Samária Ali Cader

Pilates method in personal autonomy, static balance and quality of life of elderly females

OBJECTIVE The aim of this study was to evaluate the effects of the Pilates method on the personal autonomy, static balance and quality of life in healthy elderly females. METHOD Fifty-two elderly females were selected and submitted to evaluation protocols to assess functional autonomy (GDLAM), static balance (Tinetti) and quality of life (WHOQOL-OLD). The Pilates group (PG: n=27) participated in Pilates exercises twice weekly for eight weeks. Descriptive statistics were compiled using the Shapiro-Wilk test. The level of significance was considered to be p< or =0.05. RESULTS The dependent Student-t test demonstrated significant post-test differences in the Pilates group in the following areas balance (Delta%=4.35%, p=0.0001) and General Index of GDLAM (Delta%=-13.35%, p=0.0001); the Wilcoxon test demonstrated significant post-test differences in the quality of life Index (Delta%=1.26%, p=0.0411). CONCLUSION The Pilates method can offer significant improvement in personal autonomy, static balance and quality of life.

Aerobic resistance, functional autonomy and quality of life (QoL) of elderly women impacted by a recreation and walking program

The present study had as a goal to analyze the impact of a physical activity program (recreation and walking) over the aerobic resistance, the functional autonomy and the quality of life of elderly women. To this experimental study the elderly women (65±6.40 years old) were randomly separated in experimental group (EG, n=31) and a control group (CG, n=28). A 6-min-walking test (aerobic resistance); a protocol of autonomy evaluation of the Latin-American Group for Maturity Development (functional autonomy), and the WHO QoL-old tests were utilized. The intervention happened with classes of recreation and walking practice, three times a week, for 1h, during 4 months. The results found revealed significant improvement for the EG at the aerobic resistance (Δ%=29.06%, p=0.0001), functional autonomy (Δ%=-27.15%, p=0.0001) and QoL (Δ%=15.47%, p=0.0001). It was concluded that the systematic physical exercise interferes in a positive way at the autonomy, aerobic resistance and QoL of the elderly women.

Extubation process in bed-ridden elderly intensive care patients receiving inspiratory muscle training: a randomized clinical trial

Background The purpose of this study was to evaluate the extubation process in bed-ridden elderly intensive care patients receiving inspiratory muscle training (IMT) and identify predictors of successful weaning. Methods Twenty-eight elderly intubated patients in an intensive care unit were randomly assigned to an experimental group (n = 14) that received conventional physiotherapy plus IMT with a Threshold IMT® device or to a control group (n = 14) that received only conventional physiotherapy. The experimental protocol for muscle training consisted of an initial load of 30% maximum inspiratory pressure, which was increased by 10% daily. The training was administered for 5 minutes, twice daily, 7 days a week, with supplemental oxygen from the beginning of weaning until extubation. Successful extubation was defined by the ventilation time measurement with noninvasive positive pressure. A vacuum manometer was used for measurement of maximum inspiratory pressure, and the patients’ Tobin index values were measured using a ventilometer. Results The maximum inspiratory pressure increased significantly (by 7 cm H2O, 95% confidence interval [CI] 4–10), and the Tobin index decreased significantly (by 16 breaths/ min/L, 95% CI −26 to 6) in the experimental group compared with the control group. The Chi-squared distribution did not indicate a significant difference in weaning success between the groups (χ2 = 1.47; P = 0.20). However, a comparison of noninvasive positive pressure time dependence indicated a significantly lower value for the experimental group (P = 0.0001; 95% CI 13.08–18.06). The receiver-operating characteristic curve showed an area beneath the curve of 0.877 ± 0.06 for the Tobin index and 0.845 ± 0.07 for maximum inspiratory pressure. Conclusion The IMT intervention significantly increased maximum inspiratory pressure and significantly reduced the Tobin index; both measures are considered to be good extubation indices. IMT was associated with a reduction in noninvasive positive pressure time in the experimental group.

