Brazilian Journal of Physical Therapy, Volume: 17, Issue: 4, Published: 2013
  • Family socioeconomic status and the provision of motor affordances in the home Original Articles

    Freitas, Teresa C. B.; Gabbard, Carl; Caçola, Priscila; Montebelo, Maria I. L.; Santos, Denise C. C.

    Abstract in English:

    BACKGROUND: Socioeconomic status (SES) and stimulation provided in the home environment are influential factors in aspects of child well-being including motor development. Little is known regarding the influence of SES on specific aspects of the home environment. OBJECTIVE: To evaluate the availability of affordances in the home to promote infant motor development and family SES. METHOD : The sample consisted of 300 families with infants aged 3 to 18 months. SES was assessed according to family socioeconomic class, income and parental level of education. To evaluate motor affordances found at home, the Affordances in the Home Environment for Motor Development-Infant Scale (AHEMD-IS) was used. The AHEMD-IS was designed to assess dimensions of the home environment including Physical Space (outside and inside space), Daily Activities and Play Materials (fine-motor and gross-motor toys). RESULTS: SES indicators significantly influenced the availability of Physical Space and Play Materials. The Physical Space dimension was influenced by family economic class and income. The Play Materials dimension was influenced by all SES indicators. Daily Activities were not influenced by any of the SES indicators. Daily activities and play material were influenced by the infant's age. CONCLUSIONS: This study suggests that SES indicators are influential with regard to the provision of motor affordances in the home environment for infants. However, daily activities, which represent an aspect of the environment that is highly dependent on parental generation of situations that are conducive to motor skill development, are independent of family SES.
  • Analysis of the user satisfaction level in a public physical therapy service Original Articles

    Almeida, Renato S.; Nogueira, Leandro A. C.; Bourliataux-Lajoine, Stéphane

    Abstract in English:

    BACKGROUND: The concepts of quality management have increasingly been introduced into the health sector. Methods to measure satisfaction and quality are examples of this trend. OBJECTIVE: This study aimed to identify the level of customer satisfaction in a physical therapy department involved in the public area and to analyze the key variables that impact the usersâ€(tm) perceived quality. METHOD: A cross-sectional observational study was conducted, and 95 patients from the physical therapy department of the Hospital Universitário Gaffrée e Guinle - Universidade Federal do Estado do Rio de Janeiro (HUGG/UNIRIO) - Rio de Janeiro, Brazil, were evaluated by the SERVQUAL questionnaire. A brief questionnaire to identify the sociocultural profile of the patients was also performed. RESULTS: Patients from this health service presented a satisfied status with the treatment, and the population final average value in the questionnaire was 0.057 (a positive value indicates satisfaction). There was an influence of the educational level on the satisfaction status (χ‡Â²=17,149; p=0.002). A correlation was found between satisfaction and the dimensions of tangibility (rho=0.56, p=0.05) and empathy (rho=0.46, p=0.01) for the Unsatisfied group. Among the Satisfied group, the dimension that was correlated with the final value of the SERVQUAL was responsiveness (rho=0.44, p=0.01). CONCLUSIONS: The final values of the GGUH physical therapy department showed that patients can be satisfied even in a public health service. Satisfaction measures must have a multidimensional approach, and we found that people with more years of study showed lower values of satisfaction.
  • The development and psychometric evaluation of a self-efficacy scale for practicing pelvic floor exercises Original Articles

    Sacomori, Cinara; Cardoso, Fernando L.; Porto, Isabela P.; Negri, Nubia B.

