Promoção de saúde por meios digitais durante a pandemia da Covid-19 em um projeto de extensão em Disfagia

O projeto de extensão “Disfagia Orofaríngea: eu sei o que é e posso ajudar” visa proporcionar aos estudantes da graduação uma formação global e a inserção na atuação clínica. Devido à pandemia e ao cancelamento das práticas, a extensão reinventou-se, aderindo ao uso mais frequente da Internet para a divulgação de conteúdo. Após o estabelecimento de metas para o período de suspensão das atividades, o grupo organizou-se para criação de material virtual compartilhado na internet com os temas de Disfagia e Covid-19. Houve a continuidade das ações extensionistas do projeto de forma virtual com criação de nova rede social, postagens informativas, vídeos ilustrativos, textos científicos entre outros. A utilização da Internet para divulgação de conteúdos mostrou-se eficiente, apresentando muitas visualizações e possibilitando o aumento da visibilidade do projeto por outras regiões do país e até internacionalmente. O próximo passo será nosso primeiro evento virtual

Fiabilidad y validez de un dispositivo de célula de carga para evaluar la fuerza de prensión palmar

A força de preensão palmar é uma medida influenciada por diversos fatores como sexo, idade, motivação, treinamento muscular, dominância, altura, peso, variáveis socioeconômicas, participação em esportes específicos ou profissões. Pode ser mensurado por meio da dinamometria ou por medidores de tensão como as células de carga (strain gauges ). Confiabilidade e validade são importantes propriedades psicométricas que avaliam a reprodutibilidade da medida de um instrumento e sua aplicabilidade. Desse modo, o objetivo deste estudo foi avaliar a confiabilidade teste-reteste e a validade de constructo de uma célula de carga para medida da força de preensão palmar isométrica, em voluntários assintomáticos e portadores de disfunções no punho e mão. Foram utilizados métodos padronizados de posicionamento do membro superior e realizada aleatorização da ordem das coletas. A análise estatística de confiabilidade foi realizada pelo ICC e a validade de constructo pelo coeficiente de correlação de Pearson (r), com pLa fuerza de prensión palmar es una medida influida por diversos factores tales como, sexo, edad, motivación, entrenamiento muscular, dominio, altura, peso, variables socioeconómicas, participación en deportes específicos o profesiones. Se la puede medir mediante la dinamometría o por medidores de tensión como las células de carga (strain gauges ). La fiabilidad y la validez son importantes propiedades psicométricas que evalúan la reproducibilidad de un instrumento de medición y su aplicabilidad. De esa manera, este estudio tuvo la pretensión de evaluar la fiabilidad test-retest y la validez del constructo de una célula de carga para medir la fuerza de prensión palmar isométrica, en participantes asintomáticos y en portadores de trastornos de la muñeca y de la mano. Se utilizaron métodos estandarizados de posicionamientos del miembro superior y se llevó a cabo la aleatorización del orden de la recolección de datos. El análisis estadístico de fiabilidad fue realizado por el ICC y la validez del constructo por el coeficiente de correlación de Pearson (r), con pThe grip strength is a complex measure influenced by factors such as gender, age, motivation, muscle training, handedness, height, weight, socioeconomic variables, and participation in specific sports or professions. It can be measured by dynamometers or by tension meters such as load cells (strain gauges). Reliability and validity are important psychometric properties, which analyze consistency and applicability of an instruments' measurement. Thus, the aim of this study was to evaluate the test-retest reliability and construct validity of a load cell device in isometric grip force measurements using a sample of asymptomatic subjects and patients with wrist and hand dysfunctions. Standardized methods of the upper limb positioning and randomization of the sample order were used. Statistical analysis of reliability was conducted by the ICC (Intraclass Correlation Coefficient) and the construct validity by Pearson correlation coefficient (r), with

Capacidad para el trabajo y síntomas osteomusculares en trabajadores de un hospital público

