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Background: Degenerative diseases such as Parkinson’s disease can lead to postural changes and muscular strength, this generates greater impact on the individual, on his functional capacity, respiratory system, mobility and, quality of life (QOL). Objective: The aim of this study was to verify the influence of the Global Posture Reeducation (GPR) method on respiratory muscle strength and QOL in patients with Parkinson’s disease. Methods: Twenty volunteers, the average of age is 48.8 ± 6.22 years, they are diagnosed with Parkinson’s disease at level 2 to 3 by the Hoehn & Yahr Scale. They were submitted to the protocol of treatment with the GPR method in the postures of Frog in the ground and ballerina, performed regularly twice a week lasting 60 minutes each session, for 6 weeks, totaling 12 sessions, evaluated by PDQ-39 quality of life questionnaire and by inspiratory pressure measurements and Maximum expiratory value. Results: In the quantitative analysis of inspiratory and expiratory muscle pressure, there was an increase in post-treatment for maximal inspiratory pressure (MIP) (p

Objetivo: Verificar quais são as principais disfunções corporais decorrentes da gravidez e analisar de que modo influenciam a qualidade de vida das mães. Metodologia: Trata-se de uma pesquisa observacional com corte transversal. A coleta de dados teve início após a aprovação do Comitê de Ética em Pesquisa da Universidade da Amazônia. Os dados foram coletados de forma presencial em setembro de 2019, por meio de uma ficha de avaliação e a aplicação do questionário adaptado da CELLUQOL, com questões acerca de algumas disfunções, como celulite, gordura localizada, flacidez tissular e estrias, sendo relacionadas à qualidade de vida das mulheres. Resultados: Foram avaliadas 27 primíparas com idade média de (31,9±4,3) anos, onde 85,2% apresentavam gordura localizada e celulite, 66,7% apresentavam estrias e flacidez tissular. Na inspeção corporal, os principais locais do corpo com a presença de flacidez e gordura foram o abdômen e os flancos. No tocante à celulite, foram os glúteos e as coxas e das estrias foi o abdômen. Conclusão: A gordura localizada e a celulite são as duas disfunções mais encontradas nas participantes da pesquisa, essas mudanças podem dificultar o convívio social, o ambiente de trabalho e a relação com o seu parceiro, podendo desenvolver um quadro de depressão.

Federal University of Par?. Center for Tropical Medicine. Bel?m, PA, Brazil / State University of Par?. Center for Biological and Health Sciences. Bel?m, PA, Brazil. State University of Par?. Center for Biological and Health Sciences. Bel?m, PA, Brazil. Federal University of Par?. Center for Tropical Medicine. Bel?m, PA, Brazil. State University of Par?. Center for Biological and Health Sciences. Bel?m, PA, Brazil. State University of Par?. Center for Biological and Health Sciences. Bel?m, PA, Brazil. State University of Par?. Center for Biological and Health Sciences. Bel?m, PA, Brazil. State University of Par?. Center for Biological and Health Sciences. Bel?m, PA, Brazil. Federal University of Par?. Center for Tropical Medicine. Bel?m, PA, Brazil / Santa Casa de Miseric?rdia Foundation. Bel?m, PA, Brazil. State University of Par?. Center for Biological and Health Sciences. Bel?m, PA, Brazil. Federal University of Par?. Center for Tropical Medicine. Bel?m, PA, Brazil. State University of Par?. Center for Biological and Health Sciences. Bel?m, PA, Brazil. Federal University of Par?. Center for Tropical Medicine. Bel?m, PA, Brazil / State University of Par?. Center for Biological and Health Sciences. Bel?m, PA, Brazil / Minist?rio da Sa?de. Secretaria de Vigil?ncia em Sa?de. Instituto Evandro Chagas. Ananindeua, PA, Brasil. This study analyzed the relationship between infection by human T-cell lymphotropic virus type 1 (HTLV-1) and changes in the pulmonary system. Cohort and case-control study models that analyzed a causal association between HTLV-1 and changes in the pulmonary system were considered. There were no restrictions on language and publication period. The study was registered in the PROSPERO systematic analysis database (Protocol No. CRD42017078236) and was prepared according to the recommendations of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. The following databases were used: PubMed, BVS Regional Portal, Embase, CINAHL and Web of Science. We utilized the Newcastle-Ottawa Scale to assess the methodological quality of published studies and the Kappa coefficient to assess the agreement level between two reviewers. Of the total 1156 studies retrieved by the search strategy, 28 were considered potentially eligible (Kappa test = 0.928). Of the 28 studies, three fully met the inclusion criteria. These indicated that pulmonary lesions, such as bronchiectasis and bronchitis/bronchiolitis, were observed in patients with HTLV-1, with high-resolution computed tomography of the chest being the main method of diagnostic investigation. The analyzed cohort and case-control studies indicated an etiological relationship between HTLV-1 infection and the presence of lung lesions, with emphasis on bronchiectasis in the presence of high viral loads, as well as a higher mortality in these individuals compared with the general population.

