Search

To evaluate the effects of different amplitude-modulated frequency (AMF-100Hz and AMF-10Hz) of the interferential current (IC) on autonomic nervous system (ANS) in healthy volunteers. Thirty healthy volunteers (23.7 ±2.7 years old) were randomized into placebo interventions (turned off), IC with AMF-100Hz and IC with AMF-10Hz. Interventions ware applied in the paravertebral ganglionar region for 30 minutes. ANS evaluated by the heart rate variability before and immediately after the interventions. 10Hz intervention reduced the sympathetic activity in 6% and an increase in the parasympathetic in 6%. 100Hz intervention increased 12% to sympathetic activity and decreased 12% to parasympathetic activity. IC changes the autonomic balance in healthy volunteers. 10Hz reduces the sympathetic activity and increases parasympathetic, although the 100Hz has opposite results. The IC at 10Hz improves the autonomic balance and presents potential effects to be tested in hypertensive patients.

To systematically review the effects of robotic rehabilitation with the ErigoMEDLINE, SciELO, EMBASE, The Cochrane Library - CENTRAL and PEDro databases were consulted without the restriction of date and language. Randomized controlled trials that evaluated the robotic rehabilitation and compared it to conventional or placebo therapy, isolated or in association with other therapy, were selected. Studies in which the treatment time was less than 10 sessions were excluded. The risk of bias was assessed with the use of the RoB 2.0 tool.Nine studies were included, totaling 347 patients. The robotic rehabilitation performed by the ErigoErigoErigo

Reviewing systematically the randomized controlled trials (RCTs) that evaluated aerobic exercisealone vs. usual care in exercise tolerance, functional capacity, and quality of life (QoL) in patients withpre-dialysis.Searches in the MEDLINE, Cochrane CENTRAL, EMBASE, PEDro, and LILACS databases untilFebruary 2021 included RCTs that evaluated the effects of aerobic exercise on peak VO10 RCTs, with 365 patients. Aerobic exercise increased 2.07 ml/kg/min (95% CI = 1.16 to 2.98; I2= 24%, QoE moderate) at peak VOAerobic exercise increases VO

BACKGROUND Pulmonary diseases represent a great cause of disability and mortality in the world and, considering the progression of these pathologies, pulmonary rehabilitation programs are proven to be effective. During the COVID-19 pandemic, telerehabilitation becomes an alternative for these patients. OBJECTIVE The aim of this study was to determine results in outcomes such as functional capacity and quality of life when comparing telerehabilitation to usual care in patients previously participating in face-to-face pulmonary rehabilitation program. METHODS A quasi-experimental retrospective study realized between Abril 2020 to August 2021. Thirty-two patients with chronic diseases were included, divided between control and intervention groups. The intervention group performed telerehabilitation synchronously twice a week supervised by a physical therapist with breathing, strengthening and aerobic exercises. Dyspnea and leg wear were adjusted by changing BORG. The control group did not perform any activity during the period of social isolation. Quality of life was assessed by the minute walk test and quality of life by the Medical Outcomes Study 36-item Short Form Health Survey. RESULTS The telerehabilitation group reduced 39 meters in the six-minute walk test, while the control group reduced 120 meters. There was difference of 81 meters between the groups (p=0.02). In relation to the quality of life of telerehabilitation was shown improve in two domains, social functioning and mental health. CONCLUSIONS telerehabilitation program for these patients can ease the deleterious effects of disease progression and maintain functional capacity and improve aspects of quality of life.

Purpose To compare the effects of combined training (CT) versus aerobic training (AT) or versus control on VO2 peak and quadriceps muscle strength in patients with heart failure (HF). Materials and methods Major electronic databases were searched, from inception to November 2020, for randomized clinical trials comparing the effects of CT against AT or control on VO2 peak and/or quadriceps muscle strength in patients with HF. Random effects meta-analyses were conducted, calculating the standardized mean difference (SMD). Results Twenty-eight articles were included. An increase on VO2 peak (SMD = 0.77, 95%CI 0.39-1.14, I2=80.1%) and quadriceps muscle strength (SMD = 0.67, 95%CI 0.18-1.16, I2=0%) was found in CT compared to control. CT increased quadriceps muscle strength, versus AT (SMD = 0.44, 95%CI 0.15-0.74, I2=0%). There were no differences between CT and AT on VO2 peak (SMD=-0.01, 95%CI -0.36 to 0.34, I2=65%). Time of session and training duration moderate the effects of CT over control on VO2 peak. Conclusions CT promotes increases on quadriceps muscle strength and aerobic capacity over control and provides additional gains on quadriceps muscle strength, having the same effects on VO2 peak compared to AT. A longer time of session is associated with greater benefits to aerobic capacity.Implications for rehabilitationCombining aerobic and strength training increases the functional capacity and quadriceps muscle strength in heart failure patients.Using longer sessions of training has a greater impact on aerobic capacity.

