Introdução: As alterações do assoalho pélvico nas mulheres climatéricas, decorrentes das variações hormonais, de modificações físicas e do próprio envelhecimento dos tecidos, podem ser responsáveis por disfunções urinárias e sexuais. O papel da fisioterapia no tratamento da incontinência urinária tem sido documentado, porém há poucos estudos avaliando a disfunção sexual. Objetivos: Avaliar o potencial de ativação mioelétrica das musculaturas do assoalho pélvico, a função sexual através do Índice de Função Sexual Feminina (IFSF) e a qualidade de vida (Escala de Cervantes) de mulheres climatéricas com e sem dispareunia. Métodos: Estudo transversal realizado no ambulatório de Climatério do Serviço de Ginecologia do Hospital de Clínicas de Porto Alegre (HCPA) com mulheres climatéricas entre 45 e 60 anos. As participantes eram submetidas a uma anamnese e dois questionários (de qualidade de vida - Escala de Cervantes e o Índice de Função Sexual Feminina - IFSF), além da avaliação da musculatura do assoalho pélvico por meio do biofeedback eletromiográfico. Resultados: A amostra foi composta por 51 mulheres com idade média de 52,1 anos (± 4,9). Não houve diferença estatisticamente significativa em relação ao tônus muscular de repouso entre mulheres com e sem dispareunia (p=0,152). Contudo, nas mulheres com dispareunia o IFSF apresentou um pior escore (p<0,001) assim como na escala de Cervantes (p=0,009) em comparação às mulheres sem dispareunia. Houve, também, uma associação inversa significativa entre o escore de dor do FSFI e a média do tônus de base (rs= -0,300; p= 0,033). Conclusão: O presente estudo demonstrou não haver diferença entre o tônus de repouso das musculaturas do assoalho pélvico de mulheres climatéricas com e sem dispareunia. Entretanto houve diferença entre os dois grupos quanto à qualidade de vida (Escala de Cervantes) e função sexual (IFSF). Outros estudos na área da fisioterapia e disfunção sexual são necessários para aprimorar a qualidade de investigação e intervenção de mulheres climatéricas com disfunção sexual. / Introduction. Alterations in the pelvic floor during menopausal years, which are the result of hormonal and physical changes and of tissue aging itself, can lead to urinary and sexual dysfunction. The role of physical therapy in the treatment of urinary incontinence is well documented, but few studies have assessed its role in sexual dysfunction. Aim. To assess the myoelectric action potential of pelvic floor muscles, sexual function (using the Female Sexual Function Index, FSFI) and quality of life (using the Cervantes Scale) in perimenopausal and menopausal women with and without dyspareunia. Methods. Cross-sectional study carried out at the outpatient Menopause clinic of the Department of Gynecology, Hospital de Clínicas de Porto Alegre (HCPA), Brazil, in a sample of climacteric women aged 45 to 60 years. Participants were interviewed, completed two questionnaires (Cervantes Scale and FSFI), and underwent assessment of the pelvic floor muscles by the electromyographic biofeedback method. Results. The sample comprised 51 women with a mean age of 52.1±4.9 years. There were no statistically significant differences in resting muscle tone between women with and without dyspareunia (P = 0.152). However, women with dyspareunia scored worse on the FSFI (P < 0.001) and the Cervantes Scale (P = 0.009) as compared to women without dyspareunia. Furthermore, there was a significant inverse association between FSFI pain scores and mean resting tone (rs = -0.300; P = 0.033). Conclusions. Although myoelectric activation potentials were similar in women with and without dyspareunia, there were between-group differences in FSFI and Cervantes Scale scores. Further studies are required with the possibility of standardize assessment and physical therapy interventions in climacteric women with dyspareunia.

