Avaliação da qualidade de vida com o instrumento SF-36 em lombalgia crônica

OBJETIVO: Avaliar a qualidade de vida através dos domínios do Instrumento SF-36 em portadores de lombalgia crônica inespecífica. MÉTODOS: Trinta portadores de lombalgia crônica inespecífica foram aleatorizados para três grupos (grupo Iso (Isostretching), grupo RPG (Reeducação Postural Global) e Iso+RPG), e avaliados quanto à dor e qualidade de vida antes e após as intervenções fisioterápicas e reavaliados novamente após 2 meses de acompanhamento. Após a aceitação do Termo de Consentimento Livre e Esclarecido os pacientes foram submetidos a procedimentos como: avaliação fisioterápica através do Instrumento de Avaliação da Coluna Vertebral, Escala Visual Analógica de Dor (EVA), Questionário de Qualidade de Vida através do Instrumento SF-36, antes da 1ª sessão e após três meses de tratamento, e reavaliados 2 meses após o tratamento. RESULTADOS: Mostraram que ambas as técnicas fisioterápicas diminuíram a dor (p<0,001), porém quando foram associadas as duas técnicas (Iso + RPG) a melhora da dor foi significativamente maior, e na avaliação após dois meses de acompanhamento o método de RPG foi mais eficaz. Quanto à avaliação da qualidade de vida, as técnicas fisioterápicas foram eficazes após as intervenções (P<0,001), porém o método do Iso foi mais eficaz quando os pacientes foram reavaliados no acompanhamento. CONCLUSÃO: As técnicas fisioterápicas utilizadas neste estudo foram eficazes para tratar a lombalgia crônica inespecífica apresentada pelos pacientes, pois diminuíram a algia que os mesmos apresentavam e melhoraram a qualidade de vida segundo os domínios do Instrumento SF-36. Nível de Evidência II, Ensaio Clínico Controlado e Randomizado. ____________________________________________________________________________________ ABSTRACTThe objective of this study was to evaluate the quality of life (QL) with the use of the SF-36 Questionnaire in patients with chronic nonspecific low back pain (CNLBP). Thirty patients with CNLBP were randomly assigned to one of three groups (Iso group (Isostretching), GPR group (Global Postural Reeducation), and the Iso+GPR group. Patients underwent physical therapy assessment with the use of the Vertebral Spine Assessment, the Visual Analog Scale of Pain (VASP), and the SF-36 life quality questionnaire before the first session (first assessment), after three months of treatment (second assessment) and reassessed two months after the final session in the follow-up (third assessment). The results indicated that both physical therapy techniques reduced pain (p<0.001); when the techniques (Iso+GPR) were combined, the reduction in pain was significantly greater; and, in the follow-up assessment, the GPR method was more efficient. As for the QL, physical therapy techniques were effective after the interventions (p<0.001), and the Iso method was more effective when patients were reassessed in the follow-up. We conclude that the physical therapy techniques used in this study were efficient to treat CNLBP in the patients since they reduced pain and increased QL according to the results of the SF-36 questionnaire. Level of Evidence II, Randomized Controlled Clinical Trial

Efeitos da Reeducação Postural Global em escolares com escoliose Global Posture Reeducation effects in students with scoliosis

O objetivo deste estudo foi analisar o efeito do método da Reeducação Postural Global (RPG) em escolares com diagnóstico de escoliose torácica não estrutural (ETNE). Os escolares com indicativo de ETNE ao exame postural e teste de Adams negativo foram encaminhados ao exame radiográfico para comprovação diagnóstica. Foram selecionados 20 participantes (11 meninos e 9 meninas, com 10±3 anos), divididos randomicamente em dois grupos homogêneos: o que realizou o RPG (GRPG) durante 12 semanas com duração de 25 a 30 minutos cada sessão, de acordo com o que aguentou permanecer na postura; e o grupo controle (GC), sem intervenção. Após três meses, os dois grupos repetiram a avaliação postural e o exame radiográfico. Para avaliação das estatísticas, foi utilizada análise de variância (ANOVA) univariada, com medidas repetidas, seguida do Post Hoc de Tukey para identificar as possíveis diferenças intra e intergrupos. O valor de &#945; foi de 0,05. O GRPG apresentou redução significativa no ângulo de Cobb na comparação intragrupo (&#916;%=-35,100; p=0,009), mas o GC não (&#916;%=9,520; p=0,789). Pode-se concluir que escolares submetidos ao método da RPG apresentaram melhora do quadro de escoliose torácica não estrutural.<br>The aim of this study was to analyze the effect of Global Reeducation Postural (RPG) method in scholars diagnosed with thoracic nonstructural scoliosis (ETNE). Scholars with indicative of ETNE to postural exam and Adams test negative were directed to radiographic exam to diagnostic. Twenty participants were selected (11 boys and 9 girls, 10±3 years old) and randomly divided in two homogeneous groups: group treated by RPG (GRPG) and control group (CG). The GRPG was submitted a RPG treatment during 12 weeks in sessions from 25 to 30 minutes in agreement with each student tolerance at posture. The CG didn't suffer intervention. After three months, both groups repeated the postural and radiographic exam. For statistics, it was used ANOVA univariated with repeated measures, followed by Tukey Post Hoc Test to identify the possible differences intra and intergroups. The &#945; value used was 0.05. The GRPG present significant reduction at Cobb angle between pre and posttest (&#916;%=-35.100; p=0.009), but the CG didn´t show (&#916;%=9.520; p=0.789). It was concluded that scholars submitted to RPG method presented improvement in thoracic nonstructural scoliosis

