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

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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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Sensores inerciais: Uma alternativa objetiva para classificação baseada em evidências do Basquete em cadeira de rodas
(Universidade Federal do Pará, 2021-05-19) SÁ, Karina Santos Guedes de; SILVA, Anselmo de Athayde Costa e; http://lattes.cnpq.br/4794918582092514; https://orcid.org/0000-0001-5265-619X
The classification system for Paralympic sports has evolved with the improvement of evaluations, to make competitions fairer. With this, an international movement was developed to make the classification of athletes based on evidence. Such evidence can be obtained in different ways, such as tests and valid equipment for measures of variables related to classification. Thus, the main objective of this dissertation was to investigate the use of inertial sensors in the sportive classification process of wheelchair basketball. The dissertation was written in the aggregated model of articles and has two articles: a systematic review and an original study. In the systematic review, we observed that instruments such as kinematics, dynamometers and inertial sensors have been applied in the evidence- based classification in wheelchair sports, using variables such as strength, speed and acceleration to discriminate subjects from different classes. In our original study, we observed that: 1) higher class athletes performed performance tests in less time; 2) 16 variables showed moderate and strong significant correlations with the sports class; 3) the variables collected with the sensor positioned in the wheelchair presented a greater number of strong and moderate correlations with the sports class and; 4) the Illinois agility test showed more variables correlated with the sports class when compared to the maximum speed test of 20 meters and the anteroposterior axis of both sensors showed a greater number of variables correlated with the sports class. In summary, the inertial sensors seem suitable for assessing the sporting class. Finally, we believe that the use of technologies in the sports environment will grow more and it seems to be a path of no return, taking performance and competitions to other levels.
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A predição de uma ação transitiva é modulada pela valência emocional do objeto
(Universidade Federal do Pará, 2021-06-02) AZEVEDO, Priscila da Silva; CAMPOS, Anaelli Aparecida Nogueira; http://lattes.cnpq.br/1380793960958329; SAUNIER, Ghislain; http://lattes.cnpq.br/6254015055212071; https://orcid.org/0000-0002-0882-7788
Recent experimental evidences demonstrate that the action observation and action execution directed to objects (i.e., transitive action) shared similar motor areas. This action-perception network is involved in our ability to predict the sensory consequences of actions performed by others. Thus, the main objective of the present work was to evaluate the effect of an object's emotional valence on to the action prediction process. For this, 38 undergraduate students were recruited to watch reach-to-grasp videos directed of pleasant, unpleasant or neutral objects on a computer screen. Two visual conditions were included: occlusion (a black rectangle occluded the last 50% of the movement) and full vision. In total, 90 repetitions were performed (2 visual conditions x 3 valences x 15 repetitions). The experiment always started with the occlusion block. The participant's task consisted in predict the time-to-contact (TTC) between the hand and the object by pressing the space bar on the keyboard. Prediction errors were calculated based on the temporal difference (ms) between the participants' prediction of TTC and the contact times of our videos. An ANOVA for repeated measures (2 visual conditions x 3 valences) was used to compare the prediction errors. The Tukey post-hoc test was used to compare the significant effects (p <0.05). Our results suggest that the prediction of action is modulated by the emotional valence of the object. We found a valence effect with a greater temporal precision for AGR and NEU objects when compared to DES. There was no visual effect on action prediction. Finally, we observed that the visual condition only modulated the prediction of the action directed to AGR and NEU objects. To our knowledge, this is the first behavioral demonstration that the emotional valence of objects interferes within the action prediction process. These results may contribute in the future to the development of complementary protocols to traditional motor rehabilitation.
Acesso aberto (Open Access)
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.
Acesso aberto (Open Access)
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.
Acesso aberto (Open Access)
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.