Programas de treinamento muscular respiratório: impacto na autonomia funcional de idosos

.A crescente proporcao de idosos com incapacidades e fragi-lizados nas capitais brasileiras, a reducao da disponibilidade de cuidado familiar e transferencias intergeracionais no contexto urbano, a inexistencia de servicos de apoio social e de saude, o alto custo do cuidado domiciliar, moradias com espaco fisico reduzidos e estruturas com riscos para quedas e a violencia contra o idoso sao considerados fatores de risco para a institucionalizacao

Contração muscular do assoalho pélvico de mulheres com incontinência urinária de esforço submetidas a exercícios e eletroterapia: um estudo randomizado

O estudo avaliou o efeito dos exercicios perineais (EP) associados ou nao a eletroterapia em mulheres com incontinencia urinaria de esforco (IUE) quanto a contracao dos musculos do assoalho pelvico (MAP). Estudo longitudinal, do tipo experimental. Amostra composta por 71 mulheres com diagnostico clinico de IUE divididas em tres grupos: eletroterapia associada a exercicios (GEE, n=24), exercicios exclusivamente (GE, n=25) e controle (GC, n=22). Nos grupos experimentais foram realizadas 12 sessoes com duracao de 20 minutos cada e frequencia de 2 vezes por semana. Mensurou-se a contracao dos MAP por meio da avaliacao funcional do assoalho pelvico (AFA) e perineometro (PERI) pre e pos-intervencao. Os resultados apontam melhora da contracao dos MAP para os grupos GEE e GE em relacao ao GC conforme as medias de AFA (fibras I e II) e PERI (fibras I): AFA F I (∆%=11,99; p<0,001) e AFA F II (∆%=11,60; p<0,001) para o GEE; e para o GE AFA F I (∆%=4,75; p=0,021), AFA F II (∆%=2,93; p=0,002), PERI F I (∆%=29,94; p=0,012). Os exercicios foram eficazes na melhora da contracao dos MAP em mulheres com IUE, sem diferenca entre o grupo de eletroterapia mais exercicios em relacao ao grupo de exercicios.

The anatomical-functional characteristics of the pelvic floor and quality of life of women with stress urinary incontinence subjected to perineal exercises

OBJECTIVE To determine the effects of exercise in anatomic abnormalities of the pelvic floor (SP) and the quality of life (QOL) of women with stress urinary incontinence (SUI). METHOD An experimental study with 50 women with SUI, distributed randomly into two groups, experimental (GE, 49.24±7.37 years) and control group (CG; 45.25±5.60 years). The groups performed ultrasound evaluation of the SP, evidence of pelvic floor muscle strength by palpation bidigital, surface EMG motor activity and replied to the CV before and after treatment. The GE had 16 sessions of pelvic floor exercises twice a week for 30min. RESULTS Comparison between the GE and GC revealed significant differences in favor of GE, namely: mobility of the bladder neck (Δ=-0.79mm, p=0.00), thickness of pelvic floor muscle (Δ=-0.04mm, p=0.00), EMG (Δ=0.05.V, p=0.00), muscle strength by the AFA (Δ=0.05 level, p=0.00), DOMI1 (Δ%=5.67%, p=0.00), DOMI2 (Δ%=18.00%, p=0.00), DOMI3 (Δ%=18.22%, p=0.00), DOMI4 (Δ%=4.45%, p=0.00), DOMI5 (Δ%=0.22%, p=0.00), DOMI6 (Δ%=2.00%, p=0.00), DOMI7 (Δ%=3.78%, p=0, 00), DOMI8 (Δ%=6.33%, p=0.00), DOMI9 (Δ%=4.03%, p=0.00). CONCLUSION It was modified and improved anatomic features of the pelvic floor of women from GE through perineal exercises, which will positively influence the CV of these women.

