Fisioterapia em Movimento (Physical Therapy in Movement)
Created in 1989 and available online since 2013, the journal Fisioterapia em Movimento adopted the continuous publication modality in 2018, publishing articles in a single yearly volume. Journal of the School of Medicine and Life Sciences, at Pontifícia Universidade Católica do Paraná (PUCPR), it uses single blind peer review and accepts manuscripts resulting from studies developed in the areas of physical therapy and health. Studies should be original and should not have already been published elsewhere in the peer-reviewed literature. Manuscripts that have been deposited in preprint and institutional repositories are accepted. Fisioterapia em Movimento journal is indexed in AURA, bvs, DOAJ, EZB, Google Scholar, Latindex, Periódicos, REDIB, ROAD, SciELO, Scopus, Sumários, among others.
Challenges of person-centered care in physiotherapy for chronic pain: A qualitative metasynthesis
Introduction: Person-centered care (PCC) has been recommended as a suitable model for treating people with chronic musculoskeletal pain (CMP), emphasizing the need to understand how this model has permeated clinical practice in physiotherapy. Objective: To investigate how physiotherapists understand and implement PCC in the management of chronic musculoskeletal pain (CMP). Methods: This is a metasynthesis of qualitative studies (PROSPERO CRD42021268243) involving physiotherapists considering PCC in the treatment of individuals with CMP. The Critical Appraisal Skills Program was employed for methodological evaluation of the included studies, and inductive thematic analysis was used for synthesis and result construction. Results: Elements of PCC are present in patient assessment, recognizing the importance of deep patient evaluation and establishing a strong therapeutic bond. However, divergent perspectives and conflicts regarding how to conduct therapeutic approaches were evident in the studies, indicating questions and uncertainties in balancing patient needs and preferences with adherence to clinical guidelines. Conclusion: Physiotherapists participating in the studies understand the principles of PCC as relevant to clinical practice and consistently utilize them in patient assessment and building rapport. However, uncertainties persist in implementing PCC principles in the management of CMP, highlighting the need for further research to better understand the disparities found in therapeutic approaches and enhance professionals' preparedness to administer PCC.
Copyright (c) 2025 Adriane Vieira, Sofia Paiva Sventnickas, Karime Mescouto, Mariana Moreno de Araújo, Ana Carolina Bertini https://creativecommons.org/licenses/by-nc-nd/4.0
Effects of physiotherapy methods in post-operative women with breast cancer: systematic review with meta-analysis
Introduction: Breast cancer is characterized by abnormal, disordered and rapid proliferation of breast tissue cells; however, early diagnosis and advances in treatment allow greater chances of a good treatment. Objective: To present the effects of physical therapy in postoperative breast cancer patients. Methods: This is a systematic review of the literature, with a selection of articles published in the PubMed, SCOPUS, Cochrane, Web of Science and SciELO databases. Results: A total of 1,380 publications were found in the search in the databases following the proposed research methodology. After using the selection criteria, six studies (four randomized clinical trials and two clinical trials) were included in this systematic review. Of these studies, three provided data for the meta-analysis. The results of this meta-analysis showed that the abduction variable did not differ significantly (p = 0.11; standardized mean difference [SMD] = 1.48; 95% CI [-0.35 to 3.3]), as well as the flexion variable did not show differences (p = 0.14; SMD = 1.21; 95% CI [0.41 to 2.82]). Conclusion: According to this meta-analysis, no results were obtained that demonstrated improvements in physical therapy interventions in women after breast cancer surgery in the range of motion of the upper limbs.
Copyright (c) 2025 Amanda Eduarda da Costa Sousa, Diego Gama Linhares, André Salin de Menezes Nunes, Camilly Eduarda da Cruz Pinto, Rodolfo Gomes do Nascimento, Claudio Joaquim Borba-Pinheiro https://creativecommons.org/licenses/by-nc-nd/4.0
Non-invasive ventilation on the exercise tolerance of patients with heart failure
Introduction: Heart failure (HF) is a clinical syndrome in which the heart has a decrease in blood pumping capacity, progressing to hemodynamic, metabolic and cardiovascular changes. According to the progression of HF, individuals present a decline in functional capacity (FC). FC being one of the objectives of rehabilitation. Non-invasive ventilation (NIV) has been reported as an effective strategy for increasing FC. Objective: To review the use of NIV on the FC of patients with HF. Methods: This is a systematic review using the PICO strategy, with a search performed in the PubMed, Central, PeDro, SciELO and LILACS databases, with the descriptors heart failure, non-invasive ventilation and exercise tolerance added by the Boolean operators " AND” and “OR”. Results: Seventeen articles were found after reading the title and abstract, seven of which were chosen according to the inclusion criteria, based on the evaluation of 151 patients aged between 50 and 77 years, who showed that NIV can be an effective approach to increase the FC. NIV was effective in improving the distance covered in the 6-minute walk test by 26.16 meters (95% CI 9.26 to 43.06). Conclusion: NIV was effective in improving the FC of individuals with HF.
Copyright (c) 2025 Géssica dos Santos Silva, Luana Cerqueira dos Santos, Jandesson Cena dos Santos, André Luiz Lisboa Cordeiro https://creativecommons.org/licenses/by-nc-nd/4.0
Effectiveness of whole-body vibration in older adults: systematic review overview
Introduction: The whole body vibration exercise (WBV) is considered an alternative to resistance exercises, offering a lower risk of complications and standing out for being an easy method for older adults. However, due to the great diversity of protocols used, the effectiveness of WBV in muscle performance and risk of falls for this population is inconclusive. Objective: To evaluate the systematic reviews which have analyzed the effectiveness of WBV on muscle strength and risk of falls in older adults, and to establish the best protocol for implementing training in this population. Methods: Systematic reviews of randomized controlled trials were included in this overview, being conducted according to the PRISMA guidelines. To assess methodological quality and risk of bias, the instruments AMSTAR 2 and ROBIS were used, respectively. Results: Three systematic reviews were included in the study. The studies were classified as low and critically low methodological quality according to AMSTAR 2, and risk of low and uncertain bias according to ROBIS. Conclusion: This overview finds weak evidence of effectiveness on muscle strength and reduced risk of falls in older adults through WBV training.
Copyright (c) 2025 Anna Xênya Patrício de Araújo, Dulciane Nunes Paiva, Helen Kerlen Bastos Fuzari, Willemax dos Santos Gomes, Mário Bernardo-Filho, Patrícia Érika de Melo Marinho https://creativecommons.org/licenses/by-nc-nd/4.0
Evidence on the benefits of mind-body Qigong exercise in women with breast cancer
Introduction: Despite advancements in the diagnosis, treatment, and prognosis of breast cancer, many survivors experience a decline in psycho-emotional well-being and overall quality of life. Integrative practices, such as mind-body Qigong exercises, may positively influence factors that affect the quality of life in these patients. Objective: To synthesize evidence on the impact of Qigong practice on the quality of life of patients diagnosed with breast cancer. Methods: A systematic review and meta-analysis of randomized controlled trials was conducted, focusing on the effects of body-mind Qigong exercises in women with breast cancer. For relevant studies, we searched PubMed, Web of Science, Embase, and Cochrane Library databases. Eligible trials evaluated different Qigong techniques for outcomes related to improvements in quality of life. Results: Eight studies met the inclusion criteria, examining various Qigong exercise techniques in women with breast cancer. Reported outcomes included improved quality of life, mental health, fatigue, cognitive function, and physical capacity. Positive effects were observed across all variables. Conclusion: The findings suggest that Qigong has the potential to enhance the quality of life in breast cancer patients, whether in active treatment or remission. However, the integration of Qigong into standard oncology care requires further evidence from more robust studies.
Copyright (c) 2025 Michel Marcos Dalmedico, Jackson Adriano Canavarro Ribeiro, Juliana Londero Silva Avila, Prisley Pereira de Oliveira, Paula Karina Hembecker, Sergio Ossamu Ioshii https://creativecommons.org/licenses/by-nc-nd/4.0
Cardiovascular health in master athletes engaged in competitive sport
Introduction: Aging is naturally accompanied by a decline in overall health. Regular physical activity, whether amateur or competitive, is recognized as a key strategy to promote health and well-being in older adults. However, many individuals begin exercising without prior cardiovascular assessment. Objective: This systematic review aimed to assess the prevalence and types of cardiovascular diseases in master athletes. Methods: Observational studies published within the last ten years were included if they evaluated cardiovascular outcomes or diseases in master athletes (aged >35 years) participating in any sport. Studies were excluded if they lacked data on predefined cardiovascular outcomes, focused solely on rehabilitation or training interventions, failed to identify the sport involved, were not available in full, or were letters to editors, commentaries, or unpublished manuscripts. The literature search strategy used the following keywords: "cardiovascular outcomes," "cardiac outcomes," "cardiovascular diseases," "cardiac outcomes" and "master athletes." Results: Ten studies were included, most involving master endurance athletes aged 35 to 90 years. Seven studies included both sexes, two included only men, and one did not specify sex. Reported outcomes included atrial fibrillation (n=2), arrhythmia (n=2), myocardial fibrosis (n=1), ventricular dysfunction (n=1), and atherosclerotic disease (n=5). Of the ten studies, eight reported that master athletes have a higher propensity to develop cardiovascular disease, while two found no such association. Conclusion: Master athletes may face an increased risk of cardiovascular disease. These findings highlight the importance of thorough cardiovascular screening before engaging in competitive sports at older ages.
Copyright (c) 2025 Thiago Medeiros Rodriguez, Juliana Hotta Ansai, Jhenifer de Cassia Serantola, Mariana Beretta Rossi, Cintia Sciamana, Juliana Cristina Milan-Mattos, Camila Bianca Falasco Pantoni https://creativecommons.org/licenses/by-nc-nd/4.0
Deep Inspiration Breath-Hold in the prevention of radiotherapy-induced cardiac injury
Introduction: Breast-conserving surgery followed by adjuvant radiotherapy remains the gold standard in early-stage breast cancer treatment. However, incidental cardiac irradiation increases the risk of ischemic heart disease, the leading non-malignant cause of death among these patients. Objective: To identify evidence-based implications of the Deep Inspiration Breath-Hold (DIBH) technique for preventing cardiac injury associated with adjuvant radiotherapy. Methods: A scoping review was conducted in accordance with Joanna Briggs Institute guidelines. The PubMed, LILACS and Web of Science databases were searched for studies reporting the application of DIBH within the context defined by this review. Results: Fifteen relevant studies were selected, all assessing DIBH for the prevention of cardiotoxicity secondary to adjuvant radiotherapy. Deep inspiration increases lung volume, expanding the thoracic cavity and displacing the heart to the right and downward, thereby moving the heart out of the radiation field and reducing cardiac exposure. Conclusion: The results presented across multiple studies indicate that the use of DIBH in clinical practice consistently reduced cardiac irradiation without compromising target coverage.