El objetivo de este estudio fue conocer el perfil sociodemográfico, identificar las quejas osteomusculares y evaluar la capacidad para el trabajo de los trabajadores de un hospital público. Es un estudio cuantitativo, analítico y transversal. 31 servidores del Hospital das Clínicas de la Facultad de Medicina de Ribeirão Preto de la Universidad de São Paulo y de la Unidad de Emergencia de Ribeirão Preto fueron evaluados y encaminados al servicio de Fisioterapia en el Centro de Rehabilitación en el período de mayo a diciembre de 2012. Dos cuestionarios fueron aplicados: el Cuestionario Nórdico de Síntomas Osteomusculares, de carácter sociodemográfico y desarrollado por los pesquisidores deste estudio, para la tipificación y mensuración de relatos de los síntomas osteomusculares, y el Cuestionario Índice de Capacidad para el Trabajo, que posibilita la evaluación y detección precoz de alteraciones en la calidad de vida de los trabajadores. Los 31 evaluados tienen, en media, 46,5±11,8 años, siendo 27 mujeres y 4 hombres. Las ocupaciones con mayor prevalencia fueron: auxiliar de enfermería (19,3%), auxiliar de servicios (19,3%) y tesoreros (16,13%). 74,2% no practican actividades físicas, 38,7% tienen más de 20 años en el servicio y 64,5% pasan mucho tiempo de pie. La mayoría de las quejas osteomusculares tenía relación con las rodillas, después con los hombros y lumbar. La media del Índice de Capacidad para el Trabajo fue de 33,84±8,35, revelando una capacidad para el trabajo moderada. Los resultados presentados muestran la necesidad de la evaluación de las condiciones laborales, basada en una evaluación ergonómica con base en los aspectos físicos, cognitivos y organizacionales, cómo estrategia correctiva y/o preventiva de las lesiones osteomusculares y de la mejoría de la capacidad de realización del trabajo.O objetivo do estudo foi conhecer o perfil sociodemográfico, identificar as queixas osteomusculares e avaliar a capacidade para o trabalho de trabalhadores de um hospital público. Trata-se de um estudo quantitativo, analítico e transversal. Constituiu-se de 31 servidores do Hospital das Clinicas da Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo e da Unidade de Emergência de Ribeirão Preto, que foram encaminhados ao serviço de Fisioterapia no Centro de Reabilitação no período de maio a dezembro de 2012. Três questionários foram aplicados: o Questionário Sociodemográfico, que foi desenvolvido pelos pesquisadores deste estudo, o Questionário Nórdico de Sintomas Osteomusculares, que visa a padronizar a mensuração de relatos de sintomas osteomusculares, e o questionário Índice de Capacidade para o Trabalho, que possibilita a avaliação e detecção precoce de alterações na qualidade de vida dos trabalhadores. Os 31 avaliados possuem, em média, 46,5±11,8 anos, sendo 27 mulheres e 4 homens. As ocupações mais prevalentes foram: auxiliar de enfermagem (19,3%), auxiliar de serviços (19,3%) e escriturário (16,13%). Um total de 74,2% deles não praticam atividade física, 38,7% possuem mais de 20 anos no serviço e 64,5% ficam a maior parte do tempo em pé. A prevalência das queixas osteomusculares tinha relação com os joelhos, seguida das relacionadas aos ombros e lombar. A média do Índice de Capacidade para o trabalho foi de 33,84±8,35, revelando uma capacidade para o trabalho moderada. Os resultados apresentados apontam a necessidade de avaliação das condições laborais, com base em uma avaliação ergonômica fundada nos aspectos físicos, cognitivos e organizacionais do trabalho, como estratégia corretiva e/ou preventiva das lesões osteomusculares e da melhoria da capacidade de realização do trabalho.This paper aimed to characterize the sociodemographic profile, identify musculoskeletal complaints and evaluate the work ability of a public hospital workers. This study is quantitative, analytical and cross-sectional, consisted of 31 Hospital das Clinicas' workers, from the School of Medicine, at the University of São Paulo, and the Emergency Unit of Ribeirão Preto, Brazil, which were referred to the physiotherapy service at the Centre for Rehabilitation in the period from May to December 2012. Three questionnaires were administered: the Sociographic Questionnaire, developed by the researchers of this study, the Nordic Musculoskeletal Questionnaire, with socio-demographic intent, which aims to standardize the measurement of reported musculoskeletal symptoms, and the questionnaire Index Capacity for Work, that enables the assessment and early detection of changes in the quality of life of these workers. A total of 31 workers reviews have, on average, 46.5±11.8 years, being 27 women and 4 men. The prevalent occupations were: nursing assistant (19.3 %), auxiliary services (19.3 %) and clerks (16.13%). A number of 74.2 % did not engage in physical activity, 38.7 % have more than 20 years in service and 64.5 % are most of the time standing. The higher prevalence of musculoskeletal complaints was related to the knees, followed by shoulders and lower back. The average Index Capacity for Work was 33.84±8.35, revealing a moderate capacity to work. The presented results indicate the need to evaluate working conditions, based on an ergonomic evaluation consisted of physical, cognitive and organizational aspects of work, as well as corrective and/or preventive strategy of musculoskeletal injuries and improvements of the capacity to work

