Rodrigo da Rosa Iop

Effects of Physical-Exercise-Based Rehabilitation Programs on the Quality of Life of Patients With Parkinson’s Disease: A Systematic Review of Randomized Controlled Trials

This study aimed to determine the effects of physical-exercise-based rehabilitation programs on quality of life of patients with Parkinsons disease through a systematic review of randomized clinical trials. For this purpose the following electronic databases were selected: Medline by PubMed, Cochrane, Web of Science, and PEDro. The search strategy included the proposed descriptors in the Medical Subject Headings (MeSH), associated with a sensitive list of terms to search for randomized controlled trials (RCTs), without year and language restrictions. Fourteen studies were potentially relevant, and these studies were included. Physical-exercise-based rehabilitation programs realized 2-4 times a week, 60 min each session, for 6-12 weeks, and follow-up of 3 months promotes significant positive effects on quality of life in Parkinsons disease patients at mild to moderate stages and disease duration around 6 years.

Efeito do treinamento combinado e aeróbio no controle glicêmico no diabetes tipo 2

INTRODUCAO: O diabetes tipo 2 e um grupo heterogeneo de doenca metabolica causada por uma disfuncao na secrecao da insulina e/ou acao desta. OBJETIVOS: Comparar o efeito de duas modalidades de treinamento, o combinado (aerobio e resistido) e o aerobio, no controle glicemico no diabetes tipo 2. MATERIAIS E METODOS: A pesquisa caracteriza-se por ser um estudo quase-experimental. Apos aprovacao do CEP, com registro 09.071.4.08. III, deu-se inicio ao programa de treinamento combinado e aerobio. Foram selecionados 24 participantes, de ambos os generos, sedentarios, com media de idade de 60,41 ± 7,87. Os participantes foram divididos aleatoriamente em dois grupos: treinamento combinado (n = 12) e treinamento aerobio (n = 12); ambos foram avaliados no inicio e final do estudo. A concentracao serica de glicose foi determinada pelo sistema Vitros e a hemoglobina glicosilada foi determinada pelo metodo Cromatografia Liquida de Alta Performance. O treinamento foi realizado tres vezes por semana, com duracao total de 20 semanas. Os dados sao expressos em media e desvio-padrao. Foi aplicado o teste t pareado (p < 0,05) para comparar a media basal e apos 20 semanas de treinamento. RESULTADOS: A media da glicose em jejum do treinamento combinado reduziu significativamente, de 167,41 ± 38,13 para 119,83 ± 20,91, sendo que o mesmo ocorreu com o treinamento aerobio de 189,83 ± 63,57 para 139,91 ± 34,04. Os valores da hemoglobina glicosilada no treinamento combinado e treinamento aerobio reduziram significativamente, de 8,61 ± 1,17 para 7,25 ± 1,24 e de 9,52 ± 2,46 para 8,37 ± 1,50, respectivamente. CONCLUSAO: O treinamento combinado foi mais eficaz em relacao a hemoglobina glicosilada e o treinamento aerobio, na glicose plasmatica.

Efeitos da caminhada nórdica na doença de Parkinson: uma revisão sistemática de ensaios clínicos randomizados

Several exercise modalities improve the symptoms of Parkinson’s Disease (PD). Among the variety of physical exercises, Nordic walking has been used. The aim of this study was to summarize scientific literature on effects of Nordic walking on patients with PD by a systematic review of randomized clinical trials. The following electronic databases were selected: MEDLINE by Pubmed, Cochrane, PEDro, SCOPUS and Web of Science and articles identified by manual search, without restriction of date and language. The reviewers evaluated the articles and selected studies according to the eligibility criteria. The following data were extracted from the selected studies: publication identification, participants’ characteristics (sex, age, disease stage, duration of disease), experimental intervention characteristics, control group characteristics, duration, follow-up time, outcome measures and main results. Nordic walking programs with moderate and high intensities, with a minimum of 12 sessions of 60 minutes in a period from 6 to 24 weeks promoted positive effects on the severity, gait, balance, quality of life, functional capacity and motor function in patients with PD.