Copyright (c) 2025 Prisley Pereira de Oliveira, Michel Marcos Dalmedico, Juliana Londero Silva Ávila, Jackson Adriano Canavarro Ribeiro, Paula Karina Hembecker, Sergio Ossamu Ioshii https://creativecommons.org/licenses/by-nc-nd/4.0
Ankle dorsiflexion range of motion in patellofemoral pain: systematic review and meta-analysis
Introduction: Decreased ankle dorsiflexion (ADF) range of motion (ROM) during dynamic activities has been reported in subjects with patellofemoral pain (PFP) and is theorised to play a role in its development. Objective: To compare the maximum ADF angle between individuals with PFP and asymptomatic controls. Methods: A systematic review and meta-analysis of studies of humans with PFP undergoing maximum ADF angle assessment, published in peer-reviewed journals in English. We searched CINAHL, Cochrane CENTRAL, EMBASE, LILACS, MEDLINE, PEDro, SciELO, SCOPUS, SPORTDiscus, and Web of Science databases. The outcome of interest was PFP, and the exposure of interest was maximum ADF ROM. Data extraction and risk-of-bias scoring were conducted in duplicate and independently. The Joanna Briggs Institute critical appraisal tools were used to assess the risk of bias. Effect sizes were pooled using random-effects models and reported as standardised mean differences (SMD). Subgroup analyses were conducted for ADF assessment characteristics. Results: Twelve studies providing 15 datasets were included. No significant difference in maximum ADF was found between individuals with PFP and asymptomatic controls (SMD = -0.3875; 95% CI: -1.02 to 0.25; p = 0.2123), with high heterogeneity (I² = 95.56%). Subgroup analysis showed differences related to the type of assessment (active or passive) but not to position or weight-bearing status. Conclusion: Maximum ADF does not consistently differ between individuals with PFP and asymptomatic controls. Assessment of this variable in isolation does not appear sufficient to explain the presence of patellofemoral pain.
Copyright (c) 2025 Álvaro Thyerre Miranda Catão, Mônica Batista Cunha, Nathália Nazareth Klippel, Leandro Roberto de Macedo, Leandro Roberto de Macedo, Katy Andrade Monteiro Zacaron https://creativecommons.org/licenses/by-nc-nd/4.0
Influence of elastic and non-elastic banding on patellofemoral pain
Introduction: Patellofemoral pain, characterized by pain in the anterior region of the knee that is exacerbated by activities increasing compressive load on the patellofemoral joint, is a multifactorial condition predominantly affecting women between 18 and 35 years of age. Once the condition is diagnosed, an adhesive elastic bandage is recommended as one of the treatment options. Objective: To examine the evidence on the effectiveness of elastic and non-elastic taping in postural control, functionality, pain reduction, and muscle activation in women with patellofemoral pain. Methods: A systematic review was conducted using indexed electronic databases, including MEDLINE, PubMed, LILACS, SciELO, and PEDro. The study selection utilized the terms: "Patellofemoral Pain", "Women," "Elastic Taping," "Muscle Performance," and "Quadriceps." Results: A total of 183 studies were identified, of which 142 were excluded based on the title and 19 due to duplication. This left 22 studies for evaluation, but 15 were excluded for not meeting the inclusion criteria. Ultimately, seven articles were included, with two showing positive results in postural control, three in lower limb muscle performance, and two in pain and functionality. Conclusion: Of the seven articles that were analyzed, six obtained improvements in relation to postural control, pain, functionality and muscle activation, while only one had no significant difference with the use of bandages in muscle activation. Importantly, some of the positive effects were observed when bandaging was combined with other interventions, such as strengthening or mobilization techniques, indicating that the benefits cannot be attributed exclusively to taping.
Copyright (c) 2026 Isabela Gomes Garcia Serafim , Marieli Ramos Stocco, Rodrigo Antonio Carvalho Andraus https://creativecommons.org/licenses/by-nc-nd/4.0
Physiotherapeutic intervention for a child with Koolen-de Vries Syndrome
Introduction: Koolen-de Vries Syndrome (KdVS) is a rare syndrome characterized by motor development delay, hypotonia, intellectual disability, language delay, and distinctive facial features. Objective: To describe a case report of the clinical and functional profile of a child with KdVS and to present the implementation of a physiotherapy intervention for this child. Methods: This is a retrospective case report of a male child, aged 3 years and 9 months, diagnosed with KdVS. Sociodemographic characterization was performed using the Poverty Income Ratio and the Brazil Economic Classification Criterion. Denver Developmental Screening Test II was used to screen for developmental delays. The physiotherapy program followed current recommendations focusing on task-specific training. Environmental factors were assessed by Affordances in the Home Environment for Motor Development. Additional assessments of age-expected motor skills and International Classification of Functioning, Disability and Health qualifiers were used. Results: Treatment goals were partially achieved. The child showed improvement in activity levels and maintenance of home environment affordances. Conclusion: This case report showed the benefits of physiotherapy intervention for a child with KdVS.
Copyright (c) 2025 Ana Paula Zanardi da Silva, Isabella Pessóta Sudati, Meyene Duque Weber, Stefani Raquel Sales Fritsch, Ana Carolina de Campos, Eloisa Tudella https://creativecommons.org/licenses/by-nc-nd/4.0
Virtual reality on upper limb kinesiophobia in post-stroke
Introduction: Kinesiophobia, the fear of movement due to perceived pain or re-injury, is a significant barrier to rehabilitation and recovery, particularly for stroke patients. This case study examines the impact of kinesiophobia on rehabilitation in a stroke survivor with left-sided weakness and limited shoulder range of motion. Objective: To explore the efficacy of a virtual reality-based intervention on kinesiophobia, shoulder range of motion and pain management in a post-stroke patient using the Reach Shoulder Health app. Methods: A 54-year-old male with hypertension and type 2 diabetes experienced left-sided weakness following a non-haemorrhagic infarct in the right middle cerebral artery space. Limited shoulder range of motion was observed, particularly during voluntary movements, linked to kinesiophobia and left shoulder pain. A virtual reality-based app, Reach Shoulder Health, featuring the Oculus Quest and Star Beam games, was used for 25-minute sessions, five days a week, over three weeks. The effectiveness of intervention was evaluated using the Tampa Scale of Kinesiophobia, Visual Analogue Scale, and Goniometer. Results: Post-intervention, the patient showed a marked reduction in kinesiophobia, a significant improvement in shoulder range of motion, and a noticeable decrease in pain intensity, demonstrating the positive effects of the virtual reality intervention. Conclusion: This case study demonstrates the potential of virtual reality as an effective tool for reducing kinesiophobia and improving rehabilitation outcomes in stroke patients. The integration of immersive technologies could offer substantial benefits for patients with rehabilitation challenges.
Copyright (c) 2025 Dhanusia S, Adelin Preety Y S, Prathap Suganthirababu, Vanitha J, Priyadharshini K, Vignesh Srinivasan https://creativecommons.org/licenses/by-nc-nd/4.0
Meditation intervention in a person with amyotrophic lateral sclerosis
Introduction: Amyotrophic lateral sclerosis (ALS) is a progressive neurodegenerative disease affecting motor neurons in the motor cortex, brainstem, and spinal cord, resulting in muscle weakness, atrophy, and stiffness. These symptoms severely compromise motor function, sleep quality, and overall quality of life. Meditation is a complementary practice that may enhance rehabilitation outcomes and overall quality of life for individuals with ALS by improving sleep quality and reducing anxiety, depression, and negative emotions. Objective: To describe changes in quality of life, sleep quality, and functional capacity following a guided meditation intervention in a patient with ALS. Methods: This study involved 25 guided meditation sessions with one individual diagnosed with ALS. Quality of life, sleep, and functional capacity were assessed pre and post-intervention using the WHOQOL-100, Pittsburgh Sleep Quality Index, and Amyotrophic Lateral Sclerosis Functional Rating Scale, respectively. Results: The participant showed decreases across all variables. However, a positive change suggesting improvement was observed only for quality of life. She exhibited declines in the independence level and environment domains, but improvements were noted in the physical, psychological, and personal relationships domains. Although sleep quality and functional capacity worsened, these changes were not clinically significant. Conclusion: The meditation intervention positively infuenced quality of life in the physical, psychological, and personal relationships domains, despite declines in sleep quality and functional capacity.
Copyright (c) 2025 Victor de Melo Gomes, Thais Bandouk Carvalho Ogassawara https://creativecommons.org/licenses/by-nc-nd/4.0
Respiratory and functional outcomes in post-hospitalized COVID-19 patients
Introduction: COVID-19 is a disease with systemic manifestations that can result in respiratory and functional sequelae. Understanding these consequences is crucial for developing effective preventive and rehabilitative strategies. Objective: To assess the short- and long-term respiratory and functional repercussions following hospitalization for COVID-19. Methods: This observational, longitudinal, multicenter study evaluated individuals post-hospitalization for COVID-19 at 15, 90, and 180 days post-hospital discharge using the following measures: spirometry, maximal inspiratory pressure (MIP), mMRC dyspnea scale, six-minute step test (6MST), handgrip strength, 30-second sit-to-stand test (30sSTS) and physical activity in daily life. Results: 65 participants (54.8 ±12.5 years, 54% male) were assessed at 15, 90, and 180 days post-hospital discharge. The results showed, respectively: forced vital capacity (FVC): 67.6 ± 25.4%, 76.7 ± 20.5%, and 70.1 ± 22.6% predicted; MIP: 77.4 ± 49.8%, 76.5 ± 48.8%, and 84.0 ± 54.1% predicted; mMRC: 2.0 (0.0 – 3.0), 1.0 (0.0 – 2.5), and 1.0 (0.0 – 3.0) points; 6MST: 70.7 ± 25.9%, 80.2 ± 29.8%, and 84.8 ± 31.3% predicted; 30sSTS: 61.3 ± 23.8%, 65.6 ± 19.5%, and 71.7 ± 20.0% predicted; handgrip strength: 101.3 ± 40.1%, 99.8 ± 35.5%, and 101.7 ± 31.2% predicted; physical activity: 23.1%, 10.8%, and 23.1% of participants were sedentary. Conclusion: Individuals post-hospitalization for COVID-19 exhibited persistent dyspnea, reductions in FVC, MIP, functional capacity, peripheral muscle strength, and low levels of physical activity. Dyspnea, reduced FVC, peripheral muscle strength, and low physical activity levels persisted even 180 days post- discharge.
