Artigos - Fisioterapia e Terapia Ocupacional - FFC

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Integration of nutrigenomics, melatonin, serotonin and inflammatory cytokines in the pathophysiology of pregnancy-specific urinary incontinence in women with gestational diabetes mellitus
(2023-08-01) França, Danielle Cristina Honorio [UNESP]; França, Eduardo Luzía; Sobrevia, Luis [UNESP]; Barbosa, Angélica Mércia Pascon [UNESP]; Honorio-França, Adenilda Cristina; Rudge, Marilza Vieira Cunha [UNESP]; Universidade Estadual Paulista (UNESP); Federal University of Mato Grosso (UFMT); Pontificia Universidad Católica de Chile; Universidad de Sevilla; University of Queensland; University of Groningen; School of Medicine and Health Sciences
Gestational diabetes mellitus is an important public health problem and has been associated with the development of pregnancy-specific urinary incontinence. The interaction is related to hyperglycemia, and inflammatory and hormonal patterns, which favor functional alterations in different organs and systems. Several genes associated with human diseases have been identified and partially characterized. Most of these genes are known to cause monogenic diseases. However, about 3 % of diseases do not fit the monogenic theory due to the complex interactions between multiple genes and environmental factors, as in chronic metabolic diseases such as diabetes. The nutritional, immunological, and hormonal patterns associated with changes in maternal metabolism may influence and contribute to greater susceptibility to urinary tract disorders. However, early systematic reviews have not yielded consistent findings for these associations. This literature review summarizes important new findings from integrating nutrigenomics, hormones, and cytokines in women with Gestational diabetes mellitus and pregnancy-specific urinary incontinence. Changes in maternal metabolism due to hyperglycemia can generate an inflammatory environment with increased inflammatory cytokines. This environment modulated by inflammation can alter tryptophan uptake through food and thus influence the production of serotonin and melatonin. As these hormones seem to have protective effects against smooth muscle dysfunction and to restore the impaired contractility of the detrusor muscle, it is assumed that these changes may favor the onset of urinary incontinence specific to pregnancy.
Effect of ischemic compressions versus extracorporeal shockwave therapy on myofascial trigger points: A protocol of a randomized controlled trial
(2023-01-01) Nahomi Kuroda, Melissa [UNESP]; Thomaz de Aquino Nava, Guilherme [UNESP]; Baldini Prudencio, Caroline [UNESP]; Affonso Paulo, Daiane [UNESP]; Peixouto, Isadora [UNESP]; Yoshi Moroshima, Maiki [UNESP]; de Almeida Lourenço, Mariana; Nogueira da Silva, Caroline [UNESP]; Mércia Pascon Barbosa, Angélica [UNESP]; Rodrigues Pedroni, Cristiane [UNESP]; Universidade Estadual Paulista (UNESP); Educational Foundation of the City of Assis (FEMA)
INTRODUCTION: The myofascial trigger points (MTrPs) are hyperirritable nodules present in a tight muscle band. Among the symptoms, pain is one of the most common, but the individuals may have other sensory, motor, and autonomic changes. Athletes can have MTrPs more intensely due to the high physical and emotional demand. There are a variety of treatments, but not all have strong or moderate evidence of their effectiveness. Thus, the aim of this study is to compare the effects of ischemic compression (IC) and extracorporeal shockwave therapy (ESWT) on pressure pain threshold immediately after the intervention and after 48h. METHODS: This randomized clinical trial was registered in the Brazilian Registry of Clinical Trial (RBR-6wryhb9) and was approved by the Research Ethics Committee (CAAE 46682921.9.0000.5406). Forty participants will be randomized to receive IC or ESWT treatment once in each MTrPs. The protocol will consist of evaluations before (T0), immediate after (T1), and after forty-eight hours (T2) of the intervention. The primary outcome will be pressure pain threshold and the secondary outcomes will be jump height, muscle strength, dorsiflexion range of motion (ROM), the correlation between MTrPs and temperature and participant's satisfaction. CONCLUSIONS: The IC and ESWT have been shown to be efficient in decreasing pain, however, the studies that compare the efficiency of these two treatments are limited in the literature, mainly in the muscles of the lower limbs, which are of great importance and are commonly injured. This study will provide evidence of the IC and ESWT in the triceps surae muscles, assisting in a better treatment for the individual with MTrPs.