Effectiveness of low-level laser therapy for patients with carpal tunnel syndrome: design of a randomized single-blinded controlled trial

Background: Carpal tunnel syndrome is the most common neuropathy in the upper extremity, resulting from the compression of the median nerve at wrist level. Clinical studies are essentials to present evidence on therapeutic resources use at early restoration on peripheral nerve functionality. Low-level laser therapy has been widely investigated in researches related to nerve regeneration. Therefore, it is suggested that the effect of low-level laser therapy associated with other conservative rehabilitation techniques may positively affect symptoms and overall hand function in compressive neuropathies such as carpal tunnel syndrome. The aim of this study is to evaluate the effectiveness of low-level laser therapy in addition to orthoses therapy and home orientations in patients with carpal tunnel syndrome. Methods/Design: Patients older than 18 years old will be included, with clinical diagnosis of carpal tunnel syndrome, excluding comorbidies. A physiotherapist will conduct intervention, with a blinding evaluator. Randomization will be applied to allocate the patients in each group: with association or not to low-level laser therapy. All of them will be submitted to orthoses therapy and home orientations. Outcome will be assessed through: pain visual analogic scale, Semmes Weinstein monofilaments (TM) threshold sensibility test, Pinch Gauge T, Boston Carpal Tunnel Questionnaire and two point discrimination test. Discussion: This paper describes the design of a randomized controlled trial, which aim to assess the effectiveness of conservative treatment added to low-level laser therapy for patients with carpal tunnel syndrome. Trial registration: Brazilian Clinical Trials Registry (ReBec) - 75ddtf / Universal Trial Number: U1111-1121-5184Sao Paulo Research Foundation (FAPESP)Fundacao de Apoio ao Ensino, Pesquisa e Assistencia of Clinics Hospital, Faculty of Medicine of Ribeirao Preto, University of Sao Paulo - FAEP

Effectiveness of low-level laser therapy for patients with carpal tunnel syndrome: design of a randomized single-blinded controlled trial

Abstract\ud \ud Background\ud Carpal tunnel syndrome is the most common neuropathy in the upper extremity, resulting from the compression of the median nerve at wrist level. Clinical studies are essentials to present evidence on therapeutic resources use at early restoration on peripheral nerve functionality. Low-level laser therapy has been widely investigated in researches related to nerve regeneration. Therefore, it is suggested that the effect of low-level laser therapy associated with other conservative rehabilitation techniques may positively affect symptoms and overall hand function in compressive neuropathies such as carpal tunnel syndrome. The aim of this study is to evaluate the effectiveness of low-level laser therapy in addition to orthoses therapy and home orientations in patients with carpal tunnel syndrome.\ud \ud \ud Methods/Design\ud Patients older than 18 years old will be included, with clinical diagnosis of carpal tunnel syndrome, excluding comorbidies. A physiotherapist will conduct intervention, with a blinding evaluator. Randomization will be applied to allocate the patients in each group: with association or not to low-level laser therapy. All of them will be submitted to orthoses therapy and home orientations. Outcome will be assessed through: pain visual analogic scale, Semmes Weinstein monofilaments™ threshold sensibility test, Pinch Gauge™, Boston Carpal Tunnel Questionnaire and two point discrimination test.\ud \ud \ud Discussion\ud This paper describes the design of a randomized controlled trial, which aim to assess the effectiveness of conservative treatment added to low-level laser therapy for patients with carpal tunnel syndrome.\ud \ud \ud Trial registration\ud Brazilian Clinical Trials Registry (ReBec) - 75ddtf / Universal Trial Number: U1111-1121-5184FAPESPFAEP

