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- ItemAcesso aberto (Open Access)Adaptação cultural e análise da confiabilidade da versão brasileira da Escala de Equilíbrio Pediátrica (EEP)(Associação Brasileira de Pesquisa e Pós-Graduação em Fisioterapia, 2012-06-01) Ries, Lílian Gerdi Kittel; Michaelsen, Stella Maris; Soares, Patrícia S. A. [UNIFESP]; Monteiro, Vanessa Costa [UNIFESP]; Allegretti, Kátia Maria Gonçalves [UNIFESP]; Universidade do Estado de Santa Catarina Postgraduate Program in Physical Therapy; Universidade Federal de São Paulo (UNIFESP)BACKGROUND: The Pediatric Balance Scale (PBS) was developed from a modified version of the Berg Balance Scale aiming to obtain a balance scale more appropriate for the child population. OBJECTIVES: To adapt the PBS into Brazilian-Portuguese and to evaluate the intra and inter-rater reliability of the Brazilian-Portuguese version of PBS. METHODS: To perform the cross-cultural adaptation of the American version of PBS four translators were involved, who have performed two translations and their respective back-translations. Then, a review by a multidisciplinary committee and a subsequent an assessment of the equivalence of meaning between the back-translations and the original English scale were performed by 3 and 30 healthcare professionals respectively. The intra-rater reliability of the final version of the Brazilian-Portuguese PBS was evaluated using a test-retest design with one-week interval. The Brazilian-Portuguese version of the PBS was tested twice on the same day by two different raters to test the inter-rater reliability. The inter-rater reliability, which was measured from a video of the volunteers performance, was evaluated by comparing the score given by five raters independently. Reliability was evaluated by Intraclass Correlation Coefficient (ICC). Fifteen volunteers (11±2.7 years) diagnosed with Cerebral Palsy (CP) classified at level I and II on the Gross Motor Function Classification System (GMFCS) were assessed. RESULTS: The reliability of the PBS total score for both intra-rater (ICC=0.85) and inter-rater (ICC=0.91) was excellent. The inter-rater reliability (measured from the video) for the total score was also classified as excellent (ICC=0.98). CONCLUSION: The results showed adequate reliability for the PBS for pediatric population with CP diagnostic classified at level I and II on the GMFCS.
- ItemSomente MetadadadosAtenção fisioterapêutica à criança nascida com baixo peso no sistema público de saúde do município de Embu das Artes/SP(Universidade Federal de São Paulo (UNIFESP), 2015-02-01) Lacerda, Juliana Nogueira Rocha [UNIFESP]; Puccini, Rosana Fiorini Puccini [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)The low birth weight is associated with a number of risk factors that make children vulnerable to sequels and delays in its development process. This condition requires a joint action of health services in order to identify changes and timely intervention in order to promote child development and reduce possible early and late effects. The definition of the duties of primary care and rehabilitation services at the local, regional or municipal health level remains open, as well as the articulation of Physiotherapeutic care on outpatient treatment and understanding of professionals associated with the initial care of these children, as it refers to timely and correctly directed forward, preventing the aggravation of change and the necessity of further and more costly interventions. Purpose: Describe the Physiotherapeutic care in schoolchildren born with low birth weight between 2001 and 2005 in the public healthcare system Municipality of Embu das Artes (SP). Method: Its a cross-sectional,descriptive study with two components: Component 1: Analysis of information concerning the Physiotherapeutic care of 141 children with low birth weight, with criteria for routing to Projeto Desenvolver. Component 2: Description of information about health professionals and unit managers concerning the operation of the Projeto Desenvolver and attention to risk children in the Municipality of Embú das Artes. Results: From the total of 141 children studied, 56 were enrolled and followed up in the Projeto Desenvolver. Of these, 54 were subjected to at least one Physiotherapeutic assessment, and for 13 of them was nominated specific treatment for Physiotherapeutic therapy service, in addition to general guidelines and stimulation interventions for all children in the project. The most frequent conditions which led to that specific follow-up statement were: genetic syndrome, diplegia, equine foot, double palsy, Down syndrome, chronic non-progressive encephalopathy, hydrocephalus,hemiparesis. Of those 13 children, ten were sent to other external services to the municipality for completion of treatment. Regarding the professionals, 86.1% knew the Projeto Desenvolver, however, they had difficulty in relating the routing criteria. As for managers, 100% knew the Projeto Desenvolver and its operation, but were unaware of the routing criteria. Conclusion: This study revealed that only part of the children are actually enrolled in the project and that for these, the health service of the Municipality of Embu das Artes proved in most of the monitoring conditions for children with risk potential for development. There was also the professionals who work in child care and managers know the organization and the services available to provide comprehensive care for children in the city. The structuring of services within the city aimed at children with chronic disorders of development is essential, because it takes long time monitoring and often coordination with other areas, particularly education.
