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2.
Rev. Pesqui. Fisioter ; 11(1): 173-180, Fev. 2021. ilus, tab
Artigo em Inglês, Português | LILACS | ID: biblio-1253376

RESUMO

INTRODUÇÃO: A Osteoartrite (OA) é a forma mais prevalente de artrite e requer intervenção terapêutica adequada. A Fisioterapia desempenha um importante papel no manejo desta doença. No entanto, pouco se sabe sobre as crenças e intervenções de fisioterapeutas que tratam OA no Brasil e fatores relacionados às decisões clínicas. OBJETIVO: Determinar se existe associação entre a qualificação profissional de fisioterapeutas na região Norte do Brasil e a percepção de eficiência ou ineficiência de intervenções terapêuticas para OA de joelho. MATERIAIS E MÉTODOS: Uma pesquisa transversal online foi realizada com fisioterapeutas de cinco estados do Norte do Brasil e a percepção sobre 20 intervenções foi avaliada por meio de um caso hipotético de OA de joelho. O teste qui-quadrado e regressão logística binária com nível de significância de 5% foram utilizados para a análise estatística. RESULTADOS: 370 profissionais com média de idade de 32,16 ± 6,89 responderam a pesquisa. Houve associação significativa entre qualificação e percepção de eficiência das intervenções. Fisioterapeutas apenas graduados apresentaram menos chances de reconhecer ultrassom, ondas curtas, neuroestimulação elétrica transcutânea e estimulação elétrica, crioterapia, calor, fortalecimento muscular, kinesio taping e repouso como intervenções ineficazes. O mesmo ocorreu com as intervenções ultrassom, fortalecimento muscular e kinesio taping para especialistas. CONCLUSÃO: O menor grau acadêmico leva à uma chance menor de perceber como pouco eficientes ou ineficientes algumas intervenções não recomendadas para OA de joelho.


INTRODUCTION: Osteoarthritis (OA) is the most prevalent form of arthritis, which requires appropriate therapeutic intervention. Physical therapy plays a central role in its management. However, little is known about the beliefs and interventions of physical therapists who treat OA in Brazil and factors related to clinical decisions. OBJECTIVE: To determine whether there is an association between the professional qualification of physical therapists in the North Region of Brazil and their perception of efficiency or inefficiency of therapeutic interventions for knee OA. METHODS: A cross-sectional online survey was conducted with physical therapists from five states in northern Brazil, and their perception about 20 interventions was assessed through a hypothetical case of knee OA. Statistical analyses were performed using the chi-square test and binary logistic regression with a significance level of 5%. RESULTS: 370 professionals with a mean age of 32.16 ±6.89 responded to the survey. There was a significant association between qualification and perceived efficiency of interventions. Graduated physiotherapists were less likely to recognize ultrasound, short waves, transcutaneous electrical neurostimulation and electrical stimulation, cryotherapy, heat, muscle strengthening, kinesio taping, and rest as ineffective interventions. The same occurred for ultrasound, muscle strengthening, and kinesiology tape for specialists. CONCLUSION: The lower academic degree leads to a lower chance to perceive as poorly efficient or inefficient some not recommended interventions for knee OA.


Assuntos
Osteoartrite , Prática Profissional , Modalidades de Fisioterapia
3.
J Eval Clin Pract ; 27(6): 1216-1222, 2021 12.
Artigo em Inglês | MEDLINE | ID: mdl-33386671

