Pub Date : 2025-11-01Epub Date: 2025-10-30DOI: 10.1016/j.bjpt.2025.101281
Annicia Lins Freitas , Maria Anita Oliveira Souza Paiva , Edvan José Alves Da Silva , Fabina Gondim Gomes de Vasconcelos , José Heriston de Morais Lima , Eduardo Ériko Tenório de França , Danielle Aparecida Gomes Pereira , Rafaela Pedrosa
<div><h3>Background</h3><div>Peripheral arterial disease (PAD), commonly caused by atherosclerosis, reduces blood flow to the extremities, resulting in muscle ischemia and intermittent claudication. Aerobic training is an effective strategy for treating individuals with PAD, and high-definition transcranial direct current stimulation (HD-tDCS) has been studied as an adjunct therapy due to its positive effects on exercise endurance, perceived effort, and functional capacity (FC).</div></div><div><h3>Objectives</h3><div>To identify the effects of combining aerobic exercise and transcranial neurostimulation on quality of life (QoL), FC, peripheral muscle metabolism, and subjective perception of effort in individuals with PAD.</div></div><div><h3>Methods</h3><div>This case study was conducted with four volunteers diagnosed with PAD. FC was assessed using the Incremental Shuttle Walking Test (ISWT), muscle metabolism through Near-Infrared Spectroscopy (NIRS), QoL using the Short Form 36 (SF-36), and subjective perception of effort through the Modified Borg Scale. Assessments were conducted before and after 12 weeks of intervention. Participants were divided into two groups: the intervention group (IG) and the control group (CG), with two volunteers in each. The IG received active stimulation on the left dorsolateral prefrontal cortex (DLPFC-L) during exercise on a cycle ergometer, while the CG received placebo stimulation, both for 30 minutes.</div></div><div><h3>Results</h3><div>Regarding QoL, only the two IG participants were reassessed, as the CG participants declined to participate in the reassessment. An improvement in QoL was observed in Volunteer 1 (V1) in the following domains: general health perception (55/100), vitality (95/100), social function (100/100), and mental health (92/100); and in Volunteer 2 (V2) in the domains of physical functioning (60/100), emotional role limitation (67/100), bodily pain (68/100), general health perception (70/100), and mental health (80/100). In terms of subjective perception of effort, both volunteers reported an effort level of "too light" (Borg = 1) at the beginning, end, and recovery phases of the exercise test. FC showed a clinically significant minimal difference in three cases (?V2 = 500m; ?V3 = 110m; ?V4 = 70m). No significant differences were observed between the CG and IG regarding improvements in muscle metabolism after the intervention, except for resistance time (?V1 = 31.6s; ?V2 = 225.2s; ?V3 = 26.4s; ?V4 = 101.6s) in both the occlusion maneuver and the ISWT and lower-limb cycle ergometer tests.</div></div><div><h3>Conclusion</h3><div>The combination of HD-tDCS and aerobic exercise may contribute to increased QoL and FC in individuals with PAD. Additionally, an improvement in subjective perception of effort and walking distance in the ISWT was observed in the IG. However, no significant changes were noted in tissue oxygenation behavior.</div></div><div><h3>Implications</h3><div>These findings hi
{"title":"TRANSCRANIAL NEUROSTIMULATION AND AEROBIC EXERCISE IN FUNCTIONAL CAPACITY, MUSCLE METABOLISM, AND QUALITY OF LIFE OF INDIVIDUALS WITH PERIPHERAL ARTERIAL DISEASE","authors":"Annicia Lins Freitas , Maria Anita Oliveira Souza Paiva , Edvan José Alves Da Silva , Fabina Gondim Gomes de Vasconcelos , José Heriston de Morais Lima , Eduardo Ériko Tenório de França , Danielle Aparecida Gomes Pereira , Rafaela Pedrosa","doi":"10.1016/j.bjpt.2025.101281","DOIUrl":"10.1016/j.bjpt.2025.101281","url":null,"abstract":"<div><h3>Background</h3><div>Peripheral arterial disease (PAD), commonly caused by atherosclerosis, reduces blood flow to the extremities, resulting in muscle ischemia and intermittent claudication. Aerobic training is an effective strategy for treating individuals with PAD, and high-definition transcranial direct current stimulation (HD-tDCS) has been studied as an adjunct therapy due to its positive effects on exercise endurance, perceived effort, and functional capacity (FC).</div></div><div><h3>Objectives</h3><div>To identify the effects of combining aerobic exercise and transcranial neurostimulation on quality of life (QoL), FC, peripheral muscle metabolism, and subjective perception of effort in individuals with PAD.</div></div><div><h3>Methods</h3><div>This case study was conducted with four volunteers diagnosed with PAD. FC was assessed using the Incremental Shuttle Walking Test (ISWT), muscle metabolism through Near-Infrared Spectroscopy (NIRS), QoL using the Short Form 36 (SF-36), and subjective perception of effort through the Modified Borg Scale. Assessments were conducted before and after 12 weeks of intervention. Participants were divided into two groups: the intervention group (IG) and the control group (CG), with two volunteers in each. The IG received active stimulation on the left dorsolateral prefrontal cortex (DLPFC-L) during exercise on a cycle ergometer, while the CG received placebo stimulation, both for 30 minutes.</div></div><div><h3>Results</h3><div>Regarding QoL, only the two IG participants were reassessed, as the CG participants declined to participate in the reassessment. An improvement in QoL was observed in Volunteer 1 (V1) in the following domains: general health perception (55/100), vitality (95/100), social function (100/100), and mental health (92/100); and in Volunteer 2 (V2) in the domains of physical functioning (60/100), emotional role limitation (67/100), bodily pain (68/100), general health perception (70/100), and mental health (80/100). In terms of subjective perception of effort, both volunteers reported an effort level of \"too light\" (Borg = 1) at the beginning, end, and recovery phases of the exercise test. FC showed a clinically significant minimal difference in three cases (?V2 = 500m; ?V3 = 110m; ?V4 = 70m). No significant differences were observed between the CG and IG regarding improvements in muscle metabolism after the intervention, except for resistance time (?V1 = 31.6s; ?V2 = 225.2s; ?V3 = 26.4s; ?V4 = 101.6s) in both the occlusion maneuver and the ISWT and lower-limb cycle ergometer tests.</div></div><div><h3>Conclusion</h3><div>The combination of HD-tDCS and aerobic exercise may contribute to increased QoL and FC in individuals with PAD. Additionally, an improvement in subjective perception of effort and walking distance in the ISWT was observed in the IG. However, no significant changes were noted in tissue oxygenation behavior.</div></div><div><h3>Implications</h3><div>These findings hi","PeriodicalId":49621,"journal":{"name":"Brazilian Journal of Physical Therapy","volume":"29 ","pages":"Article 101281"},"PeriodicalIF":3.2,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145398132","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.2025.101301
Izabella Lorena Batista Porto , Gabriela Matoso Melgaço , Lorrane Ferreira Soares , Camila Barroso Grossi , Maria Eduarda Campos Da Silva , Renato Fleury Cardoso , Valéria Amorim Pires Di Lorenzo , Vanessa Pereira Lima
<div><h3>Background</h3><div>Interstitial Lung Disease (ILD) encompasses a heterogeneous group of over 200 diffuse parenchymal lung disorders, primarily characterized by pulmonary interstitial involvement, frequently affected by inflammation and fibrosis. Signs and symptoms vary depending on the underlying ILD condition but generally include dyspnea, fatigue, persistent cough, bibasilar crackles, digital clubbing, and psychological symptoms. These manifestations contribute to a decline in quality of life, reduced functional capacity, and low tolerance to physical exercise.</div></div><div><h3>Objectives</h3><div>This study aimed to investigate the association between functional disability, health status, quality of life, physical performance, muscle strength, and physical activity level in people with ILD.</div></div><div><h3>Methods</h3><div>This is a preliminary cross-sectional, multicenter study, part of a larger project, conducted with people diagnosed with ILD. In addition to clinical history and spirometry for pulmonary function assessment, specific instruments were applied, including the 12-item short version of the World Health Organization Disability Assessment Schedule (WHODAS 2.0), which assesses the impact on daily activities and social participation; the King’s Brief Interstitial Lung Disease Questionnaire (K-BILD), which evaluates the quality of life and health status; the Participation Scale, measuring self-perceived social participation and daily activities; the Human Activity Profile (HAP), classifying physical activity level; the Handgrip Strength Test (HST), assessing peripheral muscle strength using a Jamar dynamometer; and the 6-Minute Walk Test (6MWT), which measures functional exercise capacity and cardiorespiratory endurance.