Abstract Background A difference in maximum tolerance to mechanical pain (MTMP) between the sexes is widely studied but there is still no consensus on whether the level of physical activity (PA) influences pain. Objectives To compare the MTMP between men and women with different levels of PA. Methods Sixty five individuals were divided in female (n = 35) and male group (n = 30). The main outcome measures were PA level and MTMP by pressure algometry. Pressure was applied three times on both sides at the following points: cervical (5th and 7th) and lumbar (3th and 5th) vertebrae; trapezius, rhomboid, gluteus, gastrocnemius, pectoralis major, tibialis anterior, and deltoid muscles, elbow, hand, knee, and ankle. Results It was observed that the PA level has little influence on the MTMP at all the assessed points and that men have greater MTMP than women. Conclusion Sex, not the PA level, influences the MTMP.

SUMMARY: The purpose of this study was to evaluate the chronic effects of stretching exercise on soleus muscle histomorphology and histomorphometry of young and aged rats. Thirty-eight female rats were divided into young control group (YCG, n=10;274±50 g); young stretching group (YSG, n=8;274±12 g); aged control group (ACG, n=10;335±39 g); and aged stretching group (ASG, n=10;321±32g). A mechanical apparatus was used to stretch muscle in 4 repetitions, 60 s each, 30 s interval between repetitions in each session, 3 times a week for 3 weeks. Twenty-four hours after the last stretching session, soleus muscle was removed for micromorphology and immunostaining analysis. Data analyses were performed with one-way ANOVA, post-hoc Tukey, or Kruskal-Wallis tests for parametric and nonparametric, respectively (p≤0.05). Muscle fiber cross-sectional area (MFCSA) of ACG was lower (18 %) compared to the YCG. Stretching increased MFCSA comparing YSG to YCG (5,681.15± 1,943.61 µm2 vs 5,119.84±1,857.73 µm2, p=0.00), but decreased comparing ASG to ACG (3,919.54± 1,694.65 µm2 vs 4,172.82±1,446.08 µm2, p=0.00). More serial sarcomere numbers were found in the YSG than YCG (12,062.91±1,564.68 vs 10,070.39±1,072.38, p=0.03). Collagen I and collagen III were higher in YSG than ASG (7.44±7.18 % vs 0.07±0.09 %, p=0.04) and (14.37 %± 9.54 % vs 5.51 %±5.52 %, p=0.00), respectively. TNF-a was greater in ASG than YSG (43.42 %±40.19 % vs 1.72 ± 2.02 %, p=0.00). Epimysium was larger in the YSG compared to YCG (201.83±132.07 % vs 181.09±147.04 %, p=0.00). After 3-week stretching the soleus muscles from aged rats were smaller than their younger counter-parts. Interestingly, while stretching appeared to positively affect young soleus muscle, the opposite was detected in the muscle of the aged rats.

