BackgroundGiven the relative importance of cognitive impairment, there was considerable interest in identifying the cognitive profile of PD patients, in order to ensure specific and appropriate therapeutic interventions.PurposeTo determine the effects of physical exercise programs on cognitive function in PD patients, compared with the control group.Data sourcesMedline, Cochrane, Scopus, PEDro and Web of Science (last searched in September 2016).Study selectionRandomized clinical trials examining the effects of physical exercise programs and cognitive function in PD patients. Nine studies fulfilled the selection criteria and were included in this review.Data extractionCharacteristics of the publication, characteristics of the participants, test used for cognitive screening, cognitive domain assessed, tools used to assess cognitive function, characteristics of the experimental intervention, characteristics of the control group, mean results and standard deviation of function cognitive. The PEDro score was used to evaluate methodological quality.Data synthesisMost eligible studies showed good methodological quality based on the PEDro scale. Studies have shown that adapted tango for PD patients, cognitive training combined with motor training, and treadmill training promote the preservation or improvement of cognitive function in PD patients.LimitationsThe diversity of cognitive tests used to assess cognitive function and the high heterogeneity identified between the physical exercise programs.ConclusionsPhysical exercise programs promote positive and significant effects on global cognitive function, processing speed, sustained attention and mental flexibility in PD patients, at a mild to moderate stage for patients with a 6-year clinical diagnosis of PD. However, treadmill training performed 3 times a week for about 60 minutes and for a period of 24 weeks produced larger improvements in cognition.
Silva, FCd, Iop, RdR, Andrade, A, Costa, VP, Gutierres Filho, PJB, and Silva, Rd. Effects of physical exercise on the expression of microRNAs: A systematic review 34(1): 270–280, 2020—Studies have detected changes in the expression of miRNAs after physical exercise, which brings new insight into the molecular control of adaptation to exercise. Therefore, the objective of the current systematic review of experimental and quasiexperimental studies published in the past 10 years was to assess evidence related to acute effects, chronic effects, and both acute and chronic effects of physical exercise on miRNA expression in humans, as well as its functions, evaluated in serum, plasma, whole blood, saliva, or muscle biopsy. For this purpose, the following electronic databases were selected: MEDLINE by Pubmed, SCOPUS, Web of Science, and also a manual search in references of the selected articles to April 2017. Experimental and quasiexperimental studies were included. Results indicate that, of the 345 studies retrieved, 40 studies met the inclusion criteria and two articles were included as a result of the manual search. The 42 studies were analyzed, and it can be observed acute and chronic effects of physical exercises (aerobic and resistance) on the expression of several miRNAs in healthy subjects, athletes, young, elderly and in patients with congestive heart failure, chronic kidney disease, diabetes mellitus type 2 associated with morbid obesity, prediabetic, and patients with intermittent claudication. It is safe to assume that miRNA changes, both in muscle tissues and bodily fluids, are presumably associated with the benefits induced by acute and chronic physical exercise. Thus, a better understanding of changes in miRNAs as a response to physical exercise might contribute to the development of miRNAs as therapeutic targets for the improvement of exercise capacity in individuals with any given disease. However, additional studies are necessary to draw accurate conclusions.
Hand grip strength is a useful measurement for individuals with rheumatoid arthritis, since this disease is often associated with functional anomalies of the hands and a consequent reduction in muscular strength. Thus, the standardization of the test protocol is important in relation to make reproducible and reliable studies. The aim of this systematic review was to verify the parameters associated with the measurement of the hand grip strength in individuals with rheumatoid arthritis. The review was carried out according to the recommendations of PRISMA, based on the databases of the Web of Science and the Journals Website of the Brazilian governmental agency CAPES. The following inclusion criteria were established: articles whose themes involved dynamometry to measure the hand grip in adult patients with rheumatoid arthritis, published in English between 1990 and 2012. The articles were selected by two independent reviewers. Initially, 628 articles were identified, and in the final review only 40 were included in the qualitative synthesis, that is, those in which the main tool used to evaluate the hand grip strength was the Jamar®. In relation to the hand grip strength parameters feedback type, hand dominance, repetitions, contraction intensity, acquisition time and rest period many data are imprecise and were not detailed in the method description. It is clear that there is a need for the standardization of a protocol which establishes the type of dynamometer and the parameters to be evaluated and also takes into consideration the clinical conditions of patients with rheumatoid arthritis.
The aim of the present study was to determine the expression of blood microRNAs (miRNAs) involved in PD in humans. For this purpose the following electronic databases were selected: MEDLINE by Pubmed, Scopus and Web of Science. The search strategy included the proposed descriptors in the Medical Subject Headings. There were no restrictions with respect to the language of the publication. In the study selection two independent reviewers initially evaluated studies that were identified by the search strategy according to titles and abstracts. The reviewers evaluated (also unassisted) the complete articles and selected studies according to the eligibility criteria specified above. Studies that were not in accordance with the adopted criteria were excluded according to the boundaries imposed by the search strategy. The following data were extracted from the selected studies: Publication identification, location where the study was conducted, study design, the sample size, the participants' characteristics, the miRNAs involved in PD, the miRNA detection and analysis method, and the type of miRNA dysregulation in PD. Through this systematic review of the literature published over the last 10 years, the expression of 91 different miRNAs were analyzed in the context of PD, with the expression of 39 of these miRNAs differing significantly between individuals with PD and healthy controls and/or between treated and untreated patients with PD. The miRNAs were extracted from mononuclear cells, leukocytes, plasma, serum and peripheral blood, and the majority of the studies used reverse transcription‑quantitative polymerase chain reaction (RT-qPCR), which is considered to be the gold standard for miRNA analysis.
We found 222 articles, of which 63 were analyzed and 24 were included in the study. The main instruments found were: PEDI, WeeFIM, ASK, PODCI, VABS-II, LIFE-H, and CAPE/PAC.
Controle postural, estabilidade nos movimentos voluntários, reação às perturbações externas e propriocepção constituem elementos básicos para a manutenção do equilíbrio. Pessoas com Artrite Reumatoide (AR) têm dificuldade em manter o controle postural, prejudicando o equilíbrio nas Atividades de Vida Diárias (AVD's), tornando-se um importante fator de risco para quedas. O presente estudo teve por objetivo avaliar o equilíbrio corporal de indivíduos com AR, em função do nível de atividade da doença. Foram avaliados 24 indivíduos com 54,66±9,52 anos. Todos foram submetidos à aplicação de questionário de identificação e história clínica, avaliações antropométricas, coleta de amostra sanguínea para análise de Proteína C-Reativa (PCR), determinação do nível de atividade da doença por meio do Disease Activity Score (DAS-28) e avaliação do equilíbrio através dos testes: Escala de Equilíbrio de Berg (EEB) e Timed Up and Go (TUG). Os pacientes foram divididos em três grupos: baixa, moderada e alta atividade da doença. Os resultados dos testes de equilíbrio demonstraram que, embora a amostra tenha apresentado baixo risco para quedas, o grupo em alta atividade da doença apresentou maior distribuição de frequência (57,2%) nos escores entre 48-52 na EEB, em comparação ao grupo moderada atividade, cuja distribuição de frequência predominou nos escores entre 53 e 56 (92,3%-p<0,05). Também foi verificada diferença no tempo de execução do TUG, entre os grupos alta (11,86±4,62s) e moderada (9,71±0,90s) atividade da doença (p<0,05). Estes dados evidenciam que o nível de atividade da doença pode influenciar na realização dos testes EEB e TUG, sugerindo um aumento do risco de quedas ou até mesmo uma dependência na realização de suas AVD's em função do aumento do nível de atividade da doença.
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