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SCREENING FOR FRAILTY, NUTRITION AND MUSCLE STRENGTH OF HOSPITALIZED ELDERLY 对住院老人进行体弱、营养和肌肉力量筛查
IF 3.4 3区 医学 Q1 ORTHOPEDICS Pub Date : 2024-03-21 DOI: 10.1016/j.bjpt.2024.100624
Ana Luiza de Arruda Camargo , Fernanda dos Santos Lima , Marcelo Olímpio de Oliveira , Elaine Gomes da Silva , Patrícia Vigano Contri Degiovani , Adriana Sanches Garcia-Araujo

Background

The increase in life expectancy in recent years has brought a scenario of multimorbidities and the presence of geriatric syndromes, such as frailty, making the elderly vulnerable to decompensation and hospitalizations. In addition, nutritional status and muscle strength have a significant association with frailty, so their characterization in the hospitalized elderly population is extremely relevant since such conditions are accompanied by adverse clinical outcomes, increasing the length of hospitalization and mortality. From this, it is possible to program multidisciplinary strategies and outline the best individualized intervention for these patients, aiming at an early discharge and higher quality of life.

Objectives

To evaluate the presence of frailty, nutritional status, and muscle strength of hospitalized elderly.

Methods

This is a prospective, observational, and cross-sectional study in which patients hospitalized in the ward of a University Hospital over 60 years of age were evaluated. Data were collected from medical records and characterization of the sample. Patients were assessed for frailty screening (Fried criteria), nutritional assessment through mini nutritional assessment (MAN) and handgrip strength.

Results

Partial data from 51 study participants were analyzed. Regarding frailty, according to Fried's criteria, 90.2% of the patients were classified as frail, 9.8% as pre-frail, and none as non-frail. The MAN scores reveal that, in relation to nutritional status, 19.6% are at risk of malnutrition and 43.13% are malnourished. Regarding muscle strength, 66.66% of men and 76.9% of women had muscle weakness, with the mean of men of 27.6 ±11.43 (76.66% of predicted) and of women of 19.3 ±5.76 (83.91% of predicted).

Conclusion

Hospitalized elderly are mostly fragile and have nutrition deficits and peripheral muscle weakness.

Implications

Faced with the presence of frailty, nutritional deficit, and muscle weakness, future intervention studies deserve attention to minimize damage to the independence and functionality of the elderly.

背景近年来,预期寿命的延长带来了多病并发症和老年综合症(如虚弱)的出现,使老年人很容易出现失代偿和住院。此外,营养状况和肌肉力量与虚弱也有很大关系,因此,对住院老年人群的营养状况和肌肉力量进行特征描述是非常重要的,因为这些情况会导致不良的临床结果,增加住院时间和死亡率。目标评估住院老年人是否存在虚弱、营养状况和肌肉力量。方法这是一项前瞻性、观察性和横断面研究,对在一所大学医院病房住院的 60 岁以上患者进行评估。数据来自医疗记录和样本特征描述。研究人员对患者进行了虚弱筛查(弗里德标准)、通过迷你营养评估(MAN)进行营养评估以及手握力评估。在体弱方面,根据弗里德的标准,90.2%的患者被归类为体弱者,9.8%的患者被归类为前期体弱者,没有患者被归类为非体弱者。MAN 评分显示,在营养状况方面,19.6% 的患者有营养不良的风险,43.13% 的患者营养不良。在肌肉力量方面,66.66% 的男性和 76.9% 的女性存在肌肉无力问题,其中男性的平均值为 27.6 ±11.43(预测值的 76.66%),女性的平均值为 19.3 ±5.76(预测值的 83.91%)。
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引用次数: 0
PHOTOBIOMODULATION MAY REVERSE CELLULAR SENESCENCE BY INDUCING CELL PROLIFERATION AND PRESERVING NUCLEAR SIZE 光生物调节可通过诱导细胞增殖和保持核大小来逆转细胞衰老
IF 3.4 3区 医学 Q1 ORTHOPEDICS Pub Date : 2024-03-21 DOI: 10.1016/j.bjpt.2024.100598
Alan Christhian Bahr , Luana Suéling Lenz , Elizama de Gregório , Guido Lenz , Patrick Türck , Pedro Dal Lago

Background

Cellular senescence is an irreversible state of cell cycle arrest, thus being characterized by decreased cell proliferation and increased nucleus area, often acting as a tumor suppressor program. Photobiomodulation (PBM) has been used in several conditions to increase the mitochondrial response, promoting nuclear changes and cell proliferation. However, the effects of PBM on cells are still unclear.

Objectives

To verify the efficacy of photobiomodulation on cell senescence processes.

Methods

We utilized A172 glioblastoma cells transduced with H2B-mCherry by lentivirus to nuclear tagging. Treatment was done with GaAIAs Laser (850nm). Cells were divided by intensity into the following groups: C= Control, L1= 1J/cm², L2= 2.2J/cm², L3= 3J/cm², L9= 9J/cm², L15= 15J/cm², L21= 21J/cm², nuclear evaluation was performed at experimental times (0h, 24h, 48h and 72h). For data analysis, two-way ANOVA with the Tukey post hoc test was used. Differences were significant when p<0.05.

Results

PBM on intensities of 1J/cm², 2.2J/cm², 3J/cm², 9J/cm² e 15J/cm² showed a lower increase at the nuclear size when compared with time 0h and 72h in the control group. All intensities (1, 2.2, 3, 9, 15, and 21 J/cm²) promoted cellular proliferation after 72 hours, while 15J/cm² presented an accentuated increase compared to groups L1, L2.2, and L3.

Conclusion

PBM enhanced cellular proliferation while causing a reduced nuclear increase in glioblastoma cells.

Implications

In this study, we found that the laser decreased the cellular senescence state from the evaluation of the morphological parameters, thus increasing cell proliferation and decreasing the nuclear area; therefore, it is an important therapeutic tool against the cellular aging process.