Avaliação do equilíbrio corporal de pacientes com artrite reumatoide

| Postural control, stability in voluntary movements in response to external disturbances and proprioception are basic elements for maintaining balance. People with Rheumatoid Arthritis (RA) have difficulty maintaining postural control, undermining the balance in the Activities of Daily Living (ADL’s), making it an important risk factor for falls. The present study aimed to evaluate the body balance of individuals with RA, according to the level of disease activity. We evaluated 24 individuals with 54.66±9.52 years. All underwent a questionnaire identification and medical history, anthropometric measurements, blood sampling for analysis of C-Reactive Protein (CRP), determining the level of disease activity using the DAS-28 and equilibrium through tests: Berg Balance Scale (BBS) and TUG. Patients were divided into three groups: low, moderate and high disease activity. The results of equilibrium tests showed that, although the sample has presented low risk for falls, the group in high disease activity had higher frequency distribution (57.2%) in scores between 48–52 in the BBS compared to the moderate activity group, whose frequency distribution prevailed in the scores between 53 and 56 (92.3%-p≤0.05). It was also observed differences in the time of the TUG execution between groups high (11.86±4.62 s) and moderate (9.71±0.90 s) disease activity (p≤0.05). These data show that the levelControle postural, estabilidade nos movimentos voluntarios, reacao as perturbacoes externas e propriocepcao constituem elementos basicos para a manutencao do equilibrio. Pessoas com Artrite Reumatoide (AR) tem dificuldade em manter o controle postural, prejudicando o equilibrio nas Atividades de Vida Diarias (AVDs), tornando-se um importante fator de risco para quedas. O presente estudo teve por objetivo avaliar o equilibrio corporal de individuos com AR, em funcao do nivel de atividade da doenca. Foram avaliados 24 individuos com 54,66±9,52 anos. Todos foram submetidos a aplicacao de questionario de identificacao e historia clinica, avaliacoes antropometricas, coleta de amostra sanguinea para analise de Proteina C-Reativa (PCR), determinacao do nivel de atividade da doenca por meio do Disease Activity Score (DAS-28) e avaliacao do equilibrio atraves dos testes: Escala de Equilibrio de Berg (EEB) e Timed Up and Go (TUG). Os pacientes foram divididos em tres grupos: baixa, moderada e alta atividade da doenca. Os resultados dos testes de equilibrio demonstraram que, embora a amostra tenha apresentado baixo risco para quedas, o grupo em alta atividade da doenca apresentou maior distribuicao de frequencia (57,2%) nos escores entre 48-52 na EEB, em comparacao ao grupo moderada atividade, cuja distribuicao de frequencia predominou nos escores entre 53 e 56 (92,3%-p<0,05). Tambem foi verificada diferenca no tempo de execucao do TUG, entre os grupos alta (11,86±4,62s) e moderada (9,71±0,90s) atividade da doenca (p<0,05). Estes dados evidenciam que o nivel de atividade da doenca pode influenciar na realizacao dos testes EEB e TUG, sugerindo um aumento do risco de quedas ou ate mesmo uma dependencia na realizacao de suas AVDs em funcao do aumento do nivel de atividade da doenca.

