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Diaphragm ultrasound after manual rib cage stabilization maneuver in premature newborns: clinical trial 早产儿手动胸腔稳定术后膈超声:临床试验
Q4 Medicine Pub Date : 2023-01-01 DOI: 10.1590/fm.2023.36132
Marimar Goretti Andreazza, Cristiane Nogueira Binotto, Regina Paula Guimarãens Vieira Cavalcante da Silva, Silvia Valderramas, Monica Nunes Lima
Abstract Introduction The manual rib cage stabilization maneu-ver (MRCSM) is a physical therapy intervention that promotes stabilization of the zone of apposition of the diaphragm, facilitating the contraction of this muscle and the work of breathing. Objective To evaluate by diaphragm ultrasound the diaphragmatic excursion in premature newborns before and after MRCSM. Methods Before-after clinical trial assessing by diaphragm ultra-sound the effectiveness of MRCSM in the amplitude of diaphragmatic excursions. Results The study sample consisted of 48 premature newborns born at a mean gestational age of 33.0 ± 2.8 weeks with a mean birth weight of 1,904.1 ± 708.9 grams. The newborns were classified in three groups: without respiratory distress syndrome (RDS; n = 26), with RDS (n = 15) and with apnea (n = 7) as a cause of admission to the neonatal intensive care unit (NICU). The measurements of diaphragmatic excursion and thickening were similar in newborns without or with RDS or apnea and there was a significant increase in the amplitude of diaphragmatic excursions after MRCSM (p < 0.001; effect size > 0.68) and less diaphragmatic thickening at exhalation in all of them. The diaphragm thickening fraction was 0.50 (0.33 - 0.72), and the diaphragm thickening rate was 0.04 (0.03 - 0.07). These measurements showed no significant variation with the presence or absence of RDS or apnea (p > 0.05). No significant variations in heart rate (p = 0.30), respiratory rate (p = 0.79), and peripheral oxygen saturation, consid-ering newborns in ambient air (p = 0.17) compared with baseline. Conclusion The MRCSM was effective, safe, and increased the amplitude of diaphragmatic excursion and thickness in premature newborns at one week of age, regardless of the presence or absence of RDS or apnea as a cause of admission to the NICU.
手动胸腔稳定操作(MRCSM)是一种物理治疗干预,促进膈肌相邻区域的稳定,促进该肌肉的收缩和呼吸工作。目的通过横膈膜超声评价早产儿MRCSM前后膈肌移位情况。方法临床试验前后用膈超声评价MRCSM对膈移位幅度的影响。结果48例平均胎龄为33.0±2.8周,平均出生体重为1904.1±708.9 g的早产儿。新生儿分为三组:无呼吸窘迫综合征(RDS);n = 26), RDS (n = 15)和呼吸暂停(n = 7)作为入院新生儿重症监护病房(NICU)的原因。无RDS或呼吸暂停的新生儿膈移位和增厚的测量结果相似,MRCSM后膈移位幅度显著增加(p <0.001;效应量>0.68),呼气时膈肌增厚较少。隔膜增厚分数为0.50(0.33 ~ 0.72),隔膜增厚率为0.04(0.03 ~ 0.07)。这些测量结果显示,RDS或呼吸暂停的存在与否没有显著差异(p >0.05)。与基线相比,心率(p = 0.30)、呼吸频率(p = 0.79)和外周血氧饱和度(p = 0.17)均无显著变化。结论MRCSM有效、安全,可增加1周龄早产儿膈肌偏移幅度和厚度,无论是否存在RDS或呼吸暂停作为入院NICU的原因。
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引用次数: 0
Perioperative care for major elective surgery: a survey of Brazilian physiotherapists 重大择期手术的围手术期护理:巴西物理治疗师的调查
Q4 Medicine Pub Date : 2022-01-01 DOI: 10.1590/fm.2022.35106
Christiane Luck Macieira, L. Chiavegato, Isabel Fialho Fontenele Garcia, A. Lunardi
Abstract Introduction: Major surgeries are highly complex procedures and have a higher incidence of respiratory morbidity and mortality compared to other types of surgery. Postoperative pulmonary complications (PPC) are common after such surgeries and are associated with increased hospital stay, health care costs and surgical patient mortality. Objective: To investigate the most commonly used physical therapy techniques for the prevention and treatment of PPC among thoracic and abdominal surgery patients in all regions of Brazil. Methods: A total of 489 randomly selected physiotherapists who provided perioperative care for patients undergoing elective abdominal, thoracic or cardiac surgeries participated in this study. A questionnaire with nine questions about