Rehabilitation interventions targeting the activity and participation of patient with neuromuscular diseases: what do we know? A systematic review

BACKGROUND

 To be objective and achievable, the rehabilitation goals must be focused on the functional expectations of patients with neuromuscular disease (NMD).

OBJECTIVE

 Investigate rehabilitation programs that are able to modify the activity/participation of patients with NMD. Data search: Embase, BVS/Lilacs, Physiotherapy Evidence Database (PEDro), CINAHL/EBSCO, and Medline were searched in June 2021. It was last updated in March 2023.

METHODS

 Randomized controlled trials investigating any rehabilitation therapy for patients with NMD with an outcome encompassing the activity/participation components of the International Classification of Functioning, Disability and Health (ICF) were included. Pharmacological therapy studies were excluded. The results were synthesized according to the ICF core sets for NMD. The methodological quality and level of evidence were assessed using PEDro criteria and Grading of Recommendations Assessment, Development, and Evaluation (GRADE). This systematic review followed the PRISMA 2020 guideline and was registered at PROSPERO (CRD42020209359).

RESULTS

 Of a total of 1943 identified studies, 12 were included in this review with a methodological quality between regular and good. Light to moderate-intensity aerobic exercise was the most studied intervention. The mobility was assessed in all included studies.

CONCLUSION

 The variability of the types of NMD and the small sample size of the included studies demonstrates that there is very limited evidence of interventions focused on the activity/participation of individuals with NMD. Light to moderate-intensity aerobic exercise seems to improve the mobility, self-care, and social participation of patients with NMD, especially those with slow progression.

Social participation and territory: possible dialogues for the sustainable management of cultural heritage

Based on the concepts of culture, territory, integrated conservation, and sustainability, this article analyses the meaning of social participation in the recognition, appropriation, preservation, and enhancement of cultural heritage. The object of analysis is the Manguinhos Historical Architectural Site, at Fundação Oswaldo Cruz, and its Requalification Plan, which aims to transform it into a "park campus." A diagnostic study was conducted of social participation in this heritage, which found that greater participation should be encouraged if the complex is to be consolidated as science and health heritage and also appropriated by the territory as an asset of symbolic, cognitive, and identity values and a structuring element for sustainable development.

[Relevance of social networks in social mobilization to deal with arboviruses in the municipality of Betim, in the State of Minas Gerais, Brazil]

This article consists of an analysis of the social networks of the residents of a community in Betim, in the State of Minas Gerais, Brazil, to understand how they can be used in social mobilization strategies against dengue, zika, and chikungunya within the territory. The life trajectory method was used to analyze the events and social conditioning factors of the formation, maintenance, and rupture of these networks, the quality and intensity of the bonds, the characteristics of social capital, and its variation along the trajectory of individuals. The understanding of the structure of the networks highlights some important aspects for the elaboration of new social mobilization strategies within the scope of the health surveillance proposal to be implemented locally. Within the trajectory of the interviewees, the neighborhood was revealed as an important network of reciprocity and provision of resources in daily life, considering the physical proximity and the duration of the relationships. Additionally, religious networks have a significant presence in the daily lives of residents, being strongly anchored in the provision of social "assistance" guided by solidarity values. We believe that the popular committees can stimulate these networks, especially the religious ones, to use their cultural and symbolic repertoire to work on issues of interest to the neighborhoods, such as the promotion of health, promotion of healthy and sustainable territories, local development and income generation, infrastructure improvement, and environmental preservation.