Copyright (c) 2025 Caroline Valle Americano, Cristino Carneiro Oliveira, Yuri Augusto de Sousa Miranda, Leandro Ferracini Cabral, Maycon Moura Reboredo, Carla Malaguti, Anderson José https://creativecommons.org/licenses/by-nc-nd/4.0
Telerehabilitation exercise program in pediatric kidney transplant patients: clinical trial protocol
Introduction: Pediatric kidney transplantation is an important therapeutic option to improve life expectancy and quality of life in this population. However, several aspects related to the functionality of children with chronic kidney disease are not fully recovered after the procedure. Telerehabilitation exercise programs can be an alternative to help in this regard. Objective: Outlines the protocol of a clinical trial that aims to evaluate the effect of an telerehabilitation exercise program on the physical conditioning of children and adolescents with kidney transplants. Methods: This is a protocol of a randomized clinical trial. Post-kidney transplant patients aged 6-18 years, randomized into intervention group (IG) and control group (CG), will undergo follow-up via telerehabilitation for six weeks. The IG will perform guided exercises through a previously scheduled video call. The CG will also receive a video call and perform simple ventilation exercises. The primary outcome is exercise capacity. The secondary outcomes are quality of life, peripheral muscle strength, and inflammatory and biochemical profile. Discussion: Given the physical deconditioning found in this population, an exercise program may help in the rehabilitation process after the procedure. In addition, we will be able to verify if a telerehabilitation tool is a valid strategy for this approach.
Copyright (c) 2025 Raquel Pinto Carbonera, Amanda Alves Luft, Ana Clara Sobotyk, Karolayne de Lima Recoba, Clotilde Druck Garcia, Janice Luisa Lukrafka https://creativecommons.org/licenses/by-nc-nd/4.0
Transversus abdominis activation is similar in healthy and unhealthy individuals
Introduction: The transversus abdominis seems to be the key stabilizing muscle of the back, and its dysfunctions are associated with the development of low back pain (LBP). Objective: To compare the activation of the transversus abdominis and back muscle strength between self-reported healthy individuals, individuals with non-specific LBP, and individuals with disc herniation. Methods: This is a cross-sectional study carried out with male individuals intentionally divided into: healthy group (HG), non-specific LBP group (LBPG), and herniated disc group (HDG). The outcomes evaluated were pain, flexibility, disability, back muscle strength and transversus abdominis activation. Results: Thirty individuals were selected. Regarding the activation of the transversus abdominis, 60% of the HG had excellent activation, while for the LBPG and HDG it was only 30% and 20%, respectively. However, there were no significant differences between groups (p = 0.155). For strength, both the LBPG and the HDG were different compared to the HG (p = 0.028 and p = 0.045, respectively). Conclusion: The activation of the transversus abdominis seems to be similar between healthy individuals, individuals with non-specific LBP, and those with disc herniation. However, individuals with a herniated disc had less strength and greater disability.
Copyright (c) 2025 César Augusto Medeiros Silva, Vinicius Batista Lima, Yago Costa de Medeiros, Sanderson José Costa de Assis, Liane Brito Macedo, Clécio Gabriel de Souza https://creativecommons.org/licenses/by-nc-nd/4.0
Manometric scale of pelvic floor muscles strength in prostatectomized men
Introduction: An assessment of muscle contraction is necessary to optimize therapeutic targets and control the evolution of stress urinary incontinence rehabilitation. Digital palpation in conjunction with perineometer are reliable for scientific requirements. However, the absence of reference values in manometer affects reading the assessment results. Objective: To develop a classification scale for manometry of pelvic floor muscle (PFM) strength in prostatectomized men. Methods: A cross-sectional study was conducted at the Department of Physiotherapy at Hospital dos Servidores (Rio de Janeiro, Brazil). We evaluated a total of 100 patients, aged 51 to 78 years, who undergone radical retropubic prostatectomy. An expert performed the test using a perineometer. PFM strength data were collected and classified according to results. An evaluated scale was developed. Results: The Normal distribution of the PFM strength was estimated by use of Kolmogorov-Smirnov test (KS d = 0.13; p = 0.10). Removal of nine outliers. The measurement of PFM strength of 91 participants was 56,4 ± 33 cmH2O. From these results, the manometric scale of the PFM strength was developed: excellent (above 123 cmH2O), very good (from 90 to 122 cmH2O), good (from 57 to 89 cmH2O), regular (from 24 to 56 cmH2O), and insufficient (below 23 cmH2O). Conclusion: The method developed has advantages: to eliminate predictor error, and to bridge the gaps among categories where PFM strength is not divided into grade levels.
Copyright (c) 2025 Ana Paula Dantas Fernandes, Patrícia Zaidan, Elirez Bezerra Silva https://creativecommons.org/licenses/by-nc-nd/4.0
Presence of home fall risk factors, fall perception, and fear of falling in older adults: a cross-sectional study
Introduction: Concerns regarding home falls, perceptions of falling, and associated fear are essential to understanding the challenges faced by older adults and to inform prevention and intervention strategies. Objective: To investigate the association of home fall risk factors with sociodemographic, health-related, perception of falls, and fear of falling variables in older adults. Methods: A cross-sectional study was conducted with 201 older adults of both sexes residing in South and Southeast of Brazil. A sociodemographic and health profile questionnaire, the Falls Risk Awareness Questionnaire (FRAQ-Brazil), a questionnaire on perception of home fall risk, and the Falls Efficacy Scale-International (FES-I-Brazil) were utilized. Data were analyzed using the chi-square test, binary logistic regression, and Hosmer-Lemeshow test (p < 0.05). Results: A higher proportion of older adults with lower levels of education, lower monthly income, and from the southern region of the country were noted to have more home fall risk factors (p < 0.05). A higher proportion of older adults with good perceived health engaged in physical exercise, and without reported osteoarthritis were highlighted to have fewer home fall risk factors (p < 0.05). A higher proportion of older adults with less fear of falling were evidenced to have fewer home fall risk factors (p < 0.05). Illiterate older adults, those with incomplete primary education, non-users or light users of medication, and those with higher income were found to have higher odds of having more than eight home fall risk factors. Conclusion: The results of this study emphasize the importance of education, income, and geographical location in identifying home fall risk factors among older adults.
José Roberto Andrade do Nascimento Júnior
Copyright (c) 2025 Caroline Rodrigues Lyra, Eduardo Quadros da Silva, Leidiane Aparecida Lima, Eduarda Patrono dos Santos, José Roberto Andrade do Nascimento Júnior, Daniel Vicentini de Oliveira https://creativecommons.org/licenses/by-nc-nd/4.0
Time spent in different body positions is associated with functional performance in critically ill patients: a prospective study
Introduction: Critically ill patients are exposed to immobility. Critical patient spend more time in bed rest and the physiologic effects can impact on functional capacity. Mobility and high posture have been encouraged for these patients. Few studies have objectively measured how long patients spend lying, sitting or standing during intensive care unit (ICU) stay and if there is association with functional outcomes. Objective: To evaluate the time patients spend lying, sitting and standing during ICU stay and its association with status functional at ICU discharge. Methods: This was a prospective observational study that included 161 patients older than 18 years, admitted to the ICU, who presented Barthel index score = 100 points before hospitalization. An accelerometer was used to assess patient’s mobility during the stay in ICU. The variables used in the analysis were percentage of time and amount of time in sitting, standing and lying down. The patient’s functionality was assessed using the Barthel index at ICU discharge. Results: Patients spent 89% of the time lying down, 7% seated and 4% on standing position. The age (OR = 1.08; 95%CI 1.04 – 1.13) and percentage of time lying down (OR = 1.1; 95%CI 1.04 – 1.17) were independent factors for functional dependence. Time in standing (OR = 0.76; 95%CI 0.66 – 0.88) was associated with maintenance of functionality. Conclusion: There is association with time in bed rest and worse status functional at ICU discharge. On the other hand, the time in standing position was a protective factor for functional dependency.
Copyright (c) 2025 Claudia Neri Peso, Carolina Fu, Adriana Claudia Lunardi, Raquel Annoni, Debora Stripari Schujmann https://creativecommons.org/licenses/by-nc-nd/4.0
Is shoulder posture during work related to neck and shoulder symptoms among cleaners?
Introduction: Cleaners perform work activities that may be related to the development of neck and shoulder symptoms. Objective: The aim of this study was to analyze the correlation between shoulder elevation during work and neck and shoulder musculoskeletal symptoms among cleaners. Methods: Neck and shoulder symptoms were assessed using the Nordic Musculoskeletal Questionnaire. Shoulder elevation was registered during work using triaxial inclinometers. The data were analyzed descriptively and using point biserial correlation. Results: Twenty-two women, outsourced workers (73%), with an average age of 44 (SD = 11.2) years, who worked an average nine hours a day, participated in this study. Shoulder elevation at work was associated with the presence of shoulder symptoms (rpb=0.51 and rpb = 0.45 for the 50th and 10th percentiles, respectively) and with the percentage of time in shoulder elevation above 30° (rpb = 0.47). There was no association between shoulder elevation and neck symptoms. Conclusion: The findings indicate the need to reduce shoulder elevation among cleaners to control shoulder symptoms.
Copyright (c) 2025 Talissa dos Santos, Viviane de Freitas Cardoso, Maria Isabel Triches, Josiane Sotrate Gonçalves, Cristiane Shinohara Moriguchi, Tatiana de Oliveira Sato https://creativecommons.org/licenses/by-nc-nd/4.0
Surface electromyography analysis of contralateral muscle irradiation in proprioceptive neuromuscular facilitation
Introduction: Proprioceptive neuromuscular facilitation (PNF) is a concept that promotes functional movement through facilitation, inhibition, strengthening, and relaxation of muscle groups. Among its principles, irradiation is defined as the propagation of the response to the stimulus, which can be evidenced as increased contraction or relaxation in synergistic muscles and movement patterns. Objective: To evaluate PNF patterns in muscle irradiation to the contralateral lower limb through surface electromyography in physical therapy students. Methods: This is a cross-sectional study with a quantitative and analytical approach. Thirty healthy volunteers participated in the study and were evaluated with surface electromyography as they performed PNF and rectilinear movement patterns. Results: It was found that PNF patterns radiate to the contralateral limb, with the flexion-abduction-internal rotation pattern with knee flexion being statistically significant (p < 0.05). It was observed that the upper patterns do not significantly irradiate to the contralateral limb when compared with lower limb movements (LL). In the correlation between strength and electromyographic activation, the medial gastrocnemius obtained the greatest strength and the lowest muscle activation in movements involving hip or shoulder flexion. Conclusion: PNF diagonals irradiate to the LL contralateral to that tested in the electromyography. New studies with a larger sample size are needed to investigate contralateral muscle irradiation in healthy individuals through surface electromyography in order to obtain a more robust correlation.
