Abstract Introduction Cardiovascular disease (CVD) is the lead-ing cause of death globally, with a high proportion of hospitalizations and costs. In view of this, it is essential to understand the main CVDs in patients admitted to hospital emergency services and the role of physiotherapists, in order to plan and direct health services, and to denote participation and encourage specific physiotherapy training in the context of tertiary care. Objective To outline the profile of cardiovascular emergencies and to evaluate physiotherapy in adult patients in the emergency department of a hospital in the interior of the state of São Paulo. Methods This was an observational study which analyzed 1,256 on-call records over a period of eight months. The data collected included age, gender, cardiovascular diagnostic hypothesis and physiotherapy treatment carried out. Results A total of 75 patients with cardiovascular emergencies were included, the most prevalent of which were: heart failure (n = 21), acute coronary syndrome (n = 14), acute myocardial infarction (n = 13), bradyarrhythmia (n = 6) and hypertensive crisis (n = 5). Regarding physiotherapeutic actions and their applications, the most frequent were invasive mechanical ventilation management (n = 34), lung re-expansion maneuvers (n = 17), orotracheal intubation assistance (n = 17), non-invasive mechanical ventilation (n = 14), bronchial hygiene maneuvers (n = 12), kinesiotherapy (n = 10) and sedation (n = 10). Conclusion Heart failure and acute coronary syndrome were the cardiovascular diseases that caused the most admissions to the hospital emergency department and that the procedures with an emphasis on the respiratory system were the most applied. CVD (CVD leading lead ing globally costs this physiotherapists care Paulo 1256 1 256 1,25 oncall call months age gender out 7 n 21, 21 , 21) 14, 14 14) 13, 13 13) 6 5. 5 . 5) applications 34, 34 34) reexpansion re expansion 17, 17 17) noninvasive non 12, 12 12) 10 10. applied 125 25 1,2 2 3 1,

Resumo Introdução As doenças cardiovasculares (DCV) repre-sentam a principal causa de morte global, destacando-se em internações e gastos. Diante disso, é essencial compreender as principais DCV em pacientes admitidos em serviços de emergência hospitalar e a atuação do fisioterapeuta para planejamento e direcionamento dos serviços de saúde e para denotar a participação e incentivar formações fisioterapêuticas específicas no contexto da atenção terciária. Objetivo Traçar o perfil de emergências cardiovasculares e avaliar a atuação fisioterapêutica em pacientes adultos de serviço de emergência de um hospital no interior do estado de São Paulo. Métodos Trata-se de um estudo observacional, em que foram analisadas 1.256 fichas de passagem de plantão, no período de oito meses. Os dados coletados foram idade, sexo, hipótese diagnóstica cardiovascular e tratamento fisioterapêutico realizado. Resultados Foram incluídos 75 pacientes que apresentavam o perfil de emergências cardiovasculares, sendo as mais prevalentes: insuficiência cardíaca (n = 21), síndrome corona-riana aguda (n = 14), infarto agudo do miocárdio (n = 13), bradarritmia (n = 6) e crise hipertensiva (n = 5). Em relação à atuação fisioterapêutica e suas aplicações, as mais frequentes foram manejo da ventilação mecânica invasiva (n = 34), manobras de reexpansão pulmonar (n = 17), auxílio a intubação orotraqueal (n = 17), ventila-ção mecânica não invasiva (n = 14), manobras de higiene brônquica (n = 12), cinesioterapia (n = 10) e sedestação (n = 10). Conclusão A insuficiência cardíaca e a síndrome coronária aguda foram as doenças cardiovasculares que mais ocasionaram internação no serviço de emergência hospitalar e as condutas com ênfase no aparelho respiratório foram as mais aplicadas. (DCV representam repre sentam global destacandose destacando se gastos disso terciária Paulo Tratase Trata observacional 1256 1 256 1.25 plantão meses idade sexo realizado 7 prevalentes n 21, 21 , 21) coronariana corona riana 14, 14 14) 13, 13 13) 6 5. 5 . 5) aplicações 34, 34 34) 17, 17 17) ventila ção 12, 12 12) 10 10. aplicadas 125 25 1.2 2 3 1.

