ABSTRACT The dynamic balance of the lower limbs has shown great importance in accomplishing activities of daily living, especially for walking and maintenance in the orthostatic position. In this context, individuals with knee osteoarthritis have changes in their physical capacity, mainly due to joint changes and muscular wear. The instrument called OctoBalance® is one of the most used to evaluate this balance, which analyses four different executions of movement in the limbs. However, individuals with knee osteoarthritis cannot perform this evaluation due to the need for single limb support during movements. This study aimed to verify whether it is reproducible to perform the dynamic balance evaluation of lower limbs with a reduction of 10% of body weight through a suspension system. A cross-sectional study was carried out with 2 collections with a 48-hour interval between them, using the Lower Body Test performed with OctoBalance®. The dynamic balance test followed the protocol of 3 repetitions observing the learning factor and then 3 repetitions where the values were collected, with the suggested adaptation for all 4 diagonals in both limbs. The interclass correlation index (ICI), coefficient of variation (CV), estimative standard error (EEE) and minimum detectable difference (MDD) were calculated as indicators of reproducibility. Also, Bland-Altman Graphs were used for visual verification of the agreement between the means. Results: The reliability tests showed a very high interclass correlation through the ICI and low variation values for all the movements evaluated through the CV. The EEE and MDD calculations showed positive responses for greater reliability, and the Bland-Altman graphs showed an agreement between the means. Reproducibility was positive for the Lower Body Test with the Octobalance® platform for the evaluation of lower limb dynamic balance in women with knee osteoarthritis.

ABSTRACT Hip joint degenerative pathology appears in young age groups, related to femoroacetabular impingement, and in advanced age, due to other inflammatory causes, with greater potential for severity in the presence of comorbidities. Within a sample group of 54 patients with surgical indication, treated at a university orthopaedic referral hospital, our objective is to carry out a descriptive analysis of anthropometric variables, level of pain in subjects with early hip osteoarthritis and to identify in the active-active group the distribution of domains of physical activity practice, according to the IPAQ. The prevalent age group was below 60 years (79.6%); most (44.4%) of those included in the study had femoroacetabular impact; among these subjects, 77.8% were active and 22.2% inactive. There was no statistically significant difference between groups in BMI (p= 0.838) and visual analogic scale (p= 0.259). There was a medium effect (ηp 2 = 0.072) for the BMI and a high effect (ηp 2 = 0.277) for VAS. 55.6% were male and 44.4% female. In conclusion, age under 60 years and increased incidence of BMI were present in osteoarthritis’s clinical diagnosis. Therefore, prevention and physical activity should be encouraged in individuals with this advanced joint disease.

RESUMO A patologia degenerativa articular do quadril surge em grupos etários jovens, relacionados ao impacto femoroacetabular e em idade avançada, por outras causas inflamatórias, com potencial maior de gravidade na presença de comorbidades. Dentro de um grupo amostral de 54 pacientes com indicação cirúrgica, atendidos em um hospital de referência ortopédica universitário, nosso objetivo foi realizar uma análise descritiva de variáveis antropométricas, nível de dor em indivíduos com osteoartrite do quadril avançada e identificar no grupo de indivíduos ativos a distribuição de domínios da prática de atividade física, conforme o IPAQ. A faixa etária prevalente foi abaixo de 60 anos (79,6%), a maior parte (44,4%) dos incluídos no estudo apresentavam impacto femoroacetabular, dentre os sujeitos 77,8% eram ativos e 22,2% inativos. Não não houve diferença estatisticamente significativa entre os grupos no IMC (p= 0,838) e escala visual analógica (p= 0,259). Para a variável IMC houve efeito médio (η2p= 0,072) e para a EVA efeito alto (η2p= 0,277). 55,6% eram do sexo masculino e 44,4% do feminino. Como conclusão, idade menor que 60 anos e o aumento do IMC e a sua maior incidência, esteve presentes no diagnóstico clínico da osteoartrite. Portanto, em indivíduos com osteoartrite avançada, atividades de prevenção e prática de atividades físicas devem ser incentivadas.