Evaluation of body balance in rheumatoid arthritis patients

| Postural control, stability in voluntary movements in response to external disturbances and proprioception are basic elements for maintaining balance. People with Rheumatoid Arthritis (RA) have difficulty maintaining postural control, undermining the balance in the Activities of Daily Living (ADL’s), making it an important risk factor for falls. The present study aimed to evaluate the body balance of individuals with RA, according to the level of disease activity. We evaluated 24 individuals with 54.66±9.52 years. All underwent a questionnaire identification and medical history, anthropometric measurements, blood sampling for analysis of C-Reactive Protein (CRP), determining the level of disease activity using the DAS-28 and equilibrium through tests: Berg Balance Scale (BBS) and TUG. Patients were divided into three groups: low, moderate and high disease activity. The results of equilibrium tests showed that, although the sample has presented low risk for falls, the group in high disease activity had higher frequency distribution (57.2%) in scores between 48–52 in the BBS compared to the moderate activity group, whose frequency distribution prevailed in the scores between 53 and 56 (92.3%-p≤0.05). It was also observed differences in the time of the TUG execution between groups high (11.86±4.62 s) and moderate (9.71±0.90 s) disease activity (p≤0.05). These data show that the levelControle postural, estabilidade nos movimentos voluntarios, reacao as perturbacoes externas e propriocepcao constituem elementos basicos para a manutencao do equilibrio. Pessoas com Artrite Reumatoide (AR) tem dificuldade em manter o controle postural, prejudicando o equilibrio nas Atividades de Vida Diarias (AVDs), tornando-se um importante fator de risco para quedas. O presente estudo teve por objetivo avaliar o equilibrio corporal de individuos com AR, em funcao do nivel de atividade da doenca. Foram avaliados 24 individuos com 54,66±9,52 anos. Todos foram submetidos a aplicacao de questionario de identificacao e historia clinica, avaliacoes antropometricas, coleta de amostra sanguinea para analise de Proteina C-Reativa (PCR), determinacao do nivel de atividade da doenca por meio do Disease Activity Score (DAS-28) e avaliacao do equilibrio atraves dos testes: Escala de Equilibrio de Berg (EEB) e Timed Up and Go (TUG). Os pacientes foram divididos em tres grupos: baixa, moderada e alta atividade da doenca. Os resultados dos testes de equilibrio demonstraram que, embora a amostra tenha apresentado baixo risco para quedas, o grupo em alta atividade da doenca apresentou maior distribuicao de frequencia (57,2%) nos escores entre 48-52 na EEB, em comparacao ao grupo moderada atividade, cuja distribuicao de frequencia predominou nos escores entre 53 e 56 (92,3%-p<0,05). Tambem foi verificada diferenca no tempo de execucao do TUG, entre os grupos alta (11,86±4,62s) e moderada (9,71±0,90s) atividade da doenca (p<0,05). Estes dados evidenciam que o nivel de atividade da doenca pode influenciar na realizacao dos testes EEB e TUG, sugerindo um aumento do risco de quedas ou ate mesmo uma dependencia na realizacao de suas AVDs em funcao do aumento do nivel de atividade da doenca.

Effects of physical exercise programs on cognitive function in Parkinson’s disease patients: A systematic review of randomized controlled trials of the last 10 years

Background Given the relative importance of cognitive impairment, there was considerable interest in identifying the cognitive profile of PD patients, in order to ensure specific and appropriate therapeutic interventions. Purpose To determine the effects of physical exercise programs on cognitive function in PD patients, compared with the control group. Data sources Medline, Cochrane, Scopus, PEDro and Web of Science (last searched in September 2016). Study selection Randomized clinical trials examining the effects of physical exercise programs and cognitive function in PD patients. Nine studies fulfilled the selection criteria and were included in this review. Data extraction Characteristics of the publication, characteristics of the participants, test used for cognitive screening, cognitive domain assessed, tools used to assess cognitive function, characteristics of the experimental intervention, characteristics of the control group, mean results and standard deviation of function cognitive. The PEDro score was used to evaluate methodological quality. Data synthesis Most eligible studies showed good methodological quality based on the PEDro scale. Studies have shown that adapted tango for PD patients, cognitive training combined with motor training, and treadmill training promote the preservation or improvement of cognitive function in PD patients. Limitations The diversity of cognitive tests used to assess cognitive function and the high heterogeneity identified between the physical exercise programs. Conclusions Physical exercise programs promote positive and significant effects on global cognitive function, processing speed, sustained attention and mental flexibility in PD patients, at a mild to moderate stage for patients with a 6-year clinical diagnosis of PD. However, treadmill training performed 3 times a week for about 60 minutes and for a period of 24 weeks produced larger improvements in cognition.