RESUMO

RATIONALE, AIMS AND OBJECTIVES: Several health information sources are available to assist physical therapists in the clinical decision-making process, with a notable increase in the importance of using evidence-based practice (EBP). The aim of this study is to investigate the health information sources most used by Brazilian physical therapists to guide their clinical decision making for knee osteoarthritis (OA) management, use of Physiotherapy Evidence Database (PEDro), knowledge about the existence of clinical practice guidelines (CPGs), and associated factors. METHODS: A cross-sectional study using an electronic survey was conducted. Physical therapists registered in a Regional Physical Therapy Council in Brazil were invited to participate. Sociodemographic data, professional training, health information sources, frequency of use of PEDro, and knowledge about CPGs were collected. Descriptive analysis of the data was performed, and the chi square test and multinomial and binary logistic regression were used to verify association between the variables. RESULTS: The survey was completed by 370 professionals. The three health information sources most used by Brazilian physical therapists were clinical experience, courses, and books. Among these professionals, only 12.1% use PEDro frequently, and 60.5% know that CPGs for knee OA management exist. Level of education was associated with PEDro use and knowledge about the existence of CPGs (P < .05). CONCLUSIONS: The study results indicated a significant deficiency in engagement with research evidence by Brazilian physical therapists to guide their clinical decision making for knee OA. Further investigations on educational needs and the development of new strategies to narrow the gap between research evidence and clinical practice should be performed.


Assuntos
Osteoartrite do Joelho , Fisioterapeutas , Brasil , Tomada de Decisão Clínica , Estudos Transversais , Humanos , Osteoartrite do Joelho/terapia
4.
Rev Assoc Med Bras (1992) ; 66Suppl 2(Suppl 2): 118-123, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32965369

RESUMO

The aim of this rapid systematic review is to analyze the prevalence of clinical, socioeconomic, and demographic characteristics, laboratory and imaging findings, diagnostic tests, and treatment information of older adults with COVID-19. To conduct this systematic review, the Cochrane Handbook recommendations will be followed. Patients aged 60 years or older with a confirmed diagnosis of SARS-CoV-2 infection will be included. A comprehensive literature search will be performed in the following databases: MEDLINE via PubMed, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), Latin American and Caribbean Health Sciences Literature (LILACS), Spanish Bibliographic Index on Health Sciences (IBECS) and Epistemonikos COVID-19 L·OVE platform. No language restrictions will be applied. To assess the methodological quality of the included studies and the certainty of the evidence, the Newcastle-Ottawa Scale, and the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach will be used. The meta-analysis will be performed using R software. We believe this rapid systematic review will be able to summarize the currently available evidence on clinical, socioeconomic characteristics, and management of COVID-19 in older adults. Therefore, it will help implement adequate strategies to fight the pandemic and assist in understanding the clinical profile of older patients with COVID-19, providing data with due scientific support upon which to base future choices of procedures and interventions.


Assuntos
Betacoronavirus , Infecções por Coronavirus/epidemiologia , Pandemias , Pneumonia Viral/epidemiologia , Idoso , COVID-19 , Região do Caribe , Humanos , Pessoa de Meia-Idade , SARS-CoV-2 , Fatores Socioeconômicos
5.
Rev. Assoc. Med. Bras. (1992, Impr.) ; 66(Suppl 2): 118-123, 2020. tab
Artigo em Inglês | Sec. Est. Saúde SP, LILACS | ID: biblio-1136380

RESUMO

SUMMARY The aim of this rapid systematic review is to analyze the prevalence of clinical, socioeconomic, and demographic characteristics, laboratory and imaging findings, diagnostic tests, and treatment information of older adults with COVID-19. To conduct this systematic review, the Cochrane Handbook recommendations will be followed. Patients aged 60 years or older with a confirmed diagnosis of SARS-CoV-2 infection will be included. A comprehensive literature search will be performed in the following databases: MEDLINE via PubMed, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), Latin American and Caribbean Health Sciences Literature (LILACS), Spanish Bibliographic Index on Health Sciences (IBECS) and Epistemonikos COVID-19 L·OVE platform. No language restrictions will be applied. To assess the methodological quality of the included studies and the certainty of the evidence, the Newcastle-Ottawa Scale, and the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach will be used. The meta-analysis will be performed using R software. We believe this rapid systematic review will be able to summarize the currently available evidence on clinical, socioeconomic characteristics, and management of COVID-19 in older adults. Therefore, it will help implement adequate strategies to fight the pandemic and assist in understanding the clinical profile of older patients with COVID-19, providing data with due scientific support upon which to base future choices of procedures and interventions.


