Many women experience pain related to the female reproductive system at different stages of life, and the causes of this pain or discomfort can be varied and sometimes difficult to identify and therefore difficult to treat. The Vulvar Pain Assessment Questionnaire (VPAQ) was developed to assess the characteristics of self-reported vulvar pain in women and to determine which areas of their lives are most affected. To date, this instrument has not undergone any other process of cross-cultural adaptation and validity in another country. The VPAQ screen is a shorter, condensed version containing eight descriptive questions and thirty Likert-type questions. Therefore, the aim of this study was to translate and cross-culturally adapt the VPAQscreen questionnaire for the Brazilian population and to evaluate its measurement properties. Two independent translators translated the VPAQ screen into Brazilian Portuguese. The two translations were then merged into a single version, which was back translated into the original language, English, by two new independent translators. Next, a committee of experts was formed to evaluate all the versions already created and to draft the pre-final version of the questionnaire in Portuguese. Finally, the version was tested online on 30 women with vulvar pain. After these steps, the final version of the questionnaire was created, called VPAQ-BRasil. Subsequently, the measurement properties of the Brazilian version were evaluated by self-administering the questionnaire on two occasions, between 2 and 7 days apart. The following measurement properties were evaluated: structural validity, internal consistency, and test-retest reliability. The process of translation and cross-cultural adaptation produced very similar versions and was completed without too much difficulty. 39 volunteers completed the VPAQ-Brazil on both occasions, with a mean interval of 7 days. The Brazilian version showed good internal consistency (Cronbach's alpha = 0.92), good test-retest reliability (Pearson's correlation (r) 0.50 to 0.84), satisfactory exploratory factor analysis with factor loadings above 0.4, and an adequate factor structure with five factors. The VPAQ-Brazil is an instrument compatible with the original version, valid and reliable for assessing the characteristics of self-reported vulvar pain in women and can be used in research and clinical practice. 

Introdução: A síndrome da fragilidade é uma condição comum entre os idosos, se caracteriza pelo acúmulo de déficits funcionais de vários sistemas, acarretando um aumento da vulnerabilidade para eventos adversos em saúde, como dependência funcional e morte. A identificação precoce desta síndrome configura-se como ponto importante, o uso de dispositivos tecnológicos, como sensores vestíveis, pode auxiliar na monitorização do risco de desenvolvimento de fragilidade na população idosa abrangente. Objetivo: Identificar a presença de fragilidade em idosos comunitários através do uso de smartwatches. Métodos: Trata-se de um estudo transversal, onde serão utilizados os dados obtidos na linha de base do projeto aprovado em Comitê de Ética em Pesquisa (número do CAAE:38993120.6.0000.5208). A população do estudo será composta por idosos vinculados a atenção primária, que residem na região metropolitana do Recife-PE. A coleta de dados será realizada na Universidade Federal de Pernambuco, onde serão avaliados em relação aos aspectos sociodemográficos e antropométricos, o seu estado de saúde, função física e composição corporal. Além disso, durante o período de seguimento de 7 dias, os participantes do estudo irão utilizar uma pulseira de monitoramento remoto. O dispositivo possibilitará coletar parâmetros como: FC, SpO2, número de passos, distância percorrida, calorias gastas, dados sobre o sono. Resultados Esperados: Espera-se que a fragilidade possa ser identificada nos idosos comunitários através do uso de smartwatches, a partir da obtenção dos parâmetros fornecidos pelo dispositivo que melhor predizem a fragilidade, como número de passos diários, frequência cardíaca e dados sobre o sono, na população em questão.

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Covid-19 is a disease that can affect functional capacities, with respiratory changes, fatigue during activities of daily living and at rest, exercise intolerance and reduced peripheral muscle function, in addition to interfering with aspects related to sleep. In this context, systemic involvement makes it necessary for medium and long-term support from health services after these patients are discharged.

The interest of recent studies in the assessment of quality of life and psychological repercussions after COVID-19 is observed, however on the relationship between sleep parameters and the physical and functional capacities of these individuals after clinical discharge, there is a lack of studies in literature. It is suggested to follow the justification used in the introduction (clinical and pathophysiological aspects of sleep involvement in this process). Thus, we question whether there is an association between sleep quality and excessive daytime sleepiness with lung function and exercise tolerance in patients after infection with COVID-19. OBJECTIVE: To determine the association between sleep quality and excessive daytime sleepiness and pulmonary function and tolerance to in individuals after COVID-19 infection. METHODS: This is a cross-sectional study, in which individuals over 18 years old who have overcome the acute phase of Covid-19 will be contacted by telephone and invited to participate in the research in the city of Garanhuns. Lung function (by spirometry), exercise tolerance (by the 6-minute step test), the subjective sleep quality (by the Pittsburg sleep quality index) and excessive daytime sleepiness (by the sleepiness scale of Epworth). Data normality will be verified using the Shapiro-Wilk Test. Data will be expressed as mean, standard deviation and confidence interval for those with normal distribution, and as median and interquartile range for those without normal distribution and absolute and relative frequency for categorical variables. According to the data normality distribution, Pearson or Spearman correlation tests will be used to verify the correlation between sleep quality and excessive daytime sleepiness and pulmonary function and exercise tolerance.

