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Garlet AB, Righi NC, Schardong J, Della Méa Plentz R. Effects of robotic rehabilitation using the Erigo ® device on patients with neurological injury: a systematic review and meta-analysis of randomized clinical trials. Disabil Rehabil Assist Technol 2024; 19:1135-1144. [PMID: 36469933 DOI: 10.1080/17483107.2022.2151656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 10/12/2022] [Accepted: 11/19/2022] [Indexed: 12/12/2022]
Abstract
OBJECTIVE To systematically review the effects of robotic rehabilitation with the Erigo® device on patients with neurological injury on safety, spasticity, muscle strength, functionality, gait/balance, and changes in the level of consciousness. METHODS MEDLINE, SciELO, EMBASE, The Cochrane Library - CENTRAL and PEDro databases were consulted without the restriction of date and language. Randomized controlled trials that evaluated the robotic rehabilitation and compared it to conventional or placebo therapy, isolated or in association with other therapy, were selected. Studies in which the treatment time was less than 10 sessions were excluded. The risk of bias was assessed with the use of the RoB 2.0 tool. RESULTS Nine studies were included, totaling 347 patients. The robotic rehabilitation performed by the Erigo® device proved to be safe for neurological patients. The meta-analysis showed an improvement for spasticity (MD = 0.29; 95% CI = -0.49 to -0.08; I2 = 0%), but there was no significant increase in muscle strength in patients with stroke (MD = 0.25; CI 95% = -0.22 to -0,71; I2 = 0%). Erigo® showed inconclusive effects on functionality, gait/balance and level of consciousness in patients with severe acquired brain injury and vegetative or minimally conscious state. All studies present some concerns for the risk of bias. CONCLUSION Erigo® as a robotic rehabilitation strategy is safe for patients with acquired brain injury and appears to reduce spasticity in patients with stroke. The effects on muscle strength, functionality, gait and balance and level of consciousness remain uncertain and the methodological quality of the clinical trials included in this review is limited.
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Affiliation(s)
- Andrieli Barbieri Garlet
- Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, Brazil
- Irmandade Santa Casa de Misericórdia de Porto Alegre (ISCMPA), Porto Alegre, Brazil
| | - Natiele Camponogara Righi
- Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, Brazil
- Irmandade Santa Casa de Misericórdia de Porto Alegre (ISCMPA), Porto Alegre, Brazil
| | - Jociane Schardong
- Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, Brazil
- Irmandade Santa Casa de Misericórdia de Porto Alegre (ISCMPA), Porto Alegre, Brazil
| | - Rodrigo Della Méa Plentz
- Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, Brazil
- Irmandade Santa Casa de Misericórdia de Porto Alegre (ISCMPA), Porto Alegre, Brazil
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Hauck M, Schardong J, Donini G, Normann TC, Plentz RDM. Effects of photobiomodulation therapy (PBMT) over endothelial function in healthy individuals: a preliminary crossover clinical trial. Lasers Med Sci 2023; 38:104. [PMID: 37072603 DOI: 10.1007/s10103-023-03762-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Accepted: 04/05/2023] [Indexed: 04/20/2023]
Abstract
Photobiomodulation therapy (PBMT) causes stimulatory effects that raise cell metabolism. The study aimed to evaluate the effects of PBMT on the endothelial function of healthy individuals. It was a controlled, randomized, crossover, triple-blind trial with 22 healthy volunteers (female: 77.3%), aged 25.45 years which were randomly divided into three groups. PBMT with gallium-aluminum-arsenide (GaAlAs) diode laser (810 nm, continuous-wave mode, 1000 mW, 0.28 cm2) was applied over the radial and ulnar artery regions in two parallel spots: group 1-30 J (n = 22, 107 J/cm2) per spot; group 2-60 J (n = 22, 214 J/cm2) per spot; and group 3-placebo (n = 22, sham). The endothelial function was measured before and immediately after PBMT by the flow-mediated dilation technique (%FMD) with high-resolution ultrasound. Statistical analysis was made with ANOVA for repeated measures, the effect size was measured by Cohen's d, and results are presented as mean and standard error (or 95% confidence intervals). A p-value < 0.05 was considered statistically significant. The %FMD increases 10.4% with 60 J (mean difference = 0.496 mm, 95% CI = 0.42 to 0.57, p < 0.001), 7.3% with 30 J (mean difference = 0.518 mm, 95% CI = 0.44 to 0.59, p < 0.001), and 4.7% with placebo (mean difference = 0.560 mm, 95% CI = 0.48 to 0.63, p < 0.001). We found a small effect size (p = 0.702; d de Cohen = 0.24) without statistical difference between interventions. PBMT with the energy density of 60 J and 30 J did not improve endothelial function.Trial registration number: NCT03252184 (01/09/2017).
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Affiliation(s)
- Melina Hauck
- Graduate Programm in Health Sciences, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Zip Code: 90050-170, Porto Alegre, Brazil.
- Graduate Programm in Rehabilitation Sciences of Universidade Federal de Santa Catarina (UFSC), Zip Code: 88.905-120, Araranguá, Brazil.
| | - Jociane Schardong
- Complexo Hospitalar Irmandade Santa Casa de Misericórdia de Porto Alegre, Porto Alegre, Zip Code: 90020-090, Brazil
| | - Gabriela Donini
- Graduate in Physiotherapy, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, Zip Code: 90050-170, Brazil
| | - Tatiana Coser Normann
- Health Multidisciplinary Residency Programm in Urgency and Emergency, Hospital de Pronto Socorro de Porto Alegre (HPS), Porto Alegre, Zip Code: 90040-192, Brazil
| | - Rodrigo Della Méa Plentz
- Graduate Programm in Health Sciences, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Zip Code: 90050-170, Porto Alegre, Brazil
- Complexo Hospitalar Irmandade Santa Casa de Misericórdia de Porto Alegre, Porto Alegre, Zip Code: 90020-090, Brazil
- Physiotherapy Department, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, Zip Code: 90050-170, Brazil
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Rubin N, Cerentini TM, Schlöttgen J, do Nascimento Petter G, Bertotto A, La Verde M, Gullo G, Telles da Rosa LH, Viana da Rosa P, Della Méa Plentz R. Urinary incontinence and quality of life in high-performance swimmers: An observational study. Health Care Women Int 2023:1-10. [PMID: 37026773 DOI: 10.1080/07399332.2023.2197861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/08/2023]
Abstract
Each day more women around the world practice high impact physical activities and this may be a risk factor for urinary incontinence (UI) in young. We verified the prevalence of UI and the impact in quality of life (QoL) in high-performance swimmers, through a cross-sectional observational study with 9 high performance swimmers and 9 sedentary women who responded the International Consultation on incontinence Questionnaire - Short Form (ICIQ-SF), participated in a functional evaluation of pelvic floor muscles with bidigital palpation and pad test. We verifed that was present in 78% of high-performance swimmers, and the quality of life was significantly worse (p =.037) when compared to sedentary women. These findings led us to conclude that presence of UI affects the quality of life, even if it is not a factor of abandonment of the sport.
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Affiliation(s)
- Nadyne Rubin
- Postgraduate Program in Rehabilitation Sciences, Federal University of Health Sciences of Porto Alegre, Porto Alegre, Brazil
| | - Taís Marques Cerentini
- Postgraduate Program in Rehabilitation Sciences, Federal University of Health Sciences of Porto Alegre, Porto Alegre, Brazil
| | - Júlia Schlöttgen
- Postgraduate Program in Rehabilitation Sciences, Federal University of Health Sciences of Porto Alegre, Porto Alegre, Brazil
| | | | - Adriane Bertotto
- Department of Physical Therapy, University Center La Salle, Canoas, Brazil
| | - Marco La Verde
- Department of Woman, Child and General and Specialized Surgery, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Giuseppe Gullo
- Department of Obstetrics and Gynecology, University of Palermo, Palermo, Italy
| | - Luís Henrique Telles da Rosa
- Postgraduate Program in Rehabilitation Sciences, Federal University of Health Sciences of Porto Alegre, Porto Alegre, Brazil
| | - Patrícia Viana da Rosa
- Postgraduate Program in Rehabilitation Sciences, Federal University of Health Sciences of Porto Alegre, Porto Alegre, Brazil
| | - Rodrigo Della Méa Plentz
- Postgraduate Program in Rehabilitation Sciences, Federal University of Health Sciences of Porto Alegre, Porto Alegre, Brazil
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Miozzo AP, Watte G, Hetzel GM, Altmayer S, Nascimento DZ, Cadore E, Florian J, Machado SDC, Plentz RDM. Ambulatory oxygen therapy in lung transplantation candidates with idiopathic pulmonary fibrosis referred for pulmonary rehabilitation. J Bras Pneumol 2023; 49:e20220280. [PMID: 36820744 PMCID: PMC9970614 DOI: 10.36416/1806-3756/e20220280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Accepted: 11/28/2022] [Indexed: 01/12/2023] Open
Abstract
OBJECTIVE To determine independent factors related to the use of oxygen and the oxygen flow rate in idiopathic pulmonary fibrosis (IPF) patients placed on a lung transplant waitlist and undergoing pulmonary rehabilitation (PR). METHODS This was a retrospective quasi-experimental study presenting functional capacity and health-related quality of life (HRQoL) data from lung transplant candidates with IPF referred for PR and receiving ambulatory oxygen therapy. The patients were divided into three groups on the basis of the oxygen flow rate: 0 L/min (the control group), 1-3 L/min, and 4-5 L/min. Data on functional capacity were collected by means of the six-minute walk test, and data on HRQoL were collected by means of the Medical Outcomes Study 36-item Short-Form Health Survey (SF-36), being collected before and after 36 sessions of PR including aerobic and strength exercises. RESULTS The six-minute walk distance improved in all three groups (0 L/min: Δ 61 m, p < 0.001; 1-3 L/min: Δ 58 m, p = 0.014; and 4-5 L/min: Δ 35 m, p = 0.031). Regarding HRQoL, SF-36 physical functioning domain scores improved in all three groups, and the groups of patients receiving ambulatory oxygen therapy had improvements in other SF-36 domains, including role-physical (1-3 L/min: p = 0.016; 4-5 L/min: p = 0.040), general health (4-5 L/min: p = 0.013), social functioning (1-3 L/min: p = 0.044), and mental health (1-3 L/min: p = 0.046). CONCLUSIONS The use of ambulatory oxygen therapy during PR in lung transplant candidates with IPF and significant hypoxemia on exertion appears to improve functional capacity and HRQoL.
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Affiliation(s)
- Aline Paula Miozzo
- . Programa de Pós-Graduação em Ciências da Saúde, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre (RS) Brasil
- . Programa de Reabilitação Pulmonar, Santa Casa de Misericórdia de Porto Alegre, Porto Alegre (RS) Brasil
| | - Guilherme Watte
- . Departamento de Transplante Pulmonar, Santa Casa de Misericórdia de Porto Alegre, Porto Alegre (RS) Brasil
- . Programa de Graduação em Patologia, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre (RS) Brasil
| | | | - Stephan Altmayer
- . Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre (RS) Brasil
| | - Douglas Zaione Nascimento
- . Departamento de Transplante Pulmonar, Santa Casa de Misericórdia de Porto Alegre, Porto Alegre (RS) Brasil
| | - Ermani Cadore
- . Programa de Graduação em Patologia, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre (RS) Brasil
| | - Juliessa Florian
- . Programa de Reabilitação Pulmonar, Santa Casa de Misericórdia de Porto Alegre, Porto Alegre (RS) Brasil
- . Departamento de Transplante Pulmonar, Santa Casa de Misericórdia de Porto Alegre, Porto Alegre (RS) Brasil
| | - Scheila da Costa Machado
- . Programa de Reabilitação Pulmonar, Santa Casa de Misericórdia de Porto Alegre, Porto Alegre (RS) Brasil
- . Departamento de Transplante Pulmonar, Santa Casa de Misericórdia de Porto Alegre, Porto Alegre (RS) Brasil
| | - Rodrigo Della Méa Plentz
- . Programa de Reabilitação Pulmonar, Santa Casa de Misericórdia de Porto Alegre, Porto Alegre (RS) Brasil
- . Departamento de Transplante Pulmonar, Santa Casa de Misericórdia de Porto Alegre, Porto Alegre (RS) Brasil
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Leung T, Sheehy L, Yumi Shizukuishi ML, Marques Ferreira Aguilar H, Florian J, da Costa Machado S, Schardong J, Della Méa Plentz R. A Telerehabilitation Program for Maintaining Functional Capacity in Patients With Chronic Lung Diseases During a Period of COVID-19 Social Isolation: Quasi-Experimental Retrospective Study. JMIR Rehabil Assist Technol 2022; 9:e40094. [PMID: 36473024 PMCID: PMC9795598 DOI: 10.2196/40094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Revised: 09/28/2022] [Accepted: 10/12/2022] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Pulmonary diseases represent a great cause of disability and mortality in the world, and given the progression of these pathologies, pulmonary rehabilitation programs have proven to be effective for people with chronic respiratory diseases. During the COVID-19 pandemic, telerehabilitation has become an alternative for patients with such diseases. OBJECTIVE The aim of this study was to compare the outcomes (ie, functional capacity and quality of life) of telerehabilitation to those of usual care among patients who previously participated in face-to-face pulmonary rehabilitation programs. METHODS We conducted a quasi-experimental retrospective study from April 2020 to August 2021. A total of 32 patients with chronic lung diseases were included and divided into the control and intervention groups. The intervention group performed telerehabilitation synchronously twice per week and was supervised by a physical therapist during breathing, strengthening, and aerobic exercises. Changes in the degree of dyspnea and leg discomfort were assessed based on changes in Borg scale scores. The control group did not perform any activities during the period of social isolation. Functional capacity was assessed with the 6-minute walk test, and quality of life was assessed with the Medical Outcomes Study 36-item Short Form Health Survey. RESULTS The telerehabilitation group's mean 6-minute walk distance decreased by 39 m, while that of the control group decreased by 120 m. There was a difference of 81 m between the groups' mean 6-minute walk distances (P=.02). In relation to the quality of life, telerehabilitation was shown to improve the following two domains: social functioning and mental health. CONCLUSIONS Telerehabilitation programs for patients with chronic lung diseases can ease the deleterious effects of disease progression, be used to maintain functional capacity, and improve aspects of quality of life.