Effects of a programme for years enderers physical force on the muscle and body composition of adults

The aim of this study was to observe the effects of a concurrent physical training programme (PTFC) on the muscle strength and body composition of adults. The sample was composed of 54 men, non-athletes, who were split into two groups: the experimental group (EG, n=42, 45±8.46 years of age) and the control group (CG, n=12, 47.17±7.41 years of age). Body composition was assessed by dual-energy X-ray absorptiometry (DEXA) and muscle strength was assessed by testing the repetition maximum (1 RM). The PTFC was composed of race training sessions in the Fatmax intensity zone and strength training. The training sessions were conducted three times a week for 40 min each over a period of 24 weeks. Statistical analysis of the data consisted of a descriptive and inferential analysis: Shapiro-Wilk (normality) and multiple comparisons (ANOVA 2×2). For this study, p<0.05 indicated statistical significance. Significant increases in 1RMs (p=0.001) and 1RMa (p=0.000) were found when comparing the post-test to the intra-EG values. The inter-group analysis revealed an increase in muscle strength in the 1RMa post-test (p=0.005) in favour of the EG group. Importantly, no significant changes in body composition were observed between the groups.The aim of this study was to observe the effects of a concurrent physical training programme (PTFC) on the muscle strength and body composition of adults. The sample was composed of 54 men, non-athletes, who were split into two groups: the experimental group (EG, n=42, 45±8.46 years of age) and the control group (CG, n=12, 47.17±7.41 years of age). Body composition was assessed by dual-energy X-ray absorptiometry (DEXA) and muscle strength was assessed by testing the repetition maximum (1 RM). The PTFC was composed of race training sessions in the Fatmax intensity zone and strength training. The training sessions were conducted three times a week for 40 min each over a period of 24 weeks. Statistical analysis of the data consisted of a descriptive and inferential analysis: Shapiro-Wilk (normality) and multiple comparisons (ANOVA 2×2). For this study, p<0.05 indicated statistical significance. Significant increases in 1RMs (p=0.001) and 1RMa (p=0.000) were found when comparing the post-test to the intra-EG values. The inter-group analysis revealed an increase in muscle strength in the 1RMa post-test (p=0.005) in favour of the EG group. Importantly, no significant changes in body composition were observed between the groups.

Sudden Death in Hypertrophic Cardiomyopathy

Hypertrophic cardiomyopathy is an autosomal dominant, genetic heart muscle disease, characterized by ventricular hypertrophy in the absence of any other medical condition causing heart overload. The disease has an estimated prevalence of 1:500 and is a significant cause of sudden death, especially in young individuals, with an annual incidence of approximately 1%. Among the risk markers for the occurrence of malignant ventricular arrhythmias and sudden death in this scenario, we emphasize, in addition to a fatal event that has occurred and was aborted, the family history of sudden death; wall thickness greater or equal to 30 mm; unexplained syncope; presence of non-sustained ventricular tachycardia on Holter; abnormal blood pressure response during exercise testing; and the presence of delayed enhancement on cardiac magnetic resonance. The presence or absence of these markers can define the need or not of an implantable cardioverterdefibrillator to prevent sudden death in these patients. However, there is still much controversy about how these patients should be stratified. It is known that these markers do not have the same weight in predicting who is more likely to suffer a fatal event. This fact becomes particularly important when it is considered that the cardioverter-defibrillator implantation procedure is not free of complications, in addition to the economic impact, in terms of cost, to the health system. The purpose of this article is to carry out a review of the main aspects involved in the sudden death in these patients, from the pathophysiology, risk assessment, prevention and future perspectives.

Effect of Inspiratory Muscle Training on Weaning Success in Critically Ill Intubated Patients

Weaning from MV is the gradual removal of the ventilatory prosthesis, a different process to extubation, which involves removing the endotracheal tube (MacIntyre et al., 2001). The best moment to start weaning depends on multiple factors. Premature exhubation puts the patient at risk of reintubation and airway trauma. However, prolonged weaning exposes individuals to risk of hospital infection and increases hospitalization costs (C. D. Epstein et al., 2002).