RESUMOEspiritualidade pode ser definida como um sistema de crenças que enfoca elementos intangíveis, que transmite vitalidade e significado a eventos da vida. Tal crença pode mobilizar energias e iniciativas extremamente positivas, com potencial ilimitado para melhorar a qualidade de vida da pessoa. As implicações da espiritualidade na saúde vêm sendo estudadas cientificamente e documentadas em centenas de artigos. Há relação entre envolvimento espiritualista e vários aspectos da saúde mental, sendo que pessoas vivenciam melhor saúde mental e se adaptam com mais sucesso ao estresse se são religiosas. Pessoas religiosas são fisicamente mais saudáveis, têm estilos de vida mais salutares e requerem menos assistência de saúde. Existe uma associação entre espiritualidade e saúde que provavelmente é válida, e possivelmente causal. É plenamente reconhecido que a saúde de indivíduos é determinada pela interação de fatores físicos, mentais, sociais e espirituais. Os profissionais da saúde já contam com indicações científicas do benefício da exploração da espiritualidade na programação terapêutica de virtualmente qualquer doença. O presente artigo cita os trabalhos mais relevantes sobre o assunto. UNITERMOSReligião e ciência, Espiritualismo, Reabilitação, Saúde SUMMARYSpirituality may be defined as a belief system that focus on intangible elements that transmit vitality and meaning to life. Such belief may mobilize highly positive energies and initiatives, with ilimited potential to improve person's quality of life. Implications of spirituality on health have being scientificaly studied and documented in hundreds of papers. There is relationship between spiritualist engagement and many aspects of mental health, so that people experience better mental health and can copy with more success to stress if they are religious.Religious people are physically healthier, have more healthy lifestyles and demand less health assistance. There is an association between spirituality and health which is likely valid and possibly causal. It is fully recognized that people's health is determined by interactions of physical, mental, social and spiritual factors. Health professionals already count on with scientific indications of the benefits of spiritual exploration on the therapeutic program of virtually any disease. The current paper cites the most relevant references about this issue.
The biopsychosocial model is a modern humanistic and holistic view of the human being in health sciences. Currently, many researchers think the biopsychosocial model should be expanded to include the spiritual dimension as well. However, “spiritual” is an open and fluid concept, and it can refer to many different things. This paper intends to explore the spiritual dimension in all its meanings: the spirituality-and-health relationship; spiritual–religious coping; the spirituality of the physician affecting his/her practice; spiritual support for inpatients; spiritual complementary therapies; and spiritual anomalous phenomena. In order to ascertain whether physicians would be willing to embrace them all in practice, each phrase from the Physician’s Pledge on the Declaration of Geneva (World Medical Association) was “translated” in this paper to its spiritual equivalent. Medical practice involves a continuous process of revisions of applied concepts, but a true paradigm shift will occur only when the human spiritual dimension is fully understood and incorporated into health care. Then, one will be able to cut stereotypes and use the term “biopsychosocial–spiritual model” correctly. A sincere and profound application of this new view of the human being would bring remarkable transformations to the concepts of health, disease, treatments, and cure.
Jones A, Alves ACM, de Oliveira LM, Saad M, Natour J. Energy expenditure during cane-assisted gait in patients with knee osteoarthritis. Clinics. 2008;63:197-200. OBJECTIVE:To compare the energy expenditure in patients with unilateral knee osteoarthritis while walking with canes of different lengths. METHODS: A quasi-experimental study (single-group) was carried out on thirty patients with unilateral knee osteoarthritis. An adjustable aluminum cane was used, and three different cane lengths were determined for each subject: C1 -length from the floor to the greater trochanter; C2 -length from the floor to the distal wrist crease; and C3 -length obtained by the formula: height x 0.45 + 0.87 m. Resting and walking heart rates were measured with a Polar hear rate meter. Walking speed was calculated by the time required for the patient to walk 10 m. Gait energy cost was estimated using the physiological cost index, and results were compared. RESULTS: The sample consisted of 25 women and five men (average age of 68 years). Statistically significant differences in physiological cost index measurements were observed between unassisted walking and assisted walking with a cane of any length (p<0.001), as well as between walking with a C2-length cane and unassisted walking, and walking with a C1-length cane and walking with a C3-length cane (p=0.001; p = 0.037; p=0.001; respectively). CONCLUSION: These data demonstrate that small alterations in the length of canes used for weight-bearing ambulation in patients with unilateral knee osteoarthritis increase the energy expenditure measured by the physiological cost index during walking. Further studies are needed for a more precise quantification of the increase in energy expenditure during cane-assisted gait and an assessment of the effectiveness of cane use in relieving pain and improving function in patients with knee osteoarthritis.
Objective:To evaluate alterations in posture and range of motion of the upper limbs in women after mastectomy and lymphadenectomy, submitted to radiotherapy as adjuvant treatment.Methods:Two groups were evaluated: 16 post-mastectomy women with lymphedema of the upper limb and 14 post-mastectomy women without lymphedema. Patients were submitted to analysis made by software, one for posture and the other to measure ranges of movement of the shoulder, elbow, and wrists. The results obtained were compared between the right and left sides, and operated and non-operated sides, and then were submitted to statistical tests.Results:Both groups presented with anteriorization of the trunk. The women with lymphedema had head rotation to the right, protrusion of the left shoulder, and trunk inclination angle smaller on the operated side, besides bilateral elevation of the scapula when compared to the group with no lymphedema. Changes in range of motion were also smaller on the operated side in terms of flexion, abduction, and external rotation of the shoulder for all women, and for those with lymphedema, elbow extension and wrist flexion had a smaller range of motion.Conclusion:Women submitted to mastectomy presented with asymmetries and modifications in posture, and lymphedema seemed to worsen this condition. Additionally, they had deficits in range of motion in the shoulders on the operated side. Women with lymphedema also showed deficits in the elbows and wrist.
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