- ItemAcesso aberto (Open Access)Avaliação antropométrica e musculoesquelética de pacientes com síndrome de Marfan(Associação Brasileira de Pesquisa e Pós-Graduação em Fisioterapia, 2011-08-01) Cipriano, Graziella França Bernardelli [UNIFESP]; Brech, Guilherme Carlos; Peres, Paulo Alberto Tayar [UNIFESP]; Mendes, Cássia Claudino [UNIFESP]; Cipriano Junior, Gerson [UNIFESP]; Carvalho, Antonio Carlos [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Universidade de São Paulo (USP); Universidade de Brasília Faculdade Ceilândia Curso de FisioterapiaBACKGROUND: Marfan syndrome (MS) is an autosomic dominant condition of the connective tissue that involves the ocular, cardiovascular and musculoskeletal systems. MS is caused by mutations in the fibrillin-1 gene, leading to joint ligaments flaccidity, joint hypermobility and an overgrowth of the long bones. OBJECTIVES: The aim of the present study was to assess anthropometry, musculoskeletal alterations and the prevalence of physical therapy treatments among patients with MS. METHODS: Twenty-six patients were included in this study [17 females (age: 13.23±2.77 years; body mass 51.5±24-68 Kg; height 1.70±1.40-1.81 m; arm span: 1.73±0.12 m) and 9 males (age: 14.44±2.18; body mass: 61.0±42-72 Kg; height: 1.83±1.66-1.97 m; arm span: 1.93±0.13 m)]. Anthropometric measurements and musculoskeletal abnormalities were determined in a standardized fashion: pectus and scoliosis were assessed through radiography and angulation (â) of the scoliosis curve using the Cobb method; arachnodactyly was assessed through the thumb sign and Walker-Murdoch test and dolichostenomelia was assessed by arm span in relation to height. Patients also responded to a questionnaire addressing participation in physical therapy. RESULTS: In comparison to values estimated for the Brazilian population, mass and height were greater among the patients with MS (females: p=0.001 e p<0.0005 e males p=0.019 e p=0.0001, respectively). The following musculoskeletal abnormalities were found: pectus in 3 patients (11%), pectus and scoliosis in 19 (73%), dolichostenomelia in 11 (42%) and arachnodactyly in 21 (80%). Eleven patients (42%) with MS had previously undergone physical therapy. CONCLUSIONS: Patients with MS exhibit altered musculoskeleto and anthropometry and have infrequent physical therapy treatment.
