DSpace Coleção: PPGFIS

Efeito agudo da neuromodulação não invasiva na função cardiovascular, percepção subjetiva de esforço e capacidade funcional de pessoas com insuficiência cardíaca : ensaio clínico randomizado e controlado

2025-08-30T06:04:31Z

Título: Efeito agudo da neuromodulação não invasiva na função cardiovascular, percepção subjetiva de esforço e capacidade funcional de pessoas com insuficiência cardíaca : ensaio clínico randomizado e controlado Autor(es): Nunes, Kaio Emanuel de Souza Orientador: Lima, José Heriston de Morais Abstract: Introduction: Heart failure is a chronic condition associated with high rates of morbidity and mortality, significantly impacting the quality of life of affected individuals. High-definition transcranial direct current stimulation (HD-tDCS) has emerged as a promising neuromodulatory approach with potential influence on cardiovascular function. However, its effects on heart failure are still poorly understood. Objective: To evaluate the effects of HD-tDCS on cardiovascular function, subjective perception of effort and functional capacity of individuals with heart failure. Methods: A randomized clinical trial was conducted with individuals diagnosed with heart failure functional class II and III according to the New York Heart Association (NYHA). Participants underwent three 20-minute sessions of HD-tDCS (stimulation, inhibition and sham) applied to the left temporal and insular cortex at an intensity of 3 mA. After each session, a six-minute walk test was performed. The variables analyzed included heart rate variability through Holter monitoring, heart rate, distance covered in the 6-minute walk test, perceived exertion, blood pressure and partial oxygen saturation. The data were analyzed using the Shapiro-Wilk test and the Friedman test, given the non-normal distribution of the data. Results: There was a difference in the power of high-frequency heart rate variability in the cathodal current group (55.90 Hz) compared to the anodal (172 Hz) and sham (219 Hz) groups (p=0.003). In addition, the cathodal group had a lower heart rate (85 bpm) compared to the anodal (92 bpm) and sham (91 bpm) groups (p=0.045). The other variables did not show significant differences between the groups. Conclusion: The findings suggest that HD-tDCS can influence autonomic modulation, particularly in high-frequency heart rate variability and in the heart rate response to exercise, with faster recovery after physical exertion. Although no significant effects were observed in other physiological variables, the results indicate a therapeutic potential for the technique in autonomic regulation in heart failure. Additional studies are needed to better elucidate the underlying mechanisms and optimize stimulation parameters for future clinical applications. Editor: Universidade Federal da Paraíba Tipo: Dissertação

Análise do tempo de latência de doenças da coluna relacionadas ao trabalho : um recorte a partir de processos trabalhistas

2025-07-25T06:06:14Z

Título: Análise do tempo de latência de doenças da coluna relacionadas ao trabalho : um recorte a partir de processos trabalhistas Autor(es): Araujo, Gilvane de Lima Orientador: Vieira, Elamara Marama de Araújo Abstract: Background: Most Work-Related Musculoskeletal Disorders (WRMDs) emerge gradually over time. The period required for such conditions to manifest can be affected by the intensity and frequency of exposure to occupational risks. Objective: To build a regression model to analyze the latency time of work-related spinal disorders in litigation in labor courts. Methods: This is a documentary study obtained from lawsuits filed with the 13th Regional Labor Court. The sample included data obtained from lawsuits with expert reports prepared by a physician and/or physiotherapist, whose results indicate the presence of a causal or co-causal link. Only lawsuits from the last five years were considered, excluding those with a percentage of missing data (greater than 10%), as well as lawsuits that contained more than one expert report with divergent results in terms of causality. The data obtained were initially analyzed descriptively, considering measures of central tendency. Latency time modeling was performed using Survival Analysis, with the event of interest being the time between the start of the activity and the onset of symptoms of work-related spinal diseases. The analyses were performed using the R Core Team software, considering a significance level of 5%. Results: he results indicate that male workers have a significant reduction in the time until the onset of symptoms. In addition, increasing age is associated with an increase in the time until the onset of symptoms related to spinal diseases. Performing manual activities was observed as a factor that reduces the survival time of workers. On the other hand, it was found that, for each additional month of activity performed in the company, there is an increase in the time until the onset of the first symptoms in the spinal column. Conclusion: The final adjusted models pointed out relevant factors that influence the onset of symptoms of spinal diseases, enabling a comprehensive discussion that includes several aspects intrinsic to the work environment and the worker, by identifying those different variables influenced the time until the onset of symptoms of spinal diseases. Editor: Universidade Federal da Paraíba Tipo: Dissertação

Estimulação magnética transespinhal theta-burst associada ao treinamento em esteira no equilíbrio postural de pessoas com doença de Parkinson: estudo piloto randomizado cruzado

