Fernanda Veruska Narciso

Avaliação da concavidade lombar pelo método radiográfico e pela cifolordometria

BACKGROUND: Clinical evaluation is the basis for making decisions regarding treatments. When radiographic images cannot be obtained, few resources allow physical therapists to quantitatively evaluate an individuals condition. One of these is the kypholordometer, a low-cost noninvasive instrument proposed for measuring spinal curvature in the sagittal plane. OBJECTIVES: To evaluate the intra- and inter-examiner reliability of the kypholordometer, to investigate its agreement with radiography, and to determine whether there is any correlation between measurements of lumbar curvature using the radiographic method and the kypholordometer. METHODS: Twenty healthy individuals of both sexes aged between 21 and 27 years were evaluated. They underwent radiographic examination of the lumbar spine in right lateral view while standing up. The radiographic images were evaluated by a radiologist using Cobbs method, with T12 and S1 as the reference points. The kypholordometry was carried out in the same position by three evaluators on two occasions, with the same vertebrae as the reference points. A straight line was drawn from T12 to the least prominent vertebra and another from S1 to the same vertebra, thus identifying the degree of lumbar concavity. RESULTS: The results demonstrated that kypholordometry presented excellent levels of reliability (both intra- and inter-examiner), but low agreement with radiography. However, there was a statistically significant positive correlation between the two methods studied (r=0.88). CONCLUSION: Kypholordometry is a quantitative method with excellent intra- and inter-examiner reliability for evaluating lumbar curvature. It may contribute greatly towards the clinical practice of physical therapists.

Avaliação do broncoespasmo induzido pelo exercício avaliado pelo Peak Flow Meter em adolescentes obesos

INTRODUCAO: Criancas e adolescentes com excesso de peso apresentam maior prevalencia de broncoespasmo induzido pelo exercicio (BIE), quando comparados a eutroficos. A espirometria e o peak flow meter sao importantes metodos avaliativos da funcao pulmonar. Porem, a aplicabilidade do medidor do pico de fluxo expiratorio (peak flow meter) na deteccao do BIE em criancas e adolescentes com excesso de peso nao e conhecida, o que justifica o desenvolvimento desta pesquisa. OBJETIVOS: Avaliar e comparar o desencadeamento de broncoespasmo induzido pelo exercicio (BIE) em criancas e adolescentes nao asmaticos com excesso de peso, avaliados pela espirometria e pelo peak flow meter (PFE). CASUISTICA E METODOS: Participaram do estudo 39 voluntarios acima do percentil 85o (OB) e 30 eutroficos (EU), de oito a 15 anos. A avaliacao da funcao pulmonar pre e pos-teste de broncoprovocacao foi realizada pela espirometria e peak flow meter, de acordo com o protocolo de Del Rio-Navarro et al., (2000). O BIE foi considerado positivo quando o voluntario apresentou uma reducao > 10% do VEF1 basal ou reducao > 20% do PFEPFM e/ou PFEE. RESULTADOS: Na deteccao do BIE, a prevalencia do grupo obeso foi de 26% avaliado pelo peak flow meter (PFEPFM) e 23% pelo VEF1. O tempo do BIE ocorreu nos primeiros 15 minutos pos-exercicio em ambos os parâmetros: (PFEPFM) e VEF1. CONCLUSAO: Os voluntarios obesos apresentaram tempo e prevalencias similares de BIE, quando avaliados por ambos os metodos de avaliacao pulmonar. O facil manejo e o baixo custo facilitam a maior acessibilidade para a populacao geral do peak flow meter, o que demonstra sua importância como parte integrante de um programa educacional no diagnostico inicial do BIE em vias aereas de grande calibre.

Robust evaluation of time since awakening using force platform posturography

INTRODUCTION: Sleepiness is responsible for a considerable proportion of traffic accidents. It is thus an important traffic safety issue to find a robust, objective and practical way to estimate the amount of time a person has been awake. To attempt to meet this goal, we investigated the relationship between sleepiness and posture control. METHODS: Subjects were kept awake for 36 hours and posturographic data during quiet standing were collected every two hours by means of a force platform. The standing surface (rigid surface or foam surface) and visual (eyes open or eyes closed) conditions were manipulated. RESULTS: In the more challenging conditions (with foam surface and/or eyes closed), the body sway variables derived from the center of the pressure measurement increased significantly when time since awakening became greater than 21 h in almost all subjects. CONCLUSION: Based on this result, we propose a practical protocol that could robustly assess whether time since awakening was greater than 21 h.