Copyright (c) 2025 Maria Carolina Isaías Oliveira, Maria Ester Ibiapina Mendes de Carvalho, Daniele Alves da Silva, Riccardo Samuel Albano Lima, Sara Sampaio de Macêdo, Lia de Sousa Pádua, Laiana Sepúlveda de Andrade Mesquita https://creativecommons.org/licenses/by-nc-nd/4.0
Correlation anthropometrics in resistant hypertensive patients with diagnosis of moderate and severe obstructive sleep apnea
Introduction: Obstructive sleep apnea (OSA) is characterized by a chronic and progressive disorder that is associated with cardiovascular diseases. Objective: To correlate the apnea-hypopnea index (AHI) with anthropometric parameters in patients of both sexes diagnosed with resistant arterial hypertension (RHTN). Methods: A total of 106 patients (57.5% women, mean age 61 ± 8 years) were evaluated, 41 with moderate OSA and 65 with severe OSA. The diagnosis of OSA was made by nocturnal polysomnography. The somatotype was determined and the waist circumference (WC), neck circumference (NC) and hip circumferences were measured, followed by the waist-to-hip ratio (WHR), waist-to-height ratio (WHtR) and neck-to-height ratio (WHtR). Height and body mass measurements were also collected to calculate the (BMI). The unpaired Student's test was applied, and the results were presented as mean and standard deviation. Pearson's correlation was used to assess the correlation between AHI and other anthropometric and body composition variables. The multiple linear regression model was applied, the significance level adopted was p < 0.05 and the analyses were performed using SigmaPlot for Windows version 11.0 software and IBM SPSS Statistics version 19.0. Results: Among the participants, 62% were obese, 64% had abdominal obesity and 25% had increased neck circumference. The anthropometric variables that best correlated with AHI were WC (r = 0.325; p = 0.0006), BMI (r = 0.245; p = 0.0115) and NHR (r = 0.245; p = 0.0115) in both sexes. Among women, the best correlation was with waist circumference (r = 0.281; p = 0.0285). Conclusion: Anthropometric and body composition variables (WC, BMI, and NHR) are important for patients with OSA, including BMI in women, optimizing the screening of these patients for polysomnography.
Copyright (c) 2025 João Carlos Moreno de Azevedo, Tiago de Oliveira Chaves, Elizabeth Silaid Muxfeldt, Michel Silva Reis https://creativecommons.org/licenses/by-nc-nd/4.0
Early mobilization and ventilatory, functional and clinical outcomes of neurocritical patients
Introduction: Neurocritical patients may suffer functional limitations for several reasons, from primary brain injury to cultural and structural barriers. Objective: To compare the functional mobility of adult neurocritical patients on invasive mechanical ventilation (IMV) undergoing an early mobilization protocol between ICU admission and discharge and to evaluate ventilatory and clinical outcomes. Methods: Retrospective study, carried out in the neurological ICU of a teaching hospital, between January and December 2022. The following data were collected from electronic medical records: sex, age, diagnosis, comorbidities, length of stay on IMV and ICU stay, discharge or death outcomes, and functionality scores from the ICU Mobility Scale and the Johns Hopkins Scale. Results: Seventy-five patients were included in the study, with a mean age of 52.1 ± 19.5 years, predominantly female (52%). The most prevalent diagnosis and comorbidity were traumatic brain injury (24%) and arterial hypertension (40%). The mean length of stay on IMV was 4.7 ± 3.3 days and 11.9 ± 6.9 days of ICU stay, 85% of IMV weaning success and 95% of ICU discharges. There was a significant improvement in functionality (p < 0.0001) from admission to discharge, with a significant reduction (p < 0.0001) in the total restriction score and a significant increase (p < 0.0001) in the moderate and slight reduction in mobility scores. Conclusion: The functional mobility of neurocritical patients improved from total restriction lying in bed to orthostatic activities, transfer out of bed and walking with assistance, between admission and discharge from the ICU. Among the outcomes analyzed, there were high rates of ventilatory weaning and discharges from the ICU.
Copyright (c) 2025 Lucas Lima Ferreira, Mônica Caroline Néspoli, Adriana Claudia Lunardi https://creativecommons.org/licenses/by-nc-nd/4.0
Active teaching-learning methods in physiotherapy training: analysis of teacher representations
Introduction: The increasing demands of social and healthcare systems necessitate the transformation of pedagogical and curricular practices in higher education through the adoption of active teaching-learning methods. Objective: This study aims to explore the representations held by physiotherapy professors regarding active teaching-learning methods and their implications for the profession. Methods: Thirty professors from two public universities were interviewed. The analysis was guided by the Theory of Social Representations and the Theory of the Central Nucleus. Data were analyzed using EVOC 2005 software, which facilitated the construction of a four-quadrant table, and IRAMUTEQ software was employed for descending hierarchical classification. Results: The representations identified include core elements such as “learning,” “student autonomy,” “dialogue,” “student,” and “teacher” (central quadrant), with peripheral elements like “interactivity.” Five classes were appointed: 1) Experience with active teaching-learning methods; 2) Conceptions on professional training based on active teaching-learning methods; 3) Aspects that contemplate active teaching-learning methods scenario; 4) active teaching-learning methods; 5) Challenges of professional practice based on active teaching-learning methods. Conclusion: We noticed that teachers of undergraduate physiotherapy courses understand active teaching-learning methods and their implications for the practice of the profession, highlighting the student's autonomy and their position as a possible central axis.
Copyright (c) 2025 Micaela Freire Fontoura, Washington da Silva Santos, Ricardo Goes de Aguiar, Karla Rocha Pithon https://creativecommons.org/licenses/by-nc-nd/4.0
Injuries characteristics and their relationship with age in kitesurfers in Brazil
Introduction: Kitesurfing is a sport that requires a combination of physical and technical skills, such as balance, strength, coordination, and knowledge of the wind and sea conditions. Objective: To evaluate the relationship between age, physical fitness and injuries, in order to understand how these factors impact kitesurfing. Methods: This cross-sectional study included male and female kitesurfers ≥ 18 years of age. All participants completed an electronic questionnaire developed by the study researchers, containing open- and closed-ended questions about their profile, physical conditioning, and injury history. Results: A total of 28 kitesurfers participated in the study with a mean age of 44.1 (± 7.6) years, 53.6% were married, 46.4% lived in the Southeast and 42.9% in the South of Brazil. The majority (64.3%) has a postgraduate degree, and 14.3% a master's or doctorate degree. Consequently, 78.6% reported a monthly income above 1,333 USD. Regarding injuries, 78.6% reported having experienced at least one, with 53.6% requiring immediate medical attention. Age was positively correlated with both the number of injuries (r = 0.38; p = 0.04) and time spent warming up before kitesurfing (r = 0.43; p = 0.02). Lower limb injuries accounted for 61% of all cases: 31% in the ankle/foot, 22% in the knees, and 8.3% in the hips. Conclusion: Kitesurfing, commonly practiced by individuals with high educational and income levels, is linked to a high incidence of lower limb injuries. Age appears to be a contributing factor to the increased risk of injury.
Copyright (c) 2025 João Vitor Plancke Marçal, Fabiana Reis Silva, Sthefany Cristiny Pereira Magalhães, Giovani Romera Garcia, Karine da Silva Alves Matias, Reinaldo Nonato da Silva, Eduardo Takeuchi, Guilherme Carlos Brech https://creativecommons.org/licenses/by-nc-nd/4.0
Spatiotemporal analysis of outpatient physiotherapy services in primary health care
Introduction: Assessing the health situation through outpatient production is one of the tools used to complement the construction of an adequate health action plan that aims to meet the real needs of the population. Objective: To analyze the spatio-temporal distribution of outpatient physiotherapy production in Primary Health Care in Brazil and its geographic regions from 2008 to 2022. Methods: This is an analytical ecological study of a time series of secondary data from the Health System. Ambulatory information and the Brazilian Institute of Geography and Statistics. The Kruskal-Wallis test was used to identify differences in outpatient production between regions per year and joinpoint regression to estimate the temporal trend between 2008 and 2022. Results: The South region had the highest outpatient production rates compared to the others regions of Brazil in six consecutive years, from 2013 to 2022, except in 2016. The temporal trend in Brazil and in the North, Northeast and Central-West regions remained stationary between 2008 and 2022. However, in the Southeast and South regions there was significant growth in 12.3% and 6.4% in consultations, respectively. The spatial distribution by septenniums demonstrated high rates of outpatient services in the South region in 2015 and 2022. Conclusion: The temporal trend of outpatient physiotherapy services in Primary Care in Brazil and the North, Northeast and Central-West regions was stationary, while the Southeast and South were increasing in the period from 2008 to 2022.
Copyright (c) 2025 Kletey Mendes da Silva Araújo, Fabiano Santana de Oliveira, Orivaldo Florêncio de Souza, Francisco Naildo Cardoso Leitão, Mauro Jose de Deus Morais https://creativecommons.org/licenses/by-nc-nd/4.0
ost-COVID-19 syndrome and obesity: findings in a sample referred for pulmonary rehabilitation
Introduction: Post-COVID-19 syndrome refers to persistent symptoms after SARS-CoV-2 infection. Objective: To investigate the profile of patients with post-COVID-19 syndrome, classified according to the Body Mass Index (BMI) as obese and non-obese, and to verify whether obese individuals have worse clinical and functional condition. Methods: Cross-sectional observational study, with adults, both sexes, history of hospitalization for SARS-CoV-2 and post-COVID-19 syndrome, referred for Pulmonary Rehabilitation, between August/2020 and October/2022. The data originated from a physiotherapeutic evaluation. The participants were classified as obese and non-obese, assessed regarding health history, length of hospitalization, dyspnea during activities of daily living, and respiratory muscle strength. Results: Fifty-four subjects participated, mostly women, with a mean age over 55 years, mostly obese (75.9%), sedentary, white, and professionals in the trade and construction industries. No significant association was identified between being obese and the variables hypertension (p = 0.057), diabetes (p = 0.113), dyspnea (p = 0.368), and fatigue (p = 0.750). The variables days of hospitalization (p = 0.592), days in Intensive care unit (p = 0.478), days on invasive mechanical ventilation (p = 0.075), modified Medical Research Council scale (p = 0.633), maximum inspiratory pressure (p = 0.625), and maximum expiratory pressure (p = 0.967) were not influenced by obesity. Conclusion: Obese participants were more likely to require pulmonary rehabilitation due to post-COVID-19 syndrome. However, they did not present worse clinical and functional conditions in the physiotherapeutic evaluation regarding health history, length of hospital stay, dyspnea during activities of daily living and respiratory muscle strength.
