BackgroundAquatic therapy promotes short-term benefits for patients with knee osteoarthritis (OA), and it may be the first therapeutic option for this pathological condition. The objective of this study was to investigate the effects of an aquatic therapy program on pain intensity, functional ability, and quality of life in older people with knee OA.Methods/designThis is a parallel, two-arm, open, randomized controlled clinical trial with older people with knee OA. Volunteers will be allocated to an aquatic intervention group (WG), subjected to the intervention, or to a control group, not be subjected to any kind of intervention. Data collection pre- and postintervention will be composed of the evaluation of the perception of pain by visual analogue scale with application of nociceptive stimuli in four anatomical points of the knee, functional fitness tests, and application of the World Health Organization Quality of Life Scale abbreviated version and Western Ontario and McMaster Universities Osteoarthritis Index. The program will last 12 weeks, consisting of aerobic and functional exercises in the form of circuit training.DiscussionThe objective of this clinical trial is to evaluate the effect of aquatic therapy in elderly patients with knee OA. The study is guided by practice-based scientific evidence for the use of aquatic rehabilitation exercises. It is expected that the WG volunteers will show reduced pain intensity, increased flexibility, and improved functional capacity and quality of life. It is believed that the desired results can be attributed to physical and physiological effects of immersion in warm water associated with the exercise protocol proposed. The data will be published after completion of the study.Trial registrationBrazilian Registry of Clinical Trials (ReBEC) registration number: RBR-78h48d. Registered on 19 August 2015.Electronic supplementary materialThe online version of this article (doi:10.1186/s13063-017-2061-x) contains supplementary material, which is available to authorized users.

INTRODUÇÃO: A alta incidência do Diabetes mellitus (DM) na população torna essa patologia alvo de muitas pesquisas. Uma das complicações do DM é a neuropatia periférica crônica caracterizada por atrofia e degeneração axonal e/ou alteração da célula de Schwann. A fisioterapia atua na estimulação da regeneração da fibra nervosa, o que reduz o risco de desenvolvimento do pé diabético. OBJETIVO: Identificar o comprometimento da sensibilidade nos membros inferiores (MMII) de diabéticos e verificar fatores que contribuíram para o desenvolvimento do pé diabético, como glicemia, hemoglobina glicada (HbA1c), tempo de diagnóstico, pressão arterial e antropometria. MATERIAIS E MÉTODOS: Os diabéticos foram avaliados na Associação dos Diabéticos de Bauru, participaram de entrevista e foram submetidos a antropometria, triagem pressórica e teste neurossensorial no Sistema Pontuação Clínica Toronto (SPCT). RESULTADOS: Os 68 pacientes (61,76% mulheres e 38,23% homens) tinham 62,93 ± 9,64 anos, apresentaram pressão sistólica de 132,54 ± 17,95 mmHg e diastólica 80,39 ± 11,35 mmHg, índice de massa corpórea 30,34 ± 5,80 kg/m², glicemia 149,20 ± 60,37mg/dL, HbA1c 7,72 ± 1,4%; tempo de diagnóstico de um a 34 anos. Dentre eles, 80,88% apresentavam sobrepeso; 72,06%, hipertensão arterial; 42,64%, dislipidemia; 14,7%, problemas renais; e 17,64%, vasculares. Pelo SPCT, 97,05% apresentavam neuropatia, 95,59% com simetria. Na avaliação, 57,35% apresentavam alteração sensitiva protetora; 60,29%, sensibilidade térmica; 26,47%, tátil; 17,64%, vibratória; 7,35%, dolorosa; e 1,47%, alteração cinestésica. Nos pés, 72,05% apresentavam pele ressecada; 64,70%, fissuras; 54,41%, calosidade; e 44,11%, micose; 50% referiram dor; 39,7%, dormência; 41,17%, parestesia; 27,94%, ataxia. Reflexos estavam ausentes ou diminuídos em 14,71% dos indivíduos; desses, 38,23% no Aquileu. Observou-se correlação positiva entre o SPCT com a glicemia e a circunferência abdominal e a hemoglobina glicada com a glicemia. CONCLUSÃO: Houve grande incidência de neuropatia simétrica; alteração de sensibilidade com presença de sinais clínicos, sintomas, arreflexia e hiporeflexia; e incidência de obesidade e hipertensão associadas. Faz-se necessário o acompanhamento da fisioterapia na avaliação da sensibilidade para prevenir, reduzir sintomas e melhorar a circulação sanguínea em MMII.