Acesso aberto (Open Access)
Perfil de lesões relacionadas à prática esportiva em atletas de voleibol sentado: revisão sistemática
(Universidade Federal do Pará, 2021-12-07) MORAES, Luana Correa Pardauil de; SILVA, Marília Passos Magno e; http://lattes.cnpq.br/9123524811984821; https://orcid.org/0000-0002-7322-6364
After Paralympic insertion, sitting volleyball experienced a solid development and greater introduction of athletes in the sport, a fact that required a greater increase in intensity and frequency in training and competitions, contributing to increase competitiveness and the occurrence of injuries. The main objective of the present study is to identify the epidemiological aspects of sports injuries in seated volleyball athletes. The systematic review followed the declaration of Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and was registered in the International Prospective Register of Systematic Reviews (PROSPERO) platform. The search platforms selected for the research were: PubMed, BVS, SciELO, SPORTDiscus and Medline. The research included studies that presented: data on the profile of sports injuries in seated volleyball athletes; with a sample composed of competitive athletes at least 1 year old and over 18 years old; published between 1980 and 2020; in English, Spanish and Portuguese. Two independent reviewers applied the search strategy and assessed the methodological quality according to the STROBE and STROBE-SIIS statements. Duplicate removal was performed using EndNote software. After collecting eligible studies, data were expressed in tables, charts and a map. Finally, we found in the included studies a clinical incidence of 0.57 and prevalence of 54.1% of injuries, with a predominance of injuries in the upper limbs (53.8%), specifically in the shoulder (28.9%), by overload mechanism (58%), acute (66%), at the time of training (48%), resulting in absence (52%), severe (38%) and non- recurring (57%). Given this epidemiological profile, we suggest guidelines for preventive conduct, training planning and protection of the athlete's health.
Acesso aberto (Open Access)
Validação de dispositivos móveis para avaliação de ajustes posturais antecipatórios e compensatórios
(Universidade Federal do Pará, 2021-12-09) DUARTE, Manuela Brito; CALLEGARI, Bianca; http://lattes.cnpq.br/0881363487176703; https://orcid.org/0000-0001-9151-3896
Article 1: Postural adjustments are triggered by the central nervous system in response to external disturbances and consist of anticipatory (APAs) or compensatory (CPAs) adjustments. APAs are muscle recruitment, associated or not with the displacement of the Center of Pressure, in advance of predictable disturbances. CPAs, on the other hand, are generated as a result of the imbalance, after the disturbance. Currently, the study of APA and CPA is restricted to research laboratories due to the need for specific equipment, difficult to handle and high cost. The objective of this project was to validate a mobile application (Momentum) for the evaluation of APAs and CPAs. Healthy young people were subjected to a predictable external disturbance produced by the impact of a pendulum. We used gold standard equipment to compare the results obtained by Momentum. Validation results, APA latency (APAonset), maximum peak (ACCpeaktime) and acceleration variation (ACCpeak) after impact and time to peak (ACCpeak) were the parameters that showed the strongest correlation indices. (r). In terms of reliability, Momentum had a very high correlation in APAonset and APAamp. In the CPA, only the ACCrange had an excellent correlation, the other parameters presented a reasonable to high correlation. In general, Momentum proved to be valid and reliable for evaluating APAs and CPAs. Article 2: New technologies mainly in the sports environment where performance and competitive power are essential, the use of inertial sensors for analysis and evaluation in sports stands out, as long as they are reliable to the gold standard evaluation equipment. The objective of this article was to validate the acceleration signals of the center of mass (COM) in the anticipatory and compensatory phase of the disturbance comparing the two equipments (Metamotion C and kinematics). Twenty healthy young men were exposed to the pendulum paradigm, which consisted of predictable anteroposterior disturbances provoked at the level of the shoulders. The validation results showed a significant linear correlation of all variables from moderate to large with r ≥ 0.5. Reliability between kinematics sessions was excellent (≥0.75). The APAonset variable presented a reasonable to high ICC, while the CPAtime showed an excellent correlation. The results show that Metamotion C proved to be reliable and valid in measuring COM acceleration in both APA and CPA.