    Abstract in Portuguese:

    CONTEXTUALIZAÇÃO: A autoeficácia tem se mostrado preditora de muitos comportamentos relacionados à saúde, dentre eles, a prática de exercícios do assoalho pélvico (AP) com foco na prevenção ou cura. OBJETIVO: Descrever o processo de construção e as propriedades psicométricas da Escala de Autoeficácia para Prática de Exercícios do Assoalho Pélvico (EAPEAP). MÉTODO: Estudo transversal de validação com 81 mulheres da comunidade e 96 puérperas, sendo que 54,8% queixavam-se de perdas urinárias. Procedeu-se com análise fatorial exploratória e análise de consistência interna. Para verificar capacidade preditiva, analisou-se a aderência em três meses pós- intervenção e comparou-se o escore de autoeficácia entre mulheres aderentes e não aderentes. A fidedignidade foi avaliada pela técnica das metades partidas. RESULTADOS: O instrumento obteve α=0,923 e revelou três fatores: expectativa de performance considerando a ação, expectativa de performance considerando a preparação para a ação e expectativa de resultado. Tais fatores foram responsáveis por 65,32% da variância total. O instrumento foi capaz de diferenciar as mulheres que aderiram daquelas que não aderiram aos exercícios (U=352, p=0,013), e houve correlação forte entre as duas metades do instrumento (rho=0,889, p<0,001). CONCLUSÃO: A escala é válida e confiável para mensurar autoeficácia para prática de exercícios do assoalho pélvico.

    Abstract in English:

    BACKGROUND: Self-efficacy has been shown to be a predictor of many health-related behaviors, including the practice of pelvic floor exercises with a focus on prevention or cure. OBJECTIVES: To describe the process of construction and the psychometric properties of the scale of self-efficacy for the practice of pelvic floor exercises (EAPEAP). METHOD: A cross-sectional study of validation was carried out with 81 from community and 96 postpartum women, 54.8% of them complained of urinary leakage. An exploratory factor analysis and internal consistency analysis was performed. To check predictive capacity, we analyzed the adherence at 3 months post - intervention and compared the scores of self-efficacy between adherent and non-adherent women. Reliability was analyzed by split half procedure. RESULTS: The instrument showed α=0.923, and revealed three factors: performance expectation considering the action, performance expectation considering the preparation for action and outcome expectations. These factors accounted for 65.32% of the total variance. The instrument was able to differentiate between women who adhere and have not adhered to the exercises (U=352, p=0.013) and there was strong correlation between the two halves of the instrument (rho=0.889, p<0.001). CONCLUSION: The scale is a valid and reliable tool to measure self-efficacy to practice pelvic floor exercises.
  • Effects of low-intensity pulsed ultrasound on injured skeletal muscle Original Articles

    Montalti, Camila S.; Souza, Natália V. C. K. L.; Rodrigues, Natália C.; Fernandes, Kelly R.; Toma, Renata L.; Renno, Ana C. M.

    Abstract in English:

    BACKGROUND: Low-intensity pulsed ultrasound (LIPUS) has been shown to stimulate tissue metabolism and accelerate muscle healing. However, the optimal parameters in the use of LIPUS are still not clear. OBJECTIVE: The aim of this study was to analyze the effects of LIPUS on muscle healing in rats subjected to a cryolesion. METHOD: Twenty rats were divided into the following groups: an injured control group (CG) and an injured treated group (TG). Both groups were divided into 2 sub-groups (n=5 each) that were sacrificed 7 and 13 days post-surgery. Treatments were started 24 hours after the surgical procedure and consisted of 3 or 6 sessions. After euthanasia, the muscles were submitted to standard histological procedures. RESULTS: Qualitative analyses were based on morphological assessments of the muscle. The histopathological analysis on day 7 revealed that the muscles in the CG and the TG presented an intense inflammatory infiltrate, a large necrotic area and a disorganized tissue structure. After 13 days, both the CG and the TG had granulation tissue and newly formed fibers. The TG presented a more organized tissue structure. The quantitative analysis of collagen indicated similar findings among the groups, although the qualitative analysis revealed a better organization of collagen fibers in the TG at 13 days. The immunohistochemical analysis indicated that, at both time points, the expression of cyclooxygenase-2 was upregulated in the TG compared to the CG. CONCLUSIONS: LIPUS used as a treatment for muscle injury induced a more organized tissue structure at the site of the injury and stimulated the expression of COX-2 and the formation of new muscle fibers.
  • Patients hospitalized for community-acquired pneumonia present reduced functional performance Original Articles

    José, Anderson; Corso, Simone D.