routine care and therapeutic choices for the surgical population was developed and assessed by 10 specialists before being administered to the physiotherapists. Results: Among the physiotherapists (63% with at least 5 years of experience with surgical patients), 50.9% considered the patient’s surgical risk in their treatment either always or often. A total of 53.8% patients were treated by the physiotherapist following a physician’s prescription. The most mentioned physical therapy techniques used to prevent PPC were postoperative mobilization/exercises (59.3%), postoperative lung expansion (52.8%), and preoperative advice (50.7%). In addition, 80.6% of the physiotherapists believe that incentive spirometry prevents PPC, while 72.8% expected this effect from positive airway pressure devices. Conclusion: Most physiotherapists in Brazil who work with surgical patients offer preoperative professional advice, use postoperative early mobilization and lung expansion techniques to prevent PPC, and consider the patient's surgical risk during treatment. In addition, some physical therapy sessions are routinely performed preoperatively.
摘要导论:大手术是高度复杂的手术,与其他类型的手术相比,呼吸系统的发病率和死亡率更高。术后肺部并发症(PPC)在此类手术后很常见,并与住院时间、医疗费用和手术患者死亡率增加有关。目的:探讨巴西各地区胸腹外科患者预防和治疗PPC最常用的物理治疗技术。方法:随机选取489名为择期腹部、胸部或心脏手术患者提供围手术期护理的物理治疗师参与本研究。在发给物理治疗师之前,由10名专家编制并评估了一份包含9个问题的问卷,内容涉及手术人群的常规护理和治疗选择。结果:有5年以上手术经验的物理治疗师(63%)中,50.9%的物理治疗师在治疗中总是或经常考虑患者的手术风险。53.8%的患者是遵医嘱接受理疗师治疗的。被提及最多的预防PPC的物理治疗技术是术后活动/运动(59.3%)、术后肺扩张(52.8%)和术前建议(50.7%)。此外,80.6%的物理治疗师认为刺激肺活量测定可以预防PPC,而72.8%的物理治疗师认为气道正压装置可以预防PPC。结论:巴西大多数物理治疗师在治疗手术患者时提供术前专业建议,术后早期活动和肺扩张技术预防PPC,并在治疗过程中考虑患者的手术风险。此外,术前常规进行一些物理治疗。
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引用次数: 0
Characteristics and perceptions of telerehabilitation consultations by neuropediatric physical therapists during the COVID-19 pandemic COVID-19大流行期间神经儿科物理治疗师远程康复咨询的特点和看法
Q4 Medicine Pub Date : 2022-01-01 DOI: 10.1590/fm.2022.35110
A. L. Meireles, Maria Eduarda Silva Mendes, Suiane da Silveira, Hanahira dos Santos Machado
Abstract Introduction: The COVID-19 pandemic brought a strong discussion about telerehabilitation, especially in countries where its practice was not allowed previous the pandemic. In the neuropediatric rehabilitation field evidence of the effectiveness of this modality of assistance and data about provider and family’s perceptions are scarce. Objective: To evaluate the characteristics of telerehabilitation physical therapy consultations for children with neurological diseases during the COVID-19 pandemic and report the perceptions of physical therapists about this modality of assistance. Methods: An online survey was created and administered to Brazilian neuropediatric physical therapists. The survey consisted of demographics data, questions about the characteristics of telerehabilitation consultations, and physical therapists’ perception of telerehabilitation assistance. Results: From July to September 2020, 394 physical therapists responded to the questionnaire. The most of them took 21 to 30 minutes per telemonitoring session (26.9%), offered one session per week (61.0%), and used electronic messages as the main method of delivery (39.9%). The main difficulty reported was caregivers’ lack of understanding about handling during sessions (41.2%) and problems with internet connection (16.7%). Additionally, most of them reported that it is highly important important to provide healthcare via telerehabilitation to the economically disadvantaged. Conclusion: The findings of this study provide insight into the complex and challenging process of telerehabilitation assistance during the first wave of the COVID-19 pandemic. Despite the reported challenges, telerehabilitation can be an opportunity to better understand children’s activities and participation in home context.