Abstract Introduction: It is crucial to integrate realistic assessment approaches for cardiovascular physiotherapeutic skills in the professional context. The Objective Structured Clinical Examination (OSCE) is notably reliable and valid. However, understanding the student's perception after this experience is important for readjusting the assessment. Objective: To evaluate the strengths and limitations of applying the OSCE to undergraduate students during the Supervised Cardiovascular Physiotherapy Internship. Methods: Descriptive, qualitative, observational, and cross-sectional study. The students were submitted to the OSCE. After completion, a questionnaire was administered to assess their perception, containing seven items: A) General exam organization; B) Clinical vignettes and instructions; C) Adequacy of the tasks required; D) Quality of post-examination explanations; E) Complexity of the content involved, in which the student could assign a grade from 1 to 5 (1 = insufficient; 2 = fair; 3 = good; 4 = great; 5 = excellent); F) Difficulty with time management; and G) Emotional stress. Items F and G were rated: 1 = very low; 2 = low; 3 = moderate; 4 = high; and 5 = very high. Results: Fifty-one students responded to the questionnaire. For items A, B, C, D, and E, the most prevalent response was excellent (72.5%, 43.1%, 52.9%, 88.2%, and 54.9% respectively). Regarding item F, 54.9% of students reported moderate difficulty managing their time. Regarding item G, 94.2% reported a very high level of emotional stress. Conclusion: Application of the OSCE provided experiences of clinical cases with adequate complexity, in an organized manner and with an enriching final evaluation. Introduction context (OSCE valid However s Internship Methods Descriptive qualitative observational crosssectional cross sectional study completion A organization B instructions C required D postexamination post examination explanations E involved ( insufficient fair good great excellent) management stress rated low Results Fiftyone Fifty one 72.5%, 725 72 (72.5% 431 43 43.1% 529 52 9 52.9% 882 88 88.2% 549 54 54.9 respectively. respectively . respectively) 942 94 94.2 Conclusion complexity evaluation 72.5% 7 (72.5 43.1 52.9 8 88.2 54. 94. 72.5 (72. 43. 52. 88. 72. (72 (7

Resumo Introdução: É crucial integrar abordagens avaliativas realistas para habilidades fisioterapêuticas cardiovasculares no âmbito profissional. O Objective Structured Clinical Examination (OSCE) é notoriamente confiável e válido, entretanto, compreender a percepção do aluno após essa experiência é importante para a readequação dessa avaliação. Objetivo: Avaliar os pontos fortes e as limitações da aplicação do OSCE em discentes do curso de graduação em fisioterapia durante estágio supervisionado de fisioterapia cardiovascular. Métodos: Trata-se de um estudo descritivo, qualitativo, observacional e transversal. Os discentes foram submetidos ao OSCE e, após a finalização, aplicou-se um questionário para avaliação da percepção contendo sete itens: A) organização geral do exame; B) casos clínicos e instruções para o exame; C) adequação das tarefas exigidas; D) qualidade das explicações pós-exame; E) complexidade do conteúdo envolvido, em que o discente poderia atribuir uma nota de 1 a 5 (1 = insuficiente; 2 = regular; 3 = bom; 4 = ótimo; 5 = excelente); F) dificuldade com o gerenciamento do tempo; e G) estresse emocional. Os itens F e G tinham as notas: 1 = muito baixo; 2 = baixo; 3 = médio; 4 = alto; e 5 = muito alto. Resultados: Cinquenta e um alunos responderam ao questionário. Para o itens A, B, C, D e E, a resposta mais prevalente foi excelente (72,5%, 43,1%, 52,9%, 88,2% e 54,9% respectivamente). Em relação ao item F, 54,9% dos alunos relataram dificuldade média a muito alta em gerenciar o tempo. Em relação ao item G, 94,2% relataram nível muito alto de estresse emocional. Conclusão: A aplicação do OSCE propiciou vivências de casos clínicos com complexidade adequada de forma organizada e com avaliação final enriquecedora. Introdução profissional (OSCE válido entretanto Objetivo cardiovascular Métodos Tratase Trata se descritivo qualitativo transversal finalização aplicouse aplicou exame B C exigidas pósexame pós pós-exame E envolvido ( insuficiente regular bom ótimo excelente) tempo emocional notas baixo médio Resultados 72,5%, 725 72 (72,5% 431 43 43,1% 529 52 9 52,9% 882 88 88,2 549 54 54,9 respectivamente. respectivamente . respectivamente) 942 94 94,2 Conclusão enriquecedora 72,5% 7 (72,5 43,1 52,9 8 88, 54, 94, 72,5 (72, 43, 52, 72, (72 (7

Abstract Alcohol has been widely consumed for centuries and is linked to the aggravation of diseases. Several studies have shown that excessive consumption of ethanol results in morphophysiological changes in the male reproductive system. One of the effects of ethanol is the decrease in testosterone concentration and hormonal therapies are an alternative to minimize the changes resulting from chronic alcoholism. Qualitative studies were commonly carried out to evaluate the male histopathological alterations resulting from ethanol consumption, being necessary quantitative and non-subjective techniques. This study analyzes the importance of fractal analysis as a useful tool to identify and quantify tissue remodeling in rats submitted to ethanol consumption and hormone therapy with testosterone. Prostate of animals submitted to chronic ethanol consumption showed tissue disorganization, which was confirmed by an increasing of fractal dimension. Regarding the prostatic stroma, collagen fractal dimension and quantification revealed lower values in animals that were only submitted to androgen therapy. Thus, we can conclude that the fractal analysis was a useful tool to quantify tissue changes caused by ethanol consumption and androgen therapy. diseases system alcoholism nonsubjective non subjective techniques disorganization stroma Thus

