Comparing exercises with and without electromyographic biofeedback in subacromial pain syndrome: A randomized controlled trial.

BACKGROUND: Deficits in movement and muscle activation of scapulohumeral joint are related to Subacromial Pain Syndrome. Electromyography biofeedback during exercise may enhance muscle activation and coordination, and consequently improve pain and shoulder function. METHODS: This study compared the effects of an exercise protocol with and without using electromyographic biofeedback on pain, function and movement of the shoulder complex in subjects with Subacromial Pain Syndrome. A total of 24 patients with subacromial pain (mean age = 46.2 + 8.1;18 women) were randomized to either therapeutic exercise or exercise plus biofeedback to the trapezius and serratus muscles. Pain and shoulder function were evaluated as the primary outcome and range of motion, muscle strength, electromyographic activity and scapulohumeral kinematics as secondary outcomes. The subjects underwent eight weeks of intervention and comparisons were made between groups in baseline, at 4 weeks, 8 weeks, and at 4 weeks post intervention. FINDINGS: There were differences between groups for pain [mean difference = 1.5 (CI 0.3, 3.2) p = 0.01] at 8 weeks in the Exercise group and scapular upward rotation at 60° of arm elevation [mean difference = 13.9 (CI 0.9, 9.3), p = 0.006] in the Biofeedback group. There was no difference for the other variables of scapular kinematics as well as for shoulder function (DASH), muscle strength, range of motion and electromyographic variables. INTERPRETATION: The addition of Biofeedback to the exercise protocol increased upward rotation of the scapula. However, the volunteers who performed only the Exercises had a better response in reducing pain.

Impact of Pelvic Floor Muscle Training Isolated and Associated with Game Therapy on Mixed Urinary Incontinence: A Randomized Controlled Trial.

Objective: To verify whether pelvic floor muscle training (PFMT) associated with game therapy (GT) can potentiate improvements in PFM pressure, urinary loss, and perception of improvement in women with mixed urinary incontinence (MUI). Materials and Methods: A randomized and blinded trial was conducted with 32 women aged between 45 to 70 years presenting diagnosis of MUI. They were randomly divided into two groups: PFMT group and PFMT+GT group. Interventions occurred twice a week during 8 weeks. Primary outcome was PFM pressure, assessed by manometry, and secondary outcomes were 1-hour pad-test, International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF), and patients global impression of improvement for incontinence (PGI-I). Two-way analysis of variance and post hoc Tukey analysis were performed. Results: Initially, no significant difference between groups was found in variables of age, body mass index, educational level, marital status, gynecological and obstetric variables, life habits, and sexual activity. Besides, at baseline clinical variables also showed similar results between groups for PFM pressure, 1-hour pad-test, and ICIQ-SF. Time-group interaction did not present statistically significant differences for PFM pressure (P = 0.56), 1-hour pad-test (P = 0.75), and ICIQ-SF (P = 0.30) in intergroup analysis. All women reported being "much better or better," considering the comparison of urinary complaints in the beginning and end of treatment. Conclusion: There were no statistically significant differences between groups for PFM pressure, 1-hour pad-test, and ICIQ-SF. However, both treatments proved to be effective for MUI symptoms. Perception of improvement was highly improved, according to women's report.

Selection of Resistance Exercises for Older Individuals: The Forgotten Variable.

Resistance training has been widely recommended as a strategy to enhance the functional autonomy and quality of life in older individuals. Among the variables that comprise a training session, the selection of exercises stands out as an important consideration for the elderly. Although a wide range of resistance exercise options exists, current guidelines generally do not indicate which exercises should be included and which muscles should be prioritized when prescribing training for older individuals. Therefore, given the lack of evidence-based information on the topic, this paper endeavors to establish recommendations to help guide the prescription of resistance exercises for older adults.

The Effects of Different Exergame Intensity Training on Walking Speed in Older Women.