RESUMEN: El propósito de este estudio fue evaluar los efectos crónicos del ejercicio de estiramiento sobre la histomorfología e histomorfometría del músculo sóleo de ratas jóvenes y envejecidas. Se dividieron 38 ratas hembras en un grupo control joven (YCG, n = 10; 274 ± 50 g); grupo de estiramiento joven (YSG, n = 8; 274 ± 12 g); grupo control de edad (ACG, n = 10; 335 ± 39 g); y grupo estiramiento envejecido (ASG, n = 10; 321 ± 32 g). Se usó un aparato mecánico para estirar el músculo en 4 repeticiones, 60 s cada una, intervalo de 30 s entre repeticiones en cada sesión, 3 veces por semana, durante 3 semanas. Veinticuatro horas después de la última sesión de estiramiento, se extrajo el músculo sóleo para análisis de micromorfología e inmunotinción. Los análisis de datos se realizaron con pruebas ANOVA de una vía, Tukey post-hoc o Kruskal-Wallis para pruebas paramétricas y no paramétricas, respectivamente (p≤0,05). El área de la sección transversal de fibra muscular (MFCSA) de GCE fue menor (18 %) en comparación con el GCJ. El estiramiento aumentó ASTFM comparando GEJ con GCJ (5.681,15 ± 1.943,61 µm2 vs 5.119,84 ± 1.857,73 µm2, p = 0,00), pero disminuyó comparando GEE con GCE (3.919,54 ± 1.694,65 µm2 vs 4.172,82 ± 1.446,08 µm2, p = 0,00). Se encontraron más sarcómeros en serie en el GEJ que en el GCJ (12.062,91 ± 1.564,68 vs 10.070,39 ± 1,072.38, p = 0,03). El colágeno I y el colágeno III fueron más numerosos en GEJ que en GEE (7,44 ± 7.18 % vs 0,07 ± 0,09 %, p = 0,04) y (14,37 % ± 9,54 % vs 5,51 % ± 5,52 %, p = 0,00), respectivamente. TNF-α fue mayor en GEE que GEJ (43,42 % ± 40,19 % vs 1,72 ± 2,02 %, p = 0,00). El epimisio fue mayor en el GEJ en comparación con el GCJ (201,83 ± 132,07 % vs 181,09 ± 147,04 %, p = 0,00). Después de 3 semanas de estiramiento, los músculos sóleo de las ratas envejecidas eran más pequeños que sus contrapartes más jóvenes. Curiosamente, si bien el estiramiento pareció afectar positivamente el músculo sóleo joven, se detectó lo contrario en el músculo de las ratas envejecidas.

RESUMO O objetivo do presente estudo foi avaliar a evidência de aplicação da diatermia por ondas curtas (DOC) em indivíduos com dor lombar crônica (DLC) e seus parâmetros de prescrição. As fontes de dados (MEDLINE, PubMed, LILACS, DARE, PsycINFO, AusportMed, SciELO, PEDro e Cochrane Central Register of Controlled Trials) foram pesquisadas sistematicamente quanto aos artigos publicados até dezembro de 2017. Estudos de ensaios clínicos randomizados e não randomizados que investigaram o efeito da aplicação da DOC na DLC foram selecionados. Dois revisores independentes avaliaram o risco de viés em estudos usando as escalas Jadad e Downs & Black. Cinco estudos (731 pacientes) foram incluídos e todos apresentaram melhora na DLC. A maioria usou a DOC de modo contínuo, com apenas um utilizando o modo pulsado (82 e 200 Hz). A DOC apresentou melhora na DLC, no entanto, há evidências limitadas para sua aplicação e ausência de padronização dos parâmetros utilizados. Além disso, os resultados que se referem a esse tópico devem ser interpretados com cautela devido à baixa qualidade metodológica e ao número limitado de estudos. Nível de evidência II; Revisão sistemática.

ABSTRACT The aim of this study was to evaluate the evidence of application of short-wave diathermy (SWD) in individuals with chronic low back pain (CLBP) and its prescription parameters. The data sources (MEDLINE, PubMed, LILACS, DARE, PsycINFO, AusportMed, SciELO, PEDro and the Cochrane Central Register of Controlled Trials) were systematically searched for articles published up to December 2017. Randomized and non-randomized clinical trial studies that investigated the effect of the application of SWD on CLBP were selected. Two independent reviewers assessed the risk of bias in studies using the Jadad and the Downs & Black scales. Five studies (731 patients) were included, all of whom presented improvements in CLBP. The majority used continuous mode SWD, with only one using pulsed mode (82 and 200 Hz). SWD produced improvements in CLBP, but there is limited evidence for its application, and a lack of standardization of the parameters used. Furthermore, the results that address this topic should be interpreted with caution due to their low methodological quality and limited number. Level of evidence II; Systematic review.