Effect of ischemic compressions versus extracorporeal shockwave therapy on myofascial trigger points: A protocol of a randomized controlled trial
(2023-03-01) Kuroda, Melissa Nahomi [UNESP]; de Aquino Nava, Guilherme Thomaz [UNESP]; Prudencio, Caroline Baldini [UNESP]; Paulo, Daiane Affonso [UNESP]; Peixouto, Isadora [UNESP]; Moroshima, Maiki Yoshi [UNESP]; de Almeida Lourenço, Mariana; da Silva, Caroline Nogueira [UNESP]; Barbosa, Angélica Mércia Pascon [UNESP]; Pedroni, Cristiane Rodrigues [UNESP]; Universidade Estadual Paulista (UNESP); Educational Foundation of the City of Assis (FEMA)
Introduction The myofascial trigger points (MTrPs) are hyperirritable nodules present in a tight muscle band. Among the symptoms, pain is one of the most common, but the individuals may have other sensory, motor, and autonomic changes. Athletes can have MTrPs more intensely due to the high physical and emotional demand. There are a variety of treatments, but not all have strong or moderate evidence of their effectiveness. Thus, the aim of this study is to compare the effects of ischemic compression (IC) and extracorporeal shockwave therapy (ESWT) on pressure pain threshold immediately after the intervention and after 48h. Methods This randomized clinical trial was registered in the Brazilian Registry of Clinical Trial (RBR-6wryhb9) and was approved by the Research Ethics Committee (CAAE 46682921.9.0000.5406). Forty participants will be randomized to receive IC or ESWT treatment once in each MTrPs. The protocol will consist of evaluations before (T0), immediate after (T1), and after forty-eight hours (T2) of the intervention. The primary outcome will be pressure pain threshold and the secondary outcomes will be jump height, muscle strength, dorsiflexion range of motion (ROM), the correlation between MTrPs and temperature and participant’s satisfaction. Conclusions The IC and ESWT have been shown to be efficient in decreasing pain, however, the studies that compare the efficiency of these two treatments are limited in the literature, mainly in the muscles of the lower limbs, which are of great importance and are commonly injured. This study will provide evidence of the IC and ESWT in the triceps surae muscles, assisting in a better treatment for the individual with MTrPs.
Use of Intrinsic Capacity Domains as a Screening Tool in Public Health
(2023-03-01) Nascimento, Livia Maria do [UNESP]; Cruz, Thainá Gabriele Camargo da [UNESP]; Silva, Juliana Fernanda de Lima e [UNESP]; Silva, Letícia Prado [UNESP]; Inácio, Beatriz Bigatão [UNESP]; Sadamitsu, Carolina Masumi Oki [UNESP]; Scheicher, Marcos Eduardo [UNESP]; Universidade Estadual Paulista (UNESP)
The World Health Organization (WHO) created the concept of Integrated Care for Older People and one of its constructs is intrinsic capacity (IC). The study aimed to carry out a screening with the tools designated by the WHO to assess the IC domains and whether they can be used as indicators for decision-making on integrated care for older people based on risk categorization. The interaction between the risk category and the domain scores was verified. One hundred and sixty three (163) community-dwelling older people of both genders were evaluated. Domains assessed: cognitive, psychological, vitality, locomotion, and sensory. Scores indicating a low, moderate and high risk were assigned to each domain. For all domains, there were individuals in all risk groups. Effect of risk on the domains: cognitive [χ2(2) = 134.042; p < 0.001], psychological [χ2(2) = 92.865; p < 0.001], vitality [χ2(2) = 129.564; p < 0.001], locomotion [χ2(2) = 144.101; p < 0.001], and sensory [χ2(2) = 129.037; p < 0.001]. Scores of the CI domains were affected by the risk category. There were individuals in all risk groups, demonstrating the importance of screening as a public health strategy, making it possible to know which risk category each elderly person belongs to and thus develop strategies in the short-, medium- and long-term.
The effect of whole body vibration on gait stability in individuals with Parkinson's disease: A preliminary study
(2023-01-02) Silveira-Ciola, Aline Prieto [UNESP]; Barbieri, Fabio Augusto [UNESP]; Soares, Carolina Favarin [UNESP]; Marques, Nise Ribeiro; Simieli, Lucas [UNESP]; Faganello-Navega, Flávia Roberta [UNESP]; Universidade Estadual Paulista (UNESP); Sacred Heart University
Background/Aims Whole body vibration could benefit functional mobility in people with Parkinson's disease. A preliminary study was undertaken to analyse the acute effect of whole body vibration on unobstructed walking and obstacle circumvention in people with Parkinson's disease. Methods People with Parkinson's disease and typically healthy individuals as matched controls were divided into four groups with nine individuals in each: experimental or placebo for people with Parkinson's disease and experimental or placebo for the control group. The participants were evaluated in two different gait conditions: unobstructed walking and obstacle circumvention. Then the participants undertook a session of whole body vibration on a KIKOS P201 lateral vibratory platform in two positions: feet shoulder-width apart, and feet shoulder-width apart with slightly flexed knees. The participants were re-evaluated after this session. Results After whole body vibration, those in the experimental Parkinson's disease group had a reduced co-contraction of the tibialis anterior and the gastrocnemius lateralis muscles during unobstructed walking, whereas the co-contraction of the tibialis anterior and the gastrocnemius lateralis muscles increased in the experimental control group. In addition, those in the experimental control group had reduced stride duration in unobstructed walking and in obstacle circumvention. After the placebo intervention, the co-contraction of the tibialis anterior and the gastrocnemius lateralis muscles increased in all conditions and stride duration was reduced in unobstructed walking. Conclusions Although whole body vibration had no acute efficiency on gait (unobstructed walking and obstacle circumvention), it can improve other components, such as strength, which could be important for people with Parkinson's disease.