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Affiliation(s)
| | | | | | | | - Juliessa Florian
- Physiotherapy Department, Irmandade Santa Casa de Misericórdia de Porto Alegre, Porto Alegre, Brazil
| | - Scheila da Costa Machado
- Physiotherapy Department, Irmandade Santa Casa de Misericórdia de Porto Alegre, Porto Alegre, Brazil
| | - Jociane Schardong
- Physiotherapy Department, Irmandade Santa Casa de Misericórdia de Porto Alegre, Porto Alegre, Brazil
| | - Rodrigo Della Méa Plentz
- Physiotherapy Department, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, Brazil
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Righi NC, Plentz RDM, De Marchi PTR, Brambatti KR, Garlet AB, Mesquita J, Oliveira APD, Schardong J. Perception of health professionals on the prone position as a therapeutic strategy for patients with COVID-19. Fisioter Pesqui 2022. [DOI: 10.1590/1809-2950/21021229022022en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
ABSTRACT The COVID-19 pandemic has led to a great number of hospitalizations. A considerable number of cases progress to the severe form of the infection and death. Prone positioning is a therapeutic strategy with strong evidence of reduced mortality in patients with acute respiratory distress syndrome (ARDS). This study aims to assess if the prone positioning strategy is used by health professionals in hospitals to treat patients with COVID-19 on invasive mechanical ventilation and the professionals’ perception of its effect on the mortality rate. This is a cross-sectional study, with a convenience sample composed of health professionals of both sexes working in hospitals throughout Brazil. Participants answered an online questionnaire composed of 16 questions using Google Forms, from July 2020 to September 2020. A total of 455 questionnaires were answered. Prone positioning is routinely performed in hospitals where 386 (95%) of the responding professionals work. Among them, 374 (96.9%) consider that the prone position strategy reduces hypoxemia and 289 (74.9%) consider that it reduces mortality in patients with COVID-19 and ARDS on invasive mechanical ventilation. Finally, most health professionals working in Brazilian hospitals perform and believe that prone positioning reduces hypoxemia and mortality in patients with COVID-19 on invasive mechanical ventilation.
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Affiliation(s)
- Natiele Camponogara Righi
- Universidade Federal de Ciências da Saúde de Porto Alegre, Brazil; Irmandade da Santa Casa de Misericórdia de Porto Alegre, Brazil
| | - Rodrigo Della Méa Plentz
- Irmandade da Santa Casa de Misericórdia de Porto Alegre, Brazil; Universidade Federal de Ciências da Saúde de Porto Alegre, Brazil
| | | | - Kaciane Roberta Brambatti
- Irmandade da Santa Casa de Misericórdia de Porto Alegre, Brazil; Universidade Federal de Ciências da Saúde de Porto Alegre, Brazil
| | - Andrieli Barbieri Garlet
- Irmandade da Santa Casa de Misericórdia de Porto Alegre, Brazil; Universidade Federal de Ciências da Saúde de Porto Alegre, Brazil
| | - Jean Mesquita
- Irmandade da Santa Casa de Misericórdia de Porto Alegre, Brazil
| | | | - Jociane Schardong
- Irmandade da Santa Casa de Misericórdia de Porto Alegre, Brazil; Universidade Federal de Ciências da Saúde de Porto Alegre, Brazil
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Cunha MCA, Schardong J, Righi NC, Lunardi AC, Sant'Anna GND, Isensee LP, Xavier RF, Brambatti KR, Pompeu JE, Frâncio F, Faria LM, Cardoso RA, Silva AMVD, Dorneles CDC, Werle RW, Ferreira JC, Plentz RDM, Carvalho CRF. Impact of prone positioning on patients with COVID-19 and ARDS on invasive mechanical ventilation: a multicenter cohort study. J Bras Pneumol 2022; 48:e20210374. [PMID: 35475866 PMCID: PMC9064626 DOI: 10.36416/1806-3756/e20210374] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Accepted: 01/19/2022] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE To identify factors that lead to a positive oxygenation response and predictive factors of mortality after prone positioning. METHODS This was a retrospective, multicenter, cohort study involving seven hospitals in Brazil. Inclusion criteria were being > 18 years of age with a suspected or confirmed diagnosis of COVID-19, being on invasive mechanical ventilation, having a PaO2/FIO2 ratio < 150 mmHg, and being submitted to prone positioning. After the first prone positioning session, a 20 mmHg improvement in the PaO2/FIO2 ratio was defined as a positive response. RESULTS The study involved 574 patients, 412 (72%) of whom responded positively to the first prone positioning session. Multiple logistic regression showed that responders had lower Simplified Acute Physiology Score III (SAPS III)/SOFA scores and lower D-dimer levels (p = 0.01; p = 0.04; and p = 0.04, respectively). It was suggested that initial SAPS III and initial PaO2/FIO2 were predictors of oxygenation response. The mortality rate was 69.3%. Increased risk of mortality was associated with age (OR = 1.04 [95 CI: 1.01-1.06]), time to first prone positioning session (OR = 1.18 [95 CI: 1.06-1.31]), number of sessions (OR = 1.31 [95% CI: 1.00-1.72]), proportion of pulmonary impairment (OR = 1.55 [95% CI: 1.02-2.35]), and immunosuppression (OR = 3.83 [95% CI: 1.35-10.86]). CONCLUSIONS Our results show that most patients in our sample had a positive oxygenation response after the first prone positioning session. However, the mortality rate was high, probably due to the health status and the number of comorbidities of the patients, as well as the severity of their disease. Our results also suggest that SAPS III and the initial PaO2/FIO2 predict the oxygenation response; in addition, age, time to first prone positioning, number of sessions, pulmonary impairment, and immunosuppression can predict mortality.
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Affiliation(s)
- Marieta C A Cunha
- . Divisão de Pneumologia, Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo (SP) Brasil
| | | | - Natiele Camponogara Righi
- . Serviço de Fisioterapia, Irmandade Santa Casa de Misericórdia de Porto Alegre, Porto Alegre (RS) Brasil.,. Departamento de Fisioterapia, Universidade Federal de Ciências da Saúde de Porto Alegre - UFCSPA - Porto Alegre (RS) Brasil
| | - Adriana Claudia Lunardi
- . Departamento de Fisioterapia, Faculdade de Medicina, Universidade de São Paulo, São Paulo (SP) Brasil
| | | | - Larissa Padrão Isensee
- . Departamento de Fisioterapia, Faculdade de Medicina, Universidade de São Paulo, São Paulo (SP) Brasil
| | - Rafaella Fagundes Xavier
- . Departamento de Fisioterapia, Faculdade de Medicina, Universidade de São Paulo, São Paulo (SP) Brasil
| | - Kaciane Roberta Brambatti
- . Serviço de Fisioterapia, Irmandade Santa Casa de Misericórdia de Porto Alegre, Porto Alegre (RS) Brasil
| | - José Eduardo Pompeu
- . Departamento de Fisioterapia, Faculdade de Medicina, Universidade de São Paulo, São Paulo (SP) Brasil
| | | | - Luiza Martins Faria
- . Departamento de Fisioterapia, Hospital Universitário Polydoro Ernani de São Thiago, Universidade Federal de Santa Catarina, Florianópolis (SC) Brasil
| | - Rozana Astolfi Cardoso
- . Departamento de Fisioterapia, Santa Casa de Misericórdia de Belo Horizonte, Belo Horizonte (MG) Brasil
| | | | | | - Roberta Weber Werle
- . Hospital Universitário de Santa Maria, Universidade Federal de Santa Maria, Santa Maria (RS) Brasil
| | - Juliana Carvalho Ferreira
- . Divisão de Pneumologia, Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo (SP) Brasil
| | - Rodrigo Della Méa Plentz
- . Serviço de Fisioterapia, Irmandade Santa Casa de Misericórdia de Porto Alegre, Porto Alegre (RS) Brasil.,. Departamento de Fisioterapia, Universidade Federal de Ciências da Saúde de Porto Alegre - UFCSPA - Porto Alegre (RS) Brasil
| | - Celso R F Carvalho
- . Departamento de Fisioterapia, Faculdade de Medicina, Universidade de São Paulo, São Paulo (SP) Brasil
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Garlet AB, Plentz RDM, Blauth AHEG, Righi TT, Righi NC, Schardong J. Reabilitação robótica em pacientes com AVC: protocolo de ensaio clínico randomizado. Fisioter Pesqui 2021. [DOI: 10.1590/1809-2950/21020028042021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
RESUMO O objetivo deste estudo foi propor um protocolo de ensaio clínico randomizado para avaliar o efeito da reabilitação robótica sobre a funcionalidade de pacientes com acidente vascular cerebral (AVC) subagudo. Trata-se de um protocolo de um ensaio clínico randomizado que será desenvolvido no hospital e centro de reabilitação do Pavilhão Pereira Filho da Irmandade da Santa Casa de Misericórdia de Porto Alegre (ISCMPA). Quarenta pacientes com AVC, de ambos os sexos, com idades entre 18 e 85 anos e que apresentem hemiparesia ou fraqueza muscular (Medical Research Council - MRC <48 pontos) serão divididos aleatoriamente em grupo controle ou grupo de intervenção. O grupo de intervenção será aquele que realizará reabilitação robótica utilizando equipamento Erigo®, além da fisioterapia convencional, e o grupo controle receberá fisioterapia convencional por meio de exercícios com movimentos semelhantes aos realizados no robô. As intervenções ocorrerão todos os dias na fase hospitalar e, após a alta, três vezes por semana, totalizando aproximadamente 18 sessões. A funcionalidade será considerada o desfecho primário do estudo e será avaliada por meio da escala de Fugl-Meyer. Consideramos como desfechos secundários a força muscular (MRC e teste de repetição máxima), espasticidade (escala de Ashworth modificada), arquitetura do músculo quadríceps e ecogenicidade (ultrassom), mobilidade (teste timed up and go), grau de incapacidade e dependência (escala de Rankin e de medida de independência funcional), qualidade de vida (questionário EQ-5D), repercussões cardiorrespiratórias (monitoramento de sinais vitais), tempo de internação (em dias) e mortalidade (número de óbitos). Os grupos serão avaliados antes das intervenções, após a décima sessão e ao final de seis semanas de tratamento ou 18 sessões.
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Dipp T, Moraes-Silva IC, Dos Santos F, Casali KR, Morris M, Signori LU, De Angelis K, Aletti F, Irigoyen MC, Plentz RDM, Schaan BD. Acute ingestion of a high-fructose drink impairs vascular autonomic modulation and reflex control of blood pressure in first-degree relatives of diabetic patients. Diabetes Res Clin Pract 2021; 177:108793. [PMID: 33951480 DOI: 10.1016/j.diabres.2021.108793] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2019] [Revised: 03/03/2021] [Accepted: 03/30/2021] [Indexed: 11/28/2022]
Abstract
First-degree relatives of diabetes patients, despite being euglycemic, presented impaired BRS and exacerbation of sympathetic modulation after ingestion of a high fructose drink when challenged to orthostatic stress. This finding alerts the importance of early autonomic dysfunction even in clinically healthy people, especially in face of a stressful situation.
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Affiliation(s)
- T Dipp
- Cardiology Institute (IC)/Cardiology University Foundation (FUC) of Rio Grande do Sul, Porto Alegre, Brazil; Physical Therapy Department, Federal University of Health Sciences of Porto Alegre (UFCSPA), Porto Alegre, Brazil
| | - I C Moraes-Silva
- Heart Institute (InCor), University of São Paulo Medical School, São Paulo, Brazil
| | - F Dos Santos
- Heart Institute (InCor), University of São Paulo Medical School, São Paulo, Brazil
| | - K R Casali
- Science and Technology Institute, Federal University of São Paulo (UNIFESP), São José dos Campos, Brazil
| | - M Morris
- Institute of Neuro-Immune Medicine, Nova Southeastern University, Fort Lauderdale, FL, USA
| | - L U Signori
- Biological Sciences Institute, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - K De Angelis
- Department of Physiology, Federal University of São Paulo (UNIFESP), São Paulo, Brazil
| | - F Aletti
- Department of Bioengineering, University of California San Diego, La Jolla, CA, USA
| | - M C Irigoyen
- Heart Institute (InCor), University of São Paulo Medical School, São Paulo, Brazil.
| | - R D M Plentz
- Cardiology Institute (IC)/Cardiology University Foundation (FUC) of Rio Grande do Sul, Porto Alegre, Brazil; Physical Therapy Department, Federal University of Health Sciences of Porto Alegre (UFCSPA), Porto Alegre, Brazil
| | - B D Schaan
- Endocrinology, Universidade Federal do Rio Grande do Sul e Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
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10
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Nicolodi GV, Della Méa Plentz R, Righi NC, Stein C. Effects of aerobic exercise on patients with pre-dialysis chronic kidney disease: a systematic review of randomized controlled trials. Disabil Rehabil 2021; 44:4179-4188. [PMID: 34033723 DOI: 10.1080/09638288.2021.1900929] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
PURPOSE Reviewing systematically the randomized controlled trials (RCTs) that evaluated aerobic exercisealone vs. usual care in exercise tolerance, functional capacity, and quality of life (QoL) in patients withpre-dialysis. METHODS Searches in the MEDLINE, Cochrane CENTRAL, EMBASE, PEDro, and LILACS databases untilFebruary 2021 included RCTs that evaluated the effects of aerobic exercise on peak VO2, functional capacity,lower limb muscle strength, and QoL. The random effect meta-analysis model was used andreported as mean difference (MD) and 95% confidence interval (CI), risk of bias through RoB2.0 and thequality of evidence by GRADE. RESULTS 10 RCTs, with 365 patients. Aerobic exercise increased 2.07 ml/kg/min (95% CI = 1.16 to 2.98; I2= 24%, QoE moderate) at peak VO2; 77.78m (95% CI= 33.27 to 122.30; I2= 44.5%, QoE moderate) in the 6MWT and 7.65 repetitions (95% CI= 5.73 to 9.58; I2= 0 %; QoE moderate) in STS-30 versus usual care. In QoL, studies reported improvements in the questionnaire scores. Eu.2 = 24%, QoE moderado) no pico de VO2; 77,78 m (IC95% = 33,27-122,30; Eu.2 = 44,5%, QoE moderado) nas repetições 6MWT e 7,65 (IC95% = 5,73-9,58; Eu.2 = 0%; QoE moderado) em STS-30". CONCLUSION Aerobic exercise increases VO2 peak, functional capacity and lower limb muscle strength in patients with pre-dialysis. Effects on QoL appear to be beneficial.IMPLICATIONS FOR REHABILITATIONAerobic exercise should be encouraged in the rehabilitation of patients at any stage of chronic kidney disease.Aerobic exercise promotes improved exercise tolerance, functional capacity, and muscle strength of the lower limbs.There is some evidence to show it is beneficial to improve the quality of life.