背景细胞衰老是一种不可逆的细胞周期停滞状态,因此以细胞增殖减少和细胞核面积增大为特征,通常是一种肿瘤抑制程序。光生物调节(PBM)已被用于多种情况,以增加线粒体反应,促进核变化和细胞增殖。方法 我们利用慢病毒转导的 H2B-mCherry A172 胶母细胞瘤细胞进行核标记。使用 GaAIAs 激光(850 纳米)对细胞进行处理。细胞按强度分为以下几组:C= 对照组,L1= 1J/cm²,L2= 2.2J/cm²,L3= 3J/cm²,L9= 9J/cm²,L15= 15J/cm²,L21= 21J/cm²,在实验时间(0h、24h、48h 和 72h)进行核评估。数据分析采用双向方差分析和 Tukey 后检验。结果与对照组的 0h 和 72h 相比,强度为 1J/cm²、2.2J/cm²、3J/cm²、9J/cm² 和 15J/cm² 的 PBM 显示核大小的增加较少。所有强度(1、2.2、3、9、15 和 21 J/cm²)在 72 小时后都促进了细胞增殖,而与 L1、L2.2 和 L3 组相比,15J/cm² 的增殖更为显著。意义 在这项研究中,我们发现从形态学参数的评估来看,激光可降低细胞的衰老状态,从而增加细胞增殖并减少细胞核面积;因此,激光是对抗细胞衰老过程的重要治疗工具。
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引用次数: 0
PHYSICAL THERAPY ASSESSMENT AND INTERVENTION IN MOTORCYCLE ACCIDENTS IN PRIMARY CARE: A NARRATIVE REVIEW 在初级保健中对摩托车事故进行物理治疗评估和干预:叙述性综述
IF 3.4 3区 医学 Q1 ORTHOPEDICS Pub Date : 2024-03-21 DOI: 10.1016/j.bjpt.2024.100626
Ana Patricia Gomes Clementino , Melquisedek Monteiro de Oliveira , Eliane Araújo de Oliveira
<div><h3>Background</h3><p>Traffic accidents are an important problem for public health, due to their great impact on morbidity and mortality, with a predominance of motorcycle accidents. Brazil is ranked 5th among the countries with the highest number of traffic deaths and is also the second leading cause of death among all deaths from external causes. Motorcyclists are 14 times more susceptible to death. In view of the vulnerability of risk factors, it is important to consider the types of injuries and body areas most frequently affected due to motorcycle accidents, observing the magnitude of the trauma, such as traumatic brain injury (TBI) and spinal cord injury (TRM); fractures in the upper and lower limbs; various injuries, dislocations, sprains and abrasions, contusions, sprains/dislocations, and cuts/lacerations. The evaluation and treatment of the grievance directed to Primary Health Care in the rehabilitation of the patient with musculoskeletal and neurological impairment resulting from these accidents, lacks a physiotherapeutic evaluation with instruments that can contribute to the process of assessment and physiotherapeutic intervention. In the evaluation, anamnesis, physical examination, using measurement instruments for pain assessment, evaluation of attitudes and behavior and driving style, and the type and severity of injuries and possibility of survival of motorcyclists involved in traffic accidents are performed.</p></div><div><h3>Objectives</h3><p>The objective of this study was to conduct a Narrative Review on traffic accidents and to investigate the type of physical therapy evaluation with its respective intervention in Primary Care.</p></div><div><h3>Methods</h3><p>To this end, a literature review was conducted in the Scielo, Lilacs, and PUBMED databases, including combining terms and keywords using the Boolean operators OR and AND, with the following descriptors: Traffic Accidents, Physical Therapy, Primary Care.</p></div><div><h3>Results</h3><p>The results found showed a certain vulnerability in the rehabilitation of patients with musculoskeletal and neurological impairment resulting from these accidents, lacking an accurate physiotherapeutic evaluation, with validated instruments that can contribute to the process of evaluation and physiotherapeutic intervention.</p></div><div><h3>Conclusion</h3><p>The physiotherapist has been dedicating his attention, almost exclusively, to the prevention, cure, and rehabilitation of polytraumatized and/or sequelae patients, whose mission is to develop actions aimed at health maintenance or, in the last case, to the prevention of sequelae, and not only to rehabilitation, and in the scope of injury prevention and health promotion.</p></div><div><h3>Implications</h3><p>This study allows us to present suggestions for possible future research paths. Some of these suggestions are related to new studies on changes in conceptions, highlighting the importance of conducting Health Education action
背景交通事故是公共卫生的一个重要问题,因为交通事故对发病率和死亡率有很大影响,其中以摩托车事故居多。巴西在交通事故死亡人数最多的国家中排名第五,也是所有外因死亡中的第二大死因。摩托车驾驶员的死亡概率是普通人的 14 倍。鉴于风险因素的脆弱性,必须考虑摩托车事故最常造成的伤害类型和身体部位,观察创伤的严重程度,如创伤性脑损伤(TBI)和脊髓损伤(TRM);上下肢骨折;各种损伤、脱臼、扭伤和擦伤、挫伤、扭伤/脱臼以及割伤/撕裂伤。在对这些意外事故造成的肌肉骨骼和神经损伤患者进行康复治疗时,初级卫生保健部门在对申诉进行评估和治疗时,缺乏使用有助于评估和理疗干预过程的仪器进行理疗评估。在评估过程中,需要对发生交通事故的摩托车手进行病史、体格检查、使用疼痛评估测量工具、态度和行为以及驾驶方式评估、受伤类型和严重程度以及存活可能性评估。方法为此,我们在 Scielo、Lilacs 和 PUBMED 数据库中进行了文献综述,包括使用布尔运算符 OR 和 AND 将术语和关键词与以下描述符相结合:交通事故、物理治疗、初级保健。结果研究结果表明,因交通事故导致肌肉骨骼和神经系统受损的患者在康复过程中存在一定的脆弱性,缺乏准确的物理治疗评估,也缺乏有助于评估和物理治疗干预过程的有效工具。结论物理治疗师几乎一直专注于多发性创伤和/或后遗症患者的预防、治疗和康复,其任务是在预防伤害和促进健康的范围内,制定旨在维护健康或在最后一种情况下预防后遗症的行动,而不仅仅是康复。其中一些建议涉及对观念变化的新研究,强调通过讲座对民众开展健康教育活动的重要性,使这些摩托车驾驶员意识到危险因素与交通事故之间的危险关系,就事故发生期间的经历进行集体经验报告,此外,还向这些公众提供小册子和手册,提醒他们注意事故预防和健康教育的条件因素,为养成教育和健康方面的新习惯提供补贴。