Clinical Assessment of Chronic Musculoskeletal Pain—A Framework Proposal Based on a Narrative Review of the Literature
(2023-01-01) Nogueira Carrer, Helen Cristina; Zanca, Gisele Garcia [UNESP]; Haik, Melina Nevoeiro; Universidade Federal de São Carlos (UFSCar); Universidade Estadual Paulista (UNESP)
The assessment of chronic musculoskeletal pain (CMP) is a challenge shared by several health professionals. Fragmented or incomplete assessment can cause deleterious consequences for the patient’s function. The objective of this paper was to propose a framework for clinical assessment of CMP based on the current literature and following the conceptual model of the International Classification of Functioning and Health (ICF). We propose that the ICF rationale may help to guide the processes, acting as a moderator of the clinical assessment, since it changes the perspective used to obtain and interpret findings during anamnesis and physical examination. Additionally, updated specific knowledge about pain, including that of pain domains and mechanisms, along with effective patient–clinician communication may act as a mediator of CMP assessment. We conduct the readers through the steps of the clinical assessment of CMP using both the proposed moderator and mediators and present a clinical example of application. We suggest that the proposed framework may help clinicians to implement a CMP assessment based on the biopsychosocial model using a critical and updated rationale, potentially improving assessment outcomes, i.e., clinical diagnosis.
Isolation and characterization of farm pig adipose tissue-derived mesenchymal stromal/stem cells
(2022-01-01) Garcia, G. A. [UNESP]; Oliveira, R. G. [UNESP]; Dariolli, R.; Rudge, M. V.C. [UNESP]; Barbosa, A. M.P. [UNESP]; Floriano, J. F. [UNESP]; Ribeiro-Paes, J. T. [UNESP]; Universidade Estadual Paulista (UNESP); Universidade de São Paulo (USP); Instituto do Corac¸ão; Icahn School of Medicine at Mount Sinai
Adipose tissue-derived mesenchymal stromal/stem cells (ASCs) are considered important tools in regenerative medicine and are being tested in several clinical studies. Porcine models are frequently used to obtain adipose tissue, due to the abundance of material and because they have immunological and physiological similarities with humans. However, it is essential to understand the effects and safe application of ASCs from pigs (pASCs) as an alternative therapy for diseases. Although minipigs are easy-to-handle animals that require less food and space, acquiring and maintaining them in a bioterium can be costly. Thus, we present a protocol for the isolation and proliferation of ASCs isolated from adipose tissue of farm pigs. Adipose tissue samples were extracted from the abdominal region of the animals. Because the pigs were not raised in a controlled environment, such as a bioterium, it was necessary to carry out rigorous procedures for disinfection. After this procedure, cells were isolated by mechanical dissociation and enzymatic digestion. A proliferation curve was performed and used to calculate the doubling time of the population. The characterization of pASCs was performed by immunophenotyping and cell differentiation in osteogenic and adipogenic lineages. The described method was efficient for the isolation and cultivation of pASCs, maintaining cellular attributes, such as surface antigens and multipotential differentiation during in vitro proliferation. This protocol presents the isolation and cultivation of ASCs from farm pig as an alternative for the isolation and cultivation of ASCs from minipigs, which require strictly controlled maintenance conditions and a more expensive process.
Consequences of the exposome to gestational diabetes mellitus
(2023-02-01) Rudge, Marilza V.C. [UNESP]; Alves, Fernanda C.B. [UNESP]; Hallur, Raghavendra L.S. [UNESP]; Oliveira, Rafael G. [UNESP]; Vega, Sofia [UNESP]; Reyes, David R.A. [UNESP]; Floriano, Juliana F. [UNESP]; Prudencio, Caroline B. [UNESP]; Garcia, Gabriela A. [UNESP]; Reis, Fabiana V.D.S. [UNESP]; Emanueli, Costanza; Fuentes, Gonzalo; Cornejo, Marcelo; Toledo, Fernando; Valenzuela-Hinrichsen, Andrés; Guerra, Catalina; Grismaldo, Adriana; Valero, Paola; Barbosa, Angelica M.P. [UNESP]; Sobrevia, Luis [UNESP]; Universidade Estadual Paulista (UNESP); Pravara Institute of Medical Sciences (DU); Imperial College London; University Medical Center Groningen; Universidad de Talca; Universidad de Antofagasta; Universidad del Bío-Bío; School of Medicine and Health Sciences; Universidad de Sevilla; University of Queensland; Pontificia Universidad Católica de Chile
The exposome is the cumulative measure of environmental influences and associated biological responses throughout the lifespan, including those from the environment, diet, behaviour, and endogenous processes. The exposome concept and the 2030 Agenda for the Sustainable Development Goals (SDGs) from the United Nations are the basis for understanding the aetiology and consequences of non-communicable diseases, including gestational diabetes mellitus (GDM). Pregnancy may be developed in an environment with adverse factors part of the immediate internal medium for fetus development and the external medium to which the pregnant woman is exposed. The placenta is the interface between maternal and fetal compartments and acts as a protective barrier or easing agent to transfer exposome from mother to fetus. Under and over-nutrition in utero, exposure to adverse environmental pollutants such as heavy metals, endocrine-disrupting chemicals, pesticides, drugs, pharmaceuticals, lifestyle, air pollutants, and tobacco smoke plays a determinant role in the development of GDM. This phenomenon is worsened by metabolic stress postnatally, such as obesity which increases the risk of GDM and other diseases. Clinical risk factors for GDM development include its aetiology. It is proposed that knowledge-based interventions to change the potential interdependent ecto-exposome and endo-exposome could avoid the occurrence and consequences of GDM.
