Programa de Pós-Graduação em Ciências do Movimento Humano - PPGCMH/ICS

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Análise da sarcopenia e a sua associação com indicadores clínicos, funcionais e de qualidade de vida em pessoas idosas atendidas no ambulatório do hospital Universitário João de Barros Barreto
(Universidade Federal do Pará, 2024-08-09) MORAES, Janine Brasil de Araújo; NEVES, Laura Maria Tomazi; http://lattes.cnpq.br/4235603520707156; HTTPS://ORCID.ORG/0000-0002-3115-2571; CARNEIRO, Saul Rassy Carneiro; http://lattes.cnpq.br/9162153771863939; https://orcid.org/0000-0002-6825-0239
Introduction: Introduction: Ageing can be accompanied by a progressive decline in muscle mass, strength and function. This resulting health condition is known as sarcopenia, a muscle disease that develops progressively and chronically. Age-related sarcopenia has several factors that accelerate this process and need to be identified and controlled in order to promote a good health prognosis and quality of life for the elderly population. Objective: To assess the association between sarcopenia and functional and quality of life indicators in elderly people treated at the geriatrics outpatient clinic of the João de Barros Barreto University Hospital (HUJBB). Methods: This is an observational, analytical, cross-sectional study carried out at the HUJBB geriatrics outpatient clinic. Sociodemographic and clinical assessments were carried out: sarcopenia assessment (SARC-Calf, handgrip strength assessment, Tetrapolar Electrical Bioimpedance (BIA) and Short Physical Performance Battery (SPPB)), functional indicators assessment (Barthel, quadriceps strength assessment, physical activity level assessment (IPAQ) and presence of falls in 60 days) and quality of life assessment (SF-12). The algorithm of the European Working Group on sarcopenia in the elderly (EWGSOP2) was used. Results: 129 participants were assessed (73% women, p = 0.001), with a mean age of 75.4 years and from the capital (80.6%). 57% were found to be at risk of sarcopenia, with a prevalence of sarcopenia of 27.1%. Handgrip strength (HGS) 18kg/f, skeletal muscle mass 18.3kg; SPPB 9 points; Barthel score 58.8% of independent participants; quadriceps strength 14kg/f; IPAQ 38.8% with a low level of physical activity and SF-12 37.7 points for the physical component and 48.2 points for the mental component. There was an association between appendicular skeletal muscle mass (ASMR) and calf circumference (WC), age, SARC-Calf, FPM and quality of life (physical component) for men (adjusted R2 0.42 and p<0.05), as well as sarcopenia, classified by ASMR, with BIA variables: body resistance, total body water in lean mass, lean mass and basal metabolic rate for men (adjusted R2 0.49 and p<0.05), and for women, intracellular water and total body water in body weight (adjusted R2 0.60 and p<0.05). Conclusion: This study concludes that WC, age, sarcopenia risk screening, HGS and quality of life were associated with MMEA measured by BIA. For the diagnosis of sarcopenia, there were different associations between the BIA markers when adjusted for gender.
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Análise Psicométrica da Versão Brasileira da Pittsburgh Fatigability Scale (PFS-Brasil)
(Universidade Federal do Pará, 2024-04-24) SANTOS, Mayara do Socorro Brito dos; TORRES, Natáli Valim Oliver Bento; http://lattes.cnpq.br/1927198788019996; https://orcid.org/0000-0003-0978-211X
Introduction: Instruments with appropriate psychometric properties are essential for ensuring the quality of assessments and reassessments in clinical practice, guiding decision-making regarding rehabilitation procedures. The Pittsburgh Fatigability Scale, originally published in English, is the only validated scale for measuring perceived fatigability in older adults. Considering the importance of this tool, it is necessary to validate its translated version into Portuguese and adapt it to the specificities of the Brazilian context. Objective: To validate the Pittsburgh Fatigability Scale Brazilian Portuguese version (PFS-Brasil) by evaluating its validity in relation to measures of physical activity, physical performance, and cognitive performance. Methodology: The scale and physical and cognitive performance tests were used to assess 121 healthy older adults residing in the community. We conducted statistical analyses of the physical and mental subscales of the PFS-Brasil, utilizing the intraclass correlation coefficient (ICC) for reliability analysis, Cronbach's alpha for internal consistency evaluation, and Spearman's correlation for convergent validity. Furthermore, we examined agreement analysis and floor and ceiling effects. The Statistical Package for Social Sciences 25.0 was used for data analysis. Results: The analyses indicated that the physical and mental subscales exhibit satisfactory test-retest reliability, with ICC values for the physical subscale (0.84; 95% CI: 0.80-0.88) and the mental subscale (0.83; 95% CI: 0.78-0.87), in addition to high internal consistency (α = 0.84 and 0.82, respectively). These values are indicative of good inter-rater reliability, revealing a low probability of random and systematic error. Bland-Altman plots demonstrated good agreement for both subscales of the PFS-Brasil. For convergent validity, the higher physical score showed a moderate association, and the higher mental score showed a weak association with lower physical performance (6-minute walk tests and the Short Physical Performance Battery (SPPB) and lower levels of physical activity (International Physical Activity Questionnaire – IPAQ). Regarding cognitive performance, there was a weak association between the higher mental score and the average accuracy on the flanker test. No ceiling effects were observed in both subscales; however, the mental subscale exhibited a floor effect (n = 24%). Conclusion: This study demonstrated that the Brazilian version of the Pittsburgh Fatigability Scale is a valid, consistent, and reliable instrument for assessing perceived fatigability in older adults.