Acesso aberto (Open Access)
Síndrome de burnout, estratégias de coping e classe funcional em atletas de basquete em cadeira de rodas
(Universidade Federal do Pará, 2021-12-16) FERREIRA, Rodrigo Weyll; PIRES, Daniel Alvarez; http://lattes.cnpq.br/4487383675643868; https://orcid.org/0000-0003-2163-5606
Wheelchair basketball athletes suffer from stressors such as inadequate preparation for competition, functional classification, and performance concerns. Therefore, when stress becomes chronic, it can result in burnout, defined as a syndrome with three dimensions: physical and emotional exhaustion, reduced sense of sporting achievement, and sporting devaluation. However, burnout can be prevented or mitigated with the use of coping strategies, which are continuous efforts of thought and action to manage situations evaluated as stressful. This dissertation was composed of two studies. The first is a systematic review study aimed at synthesizing the existing literature on burnout and coping in athletes with disabilities and identifying the psychological and physical variables associated with burnout and coping in this population. Seven articles with a predominance of cross-sectional design were selected. It is concluded that the scientific production in relation to coping and burnout in athletes with disabilities is under construction due to the few studies, mainly on burnout, found in this review. Coping is associated with self-determined motivation and functional class, and burnout is associated with socially prescribed perfectionism and sleep. The second consists of an original study with the objective of identifying the most perceived dimensions of burnout and coping strategies, analyzing the perception of burnout and coping according to the placement in the championship, and relating the functional class with the dimensions of burnout and coping strategies. Seventy-one wheelchair basketball athletes completed the Athlete Burnout Questionnaire and Athletic Coping Skills Inventory during the competitive phase. The results showed that, in relation to the burnout dimensions, the reduced sense of sporting achievement was more perceived than physical and emotional exhaustion, while the worry-free coping strategy was the least perceived. No differences were observed in the perception of burnout or coping in relation to the placement of the team in the final classification of the competition. In addition, there was no relationship between functional class and burnout or coping. We conclude that team performance does not interfere with the perception of burnout or coping, and the functional class is not a key factor for burnout or coping.
Acesso aberto (Open Access)
Respostas do pilates em dupla tarefa sobre parâmetros cognitivos e funcionais de mulheres pós-menopáusicas
(Universidade Federal do Pará, 2021-12-17) SILVA, Daniel José Fontel da; TORRES, Natáli Valim Oliver Bento; http://lattes.cnpq.br/1927198788019996; https://orcid.org/0000-0003-0978-211X
Aging may cause morphological and functional changes that may lead to decrease on physical functional and cognitive performance throughout aging, particularly on post-menopausal women. The performance in situations of divided attention (dual-task) may be reduced with advancing age, favoring the risk of falls and limiting functionality. The Pilates method is a form of physical exercise that combines strength and balance training and promotes improvement on these physical fitness variables in older adults. Considering the available evidence that dual- task training may promote additional benefits to the exercises performed isolated, including the prevention and/or improvement of cognitive decline associated with age, this study aimed to propose and evaluate the effects of a dual-task protocol composed of mat Pilates and Cognitive stimulation (PILATES-COG) on healthy, community-dwelling post-menopausal older women, compared to a group that received health education related materials. This is a non-randomized controlled trial, 47 women participated in this study (PILATES-COG =22; Control= 22), with amenorrhea for at least 12 months, and performance on the Mini-Mental State Examination compatible with normality, adjusted for schooling. Twenty-four sessions of solo Pilates were held, 2x week, during approximately 50 minutes, in classes, involving mat exercises and simultaneous cognitive tasks. Memory assessment (Word List, Delayed Recall and Recognition of the CERAD battery - Consortium to Establish a Registry for Alzheimer's Disease), language (Semantic and Phonological Verbal Fluency), balance (mini-BESTest), lower-limb muscle strength (Chair Sit-to-Stand Test), functional mobility (Timed Up and Go test – TUG; TUG with dual-task – TUG DT) and Dual-Task Cost (DT Cost). Two-way mixed ANOVA was used for data analysis, and Bonferroni was used as post-hoc to perform intra- and inter-group comparisons. Effect sizes were described with partial eta squared. Our results show that the main effects of Time were found for both Semantic Fluency (p = 0.002) and Phonological Fluency (p = 0.002), Immediate memory (p < 0.001) and Evocation Memory (p < 0.001), lower- limb muscle strength (p<0.001), balance (p<0.001) dual-task gait speed (p=0.023) and DT cost (p=0.012). Main effects of Group were found for lower-limb muscle strength, balance, TUG, TUG DT, speed in one and dual-task (p<0.001). There was interaction between Time and Group for language (p=0.017) as well as Balance and Lower-limb muscle strength (p=0.015; p=0.008). In the intragroup comparison, the participants on the Pilates group showed improvement after the intervention for the assessment of Language (p<0.001), Memory (p=0.001), Lower-limb muscle strength (p<0.001), balance (p<0.001) and DT Cost (p<0.05). The dual-task intervention, composed of mat Pilates exercises and cognitive stimulation, improved language, memory, lower limb muscle endurance and balance in postmenopausal women. We suggest this protocol may be a viable and effective strategy to reduce age-related cognitive decline and improve physical functional performance in healthy postmenopausal women.
