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BACKGROUND: Squats are considered one of the main exercises for the lower limbs and are used in resistance training under different contexts, including rehabilitation and sports performance. OBJECTIVE: To compare the EMG activity of different muscles in back squat and lunge exercises in trained women. METHODS: Ten healthy women experienced in resistance training performed back squat and lunge exercises on a Smith machine (total work: 70% of 1RM, 1 set, 10 repetitions and 2-s/2-s of execution speed) with an interval of 20-min between exercises. Both exercises were standardized in relation to the trunk inclination and were performed with an erect trunk parallel to the cursor of the guided bar. RESULTS: The EMG activity of the vastus medialis (VM), vastus lateralis (VL), biceps femoris (BF), and gluteus maximus (GM) were analyzed. There were no significant differences in the EMG activity of the VM, VL, and BF muscles between the back squat and lunge exercises (P> 0.05); however, GM activation was greater during the lunge exercise (effect size = 1.15; P= 0.001). CONCLUSIONS: Lunges were more effective in recruiting the GM when compared to back squats. However, both exercises can be recommended when the goal is knee extensor and flexor muscle activity.

Objective: The aim of this study was to evaluate the inter- and intra-examiner reliability of infrared thermography (IT) in skin temperature analysis of people with pain complaints in the upper trapezius muscle. Methods: A total of 82 subjects (24.8 ± 6.9 years; 63.8 ± 13.1 kg) of both genders who had moderate (VAS-3) or severe pain in the upper trapezius muscle were evaluated. Skin temperatures of four areas (ROIs) were analyzed by IT using a FLIR camera (model T640SC - Sweden). Each evaluator performed two area analyses at different times. Results: The evaluation of the four areas indicated a very strong overall intraclass correlation coefficient (ICC) for both intra-examiner (Examiner 1: ICC = 0.936; 95% CI = 0.905–0.959; P < 0.001; Examiner 2: ICC = 0.979; 95% CI = 0.968–0.987; P < 0.001) and inter-examiner (Measurement 1: ICC = 0.933; 95% CI = 0.902–0.958; P < 0.001; Measurement 2: ICC = 0.979; 95% CI = 0.968–0.987; P < 0.001). The ICC was regular on ROI 3 in the measurement 1 inter-exam test, and the ROI 1, ROI 2, and ROI 4 values were strong; all points were very strong in measurement 2. The ICC was rated from strong to very strong for both examiners in the intra-examiner test at all points. Conclusion: IT was reproducible in measuring the upper trapezius muscle skin temperature, and the intra and inter-examiner agreement levels can be used as a reliable tool in clinical practice.

Objective: The aim of this study was to evaluate the impact of therapeutic pool training on static and dynamic balance of sedentary elderlies. Method: 10 elderly individuals took part in the study (63.10 ± 2.33 years), and they were submitted to 24 sessions of intervention, twice a week. The assessment tools were the Balance System, Timed Up and Go Test (TUGT) and the Berg Balance System (BBS). Results: The results showed that there was a significant decrease in the global postural stability, anterior/posterior and medial/lateral scores evaluated in the dynamic platform, as well as the static global postural stability score, reduction in time to perform the TUGT and increase in the Berg Balance System score. However, no significant differences were verified in the Postural Stability tests (anterior/posterior and medial/lateral with the static platform) and in the Fall Risk. Conclusion: The regular physical training in therapeutic pool can provide sedentary elderly individuals with a significant improvement in dynamic balance.

Background: The calcific tendinitis of the shoulder is a dysfunction conservatively treated by shock waves, iontophoresis, and phonophoresis, associated or not with the use of acetic acid. Objective: To check the effects of phonophoresis with acetic acid in the treatment of calcific tendinitis of the shoulder in resorption stage. Methods: Measurements of ROM, muscle strength and functionality of the shoulder (SPADI) were made pre and post-physiotherapeutic treatment. The treatment protocol consisted of 10 sessions of therapeutic ultrasound with acetic acid (frequency = 3 MHz; intensity = 1.4 W/cm2; pulsed mode of 1:4), for 10 minutes, 3 times a week. The data were analyzed using the SPSS software (20.0), through the Student’s t-test (paired) considering a significance level of 5%. Results: There was significant improvement regarding the ROM, muscle strength and functionality of the right shoulder (SPADI) comparing pre vs. post-treatment (P0.05), in the comparison between the shoulders (right X left) in the post-treatment. Conclusion: According to the results of this case study, the protocol used (10 sessions of therapeutic ultrasound + 5% acetic acid) was effective in the treatment of calcific tendinitis of shoulder, improving the ROM, muscle strength and functional capacity, in addition to eliminating the pain of the shoulder affected.

