Pub Date : 2025-11-01Epub Date: 2025-10-30DOI: 10.1016/j.bjpt.2025.101303
Rafael Rodrigues Dall´Olmo, Murilo Santos de Carvalho, Alissa Rosa De Castro, Ana Luísa Ávila Pinheiro, Carolina Duarte, Mauro Antônio Félix, Luis Fernando Ferreira, Luis Henrique Telles da Rosa
Background
Aging is associated with changes that lead to a decline in functionality, limiting the performance of activities of daily living (ADLs). Older adults living in long-term care facilities (LTCFs) have fewer opportunities to actively engage in these activities, which affects their independence and autonomy. So far, there is limited evidence on the effects of interventions aimed at improving functionality in LTCF residents, as most studies focus on community-dwelling older adults.
Objectives
To evaluate the effectiveness of the Vivifrail program in combating frailty syndrome in institutionalized older adults by analyzing the program's effects on improving balance and muscle function in this population.
Methods
The study is a randomized clinical trial conducted over a three-month period with two weekly sessions in long-term care facilities (LTCF). A total of 30 female volunteers over the age of 60 participated, forming two groups: the Vivifrail Group (VG), which underwent multicomponent training, and the Control Group (CG), which received usual care. The training followed the Vivifrail model, adjusted according to the participants' initial functional capacity, categorizing them as "frail," "pre-frail," or "independent." Participants were assessed before starting the intervention and four weeks after its completion.
Results
Thirty older women were included in the study, with a mean age of 86 years. There were no statistically significant differences between the groups at the pre-intervention stage. However, post-intervention analysis revealed statistically significant differences in frailty levels, with lower frailty scores in the intervention group. Notably, the intervention group showed an improvement of nearly two points in the SPPB assessment, an increase of approximately 5 kg/f in handgrip strength, and a reduction of nearly 5 seconds in the time required to complete the five-times sit-to-stand test.
Conclusion
In this sample, the Vivifrail program proved effective as a strategy for combating and preventing frailty syndrome, according to Fried's Frailty Phenotype.
Implications
The results suggest that the Vivifrail program can be implemented to reduce frailty and the risk of falls. Furthermore, its adoption in LTCFs may promote greater independence and quality of life for this population.
{"title":"VIVIFRAIL TRAINING IMPROVES FUNCTIONAL CAPACITY OF INSTITUTIONALIZED ELDERLY PEOPLE: A RANDOMIZED CLINICAL TRIAL","authors":"Rafael Rodrigues Dall´Olmo, Murilo Santos de Carvalho, Alissa Rosa De Castro, Ana Luísa Ávila Pinheiro, Carolina Duarte, Mauro Antônio Félix, Luis Fernando Ferreira, Luis Henrique Telles da Rosa","doi":"10.1016/j.bjpt.2025.101303","DOIUrl":"10.1016/j.bjpt.2025.101303","url":null,"abstract":"<div><h3>Background</h3><div>Aging is associated with changes that lead to a decline in functionality, limiting the performance of activities of daily living (ADLs). Older adults living in long-term care facilities (LTCFs) have fewer opportunities to actively engage in these activities, which affects their independence and autonomy. So far, there is limited evidence on the effects of interventions aimed at improving functionality in LTCF residents, as most studies focus on community-dwelling older adults.</div></div><div><h3>Objectives</h3><div>To evaluate the effectiveness of the Vivifrail program in combating frailty syndrome in institutionalized older adults by analyzing the program's effects on improving balance and muscle function in this population.</div></div><div><h3>Methods</h3><div>The study is a randomized clinical trial conducted over a three-month period with two weekly sessions in long-term care facilities (LTCF). A total of 30 female volunteers over the age of 60 participated, forming two groups: the Vivifrail Group (VG), which underwent multicomponent training, and the Control Group (CG), which received usual care. The training followed the Vivifrail model, adjusted according to the participants' initial functional capacity, categorizing them as \"frail,\" \"pre-frail,\" or \"independent.\" Participants were assessed before starting the intervention and four weeks after its completion.</div></div><div><h3>Results</h3><div>Thirty older women were included in the study, with a mean age of 86 years. There were no statistically significant differences between the groups at the pre-intervention stage. However, post-intervention analysis revealed statistically significant differences in frailty levels, with lower frailty scores in the intervention group. Notably, the intervention group showed an improvement of nearly two points in the SPPB assessment, an increase of approximately 5 kg/f in handgrip strength, and a reduction of nearly 5 seconds in the time required to complete the five-times sit-to-stand test.</div></div><div><h3>Conclusion</h3><div>In this sample, the Vivifrail program proved effective as a strategy for combating and preventing frailty syndrome, according to Fried's Frailty Phenotype.</div></div><div><h3>Implications</h3><div>The results suggest that the Vivifrail program can be implemented to reduce frailty and the risk of falls. Furthermore, its adoption in LTCFs may promote greater independence and quality of life for this population.</div></div>","PeriodicalId":49621,"journal":{"name":"Brazilian Journal of Physical Therapy","volume":"29 ","pages":"Article 101303"},"PeriodicalIF":3.2,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145398231","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}
Pub Date : 2025-11-01Epub Date: 2025-10-30DOI: 10.1016/j.bjpt.2025.101329
Raquel Lins de Sousa Lima, Gabriel Alves Dos Santos, Sávio Douglas Ferreira Santana, Bruna Gabriella Nascimento Bezerra, Mayara Ribeiro Da Silva, Marlison Douglas Nascimento Silva, Valéria Mayaly Alves de Oliveira, Danilo Harudy Kamonseki
<div><h3>Background</h3><div>Musculoskeletal injuries are common in overhead sports. Repetitive use of the upper limb in specific movements can lead to the development of pain and significant functional impairments, affecting athletic performance and quality of life. Psychological factors, such as anxiety and depression, can influence athletes' performance and overall well-being, particularly in those experiencing musculoskeletal pain. Shoulder pain is a common issue among swimmers due to the high demands of repetitive overhead movements, potentially impacting their mental health. Identifying whether athletes with shoulder pain present higher levels of anxiety and depression can provide valuable insights for developing comprehensive rehabilitation strategies that address both physical and psychological aspects. The Hospital Anxiety and Depression Scale (HADS) is a widely used tool for assessing anxiety and depression symptoms in clinical and research settings. However, the relationship between shoulder pain and psychological distress in competitive swimmers remains unclear.</div></div><div><h3>Objectives</h3><div>To assess whether athletes with shoulder pain present higher scores for anxiety and depression based on the HADS.