DSpace Coleção: PPGFIS

Neuromodulação e treinamento de marcha na função motora e equilíbrio na Doença de Parkinson: um ensaio clínico randomizado, controlado e duplo-cego

2026-07-06T06:12:08Z

Título: Neuromodulação e treinamento de marcha na função motora e equilíbrio na Doença de Parkinson: um ensaio clínico randomizado, controlado e duplo-cego Autor(es): Férrer, Mayane Laís Veloso Orientador: Clementino, Adriana Carla Costa Ribeiro Abstract: Introduction: Bradykinesia, resting tremor, postural instability, rigidity, as well as anxiety and depression are motor and non-motor symptoms of Parkinson's Disease (PD). As a therapeutic alternative, treadmill training comprises a type of exercise considered safe and effective that allows the modification of gait speed, step length, cadence and postural stability in PD. It was hypothesized that the association of Transcranial Direct Current Stimulation (tDCS/tDCS) with treadmill gait training (TGT) would promote an increase in functional mobility, gait speed, motor function, balance and quality of life in people with PD. Objectives: To analyze the influence of the association of tDCS with TGT on functional mobility, gait speed, motor function, balance and quality of life of people with PD. Methods: People with idiopathic PD, aged 40-80 years, disease stage 1.5-3 on the modified Hoehn and Yahr scale were randomly allocated into two groups: 1) Experimental Group: application of tDCS for 20 minutes followed by 20 minutes of treadmill gait training and 2) Control Group: application of tDCS sham followed by the same gait training. Participants were evaluated at three moments (AV1, AV2 and AV3) by the Timed Up and Go (TUG), Ten meter walk test (10MWT), 5x Sit to Stand test (5XSTS), Unified Parkinson's Disease Scale part III (MDS-UPDRS-III), Mini Balance Evaluation Systems Test (Mini-BESTest), Activity-specific Balance Confidence Scale (ABC scale) and Parkinson's disease questionnaire-39 (PDQ-39). Outcome measures were analyzed using repeated measures ANOVA (3x2) in the statistical package Statistical Package for Social Sciences – SPSS 20.0 and a value of P≤0.05 was considered significant. Results: tDCS was able to potentiate the TGT by improving the balance of people with PD (P=0.043). Over time, both groups showed improvement in the TUG, 10MWT, 5XSTS, MDS-UPDRS III, Mini- BESTest and PDQ-39 tests. Conclusions: The association of tDCS with TME was superior to treadmill training alone to improve balance in people with PD, but it did not influence functional mobility, gait speed, motor function and quality of life in the sample studied. Editor: Universidade Federal da Paraíba Tipo: Dissertação

Análise comparativa da associação da tens com o método pilates na lombalgia crônica: ensaio clínico aleatorizado, sham-controlado e duplo-cego

2026-06-30T06:11:14Z

Título: Análise comparativa da associação da tens com o método pilates na lombalgia crônica: ensaio clínico aleatorizado, sham-controlado e duplo-cego Autor(es): Diniz, Letícia Souza Martins Orientador: Andrade, Palloma Rodrigues de Abstract: Introduction: Chronic low back pain is one of the leading causes of disability worldwide, generating significant impacts on quality of life and imposing a heavy burden on healthcare systems. Among the most widely used physiotherapeutic approaches for managing this condition, Pilates and Transcutaneous Electrical Nerve Stimulation (TENS) stand out. Despite the widespread use of both interventions, evidence on the possible synergistic effects of their simultaneous application remains scarce. Thus, the aim of this study was to investigate the effects of adding TENS to a Pilates protocol on pain intensity and functional capacity outcomes in individuals with chronic low back pain. Methods: A randomized, sham-controlled, double-blind clinical trial was conducted with 101 individuals with chronic low back pain, allocated into two groups: Pilates combined with active TENS (n = 49) and Pilates combined with sham TENS (n = 52). Participants underwent 12 floor-based exercise sessions, following the principles of the Pilates Method, performed twice a week over a 6-week period. The participants were divided into two groups: one receiving active TENS (100 Hz, 100 μs, strong intensity) and the other receiving sham TENS during the entire Pilates session. Pain intensity (measured using the Numeric Pain Rating Scale) and functional capacity (measured using the Roland-Morris Disability Questionnaire) were assessed before the treatment protocol (T0), immediately after the first session (T1), and after 12 sessions (T2), while participants’ perception of improvement and satisfaction with the treatment (measured using the Global Perceived Effect Scale) was assessed at the end of the protocol (T2). Data were analyzed using repeated-measures ANOVA with Bonferroni post hoc tests and independent samples t-tests, using SPSS v.25 software. Results: Both groups showed a significant reduction in pain after the first session, with improvement maintained until the 12th session. In the PILATENS group, pain intensity decreased from 6.02 (±1.95) to 1.61 (±2.01) (p < 0.001); in the SHAM group, from 6.46 (±1.81) to 2.40 (±2.49) (p < 0.001). Repeated-measures ANOVA indicated a significant time effect on pain (p < 0.001), with no difference between groups (p = 0.21). Functional capacity also improved significantly: in the PILATENS group, Roland-Morris scores decreased from 6.33 (±4.63) to 2.35 (±3.18), and in the SHAM group, from 6.31 (±4.91) to 3.21 (±3.59). The within-group differences were statistically significant (p < 0.001), but there was no significant difference between groups (p = 0.308). Both groups also reported positive perceptions regarding clinical improvement and satisfaction with treatment, with the PILATENS group showing a significantly higher mean score (5.90 ± 1.23) than the SHAM group (5.21 ± 1.49) (p = 0.013). Conclusion: Adding TENS to Pilates did not provide additional benefits in reducing pain or improving functional capacity in individuals with chronic low back pain. These results highlight the importance of the rational use of therapeutic resources and encourage further research on treatment combinations. Editor: Universidade Federal da Paraíba Tipo: Dissertação