Copyright (c) 2025 Andreane Daniele Barbosa de Lira, Isabella Luz Assolari, Alexandra Ignes Bruni Tulio, Heloísa Rodrigues Alves Bobato, Regina Helena Senff Gomes, Arlete Ana Motter https://creativecommons.org/licenses/by-nc-nd/4.0
Effects of physical training on the quality of life of patients with post-COVID-19 condition
Introduction: Post-COVID-19 syndrome has a significant impact on the quality of life of affected individuals. Objective: To describe the effects of a pulmonary rehabilitation (PR) program on the health-related quality of life (HRQoL) of patients with post-COVID-19 syndrome and to understand the aspects pertinent to the quality of life of these patients. Methods: Quasi-experimental study, of the interrupted time series type, with adults, both sexes, history of hospitalization for SARS-CoV-2 and post-COVID-19 syndrome, referred for PR, between February/2021 and December/2022. Participants were assessed regarding clinical information, quality of life (Nottingham Health Profile - PSN), global peripheral muscle strength (dynamometry) and dyspnea during activities of daily living (mMRC scale) pre and post PR. Results: A total of 39 subjects participated, 22 (56.4%) female, with a mean age of 55.8 (+ 9.98) years. The main persistent complaints were fatigue (64.1%), dyspnea (59%), memory impairment (30.8%), and pain (28.2%). Of the six PSN domains, five showed significant improvement after the intervention. The median total PSN score was 11 points before and 06 points after (p < 0.001). Dynamometry and mMRC also showed statistically significant differences after RP. Conclusion: Individuals with post-COVID-19 syndrome present significant changes in HRQoL, evidenced by physical, emotional, social, and sleep changes. RP, through physical training, demonstrated positive effects in improving quality of life and also in gaining global peripheral muscle strength and reducing dyspnea during activities of daily living.
Copyright (c) 2025 Andreane Daniele Barbosa de Lira, Alexandra Ignes Bruni Tulio, Heloísa Rodrigues Alves Bobato, Regina Helena Senff Gomes, Arlete Ana Motter https://creativecommons.org/licenses/by-nc-nd/4.0
Intra- and interrater accuracy and reliability of the ocular vergence test
Introduction: Convergence insufficiency is the inability to achieve and maintain adequate convergence without effort, associated with symptoms such as eye strain and headaches. Furthermore, the literature lacks information on the different tests used to assess convergence. Objective: To determine the accuracy and intra- and inter-rater reliability of the ocular vergence test. Methods: A cohort of 123 volunteers of both sexes, aged between 18 and 49 years, was recruited. The Convergence In-sufficiency Symptom Survey was applied, and the near point of convergence was evaluated. A battery of tests was administered by three different evaluators across two days. The linear-weighted Cohen's Kappa coeffi-cient was used to assess intra- and inter-rater reliability and agreement. Results: The analysis of agreement for the ocular vergence test revealed moderate inter-rater (Kappa = 0.43 to 0.59) and intrarater (Kappa = 0.40 to 0.75) reliability, coupled with low accuracy (AUC = 0.53) for the methodology employed. Conclusion: The ocular vergence test demonstrated moderate reliability but low accuracy.
Copyright (c) 2025 Vanessa Cristina Godoi de Paula, Tiago Del Antonio Tsunoda, Paulo Fernandes Pires, Rodrigo Antonio Carvalho Andraus, Odivan Bukalowski Barbosa Alves, Felipe Micheletti Bento, Guilherme Luis Santana Luchesi, Fabrício José Jassi https://creativecommons.org/licenses/by-nc-nd/4.0
Factors affecting independence among individuals with spinal cord injuries in Brazil: a cross-sectional study
Introduction: The spinal cord injury (SCI) affects functional independence. There are few studies that evaluate functional independence among individuals with SCI in Brazil. Objective: To evaluate the functional independence of individuals with SCI in Brazil, and explore the association between functional independence and personal, social, injury, and bladder and bowel-related factors. Methods: Data of 121 individuals with SCI about functional independence, personal, demographic, injury, bladder, and bowel factors were collected by interview and analyzed. It was used Spearman’s rank correlation coefficient and the Mann-Whitney U test with p < 0.01 for correlations and p < 0.05 for post hoc tests significance level. Results: The region of the neurological level had the most substantial correlation with functional independence (0.370 to 0.570, p ≤ 0.001), followed by sex (0.270, p = 0.003), American Spinal Injury Association (ASIA) Impairment Scale (AIS) classification (0.345, p = 0.001), and patterns in the bowel (-0.295, p = 0.001) and bladder functions (-0.281 to -0.334, p ≤ 0.002). Conclusion: The region of the neurological level emerged as the most significant non-modifiable factor influencing functional independence. Furthermore, factors like sex, AIS classification, and bladder and bowel patterns, while demonstrating weaker associations, remain pertinent to functional independence.
Scheyla Paula Bollmann Oleskovicz Nogueira
Copyright (c) 2025 Aline de Lima, Danielle Alves da Cruz, Thamyres Cristina da Silva Lima, Scheyla Paula Bollmann Oleskovicz Nogueira, Fabiana Faleiros, Adriana Dutra Tholl, Jocemar Ilha https://creativecommons.org/licenses/by-nc-nd/4.0
Impact of sensory perceptual motor core stability training on sitting control in children with cerebral palsy
Introduction: The ability to sit independently is essential for children, serving as a foundation for reaching and for daily activities. For children with cerebral palsy, especially bilateral spastic cerebral palsy (BSCP), this skill is often unattainable because of impaired neuromuscular control. Objective: We aimed to report the protocol for a randomized controlled trial of the novel Sensory Perceptual-Motor Core Stability Exercise Program (SPMCSEP) in improving sitting control in children with BSCP. Methods: This is a double-blinded, randomized, controlled trial. Seventy-two children with cerebral palsy (Gross Motor Function Classification Scale – ER III - IV) aged between 3 and 7 years will be recruited and randomly allocated to SPMCSEP and conventional therapy groups. Independent sitting will be evaluated at baseline, 6 weeks, and 8 weeks for all children using the Trunk Control Measurement Scale. Conclusion: This study explains the background, hypotheses, rationale, and methodology of the SPMCSEP protocol for children with BSCP, and will adhere to Consolidated Standards of Reporting Trials and Standard Protocol Items Recommendations for Interventional Trials guidelines for reporting. The proposed SPMCSEP represents a novel approach for addressing impaired sitting control in children with BSCP.
Copyright (c) 2025 Rathish Sivaramachandran, Meena Natarajan https://creativecommons.org/licenses/by-nc-nd/4.0
Biological motion perception in post-stroke patients
Introduction: The perception of biological motion refers to the ability to perceive the moving shape of a human figure from points of light. This ability may be altered under various conditions that compromise human perceptual and visual capabilities, such as following a stroke, impairing the acquisition of motor skills. Objective: To evaluate whether biological motion perception in post-stroke patients is compromised. Methods: It is characterized as a cross-sectional and analytical study with a quantitative approach. Two groups were formed: one consisting of 10 post-stroke patients and the other of 10 healthy elderly individuals. Study participants were clinically characterized using instruments assessing muscle tone, sensorimotor function, laterality, and cognitive status. Subsequently, they judged tasks involving presentations of natural-shaped light point stimuli divided into three categories: movements without objects, movements with objects, and social interactions. To analyze participants' biological motion perception, we calculated each participant's number of correct judgments and response times. Results: The control group had higher correct judgments in most tasks (70-90%) compared to the post-stroke group (40-60%). No significant statistical differences were found, but response times were shorter in controls. For the waving task, the mean time was 1.2 seconds for controls and 2.5 seconds for the post-stroke group (p = 0.0022). In walking (anterior-posterior view), it was 1.5 seconds versus 3.0 seconds (p = 0.0006). Conclusion: Biological motion perception in post-stroke participants appears to be slower, however, there seems to be no compromise in judgment capability.
Copyright (c) 2025 Marcella Cabral de Oliveira, Denise Soares de Araújo, Pedrina Célia Brasil, Rodrigo Lopes Barreto, Roberta Oliveira Cacho, Enio Walker Azevedo Cacho https://creativecommons.org/licenses/by-nc-nd/4.0
Analysis of the relationship between low back pain and jiu-jitsu: A cross-sectional study
Introduction: Jiu-jitsu is a contact sport with great physical demand, which presents a high prevalence of injuries in its practitioners. Low back pain (LBP) is among the most common problems in sport, however there are some gaps in the literature regarding its relationship with the practice of jiu-jitsu. Objective: To identify the prevalence and factors associated with LBP in recreational jiu-jitsu practitioners. Methods: This is a cross-sectional and analytical observational study, carried out using an online form, containing information related to the practice of jiu-jitsu and injury history. The chi-square test was used to analyze the association between variables and Poisson regression with robust estimation to determine the prevalence ratio for variables with more than two categories, considering significant values of p < 0.05. Results: One hundred three jiu-Jitsu practitioners participated, 72.8% male and 27.2% female, with an average age of 29 years. The prevalence of LBP among practitioners was 49%. There was no association with low back pain and preferred position in jiu-jitsu practitioners. Conclusion: Factors such as length of practice and previous episode of low back pain appear to be associated with a higher prevalence of low back pain in jiu-jitsu practitioners. Furthermore, practitioners believe that performing jiu-jitsu can be a protective factor for low back pain episodes.
Copyright (c) 2025 Marina Alves de França, Vinícius Batista Lima, César Augusto Medeiros Silva, Sanderson José de Costa Assis, Eleazar Marinho Freitas de Lucena, Clécio Gabriel de Souza https://creativecommons.org/licenses/by-nc-nd/4.0
Agreement and reliability between two types of portable dynamometers: traction and compression
Introduction: The measurement of quadriceps strength is crucial for various clinical applications. However, traditional isokinetic dynamometers are expensive and bulky. Handheld dynamometers represent accessible alternatives, but the agreement between compression and traction dynamometers in evaluating knee extensor torque requires investigation. Objective: To evaluate the agreement between handheld compression and traction dynamometers in knee extensor torque and to verify intra- and inter-examiner reliability. Methods: This is a methodological study with a convenience sample. Participants were recruited by researchers in the physiotherapy outpatient clinic of the Federal University of Juiz de Fora – University Hospital, between June 2021 and June 2022. Two dynamometers were used: the MMT manual dynamometer from Lafayette Instru-ment Company, and the E-lastic® 200 kg traction dynamometer. Results: The reliability of the dynamometers (compression and traction) was excellent, with high intra- and inter-examiner agreement (ICC(2,2) ranging from 0.94 to 0.99). No significant differences were observed between the dynamometers, indicating equivalence. The Bland-Altman plots also showed good agree-ment, and Student's t-tests did not detect significant differences between examiners. Conclusion: The handheld compression and traction dynamometers used in this study demonstrated high reliability and equivalence in measurements, allowing flexibility in choosing these instruments in clinical practice. Future research may explore evaluators' and patients' perceptions of these measurements.
