Yes / The aim of this study was to assess the feasibility of a randomized controlled trial (PFM) treatment in women with bladder pain syndrome (BPS). Prolonged PFM tension contributes to the bladder pain, urinary frequency and urgency associated with BPS. Pelvic health physiotherapists routinely provide intravaginal myofascial release (MFR) to the PFMs in order to effectively reduce symptoms. Rapid access A TW was designed so as to allow men with chronic pelvic pain to self- treat, and this may be effective in women with BPS. For 6 weeks, two groups received weekly physiotherapist- provided MFR, and were monitored for a further 6- week follow- up period. One group also used a TW at home three times a week throughout the pilot. Weekly outcome measures of BPS symptoms and quality of life were recorded. A clinically meaningful difference in Interstitial Cystitis Symptoms Index and Interstitial Cystitis Problem Index score changes between groups was group = 6.20 ± 0.83 and 5.00 ± 1.41, respectively), and a difference was observed during the follow- up period (control group = 4.50 ± 1.73 and 4.00 ± 2.44, respecevents. Using the TW appears to have enhanced physiotherapy treatment during the initial 6 weeks, and improved symptoms during the 6- week follow- up period. The TW may be a clinically useful tool for long- term management of BPS. The feasibility of the study method was proven, some alterations were recommended and an RCT is now warranted.

Yes / Cortico-steroid Injections (CSI) are commonly used to treat patients with Greater Trochanteric Pain Syndrome (GTPS) but it is unclear which patients will experience improvements in pain Objectives: To identify factors that influence improvements in pain for patients with GTPS treated with CSI Design: Systematic review Methods: A search was undertaken of AMED, CINAHL, Cochrane Library, EMBASE, Medline and PEDro databases. Studies were eligible for inclusion of they investigated factors that influenced changes in pain experienced by patients who received a CSI. Studies needed to include relevant summary statistics and tests of clinical significance. Risk Of Bias in Non-randomised Trials Of Interventions (ROBINS-I) and Risk of Bias 2 (ROB2) tools were used to assess bias. Results: The search identified 466 studies, 8 were included in the final review with a total of 643 participants. There was no association between demographic variables such as age, sex, symptom duration or obesity and pain outcomes post-CSI. Having a co-existing musculoskeletal (MSK) condition such as knee osteoarthritis or sacroiliac/lumbar spine pain was associated with less pain reduction post-CSI. Injections into the Trochanteric Bursa were associated with longer lasting pain reduction than Gluteus Medius Bursa or extra-bursal injections. Image guidance of CSI maintained lower pain scores at six months but did not increase the duration of the therapeutic effect past six months. The presence of specific ultrasound scan features was not associated with differences in pain scores. Conclusions: Patients with co-existing MSK conditions may not respond to CSI as well as those without. Injections into the Greater Trochanteric Bursa may have longer lasting benefit. Further research is needed on the use of USS imaging findings and image guidance. / This work was completed as part of a pre-doctoral fellowship funded by the National Institute of Health Research [NIHR301938, 2021].

Die Dysregulation von Neurotransmittersystemen spielt eine wesentliche Rolle für die Pathophysiologie des Bladder Pain Syndrom/Interstitielle Zystitis (BPS/IC). Diese Arbeit beschäftigt sich daher mit der veränderten Expression muskarinerger (M2, M3) und purinerger (P2X1, P2X2, P2X3) Rezeptoren auf Urothelzellen und suburothelialen Myofibroblasten der Harnblasenwand im Rahmen BPS/IC. Dazu wurde eine Gruppe von Patientinnen mit Verdacht auf BPS/IC (n=17) einer Kontrollgruppe (n=7) gegenübergestellt. Die Gewebeproben der Patientengruppe sind im Zuge der Basisdiagnostik (transurethrales Harnblasenmapping) bei klinischem Verdacht auf das Vorliegen eines BPS/IC entnommen worden. Das Gewebe der Kontrollgruppe entstammt