Annals of physical and rehabilitation medicine, May 1, 2014
Show evolutionary features of this condition, determine the incidence of associated lesions and i... more Show evolutionary features of this condition, determine the incidence of associated lesions and interest capital for early and appropriate rehabilitation. Patients and methods.-Prospective study of 23 cases of anteromedial dislocation of the shoulder in patients aged 50 years and older. This was a first episode in all cases. There was no neurovascular disorder associated. Dislocation was secondary to a fall low kinetics in 12 patients. After reduction, all patients had a contention by a type bandage Dujarrier. Rehabilitation was started after 10 days. Results.-After a mean follow-up of 8 months, according to the results of trading ROWE were excellent or good in 75% of cases. We had 2 cases of recurrence. Seven patients had a lesion of the rotator cuff in ultrasonography. Discussion.-In the elderly, the risk of recurrence is low, but morbidity is different, especially related to tendon injuries of the rotator cuff or neurological damage. This low rate of recurrence has been wrongly regarded as benign and they have been only a few publications.
Cardiovascular disease (CVD) is the leading cause of death in developed countries and disproporti... more Cardiovascular disease (CVD) is the leading cause of death in developed countries and disproportionately affects older adults. Frailty is a complex clinical syndrome with multiple causes and contributing factors in which there is increased vulnerability when exposed to a minor stressor and increased risk for adverse outcomes, such as disability, hospitalization and mortality. Frailty is an important prognostic factor in patients with CVD, and so identifying this feature when assessing these patients may help to individually tailor cardiovascular treatment. The first step is to identify frailty. Several tools have been validated as screening methods for frailty. However, they diverge with regard to complexity, nature, feasibility and the outcome they can predict. The aim of this review is to describe the available screening tools for frailty and to examine their usefulness in patients with CVD.
Background: The hospitalization in an Intensive Care Unit may lead to important structural and fu... more Background: The hospitalization in an Intensive Care Unit may lead to important structural and functional deficits, resulting in high morbidity and mortality. This functional decline is largely due to immobility. Methods: Narrative review of the literature published until February 2018 in the Medline, Embase, Cochrane Library, Web of Science and Scopus databases. Results: Amyotrophy, muscle strength deficit, sarcopenia, pain, contractures and osteoporosis are some of the musculoskeletal complications frequently observed in critically ill patients. However, the negative effects of immobility are rarely limited to a single system. Numerous other comorbidities may result from hospitalization in an Intensive Care Unit: Cardiovascular, respiratory, genito-urinary, gastro-intestinal, endocrine and metabolic, immune, cutaneous, neurological and cognitive-behavioral. The etiology is multifactorial and several risk factors have been described. The evidence about the benefits of early mobilization and exercise in critically ill patients is growing in the literature, focusing on different systems. Conclusion: Immobility syndrome, myopathy and neuropathy are serious complications commonly found in the Intensive Care Unit, which delay the recovery of the underlying disease itself, can lead to significant functional limitations, restriction of activities, reduction of participation and integration of patients in their social, professional and family contexts.
Revista Portuguesa de Endocrinologia, Diabetes e Metabolismo, Jun 1, 2016
Methods: Research guidelines, meta-analysis (MA), systematic reviews (SR) and randomized controll... more Methods: Research guidelines, meta-analysis (MA), systematic reviews (SR) and randomized controlled trials (RCT) in English and Portuguese, in PubMed and medical databases based on evidence. MeSH terms used: "Parkinson's disease" and "osteoporosis". Articles published between January 2006 and January 2016 were selected. Results: Four articles were obtained, but only three met the inclusion criteria. One MA, one SR and one RCT showed a relation between PD and osteoporosis, bone mineral density (BMD) and fracture risk. Patients with PD have an increased risk for osteoporosis when compared to the general population. It was also evident in PD: lower BMD, lower vitamin D levels and an increased risk of fractures. The reduction of bone mass in PD seems to be mainly caused by limited mobility. Endocrine (such as vitamin D deficiency), nutritional and iatrogenic factors also play an important role in the depletion of bone mass. Female sex, PD duration and severity, advanced age and low body mass index were associated with severe osteoporosis. Conclusions: The available evidence supports an increased risk of osteoporosis among PD patients. This fact should alert the clinician about the importance of osteoporosis screening in PD patients. However, more studies are needed, with high methodological quality and patient oriented, in order to demonstrate the health benefit of osteoporosis screening/early treatment in PD patients.