SUMMARY OBJECTIVE: To assess the credibility and the quality content of COVID-19 pandemic information on Brazilian websites. METHODS: We performed Google searches and screened the first 45 websites. The websites were categorized as academic, commercial, government, hospital, media, nongovernmental organizations, and professionals. The credibility was assessed by JAMA benchmark criteria and HONCODE. A checklist with WHO information about COVID-19 was developed to assess the quality content. For each website, the level of agreement with WHO information was categorized into “total,” “partial,” or “disagreement”. RESULTS: A total of 20 websites were analyzed. None of the websites had HONCODE certification. Six websites (30%) met none of the four JAMA criteria and only one website (5%) fulfilled all the four criteria. Only 11 out of 20 websites showed overall coverage >50% for the checklist. Overall, 70% (14/20) of the websites had at least 50% total agreement with WHO items. The government websites presented more disagreement with the WHO items than media websites in the overall quality content analysis. CONCLUSION: The COVID-19 information on Brazilian websites have a moderate-to-low credibility and quality, particularly on the government websites.

Abstract Background: Neuromuscular electrical stimulation seems to be a promising option to intensify the rehabilitation and improve the exercise capacity of patients in the immediate postoperative period of cardiac surgery. Objective: This study aimed to evaluate the hemodynamic (heart rate, systolic blood pressure, diastolic blood pressure, and mean blood pressure) and respiratory (respiratory rate and oxygen saturation) responses to neuromuscular electrical stimulation in the immediate postoperative period in patients submitted to cardiac surgery and to verify its feasibility and safety. Methods: This is a pilot randomized controlled trial, wherein critical patients in the immediate postoperative period of cardiac surgery were randomly assigned to a control group, using sham neuromuscular electrical stimulation, or an experimental group, submitted to neuromuscular electrical stimulation sessions (FES), for 60 min, with a 50-Hz frequency, 200-µs pulse duration, time on: 3 s, and time off: 9 s. Data distribution was evaluated by the Shapiro-Wilk test. The analysis of variance was used and a p-value < 0.05 was considered significant. Results: Thirty patients were included in the study. The neuromuscular electrical stimulation was applied within the first 23.13 ± 5.24 h after cardiac surgery, and no changes were found regarding the hemodynamic and respiratory variables between the patients who underwent neuromuscular electrical stimulation, and those in the control group. Conclusions: In the present study, neuromuscular electrical stimulation did not promote changes in hemodynamic and respiratory responses of patients in the immediate postoperative period of cardiac surgery.

Abstract AIMS To verify the incidence of injuries in professional soccer athletes in Aracaju-SE and to identify associated factors. METHODS This was an observational, prospective cohort study involving 39 healthy athletes, followed for seven months and evaluated on four occasions (start on preseason and two evaluations with three months of interval between each) through data collection sheet and orthopedic physical examination. RESULTS Participants were 20 athletes from Club Sportivo Sergipe and 19 from Associação Desportiva Confiança, with mean age of 26 years (CI 95%: 25.2-28 years), and mean career time of 9.6 years (CI 95%: 7.9-11.3 years). The 13 (2.4 / 1000 hours) diagnosed injuries occurred almost exclusively in the lower limbs and thigh muscle stretch was the most common injury. Injuries were mostly mild to moderate (69%). There was no significant association with any of the variables analyzed. CONCLUSION Low incidence of injuries was observed in this study. Predominantly, lesions occurred on non-rainy days and were due to trauma. Lower limbs were the most affected location and thigh stretch was the most common injury.

RESUMO A estimulação diafragmática elétrica transcutânea (EDET) é uma técnica de mobilização da musculatura respiratória que interfere no padrão e no ritmo respiratório. Na tentativa de avaliar as alterações no balanço autonômico cardíaco à EDET em indivíduos saudáveis, foi utilizado um modelo já estabelecido de eletroestimulação diafragmática. 22 voluntários com idades entre 22 e 35 anos, sem histórico cardíaco, foram randomizados em dois grupos (controle, n=8; EDET, n=14). O protocolo de eletroestimulação foi aplicado nos indivíduos em repouso (posição supina). O grupo controle foi submetido a estimulação elétrica em nível perceptivo, enquanto no grupo EDET o estímulo gerava contração diafragmática. Os intervalos cardíacos (CI) foram registrados por cardiofrequencímetro Polar (RS800CX). A variabilidade do intervalo cardíaco foi estudada nos domínios de tempo e frequência. No grupo controle, a estimulação elétrica não alterou a duração do intervalo cardíaco e sua variabilidade (CI: 761±44 vs. 807±39ms; RMSSD: 37±9 vs. 42±13ms; LF: 69±6 vs. 67±5nu; HF: 31±6 vs. 33±5nu), em comparação às condições basais). No entanto, o grupo EDET apresentou diminuição na modulação simpática cardíaca (LF: 43 ±3 vs. 63±4nu) e aumento da modulação parassimpática cardíaca (RMSSD: 109±10 vs. 41±6ms; HF: 57±3 vs. 37±4nu) durante a eletroestimulação diafragmática. No entanto, a duração do intervalo cardíaco não foi alterada por estimulação elétrica (CI: 686±59 vs. 780±31ms). Pode-se sugerir que o uso da EDET promove mudanças acentuadas no balanço simpatovagal, resultando em maior modulação parassimpática cardíaca, possivelmente induzida pelo aumento da mobilidade diafragmática.

