Rodrigo Cappato de Araújo

Motor competence and health related physical fitness in youth: a systematic review

OBJECTIVES This study aimed to review the scientific evidence on associations between motor competence (MC) and components of health related physical fitness (HRPF), in children and adolescents. DESIGN Systematic review. METHODS Systematic search of Academic Search Premier, ERIC, PubMed, PsycInfo, Scopus, SportDiscus, and Web of Science databases was undertaken between October 2012 and December 2013. Studies examining associations between MC and HRPF components (body weight status, cardiorespiratory fitness, musculoskeletal fitness and flexibility) in healthy children and adolescents, published between 1990 and 2013, were included. Risk of bias within studies was assessed using CONSORT and STROBE guidelines. The origin, design, sample, measure of MC, measure of the HRPF, main results and statistics of the studies were analyzed and a narrative synthesis was conducted. RESULTS Forty-four studies matched all criteria; 16 were classified as low risk of bias and 28 as medium risk. There is strong scientific evidence supporting an inverse association between MC and body weight status (27 out of 33 studies) and a positive association between MC and cardiorespiratory fitness (12 out of 12 studies) and musculoskeletal fitness (7 out of 11 studies). The relationship between MC and flexibility was uncertain. CONCLUSIONS Considering the noted associations between various assessments of MC and with multiple aspects of HRPF, the development of MC in childhood may both directly and indirectly augment HRPF and may serve to enhance the development of long-term health outcomes in children and adolescents.

Electromyographic Amplitude Ratio of Serratus Anterior and Upper Trapezius Muscles During Modified Push-ups and Bench Press Exercises

Imbalance and weakness of the serratus anterior and upper trapezius force couple have been described in patients with shoulder dysfunction. There is interest in identifying exercises that selectively activate these muscles and including it in rehabilitation protocols. This study aims to verify the UT/SA electromyographic (EMG) amplitude ratio, performed in different upper limb exercises and on two bases of support. Twelve healthy men were tested (average age = 22.8 ± 3.1 years), and surface EMG was recorded from the upper trapezius and serratus anterior using single differential surface electrodes. Volunteers performed isometric contractions over a stable base of support and on a Swiss ball during the wall push-up (WP), bench press (BP), and push-up (PU) exercises. All SEMG data are reported as a percentage of root mean square or integral of linear envelope from the maximal value obtained in one of three maximal voluntary contractions for each muscle studied. A linear mixed-effect model was performed to compare UT/SA ratio values. The WP, BP, and PU exercises showed UT/SA ratio mean ± SD values of 0.69 ± 0.72, 0.14 ± 0.12, and 0.39 ± 0.37 for stable surfaces, respectively, whereas for unstable surfaces, the values were 0.73 ± 0.67, 0.43 ± 0.39, and 0.32 ± 0.30. The results demonstrate that UT/SA ratio was influenced by the exercises and by the upper limb base of support. The practical application is to show that BP on a stable surface is the exercise preferred over WP and PU on either surfaces for serratus anterior muscle training in patients with imbalance between the UT/SA force couple or serratus anterior weakness.

Activation of selected shoulder muscles during unilateral wall and bench press tasks under submaximal isometric effort.

STUDY DESIGN Controlled laboratory study. OBJECTIVE To assess the activation of 7 shoulder muscles under 2 closed kinetic chain (CKC) tasks for the upper extremity using submaximal isometric effort, thus providing relative quantification of muscular isometric effort for these muscles across the CKC exercises, which may be applied to rehabilitation protocols for individuals with shoulder weakness. BACKGROUND CKC exercises favor joint congruence, reduce shear load, and promote joint dynamic stability. Additionally, knowledge about glenohumeral and periscapular muscle activity elicited during CKC exercises may help clinicians to design protocols for shoulder rehabilitation. METHODS Using surface electromyography, activation level was measured across 7 shoulder muscles in 20 healthy males, during the performance of a submaximal isometric wall press and bench press. Signals were normalized to the maximal voluntary isometric contraction, and, using paired t tests, data were analyzed between the exercises for each muscle. RESULTS Compared to the wall press, the bench press elicited higher activity for most muscles, except for the upper trapezius. Levels of activity were usually low but were above 20% maximal voluntary isometric contraction for the serratus anterior on both tasks, and for the long head triceps brachii on the bench press. CONCLUSIONS Both the bench press and wall press, as performed in this study, led to relatively low EMG activation levels for the muscles measured and may be considered for use in the early phases of rehabilitation.