Annals of physical and rehabilitation medicine, May 1, 2014
Background.-Survival in dialysis patients increases by improving their management. However, the q... more Background.-Survival in dialysis patients increases by improving their management. However, the quality of life and physical condition of dialysis patients remains compromised. Objective.-To evaluate the effects of physical adapted activity based on flexibility, strength and endurance exercises program. Methods.-A group of 30 hemodialysis patients followed from the department of nephrology and hemodialysis following a physical activity program during 3 months, 2 times a week. The evaluation is performed before and after the proposed protocol by: quality of life (SF36), anxiety and depressive symptoms (HAD), lipid and test six-minute walk (T6MM). Results.-There was no undesirable event during rehabilitation sessions. Quality of life (physical and mental component) and anxious component HAD improved significantly. Distance walked on the 6MWT increased by 16.5%. Lipid profile is also improved (HDL and LDL-cholesterol, triglyceride). Discussion/conclusion.-Prescribing of adapted physical activity is highly recommended for the population of hemodialysis patients and appears to be a safe and effective alternative to develop functional capacity, quality of life and the psychological profile of hemodialysis patients.
results and to define the specific characteristics of exercise programs that determine better res... more results and to define the specific characteristics of exercise programs that determine better results.
Revista da Sociedade Portuguesa de Medicina Física e de Reabilitação, Jan 4, 2019
The sacroiliac joints (SI) dysfunction is a condition when the normal joint biomechanics is affec... more The sacroiliac joints (SI) dysfunction is a condition when the normal joint biomechanics is affected, thereby leading to a restricted or excessive motion. Although it is a relatively common pathology, it is often underdiagnosed. This study
clinical trials have high methodological quality, so that the results are inspiring and should st... more clinical trials have high methodological quality, so that the results are inspiring and should stimulate further studies, including studies focusing on the influence of mud at the level of biochemical markers, in order to evaluate the cost effectiveness when compared to the same drug therapy. Conclusion: This study supports the literature regarding the efficacy of mud therapy in the improvement of pain, functionality and quality of life of patients with osteoarthritis of the knee.
Annals of Physical and Rehabilitation Medicine, 2014
Background.-Survival in dialysis patients increases by improving their management. However, the q... more Background.-Survival in dialysis patients increases by improving their management. However, the quality of life and physical condition of dialysis patients remains compromised. Objective.-To evaluate the effects of physical adapted activity based on flexibility, strength and endurance exercises program. Methods.-A group of 30 hemodialysis patients followed from the department of nephrology and hemodialysis following a physical activity program during 3 months, 2 times a week. The evaluation is performed before and after the proposed protocol by: quality of life (SF36), anxiety and depressive symptoms (HAD), lipid and test six-minute walk (T6MM). Results.-There was no undesirable event during rehabilitation sessions. Quality of life (physical and mental component) and anxious component HAD improved significantly. Distance walked on the 6MWT increased by 16.5%. Lipid profile is also improved (HDL and LDL-cholesterol, triglyceride). Discussion/conclusion.-Prescribing of adapted physical activity is highly recommended for the population of hemodialysis patients and appears to be a safe and effective alternative to develop functional capacity, quality of life and the psychological profile of hemodialysis patients.
Annals of Physical and Rehabilitation Medicine, 2014
Show evolutionary features of this condition, determine the incidence of associated lesions and i... more Show evolutionary features of this condition, determine the incidence of associated lesions and interest capital for early and appropriate rehabilitation. Patients and methods.-Prospective study of 23 cases of anteromedial dislocation of the shoulder in patients aged 50 years and older. This was a first episode in all cases. There was no neurovascular disorder associated. Dislocation was secondary to a fall low kinetics in 12 patients. After reduction, all patients had a contention by a type bandage Dujarrier. Rehabilitation was started after 10 days. Results.-After a mean follow-up of 8 months, according to the results of trading ROWE were excellent or good in 75% of cases. We had 2 cases of recurrence. Seven patients had a lesion of the rotator cuff in ultrasonography. Discussion.-In the elderly, the risk of recurrence is low, but morbidity is different, especially related to tendon injuries of the rotator cuff or neurological damage. This low rate of recurrence has been wrongly regarded as benign and they have been only a few publications.
Research & Investigations in Sports Medicine, 2018
Tendinopathies are one of the most common sport injuries (30% to 50% of the athlete's injuries). ... more Tendinopathies are one of the most common sport injuries (30% to 50% of the athlete's injuries). The tendon are essentially composed of type I collagen fibers and, to a lesser extent, elastic fibers. This type of fibers does not have great elongation capacity, increasing only about 8-10% in length until they reach the point of failure. Histopathologically, tendinosis is characterized by a degenerative process with increased numbers of fibroblasts, vascular hyperplasia and collagen disorganization [1-3].