RESUMO O objetivo deste estudo foi avaliar e comparar a resposta aguda de parâmetros hemodinâmicos de acordo com o uso de realidade virtual (RV) semi-imersiva e terapia convencional (TC) em indivíduos internados no serviço hospitalar de emergência por insuficiência cardíaca (IC). Trata-se de estudo de viabilidade com 11 indivíduos submetidos a sessões de terapia com e sem o uso da RV. Na TC, os participantes realizaram alongamentos, exercícios ativos ou ativo-assistidos e inspiração fracionada. Já na terapia com realidade virtual (TRV) utilizou-se os óculos VR box - virtual reality glasses aplicando VR relax associado à TC. Os parâmetros hemodinâmicos avaliados foram: frequência cardíaca, pressão arterial sistólica e diastólica e saturação de oxigênio. Para análise, foram utilizados os testes t de Student e de Mann-Whitney (p<0,05). Ao avaliar os parâmetros hemodinâmicos basal e final em ambos os grupos, não foi verificada diferença significativa entre os momentos (p>0,05). Com relação à comparação das variações absolutas entre a TC e a TRV, não foi observada diferença significativa entre as respostas hemodinâmicas (p>0,05). Os resultados demonstraram que a implementação da TRV e da TC promoveram alterações fisiológicas nas respostas dos parâmetros hemodinâmicos em indivíduos com IC hospitalizados em uma unidade de emergência, não havendo diferenças significativas entre as duas intervenções. O estudo sugere que a RV é um método hemodinamicamente seguro para aplicação em unidade de emergência.

ABSTRACT This study aimed to evaluate and to compare the acute response, due to semi-immersive virtual reality (VR) and conventional therapies (CT), of hemodynamic parameters in hospitalized individuals admitted to an emergency unity for heart failure (HF). This is a viability study with 11 individuals subjected to sessions with and without VR. At CT, stretching, active or active-assisted exercises, and fractional inspiration were performed. In VR therapy (VRT), VR box glasses were used to promote VR relaxation associated with CT. The hemodynamic parameters evaluated were heart rate, systolic and diastolic blood pressure, oxygen saturation, and double product. To analyze them, Student’s t- and Mann Whitney tests were used (p<0.05). Comparing baseline and final evaluations showed no significant differences in the hemodynamic parameters of both groups (p>0.05). Comparing absolute variations between CT and VRT also produced no significant differences between hemodynamic responses (p>0.05). Results showed that administering VRT and CT promoted physiological changes in the responses of hemodynamic parameters in individuals with HF hospitalized in an emergency unit without significant differences between the two interventions. This study suggests that VRT is a hemodynamically safe method for treating patients in emergency units.

RESUMEN El objetivo de este estudio fue evaluar y comparar la respuesta aguda de los parámetros hemodinámicos según el uso de realidad virtual (RV) semiinmersiva y terapia convencional (TC) en individuos ingresados por insuficiencia cardiaca (IC) en el servicio de urgencias de un hospital. Este es un estudio de factibilidad con la participación de 11 personas, quienes se sometieron a sesiones de terapia con el uso de RV y sin este. En la TC, los participantes realizaron estiramientos, ejercicios activos o activos-asistidos e inspiración fraccionada. En la terapia de realidad virtual (TRV), utilizaron gafas VR box virtual reality glasses aplicando realidad virtual VR relax asociada a la TC. Los parámetros hemodinámicos que se evaluaron fueron los siguientes: frecuencia cardiaca, presión arterial sistólica y diastólica, y saturación de oxígeno. El análisis de datos utilizó las pruebas t de Student y de Mann-Whitney (p<0,05). Al evaluar los parámetros hemodinámicos basales y finales en ambos grupos, se observó que no hubo diferencia significativa entre los momentos (p>0,05). En cuanto a la comparación de las variaciones absolutas entre TC y TRV, no se observó diferencia significativa entre las respuestas hemodinámicas (p>0,05). Los resultados mostraron que la implementación de la TRV y la TC posibilitó cambios fisiológicos en las respuestas de los parámetros hemodinámicos en individuos con IC hospitalizados en una unidad de urgencias, sin diferencias significativas entre las dos intervenciones. El estudio apunta que la RV es un método hemodinámico seguro para aplicarse en la unidad de urgencias.