Copyright (c) 2025 Bruno Lionardo de Paula, Liliany Fontes Loures, Wesley Oliveira de Almeida, Alcione Coelho de Souza, Priscila Monteiro Veras, Diogo Simões Fonseca https://creativecommons.org/licenses/by-nc-nd/4.0
Changes in functional capacity after one year of hospitalization for COVID-19
Introduction: Monitoring the long-term consequences of COVID-19 and its impact on different aspects is essential. Objective: To assess functional capacity and associated factors up to one year after hospital discharge in COVID-19 survivors. Methods: This cross-sectional study included individuals aged 18 years or older, residents of a medium city in Rio Grande do Sul, Brazil, with a laboratory diagnosis of COVID-19, who required hospitalization. Data collection was performed through home visits, face-to-face interviews, and physical tests, which assessed a set of sociodemographic, clinical, and health characteristics. The primary outcomes were functional status and muscle strength assessed by the Post-COVID-19 Functional Status Scale and the Medical Research Council Score. Analyses were performed using crude and adjusted logistic regression models. Results: Of the 160 individuals, the majority were female (53.1%), white (71.9%), with a mean age of 64 years. Functional limitations were identified in 67.5% (95%CI 46.2-70.2) of the sample, with 50.9% (95%CI: 41.8-60.0) presenting changes in muscle strength, 10% of which (95%CI 5.8-17.0) presented muscle weakness. An association was found between greater functional limitation and diagnosis of respiratory diseases (p = 0.002). Changes in muscle strength were associated with female gender (p = 0.009), diagnosis of sarcopenia (p = 0.036), smoking (p = 0.022) and need for orotracheal intubation (p = 0.009). Conclusion: It was observed that, within one year after hospital discharge, individuals presented significant functional limitations, with more than half presenting some type of muscle strength impairment and a portion showing signs of muscle weakness.
Copyright (c) 2025 Tainá Samile Pesente, Bruno Zilli Peroni, Dreissi Cristina Brun Bellé, Renata dos Santos Rabello, Ivana Loraine Lindemann, Gustavo Olszanski Acrani, Jossimara Polettini, Shana Ginar-Silva https://creativecommons.org/licenses/by-nc-nd/4.0
Adherence to total knee arthroplasty guidelines in Saudi physiotherapists
Introduction: Total knee arthroplasty (TKA) is a widely performed surgical procedure for managing advanced stages of knee osteoarthritis. Following clinical practice guidelines (CPGs) is essential to ensure optimal rehabilitation outcomes. Objective: To evaluate the level of knowledge and compliance with evidence-based practice guidelines and recommendations related to TKA among physiotherapists in Saudi Arabia. Methods: An online cross-sectional survey was administered among licensed physiotherapists practicing in Saudi Arabia who had managed at least one patient undergoing TKA within the past two years. The questionnaire included demographic questions, two clinical vignettes (prehabilitation and acute postoperative rehabilitation), and statements assessing agreement with evidence-based recommendations (EBR). Adherence levels were categorized, and statistical associations with demographic variables were analyzed using chi-square and ANOVA tests. Results: The study included 391 physiotherapists (mean age: 31.5 ± 6.1 years), with males comprising 78% of the sample. Only 2 and 3% of participants fully adhered to the EBR in the prehabilitation and post-operative vignettes, respectively. Adherence was significantly associated with gender, years of experience, workplace setting, educational level, specialty, and the number of TKA cases managed (p < 0.05). Knowledge gaps were also evident in consensus statements, with less than half agreeing on the use of standardized outcome measures and postoperative management protocols. Conclusion: Adherence to TKA CPGs among Saudi physiotherapists is generally low. Experience, workplace setting, and professional background influence adherence. There is a need for targeted educational interventions and systemic support to improve evidence-based practice in TKA rehabilitation.
Copyright (c) 2025 Yazeed Abdulrahman Alghamdi, Ibrahim Saeed Aljulaymi, Faisal Althumali, Mostafa S. Abdel-fattah, Ibrahim M. Dewir https://creativecommons.org/licenses/by-nc-nd/4.0
Reference values for characterizing posture of schoolchildren using the photogrammetry
Introduction: The literature describing growth adaptations related to body posture up to adolescence is limited, possible due to the lack of reference values for this population. Objective: To describe reference values for the photogrammetric method of static body posture in the sagittal plane, for children and adolescents, for the head, shoulder, spine, pelvis and knee segments. Methods: The sample size consisted of 492 schoolchildren from Rio Grande do Sul, of both sexes, aged 7 to 17 years, who were evaluated by: (1) anamnesis and (2) static postural assessment. The photographs were analyzed using the DIPA© software, which provided the postural variables (in degrees): head posture, shoulder posture, cervical, thoracic and lumbar curvature angles, and pelvic and knee posture. Descriptive statistics and ANOVA with independent factorial design for multivariate analyses were performed. Results: The level of biological maturation did not influence any of the postural variables. For head and cervical spine posture, the reference values are 43.7º - 56.6º and 30.8º - 50.6º, respectively, covering all age groups. The other postural variables were differently influenced by sex and age group. Conclusion: The study presents reference values for posture in the sagittal plane of children and adolescents, based on the mean and standard deviation (at the 15th and 85th percentiles) of the postural variables. These values may support future evaluations using the photogrammetry method in this population.
Copyright (c) 2025 Emanuelle Francine Detogni Schmit, Vanessa Rui, Luiza Rampi Pivotto, Marja Bochehin do Valle, Bruna Nichele da Rosa, Cláudia Tarragô Candotti https://creativecommons.org/licenses/by-nc-nd/4.0
Vestibular symptoms in children with spastic cerebral palsy
Introduction: In children with spastic cerebral palsy (CP), the factors associated with the development of symptoms of vestibular system dysfunction are not yet fully understood. Objective: To determine the association between clinical symptoms of vestibular system disorders and the severity of gross motor function impairment, characteristics of the brain lesion and age at the beginning of physiotherapy in a sample of children with spastic CP. Methods: A cross-sectional study was conducted involving 82 children with spastic CP. Assessments were performed of gross motor function and characteristics of the brain lesion, along with a vestibulo-oculomotor clinical examination. Results: The severity of gross motor function impairment, location of the brain lesion (motor cortex) and age at which the child began physiotherapy (more than 2 years of age) were associated with symptoms of vestibular system disorders, specifically with abnormalities of the vertical and horizontal vestibulo-ocular reflexes and the presence of central nystagmus. Conclusion: The severity of the impairment of gross motor functions, brain lesion (motor cortex) and the age at which the child began physiotherapy are associated with symptoms of vestibular system disorders.
Copyright (c) 2025 Amanda Queiróga, Claudia Santos Oliveira, Marcela de Oliveira Araujo, Veronica Mariana Palenque Unzueta, André Luís dos Santos Silva, Luanda André Collange-Grecco https://creativecommons.org/licenses/by-nc-nd/4.0
Mental stress and osteomuscular symptoms in physiotherapy students during the COVID-19 pandemic
Introduction: The migration to the remote regime due to the COVID-19 pandemic has resulted in several changes in students' lives, affecting their physical and mental health. There is no consensus on the relationship between mental stress and musculoskeletal symptoms in physical therapy undergraduate students. Objective: Correlating mental stress with musculoskeletal symptoms in physical therapy undergraduate students in Brazil during the COVID-19 pandemic. Methods: This is an analytical cross-sectional study conducted in a virtual environment with 116 physical therapy undergraduates from any region of Brazil, attending exclusively remote academic activities. A sociodemographic and academic profile questionnaire, the Nordic Musculoskeletal Questionnaire (NMQ) and the Perceived Stress Scale (PSS-10) were applied. Pearson's correlation was applied to assess the relationship between the number of body regions with musculoskeletal symptoms and perceived stress. Results: Most students were female (83.6%), with a mean age of 23.17 ± 5.37 years. Almost all (94.0%) reported musculoskeletal symptoms in at least one region of the body, and the most affected sites were the neck (69.0%), upper back (62.1%) and shoulders (59.9%). The students had a mean score of 3.99 ± 2.23 body regions with musculoskeletal symptoms on the QNSO; and 24.47 ± 6.79 on the PSS-10. There was a weak positive correlation between the number of musculoskeletal symptoms and stress (r = 0.35; p < 0.001). Conclusion: There was a high prevalence of musculoskeletal symptoms in physical therapy undergraduate students during the COVID-19 pandemic, and a relationship was found between the number of musculoskeletal symptoms and mental stress.
Copyright (c) 2025 Lorrainy Matias da Silva, Letícia Aguiar Guimarães, Cejane Oliveira Martins Prudente https://creativecommons.org/licenses/by-nc-nd/4.0
Outpatient physical therapy in the municipalities and macroregions of Minas Gerais: an ecological study
Introduction: Specialized care in outpatient physical therapy can be provided through secondary health care, which involves more specific and complex technological resources than primary health care. Despite the large percentage of professionals providing services at this level of care, access to physical therapy services is unequal and relatively lacking in Brazil. Objective: To identify the percentage of municipalities with outpatient physical therapy services by macroregion in Minas Gerais (MG) and to evaluate the attendance coefficient for physical therapy services according to the population sizes of the municipalities. Methods: This was an ecological study of data from the Outpatient Information System of the Unified Health System (Sistema Único de Saúde, SUS) and population data from the 2022 Census. The municipalities were categorized into four groups (small I, small II, medium and large). The Kruskal‒Wallis and Mann‒Whitney tests were used to compare the attendance coefficients between the groups. To clarify care gaps and visualize asymmetry in the attendance coefficients, a georeferencing map was constructed. Results: The coverage of outpatient physical therapy services was 58.1%. The West macroregion, which is composed of 53 municipalities, had the highest coverage ranking. The attendance coefficients for physical therapy care in MG and all of Brazil were 0.19 and 0.24, respectively, whereas the median coefficient for all municipalities was 0.18 (Q1 and Q3: 0.08 and 0.34, respectively). No significant differences were found in the attendance coefficients among the four groups. Twelve municipalities presented atypically positive values and were thus identified as care references. Conclusion: The availability and provision of outpatient physical therapy services by the SUS are relatively lacking and heterogeneous among the different municipalities and macroregions of MG. The size of the municipality is not a relevant indicator of the proportional number of outpatient care. The Ministry of Health from Brazil must establish guidelines defining care referrals for physical therapy services.