</div></div><div><h3>Methods</h3><div>This is a cross-sectional observational study, which was approved by the Ethics Research Committee. We included competitive swimmers, both with and without musculoskeletal pain, of both sexes, aged between 12 and 60 years, with at least one year of competitive experience and a training regimen of at least twice a week. Anxiety and depression were assessed using the HADS, which consists of 14 questions divided into two subscales. Statistical analysis was performed using the Statistical Package for the Social Sciences (SPSS), version 23.0. Data normality was assessed using the Shapiro-Wilk test. Between groups comparisons for normally distributed data were conducted using Student’s t-test, while the Mann-Whitney U test was used for non-normally distributed data. Effect size (Cohen’s d) was calculated for between-group differences.</div></div><div><h3>Results</h3><div>A total of 49 competitive swimmers were included in the study, with a mean age of 30,82 ± 14,34, 7,18 ± 6,41 years of sports practice, and 22 (44,9%) were women. No statistically significant differences were found between the groups for anxiety and depression. For the total HADS score the mean difference was 0.41 ((95% confidence interval [CI]: -3.094, 3.92, p = 0.81); Effect size (Cohen’s d) = 1.74). For the anxiety subscale the mean difference was (0.85 ((95% CI: -1.34, 2.98, p = 0.44); Effect size (Cohen’s d) = 1.83). For the depression subscale the mean difference was -0.43 ((95% CI: -2.22 to 1.35;p = 0.62); Effect size (Cohen’s d) = 0.014).</div></div><div><h3>Conclusion</h3><div>The results indicate no statistically significant difference in anxiety and depression scores between athletes with and without shoulder pain.</di
{"title":"ANXIETY AND DEPRESSION IN SWIMMERS WITH AND WITHOUT SHOULDER PAIN: A CROSS-SECTIONAL ANALYSIS","authors":"Raquel Lins de Sousa Lima, Gabriel Alves Dos Santos, Sávio Douglas Ferreira Santana, Bruna Gabriella Nascimento Bezerra, Mayara Ribeiro Da Silva, Marlison Douglas Nascimento Silva, Valéria Mayaly Alves de Oliveira, Danilo Harudy Kamonseki","doi":"10.1016/j.bjpt.2025.101329","DOIUrl":"10.1016/j.bjpt.2025.101329","url":null,"abstract":"<div><h3>Background</h3><div>Musculoskeletal injuries are common in overhead sports. Repetitive use of the upper limb in specific movements can lead to the development of pain and significant functional impairments, affecting athletic performance and quality of life. Psychological factors, such as anxiety and depression, can influence athletes' performance and overall well-being, particularly in those experiencing musculoskeletal pain. Shoulder pain is a common issue among swimmers due to the high demands of repetitive overhead movements, potentially impacting their mental health. Identifying whether athletes with shoulder pain present higher levels of anxiety and depression can provide valuable insights for developing comprehensive rehabilitation strategies that address both physical and psychological aspects. The Hospital Anxiety and Depression Scale (HADS) is a widely used tool for assessing anxiety and depression symptoms in clinical and research settings. However, the relationship between shoulder pain and psychological distress in competitive swimmers remains unclear.</div></div><div><h3>Objectives</h3><div>To assess whether athletes with shoulder pain present higher scores for anxiety and depression based on the HADS.</div></div><div><h3>Methods</h3><div>This is a cross-sectional observational study, which was approved by the Ethics Research Committee. We included competitive swimmers, both with and without musculoskeletal pain, of both sexes, aged between 12 and 60 years, with at least one year of competitive experience and a training regimen of at least twice a week. Anxiety and depression were assessed using the HADS, which consists of 14 questions divided into two subscales. Statistical analysis was performed using the Statistical Package for the Social Sciences (SPSS), version 23.0. Data normality was assessed using the Shapiro-Wilk test. Between groups comparisons for normally distributed data were conducted using Student’s t-test, while the Mann-Whitney U test was used for non-normally distributed data. Effect size (Cohen’s d) was calculated for between-group differences.</div></div><div><h3>Results</h3><div>A total of 49 competitive swimmers were included in the study, with a mean age of 30,82 ± 14,34, 7,18 ± 6,41 years of sports practice, and 22 (44,9%) were women. No statistically significant differences were found between the groups for anxiety and depression. For the total HADS score the mean difference was 0.41 ((95% confidence interval [CI]: -3.094, 3.92, p = 0.81); Effect size (Cohen’s d) = 1.74). For the anxiety subscale the mean difference was (0.85 ((95% CI: -1.34, 2.98, p = 0.44); Effect size (Cohen’s d) = 1.83). For the depression subscale the mean difference was -0.43 ((95% CI: -2.22 to 1.35;p = 0.62); Effect size (Cohen’s d) = 0.014).</div></div><div><h3>Conclusion</h3><div>The results indicate no statistically significant difference in anxiety and depression scores between athletes with and without shoulder pain.</di","PeriodicalId":49621,"journal":{"name":"Brazilian Journal of Physical Therapy","volume":"29 ","pages":"Article 101329"},"PeriodicalIF":3.2,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145398411","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}
Pub Date : 2025-11-01Epub Date: 2025-10-30DOI: 10.1016/j.bjpt.2025.101341
Thiago André Pereira Gonçales, Isabela Vitoria Souza Araujo, Vera Lúcia Freitas Carvalho, Deborah Hebling Spinoso
Background
Patellofemoral pain (PFP) is characterized by pain in the anterior region or around the patella during weight-bearing activities, being more prevalent in women. Its high recurrence rate can compromise the performance of daily activities. Functional tests are simple and low-cost tools widely used to assess functional performance in patients with musculoskeletal disorders. However, the functional deficit identified through these tests is still underexplored in the PFP population. Therefore, investigating whether functional tests can detect performance differences compared to asymptomatic individuals may be relevant to improve assessments in clinical practice.
Objectives
Compare the performance in functional tests between women with and without PFP.
Methods
Sixty women, aged between 18 and 35 years, physically active, participated in this study, divided into two groups: PFP (n = 30) and control (n = 30). Initially, anamnesis was performed to obtain personal data and eligibility criteria. Functional assessment was conducted through three tests. The forward jump test, in which the participant had to stand on one leg, jump as far as possible, and land without losing balance. The test was performed three times, and the best performance was considered for data analysis. The one-legged chair rise test, in which the participant had to rise from a chair and then sit back down using only the assessed leg, performing as many repetitions as possible in 30 seconds. The step-down test, in which the participant was asked to touch the ground with the heel of the non-tested leg while keeping the tested leg on the step, then return to the initial position, performing as many repetitions as possible in 30 seconds. For data analysis, an independent samples t-test was applied, with a significance level of p < 0.05.
Results
Women with PFP showed a deficit in functional performance in the forward jump test (p = 0.005), step-down test (p < 0.001), and one-legged chair rise test (p = 0.042) compared to asymptomatic women.
Conclusion
Women with PFP show a decline in performance in functional tests when compared to asymptomatic women, which can be detected through clinical tests.