Acesso aberto (Open Access)
Monitoramento de carga interna e respostas físicas e fisiológicas ao treinamento de CROSSFIT®
(Universidade Federal do Pará, 2021-12-20) CASTANHEIRA, Luísa Freire da Silveira; COSWIG, Victor Silveira; http://lattes.cnpq.br/0097939661129545; https://orcid.org/0000-0001-5461-7119
CrossFit® is a training program recognized for its rapid growth in popularity in competitive and non-competitive forms, with the goal of developing different fitness domains simultaneously. Accurately and effectively identifying the effect of this training is indicated to periodically analyze the responses of a subject to a given overload, to safely prescribe and control training, and to promote adaptations. However, in this training model this is still not entirely clear, and a different response is expected because it is a self-regulated sport due to the high volume. Therefore, the objectives of this research was to describe the internal training load imposed on CrossFit® athletes over three months, and relate it to physical performance indicators. Additionally, to investigate the effect of training on aerobic fitness indicators and blood markers. To this end, competitive CrossFit® athletes were evaluated daily, weekly, and pre and post training. The instruments used were a notebook of perceptual measures regarding pain sensations, recovery, sleep quality and likely performance, heart rate variability and lower limb power and aerobic power tests. Data analysis was initially done by checking the normality of the data using the Shapiro-Wilk test. If normality was confirmed, the data were presented by mean and standard deviation and the daily, weekly, and post-competition data were compared by ANOVA for repeated measures, and the correlations between training load indicators and physical performance were tested by Pearson's coefficient. Otherwise, data were presented by median and interquartile range, and daily, weekly, and post-competition data were compared by Friedman's test and correlations were tested by Spearman's coefficient. All analyses were done in SPSS 20.0 software and the alpha value was set at 5%. The main findings suggest that the imposed training loads were not sufficient to induce detectable overreaching or recovery/compensation, at least by the variables used; that training did not promote relevant changes in the aerobic power tested and; that positive correlations were not identified among the variables analyzed. In summary, the training load imposed in the preparation of elite Crossfit® athletes was relatively stable, despite the constant variation of stimuli and settings, and of moderate level. Our findings may help to explain training patterns that involve high volume and frequency of training maintained for long periods, which does not match (at least theoretically) with high intensity efforts.
Acesso aberto (Open Access)
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.