RESUMEN El objetivo del presente estudio fue evaluar la evidencia de la diatermia por ondas cortas (DOC) en individuos con dolor lumbar crónico (DLC) y sus parámetros de prescripción. Las fuentes de datos (MEDLINE, PubMed, LILACS, DARE, PsycINFO, AusportMed, SciELO, PEDro y Cochrane Central Register of Controlled Trials) fueron utilizadas para búsquedas sistemáticas de artículos publicados hasta diciembre de 2017. Fueron seleccionados los estudios de ensayos clínicos aleatorizados y no aleatorizados que investigaron el efecto de la aplicación de DOC en DLC. Dos revisores independientes evaluaron el riesgo de sesgo en estudios usando las escalas Jadad y Downs & Black. Fueron incluidos cinco estudios (731 pacientes) y todos presentaron mejora en DLC. La mayoría usó la DOC de modo continuo, con sólo uno usando el modo pulsado (82 y 200 Hz). La DOC produjo mejoras en DLC, sin embargo, hay evidencias limitadas para su aplicación y ausencia de estandarización de los parámetros utilizados. Además, los resultados que se refieren a ese tópico deben interpretarse con cautela debido a la baja calidad metodológica y al número limitado de estudios. Nivel de evidencia II; Revisión sistemática.

RESUMO Objetivo: Verificar a ocorrência e as características de atelectasias, opacidades, hipotransparências e infiltrados pulmonares evidenciados ao raio X de tórax dos recém-nascidos prematuros, de uma unidade de terapia intensiva neonatal. Métodos: Trata-se de estudo observacional transversal. No período de agosto a dezembro de 2017 foram analisadas todas as radiografias de tórax de recém-nascidos. Foram incluídas no estudo as radiografias de tórax de recém-nascidos prematuros com idade gestacional até 36 semanas, no período neonatal que apresentassem alterações evidentes na imagem ou suspeita de alterações, que fossem confirmadas após laudo do médico radiologista. As alterações radiológicas foram associadas com possíveis fatores predisponentes. Resultados: No período, foram realizadas 450 radiografias nos recém-nascidos prematuros, sendo que, em 37, foram descritas quatro alterações: 12 (2,66%) descritas como opacidades, 11 (2,44%) como atelectasias, 10 (2,22%) como infiltrados pulmonares e 4 (0,88%) como hipotransparências. Observou-se maior ocorrência das atelectasias no pulmão direito (81,8%). Dentre as radiografias com alterações, 25 (67,6%) recém-nascidos estavam sob o uso da ventilação mecânica invasiva. Conclusão: Considerando o laudo radiológico, as alterações observadas têm ocorrências sem diferença estatisticamente significante. A atelectasia não foi a alteração mais encontrada. Os fatores que podem ter predisposto ao aparecimento das alterações foram a prematuridade extrema, o baixo peso, o sexo masculino, o mal posicionamento da cânula endotraqueal e o uso de ventilação mecânica invasiva.

ABSTRACT Objective: To determine the occurrence and characteristics of atelectasis, opacities, hypolucency and pulmonary infiltrates observed on chest X-rays of preterm infants in a neonatal intensive care unit. Methods: This was a cross-sectional observational study. From August to December 2017, all chest radiographs of newborn infants were analyzed. The study included the chest radiographs of preterm neonates with gestational ages up to 36 weeks in the neonatal period that showed clear changes or suspected changes, which were confirmed after a radiologist’s report. Radiological changes were associated with possible predisposing factors. Results: During the study period, 450 radiographs were performed on preterm neonates, and 37 lung changes were identified and classified into 4 types: 12 (2.66%) changes were described as opacities, 11 (2.44%) were described as atelectasis, 10 (2.22%) were described as pulmonary infiltrate, and 4 (0.88%) were described as hypolucency. A higher occurrence of atelectasis was noted in the right lung (81.8%). Among the abnormal radiographs, 25 (67.6%) newborn infants were receiving invasive mechanical ventilation. Conclusion: Considering the radiological report, no significance was found for the observed changes. Atelectasis was not the most frequently observed change. The predisposing factors for these changes were extreme prematurity, low weight, male sex, a poorly positioned endotracheal tube and the use of invasive mechanical ventilation.