RESUMO O objetivo deste estudo foi propor um protocolo de ensaio clínico randomizado para avaliar o efeito da reabilitação robótica sobre a funcionalidade de pacientes com acidente vascular cerebral (AVC) subagudo. Trata-se de um protocolo de um ensaio clínico randomizado que será desenvolvido no hospital e centro de reabilitação do Pavilhão Pereira Filho da Irmandade da Santa Casa de Misericórdia de Porto Alegre (ISCMPA). Quarenta pacientes com AVC, de ambos os sexos, com idades entre 18 e 85 anos e que apresentem hemiparesia ou fraqueza muscular (Medical Research Council - MRC

To systematically review the effects of robotic rehabilitation with the Erigo® device on patients with neurological injury on safety, spasticity, muscle strength, functionality, gait/balance, and changes in the level of consciousness. MEDLINE, SciELO, EMBASE, The Cochrane Library - CENTRAL and PEDro databases were consulted without the restriction of date and language. Randomized controlled trials that evaluated the robotic rehabilitation and compared it to conventional or placebo therapy, isolated or in association with other therapy, were selected. Studies in which the treatment time was less than 10 sessions were excluded. The risk of bias was assessed with the use of the RoB 2.0 tool. Nine studies were included, totaling 347 patients. The robotic rehabilitation performed by the Erigo® device proved to be safe for neurological patients. The meta-analysis showed an improvement for spasticity (MD = 0.29; 95% CI = −0.49 to −0.08; I2 = 0%), but there was no significant increase in muscle strength in patients with stroke (MD = 0.25; CI 95% = −0.22 to −0,71; I2 = 0%). Erigo® showed inconclusive effects on functionality, gait/balance and level of consciousness in patients with severe acquired brain injury and vegetative or minimally conscious state. All studies present some concerns for the risk of bias. Erigo® as a robotic rehabilitation strategy is safe for patients with acquired brain injury and appears to reduce spasticity in patients with stroke. The effects on muscle strength, functionality, gait and balance and level of consciousness remain uncertain and the methodological quality of the clinical trials included in this review is limited. Erigo® device is safe to rehabilitation of patients with neurological injury.Rehabilitation with Erigo® device appears to reduce the spasticity of patients with stroke.New randomized clinical trials are needed to establish the effects on muscle strength, functionality, gait/balance and level of consciousness. Erigo® device is safe to rehabilitation of patients with neurological injury. Rehabilitation with Erigo® device appears to reduce the spasticity of patients with stroke. New randomized clinical trials are needed to establish the effects on muscle strength, functionality, gait/balance and level of consciousness.

Os exercícios resistidos (ER) realizados de forma intensa resultam no surgimento de dor muscular de inicio tardio (DMIT) e na redução da funcionalidade. Diferentes formas de recuperação após os exercícios veem sendo estudadas para atenuar o desconforto e melhorar a funcionalidade. O objetivo do presente estudo foi avaliar os efeitos das recuperações passiva (RP) e ativa (RA) sobre a DMIT e a funcionalidade de voluntários fisicamente ativos após sessão de ER. A amostra foi composta por 15 voluntários, com idade média de 24,2 (± 2,2) anos e IMC de 24,7 (± 2,5) kg/m2, submetidos ao protocolo de ER e às formas de recuperação. As sessões de ER (agachamento, cadeira extensora e leg press) consistiram em 4 séries de 10 repetições, com 80% da carga máxima (intervalo de uma semana entre a avaliação e as sessões). A DMIT foi avaliada (Escala Visual Analógica) 24 h, 48 h e 72 h após sessão de ER. A funcionalidade (força muscular avaliada pelo pico de torque isométrico, flexibilidade, potência, agilidade, velocidade e resistência à fadiga) foi avaliada 30 min após as intervenções (RA e RP). A RA foi mais eficiente na redução da DMIT em relação à RP nos três momentos avaliados (24 h: -1,3, 48 h: -1.3 e 72 h: -1.5 pontos; p < 0.005). A RA melhorou em aproximadamente 9% a força muscular dos membros inferiores em relação à RP. As demais variáveis funcionais não apresentaram diferenças entre as recuperações. A RA diminui a DMIT e atenua a perda da força muscular após ER em voluntários fisicamente ativos.