Acesso aberto (Open Access)
Perfil epidemiológico e sobrevida de pacientes em tratamento hospitalar para COVID-19: um estudo de caso no interior da Amazônia
(Universidade Federal do Pará, 2022-01-27) AFONSO, Amanda de Queiroz; BARRETO, Josafá Gonçalves; http://lattes.cnpq.br/1894551542259862
Introduction: The disease caused by the novel coronavirus (SARS-CoV-2), COVID-19, has triggered until January 2022 more than 298 million cases and 5.47 million deaths worldwide. Brazil ranks 3rd in confirmed cases with more than 22.3 million infected and 2nd in number of deaths with more than 620,000 deaths. In Pará, more than 627,000 cases and 17,100 deaths were recorded, evidencing the high infectivity of this virus, whose primary route of contamination is the upper airways, with multiple systemic repercussions. Elderly people and people with chronic diseases are more likely to develop the severe form of the disease and its functional sequelae. Physiotherapeutic monitoring has been used in order to prevent losses in functionality and reduce hospitalization time. However, as it is a new disease, it is necessary to record, describe and understand the clinical-epidemiological and functional profile of patients who progress to hospitalization and to correlate these variables with the clinical outcome of patients. The objective of this research was to trace the clinical-epidemiological profile of patients hospitalized for the treatment of COVID-19 and to identify possible factors associated with survival, including the level of functionality. Methodology: An observational research was carried out where clinical and epidemiological data were collected from the medical records of patients hospitalized for treatment of COVID-19, from April 2020 to April 2021, at Hospital de Urgência e Emprego Drª Maria Laise Moreira Pereira Lima, located in the municipality of Castanhal-Pará. To assess functionality, the Modified Barthel Scale was used, which assesses the ability to perform activities of daily living. Descriptive statistics of central tendency and dispersion were used to describe the clinical-epidemiological profile, and later the Cox survival analysis, whose purpose is to study the occurrence of an event during a period of time. Statistical analyzes were performed using the SSPS software. Results: 880 patients were included according to the established criteria. The mean age was 54 years, of which 59.54% were male. The most frequently reported comorbidities were systemic arterial hypertension, diabetes and chronic kidney disease. According to a descriptive analysis, the group that did not have access to physical therapy seemed to have the worst outcomes, with 20.28% of deaths. Regarding functionality, all patients who presented some level of functional dependence required oxygen supplementation at some point. According to the survival analysis performed, the longer the hospitalization time, the greater the risk of death, and the factors that seemed to be decisive were age and number of associated comorbidities, and functional dependence, since patients with some impairment in functionality, were 2.75 times more likely to die. Conclusion: The risk of death increases in elderly patients, with two or more comorbidities and who have moderate, severe or total functional dependence. Knowing this, it is necessary to constantly monitor patients admitted to hospital units who present any of these risk factors.
Acesso aberto (Open Access)
Predição da massa livre de gordura e do índice de massa muscular por impedancia bioelétrica em homens com tetraplegia fisicamente ativos
(Universidade Federal do Pará, 2022-05-25) VIEIRA, Andreia Bauermann; KOURY, Josely Correa; http://lattes.cnpq.br/9039270525512042; https://orcid.org/0000-0002-3189-9261; SILVA, Anselmo de Athayde Costa e; http://lattes.cnpq.br/4794918582092514; https://orcid.org/0000-0001-5265-619X
Individuals with cervical spinal cord injury (c-SCI) experience progressive loss of fat-free mass (FFM) due to decreased physical activity and neurological impairments because the function of spinal neuronal circuits below the level of injury is impaired. Therefore, there is a reduction in muscle strength and physical performance, characterizing sarcopenia, similar to what occurs in the elderly. The bioelectrical impedance (BIA) method is valid and accessible for predicting FFM in different population. The ground of the BIA method is based on the principle of constant hydration. However, individuals with c-SCI show important variations in hydration status, a fact that makes it difficult to use generalized predictive equations for FFM by BIA. Considering that the prediction of FFM in individuals with c-SCI is important to monitor changes in body composition and to support studies on sarcopenia, the present dissertation aims to: 1) test the agreement between the FFM values obtained by three different predictive equations by BIA and by dual-energy X-ray absorptiometry (DXA), 2) test the applicability of bioelectrical impedance vector analysis (BIVA) for this group; and 3) compare the use of the muscle mass index (SMI) from the FFM obtained by BIA and DXA for the diagnosis of sarcopenia in people with tetraplegia, considering different levels of physical activity (sedentary, active >150 minutes per week, and very active > 210 minutes per week). Able bodied individuals (n=23) and with c-SCI physically active (n=13) or inactive (n=10) participated in the study. Only the equation by Buchholz et al. showed agreement (coefficient of agreement=0.85) with DXA. Sarcopenia is a common disease after c-SCI and can be diagnosed using the SMI, which was tested in this group using the suggested equations for BIA and DXA. The use of the SMI-BIA to classify sarcopenia in sedentary c-SCI individuals resulted in substantial diagnostic agreement (Kappa=0.727) according to the Kappa coefficient. Buchholz et al. equation presented the best agreement, but this was not enough for this equation to be recommended for use in people with c-SCI and a specific equation for this population should be created. However, the use of cut-off points to diagnose sarcopenia from the SMI-BIA seems promising in sedentary people with c-SCI, necessitating further studies in people with c SCI that are physically active.