makroskopisch unauffälligen Bereichen von Harnblasen, welche im Rahmen einer radikalen Zystektomie oder einer lateral erweiterten endopelvinen Resektion (LEER-OP) entnommen worden sind. Die semi-quantitative Analyse der Rezeptorexpression erfolgte mittels indirekter Immunfluoreszenz, die Auswertung erfolgte mittels konfokaler Laserscanningmikroskopie. Die Ergebnisse der Patientengruppe wurden mit denen der Kontrollgruppe verglichen. Im Rahmen dessen wurde auch ein individuelles Rezeptorprofil für jeden Patienten erstellt. Es zeigte sich eine Hochregulation von M2R, M3R und P2X1R auf Urothelzellen sowie eine Hochregulation von M2R, M3R, P2X1R und P2X2R auf suburothelialen Myofibroblasten in der BPS/IC-Gruppe im Vergleich zur Kontrollgruppe. Des Weiteren zeigten sich individuelle Unterschiede in den Rezeptorprofilen der Patienten. Die Ergebnisse werden vor dem Hintergrund einer möglichen Beteiligung der Regulation von muskarinergen und purinergen Rezeptoren an der Pathophysiologie des BPS/IC diskutiert. Ferner werden diagnostische und therapeutische Möglichkeiten einer erweiterten Mollekulardiagnostik diskutiert.:Bibliografische Angaben 4 Abkürzungsverzeichnis 6 1. Einleitung 8 1.1. Das Bladder Pain Syndrom 8 1.1.1. Definition 8 1.1.2. Epidemiologie 10 1.1.3. Ätiologie und Pathophysiologie 10 1.1.4. Diagnostik 13 1.1.5. Therapie 16 1.2. Anatomische und physiologische Grundlagen 20 1.2.1. Das Urothel 21 1.2.2. Lamina propria 22 1.2.3. Muskarinerge Acetylcholinrezeptoren 23 1.2.4. Purinerge Rezeptoren 27 1.3. Fragestellung und Zielsetzung 31 2. Material und Methoden 32 2.1. Material 32 2.2. Methoden 33 2.2.1. Immunhistologie 33 2.2.2. Konfokale Laserscanning Mikroskopie und Auswertung 33 3. Ergebnisse 37 3.1. Lichtmikroskopie 37 3.2. Laserscanningmikroskopie 40 3.2.1. Rezeptorexpression im Urothel 40 3.2.2. Statistischer Vergleich von Kontroll-und BPS/IC-Gruppe im Urothel 42 3.2.4. Statistischer Vergleich von Kontroll-und BPS/IC-Gruppe auf sMF 46 3.2.5. Rezeptorprofile von Urothelzellen und sMF 47 3.3. Zusammenfassung 52 4. Diskussion 53 4.1. Diagnostisches Dilemma 53 4.2. Rezeptorverteilung im Urothel 61 4.3. Rezeptorverteilung auf sMF 64 4.4. Diagnostische und therapeutische Möglichkeiten des Rezeptorprofiling 65 4.5. Methodik der vorliegenden Arbeit 69 4.7. Zusammenfassung 71 Anhang 73 Referenzen 75 Erklärung über die eigenständige Abfassung der Arbeit 84

Die Dysregulation von Neurotransmittersystemen spielt eine wesentliche Rolle für die Pathophysiologie des Bladder Pain Syndrom/Interstitielle Zystitis (BPS/IC). Diese Arbeit beschäftigt sich daher mit der veränderten Expression muskarinerger (M2, M3) und purinerger (P2X1, P2X2, P2X3) Rezeptoren auf Urothelzellen und suburothelialen Myofibroblasten der Harnblasenwand im Rahmen BPS/IC. Dazu wurde eine Gruppe von Patientinnen mit Verdacht auf BPS/IC (n=17) einer Kontrollgruppe (n=7) gegenübergestellt. Die Gewebeproben der Patientengruppe sind im Zuge der Basisdiagnostik (transurethrales Harnblasenmapping) bei klinischem Verdacht auf das Vorliegen eines BPS/IC entnommen worden. Das Gewebe der Kontrollgruppe entstammt makroskopisch unauffälligen Bereichen von Harnblasen, welche im Rahmen einer radikalen Zystektomie oder einer lateral erweiterten endopelvinen Resektion (LEER-OP) entnommen worden sind. Die semi-quantitative Analyse der Rezeptorexpression erfolgte mittels indirekter Immunfluoreszenz, die Auswertung erfolgte mittels konfokaler Laserscanningmikroskopie. Die Ergebnisse der Patientengruppe wurden mit denen der Kontrollgruppe verglichen. Im Rahmen dessen wurde auch ein individuelles Rezeptorprofil für jeden Patienten erstellt. Es zeigte sich eine Hochregulation von M2R, M3R und P2X1R auf Urothelzellen sowie eine Hochregulation von M2R, M3R, P2X1R und P2X2R auf suburothelialen Myofibroblasten in der BPS/IC-Gruppe im Vergleich zur Kontrollgruppe. Des Weiteren zeigten sich individuelle Unterschiede in den Rezeptorprofilen der Patienten. Die Ergebnisse werden vor dem Hintergrund einer möglichen Beteiligung der Regulation von muskarinergen und purinergen Rezeptoren an der Pathophysiologie des BPS/IC diskutiert. Ferner werden diagnostische