Leonardo Brynne Ramos de Souza

Obstructive Sleep Apnea Syndrome (OSAS) is a respiratory disorder characterized by dysfunctions in the autonomic nervous system (ANS). However, the impacts on the exercise performance in heart rate variability (HRV) in these patients remains unclear. It is an observational transversal study, which included patients diagnosed with OSAS, aged over 18 of both sexes. HRV was collected with a Smart Lab HRV heart rate monitor (HMM Group, Heidelberg, Germany) during submaximal exercise testing with 6 minutes step test (6MST), which included 3 stages: pre-exercise, during exercise and post-exercise. Data were analyzed posteriorly in Kubios HRV Scientific Lite software (KUBIOS OY, Finland), in which time and frequency domain data of HRV analyses were obtained for each person. 30 volunteers were recruited, with a mean age of 53.27±13.47 years and 56.6% male. There was statistical difference between pre, during and post exercise values of all frequency domain data (LF Power and HF Power; p= <0,05), except for Ratio LF/HF (p = 0.096) and between pre and exercise and exercise and post exercise for all time domain data (SDNN, RMSSD and TINN). In time domain, there wasn’t difference between pre and post exercise values in any variable. In people with OSAS, frequency and time domain values reduced during the exercise phase, which means greater sympathetic activity. There wasn’t difference between pre and post exercise phase in time domain variables, which means fast recovery in patients with OSAS.

Objetivo: Analisar os impactos do exercício físico em indivíduos com Anemia Falciforme. Método: Revisão sistemática da literatura, cuja elaboração seguiu as recomendações propostas pela Colaboração Cochrane e pelo Preferred Reporting Items for Systematical Review and Metanalyses (PRISMA). Incluiu-se ensaios clínicos randomizados publicados entre os anos de 2019–2024, em revistas indexadas nas bases de dados WebOfScience e Scopus, nos idiomas inglês e português. Os artigos foram avaliados pela ferramenta Risk of bias in randomised trials (ROB 2), para avaliação do risco de viés pelo instrumento Grading of Recommendations Assessment, Development and Evaluation (GRADE), com objetivo de mensurar o nível de evidência dos estudos. Resultados: Ao final da seleção, foram incluídos 5 artigos, com população total de 77 indivíduos com diagnóstico de Anemia Falciforme, os quais todos foram classificados na avaliação geral da ferramenta ROB 2.0 como “algumas suspeições”. No entanto, foram classificados como “alto” nível de evidência na ferramenta GRADE. Os artigos concluíram que o exercício físico conseguiu melhorar com significância estatística todas as variáveis da capacidade física e da resposta aeróbica e da função, estrutura e organização muscular apresentadas nos estudos. Conclusão: é possível concluir que o exercício físico melhorou a capacidade física e a função muscular nos indivíduos com AF, dentro dos estudos incluídos nessa revisão sistemática.

Introduction: Obstructive Sleep Apnea Syndrome (OSAS) is a respiratory disorder characterized by dysfunctions in the autonomic nervous system (ANS). However, the impacts on the exercise performance in heart rate variability (HRV) in these patients remains unclear. Methods: observational transversal study, which included patients diagnosed with OSAS, aged over 18 of both sexes. HRV was collected with a Smart Lab HRV heart rate monitor (HMM Group, Heidelberg, Germany) during submaximal exercise testing with 6 minutes step test (6MST), which included 3 stages: pre-exercise, during exercise and post-exercise. Data were analyzed posteriorly in Kubios HRV Scientific Lite software (KUBIOS OY, Finland), in which time and frequency domain data of HRV analyses were obtained for each person. Results: 30 volunteers were recruited, with a mean age of 53.27±13.47 years and 56.6% male. There was statistical difference between pre, during and post exercise values of all frequency domain data (LF Power and HF Power; p= Conclusion: In people with OSAS, frequency and time domain values reduced during the exercise phase, which means greater sympathetic activity. There wasn’t difference between pre and post exercise phase in time domain variables, which means fast recovery in patients with OSAS.

