Submitted by Setor de Tratamento da Informa??o - BC/PUCRS (tede2@pucrs.br) on 2015-08-04T17:12:26Z No. of bitstreams: 1 473016 - Texto Completo.pdf: 1875230 bytes, checksum: e53279cd3ea9e1ed4b0273503fd159ea (MD5) / Made available in DSpace on 2015-08-04T17:12:26Z (GMT). No. of bitstreams: 1 473016 - Texto Completo.pdf: 1875230 bytes, checksum: e53279cd3ea9e1ed4b0273503fd159ea (MD5) Previous issue date: 2015-03-11 / Objective : To assess the impact of a rehabilitation protocol on the functional capacity of patients who underwent coronary artery bypass graft surgery (CABG), after phase I of rehabilitation, using the cycle ergometer.Method : this is a randomized clinical trial blinded to the evaluator. All patients, older than 50 years old, who underwent CABG and did not meet the exclusion criteria, were invited to participate in the study. After signing the Informed Consent (IC), and being submitted to the surgical procedure, participants were included and randomized to rehabilitation in the control group, with the standard protocol, or in the intervention group, keeping breathing exercises from the standard protocol and replacing the usual physical therapy for 20 minutes of activity in cycle ergometer. Functional assessment was performed at the pre-operative period and on the sixth day after surgery, in order to evaluate balance through the unipodal stance test, mobility through the TUG test and aerobic power assessed by the 6MWT.Results : 19 patients were randomized, being 9 individuals allocated to the intervention group and 10 to the control group. Mean age of the participants in the intervention group was similar to the control group (60.8 ? 4.7 vs 62.4 ? 8.1). There was a predominance of man in both groups (55.6% vs 80.0%). In the intragroup comparisons, individuals from the control group showed a significant decrease in the distance walked in the 6MWT. There was no significant difference between groups considering the other functional variables.Conclusion : Using cycle ergometer in cardiac rehabilitation phase I resulted in similar outcomes considering functional assessment; however, the cycle ergometer allowed better monitoring of hemodynamic and respiratory parameters; therefore, it can be an alternative for rehabilitation of CABG phase I. / Objetivo : Verificar o impacto de um protocolo de reabilita??o sobre a capacidade funcional de indiv?duos submetidos a cirurgia de revasculariza??o do mioc?rdio ap?s a fase I de reabilita??o com o uso do cicloerg?metro.M?todo : Trata-se de um ensaio cl?nico randomizado cegado para o avaliador. Todos pacientes acima de 50 anos que realizaram Cirurgia de Revasculariza??o do Mioc?rdio (CRM) e n?o entravam nos crit?rios de exclus?o eram convidados a participar do estudo, ap?s assinarem o Termo de Consentimento Livre e Esclarecido (TCLE) e ter realizado a cirurgia eram inclu?dos e randomizados para a reabilita??o no grupo controle com protocolo j? utilizado pelo hospital ou no grupo interven??o que mantinha os exerc?cios respirat?rios e substitu?a os exerc?cios de fisioterapia motora habituais por 20 minutos de atividade no cicloerg?metro. A avalia??o funcional utilizados com objetivo de verificar o equil?brio atrav?s do teste de Apoio Unipodal, mobilidade por meio do TUG e capacidade de exerc?cio pelo TC6 foi realizada no pr?-operatorio e no sexto dia de p?s-operat?rio.Resultados : 19 pacientes foram randomizados, sendo 9 alocados no grupo interven??o e 10 no grupo controle. A m?dia de idade do grupo interven??o foi semelhante ? do grupo controle (60,8 ? 4,7 vs 62,4? 8,1) anos. Houve predom?nio do sexo masculino em ambos os grupos (55,6% vs 80,0%). Nas compara??es intragrupo, o grupo controle apresentou uma redu??o significativa na dist?ncia percorrida no TC6,e nas demais vari?veis funcionais avaliadas n?o houve diferen?a significativa entre os grupos.Conclus?o : Uso do cicloerg?metro na fase I de reabilita??o card?aca resultou em efic?cia semelhante para os desfechos funcionais avaliados, sendo que a utiliza??o do cicloerg?metro permitiu um mais adequado monitoramento de par?metros hemodin?micos e respirat?rios, podendo ser mais uma alternativa para a reabilita??o da fase I de CRM.