    Abstract in English:

    BACKGROUND: Symptoms of fatigue and dyspnea, treatment with oral corticosteroids, high circulating levels of cytokines, and oxidant/antioxidant imbalance in patients hospitalized with community-acquired pneumonia (CAP) could affect the patients' exercise tolerance and peripheral muscle strength (PMS). OBJECTIVE: To evaluate the functional capacity (FC) of patients hospitalized for CAP and to correlate the FC with length of hospital stay. METHOD: We prospectively evaluated 45 patients (49±16 years; CAP group) and 20 healthy subjects (53±17 years; control group). They were randomized to perform, on separate days, a 6-minute walk test (6MWT), a test of PMS, and the Glittre test (GT). Additionally, the SF-36 questionnaire and the MRC scale were completed and evaluated. RESULTS: There were significant differences between the groups (CAP and controls) for the 6MWT (381.3±108 vs. 587.1±86.8 m) and GT (272.8±104.3 vs. 174±39 sec). The CAP group also presented worse health-related quality of life (HRQoL) scores, reduced strength (quadriceps and biceps), and higher scores of dyspnea. The time required to perform the GT correlated with the length of hospital stay (r=0.35, P=0.02) and dyspnea (r=0.36, P=0.02). Significant correlations were observed between GT and 6MWT (r=-0.66, P=0.0001) and between GT with the physical functioning domain of SF-36 (r=-0.51, P=0.0001). CONCLUSIONS: Patients hospitalized for CAP presented with reduced FC, PMS, and HRQoL during hospitalization. In addition, GT performance was related to the length of hospital stay.
  • Assessment of gait in toddlers with normal motor development and in hemiplegic children with mild motor impairment: a validity study Original Articles

    Figueiredo, Priscilla R. P.; Silva, Paula L. P.; Avelar, Bruna S.; Chagas, Paula S. C.; Oliveira, Luísa C. P.; Mancini, Marisa C.

    Abstract in Portuguese:

    CONTEXTUALIZAÇÃO : A otimização da marcha é objetivo relevante na reabilitação de crianças com prognóstico de locomoção na paralisia cerebral (PC). A análise da marcha com vídeos capturados por câmeras digitais necessita ser validada. OBJETIVO : Avaliar a validade de um método que envolve a inspeção de vídeos capturados por câmera digital para quantificação de variáveis temporais da marcha de lactentes com desenvolvimento motor normal e crianças com PC. MÉTODO : Onze lactentes com desenvolvimento motor normal e oito crianças com PC do tipo hemiplegia espástica capazes de deambular sem dispositivos de auxílio de marcha foram solicitadas a caminhar em um espaço contido no campo visual de dois instrumentos: câmera digital e sistema tridimensional de análise de movimento Qualisys Pro-Reflex. As medidas de duração das fases de apoio e balanço e o tempo total do ciclo da marcha foram calculados a partir da análise de vídeos de câmera digital e comparados às medidas obtidas pelo Qualisys Pro-Reflex, considerado sistema de alta acurácia. RESULTADOS: O Coeficiente de Correlação Intraclasse (CCI) demonstrou concordância excelente (CCI>0,90) nas medidas dos dois grupos, exceto para a fase de balanço dos lactentes (CCI=0,35). O erro padrão das medidas foi menor que 0,02 segundos para todas as mensurações. CONCLUSÕES : Resultados revelam semelhança entre os dois instrumentos, sugerindo que a câmera digital pode ser instrumento válido para quantificação de dois parâmetros temporais da marcha. Tal congruência tem relevância clínica e científica, preconizando uso da câmera digital como recurso auxiliar à avaliação e documentação de efeitos terapêuticos das intervenções direcionadas à marcha de crianças com PC.