Low and high-frequency TENS in post-episiotomy pain relief: a randomized, double-blind clinical trial

Objective To evaluate the effectiveness of low-frequency TENS (LFT) and high-frequency TENS (HFT) in post-episiotomy pain relief. Method A randomized, controlled, double-blind clinical trial with placebo composed of 33 puerperae with post-episiotomy pain. TENS was applied for 30 minutes to groups: HFT(100 Hz; 100 µs), LFT (5 Hz; 100 µs), and placebo (PT). Four electrodes were placed in parallel near the episiotomy and four pain evaluations were performed with the numeric rating scale. The first and the second evaluation took place before TENS application and immediately after its removal and were done in the resting position and in the activities of sitting and ambulating. The third and fourth evaluation took place 30 and 60 minutes after TENS removal, only in the resting position. Intragroup differences were verified using the Friedman and Wilcoxon tests, and the intergroup analysis employed the Kruskal-Wallis test. Results In the intragroup analysis, there was no significant difference in the PT during rest, sitting, and ambulation (P>0.05). In the HFT and LFT, a significant difference was observed in all activities (P<0.001). In the intergroup analysis, there was a significant difference in the resting position in the HFT and LFT (P<0.001). In the sitting activity, a significant difference was verified in the second evaluation in the HFT and LFT (P<0.008). No significant difference was verified among the groups in ambulation (P<0.20). Conclusions LFT and HFT are an effective resource that may be included in the routine of maternity wards.

Lombalgia gestacional: prevalência e características clínicas em um grupo de gestantes

JUSTIFICATIVA E OBJETIVOS: A lombalgia gestacional e uma das principais queixas durante a gestacao, sendo responsavel por inumeras repercussoes negativas na qualidade de vida da gestante. O objetivo deste estudo foi determinar a prevalencia dos tipos de lombalgia e suas caracteristicas em gestantes. METODO: Trata-se de estudo transversal descritivo realizado com 21 gestantes que realizavam consulta pre-natal no municipio de Petrolina-PE. Foi realizado exame fisico composto por testes especificos para classificacao da lombalgia e aplicado um questionario que abordava informacoes sociodemograficas e obstetricas. Para analise dos dados, foi aplicada estatistica descritiva no programa SPSS e intervalo de confianca (IC95%). RESULTADOS: Das gestantes analisadas 95,23% [IC95% 76,18 - 99,88] relataram dor lombar durante a gestacao, sendo que 71,43% [IC95% 47,82 - 88,72] apresentavam-na previamente a gestacao. A maioria das gestantes, 57,14% [IC95% 34,02 - 78,18], relatou sentir dor com duracao superior a 60 minutos. A combinacao de dor lombar com dor pelvica posterior foi verificada em 66,65% [IC95% 43,03 - 85,41] das gestantes, e 28,58% [IC95% 11,28 - 52,18] apresentaram somente dor lombar. CONCLUSAO: Observou-se alta prevalencia de lombalgia nas gestantes analisadas, demonstrando ser fundamental o emprego de medidas educativas, preventivas e reabilitadoras, devido ao impacto negativo que as alteracoes advindas da gravidez podem ocasionar na qualidade de vida das gestantes. A inclusao do fisioterapeuta como participante das acoes do Programa de Saude da Familia com atuacao em grupos de gestantes e fundamental para melhora das praticas assistenciais.

Reliability and validity of the Brazilian version of the Pittsburgh Sleep Quality Index in adolescents

OBJECTIVE To evaluate the reliability and validity of the Brazilian version of the Pittsburgh Sleep Quality Index. METHODS 309 adolescents, subdivided into a sample of 209 subjects, of whom 25 were reassessed, and another sample of 100 adolescents. Reliability was assessed using Cronbachs α-values, intraclass correlation coefficient, Standard Error of Measure, Minimum Detectable Change, and Bland-Altman plotting. Exploratory analysis of the questionnaire components was performed based on the sample of 209 adolescents. Confirmatory factor analysis was performed with a sample of 100 individuals. RESULTS The sample of 209 participants had a mean age of 14.38 (±1.94) years, comprising 80 (38.3%) girls and 129 (61.7%) boys. The sample of 100 adolescents had a mean age of 13.66 (±2.35) years, comprising 51 (51%) girls and 49 (49%) boys. The questionnaire obtained a Standard Error of Measure=1.12 and Minimum Detectable Change=3.10. Cronbachs α was 0.71 and the Intraclass Correlation Coefficient was 0.65 (95% CI: 0.21-0.85). The factor analysis showed that the best model of components was the one that consisted of two factors, excluding the component on the use of sleep medications. CONCLUSION The questionnaire showed high internal consistency and moderate reliability. Furthermore, a model with two factors seems to be the most appropriate to evaluate the quality of sleep in adolescents.