Submitted by Setor de Tratamento da Informa??o - BC/PUCRS (tede2@pucrs.br) on 2015-06-17T22:11:44Z No. of bitstreams: 1 470731 - Texto Completo.pdf: 2695616 bytes, checksum: dead344a8d9e134c5c604d872c4a0bd4 (MD5) / Made available in DSpace on 2015-06-17T22:11:44Z (GMT). No. of bitstreams: 1 470731 - Texto Completo.pdf: 2695616 bytes, checksum: dead344a8d9e134c5c604d872c4a0bd4 (MD5) Previous issue date: 2015-03-11 / In recent decades it has seen considerable increase in the proportion of elderly people in Brazil. The main causes of mortality in the elderly are cardiovascular and respiratory diseases in 2006 these accounted for respectively 38% and 13% of causes of death in elderly Brazilians. Cardiac surgeries are responsible for high mortality rates. Patients undergoing coronary artery bypass graft surgery (CABG) at high risk of developing pulmonary complications such as atelectasis, pneumonia and pleural effusion. These complications increase the hospital stay and the need for financial resources. After CABG physiotherapist is required to perform Cardiopulmonary and Metabolic Rehabilitation program (CPMR), whose main goal is to help the patient return ace their social and professional activities in the best possible physical condition. Generally CPMR phase I includes stretching, breathing and aerobic exercise by hiking in hospital corridors and training ladder. The bicycle ergometer is a device that has frequently been used by physiotherapists, for the realization thereof does not require the patient support its own weight during training, and also the workload that can be easily adjusted according to each fitness individual. Thus, the objective of this study was to evaluate pulmonary function and the anxiety state of the CABG subjects after undergoing phase I rehabilitation using the cycle ergometer. For this, we performed a randomized, blinded to the evaluator, with patients from 50 years of age, undergoing CABG at the Hospital S?o Lucas. For this, the individuals who agreed to participate were randomly divided into two phase I rehabilitation groups: control group or cycle ergometer group. The control group patients underwent conventional physiotherapy, as the physiotherapy service protocol of the Hospital S?o Lucas. The patients in the intervention group underwent the same protocol of chest physiotherapy, however, the physical therapy was replaced by the use of a cycle ergometer. They were evaluated in the preoperative period and after rehabilitation phase I, the following respiratory parameters: peak expiratory flow, forced expiratory volume in one second, inspiratory and expiratory pressure. Still, the state of anxiety was assessed. The study included 19 patients, and 9 in the control group and 10 in the intervention group. In intra-group comparisons, a significant reduction was observed in maximal expiratory pressure and forced expiratory volume in one second in the control group. A significant reduction in forced expiratory volume in one second in the intervention group was also observed. In intergroup comparisons without adjustment, the average values of maximal inspiratory and expiratory pressure and the inventory Trait-State Anxiety part 1 after the intervention were significantly higher in the intervention group. Based on the fact that intervention group showed similar results in the evaluated parameters, the control group, it can be concluded that the cycle ergometer can be considered as a new safe option exercise for cardiac rehabilitation phase I. / Nas ?ltimas d?cadas tem se observado aumento consider?vel na propor??o de idosos no Brasil. As principais causas de mortalidade em idosos s?o as doen?as cardiovasculares e respirat?rias, em 2006 estas representaram respectivamente 38% e 13% das causas de morte em idosos brasileiros. As cirurgias card?acas s?o respons?veis por altas taxas de mortalidade. Pacientes submetidos a Cirurgia de Revasculariza??o do Mioc?rdio (CRM) apresentam alto risco de desenvolver complica??es pulmonares, tais como atelectasias, pneumonia e derrame pleural. Estas complica??es aumentam o tempo de interna??o hospitalar e a necessidade de recursos financeiros. Ap?s a CRM o fisioterapeuta ? requisitado para realizar o programa de Reabilita??o Cardiopulmonar e Metab?lica (RCPM), cujo objetivo principal ? contribuir para o retorno do paciente ?s suas atividades sociais e laborais nas melhores condi??es f?sicas poss?veis. Geralmente a RCPM fase I inclui alongamentos, exerc?cios respirat?rios e aer?bicos atrav?s de caminhadas nos corredores do hospital e treino em escada. O cicloerg?metro ? um equipamento