Transcriptomic Profiling of Rectus Abdominis Muscle in Women with Gestational Diabetes-Induced Myopathy: Characterization of Pathophysiology and Potential Muscle Biomarkers of Pregnancy-Specific Urinary Incontinence
(2022-11-01) Alves, Fernanda Cristina Bergamo [UNESP]; Oliveira, Rafael Guilen de [UNESP]; Reyes, David Rafael Abreu [UNESP]; Garcia, Gabriela Azevedo [UNESP]; Floriano, Juliana Ferreira [UNESP]; Shetty, Raghavendra Hallur Lakshmana [UNESP]; Mareco, Edson Assunção; Dal-Pai-Silva, Maeli [UNESP]; Payão, Spencer Luiz Marques; Souza, Fátima Pereira de [UNESP]; Witkin, Steven S.; Sobrevia, Luis [UNESP]; Barbosa, Angélica Mércia Pascon [UNESP]; Rudge, Marilza Vieira Cunha [UNESP]; Universidade Estadual Paulista (UNESP); Pravara Institute of Medical Sciences; University of Western São Paulo (UNOESTE); Faculdade de Medicina de Marília (FAMEMA); Weill Cornell Medicine; Universidade de São Paulo (USP); Pontificia Universidad Católica de Chile; Universidad de Sevilla; University of Queensland; University of Groningen; School of Medicine and Health Sciences
Gestational diabetes mellitus (GDM) is recognized as a “window of opportunity” for the future prediction of such complications as type 2 diabetes mellitus and pelvic floor muscle disorders, including urinary incontinence and genitourinary dysfunction. Translational studies have reported that pelvic floor muscle disorders are due to a GDM-induced-myopathy (GDiM) of the pelvic floor muscle and rectus abdominis muscle (RAM). We now describe the transcriptome profiling of the RAM obtained by Cesarean section from GDM and non-GDM women with and without pregnancy-specific urinary incontinence (PSUI). We identified 650 genes in total, and the differentially expressed genes were defined by comparing three control groups to the GDM with PSUI group (GDiM). Enrichment analysis showed that GDM with PSUI was associated with decreased gene expression related to muscle structure and muscle protein synthesis, the reduced ability of muscle fibers to ameliorate muscle damage, and the altered the maintenance and generation of energy through glycogenesis. Potential genetic muscle biomarkers were validated by RT-PCR, and their relationship to the pathophysiology of the disease was verified. These findings help elucidate the molecular mechanisms of GDiM and will promote the development of innovative interventions to prevent and treat complications such as post-GDM urinary incontinence.
Relationship of scapular dyskinesis with the pattern of activation of periescapular muscles during exercise
(2022-01-01) Spinoso, Deborah Hebling [UNESP]; Marin, Caroline Santos [UNESP]; Navega, Marcelo Tavella [UNESP]; Universidade Estadual Paulista (UNESP)
The aim of the present study was to analyze the activation pattern of the serratus anterior (SA), upper trapezius (UT), and lower trapezius (LT) muscles during periscapular exercises in individuals with and without ED, and to identify which proposed exercise presents greater activation of the periscapular muscles. Fourteen women, aged between 18 and 30 years, participated in this study, divided into a control group (n = 8) and a dyskinesis group (n = 8). The determination of the presence of ED was performed according to the analysis of scapular movement during arm elevation, using the yes/no classification. To evaluate muscle activation, electromyography signals of the SA, UT, and LT muscles were collected during exercise. The exercise protocol was composed of three repetitions of the exercises: punch up, wall slide, and scaption. The results showed that the ED group showed less activation of the AS and TT than the control group. During the scaption and wall slide exercises, the DE group showed less activation of the AS in relation to those without DE. There was no difference in muscle activation between the exercises. That individuals with dyskinesis have less activation of the muscles that control scapular mechanics and that the type of exercise did not influence the activation of the periscapular muscles.