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Aspectos motores, funcionais e emocionais de indivíduos com sintomas vestibulares
(Universidade Federal do Pará, 2024-03-01) MONTEIRO, Luiz Humberto Figueiredo; MORAES, Suellen Alessandra Soares de; http://lattes.cnpq.br/6278397231382779
Individuals with vestibular symptoms present unstable gait, imbalance and one way to measure an individual's level of imbalance is through baropodometry, widely used in clinical practice to map the area of plantar pressure through graphic records and determine displacements and oscillations. of the center of pressure through stabilometry. Furthermore, balance and anxiety are related, as they share the same central neural circuits. Thus, psychological complaints such as anxiety and depression are common in individuals with dizziness. Therefore, the present study aims to analyze the motor, functional and emotional characteristics of individuals with vestibular symptoms. The analysis of plantar pressure and center of pressure was carried out using baropodometry and stabilometry on a force platform (BaroScan®, Londrina, Paraná, Brazil) and the BaroSys software, while for functional analysis we used the TUG test and the aspect functional of the DHI questionnaire and for emotional analysis the emotional aspect of the DHI. We found that individuals with vestibular symptoms have flat feet, with higher values of maximum pressure, mean pressure, maximum pressure in the midfoot and rearfoot and mean pressure in the rearfoot when compared to people without vestibular symptoms. Furthermore, individuals with vestibular symptoms have reduced functional mobility and a greater risk of falling, in addition to having compromised emotional and mental health, with signs of anxiety and mild to moderate depressive symptoms in the majority of individuals when compared to individuals without vestibular symptoms.
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Associação de obesidade sarcopênica, indicadores de composição corporal, de variabilidade da frequência cardíaca e de esforço no teste do degrau de seis minutos com a severidade da Síndrome da Apneia Obstrutiva do Sono: Um estudo transversal
(Universidade Federal do Pará, 2025-12-19) SOUZA, Leornado Brynne Ramos de; CRISP, Alex Harley; http://lattes.cnpq.br/1187580727139009; HTTPS://ORCID.ORG/0000-0003-4683-9576; NEVES, Laura Maria Tomazi; http://lattes.cnpq.br/4235603520707156; https://orcid.org/0000-0002-3115-2571
Introduction: Obstructive sleep apnea syndrome (OSAS) is the most common sleep- related respiratory disorder in the world, with different levels of severity. The literature indicates that increased body fat can increase energy expenditure, alter heart rate variability during sleep and wakefulness and affects the severity of the syndrome. Thus, there is a greater risk of muscle catabolism, negatively influencing cellular health, measured by the phase angle in bioelectrical impedance. However, few studies have expanded the assessment of body composition in relation to sarcopenic obesity in this population. In addition, the results of current research are also conflicting when analyzing the impacts of OSAS severity on metabolic and physical performance during stress tests. Objective: To investigate the association of indicators of body composition, heart rate variability, and stress in the six-minute step test with the severity of OSAS. Methods: Cross-sectional, quantitative study that took place between December 2023 and August 2024, with a single sample of 37 people diagnosed with OSAS, age 53,7 ± 13,8 years, minimum age 28 years and maximum age 78 years, confirmed by type 1 polysomnography. Data collection was performed in two phases: a) Rest, using bioelectrical impedance (Biodynamics BIA 450, Biodynamics Corporation, Washington, USA) to collect body composition data, indirect calorimetry (Quark CPET, Cosmed, Italy) to collect resting metabolic rate and time and frequency domain variables of heart rate variability using a heart rate monitor (SmartLab, HMMGroup, Germany); b) Exercise, using the 6-minute step test with a gas analyzer (Quark CPET, Cosmed, Italy) breath by breath to assess physical and metabolic effort. To determine data normality, the Shapiro-Wilk test was used, with normal data represented by mean and standard deviation and non-normal data represented by median and interquartile range. For multivariate data analysis, principal component analysis (PCA) was used, employing the varimax rotation algorithm to create the components. The reduced value of each component was used to perform a simple linear regression analysis. Results: Thirty-seven individuals with OSAS (54.05% men), BMI 31.1 ± 5.31 kg/m2 and AHI 31.3 (11.3-61.6) were evaluated. The PCA analysis created 6 principal components (PC), which are: 1st PC: body composition; 2nd PC: cellular health; 3rd PC: physical effort; 4th PC: ventilatory reasons; 5th PC: sympathovagal stimulation; 6th PC: sympathovagal stimulation (very low frequency). The body composition indicators component (BMI, neck circumference, resting metabolic rate, body resistance, and capacitance) was associated with higher AHI (F[3,32] = 3.05; p = 0.01), with an adjusted r2 value of 0.22. Conclusion: Body composition is associated with the severity of OSAS, while the components of cellular health, physical effort, ventilatory ratios, sympathovagal stimulation, and very low frequency sympathovagal stimulation were not associated with the severity of the syndrome.
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Atividade bioelétrica dos músculos do assoalho pélvico durante o uso de educador vaginal inovador: estudo transversal
(Universidade Federal do Pará, 2022-11-08) DUARTE, Natália de Souza; MELO NETO, João Simão de; http://lattes.cnpq.br/1547661999153615; https://orcid.org/0000-0002-4681-8532
The pelvic floor needs an integral anatomical structure due to its multiple functions. Therefore, innovative equipment is needed to improve this structure. The aim of this study was to analyze the effects of using the innovative iGeni vaginal trainer on the bioelectrical activity of the pelvic floor muscles, in addition to analyzing the different hip positions and interference factors such as age group, childbirth, sexual activity, urinary incontinence and menopause. For this, a cross-sectional study was designed, composed of 30 women, who were evaluated using the following instruments: evaluation form, International Consultation On Incontinence Questionnaire - Short Form and surface electromyography. The collected findings were: RMS of the 5-second period of contraction, peak RMS values, area values, %MVC (RMS normalized by peak signal) and median frequency. These findings were compared without and with the use of iGeni, in anteversion, neutral and retroversion pelvic positions. The results showed that the use of iGeni increased the electromyographic activity of the pelvic floor muscles in the neutral position. Women in conditions of greater tendency to dysfunction of this musculature also benefited, increasing bioelectrical activity under specific conditions. It was then concluded that this innovative biofeedback equipment was effective in the greater recruitment of muscle fibers and that it has greater effectiveness in the neutral position of the hip, being able to be an effective ally in the training of this musculature.