Resumo: Introdução: O diabetes mellitus tipo 2 (DM2) é um distúrbio crônico com morbimortalidade que limita a qualidade de vida devido às complicações. Objetivo: Avaliar, por meio de questionários, os aspectos físicos, emocionais e sociais que envolvem a doença e a qualidade de vida de pacientes com DM tipo 2 de uma unidade básica de saúde (UBS) de Bauru (SP The impact of diabetes mellitus on the quality of life of patients of Primary Health CareAbstract: Introduction: Diabetes Mellitus type 2 (DM2) is a chronic disorder with morbidity and mortality, which limits the quality of life due to complications. Objective: To evaluate through questionnaires the physical, emotional and social issues surrounding the disease and quality of life of patients with type 2 DM of a Basic Health Unit (BHU) of Bauru/SP. Method: The participants (patients type 2 DM, over 40 years, both genders, registered in the BHU Vila Cardia, Bauru-SP) answered the B-PAID questionnaire (DM impact perspective on quality of life and emotional aspects); DQOL (satisfaction, impact, social/ vocational preoccupation related to DM) and QAD (self-care). The data were presented descriptively, it was correlated with the time of DM with scores of B-PAID and DQOL questionnaires by Spearman correlation (p <0.05). Results: The sample consisted of 59 individuals, aged 63.5 ± 10 years, weight 79 ± 13 kg, BMI 29 ± 4 kg/m 2 . The questionnaire B-PAID indicated score of 19 (11-48) points evidencing low emotional suffering, the DQOL indicated that the most frequent preoccupation were the complications of DM and the QAD found lower adherence in "sweet ingest" and higher in "ingesting the indicated number of drugs". There was a positive correlation of DM time with the score of B-PAID, the shorter the duration of disease, less emotional suffering. Conclusion: It is expected that this study will contribute to provide information about the patients and direct health interventions, aiming to improve the quality of life and self-care of type 2 DM.

To verify whether there are relationships between vascular and hormonal responses to aerobic training in hypertensive persons, sedentary hypertensive patients were randomized to an aerobic training or a callisthenic exercise group. The patients' 24-hour blood pressure, arterial compliance, forearm blood flow, and hormonal profile were evaluated at baseline and after 3-month training protocols. Mean maximal oxygen consumption (VO 2 max) increased by 8% in the aerobic group (P<.001), while no change was observed in the control group. There was a decrease in insulin resistance (homeostatic model assessment of insulin resistance, P=.039) and plasma cortisol (P=.006) in the aerobic group only, that also demonstrated an increase in forearm blood flow (P<.001) after training. No relationship was observed between change in blood pressure or change in body mass and other parameters. Aerobic training can promote a decrease in cardiovascular risk in hypertensive adults by improving vascular function and insulin resistance, despite no changes in ambulatory blood pressure after a 3-month intervention. J Clin Hypertens (Greenwich). 2011;13:89-96. H ypertension is an enormous public health challenge in both industrialized and developing countries, and it is the most important risk factor for cardiovascular (CV) diseases.1 Physical exercise is recommended to help reduce blood pressure (BP) and lower the risk for developing CV disease.2 A recent meta-analysis 3 of randomized controlled trials showed that in a hypertensive population, endurance training reduced resting systolic and diastolic BP by 6.9 mm Hg and 4.9 mm Hg, respectively, and ambulatory systolic BP and diastolic BP (4 studies, 5 groups) decreased by 3.4 mm Hg and 2.7 mm Hg, respectively. Despite this apparent reduction, changes in ambulatory systolic BP were nonsignificant in 3 groups, whereas reductions in diastolic BP were nonsignificant in 4 groups of these studies. These disparate results might be partially explained by methodologic differences, including small sample sizes and poor supervision of prescribed training intensity. Ambulatory BP (ABP) may be the more appropriate method of monitoring BP in exercise studies because, unlike office BP, it is not influenced by the ''white coat effect'' during treatment, placebo-induced hypotension, and regression to the mean phenomenon.

ObjectiveTo associate the pre- and intraoperative variables with postoperative complications of patients undergoing coronary artery bypass graft surgery.MethodsThe pre- and intraoperative risk factors of individuals of both genders with diagnosis of coronary insufficiency undergoing coronary artery bypass graft have been studied.ResultsFifty-eight individuals with median age 62 ± 10 year-old were included in the study, 67% of whom were male. Fourteen (24.1%) patients were smokers, 39 (67.2%) had previous myocardial infarction history, 11 (19%) had undergone coronary angioplasty, 74% had hypertension, 27% had diabetes mellitus, 64% had dyslipidemia and 15.5% had chronic obstructive pulmonary disease. Eighteen (31%) patients presented postoperative complications, most frequent being: infection in surgical incision, difficulties in deambulation, dyspnea, urinary infection and generalized weakness. Male patients had fewer complications than females (P=0.005). Patients with chronic obstructive pulmonary disease remained hospitalized for longer time periods (P=0.019). Postoperative complications occurred in 50% of the patients with creatinine increased, while only 27.1% of the patients with normal value of creatinine had complications (P=0.049). In addition, complications occurred in 50% of the patients with diabetes mellitus, while only 23.8% of patients without diabetes mellitus had complications (P=0.032). The intraoperative factors showed no statistically significant differences.Conclusion The preoperative factors are associated with postoperative complications in patients undergoing coronary artery bypass graft surgery.