OBJECTIVE: How much force is needed to stretch skeletal muscle is still unknown. The aim of this study was to develop a device that mechanically stretches rat muscle to compare the force (N) required to stretch the soleus muscle of young and aged rats and the tibio-tarsal angle joint at neutral and stretched positions. METHODS: Twelve female Wistar rats were divided into two groups: a young group (YG, n=6, 311±11 g) of rats 3 months old and an aged group (AG, n=6, 351±43 g) of rats 15 months old. The left soleus muscle was mechanically held in full dorsal flexion and submitted to mechanical passive stretching: 1 bout of 10 repetitions, each repetition lasted 60 seconds with an interval of 45 seconds between repetitions, performed once a day, twice a week, for 1 week. The force required during stretching was measured by a load cell, and the tibio-tarsal angle joint was measured by photometry. RESULTS: The load cell calibration showed excellent reliability, as confirmed by the intraclass correlation coefficient value of 0.93. A decrease in delta force was found in the comparison between YG and AG (0.11±0.03 N vs 0.08±0.02 N, p<0.05, repeated measures ANOVA). There was no difference between the YG and the AG in the tibio-tarsal angle at resting position (87.1±3.8° vs 87.1±3.5°, p=0.35, Kruskal Wallis) and at the end of the stretching protocol (43.9±4.4° vs 42.6±3.4°, p=0.57, Kruskal Wallis). CONCLUSION: The device presented in this study is able to monitor the force necessary to stretch hindlimb rat muscles. Aged rats required less force than young rats to stretch the soleus muscle, and there was no difference regarding the tibio-tarsal angle between the two groups.

RESUMO O estudo analisou os efeitos do exercício resistido e/ou alongamento na morfologia muscular de ratas ovariectomizadas. Setenta e cinco ratas Wistar (218±22g) foram divididas em 8 grupos: Controle (CONTROLE, n=5); Ovariectomia/histerectomia (OH, n=10): foram submetidas à ovariectomia/histerectomia e aguardaram oito semanas para instalação de osteopenia; Alongamento (ALONG, n=10): alongamento manual do músculo sóleo (10 repetições de 60s), duas vezes por semana; Ovariectomia/histerectomia e Alongamento (OH+ALONG, n=10); Exercício Resistido (ER, n=10): 4 séries de 10 repetições, carga inicial de 50% do peso corporal, aumentando semanalmente até 70%, três vezes por semana; Exercício Resistido e Alongamento (ER+ALONG, n=10); Ovariectomia/histerectomia e Exercício Resistido (OH+PL, n=10); Ovariectomia/histerectomia, Exercício Resistido e Alongamento (OH+ER+Along, n=10). Alongamento e/ou Exercicio Resistido foram realizados durante 6 semanas. Após 14 semanas, as ratas foram submetidas à ortotanásia para remoção do sóleo. As seguintes variáveis foram avaliadas: peso corporal; peso e comprimento muscular; número e comprimento dos sarcômeros e área da secção transversa das fibras musculares (ASTFM). Comparação entre grupos foi realizada com ANOVA one way post hoc Tukey ou Kruskall-Wallis (p <0,05). O peso corporal e muscular das ratas submetidas aos exercícios foram maiores do que as intactas. O OH e OH+ER+ALONG aumentaram o comprimento e o número de sarcômeros. O OH apresentou menor ASTFM em comparação com todos os grupos. Ovariectomia/histerectomia induziu sarcopenia, mas os protocolos de exercícios foram suficientes para evitar a perda de ASTFM. O aumento do peso corporal associado ao exercício resistido e alongamento induziu sarcomerogenese nas ratas ovarectomizadas.