Implications
Functional tests should be incorporated into the assessment and monitoring of rehabilitation programs for women with patellofemoral pain, allowing for the identification of the level of impairment and the progression of functional capacity throughout the treatment. Furthermore, it is recommended that rehabilitation include exercises that simulate activities of daily living, aiming to improve functionality and the quality of life of these patients.
{"title":"WOMEN WITH PATELLOFEMORAL PAIN SHOW FUNCTIONAL DEFICITS WHEN COMPARED TO ASYMPTOMATIC WOMEN","authors":"Thiago André Pereira Gonçales, Isabela Vitoria Souza Araujo, Vera Lúcia Freitas Carvalho, Deborah Hebling Spinoso","doi":"10.1016/j.bjpt.2025.101341","DOIUrl":"10.1016/j.bjpt.2025.101341","url":null,"abstract":"<div><h3>Background</h3><div>Patellofemoral pain (PFP) is characterized by pain in the anterior region or around the patella during weight-bearing activities, being more prevalent in women. Its high recurrence rate can compromise the performance of daily activities. Functional tests are simple and low-cost tools widely used to assess functional performance in patients with musculoskeletal disorders. However, the functional deficit identified through these tests is still underexplored in the PFP population. Therefore, investigating whether functional tests can detect performance differences compared to asymptomatic individuals may be relevant to improve assessments in clinical practice.</div></div><div><h3>Objectives</h3><div>Compare the performance in functional tests between women with and without PFP.</div></div><div><h3>Methods</h3><div>Sixty women, aged between 18 and 35 years, physically active, participated in this study, divided into two groups: PFP (n = 30) and control (n = 30). Initially, anamnesis was performed to obtain personal data and eligibility criteria. Functional assessment was conducted through three tests. The forward jump test, in which the participant had to stand on one leg, jump as far as possible, and land without losing balance. The test was performed three times, and the best performance was considered for data analysis. The one-legged chair rise test, in which the participant had to rise from a chair and then sit back down using only the assessed leg, performing as many repetitions as possible in 30 seconds. The step-down test, in which the participant was asked to touch the ground with the heel of the non-tested leg while keeping the tested leg on the step, then return to the initial position, performing as many repetitions as possible in 30 seconds. For data analysis, an independent samples t-test was applied, with a significance level of p < 0.05.</div></div><div><h3>Results</h3><div>Women with PFP showed a deficit in functional performance in the forward jump test (p = 0.005), step-down test (p < 0.001), and one-legged chair rise test (p = 0.042) compared to asymptomatic women.</div></div><div><h3>Conclusion</h3><div>Women with PFP show a decline in performance in functional tests when compared to asymptomatic women, which can be detected through clinical tests.</div></div><div><h3>Implications</h3><div>Functional tests should be incorporated into the assessment and monitoring of rehabilitation programs for women with patellofemoral pain, allowing for the identification of the level of impairment and the progression of functional capacity throughout the treatment. Furthermore, it is recommended that rehabilitation include exercises that simulate activities of daily living, aiming to improve functionality and the quality of life of these patients.</div></div>","PeriodicalId":49621,"journal":{"name":"Brazilian Journal of Physical Therapy","volume":"29 ","pages":"Article 101341"},"PeriodicalIF":3.2,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145398475","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}
Pub Date : 2025-11-01Epub Date: 2025-10-30DOI: 10.1016/j.bjpt.2025.101300
Natielle Cecília dos Santos Ottone, Paulo Victor Mendes Santos, Henrique Silveira Costa, Sara Gabrielle Souza, Pedro Henrique Scheidt Figueiredo, Vanessa Pereira de Lima, Marcus Alessandro de Alcantara
Background
The Core Set of the International Classification of Functioning, Disability, and Health (ICF) is the methodological process that allows for the definition of categories representing a set of functional outcomes related to a specific health condition. To validate a Core Set for Chagas Disease (CD), a qualitative study was conducted to understand the functional perspectives of this population.
Objectives
Based on focus groups, this qualitative study represented the second stage in creating the Core Set and aims to list candidate categories that will be analyzed in subsequent phases.
Methods
The focus groups were conducted to identify the most relevant categories for adults of both sexes diagnosed with the cardiac form of CD, related to the functional consequences of the disease. Significant concepts were identified from the transcriptions using the condensation method. Subsequently, the concepts that emerged from the participants' statements were linked to ICF categories by two independent researchers.
Results
Sixteen adults (mean age: 67 ± 8 years), including 10 women and 6 men, participated in six focus groups. A total of 180 relevant concepts were identified, which were mapped to 41 of the 125 second-level categories from the ICF checklist. The identified concepts represented all ICF components: Body Functions (43% of concepts), Body Structures (7% of concepts), Activities and Participation (26% of concepts), and Environmental Factors (24% of concepts). The most frequently mentioned categories were: b134 (Sleep functions), b152 (Emotional functions), b280 (Pain), d930 (Religion and spirituality), and e310 (Immediate family). Patients with CD experienced a complex condition where sleep functions, emotional functions, and the presence of pain are interrelated, creating a significant impact on their quality of life.
Conclusion
The use of religious practices and the support of the immediate family appear to be important resources in managing these conditions.
Implications
The identified categories will be added to the list of candidate categories for reaching a consensus on a Core Set of the ICF for individuals with CD.
{"title":"DEVELOPMENT OF A CORE SET FOR CHAGAS DISEASE: EXPLORING PATIENT PERSPECTIVES ON FUNCTIONALITY","authors":"Natielle Cecília dos Santos Ottone, Paulo Victor Mendes Santos, Henrique Silveira Costa, Sara Gabrielle Souza, Pedro Henrique Scheidt Figueiredo, Vanessa Pereira de Lima, Marcus Alessandro de Alcantara","doi":"10.1016/j.bjpt.2025.101300","DOIUrl":"10.1016/j.bjpt.2025.101300","url":null,"abstract":"<div><h3>Background</h3><div>The Core Set of the International Classification of Functioning, Disability, and Health (ICF) is the methodological process that allows for the definition of categories representing a set of functional outcomes related to a specific health condition. To validate a Core Set for Chagas Disease (CD), a qualitative study was conducted to understand the functional perspectives of this population.</div></div><div><h3>Objectives</h3><div>Based on focus groups, this qualitative study represented the second stage in creating the Core Set and aims to list candidate categories that will be analyzed in subsequent phases.</div></div><div><h3>Methods</h3><div>The focus groups were conducted to identify the most relevant categories for adults of both sexes diagnosed with the cardiac form of CD, related to the functional consequences of the disease. Significant concepts were identified from the transcriptions using the condensation method. Subsequently, the concepts that emerged from the participants' statements were linked to ICF categories by two independent researchers.</div></div><div><h3>Results</h3><div>Sixteen adults (mean age: 67 ± 8 years), including 10 women and 6 men, participated in six focus groups. A total of 180 relevant concepts were identified, which were mapped to 41 of the 125 second-level categories from the ICF checklist. The identified concepts represented all ICF components: Body Functions (43% of concepts), Body Structures (7% of concepts), Activities and Participation (26% of concepts), and Environmental Factors (24% of concepts). The most frequently mentioned categories were: b134 (Sleep functions), b152 (Emotional functions), b280 (Pain), d930 (Religion and spirituality), and e310 (Immediate family). Patients with CD experienced a complex condition where sleep functions, emotional functions, and the presence of pain are interrelated, creating a significant impact on their quality of life.</div></div><div><h3>Conclusion</h3><div>The use of religious practices and the support of the immediate family appear to be important resources in managing these conditions.</div></div><div><h3>Implications</h3><div>The identified categories will be added to the list of candidate categories for reaching a consensus on a Core Set of the ICF for individuals with CD.</div></div>","PeriodicalId":49621,"journal":{"name":"Brazilian Journal of Physical Therapy","volume":"29 ","pages":"Article 101300"},"PeriodicalIF":3.2,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145398526","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}
Pub Date : 2025-11-01Epub Date: 2025-08-21DOI: 10.1016/j.bjpt.2025.101258
Igor Macedo Tavares Correia , Arthur de Sá Ferreira , Jessica Fernandez Mosqueira Gomes , Felipe José Jandre Reis , Leandro Alberto Calazans Nogueira , Ney Meziat-Filho
Background
There is a lack of longitudinal studies investigating the association between cervical flexion posture during smartphone use (commonly referred to as text neck [TN]) and neck pain (NP).