ABSTRACT The transcutaneous electrical diaphragmatic stimulation (TEDS) is a technique of respiratory muscle activation that affects breathing pattern and rhythm. In an attempt to evaluate changes in cardiac autonomic balance in response to TEDS in healthy individuals, we used a well-established TEDS model. Twenty-two volunteers aged between 22 and 35 years old, with no cardiac pathology history, were randomized into two groups (control, n = 8; TEDS, n = 14). The individuals were allowed to rest in supine position and were then subjected to the electrical stimulation protocol. The control group was subjected to electrical stimulation at perceptive level, whereas for the TEDS group the electric stimulus generated diaphragm contraction. Cardiac intervals (CI) were sampled by a Polar RS800CX monitor. Cardiac interval variability was studied in the time and frequency domains. In the control group, electrical stimulation did not change cardiac interval length and variability (CI: 761±44 vs. 807±39 ms; RMSSD: 37±9 vs. 42±13 ms ; LF: 69±6 vs. 67±5 nu; HF: 31±6 vs. 33±5 nu; all comparisons versus baseline). Nevertheless, as compared to baseline, TEDS group showed decreased sympathetic cardiac modulation (LF: 43±3 vs. 63±4 nu) and increased parasympathetic cardiac modulation (RMSSD: 109±10 vs. 41±6 ms; HF: 57±3 vs. 37±4 nu) during diaphragmatic stimulation. However, cardiac interval length was not changed by electrical stimulation (CI: 686±59 vs. 780±31 ms). It can be suggested that the use of TEDS stimulus leads to pronounced changes in the cardiac sympathovagal balance, with higher parasympathetic cardiac modulation, possibly induced by increased diaphragmatic excursion.

RESUMEN La estimulación eléctrica transcutánea del diafragma (EETD) es un método que moviliza la musculatura respiratoria que interfiere en el patrón y en la frecuencia respiratoria. Para evaluar las alteraciones en el balance autónomo cardiaco por la EETD en individuos sanos, se empleó un modelo prestablecido de estimulación eléctrica muscular del diagrama. Han participado 22 voluntarios con edad entre 22 y 35 años, sin enfermedades cardiacas, puestos en grupos aleatorios: Grupo control (n=8) y EETD (n=14). Se aplicó el protocolo de estimulación eléctrica en individuos en posición decúbito supino. Al grupo control se lo sometió a la estimulación eléctrica a nivel perceptual, mientras que en el EETD la estimulación le generaba contracción del diafragma. Los intervalos cardiacos (CI) se registraron a través del monitor de ritmo cardiaco polar (RS800CX). Se estudió la variabilidad del intervalo cardiaco en los dominios tiempo y frecuencia. En el grupo control, la estimulación eléctrica no presentó alteraciones en la duración del intervalo cardiaco y su variabilidad (CI: 761±44 vs. 807±39ms; RMSSD: 37±9 vs. 42±13ms; LF: 69±6 vs. 67±5nu; HF: 31±6 vs. 33±5nu; comparado con las condiciones de base). Pero si comparado las condiciones de base en el grupo EETD presentó una disminución en la modulación simpática cardiaca (LF: 43±3 vs. 63±4nu) y un aumento en la modulación parasimpática cardiaca (RMSSD: 109±10 vs. 41±6ms; HF: 57±3 vs. 37±4nu) durante la realización de este método. Sin embargo, la duración del intervalo cardiaco no presentó alteraciones por la estimulación eléctrica del diafragma (CI: 686±59 vs. 780±31ms). Se puede concluir que el empleo de la EETD promueve cambios significativos en el balance simpático, resultando en una modulación parasimpática cardiaca más grande, posiblemente inducida del aumento de la movilidad del diafragma.