- ItemSomente MetadadadosAvaliação de um pacote de medidas para prevenção de pneumonia associada à ventilação mecânica em unidades de terapia intensiva de um hospital universitário(Universidade Federal de São Paulo (UNIFESP), 2014-08-31) Pereira, Elaine Cristina [UNIFESP]; Medeiros, Eduardo Alexandrino Servolo de Medeiros [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Ventilator-associated pneumonia (VAP) is the leading cause of infection in intensive care units (ICU) is associated with high mortality rates, longer hospital stay and higher costs. Among patients using mechanical ventilation around 10-20% develop this infection. There are simple steps that when applied together appear to be favorable in reducing rates of this infection. Objective: To evaluate the impact of a protocol for prevention of VAP incidence of this infection, mortality, duration of mechanical ventilation and length of hospital stay in two ICUs. Method: Patients admitted to the ICU of Pneumology and ICU of Cardiovascular Surgery (UPOCC) of a university hospital underwent a daily protocol for prevention of VAP between January 1 to December 31, 2011 In this protocol we evaluated the suitability of elevation bedside between 30th - 45th, cuff pressure above 20 cmH2O, exchange ventilatory circuit every seven days, no condensate in the ventilatory circuit, peptic ulcer prophylaxis, prophylaxis for deep venous thrombosis and awaken daily sedation. The information collected in 2011 were compared to information collected retrospectively in 2010 when there was no application of the Protocol. For statistical analysis statistical tests such as Pearson chi-square, Student's t test, considering a significance level of 5% and a confidence interval of 95% were used. Was also used Stata 12 program to calculate the density of incidence of pneumonia, with a confidence interval of 95%. Results: In the Pulmonary ICU decreased the duration of mechanical ventilation ranged from an average of 12 days in 2010 to 9.5 days in 2011 (p = 0.024). Although this unit was a reduction in the number of reintubations which in 2010 had a mean value of 15.1 episodes in 2011 and the value was 14.9 (p = 0.001). ICU of Pneumology there was a reduction in the incidence density, which ranged from 15.4%, with a total of 19 cases in 2010 to 9.3%, with a total of 10 cases in 2011 (p = 0.193) . In UPOCC was no reduction in length of hospital stay showed that on average 45 days in 2010 and 40 days in 2011 (p = 0.014). In UPOCC was no increase in incidence density which increased from 13.6% with a total of 16 cases in 2010 to 14.5% with a total of 10 cases in 2011 (p = 0.896). The adequacy in relation to the indicators obtained a value greater than 80% in at least five of the seven indicators, with XIX better performance presented by UPOCC. The ICU of Pneumology had a worse performance than the realization of awakening diary already UPOCC was less adequate in relation to the measurement of cuff pressure. Microorganisms found in two ICUs were similar between the pre-intervention period and intervention in both ICUs. Conclusion: Although we found no statistically significant difference in ICU Pulmonology showed a lower value in the incidence density of VAP in the year in which the protocol was applied. The period of application of the Protocol statistically significant difference in ICU of pulmonology in relation to shorter mechanical ventilation, and reducing episodes of reintubation was observed. The UPOCC showed a reduction in hospital stay. We observe a good fit to the protocol in two ICUs studied. Studies with a longer period of time are needed to confirm the usefulness of prevention protocols in reducing VAP.
- ItemAcesso aberto (Open Access)Cinesioterapia previne ombro doloroso em pacientes hemiplégicos/paréticos na fase sub-aguda do acidente vascular encefálico(Academia Brasileira de Neurologia - ABNEURO, 2003-09-01) Horn, Agnes Irna [UNIFESP]; Fontes, Sissy Veloso [UNIFESP]; Carvalho, Sebastião Marcos Ribeiro de [UNIFESP]; Silvado, Rubens Augusto Brazil; Barbosa, Pedro Marco Karan; Durigan Jr, Alcides; Atallah, Álvaro Nagib [UNIFESP]; Fukujima, Marcia Maiumi [UNIFESP]; Prado, Gilmar Fernandes do [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Universidade de Marília; Faculdade de Medicina de MaríliaBACKGROUND: Painful shoulder is considered the most common complication of hemiplegic/parethic (H/P) stroke patients. It is a negative factor for neuromotor recovery. PURPOSE: To study the effects of kinesiotherapy treatment on shoulder pain prevention, and as a secondary endpoints, to analyze muscle strength of H/P shoulder looking at basic functional active mobility. METHOD: Twenty one inpatients (12 men, 9 women) aged 26 to 87 years, with post-stroke H/P were submitted to thirty minutes daily program kinesiotherapy, started at 48 hours post-stroke up to their hospital discharge. Patients were evaluated pre and post treatment according to the presence or absence of shoulder pain, movements and shoulder strength, and for presence or absence of basic functional movements. RESULTS: No patient complaining of shoulder pain at the hospital discharge (p<0.001). The muscle strength improved signifcantly for elevation, protusion, abduction and flexion of the shoulder (p<0.001). There was improvement also for functional mobility on moving from dorsal to lateral recumb, from lateral recumb to a seated position and in keeping the seated position (p<0.001). CONCLUSION: Kinesiotherapy in acute phase of stroke prevented shoulder pain.
