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This is the first study to investigate the performance of 6MST in COPD patients divided into different symptom severity groups based on the CAT questionnaire score.To evaluate the relationship between the degree symptomatology using the chronic obstructive pulmonary disease (COPD) Assessment Test (CAT) with the six- minute step test (6MST) in COPD patients.This is a cross-sectional study in which 59 patients with COPD were evaluated. The groups were stratified according to the subsequent cutoff points: CAT10 (little impact) n= 22; CAT 11-20 (moderate impact) n=20; CAT20 (large impact) n=17. During 6MST the individuals were instructed to go up and down a single step with a height of 20 centimeters (cm).Comparing the groups in relation to performance on the 6MST, the number of climbs on the step were significantly higher in the CAT group10 when compared to the CAT group20, the variation in HR between rest and peak exercise (∆ HRpeak- rest) was lower in the CAT20 group compared to the CAT10 group and the CAT 11- 20 group. We found direct relationships between the number of ascents and descents in the 6MST vs the CAT score (r=0.35, p=0.007); and 6MST vs degree of obstruction of %FEV1 (r-0.46, p=0.002) We verified a linear regression model in which the FEV1 (L) and the CAT score influenced 29% in the performance of the 6MST.The COPD severity represented by the FEV

SUMMARY OBJECTIVE: This study aimed to translate, cross-culturally adapt, and validate the Heart Disease Fact Questionnaire into Brazilian Portuguese. METHODS: The Brazilian version of the Heart Disease Fact Questionnaire was developed through the processes of translation, back-translation, review committee, and pre-test. Test-retest reliability was measured using the intraclass correlation coefficient and the kappa coefficient. Internal consistency was measured using Cronbach's alpha. For construct validity, the total Heart Disease Fact Questionnaire score was correlated with the Diabetes Knowledge Scale and the Diabetes Attitudes Questionnaire. Ceiling and floor effects were also evaluated in this study. RESULTS: For construct validity and floor and ceiling effect measurements, a total of 100 participants were selected. Reliability was measured using a sub-sample of 30 participants from the total sample. We identified adequate values of reliability (kappa between 0.22 and 1.00 and ICC=0.75) and internal consistency (Cronbach's alpha=0.79). We observed adequate correlations of the Heart Disease Fact Questionnaire score with Diabetes Knowledge Scale (r=0.348) and Diabetes Attitudes Questionnaire (r=0.136). No ceiling or floor effects found. CONCLUSION: Brazilian Portuguese version of the Heart Disease Fact Questionnaire has adequate psychometric properties according to the best scientific recommendations.

SUMMARY OBJECTIVE: The aim of this study was to verify the association among obstructive sleep apnea, functional capacity, and metabolic control. METHODS: This was a cross-sectional study involving individuals of both sexes with clinical diagnosis of diabetes mellitus type 2 who were above 18 years of age. The assessment consisted of a volunteer identification form, a 2-minute step test, and the Stop-Bang questionnaire. In order to assess metabolic control, HbA1c and fasting glucose data were collected from medical records. RESULTS: A total of 100 individuals with diabetes mellitus type 2, of whom 61% were women, were included in this study. According to the Stop-Bang instrument, 26, 57, and 17% of patients had low, intermediate, and high risk of developing OSA, respectively. There was no association between the 2-minute step test and metabolic variables and diabetes mellitus type 2 chronicity with Stop-Bang. CONCLUSIONS: We concluded that there is no association among obstructive sleep apnea measured by means of Stop-Bang instrument, functional capacity measured by means of 2-minute step test, and metabolic variables in individuals with diabetes mellitus type 2.

Individuals affected by COVID-19 have an alteration in autonomic balance, associated with impaired cardiac parasympathetic modulation and, consequently, a decrease in heart rate variability (HRV). This study examines the inter- and intrarater reliability of HRV) parameters derived from short-term recordings in individuals post-COVID. Sixty-nine participants of both genders post-COVID were included. The RR interval, the time elapsed between two successive R-waves of the QRS signal on the electrocardiogram (RRi), were recorded during a 10 min period in a supine position using a portable heart rate monitor (Polar® V800 model). The data were transferred into Kubios® HRV standard analysis software and analyzed within the stable sessions containing 256 sequential RRi. The intraclass correlation coefficient (ICC) ranged from 0.920 to 1.000 according to the intrarater analysis by Researcher 01 and 0.959 to 0.999 according to the intrarater by Researcher 02. The interrater ICC ranged from 0.912 to 0.998. The coefficient of variation was up to 9.23 for Researcher 01 intrarater analysis, 6.96 for Researcher 02 intrarater analysis and 8.83 for interrater analysis. The measurement of HRV in post-COVID-19 individuals is reliable and presents a small amount of error inherent to the method, supporting its use in the clinical environment and in scientific research.