que tem sido frequentemente empregado pelos fisioterapeutas, pois a realiza??o do mesmo n?o exige que o paciente suporte o pr?prio peso durante o treinamento, e tamb?m a carga de trabalho que pode ser facilmente ajustada de acordo com o condicionamento f?sico de cada indiv?duo. Dessa forma, o objetivo do presente trabalho foi avaliar a fun??o pulmonar e o estado de ansiedade dos indiv?duos submetidos a CRM ap?s a fase I de reabilita??o com o uso do cicloerg?metro. Para isso, realizou-se um ensaio cl?nico randomizado, cegado para o avaliador, com os pacientes a partir de 50 anos de idade, submetidos ? CRM no Hospital S?o Lucas da PUCRS. Para isso, os indiv?duos que aceitaram participar da pesquisa foram randomicamente divididos em dois grupos de reabilita??o fase I: grupo controle ou grupo cicloerg?metro. Os pacientes do grupo controle realizaram a fisioterapia convencional, conforme o protocolo do servi?o de fisioterapia do Hospital S?o Lucas da PUCRS. Os pacientes alocados no grupo interven??o realizaram o mesmo protocolo de fisioterapia respirat?ria, entretanto, a fisioterapia motora foi substitu?da pelo uso do cicloerg?metro. Foram avaliados no per?odo pr?-operat?rio e ap?s a reabilita??o fase I, os seguintes par?metros respirat?rios: pico de fluxo expirat?rio, volume expirat?rio for?ado no primeiro segundo, press?o inspirat?ria e expirat?ria m?xima. Ainda, foi avaliado o estado de ansiedade. Participaram do estudo 19 pacientes, sendo que, 9 no grupo controle e 10 no grupo interven??o. Nas compara??es intra-grupo, observou-se uma redu??o significativa na press?o expirat?ria m?xima e volume expirat?rio for?ado no primeiro segundo no grupo controle. Tamb?m foi observada uma redu??o significativa do volume expirat?rio for?ado no primeiro segundo no grupo interven??o. Nas compara??es intergrupos, sem o ajuste, os valores m?dios da press?o inspirat?ria e expirat?ria m?xima e o invent?rio de ansiedade tra?o-estado parte 1 ap?s a interven??o foram significativamente mais altos no grupo interven??o. Com base no fato de que grupo interven??o apresentou resultados semelhantes, nos par?metros avaliados, ao grupo controle, pode-se concluir que o cicloerg?metro pode ser considerado como uma nova op??o segura de exerc?cio para a reabilita??o card?aca fase I.

Made available in DSpace on 2014-12-17T14:13:28Z (GMT). No. of bitstreams: 1 SandraCA.pdf: 1939260 bytes, checksum: d309536e1e95c99f48eadd4712c26a0f (MD5) Previous issue date: 2008-09-26 / Fibromyalgia (FM) is a chronic rheumatic syndrome characterized by diffuse muscle-skeletal pain, and aerobic exercises represent a fundamental portion in therapeutic approach. Objective of this study was to evaluate the effectiveness of aerobic exercises accomplished in the water of the sea (thalassotherapy) for women with FM and to compare with exercises accomplished in the swimming pool, involving a multidisciplinary team, composed by rheumatologists, physical therapists, students of physical therapy and students of physical education. Forty six (46) women with age between 18 and 60 years with FM were randomized in 2 groups: a swimming pool group (23 patients) and a sea group (23 patients). 80th groups trained a week with the same program of aerobic conditioning 3 times (60 minutes each) for 12 weeks. Ali the patients were evaluated, before and immediately after treatment, with Visual Analogical Scale (VAS) for pain and fatigue, number of tending points, Fibromyalgia Impact Ouestionnaire (FIO), Short Form 36 Health Survey (SF-36), Pittsburgh Sleep Ouality Index (PSOI) and Beck Oepression Inventory (BOI). For statistical analysis, it was used paired-t test for analysis intra-group and non-paired test for inter-groups analysis, significance levei of p <0,05. Four patients, of each group, didn't complete the training programo Groups were homogeneous and they were compared in initial evaluation, except for BOI (p <0,05). Both groups presented statistically significant improvement for ali appraised parameters in the post-treatment compared with initial evaluation, there were reduction of intensity of pain and fatigue, number of tending points, better functional capacity (FIO), life quality (SF-36), quality of sleep (PSQI) and depression indexes (BOI). However, in comparison among the groups, group of sea (thalassotherapy) presented better results for ali parameters, however with statistically significant difference just only for depression indexes (BOI). At the end, it was observed that accomplishment of aerobic exercises in sea water or swimming pool was effective as part of treatment for patients with