Acurácia da termografia infravermelha na detecção da tendinopatia ou risco de lesão tendínea: revisão sistemática com metanálise

2026-05-17T06:10:42Z

Título: Acurácia da termografia infravermelha na detecção da tendinopatia ou risco de lesão tendínea: revisão sistemática com metanálise Autor(es): Lacerda, Angélica Palitot Dias de Orientador: Ferreira, José Jamacy de Almeida Abstract: Introduction: The sympathetic nervous system (SNS) plays a role as a component of tendinopathy, increasing its innervation and intervening in local blood flow. This alteration can be directly portrayed by the skin temperature in the pathological tendon area. Due to its ability to detect variations in skin temperature, infrared thermography (IRT) can be a tool used to evaluate these alterations caused by tendinopathy processes. Objective: To systematically review the evidence on the use of IRT in the diagnosis of tendinopathy and in the detection of risk of tendon injury. Methods: This is a systematic review with meta- analysis based on the PRISMA 2020 methodological guidelines, carried out from January to December 2021 in the PubMed, PEDro, SciELO, Embase, CENTRAL and CINAHL databases, using descriptors for tendon injury and IRT. The screening, selection and information collection steps in the primary studies were performed concurrently by two independent researchers. The included studies were assessed for risk of bias using the QUADAS-2 tool. Evidence synthesis was performed quantitatively, through the analysis of sensitivity, specificity, summary ROC curve (SROC) and diagnostic odds ratio (DOR), using the Meta-DiSc 1.4 software. Results: Eight studies were selected for the qualitative synthesis, while for the meta-analysis only seven studies were included, which showed that the IRT has a sensitivity of 72% (CI 95%: 67% - 77%), specificity of 95% (CI 95 %: 92% - 98%) DOR of 75.94 (CI 95%: 12.04 - 479.14), with an accuracy (SROC) of 97%. When performing a sensitivity analysis, this review suggests that for lateral epicondylitis, IRT has a detection capacity with a sensitivity of 93% (CI 95%: 86% - 97%), specificity of 97% (CI 95%: 93% - 99 %) and DOR of 221.38 (CI 95%: 21.09 – 2321.13). As for tendinopathies of the shoulder region, IRT also demonstrated accuracy with a sensitivity of 63% (CI 95%: 56% - 70%), 100% specificity (CI 95%: 91% - 100%) and DOR of 60.71 (CI 95%: 8.10 - 454.87). Conclusion: The IRT constitutes an accurate tool to detect tendon injuries, with a high power of specificity, both in the evaluation of lateral epicondylitis and for tendonitis in the shoulder region. Editor: Universidade Federal da Paraíba Tipo: Dissertação

O clima de trabalho em equipe dos Núcleos Ampliados de Saúde da Família e Atenção Básica

2026-05-17T06:10:28Z

Título: O clima de trabalho em equipe dos Núcleos Ampliados de Saúde da Família e Atenção Básica Autor(es): Cruz, Angélica Pereira da Orientador: Brito, Geraldo Eduardo Guedes de Abstract: Introduction: The consolidation of Primary Health Care (PHC) in recent decades represents one of the most relevant advances of the Unified Health System as a public policy and universal health system in Brazil. This advance is largely due to the scope of the Family Health Strategy, its main care model. However, given the increase in demands and limitations, the Support Center for Family Health and Primary Care (NASF-AB) was created to expand the scope of actions in primary care, through teams formed by different professions. The study of the Team Work Climate allows the evaluation of teams to monitor the effectiveness of teamwork, in the production of results in the care of users and population. Objective: To analyze the NASF-AB teamwork climate. Methods: This is a cross-sectional quantitative study of multiple cases (João Pessoa/PB and Campo Grande/MS). The sample consisted of 182 professionals from the NASF-AB in these two capitals. In order to obtain the data, from January to March 2020, a structured questionnaire with questions that characterized the participants and their work process and the Team Climate Scale (ECE) was applied. For storage, processing and analysis, using the Excel program and the R statistical package. Respondents were grouped by teams and their total score was calculated (mean of the individual scores of the ECE). From this, teams were classified into 4 types. Results: The NASF-AB consisted of 10 different professions, with physical therapists being the most prevalent. Young adult professionals, women, specialists, who wanted to work at NASF-AB, graduated about 9 years ago, with an average of 4 years of experience in PHC and with an average of 2 years of relationship with their current teams, predominated. The professionals were satisfied with their own work and with that of their team, with the relationship and communication with other team members, with the unit manager and with how much their work was centered on the users' needs, but dissatisfied with the infrastructure of the units. The services provided were predominantly individual and with curative actions. An analytical model of the characteristics of physiotherapists and their work process at NASF-AB was developed, showing that it is centered on the needs of users. It was seen that teams that support new ideas, are clear about the team's objectives, have adequate task orientation and that develop fewer activities with other professionals from the NASF-AB and the ESF, are those that had the best teamwork climate. Conclusions: In order for there to be a good teamwork climate and for interprofessional collaboration to take place in practice, the involvement of professionals is paramount. Thus, permanent education is fundamental for the transformation of professional practice, in an integrated and collaborative way. Furthermore, the development of dialogic spaces, the implementation of strategies, institutional support, the meeting of teams, the exchange of knowledge, the sharing of practices and the definition of action plans with a functioning counter-referral system must be promoted. Editor: Universidade Federal da Paraíba Tipo: Dissertação