</div></div><div><h3>Results</h3><div>The sample comprised 13 participants, with a mean age of 55.82 years (± 13.84 years), ranging from 33 to 81 years. The majority were male (7 participants, 53.8%), and five people (38.5%) were classified as overweight. Regarding educational background, 7 participants (53.8%) had completed high school, and in terms of self-reported ethnicity, 7 (53.8%) identified as mixed-race. Additionally, 4 participants (30.8%) had a prior diagnosis of post-COVID-19 pulmonary fibrosis. The mean WHODAS 2.0 score was 32.39 (±19.14), ranging from 15 to 67 points. Correlation analysis revealed an association only between the WHODAS 2.0 short version and K-BILD (ICC = -0.56; p = 0.05).</div></div><div><h3>Conclusion</h3><div>Preliminary results indicate that a more significant functional disability in people with ILD is associated with poorer health status, as assessed by the K-BILD. The lack of significant associations with other variables may be attributed to the small sample size of this preliminary study. However, the findings suggest relevant trends that warrant further exploration in future analyses.</div></div><div><h3>Implications</h3><div>These findings suggest that physiother
{"title":"ASSOCIATION BETWEEN FUNCTIONAL DISABILITY, PHYSICAL PERFORMANCE, AND SOCIAL PARTICIPATION IN PEOPLE WITH INTERSTITIAL LUNG DISEASE: PRELIMINARY RESULTS","authors":"Izabella Lorena Batista Porto , Gabriela Matoso Melgaço , Lorrane Ferreira Soares , Camila Barroso Grossi , Maria Eduarda Campos Da Silva , Renato Fleury Cardoso , Valéria Amorim Pires Di Lorenzo , Vanessa Pereira Lima","doi":"10.1016/j.bjpt.2025.101301","DOIUrl":"10.1016/j.bjpt.2025.101301","url":null,"abstract":"<div><h3>Background</h3><div>Interstitial Lung Disease (ILD) encompasses a heterogeneous group of over 200 diffuse parenchymal lung disorders, primarily characterized by pulmonary interstitial involvement, frequently affected by inflammation and fibrosis. Signs and symptoms vary depending on the underlying ILD condition but generally include dyspnea, fatigue, persistent cough, bibasilar crackles, digital clubbing, and psychological symptoms. These manifestations contribute to a decline in quality of life, reduced functional capacity, and low tolerance to physical exercise.</div></div><div><h3>Objectives</h3><div>This study aimed to investigate the association between functional disability, health status, quality of life, physical performance, muscle strength, and physical activity level in people with ILD.</div></div><div><h3>Methods</h3><div>This is a preliminary cross-sectional, multicenter study, part of a larger project, conducted with people diagnosed with ILD. In addition to clinical history and spirometry for pulmonary function assessment, specific instruments were applied, including the 12-item short version of the World Health Organization Disability Assessment Schedule (WHODAS 2.0), which assesses the impact on daily activities and social participation; the King’s Brief Interstitial Lung Disease Questionnaire (K-BILD), which evaluates the quality of life and health status; the Participation Scale, measuring self-perceived social participation and daily activities; the Human Activity Profile (HAP), classifying physical activity level; the Handgrip Strength Test (HST), assessing peripheral muscle strength using a Jamar dynamometer; and the 6-Minute Walk Test (6MWT), which measures functional exercise capacity and cardiorespiratory endurance.</div></div><div><h3>Results</h3><div>The sample comprised 13 participants, with a mean age of 55.82 years (± 13.84 years), ranging from 33 to 81 years. The majority were male (7 participants, 53.8%), and five people (38.5%) were classified as overweight. Regarding educational background, 7 participants (53.8%) had completed high school, and in terms of self-reported ethnicity, 7 (53.8%) identified as mixed-race. Additionally, 4 participants (30.8%) had a prior diagnosis of post-COVID-19 pulmonary fibrosis. The mean WHODAS 2.0 score was 32.39 (±19.14), ranging from 15 to 67 points. Correlation analysis revealed an association only between the WHODAS 2.0 short version and K-BILD (ICC = -0.56; p = 0.05).</div></div><div><h3>Conclusion</h3><div>Preliminary results indicate that a more significant functional disability in people with ILD is associated with poorer health status, as assessed by the K-BILD. The lack of significant associations with other variables may be attributed to the small sample size of this preliminary study. However, the findings suggest relevant trends that warrant further exploration in future analyses.</div></div><div><h3>Implications</h3><div>These findings suggest that physiother","PeriodicalId":49621,"journal":{"name":"Brazilian Journal of Physical Therapy","volume":"29 ","pages":"Article 101301"},"PeriodicalIF":3.2,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145398149","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}
<div><h3>Background</h3><div>The two-minute step test (2MST) is a submaximal test to assess functional capacity, but few studies analyze its reliability and learning effect.</div></div><div><h3>Objectives</h3><div>To verify the reliability and learning effect of the two-minute step test in healthy individuals.</div></div><div><h3>Methods</h3><div>Observational and methodological study, approved by local ethics committee, carried out from March to October 2024 using a non-probabilistic convenience sample. Individuals aged 18 to 80 years of both sexes were invited. The exclusion criteria were: untreated and/or unstable chronic diseases, previous diagnosis of lung and/or heart diseases, diseases and/or dysfunctions that interfered with walking, and Charlson Comorbidity Index > 4. Individuals who reached 85% of maximum heart rate (HR) and did not attend all assessments were also excluded. The test consists of marching in place for two minutes. The steps consisted of the number of times the right knee reached the predetermined height (midpoint between the iliac crest and the upper edge of the patella). Step counting was performed by two evaluators (randomized order). The test was performed twice on the same day (with 30-minute intervals) and repeated after a 7-day interval between the first and second assessment, resulting in a total of four tests. Vital signs (heart rate, blood pressure, and peripheral oxygen saturation) were monitored. Quantitative variables were described as mean (standard error), or 95% confidence interval (95% CI), and qualitative variables were expressed as absolute (relative) frequency. Intra-rater and inter-rater reliability was determined by the intraclass correlation method (ICC), considering the classification: < 0.50 (low reliability), 0.50 to 0.75 (moderate reliability), 0.76 to 0.90 (good reliability) and > 0.90 (excellent reliability). The learning effect was verified using the paired t-test (comparing the difference between the first and the last test). The significance level considered was 5% (p < 0.05).</div></div><div><h3>Results</h3><div>Thirty-one individuals aged 26 (24-34) years were included, of whom 16 (51.6%) were male. The ICC showed good inter-rater reliability on the first day [ICC = 0.838 (95% CI: 0.668-0.922); p = 0.000] and excellent inter-rater reliability on the second day [ICC = 0.911; (95%CI: 0.811-0.958); p = 0.000]. The intra-rater analyses for Evaluator 1 [ICC = 0.801 (95% CI: 0.587-0.904); p = 0.000] and Evaluator 2 [ICC = 0.758 (95% CI:0.506-0.883); p = 0.000] demonstrated good reliability. The number of steps of the last 2MST [107.6(2.3)] was significantly greater (p = 0.009) than the number of steps of the first TME2 [101.3(2,7)]. The mean difference between the two tests was 6.3 steps.</div></div><div><h3>Conclusion</h3><div>The two-minute step test presented good and excellent reliability and a significant learning effect.</div></div><div><h3>Implications</h3><div>The 2MST has p