- ItemAcesso aberto (Open Access)Efeito do ultrassom e do dexapantenol na organização das fibras colágenas em lesão tegumentar(Associação Brasileira de Pesquisa e Pós-Graduação em Fisioterapia, 2011-06-01) Guimarães, Gustavo Narvaes; Pires-de-Campos, Maria Silvia Mariani; Leonardi, Gislaine Ricci [UNIFESP]; Dib-Giusti, Helena Hanna Kalil; Polacow, Maria Luiza Ozores; Universidade Metodista de Piracicaba Faculdade de Ciências da Saúde; Universidade Estadual de Campinas (UNICAMP); Universidade Federal de São Paulo (UNIFESP); UNIARARASOBJECTIVE: To analyze the effect of ultrasound (US), dexpanthenol (d-P) and a combination of these treatments (US+d-P) on collagen fiber organization in tegumentary lesions in rats by birefringence analysis. METHODS: Wistar rats (50) were anesthetized (Thionembutal - Sodic = 50mg/Kg), 1cm² of dorsal region skin was removed, and the animals were divided into five groups: control (C), gel (G), US (3 MHz, 0.1 W/cm2, 1 minute, continuous), d-P (10%) and US+d-P. After daily treatment for 7 and 14 days, 6µm thick sections of lesioned areas were stained in picrosirius and measurements of the collagen birefringent area (µm²) were obtained using polarized light microscopy (Zeiss Axiolab-ZEISS- Germany) with histological image analysis software (KS 400 2.0 - Kontrol Eletronics, Munique, Germany). The means were compared by ANOVA followed by the Tukey test (p<0.05). RESULTS: The US+d-P group showed a significantly greater (p<0.001) birefringent area (1586.43±162.14) than the other experimental groups: C (139.36±35.35), US (317.55±129.9) and d-P (192.41±3657) by the 7th day of treatment, indicating acceleration of the wound healing process. By the 14th day of treatment, the US+d-P, US and d-P groups presented greater birefringence than the control group, but did not differ from each other. CONCLUSION: The combination of treatments (US+d-P) accelerated collagen fiber synthesis and organization in the early stages of cutaneous repair.
- ItemSomente MetadadadosEfeitos dos banhos de imersão em águas sulfurosas em pacientes com osteoartrite de joelho: ensaio clínico controlado e randomizado(Universidade Federal de São Paulo (UNIFESP), 2013-12-20) Branco, Marcelo [UNIFESP]; Trevisani, Virginia Fernandes Moca Trevisani [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)The aim of this study was to evaluate the effectiveness of immersion baths in sulphurous water in the treatment of knee osteoarthritis. A controlled experiment with blind assessment has been conducted. 140 knee osteoarthritis patients of both genders, average age 64.8 ± 8.9 years have been selected. These were randomized into three groups: Group sulphurous thermal water (n=47 patients), undergoing immersion baths in thermal water sulphurous; Group non-sulphurous thermal water (n=50 patients), undergoing immersion baths in non-sulphurous thermal water; Group C the control group (n=43 patients), that hasn’t been submited to any treatment. Patients of Group sulphurous thermal water and Group non-sulphurous thermal water have been submited to 30 individual treatment sessions, three times a week, lasting twenty minutes each session, for ten weeks. The evaluation took place at three points of time: before the therapy, refer in the data base to Baseline results; immediately after the complete therapy, refer in the data base to Endpoint results; two months after the Endpoint evaluation, refer in the data base to Follow-up results. The considered measures (parameters) analysed via different questionnaires were as follows: pain (visual analog scale); physical function (WOMAC, Lequesne and HAQ); quality of life (SF - 36) and use of pain medication. The comparisons have been made within and between groups and p values < 0.05 were considered statistically significant. Results: pain and physical function: the results showed a significant reduction in the levels of pain of the treated groups in comparison to the control group. The sulphurous water group indicated even a greater reduction in pain intensity in comparison to non-sulphurous water group. This significant improvement regarding the analysis of the 3 mentioned groups can be observed in the data base results of the questionnaires WOMAC A, WOMAC B, WOMAC C, HAQ and Lequesne. Parameter quality of life: in both treated groups a significant improvement in all 8 subitems of the SF-36 questionnaires have been observed. When comparing the 3 groups, the treated groups were significantly better than the control group C in all 8 SF-36 subitems. Paramenter use of pain medication: it has been observed that the treated groups made less use of pain medication in comparison to the control group, with statistically significant difference. Conclusion: It could be concluded that both methods “baths with sulphurous water” and “baths with non-sulphurous water” have been effective and have presented better results in comparison to the control group (non-treated group) regarding pain reduction, improved physical function, quality of life and reduction on the use of pain medication. Nevertheless it’s important to highlight the oberservation in this study that the sulphurous thermal water results were superior than the no-sulphurous water ones in the treatment of knee osteoarthritis.