Introduction: The impairment of muscle strength and fatigue in leprosy remains a problem that requires careful attention to avoid or minimize its progression, as well as prevention of disabilities and deformities. Objective: To investigate the maximum voluntary contraction and time to muscle fatigue in leprosy patients. Method: A total of 21 leprosy patients and 21 healthy subjects completed the sample. The method used to determine the maximum voluntary contraction (MVC) of the handgrip followed the recommendation of the American Society of Hand Therapists with the use of a hydraulic hand grip dynamometer. The test was performed three times with each hand, with a time interval of 60 seconds between successive trials. The subject was instructed to perform a maximal isometric force against the dynamometer for 5 seconds. The peaks were recorded and used for the fatigue test. For the fatigue test, we recorded the electromyogram of the forearm muscles to offline determine the onset time for the muscle contraction (14 bits, Miograph 2 USB®, Miotec, Brazil). Results: Leprosy patients had lower MVC compared with healthy subjects (p > 0.05), both in the dominant and the non-dominant hands. The time to fatigue in the leprosy and control groups was similar (p < 0.05). We observed that leprosy patients had more contractions than the healthy subjects (22.6 ± 11.8 contractions for the leprosy group vs. 12.3 ± 6.9 contractions for the control group, p > 0.05). Conclusion: Multibacillary leprosy patients lost muscle force without modifying the resistance to fatigue. Resumo Introdução: O comprometimento da força muscular e a fadiga na hanseníase continuam sendo problemas que requerem cuidadosa atenção para evitar ou minimizar sua progressão, bem como prevenir incapacidades e deformidades. Objetivo: Avaliar a força muscular e o tempo até a fadiga em pacientes com hanseníase Método: Vinte e um pacientes com hanseníase e 21 indivíduos saudáveis completaram a amostra. O método utilizado para determinar a contração voluntária máxima (CVM) da força de preensão palmar seguiu a recomendação da Sociedade Americana de Terapeutas da Mão com o uso de um dinamômetro de preensão manual. O teste foi realizado três vezes em cada mão, com intervalo de tempo de sessenta segundos entre tentativas sucessivas. O sujeito foi instruído a realizar força isométrica máxima contra o dinamômetro durante cinco segundos. Os picos foram registrados e usados para o teste de fadiga. Para o teste de fadiga, registrou-se o eletromiograma dos músculos do antebraço para determinar off-line o tempo de início da contração muscular (14 bits, Miograph 2 USB ® , Miotec, Brasil). Resultados: Os pacientes com hanseníase apresentaram menor CVM em relação aos saudáveis (p < 0,05) nas mãos dominante e não dominante. Não houve diferença no tempo de fadiga entre os grupos hanseníase e controle (p > 0,05). Foi observado que os pacientes com hanseníase tinham mais contrações do que os saudáveis (22,6 ± 11,8 contrações para o grupo com hanseníase vs. 12,3 ± 6,9 para o grupo controle, p < 0,05). Conclusão: Pacientes com hanseníase multibacilar apresentaram perda de força muscular sem modificação da resistência à fadiga. Resumen Introducción: El compromiso de la fuerza muscular y la fatiga en la lepra sigue siendo un problema que requiere atención cuidadosa para evitar o minimizar su progresión, así como la prevención de incapacidades y deformidades. Objetivo: Evaluar la fuerza muscular y el tiempo hasta la fatiga de pacientes con lepra. Método: Veintiún pacientes con lepra y 21 sujetos sanos completaron la muestra. El método utilizado para determinar la contracción voluntaria máxima (CVM) de la fuerza de asimiento palmar siguió la recomendación de la Sociedad Americana de Terapeutas de la Mano con el uso de un dinamómetro de asimiento manual. La prueba se realizó tres veces con cada mano, con un intervalo de tiempo de 60 segundos entre intentos sucesivos. El sujeto fue instruido a realizar una fuerza isométrica máxima contra el dinamómetro durante 5 segundos. Los picos se registraron y se utilizaron para la prueba de fatiga. Para la prueba de fatiga, registramos el electromiograma de los músculos del antebrazo para determinar fuera de línea el tiempo de inicio de la contracción muscular (14 bits, Miograph 2 USB ® , Miotec, Brasil). Resultados: Los pacientes con lepra presentaron menor CVM con relación a los sanos (p < 0,05) en las manos dominante y no dominante. No hubo diferencia en el tiempo de fatiga entre los grupos de lepra y control (p > 0,05). Se observó que los pacientes con lepra tenían más contracciones que los sanos (22,6 ± 11,8 contracciones para el grupo con hanseniasis frente a 12,3 ± 6,9 para el grupo control, p < 0,05). Conclusión: Pacientes con hanseniasis multibacilar presentaron pérdida de fuerza muscular sin modificación de la resistencia a la fatiga.