Acesso aberto (Open Access)
Os efeitos agudos do treinamento intervalado de alta intensidade (HIIT) na cognição e na variabilidade da frequência cardíaca de crianças com ansiedade e depressão
(Universidade Federal do Pará, 2022-06-29) SILVA, Luisa Matos da; TORRES NETO, João Bento; http://lattes.cnpq.br/7874863858825807; https://orcid.org/0000-0002-9155-9445
Anxiety and depression (AD) are the most common and debilitating mental health problems in childhood and adolescence. High-intensity interval training (HIIT) has been studied as a component of improving inhibitory control, commonly affected in children with AD. The aim of this study was to investigate the acute effects of HIIT on heart rate variability (HRV) and on inhibitory control of school children with AD. We performed a randomized crossover trial with 71 children aged 9 to 13 years, 36 girls and 35 boys, where children performed an acute HIIT training and stretching protocol (control) on different days. We used the RCADS questionnaire score to classify children for AD and analyzed this classification of the dispersion by quartiles (upper and lower). Inhibitory control was evaluated using the Flanker test before and after exercise, and HRV was obtained using a heart rate monitor and analyzed using the Kubios software. The effect of exercise was analyzed using pairwise estimation statistics and repeated measures ANOVA. Our results demonstrate that an acute HIIT produced improving effects on inhibitory control in both groups, such as the accuracy of incongruous latency responses, as well as the cost of conflict; in addition to improved congruent latency for the CAD group. The HRV results demonstrate that acute HIIT was not able to improve HRV, but there was a positive effect after stretching that needs further investigation in future works.
Acesso aberto (Open Access)
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.
Acesso aberto (Open Access)
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.
Acesso aberto (Open Access)
Uso de um acelerômetro para avaliação de ajustes posturais antecipatórios durante início do passo em pacientes com osteoartrite de joelho
(Universidade Federal do Pará, 2023-02-24) OLIVEIRA, Luana Karine Resende; CALLEGARI, Bianca; http://lattes.cnpq.br/0881363487176703; https://orcid.org/0000-0001-9151-3896
Introduction: Elderly people with severe and moderate levels of Knee Osteoarthritis (OA) have an adaptive strategy to perform gait initiation, which is significantly altered by the level of severity of knee osteoarthritis. In recent years, inertial sensors have been used to assess anticipatory postural adjustments (APAs) for gait initiation, since kinemetry, considered the gold standard, is expensive, difficult to transport, requires calibration and proper installation, becoming its use in clinical settings is unfeasible. There are no studies in the literature that validated the use of accelerometers to assess gait initiation in individuals with Knee OA, nor did they assess their reliability, a fact that reinforces the need for research development in this area with this objective. We also did not find clinical trials in the literature that have evaluated the impact of physiotherapeutic interventions on anticipatory step adjustments. Objective: This project is divided into two studies: Study 1: sought to validate the use of a commercial Metamotion C accelerometer to measure APAs during gait initiation in individuals with Knee Osteoarthritis, as well as to test its reliability. Study 2: will seek to assess whether the use of virtual reality with video game resources, associated with conventional physical therapy treatment, have superior effects on pain, physical capacity, balance and anticipatory postural adjustments in gait initiation in individuals with knee OA. Materials and methods: Study 1: 29 subjects were evaluated using a commercial Metamotion C accelerometer and a camera system – kinemetry with a reflective marker on the lumbar vertebrae and calcaneus. The subjects started the step after the experimenter's random command, and had variables extracted from the protocol: APAlatency, APAamp. Study 2: This is a single-blind, randomized, controlled clinical trial. 40 subjects (31 women and 9 men) were selected and randomized into the TC or VR groups by random allocation (20 in each group). The patients underwent the rehabilitation program for 8 consecutive weeks. An inertial sensor was used during the beginning of the gait to measure the APAs and tests, scales and questionnaires to assess balance, pain and physical capacity. Results: Study 1: there was a statistically significant linear correlation between all variables. The APAlatency variable showed an almost perfect correlation (r = 0.9715; p < 0.00001) and the APAamp variable (r = 0.7358; p < 0.00001) had a strong correlation. The measurements showed high to very high reliability for intraclass correlation for the kinematics and accelerometer amplitude and latency variables. Study 2: The results show that conventional treatment significantly improves pain complaints, physical capacity and balance in individuals with knee AO, but only the group that used associated VR showed improvement in PA parameters. Conclusion: Study 1: Metamotion C is valid and presents high reliability for the evaluation of APAs at step initiation in individuals with knee OA. Study 2: only the group VR showed improvement in APA parameters, demonstrating the importance of using this resource in the rehabilitation of these patients.