SUMMARY OBJECTIVE: The aim of this study was to assess the inter-reliability of the Braden scale and its subscales for different patients assisted in the intensive care unit. We hypothesized that the Braden scale has low reliability in different populations. METHODS: This reliability study involved the Braden scale in intensive care unit of a hospital. A total of 200 patients were admitted to the intensive care unit in four different groups: neurological patients, sepsis, elderly, and adults affected by trauma. The Braden scale is a tool composed of six subscales for patient assessment: sensory perception, humidity, activity, mobility, nutrition, and friction. The total score was also calculated. The Braden scale was applied by two different nurses with an interval of 20–30 min between applications. RESULTS: For all populations, kappa values considered unsuitable were observed for most categories of the Braden scale, ranging from 0.06–0.25. Only for the total Braden scale score was moderate reliability identified in all groups evaluated, with intraclass correlation coefficient values ranging from 0.48–0.75. CONCLUSIONS: Braden scale is not a reliable tool to be used in the intensive care unit, and we do not recommend the use of this scale to assess the risk of developing pressure injury.

Individuals with COPD have an imbalance of cardiac autonomic control. In this context, HRV is considered an important tool for assessing cardiac sympathetic and parasympathetic balance, however it is a dependent evaluator measure and subject to methodological biases that may compromise the interpretation of results. This study examines the inter- and intrarater reliability of HRV parameters derived from short-term recordings in individuals with COPD. Fifty-one individuals of both genders with COPD clinical diagnosis confirmed by the pulmonary function test and aged ≥ 50 years were included. The RR interval (RRi) were recorded during a 10 min period on supine position using a portable heart rate monitor (Polar® H10 model). The data were transferred into Kubios® HRV Standard analysis software and analyzed within the stable sessions containing 256 sequential RRi. The intraclass correlation coefficient (ICC) ranged from 0.942 to 1.000 according to the intrarater analyse by Researcher 01 and 0.915 to 0.998 to the intrarater by Researcher 02. The interrater ICC ranged from 0.921 to 0.998. The coefficient of variation was up to 8.28 for Researcher 01 intrarater analysis, 9.06 for Researcher 02 intrarater analysis and 13.07 for interrater analysis. The measurement of HRV using a portable heart rate device in individuals with COPD present acceptable values of intra- and interrater reliability, supporting the use of HRV in the clinical and scientific scenario. Furthermore, it is important that the data analysis be performed by the same experienced evaluator.

Acne é uma condição genético-hormonal caracterizada por manchas moderadas a graves que ocorrem devido ao acúmulo de sebo nos folículos capilares por meio da hiperqueratinização folicular. Pode ser inflamatório ou não inflamatório e é autolimitado, o que significa que tende a evoluir para resolução naturalmente. No entanto, os casos mais graves podem exigir tratamento prolongado para evitar o agravamento da condição e cicatrizes permanentes. O objetivo deste estudo foi avaliar o impacto da acne na qualidade de vida de adolescentes e determinar associações com estilo de vida e hábitos alimentares. Estudo descritivo, analítico e transversal realizado com adolescentes brasileiros de 14 a 18 anos de escolas públicas. A coleta de dados envolveu a aplicação de um questionário com informações sociodemográficas, o Global Acne Grading System (GAGS) e o Cardiff Acne Disability Index (CADI). A prevalência de acne foi de 100%. De acordo com o GAGS, 76,63% tinham acne leve, 21,99% acne moderada e 1,37% acne grave. Com base no escore CADI, 70,45% da amostra apresentou impacto leve, 25,12% impacto moderado e 3,44% impacto grave. A análise estatística dessas variáveis revelou resultados significativos (p

Ford et al. provided (via review study) an overview of the psychiatric features associated with encephalitis mediated by autoantibodies targeting neuronal cellsurface antigens and describe indicators of potential immunopathology underlying psychiatric manifestations. In this scientific context of psychiatric manifestations, studies strongly suggest that scientists include heart rate variability assessment in these patients (because this is a way to evaluate the autonomic nervous system's sympathetic and parasympathetic components). Ford's paper has significant clinical relevance and will generate new studies (experimental and observational) on psychiatric manifestations; therefore, we have six suggestions for the authors and other scientists/researchers who will use this article to perform further research using the heart rate variability assessment. Our objective is to contribute to scientific research and help to strengthen the new studies that will emerge.