ABSTRACT This study analyzed the effects of resistive exercise and/or stretching in the muscle morphology of ovariectomized rats. Seventy-five female Wistar rats (218±22g) were divided into 8 groups: Control (CONTROL, n=5); Ovariectomy/Hysterectomy (OH, n=10): ovariectomized/hysterectomized and then waited 8 weeks for the onset of osteopenia. Stretching (STRET, n=10): manual stretching of the soleus muscle (10 repetitions of 60s), twice weekly; Ovariectomy/Hysterectomy and Stretching (OH+STRET, n=10); Progressive Loading (PL, n=10): 4 sets of 10 repetitions, initial load 50% of body weight, increasing weekly until 70%, three times a week. Progressive Loading and Stretching (PL+STRET, n=10); Ovariectomy/Hysterectomy and Progressive loading exercise (OH+PL, n=10); Ovariectomy/Hysterectomy, Progressive Loading and Stretching (OH+PL+STRET, n=10). Stretching and/or progressive loading were performed for 6 weeks. After 14 weeks, the female rats were euthanized to remove the soleus muscle. The following variables were assessed: body weight; muscle weight and length; number and length of sarcomeres and the muscle fiber cross-sectional area (MFCSA). Comparisons between the groups were performed with ANOVA one-way post hoc Tukey or Kruskall-Wallis (p<0.05). The body and muscle weights of ovariectomized rats submitted to exercise were higher than the intact ones. The OH and OH+PL+STRET increased the muscle length and the serial sarcomere number. OH presented the smallest MFCSA compared to all groups. Ovariectomy/hysterectomy induced sarcopenia, but the exercise's protocols were enough to prevent the loss of MFCSA. The increase in body weight associated to resistive training and stretching enhanced sarcomerogenesis of ovariectomized rats.

RESUMEN El estudio analizó los efectos del ejercicio resistido y/o estiramiento en la morfología muscular de ratas ovarectomizadas. Se dividió setenta y cinco ratas Wistar (218±22g) en 8 grupos: Control (CONTROL, n=5); ovariectomía/histerectomía (OH, n=10): fueron sometidas a ovariectomía/histerectomía y esperaron ocho semanas para la instalación de osteopenia; Estiramiento (ESTIR, n=10): estiramiento manual del músculo sóleo (10 repeticiones de 60s), dos veces por semana; ovariectomía/histerectomía y estiramiento (OH + ESTIR, n=10), ejercicio resistido (ER, n=10): 4 series de 10 repeticiones, carga inicial de 50% del peso corporal, aumentando semanalmente hasta 70%, tres veces por semana; Ejercicio resistido y estiramiento (ER+ESTIR, n=10); ovariectomía/histerectomía y ejercicio resistido (OH + PL, n=10); ovariectomía/histerectomía, ejercicio resistido y estiramiento (OH + ER + ESTIR, n=10). Se realizó estiramiento y/o ejercicio resistido durante 6 semanas. Después de 14 semanas, las ratas fueron sometidas a ortotanasia para la remoción del sóleo. Las siguientes variables fueron evaluadas: peso corporal; peso y longitud muscular; número y longitud de los sarcómeros y área de la sección trasversa de las fibras musculares (ASTFM). Se realizó una comparación entre grupos con ANOVA one way post hoc Tukey o Kruskall-Wallis (p <0,05). El peso corporal y muscular de las ratas sometidas a los ejercicios fue mayor que el de las intactas. El OH y OH+ER+ESTIR aumentaron la longitud y el número de los sarcómeros. El OH presentó menor ASTFM en comparación con todos los grupos. Ovariectomía/histerectomía indujo sarcopenia, más los protocolos de ejercicios fueron suficientes para evitar la pérdida de ASTFM. El aumento del peso corporal asociado al ejercicio resistido y estiramiento indujo sarcomerogénesis en las ratas sometidas a ovariectomía.