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引用次数: 0
PAIN NEUROSCIENCE EDUCATION IN NECK PAIN MANAGEMENT: A SYSTEMATIC REVIEW 颈部疼痛管理中的疼痛神经科学教育:系统回顾
IF 3.4 3区 医学 Q1 ORTHOPEDICS Pub Date : 2024-03-21 DOI: 10.1016/j.bjpt.2024.100605
Alícia Correa Brant , Simone Amaral Farias , Antonio Igor de Castro Alves , Priscylla Ruany Mendes Pestana , Rebato Guilherme Trede Filho
<div><h3>Background</h3><p>Neck pain is a worldwide public health problem, highly prevalent, and varies significantly between countries. It is one of the leading causes of disability in the world. It is estimated that half of the world's population will experience an episode of neck pain. On the other hand, compared to other conditions, the number of treatments dedicated to the management of neck pain is relatively low. In comparison with traditional biomechanical models, Pain Neuroscience Education (PNE) is a recent approach, providing the patient with a better understanding of pain and the sensation experienced by him. Considering the heterogeneous nature of each individual and its multidimensionality, it is necessary to use the PNE in a heterogeneous way based on the patient.</p></div><div><h3>Objectives</h3><p>The purpose of this study was to explore the effectiveness of PNE as a treatment approach for people suffering from chronic neck pain.</p></div><div><h3>Methods</h3><p>This is a systematic review prospectively registered in PROSPERO (CRD42021283000), following the PRISMA checklist and Cochrane recommendations. Titles and abstracts were screened by independent reviewers, the inclusion criteria were published in the English language, investigating the effects of PNE on neck pain in adult subjects. The third reviewer will resolve discrepancies between reviewers The analysis of the methodological quality of the eligible studies was performed using the PEDro quality scale. Data were analyzed and extracted using the PICO strategy. For data analysis, the GRADE system was considered. Outcome measures were described in a narrative form.</p></div><div><h3>Results</h3><p>2670 studies were identified; 54 were considered potentially relevant and 10 of these were read in full. Finally, five articles met the inclusion criteria. The included studies analyzed the effect of PNE on 516 participants, of which 350 (67.82%) were female and 166 (32.17%) were male. The mean age of patients ranged between 18 and 65 years. The content of the educational sessions included approaches on peripheral sensitization, central sensitization, biopsychosocial factors related to pain, catastrophic thoughts, understanding and accepting pain, coping with pain, catastrophic factors, emotional response to pain, anxiety, fear of harm, concerns/ fear of pain, goal setting, nociceptive inhibition and facilitation, participation in social contexts, pain neurophysiology, general nervous system physiology, coping strategies, stress management, and progressive return to activities. The five studies included in this review addressed the effectiveness of PNE by addressing pain-related issues. The methodological quality ranged from 6 (moderate quality) to 10 (high quality), with an average score of 7.4. The duration of the educational sessions ranged from 30 to 90 minutes, some held in groups and others individually.</p></div><div><h3>Conclusion</h3><p>The results of this review show tha
背景颈部疼痛是一个世界性的公共卫生问题,发病率很高,而且各国的发病率差异很大。它是导致世界残疾的主要原因之一。据估计,世界上一半的人口都会经历过颈部疼痛。另一方面,与其他疾病相比,专门用于治疗颈部疼痛的疗法数量相对较少。与传统的生物力学模式相比,疼痛神经科学教育(PNE)是最近才出现的一种方法,它能让患者更好地了解疼痛及其感受。考虑到每个人的异质性及其多维性,有必要根据患者的不同情况采用不同的方法来使用 PNE。本研究旨在探讨 PNE 作为慢性颈痛患者治疗方法的有效性。标题和摘要由独立审稿人进行筛选,纳入标准为以英语发表的、研究 PNE 对成年受试者颈部疼痛影响的文章。采用 PEDro 质量量表对符合条件的研究进行方法学质量分析。采用 PICO 策略对数据进行分析和提取。数据分析采用 GRADE 系统。结果 2670 项研究被确定;54 项被认为可能相关,其中 10 项被全文阅读。最后,有 5 篇文章符合纳入标准。纳入的研究分析了 PNE 对 516 名参与者的影响,其中 350 人(67.82%)为女性,166 人(32.17%)为男性。患者的平均年龄介于 18 岁至 65 岁之间。教育课程的内容包括外周敏化、中枢敏化、与疼痛相关的生物心理社会因素、灾难性想法、理解和接受疼痛、应对疼痛、灾难性因素、对疼痛的情绪反应、焦虑、对伤害的恐惧、对疼痛的担忧/恐惧、目标设定、痛觉抑制和促进、参与社会环境、疼痛神经生理学、一般神经系统生理学、应对策略、压力管理和逐步恢复活动。纳入本综述的五项研究通过解决与疼痛相关的问题来探讨 PNE 的有效性。研究方法的质量从 6 分(中等质量)到 10 分(高质量)不等,平均分为 7.4 分。本综述的结果表明,无损检测是一种很有前景的颈部疼痛干预方法;但是,根据 GRADE 证据评级系统,证据强度较低。今后的研究必须更加严格地关注所采用的方法。
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引用次数: 0
AUTOMATIC ROTATIONAL THERAPY IN MECHANICALLY VENTILATED INDIVIDUALS AND LONG STAY IN AN INTENSIVE CARE UNIT: SYSTEMATIC REVIEW AND META-ANALYSIS 机械通气患者的自动轮换疗法和重症监护病房的长期住院:系统回顾和荟萃分析
IF 3.4 3区 医学 Q1 ORTHOPEDICS Pub Date : 2024-03-21 DOI: 10.1016/j.bjpt.2024.100641
Anna Luísa Araújo Brito , Amanda Caroline de Andrade Ferreira , Jakson Henrique Silva , Juliana Fernandes de Souza Barbosa , Shirley Lima Campos