INTRODUÇÃO: Especula-se que as cardiopatias congênitas (CC) podem afetar o desenvolvimento neuropsicomotor. No entanto, ainda se faz necessários estudos que visem avaliar esse desenvolvimento nas crianças com CC. OBJETIVO: Avaliar o desenvolvimento neuropsicomotor de crianças com cardiopatias congênitas. MÉTODOS: Estudo observacional de corte transversal, conduzido no Hospital do Coração de Alagoas (Maceió – AL, Brasil), no período de junho a outubro de 2016. Foram incluídas crianças internadas para a realização de cirurgias eletivas no referido hospital, com idade entre 1 e 72 meses, e excluídas aquelas que apresentassem algum sinal de desconforto (dispneia, taquicardia, cianose, batimento de asa de nariz e uso da musculatura acessória), baixa capacidade para responder aos comandos verbais e/ou doenças/síndromes associadas que levassem ao atraso no desenvolvimento neuropsicomotor. O desenvolvimento neuropsicomotor (DNPM) foi avaliado por meio do teste de triagem do desenvolvimento Denver II, aplicado no momento pré-cirúrgico. RESULTADOS: Foram avaliadas 20 crianças, com idade entre 1-72 meses, das quais 05 foram excluídas. As 15 restantes tiveram média de idade de 16,12 (±15,56) meses, 7 meninos (46,66%) e 8 meninas (53,33%). Oitenta por cento das crianças apresentaram atraso no DNPM, sendo o domínio motor fino-adaptativo o mais comprometido, no qual as crianças realizaram apenas 48% das tarefas propostas. A maioria das crianças com o atraso, apresentavam persistência do canal arterial (41,66%), seguida de comunicação interatrial-CIA (16,66) e coexistência de CIA e comunicação interventricular (16,66). CONCLUSÃO: Conclui-se que as crianças com CC apresentam o DNPM não compatível com a sua idade. Evidenciando a necessidade de diagnóstico e estimulação precoce das mesmas.

Introdução: Insuficiência cardíaca congestiva (ICC) é considerada uma síndrome sistêmica caracterizada por fadiga e dispneia. Objetivo: Correlacionar a qualidade de vida, capacidade funcional e força muscular respiratória de pacientes com ICC. Métodos: Pacientes com ICC, internos em hospital referência, foram avaliados. Foram avaliadas a classificação funcional pela New York Heart Association (NYHA), qualidade de vida pelo o questionário Minnesota Living with Heart Failure Questionnaire (MLHFQ), e pressão inspiratória máxima (PImáx) e pressão expiratória máxima (PEmáx) pela manuvacuometria. Resultados: Quarenta e três pacientes foram incluídos, sendo 26 (60,5%) homens, com média de idade de 73,16 (±10,28) anos. A maioria dos pacientes (44,2%) estavam na classe NYHA 3. Correlação negativa foi encontrada para PImáx e PEmáx com NYHA (rs= -0,478, rs = -0,490, respectivamente), e MLHFQ com a PImáx (rs= -0,393). Conclusão: Conclui-se que a redução da força muscular respiratória leva a diminuição na qualidade de vida e piora na capacidade funcional.

Introduo: A lombalgia se caracteriza como uma dor de origem multifatorial que pode resultar em alteraes no sistema nervoso autnomo. Estas alteraes so identificadas pelo aumento da modulao simptica cardaca levando a diminuio da variabilidade da frequncia cardaca (VFC). Objetivo: Realizar uma reviso literatura acerca do uso da VFC em pacientes com lombalgia. Mtodos: A busca sistemtica desse estudo foi conduzida atravs das bases de dados LILACS, PubMED, CINAHL e SciELO. Resultados: Foram includos na reviso apenas dez estudos que mostravam a relao entre a lombalgia e as respostas dos ndices da VFC. Destes, sete estudos relatam melhora/relao dos ndices da VFC com a lombalgia e outros estudos no mostram alterao das respostas. Concluso: Existem poucas evidncias apresentando a relao entre a lombalgia e as respostas dos ndices da VFC na literatura. Alm disso, os resultados se mostram inconclusivos, fato este que dificulta afirmar se h relao ou melhora dos ndices da VFC aps interveno em pacientes com lombalgia.