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Affiliation(s)
- Graziela Valle Nicolodi
- Physiotherapy Department, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, Brasil.,Physiotherapy Department, Universidade de Cruz Alta (UNICRUZ), Cruz Alta, Brasil
| | - Rodrigo Della Méa Plentz
- Physiotherapy Department, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, Brasil
| | - Natiele Camponogara Righi
- Physiotherapy Department, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, Brasil
| | - Cinara Stein
- Physiotherapy Department, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, Brasil
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11
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Silva FPD, Severo-Silveira L, Plentz RDM, Durigan JLQ, Baroni BM. Electrophysical agents in clinical practice of orthopedic and sports physical therapists in Brazil. Fisioter Pesqui 2020. [DOI: 10.1590/1809-2950/19019727022020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
ABSTRACT Studies have described the use of electrophysical agents (EPA) by physical therapists worldwide. However, the use of EPA by Brazilian physical therapists remains undetermined. This study aims to describe the availability, use, and perception about EPA by orthopedic and sports physical therapists in Brazil. Professionals of the area were invited to answer an online questionnaire. Demographic data and information regarding the availability, use and perception about EPA in their current clinical practice were asked. Out of 376 physical therapists included in this study, 89% declared to use EPA in clinical practice. Sensory electrotherapy with pulsed current (TENS), therapeutic ultrasound, excitomotor electrotherapy with pulsed current (FES/NMES), and cryotherapy are available for more than 3/4 of interviewees. Scientific articles and clinical experience, respectively, are the most influential factors for the choice of EPA. Ultrasound is the most frequently used EPA, followed by TENS, cryotherapy, photobiomodulation, hot packs, and FES/NMES. The top-five most useful EPA in clinical practice chosen by physical therapists are: (1) ultrasound; (2) photobiomodulation; (3) TENS; (4) cryotherapy; and (5) FES/NMES. In conclusion, EPA are widely used by orthopedic and sports physical therapists in Brazil. Therapeutic ultrasound, TENS, FES/NMES, photobiomodulation, cryotherapy, and hot packs are the most used EPA in clinical practice of these physiotherapists.
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12
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Schardong J, Falster M, Sisto IR, Barbosa APO, Normann TC, de Souza KS, Jaroceski G, Bozzetto CB, Baroni BM, Plentz RDM. Photobiomodulation therapy increases functional capacity of patients with chronic kidney failure: randomized controlled trial. Lasers Med Sci 2020; 36:119-129. [PMID: 32333337 DOI: 10.1007/s10103-020-03020-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Accepted: 04/06/2020] [Indexed: 01/13/2023]
Abstract
Photobiomodulation (PBM) has been used in different populations as a strategy to attenuate muscle fatigue and improve exercise performance. Recent findings demonstrated that a single session with specific PBM doses during hemodialysis (HD) increased the upper limb muscle strength of chronic kidney failure (CKF) patients. Now, the primary objective of this study was to evaluate the chronic effect of PBM on the functional capacity of this population. Secondarily, we aimed at investigating the effects of PBM on the patients' strength, muscle thickness and echogenicity, perception of pain, fatigue, and quality of life. A randomized controlled trial was conducted in which the intervention group (IG, n = 14) received 24 sessions of PBM (810 nm, 5 diodes × 200 mW, 30 J/application site) on lower limb during HD. The control group (CG, n = 14) did not receive any physical therapy intervention, it only underwent HD sessions. As a result, there was an increase in the functional capacity (assessed through the six-minute walk test) for the IG compared with the CG [50.7 m (CI95% 15.63; 85.72), p = 0.01, large effect size, d = 1.12], as well as an improvement on lower limb muscle strength (assessed through the sit-and-stand test) [- 7.4 s (CI95% - 4.54; - 10.37), p = 0.00, large effect size, d = 1.99]. For other outcomes evaluated, no significant difference between-group was observed. Finally, PBM applied as monotherapy for 8 weeks in the lower limb improves functional capacity and muscle strength of CKF patients.
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Affiliation(s)
- Jociane Schardong
- Physiotherapy Department, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Rua Sarmento Leite, 245, Porto Alegre, Rio Grande do Sul, Brazil.
| | - Mariana Falster
- Physiotherapy Department, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Rua Sarmento Leite, 245, Porto Alegre, Rio Grande do Sul, Brazil
| | - Isadora Rebolho Sisto
- Physiotherapy Department, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Rua Sarmento Leite, 245, Porto Alegre, Rio Grande do Sul, Brazil
| | - Ana Paula Oliveira Barbosa
- Physiotherapy Department, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Rua Sarmento Leite, 245, Porto Alegre, Rio Grande do Sul, Brazil
| | - Tatiana Coser Normann
- Physiotherapy Department, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Rua Sarmento Leite, 245, Porto Alegre, Rio Grande do Sul, Brazil
| | - Kellen Sábio de Souza
- Physiotherapy Department, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Rua Sarmento Leite, 245, Porto Alegre, Rio Grande do Sul, Brazil
| | - Gabriela Jaroceski
- Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, Rio Grande do Sul, Brazil
| | - Camila Bassani Bozzetto
- Physiotherapy Department, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Rua Sarmento Leite, 245, Porto Alegre, Rio Grande do Sul, Brazil
| | - Bruno Manfredini Baroni
- Physiotherapy Department, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Rua Sarmento Leite, 245, Porto Alegre, Rio Grande do Sul, Brazil
| | - Rodrigo Della Méa Plentz
- Physiotherapy Department, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Rua Sarmento Leite, 245, Porto Alegre, Rio Grande do Sul, Brazil
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13
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Stigger FS, Zago Marcolino MA, Portela KM, Plentz RDM. Effects of Exercise on Inflammatory, Oxidative, and Neurotrophic Biomarkers on Cognitively Impaired Individuals Diagnosed With Dementia or Mild Cognitive Impairment: A Systematic Review and Meta-Analysis. J Gerontol A Biol Sci Med Sci 2020; 74:616-624. [PMID: 30084942 DOI: 10.1093/gerona/gly173] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2018] [Indexed: 12/28/2022] Open
Abstract
Although the effects of physical exercise (PE) on cognitive function in dementia and mild cognitive impairment (MCI) have been largely studied, its biochemical effect is still poorly explored. The aim of this systematic review was to investigate the effects of PE on inflammatory, oxidative, and neurotrophic biomarkers of participants with MCI or dementia. Six electronic databases, (PubMed, Cochrane Central, Embase, PEDro, PsycINFO, and SportDiscus) were searched for randomized controlled trials assessing the effects of PE on serum and/or plasma biomarkers of elderly participants with MCI or dementia. After selection process, eight studies were included. Meta-analysis was performed by comparison of changes from baseline, using the random effects method. Meta-analysis showed a significant effect of aerobic exercise on interleukin-6 and tumor necrosis factor alpha decrease and positive effects on brain-derived neurotrophic factor expression. As only one study was included with oxidative biomarker assessment, the effects of PE on oxidative process remain unclear. Finally, even though it was possible to observe positive effects of PE on some biomarkers of MCI and dementia individuals, current evidence does not allow drawing specific practical recommendations such as type, frequency, intensity, or duration of PE in these population. Further researches aiming to estimate the PE effectiveness on biomarkers of MCI and Alzheimer's disease are needed.
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Affiliation(s)
- Felipe S Stigger
- Postgraduate Program of Rehabilitation Sciences, Federal University of Health Sciences of Porto Alegre, Brazil.,Department of Physiotherapy, Federal University of Health Sciences of Porto Alegre, Brazil
| | - Miriam A Zago Marcolino
- Postgraduate Program of Rehabilitation Sciences, Federal University of Health Sciences of Porto Alegre, Brazil
| | - Karin M Portela
- Postgraduate Program of Rehabilitation Sciences, Federal University of Health Sciences of Porto Alegre, Brazil
| | - Rodrigo Della Méa Plentz
- Postgraduate Program of Rehabilitation Sciences, Federal University of Health Sciences of Porto Alegre, Brazil.,Department of Physiotherapy, Federal University of Health Sciences of Porto Alegre, Brazil
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14
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Da Campo L, Hauck M, Marcolino MAZ, Pinheiro D, Plentz RDM, Cechetti F. Effects of aerobic exercise using cycle ergometry on balance and functional capacity in post-stroke patients: a systematic review and meta-analysis of randomised clinical trials. Disabil Rehabil 2019; 43:1558-1564. [PMID: 31577467 DOI: 10.1080/09638288.2019.1670272] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
BACKGROUND Previous studies have shown that aerobic exercise with cycle ergometer improves motor control. PURPOSE The objective of this systematic review and meta-analysis are to evaluate evidence about the effects of aerobic exercise with cycle ergometer on the balance of post-stroke patients, evaluated by the Berg Balance Scale (BBS), and functional capacity, evaluated by the maximal oxygen intake and six-minute walk test (6MWT). METHODS The research was conducted on MEDLINE, LILACS, Cochrane Library, EMBASE, Physiotherapy Evidence Database, and Google Scholar until March 2018 (CRD42015020146). Two independent reviewers performed the article selection, data extraction, and methodological quality assessment. The main outcome was balance assessed by the Berg scale and the secondary outcome was functional capacity of the maximal oxygen intake and the 6MWT. Meta-analysis was conducted using a random-effects method, and mean pre-post intervention difference with a 95% confidence interval (95%CI). RESULTS The review included 5 papers and a total of 258 patients. It was observed that the cycle ergometer did not improve balance in this population (0.03 [-0.57 to 0.64] p = 0.91) or functional capacity in maximal oxygen intake (2.40 [-0.24 to 5.04] p = 0.07) and 6MWT (-40.49 [-131.70 to 50.72] p = 0.38). CONCLUSIONS The cycle ergometer aerobic exercise did not seem to improve balance or functional capacity in post-stroke patients.IMPLICATIONS FOR REHABILITATIONAerobic exercise with cycle ergometer does not improve balance in patients after chronic stroke, but the results for functional capacity are more promising.Beneficial changes in functional capacity can be seen after 12-4 weeks of training, and are dependent on the initial level of physical fitness of each individual.The use of the cycle-ergometer to improve balance and functional capacity was not superior when compared to conventional physiotherapy; therefore, a combination of therapeutic modalities would be ideal for rehabilitation and post-stroke patients.
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Affiliation(s)
- Luigi Da Campo
- Graduate Program of Rehabilitation Sciences, Federal University of Health Sciences, Porto Alegre, Brazil
| | - Melina Hauck
- Graduate Program of Health Sciences, Federal University of Health Sciences, Porto Alegre, Brazil
| | | | - Douglas Pinheiro
- Graduate Program of Rehabilitation Sciences, Federal University of Health Sciences, Porto Alegre, Brazil
| | - Rodrigo Della Méa Plentz
- Graduate Program of Rehabilitation Sciences, Federal University of Health Sciences, Porto Alegre, Brazil.,Graduate Program of Health Sciences, Federal University of Health Sciences, Porto Alegre, Brazil
| | - Fernanda Cechetti
- Graduate Program of Rehabilitation Sciences, Federal University of Health Sciences, Porto Alegre, Brazil
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15
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Falster M, Schardong J, Santos DPD, Machado BC, Peres A, Rosa PVD, Plentz RDM. Effects of cryolipolysis on lower abdomen fat thickness of healthy women and patient satisfaction: a randomized controlled trial. Braz J Phys Ther 2019; 24:441-448. [PMID: 31375459 DOI: 10.1016/j.bjpt.2019.07.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Revised: 07/06/2019] [Accepted: 07/12/2019] [Indexed: 10/26/2022] Open
Abstract
OBJECTIVE To analyze the effects of cryolipolysis on the fat thickness of the lower abdomen of healthy women and patient's satisfaction. METHODS Design and setting: a randomized controlled trial, with concealed allocation and blinded assessor. PARTICIPANTS 34 healthy women between 18 and 48 years, skinfold in the lower abdomen ≥3cm, BMI between 18.5 and 27kg/m2, low level of physical activity, and no contraindication to cryolipolysis were allocated to intervention group (IG, n=17) or control group (CG, n=17). INTERVENTIONS The IG received one session of cryolipolysis with -10°C of temperature for 50min. The CG was not submitted to any kind of intervention. Both groups did the evaluation protocols at baseline, 30, 60 and 90 days after the intervention. MAIN OUTCOME MEASURES fat thickness was measured by ultrasonography (US), skinfold (SF) and abdominal circumference (AC1 and AC2). RESULTS No significant differences between the IG and CG were demonstrated at any evaluation at any time of follow up for the variables US (30 days: 0.05cm (95%CI: -0.12; 0.22), 60 days: 0.05cm (95%CI: -0.11; 0.20) and 90 days: 0.04cm (95%CI: -0.7; 0.25)), SF (30 days: -0.09cm (95%CI: -0.25; 0.08), 60 days: -0.14cm (95%CI: -0.36; 0.09) and 90 days: -0.001cm (95%CI: -0.237; 0.234)), AC1 (30 days: 0.42cm (95%CI: -1.1; 1.9), 60 days: -0.1cm (95%CI: -1.74; 1.54) and 90 days: -0.007cm (-1.9; 1.9)) and AC2 (30 days: 0.183cm (95%CI: -0.84; 1.20), 60 days: -0.13cm (95%CI: -1.61; 1.35) and 90 days: -0.31cm (95%CI: -1.61; 1.00)). CONCLUSIONS The current study showed that a single application of the utilized protocol of cryolipolysis does not produce any significant effect on fat thickness of the lower abdomen of healthy women. CLINICAL TRIAL REGISTRATION NUMBER NCT03160976 (https://clinicaltrials.gov/ct2/show/NCT03160976). Contribution of the Paper: the study is one of the first studies in the literature with methodological rigor to report an unfavorable result for localized abdominal fat treatment with a single session of cryolipolysis.
