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Background: Few studies have evaluated the effects of structured early mobilization (EM) protocols on the level of mobilization in critical care patients. Objective: To evaluate the impact of a structured EM protocol on the level of mobilization, muscle strength, and the level of activities of daily living (LADL) after intensive care unit (ICU) and hospital discharge. Methods: This randomized clinical trial (U1111-1245-4840) included adults patients who were randomized into two groups: intervention (n = 40) and control (n = 45). The intervention group underwent conventional physiotherapy and structured EM protocols, and the control group underwent conventional physiotherapy. The level of mobilization from 0 (no mobilization) to 5 (walking), muscle strength (Medical Research Council scale), LADL (Katz Index), and incidence of complications were evaluated. Results: The level of mobilization from day 1 to day 7 increased in the intervention group compared with the control group (p <.05). Muscle strength did not change during the protocol in the intervention and control groups {day 1 [effect size (r) = 0.15, p =.161], at ICU discharge [r = 0.16, p =.145], and after ICU discharge [r = 0.16, p =.191]}. The LADL did not differ between the intervention and control groups after ICU discharge [4 (1–6) vs. 3 (1–5), p =.702] or 30 days after hospital discharge [6 (5–6) vs. 6 (5–6), p =.945]. The structured EM protocol was safe, and no severe complications were observed during the protocol. Conclusion: A structured EM protocol increased the level of mobilization without improving muscle strength and the LADL compared with conventional physiotherapy. [ABSTRACT FROM AUTHOR]

Introduction: Soccer is the most played sport in the world and the one that causes more injuries. Imbalance between knee flexor and extensor is the main cause of muscle injuries in soccer players. Objective: The aim of this study was to verify the asymmetry and the correlation between the strength and flexibility of knee flexor and extensor as well as the difference of these variables between the right and left limbs in youth soccer players. Method: The sample consisted of 45 male youth soccer players for at least a year, aged between 13 and 16 years (14.7+0.86). The athletes underwent an assessment of flexibility of the posterior chain through the sit and reach test on Wells' Bench and an assessment of flexibility of the quadriceps using the Ely's test, with measurement of passive range of motion by goniometry. The peak of muscle strength was measured using a load cell (EMG · System, Brazil). Results: Data analysis showed difference between the values obtained in the Ely's test of right and left leg (p=0,03), which did not happen for flexion strength (p=0.45), extension (p=0.41) and H:Q ratio (p = 0.40) when comparing the two members. It was observed a significant negative correlation between the H:Q ratio and the flexibility of the posterior chain test either for the right side (r=-0.40; p=0.006) or left side (r=-0.50; p=0.0004). Also a significant positive correlation was observed between quadriceps strength and flexibility of the posterior chain, both for the right (r=0.31; p=0.03) and the left side (r=0.32; p=0.02). Just for the left side a significant positive correlation was observed when compared the flexor muscle strength with the flexibility of the quadriceps (r=0.30; p=0.03). Conclusion: We conclude from this study that the flexibility of the posterior chain may be related to the strength of the antagonists, however, when the two physical qualities were compared in the same muscles, it showed no correlation. [ABSTRACT FROM AUTHOR]

Objectives: The aim of the present study was to investigate the relationship between religiosity and mood, quality of life, number of hospitalizations, and number of severe suicide attempts among bipolar disorder patients., Methods: In a cross-sectional study of bipolar disorder outpatients (N = 168), we assessed symptoms of mania [Young Mania Rating Scale (YMRS)], depression [Montgomery-Åsberg Depression Rating Scale (MADRS)], religiosity (Duke Religious Index), religious coping (Brief RCOPE), and quality of life [World Health Organization Quality of Life-Brief Version (WHOQOL-BREF)]. Sociodemographic data, number of suicide attempts, and number of hospitalizations were obtained through an interview with the individual and analysis of the patient's medical records. Logistical and linear regressions of the association between the religious indicators and clinical variables were conducted, controlling for sociodemographic variables., Results: A total of 148 (88.1%) individuals reported some type of religious affiliation. Intrinsic religiosity [odds ratio (OR) = 0.19, 95% confidence interval (CI): 0.06-0.57, p = 0.003] and positive religious coping strategies (OR = 0.25, CI: 0.09-0.71, p = 0.01) were associated with fewer depressive symptoms. All four domains of quality of life were directly and significantly correlated with intrinsic religiosity. Positive religious coping was correlated with higher levels of the psychological (β = 0.216, p = 0.002) and environmental (β = 0.178, p = 0.028) quality-of-life domains. Negative religious coping was associated with lower scores on the psychological domain of quality of life (β = -0.182, p = 0.025)., Conclusions: Intrinsic religiosity and positive religious coping are strongly associated with fewer depressive symptoms and improved quality of life. Negative religious coping is associated with worse quality of life. Religiosity is a relevant aspect of patients' lives and should be taken into consideration by physicians when assessing and managing bipolar disorder patients. Further longitudinal studies are needed to determine the causality and therapeutic implications of our findings., (© 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)