Resumo Introdução Diferentes fatores afetam o desenvolvimento motor no primeiro ano de vida, tendo sido pouco estudada a interferência da variação sazonal. Objetivo Investigar a influência da sazonalidade e de fatores de risco e proteção para o desenvolvimento motor de lactentes nascidos a termo, aos 7 e 10 meses de idade. Método Foram incluídos no estudo lactentes a termo (N=174) que vivenciaram os marcos de desenvolvimento referentes ao 2º e 3º trimestres no período de verão ou de inverno. Prontuários, entrevistas, e a Alberta Infant Motor Scale foram utilizados. Resultados A aquisição do sentar-se e engatinhar foi mais tardia nos grupos pós-inverno (p < 0,001). Quanto aos grupos de risco e sem risco para o desenvolvimento motor, observou-se, aos 7 meses, menor prevalência de planejamento da gravidez (p=0,015), menor tempo de aleitamento materno exclusivo (p=0,004) e de amamentação (p=0,012) no grupo com risco. Aos 10 meses, os lactentes do grupo de risco se caracterizaram pela menor idade gestacional (p=0,040), por serem filhos de mães mais velhas (p=0,020), maior número de irmãos (p=0,002), níveis mais elevados de pobreza (p=0,002) e maiores restrições de movimento (p=0,000). A regressão logística evidenciou que, aos 7 meses, o aleitamento materno foi a variável associada ao desenvolvimento motor, enquanto aos 10 meses, o número de filhos, a pobreza e a restrição de movimento do lactente explicaram a variação no desenvolvimento motor. Conclusão O clima frio não se mostrou um determinante isolado para o risco de atraso motor, variáveis ambientais foram mais influentes no modelo. ABSTRACT Introduction Different factors affect motor development in the first year of life; the interference of seasonal variation lacks further investigation. Objective To investigate the influence of seasonality and the protective and risk factors on the motor development of full-term infants, at 7 months and 10 months of age. Method This study included full-term infants (N=174) who experienced developmental milestones to the 2nd and 3td quarters in summer or winter. Medical records, interviews, and the Alberta Infant Motor Scale were used. Results The acquisition of setting and crawling was later in the post-winter groups (p

Background The effect of high-intensity interval training (HIIT) protocols according to different work intervals, session volumes and training periods has not been evaluated in patients with type 2 diabetes mellitus (T2DM). Objective This was a systematic review and meta-analysis of the effect of HIIT and its different protocols compared to moderate-intensity continuous training (MICT) and the control group on VO2max and glycated hemoglobin (HbA1c) level in patients with T2DM. Methods The search strategy considered studies published up to September 2020 in the databases MEDLINE (PubMed), EMBASE, Cochrane CENTRAL, Web of Science and SPORTDiscus. Two authors independently searched the selected databases for randomized clinical trials that compared HIIT to MICT or the control in adults with T2DM. A random-effects meta-analysis was performed and the data are presented as the mean difference (95% confidence intervals [95% CIs]) between HIIT, MICT and control groups. Results A total of 20 studies (738 participants) were included. Overall, HIIT increased VO2max by 5.09 mL/kg/min (95% CI 2.99; 7.19, I² = 80.89) versus the control and by 1.9 mL/kg/min (95% CI 0.81; 2.98, I² = 25.62) versus MICT. HIIT promoted a significant reduction in HbA1c level of -0.8% (95% CI -1.06; -0.49, I² = 77.31) versus the control but with no difference versus MICT. Moderate-interval, high-volume and long-term training promoted a greater increase in VO2max. A long interval and moderate volume and period conferred a greater increase in VO2max versus MICT. A short interval and moderate volume and period conferred a greater reduction in HbA1c level versus the control. No publication bias was detected, as evaluated by a funnel chart and Egger's test (p > 0.05). Conclusions As compared with MICT, HIIT had better effect on VO2max and a similar effect on HbA1C level. Interval protocols, moderate to long training period and moderate to high volume may maximize the HIIT effect in patients with T2DM.