Copyright (c) 2025 Peterson Marco de Oliveira Andrade, Maria Eduarda Higino Schuhmacher, Luysa Helena Ribeiro Soares, Roberta de Oliveira Coelho, Ludimila Forechi https://creativecommons.org/licenses/by-nc-nd/4.0
Assessment of bioelectrical activity of pelvic floor muscles in female cross-training practitioners: A cross-sectional observational study
Introduction: Stress urinary incontinence (SUI) during high-impact exercises is common in female cross-training practitioners and may be due to failure of the pelvic floor muscles (PFM) in supporting the bladder neck and urethra. Objective: To evaluate the functional and bioelectrical activity of PFM in female cross-training practitioners with and without symptoms of SUI during sports practice. Methods: Forty women practicing cross-training for at least eight uninterrupted months, at least three times per week, over than 50 minutes were divided according to the presence or absence of SUI. The International Consultation on Incontinence Questionnaire – Short Form (ICIQ-SF), pelvic floor muscle assessment by PERFECT scheme, surface electromyography of PFM using the Glazer protocol, and tetrapolar bioimpedance for body composition evaluation were used for the assessments. Statistical analysis was performed using the Mann-Whitney test and Student t-test. A level of significance of 0.05 was adopted for all analyses. Results: The participants had a mean age of 37.25 ± 7.80 years and had practiced the modality for an average of 34.5 months. Women with SUI (n = 16) had lower number of fast and slow repetitions (p = 0.052), lower intensity of tonic contractions of PFM (p = 0.054), a longer time before peak phasic contractions (p = 0.041), a longer time before peak tonic contractions (p = 0.009), and a longer time after peak tonic contractions (p = 0.006) than women without SUI (n = 24). Conclusion: Women with SUI during physical activity exhibit deficits in the functioning of both fast and slow muscle fiber contractions, as well as reduced bioelectrical activity in the tonic and phasic fibers of the PFM. Additionally, these women frequently display a lack of abdominal-pelvic synergy. These findings indicate an important relationship between bioelectrical parameters and the presence of SUI, providing a foundation for the development of future interventions aimed at health prevention and rehabilitation.
Sidineia Silva Pinheiro Cavalcante Franco
Copyright (c) 2025 Sidineia Silva Pinheiro Cavalcante Franco, Fabio Roberto Barbosa Saiki, Ygor Thiago Cerqueira de Paula, Hugo Alexandre de Paula Santana, Gustavo Christofoletti, Ana Beatriz Gomes de Souza Pegorare https://creativecommons.org/licenses/by-nc-nd/4.0
Comparison between a standard and a modified early mobilization protocol on oxidative stress and inflammatory parameters in patients with sepsis
Introduction: Oxidative stress is considered a promoter of negative outcomes, including severe myopathy, especially in critical care patients. Early mobilization (EM) is the application of physical activity as early as possible to avoid the deleterious bed rest effects. Objective: To evaluate the effect of EM protocol on oxidative stress and inflammatory parameters in patients with sepsis. Methods: Prospective study conducted in critical patients divided in control group (CG) and intervention group (IG). Lactate, procalcitonin, Medical Research Council (MRC) sum score, inflammatory and oxidative stress parameters were obtained before and after protocol. Statistical comparisons among groups for continuous variables were performed using parametric and non-parametric tests. Results: EM increased MRC sum score and reduced lactate (IG: initial 5.40 ± 3.44, final 2.02 ± 0.92; CG: initial 4.64 ± 4.99, final 1.90 ± 0.90, p > 0.05); procalcitonin (IG: initial 43.30 ± 39.20, final 8.01 ± 8.13; CG: initial 33.10 ± 33.70, final 14.00 ± 14.80, p > 0.05); oxidative stress (protein carbonylation: IG: initial 4.82 ± 1.00, final 3.52 ± 0.82, p < 0.05; CG: initial 3.32 ± 0.86, final 2.54 ± 0.49, p > 0.05; malondialdehyde: IG: initial 5.57 ± 1.77, final 2.72 ± 1.30, p < 0.05; CG: initial 3.84 ± 2.61, final 4.84 ± 2.11, p > 0.05); and inflammation (TNF-α IG: initial 6.14 ± 2.28, final 4.85 ± 1.10, p < 0.05; CG: initial 7.98 ± 3.37, final 7.08 ± 3.33, p > 0.05). Conclusion: It is possible to conclude that the modified early mobilization protocol used in this study was effective to reduce oxidative stress and inflammation in sepsis patients.
Copyright (c) 2025 Danielle Cristina Alves Oliveira, Fabiane Valentini Francisqueti-Ferron, Marina Melo Coelho, Ana Karla de Loiola Gomes Lima, Gabriela Oliveira, Artur Junio Togneri Ferron, Camila Renata Correa, Carlos Fernando Ronchi https://creativecommons.org/licenses/by-nc-nd/4.0
Balance and functionality post-physiotherapeutic interventions among long COVID cases in the Amazon
Introduction: Among the sequelae of COVID-19, muscle weakness, acute episodes of dyspnea and fatigue, impaired motor coordination, superficial sensitivity, balance, and memory are prominent, characterizing post-COVID-19 syndrome or long COVID. Evidence-based neurofunctional physiotherapy is a treatment option for rehabilitating balance and functionality. Objectives: To assess balance and functionality in individuals with Long COVID before and after applying a neurofunctional physiotherapy protocol. Methods: A non-randomized clinical trial (quasi-experimental study), uncontrolled, paired before and after, prospective, case series, with a quantitative approach, involving 10 participants who presented neuromuscular manifestations associated with COVID-19, who underwent 25 sessions of the Neurofunctional protocol. The variables analyzed were: balance (Berg Balance Scale), basic activities of daily living - BADLs (KATZ Index), and instrumental activities of daily living - IADLs (Lawton Scale). Based on this, qualitative variables were analyzed by absolute and relative frequencies, and quantitative variables by means and standard deviation (± SD). In the analytical approach, data pairing before and after the intervention was evaluated using the Wilcoxon test. Results: Most participants were female (70%), aged between 37 and 64 years (50.80 ± 8.85), and 70% had systemic arterial hypertension. The physiotherapy intervention showed beneficial changes in balance (p = 0.034) and IADLs (p = 0.026) in the sample, which were statistically significant. Conclusion: The neurofunctional physiotherapy protocol was effective in improving balance and increasing independence in IADLs in long COVID, with no significant changes in BADLs.
Copyright (c) 2025 Daira Fernanda da Silva Chaves, Vinicius Ramos Gaia, Bruno Ferreira dos Santos, Natália Costa Ribeiro, Mírian Letícia Carmo Bastos, Tatiane Bahia do Vale Silva https://creativecommons.org/licenses/by-nc-nd/4.0
Teaching comprehensiveness in child health care within physical therapy programs: advances and challenges
Introduction: The concept and practices of comprehensiveness in health care, a core principle of the Brazilian National Health System (SUS, Sistema Único de Saúde, commonly translated as Unified Health System) are central to the education of health professionals. Objective: This study examines how comprehensiveness in child health care is taught in undergraduate physical therapy programs. Methods: A qualitative study was conducted with undergraduate physical therapy programs in Northeast Brazil. Data were collected through document analysis of course curricular documents and semi-structured interviews with faculty members responsible for teaching child health. The study involved three public undergraduate physical therapy programs in Northeast Brazil and interviews with nine female professors responsible for teaching child health care. The course documents demonstrated an emphasis on multiple levels of care, supporting the integration of comprehensiveness into the curriculum. According to the interviews, comprehensiveness was consistently valued and identified as a guiding principle of the SUS, particularly in relation to professional practice that considers the individual as a whole and promotes service integration. Conclusion: In the programs analyzed, the teaching of child health incorporated the concept of comprehensiveness into the education and training of future physical therapists, a principle recognized and valued by faculty.
Copyright (c) 2025 Ana Raquel de Carvalho Mourão, Beatriz Jansen Ferreira, Rosana Fiorini Puccini https://creativecommons.org/licenses/by-nc-nd/4.0
Acute affective and perceptual responses to resistance training with imposed and self-selected load in chronic kidney disease patients
Introduction: Resistance training (RT) has shown several benefits for chronic kidney disease (CKD) patients. The affective and perceptual responses to training may influence the initial adherence to the program. Objective: To compare the acute affective and perceptual responses to RT protocols with imposed or self-selected loads in patients undergoing conservative treatment for CKD. Methods: Fourteen elderly (66.7 ± 3.0 years old) with CKD stage 3 or 4 completed two different protocols in a randomized crossover approach: with load at 70% of one maximum repetition (70% 1RM) and self-selected load. The affective valence and rating of perceived exertion (RPE) scales were used between each exercise (total of 10 exercises), and session RPE (sRPE) was measured 30 minutes after the training session. Results: The results demonstrated that when patients self-selected loads, the relative load was lower (~50% 1RM) compared to the protocol with imposed loads. More positive affective responses were found in the session with a self-selected load, as well as lower values of RPE and sRPE. Conclusion: The results of the present work suggest that self-selected loads may be an interesting strategy to improve the affective response to RT, and that this is probably mediated by a lower RPE in elderly CDK patients undergoing conservative treatment.
Copyright (c) 2025 Wilson Max Almeida Monteiro de Moraes, Bruno Magalhães de Castro, Luana Cicília Sousa da Silva, Jonato Prestes https://creativecommons.org/licenses/by-nc-nd/4.0
Use of AccuCuffTM for continuous monitoring of cuff pressure: a clinical trial
delivered through a ventilatory prosthesis. This device consists of a cuff, a cuff that requires calibration and seals the space between the ventilatory prosthesis and the trachea, preventing respiratory complications or leaks during ventilation. Objective: To analyze the use of a low-cost device for continuous cuff pressure monitoring and compare clinical outcomes. Methods: This is a randomized clinical trial conducted in an adult intensive care unit with intubated patients on mechanical ventilation for up to 48 hours. Patients were followed throughout the study period, according to their allocation. The AccuCuff™ device was used for continuous cuff pressure measurement, which was compared to conventional care, which used a cuffometer as an assessment tool. Results: Fifty-five patients of both sexes participated in the study; 27 used the AccuCuff and 28 received conventional care. The results show homogeneity of characteristics between the groups. Regarding cuff pressure behavior, both groups experienced only one drop in pressure, with a similar percentage and no significant difference regarding the need for adjustments between periods (p = 0.307). Conclusion: The continuous cuff measurement device represents a viable alternative, producing values consistent with its specifications and being easy to monitor, making it a viable alternative within the hospital setting. Regular intervals between measurements are recommended to prevent prolonged periods of low pressure.