Background

Invasive ventilatory support and prolonged immobility in bed are predictive factors for the development of respiratory and musculoskeletal complications in critically ill patients, favoring increased length of hospital stay, morbidity and mortality, and costs associated with long hospital stays.

Objectives

To evaluate the impact of automatic rotational therapy on length of stay in the intensive care unit (ICU) in mechanically ventilated patients.

Methods

Systematic review conducted from December to January 2023 with randomized clinical trials, following criteria reported in PRISMA (Preferred Reporting Items for Systematic Review and Meta-Analysis) registered in PROSPERO (CRD42022384258). The search strategy was built based on health sciences descriptors (DeCS), Medical Subject Headings (MeSH), keywords and synonyms most found in the literature. The search was carried out in seven databases: MEDLINE/PubMed, EMBASE, Scopus, Science Direct, Cochrane Library, CINAHL, and Web of Science. The eligibility criteria involved studies that evaluated automatic rotational therapy compared with changing the manual decubitus position during the length of stay in the ICU in individuals of both genders aged 18 years or older using invasive mechanical ventilation for a period. greater than 24 hours. There was no restriction on language or year of publication. The risk of bias was assessed using the Cochrane collaboration tool.

Results

118 articles were identified, after excluding duplicates and reading in full, 9 were eligible, involving 679 participants. The number of individuals evaluated per article ranged from 27 to 124 in the control and intervention groups. For meta-analysis, four studies were included, totaling 323 participants. The standardized mean (SMD) difference was -0.03 days (95% CI -0.40, 0.35, p=0.90) between automatic rotational therapy and conventional recumbency, with no significant difference between groups with high evidence of overall heterogeneity (χ2 8.26, p= 0.04, I2 = 64%).

Conclusion

Automatic rotational therapy did not have a significant impact on the length of stay in the ICU in mechanically ventilated critical patients. Therefore, it is not possible to make definitive recommendations on this therapy, reinforcing the need for new randomized clinical trials to better answer the research question.

Implications

The development of this systematic review and meta-analysis enabled the expansion of knowledge about the possible benefits of automatic rotational therapy in critically ill patients, for future contributions to the scientific community and, due to the high heterogeneity between studies, it is shown as a field to be explored in future studies.

背景介入性通气支持和长期卧床不动是危重病人出现呼吸系统和肌肉骨骼并发症的预测因素,有利于延长住院时间、发病率和死亡率以及与长期住院相关的费用。方法根据在 PROSPERO(CRD42022384258)登记的 PRISMA(系统性综述和荟萃分析首选报告项目)中报告的标准,从 12 月至 2023 年 1 月对随机临床试验进行了系统性综述。检索策略基于健康科学描述符(DeCS)、医学主题词表(MeSH)、关键词以及文献中最常见的同义词。检索在七个数据库中进行:MEDLINE/PubMed、EMBASE、Scopus、Science Direct、Cochrane Library、CINAHL 和 Web of Science。合格标准包括对在重症监护室住院时间超过 24 小时、使用有创机械通气的 18 岁或以上男女患者进行自动旋转治疗与改变人工卧位比较评估的研究。语言或发表年份不受限制。使用 Cochrane 协作工具对偏倚风险进行了评估。结果 共发现 118 篇文章,在排除重复文章并阅读全文后,符合条件的有 9 篇,涉及 679 名参与者。在对照组和干预组中,每篇文章评估的人数从 27 人到 124 人不等。在进行荟萃分析时,共纳入了四项研究,共计 323 名参与者。自动旋转治疗与传统卧位的标准化平均值(SMD)差异为-0.03天(95% CI -0.40,0.35,P=0.90),组间无显著差异,总体异质性证据较高(χ2 8.26,P= 0.04,I2 = 64%)。本系统综述和荟萃分析有助于扩大有关自动旋转治疗对危重症患者可能带来的益处的知识,为科学界做出贡献。
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引用次数: 0
DEFINITIONS AND ASSESSMENTS OF PAIN WITH IMPACT IN CHILDREN AND ADOLESCENTS: A SCOPING REVIEW 儿童和青少年影响性疼痛的定义和评估:范围审查
IF 3.4 3区 医学 Q1 ORTHOPEDICS Pub Date : 2024-03-21 DOI: 10.1016/j.bjpt.2024.100659
Bruna Alves Hatakeyama , Mariana Nascimento Leite , G. Lorimer Moseley , Christopher M Williams , Steven J Kamper , Tiê P Yamato

Background

There is growing recognition that a substantial proportion of children and adolescents are challenged by pain. However, there are inconsistencies as to how pain is defined. There is no consensus on what constitutes pain with sufficient impact to warrant concern for a child or adolescent.

Objectives

The aim of this scoping review is to provide an overview of the descriptors used to define pain with impact on children and adolescents.

Methods

We considered studies on pain in children and adolescents of school age (6 to 19 years). The definitions of pain with impact in children and adolescents were descriptively reported. To analyze the structure of the pain definitions, we grouped the definitions according to the impact of pain and based on 4 main domains: (1) presence of physical complaint, (2) impact of physical complaint, (3) temporal characteristic of the physical complaint, and (4) association with secondary disorders.