Prevalência de cefaleia em adolescentes e associação com uso de computador e jogos eletrônicos

The aim of this study was to determine the prevalence of headache in adolescents and its association with excessive use of electronic devices and games. The sample comprised 954 adolescents of both sexes (14 to 19 years) who answered a questionnaire about use of computers and electronic games, presence of headache and physical activity. The binary and multinomial logistic regression, with significance level of 5% was used for inferential analysis. The prevalence of headache was 80.6%. The excessive use of electronics devices proved to be a risk factor (OR = 1.21) for headache. Subjects aged between 14 and 16 years were less likely to report headache (OR = 0.64). Regarding classification, 17.9% of adolescents had tension-type headache, 19.3% had migraine and 43.4% other types of headache. The adolescents aged form 14 to 16 years had lower chance (OR ≤ 0.68) to report the tension-type headache and other types of headache. The excessive use of digital equipment, electronic games and attending the third year of high school proved to be risk factors for migraine-type development (OR ≥ 1.84). There was a high prevalence of headache in adolescents and high-time use of electronic devices. We observed an association between excessive use of electronic devices and the presence of headache, and this habit is considered a risk factor, especially for the development of migraine-type.

Prevalência e impacto da incontinência urinária na qualidade de vida de idosas institucionalizadas

A incontinencia urinaria (IU) e definida como qualquer perda involuntaria de urina. Acomete mulheres de varias faixas etarias e apresenta alta incidencia em idosas, afetando de forma significativa a qualidade de vida. O objetivo deste estudo foi determinar a prevalencia de IU em idosas institucionalizadas e verificar sua influencia na qualidade de vida. A amostra foi composta por 40 idosas institucionalizadas dos municipios de Petrolina e Juazeiro que tinham idade igual ou superior a 60 anos. Inicialmente, foram coletadas informacoes sociodemograficas, ginecologicas e sobre a presenca de IU. Em seguida, as idosas que relataram perda de urina responderam ao questionario especifico Kings Health Questionnaire (KHQ). A analise de dados foi feita por meio de estatistica descritiva. A presenca de IU foi referida por 47,50% das idosas. O dominio do KHQ que sofreu maior interferencia na qualidade de vida foi o de percepcao de saude com 51,31%; nos outros dominios, o impacto da IU foi considerado baixo, mas na escala de sintomas as idosas relataram que a IU afeta mais ou menos ou muito sua vida. Foi possivel concluir que e elevada a prevalencia de IU em idosas institucionalizadas, e observar que muitas vezes essas mulheres convivem com estes sintomas como algo intrinseco ao envelhecimento, nao percebendo o quanto afetam sua qualidade de vida.

Shoulder Muscle Activation Levels During the Push-Up Plus Exercise on Stable and Unstable Surfaces.

The aim of this study was to evaluate the acute effect of the use of stable and unstable surfaces on electromyography (EMG) activity and coactivation of the scapular and upper-limb muscles during the push-up plus (with full protraction of the scapula). Muscle activation of anterior deltoid (AD), posterior deltoid (PD), pectoralis major, biceps brachii (BB), triceps brachii (TB), upper trapezius (UT), middle trapezius (MT), lower trapezius (LT), and serratus anterior (SA) levels and coactivation index were determined by surface EMG in 20 young men during push-up plus performed on a stable and unstable condition (2 unstable devices applied to hands and feet). The paired t test and Cohen d were used for statistical analysis. The results showed that during the execution of the push-up plus on the unstable surface an increased EMG activity of the scapular stabilizing muscles (SA, MT, and LT) was observed, while AD and PD muscles showed a decrease. During exercise execution on the unstable surface there was a higher index of coactivation of the scapular muscles (SA-MT and UT-LT pairs). No significant differences were observed in TB-BB and AD-PD pairs. These results suggest that the push-up-plus exercise associated with unstable surfaces produced greater EMG activity levels and coactivation index of the scapular stabilizing muscle. On the other hand, the use of an unstable surface does not promote the same effect for the shoulder muscles.

Prevalence of musculoskeletal pain in adolescents and association with computer and videogame use

OBJECTIVE This study investigated the presence of musculoskeletal symptoms in high school adolescents from public schools and its association with electronic device use. METHODS The sample consisted of 961 boys and girls aged 14-19 years who answered a questionnaire regarding the use of computers and electronic games, and questions about pain symptoms and physical activity. Furthermore, anthropometric assessments of all volunteers were performed. The chi-squared test and a multiple logistic regression model were used for the inferential analysis. RESULTS The presence of musculoskeletal pain symptoms was reported by 65.1% of the adolescents, being more prevalent in the thoracolumbar spine (46.9%), followed by pain in the upper limbs, representing 20% of complaints. The mean time of use for computers and electronic games was 1.720 and 583 minutes per week, respectively. The excessive use of electronic devices was demonstrated to be a risk factor for cervical and lumbar pain. Female gender was associated with the presence of pain in different body parts. Presence of a paid job was associated with cervical pain. CONCLUSION A high prevalence of musculoskeletal pain in adolescents, as well as an increased amount of time using digital devices was observed. However, it was only possible to observe an association between the increased use of these devices and the presence of cervical and low back pain.