No abstract

The purpose of this study was to evaluate and compare the effectiveness of muscle-strengthening exercises (MS) and a walking program (WA) in reducing pain in patients with fibromyalgia. Ninety women, 30-55 years of age, diagnosed with fibromyalgia according to the American College of Rheumatology 1990 criteria, were randomized into 3 groups: WA Group, MS Group, and control group. Pain (visual analog scale) was evaluated as the primary outcome. Physical functioning (Fibromyalgia Impact Questionnaire, FIQ), health-related quality of life (Short-Form 36 Health Survey, SF-36), and use of medication were evaluated as secondary outcomes. Assessments were performed at baseline, 8, 16, and 28 weeks. Intention-to-treat and efficacy analyses were conducted. Sixty-eight patients completed the treatment protocol. All 3 groups showed improvement after the 16-week treatment compared to baseline. At the 28-week follow-up, pain reduction was similar for the WA and MS groups (P = 0.39), but different from the control group (P = 0.01). At the end of the treatment, 80% of subjects in the control group took pain medication, but only 46.7% in the WA and 41.4% in the MS groups. Mean FIQ total scores were lower for the WA and MS groups (P = 0.96) compared with the control group (P < 0.01). Patients in the WA and MS groups reported higher scores (better health status) than controls in almost all SF-36 subscales. MS was as effective as WA in reducing pain regarding all study variables; however, symptoms management during the follow-up period was more efficient in the WA group.

The association of progressive strength training for the quadriceps and the proprioceptive training is effective for the prevention of falls, increasing the muscle power, the static and dynamic balance and increasing the speed of the motor responses, therefore improving the performance of daily activities.

BackgroundOsteoarthritis (OA) is one of the most prevalent musculoskeletal diseases. Diacerein acts differently from traditional non-steroidal antiinflammatory drugs (NSAIDs) which inhibit prostaglandin synthesis, leading to adverse gastrointestinal effects. It has been proposed that diacerein acts as a slow-acting, symptom-modifying and perhaps disease-structure modifying drug for OA. ObjectivesTo assess the effectiveness and safety of diacerein for treatment of OA in adults with peripheral or axial osteoarthritis according the American College of Rheumatology and/or EULAR diagnostic criteria. Search methodsWe searched MEDLINE (1966-2004), EMBASE (1980-2004, Cochrane Central Register of Controlled Trials (CENTRAL), The Cochrane Library, Issue 3, 2004, and LILACS(1982-2004 and hand searched reference lists of published articles. Pharmaceutical companies and authors of published articles were contacted. There was no language restriction.

Background: Muscle weakness, especially of the quadriceps muscle, is one of the major musculoskeletal effects of knee osteoarthritis. Exercises are considered one of the main interventions in the conservative treatment of those patients. Objective: To assess the effectiveness of quadriceps strengthening exercises on functional capacity and symptoms related of knee osteoarthritis by use of the Timed Up and Go test (TUG), the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and the Lequesne Index. Methods: One hundred patients were randomized into two groups: 1) Exercise Group (n = 50), which included stationary bicycle, hamstrings stretching, and quadriceps strengthening; 2) Instruction Group (n = 50), which received a manual with information about knee osteoarthritis and instructions on how to deal with knee symptoms in daily activities. The manual did not include exercise instructions. Results: The Exercise Group showed statistically signifi cant improvement regarding the TUG test, the WOMAC aspects of pain, function, and stiffness, and the Lequesne Index, as compared with the Instruction Group. Conclusion: Quadriceps strengthening exercises for eight weeks are effective to improve pain, function, and stiffness in patients with knee osteoarthritis.