Background Circulatory (CP) and ventilatory power (VP) have been used to improve the prognostic accuracy of cardiopulmonary exercise tests in cardiovascular disease, such as coronary artery disease. However, the effects of combined resistance and aerobic exercise program on VP and CP, especially in type 2 diabetes patients, have not been adequately investigated. Thus, this new parameter can be useful to prescribe exercise programs more assertive for this population. The present study aimed to assess the effect of 3 months of combined resistance and aerobic exercise training (CET) on CP and VP in patients with type 2 diabetes. Methods A randomized controlled trial was conducted involving 48 diabetic patients with an average age of 52.4 (±8.01) years old. The subjects were randomized into two groups: sedentary (SG, n = 15) and the CET group (n = 19). Cardiopulmonary exercise testing (symptom-limited incremental) was performed on a cycle ergometer, and the following parameters were measured: relative VO2 , VE /VCO2 slope, linear relationship between oxygen uptake and minute ventilation, and VCO2 . CET was performed with 30-min aerobic and 30-min resistance exercises three times a week for 12 weeks. Results Significant (p .05 and d ≥ 0.80) that favoured CET. Conclusion Three months of combined exercise training improved VP and CP indices in patients with type 2 diabetes when compared with a sedentary group.

Heart rate variability (HRV) among other methods can be used to assess diabetic cardiac autonomic neuropathy by cardiac intervals were recorded. However, the amount of error depending on this measurement methodology is unclear. To evaluate the intra- and inter-rater reliability to calculate HRV indices, comparing different times and by different trained examiners in patients with type 2 diabetes mellitus (T2DM). Thirty individuals of both genders, aged between 18 and 45 years, with T2DM. The RR interval (RRi) were recorded during a 10 min period on supine position using a portable heart rate monitor (Polar® S810i model). HRV indices were calculated by the software Kubios® HRV analysis (version 2.2). Linear (Mean RRi; STD RR; Mean HR; rMSSD; RR Tri; TINN LF; HF; total power) and non-linear (SD1; SD2; DFα1; DFα2, ApEn and, SampEn) indices were calculated by two examiners with an interval of one week between them. Substantial to excellent was found for reliability of the intra-examiner, with intraclass correlation coefficient (ICC) values ranging from 0.79 to 0.99, standard error of measurement (SEM) between 0.02 and 123.49 (in percentage: 1.83 and 16.67), and minimum detectable change (MDC) between 0.07 and 342.30. Regarding the inter-examiner reliability, substantial to excellent reliability was found, with ICC values ranging from 0.73 to 0.97, SEM between 0.04 and 178.13 (in percentage: 3.26 and 24.18), and MDC between 0.11 and 493.77. The use of the portable heart rate monitor to measure HRV showed acceptable intra and inter reliability in individuals with T2DM, supporting the use of this method of evaluation in research and clinical practice.

Objective To evaluate the intra- and inter-rater reliability of fleximetry in the measurement of range of motion (ROM) in individuals with chronic shoulder pain. Design Reliability study. Setting Physiotherapy clinic. Participants Thirty individuals of both genders, ages between 18 and 45 years, with chronic shoulder pain. Main outcome measures Fleximetry was used to measurement shoulder ROM (flexion, hyperextension, abduction, medial and lateral rotation, and horizontal abduction and adduction). Two examiners performed the evaluations of the shoulder ROM at two time points (interval of one week between them). Results In the intra-rater reliability, substantial to excellent reliability was found, with intraclass correlation coefficient (ICC) values ranging from 0.79 to 0.92, standard error of the measurement (SEM) values ranging from 5.70 to 8.72°, and minimum detectable change (MDC) values varying between 15.80 and 25.18°. Regarding the inter-rater reliability, moderate to excellent reliability was observed, with ICC values ranging from 0.68 to 0.96, SEM values ranging from 4.98 to 11.53°, and MDC values ranging from 13.82 to 31.97°. Conclusion The use of the fleximeter to measure shoulder ROM presents acceptable reliability values in individuals with chronic shoulder pain, which supports the use of this method of evaluation in research and clinical practice.