- ItemAcesso aberto (Open Access)Fisioterapia respiratória em crianças com doença falciforme e síndrome torácica aguda(Sociedade de Pediatria de São Paulo, 2011-12-01) Hostyn, Sandro Valter [UNIFESP]; Johnston, Cíntia [UNIFESP]; Braga, Josefina Aparecida Pellegrini [UNIFESP]; Carvalho, Werther Brunow de [UNIFESP]; Nogueira, Solange Cristiane; Universidade Federal de São Paulo (UNIFESP); Universidade de São Paulo (USP)OBJECTIVE: To systematically review the medical literature to identify chest physiotherapy techniques applied to children with sickle cell disease and acute chest syndrome, and to report their level of evidence and recommendation. DATA SOURCE: A bibliographic search of published articles found in Medline, Lilacs, SciELO and Cochrane databases, between 1995 and 2009, was carried out using the following keywords: sickle cell disease, acute chest syndrome, physical therapy, child, incentive spirometry, in English and Portuguese; all review studies were excluded. The recovered studies were then classified according to their level of evidence and recommendation. DATA SYNTHESIS: Five papers were retrieved. Among them, three used incentive spirometry that played an important role in the prevention of pulmonary complications associated with acute chest syndrome (evidence levels II, III and IV); one of these studies (evidence II) compared incentive spirometry versus positive expiratory pressure and did not find differences between them. One paper reported a clinical bundle to improve the quality of care, including incentive spirometry (evidence level V). Incentive spirometry was associated with shorter length of stay and less requirement of oral pain medications. Another study evaluated the effect of non-invasive ventilation on respiratory distress in children that could not perform incentive spirometry and reported improvement in the oxygenation and in the respiratory distress (evidence level V). CONCLUSIONS: Physiotherapy techniques with incentive spirometry device, positive expiratory pressure and non-invasive ventilation can be performed in children with sickle cell disease and acute chest syndrome, with a C recommendation level.
- ItemSomente MetadadadosA influência da fisioterapia nas funções cognitivas e pulmonares no pós-operatório da cirurgia de revascularização miocárdica(Universidade Federal de São Paulo (UNIFESP), 2014-04-30) Cavalcante, Elder dos Santos [UNIFESP]; Luna Filho, Braulio Luna Filho [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
- ItemAcesso aberto (Open Access)Predictive factors for spasticity among ischemic stroke patients(Academia Brasileira de Neurologia - ABNEURO, 2009-12-01) Moura, Rita de Cássia dos Reis [UNIFESP]; Fukujima, Marcia Maiumi [UNIFESP]; Aguiar, Alexandre Santos; Fontes, Sissy Veloso [UNIFESP]; Dauar, Rafi Felício Bauab [UNIFESP]; Prado, Gilmar Fernandes do [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Statistical ConsultantSpasticity is a determining for functional loss following ischemic stroke. OBJECTIVE: To detect possible predictive factors for its occurrence. METHOD: Demographic, clinical and tomographic data on 146 stroke patients were analyzed. RESULTS: Spasticity was noted more frequently among patients who underwent physiotherapy (p<0.0001; OR=19.4; 95% CI: 4.4-84.5), those who underwent such treatment for long periods (p=0.028; OR=4.80; 95% CI: 1.1-8.3) and those with manual work (p=0.041; OR=2.2; 95% CI: 1.02-4.6), lower income (p=0.038), pain complaints (p<0.0001; OR=107.0; 95% CI: 13.5-847.3), appearance of pain at the same time as spasticity (p<0.0001), previous vascular disease (p=0.001; OR=4.2; 95% CI: 1.7-10.3), muscle weakness (p<0.0001; OR=91.9; 95% CI: 12.0-699.4), extensive lesions as seen on tomography (p=0.01) and lesions affecting more than one cerebral lobe (p=0.018). Manual work had a relative risk of 2.9; previous stroke 3.9, and extensive lesion 3.6. CONCLUSION: Spasticity affected 25% of the patients, and was associated with: manual work, previous stroke, extensive lesions, decrease in individual income, underwent physiotherapy, underwent physiotherapy for longer period, pain complaints, the pain started simultaneously with the spasticity, presented changes in strength.