RESUMO O objetivo desta rápida revisão sistemática é analisar a prevalência de características clínicas, socioeconômicas e demográficas, achados laboratoriais e de imagem, testes de diagnóstico e informações de tratamento de idosos com COVID-19. Para conduzir esta revisão sistemática, serão seguidas as recomendações do Manual Cochrane. Pacientes com 60 anos ou mais com diagnóstico confirmado de infecção por Sars-CoV-2 serão incluídos. Uma pesquisa bibliográfica abrangente será realizada nas seguintes bases de dados: Medline via PubMed, Embase, Cochrane Central Register of Controlled Trials (Central), Literatura Latino-Americana e do Caribe em Ciências da Saúde (Lilacs), Índice Bibliográfico Espanhol em Ciências da Saúde (Ibecs) e Epistemonikos Plataforma COVID-19 L · OVE. Nenhuma restrição de idioma será aplicada. Para avaliar a qualidade metodológica e a certeza das evidências dos estudos incluídos, serão utilizadas a Escala Newcastle-Ottawa e a abordagem Grading of Recommendations Assessment, Development and Evaluation (Grade). A meta-análise será realizada no software R. Acreditamos que esta revisão sistemática rápida será capaz de resumir as evidências atualmente disponíveis sobre as características clínicas, socioeconômicas e sobre o manejo de idosos com COVID-19. Portanto, ajudará a implementar estratégias adequadas para combater a pandemia e ajudará a entender o perfil clínico de pacientes idosos com COVID-19, fornecendo dados com o devido apoio científico sobre o qual basear futuras escolhas de procedimentos e intervenções.


Assuntos
Humanos , Idoso , Pneumonia Viral/epidemiologia , Infecções por Coronavirus/epidemiologia , Pandemias , Betacoronavirus , Fatores Socioeconômicos , Infecções por Coronavirus , Região do Caribe , Pessoa de Meia-Idade
6.
Braz Dent J ; 29(4): 368-373, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30462763

RESUMO

Breast cancer is the most common cancer affecting women in the world and provides functional changes in the human body. Evaluate women submitted to unilateral mastectomy, through electromyographic activity (mandibular rest, right and left laterality, protrusion, maximum voluntary contraction with and without Parafilm, habitual and non-habitual mastication) and thickness (rest and maximum voluntary contraction) of the right temporal muscle (RT), left temporal (LT), right masseter (RM) and left masseter (LM), also the molar bite force (right and left) and compare the data with healthy women. Material and Methods: 32 women were divided into two groups: unilateral mastectomy group (MG), average ± standard deviation 56.50±14.50 years (n=16) and without the disease group (CG), average ± standard deviation 56.56±14.15 years (n=16). The normalized electromyographic data, muscle thickness and maximal molar bite force were tabulated and submitted to statistical analysis (SPSS 21.0; student t test, p≤0.05). Significant statistical differences between MG and CG were found in right laterality, for RM (p=0.02); left laterality, for LT (p=0.01); chewing with peanuts, for RM (p=0.04); chewing with raisins, for LM (p=0.04) and right molar bite force (p=0.03). There was no statistically significant difference between MG and CG for muscle thickness. The results of this study suggest that women undergoing unilateral mastectomy may present functional changes, with emphasis on muscular hyperactivity, lower masticatory efficiency and lower maxillary bite force.


Assuntos
Neoplasias da Mama/cirurgia , Mastectomia/métodos , Sistema Estomatognático/fisiopatologia , Adulto , Idoso , Força de Mordida , Neoplasias da Mama/fisiopatologia , Estudos de Casos e Controles , Feminino , Humanos , Músculo Masseter/fisiopatologia , Pessoa de Meia-Idade , Músculo Temporal/fisiopatologia
7.
Braz. dent. j ; 29(4): 368-373, July-Aug. 2018. tab
Artigo em Inglês | LILACS | ID: biblio-974163