Research & Investigations in Sports Medicine, 2018
The role of exercise Exercise significantly improve mobility, functionality, muscle mass, bone mi... more The role of exercise Exercise significantly improve mobility, functionality, muscle mass, bone mineral density, balance and proprioception; thus decreasing the risk of falls, increasing quality of life and reducing morbidity and mortality [9-12]. Even in previous sedentary people, the initiation of an exercise program at older age caries additional
Annals of physical and rehabilitation medicine, May 1, 2014
Show evolutionary features of this condition, determine the incidence of associated lesions and i... more Show evolutionary features of this condition, determine the incidence of associated lesions and interest capital for early and appropriate rehabilitation. Patients and methods.-Prospective study of 23 cases of anteromedial dislocation of the shoulder in patients aged 50 years and older. This was a first episode in all cases. There was no neurovascular disorder associated. Dislocation was secondary to a fall low kinetics in 12 patients. After reduction, all patients had a contention by a type bandage Dujarrier. Rehabilitation was started after 10 days. Results.-After a mean follow-up of 8 months, according to the results of trading ROWE were excellent or good in 75% of cases. We had 2 cases of recurrence. Seven patients had a lesion of the rotator cuff in ultrasonography. Discussion.-In the elderly, the risk of recurrence is low, but morbidity is different, especially related to tendon injuries of the rotator cuff or neurological damage. This low rate of recurrence has been wrongly regarded as benign and they have been only a few publications.
Cardiovascular disease (CVD) is the leading cause of death in developed countries and disproporti... more Cardiovascular disease (CVD) is the leading cause of death in developed countries and disproportionately affects older adults. Frailty is a complex clinical syndrome with multiple causes and contributing factors in which there is increased vulnerability when exposed to a minor stressor and increased risk for adverse outcomes, such as disability, hospitalization and mortality. Frailty is an important prognostic factor in patients with CVD, and so identifying this feature when assessing these patients may help to individually tailor cardiovascular treatment. The first step is to identify frailty. Several tools have been validated as screening methods for frailty. However, they diverge with regard to complexity, nature, feasibility and the outcome they can predict. The aim of this review is to describe the available screening tools for frailty and to examine their usefulness in patients with CVD.
Background: The hospitalization in an Intensive Care Unit may lead to important structural and fu... more Background: The hospitalization in an Intensive Care Unit may lead to important structural and functional deficits, resulting in high morbidity and mortality. This functional decline is largely due to immobility. Methods: Narrative review of the literature published until February 2018 in the Medline, Embase, Cochrane Library, Web of Science and Scopus databases. Results: Amyotrophy, muscle strength deficit, sarcopenia, pain, contractures and osteoporosis are some of the musculoskeletal complications frequently observed in critically ill patients. However, the negative effects of immobility are rarely limited to a single system. Numerous other comorbidities may result from hospitalization in an Intensive Care Unit: Cardiovascular, respiratory, genito-urinary, gastro-intestinal, endocrine and metabolic, immune, cutaneous, neurological and cognitive-behavioral. The etiology is multifactorial and several risk factors have been described. The evidence about the benefits of early mobilization and exercise in critically ill patients is growing in the literature, focusing on different systems. Conclusion: Immobility syndrome, myopathy and neuropathy are serious complications commonly found in the Intensive Care Unit, which delay the recovery of the underlying disease itself, can lead to significant functional limitations, restriction of activities, reduction of participation and integration of patients in their social, professional and family contexts.
Revista Portuguesa de Endocrinologia, Diabetes e Metabolismo, Jun 1, 2016
Methods: Research guidelines, meta-analysis (MA), systematic reviews (SR) and randomized controll... more Methods: Research guidelines, meta-analysis (MA), systematic reviews (SR) and randomized controlled trials (RCT) in English and Portuguese, in PubMed and medical databases based on evidence. MeSH terms used: "Parkinson's disease" and "osteoporosis". Articles published between January 2006 and January 2016 were selected. Results: Four articles were obtained, but only three met the inclusion criteria. One MA, one SR and one RCT showed a relation between PD and osteoporosis, bone mineral density (BMD) and fracture risk. Patients with PD have an increased risk for osteoporosis when compared to the general population. It was also evident in PD: lower BMD, lower vitamin D levels and an increased risk of fractures. The reduction of bone mass in PD seems to be mainly caused by limited mobility. Endocrine (such as vitamin D deficiency), nutritional and iatrogenic factors also play an important role in the depletion of bone mass. Female sex, PD duration and severity, advanced age and low body mass index were associated with severe osteoporosis. Conclusions: The available evidence supports an increased risk of osteoporosis among PD patients. This fact should alert the clinician about the importance of osteoporosis screening in PD patients. However, more studies are needed, with high methodological quality and patient oriented, in order to demonstrate the health benefit of osteoporosis screening/early treatment in PD patients.