After this analysis, the multiple linear regression test will be performed with the variables that present correlation. For all tests, p values ≤ 0.05 will be considered statistically significant.

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Although CKD evolves into its terminal phase with the need for hemodialysis and patients present physical and functional impairment, they are generally considered sedentary. As the nephrologist is the health professional who primarily monitors these patients, and considering that an intradialytic exercise program would benefit them, the present study was concerned with analyzing the knowledge of nephrologists about intradialytic exercise and its benefits. The objective of this study was to evaluate the knowledge of Brazilian nephrologists regarding guidance for carrying out intradialytic exercise for patients with CKD and information about the importance of intradialytic exercise during training as a nephrologist. This is a cross-sectional study (Survey), developed with Brazilian nephrologists registered with the Brazilian Society of Nephrology from February to July 2023 and approved by the institutional research ethics committee (nº 5,882,724). Data collection was carried out using a questionnaire specifically developed on the Google Forms platform. As a result, a total of 262 nephrologists (7.6% participation) effectively answered the questionnaire. Nephrologists who have knowledge about exercise (OR 11.36; 95% CI 2.92 to 44.07; p<0.01) and recommend exercise during the intradialysis period (OR 8.03; 95% CI 1. 50 to 42.79; p=0.01) are those who guide their patients to carry it out in clinical practice. Regarding knowledge of the importance of physical exercise received during nephrology training, both those professionals who did not receive this information during their training (OR=8.84; 95% CI 1.04 to 74.71; p=0.04) and those who had received it (OR=12.93; 95% CI 1.53 to 109.15; p=0.01), indicated intradialytic exercise. It was also observed that the more years of training in nephrology these professionals had, the less likely they were to have received information about intradialytic exercise (OR=0.13; 95% CI 0.04 to 0.39; p<0.00). In conclusion, nephrologists with knowledge about intradialytic exercise were more likely to guide their patients, and those professionals with longer experience in the area were less likely to have received information about intradialytic exercise.

Introduction: COVID-19 is an infection caused by the SARS-CoV 2 virus, currently recognized as a serious, pandemic disease with a high transmission capacity. Most of these patients when discharged from the ICU may present a set of symptoms that characterize the post-COVID syndrome, including muscle weakness acquired in the ICU, changes in sleep parameters, cardiorespiratory responses and their quality of life. Objectives: To assess sleep parameters, quality of life and cardiorespiratory responses to exertion and to determine whether there is an association between sleep parameters, quality of life and cardiorespiratory responses to exertion in post-COVID patients. Methodology: This is an observational, prospective and cross-sectional study, which will be conducted from July 2022 to December 2023. The research will be carried out in the cardiopulmonary rehabilitation laboratory of the physiotherapy department of the Federal University of Pernambuco. In which will be included patients aged between 18-65 years, of both sexes with a diagnosis of COVID-19 confirmed by a positive result in molecular and serological tests between 3-12 months of diagnosis. Those who had chronic degenerative, neuromuscular diseases or cognitive impairment that made it difficult to carry out the evaluation protocol were excluded. Expected results: Patients with post-COVID sequelae are expected to show changes in sleep parameters, cardiorespiratory responses to exertion and impairment in their quality of life over the six-month follow-up of these patients through assessments.