- ItemAcesso aberto (Open Access)Prevalence and factors associated with thoracic alterations in infants born prematurely(Associação Médica Brasileira, 2012-12-01) Davidson, Josy [UNIFESP]; Garcia, Kessey Maria Bini [UNIFESP]; Yi, Liu Chiao [UNIFESP]; Goulart, Ana Lucia [UNIFESP]; Dos Santos, Amelia Miyashiro [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)OBJECTIVE: To determine the prevalence of thoracic musculoskeletal alterations and associated factors in infants born prematurely. METHODS: This was a cross sectional study with infants in the first year of age, born prematurely with birth weight < 2,000 g, who were followed up at the Premature Clinic from February, 2007 to December, 2008. Exclusion criteria were: maj or congenital malformations as defined by the Centers for Disease Control and Prevention (CDC), grade III/IV intraventricular hemorrhage, or periventricular leucomalacia. Physical examinations performed independently by two physiotherapists were used to assess shoulder elevation and thoracic retractions. Comparisons between groups were performed using the chi-squared test or Fisher's exact test for categorical variables, and Mann-Whitney's test or Student's t-test were used for continuous variables. Interobserver reliability between the two physiotherapists was assessed by the kappa coefficient. Variables associated with these thoracic musculoskeletal alterations were studied by univariate and multiple logistic analyses. Statistical differences were considered significant when p < 0.05. This study was approved by the ethical committee of the institution, and parents/guardians signed an informed consent. RESULTS: 121 infants with a gestational age of 31.1 ± 2.8 weeks and birth weight of 1,400 ± 338 g were included. Thoracic alterations were detected by Physiotherapist 1 in 81 (66.9%) infants, and in 83 (68.6%) by Physiotherapist 2 (kappa coefficient = 0.77). By multivariate logistic regression analysis, factors associated with thoracic musculoskeletal alterations were: respiratory distress syndrome (odds ratio [OR] = 3.246, 95% confidence interval [CI]: 1.237-8.732), bronchopulmonary dysplasia (OR = 11.138, 95% CI: 1.339-92.621), and low length/age ratio (OR = 4.571, 95% CI: 1.371-15.242). CONCLUSION: The prevalence of thoracic alterations was high in infants born prematurely, and was associated with pulmonary disease and low length/age ratio.
- ItemAcesso aberto (Open Access)Spinal muscular atrophy type II (intermediary) and III (Kugelberg-Welander): evolution of 50 patients with physiotherapy and hydrotherapy in a swimming pool(Academia Brasileira de Neurologia - ABNEURO, 1996-09-01) Cunha, Márcia C. B. [UNIFESP]; Oliveira, Acary Souza Bulle [UNIFESP]; Labronici, Rita Helena D. D. [UNIFESP]; Gabbai, Alberto Alain [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)We added hydrotherapy to 50 patients with spinal muscular atrophy (SMA) who were being treated with individual conventional physiotherapy. Hydrotherapy was performed at an approximate temperature of 30 degrees Celsius, twice a week, for thirty minutes in children and for forty-five minutes in adults during a 2-year period. The outcome derived from this combined modality of treatment was rated according to physiotherapeutic evaluations, the MMT (Manual Muscular Test), and the Barthel Ladder. Patients were reevaluated at 2-month intervals. After two years of ongoing treatment, we were able to observe that the deformities in hip, knee and foot were progressive in all SMA Type II patients, and in some Type III. Muscle strength stabilized in most SMA Type III patients, and improved in some. MMT was not done in SMA Type II. In all patients we were able to detect an improvement in the Barthel Ladder scale. This study suggests that a measurable improvement in the quality of daily living may be obtained in patients with SMA Types II and III subjected to conventional physiotherapy when associated with hydrotherapy.