Effects of Shift Work on the Postural and Psychomotor Performance of Night Workers

The purpose of the study was to investigate the effects of shift work on the psychomotor and postural performance of night workers. The study included 20 polysomnography technicians working schedule of 12-h night shift by 36-h off. On the first day of protocol, the body mass and height were measured, and an actigraph was placed on the wrist of each participant. On the second day of protocol, sleepiness by Karolinska Sleepiness Scale, postural control by force platform (30 seconds) and psychomotor performance by Psychomotor Vigilance Task (10 minutes) were measured before and after 12-h night work. Results showed that after 12-h night work, sleepiness increased by 59% (p<0.001), postural control variables increased by 9% (p = 0.048), and 14% (p = 0.006). Mean reaction time, and the number of lapses of attention increased by 13% (p = 0.006) and 425% (p = 0.015), respectively, but the mean reciprocal reaction time decreased by 7%. In addition, there were correlations between sleepiness and postural control variables with opened eyes (r = 0.616, 95% confidence interval [CI] = 0.361–0.815; r = 0.538; 95% CI = 0.280–0.748) and closed eyes (r = 0.557; 95% CI = 0.304–0.764, r = 0497; 95% CI = 0.325–0.715) and a pronounced effect of sleepiness on postural sway (R2 = 0.393; 95% CI = 0.001–0.03). Therefore, 12-h night work system and sleepiness showed a negative impact in postural and psychomotor vigilance performance of night workers. As unexpected, the force platform was feasibility to detect sleepiness in this population, underscoring the possibility of using this method in the workplace to prevent occupational injuries and accidents.

Effect of bright light therapy on delayed sleep/wake cycle and reaction time of athletes participating in the Rio 2016 Olympic Games

ABSTRACT This study investigated the effect of using an artificial bright light on the entrainment of the sleep/wake cycle as well as the reaction times of athletes before the Rio 2016 Olympic Games. A total of 22 athletes from the Brazilian Olympic Swimming Team were evaluated, with the aim of preparing them to compete at a time when they would normally be about to go to bed for the night. During the 8-day acclimatization period, their sleep/wake cycles were assessed by actigraphy, with all the athletes being treated with artificial light therapy for between 30 and 45 min (starting at day 3). In addition, other recommendations to improve sleep hygiene were made to the athletes. In order to assess reaction times, the Psychomotor Vigilance Test was performed before (day 1) and after (day 8) the bright light therapy. As a result of the intervention, the athletes slept later on the third (p = 0.01), seventh (p = 0.01) and eighth (p = 0.01) days after starting bright light therapy. Regarding reaction times, when tested in the morning the athletes showed improved average (p = 0.01) and minimum reaction time (p = 0.03) when comparing day 8 to day 1. When tested in the evening, they showed improved average (p = 0.04), minimum (p = 0.03) and maximum reaction time (p = 0.02) when comparing day 8 to day 1. Light therapy treatment delayed the sleep/wake cycles and improved reaction times of members of the swimming team. The use of bright light therapy was shown to be effective in modulating the sleep/wake cycles of athletes who had to perform in competitions that took place late at night.

Segurança e saúde dos motoristas profissionais que trafegam nas rodovias do Brasil

RESUMO Acidentes de trânsito com consequentes lesoes e mortes tem se tornado uma epidemia em nivel mundial. No Brasil, a maioria dos motoristas profissionais, sobretudo motoristas de transporte de cargas, enfrenta jornada de trabalho irregular e permanece acordado por mais de 18 horas/dia, o que reduz seu desempenho e estado de alerta. Neste artigo, discutimos […]ABSTRACT Traffic accidents and resulting injuries and deaths have become a global epidemic. In Brazil, most professional drivers, especially truck drivers, face irregular working hours and can be awake for more than 18 hours/day, which reduces their performance and alertness. In this article, we discuss the laws related to Brazilian professional drivers and their current amendments (No. 12,619/2012 and No. 13,103/2015) in relation to working hours at the wheel and rest breaks, which are vital for the quality of life of drivers and society in general. We note that the new law appears to be less efficient than the previous one as it causes insecurity and concern to the users of the transportation system, drivers, and employers. To restrict and reduce accidents, deaths, and injuries in traffic, appropriate legislation is essential, aiming at the safety of workers and users of highways. The law must also benefit the commercial aspect, strengthening the reduction in production and logistics losses. Additionally, traffic education programs are needed, as well as better supervision in relation to total working hours.

Maquinistas ferroviários: trabalho em turnos e repercussões na saúde

Objective to describe the impact of shiftwork on the health, sleep and quality of life of railway drivers. Methods six hundred eleven railway drivers (schedule 4x1 and 6x2) were evaluated by polysomnography, Pittsburgh Sleep Quality Index, Insomnia Severity Index, Work Capacity Index, Quality of Life questionnaire (SF-36), Morningness-eveningness questionnaire (MEQ), and Epworth Sleepiness Scale. 
Results railway drivers assessed were 36.6 ± 15.1 years of age, 22% were obese, and 38.1% presented risks for cardiovascular disease. Poor sleep quality 64.2%, 11.6% had sleep disorders and 29.3% excessive sleepiness. The polysomnography results showed that 36.1% of them presented sleep apnea and 47.2% had significant reduction in sleep efficiency. The railway drivers showed low levels of quality of life, especially those working under the 4x1 schedule. Conclusion it is possible to assert that exposure to shiftwork, reverse rotation schedule, few days off, and working overtime are associated with impairment to well-being, health, sociability and workers’ sleep quality, and the factors related to shiftwork probably contribute to these findings.