{"title":"RELIABILITY AND LEARNING EFFECT OF THE TWO-MINUTE STEP TEST","authors":"Camila Mascarelo Panisson , Nicoli Silveira Vieira , Luize Monte Blancb , Esther Cecília Wilches-Luna , Danielle Vieira , Heloyse Uliam Kuriki , Lívia Arcêncio do Amaral","doi":"10.1016/j.bjpt.2025.101274","DOIUrl":"10.1016/j.bjpt.2025.101274","url":null,"abstract":"<div><h3>Background</h3><div>The two-minute step test (2MST) is a submaximal test to assess functional capacity, but few studies analyze its reliability and learning effect.</div></div><div><h3>Objectives</h3><div>To verify the reliability and learning effect of the two-minute step test in healthy individuals.</div></div><div><h3>Methods</h3><div>Observational and methodological study, approved by local ethics committee, carried out from March to October 2024 using a non-probabilistic convenience sample. Individuals aged 18 to 80 years of both sexes were invited. The exclusion criteria were: untreated and/or unstable chronic diseases, previous diagnosis of lung and/or heart diseases, diseases and/or dysfunctions that interfered with walking, and Charlson Comorbidity Index > 4. Individuals who reached 85% of maximum heart rate (HR) and did not attend all assessments were also excluded. The test consists of marching in place for two minutes. The steps consisted of the number of times the right knee reached the predetermined height (midpoint between the iliac crest and the upper edge of the patella). Step counting was performed by two evaluators (randomized order). The test was performed twice on the same day (with 30-minute intervals) and repeated after a 7-day interval between the first and second assessment, resulting in a total of four tests. Vital signs (heart rate, blood pressure, and peripheral oxygen saturation) were monitored. Quantitative variables were described as mean (standard error), or 95% confidence interval (95% CI), and qualitative variables were expressed as absolute (relative) frequency. Intra-rater and inter-rater reliability was determined by the intraclass correlation method (ICC), considering the classification: < 0.50 (low reliability), 0.50 to 0.75 (moderate reliability), 0.76 to 0.90 (good reliability) and > 0.90 (excellent reliability). The learning effect was verified using the paired t-test (comparing the difference between the first and the last test). The significance level considered was 5% (p < 0.05).</div></div><div><h3>Results</h3><div>Thirty-one individuals aged 26 (24-34) years were included, of whom 16 (51.6%) were male. The ICC showed good inter-rater reliability on the first day [ICC = 0.838 (95% CI: 0.668-0.922); p = 0.000] and excellent inter-rater reliability on the second day [ICC = 0.911; (95%CI: 0.811-0.958); p = 0.000]. The intra-rater analyses for Evaluator 1 [ICC = 0.801 (95% CI: 0.587-0.904); p = 0.000] and Evaluator 2 [ICC = 0.758 (95% CI:0.506-0.883); p = 0.000] demonstrated good reliability. The number of steps of the last 2MST [107.6(2.3)] was significantly greater (p = 0.009) than the number of steps of the first TME2 [101.3(2,7)]. The mean difference between the two tests was 6.3 steps.</div></div><div><h3>Conclusion</h3><div>The two-minute step test presented good and excellent reliability and a significant learning effect.</div></div><div><h3>Implications</h3><div>The 2MST has p","PeriodicalId":49621,"journal":{"name":"Brazilian Journal of Physical Therapy","volume":"29 ","pages":"Article 101274"},"PeriodicalIF":3.2,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145398153","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.2025.101275
Dalyla Silva Lemos de Souza, Marina Silva Reis, Iane Renata Carvalhais Mesquita, Antonielly Rocha de Souza Pereira, Keity Lamary Souza Silva, Henrique Silveira Costa
<div><h3>Background</h3><div>Chronic venous insufficiency (CVI) is a progressive condition affecting the venous system, involving superficial, deep, or both venous networks. The pathophysiology is primarily attributed to valvular incompetence and dysfunction of the calf muscle pump, which includes deficits in lower limb muscle strength. Given the pivotal role of the calf muscles in venous return, their functional assessment should be integrated into the routine clinical evaluation of patients with CVI. The Heel-Raise Test (HRT) has been proposed as a method to evaluate calf muscle function; however, its correlation with other validated strength and functional performance assessments remains underexplored.</div></div><div><h3>Objectives</h3><div>To determine the applicability of the HRT in assessing calf muscle strength and endurance in CVI patients through its association with other muscle strength and endurance tests, as well as functional performance measures.</div></div><div><h3>Methods</h3><div>A cross-sectional study was conducted involving 40 patients diagnosed with CVI (mean age 67.4 ± 11.3 years, 37% females). Participants underwent the HRT, where they performed maximal plantar flexion repetitions until exhaustion. The total number of repetitions and the time taken to complete the test were recorded. Additionally, participants were subjected to the Five-Times Sit-to-Stand Test (STS-5), Ten-Times Sit-to-Stand Test (STS-10), 30-Second Sit-to-Stand Test (STS-30), and 1-Minute Sit-to-Stand Test (STS-60), which evaluated lower limb strength (STS-5 and STS-10) and muscular endurance (STS-30 and STS-60). Complementary assessments included handgrip dynamometry and the Human Activity Profile (HAP) questionnaire. Pearson and Spearman correlation analyses were performed to examine associations between the HRT and other measures.</div></div><div><h3>Results</h3><div>The number of HRT repetitions demonstrated significant correlations with STS-5 (r = -0.751; p < 0.001), STS-10 (r = -0.741; p < 0.001), STS-30 (r = 0.724; p < 0.001), STS-60 (r = 0.765; p < 0.001), handgrip dynamometry (r = 0.325; p = 0.041), maximum HAP score (r = 0.401; p = 0.014), and adjusted HAP score (r = 0.330; p = 0.046). Similarly, the time required to complete the HRT correlated with the STS-5 (r = -0.386; p = 0.005), STS-10 (r = -0.399; p = 0.003), STS-30 (r = 0.347; p = 0.012), STS-60 (r = 0.406; p = 0.003), maximum HAP score (r = 0.427; p = 0.002), and adjusted HAP score (r = 0.360; p = 0.011), but not with handgrip dynamometry (r = 0.236; p = 0.092).</div></div><div><h3>Conclusion</h3><div>The number of repetitions and time spent in the HRT are indicators of calf muscle strength, endurance, and functional capacity in individuals with CVI. Its inclusion in functional assessments can enhance the clinical evaluation of these patients.</div></div><div><h3>Implications</h3><div>The HRT emerges as a viable, practical tool for complementing clinical and functional asses
{"title":"HEEL-RAISE TEST FOR CALF MUSCLE ASSESSMENT IN CVI: CORRELATION WITH STRENGTH AND FUNCTIONAL PERFORMANCE TESTS","authors":"Dalyla Silva Lemos de Souza, Marina Silva Reis, Iane Renata Carvalhais Mesquita, Antonielly Rocha de Souza Pereira, Keity Lamary Souza Silva, Henrique Silveira Costa","doi":"10.1016/j.bjpt.2025.101275","DOIUrl":"10.1016/j.bjpt.2025.101275","url":null,"abstract":"<div><h3>Background</h3><div>Chronic venous insufficiency (CVI) is a progressive condition affecting the venous system, involving superficial, deep, or both venous networks. The pathophysiology is primarily attributed to valvular incompetence and dysfunction of the calf muscle pump, which includes deficits in lower limb muscle strength. Given the pivotal role of the calf muscles in venous return, their functional assessment should be integrated into the routine clinical evaluation of patients with CVI. The Heel-Raise Test (HRT) has been proposed as a method to evaluate calf muscle function; however, its correlation with other validated strength and functional performance assessments remains underexplored.</div></div><div><h3>Objectives</h3><div>To determine the applicability of the HRT in assessing calf muscle strength and endurance in CVI patients through its association with other muscle strength and endurance tests, as well as functional performance measures.</div></div><div><h3>Methods</h3><div>A cross-sectional study was conducted involving 40 patients diagnosed with CVI (mean age 67.4 ± 11.3 years, 37% females). Participants underwent the HRT, where they performed maximal plantar flexion repetitions until exhaustion. The total number of repetitions and the time taken to complete the test were recorded. Additionally, participants were subjected to the Five-Times Sit-to-Stand Test (STS-5), Ten-Times Sit-to-Stand Test (STS-10), 30-Second Sit-to-Stand Test (STS-30), and 1-Minute Sit-to-Stand Test (STS-60), which evaluated lower limb strength (STS-5 and STS-10) and muscular endurance (STS-30 and STS-60). Complementary assessments included handgrip dynamometry and the Human Activity Profile (HAP) questionnaire. Pearson and Spearman correlation analyses were performed to examine associations between the HRT and other measures.</div></div><div><h3>Results</h3><div>The number of HRT repetitions demonstrated significant correlations with STS-5 (r = -0.751; p < 0.001), STS-10 (r = -0.741; p < 0.001), STS-30 (r = 0.724; p < 0.001), STS-60 (r = 0.765; p < 0.001), handgrip dynamometry (r = 0.325; p = 0.041), maximum HAP score (r = 0.401; p = 0.014), and adjusted HAP score (r = 0.330; p = 0.046). Similarly, the time required to complete the HRT correlated with the STS-5 (r = -0.386; p = 0.005), STS-10 (r = -0.399; p = 0.003), STS-30 (r = 0.347; p = 0.012), STS-60 (r = 0.406; p = 0.003), maximum HAP score (r = 0.427; p = 0.002), and adjusted HAP score (r = 0.360; p = 0.011), but not with handgrip dynamometry (r = 0.236; p = 0.092).</div></div><div><h3>Conclusion</h3><div>The number of repetitions and time spent in the HRT are indicators of calf muscle strength, endurance, and functional capacity in individuals with CVI. Its inclusion in functional assessments can enhance the clinical evaluation of these patients.</div></div><div><h3>Implications</h3><div>The HRT emerges as a viable, practical tool for complementing clinical and functional asses","PeriodicalId":49621,"journal":{"name":"Brazilian Journal of Physical Therapy","volume":"29 ","pages":"Article 101275"},"PeriodicalIF":3.2,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145398154","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.2025.101349