- ItemAcesso aberto (Open Access)Tabagismo não limita o incremento da força muscular respiratória em pacientes submetidos ao treinamento muscular inspiratório pré-esofagectomia(Universidade de São Paulo, 2012-03-01) Ramos, Marisa De Carvalho; Agrelli, Taciana Freitas; Carneiro, Élida Mara [UNIFESP]; Crema, Eduardo; UFTM; Universidade Federal de São Paulo (UNIFESP)A program of muscular respiratory training to smoker patients in pre-operatory ambulatory can improve the muscle strength and the functional respiratory capacity, avoiding complications which increase the hospitalization period of the patient. The aim of this work was to evaluate the effectiveness of the inspiratory muscle training in smoker and non-smoker patients who would be submitted to a megaesophagus surgery. Seventeen patients were studied, divided into two groups: smoker (GT), composed of 10 patients (58.82%), and the non-smoker (GNT), with 7 patients (41.18%). Data analysis comparing the two groups was expressed as follows: the values of age and anthropometric measurements were compared by Student's t-test and the values of Maximal Inspiratory Pressure (MIP) and Maximal Expiratory Pressure (MEP) were compared by the paired Student's t-test. Data were expressed as mean±standard deviation when checked to normal. Differences were considered statistically significant if p<0.05. Level of significance adopted was p=0.05. Considering the comparative analysis, it was observed a significant increase of Maximal Inspiratory Pressure MIP after the 4 weeks of inspiratory muscle training (IMT), as follows: MIP in GT from -57.20±18.76 to -79.00±15.38 and in GNT from -52.00±18.76 to -72.66±19.33. The prophylactic therapy in the preoperative outpatient provides a significant increase in inspiratory muscle strength in both groups, as evidenced by the increase in MIP with consequent improvement in ventilatory capacity.
- ItemAcesso aberto (Open Access)A visão do ortopedista brasileiro sobre a descarga parcial de peso em ortostase nas fraturas expostas da diáfise da tíbia após osteossíntese(Associação Brasileira de Pesquisa e Pós-Graduação em Fisioterapia, 2009-12-01) Sella, Valéria Regina Gonzalez [UNIFESP]; Machado, Paula Carolina Dias [UNIFESP]; Fernandes, Hélio Jorge Alvachian [UNIFESP]; Limonge, William Ricardo [UNIFESP]; Reis, Fernando Baldy dos [UNIFESP]; Faloppa, Flávio [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)BACKGROUND: Tibial shaft fractures are the most frequent among long bone fractures. They are described in the literature according to the device and method of treatment, with recommendations that range from full weight bearing to non-weight bearing restrictions. There are studies comparing osteosynthesis devices and surgical aspects, but no references were found on how or when to allow weight bearing on the affected limb in the standing position. OBJECTIVES: The present study learned from Brazilian orthopedists which methods of osteosynthesis they use to treat open tibial fractures, whether they refer patients to physical therapy, when and why they allow partial weight bearing for both physical activity and therapy. METHODS: Two hundred and thirty-five orthopedists answered a questionnaire during the 14th Brazilian Conference of Orthopedic Trauma. Results: The results showed that, in Brazil, the most widely used osteosynthesis device is the external fixator, but earlier weight bearing while standing occurs when intramedullary nails are used. Most orthopedists refer patients to physical therapy and allow partial weight bearing in the standing position according to the material used for synthesis. CONCLUSIONS: It was concluded that there is a preference for external fixation, that most orthopedists refer patients to physical therapy and that the synthesis material influences restrictions on partial weight bearing.