CONTEXT AND OBJECTIVE Neuromuscular electrical stimulation (NMES) has been used in rehabilitation protocols for patients suffering from muscle weakness resulting from knee osteoarthritis. The purpose of the present study was to assess the effectiveness of an eight-week treatment program of NMES combined with exercises, for improving pain and function among patients with knee osteoarthritis. DESIGN AND SETTING Randomized clinical trial at Interlagos Specialty Ambulatory Clinic, Sao Paulo, Brazil. METHODS One hundred were randomized into two groups: NMES group and control group. The following evaluation measurements were used: numerical pain scale from 0 to 10, timed up and go (TUG) test, Lequesne index and activities of daily living (ADL) scale. RESULTS Eighty-two patients completed the study. From intention-to-treat (ITT) analysis comparing the groups, the NMES group showed a statistically significant improvement in relation to the control group, regarding pain intensity (difference between means: 1.67 [0.31 to 3.02]; P = 0.01), Lequesne index (difference between means: 1.98 [0.15 to 3.79]; P = 0.03) and ADL scale (difference between means: -11.23 [-19.88 to -2.57]; P = 0.01). CONCLUSION NMES, within a rehabilitation protocol for patients with knee osteoarthritis, is effective for improving pain, function and activities of daily living, in comparison with a group that received an orientation program. CLINICAL TRIAL REGISTRATION ACTRN012607000357459.

RESUMOOBJETIVO. Avaliar a ocorrência de incontinência urinária (IU) em atletas corredoras de longa distância e associá-la a presença ou não de distúrbios alimentares. MÉTODOS. Um total de 37 corredoras de longa distância completaram os questionários ¨International Consultation on Incontinence Questionnaire-Short Form¨ (ICIQ-SF) e o ¨Eating Attitudes Test¨ . O teste do absorvente de uma hora foi realizado para quantificar a perda de urina. A análise estatística das variáveis contínuas foi feita pelo teste t pareado, ou teste de Mann-Whitney. RESULTADOS. 23 atletas (62,2%) tinham queixa de perda de urina. A média dos escores do ICIQ-SF neste grupo foi de 4,03 ± 5,06. Houve diferença estatisticamente significante entre o valor do teste do absorvente (p=0,02) e o resultado do questionário 03) INTRODUÇÃOAs corridas de longa distância, praticadas em vias públicas, incluem: provas de 10 km, meia maratona (21,095km) e maratona (42,195km) 1 . Também chamada de "pedestrianismo", esta modalidade esportiva vem crescendo e atraindo adeptos em todo o mundo. Os corredores, profissionais ou amadores, treinam diariamente, sob a supervisão de um técnico, e participam de competições em busca de superação, recordes ou melhora da qualidade de vida.As distâncias percorridas, assim como as diferenças de superfície e as características da prova, exigem do atleta técnica e estratégias específicas. A biomecânica da corrida de longa distância difere da mecânica das demais provas de corrida 2 . Também é importante ressaltar o aumento da participação feminina neste tipo de modalidade esportiva, e que a mulher atleta não pode ser avaliada e treinada da mesma forma que o homem 3 . Além das alterações hormonais fisiológicas envolvidas no ciclo menstrual, os técnicos e preparadores físicos devem estar cientes de eventuais distúrbios clínicos que podem ocorrer, como a incontinência urinária e os distúrbios alimentares 3 . A incontinência urinária (IU) é definida pela Sociedade Internacional de Continência (ICS) como qualquer perda involuntária de urina 4,5,6 . Estudos mostram que a prevalência da IU durante a prática esportiva nas atletas de elite varia de 0% (golfe) até 80% (trampolinistas) 7,8 . As maiores prevalências ocorrem em esportes que envolvem atividades de alto impacto como: ginástica, atletismo e alguns jogos com bola 7,9 . Uma grande proporção destas atletas relata que a perda de urina é muito embaraçosa e que afeta a concentração e a performance 6,10 . Algumas teorias tentam explicar a ocorrência de IU nas atletas. Uma delas afirma que, embora as atletas tenham os músculos do assoalho pélvico fortes, a atividade física árdua levaria ao aumento da pressão abdominal, predispondo a IU 9 . Outros autores acreditam que estas atletas têm sobrecarga, estiramento e enfraquecimento do assoalho pélvico 6, 11 . Reforça esta teoria o fato de que a força vertical de reação máxima do solo durante diferentes atividades esportivas é três a quatro vezes o peso do corpo quando corremos, cinco a 12 vezes pulando, e nove vezes na queda após u...

Interventions for treating traumatised permanent front teeth: luxated (dislodged) teeth.