Patrícia Azevedo Garcia

Background and Purpose: Cognitive impairment manifests early in Parkinson’s disease (PD), adversely affecting patients’ daily activities and mental health. Utilizing exergames via the Xbox 360 Kinect (XBK) console presents a promising therapeutic avenue to mitigate cognitive decline in PD. This study aimed to assess the efficacy of the XBK system in enhancing cognitive performance and reducing anxiety levels among individuals with PD. Method: A non‐randomized controlled trial, controlled, single‐blind clinical trial was conducted. Forty‐three PD participants were selected through convenience sampling and non‐randomly assigned to either the XBK experimental group ( n = 23) or the Control Group ( n = 23). Participants underwent pre, post, and 30‐day post‐intervention evaluations using the Digit Span Tests, Semantics, Verbal Fluency Test, and Beck Anxiety Inventory. The control group received no intervention, while the experimental group underwent 10 sessions employing four XBK games. This study was approved by the Institutional Ethics Committee of the University of Brasília (Approval No. 2.109.826). Analysis of variance (ANOVA 2 × 3) with Sidak post hoc test and Bonferroni correction was utilized to examine intergroup outcomes. Results: The XBK‐trained group exhibited enhancements in short‐term memory post‐intervention ( p = 0.04) and at follow‐up ( p = 0.01), as well as operational memory post‐intervention ( p = 0.006) and at follow‐up ( p = 0.001), although without significant between‐group differences. Although no significant interaction effect was observed ( p = 0.126), a reduction in anxiety levels was verified up to 30 days post‐training ( p = 0.03), exclusively within the XBK group, accompanied by a significant between‐group difference ( p = 0.01), also in follow‐up. Discussion: Although the intervention did not demonstrate a superior effect compared with the control group, our findings suggest that training with the Xbox 360 Kinect may have the potential to reduce anxiety in individuals with Parkinson's disease. Further research through randomized clinical trials is necessary to validate these findings and evaluate the long‐term benefits of this intervention. Trail Registration: University of Brasília, CAAE: 12248513.9.0000.0030. N°: 2.109.826 https://ensaiosclinicos.gov.br/rg/RBR‐7h6b8mg .

BACKGROUND Technology has emerged as a valuable tool for promoting a healthy lifestyle, encouraging physical activity and helping prevent or delay functional declines. Although remote interventions have been widely investigated, their effectiveness remains inconclusive, partly because of variability in intervention modalities. OBJECTIVE To evaluate muscle strength, functional performance, and balance of older adults before and after synchronous and asynchronous tele-exercise interventions. METHODS This was a randomized, controlled, parallel-group clinical trial with blinded assessments. The assessments included isokinetic dynamometry, handgrip strength, SPPB, and the unipedal stand test. Participants underwent synchronous or asynchronous interventions 3 times per week for 12 weeks. RESULTS A total of 49 older adults were included. Adherence was higher in the synchronous group than in the asynchronous group (71.75% vs 51.46%; p =0.003). A group-by-gender interaction was found for change in right handgrip strength (p = 0.031), with greater gains among men in the synchronous group than among men in the asynchronous group (p = 0.001). No significant between-group differences were observed for SPPB or TUG. CONCLUSIONS Tele-exercise in synchronous mode has potential for applicability aiming at promoting health, improving muscle strength and physical activity levels, as well as preventing negative outcomes resulting from a sedentary lifestyle. CLINICALTRIAL The clinical trial was registered and approved by The Brazilian Registry of Clinical Trials (ReBEC) (trial registration: https://ensaiosclinicos.gov.br/rg/RBR-75dvnfm.)

Objetivo: Avaliar o equilíbrio dinâmico de atletas de voleibol universitário em comparação com mulheres sedentárias. Métodos: A amostra total foi constituída por 24 participantes, com idades entre 18 e 35 anos, distribuídas em dois grupos: 12 atletas de voleibol feminino universitário e 12 mulheres classificadas como sedentárias, conforme o Questionário Internacional de Atividade Física (IPAQ). Para a avaliação do equilíbrio dinâmico, foram selecionados o Y-Balance Test (YBT) e o Side Hop Test (Teste de salto lateral). Os dados foram analisados no Statistical Package for Social Sciences (SPSS) versão 20.0 e o nível de significância adotado foi de 5%. Resultados: As atletas de voleibol feminino universitário apresentaram médias de alcance significativamente maiores para o membro inferior não dominante na direção anterior (p=0,018) e nas direções posteromedial (p=0,009) e posterolateral (p=0,017) com o membro inferior dominante, quando comparadas às mulheres sedentárias. Para as demais variáveis, não foram observadas diferenças estatisticamente significativas. Não houve diferenças significativas entre os valores de alcance do membro inferior dominante em relação ao não dominante em nenhuma das variáveis testadas. Ambos os grupos apresentaram valores de score composto inferiores ao determinado pela literatura. Conclusão: Conclui-se que atletas de voleibol feminino universitário apresentam maiores valores de média de alcance para a direção anterior com o membro não dominante e para as direções posteromedial e posterolateral com o membro dominante, sugerindo que a prática regular do voleibol contribui para a função do equilíbrio.