Viability of ex-vivo myography as a diagnostic tool for rectus abdominis muscle electrical activity collected at Cesarean section within a diamater cohort study
(2022-12-01) Reyes, David R. A. [UNESP]; Barbosa, Angelica M. P. [UNESP]; Juliana, Floriano F. [UNESP]; Sofia, Quiroz B. C. V. [UNESP]; Costa, Sarah M. B. [UNESP]; Hallur, Raghavendra L. S. [UNESP]; Enriquez, Eusebio M. A. [UNESP]; Oliveira, Rafael G. [UNESP]; de Souza Rossignolli, Patricia [UNESP]; Pedroni, Cristiane Rodrigues [UNESP]; Alves, Fernanda C. B. [UNESP]; Garcia, Gabriela A. [UNESP]; Abbade, Joelcio F. [UNESP]; Carvalho, Carolina N. F. [UNESP]; Sobrevia, Luis [UNESP]; Rudge, Marilza V. C. [UNESP]; Calderon, Iracema I. M. P. [UNESP]; Souza, F. P.; Lehana, T.; Graeff, C. F.O.; Magalhães, C. G.; Costa, R. A.A.; Lima, S. A.M.; Rodrigues, M. R.K.; Felisbino, S. L.; Barbosa, W. F.; Campos, F. J.; Bossolan, G.; Corrente, J. E.; Nunes, H. R.C.; Rossignoli, P. S.; Atallah, N.; Jármy-Di Bella, Z. I.; Uchôa, S. M.M.; Duarte, M. A.H.; Mareco, E. A.; Sakalem, M. E.; Martinho, N. M.; Bussaneli, D. G.; Orlandi, M. I.G.; Pascon, C.; Dangió, T. D.; Piculo, F.; Prata, G. M.; Avramidis, R. E.; Magyori, A. B.M.; Nava, G. T.A.; Caldeirão, T. C.D.; Shetty, R. H.L.; Marcondes, J. P.C.; Takemoto, M. L.S.; Prudencio, C. B.; Pinheiro, F. A.; Sartorao Filho, C. I.; Quiroz, S. B.C.V.; Pascon, T.; Nunes, S. K.; Catinelli, B. B.; Reis, F. V.D.S.; Menezes, M. O.; Santos, N. J.; Takano, L.; Carr, A. M.; Iamundo, L. F.; Bassin, H. C.M.; Barbosa, V. P.; Jacomin, M.; Silva, A. J.B.; Lourenço, I. O.; Marosticadesá, J.; Caruso, I. P.; Rasmussen, L. T.; Nogueira, V. K.C.; Ribeiro-Paes, J. T.; França, D. C.H.; Bastos, H. V.M.; Heliodoro, M. L.A.; Kuroda, M. N.; Carvalho, H. L.; Universidade Estadual Paulista (UNESP); Pravara Institute of Medical Sciences (Deemed to Be University); Pontificia Universidad Católica de Chile; Universidad de Sevilla; University of Queensland; University Medical Center Groningen (UMCG)
Background: Ex-vivo myography enables the assessment of muscle electrical activity response. This study explored the viability of determining the physiological responses in muscles without tendon, as rectus abdominis muscle (RAM), through ex-vivo myography to assess its potential as a diagnostic tool. Results: All tested RAM samples (five different samples) show patterns of electrical activity. A positive response was observed in 100% of the programmed stimulation. RAM 3 showed greater weight (0.47 g), length (1.66 cm), and width (0.77 cm) compared to RAM 1, RAM 2, RAM 4 and RAM 5 with more sustained electrical activity over time, a higher percentage of fatigue was analyzed at half the time of the electrical activity. The order of electrical activity (Mn) was RAM 3 > RAM 5 > RAM 1 > RAM 4 > RAM 2. No electrical activity was recorded in the Sham group. Conclusions: This study shows that it is feasible to assess the physiological responses of striated muscle without tendon as RAM, obtained at C-section, under ex vivo myography. These results could be recorded, properly analyzed, and demonstrated its potential as a diagnostic tool for rectus abdominis muscle electrical activity.