    Abstract in English:

    BACKGROUND: The optimization of gait performance is an important goal in the rehabilitation of children with cerebral palsy (CP) who present a prognosis associated with locomotion. Gait analysis using videos captured by digital cameras requires validation. OBJECTIVE: To evaluate the validity of a method that involves the analysis of videos captured using a digital camera for quantifying the temporal parameters of gait in toddlers with normal motor development and children with CP. METHOD: Eleven toddlers with normal motor development and eight children with spastic hemiplegia who were able to walk without assistive devices were asked to walk through a space contained in the visual field of two instruments: a digital camera and a three-dimensional motion analysis system, Qualisys Pro-Reflex. The duration of the stance and swing phases of gait and of the entire gait cycle were calculated by analyzing videos captured by a digital camera and compared to those obtained by Qualisys Pro-Reflex, which is considered a highly accurate system. RESULTS: The Intraclass Correlation Coefficient (ICC) demonstrated excellent agreement (ICC>0.90) between the two procedures for all measurements, except for the swing phase of the normal toddlers (ICC=0.35). The standard error of measurement was less than 0.02 seconds for all measures. CONCLUSIONS: The results reveal similarities between the two instruments, suggesting that digital cameras can be valid instruments for quantifying two temporal parameters of gait. This congruence is of clinical and scientific relevance and validates the use of digital cameras as a resource for helping the assessment and documentation of the therapeutic effects of interventions targeted at the gait of children with CP.
  • The perceptions of Unified Health System (Sistema Único de Saúde) users about including undergraduate students in Family Health Units (Unidades de Saúde da Família) Original Articles

    Driusso, Patricia; Sato, Tatiana O.; Joaquim, Regina H. V. T.; Moccellin, Ana S.; Mascarenhas, Silvia H. Z.; Salvini, Tania F.

    Abstract in Portuguese:

    CONTEXTUALIZAÇÃO: As diretrizes curriculares preconizam a inserção dos alunos das áreas de saúde nos diferentes níveis assistenciais do Sistema Único de Saúde (SUS), surgindo a necessidade de se investigar a percepção dos usuários do SUS a respeito da atuação discente. OBJETIVO: Avaliar a percepção dos usuários do SUS sobre a inserção e atuação de estudantes dos cursos da área de saúde nas Unidades de Saúde da Família (USF). MÉTODO: Foram entrevistadas 518 pessoas em sala de espera de oito USF do município de São Carlos/São Paulo. As entrevistas foram realizadas pelos estudantes por meio de questionário semiestruturado. Os dados foram analisados descritivamente. RESULTADOS: Foram entrevistadas 391 (75,5%) mulheres e 127 (24,5%) homens, com média de idade de 42,0 ± 17,5 anos. Entre os usuários, 33,1% haviam realizado alguma atividade com alunos nas USF, principalmente atendimento clínico (52,1%) e visita domiciliar (20,1%); 55,3% consideraram a atividade como muito boa e 0,6%, como péssima. A maioria (58,2%) avaliou a atividade realizada pelo aluno como resolutiva e 8,2%, como não resolutiva. CONCLUSÃO: A inserção discente se deu, prioritariamente, na forma de atividades assistenciais individuais, e houve boa aceitação do atendimento realizado pelos alunos, já que tanto a satisfação quanto as expectativas relatadas foram positivas.

    Abstract in English:

    BACKGROUND: Curriculum guidelines for health professionals in training recommend including health students in different levels of service in the Unified Health System (Sistema Único de Saúde - SUS). Thus, there is a need to investigate the perceptions of SUS users with regard to the students' participation. OBJECTIVE: To evaluate the perceptions of SUS users about the participation of health students in Family Health Units (Unidades de Saúde da Família - USF). METHOD: A total of 518 people were interviewed in the waiting room of eight USFs in São Carlos/São Paulo. The interviews were conducted by students using a semi-structured questionnaire, and the data were analyzed descriptively. RESULTS: A total of 391 (75.5%) women and 127 (24.5%) men, with a mean age of 42.0±17.5 years, were interviewed. Among these users, 33.1% had encountered students in the USF, mainly while receiving clinical care (52.1%) or during home visits (20.1%); 55.3% considered the student's performance very good, and 0.6% considered it very bad. Most of the interviewees (58.2%) evaluated the activity performed by the student as effective, whereas 8.2% considered it ineffective. CONCLUSIONS: The students were included primarily in individual assistance activities, and the care provided by the students was well accepted. Both the users' satisfaction scores and their reported expectations were positive.
  • Influence of sarcopenia and functionality indicators on the frailty profile of community-dwelling elderly subjects: a cross-sectional study Original Articles