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Atividade física, qualidade do sono e fatores associados à capacidade para o trabalho de fisioterapeutas da linha de frente contra a COVID-19
(Universidade Federal do Pará, 2021-06-28) MORAES, William Rafael Almeida; NEVES, Laura Maria Tomazi; http://lattes.cnpq.br/4235603520707156; https://orcid.org/0000-0002-3115-2571
INTRODUCTION: The COVID-19 pandemic highlighted the importance of physical therapy for the control and prevention of pulmonary and musculoskeletal complications, with emphasis on the specialty Respiratory Physical Therapy and Physical Therapy in Intensive Care. However, the physical and mental demands required for work on the front lines, as well as the changes in lifestyle in the face of the pandemic, may have negatively interfered with the physical therapists' ability to work. OBJECTIVE: To associate the level of physical activity, sleep quality, and demographic and occupational factors with the work ability of physical therapists on the front lines against COVID-19. METHODS: Analytical, cross-sectional and quantitative study. Brazilian physiotherapists working on the front lines against COVID-19 answered an online questionnaire that grouped four instruments: a) demographic, occupational and lifestyle data; b) the International Physical Activity Questionnaire (IPAQ); c) the Pittsburgh Sleep Quality Index (PSQI); d) the Work Ability Index (ICT). Data were analyzed and presented in descriptive statistics (absolute and relative values, mean, standard deviation) and associations between the ICT results and the independent variables, giving significance when p ≤ 0.05. The statistical software R version 4.0.0 was used. RESULTS: Answers were obtained from all regions of Brazil. There was no association between work ability and physical activity level, but inadequate work ability was associated with poor sleep quality (p < 0.001) and ICT and PSQI values showed a significant negative correlation (r = - 0.340; p < 0.001). In the adjusted analysis, work ability was associated with female gender (p = 0.018) and with a clinical diagnosis of previous COVID-19 (p < 0.001). CONCLUSION: In times of pandemic, reduced work ability is associated with poor sleep quality but not with physical activity level among frontline physical therapists against COVID-19. The results warn about the potential impact of sleep on the work of professionals who deal with the health of the population, highlighting the need for occupational health support strategies for physical therapists, especially in periods of public health crisis.
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Avaliação da força muscular isocinética em mulheres no pós operátorio de câncer de mama
(Universidade Federal do Pará, 2025-01-16) BRANDÃO, Rayane de Nazaré Monteiro; CARNEIRO, Raul Rassy; http://lattes.cnpq.br/9162153771863939; https://orcid.org/0000-0002-6825-0239
Breast cancer (BC) is a neoplasm that develops from the interaction between genetic mutations and epigenetic factors and has a significant impact on the physical and emotional health of patients. Surgical treatment, including mastectomy and breast-conserving surgery, can result in changes in muscle function, particularly in the upper limbs, affecting the quality of life (QoL) of female survivors. Analyzing muscle strength in post-BC surgery patients using isokinetic dynamometry to assess movements of the shoulder on the operated (ipsilateral) and non- operated (contralateral) sides is extremely important. This cross-sectional, observational study was conducted with 37 women who had undergone oncological breast surgery. Muscle strength was assessed using isokinetic dynamometry, considering shoulder flexion, extension, internal rotation, and external rotation movements at a speed of 60°/s. Statistical analysis was performed using STATA 18.0 software, with t-tests and Kruskal-Wallis tests to compare peak torque (PT) and total work (TW) indices between limbs. The results indicated that, overall, there were no significant differences between the involved and uninvolved limbs for flexion, extension, internal rotation, and external rotation movements, in terms of both total work and peak torque. Internal rotation showed a trend toward difference but did not reach statistical significance. No statistically significant differences in muscle strength were observed between the limbs involved and not involved in surgery. However, radical mastectomy was associated with higher peak torque in all movements, especially in external rotation, indicating that the type of surgery may impact muscle strength. The analysis also revealed that shoulder flexion strength was related to better QoL, although fatigue did not show a significant correlation. Post-surgical rehabilitation should take these differences in muscle function and the impacts of surgery into account, aiming to optimize recovery and improve patients' quality of life.
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Avaliação da função neuromuscular e estresse oxidativo de pessoas com doença renal crônica no início do tratamento hemodialítico
(Universidade Federal do Pará, 2023-04-05) ALMEIDA, Clara Narcisa Silva; NEVES, Laura Maria Tomazi; http://lattes.cnpq.br/4235603520707156; https://orcid.org/0000-0002-3115-2571
Introduction: Chronic kidney disease (CKD) often evolves silently at different stages, and stage 5 is the most advanced and severe, usually requiring renal replacement therapy. As the disease progresses, the metabolic alterations resulting from reduced renal function can lead to neuromuscular disorders and reduced functional performance in this population. Objectives: To assess neuromuscular function and oxidative stress in people undergoing an unplanned transition to stage 5 CKD at the start of hemodialysis. Methods: Cross-sectional study evaluating neuromuscular function (functional capacity [1-minute sit-to-stand test], peripheral muscle strength [isometric dynamometry of lower limbs], respiratory muscle strength [manovacuometry] and neuromuscular excitability [stimulus electrodiagnostic test]) and oxidative stress [malondialdehyde] in people in unplanned transition to stage 5 CKD who started hemodialysis on an emergency basis (CKD group) compared to people without CKD (control group) and them association. Results: Twenty-four participants, 14 in the control group without CKD (42 ± 12 years) and 14 in the CKD group (53 ± 18 years), were evaluated. The CKD group compared to controls without CKD present impaired functional capacity (13.8 ± 4.9 vs 36.7 ± 9.1 repetitions, p < 0.001), on peripheral muscle strength of lower limbs (knee extenders [12.3 ± 4.6 vs 23.5 ± 9 kgf], knee flexors [11.3 ± 3.2 vs 17.8 ± 4.3 kgf], dorsiflexors [8.7 ± 2.8 vs 16.7 ± 4.3 kgf] and plantar flexors [11.2 ± 2.5 vs 16.6 ± 4.4 kgf], all p < 0.001), expiratory muscle strength (60 ± 23 vs 83 ± 27 cmH2O, p = 0.02) and neuromuscular excitability (chronaxy of the vastus lateralis, 654 ± 230 vs 415 ± 190 μs, p = 0.008; chronaxy of the tibialis anterior, 600 [500 – 1000] vs 400 [300 – 400] μs, p = 0.001),. Inspiratory muscle strength (-70 ± 33 vs -87 ± 29 cmH2O, p = 0.7) and oxidative stress (3.51 ± 1.13 vs 3.53 ± 0.92 nmol/ml, p = 0.95) showed no significant differences. In the CKD group, functional capacity was influenced only by peripheral muscle strength, while expiratory muscle strength and functional capacity demonstrated influence on peripheral muscle strength. Conclusion: People in unplanned transition to stage 5 CKD who start hemodialysis on an emergency basis have altered in neuromuscular function. The findings of this study can guide screening and monitoring strategies for neuromuscular deficiencies and rehabilitation planning.