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Affiliation(s)
- Mariana Falster
- Department of Physical Therapy, Universidade Federal de Ciências da Sáude de Porto Alegre (UFCSPA), Porto Alegre, RS, Brazil
| | - Jociane Schardong
- Department of Physical Therapy, Universidade Federal de Ciências da Sáude de Porto Alegre (UFCSPA), Porto Alegre, RS, Brazil
| | - Débora Piassarollo Dos Santos
- Department of Physical Therapy, Universidade Federal de Ciências da Sáude de Porto Alegre (UFCSPA), Porto Alegre, RS, Brazil
| | - Bruna Coimbra Machado
- Department of Physical Therapy, Universidade Federal de Ciências da Sáude de Porto Alegre (UFCSPA), Porto Alegre, RS, Brazil
| | - Alessandra Peres
- Department of Basic Health Sciences, Universidade Federal de Ciências da Sáude de Porto Alegre (UFCSPA), Porto Alegre, RS, Brazil
| | - Patrícia Viana da Rosa
- Department of Physical Therapy, Universidade Federal de Ciências da Sáude de Porto Alegre (UFCSPA), Porto Alegre, RS, Brazil
| | - Rodrigo Della Méa Plentz
- Department of Physical Therapy, Universidade Federal de Ciências da Sáude de Porto Alegre (UFCSPA), Porto Alegre, RS, Brazil.
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16
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Ferreira DDC, Marcolino MAZ, Macagnan FE, Plentz RDM, Kessler A. Safety and potential benefits of physical therapy in adult patients on extracorporeal membrane oxygenation support: a systematic review. Rev Bras Ter Intensiva 2019; 31:227-239. [PMID: 31090853 PMCID: PMC6649220 DOI: 10.5935/0103-507x.20190017] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2018] [Accepted: 09/03/2018] [Indexed: 01/22/2023] Open
Abstract
Scientific and technological advances, coupled with the work of multidisciplinary teams in intensive care units, have increased the survival of critically ill patients. An essential life support resource used in intensive care is extracorporeal membrane oxygenation. Despite the increased number of studies involving critically ill patients, few studies to date have demonstrated the safety and benefits of physical therapy combined with extracorporeal membrane oxygenation support. This review identified the clinical outcomes of physical therapy in adult patients on extracorporeal membrane oxygenation support by searching the MEDLINE®, PEDro, Cochrane CENTRAL, LILACS, and EMBASE databases and by manually searching the references of the articles published until September 2017. The database search retrieved 1,213 studies. Of these studies, 20 were included in this review, with data on 317 subjects (58 in the control group). Twelve studies reported that there were no complications during physical therapy. Cannula fracture during ambulation (one case), thrombus in the return cannula (one case), and leg swelling (one case) were reported in two studies, and desaturation and mild vertigo were reported in two studies. In contrast, improvements in respiratory/pulmonary function, functional capacity, muscle strength (with reduced muscle mass loss), incidence of myopathy, length of hospitalization, and mortality in patients who underwent physical therapy were reported. The analysis of the available data indicates that physical therapy, including early progressive mobilization, standing, ambulation, and breathing techniques, together with extracorporeal membrane oxygenation, is feasible, relatively safe, and potentially beneficial for critically ill adult patients.
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Affiliation(s)
- Daniele da Cunha Ferreira
- Residência Multiprofissional Integrada em Saúde com
ênfase em Atenção em Terapia Intensiva, Universidade Federal de
Ciências da Saúde de Porto Alegre - Porto Alegre (RS), Brasil
| | - Miriam Allein Zago Marcolino
- Programa de Pós-Graduação em Ciências
da Reabilitação, Universidade Federal de Ciências da
Saúde de Porto Alegre - Porto Alegre (RS), Brasil
| | - Fabrício Edler Macagnan
- Programa de Pós-Graduação em Ciências
da Reabilitação, Universidade Federal de Ciências da
Saúde de Porto Alegre - Porto Alegre (RS), Brasil
- Departamento de Fisioterapia, Universidade Federal de
Ciências da Saúde de Porto Alegre - Porto Alegre (RS), Brasil
| | - Rodrigo Della Méa Plentz
- Programa de Pós-Graduação em Ciências
da Reabilitação, Universidade Federal de Ciências da
Saúde de Porto Alegre - Porto Alegre (RS), Brasil
- Departamento de Fisioterapia, Universidade Federal de
Ciências da Saúde de Porto Alegre - Porto Alegre (RS), Brasil
| | - Adriana Kessler
- Residência Multiprofissional Integrada em Saúde com
ênfase em Atenção em Terapia Intensiva, Universidade Federal de
Ciências da Saúde de Porto Alegre - Porto Alegre (RS), Brasil
- Departamento de Fisioterapia, Universidade Federal de
Ciências da Saúde de Porto Alegre - Porto Alegre (RS), Brasil
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17
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Dipp T, Macagnan FE, Schardong J, Fernandes RO, Lemos LC, Plentz RDM. Short period of high-intensity inspiratory muscle training improves inspiratory muscle strength in patients with chronic kidney disease on hemodialysis: a randomized controlled trial. Braz J Phys Ther 2019; 24:280-286. [PMID: 31122717 DOI: 10.1016/j.bjpt.2019.04.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2018] [Revised: 03/01/2019] [Accepted: 04/16/2019] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Chronic kidney disease is a complex disease that impacts multiple organs and systems (including musculoskeletal and cardiorespiratory) leading to reduction of functional capacity. OBJECTIVE The aim of this study was to investigate the effect of a short period of high intensity inspiratory muscle training on maximum inspiratory pressure, functional capacity and endothelial function of chronic kidney disease patients on hemodialysis. METHODS This randomized controlled trial enrolled 25 patients who were allocated into two groups: intervention (IMTG=14) and control (CG=11) groups. Intervention patients received the exercise protocol over a period of 5 weeks, 6 times per week, with each session consisting of 5 sets of 10 repetitions with an initial load of 50% progressing to 70% of maximum inspiratory pressure , measured weekly. The primary outcome was inspiratory muscle strength and the secondary outcomes were functional capacity and endothelial function evaluated before and after the training protocol. RESULTS The inspiratory muscle training induced a marked improvement in maximum inspiratory pressure which was evident after the training period (mean difference 19.0cmH2O - 95%CI 0.4-37.5; IMTG: 102±25.7cmH2O vs CG: 83±19.2; p=0.046). The magnitude of maximum inspiratory pressure improvement was 33.5% at the end of the protocol for the IMTG. Functional capacity and endothelial function did not vary between or within groups. CONCLUSION A short period of high-intensity inspiratory muscle training for five weeks was able to improve inspiratory muscle strength of chronic kidney disease patients on hemodialysis (ClinicalTrials.gov registration NCT03082404).
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Affiliation(s)
- Thiago Dipp
- Department of Physical Therapy, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, RS, Brazil.
| | - Fabrício Edler Macagnan
- Department of Physical Therapy, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, RS, Brazil
| | - Jociane Schardong
- Department of Physical Therapy, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, RS, Brazil
| | - Rafael Oliveira Fernandes
- Department of Physiology, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
| | - Luisa Cioato Lemos
- Department of Physical Therapy, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, RS, Brazil
| | - Rodrigo Della Méa Plentz
- Department of Physical Therapy, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, RS, Brazil
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18
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Vaz PG, Salazar APDS, Stein C, Marchese RR, Lukrafka JL, Plentz RDM, Pagnussat AS. Noninvasive brain stimulation combined with other therapies improves gait speed after stroke: a systematic review and meta-analysis. Top Stroke Rehabil 2019; 26:201-213. [PMID: 30735104 DOI: 10.1080/10749357.2019.1565696] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
BACKGROUND Repetitive transcranial magnetic stimulation (rTMS) and transcranial direct current stimulation (tDCS) are noninvasive brain stimulation (NIBS) techniques able to modulate cortical excitability. OBJECTIVE To determine the effects of NIBS combined with other therapies on gait speed after stroke. METHODS Electronic databases searched were PUBMED, EMBASE, COCHRANE, SCOPUS, SCIELO and PEDro. Eligibility criteria were randomized controlled trials that reported the effects of tDCS and rTMS combined with other therapies for improving gait speed, walking cadence, functional ambulation category (FAC) and motricity index (MI-LE) after stroke. Risk of bias was assessed by Cochrane risk of bias assessment tool. Mean differences (MD) and 95% confidence intervals were calculated. Quality of evidence was assessed by Grades of Researches, Assessment, Development and Evaluation approach. RESULTS Ten studies (226 subjects) were included in the meta-analysis. NIBS combined with other therapies was effective for improving gait speed (MD 0.09 m/s [95% CI, 0.05 to 0.13; I2 0%, p < 0.0001]). Gait speed improved in both acute/subacute (MD 0.08 m/s [95% CI, 0.02 to 0.14]) and chronic phases (MD 0.08 m/s [95% CI, 0.03 to 0.13]). Furthermore, inhibitory (MD 0.09 m/s [95% CI, 0.04 to 0.14]) and excitatory (MD 0.07 m/s [95% CI, 0.02 to 0.12]) protocols were effective to improve gait speed. NIBS was also effective to improve walking cadence but was unable to modify other outcomes (FAC and MI-LE). CONCLUSIONS This systematic review with meta-analysis synthesizes moderate-quality evidence that NIBS combined with other therapies are effective to improve gait speed after stroke. Systematic Review registration number: PROSPERO registration number CDR42015024237.
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Affiliation(s)
- Patricia Graef Vaz
- a Health Sciences Graduate Program , Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA) , Porto Alegre , Brazil.,b Department of Physiotherapy , Centro Universitário Ritter dos Reis (UniRitter) - Laureate International Universities , Porto Alegre , Brazil.,c Movement Analysis and Neurological Rehabilitation Laboratory , Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA) , Porto Alegre , Brazil
| | - Ana Paula da Silva Salazar
- c Movement Analysis and Neurological Rehabilitation Laboratory , Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA) , Porto Alegre , Brazil.,d Rehabilitation Sciences Graduate Program , Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA) , Porto Alegre , Brazil
| | - Cinara Stein
- a Health Sciences Graduate Program , Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA) , Porto Alegre , Brazil
| | - Ritchele Redivo Marchese
- c Movement Analysis and Neurological Rehabilitation Laboratory , Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA) , Porto Alegre , Brazil
| | - Janice Luisa Lukrafka
- c Movement Analysis and Neurological Rehabilitation Laboratory , Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA) , Porto Alegre , Brazil.,d Rehabilitation Sciences Graduate Program , Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA) , Porto Alegre , Brazil
| | - Rodrigo Della Méa Plentz
- a Health Sciences Graduate Program , Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA) , Porto Alegre , Brazil.,d Rehabilitation Sciences Graduate Program , Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA) , Porto Alegre , Brazil
| | - Aline Souza Pagnussat
- a Health Sciences Graduate Program , Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA) , Porto Alegre , Brazil.,c Movement Analysis and Neurological Rehabilitation Laboratory , Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA) , Porto Alegre , Brazil.,d Rehabilitation Sciences Graduate Program , Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA) , Porto Alegre , Brazil
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Marcolino MAZ, Hauck M, Stein C, Schardong J, Pagnussat ADS, Plentz RDM. Effects of transcutaneous electrical nerve stimulation alone or as additional therapy on chronic post-stroke spasticity: systematic review and meta-analysis of randomized controlled trials. Disabil Rehabil 2018; 42:623-635. [PMID: 30326752 DOI: 10.1080/09638288.2018.1503736] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Purpose: To evaluate the effects and to compare transcutaneous electrical nerve stimulation protocols, alone or as additional therapy in chronic post-stroke spasticity through a systematic review and meta-analysis of randomized clinical trials.Methods: Search was conducted in MEDLINE, Cochrane Library, EMBASE and Physiotherapy Evidence Database through November 2017 (CRD42015020146). Two independent reviewers performed articles selection, data extraction and methodological quality assessment using the Cochrane Collaboration's risk of bias tool. The main outcome was spasticity assessed with Modified Ashworth Scale or other valid scale. Meta-analysis was conducted using random effects method, and pooled-effect results are mean difference with 95% confidence interval.Results: Of 6506 articles identified, 10 studies with 360 subjects were included in the review. Transcutaneous electrical nerve stimulation alone or as additional therapy is superior to placebo TENS to reduce post-stroke spasticity assessed with Modified Ashworth Scale (-0.52 [-0.74 to -0.30] p < 0.0001, 6 studies), especially in lower limbs (-0.58 [-0.82 to -0.34] p < 0.0001, 5 studies), which is in accordance with the studies that used other scales. Low frequency TENS showed a slightly larger improvement than high-frequency, but without significant difference between subgroups. Most studies present low or unclear risk of bias.Conclusion: Transcutaneous electrical nerve stimulation can provide additional reduction in chronic post-stroke spasticity, mainly as additional therapy to physical interventions. Studies with better methodological quality and larger sample are needed to increase evidence power.Implications for RehabilitationTranscutaneous electrical nerve stimulation as additional treatment to physical interventions can lead to additional reduction in chronic post-stroke spasticity.High and low frequency transcutaneous electrical nerve stimulation showed similar results, with a smaller numerical superiority of low frequency TENS.More studies are needed to substantiate the best protocol of transcutaneous electrical nerve stimulation to the treatment of spasticity.