Introduction: Total hip replacement (THR) is common in older adults with fragility fractures. Early mobilization is a key goal, but optimizing recovery remains challenging. Identifying factors associated with postoperative standing and walking abilities can support targeted interventions. Objective: To analyze recovery of standing and walking within 3 days after THR in older adults with femoral neck fractures, and to assess associations with age, cognitive status, body mass index (BMI), sarcopenia, and functional capacity. Methods: This was a prospective study of 71 older adults with femoral neck fractures undergoing THR between 2021 and 2024 at a reference hospital in Brazil. Preoperative assessments included age, BMI, cognitive status (Mini-Mental State Examination), functional capacity (Modified Barthel Index), and sarcopenia (handgrip dynamometry and calf circumference). Immediate postoperative evaluations (up to the third day) included standing ability (1 minute) and ambulation capacity (≥10 steps), with patients classified as able or unable for each task. Associations between predictors and outcomes were analyzed using multivariate analysis of covariance, Kaplan–Meier curves, and receiver operating characteristic analyses. Results: Mean age and BMI were 75.9 years and 23.1 kg/m ² ; 66.2% were female. By day 3, 50.7% stood and 39.4% walked ≥10 steps. Standing ability was associated with younger age, better cognition status, and higher functional capacity, while ambulation was additionally linked to the absence of sarcopenia. Kaplan–Meier analyses showed faster recovery in participants aged <80 years, with preserved cognition, functional independence, and no sarcopenia. Receiver operating characteristic curve analysis confirmed good predictive accuracy. Conclusion: Advanced age, cognitive impairment, and low prefracture functional capacity were associated with delayed recovery of standing and walking in the first 3 postoperative days. Sarcopenia showed a weaker but relevant association; BMI was not predictive. These findings highlight the value of preoperative clinical and functional factors and the need for targeted strategies to optimize early recovery.

Handball is a collective sport that involves a large amount and variety of movement associated with ball manipulation and interaction with other athletes. The objective was to verify the incidence of injuries in a university handball team with male and female athletes, as well as to identify the most frequent type of injury and the body segment most affected by it. A cohort study was carried out, related to the incidence of injuries that occurred during the 2019 season in a university team. Were observed 29 injuries, 11 in men (37,93%) and 18 (62,07%) in women. There were more injuries in games than during training and the most affected places were the ankle (24,14%) and the shoulder (17,24%). The most recurrent diagnoses were sprain and contusion (20,69%), followed by muscle injury (17,24%). The study observed that the female team suffered more injuries than the male team and that these occurred mostly in the lower limbs, taking the athletes largely to a few days away. Key words: handball; injury; incidence; physical therapy; sport.

Introdução: Os Bombeiros Militares (BM) colocam sua vida em risco para salvar a vida de terceiros e/ou para defender o patrimônio público e privado da sociedade e lidam com situações de emergência em saúde, e estão mais suscetíveis ao desenvolvimento de estresse no trabalho que podem ser prejudiciais à qualidade de vida (QV). Objetivo: Avaliar a QV de BM do Distrito Federal, Brasil. Metodologia: Estudo transversal descritivo, com BM de ambos os sexos. Utilizou-se o questionário SF-36 e seus oito domínios, além de um questionário estruturado para caracterizar o perfil da população. Resultados: Dos 178 BM avaliados, 158 eram do sexo masculino. A média geral de QV foi de 69,11 ± 26,53 pontos. A pontuação média (69,15 ± 1,41) dos homens foi similar a das mulheres (68,75 ± 26,71). A capacidade funcional apresentou a maior pontuação (80,67 ± 20,25) e a dor a menor (61,21 ± 22,89). O maior número de resposta ocorreu na estratificação de 81 a 100 pontos, nos domínios limitação capacidade funcional e limitação por aspectos emocionais, enquanto o menor foi encontrado na estratificação de 0 a 20, no domínio estado geral de saúde e na estratificação de 41 a 60, no domínio limitação por aspectos emocionais. Discussão: A pontuação média geral encontrada nos BM do Distrito Federal diferiu da encontrada em BM ativos em um município do interior do estado de São Paulo. Conclusões: Sugere-se a implementação de medidas de prevenção e promoção de saúde, na tentativa de melhorar a saúde e QV dos BM.