Neuromuscular efficiency of the quadriceps in women with and without patellofemoral pain
(Universidade de São Paulo, 2023-04-28) Paula, Julia Paixão De [UNESP]; Navega, Marcelo Tavella [UNESP]; Spinoso, Deborah Hebling [UNESP]; Universidade Estadual Paulista (UNESP)
Patellofemoral pain (PFP) may contribute to less activation of the quadriceps muscle, favoring joint overload and pain. Neuromuscular efficiency (NME) is a variable that evaluates the relationship between the amount of neural stimuli and the ability to generate force of in a given muscle, with the most efficient being the one that produces greater muscle force, with less activation of muscle fibers. In this sense, this study aimed to evaluate the strength and NME of knee extensors in women with and without patellofemoral pain. A total of 24 adult women, recruited via a questionnaire, aged from 18 to 30 years, with and without patellofemoral pain, participated in this study. Anamnesis, anterior knee pain scale, and numerical visual scale were applied. Subsequently, the knee extensor strength, with a hand-held dynamometer, and the NME of vastus medialis (VM), vastus lateralis (VL), and rectus femoris (RF) were assessed. For statistical analysis, appropriate tests were adopted to compare variables between groups and correlate them. In all statistical tests, a α<0.05 was adopted. Results showed that women with PFP had 61% lower NME in the VM and 52% in the VL, compared to the group without pain. No significant difference was found for knee extensor strength between groups. We conclude that pain negatively influences VM and VL recruitment but does not change quadriceps ability to generate strength.
Postural alteration, low back pain, and trunk muscle resistance in university students
(2022-01-01) de Almeida Fischer, Rebeca [UNESP]; Spinoso, Deborah Hebling [UNESP]; Navega, Marcelo Tavella [UNESP]; Universidade Estadual Paulista (UNESP)
Introduction: Low back pain, the most prevalent musculoskeletal disorder, is common in individuals with postural changes and has a high incidence in university students. Trunk muscle instability and weakness can contribute to the presence of low back pain. However, no research has investigated the relationship between low back pain in conjunction with postural changes and the resistance of the trunk stabilizing muscles. Objective: To analyze the correlation between postural alterations and muscular resistance of the trunk of women with and without low back pain. Methods: Forty university women were recruited and divided into a group with low back pain (n = 20; 20.85 ± 1.69 years) and a group without low back pain (n = 20; 20.05 ± 2.54 years). On the first day, the postural assessment was carried out by photogrammetry with Kinovea software. On the second day, the resistance tests of the trunk flexor and extensor muscles, lateral and ventral plank, bridge, and lumbar traction were performed through the traction dynamometer. Pearson's correlation test was applied to verify the relationship between the analyzed variables, Student's T test was used for comparison between groups, and a significance level of p < 0.05 was adopted. Results: There was no correlation between the variables related to postural changes and muscle resistance tests (p > 0.05). There was a difference between the groups only for the bridge exercise test (p = 0.04) and vertical alignment of the head, left lateral view (p = 0.041), and right lateral view (p = 0.034). Conclusion: This study did not show a direct and significant relationship between postural changes in young university students with and without complaints of low back pain and resistance of the trunk-stabilizing muscles
Motor control exercises versus general exercises for greater trochanteric pain syndrome: A protocol of a randomized controlled trial
(2022-01-01) Thomaz de Aquino Nava, Guilherme [UNESP]; Baldini Prudencio, Caroline [UNESP]; Krasic Alaiti, Rafael; Mendes Tozim, Beatriz [UNESP]; Mellor, Rebecca; Rodrigues Pedroni, Cristiane [UNESP]; Mércia Pascon Barbosa, Angélica [UNESP]; Tavella Navega, Marcelo [UNESP]; Universidade Estadual Paulista (UNESP); Universidade de São Paulo (USP); University of Queensland
INTRODUCTION: Greater trochanteric pain syndrome is an overarching term used to define pain and tenderness in the greater trochanteric region of the femur, which is more common in women. Abnormal control of lower limb movements and deficient neuromuscular parameters may lead to greater trochanteric pain syndrome; however, no studies have used neuromuscular training as a treatment strategy. Thus, this study aims to compare the effect of a protocol of general exercises versus a program of motor control training on pain at baseline and after treatment in women with greater trochanteric pain syndrome. METHODS: The study was approved by the Research Ethics Committee (CAAE: 87372318.1.0000.5406) and has been prospectively registered on the Brazilian Registry of Clinical Trials (RBR-37gw2x). Sixty participants will be randomized to receive motor control exercises or general exercises. The application will be performed twice a week for 8 weeks. The participants will be evaluated before the treatment (T0), after 8 weeks of intervention (T8) and after 60 weeks of intervention (T60). The primary outcome measures will be the hip pain intensity, and secondary outcomes will be muscle strength, kinesiophobia, global perceived effect, pain catastrophization, central sensitization and quality of life. CONCLUSIONS: Studies have suggested that greater trochanteric pain syndrome may be related to poor hip and pelvic control, however, no study has investigated an exercise protocol focused on increasing the strength of the abductor and extensor muscles of the hip associated with pelvic control training, especially in positions of unilateral support, such as gait. This study will help determine whether greater trochanteric pain syndrome is related to abnormal control of lower limb movements.