摘要导语:2019冠状病毒病大流行引发了关于远程康复的热烈讨论,特别是在疫情前不允许远程康复的国家。在神经儿科康复领域,这种援助方式的有效性的证据和关于提供者和家庭观念的数据是稀缺的。目的:了解新冠肺炎疫情期间神经系统疾病患儿远程康复物理治疗会诊特点,了解物理治疗师对远程康复物理治疗方式的看法。方法:创建了一项在线调查,并对巴西神经儿科物理治疗师进行了调查。调查内容包括人口统计数据、远程康复咨询的特点以及物理治疗师对远程康复援助的看法。结果:2020年7月至9月,共有394名物理治疗师参与了问卷调查。最多的是每次远程监护时间为21 ~ 30分钟(26.9%),每周监护1次(61.0%),以电子信息为主要传递方式(39.9%)。报告的主要困难是护理人员在治疗期间缺乏对处理的理解(41.2%)和互联网连接问题(16.7%)。此外,他们中的大多数报告说,通过远程康复向经济上处于不利地位的人提供保健非常重要。结论:本研究结果揭示了COVID-19大流行第一波期间远程康复援助的复杂和具有挑战性的过程。尽管报告中存在挑战,但远程康复可以成为更好地了解儿童在家庭环境中的活动和参与的机会。
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引用次数: 1
Breathing pattern, orthognathic surgery and head posture in dentofacial deformity 牙面畸形患者的呼吸模式、正颌手术和头部姿势
Q4 Medicine Pub Date : 2022-01-01 DOI: 10.1590/fm.2022.35105
Rogerio Eduardo Santos Tiossi Castello Branco, Letícia Korb da Silva, Reinaldo Monteiro Marques, Raquel Rodrigues Rosa, G. Berretin-Félix
Abstract Introduction: Dentofacial deformity (DFD) and the breathing mode can change the head posture. However, head posture changes after orthognathic surgery are controversial, and no studies were found on the relationship between the head posture and breathing mode in adults with DFD. Objective: To identify the main head posture changes in young adults affected by DFD, to verify if orthognathic surgery modifies the breathing mode and head posture, and if the breathing mode is associated with the head posture. Methods: Twenty-five young adults were assessed and divided in dentofacial deformity group (DFD; n = 15; x̅ = 28 years) and control group with dentofacial harmony (CG; n = 10; balanced by gender and age with the study group). Breathing mode was evaluated according to the orofacial myofunctional evaluation protocol, and biophotogrammetry was used in the head posture analyses. For the DFD group, the evaluations were performed pre and post the orthognathic surgery (pre- and post-DFD). Results: For the DFD group, the breathing mode modified after orthognathic surgery (p = 0.003), but with difference from GC (p = 0.027). No changes were found in head posture after orthognathic surgery, but significant difference was seen between post-DFD and GC for head inclination (p = 0.017). No relationship was observed between breathing mode and head posture (p > 0.05). Conclusion: After orthognathic surgery, a spontaneous improvement of breathing was seen in the sample. It was not possible to verify changes in head posture and association with breathing mode and head posture.
