Objective: To evaluate respiratory muscle strength and hand strength in patients on a liver transplant waiting list and to associate these with mortality. Methods: one hundred and thirty-two patients who underwent routine physical therapy evaluation while waiting for liver transplantation were studied retrospectively. Respiratory muscle strength was assessed by measuring the maximum inspiratory pressure (MIP) and maximum expiratory pressure (MEP), and upper-limb strength was evaluated by dynamometry. The patients were divided into two groups: group A, consisting of 51 patients (14 females, 50.1±12.3 years) who died while on the waiting list; and group B, consisting of 81 patients (31 females, 45.0±3.8 years) who survived until the time of liver transplant. Student's t test was used with a 5% significance level. Results: The mean MIP values for groups A and B were 65.7±28.0 and 77.5±33.8mmHg (p=0.04), respectively, and the mean MEP values were 72.9±32.9 and 84.4±33.1mmHg (p=0.07), respectively. The mean values for left-hand strength in groups A and B were 18.5±8.1 and 21.5±10.5kgf (p=0.08), and the mean values for right-hand strength were 20.2±9.7 and 23.5±12.5kgf (p=0.10), respectively. Conclusions: MIP was lower in the patients who died while waiting for liver transplantation. In the same group, it was observed that the MEP values and right and left-hand strength were numerically lower, although they did not reach statistically significant differences.Key words: liver transplantation; respiratory muscles; mortality; hand strength; physical therapy.
ResumoObjetivo: Avaliar a força de músculos respiratórios e de mão em pacientes na lista de espera para o transplante de fígado e associá- Palavras-chave: transplante de fígado; músculos respiratórios; mortalidade; força da mão; fisioterapia.
Resumo Como se conceitua criatividade na teoria da Gestalt-terapia? Qual o papel e a função da criatividade nesta abordagem? O que se considera como um comportamento criativo no senso comum é tão diferente do que compreendemos, na abordagem gestáltica, como criatividade? Estas são algumas das perguntas sobre as quais buscaremos transcorrer ao longo deste artigo. Partimos de simples perguntas, pois talvez um bom recurso para se "tratar" da criatividade seja a curiosidade. Para isto, iremos apresentar a contribuição de alguns autores que discorreram sobre o tema da criatividade em suas obras, iniciando por Kurt Goldstein e sua Teoria Organísmica, que consideramos o principal substrato teórico para se pensar a criatividade na Gestalt-terapia.
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