RESUMOIntrodução: O exercício físico tem sido proposto como tratamento não farmacológico do diabetes por seu efeito hipoglicemiante. Objetivo: Verificar o efeito agudo do exercício sobre a glicemia capilar em indivíduos diabéticos que fazem uso de insulina ou antidiabéticos orais. Métodos: Foram estudados diabéticos em uso de hipoglicemiantes orais (G1, n=7), não diabéticos (G2, n=8, grupo controle) e diabéticos em uso de insulina (G3, n=8) da Associação de Diabéticos de Bauru (ADB). Foram submetidos a avaliações clínicas, bioquímicas, pressóricas, antropométricas e a uma sessão de exercício aeróbio (60% a 80% FC máx ). A glicemia capilar foi mensurada em oito momentos durante a sessão (M1 ao M8). A análise estatística foi descritiva (média ± desvio padrão), os testes utilizados foram de Kruskal Wallis e Friedman, não paramétricos. Resultados: Participaram 23 indivíduos com idade média 59,35 ± 14,59 anos, 17 do gênero feminino e seis masculino. As taxas de glicemia do M2 ao M8 foram comparadas ao M1, sendo observadas diminuições significativas nos momentos 4, 5, 6, 7, 8 (p≤0,05). Na análise inicial dos grupos G1 e G3 eram obesos e G2 sobrepeso. Na análise da variação da glicemia durante o exercício foi observado que G1 e G3 diferiram nos momentos 2, 3 e 5, G2 e G3 em todos os momentos (p<0,05). Houve redução significativa apenas no G2 (grupo controle), nos momentos 4, 5, 6 e 7 (p<0,05). Conclusão: O exercício tem ação hipoglicemiante, entretanto, nos indivíduos com alteração do metabolismo de carboidratos (G1 e G3), a redução glicêmica não é tão evidente.Palavras-chave: exercício, diabetes mellitus, glicemia. Wallis and Friedman' s. Results: Participants were 23 individuals aged 59.35 ± 14.59 years,17 female and six male. The blood glucose levels of M2 to M8 have been compared to M1, with significant reductions in times 4, 5, 6, 7, 8 (p ≤ 0.05). In the initial analysis of G1 and G3 were obese and G2 overweight. In the analysis of the variation in blood glucose during the exercise, it was observed that G1 and G3 have differed at times 2, 3 and 5, G2 and G3 at all times (p <0.05). There was a significant reduction only in G2 (control group) at times 4, 5, 6 and 7 (p < 0.05). Conclusion: Exercise has hypoglycemic action, however, in individuals with altered carbohydrate metabolism (G1 and G3) glycemic reduction is not so evident. ABSTRACT Introduction: Physical exercise has been proposed as a non-pharmacological treatment of diabetes due to its hypoglycemic effect. Objective: To investigate the acute effect of exercise on blood glucose in diabetics who use insulin or oral antidiabetic agents. Methods: We have studied patients using oral hypoglycemic agents (G1, n=7), non-diabetics (G2, n=8, control group) and patients using insulin (G3, n=8) at the Diabetic Association of Bauru (ADB). Subjects were submitted to clinical and biochemical evaluation, blood pressure and anthropometric measurements and to a session of aerobic exercise (60% to 80% HR max ). Blood glucose was measured at eight times during the session ...

Background: The activity of the renin-angiotensin-aldosterone system (RAAS) is directly related to overweight and sedentary lifestyles, both of which are associated with hypertension. Aerobic exercise helps control blood pressure (BP) by acting on mechanisms of blood pressure regulation, such as plasma renin activity (PRA).

Introduction:The "Hiperdia System" sets goals and guidelines to expand prevention, diagnosis, treatment and control of Diabetes Mellitus and Hypertension. Knowing the epidemiological characteristics of the population is important to strengthen public health programs. Objective: The objective of the study was to describe the sociodemographic pro ile, risk factors and complications of hypertensive, diabetic and hypertensive diabetic people registered in the HiperDia system of the Ministry of Health of the Basic Health Units (Unidades Básicas de Saúde -UBS) in Barra Bonita, São Paulo State. Methods: This is a descriptive cross-sectional study, which used 113 medical records of diabetic and hypertensive patients as a data source for information about gender, age, race, education, marital status, body mass index (BMI), family history, smoking, sedentarism, acute myocardial infarction, stroke, kidney disease, amputation and diabetic foot. Descriptive statistics were used. Results: As a result, the epidemiological pro ile of patients registered in the HiperDia system was characterized by: a mean age of 57.3 years; 61.9% women, 82.1% Caucasians, 66.4% with education level up to incomplete primary education, 48.5% lived with partners and children, 19.5% were smokers, 51.4% were sedentary, 44.3% were overweight and obese and 69% had a diagnosis of hypertension and diabetes. Conclusion: The results were relevant allowing professionals and health managers to institute preventive programs to intervene in the risk factors involved in the genesis and complications of hypertension and diabetes.