This blind randomized clinical trial evaluated the effect of CIMT on the functionality and quality of life (QOL) of chronic hemiparetics. Thirty volunteers were divided into two groups: Control (CG) and CIMT (CIMTG); evaluated before and after 12 and 24 intervention sessions. The scales used were: adapted Fugl-Meyer Motor Assessment (FMA), Modified Ashworth, Stroke Specific Quality Of Life (SS-QOL) and the Functional Reach Test (FRT). The scores for all FMA variables in the CIMTG increased until the 24th session, differing from the pre-treatment. In the CG, the scores increased for pain, coordination/ speed and sensitivity. In the FRT there was an increase in the scores in both groups; after the 12th and 24th sessions, the result of the CIMTG was superior to the CG. For the SS-QOL in the CIMTG, the general score and most of the variables increased, as well as in the CG. Muscle tone in CIMTG was lower compared to CG after 24 sessions. Both protocols used in the study were effective, the CIMT protocol showed benefits in recovering the functionality of the paretic upper limb, in the functional range and in reducing muscle tone, with a consequent improvement in quality of life.

Background: To evaluate the relationship between Human T- cell lymphotropic virus type 1 (HTLV-1) infection and respiratory system alterations. Methods: Cohort and case-control studies that analysed the causal association between HTLV-1 and pulmonary complications were considered. There was no restriction on language and publication period. The study was registered in PROSPERO (Protocol No. CRD42017078236), and was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Statement. PubMed, Bireme, ScienceDirect, PeDo, Scielo, Ibecs e Cochrane Central Register of Controlled Trials were searched, with the combination of following keywords: HTLV 1; human T-lymphotropic virus 1; HTLV-1 infectious; lung disease; pulmonary disease; lung injury; pulmonary injury; respiratory tract disease. The Newcastle-Ottawa Scale (NOS) was utilized for methodologic quality evaluation of published studies and Kappa coefficient for evaluation of agreement level between two reviewers. Findings: Initially 826 studies were retrieved by the search strategy, 33 of these were considered to be potentially eligible (Kappa test = 0.92), only three met the inclusion criteria. These include bronchiectasis, diffuse panbronchiolitis (DPB), bronchioalveolitis associated with HTLV-1 (BAH), non-specific interstitial pneumonia (NSIP) as a reaction against pulmonary complications in patients with HTLV-1 virus. Interpretation: This systematic review with an approach to cohort and case control studies suggests the need of further investigations to understand the mechanisms underlying persistence and viral pathogenesis, focusing on preventive and therapeutic strategies with a view into the respiratory system of symptomatic or asymptomatic HTLV-1 virus carriers. Funding Statement: There was no funding source for this study. Declaration of Interests: The authors have nothing to declare. Ethics Approval Statement: The systematic review was registered in the PROSPERO International Prospective Register of Systematic Reviews (Protocol No. CRD42017078236), elaborated according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) recommendations.