Objective
To investigate whether TN is a risk factor for NP, considering the influence of lifestyle and psychosocial factors.
Methods
A 12-month longitudinal study. The sample consisted of 457 volunteers of both sexes, aged between 18 and 65 years, without NP. Sociodemographic, anthropometric, lifestyle, psychosocial, and smartphone-use data were collected through a self-reported questionnaire. TN was assessed objectively at baseline by measuring the cervical flexion angle using the cervical range of motion device (CROM) with participants standing and sitting while texting on their smartphones. One year after the initial assessment, participants were assessed regarding the point prevalence and frequency of NP.
Results
Of the total, 396 (87 %) participants completed the one-year follow-up. NP was reported by 40 (10 %) participants. Multiple logistic regression analysis showed that TN did not increase the chance of NP (standing OR [95 % confidence interval] = 1.0 [0.97, 1.04]; sitting OR = 1.01 [0.98, 1.04]) or frequency of NP (standing OR = 1.01 [0.99, 1.03]; sitting OR = 1.00 [0.99, 1.02]) after baseline. However, low sleep quality (OR = 1.76 [1.17, 2.63]) and insufficient level of physical activity (OR = 2.41 [1.03, 5.65]) increased the chance of NP.
Conclusion
Cervical flexion posture during smartphone use was not a risk factor for NP or frequency of NP, but low sleep quality and insufficient levels of physical activity were.
{"title":"Cervical flexion posture during smartphone use was not a risk factor for neck pain, but low sleep quality and insufficient levels of physical activity were. A longitudinal investigation","authors":"Igor Macedo Tavares Correia , Arthur de Sá Ferreira , Jessica Fernandez Mosqueira Gomes , Felipe José Jandre Reis , Leandro Alberto Calazans Nogueira , Ney Meziat-Filho","doi":"10.1016/j.bjpt.2025.101258","DOIUrl":"10.1016/j.bjpt.2025.101258","url":null,"abstract":"<div><h3>Background</h3><div>There is a lack of longitudinal studies investigating the association between cervical flexion posture during smartphone use (commonly referred to as text neck [TN]) and neck pain (NP).</div></div><div><h3>Objective</h3><div>To investigate whether TN is a risk factor for NP, considering the influence of lifestyle and psychosocial factors.</div></div><div><h3>Methods</h3><div>A 12-month longitudinal study. The sample consisted of 457 volunteers of both sexes, aged between 18 and 65 years, without NP. Sociodemographic, anthropometric, lifestyle, psychosocial, and smartphone-use data were collected through a self-reported questionnaire. TN was assessed objectively at baseline by measuring the cervical flexion angle using the cervical range of motion device (CROM) with participants standing and sitting while texting on their smartphones. One year after the initial assessment, participants were assessed regarding the point prevalence and frequency of NP.</div></div><div><h3>Results</h3><div>Of the total, 396 (87 %) participants completed the one-year follow-up. NP was reported by 40 (10 %) participants. Multiple logistic regression analysis showed that TN did not increase the chance of NP (standing OR [95 % confidence interval] = 1.0 [0.97, 1.04]; sitting OR = 1.01 [0.98, 1.04]) or frequency of NP (standing OR = 1.01 [0.99, 1.03]; sitting OR = 1.00 [0.99, 1.02]) after baseline. However, low sleep quality (OR = 1.76 [1.17, 2.63]) and insufficient level of physical activity (OR = 2.41 [1.03, 5.65]) increased the chance of NP.</div></div><div><h3>Conclusion</h3><div>Cervical flexion posture during smartphone use was not a risk factor for NP or frequency of NP, but low sleep quality and insufficient levels of physical activity were.</div></div>","PeriodicalId":49621,"journal":{"name":"Brazilian Journal of Physical Therapy","volume":"29 6","pages":"Article 101258"},"PeriodicalIF":3.2,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144886369","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}
Pub Date : 2025-11-01Epub Date: 2025-08-12DOI: 10.1016/j.bjpt.2025.101255
Taís Beppler Martins , Emanuella Cristina Cordeiro , Giane Amorim Ribeiro-Samora , Luciana Sayuri Sanada , Gentil Gomes da Fonseca Filho , Silvana Alves Pereira , Dayane Montemezzo
Introduction
Newborns (NB) undergoing invasive mechanical ventilation (IMV) should be extubated as early as possible. Predictive factors for successful extubation are often considered in isolation, focusing on personal factors and the functions and structures of the NB's body, according to the International Classification of Functioning, Disability and Health (ICF).
Objectives
To assess the contribution of ICF components to the successful extubation of NB.
Method
A multicenter, observational and retrospective study was conducted using medical records of NB from five macroregions of Brazil. NB who underwent IMV of >24 h were included. Clinical and sociodemographic variables were organized according to ICF components, and factors associated with successful extubation were analyzed using a generalized linear model.
Results
A total of 498 NB were included, with an extubation success rate of 82.3 %. The body functions and structures component included pH (p = 0.006), the environmental factors component included the number of prenatal consultations (p = 0.002) and mode of ventilation (p = 0.004), and the personal factors component included gestational age (p < 0.001), birth weight (p < 0.001), gestational age at extubation (p < 0.001), and weight at extubation (p < 0.001). Environmental factors increased the probability of successful extubation by 1.72 times (95 % CI: 1.26, 2.35).