Instrumentos que avaliam a independência funcional em crianças com paralisia cerebral: uma revisão sistemática de estudos observacionais

This article aimed to do a systematic review of instruments that assess functional independence of children with cerebral palsy. We used MEDLINE/Pubmed, Scopus, and Web of Science for the search. Observational studies of the past five years, with full text available and without language restriction, were included in this review. We found 222 articles, of which 63 were analyzed and 24 were included in the study. The main instruments found were: PEDI, WeeFIM, ASK, PODCI, VABS-II, LIFE-H, and CAPE/PAC.| This article aimed to do a systematic review of instruments that assess functional independence of children with cerebral palsy. We used MEDLINE/Pubmed, Scopus, and Web of Science for the search. Observational studies of the past five years, with full text available and without language restriction, were included in this review. 318 We found 222 articles, of which 63 were analyzed and 24 were included in the study. The main instruments found were: PEDI, WeeFIM, ASK, PODCI, VABS-II, LIFE-H, and

Instrumentos que evalúan la independencia funcional en niños con parálisis cerebral: revisión sistemática de estudios observacionales

This article aimed to do a systematic review of instruments that assess functional independence of children with cerebral palsy. We used MEDLINE/Pubmed, Scopus, and Web of Science for the search. Observational studies of the past five years, with full text available and without language restriction, were included in this review. We found 222 articles, of which 63 were analyzed and 24 were included in the study. The main instruments found were: PEDI, WeeFIM, ASK, PODCI, VABS-II, LIFE-H, and CAPE/PAC.| This article aimed to do a systematic review of instruments that assess functional independence of children with cerebral palsy. We used MEDLINE/Pubmed, Scopus, and Web of Science for the search. Observational studies of the past five years, with full text available and without language restriction, were included in this review. 318 We found 222 articles, of which 63 were analyzed and 24 were included in the study. The main instruments found were: PEDI, WeeFIM, ASK, PODCI, VABS-II, LIFE-H, and

Instruments that evaluate functional independence in children with Cerebral Palsy: a systematic review of observational studies

This article aimed to do a systematic review of instruments that assess functional independence of children with cerebral palsy. We used MEDLINE/Pubmed, Scopus, and Web of Science for the search. Observational studies of the past five years, with full text available and without language restriction, were included in this review. We found 222 articles, of which 63 were analyzed and 24 were included in the study. The main instruments found were: PEDI, WeeFIM, ASK, PODCI, VABS-II, LIFE-H, and CAPE/PAC.| This article aimed to do a systematic review of instruments that assess functional independence of children with cerebral palsy. We used MEDLINE/Pubmed, Scopus, and Web of Science for the search. Observational studies of the past five years, with full text available and without language restriction, were included in this review. 318 We found 222 articles, of which 63 were analyzed and 24 were included in the study. The main instruments found were: PEDI, WeeFIM, ASK, PODCI, VABS-II, LIFE-H, and

Aspecto sociodemográfico, clínico e qualidade de vida em pacientes com artrite reumatoide

Objective: To characterize the sociodemographic clinical aspects and quality of life of patients with rheumatoid arthritis (RA). Methods: This was a descriptive, cross-sectional quantitative research that evaluated 22 individuals with RA over 18 years old, regardless of sex. Participants were referred to the Mulstisectoral Analysis Laboratory of the State University of Santa Catarina by rheumatologists of the Brazilian National Health System in the period from June to September 2010. It was used a form to obtain sociodemographic and clinical data, the level of disease activity (Disease Activity Score 28) and the Quality of Life Questionnaire (36 Item Short-Form Health Survey). Results: There was a prevalence of female gender, with 81.8% (n=18); white ethnicity, with 90.9% (n=20); and sixth decade of life, with 60 (±12.9) years for male gender. Among the symptoms, 17 individuals (77.3%) reported pain as the main complaint. Regarding the level of disease activity, the mean values were 4.47±1.56 with a prevalence of 10 patients (45.5%) presenting moderate activity. Concerning QoL, it was found a significant difference in the domains pain / social aspect and the level of disease activity (p <0.05). Regarding the domain pain, there was a significant difference when comparing the groups high and low disease activity (p<0.01) and between the low and moderate groups (p <0.01). Conclusion: It was possible to identify in the individuals with RA participating in this study a deficit in their general state of health. Additionally, the high level of disease activity interfered with painful symptomatology and hindered social aspects. doi:10.5020/18061230.2014.p5