Joaquim Henrique Lorenzetti Branco

Student sleepiness during classes is a frequently reported condition that can impair performance in the teaching–learning process and is even unsustainable for health. Although the environmental quality of the classroom may affect the students’ sleepiness, studies that exhaustively investigate the relationship between indoor environmental quality (IEQ) and sleepiness levels in classrooms are lacking. To this end, in the present paper, we carried out an experimental pilot study involving twenty-seven Italian adolescent students to determine the increase in their sleepiness rate during the school period utilizing the Epworth Sleepiness Scale (ESS). The analysis was performed in a classroom in which the indoor environmental quality was monitored, including measurements of the thermal comfort, sound pressure level, illuminance, carbon dioxide (CO₂) concentrations, and airborne particle concentrations (both sub-micrometric particles and PM₁₀). Three measurement days were considered. The results showed that student sleepiness significantly increased during the school period (Day 1 p = 0.00, Day 2 p = 0.03, and Day 3 p = 0.03). This increase was observed on measurement days characterized as having both perceived higher and lower thermal comfort and even in the presence of limited exposure to airborne particle concentrations, presenting an association with the high indoor concentration of CO₂ detected in the classroom (Day 1 between 978 and 3261 ppm; Day 2 between 1044 and 2338 ppm; Day 3 between 1116 and 2623 ppm), due to reduced ventilation rates and the students’ sleepiness. Thus, the findings suggest that adequate ventilation rates can limit the increase in the rate of sleepiness, indicating, from our pilot study, that recommendations of sustainable environmental practices through comprehensive feasibility studies can promote positive changes in indoor environments such as classrooms.

Background Resistance training (RT) has become an important topic for the treatment of fibromyalgia (FM); however, there are still controversies regarding its ability to significantly improve physical symptoms and a lack of adequate recommendations for evidence-based practice. Aim The aim of this study is to analyze the effects of RT on the physical symptoms of patients with FM through a systematic review with meta-analysis. Methods We conducted a systematic review of randomized controlled trials in June 2022, according to PRISMA recommendations. The searches were carried out on the databases PubMed, Embase, Science Direct, Web of Science, PEDro, CINAHL, SciELO, and Google Scholar for gray literature, and the protocol was recorded in PROSPERO. Studies that evaluated patients with FM undergoing an RT program lasting more than 2 weeks and that analyzed physical health were selected. To carry out the meta-analysis, the recommendations of the Cochrane Handbook for Systematic Reviews of Interventions were followed. Results In total, 13 studies were included for qualitative analysis and nine for meta-analysis. Regarding meta-analysis, a favorable improvement was found for pain ([MD = − 10.22 (95% CI: − 18.86 to − 1.58; I²: 64%; P for heterogeneity: 0.003)]; very low quality of evidence {QoE}), fatigue ([SMD = − 0.39 (95% CI: − 0.61 to − 0.17; I²: 0%; P = 0.91)]; moderate QoE), and muscle strength ([SMD = 0.94 (95% CI: 0.02 to 1.85; I²: 93%; for heterogeneity: < 0.0001)]; very low QoE) and improvement in functional capacity ([MD = 18.75 (95% CI: 4.27 to 33.22; I²: 39%; P = 0.19)]; low QoE), in the general comparison. Conclusion RT was effective in reducing pain and fatigue and increasing strength and functional capacity; however, due to the quality of the evidence, more studies are needed.

Fibromyalgia (FM) is a disease characterized by generalized and chronic musculoskeletal pain. It is common, the presence of other symptoms such as fatigue, depression, sleep disorders, leading patients to adopt a sedentary lifestyle. Objective: Verify the muscular and respiratory strength of women with FM. Method: Is a cross-sectional study that evaluated 41 women with clinical diagnosis of FM. We analyzed handgrip strength (HS), the strength of the lower limbs, and respiratory muscle endurance using the spirometric maneuver. Results: Patients with FM had a significant reduction in HS, both in the dominant and non-dominant upper limb. Furthermore, peripheral muscle strength in the lower limbs was reduced because on average, participants exceeded the normative five-repetition sit-to-stand test times stipulated for the age groups. Approximately two-thirds of the sample had maximal voluntary ventilation values below the lower limit of normality. We detected inverse and moderate correlation between peripheral muscle strength and HS of non-dominant upper limb (r= −0.472; p= 0.002) and inverse and weak correlation with the HS of dominant upper limb (r= −0.374; p= 0.016); weak correlations between respiratory muscle endurance and HS of dominant upper limb (r= 0.299; p= 0.058), HS of non-dominant upper limb (r= −0.317; p= 0.043), and peripheral muscle strength (r= −0.372, p= 0.017); and strong correlation between HS of dominant upper limb and non-dominant upper limb (r= 0.899; p<0.001). Conclusion: Women with FM present with reduced muscle strength in the upper and lower limbs, as well as lower respiratory muscle resistance.

Fibromyalgia is a chronic disease characterized by generalized skeletal muscle pain and the presence of mental disorders is common among patients. As there is no cure, several treatment alternatives have been investigated, including the practice of resistance training. Thus, the aim of the current study is to analyze the effects of resistance training on the mental health of patients with fibromyalgia. This is a systematic review of the literature that followed the recommendations of the PRISMA statement. The search for articles occurred in May 2020 in the databases PubMed, Embase, Science Direct, Web of Science, PEDro, and CINAHL, as well as Google Scholar for gray literature. The protocol was recorded in PROSPERO and assessment of quality was performed using the Cochrane tool. In total, 481 studies were found in the database searches, of which seven were included in the analysis. The only variables investigated in studies related to mental health were depression and anxiety. The results demonstrate that resistance training reduces symptoms of depression and anxiety in patients with fibromyalgia. It is concluded that resistance training is efficient to improve the mental health of patients with fibromyalgia, reducing depression and anxiety. The main limitation is that few variables related to mental health were analyzed. Key Points • Resistance training improves the mental health of patients with FM. • The most commonly studied variables related to mental health are depression and anxiety. • The study protocols are similar, starting with low-intensity training and gradually increasing the intensity.

OBJETIVO: Analisar a qualidade de vida relacionada à saúde (QVRS) de obesos mórbidos (OMs) participantes do Programa de Extensão PREPARA – Núcleo de Ensino, Pesquisa e Extensão em Fisioterapia Pré e Pós-Operatória de Cirurgias de Grande Porte, antes e após um programa fisioterapêutico estruturado de preabilitação cirúrgica.MÉTODOS: Trata-se de um estudo prospectivo, unicêntrico, do tipo ensaio clínico não controlado, realizado com 46 indivíduos OMs. A coleta de dados foi feita através de uma entrevista estruturada e do questionário WHOQOL-Bref-Obesidade, antes e após o programa de preabilitação, para avaliação da QVRS. A análise foi realizada por meio de estatística descritiva e teste de comparação (teste t pareado e Wilcoxon).RESULTADOS: Houve acréscimo na pontuação de todos os domínios avaliados pelo questionário, entretanto os domínios que apresentaram diferença estatística significante foram os domínios físico (p=0,05), meio ambiente (p=0,04) e o WHOQOL total (p=0,04).CONCLUSÕES: Um programa fisioterapêutico estruturado de preabilitação para pacientes que serão submetidos à cirurgia bariátrica (CB) é capaz de melhorar significativamente a QVRS dos participantes, em especial o domínio físico.