Introduction:Cardiovascular autonomic dysfunction reflex of the pathophysiology of diabetes mellitus (DM) favors an increase in morbidity and mortality related to cardiovascular events, and for this reason has been one of the most studied clinical entities.Method:An experimental study of a randomized clinical trial type was therefore proposed to analyze the hemodynamic and glycemic response after the practice of a rehabilitation program in patients with type 2 diabetes mellitus (T2DM). In this clinical trial the patients will initially be submitted to an evaluation protocol that consists of assessing blood pressure, heart rate, Borg scale, respiratory rate, oxygen saturation, distance traveled through the 6-minute walk test, quality of life questionnaire, Pittsburgh sleep quality questionnaire, and still glycated hemoglobin and heart rate variability through the cardiofrequency meter. After careful evaluation of the patients, they will be submitted to a metabolic rehabilitation program composed of aerobic and resisted exercises, performed for 12 weeks, in 3 weekly meetings of 60 minutes each. With such evaluations, it will be possible to construct with evidence that it is possible to work safer metabolic rehabilitation programs in patients with T2DM or other diseases that generate cardiovascular risks, guaranteeing them an improvement in cardiorespiratory fitness, hemodynamic and glycemic variables, allowing improvement of the quality of life.Ethics and Dissemination:The protocol is approved by the host institution's ethics committee under the number 1.616.721. Results will be disseminated via peer-reviewed journal articles and conferences. This clinical trial is registered at ClinicalTrials.gov identifier: NCT3094767.
Introduction: The introduction of biological medication in Juvenile Idiopathic Arthritis (JIA) proposes better therapeutic results with decreased pain and inflammation and consequent reduction in joint damage. The autonomic state can be a predictor for verifying the response to immunomodulation therapy. Thus, measuring heart rate variability can express autonomous behavior and possibly accompany the response to therapy through the expression of the inflammatory condition. Objective: Analysis of heart rate variability in a child with Juvenile Idiopathic Arthritis using the anti-Tumor Necrosis Factor. Methods: This is a clinical case report of an 8-year-old male with a diagnosis of JIA - oligoarticular form, using etanercept, admitted to Clínica Escola de Fisioterapia UNINORTE, Acre, Brazil in 2017. We analyzed laboratory and imaging tests, kinetic-functional evaluation, examination of cardiac autonomic modulation and physiotherapeutic treatment for analgesic, anti-inflammatory purposes, gaining flexibility, strength and postural re-education, according to CARE guidelines, case report guidelines. Results: After medication administration, there was a decrease in pain and normalization of serum creatinine (0.50 mg / dL) and CRP (less than 6 mg / dL) and an increase in erythrocyte sedimentation rate (17 mm3). In the examination of heart rate variability, the linear indices in the time domain showed a predominance of parasympathetic activity (RMSSD: 35ms), with decreased sympathetic control measured through the frequency domain (LF: 27.1 un). However, non-linear methods showed low variability with little dispersion of RR intervals. Conclusion: In the present report, the linear indices showed parasympathetic predominance and in the non-linear analysis a low heart rate variability with abnormal and insufficient adaptation of the autonomic nervous system in a child with juvenile idiopathic arthritis using biological medication.
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