    Viana, Joana U.; Silva, Silvia L. A.; Torres, Juliana L.; Dias, João M. D.; Pereira, Leani S. M.; Dias, Rosângela C.

    Abstract in English:

    BACKGROUND: Frailty and sarcopenia are frequent conditions in the elderly and are related to inactivity and functionality. However, little is known about the influence of the sarcopenia indicators on the frailty profile or their functional implications. OBJECTIVE: To evaluate whether the indirect indicators of sarcopenia and functionality influence the frailty profile in elderly subjects. METHOD : This was a cross-sectional study with 53 elderly subjects recruited by an active search in a secondary health care service. The indirect indicators of sarcopenia were body mass index (BMI), gait speed, Mini-Nutritional Assessment (MNA), Human Activity Profile (HAP), and handgrip strength. Frailty was characterized according to Fried's Frailty Phenotype. Functional capacity was assessed according to the Short Physical Performance Battery (SPPB). Physical activity level was assessed by HAP. Data were analyzed by analysis of variance (ANOVA) and multiple regression. RESULTS: Overall, 75.5% of the subjects were women, with a mean age of 76.72 (±5.89) years; 15.1% were frail and 54.7% pre-frail; and the level of physical activity was the most prevalent indicator of sarcopenia. Significant differences (p<0.05) were observed in both the physical activity level and gait speed between the non-frail and pre-frail groups and between the non-frail and frail groups. In addition, some sarcopenia indicators were associated with functional capacity and geriatric depression score. CONCLUSION: The level of physical activity and gait speed appeared to be the most relevant factors in the development of frailty in the study sample, which may have functional implications.
  • The work ability index and functional capacity among older workers Original Articles

    Padula, Rosimeire S.; Comper, Maria L. C.; Moraes, Suzana A.; Sabbagh, Catherine; Pagliato Junior, Wagner; Perracini, Monica R.

    Abstract in Portuguese:

    CONTEXTUALIZAÇÃO: O declínio da capacidade funcional, decorrente do envelhecimento, pode comprometer a capacidade para o trabalho e a produtividade dos trabalhadores mais velhos. OBJETIVO: Comparar o perfil sociodemográfico, as condições de saúde e a capacidade físico-funcional de trabalhadores jovens e mais velhos e correlacionar as medidas físico-funcionais ao índice de capacidade para o trabalho (ICT). MÉTODO: Estudo exploratório, transversal, com trabalhadores de uma Instituição de Ensino Superior e uma Indústria Metalúrgica. Os trabalhadores mais velhos (50 anos ou mais) foram pareados em relação ao gênero e ao tipo de ocupação a trabalhadores jovens (menos de 50 anos). Foram utilizados questionário de avaliação multidimensional, contendo dados sociodemográficos, clínicos, percepção da saúde e saúde física, o ICT e uma bateria de testes físico-funcionais. RESULTADOS: O número de doenças e número de medicamentos de uso regular foram maiores para o grupo de trabalhadores mais velhos. O ICT não apresentou diferença entre os grupos (p=0,237). A capacidade físico-funcional revelou desempenho similar entre os grupos em medidas de velocidade de caminhada, de força muscular e de função física de MMII. Os trabalhadores mais velhos apresentaram um pior desempenho apenas no teste de apoio unipodal direito (p=0,004). O ICT se mostrou correlacionado de forma moderada ao sit-to-stand test entre as mulheres do grupo de trabalhadores mais velhos (r=0,573, p=0,051). CONCLUSÃO: A avaliação da capacidade para o trabalho e a maior parte dos testes de capacidade físico-funcional no grupo mais velho parecem não ter sido afetadas pelas condições gerais de saúde desfavoráveis.

