Efeitos da crioterapia e facilitação neuromuscular proprioceptiva sobre a força muscular nas musculaturas flexora e extensora de joelho

Knee extensor and flexor muscles are often injured due to an imbalance between these groups, which may lead to a deficit in muscle performance. Thermal resources, such as cryotherapy, and stretching techniques, such as the "hold-relax" of proprioceptive neuromuscular facilitation (PNF), influence flexibility and muscle strength and may reduce the chances of muscle tendon injuries. The aim of the study was to verify the effects of cryotherapy and of the PNF hold-relax technique on muscle strength at the flexor and extensor muscles of the knee. The sample was made up by 18 sedentary women aged 18 to 24 years old, who were divided into two groups: one was submitted to cryotherapy and the other, to the hold-relax technique. Before and after one session of either technique subjects were submitted to isokinetic evaluation. The hold-relax technique brought an increase in strength of both muscle groups in both limbs, reaching significance level at the right limb flexors (p=0.04). Cryotherapy reduced the strength of the extensors and had the opposite effect at the flexors, generating a significant increase at right limb flexors (p=0.035). When comparing both techniques, the hold-relax technique generated higher peak torque values, mainly at the extensor muscle of the left limb (p=0.042). Hence the PNF hold-relax technique was able to generate higher knee muscle peak torque than cryotherapy.As musculaturas flexora e extensora do joelho são freqüentemente lesionadas devido a um desequilíbrio entre esses grupos. Recursos térmicos, como a crioterapia, e técnicas de alongamento, como a técnica mantém-relaxa da facilitação neuromuscular proprioceptiva (FNP), influenciam a flexibilidade e força muscular, proporcionando maior homogeneidade entre essas musculaturas e diminuindo a incidência de lesões. Este estudo objetivou verificar os efeitos da crioterapia e da FNP sobre a força das musculaturas flexora e extensora de joelho. A amostra foi composta por 18 mulheres com idade entre 18 e 24 anos, não-praticantes de atividade física regular, divididas em dois grupos: um submetido a crioterapia e o outro à técnica mantém-relaxa da FNP. Antes e após uma sessão de aplicação das técnicas foi feita avaliação isocinética. A aplicação da técnica mantém-relaxa provocou aumento da força em ambas as musculaturas em ambos os membros, atingindo nível de significância nos flexores do membro inferior direito (p=0,04). A crioterapia diminuiu a força dos extensores e exerceu efeito contrário sobre os flexores, tendo gerado aumento significativo nos flexores do membro inferior direito (p=0,035). Quando comparadas as técnicas, a técnica mantém-relaxa gerou maiores valores de pico de torque, principalmente nos extensores do membro inferior esquerdo (p=0,042). Conclui-se que a técnica mantém-relaxa da FNP gerou maiores valores no pico de torque em relação à crioterapia

Efeitos do tratamento da síndrome da apnéia obstrutiva do sono através de pressão positiva contínua nas vias aéreas sobre a capacidade física

OBJETIVO- Verificar os efeitos do tratamento da Síndrome da Apnéia Obstrutiva do Sono (SAOS) através de pressão positiva contínua na via aérea (CPAP) sobre a capacidade física. MÉTODOS- Indivíduos portadores de SAOS moderada a grave com indicação de tratamento com CPAP foram recrutados para teste de exercício cardiopulmonar máximo em esteira antes e após 3 meses em tratamento. O desfecho primário foi avaliar possíveis mudanças na capacidade física, enquanto secundariamente avaliou-se o impacto do CPAP sobre a qualidade de sono e sobre a sonolência diurna. RESULTADOS- Os valores de VO2pico não foram diferentes após o tratamento. Houve uma significativa melhora da qualidade de sono (p=0,001) e os níveis subjetivos de sonolência diurna foram menores (p=0,001) após o uso do CPAP. CONCLUSÃO- O tratamento da SAOS através de CPAP parece não exercer impacto sobre a capacidade física dos indivíduos, porém a qualidade de sono e os níveis de sonolência diurna melhoraram após o tratamento.OBJECTIVE- To evaluate the effects of Obstructive Sleep Apnea Syndrome (OSAS) treatment through continuous positive airway pressure (CPAP) on exercise capacity. METHODS- Patients with moderate to severe OSAS prescribed for CPAP usage were enrolled for maximum cardiopulmonary exercise test on treadmill before and after 3 months under treatment. The primary outcome was to evaluate possible changes in exercise capacity, while the secondary outcomes were to measure the CPAP impact on sleep quality and daytime sleepiness. RESULTS- Mean VO2peak values did not change after CPAP treatment. After three months, sleep quality improved (p=0,001) and daytime sleepiness decreased (p=0,001). CONCLUSION- Nocturnal CPAP for OSA treatment seems not to change exercise capacity, although sleep quality and daytime sleepiness are improved