und therapeutische Möglichkeiten einer erweiterten Mollekulardiagnostik diskutiert.:Bibliografische Angaben 4 Abkürzungsverzeichnis 6 1. Einleitung 8 1.1. Das Bladder Pain Syndrom 8 1.1.1. Definition 8 1.1.2. Epidemiologie 10 1.1.3. Ätiologie und Pathophysiologie 10 1.1.4. Diagnostik 13 1.1.5. Therapie 16 1.2. Anatomische und physiologische Grundlagen 20 1.2.1. Das Urothel 21 1.2.2. Lamina propria 22 1.2.3. Muskarinerge Acetylcholinrezeptoren 23 1.2.4. Purinerge Rezeptoren 27 1.3. Fragestellung und Zielsetzung 31 2. Material und Methoden 32 2.1. Material 32 2.2. Methoden 33 2.2.1. Immunhistologie 33 2.2.2. Konfokale Laserscanning Mikroskopie und Auswertung 33 3. Ergebnisse 37 3.1. Lichtmikroskopie 37 3.2. Laserscanningmikroskopie 40 3.2.1. Rezeptorexpression im Urothel 40 3.2.2. Statistischer Vergleich von Kontroll-und BPS/IC-Gruppe im Urothel 42 3.2.4. Statistischer Vergleich von Kontroll-und BPS/IC-Gruppe auf sMF 46 3.2.5. Rezeptorprofile von Urothelzellen und sMF 47 3.3. Zusammenfassung 52 4. Diskussion 53 4.1. Diagnostisches Dilemma 53 4.2. Rezeptorverteilung im Urothel 61 4.3. Rezeptorverteilung auf sMF 64 4.4. Diagnostische und therapeutische Möglichkeiten des Rezeptorprofiling 65 4.5. Methodik der vorliegenden Arbeit 69 4.7. Zusammenfassung 71 Anhang 73 Referenzen 75 Erklärung über die eigenständige Abfassung der Arbeit 84 Lebenslauf: 85 Danksagung: 86

Thesis (MScPhysio)--Stellenbosch University, 2015. / ENGLISH ABSTRACT: This review aims to present the available evidence for the effect of McConnell taping on knee biomechanics in individuals with Anterior Knee Pain (AKP). Pubmed, Medline, Cinahl, Sportdiscus, Pedro and Science Direct electronic databases were searched from inception until September 2014. Experimental research into knee biomechanical or EMG outcomes of McConnell taping compared to no tape or placebo tape were included. Two reviewers completed the searches, selected the full text articles and assessed the risk of bias of eligible studies. Authors were contacted for missing data. Eight heterogeneous studies with a total sample of 220 were included in this review. All of the studies had a moderate to low risk of bias and compared taping to no tape and/ or placebo tape. Pooling of data was possible for three outcomes; average knee extensor moment, average VMO/VL ratio and average VMO-VL onset timing. None of these outcomes revealed significant differences. The evidence is currently insufficient to justify the routine use of the McConnell Taping technique in the treatment of Anterior Knee Pain. There is a need for more evidence on the aetiological pathways of Anterior knee Pain; level one evidence and studies investigating other potential mechanisms of McConnell taping. / AFRIKAANSE OPSOMMING: Die objektief van hierdie resensie was om te bepaal wat die effekte van McConnell Patellar Vasbinding is op knie kinematika, kinetiek en spier aktivering in diegene met Voorafgaande Knie Pyn (VKP). Die navorsers het elektroniese databases soos Pubmed, Medline, Cinahl, Sportdiscus, Pedro en Science Direct, van aanvang tot September 2014, ondersoek. Eksperimenteel studie ontwerpe wat biomeganiese of EMG gevolge van McConnell Vasbinding vergelyk met geen vasbinding of placebo vasbinding, is ingesluit. Twee resente het die ondersoek voltooi, die volle tekse artikels gekies en die partydigheid risiko van die ingeslote studies, geskat. Skrywers is gekontak vir enige verlore data. Agt heterogeen studies uit ‘n totalle monster van 220 is in hierdie resensie ingesluit. Al die studies het ‘n gematigde tot laag risiko vir eensydigheid en vergelyk vasbinding met geen of placebo vasbinding. Data saamvoeging was moontlik vir drie uitslae, naamlik: gemiddelde knie ekstensor moment; gemiddelde VMO/VL ratio en gemiddelde aanval tydmeting. Geen gevolge het veelseggende verskille of afwykings vertoon. Tans is die bewys nie genoegsaam om die routiene gebruik van McConnell Vasbinding tegniek te regverdig nie in die behandeling van VKP. Meer bewyslewering op die etiologiese paaie van VKP; Graad een bewys en studies wat ander moontlike meganisme van Mc Connell Vasbinding ondersoek, is noodsaaklik.