Carolina da Silva Santos, Julia Beatriz Rodrigues, Richelle Silva de Oliveira, Vitor Profeta, Maicon Rodrigues, Luciano Prado, Larissa Santos Pinto Pinheiro, Juliana de Melo Ocarino
<div><h3>Background</h3><div>Pain catastrophizing, an exaggerated tendency to anticipate and amplify painful sensations, is a critical factor in the evaluation and treatment of athletes. The Pain Catastrophizing Scale (PCS) is a self-assessment questionnaire, consisting of 13 statements that assess thoughts and feelings related to pain. In the context of swimming, a high-performance sport, understanding the differences in pain catastrophizing between age and sex categories can provide information about each individual's perception of pain. This study aims to explore how these factors influence the level of sleep catastrophizing in athletes.</div></div><div><h3>Objectives</h3><div>To characterize the level of catastrophizing in swimming athletes and analyze the association of category and sex with the level of pain catastrophizing in swimming athletes.</div></div><div><h3>Methods</h3><div>This is an observational cross-sectional study. Forty-four swimmers of both sexes classified in the children's, youth and junior categories participated in the study. The athletes responded to the Pain Catastrophizing Scale, which ranges from 0 to 52 points, with values ??above 30 points representing a significant level of pain catastrophizing. The Total Pain Catastrophizing score was calculated. Analysis of Variance and independent t-test were used for analysis.</div></div><div><h3>Results</h3><div>Of the 44 athletes evaluated, 33 completed the Pain Catastrophizing Scale, 13 of whom were in the Children's category, 10 in the Youth category and 10 in the Junior category. Of these, 21 were men and 12 were women. Only 6 athletes had a score higher than the cutoff point. There was no significant difference between the categories (p = 0.946) and, when comparing genders, there was no significant difference in pain catastrophizing (p = 0.145).</div></div><div><h3>Conclusion</h3><div>The study revealed that most of the athletes evaluated presented low levels of pain catastrophizing, with only 6 athletes demonstrating scores above 30 points, indicating a significant level of catastrophizing. Furthermore, there was no significant difference between categories and genders. Future studies with larger sample sizes and with athletes at different levels of competition need to be carried out to better investigate the factors that influence catastrophizing.</div></div><div><h3>Implications</h3><div>Pain catastrophizing is an exaggerated negative orientation towards harmful stimuli and should be considered important for the performance and well-being of athletes, especially those with a history of previous injuries. The presence of catastrophic thoughts can impair adaptation to physical discomfort and negatively influence sports performance. Therefore, it is essential that sports training and rehabilitation programs include psychological approaches that help to reduce pain catastrophizing, covering different factors that may be associated with the amplification of pain sensation.
{"title":"INFLUENCE OF CATEGORY AND BIOLOGICAL SEX ON THE LEVEL OF PAIN CATASTROPHIZING IN SWIMMING ATHLETES","authors":"Carolina da Silva Santos, Julia Beatriz Rodrigues, Richelle Silva de Oliveira, Vitor Profeta, Maicon Rodrigues, Luciano Prado, Larissa Santos Pinto Pinheiro, Juliana de Melo Ocarino","doi":"10.1016/j.bjpt.2025.101349","DOIUrl":"10.1016/j.bjpt.2025.101349","url":null,"abstract":"<div><h3>Background</h3><div>Pain catastrophizing, an exaggerated tendency to anticipate and amplify painful sensations, is a critical factor in the evaluation and treatment of athletes. The Pain Catastrophizing Scale (PCS) is a self-assessment questionnaire, consisting of 13 statements that assess thoughts and feelings related to pain. In the context of swimming, a high-performance sport, understanding the differences in pain catastrophizing between age and sex categories can provide information about each individual's perception of pain. This study aims to explore how these factors influence the level of sleep catastrophizing in athletes.</div></div><div><h3>Objectives</h3><div>To characterize the level of catastrophizing in swimming athletes and analyze the association of category and sex with the level of pain catastrophizing in swimming athletes.</div></div><div><h3>Methods</h3><div>This is an observational cross-sectional study. Forty-four swimmers of both sexes classified in the children's, youth and junior categories participated in the study. The athletes responded to the Pain Catastrophizing Scale, which ranges from 0 to 52 points, with values ??above 30 points representing a significant level of pain catastrophizing. The Total Pain Catastrophizing score was calculated. Analysis of Variance and independent t-test were used for analysis.</div></div><div><h3>Results</h3><div>Of the 44 athletes evaluated, 33 completed the Pain Catastrophizing Scale, 13 of whom were in the Children's category, 10 in the Youth category and 10 in the Junior category. Of these, 21 were men and 12 were women. Only 6 athletes had a score higher than the cutoff point. There was no significant difference between the categories (p = 0.946) and, when comparing genders, there was no significant difference in pain catastrophizing (p = 0.145).</div></div><div><h3>Conclusion</h3><div>The study revealed that most of the athletes evaluated presented low levels of pain catastrophizing, with only 6 athletes demonstrating scores above 30 points, indicating a significant level of catastrophizing. Furthermore, there was no significant difference between categories and genders. Future studies with larger sample sizes and with athletes at different levels of competition need to be carried out to better investigate the factors that influence catastrophizing.</div></div><div><h3>Implications</h3><div>Pain catastrophizing is an exaggerated negative orientation towards harmful stimuli and should be considered important for the performance and well-being of athletes, especially those with a history of previous injuries. The presence of catastrophic thoughts can impair adaptation to physical discomfort and negatively influence sports performance. Therefore, it is essential that sports training and rehabilitation programs include psychological approaches that help to reduce pain catastrophizing, covering different factors that may be associated with the amplification of pain sensation.","PeriodicalId":49621,"journal":{"name":"Brazilian Journal of Physical Therapy","volume":"29 ","pages":"Article 101349"},"PeriodicalIF":3.2,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145398417","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.2025.101302
Ednaldo D'Angelis , Monica Silva Damasceno , Elizabeth Rocha E. Rocha , Paula Chartone Cabral , Thelma Junqueira Maciel , Tatiana Costa , Christiane Perme , Fernanda C. Lanza
Background
Early mobilization in pediatric intensive care units (PICUs) is essential to minimize complications and promote functional recovery. However, there is a lack of validated tools specifically designed to assess mobility in children with critical illness. The Perme ICU Mobility Score (Perme Score), originally developed for adults, assesses mobility considering barriers such as medical devices and ventilatory support. The validation of the Perme Score for pediatric use is crucial to guide rehabilitation strategies in this population.