Results

Searches identified a total of 52,731 records and based on our inclusion criteria, 436 articles were included in this scoping review. Of these, 352 studies proposed to assess pain as a primary outcome but did not provide information on how pain was defined. In these studies, the most reported painful condition was “chronic pain,” with symptoms over 3 months, and the most used measurement instrument was the Numerical Rating Scale (NRS). Eighty-four studies assessed the impact of pain and provided a definition. For the description of 'symptoms', the most used terms were “pain” or “discomfort”, but few studies mentioned “impact”, the most used terms being “not being able to participate in daily activities” and “functional disability”. The most used assessment instrument was the Numerical Rating Scale (NRS).

Conclusion

Most studies did not propose a detailed definition and there is no standardization of the terms used even to search for the same concept. The lack of consensus on a definition of pain with impact in children and adolescents makes it difficult to compare the findings.

Implications

Although many studies include in their primary data the investigation of pain with impact, there is a lack of descriptions regarding the 'impact' of the condition in children and adolescents. Although the most used tools for assessing pain with impact have been the Numerical Rating Scale (NRS) and the Visual Analog Scale (VAS), these tools are quantitative and may not capture the complexity of the pain or its potential impact on the patient's life.

背景越来越多的人认识到,相当一部分儿童和青少年面临着疼痛的挑战。然而,对疼痛的定义并不一致。本范围综述旨在概述用于定义对儿童和青少年有影响的疼痛的描述。我们对儿童和青少年受影响疼痛的定义进行了描述性报告。为了分析疼痛定义的结构,我们根据疼痛的影响以及 4 个主要领域对疼痛定义进行了分组:(1) 身体不适的存在,(2) 身体不适的影响,(3) 身体不适的时间特征,以及 (4) 与继发性疾病的关联。其中,352 项研究提出将疼痛作为主要结果进行评估,但未提供有关如何定义疼痛的信息。在这些研究中,报告最多的疼痛情况是症状超过 3 个月的 "慢性疼痛",使用最多的测量工具是数值评定量表 (NRS)。有 84 项研究评估了疼痛的影响并给出了定义。对于 "症状 "的描述,使用最多的术语是 "疼痛 "或 "不适",但很少有研究提到 "影响",使用最多的术语是 "无法参与日常活动 "和 "功能性残疾"。结论 大多数研究都没有提出详细的定义,甚至在搜索同一概念时使用的术语也没有标准化。虽然许多研究在其主要数据中包含了对有影响的疼痛的调查,但缺乏对儿童和青少年有影响的疼痛的 "影响 "的描述。虽然评估疼痛影响最常用的工具是数字评分量表(NRS)和视觉模拟量表(VAS),但这些工具都是定量的,可能无法反映疼痛的复杂性或对患者生活的潜在影响。
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引用次数: 0
ASSESSMENT OF EXERCISE CAPACITY IN INDIVIDUALS HOSPITALIZED FOR COVID-19: COMPARISON BETWEEN 30 DAYS AND 12 MONTHS AFTER HOSPITAL DISCHARGE 评估因 "Covid-19 "住院者的运动能力:出院后 30 天和 12 个月的比较
IF 3.4 3区 医学 Q1 ORTHOPEDICS Pub Date : 2024-03-21 DOI: 10.1016/j.bjpt.2024.100615
Ana Carolina Vaz dos Santos , Daiane Roberta Viana , Lívia Maria Petilli Zopelari , Marielle Cristina Luciano , Maria Gabriela Colucci , Valéria Amorim Pires Di Lorenzo
<div><h3>Background</h3><p>The 6-Minute Step Test (6MST) has been used to evaluate exercise capacity and physiological responses during the test in different populations, to assess physical performance for the activity of stepping up and down a step, as well as check for possible symptoms that the individual may present during the test. The use of 6MST to evaluate the exercise capacity of individuals who were hospitalized for COVID-19 can identify the persistence of symptoms and exercise intolerance.</p></div><div><h3>Objectives</h3><p>To compare the exercise capacity and physiological responses of individuals hospitalized for COVID-19 using the 6MST, at 30 days and 12 months after hospital discharge.</p></div><div><h3>Methods</h3><p>A longitudinal study was conducted with individuals hospitalized for COVID-19 and evaluated at two-time points: 30 days after hospital discharge and 12 months after hospital discharge. The 6MST was applied with monitoring of vital signs (blood pressure - BP, heart rate - HR, and peripheral oxygen saturation - SpO2) and recording of perceived pain/fatigue in the lower limbs and respiratory fatigue. At the end of the test, the number of steps executed was recorded to establish the individual's exercise capacity and to identify the percentage of the number of steps achieved according to predicted values for sex, age, height, and weight.</p></div><div><h3>Results</h3><p>Twenty-three individuals were evaluated, and a significant difference was found in the 6MST performance (p≤0.05), with a higher number of steps recorded in the evaluation after 12 months of hospital discharge in 82.6% of individuals. Regarding vital signs, there was a statistically significant difference (p≤0.05) in SpO2 at the peak of the 6MST, with better saturation in the evaluation performed after 12 months of hospital discharge. There was a moderate positive correlation (R=0.420, p≤0.046) between a worse 6MST performance (evaluated by the number of steps) in individuals who required intensive care. There was no statistically significant difference (p≤0.05) in HR and SpO2 at the peak of the test and in the first minute of recovery.</p></div><div><h3>Conclusion</h3><p>The exercise capacity verified by the 6MST performance in individuals who were hospitalized and received intensive care due to COVID-19 is significantly lower in the first days after hospital discharge, compared to a period of 12 months after discharge. The 6MST performance was better after 12 months of hospital discharge, indicating improvement in exercise tolerance in 82.6% of individuals. The mean SpO2 measured at the peak of the 6MST was lower in the evaluation at 30 days compared to the assessment at 12 months after hospital discharge. It may be related to lower exercise capacity in individuals affected by COVID-19.</p></div><div><h3>Implications</h3><p>It is necessary to monitor these individuals affected by COVID-19, and when indicated, they should be included in a pulmonary rehabi