Automatic learning for improvement in joint mobility in the elderly

In Europe, the elderly are the majority group, an issue that implies specific attention. On many occasions, they need to be taken care of by other people. It is essential to talk about the gait, this plays an important role and it is necessary to maintain a joint width of movement adequate in the hip, knee and ankle so that the standing and walking are functional. Among the physical factors that limit mobility in the elderly are the articular and capsular, which can produce an immobility of the person and the appearance of pain, causing a significant deterioration in the quality of life of the elderly, a question that will give rise in most cases to the appearance of depressive symptoms. It is an obvious fact that public coverage must offer health activities to promote the health of this group. The purpose of this work is to document in a bibliographic and visual way a table of physical exercises and psychological techniques for its future implantation within the Primary Health Care (PHC) and the Machine Learning tools to develop a virtual gerontology nurse to assist in deploying the exercises at home. After an adequate automatic learning and health education, with greater implication of the nursing specialist in geriatrics and gerontology (GS) and once exercised, allow the elderly to develop with a maximum of autonomy and independence at home, as well as reduce the doses of drugs, an issue that will benefit health expenditure. We are proposing a Virtual Agent based in Computer Vision, Artificial Intelligence and Natural Interfaces that can perform unattended sessions for joint mobility improvement

Lombalgia durante a gestação: eficácia do tratamento com Reeducação Postural Global (RPG) Lumbar pain during pregnancy: efficacy of Global Postural Reeducation (GPR) treatment

Realizou-se um estudo clínico comparativo com o objetivo de avaliar o efeito da Reeducação Postural Global (RPG) no tratamento da lombalgia durante a gravidez e sua relação com limitações funcionais das gestantes. Os sujeitos foram 34 gestantes nulíparas atendidas em três centros de saúde e um hospital privado de Campinas, com idade gestacional entre 20 e 25 semanas e queixa de dor lombar. Dezessete gestantes foram submetidas a sessões de RPG durante oito semanas consecutivas, e as demais seguiram orientações de rotina para controle da dor lombar. Em cada sessão de RPG avaliou-se a intensidade da dor percebida pela mulher, antes e após os procedimentos. O grupo controle foi avaliado quanto à intensidade da dor na admissão, às quatro e oito semanas do estudo. Aplicou-se o questionário Roland-Morris para avaliar limitações funcionais, ao início e final do acompanhamento. O grupo de RPG apresentou decréscimo estatisticamente significativo na intensidade da dor antes e depois das sessões. Ao longo do estudo, as mulheres submetidas a RPG tiveram medianas de intensidade da dor e médias do escore de limitações funcionais significativamente menores que as do grupo controle. Análise de covariância indicou que o tratamento com RPG estava associado à menor intensidade da dor percebida ao final do estudo. Conclui-se que a RPG pode dar importante contribuição no tratamento da dor lombar durante a gestação, reduzindo, ao mesmo tempo, as limitações funcionais.<br>A clinical comparative study was carried out to evaluate the effectiveness of Global Postural Reeducation (GPR) in low back pain treatment during pregnancy, and its association with pregnant women functional limitations. The subjects were 34 nulliparous women attended in 3 public health units and 1 private hospital in Campinas. All women were at 20-25 weeks gestation and experiencing low back pain. Seventeen women were submitted to 8 GPR weekly consecutive sessions and 17 followed the routine recommendations for treating lumbar pain. In each GPR session the low back pain severity was assessed, before and after procedures. The control group had 3 low back pain intensity and treatment evaluation sessions (at admission, 4 and 8 weeks). Roland Morris questionnaire was applied in order to assess functional limitations in the beginning and at the end of the study. Women in the GPR group had a significant decrease of low back pain severity, before and after each session. Throughout the study, women in the GPR group had significantly lower pain medians and lower functional limitations score means than women in the control group. Covariance analysis pointed out that GPR treatment was associated to lower perceived pain intensity at the end of the follow-up. It is concluded that GPR can be an important contribution to the low back pain treatment during pregnancy and also it would help to reduce the damage caused by functional limitations. This will certainly has a positive influence upon women's quality of life