Introdução: A artrite reumatoide (AR) é uma doença articular inflamatória crônica que gera forte impacto nas atividades e participações dos indivíduos acometidos. Os pacientes com AR tendem a ser mais inativos do que os indivíduos em geral, além de terem grau elevado de incapacidade, fadiga, dor e piore percepção de qualidade de vida. Objetivo: Avaliar a associação entre nível de atividade física e características demográficos, clínicos e funcionais em pacientes com artrite reumatoide. Métodos: estudo transversal, com amostra composta por indivíduos de ambos os sexos com diagnóstico de AR, entre 18 e 65 anos, sem troca de medicamento nos últimos três meses; capacidade de ter alguma atividade física em sua rotina e capacidade de responder perguntas; e também de indivíduos saudáveis contatados entre os acompanhantes dos pacientes e na região circunvizinha ao hospital. Serão avaliados os seguintes desfechos: nível de atividade física (Questionário Internacional de Atividade Física); incapacidade (Health Assessment Questionnaire); dor (Escala Analógica Visual); fadiga (Escala de Gravidade da Fadiga); qualidade de vida (12-Item Short-Form Health Survey); qualidade do sono (Pittsburgh Sleep Quality Index); força de preensão palmar (dinamometria); cinesiofobia (Escala de Tampa de Cinesiofobia) e grau de atividade da doença (Clinical Disease Activity Index). Resultados esperados: o menor nível de atividade física em pacientes com artrite reumatoide está relacionado a um maior grau de incapacidade.

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The pad test is a diagnostic tool for urinary incontinence (UI) severity classification and therapeutic response monitoring. However, the reliability and reproducibility of this test have been questioned. The objective was to investigate the quality of evidence from pad test accuracy studies on urinary incontinence diagnosis in adults compared to the urodynamic exam and summarize the accuracy and reproducibility properties.  A systematic review of the diagnostic test accuracy was performed (PROSPERO: CRD42020219392). The eligibility criteria was studies that evaluated the diagnostic accuracy and reproducibility properties of four pad test protocols in adults of both sexes. Data sources was MEDLINE, Science Direct, Cochrane Database, Web of Science, LILACS, and Pedro databases. Two reviewers independently screened the eligibility of the articles. The risk of bias was evaluated with the QUADAS-2 tool. Eighteen studies, of which eight measured pad test accuracy, were included. A total of 1070 individuals were analyzed, the mean age ranged from 20 to 90 years. The risk of bias among the studies was high and, due to different cut-off points adopted by studies, the bivariate model was not satisfied to perform a meta-analysis. The accuracy of the long-duration protocols was generally moderate to high (sensitivity: 60%–93%; specificity: 60%–84%). The 1-hour protocols obtained higher accuracy values than the long-duration protocols. The overall reproducibility was moderate to high (κ ≥ 0.66). The 1-hour pad test had better accuracy, but poorer reproducibility compared to the long-duration tests. Pad test results should be used with caution in clinical practice.

INTRODUCTION: Misoprostol induction is one of the most used forms in clinical practice in maternity hospitals when the objective is to promote labor. However, induction does not always progress to vaginal delivery. Physiotherapeutic monitoring through kinesiotherapy is a strategy that can be used in this period and has several benefits, nevertheless, the study of the application of kinesiotherapy in induced women is not yet known. OBJECTIVE: To analyze the effectiveness of kinesiotherapy in the labor of pregnant women induced by misoprostol regarding the performance of vaginal deliveries when compared to the usual care group. METHODS: This is a clinical trial carried out at the Maternity Hospital of the Lauro Wanderley University Hospital of the Federal University of Paraíba HULW from January to December 2021 with pregnant women pharmacologically induced by misoprostol (25mcg, vaginally). The pregnant women were randomized into two groups: Intervention Group (IG): induced pregnant women who underwent kinesiotherapy during the active phase of labor; Control Group (CG): induced pregnant women who did not physical therapy during the active phase of labor. The variables studied were: vaginal delivery, induction time, duration of the active phase of labor, duration of the expulsive period of labor, number of misoprostol doses, pain level, grade 3 or 4 lacerations, and 5th-minute Apgar. Data were collected through pre-established collection forms and later analyzed by the Statistical Package for the Social Sciences (SPSS) program to perform statistical tests. RESULTS: The sample of pregnant women in the intervention group had a greater number of vaginal deliveries (p=0.016). The variables induction time, duration of the active phase and expulsive period, pain level, presence of laceration, Apgar, and fetal weight had no difference between groups. CONCLUSION: Kinesiotherapy during the active phase of labor in women induced by misoprostol was effective for performing more vaginal deliveries despite not showing any difference in the other outcomes studied.