Copyright (c) 2025 Nathalia Prado de Melo, Rayssa Bruna Holanda Lima, Maryelle Desirée Cardoso Daniel, Carmira Fernandes Jerônimo, Karla Luciana Magnani Seki https://creativecommons.org/licenses/by-nc-nd/4.0
Effects of a physical exercise program using exergames on gross motor development in children with autism spectrum disorder
Introduction: Autism spectrum disorder (ASD) is classified in the literature as a disorder of human neurodevelopment and present in a unique way in each individual. It can alter various behaviors related to communication, speech, social interaction, repetitive movements, and fine and gross motor coordination. In this sense, various functional impairments are observed in people with the disorder. Because of these functional deficiencies, much research has been done on the motor functions and conditions of these individuals, given the detrimental impact that deficits in motor coordination and executive functions have on independence and the development of social skills, as well as their direct impact on health conditions and physical and mental integrity. Objective: To assess the gross motor development of children diagnosed with ASD before and after a period of therapeutic physiotherapy intervention using exergames as a tool. The study included nine prepubertal males between the ages of 7 and 10 who underwent a 12-week intervention with two weekly half-hour sessions of exergames. Results: A significant difference was observed in overall performance on the Global Motor Quotient and in subtests assessing object control and locomotor performance. Conclusion: The intervention using exergames as a therapeutic tool was the main factor responsible for improving the gross motor development of the children diagnosed with ASD.
Copyright (c) 2025 Natã Rafael Grola, Henrique Santa Capita Cerqueira, Rodrigo José Custódio, Carlos Eduardo Martinelli Jr. , Hugo Tourinho Filho https://creativecommons.org/licenses/by-nc-nd/4.0
Dynapenia in climacteric women: prevalence and risk factors
Introduction: Climacteric is a significant period in a woman's life, marked by hormonal decline and bodily changes such as declining muscle strength, which increases the risk of falls, fractures, and mortality, impacting quality of life. Objective: To estimate the prevalence and factors associated with dynapenia in climacteric women. Methods: This is an epidemiological, cross-sectional, and analytical study, with probabilistic sampling, conducted with climacteric women treated at the Family Health Strategies of Montes Claros, Minas Gerais, between August and October 2024. The variables included sociodemographic factors, gynecological-obstetric characteristics, anthropometric measurements, and physical fitness assessment. The outcome variable, dynapenia, was assessed by measuring handgrip strength. The association between the studied variables and the presence of dynapenia was verified by bivariate analysis followed by Poisson regression, with robust variance, in a hierarchical model. Results: Of the 533 women evaluated, 43.9% presented dynapenia. The condition remained associated with factors such as having a partner, above-median body fat percentage, and below-median performance on the push-up test. On the other hand, body mass index proved to be a protective factor against dynapenia. Conclusion: A high prevalence of dynapenia and its association with sociodemographic, clinical, and behavioral factors were found. Understanding the determinants of dynapenia during menopause is essential for developing effective prevention and intervention strategies to promote health and quality of life.
Copyright (c) 2025 Aline Amaral Versiani, Analice Veloso Dias, Maria Teresa Borges Ferreira Cardoso, Maria Victoria Lima Gonçalves, Nathan Pinheiro Fernandes, Samela Vitória Moura Soares, Josiane Santos Brant Rocha https://creativecommons.org/licenses/by-nc-nd/4.0
A sensitive practice framework for treating genitopelvic pain in women with sexual trauma
Introduction: Sexual trauma and sexual dysfunction are cause–effect related. Treatment includes specialized physical therapy to manage trauma triggers. Nevertheless, few studies have examined physical therapy approaches in women after sexual trauma. Objective: To propose approaches for genito-pelvic pain in women with sexual trauma. Methods: Twenty-four women were evaluated. Dyspareunia was assessed before and after the treatment of sexual pain by comparing anxiety score, level of distraction during sex, and touch aversion. A detailed protocol of sensitive practice for approach and treatment was developed to deal with the signs and symptoms of trauma. A structured framework of approach for the treatment of women with a history of sexual abuse history was presented. Results: Women treated with our sensitive care approach showed high baseline levels of anxiety and cognitive distraction during sex (n = 8; 33.3%; Cronbach’s α = 0.8 for ‘sexual abuse thoughts’ and 0.75 for ‘partner´s lack of affection’). However, anxiety (1.7 ± 2.1 vs. 0.1 ± 0.5), sexual pain intensity (6.0 ± 3.2 vs. 0.7 ± 0.8) and pain during physical therapy assessment (4.6 ± 1.9 vs. 0.3 ± 0.5) were all significantly reduced after treatment (p < 0.05). The total number of sessions until therapy discharge was 7.4 (± 4.1). Conclusion: Our study provides a framework for physical therapists of how to deal with women with dyspareunia after sexual trauma. However, a prospective study with a control group should be encouraged to test the effects of sensitive approaches on the treatment outcomes.
Copyright (c) 2025 Waleska Oliveira Modesto, Bhianca Lopes Teixeira, Marcela Grigol Bardin https://creativecommons.org/licenses/by-nc-nd/4.0
Evaluation of digital applications in learning and interactivity of young children
Introduction: Early childhood (0 to 36 months of age) is a crucial period for a child's physical, cognitive and social development, being a decisive moment for the foundations of learning and social interaction. Objective: To Evaluate the interactivity, age-appropriateness, learning potential, and motivational appeal of free games and apps for early childhood children. Methods: This is a cross-sectional, descriptive study that followed the following steps: search and selection of free apps available on Google Play®; use by children aged 24 to 36 months attending public daycare centers; participant observation and evaluation by two independent researchers, according to the following criteria: interactivity, learning, appropriateness, and results. A form was created for the analysis to assess the aforementioned criteria, with response options on a Likert scale from 0 (“not at all”) to 3 (“quite a bit”) for each criterion. Scores were calculated, with a maximum value of 1.00, with 0.60 being the minimum appropriate value. Results: Twenty apps were found, and 7 were selected based on the established criteria. The average score was 0.74 for learning (0.59–0.84), 0.82 for interactivity (0.41–0.95), 0.78 for adequacy (0.53–0.90), and 0.81 for outcomes (0.47–0.96). Conclusion: Just over 2/3 of the seven free-access applications performed well on the criteria, revealing potential for use in research and by educators and parents.
Copyright (c) 2025 Évelyn Daynnara Miranda Corrêa, Mylena Francielle Ribeiro Lima, Lucas Barbosa da Costa, Rosane Luzia de Souza Morais, Juliana Nunes Santos https://creativecommons.org/licenses/by-nc-nd/4.0
Manual therapy for chronic migraine: a randomized clinical trial
Introduction: Chronic migraine is a common neurological condition, especially among women, and significantly affects quality of life and productivity. Although pharmacological treatment is the main strategy, its limited effectiveness and adverse effects justify the search for complementary approaches such as manual therapy (MT). Objective: To analyze the effectiveness of MT on pain intensity, frequency of episodes, disability, self-efficacy, sleep quality, and quality of life in adults with chronic migraine. Methods: A randomized controlled clinical trial was performed with 40 adults with chronic migraine. Participants were randomly allocated to a control group (CG; n = 20) or a manual therapy group (MTG; n = 20). The MTG received ten MT sessions, once a week for 12 weeks. Both groups continued the use of pharmacological treatment. The choice of MT was based on its potential to modulate pain and improve musculoskeletal function. Outcome measures included: HIT-6, MIDAS, PSQI-BR, SF-36, and HMSE-10. Results: Mean age was 36.7 ± 10.2 years. The intervention was associated with a significant improvement in the total HIT-6 score (p = 0.014) and in the domains of physical limitations (p = 0.02) and general health status (p = 0.03) of the SF-36. The proportion of participants with severe disabilities was 57.14% in the CG and 21.42% in the MTG (p < 0.05). The median cervical flexion was -10.0° in the CG and 5.0° in the MTG (p = 0.005). Conclusion: MT associated with pharmacological treatment demonstrated positive outcomes and may be an effective approach for managing chronic migraine.
Copyright (c) 2025 Mickael de Souza, Camila Milenna dos Santos Vieira, Alzira Maria de Andrade Araújo, Jeovana dos Santos Ferreira, Adriano dos Santos Sousa, Baldomero Antonio Kato da Silva, Raimundo Pereira Silva-Néto, Marcelo de Carvalho Filgueiras https://creativecommons.org/licenses/by-nc-nd/4.0
Benefits of TREINI on functional goals of children with myelomeningocele
Introduction: Children with myelomeningocele (MMC) often experience limitations that affect their daily activities and family routines. Understanding parental priorities and applying effective interventions is essential to promote functional gains and satisfaction. Objective: To characterize the functional goals of children with MMC, organize them according to the F-words framework, and evaluate the effects of the TREINI Program on the improvement in these functional goals. Methods: A non-randomized pilot study was conducted involving 26 children (ages 2-14) with MMC. The Canadian Occupational Performance Measure (COPM) was used to characterize functional goals and evaluate the benefits of the TREINI program. The protocol consisted of training functional goals in a naturalistic environment combined with the use of a flexible therapeutic suit, over three months, five times a week, for 3-4 hours per day. Descriptive statistics were used to provide the profile of priorities. Pre- and post-intervention data were analyzed using the paired t-test. Results: A total of 130 goals were established by parents, among which activities of daily living (ADLs), such as functional mobility, dressing, and personal hygiene, were the most frequently set goals. More goals were associated with the terms "function" (45.8%) and "fitness" (37.5%). The TREINI program resulted in significant improvements in performance and satisfaction for most functional priorities (p < 0.05). Conclusion: For parents of children with MMC, ADLs were identified as the main treatment priorities. The TREINI program resulted in significant improvements in the performance of functional goals and increased parental satisfaction.
Copyright (c) 2026 Thalita Karla Flores Cruz, Arthur Felipe Barroso de Lima, Reinaldo da Costa Paulino Netto, Ana Clara de Carvalho Silva, Amanda Aparecida Alves Cunha Nascimento, Deisiane Oliveira Souto https://creativecommons.org/licenses/by-nc-nd/4.0