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Background: Fibromyalgia (FM) is a syndrome characterized by widespread chronic pain associated to other symptoms, such as: fatigue, anxiety, depression and sleep disorders. Health education programs (HEP) have emerged as good non-pharmacological strategies to treat it. However, it is still not clear if the benefits are only subjective, or it has also objective impacts on immune and or neuroendocrine systems. Methods: Fifty-eight fibromyalgia women were randomly allocated in experimental group (n = 27) or control group (n = 31). The experimental group was submitted to HEP treatment for 11 weeks, while control group did not receive intervention at the same period. All data were collected at zero and 11th week by a blinded researcher. The statistical analysis were made in GraphPad Prism software (version 5.0) with significant level adjusted for α = 0.05. Results: Forty-four patients concluded the full study, 21 in the experimental group and 23 in the control group. Intragroup and intergroup analysis revealed that treatment induced significant increases of IL-4 plasma levels, antiinflammatory cytokine/inflammatory cytokine ratio (AC/IC ratio), salivary cortisol levels, in addition to significant decreases on FIQ scores. Intergroup variation analyses revealed also significant increases of IL-10 plasma levels. Conclusion: The results presented suggest that this kind of HEP could induce subjective and objective changes (immune and neuroendocrine), that could explain, at least in part the improvement of fibromyalgia patient's health status. (Clinical Trial Registration Number-ReBEC-RBR-5tdnbr).

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Introduction:The new diagnostic criteria for fibromyalgia (FM) include the presence of chronic, widespread pain associated with other symptoms such as fatigue, sleep disturbance, anxiety and depression. All these symptoms should be considered when thinking and clinical decision making of physiotherapists dealing with FM. However, it is clear that the other symptoms that accompany the pain are often neglected. Objective: To measure the levels of fatigue, sleep disturbances, anxiety and depression in patients with FM and compare them to levels found in healthy controls. Methods: Forty-six women diagnosed with FM and 30 healthy controls participated in the study. The levels of each of the symptoms were assessed by four validated questionnaires in Brazil (Piper Fatigue Scale -Revised, Pittsburgh Sleep Quality Index, Beck Anxiety Inventory and the Beck Depression Inventory). Statistical analysis was performed using GraphPad Prism software and all tests used a significance level of 5% (α = 0.05). Results: FM patients had significantly elevated levels of fatigue (p = 0.0005), sleep disturbances (p = 0.003), anxiety (p = 0.0012) and depression (p = 0.0003) compared to healthy controls. Symptoms fatigue and depression correlated strongly and positively with one another and with other symptoms evaluated. Conclusion: The other symptoms that comprise the clinical picture of FM need be considered not only in order to recover the health of patients, but above all in an attempt to preserve it and promote it.

Introdução: A fibromialgia (FM) leva a um impacto negativo na qualidade de vida, afetando a vida profissional, familiar, e social destes indivíduos, fazendo-se necessário uma avaliação multidimensional. Objetivos: O presente estudo buscou avaliar os fatores que estão associados ao impacto da FM na qualidade de vida de mulheres com essa condição. Material e métodos: Participaram do estudo 34 pessoas com FM e 21 controles saudáveis (CS). Os instrumentos utilizados foram: Questionário da dor de McGill, Índice de Religiosidade de Duke, Índice de qualidade do sono de Pittsburgh (PSQI), World Health Disability Assessment Schedule (WHODAS 2.0), Questionário de impacto da fibromialgia (FIQ). As análises, descritiva, intergrupos e de regressão foram realizadas no pacote estatístico IBM SPSS com nível de significância ajustado para a = 0,05. Resultados: As participantes com FM apresentaram níveis estatisticamente significativos de dor (p < 0,0001), pior qualidade do sono (p < 0,0001), maior nível de incapacidade (p < 0,0001) em relação aos CS. Em nenhuma dimensão da religiosidade houve diferença significativa. No FIQ o grupo FM obteve média de 65,56 ± 17,95 pontos. A análise de regressão mostrou que os domínios atividade e participação do WHODAS 2.0 estão fortemente relacionados com impacto da fibromialgia na qualidade de vida. Conclusão: A avaliação dos indivíduos com FM deve ser realizada de forma multidimensional, baseando-se em modelos como a Classificação Internacional de Funcionalidade, Incapacidade e Saúde, para que os tratamentos propostos sejam voltados às reais necessidades do indivíduo.Palavras-chave: fibromialgia, qualidade de vida, Classificação Internacional de Funcionalidade, Incapacidade e Saúde.

This study aims to evaluate the profile and knowledge of physiotherapists and occupational therapists from Minas Gerais about the International Classification of Functioning, Disability and Health (ICF) application in professional practice, trying to understand the reason for the underutilization of this universal instrument in Brazil. Observational and cross-sectional study was conducted using an online questionnaire prepared by specialists. An email was sent to all physiotherapists and occupational therapists enrolled in the Regional Council of the 4th Region. Of 22,121 emails, 1,313 were answered. 53% of the sample had graduate certificate, 65% had between two to ten years of experience, and 62% reported that clinics and patients’ houses are the places where they work. 72% of the professionals knew the ICF and 84% correctly answered the meaning of the acronym. However, 71% of professionals are unaware of the fields that make up this classification. The first contact with the ICF happened during graduation to 50% of professionals, and 28% had never had contact with ICF. 74% reported not using it in clinical practice. However, 82% of the participants believed that the use of ICF is viable in clinical practice. Most professionals had graduate certificate, worked in clinics and patients’ homes and, although most of them claim to know the ICF, the largest portion of the sample reported they did not use this classification in their professional lives, even though believing the ICF use is feasible. The lack of knowledge about the ICF prevents professionals from complying with the recommendations of the World Health Organization (WHO), the Brazilian National Health Council (CNS) and COFFITO (Brazilian Federal Council of Physical Therapy and Occupational Therapy) on the adoption of this instrument in exchange of information about health and clinical practice.

Introdução: A doença de Parkinson é uma doença degenerativa que leva os pacientes a apresentarem alterações no equilíbrio. A realidade virtual tem sido estudada como um recurso para reabilitação destes pacientes. Objetivo: Verificar a influência da realidade virtual, com a utilização do Wii Fit, na melhora do equilíbrio, da qualidade de vida e do medo de quedas dos portadores da doença de Parkinson. Métodos: Onze voluntários, com doença de Parkinson até o estágio 3 da escala de Hoehn e Yahr, foram recrutados para este estudo. Os pacientes participaram de 12 sessões de cinesioterapia e de 12 sessões de terapia com realidade virtual. Foram utilizados os seguintes testes na coleta de dados para as avaliações inicial, pós-cinesioterapia e pós-realidade virtual: Timed Get Up and Go, Escala de Equilíbrio de Berg, teste de caminhada de 10 metros, Escala de Eficácia de Quedas e o Perfil de Saúde de Nottinghan. Após as intervenções foi aplicado um questionário qualitativo. Resultados: Não houve diferença estatística nas variáveis analisadas, porém no questionário qualitativo a maioria dos pacientes demonstrou preferência pela realidade virtual. Conclusão: Apesar de os resultados não apresentarem diferenças estatísticas, a realidade virtual pode ser uma nova ferramenta associada à fisioterapia tradicional.Palavras-chave: doença de Parkinson, realidade virtual, reabilitação, equilíbrio.