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Affiliation(s)
- Miriam Allein Zago Marcolino
- Graduate Program in Rehabilitation Sciences, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, Brazil
| | - Melina Hauck
- Graduate Program in Health Sciences, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, Brazil
| | - Cinara Stein
- Graduate Program in Health Sciences, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, Brazil
| | - Jociane Schardong
- Graduate Program in Rehabilitation Sciences, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, Brazil
| | - Aline de Souza Pagnussat
- Graduate Program in Rehabilitation Sciences, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, Brazil.,Graduate Program in Health Sciences, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, Brazil
| | - Rodrigo Della Méa Plentz
- Graduate Program in Rehabilitation Sciences, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, Brazil.,Graduate Program in Health Sciences, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, Brazil
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20
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Furlanetto MP, Grivicich I, Dihl RR, Lehmann M, de Souza DS, Plentz RDM. In Vivo Analysis of Photobiomodulation Genotoxicity Using the Somatic Mutation and Recombination Test. Photomed Laser Surg 2018; 36:536-540. [PMID: 30251923 DOI: 10.1089/pho.2018.4468] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Photobiomodulation (PBM) has been studied mainly for its effects on the repair, regeneration, and healing of tissue due to its direct and indirect actions on cell proliferation. However, it is necessary to consider the way in which laser acts, that is, whether it affects the rates of spontaneous mutation and mitotic recombination of cells. OBJECTIVE This study investigated the genotoxic potential of PBM (904 nm) based on an in vivo bioassay that concomitantly evaluates mitotic recombination and point and chromosomal mutations. METHODS Strains of Drosophila melanogaster that carry specific marker genes were used to detect the induction of mutation and somatic recombination when exposed to different fluences (3, 5, 10, and 20 J/cm2). DNA damage was measured using the somatic mutation and recombination test (SMART), which is based on the identification of wing hair with mutant phenotypes that express lesions at DNA level. RESULTS The doses 5, 10, and 20 J/cm2 induced significant increase in the total number of spots compared with the negative control. The highest frequency of spots was caused by the 10 J/cm2. CONCLUSIONS Besides recombination events, the quantitative and qualitative analysis of mutant hairs revealed the occurrence of mutagenic events, both punctual and chromosomal. In addition, the results point to a dose-dependent response.
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Affiliation(s)
- Magda Patrícia Furlanetto
- 1 Pós-Graduação em Ciências da Saúde, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA) , Porto Alegre, Rio Grande do Sul, Brazil .,2 PPG Biosaúde, Universidade Luterana do Brasil (ULBRA) , Canoas, Rio Grande do Sul, Brazil .,3 Centro Universitário Ritter dos Reis , Porto Alegre, Rio Grande do Sul, Brazil
| | - Ivana Grivicich
- 2 PPG Biosaúde, Universidade Luterana do Brasil (ULBRA) , Canoas, Rio Grande do Sul, Brazil
| | - Rafael Rodrigues Dihl
- 2 PPG Biosaúde, Universidade Luterana do Brasil (ULBRA) , Canoas, Rio Grande do Sul, Brazil
| | - Mauricio Lehmann
- 2 PPG Biosaúde, Universidade Luterana do Brasil (ULBRA) , Canoas, Rio Grande do Sul, Brazil
| | | | - Rodrigo Della Méa Plentz
- 1 Pós-Graduação em Ciências da Saúde, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA) , Porto Alegre, Rio Grande do Sul, Brazil
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21
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Miozzo AP, Stein C, Marcolino MZ, Sisto IR, Hauck M, Coronel CC, Plentz RDM. Effects of High-Intensity Inspiratory Muscle Training Associated with Aerobic Exercise in Patients Undergoing CABG: Randomized Clinical Trial. Braz J Cardiovasc Surg 2018; 33:376-383. [PMID: 30184035 PMCID: PMC6122761 DOI: 10.21470/1678-9741-2018-0053] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2018] [Accepted: 04/10/2018] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE Evaluate the interaction between high-intensity inspiratory muscle training (IMT) and aerobic exercise on physical capacity, respiratory muscle strength, peripheral muscle strength, and quality of life of patients who underwent coronary artery bypass grafting (CABG). METHODS Twenty-four patients underwent CABG were randomized into two groups. During 36 sessions, one group received IMT associated with aerobic exercise and the other group received only aerobic exercise. Primary outcome was the distance in the six-minute walk distance (6MWD) test. Secondary outcomes included respiratory muscle strength, peripheral muscle strength, and quality of life. Measures were taken at the baseline, at the 12th session, the 24th session, and 36th session. RESULTS Baseline characteristics were similar between the groups. There was no statistically significant difference between the two groups in any outcome [6MWD - P=0.935; peak oxygen consumption (PeakVO2) - P=0.853; maximal inspiratory pressure (MIP) - P=0.243; maximal expiratory pressure (MEP) - P=0.268; sitting-rising test (SRT) - P=0.212], but there was interaction in MIP (P=0.000) and all outcomes improved in the two groups (6MWD - P=0.000; PeakVO2 - P=0.000; MIP - P=0.000; MEP - P=0.000; SRT - P=0.000). CONCLUSION There was an improvement of all outcomes in both groups, but IMT was not able to provide additional benefits. The use of this combination should be used with caution to not generate higher costs in the rehabilitation process of these patients.
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Affiliation(s)
- Aline Paula Miozzo
- Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, RS, Brazil.,Instituto de Cardiologia, Porto Alegre, RS, Brazil
| | - Cinara Stein
- Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, RS, Brazil.,Instituto de Cardiologia, Porto Alegre, RS, Brazil
| | - Miriam Zago Marcolino
- Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, RS, Brazil.,Instituto de Cardiologia, Porto Alegre, RS, Brazil
| | - Isadora Rebolho Sisto
- Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, RS, Brazil.,Instituto de Cardiologia, Porto Alegre, RS, Brazil
| | - Melina Hauck
- Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, RS, Brazil.,Instituto de Cardiologia, Porto Alegre, RS, Brazil
| | - Christian Corrêa Coronel
- Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, RS, Brazil.,Instituto de Cardiologia, Porto Alegre, RS, Brazil
| | - Rodrigo Della Méa Plentz
- Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, RS, Brazil.,Instituto de Cardiologia, Porto Alegre, RS, Brazil
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22
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Robinson CC, Barreto RPG, Plentz RDM. Effects of whole body vibration in individuals with diabetic peripheral neuropathy: a systematic review. J Musculoskelet Neuronal Interact 2018; 18:382-388. [PMID: 30179216 PMCID: PMC6146195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
BACKGROUND Whole-body vibration (WBV) is an alternative intervention for patients with diabetic peripheral neuropathy (DPN) but its clinical efficacy is unclear. OBJECTIVE To summarize the effects of WBV on important outcomes for patients with DPN. DATA SOURCES Medline, PEDro, Cochrane CENTRAL and Google Scholar were searched up to July 2017. Search terms included diabetic neuropathies and WBV. STUDY SELECTION Interventional studies that utilized WBV for treating DPN outcomes with at least one-week follow-up were included. DATA EXTRACTION Data were independently extracted by two reviewers using a standardized checklist. DATA SYNTHESIS Twenty-two registers were identified. Three studies (83 patients) satisfied the selection criteria. Studies assessed the effect of WBV on the glycemic profile, neuropathic pain, and balance. WBV presented positive effects on these outcomes, but a high risk of bias was identified in most studies. No study assessed plantar tactile sensitivity. LIMITATIONS Most studies have a high level of bias. No pooling data was possible due to few studies included. CONCLUSIONS Very low-quality evidence suggests that WBV has a slight positive effect on glycemic control in patients with DPN, improving neuropathic pain and balance. Future studies may change the WBV estimated effect on DPN outcomes.
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Affiliation(s)
- Caroline Cabral Robinson
- Programa de Pós-Graduação em Ciências da Saúde, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Brazil,Corresponding author: Caroline Cabral Robinson, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Rua Sarmento Leite, 245, Porto Alegre, Rio Grande do Sul, 90050-170, Brazil E-mail:
| | - Rodrigo Py Gonçalves Barreto
- Programa de Pós-Graduação em Fisioterapia, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Brazil
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23
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Macagnan FE, Baroni BM, Cristofoli ÉZ, Godoy M, Schardong J, Plentz RDM. Acute effect of photobiomodulation therapy on handgrip strength of chronic kidney disease patients during hemodialysis. Lasers Med Sci 2018; 34:835-840. [PMID: 30056586 DOI: 10.1007/s10103-018-2593-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2018] [Accepted: 07/16/2018] [Indexed: 10/28/2022]
Abstract
Pre-exercise photobiomodulation therapy (PBMT) reduces fatigue and enhances performance in different populations. However, PBMT benefits have never been tested on chronic kidney disease (CKD) patients, who present muscle weakness, fatigue, and reduced functional performance. The objective of this study was to evaluate the acute effect of three different doses of the PBMT on maximal handgrip strength of CKD patients. Fifteen volunteers (58 ± 8 years, 10 male/5 female) under chronic hemodialysis treatment (6 ± 4 years) participated in a randomized, crossover, double-blind, placebo-controlled trial. Each patient was assessed at four hemodialysis sessions with 1 week interval between evaluations. Placebo or PBMT (cluster probe with five 850 nm/200 mW laser diodes) were applied at three sites along the flexors of the finger (total doses of 60, 90, or 120 J per arm). The maximal handgrip strength was evaluated before and after PBMT/placebo treatment in each session. Repeated measures ANOVA and intraclass correlation coefficients (ICC) confirmed no learning effect on handgrip tests, and high scores for test-retest reliability (ICC scores = 0.89 to 0.95). Significant strength increases occurred after PBMT application with doses of 60 J/arm (4.85%, p = 0.005, ES = 0.32) and 90 J/arm (4.45%, p = 0.013, ES = 0.25), while no changes were detected with placebo or 120 J/arm. In conclusion, in consensus with a recent systematic review, a single bout of the 60 J/arm was the best dose/response for increased strength of the small muscles (handgrip strength). In view of the increasing implementation of exercise programs during hemodialysis, the current study opens a new field for PBMT for CKD patients.
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Affiliation(s)
- Fabrício Edler Macagnan
- Graduate Program in Rehabilitation Sciences, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Sarmento Leite, 245, Porto Alegre, Rio Grande do Sul, 90050-170, Brazil.
| | - Bruno Manfredini Baroni
- Graduate Program in Rehabilitation Sciences, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Sarmento Leite, 245, Porto Alegre, Rio Grande do Sul, 90050-170, Brazil
| | - Érika Zanchet Cristofoli
- Physiotherapy Course, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, Rio Grande do Sul, Brazil
| | - Marília Godoy
- Physiotherapy Course, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, Rio Grande do Sul, Brazil
| | - Jociane Schardong
- Graduate Program in Health Sciences, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, Rio Grande do Sul, Brazil
| | - Rodrigo Della Méa Plentz
- Graduate Program in Rehabilitation Sciences, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Sarmento Leite, 245, Porto Alegre, Rio Grande do Sul, 90050-170, Brazil.,Graduate Program in Health Sciences, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, Rio Grande do Sul, Brazil
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Schardong J, Brito VB, Dipp T, Macagnan FE, Saffi J, Méa Plentz RD. Intradialytic neuromuscular electrical stimulation reduces DNA damage in chronic kidney failure patients: a randomized controlled trial. Biomarkers 2018. [DOI: 10.1080/1354750x.2018.1452049] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
- Jociane Schardong
- Department of Physical Therapy, Universidade Federal de Ciencias da Saude de Porto Alegre, Porto Alegre, Brazil
| | - Verônica Bidinotto Brito
- Department of Physical Therapy, Universidade Federal de Ciencias da Saude de Porto Alegre, Porto Alegre, Brazil
| | - Thiago Dipp
- Department of Physical Therapy, Universidade Federal de Ciencias da Saude de Porto Alegre, Porto Alegre, Brazil
| | - Fabrício Edler Macagnan
- Department of Physical Therapy, Universidade Federal de Ciencias da Saude de Porto Alegre, Porto Alegre, Brazil
| | - Jenifer Saffi
- Department of Physical Therapy, Universidade Federal de Ciencias da Saude de Porto Alegre, Porto Alegre, Brazil
| | - Rodrigo Della Méa Plentz
- Department of Physical Therapy, Universidade Federal de Ciencias da Saude de Porto Alegre, Porto Alegre, Brazil
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Stein C, Fernandes RO, Miozzo AP, Coronel CC, Baroni BM, Belló-Klein A, Plentz RDM. Acute Effects of Low-Level Laser Therapy on Patients' Functional Capacity in the Postoperative Period of Coronary Artery Bypass Graft Surgery: A Randomized, Crossover, Placebo-Controlled Trial. Photomed Laser Surg 2018; 36:122-129. [PMID: 29466116 DOI: 10.1089/pho.2017.4270] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
OBJECTIVE The aim of this study was to evaluate the acute effects of low-level laser therapy (LLLT) on the functional capacity to exercise tested by incremental shuttle walking test (ISWT) after coronary artery bypass graft (CABG) surgery. METHODS Fifteen male patients (60 ± 9 years) were crossed over during the experiment, to compare the outcomes after active LLLT and placebo LLLT treatments. LLLT (850 nm, 200 mW, 30 J to each point, resulting in a total of 240 J per quadriceps muscle), using a multidiode cluster (five spots; 6 J/spot) in eight points per leg was performed 3 min before the ISWT. We analyzed distance walked, Borg scale of perceived exertion, heart rate, and brachial arterial blood pressure. Markers of tissue damage [lactate dehydrogenase (LDH)] and oxidative stress [lipid peroxidation, total thiol levels, and antioxidant enzyme activity of superoxide dismutase (SOD) and catalase (CAT)] were also measured in peripheral blood. RESULTS Comparison of the distances walked revealed no significant differences between the LLLT and placebo LLLT groups (p = 0.779). Regarding the Borg scale (p = 0.567), heart rate (p = 0.506) as well as systolic and diastolic blood pressure (p = 0.164 and p = 0.140, respectively), no differences were observed between LLLT and placebo LLLT groups. Application of LLLT was not able to change levels of LDH (p = 0.214), oxidative lipid damage (p = 0.733), total thiol levels (p = 0.925), SOD (p = 0.202), and CAT (p = 0.825) enzyme activities. CONCLUSIONS Acute LLLT improved neither functional capacity to exercise nor the markers of oxidation after CABG. TRIAL REGISTRATION Registered as a clinical trial (NCT02688426).