SUMMARY: Intermittent fasting and concurrent training have been performed frequently to decrease body mass. The aim was to analyze the effects of concurrent training (CT) and intermittent fasting (IF) on cardiac remodeling. In total, 39 adult male Wistar rats were used, divided into four groups: control (C [n = 12]), fasting control (FC [n = 11]), training (T [n = 8]) and fasting training (FT [n = 8]). The CT protocol was composed of 12 sessions, with 30 minutes of aerobic training (AT) in the liquid medium at an intensity of 80 % of the anaerobic threshold, followed by resistance training (RT) with 4 series of 10 aquatic jumps at an corresponding to 50 % of body weight. The IF period was established at 12/12 hours, starting at 9 p.m. and ending at 9 a.m. Echocardiographic analyzes were performed before and after the intervention and, at the end of the experiment, samples of the cardiac tissue were collected to perform the histological analyses. Data analysis was performed using the Shapiro-Wilk tests, Analysis of Variance - ANOVA with Tukey's post-test, and Kruskal- Wallis with Dunn's post-test. All procedures assumed an error of 5 % (p<0.05). Neither group showed alterations in the functional (min. p= 0.12 - max. p= 0.83) and structural parameters of the heart (min. p=0.31 - max. p=0.83). A decrease was observed in the area of cardiomyocytes in the T (p=0.001) and FT groups (p=0.001). The CT and IF did not alter the functional and structural parameters of the heart, but did cause a decrease in the area of the cardiomyocytes.

RESUMEN: El ayuno intermitente y el entrenamiento concurrente se han realizado frecuentemente para disminuir la masa corporal. El objetivo fue analizar los efectos del entrenamiento concurrente (EC) y el ayuno intermitente (AI) sobre el remodelado cardíaco. En total, se utilizaron 39 ratas Wistar macho adultas, divididas en cuatro grupos: control (C [n = 12]), control en ayunas (AC [n = 11]), entrenamiento (E [n = 8]) y ayuno, entrenamiento [n = 8]). El protocolo de EC estuvo compuesto de 12 sesiones, con 30 minutos de entrenamiento aeróbico (EA) en el medio líquido a una intensidad del 80 % del umbral anaeróbico, seguido de entrenamiento de resistencia (ER) con 4 series de 10 saltos acuáticos correspondiente al 50 % del peso corporal. El período de AI se estableció a las 12/12 horas, a partir de las 21:00 horas. finalizando a las 9 a.m. Se realizaron análisis ecocardiográficos antes y después de la intervención y, al finalizar el experimento, se reco- lectaron muestras del tejido cardíaco para realizar los análisis histológicos. El análisis de los datos se realizó mediante las pruebas de Shapiro-Wilk, Análisis de Varianza - ANOVA con pos test de Tukey y Kruskal-Wallis con postest de Dunn. Todos los procedimientos asumieron un error del 5 % (p <0,05). No se observaron alteraciones funcionales de los grupos (mín. P = 0,12 - máx. P = 0,83) y estructurales del corazón (mín. P = 0,31 - máx. P = 0,83). Se observó una disminución en el área de cardiomiocitos en los grupos E (p = 0,001) y EA (p = 0,001). La EC y la AI no alteraron los parámetros funcionales y estructurales del corazón, pero sí provocaron una disminución del área de los cardiomiocitos.

Abstract Background Resistance training is effective in cardiac rehabilitation; however, it is conventionally performed using free weights or machines, which can pose logistic challenges to patients with restricted mobility. For its ease of access and cost-effectiveness, elastic tubing is a particularly appealing alternative, but it remains underutilized for this purpose. Objective To evaluate muscle strength, functional capacity, aerobic capacity, and quality of life in patients with heart disease in phase II of cardiovascular rehabilitation after a resistance training intervention based solely on elastic tubing. Methods Thirteen patients with heart disease (age 63.33±10.80 years) trained with elastic tubing twice weekly for 6 weeks, with progressive load increase every 15 days. The following muscle groups were evaluated and trained: shoulder abductors and flexors, elbow flexors, and knee flexors and extensors. Muscle strength was evaluated using a dynamometer; functional capacity, with a 6-minute walk test and cardiopulmonary exercise test; and quality of life, using the SF-36 questionnaire. Data normality was assessed using the Shapiro–Wilk test. The paired Student’s t-test was used for comparisons before and after training, at a significance level of <5%. Results There were significant differences in muscle strength (except for elbow flexion) and functional capacity (485.5 ± 123.3 vs 578.7 ± 110.5; p=0.0399) after the intervention. No statistical differences were found in cardiorespiratory fitness or quality of life. Conclusions Short-term resistance training with elastic tubing improved peripheral muscle strength and functional capacity in patients with heart disease, and should be encouraged for this population. (Int J Cardiovasc Sci. 2020; xx(x):xxx-xxx)

Abstract Aim: This study aimed to evaluate the effect of High-Intensity Interval Training (HIIT) on the skeletal muscle of Spontaneously Hypertensive Rats (SHR). Method: In total, 20 male rats, SHR, 12 months old, were used, distributed into 2 groups: Control Group (C) and Training Group (HIIT). The training lasted approximately 50 minutes/day, 5 days/week, for 8 weeks. Systolic blood pressure (BP) was measured at the beginning and end of the study. Analysis: The medial gastrocnemius muscle was used to measure the smallest fiber diameter, after which the Shapiro-Wilk normality test was performed, followed by the Mann Whitney test to compare the medians and interquartile intervals (IQI) of the muscle fibers and Student t-test for performance. For analysis of BP, Analysis of Variance - ANOVA was used, followed by Tukey's post-test. All procedures adopted a significance value of 5% (p < 0.05). Results: The median values for the variable “smallest diameter” of muscle fibers were 29.48 (IQI: 9.96) µm in the C group and 33.45 (IQI: 9.44) µm in the HIIT group (p < 0.05). Also, the performance was increased in the trained animal group and blood pressure values decreased significantly at the end of the experiment (p < 0.05). Conclusion: The HIIT intensity promoted an increase in the median values of the muscle fibers and performance. Finally, a significant decrease was observed in blood pressure variation values.