Objective: It is not known if the intensity in which exergames are performed can change gait parameters at different walking speeds. This study was designed to determine if a training program based on exergame exercises performed at different intensities (moderate vs. vigorous) influences walking speed and gait parameters in older adult women. Methods: After applying the inclusion criteria, 20 participants (69.5 ± 5.4 years) were randomized into two groups: moderate (11-13 perceived exertion) and vigorous (14-16 perceived exertion). Walking speed and gait parameters at self-selected walking speed (SSWS) and maximal walking speed (MWS) were evaluated before and after 3 months of exergame training. The walking speed and gait parameters were measured with an instrumented walkway. The walking speed reserve (WSR) was calculated as a difference and ratio. Results: There was pre-to-post effect of walking speed at self-selected walking pace (pre = 112.1 ± 16.4 cm.s-1; post = 124.8 ± 16.4 cm.s-1), in WSR calculated as ratio (pre = 1.35 ± 0.08; post = 1.28 ± 0.09), in a number of gait parameters at SSWS (step length, stride length, stride velocity, step time, stride time, swing time, stance time, single support, double support, gait cycle time, and cadence) and at MWS (step time, stride time, swing time, single support, double support, gait cycle time, and cadence). Conclusion: Irrespective of the exercise intensity, exergame training improved walking speed only at a self-selected walking pace and some gait parameters at self-selected and MWS in older women.

Post-stroke shoulder pain subtypes classifying criteria: towards a more specific assessment and improved physical therapeutic care.

BACKGROUND: Post-stroke Shoulder Pain (PSSP) is a common stroke-related syndrome that prolongs hospitalization and diminishes quality of life. PSSP studies were unsuccessful in clarifying pathophysiological mechanisms. Therefore, cohort's studies with greater variety of the sample and larger follow-up period could provide additional clinical data and may improve medical care. OBJECTIVE: To classify people with PSSP and identify intergroup clinical differences, providing additional data useful for therapeutic care planning. METHODS: One thousand individuals with stroke were selected from all levels of one health Area and followed up during one year. Demographic data, stroke clinical characteristics, stroke-related symptoms and rehabilitation parameters were collected. The shoulder muscle impairment was used to group participants into three clinical profiles: severe muscular impairment, moderate muscular impairment and low muscular impairment groups. RESULTS: A total of 119 individuals were diagnosed with PSSP. The suggested classification criteria showed two groups that differed significantly in relation to the onset and duration of PSSP, presence of sensory and speech impairment, and spasticity. The outcomes did not firmly support the existence of a third suggested PSSP subtype. CONCLUSIONS: PSSP may vary in onset, clinical manifestations, severity and syndrome duration. These results highlight the course of different clinical profiles and require multidisciplinary management approaches.

Cognitive stimulations effects and Taigeiko in elderly women's cognition: an intervention.

OBJECTIVE: To evaluate the effectiveness of an intervention through cognitive stimulation associated with Taigeiko practice in memory performance and executive function of elderly women, compared to a group exposed to Taigeiko alone. METHOD: A quasi-experimental study was performed with 16 elderly women. 10 were allocated to the experimental group (EG) submitted to 16 sessions of cognitive stimulation and Taigeiko, and 6 elderly women in the control group (CG) submitted to Taigeiko alone. Cognition was assessed before and after intervention by the tests: Rey Auditory-Verbal Learning (RAVLT); Rey-Osterrieth Complex Figure Test; Trail-Making Test; Stroop Effect; Digit Span Test and Semantic Verbal Fluency Test. RESULTS: Both groups presented differences in RAVLT domains (EG p=0.004, CG p=0.005) and Stroop Effect (EG p=0.012; CG p=0.024). However, in EG, better scores were shown in the tests, although not statistically significant. CONCLUSION: Taigeiko has been shown to be a potential activity in obtaining cognitive gains, independently of the associated cognitive stimulation.

Effects of Exercise Training Combined with Virtual Reality in Functionality and Health-Related Quality of Life of Patients on Hemodialysis.