Covid-19 causes several systemic manifestations, especially affecting the respiratory system, ranging from mild cold symptoms to severe acute respiratory distress syndrome (ARDS). At the beginning of the pandemic, there was a recommendation for early intubation in order to avoid respiratory deterioration and further lung injury, and non-invasive ventilation (NIV) was seen as an unsafe method for such patients due to the lack of scientific evidence for this and previous research involving viral pneumonias. The objective of this research was to compare the effects of the use of the adapted diving mask (Owner) with the conventional orofacial mask in patients with and without the diagnosis of Covid-19 with NIV indication regarding oxygenation and non-intubation. This is a randomized clinical trial, resulting from a larger study, approved by the Research Ethics Committee and the National Research Ethics Committee (CAAE: 30783720.7.0000.5343, opinion nº. 4.305.813), respecting all the norms of the Resolution 466/12 of the National Health Council and registered in the Brazilian Clinical Trial Registry (ReBEC) (RBR – 7xmbgsz). Patients admitted to the intensive care units (ICU) of two hospitals, of both sexes, aged between 18 and 90 years and with an indication for NIV due to ARDS, were included in the study. 48 patients were recruited. Patients diagnosed with Covid-19 were considered to be those with a positive reverse transcriptase test (RT-PCR) or serological test. The primary outcomes studied were the PaO₂/FiO₂ ratio (RPaO₂/FiO₂) as a parameter to assess oxygenation and NIV success (non-evolution to intubation/death). The normality and homogeneity of the sample were verified, respectively, through the Kolmorogov-Smirnov and Levene tests. Single-factor ANOVA was used to evaluate the behavior of RPaO₂/FiO₂ (before NIV, after 1h, 24h and 48h). The Mauchly sphericity test and the Greenhouse-Geisser correction were performed. For the post hoc analysis, the Sidak test was used (P<0.05). Statistical analysis was performed using SPSS version 20.0. Patients with Covid-19 were allocated in the adapted diving mask group (G1, n=12) and in the conventional orofacial mask group (G2, n=12) and the patients without Covid-19 were allocated in the adapted diving mask group (G3, n=12) and conventional orofacial mask group (G4, n=12). There was no sample loss. The adapted and conventional diving masks differed from each other regarding the behavior of RPaO₂/FiO₂ in 1h (309.66±11.48 vs. 275.708±11.48, respectively) (p= 0.042) and in 48h (365.81± 16.85 vs. 308.787±18.86, respectively) (p=0.021). The success of NIV (non-intubation) was high in all groups, with 91.7% in G1, G3 and G4 and 83.3% in G2, demonstrating a low failure rate in all groups. It is concluded that NIV was safe and effective in the evaluated patients and there was a better result of the adapted diving mask in improving RPaO₂/FiO₂ and in terms of non-intubation.

Introduction: The evaluation of the measurement properties of patient-reported outcome measures (PROMs) is necessary for professionals and researchers to select instruments that guarantee the quality of the results. Thus, reliable instruments are important to provide information on the impact of migraine. Objective: To analyze the properties of measures of instruments that assess the impact of migraine developed for the Brazilian population. Methods: A search was performed in February 2021 and an update in June 2021 in the MEDLINE/Pubmed, Web of Science, LILACS and Embase databases, including studies that evaluated properties of PROMs measures developed to assess the impact caused by migraine, and translated and validated for the Brazilian population. Methodological quality, risk of bias, and quality of evidence were assessed following the COnsensus-based Standards for the selection of health Measurement INstruments (Cosmin) guidelines for systematic reviews of PROMs. Results: A total of 112 studies were identified, and four were included for full reading. Three instruments were analyzed: Headache Impact Test, which presented a serious risk of bias with moderate quality of evidence; Pediatric Migraine Disability Assessment, which had an extremely severe risk of bias and very low quality of evidence; and the Headache Disability Inventory¸ which presented a very serious risk of bias and low quality of evidence. Conclusion: The analysis performed identified that the three instruments evaluated had important limitations in the quality of evidence of the instruments evaluated. The Headache Impact Test was the most recommended for presenting moderate quality of evidence.

The clinical management of esophageal or gastric cancer involves a combination of treatments, neoadjuvants and surgical resection. The malnutrition inherent to this type of cancer results in a decline in functional capacity (FC) and muscle strength (FM). The objective of this review is to evaluate the evidence on the effects of physical exercise on the functional capacity of patients with esophageal and stomach cancer. This is a systematic review of randomized clinical trials that evaluated the impact of an exercise program on the functional capacity of patients with esophagogastric cancer. The searches involved PubMed, PEDro, Cochrane Library, Embase and CINAHL databases. The primary outcome of the review was FC. FM appeared as a secondary outcome. The risk of bias was assessed using the Cochrane Collaboration tool, using the RevMan software, and the degree of evidence was assessed using the GRADE system. Of 111 articles screened, eight studies involving a total of 673 patients were included in the qualitative synthesis. The studies varied in terms of measures of functional capacity, exercise protocols, and the therapeutic time at which the training program was implemented (during neoadjuvant therapy, pre- or post-surgical). The approach during neoadjuvant therapy had a positive effect on the 6-minute walk test (6MWT) and on handgrip strength (HPF), p<.05. The effect of the exercise performed in the preoperative period presented divergent results for the inspiratory muscle strength (PImax), being inconclusive for this outcome. However, in the assessment of functional capacity by the 6MWT, the result was statistically significant (p<0.001). The implementation of exercise in the postoperative period had an impact on the improvement of the 6MWT, maximum oxygen consumption (VO2max). However, in the assessment of muscle strength by HGS, there was no significant difference between the groups (p=0.758). Although some studies point to positive results in favor of physical exercise in improving functional capacity and muscle strength in patients undergoing treatment for esophagogastric cancer, further research is needed, not only to confirm the existing evidence but also for a better prescription and clinical application of these intervention protocols.