Introdução: Ensaio clínico randomizado e controlado com o propósito de comparar a eficácia da técnica de treinamento dos músculos do assoalho pélvico (TMAP) com ou sem biofeedback eletromiográfico (BFE) e a qualidade de vida (QV) em mulheres com queixas de perda urinária aos esforços. Métodos: Após seleção, as mulheres pós-menopáusicas com Incontinência Urinária de Esforço (IUE) foram randomizadas e alocadas em três grupos: grupo controle (GC), grupo treinamento assoalho pélvico (GTMAP) e grupo treinamento assoalho pélvico + biofeedback (GTMAP+BIO) Após a coleta de dados demográficos, antropométricos e gestacionais aplicou-se o questionário de qualidade de vida (QV) o International Consultation on Incontinence Questionnaire – Short Form (ICIQ-SF) e a escala de OXFORD. Foi realizada a avaliação eletromiográfica do repouso inicial e final, presença de contração automática durante a tosse, contração voluntária máxima (CVM) e tempo de sustentação da contração, antes e depois da intervenção do GC, GTMAP e GTMAP+BIO. A intervenção no GTMAP e GTMAP+BIO foi de 20 minutos por dia, 2 vezes por semana, durante 4 semanas. Resultados: O estudo foi concluído com 45 mulheres. Houve aumento significativo nos grupos GTMAP e GTMAP+BIO no incremento da força muscular na OXFORD, na contração automática durante a tosse, na CVM, no tempo de sustentação e no ICIQ-SF em relação ao GC e na comparação ao tempo basal e pós-tratamento. O grupo GTMAP+BIO, quando comparado ao GTMAP, foi superior no incremento na força muscular na escala de OXFORD, na contração automática durante a tosse, na CVM e no tempo de sustentação (p<0.05). Considerações finais: O TMAP foi eficaz para a amostra estudada, porém, foi superior na adição do Biofeedback Eletromiográfico (BFE), sendo recomendado a utilização do TMAP associado ao BFE para pacientes com Incontinência Urinária de Esforço. / Introduction: This randomized controlled trial sought to compare the efficacy of pelvic floor muscle exercises (PFME) with and without electromyographic biofeedback (EMG-BF) and quality of life in women with stress urinary incontinence (SUI). Methods: Postmenopausal women with SUI were randomly allocated across three groups: control, pelvic floor muscle exercises (PFME), and PFME + biofeedback (PFME+BF). Demographic, anthropometric and gestational data were collected and the ICIQ-SF QoL questionnaire and Oxford grading scale were administered. Before and after the study intervention, women in all groups underwent EMG assessment to evaluate initial and final baseline, presence of automatic contraction while coughing (“the Knack”), maximum voluntary contraction (MVC), and duration of endurance contraction. In the PFME and PFME+BF groups, the duration of intervention was 20 min/day, twice weekly for 4 weeks. Results: The study involved 45 women. The PFME and PFME+BF groups exhibited significant increases in muscle strength (Oxford scale), automatic contraction while coughing, MVC, duration of endurance contraction, and ICIQ-SF as compared to controls and when comparing baseline vs. post-treatment. PFME+BF was associated with significantly superior improvement of muscle strength, automatic contraction while coughing, MVC, and duration of endurance contraction as compared to PFME alone (p<0.05). Conclusion: PFME was effective in this sample, but superior results were achieved when EMG-BF was added. We recommend that PFME+BF be offered to women with SUI.

A retroalimentação por eletromiografia é uma técnica de aprendizado para controle voluntário de respostas fisiológicas pelo condicionamento operante. Compararam-se os sinais eletromiográficos dos músculos quadríceps de duas séries de retroalimentação pelo "Método Brucker" com duração de 50 minutos semanais durante quatro semanas com um intervalo de três meses em 20 pacientes com trauma raquimedular cervical na posição sentado e na transição da posição sentado para a ortostática. Demonstrou aumento amplitude do potencial eletromiográfico na segunda série. Comprovou que na transição de sentado para a posição ortostática consegue-se arregimentar um maior número de fibras do quadríceps do que na sentado / Electromyography biofeedback is a learning technique for voluntary control of physiological responses through operant conditioning. The electromyographic signals from the quadriceps muscles of two biofeedback series were compared using the Brucker method, with a 50-minute weekly session during four weeks and a three-month interval, in 20 patients with cervical spinal cord injury, in the sitting position and during the transition from the sitting to the orthostatic position. An increase in the amplitude of the electromyographic potential was shown in the second series. It was proven that during the transition from the sitting to the orthostatic position it is possible to gather a larger number of fibers of the quadriceps as compared to the sitting position