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Affiliation(s)
- Cinara Stein
- 1 Physical Therapy Department, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA) , Porto Alegre, RS, Brazil .,2 Instituto de Cardiologia do Rio Grande do Sul (IC), Fundação Universidade de Cardiologia (FUC) , Porto Alegre, RS, Brazil
| | - Rafael Oliveira Fernandes
- 3 Laboratory of Cardiovascular Physiology, Institute of Basic Sciences of Health (ICBS), Universidade Federal do Rio Grande do Sul (UFRGS) , Porto Alegre, Rio Grande do Sul, Brazil
| | - Aline Paula Miozzo
- 1 Physical Therapy Department, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA) , Porto Alegre, RS, Brazil .,2 Instituto de Cardiologia do Rio Grande do Sul (IC), Fundação Universidade de Cardiologia (FUC) , Porto Alegre, RS, Brazil
| | - Christian Correa Coronel
- 1 Physical Therapy Department, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA) , Porto Alegre, RS, Brazil .,2 Instituto de Cardiologia do Rio Grande do Sul (IC), Fundação Universidade de Cardiologia (FUC) , Porto Alegre, RS, Brazil
| | - Bruno Manfredini Baroni
- 1 Physical Therapy Department, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA) , Porto Alegre, RS, Brazil
| | - Adriane Belló-Klein
- 3 Laboratory of Cardiovascular Physiology, Institute of Basic Sciences of Health (ICBS), Universidade Federal do Rio Grande do Sul (UFRGS) , Porto Alegre, Rio Grande do Sul, Brazil
| | - Rodrigo Della Méa Plentz
- 1 Physical Therapy Department, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA) , Porto Alegre, RS, Brazil
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Abstract
The renal damage and loss of kidney function that characterize chronic kidney disease (CKD) cause several complex systemic alterations that affect muscular homeostasis, leading to loss of muscle mass and, ultimately, to muscle atrophy. CKD-induced muscle atrophy is highly prevalent and, in association with common CKD comorbidities, is responsible for the reduction of physical capacity, functional independence, and an increase in the number of hospitalizations and mortality rates. Thus, this chapter summarizes current knowledge about the complex interactions between CKD factors and the pathophysiological mechanisms that induce muscle atrophy that, despite growing interest, are not yet fully understood. The current treatments of CKD-induced muscle atrophy are multidisciplinary, including correction of metabolic acidosis, nutritional supplementation, reducing insulin resistance, administration of androgenic steroids, resisted and aerobic exercise, neuromuscular electrical stimulation, and inspiratory muscle training. However, further studies are still needed to strengthen the comprehension of CKD-induced muscle atrophy and the better treatment strategies.
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Affiliation(s)
- Jociane Schardong
- Graduate Program in Health Sciences, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, Rio Grande do Sul, Brazil
| | - Miriam Allein Zago Marcolino
- Graduate Program in Rehabilitation Sciences, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, Rio Grande do Sul, Brazil
| | - Rodrigo Della Méa Plentz
- Graduate Program in Health Sciences, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, Rio Grande do Sul, Brazil. .,Graduate Program in Rehabilitation Sciences, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, Rio Grande do Sul, Brazil. .,Department of Physical Therapy, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, Rio Grande do Sul, Brazil.
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Araujo FXD, Scholl Schell M, Ferreira GE, Pessoa MDV, de Oliveira LR, Borges BG, Macagnan FE, Plentz RDM, Silva MF. Autonomic function and pressure pain threshold following thoracic mobilization in asymptomatic subjects: A randomized controlled trial. J Bodyw Mov Ther 2017; 22:313-320. [PMID: 29861225 DOI: 10.1016/j.jbmt.2017.09.005] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2017] [Revised: 08/21/2017] [Accepted: 09/02/2017] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To compare the effects of two different mobilization techniques and a placebo intervention applied to the thoracic spine on heart rate variability (HRV) and pressure pain threshold (PPT) in asymptomatic individuals. METHODS Sixty healthy asymptomatic subjects aged between 18 and 40 years old were randomized to a single session of one of the three interventions: posterior-to-anterior (PA) rotatory thoracic passive accessory intervertebral mobilization (PAIVM) (PA group), unilateral thoracic PA in slump position (SLUMP group) or placebo intervention (Placebo group). HRV and PPT at C7 and T4 spinous process, first dorsal interossei muscles bilaterally, and muscle belly of tibialis anterior bilaterally were measured before and immediately after the intervention. A univariate analysis of covariance (ANCOVA) adjusted for baseline values assessed the effect of "Group". Pairwise comparisons with Bonferroni adjustment for multiple comparisons were performed. RESULTS There were no significant between-group differences for HRV. A significant between-group difference for PPT in the ipsilateral tibia was found favoring the SLUMP group in comparison with the PA group. There were no significant between-group differences for PPT in the other landmarks. CONCLUSION A single treatment of thoracic PAIVM in prone lying and slump position did not alter PPT and HRV compared to placebo in asymptomatic subjects.
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Affiliation(s)
- Francisco Xavier de Araujo
- Physical Therapy Department, Graduate Program in Rehabilitation Sciences, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, Brazil; Centro Universitário Ritter dos Reis (UniRitter) - Laureate International Universities, Porto Alegre, Brazil.
| | - Maurício Scholl Schell
- Physical Therapy Department, Graduate Program in Rehabilitation Sciences, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, Brazil
| | - Giovanni Esteves Ferreira
- Physical Therapy Department, Graduate Program in Rehabilitation Sciences, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, Brazil
| | - Mariana Della Valentina Pessoa
- Physical Therapy Department, Graduate Program in Rehabilitation Sciences, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, Brazil
| | - Luiza Raulino de Oliveira
- Physical Therapy Department, Graduate Program in Rehabilitation Sciences, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, Brazil
| | - Brian Giacomini Borges
- Physical Therapy Department, Graduate Program in Rehabilitation Sciences, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, Brazil
| | - Fabrício Edler Macagnan
- Physical Therapy Department, Graduate Program in Rehabilitation Sciences, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, Brazil
| | - Rodrigo Della Méa Plentz
- Physical Therapy Department, Graduate Program in Rehabilitation Sciences, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, Brazil
| | - Marcelo Faria Silva
- Physical Therapy Department, Graduate Program in Rehabilitation Sciences, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, Brazil
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Lorscheitter J, Stein C, Plentz RDM. Methodological Quality of Randomized Clinical Trials of Respiratory Physiotherapy in Coronary Artery Bypass Grafting Patients in the Intensive Care Unit: a Systematic Review. Braz J Cardiovasc Surg 2017; 32:318-337. [PMID: 28977205 PMCID: PMC5613714 DOI: 10.21470/1678-9741-2017-0014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2017] [Accepted: 05/11/2017] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To assess methodological quality of the randomized controlled trials of physiotherapy in patients undergoing coronary artery bypass grafting in the intensive care unit. METHODS The studies published until May 2015, in MEDLINE, Cochrane and PEDro were included. The primary outcome extracted was proper filling of the Cochrane Collaboration's tool's items and the secondary was suitability to the requirements of the CONSORT Statement and its extension. RESULTS From 807 studies identified, 39 were included. Most at CONSORT items showed a better adequacy after the statement's publication. Studies with positive outcomes presented better methodological quality. CONCLUSION The methodological quality of the studies has been improving over the years. However, many aspects can still be better designed.
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Affiliation(s)
- Jaqueline Lorscheitter
- Graduate Program in Health Sciences, Universidade Federal de
Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, RS,
Brazil
| | - Cinara Stein
- Graduate Program in Health Sciences, Universidade Federal de
Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, RS,
Brazil
- Laboratory of Clinical Investigation, Instituto de Cardiologia do
Rio Grande do Sul (IC), Porto Alegre, RS, Brazil
- Fundação Universidade de Cardiologia (FUC), Porto
Alegre, RS, Brazil
| | - Rodrigo Della Méa Plentz
- Graduate Program in Health Sciences, Universidade Federal de
Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, RS,
Brazil
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Schardong J, Dipp T, Bozzeto CB, da Silva MG, Baldissera GL, Ribeiro RDC, Valdemarca BP, do Pinho AS, Sbruzzi G, Plentz RDM. Effects of Intradialytic Neuromuscular Electrical Stimulation on Strength and Muscle Architecture in Patients With Chronic Kidney Failure: Randomized Clinical Trial. Artif Organs 2017. [DOI: 10.1111/aor.12886] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Affiliation(s)
- Jociane Schardong
- Departamento de Fisioterapia, Programa de Pós-graduação de Ciências da Saúde de Porto Alegre; Universidade Federal de Ciências da Saúde de Porto Alegre; Rio Grande do Sul Brazil
| | - Thiago Dipp
- Departamento de Fisioterapia, Programa de Pós-graduação de Ciências da Saúde de Porto Alegre; Universidade Federal de Ciências da Saúde de Porto Alegre; Rio Grande do Sul Brazil
| | - Camila Bassani Bozzeto
- Departamento de Fisioterapia, Programa de Pós-graduação de Ciências da Saúde de Porto Alegre; Universidade Federal de Ciências da Saúde de Porto Alegre; Rio Grande do Sul Brazil
| | - Marília Godoy da Silva
- Departamento de Fisioterapia, Programa de Pós-graduação de Ciências da Saúde de Porto Alegre; Universidade Federal de Ciências da Saúde de Porto Alegre; Rio Grande do Sul Brazil
| | - Gabriela Leivas Baldissera
- Departamento de Fisioterapia, Programa de Pós-graduação de Ciências da Saúde de Porto Alegre; Universidade Federal de Ciências da Saúde de Porto Alegre; Rio Grande do Sul Brazil
| | - Raíssa de Castro Ribeiro
- Departamento de Fisioterapia, Programa de Pós-graduação de Ciências da Saúde de Porto Alegre; Universidade Federal de Ciências da Saúde de Porto Alegre; Rio Grande do Sul Brazil
| | - Bruna Pan Valdemarca
- Departamento de Fisioterapia, Programa de Pós-graduação de Ciências da Saúde de Porto Alegre; Universidade Federal de Ciências da Saúde de Porto Alegre; Rio Grande do Sul Brazil
| | - Alexandre Severo do Pinho
- Departamento de Fisioterapia, Programa de Pós-graduação de Ciências da Saúde de Porto Alegre; Universidade Federal de Ciências da Saúde de Porto Alegre; Rio Grande do Sul Brazil
| | - Graciele Sbruzzi
- Departamento de Fisioterapia, Programa de Pós-graduação em Ciências do Movimento; Universidade Federal do Rio Grande do Sul; Porto Alegre Rio Grande do Sul Brazil
| | - Rodrigo Della Méa Plentz
- Departamento de Fisioterapia, Programa de Pós-graduação de Ciências da Saúde de Porto Alegre; Universidade Federal de Ciências da Saúde de Porto Alegre; Rio Grande do Sul Brazil
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Schardong J, Kuinchtner GC, Sbruzzi G, Plentz RDM, Silva AMVD. Functional electrical stimulation improves muscle strength and endurance in patients after cardiac surgery: a randomized controlled trial. Braz J Phys Ther 2017; 21:268-273. [PMID: 28571696 PMCID: PMC5537479 DOI: 10.1016/j.bjpt.2017.05.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2016] [Revised: 07/19/2016] [Accepted: 10/17/2016] [Indexed: 10/31/2022] Open
Abstract
BACKGROUND Functional electrical stimulation (FES) has shown benefits in patients with chronic heart failure. Therefore, it is possible that FES can benefit patients similarly after cardiac surgery. OBJECTIVE This randomized placebo-controlled trial aimed to evaluate the effects of FES on lower limb functional capacity, strength, endurance, and muscle mass after discharge from cardiac surgery. METHODS Twenty patients were allocated (1:1) to the group receiving FES to the quadriceps (FESG) or FES placebo (FESPG). FES was applied at a frequency of 15Hz, with 0.5ms pulse width, 5s contraction time, and 10s resting time, twice a week for 40min over a period of eight weeks. Functional capacity was assessed using the six-minute walk test (6MWT), lower limb muscle strength using the one repetition maximum test (1RM), endurance using the sit-and-stand test (SST), and muscle using the perimeter of the thighs. RESULTS Both groups increased the distance covered in the 6MWT (FESG: 49.6m, 95% CI 15.9-83.3; FESPG: 41.5m, 95% CI 7.8-75.2), but without a difference between groups. There were significant between-group differences for quadriceps muscle strength (7.2kg, 95% CI 0.2-14.2) and muscle endurance (2.2 repetitions, 95% CI 1.0-3.4) in favor of the FESG. CONCLUSION FES improves lower limb muscle strength and endurance in patients after cardiac surgery. Larger trials are needed to confirm our findings.
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Affiliation(s)
- Jociane Schardong
- Departamento de Fisioterapia, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil
| | - Gabriela Castro Kuinchtner
- Departamento de Fisioterapia e Reabilitação, Universidade Federal de Santa Maria, Santa Maria, Rio Grande do Sul, Brazil
| | - Graciele Sbruzzi
- Departamento de Educação Física, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Rodrigo Della Méa Plentz
- Departamento de Fisioterapia, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil
| | - Antônio Marcos Vargas da Silva
- Departamento de Fisioterapia e Reabilitação, Universidade Federal de Santa Maria, Santa Maria, Rio Grande do Sul, Brazil.