Objective: The progression of chronic kidney disease can directly affect patient's health-related quality of life (HRQoL). Exercise training is a good option to reverse the impacts caused by the disease. To escape from the monotonous routine and stimulate further practice, the therapist should consider making physical activity more playful. Using videogames during exercise training is possible to rehabilitate the patient aiming for fun beyond the organic condition. The present study aimed to evaluate the effects of exercise training combined with Virtual Reality (VR) in functionality and HRQoL of patients on hemodialysis. Materials and Methods: A randomized controlled study in which control group (n = 20) maintained only hemodialysis without any physical effort or intervention from the researchers and intervention group (n = 20) who performed endurance and strength physical exercises in combination with VR during hemodialysis for 12 weeks. All eligible patients underwent a familiarization of games and were evaluated by an investigator-blind for functional capacity, quality of life, and depressive symptoms. Functional capacity tests included walking speed, timed up and go (TUG), and Duke Activity Status Index (DASI). To evaluate a HRQoL, Kidney Disease and Quality-of-Life Short-Form (KDQOL-SF™, v. 1.3) was used and to investigate depressive symptoms, the Center for Epidemiological Scale-Depression. Paired sample t-tests were conducted to determine differences within each group. Repeated-measures analysis of variance (group vs. time) was used to assess group differences in our major outcomes. The level of significance was 5%. Results: The exercise improved functional capacity (TUG: P = 0.002, DASI: P < 0.001) and HRQoL in physical and specific domains: physical functioning (P = 0.047), role physical (P = 0.021), as well as in physical composite summary (P < 0.001) and effects of kidney disease (P = 0.013). There was no influence on depressive symptoms (P = 0.154). Conclusion: Physical training combined with VR improved functional capacity and some quality-of-life domains of hemodialysis patients.

Interaction Modalities Used on Serious Games for Upper Limb Rehabilitation: A Systematic Review.

This systematic review aims to analyze the state-of-the-art regarding interaction modalities used on serious games for upper limb rehabilitation. A systematic search was performed in IEEE Xplore and Web of Science databases. PRISMA and QualSyst protocols were used to filter and assess the articles. Articles must meet the following inclusion criteria: they must be written in English; be at least four pages in length; use or develop serious games; focus on upper limb rehabilitation; and be published between 2007 and 2017. Of 121 articles initially retrieved, 33 articles met the inclusion criteria. Three interaction modalities were found: vision systems (42.4%), complementary vision systems (30.3%), and no-vision systems (27.2%). Vision systems and no-vision systems obtained a similar mean QualSyst (86%) followed by complementary vision systems (85.7%). Almost half of the studies used vision systems as the interaction modality (42.4%) and used the Kinect sensor to collect the body movements (48.48%). The shoulder was the most treated body part in the studies (19%). A key limitation of vision systems and complementary vision systems is that their device performances might be affected by lighting conditions. A main limitation of the no-vision systems is that the range-of-motion in angles of the body movement might not be measured accurately. Due to a limited number of studies, fruitful areas for further research could be the following: serious games focused on finger rehabilitation and trauma injuries, game difficulty adaptation based on user's muscle strength and posture, and multisensor data fusion on interaction modalities.

Acute Effect of Exergames on Children's Mood States During Physical Education Classes.

Objective: We aimed to confirm whether the practice of exergames produces an effect on children's mood states during school physical education (PE) classes. Materials and Methods: The children were allocated to experimental group (EG) and control group (CG). The EG performed exergames during PE classes, and the CG attended regular school PE classes. The Brunel Mood Scale, which evaluates six mood dimensions (tension, mental confusion, anger, vigor, depression, and fatigue), was used to assess the children's moods before (pre) and immediately after the third lesson (acute effect). Results: The practice of exergames during PE classes produced an acute effect on children's moods. The results indicated that playing exergames helped to increase vigor (P < 0.01; effect size [ES]: 0.50; confidence interval [CI]: 0.16-0.84) and fatigue (P < 0.01; ES: 0.50; CI: 0.16-0.84). Conclusion: Three exergame sessions produced an acute effect and improved children's moods during school PE classes. More research is needed to evaluate the long-term effect of exergames on children and adolescents.

Systematic review and meta-analysis of experimental studies: In-hospital mobilization for patients admitted for medical treatment.