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Avaliação da potência vertical de membros inferiores em pessoas com Parkinson
(Universidade Federal do Pará, 2024-12-23) SILVA, Vinicius Baia; MONTEIRO, Elren Passos; http://lattes.cnpq.br/0920248966438368; https://orcid.org/0000-0001-7757-6620
Parkinson's disease (PD) is considered neurodegenerative, polysomatic, and idiopathic, which affects the central nervous system, more precisely the dopaminergic neurons of the basal ganglia. The neural disorders of the disease cause neuromuscular declines, such as a reduction in motoneuron responses, potential action firing, muscle recruitment, power, strength, and muscle mass. Muscle power is fundamental in initiating movements, and its decline implies frailty, risk of falls, greater dependence, and low quality of life. In this context, it is relevant to evaluate muscle power in people with Parkinson's (PwP). However, using high- cost equipment that is difficult to transport and handle presents challenges for carrying out clinical assessments in this population. The evaluation of the vertical power of the lower limbs allows the interpretation of biomechanical mechanisms, such as strength, speed, and power. Clinically, the analysis of these aspects of Parkinson's disease is essential for rehabilitation strategies that emphasize the maintenance and improvement of these components. The literature reports that mobile applications are an alternative to specific instruments (for example, photoelectric cells, and goniometers). However, it is necessary to test the reproducibility and agreement of these instruments in populations with significant motor declines, such as individuals with Parkinson's disease (PD). Objective: To describe the vertical power of PcP through the performance of the vertical countermovement jump (CMJ) and evaluate the agreement in jump performance measurements by different evaluators (intra-evaluators) and between equipment (inter-instruments): a contact for vertical jumps and a My Jump 2® mobile app. Methods: The participants were 19 PwPs over 40 years old (15 men and 4 women), with PD staging between 1 and 3 according to the Hohn & Yearh Scale. The participants underwent clinical assessments: cognitive screening, anamnesis, and disease monitoring. For anthropometric assessments, we used a stadiometer, digital scale, and anthropometric tape measure. To assess performance, we used the CMJ vertical jump test, which was recorded simultaneously using the contact mat for vertical jumps and the My Jump 2® app installed on an IOS version 17.2 smartphone, recording at 240 Hz and 1080 HD. The volunteers were instructed to perform 3 consecutive jumps, with an interval of 120 seconds between each jump. For the statistical analysis, descriptive statistics were used to characterize the sample and then a mixed model was adjusted to assess the difference between the measurements. Next, the Bootstrap technique with 10,000 resamples was applied to calculate the limits of agreement, and histograms were generated to visualize the distribution of the Intraclass Correlation Coefficient (ICC). Finally, Bland-Altman plots were created to visualize the agreement between raters and instruments. All the intra-rater and later inter-instrument analyses were carried out using the R software. Results: As result, the values of ICC= 0.952 between evaluators and ICC= 0.948 between instruments indicate a very strong intra-evaluator and inter-instrument correlation. In both analyses, the limits of the confidence interval were close, with little variation in the estimates and reliability of the ICC. In the Bland-Altman analyses, there was agreement and consistency between assessors and instruments, with biases of 0.36 cm between assessors and -1.3 cm between instruments. Conclusion: Our results suggest that the My Jump 2® app is an alternative tool for assessing lower limb power using the CMJ vertical jump test in people with Parkinson's disease.
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Câncer de mama: aspectos epidemiológicos sobre a mortalidade e os efeitos da fisioterapia na sintomatologia e amplitude de movimento
(Universidade Federal do Pará, 2021-04-07) COSTA, Thalita da Luz; MELO NETO, João Simão de; http://lattes.cnpq.br/1547661999153615; https://orcid.org/0000-0002-4681-8532
INTRODUCTION: Breast cancer is the most commonly diagnosed cancer, and the most common cause of death from cancer, in women worldwide. Despite the advancement of treatment, there are still many associated complications. OBJECTIVE: to analyze the influence of social, demographic factors, screening procedures and population coverage of primary care on breast cancer mortality in Brazil, and to verify the effect of physical therapy on clinical symptoms and range of motion in women undergoing mastectomy with axillary lymphadenectomy, after chemotherapy and radiotherapy. METHOD: Available and open access secondary data from the SUS Information and Informatics Department, SIDRA (IBGE Automatic Recovery System) and eGestor AB (Primary Care Information and Management) were analyzed. The medical records of 25 women (mean age 55 ± 14 years) after surgical treatment of mastectomy with axillary lymphadenectomy for the diagnosis of breast cancer were also analyzed. The signs and symptoms evaluated were pain, tenderness, phantom breast syndrome, heavy and swollen arm, lymphedema and axillary web syndrome. The range of motion of flexion, abduction, internal rotation and external rotation of the glenohumeral joint was also assessed. RESULTS: It was observed that the mortality rate is higher in brown women; in the Southeast and South regions; and it grows with increasing age. The North region has lower mortality and lower survival. The mortality rate did not decrease with the increase in the coverage of primary health care coverage and the number of biopsy procedures. However, the rate decreased with the increased execution of cytopathological analysis. In addition, physical therapy contributed to the reduction of pain resulting from the clinical-surgical treatment of breast cancer, and promoted an increase in the range of motion of the glenohumeral joint. CONCLUSION: The coverage of health services and the number of screening procedures are not correlated with the breast cancer mortality rate and physical therapy contributes to the improvement of pain and range of motion.