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Ferreira GE, Stieven FF, Araújo FX, Wiebusch M, Rosa CG, Plentz RDM, Silva MF. Neurodynamic treatment for patients with nerve-related leg pain: Protocol for a randomized controlled trial. J Bodyw Mov Ther 2016; 20:870-878. [DOI: 10.1016/j.jbmt.2016.02.012] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2015] [Revised: 01/15/2016] [Accepted: 02/15/2016] [Indexed: 01/27/2023]
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Cruz JM, Hauck M, Cardoso Pereira AP, Moraes MB, Martins CN, da Silva Paulitsch F, Plentz RDM, Peres W, Vargas da Silva AM, Signori LU. Effects of Different Therapeutic Ultrasound Waveforms on Endothelial Function in Healthy Volunteers: A Randomized Clinical Trial. Ultrasound Med Biol 2016; 42:471-480. [PMID: 26578361 DOI: 10.1016/j.ultrasmedbio.2015.10.002] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/25/2015] [Revised: 09/16/2015] [Accepted: 10/01/2015] [Indexed: 06/05/2023]
Abstract
The purpose of this study was to determine the effects of different therapeutic 1-MHz ultrasound waveforms on endothelial function before and after cyclooxygenase (COX) inhibition. Forty-two healthy volunteers aged 27.2 ± 3.8 y underwent interventions and an evaluation for endothelial function (n = 15; with COX inhibition, n = 15; duration of the vasodilator effect, n = 12) by technique flow-mediated dilation. Continuous ultrasound therapy (0.4 W/cm(2 SATA)), pulsed ultrasound therapy (20% duty cycle, 0.08 W/cm(2 SATA)) or placebo (equipment power off) was randomly applied over the brachial artery for 5 min. COX inhibition (aspirin) was carried out 30 min before treatments. In relation to the placebo, flow-mediated dilation increased by 4.8% using continuous ultrasound and by 3.4% using pulsed ultrasound. After COX, flow-mediated dilation was enhanced by 2.1% by continuous ultrasound and 2.6% by pulsed ultrasound. This vasodilation persisted for 20 min. Continuous and pulsed therapeutic 1-MHz ultrasound waveforms improved endothelial function in humans, which provided them with anti-inflammatory vascular effects.
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Affiliation(s)
- Jeferson Mendes Cruz
- Programa de Pós-Graduação em Ciências da Saúde, Universidade Federal do Rio Grande, Rio Grande do Sul, Brazil
| | - Melina Hauck
- Programa de Pós-Graduação em Ciências da Saúde, Universidade Federal do Rio Grande, Rio Grande do Sul, Brazil
| | - Ana Paula Cardoso Pereira
- Programa de Pós-Graduação em Ciências da Saúde, Universidade Federal do Rio Grande, Rio Grande do Sul, Brazil
| | - Maicon Borges Moraes
- Programa de Pós-Graduação em Ciências da Saúde, Universidade Federal do Rio Grande, Rio Grande do Sul, Brazil
| | - Cassio Noronha Martins
- Programa de Pós-Graduação em Ciências da Saúde, Universidade Federal do Rio Grande, Rio Grande do Sul, Brazil
| | - Felipe da Silva Paulitsch
- Programa de Pós-Graduação em Ciências da Saúde, Universidade Federal do Rio Grande, Rio Grande do Sul, Brazil
| | - Rodrigo Della Méa Plentz
- Departamento de Fisioterapia, Universidade Federal de Ciências da Saúde de Porto Alegre, Rio Grande do Sul, Brazil
| | - William Peres
- Universidade Federal de Pelotas, Rio Grande do Sul, Brazil
| | | | - Luis Ulisses Signori
- Programa de Pós-Graduação em Ciências da Saúde, Universidade Federal do Rio Grande, Rio Grande do Sul, Brazil; Departamento de Fisioterapia e Reabilitação, Universidade Federal de Santa Maria, Rio Grande do Sul, Brazil.
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Nicolodi GV, Sbruzzi G, Macagnan FE, Dipp T, Macedo ACPD, Casali KR, Plentz RDM. Acute Effects of Functional Electrical Stimulation and Inspiratory Muscle Training in Patients With Heart Failure: A Randomized Crossover Clinical Trial. International Journal of Cardiovascular Sciences 2016. [DOI: 10.5935/2359-4802.20160038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Stein C, Fritsch CG, Robinson C, Sbruzzi G, Plentz RDM. Effects of Electrical Stimulation in Spastic Muscles After Stroke. Stroke 2015; 46:2197-205. [DOI: 10.1161/strokeaha.115.009633] [Citation(s) in RCA: 66] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2015] [Accepted: 06/15/2015] [Indexed: 11/16/2022]
Abstract
Background and Purpose—
Neuromuscular electric stimulation (NMES) has been used to reduce spasticity and improve range of motion in patients with stroke. However, contradictory results have been reported by clinical trials. A systematic review of randomized clinical trials was conducted to assess the effect of treatment with NMES with or without association to another therapy on spastic muscles after stroke compared with placebo or another intervention.
Methods—
We searched the following electronic databases (from inception to February 2015): Medline (PubMed), EMBASE, Cochrane Central Register of Controlled Trials and Physiotherapy Evidence Database (PEDro). Two independent reviewers assessed the eligibility of studies based on predefined inclusion criteria (application of electric stimulation on the lower or upper extremities, regardless of NMES dosage, and comparison with a control group which was not exposed to electric stimulation), excluding studies with <3 days of intervention. The primary outcome extracted was spasticity, assessed by the Modified Ashworth Scale, and the secondary outcome extracted was range of motion, assessed by Goniometer.
Results—
Of the total of 5066 titles, 29 randomized clinical trials were included with 940 subjects. NMES provided reductions in spasticity (−0.30 [95% confidence interval, −0.58 to −0.03], n=14 randomized clinical trials) and increase in range of motion when compared with control group (2.87 [95% confidence interval, 1.18–4.56], n=13 randomized clinical trials) after stroke.
Conclusions—
NMES combined with other intervention modalities can be considered as a treatment option that provides improvements in spasticity and range of motion in patients after stroke.
Clinical Trial Registration Information—
URL:
http://www.crd.york.ac.uk/PROSPERO
. Unique identifier: CRD42014008946.
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Affiliation(s)
- Cinara Stein
- From the Physical Therapy Department, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, RS, Brazil (C.S., C.G.F., C.R., R.D.M.P.); Laboratory of Clinical Investigation, Instituto de Cardiologia do Rio Grande do Sul (IC), Fundação Universidade de Cardiologia (FUC), Porto Alegre, RS, Brazil (C.S.); and Physical Therapy Undergraduation, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil (G.S.)
| | - Carolina Gassen Fritsch
- From the Physical Therapy Department, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, RS, Brazil (C.S., C.G.F., C.R., R.D.M.P.); Laboratory of Clinical Investigation, Instituto de Cardiologia do Rio Grande do Sul (IC), Fundação Universidade de Cardiologia (FUC), Porto Alegre, RS, Brazil (C.S.); and Physical Therapy Undergraduation, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil (G.S.)
| | - Caroline Robinson
- From the Physical Therapy Department, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, RS, Brazil (C.S., C.G.F., C.R., R.D.M.P.); Laboratory of Clinical Investigation, Instituto de Cardiologia do Rio Grande do Sul (IC), Fundação Universidade de Cardiologia (FUC), Porto Alegre, RS, Brazil (C.S.); and Physical Therapy Undergraduation, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil (G.S.)
| | - Graciele Sbruzzi
- From the Physical Therapy Department, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, RS, Brazil (C.S., C.G.F., C.R., R.D.M.P.); Laboratory of Clinical Investigation, Instituto de Cardiologia do Rio Grande do Sul (IC), Fundação Universidade de Cardiologia (FUC), Porto Alegre, RS, Brazil (C.S.); and Physical Therapy Undergraduation, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil (G.S.)
| | - Rodrigo Della Méa Plentz
- From the Physical Therapy Department, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, RS, Brazil (C.S., C.G.F., C.R., R.D.M.P.); Laboratory of Clinical Investigation, Instituto de Cardiologia do Rio Grande do Sul (IC), Fundação Universidade de Cardiologia (FUC), Porto Alegre, RS, Brazil (C.S.); and Physical Therapy Undergraduation, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil (G.S.)
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Rossato DD, Dal Lago P, Hentschke VS, Rucatti AL, Signori LU, Silveira MN, Plentz RDM. Ultrasound modulates skeletal muscle cytokine levels in rats with heart failure. Ultrasound Med Biol 2015; 41:797-805. [PMID: 25619785 DOI: 10.1016/j.ultrasmedbio.2014.11.017] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/22/2014] [Revised: 11/11/2014] [Accepted: 11/24/2014] [Indexed: 06/04/2023]
Abstract
Heart failure is a multisystemic disorder that leads to an imbalance between pro- and anti-inflammatory cytokines. Therapeutic ultrasound (TU) has been reported to modulate the inflammatory process. The aim of this study was to evaluate the effect of TU on pro- and anti-inflammatory cytokine levels in soleus muscle and plasma of rats with heart failure. Thirty male Wistar rats (230-260 g) were submitted to ligation of the left coronary artery or sham surgery. Six weeks after surgery, TU was administered directly to the right lower limb. The results indicate that TU promotes reduction of pro-inflammatory cytokine levels (tumor necrosis factor α, interleukin-6) and increases anti-inflammatory cytokine levels (interleukin-10) in the soleus muscle of rats with heart failure. This is the first study to find that TU can modulate cytokine levels in rats with heart failure. Additionally, this is a first report that TU can modulate interleukin-10 levels in the soleus muscle.
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Affiliation(s)
- Douglas Dalcin Rossato
- Programa de Pós-Graduação em Ciências da Saúde, Laboratório de Fisiologia, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, Brazil; Centro Universitário Franciscano, Santa Maria, Brazil
| | - Pedro Dal Lago
- Programa de Pós-Graduação em Ciências da Saúde, Laboratório de Fisiologia, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, Brazil
| | - Vítor Scotta Hentschke
- Programa de Pós-Graduação em Ciências da Saúde, Laboratório de Fisiologia, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, Brazil
| | - Ananda Lazzarotto Rucatti
- Programa de Pós-Graduação em Ciências da Saúde, Laboratório de Fisiologia, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, Brazil
| | - Luis Ulisses Signori
- Departamento de Fisioterapia e Reabilitação, Universidade Federal de Santa Maria, Santa Maria, Brazil
| | - Matheus Noronha Silveira
- Programa de Pós-Graduação em Ciências da Saúde, Laboratório de Fisiologia, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, Brazil
| | - Rodrigo Della Méa Plentz
- Programa de Pós-Graduação em Ciências da Saúde, Laboratório de Fisiologia, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, Brazil.
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de Araujo FX, Macagnan FE, Della Méa Plentz R, Silva MF. Autonomic effects after anterior-to-posterior cervical mobilization. J Orthop Sports Phys Ther 2015; 45:46-7. [PMID: 25741558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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da Silva Klahr P, Corrêa Coronel C, Cabral Robinson C, Fonseca JM, Dias Flores C, Della Méa Plentz R. Influence Diagram As a Support Tool for Clinical Decisions In Cardiopulmonary And Metabolic Rehabilitation. Stud Health Technol Inform 2015; 216:290-294. [PMID: 26262057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
An influence diagram (ID) is a method of graphical representation of uncertain knowledge, which can be employed to support decisions in health care using probabilistic reasoning. We aimed to describe the development of an ID to support the decision-making process in phase II at Cardiopulmonary and Metabolic Rehabilitation Program (CPMR). The development of the ID was carried out through the identification of relevant variables and their possible values, as well as the identification of details of each variable, in order to find a network structure that appropriately connects the nodes that represent the variables, with arcs linking acyclic graphs, and to build the graph using specialized knowledge and the conditional probability table for each node in the graph. In spite of the complexity of the interactions, the model obtained with the ID seems to contribute in the decision-making process in phase II CPMR, providing a second opinion to the health pratictioner and helping in diagnostic, therapeutic and decision-making processes, since it is useful in situations with non-linear modeling or with absent or uncertain information.
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Teixeira ADO, Martins CN, Silva AMVD, Tozetti AM, Plentz RDM, Signori LU. <b>Temperature of cutaneous and subcutaneous tissue during the application of aerosols in rats. Acta Sci Health Sci 2014. [DOI: 10.4025/actascihealthsci.v36i2.13885] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Franco OS, Paulitsch FS, Pereira APC, Teixeira AO, Martins CN, Silva AMV, Plentz RDM, Irigoyen MC, Signori LU. Effects of different frequencies of transcutaneous electrical nerve stimulation on venous vascular reactivity. ACTA ACUST UNITED AC 2014; 47:411-8. [PMID: 24820225 PMCID: PMC4075310 DOI: 10.1590/1414-431x20143767] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2013] [Accepted: 02/10/2014] [Indexed: 12/22/2022]
Abstract
Transcutaneous electrical nerve stimulation (TENS) is a type of therapy used
primarily for analgesia, but also presents changes in the cardiovascular system
responses; its effects are dependent upon application parameters. Alterations to the
cardiovascular system suggest that TENS may modify venous vascular response. The
objective of this study was to evaluate the effects of TENS at different frequencies
(10 and 100 Hz) on venous vascular reactivity in healthy subjects. Twenty-nine
healthy male volunteers were randomized into three groups: placebo (n=10),
low-frequency TENS (10 Hz, n=9) and high-frequency TENS (100 Hz, n=10). TENS was
applied for 30 min in the nervous plexus trajectory from the superior member (from
cervical to dorsal region of the fist) at low (10 Hz/200 μs) and high frequency (100
Hz/200 μs) with its intensity adjusted below the motor threshold and intensified
every 5 min, intending to avoid accommodation. Venous vascular reactivity in response
to phenylephrine, acetylcholine (endothelium-dependent) and sodium nitroprusside
(endothelium-independent) was assessed by the dorsal hand vein technique. The
phenylephrine effective dose to achieve 70% vasoconstriction was reduced 53%
(P<0.01) using low-frequency TENS (10 Hz), while in high-frequency stimulation
(100 Hz), a 47% increased dose was needed (P<0.01). The endothelium-dependent
(acetylcholine) and independent (sodium nitroprusside) responses were not modified by
TENS, which modifies venous responsiveness, and increases the low-frequency
sensitivity of α1-adrenergic receptors and shows high-frequency opposite effects.
These changes represent an important vascular effect caused by TENS with implications
for hemodynamics, inflammation and analgesia.