AIM: To determine the impact of strategies to promote mobilization on physical function in hospitalized adults with medical conditions. BACKGROUND: Slow progress is noted on the promotion of mobilization during hospitalization for adult patients admitted for medical conditions. This may reflect the limited evidence on the evaluation of the impact of progressive mobilization activities on clinical endpoints in adult patients throughout hospitalization. DESIGN: A systematic review and meta-analysis of published randomized controlled trials in any language. DATA RESOURCES: The literature search was performed in the MEDLINE, CINAHL online, HealthStar, EMBASE, the Cochrane Library Controlled Trials Registry and LILACS databases (January 2000-February 2017). REVIEW METHODS: Two authors independently identified randomized trials meeting inclusion criteria, assessed their quality and extracted relevant data. Outcomes assessed were the changes in physical function evaluated by scales measuring either the aerobic (metres walked/second) or the balance domain (using the Time Up and Go test, in seconds), length of hospital stay (days), and adverse clinical events. We calculated pooled mean differences or Mantel-Haenszel odds ratios and 95% confidence intervals for continuous or dichotomous outcome data and obtained heterogeneity statistics across studies. RESULTS: Thirteen studies, including in total 2,703 participants, met our eligibility criteria. Patients in the intervention group showed significant improvement in physical function (aerobic domain), reduced length of stay, and a reduction of pulmonary embolism. CONCLUSION: Patients and health providers should consider a course of therapy that enhances the functional capacity of medical patients during hospitalization.

Effectiveness of Kinesio Taping in Patients With Chronic Nonspecific Low Back Pain: A Systematic Review With Meta-analysis.

STUDY DESIGN: Systematic review. OBJECTIVE: To investigate the effects of Kinesio Taping (KT) in patients with nonspecific low back pain. SUMMARY OF BACKGROUND DATA: KT is widely used in patients with low back pain. METHODS: We conducted searches on PubMed, EMBASE, PEDro, SciELO, and LILACS up to February 26, 2018. We included only randomized controlled trials (RCTs) in adults with chronic nonspecific low back pain that compared KT to no intervention or placebo as well as RCTs that compared KT combined with exercise against exercise alone. The methodological quality and statistical reporting of the eligible trials were measured by the 11-item PEDro scale. The quality of the evidence was assessed using the GRADE classification. We considered pain intensity and disability as the primary outcomes. Whenever possible, the data were pooled through meta-analysis. RESULTS: We identified 11 RCTs for this systematic review (pooled n = 743). Two clinical trials (pooled n = 100) compared KT to no intervention at the short-term follow-up. Four studies compared KT to placebo (pooled n = 287) at short-term follow-up and two trials (pooled n = 100) compared KT to placebo at intermediate-term follow-up. Five trials (pooled n = 296) compared KT combined with exercises or electrotherapy to exercises or spinal manipulation alone. No statistically significant difference was found for most comparisons. CONCLUSION: Very low to moderate quality evidence shows that KT was no better than any other intervention for most the outcomes assessed in patients with chronic nonspecific low back pain. We found no evidence to support the use of KT in clinical practice for patients with chronic nonspecific low back pain. LEVEL OF EVIDENCE: 1.

Cognitive stimulations effects and Taigeiko in elderly women's cognition: an intervention / Los efectos de estímulos cognitivos y Taigeiko en la cognición de idosas: una intervención / Efeitos de estímulos cognitivos e Taigeiko na cognição de idosas: uma intervenção

ABSTRACT Objective: To evaluate the effectiveness of an intervention through cognitive stimulation associated with Taigeiko practice in memory performance and executive function of elderly women, compared to a group exposed to Taigeiko alone. Method: A quasi-experimental study was performed with 16 elderly women. 10 were allocated to the experimental group (EG) submitted to 16 sessions of cognitive stimulation and Taigeiko, and 6 elderly women in the control group (CG) submitted to Taigeiko alone. Cognition was assessed before and after intervention by the tests: Rey Auditory-Verbal Learning (RAVLT); Rey-Osterrieth Complex Figure Test; Trail-Making Test; Stroop Effect; Digit Span Test and Semantic Verbal Fluency Test. Results: Both groups presented differences in RAVLT domains (EG p=0.004, CG p=0.005) and Stroop Effect (EG p=0.012; CG p=0.024). However, in EG, better scores were shown in the tests, although not statistically significant. Conclusion: Taigeiko has been shown to be a potential activity in obtaining cognitive gains, independently of the associated cognitive stimulation.