OBJECTIVE: To identify the prevalence of injuries occurred during training and/or competition in triathlon athletes at SESC Triathlon Caiobá-2011. METHODS: One hundred and ninety athletes participated in the study (153 males and 37 females). RESULTS: Athletes reported time of practice between 3 to 6 years (20%), training frequency of 5 days per week (48%), at least one injury during trainings (76%). The prevalence of injuries according to the sports category was: running (79%), cycling (16%) and swimming (5%). The most injured region during training (39%) and competition (46%) was the calf. Female athletes reported 92% of injuries during running training and 35% of those injuries were on ankle and foot. During competition only two athletes reported injuries. Muscle injury was the most prevalent (54%) among male athletes, followed by tendon (19%), ligament (17%) and bone (9%) injuries. Among female athletes prevalent injuries were: 32% muscle, 32% bone, 32% tendon and only 4% ligament injuries. CONCLUSION: Skeletal muscle injuries were the most commom lesions during running training, however, male athletes reported mostly calf injuries, while female had mostly ankle and foot injuries. Level of Evidence III. Study of Non-Consecutive Patients; Without Consistently Applied Reference ''Gold'' Standard.

INTRODUÇÃO: Modelos experimentais da Doença de Parkinson (DP) que reproduzem a desnervação dopaminérgica têm sido desenvolvidos para estudar a patofisiologia desta doença e analisar a eficácia de novas terapêuticas. Dentre os sinais cardinais da DP temos a rigidez muscular, estudos sugerem que mudanças intrínsecas nas propriedades mecânicas do músculo podem ser responsáveis pelo aumento dessa alteração tônica. OBJETIVO: Analisar a morfologia geral e a histomorfometria do músculo sóleo de ratos Wistar induzidos ao Parkinsonismo por 1-metil-4-fenil-1,2,3,6-tetrahidropiridina (MPTP). MATERIAIS E MÉTODOS: Utilizaram-se 24 ratos Wistar machos, com idade de 13 semanas e peso de 279 ± 13 g, divididos em quatro grupos: 1- controle-controle (n = 6): sham tratados com benserazida + salina; 2 - controle-L-DOPA (n = 6): sham tratados com benserazida + L-DOPA; 3 - MPTP- controle (n = 6): lesão na substância negra (SNc) por MPTP tratados com benserazida + salina; 4 - MPTP-L-DOPA (n = 6): lesão na SNc por MPTP tratados com benserazida + L-DOPA. Esses animais foram submetidos a eutanásia 35 dias após os procedimentos experimentais. Foram analisados: peso corporal, peso muscular, morfologia geral do músculo com microscopia de luz e mensuração da área de secção transversa das fibras musculares. Realizaram-se comparações com o teste t pareado entre o peso corporal inicial e final. A ANOVA post-hoc Tukey foi usada para comparações entre os grupos, sendo considerado significativo p ≤ 0,05. RESULTADOS: Não foram encontradas diferenças estatisticamente significativas nas variáveis analisadas. CONCLUSÃO: Os dados analisados não excluem a possibilidade de alterações ocorrerem no interior dessas células, nos tipos de fibras musculares ou em longo prazo.

INTRODUCTION: Animal models for Parkinson's disease (PD) which mimetize dopaminergic degeneration of nervous cells have been developed to study the pathology of this disease and to analyze the efficiency of new therapies. One of the cardinal signs of PD have muscle stiffness, studies suggest that intrinsic changes in mechanical properties of muscle may be responsible for the increase of this amendment tonic. OBJECTIVE: To analyze the morphology and histomorphometry of soleus muscle of rats PD-induced by 1-methyl-4-phenyl-1,2,3,6-tetrahydropiridine (MPTP). MATERIALS AND METHODS: We used 24 male Wistar rats, with the age of 13 weeks and 279 ± 13 g weight, divided into four groups: 1- control-control (n = 6): sham treated with benserazidasalina; 2 - control-L-DOPA (n = 6): sham treated with benserazida + L-DOPA; 3 - MPTP-control (n = 6): injury in substantia nigra (SNc) by MPTP treated with benserazidasalina; 4 - MPTP-L-DOPA (n = 6): CNS injury by MPTP treated with benserazida + L-DOPA. These animals were euthanized 35 days after the experimental procedures. It was analyzed: body weight, muscle weight, General muscle morphology with light microscopy and measurement of the cross-sectional area of muscle fibers. Comparisons between initial and final body weight were developed with the paired T-test. The Tukey post-hoc ANOVA was used for comparisons between groups, being considered significant p ≤ 0.05. RESULTS: No statistically significant differences were found in the analyzed variables. CONCLUSION: The data analyzed do not exclude the possibility of occurrence of changes in the interior of these cells, in the types of muscle fibers or long term.