背景6分钟台阶试验(6MST)已被用于评估不同人群的运动能力和试验期间的生理反应,以评估上下台阶活动的体能表现,并检查个人在试验期间可能出现的症状。使用 6MST 评估因 COVID-19 而住院的患者的运动能力,可以识别症状的持续性和运动不耐受性。方法 对因 COVID-19 而住院的患者进行纵向研究,并在两个时间点进行评估:对 COVID-19 患者进行了纵向研究,并在出院后 30 天和出院后 12 个月这两个时间点进行了评估。在进行 6MST 测试的同时监测生命体征(血压、心率和外周血氧饱和度),并记录下肢疼痛/疲劳感和呼吸疲劳感。在测试结束时,记录所完成的步数,以确定个人的运动能力,并根据性别、年龄、身高和体重的预测值确定所完成步数的百分比。结果有 23 人接受了评估,发现 6MST 的表现存在显著差异(P≤0.05),82.6% 的人在出院 12 个月后的评估中记录的步数更高。在生命体征方面,6MST 峰值时的 SpO2 有显著统计学差异(p≤0.05),出院 12 个月后进行的评估中饱和度更高。需要重症监护的患者的 6MST 表现(以步数评估)较差,两者之间存在中度正相关(R=0.420,p≤0.046)。结论与出院后 12 个月相比,因 COVID-19 住院并接受重症监护的患者出院后最初几天的 6MST 运动能力明显较低。出院 12 个月后的 6MST 表现更好,表明 82.6% 的患者的运动耐量有所改善。与出院后 12 个月的评估结果相比,在出院 30 天的评估中,6MST 峰值时测得的平均 SpO2 值较低。这可能与受 COVID-19 影响的患者运动能力较低有关。暗示有必要对这些受 COVID-19 影响的患者进行监测,如有必要,应将其纳入肺康复计划,并为其开具个性化的体能训练处方,以促进运动能力的提高和持续症状的减轻。
{"title":"ASSESSMENT OF EXERCISE CAPACITY IN INDIVIDUALS HOSPITALIZED FOR COVID-19: COMPARISON BETWEEN 30 DAYS AND 12 MONTHS AFTER HOSPITAL DISCHARGE","authors":"Ana Carolina Vaz dos Santos ,&nbsp;Daiane Roberta Viana ,&nbsp;Lívia Maria Petilli Zopelari ,&nbsp;Marielle Cristina Luciano ,&nbsp;Maria Gabriela Colucci ,&nbsp;Valéria Amorim Pires Di Lorenzo","doi":"10.1016/j.bjpt.2024.100615","DOIUrl":"https://doi.org/10.1016/j.bjpt.2024.100615","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;p&gt;The 6-Minute Step Test (6MST) has been used to evaluate exercise capacity and physiological responses during the test in different populations, to assess physical performance for the activity of stepping up and down a step, as well as check for possible symptoms that the individual may present during the test. The use of 6MST to evaluate the exercise capacity of individuals who were hospitalized for COVID-19 can identify the persistence of symptoms and exercise intolerance.&lt;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Objectives&lt;/h3&gt;&lt;p&gt;To compare the exercise capacity and physiological responses of individuals hospitalized for COVID-19 using the 6MST, at 30 days and 12 months after hospital discharge.&lt;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;p&gt;A longitudinal study was conducted with individuals hospitalized for COVID-19 and evaluated at two-time points: 30 days after hospital discharge and 12 months after hospital discharge. The 6MST was applied with monitoring of vital signs (blood pressure - BP, heart rate - HR, and peripheral oxygen saturation - SpO2) and recording of perceived pain/fatigue in the lower limbs and respiratory fatigue. At the end of the test, the number of steps executed was recorded to establish the individual's exercise capacity and to identify the percentage of the number of steps achieved according to predicted values for sex, age, height, and weight.&lt;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;p&gt;Twenty-three individuals were evaluated, and a significant difference was found in the 6MST performance (p≤0.05), with a higher number of steps recorded in the evaluation after 12 months of hospital discharge in 82.6% of individuals. Regarding vital signs, there was a statistically significant difference (p≤0.05) in SpO2 at the peak of the 6MST, with better saturation in the evaluation performed after 12 months of hospital discharge. There was a moderate positive correlation (R=0.420, p≤0.046) between a worse 6MST performance (evaluated by the number of steps) in individuals who required intensive care. There was no statistically significant difference (p≤0.05) in HR and SpO2 at the peak of the test and in the first minute of recovery.&lt;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusion&lt;/h3&gt;&lt;p&gt;The exercise capacity verified by the 6MST performance in individuals who were hospitalized and received intensive care due to COVID-19 is significantly lower in the first days after hospital discharge, compared to a period of 12 months after discharge. The 6MST performance was better after 12 months of hospital discharge, indicating improvement in exercise tolerance in 82.6% of individuals. The mean SpO2 measured at the peak of the 6MST was lower in the evaluation at 30 days compared to the assessment at 12 months after hospital discharge. It may be related to lower exercise capacity in individuals affected by COVID-19.&lt;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Implications&lt;/h3&gt;&lt;p&gt;It is necessary to monitor these individuals affected by COVID-19, and when indicated, they should be included in a pulmonary rehabi","PeriodicalId":49621,"journal":{"name":"Brazilian Journal of Physical Therapy","volume":"28 ","pages":"Article 100615"},"PeriodicalIF":3.4,"publicationDate":"2024-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140179773","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
INFRARED THERMOGRAPHY FOR EVALUATION OF TENDING INJURIES: AN INTEGRATIVE REVIEW 红外热成像技术用于评估绷带损伤:综述
IF 3.4 3区 医学 Q1 ORTHOPEDICS Pub Date : 2024-03-21 DOI: 10.1016/j.bjpt.2024.100650
Beatriz Rozendo da Silva , José Jamacy de Almeida Ferreira , Eliane Araújo de Oliveira

Background

Tendon dysfunctions are classified into overuse tears, injuries, and inflammatory conditions such as tendinopathies. Infrared thermography (IT) is a diagnostic technique that has been used to evaluate these disorders.