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Desigualdade e interseccionalidade em domínios da atividade física e tempo de tela entre adolescentes de Belém
(Universidade Federal do Pará, 2024-12-27) SILVA, Lucas Fernando Alves E; CRISP, Alex Harley; http://lattes.cnpq.br/1187580727139009; https://orcid.org/0000-0003-4683-9576
Inequities influence various aspects of health, including physical activity and sedentary behaviors among adolescents. In Belém, these disparities may be exacerbated by the socioeconomic and demographic conditions characteristic of the Amazon region. This study investigated inequalities across different domains of physical activity and screen time among adolescents in Belém (PA), considering the wealth index, sex, and school administrative dependency, while also exploring the intersectionality of vulnerabilities across multiple dimensions. Data from 1,719 adolescents (49% girls, 58% from public schools) were analyzed. Prevalence rates were calculated for school-based physical education (≥1 day/week and ≥30 minutes), active transport (≥5 days/week), leisure-time physical activity (≥60 minutes/day), and excessive screen time (≥4 hours/day). Inequalities were assessed using the Slope Index of Inequality (SII) and absolute differences, with 95% confidence intervals obtained via bootstrap. Determinants included the wealth index (quintiles), sex, school administrative dependency, and the Jeopardy Index for multiple risk factors. Adolescents in the fourth quintile of the wealth index had higher prevalence rates for leisure-time activities (32.9%) and participation in physical education classes (39.9%), while active transport was more frequent among those in the first quintile (58.7%). Excessive screen time was more prevalent among girls (57.0%) and private school students (72.3%), whereas boys (46.5%) and public-school students (54.4%) had higher prevalence rates for active transport. Analysis using the Jeopardy Index revealed greater inequality in excessive screen time (66.2%) among girls attending private schools with higher socioeconomic levels, while boys in the same group showed higher prevalence of leisure-time activities (44.4%). Conversely, students with greater vulnerability according to the Jeopardy Index demonstrated a higher prevalence of active transport (57.0%). The greatest magnitude of inequality was observed for active transport (SII = 0.398; 95% CI: 0.324 to 0.466) and screen time (SII = -0.328; 95% CI: -0.405 to -0.258). Leisure-time activities (SII = -0.180; 95% CI: - 0.244 to -0.110) and physical education (SII = -0.104; 95% CI: -0.182 to -0.026) also exhibited significant inequalities, albeit with lower magnitudes, disproportionately affecting more vulnerable adolescents. In conclusion, physical activities and screen time are influenced by various layers of inequality, with boys of higher socioeconomic status being more active in leisure-time activities and girls more exposed to excessive screen time. Among the most vulnerable groups, higher rates of active transport were observed, potentially reflecting a need rather than a choice.
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Determinantes de sarcopenia e fragilidade em pessoas com Parkinson no contexto amazônico
(Universidade Federal do Pará, 2025-03-26) SANTOS, Ana Carla de Matos; MONTEIRO, Elren Passos; http://lattes.cnpq.br/0920248966438368; https://orcid.org/0000-0001-7757-6620
Introduction: Aging is a natural process characterized by the progressive loss of tissue and organ function, increasing the predisposition to various diseases, including Parkinson's Disease (PD). Among the conditions associated with PD, sarcopenia and frailty stand out as relevant geriatric syndromes. Sarcopenia is defined by the progressive reduction of muscle mass, strength, and function, while frailty is characterized by greater vulnerability to stressors, impacting physiological reserve and functional capacity. Despite distinct concepts, both share pathophysiological mechanisms affecting muscle power, such as chronic inflammation, oxidative stress, and neuromuscular degeneration. The absence of accessible and standardized instruments for screening these geriatric syndromes in clinical settings represents a challenge, especially considering the applicability of these methods in different sociodemographic contexts, such as in the Amazon region. Objective: This study aimed to analyze the profile of sarcopenia and frailty, as well as possible associations with clinical parameters of PD and sociodemographic aspects in people with Parkinson's disease (PwP) living in the community of a state in the Amazon region. Methods: This is an observational and analytical study, including PwP over 40 years of age, of both sexes. Initially, an anamnesis was conducted to collect sociodemographic data, followed by using instruments such as SARC-Calf and Short Physical Performance Battery (SPPB) for sarcopenia screening, and Fried's Phenotype for frailty screening. Vertical power was analyzed using the My Jump 2 app, considering parameters such as jump height, flight time, take-off velocity, force, and power. For statistical analysis, Spearman's correlation coefficient was used to identify possible associations between sarcopenia and frailty with clinical and sociodemographic variables. Subsequently, logistic regression was conducted to assess whether body mass predicted sarcopenia. Regarding frailty, none of the predictors were significant. All analyses were performed using SPSS software (IBM, Greenville, SC), version 25.0. Results: A total of 24 people with Parkinson's disease (PwP) were evaluated, 83.3% of whom were male, with a mean age of 66.35 years, living with a spouse and children (37.5%). They were stratified into sarcopenic (29.2%) and non- sarcopenic (70.8%) groups. An association was observed between sarcopenia and body mass (OR = 1.438; CI = 1.045 – 1.980). Regarding frailty, the prevalence was lower than reported in the literature, possibly due to the small sample size. Conclusion: This study concluded that body mass was a risk predictor for sarcopenia in PwP, and that the sample profile was predominantly male, with a higher occurrence of falls in stage 2 of PD and a high prevalence of pre-frailty. Despite the absence of other significant predictors for sarcopenia and frailty, the findings highlight the need for clinical standardization and universal diagnostic criteria, considering regional sociodemographic aspects.
