas, impossibilitando a criação de manuais e/ou padronização de condutas específicas a cada estágio da doença.

RESUMEN Este estudio analizó el perfil de actuación de los fisioterapeutas de Rio de Janeiro (RJ) y de Rio Grande do Sul (RS) en el manejo de personas con enfermedad de Alzheimer (EA). Un total de 256 respuestas se obtuvo de un cuestionario enviado electrónicamente a los Consejos Regionales de Fisioterapia y Terapia Ocupacional de las regiones 2 (RJ) y 5 (RS) -CREFITOS 2 y 5-, en el período de marzo a diciembre de 2020. El cuestionario constaba de 36 preguntas cerradas, con variables que se agruparon en: (1) caracterización de la muestra; (2) datos específicos sobre la profesión de fisioterapeuta; y (3) preguntas relacionadas con EA. Este artículo solo analizó los problemas relacionados con la EA. Todas las preguntas eran de opción múltiple, con 2 a 15 opciones de respuesta. La mayoría de los encuestados (88,3%) ya había asistido a pacientes con EA, pero el 50,8% haría una revisión de la literatura para asistir nuevamente a estos pacientes. El principal objetivo informado en el manejo del individuo con EA fue "retrasar la progresión de las pérdidas motoras". Las conductas fueron significativamente diferentes según el estadio de la enfermedad (p<0,001). Más del 85% citó como beneficio que la fisioterapia "retrasa la dependencia física". Este estudio apunta la necesidad de más investigaciones que aborden específicamente las etapas intermedias y avanzadas de la EA, ya que la literatura existente es poco concluyente y con poca evidencia respecto a la fisioterapia en el manejo de estas personas con la enfermedad, lo que impide la elaboración de manuales y/o estandarización de conductas específicas para cada estadio de la enfermedad.

ABSTRACT This study analyzes the working profile of physical therapists from the states of Rio de Janeiro (RJ) and Rio Grande do Sul (RS) in the management of people with Alzheimer's disease (AD). A total of 256 responses were obtained to a questionnaire sent via the electronic address of the Regional Councils of Physical Therapy and Occupational Therapy (CREFITOS) 2 (RJ) and 5 (RS), from March to December 2020. The questionnaire comprises 36 closed questions, the variables of which were grouped into: (1) sample characterization; (2) specific data on the profession of physical therapist; and (3) issues related to AD. In this article, only issues related to AD will be analyzed. All questions were multiple choice with 2 to 15 options of answer. Most respondents (88.3%) had already treated patients with AD, but 50.8% needed to review the literature to assist these patients. The main objective reported in the management of the individual with AD was to "delay the progression of motor losses." The practices were significantly different according to the stage of the disease (p<0.001). More than 85% of the participants cited as a benefit that physical therapy "delays physical dependence." This study shows the need for further studies that specifically address the intermediate and advanced stages of AD since the current literature is inconclusive and with little evidence regarding physical therapy in the management of this population, making it impossible to create manuals and /or standardization of specific practices for each stage.

Evaluation of Ibuprofen Use on the Immune System Indicators and Force in Disabled Paralympic Powerlifters of Different Sport Levels.