摘要简介:牙面畸形(DFD)和呼吸方式可以改变头部姿势。然而,正颌手术后的头部姿势变化存在争议,目前尚未发现成人DFD患者头部姿势与呼吸方式之间的关系。目的:确定受DFD影响的年轻人的主要头部姿势变化,验证正颌手术是否改变了呼吸方式和头部姿势,以及呼吸方式是否与头部姿势相关。方法:对25名青壮年进行评估并分为牙面畸形组(DFD;N = 15;x = 28岁)和牙面和谐对照组(CG;N = 10;按性别和年龄与研究组进行平衡)。呼吸方式根据口面部肌功能评估方案进行评估,头部姿势分析采用生物摄影测量法。对于DFD组,在正颌手术前后(DFD前后)进行评估。结果:DFD组正颌手术后呼吸方式有所改变(p = 0.003),与GC组差异有统计学意义(p = 0.027)。正颌手术后的头部姿势没有变化,但dfd后和GC后的头部倾斜有显著差异(p = 0.017)。呼吸方式与头部姿势无相关性(p < 0.05)。结论:在正颌手术后,在样本中可以看到呼吸的自发改善。不可能证实头部姿势的变化以及与呼吸方式和头部姿势的关系。
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引用次数: 0
Impact of mechanical ventilation time on functional capacity and muscular strength of patients under intensive care 机械通气时间对重症监护患者功能能力和肌力的影响
Q4 Medicine Pub Date : 2022-01-01 DOI: 10.1590/fm.2022.35125
Monique Canelhas, Melissa Sibinelli, L. C. Figueiredo, L. C. Martins
Abstract Introduction: A prolonged assisted ventilation (AV) period might induce complications. Objective: To compare functional capacities and muscle strength of patients under AV. Methods: This is a prospective cohort observational study. The patients selected were under mechanical ventilation in any given moment, and they were evaluated only at the time of discharge from the intensive care unit (ICU). The convenience sample of 103 was selected and divided into a group with up to six days of AV (G6) and another with seven days or more of AV (G7). The protocol proposed was: application of the Medical Research Council (MRC) scale, dynamometry, Barthel index, ability to ambulate at ICU discharge. A call was made to the patients six and 12 months after hospital discharge for the application of the Barthel index. Results: We verified that G6 patients obtained better muscular strength measured through right 14 (8-30) and left 18 (8-26) dynamometry and MRC scale 48 (44-56). Only seven (14%) patients from the G7 group were able to ambulate. G7 patients showed greater functional loss at hospital discharge 32 (15-60). After one year of hospital discharge, both groups had recovered their functional capacity 100 (100-100). Conclusion: When evaluating the process of AV, it is possible to conclude that the longer the ventilator is used, the greater the loss of strength and functionality. In addition, there is a significant recovery of functionality after one year of hospital discharge.
摘要简介:辅助通气(AV)时间过长可能诱发并发症。目的:比较房颤患者的功能能力和肌力。方法:这是一项前瞻性队列观察研究。所选择的患者在任何给定时刻都处于机械通气状态,并且仅在从重症监护病房(ICU)出院时进行评估。选择103例方便样本,并将其分为AV最长6天组(G6)和AV最长7天组(G7)。建议的方案是:应用医学研究委员会(MRC)量表、动力学、Barthel指数、ICU出院时的行走能力。在病人出院后6个月和12个月,要求他们应用Barthel指数。结果:我们通过右14(8-30)和左18(8-26)测力和MRC量表48(44-56)验证了G6患者获得了更好的肌肉力量。G7组中只有7名(14%)患者能够行走。G7患者在出院时表现出更大的功能丧失32(15-60)。出院1年后,两组功能恢复100(100-100)。结论:在评估AV过程时,可以得出呼吸机使用时间越长,强度和功能损失越大的结论。此外,出院一年后功能有显著恢复。
{"title":"Impact of mechanical ventilation time on functional capacity and muscular strength of patients under intensive care","authors":"Monique Canelhas, Melissa Sibinelli, L. C. Figueiredo, L. C. Martins","doi":"10.1590/fm.2022.35125","DOIUrl":"https://doi.org/10.1590/fm.2022.35125","url":null,"abstract":"Abstract Introduction: A prolonged assisted ventilation (AV) period might induce complications. Objective: To compare functional capacities and muscle strength of patients under AV. Methods: This is a prospective cohort observational study. The patients selected were under mechanical ventilation in any given moment, and they were evaluated only at the time of discharge from the intensive care unit (ICU). The convenience sample of 103 was selected and divided into a group with up to six days of AV (G6) and another with seven days or more of AV (G7). The protocol proposed was: application of the Medical Research Council (MRC) scale, dynamometry, Barthel index, ability to ambulate at ICU discharge. A call was made to the patients six and 12 months after hospital discharge for the application of the Barthel index. Results: We verified that G6 patients obtained better muscular strength measured through right 14 (8-30) and left 18 (8-26) dynamometry and MRC scale 48 (44-56). Only seven (14%) patients from the G7 group were able to ambulate. G7 patients showed greater functional loss at hospital discharge 32 (15-60). After one year of hospital discharge, both groups had recovered their functional capacity 100 (100-100). Conclusion: When evaluating the process of AV, it is possible to conclude that the longer the ventilator is used, the greater the loss of strength and functionality. In addition, there is a significant recovery of functionality after one year of hospital discharge.","PeriodicalId":33749,"journal":{"name":"Fisioterapia em Movimento","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67163442","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Relationship between physical activity level and balance in middle-aged and older women 中老年妇女身体活动水平与身体平衡的关系