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Dor Musculoesquelética na Coluna Vertebral em Crianças e Adolescentes: uma análise de rede
(Universidade Federal do Pará, 2024-08-27) GOMES, Marcella Veronnica Pereira; MAGALHÃES, Maurício Oliveira; http://lattes.cnpq.br/7766377002832983; https://orcid.org/0000-0002-7857-021X
Introduction: Musculoskeletal pain is common in children and adolescents, with prevalence ranging from 4% to 40%. Back pain-related symptoms rank 5th in terms of years lived with disability among children aged 10 to 19 years, affecting approximately 2.443 million people. Additionally, it is associated with high healthcare costs and can lead to persistent pain in adulthood. Objective: To analyze the relationship between musculoskeletal pain in the spine in children and adolescents through a network approach. Methods: The study population consists of children and adolescents of both genders, who are regularly enrolled in elementary and high school. Children and adolescents of both genders aged between 10 and 16 years were included. The Back Pain and Body Posture Assessment Instrument (BackPEI-CA) and the Instrutherm pressure algometer, model DD-500, were used to assess pain intensity and threshold, respectively. Data were tabulated, and JASP was used for statistical analysis. A network analysis was conducted to investigate descriptive relationships between individual and contextual factors with self-reported symptoms of back and neck pain. Results: 185 participants were included in the analysis. The network analysis observed that the variable 'Lower Back Pain' was negatively correlated with 'Family Pain History' (-0.14) and positively correlated with 'Sex' (0.19) and 'Neck Pain' (0.12). The 'Sitting Position When Using Cell Phone/ tablet' showed a negative correlation with 'Neck Pain' (-0.19). A negative correlation was observed between 'Sex' and 'Physical Activity Outside School'. Centrality metrics indicated that 'Age' (betweenness = 1.420) and 'Sex' (betweenness = 1.278) had the highest betweenness values. Conclusion: The study concludes that sex is a significant variable in back pain among children and adolescents, with a higher prevalence among girls, possibly due to sexual maturation and lower levels of physical activity compared to boys, who are more active. Additionally, the pain is influenced by poor posture while writing at school and using electronic devices. However, the results should be interpreted with caution due to the limitations of the analysis.
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Efeito agudo do HIIT e do alongamento no controle inibitório, desempenho matemático e na variabilidade da frequência cardíaca: Um ensaio randomizado e cruzado
(Universidade Federal do Pará, 2021-07-01) MODA, Tomé Edson dos Reis; COSWIG, Victor Silveira; http://lattes.cnpq.br/0097939661129545; https://orcid.org/0000-0001-5461-7119
Resistance Training (RT) is a modality that has high applicability and efficiency in physical, clinical and functional contexts. The scientific advance in this modality, a series of recommendations for the manipulation of variables and dosage of RT emerged for different purposes and population. However, it is not clear how these RT prescription guidelines affect responsiveness, characterized like an individual's particular capacity for respond to/benefit from an intervention, for a given measure. Therefore, the aim of the study was to carry out a systematic review to investigate the effect of RT on the responsiveness of healthy adults, in variables of strength, power, functionality and muscle hypertrophy, based on the prevalence rate. Only randomized clinical trials, in English, indexed in the PubMed/MEDLINE, SCOPUS, EMBASE and SPORTDiscus databases, published until June 2021, were considered. The study was registered in the International Prospective Register of Systematic Reviews (PROSPERO), identified by the code CRD42021265378. After the study selection process, the risk of bias was analyzed using the ROB2 tool from Chrocrane. After the search strategy, 3033 studies were found and, through the screening process, 13 studies were selected for systematic analysis. As for the effectiveness of the RT, the prevalence range for non-responders individuals to muscle strength was 0% to 44%, for hypertrophy 0% and 84% and functionality 0 to 42%, while, for muscle power, only one study investigated the responsiveness rate and reported 37%. Therefore, it seems that alterations to muscle hypertrophy may be less sensitive to RT, compared to other variables. Larger RT volume tends to be more effective overall, however intensity may be a key factor in some cases. However, the principle of specificity can be the most important aspect to effectivity of TR in these variables of interest. Moreover, it is important to consider methodological and statistical aspects when analyzing outcomes in responsiveness.
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Efeito do exercício físico na força muscular, massa muscular e desempenho físico em pessoas sarcopenicas com câncer: uma revisão sistemática
(Universidade Federal do Pará, 2024-12-20) GUEDES, Laerte Jonatas Leray; NEVES, Laura Maria Tomazi; http://lattes.cnpq.br/4235603520707156; https://orcid.org/0000-0002-3115-2571
Cancer is the leading cause of secondary sarcopenia, representing a growing problem among people diagnosed with cancer. This condition is associated with unfavorable outcomes both in relation to disease progression and to the various types of cancer treatment. Physical exercise is recommended by several guidelines for cancer patients. However, the guidelines do not present specific recommendations for sarcopenia, and few systematic reviews have explored this topic. In addition, the effect of physical exercise on improving sarcopenia (muscle strength, muscle mass and physical performance) in cancer patients is not yet fully elucidated. Objective: To verify the effect of physical exercise on muscle strength, muscle mass and physical performance in sarcopenic people with cancer. Materials and methods: The study is a systematic review, we used the acronym PICOS as the inclusion criterion, population: adult patients diagnosed with cancer and diagnosed with sarcopenia; Intervention: physical exercise alone or associated with other interventions; control: patients in usual care, without treatment or without physical exercise; outcome: muscle strength, muscle mass, and physical performance; Types of studies: randomized controlled clinical trials. The databases used were Pubmed, Excerpta Medica database (EMBASE), Cochrane (CENTRAL), Physiotherapy Evidence Database (PEDro), Latin American and Caribbean Health Literature in Health Sciences (LILACS), Cumulative Index to Nursing and Allied Health Literature (CINAHL), and SPORTDiscus. For gray literature, Clinical trials.gov, Proquest, and the Catalog of Theses and Dissertations of the Coordination for the Improvement of Higher Education Personnel were checked, with no language or time limit. The searches were conducted until October 10, 2024. The risk of bias of the included studies was assessed by the Cochrane Risk of Bias Tool 2 and the level of evidence by the Grading of Recommendations Assessment, Development and Evaluation. Qualitative (narrative) synthesis was performed in the review, presenting the effect measures extracted from the studies individually. Results: Eight randomized controlled clinical trials were included. Three studies demonstrated an effect on skeletal muscle mass index in favor of resistance exercise (MD = 0.32 kg/m2, 95% CI [0.04; 0.60), resistance and aerobic exercise on appendicular skeletal muscle mass index (MD = 2.4 kg/m2, 95% CI [4.1; 1.30]) and resistance exercise associated with protein supplementation (MD = 0.03 kg/m2, 95% CI [0.1 0.5]). There were no differences between the intervention and control groups for the variables muscle strength and physical performance. The included studies presented risk of bias with some concerns and high risk. Additionally, all outcomes received a low level of evidence in GRADE. Conclusion: Although exercise appears to be safe and three articles indicate a possible effect on muscle mass, the studies did not have sarcopenia as a primary outcome, with prevalence rates of <50% of sarcopenic individuals in 7 studies. Thus, there is still a lack of evidence on the real effect of physical exercise on sarcopenia in cancer patients.