Objectives
To validate the Perme Score for evaluating mobility in patients admitted to PICU and pediatric wards, by analyzing its inter-rater reliability and its correlation with the Functional Status Scale (FSS), a widely used instrument in the pediatric population.
Methods
A cross-sectional observational study was conducted in two hospitals including pediatric patients aged 6 to 17 years. The Perme Score and FSS were applied independently by trained physical therapists. Inter-rater reliability was assessed using the intraclass correlation coefficient (ICC), while the correlation between the two tools was analyzed using Pearson's test. P-value < 0.05 was defined statistically significant.
Results
A total of 166 participants were included, with a median age of 11 years. The initial assessment showed a mean Perme Score of 26.13±7.89 and a mean FSS of 7.25±2.21. A moderate to strong negative correlation was observed between the Perme Score and FSS (r = -0.642; p < 0.01), indicating that better mobility is associated with less functional impairment. Interrater reliability was excellent (ICC = 0.99).
Conclusion
The Perme Score proved to be a valid and reliable tool for assessing mobility in hospitalized pediatric patients. Its structured approach allows for the identification of mobility barriers and effective monitoring of functional progress throughout hospitalization.
Implications
Validating the Perme Score for the pediatric population supports its integration into clinical practice in both ICU and ward settings. The Perme Score can support early mobilization protocols and contribute to personalized rehabilitation strategies by objectively assessing mobility status of patients. Consequently, it has the potential to improve functional outcomes for critically ill children and promote evidence-based decision-making in physical therapy.
{"title":"INTER-RATER RELIABILITY AND VALIDITY OF THE PERME ICU MOBILITY SCORE IN PEDIATRIC INTENSIVE CARE AND WARD SETTINGS","authors":"Ednaldo D'Angelis , Monica Silva Damasceno , Elizabeth Rocha E. Rocha , Paula Chartone Cabral , Thelma Junqueira Maciel , Tatiana Costa , Christiane Perme , Fernanda C. Lanza","doi":"10.1016/j.bjpt.2025.101302","DOIUrl":"10.1016/j.bjpt.2025.101302","url":null,"abstract":"<div><h3>Background</h3><div>Early mobilization in pediatric intensive care units (PICUs) is essential to minimize complications and promote functional recovery. However, there is a lack of validated tools specifically designed to assess mobility in children with critical illness. The Perme ICU Mobility Score (Perme Score), originally developed for adults, assesses mobility considering barriers such as medical devices and ventilatory support. The validation of the Perme Score for pediatric use is crucial to guide rehabilitation strategies in this population.</div></div><div><h3>Objectives</h3><div>To validate the Perme Score for evaluating mobility in patients admitted to PICU and pediatric wards, by analyzing its inter-rater reliability and its correlation with the Functional Status Scale (FSS), a widely used instrument in the pediatric population.</div></div><div><h3>Methods</h3><div>A cross-sectional observational study was conducted in two hospitals including pediatric patients aged 6 to 17 years. The Perme Score and FSS were applied independently by trained physical therapists. Inter-rater reliability was assessed using the intraclass correlation coefficient (ICC), while the correlation between the two tools was analyzed using Pearson's test. P-value < 0.05 was defined statistically significant.</div></div><div><h3>Results</h3><div>A total of 166 participants were included, with a median age of 11 years. The initial assessment showed a mean Perme Score of 26.13±7.89 and a mean FSS of 7.25±2.21. A moderate to strong negative correlation was observed between the Perme Score and FSS (r = -0.642; p < 0.01), indicating that better mobility is associated with less functional impairment. Interrater reliability was excellent (ICC = 0.99).</div></div><div><h3>Conclusion</h3><div>The Perme Score proved to be a valid and reliable tool for assessing mobility in hospitalized pediatric patients. Its structured approach allows for the identification of mobility barriers and effective monitoring of functional progress throughout hospitalization.</div></div><div><h3>Implications</h3><div>Validating the Perme Score for the pediatric population supports its integration into clinical practice in both ICU and ward settings. The Perme Score can support early mobilization protocols and contribute to personalized rehabilitation strategies by objectively assessing mobility status of patients. Consequently, it has the potential to improve functional outcomes for critically ill children and promote evidence-based decision-making in physical therapy.</div></div>","PeriodicalId":49621,"journal":{"name":"Brazilian Journal of Physical Therapy","volume":"29 ","pages":"Article 101302"},"PeriodicalIF":3.2,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145398479","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.2025.101337
Matheus Lemos Dos Santos, Gabriel Alves Dos Santos, Raquel Lins de Sousa Lima, 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>The pelvic drop can indicate a sign of muscle weakness during the lumbopelvic stability test. The integrity of this region ensures the proper transfer of energy to the distal segments for the body's kinematics and biomechanics, such as muscle strength, which is an important component of the kinetic chain. In swimming athletes, it is not yet clear which factors may be related to the injuries and pain they experience, making it necessary to understand if there is any correlation between the lumbopelvic stability test and trunk muscle endurance due to the scarcity of studies.</div></div><div><h3>Objectives</h3><div>To assess the correlation between the lumbopelvic stability test and endurance tests of the trunk in swimmers.</div></div><div><h3>Methods</h3><div>This was a cross-sectional observational study approved by the research ethics committee. The inclusion criteria were swimmers athletes of both sex, age between 18 and 60 years old, with competitive practice in the past one year, and regular training for at least twice a week. Lumbopelvic stability was assessed using the one-legged bridge test with spherical markers on the anterior superior iliac spines, where the pelvic tilt (in degrees) was observed and recorded. Two-dimensional analyses were conducted using the Kinovea 0.9.5 software (Kinovea Open Source Project) for Windows®. Additionally, muscle endurance of the trunk flexors (front plank), extensors (Biering-Sorenson test), and lateral flexors (side plank) was assessed by having the individual maintain a pre-established ideal posture for each muscle group for as long as possible. Pearson coefficient correlation was used to assess the association between the lumbopelvic stability test and endurance tests, which was classified as weak (0–0.39), moderate (0.40–0.69), and strong (0.70–1.00). Data analysis was performed using SPSS Inc, Chicago, IL version 23.0.</div></div><div><h3>Results</h3><div>A total of 27 athletes participated in the study, with mean age of 32.78 ± 14.64, 6.96 ± 6.05 years of sports practice, and 15 (56 %) were men. The results of the lumbopelvic stability test showed a weak negative correlation for the endurance of the flexor muscles (front plank) (r = - 0.233), right lateral flexors (side plank) (r = - 0.217), left lateral flexors (side plank) (r = - 0.003), and a weak positive correlation for the trunk extensor muscles (Biering-Sorenson test) (r = 0.109).</div></div><div><h3>Conclusion</h3><div>The lumbopelvic stability test has a weak negative correlation for the endurance of the flexor muscles, lateral flexors, and a weak positive correlation for the trunk extensor muscles in swimming athletes.</div></div><div><h3>Implications</h3><div>The study suggests that endurance does not influence pelvic tilt during the lumbopelvic stability test in swimming athletes, and therefore, it is important to investigate and evaluate other factors that may actually influence instability in this region.</