FM. However, exercise programs with thalassotherapy seems to bring more benefits, mainly related to emotional aspects, could be a therapeutic option of low cost for patients with FM in our area / A Fibromialgia (FM) ? uma s?ndrome reum?tica cr?nica, caracterizada por dor m?sculo esquel?tica difusa, onde os exerc?cios aer?bicos representam uma parcela fundamental na sua abordagem terap?utica. O objetivo deste estudo foi avaliar a efic?cia de exerc?cios aer?bicos realizados na ?gua do mar (talassoterapia) para mulheres com FM e comparar com exerc?cios realizados na piscina, envolvendo uma equipe multidisciplinar, composta por reumatologistas, fisioterapeutas e estudantes de fisioterapia e educa??o f?sica. Quarenta e seis (46) mulheres com idade entre 18 e 60 anos com FM foram randomizadas em 2 grupos: grupo da piscina (23 pacientes) e grupo do mar (23 pacientes). Ambos os grupos foram treinados com o mesmo programa de condicionamento aer?bico: tr?s vezes por semana, durante 60 minutos, por 12 semanas. Todas as pacientes foram avaliadas, antes e imediatamente ap?s o tratamento, pela Escala Visual Anal?gica (EV A) para dor e fadiga, contagem do n?mero de tender points, Fibromyalgia Impact Questionnaire (FIQ), Short Form 36 Health Survey (SF-36), Pittsburgh Sleep Quality Index (PSQI) e Beck Oepression Inventory (BDI). Na an?lise estat?stica, foram utilizados o teste t pareado para an?lise intragrupo e o teste t n?o-pareado para an?lise intrergrupos, sendo considerado um n?vel de signific?ncia p < 0,05. Quatro pacientes de cada grupo n?o completaram o programa de treinamento. Os grupos foram homog?neos e compar?veis na avalia??o inicial, com exce??o do BOI (p <0,05). Ambos os grupos apresentaram melhora estatisticamente significante em todos os par?metros avaliados no p?s-tratamento, comparado com a avalia??o inicial, com redu??o da intensidade da dor e fadiga, do n?mero de tend,er points, melhora da capacidade funcional (FIQ), qualidade de vida (SF-36), qualidade do sono (PSQI) e dos ?ndices e depress?o (BOI). Entretanto, na compara??o entre os grupos, o grupo do mar (talassoterapia) apresentou melhores resultados em todos os par?metros, por?m com diferen?a estatisticamente significante apenas nos ?ndices de depress?o (BOI). Ao final, observamos que a realiza??o de exerc?cios aer?bicos na ?gua do mar ou da piscina se mostrou efetiva como parte do tratamento de pacientes com FM. Entretanto, o programa de exerc?cios associado ? talassoterapia parece trazer mais benef?cios, principalmente relacionados a aspectos emocionais, podendo ser uma op??o terap?utica de baixo custo para pacientes com FM em nossa regi?o

Submitted by Sara Ribeiro (sara.ribeiro@ucb.br) on 2017-04-10T13:40:31Z No. of bitstreams: 1 VeruscaNajaradeCarvalhoCunhaTese2015.pdf: 1703847 bytes, checksum: a9661f4b3c0b28fe801235efd03b727c (MD5) / Approved for entry into archive by Sara Ribeiro (sara.ribeiro@ucb.br) on 2017-04-10T13:40:39Z (GMT) No. of bitstreams: 1 VeruscaNajaradeCarvalhoCunhaTese2015.pdf: 1703847 bytes, checksum: a9661f4b3c0b28fe801235efd03b727c (MD5) / Made available in DSpace on 2017-04-10T13:40:39Z (GMT). No. of bitstreams: 1 VeruscaNajaradeCarvalhoCunhaTese2015.pdf: 1703847 bytes, checksum: a9661f4b3c0b28fe801235efd03b727c (MD5) Previous issue date: 2015-07-14 / Telomeres are composed of complex deoxyribonucleic acid and proteins located at the ends of chromosomes, formed by a short sequence of nitrogenous bases (5'-TTAGGGn -3 ') repeated several times. Are connected to a multiprotein complex called "shelterin" consists of six proteins (TRF1, TRF2, POT1, TIN2, RAP1 and TPP1) which maintains telomere homeostasis, preventing degradation. Telomeres are affected by the DNA polymerase inability fully replicate the tape 5' end of the chromosome. The results of such failure are successors shortenings with each cell division, which leads to extremely short telomeres at the end of cell division, resulting in cell senescence. Therefore telomeres are considered a potential biomarker of aging at the cellular level. The shortening of telomeres has been associated with an increased risk of developing age-related diseases such as diabetes, cardiovascular disease and obesity. In contrast, it is believed that physical exercise can attenuate the shortening rate of telomeres, even in the elderly. However, it is possible that there is a 'dose' ideal of physical exercise that can enhance this beneficial effect. The objective of this study was to analyze and compare the effects of aerobic training intensity swimming conducted in two intensity domains (high and low) on the expression of