Acesso aberto (Open Access)
Mensuração das propriedades do Spinal Appearance Questionnaire em adolescentes com escoliose idiopática: uma revisão sistemática
(Universidade Federal do Pará, 2023-03-01) MALAQUIAS, Lorenna Costa; MAGALHÃES, Maurício Oliveira; http://lattes.cnpq.br/7766377002832983; https://orcid.org/0000-0002-7857-021X
Objective: to systematically examine the clinical properties of the Spinal Appearance Questionnaire (SAQ) in its cross-cultural adaptations in different languages. Methods: The databases Medline (PubMed), CINAHL, EMBASE, Science Direct, PsycINFO and WorldWideScience.org. Used for screening studies until July 16, 2022. Records on the development, evaluation and translations of the SAQ instrument with adolescents in idiopathic scoliosis were included in this review. In addition, two reviewers defined whether the studies were eligible, as well as analyzed their psychometric properties of Internal Consistency, Reliability, Content Validity, Cross-cultural Validity, Construct Validity and Structural Validity, according to Consensus-based Standards for the Selection of health Measurement Instruments (COSMIN). The Grading of Recommendations Assessment, Development, and Evaluation (GRADE), recommendation of modified quality classification was applied for evidence synthesis. Results: 95 articles were selected by title and abstract. After the removal of duplicates, complete reading and search in the references, there were 13 studies in this review. The original version of the SAQ was described in English and its analysis was made in 2 articles and the instrument was translated into Polish, Canadian French, Simple Chinese, Spanish (Europe), Danish, Traditional Chinese, Portuguese (Brazil), Korean, German, Turkish and Persian. The evidence was moderate for construct validity, low for internal consistency, very low for reliability and cross-cultural validity; the properties of content and structural validity did not present minimum data for classification. Conclusion: The quality of the clinical properties of the SAQ instrument for patients with Adolescent Idiopathic Scoliosis was low, due to the absence of clinical analysis properties or doubtful methodological quality. However, we recommend the instrument for the evaluation of the self-perception of the column in adolescents for its own organizational characteristics, its most current translation in the language if before the others by their sample and organization of statistical tests clearly described, compatible with the general proposal of the research and strengthening the exposures of the studied measurement properties.
Acesso aberto (Open Access)
Representações das ações em mulheres mas mastectomizadas: exemplo de uma tarefa de rotação mental
(Universidade Federal do Pará, 2023-03-06) ALMEIDA, Larissa Nazaré Queiroz de Araújo; SAUNIER, Ghislain; http://lattes.cnpq.br/6254015055212071; https://orcid.org/0000-0002-0882-7788
Breast cancer is an aggressive and mutilating disease responsible for the highest number of deaths among women in Brazil. The mastectomy postoperative period leads to limitations of upper limb movement, particularly of ipsilateral side to the affected breast. This research aimed to investigate whether motor representations of upper limb are modulated after mastectomy surgery. For this, a hand laterality judgment experiment was carried out, in which the participant identified whether the images projected on a computer screen represented a right or left hand. Respecting the inclusion criteria, 17 women participated in the study, 9 with mastectomy with some limitations of upper limb movements, ipsilateral to the affected breast and 8 healthy women who underwent the same experiment, at the Laboratory for the Evaluation and Rehabilitation of Cardiovascular Dysfunctions, Oncology and Respiratory - LACOR (UFPA). The results showed a lower accuracy for mastectomized women when assessing the laterality of the ipsilateral hand to the affected breast compared to the control group, particularly for restricted biomechanically postures (i.e., palmar view and 90° lateral orientation). Such results suggest changes in the motor representations of the upper limb ipsilateral to the affected breast.