Chronic Prostatitis/Chronic Pelvic Pain Syndrome (CP/CPPS) is a prevalent, refractory pelvic pain condition characterized by pain in the pelvic area and urinary frequency, largely unresponsive to medical interventions. This study used multiple mediations to test the associations of validated pain appraisal and behavioural coping strategies between pain and quality of life. Patients (N = 175) were recruited from tertiary care urology clinics and completed questionnaires. Exploratory factor analyses were conducted on four individual measures (Chronic Pain Coping Inventory, Survey of Pain Attitudes – Control subscale, Center for Epidemiologic Studies Depression Scale, and Pain Catastrophizing Scale), then on the empirically derived factors that produced four factors to be used in regression and multiple mediation models: illness-focused behavioural coping, catastrophizing, wellness-focused behavioural coping, and depression. In regressions, CP/CPPS patient symptoms (p < .01), illness-focused behavioural coping (p < .01) and wellness-focused behavioural coping (p < .05) predicted physical quality of life, while catastrophizing (p < .01) and illness-focused behavioural coping (p < .05) predicted mental quality of life. Mediation analyses showed that illness-focused behavioural coping strategies partially mediated the relationship between pain and physical quality of life, whereas catastrophizing and illness-focused behavioural coping strategies both fully mediated the relationship between pain and mental quality of life. These results identify catastrophizing and illness-focused coping as key psychosocial targets for interventions for patient quality of life in CP/CPPS. / Thesis (Master, Psychology) -- Queen's University, 2013-08-27 17:07:11.853

Patellofemoral pain syndrome (PFPS) is the most common injury in runners. This thesis investigates the theory that prolonged eversion at the rear-foot causes prolonged tibial internal rotation and excessive femoral internal rotation, and predisposes female, distance runners to PFPS. Since eversion occurs at the subtalar joint, the morphology of the talus and calcaneus were also assessed. The study was a case-control investigation between female runners with a history of PFPS (n = 9) and normal controls (n = 10). Gait analysis was used to measure lower-limb joint angles during barefoot, treadmill running. It was hypothesised that runners with PFPS would demonstrate prolonged rearfoot eversion and tibial internal rotation, and increased hip internal rotation compared to normal controls. Computed tomography was used to image the foot and ankle in simulated weight-bearing using a custom-built loading rig. Three-dimensional models of the talus and calcaneus were generated and their shapes were quantified using principal axis lengths and orientations. The results did not support the theory that prolonged eversion and rear-foot structure predispose to PFPS during running, and attributing PFPS to these factors should be done with discretion. However, runners with a history of PFPS exhibited increased rear-foot eversion, reduced rear-foot dorsiflexion and increased knee internal rotation compared to normal controls during running, walking and squatting. Subjects with PFPS also demonstrated increased dorsiflexion at the mid-foot. It was proposed that increased eversion was secondary to reduced rear-foot dorsiflexion as this enabled compensatory dorsiflexion at the mid-tarsal complex. Due to the tight articulation of the ankle mortise, increased knee internal rotation corresponds well with excessive rear-foot eversion. A prospective study is required to establish whether these kinematic alterations are a cause or an effect of PFPS.

