BackgroundType 2 diabetes Mellitus (T2DM) is associated with cardiac autonomic dysfunction, which is an independent predictor of mortality in chronic diseases. However, whether the coexistence of systemic arterial hypertension (HTN) with DMT2 alters cardiac autonomic modulation remains unknown.ObjectiveTo evaluate the influence of HTN on cardiac autonomic modulation and cardiorespiratory fitness in subjects with DMT2.Methods60 patients of both genders were evaluated and allocated to two groups: DMT2 patients (n = 32; 51 ± 7.5 years old) and DMT2 + HTN patients (n = 28; 51 ± 6.9 years old). RR intervals were obtained during rest in supine position. Linear and nonlinear indices of heart rate variability (HRV) were computed using Kubios HRV software. Pulmonary gas exchange was measured breath-by-breath, using a portable telemetric system during maximal incremental exercise testing on a cycle ergometer. Statistical analysis included Shapiro-Wilk test followed by Student’s t Test, Pearson correlation and linear regression.ResultsWe found that patients in the DMT2+HTN group showed lower values of mean RR intervals (801.1 vs 871.5 ms), Shannon entropy (3 vs 3.2) and fractal dimension SD 1 (9.5 vs 14.5), when contrasted with patients in the DMT2 group. Negative correlations were found between some HRV nonlinear indices and exercise capacity indices.ConclusionHTN negatively affects the cardiac autonomic function in diabetic patients, who are already prone to develop autonomic dysfunction. Strategies are need to improve cardiac autonomic functionality in this population.

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The objective of this study was to verify whether women in the initial stages of hand osteoarthritis (HOA) already have impaired grip strength and flexor and extensor torque of the wrist compared to healthy women. It also aimed to correlate these variables with pain, stiffness, and function of the hand. Twenty-six women were divided into a control group [CG, n = 13; 56 (51–61) years old] and a hand osteoarthritis group [HOAG, n = 13; 58 (53–63) years old]. Grades II and III were included in the HOA group according to the criteria of Kellgren and Lawrence. All volunteers answered an initial assessment form, the Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire and the Australian/Canadian Hand Osteoarthritis Index (AUSCAN). The grip strength and isometric wrist flexor and extensor torque were evaluated by a hydraulic dynamometer. Comparisons between groups used Student’s t test for independent samples and the Mann–Whitney test. Spearman's correlation was used to correlate grip strength and flexor and extensor wrist torque to the degree of disease and DASH and AUSCAN scores. There were no differences between the groups in grip strength or flexor and extensor torque values. In terms of the DASH and the AUSCAN, the HOA group had higher scores, indicating worse hand function. A strong negative correlation was found between grip strength and the degree of HOA (r =  − 0.70, p = 0.008), and a moderate positive correlation was found between flexor torque and the degree of HOA (r = 0.53, p = 0.05). The pain (r =  − 0.61, p = 0.02) and function (r =  − 0.66, p = 0.01) sections of the AUSCAN correlated negatively with grip strength. Pain can be an important feature in the HOA rehabilitation process, as it can influence handgrip strength and function. It is important that rehabilitation is implemented as soon as possible to guarantee the maintenance of strength and function since with the severity of the disease, patients tend to have deficits in grip strength and function.

Objective: The objective of this study was to evaluate the effect of Virtual Reality (VR) associated with physical exercises on quality of life, fatigue, pain levels, and functional capacity in a woman with Fibromyalgia. Methods: This is a case report that evaluated one patient diagnosed with FM before and after the intervention with VR associated with physical exercise. The evaluation scales used were: Fibromyalgia Impact Questionnaire, Health Assessment Questionnaire, Visual Analogue Scale for Pain, Pain Catastrophizing Scale, Fatigue Severity Scale and pressure pain threshold evaluation at 18 tender points with a digital pressure algometer. Treatment was conducted for 6 weeks, with 2 sessions per week, totaling 12 treatment sessions. Results: The study showed that treatment with VR promoted an improvement in the impact of FM in the volunteer's quality life, a decrease in catastrophic sensation of pain and a decrease in fatigue. It was also possible to notice an improvement in the pressure pain threshold at 16 tender points. Conclusion: A rehabilitation program for people with FM that involves VR combined with the practice of physical exercises contributed to the improvement of cognitive and physical aspects. The association of these two therapies was beneficial, since cognitive stimuli and the practice of a physical activity could promote improvements in function, fatigue, quality of life, and pain perception of these individuals.

Objetivo: Avaliar o efeito da Realidade Virtual (RV) associado a exercícios físicos na qualidade de vida, fadiga, níveis de dor e capacidade funcional em uma mulher com Fibromialgia (FM). Métodos: Trata-se de um estudo de caso que avaliou uma paciente com diagnóstico de FM, antes e após a intervenção com a RV associada a prática de exercícios físicos. Os instrumentos de avaliação utilizadas foram: Questionário de Impacto da Fibromialgia, Questionário de Capacidade Funcional, a Escala Visual analógica de Dor, Escala de Pensamento catastrófico sobre a dor, Escala de severidade da fadiga e avaliação do limiar de dor à pressão sobre os 18 tender points por meio de um algômetro de pressão digital. O tratamento ocorreu durante 6 semanas, com 2 sessões de tratamento por semana, totalizando 12 sessões. Resultados: O estudo proposto mostrou que o tratamento associado a RV promoveu uma melhora no impacto da FM na qualidade de vida da voluntária, uma diminuição na catastrofização da dor e uma diminuição da fadiga. Também foi possível notar uma melhora no limiar de dor a pressão em 16 tender points. Conclusão: Um programa de reabilitação para pessoas com FM que envolva a RV somado a prática de exercícios físicos contribuiu para melhora dos aspectos cognitivo e físico. A associação destas duas terapias foi benéfica, uma vez que estímulos cognitivos e a prática de uma atividade física foi capaz de promover melhora na função, na fadiga, na qualidade de vida e na percepção de dor desses.