    Abstract in English:

    BACKGROUND: Decreases in functional ability due to aging can impair work capacity and productivity among older workers. OBJECTIVE: This study compares the sociodemographics, health conditions, and physical functioning abilities of young and old workers as well as correlates of physical functioning capacity with the work ability index (WAI). METHOD: This exploratory, cross-sectional study examined employees of a higher education institution (HEI) and those of a metallurgical industry. Older workers (50 years old or above) were matched for gender and occupation type with younger workers (less than 50 years old). The following evaluations were applied: the multidimensional assessment questionnaire (which included sociodemographic, clinical, health perception, and physical health indices), the WAI, and a battery of physical functional tests. RESULTS: Diseases and regularly used medications were more common among the group of aging workers. The WAI did not differ between groups (p=0.237). Both groups showed similar physical functional capacity performances with regard to walking speed, muscle strength, and lower limb physical functioning. Aging workers showed a poorer performance on a test of right-leg support (p=0.004). The WAI was moderately correlated with the sit-to-stand test among older female workers (r=0.573, p=0.051). CONCLUSIONS: Unfavorable general health conditions did not affect the assessment of work ability or most of the tests of physical functional capacity in the aging group.
  • Relationship of musculoskeletal pain with physical and functional variables and with postural changes in school children from 6 to 12 years of age Original Articles

    Pereira, Daniela S. L.; Castro, Shamyr S.; Bertoncello, Dernival; Damião, Renata; Walsh, Isabel A. P.

    Abstract in Portuguese:

    CONTEXTUALIZAÇÃO: Afecções dolorosas podem acometer a criança e o adolescente, gerando sofrimento e importante demanda aos serviços de saúde. OBJETIVO: Identificar a prevalência de dor musculoesquelética e sua relação com idade, sexo, Índice de massa corporal (IMC), forma de carregar o material escolar, posturas utilizadas nas atividades da vida diária (AVDs), realização de exercícios físicos orientados fora do ambiente escolar e alterações posturais. MÉTODO: Pesquisa de campo com delineamento transversal e caráter exploratório, com amostra de conveniência de 262 escolares de seis a 12 anos (137 mulheres), realizada com questionário contendo dados pessoais, presença e localização de dor, meio de locomoção, forma de carregar material escolar e posturas adotadas nas AVDs. A avaliação postural ocorreu por análise observacional. Na análise descritiva, usou-se números brutos e porcentagens. Na estatística inferencial, a comparação da idade segundo a presença de dor foi realizada pelo Teste de Kruskal-Wallis com pós-teste de Dunn. As variáveis categóricas foram comparadas pelo teste de qui-quadrado. RESULTADOS: A presença de dor musculoesquelética foi relatada por 51,1% dos escolares e 38,93% apresentaram dor em uma região. As regiões mais acometidas foram pernas, coluna, braços e ombros. Verificou-se que a dor aumentou com a idade e com a prática de atividade física. CONCLUSÕES: Na amostra, 51,1% dos estudantes relataram dor, sendo que 38,93% reportaram dor em somente uma região. Não houve associação entre presença de dor e sexo, IMC, forma de carregar o material escolar, posturas nas AVDs e alterações posturais. O aumento da idade e a prática de exercícios físicos influenciaram significativamente a presença da dor.

