Navegando por Assunto "Rehabilitation"

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Acesso aberto (Open Access)
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.
Acesso aberto (Open Access)
Construção de um protocolo de exercícios físicos para o atendimento a pessoas com diabetes mellitus tipo 2: revisão rápida
(Universidade Federal do Pará, 2022-08-30) RIBEIRO, Andressa Karoline Pinto de Lima; TORRES, Natáli Valim Oliver Bento; http://lattes.cnpq.br/1927198788019996; https://orcid.org/0000-0003-0978-211X
Type 2 Diabetes Mellitus (DM2) accounts for 90-95% of all diabetes cases. This form covers individuals with relative insulin deficiency and peripheral insulin resistance. Physical exercise is an efficient therapeutic strategy for the treatment of people with DM2 as it contributes to glycemic control, as well as reducing cardiovascular risk factors, increasing physical fitness, contributing to body weight control and improving people's quality of life. Objective: Formulate a physical exercise protocol aimed at health professionals for the treatment and maintenance of glycemic control of adults with type 2 Diabetes Mellitus. Methodology: The study consists in the elaboration of the protocol from a rapid review in search of studies who investigated the effects of physical exercise on the glycemic control of adults with type 2 Diabetes Mellitus (DM2) to analyze which exercise parameters (modality, frequency, volume, intensity, interval and progression) are recommended to achieve better glycemic control in the population of interest. The PICOT strategy was adopted for the elaboration of the inclusion criteria of the studies and the PRISMA protocol for the writing of the manuscript. PubMed and LILACS databases were used. The study selection process took place through 4 steps: identification, selection by title and abstract, eligibility assessment and inclusion. Two authors independently extracted data on population, intervention and outcome from each study, and the extracted information was organized into tables. The methodological quality of each study was analyzed based on the PEDro scale (PROSPERO - CRD 42021262614). Results: From a total of 1152 articles, 17 studies met the inclusion criteria and were analyzed. A total of 1,141 (745 in exercise groups and 396 in sedentary control groups) people with T2DM were included. Regarding the type of study, 15 (88.2%) were randomized clinical trials and 2 (11.8%) were non-randomized clinical trials. The age of patients ranged from 45.6 to 61.7 years. The mean intervention time was 17 weeks, ranging from 9 to 48 weeks. Six studies 35.3% reported that no adverse events occurred during the intervention, two (11.8%) reported some event and nine (52.9%) did not present any information. The theoretical basis obtained from the rapid review and other studies supported the construction of a guidance protocol for professionals about physical exercise as a treatment for DM2 and management of glycemic control. The following elements were elaborated: frameworks of concepts, flowcharts and explanatory texts constructed with objective and easy-to-understand language as didactic tools in order to assist in the outpatient routine of professionals responsible for prescribing exercises in the management of patients treated at all levels of care of the Unified Health System (SUS). Discussion: Aerobic, resistance and combined training are associated with decreases in HbA1c, fasting glucose or postprandial glucose. however, combined training should be prioritized as they appear to have greater effects on glycemic control than either method alone. Conclusion: The protocol created from this review aims to offer professionals working at the various levels of health care in the SUS, updated, objective information, presented in a didactic way about physical exercise as a form of treatment for DM2. It is recommended that physical exercise protocols include both resistance and aerobic exercise, as their effects are greater on glycemic control than either method alone.
Acesso aberto (Open Access)
A intervenção em dupla-tarefa protege do declínio associado à idade nas atividades em dupla-tarefa
(Universidade Federal do Pará, 2023-04-18) PONTES, Helen Tatiane Santos; TORRES, Natáli Valim Oliver Bento; http://lattes.cnpq.br/1927198788019996; https://orcid.org/0000-0003-0978-211X
Introduction: Older adult’s functionality is related to the ability to divide attention into daily life multitasking activities. The ability to coordinate attention in motor and cognitive activities performed simultaneously decreases with aging, compromising functional ability, and therefore older adults' participation and healthy aging. Objectives: The main objective of the present study is to evaluate the effects of a multimodal physical exercise intervention protocol, at moderate intensity, simultaneously with cognitive stimulation (dual-task) on the dual task cost in healthy community-dwelling older adults. Methods: 70 older adults, with no cognitive disfunction participated in the study. Participants were grouped into a Dual Task Exercise group (DTEx, n=40) who performed the intervention protocol of 24 sessions, twice a week, for 75 minutes, and a control group (CG, n=30) who received information on health education and did not perform physical exercises. Two-way mixed ANOVA was used for dual-task cost analysis and Bonferroni tests were used as post-hoc for within-group and between-group comparisons. The project was registered in the Brazilian Registry of Clinical Trials (UTN code: U1111-1233 6349) and approved by the Research Ethics Committee of the Institute of Health Sciences of the Federal University of Pará (CAAE no. 03427318.3.0000.0018). Results: There was Group x Time interaction (F (1.68) = 7.207 p ≤ 0.009, η2 p = 0.096) observed for the performance of the motor component of the dual task cost. The DTEx group showed maintenance of the gait speed as the motor component of the dual task cost (Assessment = -11.4% ± 3.0; Reassessment = 10.2% ± -2.6, p = 0.665) while the CG showed an increased cost of approximately 49.76% (Assessment: -10.4% ± 3.4; Reassessment: -20.9% ± 3.0 p ≤ 0.002). Significant differences were found on the performance of the motor component of the cost of the dual task between the groups in the post-intervention condition (GC Reassessment: -20.9 ± 3.0. Reassessment DTEx = -10.2% ± -2.6, p ≤ 0.011). No main effects were observed in the assessment of the cost of the cognitive component. Conclusions: The results suggest that moderate-intensity multimodal physical exercise associated with dual-task cognitive stimulation attenuated the decline in the dual-task cost in the older adults. The cost of dual task is an important clinical measure to assess the functional and cognitive ability to perform tasks of daily living in aging.