Black holes, gravitational waves and fundamental physics: a roadmap

The grand challenges of contemporary fundamental physics—dark matter, dark energy, vacuum energy, inflation and early universe cosmology, singularities and the hierarchy problem—all involve gravity as a key component. And of all gravitational phenomena, black holes stand out in their elegant simplicity, while harbouring some of the most remarkable predictions of General Relativity: event horizons, singularities and ergoregions. The hitherto invisible landscape of the gravitational Universe is being unveiled before our eyes: the historical direct detection of gravitational waves by the LIGO-Virgo collaboration marks the dawn of a new era of scientific exploration. Gravitational-wave astronomy will allow us to test models of black hole formation, growth and evolution, as well as models of gravitational-wave generation and propagation. It will provide evidence for event horizons and ergoregions, test the theory of General Relativity itself, and may reveal the existence of new fundamental fields. The synthesis of these results has the potential to radically reshape our understanding of the cosmos and of the laws of Nature. The purpose of this work is to present a concise, yet comprehensive overview of the state of the art in the relevant fields of research, summarize important open problems, and lay out a roadmap for future progress. This write-up is an initiative taken within the framework of the European Action on 'Black holes, Gravitational waves and Fundamental Physics'

Reliability of the positioning of the electrodes in the acquisition of electromyography activity in forearm muscles in the hand grip task