Conclusion
The environmental factors component of the ICF significantly influenced extubation outcomes in NB, increasing the probability of success. These findings highlight the importance of developing extubation protocols that integrate predictive variables from all ICF components, considering both functional and structural alterations along with contextual factors.
{"title":"Environmental factors contribute to the success of extubation in newborns: A multicenter cross-sectional study","authors":"Taís Beppler Martins , Emanuella Cristina Cordeiro , Giane Amorim Ribeiro-Samora , Luciana Sayuri Sanada , Gentil Gomes da Fonseca Filho , Silvana Alves Pereira , Dayane Montemezzo","doi":"10.1016/j.bjpt.2025.101255","DOIUrl":"10.1016/j.bjpt.2025.101255","url":null,"abstract":"<div><h3>Introduction</h3><div>Newborns (NB) undergoing invasive mechanical ventilation (IMV) should be extubated as early as possible. Predictive factors for successful extubation are often considered in isolation, focusing on personal factors and the functions and structures of the NB's body, according to the International Classification of Functioning, Disability and Health (ICF).</div></div><div><h3>Objectives</h3><div>To assess the contribution of ICF components to the successful extubation of NB.</div></div><div><h3>Method</h3><div>A multicenter, observational and retrospective study was conducted using medical records of NB from five macroregions of Brazil. NB who underwent IMV of >24 h were included. Clinical and sociodemographic variables were organized according to ICF components, and factors associated with successful extubation were analyzed using a generalized linear model.</div></div><div><h3>Results</h3><div>A total of 498 NB were included, with an extubation success rate of 82.3 %. The body functions and structures component included pH (<em>p</em> = 0.006), the environmental factors component included the number of prenatal consultations (<em>p</em> = 0.002) and mode of ventilation (<em>p</em> = 0.004), and the personal factors component included gestational age (<em>p</em> < 0.001), birth weight (<em>p</em> < 0.001), gestational age at extubation (<em>p</em> < 0.001), and weight at extubation (<em>p</em> < 0.001). Environmental factors increased the probability of successful extubation by 1.72 times (95 % CI: 1.26, 2.35).</div></div><div><h3>Conclusion</h3><div>The environmental factors component of the ICF significantly influenced extubation outcomes in NB, increasing the probability of success. These findings highlight the importance of developing extubation protocols that integrate predictive variables from all ICF components, considering both functional and structural alterations along with contextual factors.</div></div>","PeriodicalId":49621,"journal":{"name":"Brazilian Journal of Physical Therapy","volume":"29 6","pages":"Article 101255"},"PeriodicalIF":3.2,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144831551","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}
Pub Date : 2025-11-01Epub Date: 2025-10-30DOI: 10.1016/j.bjpt.2025.101307
Murilo Santos de Carvalho, Vitória Flores Santos, Maria Eduarda da Cas, Franciele Souza Santos, Mauro Antônio Félix, Rafael Rodrigues Dall’Olmo, Luis Fernando Ferreira, Luis Henrique Telles da Rosa
<div><h3>Background</h3><div>The increasing elderly population presents a significant challenge to health and social systems worldwide. Frailty is recognized as a condition that can substantially impact the quality of life, autonomy, and independence of older adults, elevating the risk of adverse events and hospitalization.</div></div><div><h3>Objectives</h3><div>To identify the impacts and factors associated with hospitalization among elderly individuals living in the community.</div></div><div><h3>Methods</h3><div>This is a cross-sectional, descriptive, and observational study conducted in a community assisted by a Family Health Team. The sample consisted of 202 elderly individuals, aged 60 years or older, of both sexes. Structured questionnaires developed by the researchers were used to collect data on personal information, socio-environmental factors, and risk factors for frailty. Physical assessments were conducted using tests based on frailty conceptual models, including Fried’s phenotype and the Edmonton Frail Scale. Statistical analysis was performed using the Spearman correlation test.</div></div><div><h3>Results</h3><div>Of the 202 patients evaluated, 39 (19.3%) had been hospitalized in the previous 12 months, with an average of more than one hospitalization (1.69). It is important to highlight that the group of patients with hospitalizations had more falls (average of 2.61 versus 0.72) in the last 12 months, lower handgrip strength (24 kg/f versus 27 kg/f), and lower walking speed (1.38 m/s versus 1.51 m/s). In addition, significant correlations were found between hospitalizations in the last 12 months and the number of falls, forgetting to take their medication, unintentional weight loss, difficulty in carrying out daily activities, inability to carry out their tasks, number of medical appointments, and having a caregiver.</div></div><div><h3>Conclusion</h3><div>From this sample, it can be stated that having had hospitalizations in the last year can significantly affect the adaptability capacity, possibly with major impacts on the perception of quality of life, and on functional aspects and risks of falls, with worse outcomes and higher risk for a new hospitalization. Furthermore, for this sample, the number of hospitalizations was directly related to the fact of having a caregiver.</div></div><div><h3>Implications</h3><div>In physiotherapy practice, the need for integrated post-hospital interventions stands out, encompassing functional rehabilitation, fall prevention strategies, and emotional support, in addition to preventing re-hospitalizations, with a focus on Primary Health Care. Health management should prioritize continuous care for older adults with a history or risk of hospitalizations, implementing programs for muscle strengthening, mobility, and disability prevention. Physiotherapy professionals' training should adopt an approach that considers the physical, psychological, and social aspects of patients. Finally, public pol
{"title":"BETWEEN FRAGILITY AND RECOVERY: THE IMPACT AND FACTORS ASSOCIATED WITH HOSPITALIZATIONS ON COMMUNITY-DWELLING ELDERLY","authors":"Murilo Santos de Carvalho, Vitória Flores Santos, Maria Eduarda da Cas, Franciele Souza Santos, Mauro Antônio Félix, Rafael Rodrigues Dall’Olmo, Luis Fernando Ferreira, Luis Henrique Telles da Rosa","doi":"10.1016/j.bjpt.2025.101307","DOIUrl":"10.1016/j.bjpt.2025.101307","url":null,"abstract":"<div><h3>Background</h3><div>The increasing elderly population presents a significant challenge to health and social systems worldwide. Frailty is recognized as a condition that can substantially impact the quality of life, autonomy, and independence of older adults, elevating the risk of adverse events and hospitalization.</div></div><div><h3>Objectives</h3><div>To identify the impacts and factors associated with hospitalization among elderly individuals living in the community.</div></div><div><h3>Methods</h3><div>This is a cross-sectional, descriptive, and observational study conducted in a community assisted by a Family Health Team. The sample consisted of 202 elderly individuals, aged 60 years or older, of both sexes. Structured questionnaires developed by the researchers were used to collect data on personal information, socio-environmental factors, and risk factors for frailty. Physical assessments were conducted using tests based on frailty conceptual models, including Fried’s phenotype and the Edmonton Frail Scale. Statistical analysis was performed using the Spearman correlation test.</div></div><div><h3>Results</h3><div>Of the 202 patients evaluated, 39 (19.3%) had been hospitalized in the previous 12 months, with an average of more than one hospitalization (1.69). It is important to highlight that the group of patients with hospitalizations had more falls (average of 2.61 versus 0.72) in the last 12 months, lower handgrip strength (24 kg/f versus 27 kg/f), and lower walking speed (1.38 m/s versus 1.51 m/s). In addition, significant correlations were found between hospitalizations in the last 12 months and the number of falls, forgetting to take their medication, unintentional weight loss, difficulty in carrying out daily activities, inability to carry out their tasks, number of medical appointments, and having a caregiver.</div></div><div><h3>Conclusion</h3><div>From this sample, it can be stated that having had hospitalizations in the last year can significantly affect the adaptability capacity, possibly with major impacts on the perception of quality of life, and on functional aspects and risks of falls, with worse outcomes and higher risk for a new hospitalization. Furthermore, for this sample, the number of hospitalizations was directly related to the fact of having a caregiver.</div></div><div><h3>Implications</h3><div>In physiotherapy practice, the need for integrated post-hospital interventions stands out, encompassing functional rehabilitation, fall prevention strategies, and emotional support, in addition to preventing re-hospitalizations, with a focus on Primary Health Care. Health management should prioritize continuous care for older adults with a history or risk of hospitalizations, implementing programs for muscle strengthening, mobility, and disability prevention. Physiotherapy professionals' training should adopt an approach that considers the physical, psychological, and social aspects of patients. Finally, public pol","PeriodicalId":49621,"journal":{"name":"Brazilian Journal of Physical Therapy","volume":"29 ","pages":"Article 101307"},"PeriodicalIF":3.2,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145398180","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}