Resumo Introdução: Diversas modalidades de tratamento são utilizadas para recuperação do tecido muscular, dentre elas a fotobiomodulação pode ser empregada para melhorar a qualidade da regeneração e a dimensão fractal se apresenta como uma metodologia inovadora na avaliação quantitativa da eficácia do tratamento. Objetivo: Utilizar a dimensão fractal como método de análise quantitativa do efeito do Laser de Arseneto de Gálio (AsGa) na fase inicial do processo de regeneração muscular. Método: Foram utilizados trinta ratos Wistar, machos divididos em: Grupo Controle (CT), Grupo lesado e não tratado (LNT) e Grupo Lesado e tratado (LT). A lesão muscular foi induzida por criolesão na região central do ventre do músculo tibial anterior (TA) do membro posterior esquerdo, por meio de uma haste de ferro previamente imersa em nitrogênio líquido. As aplicações foram iniciadas 24 horas após a lesão, diariamente, durante cinco dias, em dois pontos na área da lesão. No sétimo dia os animais foram eutanasiados; o músculo TA retirado, congelado em nitrogênio líquido e os cortes histológicos corados com a técnica de Hematoxilina-Eosina para serem então submetidos à análise de dimensão fractal realizada pelo método boxcounting através do software Image J. Para a normalidade dos dados utilizou-se Kolmogorov Smirnov, para as comparações teste de Kruskall-Wallis com pós teste de Dunn (p<0,05%). Resultados: A comparação entre LT e LNT foi estatisticamente significativa, sendo possível observar a redução da fractabilidade com p=0,0034. Conclusão: A dimensão fractal é uma ferramenta útil para análise da desorganização músculo esquelética na fase inicial da regeneração e mostra o potencial efeito benéfico da fotobiomodulação nesse processo.

Abstract Introduction: Many treatment modalities are used for muscle tissue recovery. Photobiomodulation is a modality that can be employed to improve the quality of tissue repair. The use of fractal dimension (FD) is an innovative methodology in the quantitative evaluation of treatment efficacy. Objective: Use FD as a quantitative analysis method to evaluate the effect of photobiomodulation of 904 nanometers (nm) in the initial phase of the muscle regeneration process. Method: Thirty male Wistar rats were divided into three groups: Control Group (CG), Injured and Untreated Group (IUT), and Injured and Treated Group (IT). Muscle injury was induced by cryoinjury in the central region of the anterior tibial (AT) belly of the left posterior limb. This was performed by an iron rod that was previously immersed in liquid nitrogen. Applications started 24 hours after the injury and occurred daily for five days. They were performed at two points in the lesion area. The rats were euthanized on the seventh day. The AT muscles were removed and frozen in liquid nitrogen. Then, the histological sections were stained using the Hematoxylin-Eosin (HE) technique and submitted to FD analysis performed by the box-counting method using ImageJ software. The Kolmogorov-Smirnov test was used for data normality, and the Kruskall-Wallis test and Dunn's post-test were used for group comparison (p<0.05%). Results: Differences between IT and IUT groups were statistically significant, and it was possible to observe the reduction of fractability with p=0.0034. Conclusion: FD is a useful tool for the analysis of skeletal muscle disorganization in the initial phase of regeneration and confirms the potentially beneficial effects of photobiomodulation to this process.

Abstract Background: Brazil is the worldwide leader in the long-term use of pesticides and herbicides. This compromises the health of handlers by causing harmful neurological, respiratory, and cardiovascular changes. The herbicide 2.4D has been shown to cause cardiac overload with subsequent pathological remodeling. Objective: To analyze the cardiac morphological repercussions on the left ventricle (LV) of mice submitted to nebulization by the herbicide 2.4D. Methods: Fifteen mice were divided into three groups: control group (CG; n = 5) exposed to nebulization with sodium chloride solution; low concentration group (LCG; n = 5) exposed to nebulization of the herbicide 2.4D with 3.71 x 10-3 grams; and high concentration group (HCG; n = 5) exposed to nebulization of the herbicide 2.4D with 9.28 x 10-3 grams for 15 minutes. The fractal dimension analysis was performed through the box-counting method. Later, the ImageJ program was used to calculate the fractal dimension of each group. To evaluate cardiac remodeling, histological slides were prepared and stained with Hematoxylin-Eosin (HE). Fifty areas of cardiomyocytes were analyzed per animal. The comparisons between groups were performed by ANOVA One-Way with Tukey’s posttest (p < 0.05). Results: There was no change in fractal dimension values between the CG = 1.37 ± 0.02, LCG = 1.33 ± 0.04 and the HCG = 1.33 ± 0.07 groups. However, cardiac hypertrophy occurred in the HCG = 303.9 ± 38.80 µm(2) when compared to the CG group = 236.9 ± 61.71 µm(2) (p = 0.034). Conclusion: The herbicide 2.4D used for 72 hours did not promote cardiotoxicity when evaluated by fractal dimension. However, cardiomyocyte hypertrophy was observed in the LV.