Q4 Medicine Pub Date : 2022-01-01 DOI: 10.1590/fm.2022.35126
P. Macêdo, S. Fernandes, I. G. Azevedo, J. Costa, Dimitri Taurino Guedes, S. Câmara
Abstract Introduction: Physical exercise may improve motor skills, such as static standing balance. However, the association between physical activity level based on activities of daily living and static balance is unknown. Objective: To assess the association between the physical activity level and static balance in middle-aged and older women. Methods: This cross-sectional study involved 589 community-dwelling women. Static balance was assessed using the single-leg stance test (SLST) with eyes open and closed. Physical activity level was assessed using the International Physical Activity Questionnaire Short Form and classified as high, moderate, or low. Kruskal-Wallis test compared balance performance between participants with different physical activity levels. Multiple quantile regression analyses assessed the association between variables adjusted for age, family income, educational level, body mass index, comorbidities, and parity. Results: Participants with low physical activity level showed worse SLST performance with eyes open and closed than participants with high physical activity level in the bivariate analysis. However, physical activity level and SLST performance were not associated in the analysis adjusted for covariates. Conclusion: Our results suggested that only being active in daily living activities is not associated with better standing balance in middle-aged and older women. Specific physical exercise programs should be implemented to improve balance in this population.
摘要:体育锻炼可以提高运动技能,如静态站立平衡。然而,基于日常生活活动的身体活动水平与静态平衡之间的关系尚不清楚。目的:探讨中老年妇女体力活动水平与静态平衡的关系。方法:横断面研究涉及589名社区妇女。静平衡评估采用单腿站立试验(SLST),眼睛睁开和闭上。使用国际体育活动问卷简表评估体育活动水平,并将其分为高、中、低。Kruskal-Wallis测试比较了不同体力活动水平参与者的平衡能力。多分位数回归分析评估了年龄、家庭收入、教育水平、体重指数、合并症和胎次等变量之间的相关性。结果:在双变量分析中,低体力活动水平的被试在睁眼和闭眼时的SLST表现都不如高体力活动水平的被试。然而,在协变量调整后的分析中,体力活动水平和SLST表现并不相关。结论:我们的研究结果表明,仅在日常生活活动中活跃与中老年妇女站立平衡的改善无关。应该实施特定的体育锻炼计划来改善这一人群的平衡。
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引用次数: 1
Effect of pompage on pain, disability and craniocervical position of female teachers - Randomized clinical trial 按摩对女教师疼痛、残疾及头颈位的影响——随机临床试验
Q4 Medicine Pub Date : 2022-01-01 DOI: 10.1590/fm.2022.35118
Débora Bonesso Andriollo, L. Frigo, C. Cielo
Abstract Introduction: Education professionals are one of the most important occupational groups and represents one of the main parts of the economy of modern society. The vocal demands most mentioned by the teachers are talking while standing up, talking a lot and in a closed environment, which corresponds to the most frequent situations encountered in teaching. In addition, remaining in the standing position for a prolonged period may have repercussions on other systems and generate postural deviations, pain and reduced functionality. Objective: To verify changes in pressure pain threshold, in disability index and in craniocervical posture of female teachers with vocal and musculoskeletal complaints, and with normal larynx, after myofascial release - pompage. Methods: This study was a controlled and randomized clinical trial. The following procedures were performed: anamnesis, videolaryngoscopy, hearing screening, clinical and photogrammetric postural assessment using the SAPo® protocol, completion of the neck pain self-assessment protocol Neck Disability Index, and pain threshold in the cervical muscles using the Pain Pressure Threshold. Myofascial therapy with pompage had a total of 24 sessions of 40 min each, three times a week, in 28 teachers assigned to the study group (SG), and 28 to the control group (CG). Afterwards, the groups were reassessed. Results: The SG presented a significant improvement in the pain threshold of all the muscles evaluated, in the posture of most of the body segments evaluated, and in the cervical disability. In the CG there was a significant improvement in angle A2 after therapy. Conclusion: After myofascial release therapy with pompage, the subjects presented a reduction in cervical pain and in functional disability, an increase in pain threshold, and posture improvement.