Objective To evaluate and compare the physical-functional performance of eutrophic and overweight older adults following a multicomponent tele-exercise program. Methods This longitudinal observational study was conducted between February 2022 and November 2023. Community-dwelling older adults (aged 60 to 80 years), classified as eutrophic (BMI = 22–27 kg/m²) or overweight (BMI > 27 kg/m²), participated in multicomponent tele-exercise sessions three times per week for 12 weeks, delivered either synchronously or asynchronously. Functional mobility was assessed using the Timed Up and Go (TUG) test, and muscle quality of upper and lower limbs was determined by the ratio of muscle strength to lean mass. Group comparisons were performed using ANCOVA, with the type of tele-exercise included as a covariate (α = 5%). Results A total of 64 older adults were included (26 eutrophic and 38 overweight), with similar baseline characteristics. After 12 weeks of tele-exercise, an overall improvement in muscle quality was observed, with a significant time effect and no interaction with nutritional status. Within-group analysis showed improvements across all outcomes in the eutrophic group, whereas in the overweight group improvements were limited to upper-limb muscle quality. A significant interaction between time and nutritional status was found for the TUG test (F(1,60) = 4.664; p = 0.035), with superior post-test performance in the eutrophic group (p = 0.012). Significant between-group differences were also observed in the muscle quality of knee extensors (p = 0.025) and flexors (p = 0.041), favoring eutrophic participants. Conclusion Nutritional status influenced the physical-functional performance of older adults undergoing tele-exercise, with differences in muscle quality and mobility between eutrophic and overweight individuals, highlighting the need for tailored strategies.

Resumo Objetivo avaliar e comparar o desempenho físico-funcional de pessoas idosas eutróficas e com sobrepeso após programa de tele-exercícios multicomponentes. Métodos estudo observacional longitudinal, entre fevereiro de 2022 e novembro de 2023. Participaram pessoas idosas (60 a 80 anos) da comunidade, eutróficas (IMC=22 a 27 kg/m²) ou com sobrepeso (IMC> 27 kg/m²), que realizaram tele-exercícios multicomponentes, 3 vezes por semana, por 12 semanas, de forma síncrona ou assíncrona. Foram analisadas a mobilidade funcional (Timed Up and Go - TUG) e a qualidade muscular dos membros superiores e inferiores, determinada pela razão entre força muscular e massa magra. A comparação entre grupos foi realizada por ANCOVA, considerando o tipo de tele-exercício como covariável (α=5%). Resultados foram incluídas 64 pessoas idosas (26 eutróficos e 38 com sobrepeso), com características basais semelhantes. Após 12 semanas de tele-exercícios, observou-se melhora geral na qualidade muscular, com efeito significativo do tempo, sem interação com o estado nutricional. A análise intragrupo indicou melhora em todos os desfechos no grupo eutrófico, enquanto o grupo com sobrepeso foi restrita à qualidade muscular de membros superiores. Houve interação significativa entre tempo e estado nutricional para o TUG (F(1,60)=4,664;p=0,035), com desempenho superior no grupo eutrófico no pós-teste (p=0,012). Diferenças significativas entre os grupos também foram identificadas na qualidade muscular de extensores (p=0,025) e flexores de joelho (p=0,041), favorecendo os eutróficos. Conclusão o estado nutricional influenciou o desempenho físico-funcional de pessoas idosas submetidas a tele-exercício, com diferenças na qualidade muscular e mobilidade entre eutróficos e indivíduos com sobrepeso, destacando a necessidade de estratégias personalizadas.

Postural Imbalance (PI) is a common complaint in cognitively impaired older adults. It is unknown whether the Cognitive Impairment (CI) affects the validity and interpretability of balance perception in this population when standing up or walking. This study aims to investigate the validity of self-reported PI perception to screen performance limitations related to the task proposed by the Timed Up and Go (TUG) test in older adults with CI. This is a cross-sectional study using the data collected from older people evaluated in 2019-2020 at a specialized geriatric care facility. The sample was composed of 136 older adults with CI identified by the Mini-Mental State Examination (MMSE). The participants were questioned about PI perception (test index) and were submitted to the TUG test (reference standard; cutoff point>20 seconds). The subject’s answers were confirmed by the accompanying caregiver. The Sensitivity (SE), Specificity (SP), Positive Predictive Values (PPV) and Negative Predictive Values (NPV) were estimated, measuring the agreement percentage (Cohen’s Kappa test). Out of the 136 individuals studied herein, 60.3% (n=82) had self-reported PI and 25.3% (n=35) experienced it during the TUG test. Validity estimates presented high sensitivity and NPV values (SE=85.7%, SP=48.5%, PPV=36.6%, NPV=90.7%). The agreement percentage between the two tools in the overall sample was 58.1%. Despite the low agreement between instruments, the self-reported PI showed low false-negative percentages, indicating that it could be a potential tool for screening limitations in the TUG test, favoring the identification of individuals at risk of imbalance among older adults with CI.