Background: Paralympic powerlifting (PP) training is typically intense and causes fatigue and alterations in the immune system. Objective: To analyze whether IBU would affect performance and the immune system after training in PP. Methodology: 10 athletes at the national level (NL) and 10 at the regional level (RL) participated in the study, where force and blood indicators were evaluated after training. The study took place over three weeks: (1) familiarization and (2 and 3) comparison between recovery methods, with ibuprofen or placebo (IBU vs. PLA), 800 mg. In the evaluation of the force, the peak torque (PT), fatigue index (FI), and blood immune system biomarkers were analyzed. The training consisted of five sets of five repetitions with 80% of one maximum repetition (5 × 5, 80% 1RM) on the bench press. Results: The PT at the national level using IBU was higher than with PLA (p = 0.007, η2p = 0.347), and the FI in the NL was lower with IBU than with PLA (p = 0.002, η2p = 0.635), and when comparing the use of IBU, the NL showed less fatigue than the regional level (p = 0.004, η2p = 0.414). Leukocytes, with the use of IBU in the NL group, were greater than in the RL (p = 0.001, η2p = 0.329). Neutrophils, in the NL with IBU, were greater than in the RL with IBU and PLA (p = 0.025, η2p = 0.444). Lymphocytes, in NL with IBU were lower than in RL with IBU and PLA (p = 0.001, η2p = 0.491). Monocytes, in the NL with IBU and PLA, were lower than in the RL with IBU (p = 0.049, η2p = 0.344). For hemoglobin, hematocrit, and erythrocyte, the NL with IBU and PLA were higher than the RL with IBU and PLA (p < 0.05). Ammonia, with the use of IBU in the NL, obtained values higher than in the RL (p = 0.007), and with the use of PLA, the NL was higher than the RL (p = 0.038, η2p = 0.570). Conclusion: The training level tends to influence the immune system and, combined with the use of the IBU, it tends to improve recovery and the immune system.

Negative neuromuscular and functional repercussion of forced swimming after axonotmesis.

Peripheral nerve injuries are cause of sensory disturbances and in functional abilities, and are associated personal and social costs. Strategies that maximize nerve regeneration and functional recovery are necessary, the exercise is an option. This study evaluated the effects of forced swimming exercise on neuromuscular histomorphometry and on functional recovery in a median nerve crush model. Sixteen Wistar rats underwent median nerve crush and were divided into control group (CG) and swimming group (SG). The forced swimming protocol started one week after the injury and was performed for 1 hr a day, 5 days per week, for 2 weeks. The rats swam with an overload of 5% and 10% of body weight in the first and second week, respectively. The functional recovery was assessed in three moments using the grasping test. On day 21, fragments of the median nerve and of the forearm flexors muscles were removed for histomorphometric analysis. The SG had functional recovery impaired (P<0.001) and presented lower myelinated fibers number, fiber and axon minimal diameter, myelin thickness and g-ratio in the proximal e distal segments of the median nerve (P<0.005) and area muscle fiber (P<0.005) than CG. Also, the SG presented a number of capillaries in the proximal segments of the median nerve greater than CG (P<0.005). The exercise protocol used in this study impaired the regeneration of the median nerve and negatively influenced the functional recovery.

Versão brasileira da Critical Care Functional Rehabilitation Outcome Measure: tradução, adaptação transcultural e avaliação das propriedades clinimétricas / Brazilian version of the Critical Care Functional Rehabilitation Outcome Measure: translation, cross-cultural adaptation and evaluation of clinimetric properties

RESUMO Objetivo: Realizar a tradução, a adaptação transcultural e a avaliação das propriedades clinimétricas da Critical Care Functional Rehabilitation Outcome Measure para avaliação da funcionalidade de pacientes internados em unidades de terapia intensiva no Brasil. Métodos: O processo de tradução e adaptação transcultural seguiu as seguintes etapas: tradução inicial, síntese, retrotradução, revisão por comitê de especialistas e pré-teste. Foram analisadas a confiabilidade intra e interavaliador e a concordância, com dados gerados a partir da avaliação de dois fisioterapeutas no mesmo grupo de pacientes (n = 35). As avaliações foram feitas de forma independente e cega quanto ao escore atribuído pelo outro profissional. A análise qualitativa foi realizada pelo comitê de revisão, e os especialistas adaptaram e sintetizaram a tradução da escala Critical Care Functional Rehabilitation Outcome Measure na língua portuguesa. Resultados: Observou-se concordância entre as traduções da escala Critical Care Functional Rehabilitation Outcome Measure para versão brasileira. As equivalências conceitual, idiomática, semântica e experimental entre a versão original e a traduzida foram obtidas, resultando na versão brasileira, denominada Medida de Resultado da Reabilitação Funcional em Cuidados Intensivos. A avaliação das propriedades clinimétricas demonstrou evidências de alto grau de concordância e de confiabilidade, visto que todos tiveram Coeficiente de Correlação Intraclasse acima de 0,75. O Coeficiente de Correlação Intraclasse total foi de 0,89. Conclusão: A versão da escala Critical Care Functional Rehabilitation Outcome Measure para avaliação da funcionalidade de pacientes internados em unidade de terapia intensiva pode ser utilizada de forma confiável no Brasil, pois foi traduzida e adaptada transculturamente para o português brasileiro e apresenta evidências de excelentes propriedades

