Progressive muscle strengthening using a Swiss ball is effective for improving muscle strength and walking performance in patients with AS.

ACEITO PARA PUBLICAÇÃO maio 2009RESUMO: A estimulação elétrica nervosa transcutânea (TENS) é um recurso não-farmacológico já consagrado na modulação de dores agudas e crônicas. O objetivo deste estudo foi verificar o efeito da TENS convencional e na modalidade TENSacupuntura na dor induzida pelo frio. Trinta indivíduos saudáveis com idade entre 18 e 40 anos foram distribuídos ao acaso em três grupos: placebo, TENS convencional e TENS-acupuntura. Foi utilizado um protocolo de indução de dor pelo frio composto por seis ciclos: dois pré-tratamento, dois durante e dois após o tratamento. A TENS foi aplicada por 20 minutos por dois canais, sendo a modalidade convencional, no nível sensorial, na freqüência de 80 Hz e a modalidade acupuntura, no nível motor, a 4 Hz. Foram medidos limiar de dor, tolerância à dor e intensidade da dor. Não foi encontrada diferença estatisticamente significante nos valores medidos durante a após o tratamento quando comparados aos dos ciclos pré-tratamento, em todas as variáveis. Nas duas modalidades estudadas pois, a TENS, nos parâmetros de aplicação utilizados, não modificou a dor induzida por frio, sugerindo-se novos estudos com maior tempo de aplicação da TENS e diferentes modelos de dor experimental. DESCRITORES: Dor; Estimulação elétrica nervosa transcutânea/métodos; Limiar da dor ABSTRACT: Transcutaneous electrical nerve stimulation (TENS) is a non-pharmacological method already established in the modulation of acute and chronic pain. The purpose of this study was to assess the effect of conventional TENS and acupuncture-like TENS on cold-induced pain. Thirty healthy subjects aged 18 to 40 years old were randomized into in three groups: placebo, conventional TENS, and acupuncturelike TENS. A cold-induced pain protocol was used, in six cycles (two pre-treatment, two during, and two after treatment); TENS was applied for 20 minutes through 2 channels, the conventional modality at sensory level at 80 Hz, and the acupuncture modality at motor level at 4 Hz. Variables analysed were pain threshold, tolerance to pain, and pain intensity. No statistically significant differences were found in any variable between post and pre-treatment measures in all groups. Hence neither conventional or acupuncture-like TENS had any effect on cold-induced pain. Further studies are suggested, with different experimental pain models, and with longer time of TENS application.

Background: Low back pain is particularly problematic among nursing professionals. Education is part of the rehabilitation process for low back pain and has been heavily studied. In parallel, gestural behaviors play an important role during the evaluation of the low back pain, especially while performing the activities of daily living. The aim of the present study was to evaluate gesture behavior and knowledge on LBP among nurses with and without LBP and correlate these factors with pain, physical functioning and quality of life. Methods: An observational, controlled, cross-sectional study was carried out in 120 female nurses: 60 with LBP and 60 without LBP. The two groups were matched for age. The measures used for the evaluation were the Gesture Behavior Test, LBP Knowledge Questionnaire, Numerical Pain Scale for LBP, Roland Morris Disability Questionnaire and the Short Form-36 (SF-36) to assess quality of life. Results: Mean age in both groups was 31 years. In the group with LBP, the mean Numerical Pain Scale score was 5.6 cm and the mean score on the Roland Morris questionnaire was 2.7. No statistically differences between groups were found regarding the scores of the LBP Knowledge Questionnaire or Gesture Behavior Test (p = 0.531 and p = 0.292, respectively). Statistically lower scores were found in the group with LBP for the following SF-36 domains: physical functioning (p < 0.001), physical role (p = 0.015), pain (p = 0.001), general health perceptions (p = 0.015), vitality (p < 0.001) and mental health (p = 0.001). Conclusions: No differences were found when comparing nurses with or without LBP regarding gesture behavior or knowledge on LBP. Nurses with LBP showed a decrease in some domains of quality of life.

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Background Ankylosing spondylitis (AS) is a systemic inflammatory disease that affects the physical capacity of patients globally. Exercises are recommended to the management of patients with AS, although the benefits of specific exercise programs are not yet well defined. Objectives To evaluate the effectiveness of a progressive muscle strengthening program using a Swiss ball in improving functional capacity, muscle strength, disease activity, mobility and quality of life of patients with AS. Methods Sixty patients were randomized to intervention group (IG) or to control group (CG), with 30 patients in each group. Eight exercises were done by GI with free weights on a Swiss ball, 2 times per week for 16 weeks. Loads were reassessed and increased every 4 weeks. The GC continued drug therapy without any exercise, on a waiting list. The evaluations were performed by a blinded evaluator immediately before randomization and at 4, 8, 12 and 16 weeks after initiation of the study. Functional capacity were evaluated using the BASFI (Bath Ankylosing Spondylitis Functional The Index), HAQ-S (Health Assessment Questionnaire for Spondyloarthropathies), the 6-minute walk test and the Time Up and Go test. Muscle strength was assessed by the 1-repetition maximum (1 RM) test. Disease activity was measured by BASDAI (The Bath Ankylosing Spondylitis Disease Activity Index) and by dosage of ESR and C-reactive protein. The BASMI (The Bath Ankylosing Spondylitis Metrologyl Index) was used to assess spinal mobility and the SF-36 questionnaire to assess quality of life. Patients were also evaluated by Likert scale for satisfaction. In addition, the amount of analgesic and non-steroidal anti-inflammatory used was controlled. Results The groups were homogeneous at baseline for clinical and demographic characteristics. There was a statistically significant difference between the two groups in the improvement of strength in IG compared to the CG for the muscles used in the exercises: abdominal (p = 0.003), rowing exercises (p = 0.02), squat (p = 0.01), triceps (p = 0.021) and reverse fly (p = 0.02). The IG also improved the 6-minute walk test (p = 0.005) at week 16 compared with the CG. We also found a statistically significant difference between groups in the Likert scale at all times (p <0.001) with IG showing greater treatment satisfaction. We found no differences between groups in other variables and there was no worsening of disease activity in IG. Conclusions The progressive muscle strengthening using a Swiss ball is effective in improving muscle strength and walking performance in patients with AS. The exercise program has shown good tolerance assessed by patient satisfaction without deleterious effects on disease activity. The trial was registered in (NCT01351311). References American College of Sports Medicine. American College of Sports Medicine position stand. Progression models in resistance training for healthy adults. Med Sci Sports Exerc. 2009 Mar;41(3):687-708. Review. Dagfinrud, H.;Kvien, T. K.; Hagen, K. B....