genes encoding the protective telomeric proteins (trf1 and trf2), associated proteins cellular senescence (p53 and Chek2), in addition to measuring telomere length in gastrocnemius and myocardium old mice. Sixteen animals were divided into four groups: two groups submitted to twelve weeks of physical training of swimming at low intensity (BI) and high intensity (AI) and two who remained sedentary for the same period, with a group of young animals (CONTj) and elderly animals (CONTi). Training consisted of swimming exercise three times a week, 20 minutes per session for the group AI and 40 minutes for BI with load corresponding to 3% body weight (%PC) (BI) and 6%PC (AI). An incremental test for functional evaluation was performed every four weeks to measure the maximum load (Gm??x). After the training period, animals were sacrificed for removal of tissue samples for analysis of genes expression related to telomeres. The results suggest that high intensity exercise is "teloprotetor" in the gastrocnemius tissue, since telomere length of the elderly animals did not differ from each other, however, the animals in this group (AI) had a lower expression of genes of proteins protective (trf1 and trf2) and cellular senescence (p53). These results suggest that the intensity at which the exercise is performed interfere with telomere length and that this response is tissue dependent, since the same results were not observed in cardiac tissue of animals. / Tel??meros s??o complexos compostos por ??cido desoxirribonucleico e prote??nas, localizados nas extremidades dos cromossomos, formados por uma pequena sequ??ncia de bases nitrogenadas (5???-TTAGGGn -3???) repetida diversas vezes. Encontram-se ligados a um complexo multiprot??ico denominado ???shelterin??? composto por seis prote??nas (TRF1, TRF2, POT1, TIN2, RAP1 e TPP1) que mant??m a homeostase telom??rica, prevenindo sua degrada????o. Os tel??meros s??o afetados pela incapacidade da DNA polimerase replicar completamente o final da fita 5??? do cromossomo. Os resultados de tal falha s??o sucess??veis encurtamentos a cada divis??o celular, o que leva ?? tel??meros extremamente curtos ao t??rmino das divis??es celulares, resultando na senesc??ncia celular. Sendo assim, considerados um potencial biomarcador do envelhecimento a n??vel celular. O encurtamento dos tel??meros tem sido associado a um maior risco de desenvolvimento de doen??as associadas ao envelhecimento, tais como, diabetes mellitus, doen??as cardiovasculares e obesidade. Em contrapartida, acredita-se que o exerc??cio f??sico possa atenuar a taxa de encurtamento dos tel??meros, mesmo em indiv??duos idosos. Contudo, ?? poss??vel que exista uma ???dose??? ideal de exerc??cio f??sico que possa potencializar este efeito ben??fico. Assim, o objetivo do presente estudo foi analisar e comparar os efeitos do treinamento aer??bio de nata????o realizado em dois dom??nios de intensidade (alta e baixa) sobre a express??o dos genes que codificam as prote??nas de prote????o telom??rica (trf1 e trf2), prote??nas associadas ?? senesc??ncia celular (p53 e Chek2), al??m de mensurar o comprimento do tel??mero no gastrocn??mio e no mioc??rdio de camundongos idosos. Dezesseis animais foram divididos em quatro grupos: dois grupos submetidos a doze semanas de treinamento f??sico de nata????o em baixa intensidade (BI) ou alta intensidade (AI) e dois que permaneceram sedent??rios pelo mesmo per??odo, sendo um grupo de animais jovens (CONTj) e um de animais idosos (CONTi). O treinamento consistiu do exerc??cio de nata????o, tr??s vezes por semana, 20 minutos por sess??o para o grupo AI e 40 minutos para o BI, com carga correspondente a 3% do peso corporal (%PC) (BI) e 6%PC (AI). Um teste incremental para avalia????o funcional fora realizado a cada quatro semanas para mensura????o da carga m??xima (Gm??x). Ap??s o t??rmino do per??odo de treinamento, os animais foram sacrificados para retirada de amostras de tecido para an??lise da express??o dos genes relacionados aos tel??meros. Os resultados obtidos sugerem que o exerc??cio de alta intensidade seja ???teloprotetor??? no tecido gastrocn??mio, uma vez que o comprimento do tel??mero dos animais idosos n??o diferiu entre si, embora, os animais desse grupo (AI) apresentaram uma menor express??o dos genes das prote??nas protetoras (trf1 e trf2) e da senesc??ncia celular (p53). Esses resultados sugerem que a intensidade na qual o exerc??cio ?? realizado interfere no comprimento dos tel??meros e que tal resposta ?? tecido dependente, uma vez que os mesmos resultados n??o foram observados no tecido card??aco dos animais.