RESUMO

Abstract Breast cancer is the most common cancer affecting women in the world and provides functional changes in the human body. Evaluate women submitted to unilateral mastectomy, through electromyographic activity (mandibular rest, right and left laterality, protrusion, maximum voluntary contraction with and without Parafilm, habitual and non-habitual mastication) and thickness (rest and maximum voluntary contraction) of the right temporal muscle (RT), left temporal (LT), right masseter (RM) and left masseter (LM), also the molar bite force (right and left) and compare the data with healthy women. Material and Methods: 32 women were divided into two groups: unilateral mastectomy group (MG), average ± standard deviation 56.50±14.50 years (n=16) and without the disease group (CG), average ± standard deviation 56.56±14.15 years (n=16). The normalized electromyographic data, muscle thickness and maximal molar bite force were tabulated and submitted to statistical analysis (SPSS 21.0; student t test, p≤0.05). Significant statistical differences between MG and CG were found in right laterality, for RM (p=0.02); left laterality, for LT (p=0.01); chewing with peanuts, for RM (p=0.04); chewing with raisins, for LM (p=0.04) and right molar bite force (p=0.03). There was no statistically significant difference between MG and CG for muscle thickness. The results of this study suggest that women undergoing unilateral mastectomy may present functional changes, with emphasis on muscular hyperactivity, lower masticatory efficiency and lower maxillary bite force.


Resumo Câncer de mama é a neoplasia mais comum que mais acomete mulheres no mundo e proporciona alterações funcionais no corpo humano. Objetivo: avaliar mulheres submetidas à mastectomia unilateral, por meio da atividade eletromiográfica (repouso mandibular, lateralidade direita e esquerda, protrusão, contração voluntária máxima com e sem parafilme, mastigação habitual e não habitual) e espessura (repouso e contração voluntária máxima) do músculo temporal direito (TD), temporal esquerdo (TE), masseter direito (MD) e masseter esquerdo (ME), além da força de mordida molar (direita e esquerda) e comparar os dados com mulheres saudáveis. 32 mulheres foram distribuídas em dois grupos: grupo mastectomia unilateral (GM), média ± desvio padrão 56,50 ± 14,50 anos (n=16) e grupo sem a doença (GC), média ± desvio padrão 56,56 ± 14,15 anos (n=16). Os dados eletromiográficos normalizados, espessura muscular e força de mordida molar máxima foram tabulados e submetidos à análise estatística (SPSS 21.0; teste t de student, p≤0,05). Foram encontradas diferenças estatísticas significantes entre GM e GC na lateralidade direita, para o MD (p=0,02); lateralidade esquerda, para o TE (p=0,01); mastigação com amendoim, para o MD (p=0,04); mastigação com uva-passa, para o ME (p=0,04) e força de mordida molar direita (p=0,03). Não houve diferença estatística significante entre GM e GC para espessura muscular. Os resultados deste estudo sugerem que mulheres submetidas à mastectomia unilateral podem apresentar alterações funcionais do sistema estomatognático, com destaque para hiperatividade muscular, menor eficiência mastigatória e menor força de mordida molar máxima.


Assuntos
Humanos , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Sistema Estomatognático/fisiopatologia , Neoplasias da Mama/cirurgia , Mastectomia/métodos , Músculo Temporal/fisiopatologia , Força de Mordida , Neoplasias da Mama/fisiopatologia , Estudos de Casos e Controles , Músculo Masseter/fisiopatologia
8.
Complement Ther Clin Pract ; 32: 46-50, 2018 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-30057056

RESUMO

OBJECTIVE: To analyze the effects of Lower Limb (LL) auricular stimulation points on the static equilibrium of healthy subjects, assessed by computerized baropodometry. METHODS AND MATERIALS: Forty volunteers were assigned to one of two groups: Auriculotherapy (AT) who received unilateral needle stimulation of the coxofemoral, knee, and ankle points. Control (C) who did not receive any stimulation. We analyzed the contact area (CA) and the peak pressure (PP) for both feet at baseline, 20 and 25 min after the baseline was recorded. Three-Way ANOVA (P < 0.05) was used for data analysis. RESULTS: AT showed an increase in CA (F:6.49) and a decrease in PP (F:3.11) at 20 and 25 min, when compared to C. The PP decreased was only for the right LL at 20 and 25 min (F:6.45). CONCLUSION: The auriculotherapy points were able to modify the ipsilateral weight discharge on the same side of the stimulated auricular pavilion.