2025-07-15T06:06:38Z

Título: Estimulação magnética transespinhal theta-burst associada ao treinamento em esteira no equilíbrio postural de pessoas com doença de Parkinson: estudo piloto randomizado cruzado Autor(es): Melo, Maria Clara Silva de Orientador: Costa-Ribeiro, Adriana Abstract: Introduction: Postural instability is a significant limitation in Parkinson's Disease (PD) that is refractory to dopaminergic treatment. Objective: To compare two distinct protocols of Theta Burst repetitive Transspinal Magnetic Stimulation (rTSMS) combined with treadmill training on postural balance in individuals with PD. Method: A pilot randomized, single-blind, crossover clinical trial conducted at the Federal University of Paraíba. Participants included individuals with idiopathic PD between stages 1.5 and 4 according to the modified Hoehn & Yahr scale, who reported postural instability. The primary outcome, postural balance, was assessed using the MiniBest Test before the initiation of the protocol and immediately after the first and second phases of the study, during which participants received different doses of rTSMS pulses (60 trains and 20 trains) over 5 consecutive days. Secondary outcomes included fear of falling, turning ability, quality of life, and motor function. Results: Ten individuals with PD participated, with a mean age of 64.20 ± 7.46 years, a diagnosis duration of 129.40 ± 110.24 months, and predominantly presenting with the akinetic-rigid phenotype (50%). Treatment with 60 trains of rTSMS resulted in a significant change in postural balance (p = 0.025) and motor function (p = 0.020). No significant changes were observed between treatments for turning ability (p > 0.05), quality of life (p = 0.208), and fear of falling (p = 0.591). Seventy percent of participants reported improved balance, and 40% reported enhanced postural stability. Conclusions: The rTSMS stimulation protocol with 60 trains resulted in modifications in postural balance and a reduction in fall risk in individuals with PD. Editor: Universidade Federal da Paraíba Tipo: Dissertação

Perfil de participação na comunidade e ambiente de crianças pequenas brasileiras com Paralisia Cerebral : Recorte do estudo multicêntrico PartiCipa Brasil

2025-07-05T06:05:21Z

Título: Perfil de participação na comunidade e ambiente de crianças pequenas brasileiras com Paralisia Cerebral : Recorte do estudo multicêntrico PartiCipa Brasil Autor(es): Pontes, Viviann Alves de Orientador: Hull, Egmar Longo Abstract: Introduction: Participation is an important indicator of early childhood health in children with Cerebral Palsy (CP) and should be prioritized in rehabilitation programs. However, young children with CP tend to face restrictions in participating in community activities, which reinforces the need to investigate this outcome in low- and middle-income countries such as Brazil. Objective: To describe community participation and the environmental profile of young Brazilian children with CP, to analyze the correlation between participation domains, environmental factors and the child's GMFCS level, and to suggest an intervention strategy to improve participation. Methods: This study, part of the “PartiCipa Brasil” multicenter project, involved Brazilian children with CP, aged between 2 and 5 years and 11 months. A questionnaire of contextual factors, the Gross Motor Function Classification System (GMFCS) - Family Report was used to classify gross motor function, and the Young Children's Participation and Environment Measure (YC-PEM) was used to assess participation (Frequency, Involvement and Desire for change) and the environment (Supports, Barriers, Aids, Resources and General Environmental Support). The analyses were carried out using Jamovi software (version 2.3.28) with descriptive statistics and Spearman's correlation, adopting p<0.05. In addition, as a second product, a book chapter was written with a clinical case of a 7-year-old child with CP, with an intervention based on the Pathways and Resources for Engagement and Participation (PREP) approach. The Canadian Occupational Therapy Measure (COPM), Participation and Environment Measure for Children and Youth (PEM-CY) and the Therapeutic Goals Scale agreed in partnership with the family (GAS) were used. Results: Of the 541 children with CP followed up by PartiCipa Brasil, 109 answered the YC-PEM and were included in this study, with a mean age of 44.8 months (SD=12.0). There was a predominance of males, spastic CP and GMFCS level V, with children from low-income families. On average, the children participated in the community “once in the last month” and were involved at the “more or less” level, with an emphasis on activities related to “commitments”. A higher level of support was observed compared to the barriers faced, and 49.8% of caregivers expressed a desire for change in participation. Frequency of Participation correlated significantly with the child's GMFCS (r²=-0.240, p=0.011); Involvement with Supports (r²=0.230, p=0.016), Environmental Helpfulness (r²=0.210, p=0.028) and Overall Environmental Support (r²=0.238, p=0.012); and Desire to Change with Supports (r²=-0.274, p=0.003), Barriers (r²=0.340, p=0.001), Environmental Helpfulness (r²=-0.359, p=0.001) and Overall Environmental Support (r²=-0.344, p=0.001). For the book chapter, clinically significant changes were seen in the COPM and GAS with scores above 2 points and 50 points, respectively, and improvement in the Participation and Environment scores on the PEM-CY. Conclusion: This is the first study using PartiCipa Brasil data to describe how young children with CP from different regions of Brazil participate in the community. Understanding participation and environmental factors can support interventions, such as the PREP approach, to improve opportunities for this audience to participate in society. Editor: Universidade Federal da Paraíba Tipo: Dissertação