RESUMEN Objetivo: Evaluar la efectividad de una intervención por medio de estímulos cognitivos asociados a la práctica de Taigeiko en el desempeño de la memoria y función ejecutiva de ancianas, comparado a un grupo expuesto al Taigeiko aisladamente. Método: Estudio casi experimental con 16 ancianas, siendo 10 asignadas en el grupo experimental (GE) y sometidas a 16 sesiones de estimulación cognitiva y Taigeiko; y 6 ancianas en el grupo control (GC), sometidas al Taigeiko aisladamente. La cognición fue evaluada antes y después de la intervención por medio de las pruebas: Aprendizaje Aditivo-Verbal de Rey (RAVLT); Figuras Complejas de Rey; Rutas; Efecto Stroop; Span de Dígitos y Fluidez Verbal Semántica. Resultados: Los dos grupos presentaron diferencias en los dominios del RAVLT (GE p=0,004; GC p=0,005) y en el Efecto Stroop (GE p=0,012; GC p=0,024). Sin embargo, en el GE se evidenciaron mejores puntuaciones en las pruebas, aunque sin significancia estadística. Conclusión: El Taigeiko demostró ser una potencial actividad en la obtención de ganados cognitivos, independientemente de la estimulación cognitiva asociada.

RESUMO Objetivo: Avaliar a efetividade de uma intervenção por meio de estímulos cognitivos associados à prática de Taigeiko no desempenho da memória e função executiva de idosas, comparado a um grupo exposto ao Taigeiko isoladamente. Método: Estudo quase-experimental com 16 idosas, sendo 10 alocadas no grupo experimental (GE) submetidas a 16 sessões de estimulação cognitiva e Taigeiko, e 6 idosas no grupo controle (GC) submetidas ao Taigeiko isoladamente. A cognição foi avaliada pré e pós-intervenção pelos testes: Aprendizagem Aditivo-Verbal de Rey (RAVLT); Figuras Complexas de Rey; Trilhas; Stroop; Span de Dígitos e Fluência Verbal Semântica. Resultados: Ambos os grupos apresentaram diferenças em domínios do RAVLT (GE p=0,004; GC p=0,005) e do Teste Stroop (GE p=0,012; GC p=0,024). No entanto, no GE foram evidenciados melhores escores nos testes, embora sem significância estatística. Conclusão: O Taigeiko demonstrou ser uma potencial atividade na obtenção de ganhos cognitivos, independente da estimulação cognitiva associada.

The effectiveness of post-partum interventions to prevent urinary incontinence: a systematic review.

OBJECTIVE: to assess the effectiveness of post-partum interventions to prevent urinary incontinence: a systematic review. METHOD: systematic review of randomized controlled studies conducted in the MEDLINE, Cochrane, Scopus and the Virtual Library on Health (Biblioteca Virtual em Saúde, BVS) databases. RESULTS: six articles were included in this review. All studies used the Pelvic Floor Muscle Training as the main procedure to prevent urinary incontinence. The results pointed to a positive and effective intervention in the post-partum period. CONCLUSION: there is evidence that programs of exercise of the pelvic floor musculature performed both in the immediate and late post-partum result in a significant increase in muscle strength and contribute to prevent urinary incontinence.

Predictive factors for progression through the difficulty levels of Pilates exercises in patients with low back pain: a secondary analysis of a randomized controlled trial.

BACKGROUND: The progression through the difficulty levels of Pilates exercises is a subjective criterion, that depends on the therapist's experience and ability to identify the best moment to progress to the next level. OBJECTIVE: To identify the factors that interfere in the progression through the difficulty levels of the Pilates exercises in patients with chronic nonspecific low back pain. METHODS: Data from 139 patients with chronic nonspecific low back pain from a randomized controlled trial were used for statistical analysis using binary logistic regression. The dependent variable was the progression through the difficulty levels, and the independent variables were age, gender, educational level, low back pain duration, pain intensity, general disability, kinesiophobia, previous physical activity, and number of absences. RESULTS: The factors that interfered in the progression through the difficulty levels were previous physical inactivity (odds ratio [OR]=5.14, 95% confidence interval [CI]: 1.53-17.31), low educational level (OR=2.62, 95% CI: 1.12-6.10), more advanced age (OR=0.95, 95% CI: 0.92-0.98) and more absences (OR=0.63, 95% CI: 0.50-0.79). These variables explain 41% of the non-progression through the difficulty level of the exercises. CONCLUSION: Physical inactivity, low educational level, more advanced age and greater number of absences can be interfering factors in the progression through the difficulty levels of the Pilates exercises in patients with chronic nonspecific low back pain.