Abstract Background: Virtual reality is an alternative therapeutic resource to be inserted into cardiovascular rehabilitation, stimulating the practice of physical activity through man-machine interaction. Objective: To compare the effects of conventional and virtual reality cardiac rehabilitation on body composition and functional capacity in patients with heart disease. Methods: Randomized clinical trial with 27 cardiac patients divided into conventional rehabilitation group (CRG) and virtual reality rehabilitation group (VRG). They underwent a rehabilitation program with 60-minute training sessions twice a week for eight weeks. The VRG training consisted of exercises from the Xbox 360® with Kinect(tm), using YourShape(tm) and Dance Central 3(tm) games. The CRG used conventional treadmills for aerobic exercise and free weights for resistance exercise. Bioimpedance and 6-minute walk test (6MWT) were evaluated at baseline and after training. For main outcome analysis, Student t and Mann Whitney tests were used with a 5% significance level. Results: The VRG showed a significant increase in body fat percentage and fat weight when compared to the CRG, and a smaller amount of total water. There was a significant improvement in functional capacity evidenced by the increase in the distance covered in the 6MWT (54.00 m and 32.25 m in the CRG and VRG, respectively), but the gains did not differ between the groups. Conclusion: The two rehabilitation modalities had no effect on the body composition of the groups. In addition, the improvement in functional capacity was similar in both groups.

RESUMO Objetivo: Avaliar se a presença de síndrome da apneia obstrutiva do sono (SAOS) modifica a percepção de queixas respiratórias e de qualidade de vida em pacientes com DPOC por meio de questionários específicos, além de verificar se escalas de sonolência diurna e de rastreamento para SAOS podem ser empregadas na tríade SAOS, DPOC e obesidade. Métodos: Foram incluídos no estudo 66 portadores diagnosticados com DPOC leve/moderada ou grave e com índice de massa corpórea > 27 kg/m2. Após a polissonografia, foram aplicados escala de sonolência de Epworth (ESE), Questionário de Berlim (QB), escala modificada do Medical Research Council (mMRC), Baseline Dyspnea Index (BDI) e Saint George’s Respiratory Questionnaire (SGRQ). Resultados: Foram analisados os grupos DPOC e SAOS (n = 46) vs. DPOC sem SAOS (n = 20). Do primeiro grupo, foram formados os subgrupos DPOC+SAOS leve/moderada (n = 32) e DPOC+SAOS grave (n = 14), que foram comparados com o grupo DPOC sem SAOS. Houve diferença significativa nas médias de VEF1 (l) entre os grupos DPOC com e sem SAOS (p = 0,073). A presença da tríade não aumentou significativamente o escore de ESE, tendo o escore > 10 especificidade de 0,58. O QB não identificou alto risco para SAOS na presença da tríade (especificidade de 0,31). Não houve diferenças significativas nos domínios e no escore total do SGRQ entre os grupos DPOC com e sem SAOS. Conclusões: Os fatores de confusão presentes na tríade SAOS, DPOC e obesidade impediram a percepção de maior sonolência diurna e de risco elevado de SAOS. Não foi identificada piora na percepção de dispneia e na qualidade de vida.

ABSTRACT Objective: To investigate whether the presence of obstructive sleep apnea syndrome (OSAS) alters the perception of respiratory symptoms and quality of life in COPD patients, by using specific questionnaires, as well as to determine whether scales for assessing daytime sleepiness and for screening for OSAS can be used in the triad of OSAS, COPD, and obesity. Methods: We included 66 patients diagnosed with mild-to-moderate or severe COPD and presenting with a body mass index > 27 kg/m2. After polysomnography, patients completed the Epworth sleepiness scale (ESS), the Berlin questionnaire (BQ), the modified Medical Research Council (mMRC) scale, the Baseline Dyspnea Index (BDI), and the Saint George’s Respiratory Questionnaire (SGRQ). Results: Patients were first divided into two groups: COPD + OSAS (n = 46); and COPD-only (n = 20). The COPD + OSAS group was subdivided into a COPD + mild-to-moderate OSAS group (n = 32) and a COPD + severe OSAS group (n = 14), all of which were compared with the COPD-only group. There was a significant difference in mean FEV1 (L) between the COPD + OSAS groups and the COPD-only group (p = 0.073). The presence of the triad did not lead to significantly higher ESS scores, and scores > 10 had a specificity of 0.58. The BQ did not identify high risk for OSAS in the presence of the triad (specificity of 0.31). There were no significant differences in domain or total scores of the SGRQ between the COPD + OSAS groups and the COPD-only group. Conclusions: The confounding factors present in the triad of OSAS, COPD, and obesity prevented the perception of increased daytime sleepiness and high risk for OSAS. We observed no worsening of dyspnea perception or quality of life.