This study examined effectiveness of heart rate variability (HRV) biofeedback-assisted stress management training in reducing anxiety and stress in pregnant women and the effect of maternal stress management skills practice on fetal heart rate measures in real time. Participants were seven working pregnant women who volunteered in response to recruitment announcements and invitations from cooperating midwives. Reported state and trait anxiety and pregnancy specific stress were measured during five 45- to 50-minute training sessions. Training included bibliotherapy, instruction in the use of emotion-focused stress management techniques, and HRV biofeedback. Subjects used portable biofeedback units for home practice and were encouraged to practice the skills for 20 minutes a day and for short periods of time during stressful life events. At the end of training, fetal heart rate was monitored and concurrent maternal HRV measures were recorded. Repeated measures ANOVA and paired samples t-test analysis of study data revealed no statistically significant reductions in state or trait anxiety measures or in pregnancy specific stress measures. Partial eta squared (n²) and Cohen's d calculations found small to medium effect sizes on the various test scales. Friedman's analysis of variance of biofeedback measures showed a statistically significant decrease in low HRV coherence scores (X2 = 10.53, p = .03) and medium HRV coherence scores (X2 = 11.58, p = .02) and a statistically significant increase in high HRV coherence scores (X2 = 18.16, p = .001). This change is an indication of improved autonomic function. Results of concurrent maternal and fetal HRV recordings were generally inconclusive. A qualitative discussion of individual subject results is included. During follow-up interviews five subjects reported that they felt they were better able to cope with stress at the end of the study than at the beginning, that they used the stress management skills during labor, and that they continue to practice the skills in their daily lives.

Airway travel is an easy and accessible form of transportation that allows billions of people to travel the world each year. Many passengers are however not perfectly comfortable on flights, with stressful flight-related anxieties or phobias being common. These issues are all sources of various negative emotions and can be difficult to circumvent or tone down when on long flights. Previous research has shown that controlled breathing techniques and distraction from the situation are good approaches when dealing with the body's physiological stress responses, but both techniques have seldom been used in conjunction.    This thesis is targeting In-Flight Entertainment (IFE) systems used onboard modern aeroplanes to provide passengers with a serious game for alleviating stressful emotions during flights. The study aims to determine whether guided breathing combined with gameplay distraction can help passengers with various flight-related anxieties to relax and regain a calm state of mind. This was done in comparison to a standard breathing exercise. The data was collected from user testing involving Visual Analogue Scales (VAS) for happy and sad moods and the Strait-Trait Anxiety Inventory (STAI) to evaluate participants' emotional states. Heart rate measurements were used to analyse correlations between stress and heart rate. Finally, the game itself was evaluated for its intrinsic value, effectiveness for stress relief and the participants' intention to engage with it.  The results of the study could however not draw any conclusions that indicate that the serious game was any more effective than standard breathing exercises in most aspects, with both having a similar influence overall. A few components, namely immersion, enjoyment, entertainment, concentration and usability did however show a significant increase indicating that the serious game is a more enjoyable experience while remaining effective for relaxation and stress relief.  In conclusion, having a larger number of participants would have enabled the results to make more accurate and reliable findings. Heart rate was also found to be a poor predictor of stress, with more appropriate sensors being an area of improvement for future studies. Using both breathing techniques and distraction can however be considered to be a useful way to provide stress relief as both components were found to complement each other well.

Objective: Drugs increase fall risk and decrease performance on balance and mobility tests. Conversely, whether biofeedback training to reduce fall risk also decreases scores on a published drug-based fall risk index has not been documented. Forty-eight community-dwelling older adults underwent either treadmill gait training plus visual feedback (+VFB), or walked on a treadmill without feedback. The Quantitative Drug Index (QDI) was derived from each participant's drug list and is based upon all cause drug-associated fall risk. Analysis of covariance assessed changes in the QDI during the study, and data is presented as mean ± standard error of the mean. Results: The QDI scores decreased significantly (p = 0.031) for participants receiving treadmill gait training +VFB (- 0.259 ± 0.207), compared to participants who walked on the treadmill without VFB (0.463 ± 0.246). Changes in participants QDI scores were dependent in part upon their age, which was a significant covariate (p = 0.007). These preliminary results demonstrate that rehabilitation to reduce fall risk may also decrease use of drugs associated with falls. Determination of which drugs or drug classes that contribute to the reduction in QDI scores for participants receiving treadmill gait training +VFB, compared to treadmill walking only, will require a larger participant investigation. Trial Registration ISRNCT01690611, ClinicalTrials.gov #366151-1, initial 9/24/2012, completed 4/21/2016

No description available.