背景：在腰盆腔稳定性试验中，盆腔下垂可能表明肌肉无力。该区域的完整性确保了身体运动学和生物力学的能量适当转移到远端节段，如肌肉力量，这是动力链的重要组成部分。在游泳运动员中，目前尚不清楚哪些因素可能与他们所经历的损伤和疼痛有关，因此由于研究较少，有必要了解腰骨盆稳定性试验与躯干肌肉耐力之间是否存在相关性。目的探讨游泳运动员腰骨盆稳定性试验与躯干耐力试验的相关性。方法本研究为经研究伦理委员会批准的横断面观察性研究。入选标准为男女游泳运动员，年龄在18岁至60岁之间，过去一年有竞技训练，每周至少定期训练两次。采用单腿桥试验评估腰骨盆稳定性，在髂前上棘上放置球形标记物，观察并记录骨盆倾斜（以度为单位）。使用Windows®的Kinovea 0.9.5软件（Kinovea Open Source Project）进行二维分析。此外，躯干屈肌（前平板）、伸肌（Biering-Sorenson试验）和侧屈肌（侧平板）的肌肉耐力通过让个体尽可能长时间地保持每个肌肉群的预先建立的理想姿势来评估。采用Pearson相关系数评价腰骨盆稳定性试验与耐力试验之间的相关性，其相关性分为弱（0-0.39）、中（0.40-0.69）和强（0.70-1.00）。数据分析使用SPSS Inc， Chicago, IL version 23.0进行。结果共有27名运动员参与研究，平均年龄32.78±14.64岁，运动经验6.96±6.05年，其中男性15名，占56%。腰骨盆稳定性测试结果显示，屈肌（前平板）耐力（r = - 0.233）、右侧屈肌（侧平板）耐力（r = - 0.217）、左侧屈肌（侧平板）耐力（r = - 0.003）与躯干伸肌耐力（r = 0.109）呈弱负相关。结论腰骨盆稳定性试验与游泳运动员屈肌、侧屈肌耐力呈弱负相关，与躯干伸肌耐力呈弱正相关。本研究提示游泳运动员在腰骨盆稳定性试验中耐力并不影响骨盆倾斜，因此，研究和评估其他可能影响该区域不稳定性的因素是很重要的。
{"title":"CORRELATION BETWEEN LUMBOPELVIC STABILITY TEST AND ENDURANCE TESTS OF THE TRUNK IN SWIMMERS","authors":"Matheus Lemos Dos Santos, Gabriel Alves Dos Santos, Raquel Lins de Sousa Lima, 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.2025.101337","DOIUrl":"10.1016/j.bjpt.2025.101337","url":null,"abstract":"<div><h3>Background</h3><div>The pelvic drop can indicate a sign of muscle weakness during the lumbopelvic stability test. The integrity of this region ensures the proper transfer of energy to the distal segments for the body's kinematics and biomechanics, such as muscle strength, which is an important component of the kinetic chain. In swimming athletes, it is not yet clear which factors may be related to the injuries and pain they experience, making it necessary to understand if there is any correlation between the lumbopelvic stability test and trunk muscle endurance due to the scarcity of studies.</div></div><div><h3>Objectives</h3><div>To assess the correlation between the lumbopelvic stability test and endurance tests of the trunk in swimmers.</div></div><div><h3>Methods</h3><div>This was a cross-sectional observational study approved by the research ethics committee. The inclusion criteria were swimmers athletes of both sex, age between 18 and 60 years old, with competitive practice in the past one year, and regular training for at least twice a week. Lumbopelvic stability was assessed using the one-legged bridge test with spherical markers on the anterior superior iliac spines, where the pelvic tilt (in degrees) was observed and recorded. Two-dimensional analyses were conducted using the Kinovea 0.9.5 software (Kinovea Open Source Project) for Windows®. Additionally, muscle endurance of the trunk flexors (front plank), extensors (Biering-Sorenson test), and lateral flexors (side plank) was assessed by having the individual maintain a pre-established ideal posture for each muscle group for as long as possible. Pearson coefficient correlation was used to assess the association between the lumbopelvic stability test and endurance tests, which was classified as weak (0–0.39), moderate (0.40–0.69), and strong (0.70–1.00). Data analysis was performed using SPSS Inc, Chicago, IL version 23.0.</div></div><div><h3>Results</h3><div>A total of 27 athletes participated in the study, with mean age of 32.78 ± 14.64, 6.96 ± 6.05 years of sports practice, and 15 (56 %) were men. The results of the lumbopelvic stability test showed a weak negative correlation for the endurance of the flexor muscles (front plank) (r = - 0.233), right lateral flexors (side plank) (r = - 0.217), left lateral flexors (side plank) (r = - 0.003), and a weak positive correlation for the trunk extensor muscles (Biering-Sorenson test) (r = 0.109).</div></div><div><h3>Conclusion</h3><div>The lumbopelvic stability test has a weak negative correlation for the endurance of the flexor muscles, lateral flexors, and a weak positive correlation for the trunk extensor muscles in swimming athletes.</div></div><div><h3>Implications</h3><div>The study suggests that endurance does not influence pelvic tilt during the lumbopelvic stability test in swimming athletes, and therefore, it is important to investigate and evaluate other factors that may actually influence instability in this region.</","PeriodicalId":49621,"journal":{"name":"Brazilian Journal of Physical Therapy","volume":"29 ","pages":"Article 101337"},"PeriodicalIF":3.2,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145398468","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.2025.101298
Julio Henrique Policarpo, Lucas Leonardo Vilela Medeiros, Rafael Barros Dos Santos, Julia Galindo Soares, Ana Laís Vieira da Cunha, Josefa Amile Rodrigues da Silva, Armele Dornelas de Andrade, Patricia Erika M Marinho
<div><h3>Background</h3><div>The critical scenario disease with immobility, physical deconditioning and hemodialysis (HD) has led to the implementation of physiotherapy aimed at early functional recovery and, as a result, a reduction in the length of hospital stays. However, barriers such as lack of knowledge and professional experience limit the implementation of physical therapy intra-dialytic assistance in the Intensive Care Unit (ICU) environment.</div></div><div><h3>Objective</h3><div>s: To summarize and present the evidence of adverse events of early physiotherapy applied to critically ill patients during hemodialysis in the ICU stay.</div></div><div><h3>Methods</h3><div>This was a scoping review carried out from May to July 2024, developed in accordance with the PRISMA-ScR guidelines. The Concept, Population, and Context strategy was used to develop research questions and carry out the literature search. Descriptors standardized by DECS and MESH in English and Portuguese were used, arranged in different strategies to maximize the search for results. The search was performed in the MEDLINE via PUBMED, EMBASE, LILACS-BVS, PEDro, Scielo, WoS, Portal de Periódicos CAPES, and CInaHL databases. The gray literature was consulted using Google Scholar. The studies were analyzed in terms of population, outcomes, and results. The main outcome was reported safety and the presence of adverse events during physiotherapy applied to critically ill patients during HD. Inclusion criteria were all experimental and observational studies and literature reviews available in full were included.</div></div><div><h3>Results</h3><div>The evidence was published in 2016 to 2024. The population of these studies include adults in ICU stay that is performed intermittent or continuous HD. Physiotherapy applied in ICU stay was considered safe. The adverse events were minimal and may have hemodynamic transitory changes. By the way, there is no record of any specific adverse events directly related to physiotherapy. The results were also framed into seven themes on the particularities of early physiotherapy. The context of physiotherapy in the ICU, hemodialysis and vascular access to the necessary care, physiotherapy applied in the intra-dialytic period, the importance of multi-professional action, the recording of adverse events, and the patient's perception.</div></div><div><h3>Conclusion</h3><div>Early physiotherapy performed on critically ill patients during the hemodialysis period was considered safe and there are no specific adverse events directly related.</div></div><div><h3>Implications</h3><div>Although physiotherapy during hemodialysis in ICU is not associated with significant adverse events, the assistance must be performed by criteria assessment to promote safety and better practices. It is also necessary to break down cultural factors and personal beliefs of the team member, like inappropriate manipulation as well as prevent the loss of vascular access and imp