Introdução: A autoliberação miofascial com o Foam Roller (FR) ou Roller Massager (RM) pode ser uma intervenção que favorece a recuperação após exercí­cios. Objetivo: Revisar de forma integrativa os efeitos do FR ou RM sobre a dor e a funcionalidade musculoesquelética de voluntários saudáveis após a realização de exercí­cios. Métodos: Revisão integrativa da literatura. A busca foi realizada nas bases de dados Medline (PubMed), Cochrane Library, Biblioteca Virtual em Saúde e PeDro, sem restrições de ano de publicação ou idioma, através dos descritores em inglês "Healthy Volunteers"; "Exercise"; "Clinical Trial"; e das palavras-chave "Myofascial Release", "Foam Rolling", "Roller Massage". Resultados: Inicialmente a busca incluiu 84 estudos e posterior análise dos critérios de elegibilidade foram incluí­dos apenas quatro estudos. Nestes estudos a intervenção melhorou a percepção da dor e algumas variáveis funcionais, dentre estas, a amplitude de movimento, força, resistência, velocidade de reação e a potência após os exercí­cios. Conclusão: Os estudos demonstram que o FR ou RM reduziram a dor e melhoram algumas variáveis funcionais. No entanto, estes resultados ainda são inconsistentes pelo baixo número de estudos, carecendo de maior investigação para aumentar o ní­vel de evidência e a aplicação da técnica nesta condição.Palavras-chave: autoliberação miofascial, exercí­cio, foam roller, voluntários saudáveis.

Objective: To identify factors that lead to a positive oxygenation response and predictive factors of mortality after prone positioning. Methods: This was a retrospective, multicenter, cohort study involving seven hospitals in Brazil. Inclusion criteria were being > 18 years of age with a suspected or confirmed diagnosis of COVID-19, being on invasive mechanical ventilation, having a PaO2/FIO2 ratio < 150 mmHg, and being submitted to prone positioning. After the first prone positioning session, a 20 mmHg improvement in the PaO2/FIO2 ratio was defined as a positive response. Results: The study involved 574 patients, 412 (72%) of whom responded positively to the first prone positioning session. Multiple logistic regression showed that responders had lower Simplified Acute Physiology Score III (SAPS III)/SOFA scores and lower D-dimer levels (p = 0.01; p = 0.04; and p = 0.04, respectively). It was suggested that initial SAPS III and initial PaO2/FIO2 were predictors of oxygenation response. The mortality rate was 69.3%. Increased risk of mortality was associated with age (OR = 1.04 [95 CI: 1.01-1.06]), time to first prone positioning session (OR = 1.18 [95 CI: 1.06-1.31]), number of sessions (OR = 1.31 [95% CI: 1.00-1.72]), proportion of pulmonary impairment (OR = 1.55 [95% CI: 1.02-2.35]), and immunosuppression (OR = 3.83 [95% CI: 1.35-10.86]). Conclusions: Our results show that most patients in our sample had a positive oxygenation response after the first prone positioning session. However, the mortality rate was high, probably due to the health status and the number of comorbidities of the patients, as well as the severity of their disease. Our results also suggest that SAPS III and the initial PaO2/FIO2 predict the oxygenation response; in addition, age, time to first prone positioning, number of sessions, pulmonary impairment, and immunosuppression can predict mortality.

The effect of high-intensity interval training (HIIT) protocols according to different work intervals, session volumes and training periods has not been evaluated in patients with type 2 diabetes mellitus (T2DM).This was a systematic review and meta-analysis of the effect of HIIT and its different protocols compared to moderate-intensity continuous training (MICT) and the control group on VOThe search strategy considered studies published up to September 2020 in the databases MEDLINE (PubMed), EMBASE, Cochrane CENTRAL, Web of Science and SPORTDiscus. Two authors independently searched the selected databases for randomized clinical trials that compared HIIT to MICT or the control in adults with T2DM. A random-effects meta-analysis was performed and the data are presented as the mean difference (95% confidence intervals [95% CIs]) between HIIT, MICT and control groups.A total of 20 studies (738 participants) were included. Overall, HIIT increased VOAs compared with MICT, HIIT had better effect on VO

de Brito, E, Teixeira, AdO, Righi, NC, Paulitcth, FdS, da Silva, AMV, and Signori, LU. Vitamins C and E associated with cryotherapy in the recovery of the inflammatory response after resistance exercise: A randomized clinical trial. J Strength Cond Res XX(X): 000-000, 2019-The objective of this research was to compare the effects of cryotherapy associated with vitamins (C and E) on the recovery of the inflammatory response from the resistance exercise (RE) session of untrained volunteers. Fourteen subjects (26.2 ± 5 years old, 25.8 ± 3 kg·m) underwent 4 sessions of RE with different forms of recovery. The RE consisted of 4 sets of 10 maximal repetitions for each exercise (extensor bench, squat, and leg press). The recoveries were randomized and comprised the passive (control), with vitamins C (1 g) and E (800 UI) supplementation 40 minutes before exercise, with cryotherapy (immersion in water 15° C for 10 minutes), and the association (vitamins and cryotherapy). Hemogram, inflammatory markers (C-reactive protein and creatine kinase [CK]), and parameters of oxidative stress (lipid peroxidation [LPO] and antioxidant capacity against radical peroxyl) were evaluated before (baseline) and after (0, 30, and 120 minutes) the RE sessions. Muscle pain (primary outcome) was evaluated 24 hours after exercise. C-reactive protein (p = 0.010) and LPO (p < 0.001) increased (120 minutes) only in passive recovery. Recovery with cryotherapy (30 minutes), with vitamins and the association (0 and 30 minutes) delayed increases in CK (p < 0.001). Antioxidant capacity against radical peroxyl increased (30 minutes) only in recovery with the association (p < 0.011). The pain decreased in the recoveries with cryotherapy and association (p < 0.001). The association of vitamins (C and E) with cryotherapy attenuated the inflammatory response and pain, favoring recovery after an acute RE session.