Annals of physical and rehabilitation medicine, May 1, 2014
Background.-Survival in dialysis patients increases by improving their management. However, the q... more Background.-Survival in dialysis patients increases by improving their management. However, the quality of life and physical condition of dialysis patients remains compromised. Objective.-To evaluate the effects of physical adapted activity based on flexibility, strength and endurance exercises program. Methods.-A group of 30 hemodialysis patients followed from the department of nephrology and hemodialysis following a physical activity program during 3 months, 2 times a week. The evaluation is performed before and after the proposed protocol by: quality of life (SF36), anxiety and depressive symptoms (HAD), lipid and test six-minute walk (T6MM). Results.-There was no undesirable event during rehabilitation sessions. Quality of life (physical and mental component) and anxious component HAD improved significantly. Distance walked on the 6MWT increased by 16.5%. Lipid profile is also improved (HDL and LDL-cholesterol, triglyceride). Discussion/conclusion.-Prescribing of adapted physical activity is highly recommended for the population of hemodialysis patients and appears to be a safe and effective alternative to develop functional capacity, quality of life and the psychological profile of hemodialysis patients.
results and to define the specific characteristics of exercise programs that determine better res... more results and to define the specific characteristics of exercise programs that determine better results.
Revista da Sociedade Portuguesa de Medicina Física e de Reabilitação, Jan 4, 2019
The sacroiliac joints (SI) dysfunction is a condition when the normal joint biomechanics is affec... more The sacroiliac joints (SI) dysfunction is a condition when the normal joint biomechanics is affected, thereby leading to a restricted or excessive motion. Although it is a relatively common pathology, it is often underdiagnosed. This study
clinical trials have high methodological quality, so that the results are inspiring and should st... more clinical trials have high methodological quality, so that the results are inspiring and should stimulate further studies, including studies focusing on the influence of mud at the level of biochemical markers, in order to evaluate the cost effectiveness when compared to the same drug therapy. Conclusion: This study supports the literature regarding the efficacy of mud therapy in the improvement of pain, functionality and quality of life of patients with osteoarthritis of the knee.
Annals of Physical and Rehabilitation Medicine, 2014
Background.-Survival in dialysis patients increases by improving their management. However, the q... more Background.-Survival in dialysis patients increases by improving their management. However, the quality of life and physical condition of dialysis patients remains compromised. Objective.-To evaluate the effects of physical adapted activity based on flexibility, strength and endurance exercises program. Methods.-A group of 30 hemodialysis patients followed from the department of nephrology and hemodialysis following a physical activity program during 3 months, 2 times a week. The evaluation is performed before and after the proposed protocol by: quality of life (SF36), anxiety and depressive symptoms (HAD), lipid and test six-minute walk (T6MM). Results.-There was no undesirable event during rehabilitation sessions. Quality of life (physical and mental component) and anxious component HAD improved significantly. Distance walked on the 6MWT increased by 16.5%. Lipid profile is also improved (HDL and LDL-cholesterol, triglyceride). Discussion/conclusion.-Prescribing of adapted physical activity is highly recommended for the population of hemodialysis patients and appears to be a safe and effective alternative to develop functional capacity, quality of life and the psychological profile of hemodialysis patients.
Annals of Physical and Rehabilitation Medicine, 2014
Show evolutionary features of this condition, determine the incidence of associated lesions and i... more Show evolutionary features of this condition, determine the incidence of associated lesions and interest capital for early and appropriate rehabilitation. Patients and methods.-Prospective study of 23 cases of anteromedial dislocation of the shoulder in patients aged 50 years and older. This was a first episode in all cases. There was no neurovascular disorder associated. Dislocation was secondary to a fall low kinetics in 12 patients. After reduction, all patients had a contention by a type bandage Dujarrier. Rehabilitation was started after 10 days. Results.-After a mean follow-up of 8 months, according to the results of trading ROWE were excellent or good in 75% of cases. We had 2 cases of recurrence. Seven patients had a lesion of the rotator cuff in ultrasonography. Discussion.-In the elderly, the risk of recurrence is low, but morbidity is different, especially related to tendon injuries of the rotator cuff or neurological damage. This low rate of recurrence has been wrongly regarded as benign and they have been only a few publications.
Research & Investigations in Sports Medicine, 2018
Tendinopathies are one of the most common sport injuries (30% to 50% of the athlete's injuries). ... more Tendinopathies are one of the most common sport injuries (30% to 50% of the athlete's injuries). The tendon are essentially composed of type I collagen fibers and, to a lesser extent, elastic fibers. This type of fibers does not have great elongation capacity, increasing only about 8-10% in length until they reach the point of failure. Histopathologically, tendinosis is characterized by a degenerative process with increased numbers of fibroblasts, vascular hyperplasia and collagen disorganization [1-3].
Research & Investigations in Sports Medicine, 2018
The role of exercise Exercise significantly improve mobility, functionality, muscle mass, bone mi... more The role of exercise Exercise significantly improve mobility, functionality, muscle mass, bone mineral density, balance and proprioception; thus decreasing the risk of falls, increasing quality of life and reducing morbidity and mortality [9-12]. Even in previous sedentary people, the initiation of an exercise program at older age caries additional
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