Introduction: chronic venous insufficiency (CVI) is a change in the venous system due to a valve inability, generating reflux that is associated or not with venous flow obstruction, and might be caused by dysfunction in the muscles of the sural triceps. The purpose of this study was to evaluate the acute effect of neuromuscular electrostimulation and kinesiotherapy on ankle joint flexibility, infrared radiation and sural triceps strength of individuals with CVI.

Method: this is a comparative study. Which infrared radiation was obtained by quantitative analysis of thermograms of both calves using thermographic camera; to evaluate ankle flexibility, the ‘‘goniometer’’ application was used and a portable dynamometer was used to evaluate the muscle strength of dorsiflexion and plantar flexion. One session of electrostimulation was performed by the Aussie current of 1kHz with Burst of duration equal to 2 ms (EG- electrostimulation group), in the right lower limb and kinesiotherapy (GC-kinesiotherapy group) in the left lower limb with stretching and metabolic exercises involving the ankle.

Results: 19 female patients were evaluated. Ankle flexibility analysis did not show statistically significant changes. In the evaluation of muscle strength there was no intergroup difference and in the intragroup evaluation only the CG showed an increase for dorsiflexion when compared to before treatment and 24 h after (respectively 11.6±3.5; 13.5±3.0, p=0.02), and for plantar flexion (11.8±6.3; 14.4±5.06, p=0.04). There was no statistically significant difference when intergroups and intragroup flexibility was evaluated. Regarding thermography, there was no intragroup difference while in the intergroup evaluation, the CG presented an increase in temperature immediately and 24 hours after (respectively 0.44±0.68, p=0.01 and 0.25±0.83, p=0.07). When analyzed the correlation between dorsiflexion force and plantar flexion of both lower body with the amplitude of the total arch of the right and left ankle, a positive correlation was observed only between plantar flexion strength immediately after and 24 hours after ankle ROM (rang of movement) in the kinesiotherapy group (respectively r=0.49, p=0.03 and r=0.51, p=0.03). Conclusion: There were no significant differences between the kinesiotherapy procedure and electrotherapy when analyzing muscle flexibility and strength. However Kinesiotherapy was superior to electrostimulation in the increase in calf temperature before and after 24 hours of the intervention.

Handgrip strength is an indicator of general muscle strength and in cancer patients it acts as a relevant marker associated with mortality and health. The systematic review aimed to assess the association between peripheral muscle function and health-related quality of life in breast cancer survivors. A registered systematic review was performed (PROSPERO: CRD 42021225206). Searches were performed in MEDLINE via Pubmed, PEDro, Cochrane Library, Embase, CINAHL via EBSCO and Science Direct databases. Observational studies evaluating the association between handgrip strength and health-related quality of life in adult female breast cancer survivors were included. No language or time restrictions were applied. Two reviewers reviewed full texts for inclusion and performed data extraction and risk of bias using the Newcastle and Ottawa scale. Five articles were included and involved 587 patients, with a mean age of 47 to 59 years. The percentage of decreased handgrip strength ranged from 38.3% to 60.3%. Handgrip strength was associated with different measures of quality of life. From the meta-analysis including 220 patients, the correlation coefficient between handgrip strength and health-related quality of life was 0.26 (95% CI: 0.07-0.35). Thus, we conclude that breast cancer survivors face a decline in handgrip strength. In this population, handgrip strength was correlated with health-related quality of life. However, more evidence is needed.