Objective

Identify how IT can be useful in tracking normal and/or abnormal thermal profiles in tendinopathies.

Methods

An integrative bibliographic review was carried out in the PUBMED, PEDro and CENTRAL databases, from 03/24/2022 to 04/05/2022, including the combination of terms and keywords using the Boolean operators OR and AND, with the following descriptors: Tendinopathy; Tendinitis; Tendinitis; Tendon injury; Tendon injuries; Risk of tendon injury; Risks of tendon injuries; Tendinosis; Tenosynovitis; Tendon overload; Paratendinitis; Paratendinitis; Peritendonitis; peritendinitis; Impact; impacts; Loom; Tears; Infrared thermography; Thermography; Thermographic change; Thermal imaging; Thermal Imaging; Infrared imaging; Infrared imaging; Temperature mapping; Temperature mapping; Infrared thermal imaging; Skin temperature; Grouped thermographic changes. Inclusion criteria: The search was carried out in English, without time restrictions, and articles with results and discussion: journals in all languages, clinical trial-type studies, precision and observational type of case study, case-control, cohort and cross-sectional studies, with a population of both sexes, and which used thermography as a screening method for tendon injuries. Exclusion criteria: Articles that did not present all the results used in the study.

Results

1,279 studies were selected, and after reading the titles and abstracts, those that did not meet the criteria and duplicates were excluded, leaving 16 articles included. Of these, seven were selected to compose the results. In general, it was analyzed that IT is an excellent tool with potential for evaluation, diagnosis, monitoring, and prevention purposes, as it is possible to track asymmetries, inflammation, training effects, performance improvement and prevention of tendon injuries.

Conclusion

According to the literature review carried out, it was observed that IT is suitable for analyzing tendon tissues, taking into account different research strategies. However, it is important that new accuracy studies, such as randomized clinical trials, are developed since current studies do not yet have a consensual level of scientific evidence.

Implications

The IT used in this context of assessing tendon injuries becomes useful so that the physiotherapist has an assessment tool with excellent predictive power, so that his practice is safer and more supported.

背景肌腱功能障碍分为过度使用性撕裂、损伤和炎症,如肌腱病。方法从 2022 年 3 月 24 日至 2022 年 5 月 4 日,在 PUBMED、PEDro 和 CENTRAL 数据库中进行了综合文献综述,包括使用布尔运算符 OR 和 AND 将术语和关键词与以下描述符进行组合:肌腱病;肌腱炎;肌腱炎;肌腱损伤;肌腱损伤的风险;肌腱损伤的风险;肌腱病;腱鞘炎;肌腱超负荷;副腱鞘炎;副腱鞘炎;腱鞘周围炎;腱鞘周围炎;冲击;撞击;织布机;撕裂;红外热成像;热成像;热变化;热成像;热成像;红外成像;红外热成像;温度绘图;温度绘图;红外热成像;皮肤温度;分组热成像变化。纳入标准:检索以英文进行,无时间限制,并包含结果和讨论的文章:所有语言的期刊、临床试验型研究、精确和观察型病例研究、病例对照研究、队列研究和横断面研究,研究对象包括男性和女性,并使用热成像技术作为肌腱损伤的筛查方法。排除标准:结果 选出了 1,279 篇研究文章,在阅读了标题和摘要后,排除了不符合标准的文章和重复的文章,最后纳入了 16 篇文章。在这些文章中,有 7 篇被选为研究结果。总的来说,分析认为信息技术是一种极好的工具,具有评估、诊断、监测和预防的潜力,因为它可以跟踪肌腱损伤的不对称、炎症、训练效果、性能改善和预防。意义在评估肌腱损伤方面使用信息技术非常有用,这样物理治疗师就有了一个预测能力极强的评估工具,从而使其工作更安全、更有保障。
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引用次数: 0
EFFECTIVENESS OF CONSERVATIVE THERAPY ON PAIN, DISABILITY AND QUALITY OF LIFE FOR LOW BACK PAIN IN PREGNANCY: A SYSTEMATIC REVIEW OF RANDOMIZED CONTROLLED TRIALS 保守疗法对妊娠期腰背痛的疼痛、残疾和生活质量的影响:随机对照试验的系统回顾
IF 3.4 3区 医学 Q1 ORTHOPEDICS Pub Date : 2024-03-21 DOI: 10.1016/j.bjpt.2024.100654
Laísa B Maia , Letícia G Amarante , Débora FM Vitorino , Rodrigo O Mascarenhas , Ana Cristina R Lacerda , Bianca M Lourenço , Vinícius C Oliveira

Background

The efficacy of conservative therapy for low back pain in pregnancy (PLBP) is unclear.

Objective

To investigate the efficacy of conservative therapy on pain, disability, and quality of life in PLBP.

Methods

The search strategy was conducted on six databases up to August 24, 2020, without date or language restrictions. Minimal intervention (i.e., placebo, sham, waiting list, or no intervention) was the comparator of interest. Selection of randomized controlled trials, data extraction and methodological quality assessment of included trials were conducted independently by two reviewers. The PEDro scale (0-10) was used to assess methodological quality. Effect sizes for specific therapies were pooled when possible, using random-effects models. The quality of the evidence was assessed using the Grading of Recommendations Assessment (GRADE) approach.

Results

Ten included trials provide uncertain evidence (low to very low quality) about the effects of auriculotherapy, education, exercise, exercise plus education, oil treatment, and osteopathy in pain, disability, and quality of life at short- and long-term. At short-term, mean differences (MDs) and 95% confidence intervals (CI) on a 0-10 points pain intensity scale were: for oil treatment, 2.8 points (2.6, 3.1) (n = one trial, 114 participants); for auriculotherapy, 1.6 points (1.2, 2.0) (n = one trial, 112 participants); for exercise, 2.2 points (-1.8, 6.2) (n = three trials, 297 participants).