Previous studies for treating Patellofemoral Pain Syndrome (PFPS) are controversial regarding the effectiveness in alleviating anterior knee pain (AKP). The muscular imbalance between the vastus medialis oblique/vastus lateralis (VMO/VL) may be the underlying mechanical issue causing PFPS. It is hypothesized that Botox can decrease the force production capability of the lateral musculature mechanically similar to surgery. Strengthening the VMO while using Botox treatment can alleviating the muscular imbalance that occurs with subjects with PFPS. A double blind study, having all participants blinded and uninformed of the injection contents, was implemented to test this hypothesis testing three female subjects. Four knees were treated. One subject received the Botox treatment and serially a placebo injection in the other limb. Two other subjects received placebo injections. EMG was executed to evaluate functional testing and the performance of the injections during extension exercises. Electromyography (EMG) data were collected from the muscle groups while the subjects performed forceful knee extension activities on an isokinetic dynamometer. In addition, kinetic jump data and self-reports of pain and activity were collected. Data were collected four times during a 12-week period. The subject who received Botox injections expressed a significant decrease in reported PFP and an increase in daily activities. Botox was safe and effective in eliminating anterior knee pain. The VMO and VL resulted in similar fatigue indices at the completion of the 12- week study. The VMO and VL both resisted fatigue during at week 12.

A Síndrome Dolorosa Femoropatelar (SDFP), possui etiologia multifatorial e acomete cerca de 7 a 15% da população, em sua maioria mulheres, jovens, adultas e ativas. Ela causa dor anterior ou retropatelar e é exacerbada durante gestos motores funcionais, tais como subir e descer escadas ou permanecer longos períodos de tempo sentado, agachado ou ajoelhado. Como a avaliação diagnóstica desta síndrome ainda é indireta, diversos mecanismos e metodologias buscam realizar uma classificação que diferencie os portadores de SDFP com relação aos assintomáticos. Deste modo, o objetivo desse trabalho é estudar as relações entre os sinais eletromiográficos (EMG) do músculo quadríceps em indivíduos com SDFP durante exercícios isométricos distintos (dissipativo e conservativo) em diferentes ângulos da articulação tíbiofemoral, e compará-los com os indivíduos sem SDFP. Foram analisadas a intensidade do sinal EMG (RMS), a frequência mediana (Fmed) e a frequência em 95% (F95) do espectro de potência dos músculos vasto medial oblíquo (VMO), vasto lateral (VL) e reto femoral (RF) para as contrações isométricas dissipativa e conservativa. Participaram deste estudo 24 voluntários do sexo feminino (17 assintomáticos e 7 com SDFP) que realizaram 18 contrações nos ângulos de 90º, 60º e 20º de extensão de joelho, utilizando 30% da carga voluntária máxima. Eletrodos EMG foram posicionados nos referidos músculos para a coleta dos dados, os quais foram posteriormente tratados e processados, possibilitando a análises do sinal EMG nos domínio do tempo e da frequência. Os resultados indicam que o RMS do sinal EMG apresenta-se distinto entre as contrações isométricas para o grupo sintomático e evidenciam que não existe uma relação de intensidade de contração EMG de um músculo comparativamente ao outro quando se altera o gesto motor. A Fmed de VMO e VL podem ser utilizadas como ferramenta na detecção de SDFP, visto que atuam de maneira distinta entre os grupos. A F95 do músculo VMO comporta-se de um modo diferente entre os grupos, sendo que durante a contração isométrica dissipativa em 20º e 60º, seus valores em SDFP foram maiores do que no grupo Controle. Desta maneira, foi possível relatar que é possível diferenciar a SDFP, ou até mesmo detectá-la, utilizando parâmetros EMG de padrões diferentes de contrações isométricas. / The Patellofemoral Pain Syndrome (PFPS) has a multifactorial etiology and affects approximately 7-15% of the population, mostly active young women. PFPS causes retropatellar pain, that is exacerbated during motor functional gestures, such as climbing stairs, sitting, squatting or kneeling for long periods of time. Since the diagnostic evaluation of this syndrome is still indirect, different mechanisms and methodologies seek to achieve a classification able to distinguish patients with PFPS from asymptomatic ones. Thus, the purpose of this study is to find the relationship between the electromyographic (EMG) signals of quadriceps in individuals with and without PFPS during isometric exercises (dissipative and conservative) at different angles of the tibiofemoral joint, to analyze the signal pattern of the control subjects and to compare with the SDFP group. We compared the root means square (RMS) of the EMG signal, median frequency (Fmed) and frequency in 95% of the power spectrum (F95) on the vastus medialis oblique (VMO), vastus lateralis (VL) and rectus femoris (RF) for dissipative and conservative contractions. 