Pub Date : 2025-11-01Epub Date: 2025-10-30DOI: 10.1016/j.bjpt.2025.101309
Murilo Santos de Carvalho, Alissa Rosa De Castro, Mayara Cristina Pinto da Luz, Franciele Souza Santos, Tania Cristina Malezan Fleig, Rafael Rodrigues Dall’Olmo, Luis Fernando Ferreira, Luis Henrique Telles da Rosa
<div><h3>Background</h3><div>Population aging is a global trend that presents significant challenges for public health. Community-dwelling older adults represent a diverse population with different levels of autonomy and healthcare needs. Therefore, it is essential to use specific assessment tools that are sensitive to the characteristics and contexts of this population.</div></div><div><h3>Objectives</h3><div>To identify the characteristics of the elderly population in a neighborhood of the municipality in Rio Grande do Sul, aiming to understand frailty and factors associated with certain risks, such as falls and hospitalizations, preventing functional incapacity and promoting independence and autonomy in their daily activities with safety and dignity.</div></div><div><h3>Methods</h3><div>This research consists of an observational cross-sectional descriptive study. Individuals aged 60 years or older, of both sexes, and living in households within a specific community monitored by a Family Health team were evaluated. Data collection was conducted through the application of a structured questionnaire developed by researchers, which included personal data, risk factors and socio-environmental aspects. Additionally, information on fall history, use of walking aids, past hospitalizations, and whether the individual had a formal or informal caregiver, among other aspects, was gathered. Physical assessment was conducted using tests based on the conceptual models of frailty according to Fried's phenotype and the Edmonton Frail Scale.</div></div><div><h3>Results</h3><div>A total of 202 individuals were evaluated, the majority of whom were women (59%), with a mean age of 71.7 years. 76% of the sample were overweight or obese to some degree, and 46% perceived their health status as poor or average, and another third of the sample reported having difficulty performing daily activities (40%), which resulted in 46% of the sample reporting feeling sad or depressed. Regarding the functional tests, it is important to highlight that women had more falls, lower handgrip strength, slower speed to perform the timed-up-and-go test and slower gait speed than men, with statistically significant differences (p < 0,05).</div></div><div><h3>Conclusion</h3><div>The findings of this study highlight the predominance of women in the evaluated elderly population, with greater functional vulnerability among them, including a higher occurrence of falls, lower handgrip strength, and slower performance in functional tests. Additionally, the reported difficulty in performing daily activities by one-third of the participants reinforces the need for strategies focused on promoting functionality and preventing disabilities.</div></div><div><h3>Implications</h3><div>These results highlight the importance of targeted physiotherapy interventions aimed at improving mobility, nutritional status, and mental health in the elderly population. The high prevalence of overweight and functiona
{"title":"AGING IN FOCUS: CHARACTERIZATION OF THE ELDERLY POPULATION OF A FAMILY HEALTH TEAM","authors":"Murilo Santos de Carvalho, Alissa Rosa De Castro, Mayara Cristina Pinto da Luz, Franciele Souza Santos, Tania Cristina Malezan Fleig, Rafael Rodrigues Dall’Olmo, Luis Fernando Ferreira, Luis Henrique Telles da Rosa","doi":"10.1016/j.bjpt.2025.101309","DOIUrl":"10.1016/j.bjpt.2025.101309","url":null,"abstract":"<div><h3>Background</h3><div>Population aging is a global trend that presents significant challenges for public health. Community-dwelling older adults represent a diverse population with different levels of autonomy and healthcare needs. Therefore, it is essential to use specific assessment tools that are sensitive to the characteristics and contexts of this population.</div></div><div><h3>Objectives</h3><div>To identify the characteristics of the elderly population in a neighborhood of the municipality in Rio Grande do Sul, aiming to understand frailty and factors associated with certain risks, such as falls and hospitalizations, preventing functional incapacity and promoting independence and autonomy in their daily activities with safety and dignity.</div></div><div><h3>Methods</h3><div>This research consists of an observational cross-sectional descriptive study. Individuals aged 60 years or older, of both sexes, and living in households within a specific community monitored by a Family Health team were evaluated. Data collection was conducted through the application of a structured questionnaire developed by researchers, which included personal data, risk factors and socio-environmental aspects. Additionally, information on fall history, use of walking aids, past hospitalizations, and whether the individual had a formal or informal caregiver, among other aspects, was gathered. Physical assessment was conducted using tests based on the conceptual models of frailty according to Fried's phenotype and the Edmonton Frail Scale.</div></div><div><h3>Results</h3><div>A total of 202 individuals were evaluated, the majority of whom were women (59%), with a mean age of 71.7 years. 76% of the sample were overweight or obese to some degree, and 46% perceived their health status as poor or average, and another third of the sample reported having difficulty performing daily activities (40%), which resulted in 46% of the sample reporting feeling sad or depressed. Regarding the functional tests, it is important to highlight that women had more falls, lower handgrip strength, slower speed to perform the timed-up-and-go test and slower gait speed than men, with statistically significant differences (p < 0,05).</div></div><div><h3>Conclusion</h3><div>The findings of this study highlight the predominance of women in the evaluated elderly population, with greater functional vulnerability among them, including a higher occurrence of falls, lower handgrip strength, and slower performance in functional tests. Additionally, the reported difficulty in performing daily activities by one-third of the participants reinforces the need for strategies focused on promoting functionality and preventing disabilities.</div></div><div><h3>Implications</h3><div>These results highlight the importance of targeted physiotherapy interventions aimed at improving mobility, nutritional status, and mental health in the elderly population. The high prevalence of overweight and functiona","PeriodicalId":49621,"journal":{"name":"Brazilian Journal of Physical Therapy","volume":"29 ","pages":"Article 101309"},"PeriodicalIF":3.2,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145398182","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}
Type 2 Diabetes Mellitus (T2DM) is associated with cognitive decline in older adults due to metabolic, neuroinflammatory, and vascular alterations. These changes contribute to functional impairment, increasing the risk of falls and dependence on daily activities. Effective interventions are necessary to mitigate these effects and promote healthy aging. Physical exercise, particularly resistance training, and dual-task cognitive stimulation have been proposed as promising strategies to enhance cognitive function and functional independence in this population.