Efeitos do tratamento da síndrome da apnéia obstrutiva do sono através de pressão positiva contínua nas vias aéreas sobre a capacidade física

OBJETIVO- Verificar os efeitos do tratamento da Síndrome da Apnéia Obstrutiva do Sono (SAOS) através de pressão positiva contínua na via aérea (CPAP) sobre a capacidade física. MÉTODOS- Indivíduos portadores de SAOS moderada a grave com indicação de tratamento com CPAP foram recrutados para teste de exercício cardiopulmonar máximo em esteira antes e após 3 meses em tratamento. O desfecho primário foi avaliar possíveis mudanças na capacidade física, enquanto secundariamente avaliou-se o impacto do CPAP sobre a qualidade de sono e sobre a sonolência diurna. RESULTADOS- Os valores de VO2pico não foram diferentes após o tratamento. Houve uma significativa melhora da qualidade de sono (p=0,001) e os níveis subjetivos de sonolência diurna foram menores (p=0,001) após o uso do CPAP. CONCLUSÃO- O tratamento da SAOS através de CPAP parece não exercer impacto sobre a capacidade física dos indivíduos, porém a qualidade de sono e os níveis de sonolência diurna melhoraram após o tratamento.OBJECTIVE- To evaluate the effects of Obstructive Sleep Apnea Syndrome (OSAS) treatment through continuous positive airway pressure (CPAP) on exercise capacity. METHODS- Patients with moderate to severe OSAS prescribed for CPAP usage were enrolled for maximum cardiopulmonary exercise test on treadmill before and after 3 months under treatment. The primary outcome was to evaluate possible changes in exercise capacity, while the secondary outcomes were to measure the CPAP impact on sleep quality and daytime sleepiness. RESULTS- Mean VO2peak values did not change after CPAP treatment. After three months, sleep quality improved (p=0,001) and daytime sleepiness decreased (p=0,001). CONCLUSION- Nocturnal CPAP for OSA treatment seems not to change exercise capacity, although sleep quality and daytime sleepiness are improved

Exercise capacity in patients with obstructive sleep apnea syndrome

The association between obstructive sleep apnea syndrome (OSAS) and exercise capacity is still not well determined. However, it is known that many OSAS patients present limited response to physical exercise. Such limitation, among other reasons, may be associated to the poor sleep quality that leads, mainly, to excessive daytime sleepiness. The aim of this study was to perform a literature review about exercise capacity in OSAS patients. The search was performed at the data basis Pubmed, LILACS and SciELO. We performed 3 searches in each data basis, with the following terms combination: “apnea” and “exercise” and “capacity”, “apnea” and “exercise” and “CPAP” and “apnea” and “cardiopulmonary” and “test”. Articles in Portuguese, English and Spanish would be included; with samples composed by OSAS patients treated or not. From the 108 articles identified, 24 filled the inclusion criteria and were then analyzed. In conclusion, exercise capacity seems to be diminished in OSAS patients and CPAP is associated to an improvement in physical performance

Exercise capacity in patients with obstructive sleep apnea syndrome

The association between obstructive sleep apnea syndrome (OSAS) and exercise capacity is still not well determined. However, it is known that many OSAS patients present limited response to physical exercise. Such limitation, among other reasons, may be associated to the poor sleep quality that leads, mainly, to excessive daytime sleepiness. The aim of this study was to perform a literature review about exercise capacity in OSAS patients. The search was performed at the data basis Pubmed, LILACS and SciELO. We performed 3 searches in each data basis, with the following terms combination: “apnea” and “exercise” and “capacity”, “apnea” and “exercise” and “CPAP” and “apnea” and “cardiopulmonary” and “test”. Articles in Portuguese, English and Spanish would be included; with samples composed by OSAS patients treated or not. From the 108 articles identified, 24 filled the inclusion criteria and were then analyzed. In conclusion, exercise capacity seems to be diminished in OSAS patients and CPAP is associated to an improvement in physical performance

Practice recommendations for the role of physiotherapy in the management of sleep disorders: the 2022 Brazilian Sleep Association Guidelines

This clinical guideline supported by the Brazilian Sleep Association comprises a brief history of the development of Brazilian sleep physiotherapy, outlines the role of the physiotherapist as part of a sleep health team, and describes the clinical guidelines in respect of the management of some sleep disorders by the physiotherapist (including sleep breathing disorders, i.e., obstructive sleep apnea, central sleep apnea, upper airway resistance syndrome, hypoventilation syndromes and overlap syndrome, and pediatric sleep breathing disorders; sleep bruxism; circadian rhythms disturbances; insomnia; and Willis-Ekbom disease/periodic limb movement disorder. This clinical practice guideline reflects the state of the art at the time of publication and will be reviewed and updated as new information becomes available