Introduction: Type II diabetes mellitus is a metabolic disease with a high prevalence, responsible for clinics and high demand for self-management. The use of patient-reported health outcome measures (PROMs) assist healthcare professionals in evaluating treatment strategies. The International Classification of Functioning (ICF), in turn, operationalizes the biopsychosocial model for a broader understanding of the health condition of people with diabetes. Objective: Binding instruments validated PROMs for patients with Type II Diabetes and the ICF, in order to identify differences between the components and describe a common appearance of the ICF. Study method was developed in two steps: (i) identification of validated PROMs and specificity for type 2 diabetes, and (ii) linkage between the instruments and the ICF through the ICF linking methodology proposed by Cieza et al. Additionally, a list of proposed categories was used to classify personal factors. Such methodology, among other conclusions and proposals, the identification of issues and the correspondence with representative ICF categories to the other conclusions and proposals in the PROMs. Results: From the 12 PROMs included, 184 statements were identified that were linked to 84 different categories, 78 of which were from the ICF and from the list of personal factors. Of these, 40% body function, 38% activity and participation, 8% environmental factors, 7% body structure followed by 7% personal factors. The categories were cited 365 times, and the activity and participation component was the most representative component. The most cited categories are related to health control of food, self-care and management activities in physical contexts. Conclusion: Overall, PROMs included in the ICF coverage, covering all categories of structure and function of activity and participation, environmental and personal factors to describe the components of patients with type II diabetes. There is divergence as to the degree of coverage of these components among the PROMs.

Introduction: COVID-19 is a systemic disease characterized by pro-inflammatory, pro-oxidative, prothrombotic state, excess circulating cytokines, dysregulation of the nine-year-old system, autonomic dysfunction and tissue lesions, which may cause changes in endothelial function, vascular structure and exacerbation of previous cardiovascular diseases. Thus, patients with underlying cardiovascular risk factors are prone to greater severity of the disease and worse prognosis. Objective: To evaluate the endothelial function, arterial stiffness and heart rate variability (HRV) of adults with CVD hospitalized by COVID-19 and to relate them to clinical outcomes. Methods: Cross-sectional study conducted from July 2020 to February 2021 at Hospital Agamenon Magalhães, Pernambuco, Brazil. A convenience sample of adults of both sexes, aged 40 to 60 years, hospitalized with COVID-19 and previous CVD was selected. Personal data, comorbidities, admission laboratory tests, in addition to clinical outcomes and possible clinical complications during hospitalization were analyzed. Endothelial function, arterial stiffness and HRV were evaluated by peripheral arterial tonometry. The sample was categorized according to endothelial dysfunction and statistical significance was set at 5%. Resultados: Fourteen of the twenty (51.8%) and seven adults included had endothelial dysfunction (median natural logarithm of the reactive hyperemia index of 0.29, interquartile interval between 0.06 and 0.42). The rate of increase normalized for heart rate (75 beats per minute) was significantly high in patients with preserved endothelial function (p<0.01), suggesting a high rate of arterial stiffness. Patients with endothelial dysfunction had higher values of high frequency (p<0.03) of HRV. No differences were observed between the groups in relation to clinical outcomes. Conclusion: This study shows that the endothelial function assessed by PAT seems to be an important early marker of endothelial dysfunction, arterial stiffness and VhF in patients with CVD hospitalized by COVID-19.

The main systemic manifestations of patients with COVID-19, highlights the commitment of cardiovascular, metabolic and central nervous systems, as well as musculoskeletal dysfunctions and emotional impacts due to traumatic events during hospitalization. Post traumatic stress disorder (PTSD), characterized by involuntary and intrusive distressing memories can be considered an emotional impact that deserves to be investigated. The objective of this research was to verify the prevalence of PTSD and its association with body composition, muscle strength and thickness, functional capacity and quality of life of patients who had the moderate and severe form of COVID-19, after a minimum period of four months after discharge from the ward and/or ICU. This is a cross-sectional study, approved by the institutional ethics committee (CAAE: 43309621.6.0000.5208), under the number of opinion nº 4,666,479 and developed at the Cardiopulmonary Physiotherapy Laboratory of the Department of Physiotherapy of the Federal University of Pernambuco. Individuals of both sexes, aged between 45 and 70 years, who had COVID-19 duly proven and who had been admitted to the ICU or ward and presented clinically recovered, from the 4th month of recovery, were included. Individuals with musculoskeletal changes that prevented the performance of functional tests, cognitive changes that hindered the understanding of the questionnaires, hemodynamic instability and who performed a post-discharge training program were excluded from the study. Individuals were evaluated for PTSD, level of physical activity quality of life, body composition, inspiratory and expiratory muscle strength, palmar grip strength, mobility and balance, quadriceps muscle thickness of the dominant lower limb, distance covered in the 6 min walk test and quality of life. This dissertation presents as results the following articles: "Risk factors associated with post-traumatic stress disorder in post-COVID-19 patients: a systematic review". In this review, it was observed that factors such as the female gender, age group between 40 and 50 years and previous pathologies mainly of psychological order constituted risk factors associated with PTSD in post-COVID-19 patients. It was also observed that education level, economic status, belief in increased mortality from COVID-19, admission to the ICU, length of hospital stay, The death of a patient in the ICU and isolation during hospitalization also contributed to higher rates of PTSD. And an original article: "Post-traumatic stress Disorder in individuals who required Hospitalization for COVID-19: A cross-sectional Study". The prevalence of PTSD in the individuals evaluated was 48.3%, however, another 38.7% had partial symptoms. In individuals with PTSD, 65.5% were obese, 62.1% hypertensive and sedentary (p = 0.009). These individuals had hospitalization in the ICU and a higher number of days hospitalized, respectively (p <0.001 and p = 0.010). As for functionality, individuals with PTSD also had more time to perform the TUG (p = 0.014), less distance covered predicted in 6MWT min (p = 0.001) and reduction in all domains of the SF-36 questionnaire.  As a conclusion, there is a relative prevalence of PTSD after 4 months of hospital discharge in individuals recovered from COVID-19 and functional repercussions. 