Objectives
This study aimed to analyze the effects of physical exercise and dual-task cognitive stimulation on cognitive decline in individuals with T2DM through an integrative review of the literature.
Methods
An integrative review was conducted by searching PubMed, SciELO, LILACS, Web of Science, and Scopus databases. Original studies, systematic reviews, and meta-analyses published between 2005 and 2025 were included. The selected studies investigated interventions involving physical exercise and dual-task cognitive stimulation targeting cognitive decline in individuals with T2DM. Studies were analyzed regarding methodological characteristics, interventions, and cognitive outcomes.
Results
The findings indicate that insulin resistance, neuroinflammation, and vascular dysfunction contribute to cognitive decline in individuals with T2DM. Physical exercise, especially resistance training, and dual-task interventions have demonstrated benefits in neural plasticity, cerebral metabolism, and cognitive function. Improvements were observed in executive functions, memory, attention, balance, and motor coordination, which are crucial for functional independence and fall prevention. However, the methodological heterogeneity across studies and the limited number of longitudinal clinical trials highlight the need for further research.
Conclusion
Evidence suggests that physical exercise and dual-task cognitive stimulation are effective in mitigating cognitive decline in older adults with T2DM. These interventions contribute to glycemic control, reduce neuroinflammation, and improve cognitive and motor functions. Future studies should focus on high-quality, longitudinal clinical trials to establish standardized protocols and confirm long-term benefits.
Implications
The incorporation of resistance training and dual-task cognitive stimulation into rehabilitation programs for individuals with T2DM may enhance cognitive and functional outcomes, promoting independence and reducing the risk of falls. Further research is needed to strengthen evidence-based practice in this field.
背景2型糖尿病（T2DM）与老年人认知能力下降有关，原因是代谢、神经炎症和血管改变。这些变化会导致功能损害，增加跌倒的风险和对日常活动的依赖。有效的干预措施是必要的，以减轻这些影响，促进健康老龄化。体育锻炼，特别是阻力训练和双任务认知刺激被认为是提高这一人群认知功能和功能独立性的有希望的策略。目的通过文献综述，分析体育锻炼和双任务认知刺激对2型糖尿病患者认知能力下降的影响。方法通过检索PubMed、SciELO、LILACS、Web of Science、Scopus等数据库进行综合评价。纳入了2005年至2025年间发表的原始研究、系统综述和荟萃分析。选定的研究调查了针对T2DM患者认知能力下降的干预措施，包括体育锻炼和双任务认知刺激。研究分析了方法学特征、干预措施和认知结果。结果胰岛素抵抗、神经炎症和血管功能障碍导致T2DM患者认知能力下降。体育锻炼，特别是阻力训练和双任务干预已被证明对神经可塑性、脑代谢和认知功能有好处。在执行功能、记忆、注意力、平衡和运动协调方面观察到改善，这些对功能独立和预防跌倒至关重要。然而，研究方法的异质性和有限数量的纵向临床试验突出了进一步研究的必要性。结论体育锻炼和双任务认知刺激可有效缓解老年T2DM患者的认知能力下降。这些干预措施有助于控制血糖，减少神经炎症，改善认知和运动功能。未来的研究应侧重于高质量的纵向临床试验，以建立标准化的方案并确认长期效益。将抗阻训练和双任务认知刺激纳入T2DM患者的康复计划可能会提高认知和功能结果，促进独立性并降低跌倒风险。需要进一步的研究来加强这一领域的循证实践。
{"title":"EFFECTS OF PHYSICAL EXERCISE AND DUAL-TASK COGNITIVE STIMULATION ON COGNITIVE DECLINE IN TYPE 2 DIABETES: AN INTEGRATIVE REVIEW","authors":"Josilayne Patrícia Ramos Carvalho, Renan Wallace Guimarães da Rocha, Renato Sobral Monteiro Junior, Elren Passos Monteiro, Cristovam Wanderley Picanço Diniz, Natáli Valim Oliver Bento-Torres","doi":"10.1016/j.bjpt.2025.101313","DOIUrl":"10.1016/j.bjpt.2025.101313","url":null,"abstract":"<div><h3>Background</h3><div>Type 2 Diabetes Mellitus (T2DM) is associated with cognitive decline in older adults due to metabolic, neuroinflammatory, and vascular alterations. These changes contribute to functional impairment, increasing the risk of falls and dependence on daily activities. Effective interventions are necessary to mitigate these effects and promote healthy aging. Physical exercise, particularly resistance training, and dual-task cognitive stimulation have been proposed as promising strategies to enhance cognitive function and functional independence in this population.</div></div><div><h3>Objectives</h3><div>This study aimed to analyze the effects of physical exercise and dual-task cognitive stimulation on cognitive decline in individuals with T2DM through an integrative review of the literature.</div></div><div><h3>Methods</h3><div>An integrative review was conducted by searching PubMed, SciELO, LILACS, Web of Science, and Scopus databases. Original studies, systematic reviews, and meta-analyses published between 2005 and 2025 were included. The selected studies investigated interventions involving physical exercise and dual-task cognitive stimulation targeting cognitive decline in individuals with T2DM. Studies were analyzed regarding methodological characteristics, interventions, and cognitive outcomes.</div></div><div><h3>Results</h3><div>The findings indicate that insulin resistance, neuroinflammation, and vascular dysfunction contribute to cognitive decline in individuals with T2DM. Physical exercise, especially resistance training, and dual-task interventions have demonstrated benefits in neural plasticity, cerebral metabolism, and cognitive function. Improvements were observed in executive functions, memory, attention, balance, and motor coordination, which are crucial for functional independence and fall prevention. However, the methodological heterogeneity across studies and the limited number of longitudinal clinical trials highlight the need for further research.</div></div><div><h3>Conclusion</h3><div>Evidence suggests that physical exercise and dual-task cognitive stimulation are effective in mitigating cognitive decline in older adults with T2DM. These interventions contribute to glycemic control, reduce neuroinflammation, and improve cognitive and motor functions. Future studies should focus on high-quality, longitudinal clinical trials to establish standardized protocols and confirm long-term benefits.</div></div><div><h3>Implications</h3><div>The incorporation of resistance training and dual-task cognitive stimulation into rehabilitation programs for individuals with T2DM may enhance cognitive and functional outcomes, promoting independence and reducing the risk of falls. Further research is needed to strengthen evidence-based practice in this field.</div></div>","PeriodicalId":49621,"journal":{"name":"Brazilian Journal of Physical Therapy","volume":"29 ","pages":"Article 101313"},"PeriodicalIF":3.2,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145398186","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}
Pub Date : 2025-11-01Epub Date: 2025-10-30DOI: 10.1016/j.bjpt.2025.101265
Luciana Angélica da Silva de Jesus , Luciano Luporini Menegaldo , Gabrielle Gomes Queiroz , Helena Mucci , Letícia Maria Do Carmo Corrêa , Ricardo Enrico Rocha Moreira , Leda Marília Fonseca Lucinda , Maycon Moura Reboredo
Background
Individuals with chronic kidney disease in hemodialysis have a high risk of falls. Additionally, these individuals present high sedentary time. The relation between sedentary behavior and the risk of falls needs to be investigated for individuals on hemodialysis.