Introdução Crioterapia é a aplicação de modalidades de frio com temperatura de 0ºC a 18,3ºC, podendo interferir no desempenho físico e equilíbrio, dependendo da capacidade do indivíduo em manter a estabilização, direcionar padrões de movimentos, controlar a postura e posição articular. Objetivo Avaliar o desempenho físico, a frequência cardíaca e o equilíbrio estático com olhos abertos, em atletas de futsal (futebol de salão), antes e depois da crioimersão nos membros inferiores. Métodos Trinta e dois indivíduos do gênero masculino participaram do estudo, distribuídos aleatoriamente em dois grupos: (A) grupo controle, imersão em água a 24°C por 10 min; (B) grupo intervenção, crioimersão em água com gelo a 10°C por 10 min. Os voluntários realizavam a avaliação do equilíbrio no baropodômetro, em seguida corriam em linha reta e em ziguezague por 100 m, entravam na crioimersão, terminando com uma nova avaliação. Foram analisados o desempenho físico, através dos tempos das corridas, a frequência cardíaca, por meio de um frequencímetro e o equilíbrio, através da baropodometria e estabilometria em apoio bipodal de olhos abertos. Resultados O desempenho físico foi alterado após a crioimersão quando das análises intra e intergrupos. A frequência cardíaca apresentou diferença ao comparar-se antes e após a crio, porém sem diferenças em comparação ao controle. O equilíbrio não foi alterado após a crioimersão e nem em comparação com o grupo controle. Conclusão A crioimersão prejudicou o desempenho físico, quando a atividade foi imediatamente após a mesma, sendo desta forma o gelo não aconselhável quando se deseja desempenho na atividade desportiva. Porém não apresentou interferência na frequência cardíaca e no equilíbrio de atletas de futsal, que podem não ter sido alterados devido ao tempo da crioimersão.

Introduction Cryotherapy is the application of methods of cold temperature of 0°C to 18.3°C, which may interfere in physical performance and balance, depending on the individual's capacity of maintaining stabilization, targeting movement patterns, controlling posture and joint position. Objective To evaluate physical performance, heart rate and static balance with eyes open, in indoor soccer players before and after cold-water immersion of lower limbs. Methods Thirty-two male subjects participated in the study, being randomly divided into two groups: (A) control group, immersion in water at 24°C for 10 minutes, (B) intervention group, immersion in cold-water at 10°C for 10 minutes. The volunteers performed evaluation of balance through a baropodometer, then they ran straight and in zigzag for 100 meters, entered in cold-water immersion, ending with a new assessment. We analyzed physical performance throughout the time of race, the heart rate by means of a frequency counter, and balance through a baropodometer and stabilometry in bipedal support with their eyes open. Results The physical performance was modified after immersion in cold-water in intragroup and intergroup analysis. The heart rate showed difference when comparing before and after cryotherapy, but no differences compared to control. The balance showed no alteration after cryotherapy nor in comparison with the control group. Conclusion Cryotherapy impaired physical performance when the activity was performed immediately thereafter, therefore ice is not recommended when you want performance in sporting activities. Nevertheless, ice had no interference on heart rate and balance of indoor soccer players, which may not have been altered due to the time of immersion.

Introducción Crioterapia es la aplicación de diferentes modalidades de frio con temperatura de 0ºC a 18,3ºC, pudiendo interferir en el rendimiento físico y en el equilibrio, dependiendo de la capacidad del individuo de mantener la estabilización, direccionar padrones de movimientos, controlar la postura y posición articular. Objetivo Evaluar el rendimiento físico, la frecuencia cardíaca y el equilibrio estático con ojos abiertos, en jugadores de fútbol sala, antes y después de crioinmersión en los miembros inferiores. Métodos Treinta y dos individuos del género masculino participaron del estudio, distribuidos aleatoriamente en dos grupos: (A) grupo control, inmersión en agua a 24°C por 10 minutos; (B) grupo intervención, crioinmersión en agua con hielo a 10°C durante 10 minutos. Los voluntarios realizaban la evaluación del equilibrio en un baropodómetro, luego corrían en línea recta y en zigzag durante 100 metros, entraban en la crioinmersión, finalizando con una nueva evaluación. El rendimiento físico fue analizado a través de los tempos de carreras, la frecuencia cardíaca, por medio de un frecuencímetro cardiaco, y el equilibrio a través de baropodometría y estabilometría en apoyo bipodal con ojos abiertos. Resultados El rendimiento físico fue modificado después de la crioinmersión, tanto cuando analizados intra como intergrupal. La frecuencia cardíaca presentó diferencia significativa al comparar-se antes e después de la crioterapia, pero sin diferencias en comparación al control. El equilibrio no fue alterado después de la crioterapia ni en comparación con el grupo control. Conclusión La crioinmersión afectó negativamente el rendimiento físico, cuando la actividad fue realizada inmediatamente después de la misma, siendo de esta manera la crioinmersión no aconsejable cuando se desea incrementar el rendimiento en la actividad deportiva. Pero no presentó interferencia en la frecuencia cardíaca ni en el equilibrio en jugadores de fútbol sala, que pueden no haber sido alterados debido al tempo da crioinmersión.