RESUMO O objetivo deste estudo é avaliar o perfil antropométrico, o nível de atividade física e a postura em universitários da área da saúde. Este é um estudo transversal envolvendo 100 estudantes de uma universidade na Zona Oeste de São Paulo. Peso, altura, circunferência da cintura e índice de massa corporal foram coletados. Também foram aplicados o Questionário Internacional de Atividade Física, o Inventário de Ansiedade Traço-Estado e o Instrumento de Avaliação Postural. Os resultados deste estudo mostram que 67% dos estudantes têm IMC médio de 22,12±4,84 kg/m² e 38% são regularmente ativos. Acerca dos níveis de ansiedade, a amostra obtida (média IDATE E 40,6 pontos e IDATE T 40,05) pode ser classificada como moderada. Além disso, 50% da amostra tem concavidade lombar. Portanto, a maioria dos estudantes demonstrou valores antropométricos normais, eram regularmente ativos, tinham nível moderado de ansiedade e nenhum defeito na postura corporal.

ABSTRACT The objective of this study was to evaluate the anthropometric profile, level of physical activity, anxiety level, and posture of graduate students in the health field. This is a cross-sectional study involving 100 college students from health courses at a university in the western state of São Paulo. Weight, height, waist circumference, and body mass index data were collected. We also applied the International Physical Activity Questionnaire for physical activity; the State-Trait Anxiety Inventory for anxiety; and the Postural Assessment Instrument for postural defects. The results of this study show that 67% of students have an average BMI of 22.12±4.84 kg/m², and 38% are regularly active. Regarding anxiety levels, the sample obtained (mean STAI E 40.6 points and STAI T 40.05) can be classified as moderate. In addition, 50% of the sample have lumbar concavity. Therefore, most health care university students displayed normal anthropometric values, were regularly active, had a moderate level of anxiety and had no postural defects.

RESUMEN El objectivo de este estudio fue evaluar perfil antropométrico, nivel de actividad física, grado de ansiedad y postura de estudiantes universitarios de la salud. Este es un estudio transversal de observación envolviendo 100 estudiantes universitarios de cursos de la salud en una universidad del Oeste del estado de São Paulo, Brasil. Datos como peso, altura, circunferencia de la cintura y índice de masa corporal (IMC) fueron recogidos. Nosotros también aplicamos el Cuestionario Internacional de Actividad Física para actividad física; el Inventario de Ansiedad Trazo-Estado (Idate) para ansiedad; y el Instrumento de Evaluación Postural para defectos de postura. Los resultados de este estudio mostraron que 67% de los estudiantes tienen IMC medio de 22.12±4.84 kg/m² y 38% son regularmente activos. Considerándose los grados de ansiedad, el ejemplo obtenido (Idate-E de 40,6 puntos y Idate-T de 40,05) puede ser clasificado como moderado. Además, 50% de los estudiantes del ejemplo presenta concavidad lumbar. Por lo tanto, la mayoría de los estudiantes de la salud analizados presentan valores antropométricos normales, son regularmente activos, tienen grado moderado de ansiedad y no presentan defectos posturales.

Resumo Introdução: Apesar da prevalência da asma definida, há imprecisão sobre incidência de broncoespasmo induzido por exercício (BIE). Objetivo: Comparar a freqüência de BIE entre nadadores e sedentários, e observar a variabilidade da freqüência cardíaca durante a atividade de broncoprovocação. Métodos: Incluídos 18 nadadores (grupo 1) e 18 sedentários (grupo 2). Permaneceram por 30 minutos de repouso para a avaliação da VFC. Foi aferida a pressão arterial (PA), frequência respiratória (f) e a saturação de pulso de oxigênio (SpO2). Permaneceram sentados, para o teste de espirometria (manobra da capacidade vital forçada - CVF). Essa foi repetida em 5, 10, 15, 20 e 30 minutos após o teste de esforço. A análise estatística usou os testes t de Student, Mann Whitney de Shapiro-Wilk, com nível de significância p<0,05. Resultados: A espirometria evidenciou 3 sedentários e 10 nadadores com distúrbio ventilatório obstrutivo (DVO). Apenas 2 do grupo sedentário apresentaram broncoprovocação positiva e nenhum do grupo de nadadores. Um critério fundamental para diagnosticar DVO, a relação entre o volume expiratório no primeiro segundo e a CVF (VEF1/CVF) foi estatisticamente menor no grupo de nadadores. As médias da raiz quadrada da média do quadrado das diferenças entre intervalos RR normais adjacentes, em um intervalo de tempo (RMSSD) e no desvio padrão de todos os intervalos RR normais gravados em um intervalo de tempo (SDNN), foram estatisticamente maiores entre os atletas. Conclusão: O teste de broncoprovocação identificou maior prevalência de broncoespasmo entre os sedentários. Entretanto, houve redução na relação VEF1/CVF e maior VFC no grupo de nadadores.