The purpose of this study was to correlate the heart rate variability (HRV) indices with variables of pain that were experienced by individuals with chronic neck pain.This was a blinded cross-sectional study. Individuals with chronic neck pain (n = 15) and healthy participants (n = 15), both sedentary and between 18 and 45 years of age, were included. The neck pain was assessed with the Numerical Rating Scale at rest and during cervical movements, Neck Disability Index, Catastrophic Thoughts about Pain Scale, and Tampa Scale of Kinesiophobia. The HRV indices (linear and nonlinear) were used for assessment of autonomic function at rest (in supine, sitting, and standing positions).We observed significant correlations between the NRS, Neck Disability Index, and Catastrophic Thoughts about Pain Scale with the linear and nonlinear HRV indices (P.05, r ≥ 0.362), so that the worst HRV indices are associated with conditions of more intense and disabling neck pain.The HRV indices were significantly associated with pain intensity, disabilty, and catastrophizing in individuals with chronic neck pain.

ResumoIntrodução: O Diabetes Mellitus (DM) é uma doença incurável causada pela pouca ou quase nenhuma produção de insulina, onde a prevenção e o autocuidado são os caminhos para evitar complicações decorrentes de sua cronicidade. A Organização Mundial da Saúde (OMS) alerta para o autocuidado como uma medida proativa ao tratamento das doenças crônicas, por exemplo, o DM, possibilitando um estreito relacionamento entre o paciente e a doença. Objetivo: Avaliar o autocuidado nos pacientes com DM. Metodologia: Trata-se de um estudo transversal, descritivo e prospectivo realizado em uma população de 30 pacientes com DM tipo 1 e 2, com idade entre 18 e 70 anos, de ambos os sexos no Centro Especializado de Medicina – CEMESP. A adesão dos pacientes de DM as atividades de autocuidado foi avaliada por meio do “Questionário de Atividades de Autocuidado com o Diabetes” (QAD). Resultados: Foram observadas alta aderência ao autocuidado em relação ao uso das medicações e inversamente proporcional para os itens relativos às “Atividades Físicas” e “Monitorização da Glicemia”. Conclusão: O resultado da amostra estudada apresentou índices de adesão ao autocuidado dentro de um quadro positivo, mas relativamente baixo e próximo da média do não desejável.

OBJECTIVE To correlate the range of movement and functional performance of the shoulder with pain measures in inactive individuals with and without neck pain. In addition, comparisons were made between the groups. METHODS The sample comprised two groups of inactive adults, aged 18-45 years: chronic neck pain (n = 30) and healthy subjects (n = 30). All participants had no clinical dysfunction in the shoulder joint. Aspects related to neck pain were evaluated with the Numerical Rating Scale, Neck Disability Index, and the Catastrophic Thoughts about Pain Scale. Range of motion and shoulder functionality was evaluated by means of goniometry and the Closed Kinetic Chain Upper Extremity Stability (CKCUES) test, respectively. RESULTS Individuals with neck pain presented reduction in CKCUES test (absolute score, mean difference [MD] = -1.50, 95% confidence interval [CI] [-2.87, -0.12]) and in abduction (MD = -7.36°, 95% CI [-13.84, -0.89]) and lateral rotation (MD = -8.61°, CI [-15.94, -1.28]) range of motion. Moreover, weak, significant, and negative association (p

Um posicionamento adequado influencia o desenvolvimento neurossensorial, proporcionando conforto, além de auxiliar na melhora da função respiratória de um recém-nascido (RN), o que por sua vez, também reduz a sensação dolorosa. O objetivo desta pesquisa consiste em verificar a utilização das redes de descanso e do posicionamento em prono no alívio da dor e no comportamento dos sinais vitais em recém-nascidos pré-termo (RCPT). Trata-se de pesquisa intervencionista com uma amostra de 20 recém-nascidos pré-termos internados na Unidade de Terapia Intensiva Neonatal (UTIN) do Hospital do Açúcar na cidade de Maceió (AL, Brasil). Avaliaram-se os sinais vitais e o escore de dor (escala NFCS - Sistema de Codificação da Atividade Facial Neonatal) antes e após os posicionamentos propostos. Esta pesquisa teve os seguintes resultados: ao comparar os valores iniciais e finais para cada variável entre as intervenções prono e redes de descanso, foi observada melhora significativa nos sinais vitais e na dor em ambos os posicionamentos, mas não houve significância estatística (p > 0,05) entre as intervenções, indicando que as mesmas causaram alterações semelhantes nos recém-nascidos. Os achados apontam a importância das mudanças de decúbito citados em RNPT estáveis internados em UTIN por se tratarem de métodos não invasivos e de baixo custo que proporcionam benefícios para o desenvolvimento como um todo desses RN.Palavras-chave: Recém-nascido. Posicionamento. Unidade de terapia intensiva neonatal.