具有行动不便、身体去适应和血液透析（HD）的危重情景疾病导致了旨在早期功能恢复的物理治疗的实施，从而减少了住院时间。然而，缺乏知识和专业经验等障碍限制了在重症监护病房（ICU）环境中实施物理治疗透析内辅助。目的：总结重症血液透析患者ICU住院期间早期物理治疗不良事件的证据。方法：根据PRISMA-ScR指南，于2024年5月至7月进行了范围审查。使用概念、人口和语境策略来制定研究问题并进行文献检索。使用DECS和MESH标准化的英语和葡萄牙语描述符，以不同的策略排列以最大限度地搜索结果。通过PUBMED、EMBASE、LILACS-BVS、PEDro、Scielo、WoS、Portal de Periódicos CAPES和CInaHL数据库在MEDLINE中进行检索。使用谷歌Scholar查阅灰色文献。这些研究在人群、结果和结果方面进行了分析。主要结果是报告的安全性和在HD期间对危重患者进行物理治疗期间不良事件的存在。纳入标准为所有实验和观察性研究，并纳入完整的文献综述。结果证据发表时间为2016 - 2024年。这些研究的人群包括在ICU接受间歇性或连续HD治疗的成年人。在ICU住院期间应用物理治疗被认为是安全的。不良事件很小，可能有血流动力学的短暂改变。顺便说一下，没有任何与物理治疗直接相关的特定不良事件的记录。研究结果也被归纳为早期物理治疗特殊性的七个主题。ICU物理治疗的背景，血液透析和血管获得必要的护理，物理治疗在透析期间的应用，多专业行动的重要性，不良事件的记录，以及患者的感知。结论危重患者在血液透析期间进行早期物理治疗是安全的，没有直接相关的特异性不良事件。虽然ICU血液透析期间的物理治疗与重大不良事件无关，但必须通过标准评估来提供帮助，以促进安全性和更好的实践。还需要打破团队成员的文化因素和个人信仰，如不适当的操作，防止血管通路的丧失，并通过多专业经验提高透析期间的治疗性运动知识。
{"title":"ABSENCE OF ADVERSE EVENTS WITH EARLY PHYSIOTHERAPY APPLICATION TO CRITICALLY ILL PATIENTS DURING HEMODIALYSIS IN INTENSIVE CARE UNIT: SCOPING REVIEW","authors":"Julio Henrique Policarpo, Lucas Leonardo Vilela Medeiros, Rafael Barros Dos Santos, Julia Galindo Soares, Ana Laís Vieira da Cunha, Josefa Amile Rodrigues da Silva, Armele Dornelas de Andrade, Patricia Erika M Marinho","doi":"10.1016/j.bjpt.2025.101298","DOIUrl":"10.1016/j.bjpt.2025.101298","url":null,"abstract":"<div><h3>Background</h3><div>The critical scenario disease with immobility, physical deconditioning and hemodialysis (HD) has led to the implementation of physiotherapy aimed at early functional recovery and, as a result, a reduction in the length of hospital stays. However, barriers such as lack of knowledge and professional experience limit the implementation of physical therapy intra-dialytic assistance in the Intensive Care Unit (ICU) environment.</div></div><div><h3>Objective</h3><div>s: To summarize and present the evidence of adverse events of early physiotherapy applied to critically ill patients during hemodialysis in the ICU stay.</div></div><div><h3>Methods</h3><div>This was a scoping review carried out from May to July 2024, developed in accordance with the PRISMA-ScR guidelines. The Concept, Population, and Context strategy was used to develop research questions and carry out the literature search. Descriptors standardized by DECS and MESH in English and Portuguese were used, arranged in different strategies to maximize the search for results. The search was performed in the MEDLINE via PUBMED, EMBASE, LILACS-BVS, PEDro, Scielo, WoS, Portal de Periódicos CAPES, and CInaHL databases. The gray literature was consulted using Google Scholar. The studies were analyzed in terms of population, outcomes, and results. The main outcome was reported safety and the presence of adverse events during physiotherapy applied to critically ill patients during HD. Inclusion criteria were all experimental and observational studies and literature reviews available in full were included.</div></div><div><h3>Results</h3><div>The evidence was published in 2016 to 2024. The population of these studies include adults in ICU stay that is performed intermittent or continuous HD. Physiotherapy applied in ICU stay was considered safe. The adverse events were minimal and may have hemodynamic transitory changes. By the way, there is no record of any specific adverse events directly related to physiotherapy. The results were also framed into seven themes on the particularities of early physiotherapy. The context of physiotherapy in the ICU, hemodialysis and vascular access to the necessary care, physiotherapy applied in the intra-dialytic period, the importance of multi-professional action, the recording of adverse events, and the patient's perception.</div></div><div><h3>Conclusion</h3><div>Early physiotherapy performed on critically ill patients during the hemodialysis period was considered safe and there are no specific adverse events directly related.</div></div><div><h3>Implications</h3><div>Although physiotherapy during hemodialysis in ICU is not associated with significant adverse events, the assistance must be performed by criteria assessment to promote safety and better practices. It is also necessary to break down cultural factors and personal beliefs of the team member, like inappropriate manipulation as well as prevent the loss of vascular access and imp","PeriodicalId":49621,"journal":{"name":"Brazilian Journal of Physical Therapy","volume":"29 ","pages":"Article 101298"},"PeriodicalIF":3.2,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145398524","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.2025.101296
Sandyelle Teixeira Vieira , Bianca Maria Santos Alcântara , Carlos André Sousa Ferreira , Pollyana Soares De Abreu , Ana Tereza Fernandes , Rafaela Pedrosa , José Heriston de Morais Lima , Eduardo Ériko Tenório de França
<div><h3>Background</h3><div>Chronic obstructive pulmonary disease (COPD) is characterized by progressive airflow obstruction of an irreversible nature, causing persistent respiratory and peripheral symptoms. Diaphragmatic dysfunction can be observed in all stages of COPD development, presenting through structural and functional alterations. This dysfunction may be associated with hyperinflation, systemic inflammation, oxidative stress, and malnutrition. These interactions affect respiratory muscle function and diaphragmatic biomechanics, with diaphragmatic ultrasonography being a valuable method to analyze the anatomy and function of this muscle.</div></div><div><h3>Objectives</h3><div>To correlate respiratory muscle function with expiratory thickness, thickening fraction, and diaphragmatic mobility in individuals diagnosed with COPD.</div></div><div><h3>Methods</h3><div>This was a descriptive, quantitative cross-sectional study conducted in accordance with the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) recommendations and approved by the research ethics committee. To assess respiratory muscle function, an electronic computerized device (KH2; PowerBreath International Ltd. UK) was used. The evaluation of expiratory thickness, thickening fraction, and diaphragmatic mobility was performed using diaphragmatic ultrasonography with a 2.5-5.0 MHz convex transducer and a 7.5-10.0 MHz linear transducer. Statistical analysis was conducted using IBM SPSS Statistics version 25. Descriptive statistics were initially applied to characterize the data, including measures of central tendency (mean) and dispersion (standard deviation). To assess data normality, the Shapiro-Wilk test was used. The correlation between variables was analyzed using Pearson's correlation coefficient, considering a significance level of 5% (p < 0.05). Differences between measurements were evaluated using the paired t-test, with the effect size estimated by Cohen's d. All analyses were performed with a 95% confidence interval.</div></div><div><h3>Results</h3><div>The study sample consisted of 11 participants, 6 male and 5 female. When analyzing the respiratory muscle strength of the patients studied, a reduction in maximal inspiratory pressure was observed compared to predicted values for individuals of the same age group without COPD (p < 0.002), indicating that the sample of patients studied demonstrates respiratory muscle weakness. Regarding the correlation analyses of maximal inspiratory pressure with expiratory thickness, thickening rate, and diaphragmatic mobility, only a negative correlation (r = -0.729, p = 0.011) was observed between inspiratory muscle strength, measured by maximal inspiratory pressure, and the expiratory thickness of the diaphragm muscle. This indicates that for this population of COPD patients, the lower the inspiratory muscle strength, the greater the expiratory thickness of the diaphragm.</div></div><div><h3>Conclus