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Os efeitos da estimulação transcraniana por corrente contínua na dupla tarefa de indivíduos com doença de Parkinson: uma revisão sistemática
(Universidade Federal do Pará, 2022-10-31) ARAÚJO, Ana Paula Monteiro de; ALVES, Erik Artur Cortinhas; http://lattes.cnpq.br/9125390243566397; https://orcid.org/0000-0001-8824-8075
Introduction: In Parkinson's disease (PD), there are changes in brain connectivity, specifically in the motor areas and the cerebellum, when it is necessary to perform a Dual Task (DT). Added to the signs and symptoms, it causes negative repercussions on carrying out activities of daily living and the risk of falling, which is aggravated in TD conditions. On the other hand, Transcranial Direct Current Stimulation (tDCS) is capable of modulating the brain to establish new patterns of activity, acting on cognitive and motor variables, improving the functionality of these individuals. However, in the important context of TD, there is no review with this outcome in PD. Objective: To investigate whether isolated or associated tDCS is capable of altering the DT performance of people with PD. Methods: this review was based on the Core Items Guidelines for Reporting Systematic Reviews and Meta-Analyses (PRISMA) and was registered in the PROSPERO Database. The databases PubMed, Wiley, Scopus and Web of Science were used, without language or time restrictions. Clinical trials were included, which evaluated DT after tDCS (anodal or cathodal), isolated or associated when compared to the Sham or control group. Results: Only 4 studies were included. 62 participants were evaluated with Hoehn and Yahr (HY) minimum 1 and maximum 4.2 studies applied it alone (50%) and 2 studies associated it with physical exercise protocols (50%). Regarding the number of sessions, 3 authors evaluated a single session (75%) and 1 author evaluated 9 sessions (25%) associated with motor intervention. All used 2mA intensity. 3 authors used tDCS for 20 min (75%) and 1 author for 30 min (25%). 75% positioned the anode electrode in the Left Lateral Pre-Frontal Cortex (DLPFC) and the most used evaluation instrument was the Timed Up Go (75%). Conclusion: tDCS can have a positive effect on the performance of DT in PD, especially associated with pharmacological and non-pharmacological therapy. The main area stimulated was the left DLPFC, but the sample was not sufficient to define it as the best target. 20 minutes of stimulation seems to be sufficient and a greater number of sessions may provide a greater effect. Larger clinical trials with greater standardization are needed to allow better comparison between studies and reduce possible bias.
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Os efeitos do treinamento pliométrico sobre o desempenho do tempo de resposta em praticantes de esportes de combate de percussão
(Universidade Federal do Pará, 2025-02-12) MACHADO, Hugo Enrico Souza; PENNA, Eduardo Macedo; http://lattes.cnpq.br/3746450308327976; https://orcid.org/0000-0003-0058-7967
Reaction time is an important variable in combat sports, as it depends on both central mechanisms (perception and information processing) and peripheral mechanisms (movement execution). Additionally, the ability to maximize force production in the shortest possible time can enhance muscle contraction speed and make strikes faster. However, little is known about the effects of power training adaptations on overall reaction time performance in combat sports practitioners. Thus, this study aimed to investigate the effects of six weeks of plyometric training on the performance of simple and choice reaction times (SRT and CRT, respectively) in striking combat sports athletes. For this purpose, 16 volunteers were divided into two groups: traditional training group (TTG = 8) and TTG + plyometric training group (TTG+PLYO = 8). Participants were assessed at two time points (pre- and post-intervention) for SRT and CRT in specific semicircular kick tasks, as well as for countermovement jump (CMJ), squat jump (SJ), horizontal jump (HJ), and reactive strength index (RSI). The TTG+PLYO group followed a six-week plyometric training (PT) program, training twice a week in addition to their regular sport-specific training. In contrast, the TTG group continued with their regular training only. For statistical analysis, a two-way ANOVA (group × time) and an independent t-test were used to evaluate the percentage of variation between groups. A significance level of p < 0.05 was adopted. Results showed no significant group × time interaction for SRT (F = 0.73; p = 0.40; η2 = 0.003) or CRT (F = 0.04; p = 0.83; η2 = 0.001). Regarding jump performance, only SJ presented a significant group × time interaction (F = 6.16, p = 0.026, η2 = 0.01), with an increase in jump height observed only in the TTG+PLYO group (pre = 30.3 ± 5.7 cm, post = 33.4 ± 5.8 cm, p = 0.01) and a significant difference in percentage variation (TTG: 0.4 ± 4.8%; TTG+PLYO: 9.1 ± 8.1%; p = 0.02). Additionally, RSI showed a significant variation only for the TTG+PLYO group (TTG = -2.3 ± 8.3%; TTG+PLYO = 24.4 ± 31.4%; p = 0.03). We conclude that six weeks of PT improved the physical performance related to power production in the TTG+PLYO group, without significant improvements in overall specific reaction time performance in combat sports practitioners.