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Affiliation(s)
- O S Franco
- Programa de Pós-Graduação em Ciências da Saúde, Faculdade de Medicina, Universidade Federal do Rio Grande, Rio Grande, RS, Brasil
| | - F S Paulitsch
- Programa de Pós-Graduação em Ciências da Saúde, Faculdade de Medicina, Universidade Federal do Rio Grande, Rio Grande, RS, Brasil
| | - A P C Pereira
- Programa de Pós-Graduação em Ciências da Saúde, Faculdade de Medicina, Universidade Federal do Rio Grande, Rio Grande, RS, Brasil
| | - A O Teixeira
- Programa de Pós-Graduação em Ciências da Saúde, Faculdade de Medicina, Universidade Federal do Rio Grande, Rio Grande, RS, Brasil
| | - C N Martins
- Programa de Pós-Graduação em Fisiologia Animal Comparada, Instituto de Ciências Biológicas, Universidade Federal do Rio Grande, Rio Grande, RS, Brasil
| | - A M V Silva
- Departamento de Fisioterapia e Reabilitação, Universidade Federal de Santa Maria, Santa Maria, RS, Brasil
| | - R D M Plentz
- Programa de Pós-Graduação em Ciências da Saúde, Programa de Pós-Graduação em Ciências da Reabilitação, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, RS, Brasil
| | - M C Irigoyen
- Unidade de Hipertensão, Instituto do Coração, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil
| | - L U Signori
- Programa de Pós-Graduação em Ciências da Saúde, Faculdade de Medicina, Universidade Federal do Rio Grande, Rio Grande, RS, Brasil
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Signori LU, Teixeira ADO, Silva AMVD, Costa STD, Dipp T, Plentz RDM. Effects of therapeutic ultrasound on haematological dynamics and fibrinogen during the inflammatory phase after muscle injury in rats . ACTA ACUST UNITED AC 2014. [DOI: 10.4025/actascihealthsci.v36i1.14472] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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41
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Gurgel LG, Plentz RDM, Joly MCRA, Reppold CT. Avaliação da resiliência em adultos e idosos: revisão de instrumentos. Estud psicol (Campinas) 2013. [DOI: 10.1590/s0103-166x2013000400002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Este estudo revisa sistematicamente na literatura os instrumentos utilizados para a avaliação da resiliência em adultos e idosos. A pesquisa foi realizada em: MedLine, PsycINFO, Scopus, SciELO, Interscience databases, envolvendo os termos resilience, psychological, scales e validation studies. Foram incluídos estudos de avaliação da resiliência em indivíduos acima de 18 anos. A busca resultou em 59 estudos, sendo que apenas 16 preencheram os critérios de elegibilidade. Foram considerados 13 instrumentos validados para avaliação de resiliência. O total de 8 689 indivíduos foi incluído nos 16 estudos, e a idade variou de 12 a 97 anos. Os testes apresentam principalmente estudos de precisão e são compostos por poucos itens. Poucos estudos de validade preditiva foram encontrados. Algumas pesquisas incluídas são específicas para populações indígenas, mulheres, veteranos de guerra e esquizofrênicos. São poucos os instrumentos disponíveis para avaliação da resiliência em adultos e idosos, sobretudo para uso em estudos nacionais.
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Sbruzzi G, Dal Lago P, Ribeiro RA, Plentz RDM. Efficacy of inspiratory muscle training in chronic heart failure patients. Int J Cardiol 2012; 161:119-20. [DOI: 10.1016/j.ijcard.2012.06.035] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2012] [Accepted: 06/09/2012] [Indexed: 10/28/2022]
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43
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Stein C, Méa Plentz RD. The effect of transcutaneous electrical nerve stimulation on blood pressure. Blood Press 2012; 22:188-9. [PMID: 23004921 DOI: 10.3109/08037051.2012.722271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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44
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Plentz RDM, Sbruzzi G, Ribeiro RA, Ferreira JB, Dal Lago P. Treinamento muscular inspiratório em pacientes com insuficiência cardíaca: metanálise de estudos randomizados. Arq Bras Cardiol 2012; 99:762-71. [DOI: 10.1590/s0066-782x2012001100011] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2011] [Accepted: 03/07/2012] [Indexed: 11/21/2022] Open
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45
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Sbruzzi G, Silveira SA, Silva DV, Coronel CC, Plentz RDM. Estimulação elétrica nervosa transcutânea no pósoperatório de cirurgia torácica. Braz J Cardiovasc Surg 2012; 27:75-87. [DOI: 10.5935/1678-9741.20120012] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2011] [Accepted: 01/16/2012] [Indexed: 11/20/2022] Open
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46
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Kohl LDM, Signori LU, Ribeiro RA, Silva AMV, Moreira PR, Dipp T, Sbruzzi G, Lukrafka JL, Plentz RDM. Prognostic value of the six-minute walk test in end-stage renal disease life expectancy: a prospective cohort study. Clinics (Sao Paulo) 2012; 67:581-6. [PMID: 22760895 PMCID: PMC3370308 DOI: 10.6061/clinics/2012(06)06] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/26/2011] [Accepted: 02/22/2012] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVES The six-minute walk test has been widely used to evaluate functional capacity and predict mortality in several populations. Thus, the aim of this study was to evaluate the prognostic value of the six-minute walk test for the life expectancy of end-stage renal disease patients. METHODS Patients over 18 years old who underwent hemodialysis for at least six months were included. Patients with hemodynamic instability, smoking, chronic obstructive pulmonary disease, physical incapacity and acute myocardial stroke in the preceding three months were excluded. RESULTS Fifty-two patients (54% males; 36+11 years old) were followed for 144 months. The distance walked in the six-minute walk test was a survival predictor for end-stage renal disease patients. In the multivariate analysis, for each 100 meters walked with a 100-meter increment, the hazard ratio was 0.53, with a 95% confidence interval of 0.37-0.74. There was a positive correlation between the distance walked in the six-minute walk test and peak oxygen consumption (r = 0.508). In the multivariate analysis, each year of dialysis treatment represented a 10% increase in death probability; in the severity index analysis, each point on the scale represented an 11% increase in the death risk. CONCLUSIONS We observed that survival increased approximately 5% for every 100 meters walked in the six-minute walk test, demonstrating that the test is a viable option for evaluating the functional capacity in patients with end-stage renal disease.
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Affiliation(s)
- Leandro de Moraes Kohl
- Institute of Cardiology of Rio Grande do Sul, University Foundation of Cardiology, Porto Alegre, RS, Brazil
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47
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Ferreira JB, Plentz RDM, Stein C, Casali KR, Arena R, Lago PD. Inspiratory muscle training reduces blood pressure and sympathetic activity in hypertensive patients: a randomized controlled trial. Int J Cardiol 2011; 166:61-7. [PMID: 21985749 DOI: 10.1016/j.ijcard.2011.09.069] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2011] [Accepted: 09/17/2011] [Indexed: 10/16/2022]
Abstract
BACKGROUND Autonomic imbalance, characterized by sympathetic hyperactivity and diminished vagal tone, is a known mechanism for essential hypertension. Inspiratory muscle training (IMT) demonstrates beneficial outcomes in a number of cardiovascular populations, which may potentially extend to patients with hypertension. The aim of this study was to further elucidate the effects of IMT on blood pressure and autonomic cardiovascular control in patients with essential hypertension. METHODS Thirteen patients with hypertension were randomly assigned to an eight-week IMT program (6 patients) or to a placebo-IMT (P-IMT, 7 patients) protocol. We recorded RR interval for posterior analysis of heart rate variability and blood pressure, by ambulatory blood pressure monitoring (ABPM), before and after the program. RESULTS There was a significant increase in inspiratory muscle strength in the IMT group (82.7 ± 28.8 vs 121.5 ± 21.8 cmH2O, P<0.001), which was not demonstrated by P-IMT (93.3 ± 25.3 vs 106.1 ± 25.3 cmH2O, P>0.05). There was also a reduction in 24-hour measurement of systolic (133.2 ± 9.9 vs 125.2 ± 13.0 mm Hg, P=0.02) and diastolic (80.7 ± 12.3 vs 75.2 ± 1.0 mm Hg, P=0.02) blood pressure, as well as in daytime systolic (136.8 ± 12.2 vs 127.6 ± 14.2 mm Hg, P=0.008) and diastolic (83.3 ± 13.1 vs. 77.2 ± 12.2 mm Hg, P =0.01) blood pressure in the IMT group. In relation to autonomic cardiovascular control, we found increased parasympathetic modulation (HF: 75.5 ± 14.6 vs. 84.74 ± 7.55 n.u, P=0.028) and reduced sympathetic modulation (LF: 34.67 ± 20.38 vs. 12.81 ± 6.68 n.u; P=0.005). Moreover, there was reduction of cardiac sympathetic discharge (fLF) in IMT group (P=0.01). CONCLUSIONS IMT demonstrates beneficial effects on systolic and diastolic blood pressure as well as autonomic cardiovascular control in hypertensive patients.
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Affiliation(s)
- Janaína Barcellos Ferreira
- Post Graduation Program in Health Sciences, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, RS, Brazil
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Schaun MI, Dipp T, Silva Rossato J, Wilhelm EN, Pinto R, Rech A, Plentz RDM, Homem de Bittencourt PI, Reischak-Oliveira A. The effects of periodized concurrent and aerobic training on oxidative stress parameters, endothelial function and immune response in sedentary male individuals of middle age. Cell Biochem Funct 2011; 29:534-42. [DOI: 10.1002/cbf.1781] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2010] [Revised: 05/18/2011] [Accepted: 06/03/2011] [Indexed: 12/12/2022]
Affiliation(s)
- Maximiliano Isoppo Schaun
- School of Physical Education; Federal University of Rio Grande do Sul (UFRGS); Porto Alegre; Rio Grande do Sul; Brazil
| | - Thiago Dipp
- Institute of Cardiology of Rio Grande do Sul (IC-FUC); Porto Alegre; Rio Grande do Sul; Brazil
| | - Juliane Silva Rossato
- Laboratory of Cellular Physiology; Federal University of Rio Grande do Sul (UFRGS); Porto Alegre; Rio Grande do Sul; Brazil
| | - Eurico Nestor Wilhelm
- Laboratory of Cellular Physiology; Federal University of Rio Grande do Sul (UFRGS); Porto Alegre; Rio Grande do Sul; Brazil
| | - Ronei Pinto
- School of Physical Education; Federal University of Rio Grande do Sul (UFRGS); Porto Alegre; Rio Grande do Sul; Brazil
| | - Anderson Rech
- Laboratory of Cellular Physiology; Federal University of Rio Grande do Sul (UFRGS); Porto Alegre; Rio Grande do Sul; Brazil
| | | | | | - Alvaro Reischak-Oliveira
- School of Physical Education; Federal University of Rio Grande do Sul (UFRGS); Porto Alegre; Rio Grande do Sul; Brazil
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Silva AMV, Schaan BD, Signori LU, Plentz RDM, Moreno H, Bertoluci MC, Irigoyen MC. Microalbuminuria is associated with impaired arterial and venous endothelium-dependent vasodilation in patients with Type 2 diabetes. J Endocrinol Invest 2010; 33:696-700. [PMID: 20354354 DOI: 10.1007/bf03346672] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND Microalbuminuria in Type 2 diabetes is associated with arterial endothelial dysfunction, but the venous bed was never evaluated. AIM To study the endothelial function in the venous and arterial bed in patients with Type 2 diabetes with normoalbuminuria or microalbuminuria. MATERIAL AND METHODS We evaluated 28 patients with Type 2 diabetes, glycated hemoglobin (HbA(₁c)) <7.5%, who were classified as normo- (albuminuria <30 mg/24 h; no.=16) or microalbuminuric (albuminuria 30-300 mg/24 h; no.=12). Venous and arterial endothelial function were assessed by the dorsal hand vein technique (venodilation by acetylcholine) and brachial artery flow-mediated vasodilation, respectively. RESULTS Patients were normotensive (systolic arterial pressure: 131.1±10.6 mmHg) and on good metabolic control (HbA(₁c): 6.6±0.6%). Microalbuminuric patients presented impaired venous (32.9±17.4 vs 59.3±26.5%; p=0.004) and arterial vasodilation (1.8±0.9 vs 5.1±2.4; p<0.001), as compared to normoalbuminuric patients. There was a negative correlation between acetylcholine-induced venodilation and albuminuria (r=-0.62; p<0.001) and HbA(₁c) (r=-0.41; p=0.032). The same was observed between flow mediated arterial vasodilation and albuminuria (r=-0.49; p=0.007) and HbA(₁c) (r=-0.44; p=0.019). Venous and arterial vasodilation was positively correlated (r=0.50; p=0.007). CONCLUSIONS Both venous and arterial endothelial function are impaired in Type 2 microalbuminuric diabetics, in spite of good metabolic control, suggesting that other factors are involved in its pathogenesis.
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Affiliation(s)
- A M V Silva
- Department of Physiology, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
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50
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Dipp T, Silva AMVD, Signori LU, Strimban TM, Nicolodi G, Sbruzzi G, Moreira PR, Plentz RDM. Força muscular respiratória e capacidade funcional na insuficiência renal terminal. REV BRAS MED ESPORTE 2010. [DOI: 10.1590/s1517-86922010000400002] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
OBJETIVO: Verificar a associação da força muscular respiratória com a capacidade funcional, força proximal de membros inferiores e variáveis bioquímicas em pacientes em hemodiálise (HD). MÉTODOS: Participaram deste estudo 30 indivíduos (18 homens), com 53,4 ± 12,9 anos e tempo de HD de 41,1 ± 55,7 meses. Foram avaliados pressão inspiratória máxima (PImax), pressão expiratória máxima (PEmax), distância percorrida no teste de caminhada de seis minutos (6MWT), número de repetições no teste de sentar-e-levantar em 30 segundos (TSL) e registrados os exames bioquímicos de rotina no serviço. RESULTADOS: Houve diminuição da PEmax em relação aos valores preditos (p = 0,015) e redução na distância percorrida no 6MWT quando comparados com equações de predição (p < 0,001). O logPImax e o logPEmax correlacionaram-se com o número de repetições no TSL (r = 0,476, p = 0,008; r = 0,540, p = 0,002, respectivamente), e com os níveis séricos de fósforo (r = 0,422, p = 0,020; r = 0,639, p < 0,001, respectivamente). A distância no 6MWT correlacionou-se com o logPEmax (r = 0,511; p = 0,004) e com o número de repetições no TSL (r = 0,561; p = 0,001). CONCLUSÃO: A redução da PEmax em pacientes com IRT em HD está associada à capacidade funcional, força proximal de membros inferiores e níveis de fósforo sérico, podendo representar, pelo menos em parte, o baixo desempenho físico-funcional desses pacientes.
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