Predicting successful prosthetic rehabilitation in major lower-limb amputation patients: a 15-year retrospective cohort study.

OBJECTIVE: To determine and compare specific factors that could be associated and predictive with successful prosthetic rehabilitation in major lower-limb amputations. METHODS: A 15-year long (2000-2014) retrospective observational cohort study was conducted. Two different criteria were used to define successful prosthetic rehabilitation: (1) the ability to walk at least 45m, regardless of assistive devices; and (2) walking >45m without other ambulatory aids than one cane (if required). Age, gender, comorbidities, cause and level of amputation, stump characteristics, ulcers in the preserved limb, and time between surgery and physical therapy were examined as predictors of successful prosthetic rehabilitation. RESULTS: A total of 169 patients (61.60±15.9 years) were included. Regarding walking ability with or without walking aids, the presence of ulcers in the preserved limb was individually associated with failed prosthetic rehabilitation (p<0.001), while being male (OR=0.21; 95%CI=0.06-0.80) and transtibial level of amputation (OR=6.73; 95%CI=1.92-23.64) were identified as independent predictors of failure and success, respectively. Regarding the criterion of successful rehabilitation, a shorter time until rehabilitation was individually associated with improved walking ability (p<0.013), while failure could be predicted by comorbidities (OR=0.48; 95%CI=0.29-0.78) and age groups of 65-75 years old (OR=0.19; 95%CI=0.05-0.78) and over 75 years old (OR=0.19; 95%CI=0.04-0.91). CONCLUSIONS: Regarding walking ability with or without walking aids, male gender and transtibial level of amputation are independently associated with failure and success respectively, whereas older age and comorbidities can predict failed prosthetic rehabilitation when assistive walking devices are considered. Future prospective cohort studies are needed to confirm these findings.

Electromyography Biofeedback Exergames to Enhance Grip Strength and Motivation.

BACKGROUND: Hand strength weakness affects the performance of most activities of daily living. This study aims to design, develop, and test an electromyography (EMG) biofeedback training system based on serious games to promote motivation and synchronization and proper work intensity in grip exercises for improving hand strength. MATERIALS AND METHODS: An EMG surface sensor, soft balls with different stiffness and three exergames, conforms the system to drive videogame clues in response to EMG-inferred grip strength, while overseeing motivation. An experiment was designed to study the effect of performing handgrip (HG) exercises with the proposed system versus traditional exercises. Participants, organized into two groups, followed a training program for each hand. One group followed a HG exergame training (ET) with the dominant hand and traditional HG training with the nondominant hand and inverse sequence by the second group. Initial and final grip forces were measured using a digital dynamometer. Questionnaires evaluated motivation and user experience, and exercise performance was evaluated in terms of work and rest time percentage and maximal voluntary contraction percentage over contraction periods. Data were analyzed for statistically significant differences and increase of means. RESULTS: Participants showed significantly better exercise performance and higher grip forces, with sustained intrinsic motivation and user experience, with the ET. CONCLUSION: Improvement in force level arises evidently from the synchronized work-rest time pattern and appropriated intensity of the muscle activity. This leads to support that EMG biofeedback exergames improve motor neurons firing and resting.

Effects of Kinect Adventures Games Versus Conventional Physical Therapy on Postural Control in Elderly People: A Randomized Controlled Trial.