摘要:教育专业人员是现代社会最重要的职业群体之一,代表着现代社会经济的重要组成部分之一。教师提到最多的发声需求是站着说话、说话多、在封闭的环境中说话,这与教学中最常见的情况相对应。此外,长时间保持站立姿势可能会对其他系统产生影响,并产生姿势偏差、疼痛和功能降低。目的:探讨有声带及肌肉骨骼疾患的女教师与喉喉正常的女教师,在肌筋膜松解术后,压痛阈值、失能指数及颅颈姿势的变化。方法:采用随机对照临床试验。进行了以下程序:记忆、视频喉镜检查、听力筛查、使用SAPo®方案进行临床和摄影测量姿势评估、完成颈部疼痛自我评估方案颈部残疾指数、使用疼痛压力阈值测量颈部肌肉疼痛阈值。28名教师被分配到研究组(SG), 28名教师被分配到对照组(CG),肌筋膜治疗共24次,每次40分钟,每周三次。之后,对各组进行重新评估。结果:SG在所有评估的肌肉疼痛阈值、大多数评估的身体节段姿势以及颈椎残疾方面均有显著改善。在CG中,治疗后A2角明显改善。结论:经肌筋膜松解治疗后,受试者的颈椎疼痛和功能障碍减轻,痛阈增加,姿势改善。
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引用次数: 4
Prevalence and factors associated with pelvic floor dysfunction in university women: a cross-sectional study 大学女性盆底功能障碍的患病率及相关因素:一项横断面研究
Q4 Medicine Pub Date : 2022-01-01 DOI: 10.1590/fm.2022.35133
L. F. Iamundo, G. T. A. Nava, Paulo Roberto da Rocha Júnior, C. Prudêncio, A. P. Barbosa
Abstract Introduction Urinary incontinence (UI), fecal inconti-nence (FI), and genito-pelvic pain or penetration disorder (GPPPD) are considered pelvic floor dysfunction (PFD), and are mainly characterized by poor functionality of the pelvic floor muscles. Despite the relevance of these dysfunctions in women's lives, the demand for care is low. Objective To analyze the prevalence of PFD, in university women, and factors associated with PFD. Methods This is a cross-sectional study conducted at São Paulo State University, Marília, SP, Brazil, with undergraduate and/or postgraduate women aged over 18 years. An online questionnaire containing 40 open and multiple-choice questions about PFD was developed by the authors and a Google form was disclosed via social media (Facebook, Instagram) to the participants. The questionnaire was applied between April and July 2020. Results A sample of 707 participants was included. The average age was 22.5 ± 21.0 years old. The most prevalent PFD was GPPPD, reported by 30.7% of women, followed by UI (16.8%) and FI (3.2%). PFD was significant less reported in the Midwest region compared to other regions (p = 0.015) and significantly more prevalent in women who attended public university (p = 0.038), in women with UI, FI, and GPPPD. The association-test showed that attending public university showed association to UI (p < 0.001), FI (p = 0.008) and GPPPD (p = 0.006). In addition, parity showed association with GPPD (p = 0.032) and to attend health courses with UI (p = 0.002). Conclusion PFD is prevalent among university women and GPPPD was the most recurrent, followed by UI and FI. GPPPD was associated with parity and attending a public university. UI was associated with attending public university and health courses. FI was associated with attending a public university.