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Força de preensão manual e funcionalidade em pessoas atingidas pela hanseníase, seus contatos intradimiciliares e escolares de área endêmica: Correlação com biomarcador molecular e sorológico de infecção pelo Mycobacterium leprae
(Universidade Federal do Pará, 2023-04-26) CONDE, Renatto Castro; BARRETO, Josafá Gonçalves; http://lattes.cnpq.br/1894551542259862
Leprosy can cause significant physical disabilities if not early diagnosed and treated. The diagnosis is essentially clinical, through dermatoneurological examination, including a subjective and low sensitivity manual muscle strength test. Household contacts of untreated patients are most at risk of developing the disease. Early diagnosis is essential for breaking the chain of transmission and preventing disability. In this context, the use of dynamometry provides objective data on handgrip strength through a simple and cost-effective clinical test, and with functional tests, could contribute to an early detection of peripheral nerve disorders. The aim of this study is to correlate handgrip strength and functionality data with biomarkers of Mycobacterium leprae infection among people affected by leprosy, their household contacts, and schoolchildren in endemic areas. The study was approved (report 5384136) and carried out in Imperatriz (MA), São Luís (MA) and Marituba (PA). Subjects diagnosed with leprosy, their household contacts and school contacts <15 years old were clinically examined and have biological samples collected for the detection of IgM-anti-PGL-I antibodies and for the molecular detection of M. leprae by means of RT-PCR. Strength was measured using a handheld dynamometer, while we used a scale and functional tests to assess functionality. A total of 179 subjects were included in the study, 94 females (52.51%), 67 cases of leprosy (28 new cases and 10 index cases) and 60 healthy household contacts (36.5 ±14.69 years) and 52 healthy schoolchildren from an endemic region. We found a significant prevalence of loss of muscle weakness (p=0.0003) in leprosy cases compared to healthy individuals. Healthy male subjects >15 years old had significantly higher mean values of grip strength and pinch strength (p<0.05) compared to male leprosy cases, except for the pulp pinch. Leprosy cases > 15 years old showed significant functional losses (p<0.05), evaluated by TFMJT and 9-PnB and a longer test time, when compared to the healthy group, mainly women. It was observed that leprosy cases had significantly more activity limitations when assessed on the SALSA scale (p<0.05). Subjects with changes in nerve palpation and decreased tactile sensitivity showed significantly more muscle weakness and functional loss (p<0.05). We found an inversely proportional correlation between anti-PGL-I IgM titers and muscle grip strength and pinch strength in individuals over 15 years of age (p<0.05). While muscle weakness was observed in most RT-PCR positive cases. Of the positive individuals for RT-PCR, 42.31% presented functional loss in the tests, showing a significantly longer time in the TFMJT (p=0.028). Those positive for RT-PCR presented significantly greater times in the block stacking (p=0.046) and feeding simulation (p=0.025) subtests. We observed muscle weakness in 28.75% and loss of function in 33.33% of subjects double positive for anti-PGL-I and RT-PCR. Therefore, these data show us that there may be motor and functional impairment in this population that is more vulnerable to the development of leprosy, where these tests can find disabilities, in addition to those of the traditional clinical evaluation.
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Funcionalidade após hospitalização por COVID-19 não crítico: implicações à curto e médio prazo na independência funcional, atividades de vida diária, capacidade funcional e dessaturação ao exercício
(Universidade Federal do Pará, 2021-11-03) CRUZ, Soany de Jesus Valente; NEVES, Laura Maria Tomazi; http://lattes.cnpq.br/4235603520707156; https://orcid.org/0000-0002-3115-2571
Coronavirus 2019 disease (COVID-19) is a highly infectious disease that can lead to hospitalization. The disease can compromise the musculoskeletal, cardiopulmonary and vascular systems, which can result in impacts on mobility and functional capacity. Objective: To assess functionality after hospitalization for non-critical COVID-19: short- and medium-term implications for functional independence, activities of daily living, functional capacity and exercise desaturation. Methods: This is a cross-sectional, analytical and descriptive study. Individuals over 18 years of age, diagnosed with non-critical COVID-19, who were hospitalized for at least 24 hours and who were discharged from the hospital, in the state of Pará, were included. Functionality and activities of daily living (ADLs) were assessed. with application of electronic forms from 30 to 180 days after hospital discharge (Barthel Index and London Chest Activity of Daily Scale (LCADL) – Article 1), and assessment of functional capacity and exercise desaturation from 90 to 180 days after hospitalization (Test 6-minute walk (6MWT) – Article 2). Results: 216 individuals were recruited, 58 individuals were included in article 1 and 46 individuals in article 2. In article 1, there was a significant difference in the Barthel Index between 1 and 6 months after hospitalization (p=0.042). No significant difference was observed in the LCADL scale. Physically active people are more likely to score higher on the Barthel Index (OR 7.32, p=0.025). In article 2, individuals after 3 months of hospital discharge walked 420m in the 6MWT, with 28% presenting a >=4% drop in SpO2. After 6 months, the distance covered was 442m, with 19.05% showing desaturation. There was no difference between groups. Conclusion: Reduced functionality, dependence to perform ADLs, reduced functional capacity and exercise desaturation were observed in post-COVID-19 non-critical patients in the short and medium term after hospital discharge.
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Indicadores de desempenho e aptidão física em atletas de voleibol sentado: Uma revisão sistemática
(Universidade Federal do Pará, 2021-12-21) LOPES JÚNIOR, Doriedson Barbosa; SILVA, Marília Passos Magno e; http://lattes.cnpq.br/9123524811984821; https://orcid.org/0000-0002-7322-6364
Sitting volleyball is a paralympic sport that has shown significant growth in competitive terms in recent years, increasing the need for methods of evaluating technical-tactical aspects and physical fitness that help in monitoring the level of performance and increase in sports performance in the modality. The present systematic review was conducted in accordance with the guidelines of the Main Items for Reporting Systematic Reviews and Meta-Analyses (PRISMA) and aimed to identify and analyze indicators of performance and physical fitness in sitting volleyball players. The searche was carried out in four databases (Scopus, Pubmed, Web of Science and Scielo) and studies that quantitatively evaluated performance indicators or physical fitness components in sitting volleyball athletes of any gender, age or competitive level were included. The methodological quality of the articles included was evaluated by the Critical Review Form for Quantitative Studies (LAW et al., 1998) and the results presented through narrative synthesis. In total, 37 studies were included, with an average quality score of 72.25%. The findings showed that attacking and blocking were the main terminal actions in sitting volleyball. Significant correlations between physical fitness measures (power, speed, agility, endurance, flexibility, reaction speed and body composition) with specific technical skills were identified. While limited evidence indicates that: male athletes perform better than female athletes; that elite athletes are physically and technically superior to sub-elite ones. In addition, the studies did not point out significant differences in the effectiveness in game actions between athletes of different functional classes.