Conclusion

There is an urgent need for larger, high-quality trials investigating the effects of conservative therapy on pain, disability, and quality of life in this population.

Implications

Our systematic review shows that the evidence is very uncertain about the effect of conservative therapy (e.g., oil treatment, auriculotherapy, and exercise) on pain, disability, and quality of life in the short- and long term.

背景保守疗法对妊娠期腰背痛(PLBP)的疗效尚不明确。目的研究保守疗法对妊娠期腰背痛患者的疼痛、残疾和生活质量的疗效。方法在截至 2020 年 8 月 24 日的六个数据库中进行了检索,没有日期或语言限制。最小干预(即安慰剂、假干预、候补干预或无干预)是关注的比较对象。随机对照试验的筛选、数据提取和纳入试验的方法学质量评估由两名审稿人独立完成。方法学质量评估采用PEDro评分法(0-10分)。在可能的情况下,采用随机效应模型对特定疗法的效应大小进行汇总。结果十项纳入的试验提供了不确定的证据(低质量到极低质量),说明耳穴疗法、教育、运动、运动加教育、精油治疗和骨疗法对疼痛、残疾和生活质量的短期和长期影响。在短期,0-10 分疼痛强度量表的平均差(MDs)和 95% 置信区间(CI)分别为:精油治疗,2.8 分(2.6, 3.1)(n = 1 项试验,114 名参与者);耳穴疗法,1.6 分(1.2, 2.0)(n = 1 项试验,112 名参与者);运动,2.2 分(-1.8, 6.我们的系统综述显示,关于保守疗法(例如:精油治疗、耳穴疗法)效果的证据非常不确定、我们的系统综述显示,关于保守疗法(如精油治疗、耳穴疗法和运动)对疼痛、残疾和生活质量的短期和长期影响,证据还很不确定。
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引用次数: 0
CARACTERIZATION OF MANUAL PREFERENCE IN CORPUS CALLOSUM DYSGENESIS 胼胝体发育不良的手动偏好特征
IF 3.4 3区 医学 Q1 ORTHOPEDICS Pub Date : 2024-03-21 DOI: 10.1016/j.bjpt.2024.100691
Danielle Agostinho , Myriam Monteiro , Bruna Barreto , Fabio dos Anjos , Fernanda Tovar-Moll

Background

Corpus callosum dysgenesis (CCD) is a neurodevelopmental malformation characterized by the total or partial absence or hypoplasia of the corpus callosum (CC); the structure responsible for connecting both cerebral hemispheres. CCD is associated with cognitive, social, visual, auditory, motor, somatosensory and language alterations. Considering that CC seems to play an important role in the establishment of cerebral asymmetries, whether DCC patients have an indeterminate or strong handedness is an open question we addressed here.

Objectives

This study aimed at investigating the influence of CCD on manual preference.

Methods

An observational study with nine DCC patients were recruited from the Instituto D'Or de Pesquisa e Ensino (Rio de Janeiro, Brazil). The Edinburgh Handedness Inventory was used to assess manual preference. The inventory has 10 items: writing, drawing, throwing, scissors, toothbrush, knife, spoom, broom, match and open a box. The laterality quotient (LQ) was applied as follows: LQ = [(R-L) / (R+L) X 100], ranging from -100 (strong left-handedness) to +100 (strong right-handedness). The statistical analysis involves data description by means of number (%) of occurrences or mean (±standard deviation).

Results

Regarding the clinical characteristics of the sample, two types of CCD were identified: Total Agenesis (N = 6, 66.3%) and CC Hypoplasia (N = 3, 33%). Furthermore, the results showed that the type of CDD was isolated (Total Agenesis: N = 4, 44.4%; CC Hypoplasia: N = 2, 22.2%) or associated with other nervous system conditions (Total Agenesis: N = 1, 11.1%; CC Hypoplasia: N = 1, 11.1%). For manual preference, all subjects obtained the maximum score of the assessment instrument (strong left-handedness: N = 3, 33.3%; strong right-handedness: N = 6, 66.6%).

Conclusion

These results indicate that patients have a strong manual preference, regardless of the type of CDD and associations with nervous system conditions.

Implications

These findings can advance knowledge in the clinical condition of CCD and, consequently, influence the treatment and further research.

背景胼胝体发育不良(CCD)是一种神经发育畸形,其特征是胼胝体(CC)全部或部分缺失或发育不良;胼胝体是连接大脑两半球的结构。CCD 与认知、社交、视觉、听觉、运动、躯体感觉和语言的改变有关。考虑到CC似乎在大脑不对称的形成过程中起着重要作用,DCC患者是否具有不确定的或强烈的手性是我们在此探讨的一个未决问题。研究采用爱丁堡手性量表来评估患者的手动偏好。该量表共有 10 个项目:写字、画画、投掷、剪刀、牙刷、小刀、勺子、扫帚、火柴和开盒子。侧向商数(LQ)的应用如下:LQ=[(R-L) / (R+L) X 100],范围从-100(强左撇子)到+100(强右撇子)。统计分析采用出现次数(%)或平均值(±标准偏差)来描述数据:全缺失型(6 例,66.3%)和 CC 发育不全型(3 例,33%)。此外,研究结果还显示,CCDD的类型有单独存在的(全无畸形:4人,占44.4%;CC发育不全:2人,占22.2%),也有与其他神经系统疾病相关的(全无畸形:1人,占11.1%;CC发育不全:1人,占11.1%)。结论这些结果表明,无论 CDD 属于哪种类型,也无论是否与神经系统疾病相关,患者都有强烈的手动偏好。
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Brazilian Journal of Physical Therapy
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