尿失禁(UI)、大便失禁(FI)和生殖盆腔疼痛或穿透障碍(GPPPD)被认为是盆底功能障碍(PFD),主要表现为盆底肌肉功能不良。尽管这些功能障碍与妇女的生活息息相关,但对护理的需求很低。目的分析女大学生PFD的患病率及相关因素。方法:本研究是在巴西圣保罗州立大学Marília进行的一项横断面研究,研究对象为年龄在18岁以上的本科和/或研究生女性。作者开发了一份包含40个关于PFD的开放式和多项选择题的在线问卷,并通过社交媒体(Facebook, Instagram)向参与者披露了谷歌表格。该问卷于2020年4月至7月期间进行。结果共纳入707名受试者。平均年龄22.5±21.0岁。最常见的PFD是GPPPD, 30.7%的女性报告,其次是UI(16.8%)和FI(3.2%)。与其他地区相比,中西部地区PFD的报道明显较少(p = 0.015),而在公立大学就读的女性中(p = 0.038),在患有UI, FI和GPPPD的女性中更为普遍(p = 0.038)。关联检验显示,就读公立大学与UI (p < 0.001)、FI (p = 0.008)和GPPPD (p = 0.006)存在关联。此外,产次与GPPD相关(p = 0.032),参加健康课程与UI相关(p = 0.002)。结论PFD在女大学生中普遍存在,以GPPPD最为常见,其次为UI和FI。GPPPD与平等和上公立大学有关。UI与参加公立大学和卫生课程有关。FI与上公立大学有关。
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引用次数: 0
Functional ambulation decline and factors associated in amyotrophic lateral sclerosis 肌萎缩性侧索硬化症的功能活动能力下降及其相关因素
Q4 Medicine Pub Date : 2022-01-01 DOI: 10.1590/fm.2022.35127
M. A. Alencar, Maria Clara Araújo Guedes, Tayná Amaral Leite Pereira, Marcela Ferreira de Andrade Rangel, Juliana Silva Abdo, L. Souza
Abstract Introduction: Amyotrophic lateral sclerosis (ALS) is a disabling neurodegenerative disease, which compromises locomotion and functional independence. As the goal of physical therapy is to maintain the individual's locomotion capacity and independence as long as possible, it is necessary to gain a better understanding of the possible factors associated with the loss of this capacity. Objective: To evaluate functional ambulation in patients with ALS and possible factors associated with its decline. Methods: A cross-sectional study was conducted with sporadic ALS patients. Demographic and clinical/functional aspects were evaluated. ALS Functional Rating Scale-Revised (ALSFRS-R), Functional Ambulation Category, Medical Research Council scale and Fatigue Severity Scale were used. Descriptive and comparative analyses were conducted of the groups capable and incapable of functional ambulation. Binary logistic regression (stepwise forward method) was performed to determine potential factors associated with the loss of functional ambulation. Results: Among the 55 patients (mean age: 56.9 ± 11.2 years), 74.5% were able to walk functionally. Differences were found between groups regarding time of diagnosis, number of falls, pain, use of noninvasive ventilation, gastrostomy, ability to turn in bed, mobility aids, home adaptations, functional performance, muscle strength and fatigue. The possible predictors of walking disability were overall muscle strength (OR = 0.837; p = 0.003) and fatigue (OR =1.653; p = 0.034). Conclusion: Muscle strength and fatigue are associated with the decline in ambulation capacity in patients with ALS. In view of the complexity of elements involved in walking, further studies are needed to investigate the influence of these aspects in this population.