O objetivo deste estudo foi de analisar a confiabilidade teste reteste do posicionamento dos eletrodos na aquisição do sinal eletromiográfico dos músculos do antebraço na tarefa de preensão palmar, por meio de dois posicionamentos. O primeiro posicionamento proposto por Cram; Durie e o segundo proposto por Mogk; Keir. Foram recrutados 30 voluntários sendo divididos em 2 grupos com 15 indivíduos cada. O primeiro grupo era formado por indivíduos saudáveis, isto é, que não apresentavam qualquer patologia, trauma ou dor no membro superior. Este grupo era composto por 13 mulheres e 2 homens com idade média de 23,4 anos, sendo 13 destros e 2 canhotos. O segundo grupo era formado por indivíduos que apresentavam algum trauma no antebraço, punho ou mão, recrutados no centro de reabilitação e no ambulatório de cirurgia do membro superior do Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo. A amostra era composta por 13 homens e 2 mulheres com idade média de 34,6 anos, sendo 14 destros e 1 canhoto. Todos os participantes assinaram o Termo de Consentimento Livre e Esclarecido. O procedimento foi realizado em dois dias com diferença de 24h entre as avaliações. A avaliação consistia em realizar a tarefa de preensão palmar com o dinamômetro analógico da marca Jamar® , realizando a máxima contração voluntária pelo período de 10 segundos com repouso de 3 minutos entre cada preensão, sendo coletados o sinal eletromiográfico de sete canais dos músculos do antebraço volar e dorsal, segundo cada método. Foi analisada a confiabilidade pelo índice de ICC e o SEM (Standard Error of Measurement). Os resultados obtidos mostram excelente correlação entre os dois posicionamentos em ambos os grupos. Quando verificado o valor de ICC do grupo de saudáveis verificou valores acima de 0.75 em todos os canais, o que demonstrou uma alta correlação entre as medidas em ambos os posicionamentos, com pequeno SEM. No grupo pacientes foi observado que nos músculos FUC, FSD e ERC uma correlação moderada para o posicionamento Mogk; Keir e somente no músculo FRC apresentou correlação moderada no posicionamento Cram; Durie. Os gráficos de Bland e Altman mostraram alta concordância entre as medidas, visto que, em ambos os posicionamentos, os valores ficaram entre o intervalo de confiança de 95% e próximos da linha média. Como conclusão pode-se inferir que ambos os posicionamentos apresentaram alta confiabilidade e alta correlação quando avaliado por meio do teste e re-teste, podendo ser utilizados para medida eletromiográfica dos músculos do antebraçoThe objective of this study was to analyze test retest reliability of the electrodes placement in the acquisition of electromyography forearm muscles during a isometric hand grip task, through two different methods. The first method was proposed by Cram; Durie and the second by Mogk; Keir. We recruited 30 volunteers divided into 2 groups with 15 subjects each. The first group consisted of healthy subjects, who did not show any pathology, trauma or pain in the upper extremity. This group consisted of 13 women and 2 men with a mean age of 23.4 years, and 13 right-handed and 2 left-handed. The second group consisted of individuals who had previous trauma on the forearm, wrist or hand. They were recruited from the rehabilitation center and upper limb surgery clinic of the Medical School of Ribeirão Preto Clinical Hospital. The sample consisted of 13 men and 2 women with a mean age of 34.6 years, 14 right-handed and left-handed one. All participants signed the consent form. The procedure was performed in two days with 24 hours difference between assessments. The evaluation was to carry by a isometric handgrip task with a analog dynamometer Jamar®, with maximum voluntary contraction for 10 seconds with 3 minutes of rest and analised by CCI and SEM (Standard Error of Measurement) . The results obtained have a high correlation between the two methods in both groups. Analyzing the ICC value of the healthy group value noted above 0.75 in all channels, demonstrating a excelent correlation between the measurements in both positions and low SEM. Checking in group patients realize that the FUC, FSD and ERC muscles has a moderate correlation for Mogk; Keir positioning and only on FRC showed moderate correlation in Cram; Durie electrode placement method. Analyzing Bland and Altman method a high concordance was found between the measures, since in both positions, the values were between the confidence interval of 95% and close to the midline. Through this we can infer that both positions have high reliability and high correlation when measured by the test and retes

Dissociation between video head impulse test and caloric test: a marker of menière's disease? – A systematic review and meta-analysis

Objective: To analyze, by means of a systematic review and meta-analysis, the proportion of patients with Meniere’s disease who have altered caloric test and vHIT, as well as to determine the prevalence of altered caloric test and normal vHIT dissociation in the diagnosis of Meniere’s disease. Methods: The literature search had no restriction regarding the period of publication on the following indexed data platforms: PubMed, PubMed PMC, BVS-Bireme, Web of Science, Embase and Cochrane Library. Articles that evaluated patients with Meniere’s disease who underwent caloric test and vHIT were included. Two researchers independently conducted the analysis of the articles, promoting the selection and capture of data, following the recommendations of the PRISMA method, and complying with the criteria for articles inclusion and exclusion defined in the research protocol. In case of disagreement during the selection process, a third researcher was included for analysis. Results: From a total of 427 initial studies, the researchers selected 12 articles, published between 2014 and 2021, with a total of 708 patients evaluated, with a mean age of 52.72 years old. The prevalence of patients with Meniere’s disease with altered caloric reflex test was 64% (95% CI 57%‒71%), while the prevalence of altered vHIT was only 28% (95% CI 16%–40%). The prevalence of the altered caloric test + normal vHIT dissociation was 47% (95% CI 37%–57%). Conclusion: The video head impulse test and the caloric test are valuable tools for vestibular assessment. The dissociation of findings between these two tests in patients with Meniere’s disease was more prevalent in this meta-analysis and may be a result of the tonotopy of specialized hair cells in the ampullary crest. The prevalence of altered caloric test was 64% and anormal vHIT was 28%. The dissociation caloric asymmetry and normal vHIT was observed in 47% of the patients. Level of evidence: 1