Motor control exercises versus general exercises for greater trochanteric pain syndrome: A protocol of a randomized controlled trial
(2022-06-01) de Aquino Nava, Guilherme Thomaz [UNESP]; Prudencio, Caroline Baldini [UNESP]; Alaiti, Rafael Krasic; Tozim, Beatriz Mendes [UNESP]; Mellor, Rebecca; Pedroni, Cristiane Rodrigues [UNESP]; Barbosa, Angélica Mércia Pascon [UNESP]; Navega, Marcelo Tavella [UNESP]; Universidade Estadual Paulista (UNESP); Universidade de São Paulo (USP); The University of Queensland
Introduction Greater trochanteric pain syndrome is an overarching term used to define pain and tenderness in the greater trochanteric region of the femur, which is more common in women. Abnormal control of lower limb movements and deficient neuromuscular parameters may lead to greater trochanteric pain syndrome; however, no studies have used neuromuscular training as a treatment strategy. Thus, this study aims to compare the effect of a protocol of general exercises versus a program of motor control training on pain at baseline and after treatment in women with greater trochanteric pain syndrome. Methods The study was approved by the Research Ethics Committee (CAAE: 87372318.1.0000.5406) and has been prospectively registered on the Brazilian Registry of Clinical Trials (RBR-37gw2x). Sixty participants will be randomized to receive motor control exercises or general exercises. The application will be performed twice a week for 8 weeks. The participants will be evaluated before the treatment (T0), after 8 weeks of intervention (T8) and after 60 weeks of intervention (T60). The primary outcome measures will be the hip pain intensity, and secondary outcomes will be muscle strength, kinesiophobia, global perceived effect, pain catastrophization, central sensitization and quality of life. Conclusions Studies have suggested that greater trochanteric pain syndrome may be related to poor hip and pelvic control, however, no study has investigated an exercise protocol focused on increasing the strength of the abductor and extensor muscles of the hip associated with pelvic control training, especially in positions of unilateral support, such as gait. This study will help determine whether greater trochanteric pain syndrome is related to abnormal control of lower limb movements.
Pelvic floor muscle dysfunction at 3D transperineal ultrasound in maternal exposure to gestational diabetes mellitus: A prospective cohort study during pregnancy
(2022-06-01) Pinheiro, Fabiane A. [UNESP]; Sartorão Filho, Carlos I. [UNESP]; Prudencio, Caroline B. [UNESP]; Nunes, Sthefanie K. [UNESP]; Pascon, Tawana [UNESP]; Hallur, Ragavendra L. S. [UNESP]; Takano, Luis [UNESP]; Enriquez, Eusébio M. A. [UNESP]; Catinelli, Bruna B. [UNESP]; Carr, Aline M. [UNESP]; Junginger, Baerbel; Rudge, Marilza V. C. [UNESP]; Barbosa, Angélica M. P. [UNESP]; Universidade Estadual Paulista (UNESP); Assis Municipality Educational Foundation (FEMA); Pravara Institute of Medical Sciences (Deemed to be University); Charitè University Hospital
Aim: This study aimed to assess, for the first time, the dynamic morphometry of pelvic floor muscles (PFM) using three-dimensional transperineal ultrasound (3D-TPUS) and its progression at two-time points of gestation between women with and without gestational diabetes mellitus (GDM), and whether the PFM dysfunction is connected to GDM. Methods: The study comprised 83 consecutive pregnant women with (n = 38) and without (n = 45) GDM screened at 24–30 and 38–40 weeks of gestation. 3D-TPUS and a mobility test were used to quantify PFM dynamic morphometry during maximum contraction and the Valsalva maneuver. Results: When compared to the control group, GDM women had no significant variations in all levator hiatal dimensions at 24–30 weeks of gestation. Meanwhile, women with GDM experienced an increase in levator hiatal area (LHa) (p < 0.000) during PFM contraction and enlargement in LHa (p < 0.001) during Valsalva maneuver (p = 0.010) at 38–40 weeks of gestation. As a result, the mobility index among GDM women had a lower value (p = 0.000). The dynamic morphometry development of PFM in GDM women at two stages during pregnancy revealed a substantial decrease (p = 0.000) in all LHa dimensions of contraction, distension, and mobility. Conclusions: Using 3D-TPUS, we found that GDM women had a specific pattern of PFM functional changes in the third trimester of pregnancy. These initial findings revealed alterations in PFM functionality, such as decreased contractility, distensibility, or mobility. This dysfunctional PFM could contribute to the long-term development of pelvic floor dysfunction years after a GDM pregnancy.
Microbiological analysis of mineral water and drinking water of reservoir supplies, Brazil
(2002-01-01) Alves, Nilton César; Odorizzi, Augusto Cesar; Goulart, Flávia Cristina; Universidade de Marilia (Unimar); Saúde da Unimar
The aim of this study was to evaluate the microbiological quality of different commercial mineral water brands, wells and reservoir supplies in surrounding areas of the city of Marilia, Brazil, to determine the amount of total and fecal coliforms. Eighteen samples of each source (mineral and reservoir supplies) were analyzed using Colilert Technique in cellophane. The results revealed that one sample of mineral water and one sample collected from the reservoir supply had been contaminated by a bacterium of the total coliform group, and there were found one bacterium/100 ml of water. None of the water samplesshowed contamination by fecal coliforms.