Objectives
The primary aim of this study was to verify the association between sedentary behavior and the risk of falls in individuals on hemodialysis. The secondary aims were to identify the incidence of falls and to compare the sedentary behavior between fallers (at least one recording of falls) and nonfallers (without recording of falls).
Methods
This 12-month prospective study included individuals in regular hemodialysis. Sociodemographic, clinical, and laboratory data were recorded from an interview. Sedentary behavior was evaluated by the sedentary time recorded on dialysis and nondialysis days using a triaxial accelerometer (wGT3X-BT, ActiGraph). The accelerometer was positioned on the individuals’ dominant waist, and they were instructed to wear it for eight consecutive days during waking hours. After the initial assessment, the occurrence of falls was monitored monthly for 12 months according to the fall definition as an unexpected event in which the individual came to rest on the ground, floor, or lower level. A descriptive analysis was conducted and comparisons between fallers and nonfallers were made by Student T-test. Unadjusted and adjusted logistic regression models investigated the association between sedentary time and the risk of falls, with falls as the dependent variable. A p-value of < 0.05 was considered statistically significant.
Results
This study included 96 individuals (59.3 ± 12.3 years old, 57.3% male). The incidence of falls was 29.2%. Fallers presented lower sedentary time on nondialysis days than nonfallers did (504.9 ± 136.7 vs. 580.9 ± 120.0 minutes per day, p = 0.012). In the unadjusted logistic regression analysis, sedentary time on nondialysis days was directly associated with risk of falls [OR: 1.005 (1.001 to 1.009); p = 0.016]. After adjustment for potential confounders, including age, gender, time on hemodialysis, body mass index, cardiovascular disease, diabetes mellitus, sedentary time on nondialysis days remained associated with risk of falls [OR: 1.005 (1.000 to 1.009) p = 0.037].
Conclusion
Higher sedentary behavior on nondialysis days increased the risk of falls for individuals on hemodialysis.
Implications
The assessment of sedentary behavior can be used to identify individuals on hemodialysis with higher risk of falls and to contribute for the development of preventive strategies.
{"title":"ASSOCIATION BETWEEN SEDENTARY BEHAVIOR AND RISK OF FALLS IN INDIVIDUALS ON HEMODIALYSIS","authors":"Luciana Angélica da Silva de Jesus , Luciano Luporini Menegaldo , Gabrielle Gomes Queiroz , Helena Mucci , Letícia Maria Do Carmo Corrêa , Ricardo Enrico Rocha Moreira , Leda Marília Fonseca Lucinda , Maycon Moura Reboredo","doi":"10.1016/j.bjpt.2025.101265","DOIUrl":"10.1016/j.bjpt.2025.101265","url":null,"abstract":"<div><h3>Background</h3><div>Individuals with chronic kidney disease in hemodialysis have a high risk of falls. Additionally, these individuals present high sedentary time. The relation between sedentary behavior and the risk of falls needs to be investigated for individuals on hemodialysis.</div></div><div><h3>Objectives</h3><div>The primary aim of this study was to verify the association between sedentary behavior and the risk of falls in individuals on hemodialysis. The secondary aims were to identify the incidence of falls and to compare the sedentary behavior between fallers (at least one recording of falls) and nonfallers (without recording of falls).</div></div><div><h3>Methods</h3><div>This 12-month prospective study included individuals in regular hemodialysis. Sociodemographic, clinical, and laboratory data were recorded from an interview. Sedentary behavior was evaluated by the sedentary time recorded on dialysis and nondialysis days using a triaxial accelerometer (wGT3X-BT, ActiGraph). The accelerometer was positioned on the individuals’ dominant waist, and they were instructed to wear it for eight consecutive days during waking hours. After the initial assessment, the occurrence of falls was monitored monthly for 12 months according to the fall definition as an unexpected event in which the individual came to rest on the ground, floor, or lower level. A descriptive analysis was conducted and comparisons between fallers and nonfallers were made by Student T-test. Unadjusted and adjusted logistic regression models investigated the association between sedentary time and the risk of falls, with falls as the dependent variable. A p-value of < 0.05 was considered statistically significant.</div></div><div><h3>Results</h3><div>This study included 96 individuals (59.3 ± 12.3 years old, 57.3% male). The incidence of falls was 29.2%. Fallers presented lower sedentary time on nondialysis days than nonfallers did (504.9 ± 136.7 vs. 580.9 ± 120.0 minutes per day, p = 0.012). In the unadjusted logistic regression analysis, sedentary time on nondialysis days was directly associated with risk of falls [OR: 1.005 (1.001 to 1.009); p = 0.016]. After adjustment for potential confounders, including age, gender, time on hemodialysis, body mass index, cardiovascular disease, diabetes mellitus, sedentary time on nondialysis days remained associated with risk of falls [OR: 1.005 (1.000 to 1.009) p = 0.037].</div></div><div><h3>Conclusion</h3><div>Higher sedentary behavior on nondialysis days increased the risk of falls for individuals on hemodialysis.</div></div><div><h3>Implications</h3><div>The assessment of sedentary behavior can be used to identify individuals on hemodialysis with higher risk of falls and to contribute for the development of preventive strategies.</div></div>","PeriodicalId":49621,"journal":{"name":"Brazilian Journal of Physical Therapy","volume":"29 ","pages":"Article 101265"},"PeriodicalIF":3.2,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145398190","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}
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