Assuntos
Auriculoterapia , Extremidade Inferior/fisiologia , Equilíbrio Postural/fisiologia , Humanos
9.
Lymphat Res Biol ; 16(3): 282-286, 2018 06.
Artigo em Inglês | MEDLINE | ID: mdl-29252100

RESUMO

The objective of the study was to evaluate the intra- and inter-rater reliability of bioimpedance in determining upper limb volume in women with lymphedema resulting from breast cancer treatment, as well as its correlation with the upper limb volume calculated by circumferential measurement. A blind cross-sectional study was performed in which 27 women (62.59 ± 10.50 years) were evaluated with upper limb lymphedema secondary to breast cancer treatment. Two examiners performed assessments in the same volunteers independently and twice, with an interval of 1 week between assessments. The collections were performed by the direct tetrapolar multifrequency segmental bioimpedance and by the circumference of the upper limb homolateral to the breast cancer. The results of the circumference showed that the homolateral limb had lymphedema. The intra- and inter-rater analysis showed excellent reliability with intraclass correlation coefficient (ICC) values ranging from 0.954 to 0.999 for the amount of liquid and excellent reliability with ICC values ranging from 0.852 to 0.999 for the electrical impedance of the upper limb with lymphedema. The correlation was strong and negative (p < 0.05) between intracellular, extracellular, and total water when associated with electrical impedance and moderate and positive (p < 0.05) when associated with upper limb volume for all frequencies. The correlations between upper limb volume and water quantities were moderate and positive (p < 0.05). The results indicate that bioimpedance is a reliable method for the evaluation of lymphedema, and the volume of the homolateral upper limb is associated with the amount of water in women with lymphedema secondary to the treatment of breast cancer.


Assuntos
Linfedema Relacionado a Câncer de Mama/diagnóstico , Linfedema Relacionado a Câncer de Mama/fisiopatologia , Impedância Elétrica , Variações Dependentes do Observador , Idoso , Estudos Transversais , Feminino , Humanos , Pessoa de Meia-Idade , Reprodutibilidade dos Testes , Sensibilidade e Especificidade , Extremidade Superior/patologia , Extremidade Superior/fisiopatologia
10.
J Manipulative Physiol Ther ; 40(4): 241-245, 2017 05.
Artigo em Inglês | MEDLINE | ID: mdl-28410763

RESUMO

OBJECTIVE: The purpose of this study was to correlate upper limb volume and arterial and venous blood flow velocity in breast cancer survivors. METHODS: A cross-sectional study was conducted on 30 women with lymphedema and a mean age of 55.60 years (standard deviation = 8.12). For the assessment of upper limb volume, perimetry was performed with measures at 6 points on the limb, which were mathematically calculated as volume. The blood flow velocity of the axillary and brachial arteries and veins were assessed by Doppler ultrasound with a probe at 4 MHz. In the statistical analysis, a Shapiro-Wilk test determined a non-normal data distribution. Spearman correlation coefficients (ρ) were calculated to determine the association between the variables blood flow velocity and lymphedema volume. RESULTS: We identified significant and positive associations between all variables correlated with limb volume: blood flow velocity of the axillary artery (ρ = 0.381, P = .041), axillary vein (ρ = 0.383, P = .039), brachial artery (ρ = 0.375, P = .044), and the brachial vein (ρ = 0.373, P = .045). CONCLUSION: There is a positive association between limb volume and blood flow velocity in the upper limbs of women with lymphedema secondary to breast cancer treatment.


Assuntos
Velocidade do Fluxo Sanguíneo/fisiologia , Linfedema/diagnóstico por imagem , Mastectomia/efeitos adversos , Ultrassonografia Doppler/métodos , Adulto , Idoso , Artéria Axilar/diagnóstico por imagem , Artéria Braquial/diagnóstico por imagem , Neoplasias da Mama/patologia , Neoplasias da Mama/cirurgia , Estudos Transversais , Feminino , Humanos , Linfedema/etiologia , Linfedema/fisiopatologia , Mastectomia/métodos , Pessoa de Meia-Idade , Valores de Referência , Índice de Gravidade de Doença
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