Acesso aberto (Open Access)
Respostas de um programa de reabilitação locomotora de caminhada nórdica e livre em variáveis fisiomecânicas da marcha de pessoas com doença de Parkinson: um ensaio clínico randomizado
(Universidade Federal do Pará, 2023-04-27) RODRIGUES, Jacqueline Lima; MONTEIRO, Elren Passos; http://lattes.cnpq.br/0920248966438368; https://orcid.org/0000-0001-7757-6620
Introduction: Muscle performance patterns during gait are altered in people with Parkinson's disease. In addition, the analysis of the pendular mechanism is important because it reflects the reduction of muscular effort required to accelerate and raise the center of mass during walking. This inefficient gait pattern in people with Parkinson's disease (PwP) can result in increased energy expenditure during walking, requiring therapeutic interventions that can reduce these symptoms in order to provide greater mobility and quality of life to this population. Recent findings demonstrate that the pendular mechanism (Recovery) is greater with the use of poles, which allows to indicate the hypothesis that a neurofunctional locomotor Nordic walking (NW) rehabilitation program may induce greater adaptations in the pendular mechanism compared to free walking (FW) in individuals with PwP. Objective: To analyze the responses of a neurofunctional locomotor rehabilitation program with and without poles of NW on physiomechanical parameters of gait in PwP. Materials and Methods: This study was characterized as a longitudinal randomized controlled trial, in which we investigated volunteers who met the following eligibility criteria: clinical diagnosis of idiopathic Parkinson's disease, with staging between 1 to 4 on the Hoehn & Yahr (H&Y) scale, sedentary, over 50 years of age, of both sexes. The volunteers were randomized into two groups: NW (with poles) and FW (without poles), and performed the exercises for nine weeks. The evaluations of the physiomechanical parameters, more specifically, Recovery, Internal mechanical work (Wint), Internal mechanical work of the arm, trunk, and leg (Wint arm, Wint trunk, Wint leg, respectively), External mechanical work (Wext), vertical external work (Wext vertical) and horizontal (Wext horizontal), and Total mechanical work (Wtot) of PwP's gait were analyzed during a treadmill walk at a self-selected speed pre- and post-rehabilitation program. A three- dimensional kinematic analysis was performed, with a video capture system composed of six infrared cameras from the VICON Motion Capture System 3D kinematics (Oxford, United Kingdom), with a camera sampling rate of 100 Hz. Thirty-six reflective markers (Vicon Biomechanics Marker Accessories) in the form of a sphere, with a diameter of 14 mm, were used and located on both sides of the body and in the regions of interest. The collected data were analyzed in NEXUS software, tabulated, and organized into spreadsheets in Excel 2016 software. After these steps, mathematical routines were employed in the Matlab® software for calculating the study outcomes. Generalized Estimating Equations were used to compare between groups (NW and FW) at different time points (pre and post). We used H&Y and Froude number values of volunteers as covariates, so that the values were fixed in the statistical model at the following values: H&Y (1.5) and Froude number (0.07). For the analysis of Group, Time, and Group*Time interactions effects, Bonferroni post-hoc was used to identify differences between means in all variables. The effect size was calculated by Hedge's g, and an α=0.05 was adopted. Results: The final sample consisted of 20 volunteers (NW: n=13 and FW: n=7), with NW group (64.23 ± 10.52 years) and FW group (69.71 ± 6.82 years) mean age, NW group (80.07 ± 14.79 kg) and FW group (80.07 ± 14.79 kg) body mass, NW group (1.68 ± 0.07 m) and FW group (1.68 ± 0.06 m) height. Significant differences were found for the factor Time for the Recovery (p=0.04), Wext (p<0.001), horizontal Wext (p=0.04), and vertical Wext (p<0.001) variables. For the interaction Group*Time, significant differences were found for the Wext (p=0.03) and vertical Wext (p=0.02) variables, whereas for the other variables, the values remained similar or were not modified (p>0.05). Conclusion: We concluded that the Recovery was performed more efficiently after the locomotor rehabilitation intervention for both groups, therefore individuals with Parkinson's disease presented a more optimized pendular mechanism. The Wext of individuals with Parkinson's disease who walked with and without poles reduced after the intervention, but the FW group presented lower Wext, meaning less energy was required to move in the environment in relation to the center of mass. Both NW and FW groups reduced their vertical Wext after the rehabilitation program, but the FW group demonstrated lower post-intervention values, indicating that the volunteers did not show as much efficiency in raising their center of mass. Horizontal Wext increased for both groups after the rehabilitation program, demonstrating that both groups showed improvements in their acceleration with respect to projection forward after the intervention. Our findings indicate that the locomotor rehabilitation model with and without sticks can be used by healthcare professionals to rehabilitate locomotion, making the pendular mechanism more optimized and the gait more efficient for mild to severe PwD. Clinical Trials Registration Number: NCT03355521.