INTRODUÇÃO: Dentre as incapacidades motoras da Doença de Parkinson (DP), as alterações posturais e de equilíbrio são parâmetros importantes para fisioterapeutas que necessitam escolher terapias específicas e direcionadas a seus pacientes. Dentre muitas opções de terapia para essa condição, a terapia virtual é estudada como um método viável para reabilitação. OBJETIVO: Verificar a aplicabilidade da reabilitação virtual em pacientes com DP para a melhora de seu equilíbrio e da qualidade de vida. MATERIAL E MÉTODOS: Seis voluntários, diagnosticados como portadores da DP nas fases II e III (escala de Hoehn e Yahr), foram recrutados para este estudo. Os pacientes (de 65 ± 13 anos) participaram de atividades envolvendo o Wii Fit, em um total de doze intervenções, duas vezes por semana. Métodos clínicos e qualitativos foram utilizados na coleta de dados para as avaliações iniciais e finais: escala de Borg, escala de equilíbrio funcional de Berg, time Up and Go, reação funcional anterior e lateral e escala de Nottingham foram aplicadas durante o estudo. Penguin Slide, Slalom Ski, Futebol e Inclinação da Mesa foram os jogos de Wii selecionados como forma de terapia virtual. RESULTADOS: Os dados coletados foram analisados utilizando o teste de Wilcoxon. Habilidade motora, capacidade funcional e qualidade de vida foram analisadas como variáveis de equilíbrio dos pacientes. Foram encontradas diferenças estatisticamente significativas nos seguintes testes: escala de Borg (p = 0.0464), escala de equilíbrio funcional de Berg (p = 0.0277), alcance lateral funcional à direita (p = 0.0431) e alcance lateral funcional à esquerda (p = 0.0277). CONCLUSÃO: Estima-se que os exercícios com terapia de realidade virtual podem ser uma ferramenta útil para melhorar o equilíbrio em pacientes com DP.

INTRODUCTION: Among Parkinson's disease (PD) motor disabilities, postural and balance alterations are important parameters to physical therapists who need to choose specific, targeted therapies for their patients. Among many therapy options, virtual therapy is studied as to whether it can be a viable rehabilitation method. OBJECTIVE: To verify the applicability of virtual rehabilitation in PD patients for the improvement of their balance and quality of life. MATERIAL AND METHODS: Six volunteers, diagnosed to be in Stages II and III of PD (Hoehn and Yahr Scale), were recruited for this study. Patients (65 ± 13 years old) participated in activities involving Wii Fit, for a total of twelve interventions, twice per week. Clinical and qualitative methods were used for the data collection for the initial and final evaluations: Borg's Scale, Berg Functional Balance Scale, Time Up and Go, anterior and lateral functional reach and Nottingham's Scale were performed during the study. Penguin Slide, Ski Slalom, Soccer Heading and Table Tilt were the Wii games selected as a form of virtual therapy. RESULTS: The collected data were analyzed using the Wilcoxon test. Motor skill, functional capacities and quality of life were analyzed as variables of the patients' balance. Statistically significant differences were found in the following tests: Borg's Scale (p = 0.0464), Berg Functional Balance Scale (p = 0.0277), lateral functional reach to the right (p = 0.0431*) and lateral functional reach to the left (p = 0.0277). CONCLUSION: It is believed that exercises with virtual reality therapy can be a useful tool to improve the balance in PD patients.