摘要简介:肌萎缩性侧索硬化症(ALS)是一种致残性神经退行性疾病,损害运动和功能独立性。由于物理治疗的目标是尽可能长时间地维持个体的运动能力和独立性,因此有必要更好地了解与这种能力丧失相关的可能因素。目的:探讨肌萎缩侧索硬化症患者的功能活动能力及其可能的影响因素。方法:对散发性ALS患者进行横断面研究。对人口统计学和临床/功能方面进行评估。采用ALS功能评定量表-修订版(ALSFRS-R)、功能活动分类、医学研究委员会量表和疲劳严重程度量表。对能和不能行走的两组进行描述性和对比性分析。采用二元逻辑回归(逐步正演法)来确定与功能活动丧失相关的潜在因素。结果:55例患者(平均年龄:56.9±11.2岁)中,74.5%的患者能够正常行走。在诊断时间、跌倒次数、疼痛、使用无创通气、胃造口术、在床上翻身能力、活动辅助、家庭适应、功能表现、肌肉力量和疲劳方面,两组之间存在差异。行走障碍的可能预测因子为:整体肌力(OR = 0.837;p = 0.003)和疲劳(OR =1.653;P = 0.034)。结论:肌萎缩侧索硬化症患者的肌肉力量和疲劳与行走能力下降有关。鉴于步行所涉及的因素的复杂性,需要进一步的研究来调查这些方面对这一人群的影响。
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引用次数: 1
Neuropsychomotor development and functional skills in preschool children with liver diseases 学龄前肝病患儿的神经精神运动发育和功能技能
Q4 Medicine Pub Date : 2022-01-01 DOI: 10.1590/fm.2022.35138
Juliana Costa Santos, N. M. P. V. Barreto, L. Silva
Abstract Introduction Children with chronic liver diseases are exposed to biological and/or environmental risk factors that can compromise their neuromotor acquisition and development of functional skills. Objective To describe the neuropsychomotor development (NPMD) and functional skills of children with chronic liver diseases. Methods Cross-sectional, descriptive and exploratory study carried out with children up to 6 years old who were selected at a reference hospital in the state of Bahia, Brazil, from November 2019 to March 2020. Children in outpatient care with clinical, laboratory and histological diagnosis compatible with chronic liver disease were considered eligible. The instrument for assessing neuropsychomotor development was Denver II. Functional skills were obtained by applying the Pediatric Evaluation of Disability Inventory computer-adaptive test (PEDI-CAT) to parents or primary caregivers, Speedy version (Speedy-CAT). Results Of the 34 children with chronic liver disease, 52.9% were female, aged between 4 and 6 years (64%). The results of the Denver II test showed that 68.7% (22/32) of the sample were at risk for NPMD. In the PEDI-CAT, the scores of children with liver disease at risk for NPMD were 60.7 ± 9.1 in the daily activity domains, 57.6 ± 11.8 in mobility and 48.3 ± 6.2 in the social/cognitive domains. Conclusion Children with chronic liver disease are at risk for NPMD, although not presenting impaired functional skills when evaluated by the PEDI-CAT.
慢性肝病儿童暴露于生物和/或环境危险因素中,可能损害其神经运动的获得和功能技能的发展。目的探讨慢性肝病患儿的神经精神运动发育(NPMD)和功能技能。方法对2019年11月至2020年3月在巴西巴伊亚州一家参考医院选择的6岁以下儿童进行横断面、描述性和探索性研究。临床、实验室和组织学诊断符合慢性肝病的门诊儿童被认为是合格的。评估神经精神运动发展的工具是Denver II。对父母或主要照顾者应用儿童残疾评估量表计算机适应测试(PEDI-CAT),快速版(Speedy- cat)获得功能技能。结果34例慢性肝病患儿中,女性占52.9%,年龄4 ~ 6岁,占64%。Denver II检测结果显示68.7%(22/32)的样本存在NPMD风险。在PEDI-CAT中,有NPMD风险的肝病儿童在日常活动领域的得分为60.7±9.1,在流动性方面的得分为57.6±11.8,在社会/认知领域的得分为48.3±6.2。结论慢性肝病患儿存在NPMD的风险,尽管在PEDI-CAT评估中没有表现出功能技能受损。
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引用次数: 0
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Fisioterapia em Movimento
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