    Abstract in English:

    BACKGROUND: Painful disorders can affect children and adolescents, causing distress and significant demand for health services. OBJECTIVE: To identify the prevalence of musculoskeletal pain and its relation to age, sex, body mass index (BMI), how to carry school supplies, postures used in ADLs, outside school physical exercises and postural changes in students. METHOD: Cross-sectional exploratory study with a convenience sample consisted of 262 schoolchildren aged 6 to 12 years (137 female). Data collection was conducted by questionnaire containing personal data, presence and location of pain, means of transportation and illustrative figures for choosing the way of carrying school supplies and postures ADL's. Postural evaluation was performed by observational analysis and body mass index calculated from information on height, weight, age and sex. Descriptive analysis was carried out with numbers and percentages. For inferential statistics, comparison of average age according to the presence of pain was performed by Kruskal-Wallis with Dunn's post-test. Categorical variables were compared with chi-square test. RESULTS: The presence of musculoskeletal pain was reported by 51.1% of the students and 38.93% had pain in only one region. The most affected regions were legs, spine, arms and shoulders. The pain increased with age and with physical activity. CONCLUSIONS: In the our sample, 51.1% of students reported pain and 38.93% reported pain in only one region. There was no association between the presence of pain and sex, BMI, how to carry school supplies, postures used in ADLs and postural changes. The increasing age and physical exercise influenced significantly the presence of pain.
  • Acute effects of different inspiratory resistive loading on heart rate variability in healthy elderly patients Original Articles

    Archiza, Bruno; Simões, Rodrigo P.; Mendes, Renata G.; Fregonezi, Guilherme A. F.; Catai, Aparecida M.; Borghi-Silva, Audrey

    Abstract in English:

    BACKGROUND: The cardiovascular system is noticeably affected by respiration. However, whether different inspiratory resistive loading intensities can influence autonomic heart rate (HR) modulation remains unclear. OBJECTIVE: The objective was to investigate HR modulation at three different inspiratory resistive loading intensities in healthy elderly men. METHOD: This was a prospective, randomized, double-blind study that evaluated 25 healthy elderly men. Cardiac autonomic modulation was assessed using heart rate variability (HRV) indices. All of the volunteers underwent maximal inspiratory pressure (MIP) measurements according to standardized pulmonary function measurements. Three randomly-applied inspiratory resistive loading (30, 60 and 80% of MIP) intensities were then applied using an inspiratory resistance device (POWERbreathe, Southam, UK), during which the volunteers were asked to inhale for 2 seconds and exhale for 3 seconds and complete 12 breaths per minute. Each effort level was performed for 4 minutes, and HR and the distance between 2 subsequent R waves of electrocardiogram (R-R intervals) were collected at rest and at each intensity for further HRV analysis. RESULTS : The parasympathetic HRV (rMSSD, SD1 and HF) indices demonstrated lower values at 80% (rMSSD: 19±2 ms, SD1: 13±2 ms and HF: 228±61 ms2) than at 30% MIP (rMSSD: 25±3 ms, SD1: 18±2 ms and HF: 447±95 ms2; p<0.05). CONCLUSIONS: Lower inspiratory resistive loading intensities promoted a marked and positive improvement of parasympathetic sinus node modulation.
  • Influence of specific training on spatio-temporal parameters at the onset of goal-directed reaching in infants Original Articles

    Cunha, Andréa B.; Woollacott, Marjorie; Tudella, Eloisa

    Abstract in English:

    BACKGROUND: There is evidence that long-term experience can promote functional changes in infants. However, much remains unknown about how a short-term experience affects performance of a task. OBJECTIVE: This study aims to investigate the influence of a single training session at the onset of goal-directed reaching on the spatio-temporal parameters of reaching and whether there are differences in the effects of training across different reaching positions. METHOD: Thirty-three infants were divided into three groups: 1) a control group; 2) a group that was reach trained in a reclined position; and 3) a group trained in the supine position. The infants were submitted to two assessments (pre- and post-training) in two testing positions (supine and reclined at 45°). RESULTS: The short-duration training sessions were effective in promoting shorter reaches in the specific position in which the training was conducted. Training in the reclined position was associated with shorter and faster reaches upon assessment in the reclined position. CONCLUSIONS: A few minutes of reach training are effective in facilitating reaching behavior in infants at the onset of reaching. The improvements in reaching were specific to the position in which the infants were trained.
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