慢性阻塞性肺疾病（COPD）以进行性气流阻塞为特征，具有不可逆性，可引起持续的呼吸和外周症状。在COPD发展的所有阶段均可观察到膈肌功能障碍，表现为结构和功能改变。这种功能障碍可能与恶性通货膨胀、全身炎症、氧化应激和营养不良有关。这些相互作用影响呼吸肌功能和膈肌生物力学，膈超声是分析该肌肉解剖和功能的有价值的方法。目的探讨慢性阻塞性肺病患者的呼吸肌功能与呼气厚度、增厚分数和膈活动性之间的关系。方法：本研究是一项描述性、定量的横断面研究，按照加强流行病学观察性研究报告（STROBE）的建议进行，并经研究伦理委员会批准。为了评估呼吸肌功能，一种电子计算机设备（KH2; PowerBreath International Ltd.）。英国)被使用。使用2.5-5.0 MHz凸换能器和7.5-10.0 MHz线性换能器进行膈超声检查，评估呼气厚度、增厚分数和膈活动性。采用IBM SPSS Statistics version 25进行统计分析。描述性统计最初用于描述数据的特征，包括集中趋势（平均值）和离散度（标准差）的测量。为了评估数据的正态性，采用Shapiro-Wilk检验。变量之间的相关性采用Pearson相关系数进行分析，考虑显著性水平为5% （p < 0.05）。使用配对t检验评估测量值之间的差异，效应量由Cohen’s d估计。所有分析均以95%置信区间进行。结果研究样本共11人，其中男6人，女5人。在分析所研究患者的呼吸肌力量时，与无COPD的同年龄组个体的预测值相比，观察到最大吸气压力降低（p < 0.002），表明所研究的患者样本存在呼吸肌无力。在最大吸气压力与呼气厚度、增厚率、膈肌活动性的相关性分析中，最大吸气压力测量的吸气肌力与膈肌呼气厚度仅呈负相关（r = -0.729,p = 0.011）。这表明，对于这类COPD患者，吸气肌力量越低，膈肌的呼气厚度越大。结论我们的研究结果表明，在诊断为吸气肌无力的COPD患者的研究人群中，吸气肌力量与膈肌呼气厚度呈负相关。这些因素可以通过在该人群中发现的吸气肌的机械缺陷来证明。结果可能有助于更好地理解病理及其影响，从而有利于更有效的康复过程，并积极影响COPD患者的生活质量。
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Aging population is an irreversible phenomenon; therefore, it is essential that it is addressed actively, ensuring the possibility of continued education for the elderly.
Objectives
To assess and compare the non-formal content learning of participants from the University of the Third Age (U3A) before and after they participated in various theoretical and practical modules of the extension program offered by different health courses.
Methods
This is longitudinal research of analytical and descriptive approaches. The sample consisted of 23 elderly individuals of both sexes from a University of the Third Age, using convenience sampling. Two tests, comprising 24 questions divided into 7 domains, were used to assess participants' learning before and after the extension project, and a telephone interview was conducted to outline the sociodemographic and educational profile. Data analysis was performed using SPSS version 20.0 software.
Results
The sample consisted of 23 participants, with 20 females (87%), and an average age of 70.22 ± 7.42 years. Regarding education, 10 (43.5%) had completed elementary school, and 15 (65.2%) earned up to one minimum wage. Performance comparisons between the first and second tests showed an increase in the number of correct answers and a decrease in the number of errors; however, these results did not reach statistical significance. There was a statistically significant reduction in unanswered questions. The question about "aid devices" had the highest rate of blank responses. In the philosophical domain, only the item "social life" showed a statistically significant difference. In both evaluations, the questions with the highest accuracy rates were about "aging and tasks" and "medical specialty." The highest error rate was for "types of dementia" and "medicinal plants." In test 2, the topics "first aid" and "physical activity" were the most mentioned in the discussion question.
Conclusion
The aspect of "social life" was the only one that showed a statistically significant difference, demonstrating that the main role of U3A in socialization was fulfilled and overshadowed non-formal learning.
Implications
The results highlight the significant contribution of the University of the Third Age in promoting socialization and the need for more opportunities to be made available for this target group in our country.
{"title":"PARTICIPANTS OF THE OPEN UNIVERSITY OF THE THIRD AGE ACQUIRE INFORMAL KNOWLEDGE?","authors":"Gabriela Matoso Melgaço, Adriana Netto Parentoni, Jousielle Márcia dos Santos, Juliana Nogueira Pontes Nobre","doi":"10.1016/j.bjpt.2025.101310","DOIUrl":"10.1016/j.bjpt.2025.101310","url":null,"abstract":"<div><h3>Background</h3><div>Aging population is an irreversible phenomenon; therefore, it is essential that it is addressed actively, ensuring the possibility of continued education for the elderly.</div></div><div><h3>Objectives</h3><div>To assess and compare the non-formal content learning of participants from the University of the Third Age (U3A) before and after they participated in various theoretical and practical modules of the extension program offered by different health courses.</div></div><div><h3>Methods</h3><div>This is longitudinal research of analytical and descriptive approaches. The sample consisted of 23 elderly individuals of both sexes from a University of the Third Age, using convenience sampling. Two tests, comprising 24 questions divided into 7 domains, were used to assess participants' learning before and after the extension project, and a telephone interview was conducted to outline the sociodemographic and educational profile. Data analysis was performed using SPSS version 20.0 software.</div></div><div><h3>Results</h3><div>The sample consisted of 23 participants, with 20 females (87%), and an average age of 70.22 ± 7.42 years. Regarding education, 10 (43.5%) had completed elementary school, and 15 (65.2%) earned up to one minimum wage. Performance comparisons between the first and second tests showed an increase in the number of correct answers and a decrease in the number of errors; however, these results did not reach statistical significance. There was a statistically significant reduction in unanswered questions. The question about \"aid devices\" had the highest rate of blank responses. In the philosophical domain, only the item \"social life\" showed a statistically significant difference. In both evaluations, the questions with the highest accuracy rates were about \"aging and tasks\" and \"medical specialty.\" The highest error rate was for \"types of dementia\" and \"medicinal plants.\" In test 2, the topics \"first aid\" and \"physical activity\" were the most mentioned in the discussion question.</div></div><div><h3>Conclusion</h3><div>The aspect of \"social life\" was the only one that showed a statistically significant difference, demonstrating that the main role of U3A in socialization was fulfilled and overshadowed non-formal learning.</div></div><div><h3>Implications</h3><div>The results highlight the significant contribution of the University of the Third Age in promoting socialization and the need for more opportunities to be made available for this target group in our country.</div></div>","PeriodicalId":49621,"journal":{"name":"Brazilian Journal of Physical Therapy","volume":"29 ","pages":"Article 101310"},"PeriodicalIF":3.2,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145398183","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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