Objetivo: traçar o perfil epidemiológico dos casos de toxoplasmose gestacional e congênita notificados na cidade de Santa Maria – RS, decorrentes do surto ocorrido no ano de 2018 e investigar a associação entre as variáveis maternas e o diagnóstico do bebê.Método: foram avaliados retrospectivamente os casos notificados entre o período de março de 2018 a março de 2019. O diagnóstico do bebê e variáveis maternas foram analisados através de estatística descritiva e teste qui-quadrado.Resultados: Durante o período do estudo, foram notificados 206 casos de toxoplasmose gestacional, dos quais 74 foram confirmados como infecção recente. A transmissão vertical foi confirmada em 27% dos casos. Houve maior freqüência de transmissão em gestantes que tiveram o diagnóstico no terceiro trimestre de gestação (p=0,001) e que não realizaram tratamento durante a gestação (p

To verify the relationship between the risk of dysphagia and health status in patients with Chronic Obstructive Pulmonary Disease (COPD).Cross-sectional study with convenience sample. Twenty-three individuals with a diagnosis of COPD according to GOLD 2019 criteria. The individuals participated in a pulmonary rehabilitation program, clinically stable (without exacerbations of at least 30 days) and in optimized drug treatment were included. The study analyzed anthropometric measures (BMI), peak expiratory flow (PEF), mental status (MEEM), eating assessment tool (EAT-10), and health status (COPD Assessment Test -CAT). The mean age was 60.39 ± 9.90 years, 11 individuals were female and eutrophic.We observed a positive and moderate association (r = 0.57, p = 0.004) between the CAT and EAT-10 scores in the sample studied.The results demonstrated relationship between the risk of dysphagia and the health status in individuals with COPD.

A Organização Mundial de Saúde considera prematuro aquele nascido com idade gestacional entre 20 a 37 semanas. Com os avanços tecnológicos existentes nas Unidades de Terapia Intensiva Neonatal, têm-se maior sobrevida destes, que apresentam desenvolvimento neuromotor inferior aos recém-nascidos a termo. Este estudo objetivou caracterizar o desenvolvimento motor e variáveis clínicas de prematuros nascidos em um hospital público. Trata-se de um estudo misto. A pontuação na Escala Motora Infantil de Alberta, peso ao nascimento, idade gestacional, tempo de internação na Unidade de Terapia Intensiva Neonatal e Apgar de 1o e 5o minuto de prematuros com idade corrigida entre 0 e 18 meses foram coletadas dos prontuários entre maio de 2013 a abril de 2014. Para análise estatística, utilizou-se o teste do Qui-Quadrado (nível de significância p

Avaliar a influência da correção da idade na detecção de riscos no desenvolvimento motor de prematuros. Trata-se de um estudo observacional retrospectivo, com 59 prematuros, atendidos no Ambulatório de Seguimento de Prematuros de um hospital-escola de uma cidade da região Central do Rio Grande do Sul, nos anos de 2014 e 2015. As crianças foram avaliadas a partir da Albert Infant Motor Scale aos quatro e oito meses. A normalidade dos dados foi verificada pelo teste de Shapiro-Wilk e a comparação dos grupos foi realizada a partir do Teste de Wilcoxon. Utilizando a idade corrigida, 39% dos prematuros avaliados aos quatro meses apresentaram alto risco para atraso do desenvolvimento motor, assim como 33% dos prematuros avaliados aos oito meses. Este resultado foi mais acentuado quando a idade cronológica foi utilizada (p=0,000). A correção da idade gestacional se mostrou como a melhor forma de avaliar o desempenho real dos bebês nascidos pré-termo, sem superestimar riscos que não se configuram de fato em problemas no desenvolvimento das crianças.