O presente estudo comparou a função pulmonar e a fadiga de mulheres antes e após a radioterapia (RT) adjuvante para tratamento do câncer de mama, e correlacionou a função pulmonar com a dose de radiação e fadiga. Foi conduzido um estudo observacional longitudinal envolvendo 20 mulheres. A função pulmonar foi avaliada pela espirometria (ClementClarke®) e manovacuometria (GlobalMed®, modelo MVD 300), e a fadiga pelo Functional Assessment of Cancer Therapy Fatigue (FACT-F). Todas as avaliações foram realizadas antes da primeira sessão e uma semana após o término da RT adjuvante. Para a análise estatística foram utilizados os testes Wilcoxon Signed Rank Test e correlação de Spearman, adotando-se nível de significância p<0,05. Na espirometria, encontrou-se redução significativa da capacidade vital forçada (23,52%), do volume expiratório forçado no primeiro segundo (26,23%) e do pico de fluxo expiratório (10,12%) (p=0,001). As pressões expiratórias e inspiratórias máximas também diminuíram significativamente (25,45 e 32,92%, respectivamente). Observou-se diminuição significativa do bem-estar físico e do bem-estar funcional, e um aumento significativo da fadiga no FACT-F (p=0,001). Não foram observadas correlações entre as variáveis da função pulmonar com a dose de radiação e fadiga. Em curto prazo, a RT promoveu redução na função pulmonar, mas a mesma permaneceu próxima à normalidade para a amostra estudada. Observou-se aumento significativo da fadiga e diminuição dos escores dos domínios bem-estar físico e funcional.

This study compared the pulmonary function and fatigue in patients before and after adjuvant radiotherapy (RT) and correlated the pulmonary function with the radiotherapy dose and fatigue. A longitudinal and observational study was conducted involving 20 women. Pulmonary function was evaluated by digital lung spirometry (ClementClarke®) and manometry (GlobalMed®, model MVD 300) and fatigue was analyses by the Functional Assessment of Cancer Therapy Fatigue (FACT-F). All evaluations were conducted before the first RT session and up to one week after this treatment. Statistical analyses were conducted by the Wilcoxon Signed Rank Test and Spearman, considering p<0.05. There was significant reduction at spirometry parameters: forced vital capacity (23.52%), forced expiratory volume in the first second (26.23%), peak expiratory flow (10.12%) (p=0.001). Maximal expiratory pressure (25.45%) and maximal inspiratory pressure (32.92%) also showed significant reduction at manometry. There was a significant reduction on physical well-being and functional well-being and a significant increase in fatigue evaluated by the FACT-F (p=0.001). There was no correlation between pulmonary function, radiation dose and fatigue. Short-term effects of radiotherapy showed reduction of pulmonary function, but the values were considered similar to normal. There was a significant increase in fatigue, and significant decrease of physical well-being and functional well-being.

El presente estudio comparó la función pulmonar y la fatiga de mujeres antes y después de la radioterapia (RT) como ayudante para el tratamiento del cáncer de mama, y se correlacionó la función pulmonar con la dosis de radiación y fatiga. Fue realizado un estudio observacional longitudinal involucrando 20 mujeres. La función pulmonar fue evaluada por espirometría (ClementClarke®) y manovacuometría (GlobalMed®, modelo MVD 300) y, la fatiga fue evaluada por la Functional Assessment of Cancer Therapy Fatigue (FACT-F). Todas las evaluaciones fueron realizadas antes de la primera sesión y una semana después del término de la RT. Para el análisis estadístico fueron utilizados los tests Wilcoxon Signed Rank Test y correlación de Spearman, adoptando un nivel de significancia p<0,05. En la espirometría, se encontró reducción significativa de la capacidad vital forzada (23,52%), del volumen espiratorio forzado en el primer segundo (26,23%) y del peak de flujo espiratorio (10,12%) (p=0,001). Las presiones espiratorias e inspiratorias máximas también disminuyeron significativamente (25,45 y 32,92%, respectivamente). Se observó disminución significativa del bienestar físico y del bienestar funcional, y un aumento significativo de la fatiga en el FACT-F (p=0,001). No fueron observadas correlaciones entre las variables de la función pulmonar con la dosis de radiación y fatiga. En corto plazo, la RT promueve la reducción de la función pulmonar, pero los valores son considerados similares a los normales. Se observó aumento significativo de la fatiga y disminución de los puntajes en los dominios de bienestar físico y funcional.