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The multisystemic infection caused by the New Coronavirus-19 (nCoV-19) causes consequences beyond the acute phase and respiratory symptoms, often observed in the first cases of infection. The identification of persistent sequelae in survivors of the New Coronavirus-19 Disease (COVID-19) has led to an increase in demand for rehabilitation services and has highlighted the need for a functional recovery intervention that is safe and well tolerated for this population. Whole Body Vibration (WBV) is an alternative strategy to conventional rehabilitation programs that has been studied in several people. The aim of this study was to evaluate the effectiveness of a whole-body vibration program on the risk of falls, balance, mobility and heart rate variability (HRV) in patients affected by moderate or severe forms of COVID-19. This is a randomized clinical trial approved by the Research Ethics Committee and the National Research Ethics Committee (CAAE 50633321.0.0000.5208, opinion nº 5.007.272), respecting all the norms of Resolution 466/12 of the National Health Council and registered in the Brazilian Clinical Trial Registry (ReBEC) (RBR-10c2pb73). Patients affected by COVID-19 who required hospitalization in a ward or ICU, discharged at least 4 months before the start of training, of both sexes, aged between 18 and 70 years were included in the research. The sample consisted of 13 patients. The study's primary endpoints were risk of falls, mobility and balance, and heart rate variability in its time and frequency domains. The normality and homogeneity of the sample were verified, respectively, using the Shapiro-Wilk and Levene tests. For comparison between the groups, the Anova test for repeated measures or the Kruskall-Wallis test were used for the risk of falls, mobility and balance and heart rate variability (HRV), based on time variations (pre and post) and intervention (Sham, IVC 4mm and IVC 2mm), followed by Tukey's or Nemenyi's post-hoc test. Statistical analysis was performed using the SPSS program, version 20.0. There was analysis by intention to treat in the groups where the loss was greater than 20%. Patients were allocated into the control group (G Sham, n=4), the 4 mm IVC group (G 4mm, n = 5) and the 2mm IVC group (G 2mm, n=4). Training with WBV at 2mm and 4mm amplitude resulted in a reduction in the risk of falls when compared to Sham (p= 0.023), with a large effect size of 0.530. No changes were observed for mobility and balance outcomes (p= 0.127) or for any of the HRV variables (p= 0.386). Whole-body vibration training was a safe and well-tolerated therapeutic modality by patients after 4 months of the acute phase of COVID-19. In addition, the perception of improvement in global status was satisfactory even in patients allocated to the Sham group. Adverse reactions such as mild itching in lower limbs and post-intervention muscle pain, which regressed within 24 hours, were observed in the studied population. Considering these findings, in order to strengthen the evidence regarding WBV training in post-COVID patients, this study will remain ongoing.