Modern advances in technology have allowed for an increase in the precision with which we are able to measure, record, and affect behavior. These developments suggest that the domains in which behavior analysis might contribute are considerably broader than previously appreciated, for instance the area of behavioral medicine. One way the field of behavior analysis can begin to address problems in behavioral medicine is with biosensor technology, like surface electromyography (sEMG). For sEMG technology to be useful in behavioral medicine, specifically recovery from total knee arthroplasty, a reference value (the maximum voluntary individual contraction-MVIC) must be established. The MVIC value allows for the comparison of data across days and may allow the programming of contingencies. However, current MVIC methods fall short. Study 1 compares MVIC values produced by a participant given the typical instruction only method with two alternative methods: instruction + feedback, and instruction + feedback in a game context. Across 10 participants both feedback conditions lead to higher MVIC values then the instruction only condition. Study 2 applies the MVIC techniques developed during Study 1 to an exercise procedure. Using an MVIC value as the criteria for feedback Study 2 compares the same three conditions, however this time assessing for the conditions under which exercise performance is optimal. Across all 9 participants the instruction + feedback in a game context lead to the participant ‘working harder' and 8 out of 9 participants exceeded the MVIC value more often during this condition then in the other two conditions.

Knee osteoarthritis affects approximately 25 million adults. In severe cases, total knee arthroplasty (TKA) is the most common solution. TKA is effective at addressing pain and reducing continued degeneration of articular cartilage. However, effective physical therapy (PT) following TKA is vital for a full functional recovery. Despite the importance of PT, half of patients never achieve a full functional recovery. Decreases in proprioceptive feedback, severe atrophy, and pain inhibition all likely contribute to the variability in effectiveness. Surface electromyography-based biofeedback (sEMGBF) may allow clinicians to address some of these barriers by supplementing proprioceptive feedback and targeting small muscle contractions before eventually increasing the contraction requirement. Using a between group design, we compare the effectiveness of sEMGBF (7) to neuromuscular stimulation (NMES) (6), and a control group (6) in recovery following TKA. Effectiveness was evaluated across 4 metrics (quadriceps strength, range of motion, functional improvement, and quality of life) in a pre-test/post-test fashion. At the statistical level this study suggest that sEMGBF leads to greater improvements in quadriceps strength relative to the NMES and control group. Additionally, visual analysis suggests that sEMGBF may also lead to greater improvements in range of motion, and functional improvement relative to the NMES and control group. The results for quality of life are mixed. Overall, the study provides initial clinical support for the utility of sEMGBF following TKA.

Учитывая высокую распространенность травм верхней конечности, в настоящее время существует необходимость разработки методики реабилитации после перелома лучевой кости в типичном месте, которая позволит существенно сократить сроки восстановления трудоспособности, улучшит качество жизни пациентов и будет способствовать их психическому благополучию. Внедрение данной методики должно иметь высокую эффективность по сравнению с традиционными способами, используемыми в большинстве медицинских учреждений. Цель исследования: обосновать эффективность использования инновационных средств физической реабилитации. В исследовании приняло участие 30 человек с диагнозом – перелом лучевой кости в типичном месте. По результатам исследования была разработана эффективная комплексная методика для реабилитации после перелома лучевой кости в типичном месте. Разработаны рекомендации для врачей и специалистов физической реабилитации по внедрению программы восстановления после перелома лучевой кости в типичном месте. / Taking into consideration high prevalence of upper extremities injuries, there is a particular demand on development of effective methods of physical rehabilitation after typical radius fracture. This will enable significantly decrease the recovery time, improve quality of life and will promote psychological health of patients. Implementation of the proposed method will be more effective in comparison with traditional methods used in medical departments at the moment. The aim of the study is to justify effectiveness of innovative physical rehabilitation methods. Thirty patients with typical radius fracture were recruited for the study. The obtained research enabled to develop effective complex methodic for rehabilitation after radius fracture in typical place. Guidelines and recommendations for healthcare practitioners and physical rehabilitation specialists were proposed for implementation of this methodic in patients after radius fractures in typical place.