Introduction: Parkinson's disease is an chronic neurodegenerative disorder, whose prevalence has become a major public health problem associated with aging. Physical therapy is a treatment modality that is known to improve the functionality of individuals, but there are few studies that evaluate it when applied at home. Objectives: to investigate the effects of a home rehabilitation physical therapy program for patients with Parkinson's disease. Methods: it’s a therapeutic intervention study, carried out between July and November 2022. This work was approved by the Research Ethics Committee (CEP) of Federal University of Pará (UFPA). 22 participants were evaluated before and after 12 sessions using an evaluation form consisting of anamnesis, physical examination and a composite form Hoehn & Yahr Scale (EH&Y), Time Up and Go Test, Sitting and Standing Test - 5 times , International Physical Activity Questionnaire (IPAQ), Brazilian OARS (BOMFAQ) and Parkinson's Disease Questionnaire - 39 questions (PDQ-39). Results: 88% of patients were classified in EH&Y as grade I or III. 6 seniors (68% male and 32% female) completed the treatment. The intervention had strong statistical significance on the TUG, TSL and BOMFAQ (p=0.00) and PDQ-39 (p=0.01). There was no statistical stability in the data collected with the IPAQ (p=0.31). Conclusion: In the observed population, the home rehabilitation protocol was effective in improving gait, lower limb strength, performing activities of daily living and quality of life.

Introdução: O câncer de mama é o mais incidente nas mulheres e a cirurgia é o principal tratamento de escolha. A síndrome da rede axilar (SRA) é uma condição recorrente que ocorre em até 86% das pacientes após cirurgia, se apresenta como um único cordão ou múltiplos cordões nos tecidos subcutâneos da axila ipsilateral e gera dor e limitação do movimento. Objetivo: Investigar estudos sobre a ocorrência e fatores associados à SRA após tratamento do câncer de mama. Método: Revisão sistemática com metanálise, nas bases de dados PubMed, LILACS e EMBASE, com a metodologia PECOS, seguindo a diretriz PRISMA. Resultados: Cinco artigos foram selecionados, com taxa de ocorrência da SRA de 35%. Os fatores associados encontrados apresentaram um menor risco relativo (RR) de recorrência para quem realizou biópsia de linfonodo sentinela em comparação aos que se submeteram à dissecção axilar (RR 0,49; IC 95% [0,42; 0,57] I²=95%, p=0,01). Houve uma variação de 35% a 39% de desenvolvimento para a SRA em pacientes que se submeteram à quimioterapia e radioterapia, porém o tipo de cirurgia não teve resultado estatisticamente significativo para o desencadeamento da síndrome. Conclusão: Indivíduos que realizaram biópsia de linfonodo sentinela têm menos chance de desenvolver a SRA quando comparados aos que fizeram dissecção axilar. As terapias oncológicas apresentaram proporções parecidas de aparecimento da SRA e o tipo de cirurgia não interferiu na evolução da patologia.

Aging is characterized by a reduction in physical, cognitive, and emotional functions, allowing multiple losses in the quality of life of the elderly. As a clinical situation that has a common association with pathological aging, neurocognitive disorder, previously named dementia, has become epidemiologically more relevant over the years. Thus, art therapy has recently emerged as an alternative technique for approaching these individuals, with the aim of improving cognitive, emotional, and quality of life aspects. Objective: The objective of this study was to analyze the effects of the application of art therapy based on visual creative processes on cognitive, emotional, and quality of life aspects in elderly people with neurocognitive disorder. Methods: This was a systematic review, carried out using CAPES, PubMed, SciELO, Bireme, PEDro, LILACS, and Scorpus databases between December 2020 and April 2021. Controlled and uncontrolled clinical trials were included in English, Spanish, French, and Portuguese, published between 1970 and 2021, with a focus on modalities of visual art production. The articles included at the end of the selection process were evaluated methodologically by the PEDro Scale of clinical trials. Results: A total of 14 articles were obtained at the end of the selection. Of note, 13 articles had a statistically significant outcome (p≤0.005) for quality of life, cognitive, and emotional functions after intervention with art therapy, being the most used interventions, such as drawing, paintings, and sculptures. Conclusions: The results show significant impacts after the application of art therapy in its visual modality. However, studies with greater methodological rigor are needed to strengthen the evidence presented.