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Introdução: Recentemente, um novo surto de doença infecciosa, de caráter pandêmico, denominada COVID-19 fez com que a demanda dos profissionais de saúde aumentasse ainda mais. Neste contexto, medidas de isolamento e distanciamento social foram tomadas para conter o avanço da pandemia, contribuindo para uma possível redução do nível de atividade física. Além disso, as condições de estresse nesse período foram exponencialmente aumentadas, levando ao desenvolvimento de transtornos de humor e distúrbios do sono. Objetivo: Verificar associações entre a qualidade do sono, a sonolência diurna excessiva, os sintomas de transtornos de humor e o nível de atividade física em profissionais de saúde da linha de frente COVID-19. Métodos: Trata-se de uma pesquisa de corte transversal, realizada através da aplicação de questionários validados para avaliar qualidade do sono (Índice de qualidade do sono de Pittsburgh-PSQI), sonolência diurna excessiva (Escala de sonolência de Epworth-ESE), sintomas de ansiedade (Inventário de ansiedade de Beck-IAB) e depressão (Inventário de depressão de Beck-IDB) e nível de atividade física (Questionário internacional de atividade física-IPAQ). Os questionários foram aplicados através de formulário online, divulgados através de mídias sociais. Foram recrutados profissionais de saúde (médicos, fisioterapeutas, enfermeiros e técnicos/auxiliares de enfermagem) que atuavam em unidades hospitalares na assistência a pacientes com COVID-19. Os dados foram analisados no software Statistical Package for the Social Sciences (SPSS) versão 20.0, utilizando-se técnicas de estatística descritiva e inferencial. Para análise estatística dos resultados foi atribuído um nível de significância de 95% (p<0,05). significativas. Resultados: 96 indivíduos completaram o estudo. Foram observadas uma alta prevalência de má qualidade do sono (86,5%) e sonolência diurna excessiva (42,7%). 42,8% e 51% da amostra apresentaram algum sintoma de ansiedade e depressão, respectivamente. Quanto ao nível de atividade física, a maior parte dos sujeitos foi classificada como altamente ativo (45,8%). Foram observadas correlações moderadas entre transtornos de humor e qualidade do sono (ansiedade: r = 0,587; p < 0,001) (depressão: r = 0,588; p < 0,001), bem como correlações fracas entre transtornos de humor e sonolência diurna excessiva (ansiedade: r = 0,220; p < 0,05) (depressão: r = 0,217; p < 0,05). Não foram observadas correlações entre o nível de atividade física e os parâmetros do sono (PSQI: r = 0,180; p > 0,05) (ESE: r = 0,030; p > 0,05). A análise de regressão linear múltipla resultou em um modelo sifnificativo para qualidade do sono [F (2, 93) = 28,985; p < 0,001; R² = 0,384], no qual a ansiedade (β = 0,355; t = 2,883; p = 0,005)  e a depressão (β = 0,307; t = 2,494; p = 0,014) foram fatores preditores da qualidade do sono. Não houve associação entre sonolência diurna excessiva e os sintomas de transtorno de humor [F (2, 93) = 2,121; p = 0,126; R² = 0,044]. Conclusões: De acordo com os resultados, A qualidade do sono e a sonolência diurna excessiva foram correlacionados positivamente com os transtornos de humor. Entretanto, apenas a qualidade do sono apresentou associação com os sintomas de transtorno de humor, e os sintomas de ansiedade e depressão foram fatores preditores da qualidade do sono. O nível de atividade física não foi correlacionado com nenhum dos parâmetros do sono.

 

 

Introduction: Visceral Osteopathy is a philosophy and science of manual therapy treatment aimed at recovery of movement, through the manipulation of fascial chains, visceral somato and visceral somatic. By mobilizing the fascia that interconnect with the viscera, it can improve visceral and diaphragmatic mobility, as well as vertebral segmental restrictions in individuals with chronic gastritis. Objective: To assess stomach and diaphragm mobility and vertebral segmental restrictions among adults diagnosed with chronic gastritis compared to healthy adults. Method: Observational study formed by individuals diagnosed with chronic gastritis who will be evaluated for stomach mobility, diaphragm and vertebral segmental restrictions. The sample was calculated through a pilot study, composed of 60 individuals diagnosed with chronic gastritis, between 18 and 59 years of age and of both sexes. The research was carried out at the Learning and Motor Control Laboratory (LACOM), of the Physical Therapy Department of the Federal University of Pernambuco (UFPE), from October 2018 to November 2019. For statistical analysis, the Shapiro test was used - Wilk for normalcy. Outcomes were considered using a 95% confidence interval. For the intra-group analysis of the qualitative variables, the Kappa was used and for the quantitative, the ICC. Result: In the comparison between the groups, restriction of stomach mobility was found in all directions (p&lt;0.02) with the exception of the counterclockwise direction (p = 0.09). In the GG, 93% of the individuals had diaphragm mobility restriction. (p = 0.00) with excellent intra-rater agreement. The study also showed a musculoskeletal restriction in the cervical spine in more evident rotation between C2 and C4 and in asymmetry in the thoracic spine between T5 and T9. Conclusion: Individuals with chronic gastritis had greater restriction of stomach and diaphragm mobility, in addition to a higher prevalence of cervical and thoracic somatic dysfunction, affecting more than three vertebrae in individuals with chronic gastritis, when compared to healthy individuals.