ABSTRACT Objective: To translate, crossculturally adapt and evaluate the clinimetric properties of the Critical Care Functional Rehabilitation Outcome Measure for evaluating the functionality of patients admitted to intensive care units in Brazil. Methods: The process of translation and cross-cultural adaptation involved the following steps: initial translation, synthesis, back-translation, expert committee review and pretesting. The intra- and interrater reliability and agreement were analyzed between two physical therapists who evaluated the same group of patients (n = 35). The evaluations were performed by each therapist independently and blinded to the score assigned by the other professional. The qualitative analysis was performed by the review committee, and the experts adapted and synthesized the Portuguese translation of the Critical Care Functional Rehabilitation Outcome Measure. Results: There was agreement between the initial Brazilian translations of the Critical Care Functional Rehabilitation Outcome Measure scale. The conceptual, idiomatic, semantic and experimental equivalences between the original and translated versions were assessed, resulting in the final Brazilian version of the scale, called the Medida de Resultado da Reabilitação Funcional em Cuidados Intensivos. The evaluation of the clinimetric properties showed evidence of a high degree of agreement and reliability, as all had an intraclass correlation coefficient above 0.75. The overall intraclass correlation coefficient was 0.89. Conclusion: The translated version of the Critical Care Functional Rehabilitation Outcome Measure scale for assessing the functionality of patients admitted to an intensive care unit can be used reliably in Brazil following translation and cross-cultural adaptation to Brazilian Portuguese and presents evidence of excellent interrater reliability.

Photobiomodulation therapy applied during an exercise-training program does not promote additional effects in trained individuals: A randomized placebo-controlled trial.

BACKGROUND: Previous studies have shown positive results of photobiomodulation (PBM) for improving performance and accelerating post-exercise recovery. However, the effects of PBM in healthy individuals who underwent a neuromuscular adaptation training remain unclear. OBJECTIVE: To investigate the effects of PBM during a training program combining sprints and explosive squats exercises on clinical, functional, and systemic outcomes in trained healthy individuals compared to a placebo intervention and a control. METHODS: We conducted a randomized placebo-controlled trial. Healthy males were randomly assigned to three groups: active PBM (30 J per site), placebo, or control (passive recovery). The participants performed a six-week (12 sessions) of a training program consisting of a combination of sprints and squats with recovery applied between sprints and squats. To prevent the influence of the primary neuromuscular adaptation to exercise on the results, all participants had to participate in a period of six weeks of exercise training program. Functional, clinical, and psychological outcomes and vascular endothelial growth factor (VEGF) were assessed at baseline and after six weeks. Results are expressed as mean difference (MD) and 95% confidence intervals (CI). RESULTS: Thirty-nine healthy male volunteers (aged 18-30 years; body mass index 23.9 ±â€¯3 kg/m²) were recruited. There was no significant time by group interaction, and no significant effect of group, but there was a significant effect of time for maximal voluntary isometric contraction (primary outcome) (MD=22 Nm/kg; 95%CI: 3.9, 40) and for squat jump (MD=1.6 cm; 95CI%: 0.7, 2.5). There was no significant interaction (time*group), time, or group effect for the other outcomes. CONCLUSION: The addition of PBM to a combined training performed for six weeks in previously trained individuals did not result in additional benefits compared to placebo or no additional intervention.