Pelvic floor muscle training and postural balance in elderly women: An exploratory single arm trial
(2022-01-01) Loyolla Montanari Leme, Gianluca [UNESP]; Baldini Prudencio, Caroline [UNESP]; Thomaz de Aquino Nava, Guilherme [UNESP]; Mércia Pascon Barbosa, Angélica [UNESP]; Scheicher, Marcos Eduardo [UNESP]; Universidade Estadual Paulista (UNESP)
Introduction: To investigate the influence of a training of mobility, gait speed and postural balance of pelvic floor muscles (PFM). Methods: A single-arm clinical trial study was approved and registered at the Brazilian Clinical Trials Registry (RBR-4rxhd4). Eighteen women over the age of 60 with pelvic floor dysfunction complaints were subjected to 10 sessions of functional electrical stimulation and digital palpation of PFM. Mobility and gait speed were evaluated by the Timed up and Go and the 10-m walk tests respectively. Standing balance was evaluated using a force plate. Results: No significant differences were found in mobility, gait speed, and standing balance. PFM contraction worsened mobility, gait speed, and standing balance performance. Conclusions: The training protocol enhanced PFM strength and endurance, but the improved ability to recruit PFM did not positively affect balance, mobility, and gait speed.
Improvement of quality of life and postural balance of institutionalized elderly people undergoing to a treadmill walking training
(2021-10-01) Rodrigues Pereira, Natalia Moya [UNESP]; Pierre Massè Araya, Marcel Jean [UNESP]; Scheicher, Marcos Eduardo [UNESP]; Universidade Estadual Paulista (UNESP)
Introduction: Institutionalized older adults have fewer opportunities to participate in daily living activities and tasks in an independent manner, with greater deleterious effects on the physiological losses inherent to aging and with increased gait and balance impairment compared to community-dwelling older adults. The use of a treadmill for rehabilitation, with or without partial weight support, has been studied in different groups, but not on institutionalized older adults. Objectives: To assess the effects of a treadmill walking program on the postural balance and quality of life of institutionalized older adults. Methods: Thirty-seven institutionalized older adults: intervention group (n = 23, 75.7 ± 7.8 years) and control group (n = 14, 78.9 ± 10.2 years). A total of 10 weeks of treadmill walking, twice a week (intervention group) vs. no training (control group). Postural balance was assessed by the Tinetti test, 6-min walk test (6MWT), and 10-m walk test and Quality of life with the WHOQOL-Bref questionnaire. Results: Significant improvement was observed in balance parameters (6MWT distance: p < 0.001; gait speed 6MWT: p < 0.001; gait speed 10MWT: p < 0.001; Tinetti scale: p = 0.001), and in the physical (p = 0.01), psychological (p = 0.002), self-assessed quality of life (p = 0.01) and overall quality of life domains (p = 0.002). Conclusions: Treadmill walking program had positive effects on the postural balance and quality of life of institutionalized older adults.
Usual and dual-task gait adaptations under visual stimulation in older adults at different ages
(2022-02-01) Magnani, Paola Errera; Zanellato, Nathalia Fernanda Grecco; Genovez, Maiara Baena; Alvarenga, Isabella Camargo; Faganello-Navega, Flávia Roberta [UNESP]; de Abreu, Daniela Cristina Carvalho; Universidade de São Paulo (USP); Universidade Estadual Paulista (UNESP)
Background: During the walk along the streets, older adults are exposed to various visual stimuli that can affect their gait in a harmful or beneficial way. Aims: To evaluate gait strategies during different situations with and without visual stimulation in older adults to identify the influence of the visual stimulus on these gait parameters. Methods: A total of 200 older adults were divided into 4 groups according to age range between 60 and 102 years. Gait was evaluated in the following situations: (1) habitual gait (HG); (2) gait with the visual stimulation (GVS) provided by a pedestrian traffic light, and (3) GVS associated with a cognitive task (GVS-C). The GAITRite Platinum equipment was used to assess gait variables. Results: Comparison of GVS and HG revealed that the visual stimulus influences the gait parameters and promotes a gait speed increase. However, to increase their gait speed, older adults aged 60–89 years used strategies of increased step length and cadence, whereas subjects older than 90 years used only strategies of increased cadence. In addition, comparison of GVS and GVS-C revealed a decrease in gait speed in all age ranges when the cognitive task was added, although this reduction was more pronounced in subjects older than 70 years. Conclusion: Visual stimulus influences the gait parameters in older adults and the strategy used is different depending on their age, a fact that shows that traffic light may be an interesting strategy to improve the gait performance during physical therapy.

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