The aim of this study was to compare computed tomography (CT) scans of chest and lung function among patients with Human T-Lymphotropic Virus Type 1 (HTLV) with and without HTLV-1 associated myelopathy/tropical spastic paraparesis (HAM/TSP). In this cross-sectional study performed between January 2013 and June 2016, we included 48 patients with HAM/TSP (19 women and 11 men) and without HAM/TSP (12 women and 6 men). We compared CT findings and lung functions of these groups. Patients who had HAM/TSP had abnormal CT findings (P = 0.000), including more frequent bronchiectasis (P = 0.049), parenchymal bands (P = 0.007), interlobular septal thickening (P = 0.035), and pleural thickening (P = 0.009). In addition, neither patients with HAM/TSP (9/30; 30%) nor the controls (0/18; 0%) had obstructive or restrictive lung disease (P = 0.009). HTLV diagnosis should be considered in all patients with abnormal CT findings in whom no other cause is apparent. It is important to remember that lung disease increases the rates of morbidity and mortality in developing countries.

Introduction: Chronic obstructive pulmonary disease (COPD) alters the cardiac autonomic modulation, rehabilitation protocols can influence heart rate variability. Objective: This study aimed to verify if a pulmonary rehabilitation protocol modifies the autonomic modulation of the heart rate of individuals with COPD. Methods: Twenty-eight volunteers with severe and very severe obstructive disease who underwent heart rate variability evaluation with a POLAR® RS800CX cardiac monitor for 10 minutes in a supine position and analyzed in the Kubios HRV 2.2 program. The rehabilitation protocol consisted of In aerobic physical training and muscle strengthening during 8 weeks, with 2 sessions per week, lasting 50 minutes. Statistical analysis was performed in the softwere BioEstat® 5.2. The Shapiro-Wilk test was used to verify the distribution of the data. From their normality, the student9s t-test was used for the analysis of significance. For the nominal variables the Binominal test was used. Values of p Conclusion: The pulmonary rehabilitation protocol in COPD patients improves the autonomic modulation of the heart rate, increasing the parasympathetic influence.

HTLV, the causative agent of HTLV-1 associated myelopathy (HAM/TSP), features obscurity to pulmonary lesions. To investigate the pulmonary function in patients who ware HAM/TSP in the Amazon. From 2013 to 2015, 19 patients who were HAM/TSP definitive, 11 who were HAM/TSP probable and 13 without HAM/TSP participated in the study and underwent a spirometry test in compliance with the standards established by the Brazilian Consensus on Spirometry (Pereira,C.A.C.J.Pneumol.2002;3:1-82).This research was approved by Ethics Committee-Instituto Evandro Chagas (292251). 18.5%(8/43) of all of the patients had obstructive or restrictive lung disease, however none was without HAM/TSP (p=0.04). Pulmonary function values were also compared. The results suggest changes in lung function in those who have developed HAM/TSP. Thus, it seems reasonable to assume that such changes may be linked to possible lung inflammation.

Heart activity is largely modulated by the autonomic nervous system (ANS), which promotes rapid adjustments in the cardiovascular system during different stimuli (i.e., physical exercise, mental stress and postural change) (Hainsworth, 1998). HRV is a noninvasive measure used to analyze the influence of the autonomic nervous system on the heart, providing information about both sympathetic and parasympathetic contributions to consecutive heart rate (HR) oscillations. It has been proposed that a decrease in HRV is a powerful predictor of morbidity and mortality resulting from arrhythmic complications. HRV decreases with age (Catai et al., 2002; Melo et al., 2005) as a consequence of parasympathetic reduction and predominance of sympathetic modulation (Lipsitz et al., 1990; Longo & Correia, 1995; Akselrod, 1995).