24 female volunteers participated in this study (17 asymptomatic patients and 7 with PFPS), who performed 18 contractions at angles of 90º, 60º and 20º of knee extension, using 30% of the maximal voluntary contraction. EMG electrodes were placed on those muscles for data collection, which were further processed using AqDAnalysis software for selection of traits, and MatLab® for processing and analysis of the signal in time and frequency domain. The results indicate that the RMS of EMG signal presents differences among the isometric contractions for the symptomatic group and show that there is a relationship of contraction of a muscle compared to the other when it changes the motor gesture. The Fmed of VMO and VL can be used as a tool in the detection of PFPS, because it acts differently in each group. The F95 of the VMO muscle behaves differently between groups, and during the dissipative isometric contraction at 20º and 60º, their values were higher in PFPS than in the control group. Thus, it was possible to report that it is possible to differentiate the PFPS, or even detect it using EMG parameters of different patterns of isometric contractions

Resumo: A Síndrome da Dor Pélvica Crônica (SDPC) é uma nova categoria na classificação atual das prostatites. A causa da SDPC é desconhecida, a teoria mais aceita é o refluxo intraprostático. Não há estudo que comprove qual o melhor tratamento. A finasterida, uma das drogas utilizadas para o tratamento, é um antiandrogênio que bloqueia a enzima 5-alfa redutase, diminuindo o tamanho da próstata. A finasterida agiria na SDPC reduzindo o tecido glandular prostático, diminuindo a tensão intraprostática e conseqüentemente o refluxo intraprostático. Avaliar a efetividade e a segurança da finasterida no tratamento da SDPC. Uma revisão sistemática de ensaios clínicos aleatorizados foi realizada, sem restrições de língua, datas ou outras considerações. As fontes de informação utilizadas foram Medline, Registro de Ensaios Controlados da Cochrane, Embase, Lilacs e SciELO. Contato com autores de artigos, laboratórios que comercializam finasterida e revistas médicas em geral e específicas. Foram incluídos pacientes com diagnóstico da SDPC tipo IIIA e/ou IIIB, participantes de estudos em que foi comparado o uso da finasterida com placebo ou outro tipo de tratamento. Os desfechos clínicos avaliados foram os questionários dos sintomas prostáticos, exames para avaliar a melhora bioquímica ou variável fisiológica e eventos adversos. A coleta de dados e análise foram realizadas por dois revisores que inspecionaram as referências encontradas independentemente pela estratégia de busca e aplicaram os critérios de inclusão nos estudos selecionados usando os critérios de qualidade metodológica descritos no Cochrane handbook. A escala de Jadad e Schutz também foram usadas. Os dados dos estudos elegíveis foram sumarizados em metanálise. A análise estatística foi realizada utilizando o ...(Resumo completo, clicar acesso eletrônico abaixo) / Abstract: Chronic Pelvic Pain Syndrome (CPPS) is a new category in the current classification of prostatitis. The cause of CPPS is unknown; the most accepted theory is intraprostatic ductal reflux. The best treatment is not known. Finasteride, a specific type II 5a-reductase inhibitor, decreases the size of the prostate. A potential mechanism of action for finasteride is the reduction of the intraprostatic tension due to the glandular shrinkage, decreasing the intraprostatic ductal reflux. To assess the effectiveness and harms of finasteride in the treatment of CPPS. A systematic review of randomized controlled trials was performed, with no restrictions on language, dates or other considerations. The information sources used were Medline, the Cochrane Central Register of Controlled Trials, Embase, Lilacs and SciELO; contact authors of articles, laboratories that work with finasteride and general and specific medical magazines. It included participants with a diagnosis of CPPS type IIIA and/or IIIB taking part of studies comparing the use of finasteride to placebo or another type of treatment. The clinical outcomes evaluated were the questionnaires of prostatic symptoms, improvement in biochemical or physiologic variables and adverse events. The collecting data and analysis were performed by two reviewers that checked the found references independently by the search strategy, and applied the inclusion criteria in the selected studies using the criteria of methodological quality described on Cochrane Handbook. The Jadad and the Schutz scales were also used. After finding all eligible studies, the data were summarized in meta-analysis. The statistical analysis was undertaken using the MetaView statistical program within Review Manager software of the Cochrane Collaboration. Three studies with 181 patients were included. The length ...(Complete abstract click electronic access below) / Orientador: Antônio José Maria Catâneo / Coorientador: Paulo Eduardo de Oliveira Carvalho / Banca: Tânia Ruiz / Banca: Bernardo Garcia de Oliveira Soares / Mestre