Abstract Introduction: Despite the prevalence of prescribed asthma, there is uncertainty about the incidence of exercise-induced bronchospasm (EIB). Objective: Compare the frequency of EIB between swimmers and sedentary individuals, and observe heart rate variability during bronchial activity. Methods: In total, 18 swimmers (group 1) and 18 sedentary individuals (group 2) were included. The participants rested for 30 minutes for evaluation of HRV. Blood pressure (PA), respiratory rate (RR), and pulse oxygen saturation (SpO2) were measured. The volunteers remained seated for the spirometry test (maneuver of forced vital capacity - FVC). This was repeated 5, 10, 15, 20, and 30 minutes after the exercise test. The statistical analysis used the Student t, Mann Whitney, and Shapiro-Wilks tests. The significance level was p <0.05. Results: The spirometry findings showed 3 sedentary individuals and 10 swimmers with obstructive ventilatory disorder (OVD). Only 2 of the sedentary and none of the swimmer group demonstrated positive bronchial provocation. A key criterion for diagnosing OVD, the relationship between forced expiratory volume in one second and FVC (FEV1/FVC), was statistically lower in the swimmer group. The measures of the root mean square of the successive differences between adjacent normal RR intervals, in a time interval (RMSSD), and the standard deviation of all normal RR intervals recorded in a time interval (SDNN) were significantly higher among the athletes. Conclusion: The bronchial provocation test identified a higher prevalence of bronchospasm among sedentary individuals. However, there was a reduction in the FEV1/FVC ratio and higher HRV in the group of swimmers.

Resumo Introdução: A corrente russa é uma corrente elétrica de média frequência que é capaz de restabelecer as propriedades do músculo esquelético a baixo custo de tratamento. É imprescindível conhecer os efeitos da corrente russa no tecido ósseo, visto que a energia eletromagnética pode ser uma forma eficiente e de menor custo para tratar alterações ósseas. Objetivo: Avaliar a eficácia da corrente russa na consolidação de fratura experimental de tíbia em ratos adultos. Métodos: Foram utilizados 24 ratos machos adultos Albinus Wistar. Os animais foram distribuídos de forma randomizada em dois grupos: Grupo Controle (GC), composto por 12 animais e Grupo Intervenção (GI) compostos por 12 animais, ambos os sofreram osteotomia (face medial proximal da tíbia). O GI foi submetido a um protocolo de eletroestimulação com corrente russa, enquanto o GC não sofreu nenhum tipo de intervenção. Foi realizada a eutanásia de três animais de cada grupo nos seguintes períodos: 5°, 10°, 20° e 30° dia de tratamento. Resultados: Os resultados sugeriram maior ossificação primária, intensa atividade osteogênica e aumento da espessura de periósteo, caracterizando assim uma ossificação mais avançada com maior presença de trabéculas na medula óssea no grupo de ratos submetidos ao tratamento. Desta forma, pode-se atribuir mais um efeito benéfico nas intervenções com corrente russa, para o tratamento de reabilitação pós-fratura. Conclusão: Em ambos os grupos analisados ocorreu processo de reparação tecidual ósseo, porém no grupo eletroestimulado o processo de osteogênese foi mais avançado.

Abstract Introduction: Russian current is an electric current of average frequency that is able to restore the properties of skeletal muscle at a low treatment cost. It is essential to know the effects of Russian current in bone tissue, since electromagnetic energy could be an efficient and low cost method to treat bone disorders. Objective: The aim of the study was to evaluate the effectiveness of Russian current in the consolidation of tibia fracture in adult rats. Methods: 24 adult male Albinus Wistar rats wereused. The animals were divided randomly into two groups: control group (CG), composed of 12 animals, and Intervention Group (IG) consisting of 12 animals, both groups were submitted to osteotomy (proximal medial surface of the tibia). The IG underwent an electrical stimulation protocol with Russian current, while the CG did not undergo any kind of intervention. Euthanasia was performed in three animals of each group on the following days: 5, 10, 20, and 30 days of treatment. Results: The results suggested higher primary ossification, intense osteogenic activity, and increased thickness of the periosteum, characterizing more advanced ossification and a greater presence of trabecular bone marrow in rats in the group subjected to the treatment. In this way, we can assign one more beneficial effect to interventions with Russian current, for the treatment of postfracture rehabilitation. Conclusion: In both groups the bone tissue repair process occurred, but in the electrically stimulated group the osteogenesis process was more advanced.