OBJECTIVE: To compare the effectiveness of Kinect Adventures games versus conventional physiotherapy to improve postural control (PC), gait, cardiorespiratory fitness, and cognition of the elderly. In addition, we evaluated the safety, acceptability, and adherence to the interventions. MATERIALS AND METHODS: The study was a randomized clinical trial in which 46 elderly individuals were selected, mean age 69.3 (5.34) years. Participants were allocated to the Kinect Adventures Training Group (KATG) or the Conventional Physical Therapy Group (CPTG), 23 individuals in each group. Participants of both groups participated in 14 training sessions lasting 1 hour each, twice a week. The KATG practiced four Kinect Adventures games. The CPTG participated in conventional physiotherapy. The primary outcome was PC: Mini-Balance Evaluation Systems Test (Mini-BESTest), and secondary outcomes were gait: Functional Gait Assessment (FGA), cardiorespiratory fitness: Six-minute step test (6MST), and cognition: Montreal Cognitive Assessment (MoCA). Acceptability was assessed through a questionnaire created by the researchers themselves. Adherence was assessed by the "frequency of the number of elderly individuals who completed the interventions and safety through the presence of adverse effects." Participants were assessed immediately pre- and posttreatment and fourth week after the end of the treatment. Statistical analysis was done through repeated-measures analysis of variance and Tukey post hoc test. RESULTS: Both groups presented a significant improvement in the PC (Mini-BEST), gait (FGA), and cognition (MoCA) posttreatment that was maintained at fourth week after treatment (post hoc Tukey test; P < 0.05). Regarding cardiorespiratory fitness (6MST), the KATG presented improvement posttreatment and maintenance of the results in the fourth week after treatment. CPTG showed improvement only in fourth week after treatment (post hoc Tukey tests; P < 0.05). Regarding the acceptability, the questionnaire showed that both groups were satisfied with regard to the proposed interventions. There was 91% adherence in both training sessions. Regarding the safety, 34% and 26% of the individuals of the KATG and CPTG, respectively, presented adverse effects of delayed muscle pain in the lower limbs after the first session only. CONCLUSION: There were no significant differences between the KATG and CPTG; both interventions provided positive effects on PC, gait, cardiorespiratory fitness, and cognition of the elderly.

The effectiveness of post-partum interventions to prevent urinary incontinence: a systematic review / Eficacia de las intervenciones realizadas en el posparto para prevenir la incontinencia urinaria: revisión sistemática / Eficácia das intervenções realizadas no pós-parto para prevenir incontinência urinária: revisão sistemática

ABSTRACT Objective: to assess the effectiveness of post-partum interventions to prevent urinary incontinence: a systematic review. Method: systematic review of randomized controlled studies conducted in the MEDLINE, Cochrane, Scopus and the Virtual Library on Health (Biblioteca Virtual em Saúde, BVS) databases. Results: six articles were included in this review. All studies used the Pelvic Floor Muscle Training as the main procedure to prevent urinary incontinence. The results pointed to a positive and effective intervention in the post-partum period. Conclusion: there is evidence that programs of exercise of the pelvic floor musculature performed both in the immediate and late post-partum result in a significant increase in muscle strength and contribute to prevent urinary incontinence.

RESUMEN Objetivo: analizar la eficacia de las intervenciones realizadas en el posparto para prevenir la incontinencia urinaria. Método: revisión sistemática de estudios aleatorizados controlados, realizada en las bases de datos MEDLINE, Cochrane, Scopus y Biblioteca Virtual en Salud - BVS. Resultados: seis artículos fueron incluidos en la revisión. Todos los estudios utilizaron el Entrenamiento de la Musculatura del Piso Pélvico como intervención principal para prevenir la incontinencia urinaria y los resultados de las intervenciones apunta a un efecto positivo y eficaz del mismo en el posparto. Conclusión: hay evidencias de que programas de ejercicios de la musculatura del piso pélvico realizados tanto en el posparto inmediato como en el tardío resultan en un aumento significativo de la fuerza muscular y contribuyen a la prevención de la incontinencia urinaria.

RESUMO Objetivo: analisar a eficácia das intervenções realizadas no pós-parto para prevenção da incontinência urinária. Método: revisão sistemática de estudos randomizados controlados realizada nas bases de dados MEDLINE, Cochrane, Scopus e Biblioteca Virtual em Saúde - BVS. Resultados: seis artigos foram inclusos na revisão. Todos os estudos utilizaram o Treinamento da Musculatura do Assoalho Pélvico como intervenção principal para prevenção da incontinência urinária e os resultados das intervenções apontaram para um efeito positivo e eficaz do mesmo no pós-parto. Conclusão: há evidências de que programas de exercícios da musculatura do assoalho pélvico realizados tanto no pós-parto imediato quanto no tardio resultam em aumento significativo da força muscular e contribuem para a prevenção da incontinência urinária.