Introduction: The cuff pressure is measured in industrial equipment, however, be valid in the craft equipment is still questioned. Objective: To evaluate the reliability of the measurement methods of cuff pressure endotracheal tubes with industrialized and handmade equipment. Method: Were analyzed 40 endotracheal tubes, two brands (Solidor and Ruschelit) and different diameter (8,0 mm and 8,5mm), inflated 20mL of air in the pilot balloon with plastic syringe and 20 mL, followed by pressure measurement device with industrial (cmH2 O) and handmade device (mmHg). After the conversion of cmH2O values for mmHg, the reliability and agreement of measurements were performed by intra-class correlation (ICC) and Bland-Altman tests, respectively, using SPSS (version 15.0) and adopting a significance level of 5% for all comparisons. Results: The data showed similarity between the different pressure equipment, brands and diameter, and demonstrated strong correlation and agreement between the methods. Tube Rus8,0mm industrial versus handmade (28.2±5.8 vs 28.4±6.2 mmHg: ICC=0.998; bias=0.20); Tube Solidor8.0mm industrial versus handmade (75.9±1.1 vs 76.4±1.2 mmHg: ICC=0.878; bias=0.40); Tube Rus8.5mm industrial versus handmade (17.1±8.8 vs 17.8±8.9 mmHg: ICC=0.999; bias=0.67); Tube Sol8.5mm industrial versus handmade (78.7±4.7 vs 78.6±4.6 mmHg: ICC=0.996; bias=-0.1). Conclusion: The high reliability and agreement presented in this study suggest that the cuff pressure gauge handmade can be used safely to evaluate the cuff pressure of the endotracheal tube.

Background: Chronic obstructive pulmonary disease (COPD) modifies the electrical activity of accessory respiratory muscles, also leading to a marked peripheral muscular dysfunction, measured by the handgrip strength taken as an indicator of total body strength. Objective: To compare the effects of two different physiotherapeutic programs on handgrip strength and myoelectric activity in COPD patients. Methods: Participated in the study 17 individuals, randomly allocated into 2 groups: 1) Maneuvers: 62.7±15.4 years, 1.65±0.12 m, 81.4±18.2 kg, BMI: 29.9±5.0 kg/m2 ; 2) Threshold: 64.4±11.2 years, 1.58±0.08 m, 70.7±9.4 kg, BMI: 28.6±3.7 kg/m2 , diagnosed with COPD, submitted to surface electromyographic (sEMG) evaluation of sternocleidomatoid (SCM) and anterior scalene (AS), and handgrip strength, before and after the interventions. The data were analyzed with SPSS (20.0). Pared t-student and Wilcoxon tests were used to compare mean values of the handgrip strength and the Root Mean Square (RMS) of the sEMG signal (SCM and AS muscles), pre- and post-interventions. In addition, independent t-Student and Mann-Whitney tests were used to compare the RMS average of the sEMG signal between the right and left sides. Significant level was set at 5%. Results: When comparing pre and post-intervention values, there was a significant increase for the Threshold group handgrip strength (P=0.037). It was observed a sEMG activity of SCM and AS during dynamometry, vital capacity, forced vital capacity on inspiratory and expiratory pressure (P

Background: Chronic Obstructive Pulmonary Disease (COPD) treatment includes a multidisciplinary approach, with physiotherapy a prominent role that promotes a positive impact on the quality of life (QOL) of these patients. Objective: To analyze the effects of physiotherapeutic interventions on QOL, lung volumes and capacities, and respiratory muscle strength in COPD patients. Methods: 17 subjects participated in the study, randomly divided into 2 groups: 1) Maneuvers: 62.7 ± 15.4 years, 1.65 ± 0.12 m, 81.4 ± 18.2 kg, body Mass Index (BMI) 29.9± 5.0 kg/m2 ; 2) Threshold: 64.4 ± 11.2 years, 1.58 ± 0.08 m, 70.7 ± 9.4 kg, BMI 28.6 ± 3.7 kg/m2 , with COPD, without neurological, musculoskeletal, cardiovascular or cognitive impairment, which made it impossible to participate in the physiotherapeutic intervention programs. QOL was analyzed using the Saint George Hospital questionnaire on Respiratory Disease (SGRQ); spirometry and respiratory muscle strength were analyzed by manovacuometry using a pneumotachograph. Data were analyzed in SPSS (20.0), Student’s t-test (paired) and Wilcoxon test were used for pre and post-intervention comparison of the SGRQ domains and total score, Vital Capacity (VC), Forced Vital Capacity (FVC), Forced Expiratory Volume (FEV1 ), Maximal Inspiratory Pressure (MIP) and Maximal Expiratory Pressure (MEP); and Student’s t-tests (independent) and Mann-Whitney were used in the intergroup comparison, all with a significance level of 5%. Results: There was a significant difference in both groups (P

Background: The anterior cruciate ligament (ACL) lesion causes a deficit in joint stability and mobility, trophism and muscular strength, generating asymmetries between the lower limbs. Objective: To verify the effect of a physiotherapeutic protocol on the Lower Limb Symmetry Index (LLSI) and the correlation between strength and EMGs, pre and post reconstruction of the ACL. Methods: Twenty subjects (10 ACLrg + 10 CONTg) were evaluated regarding isometric force and electrical activity of knee extensors, knee flexors and hip abductors. Results: A significant increase (P

Background Circular dance CD has been used to improve flexibility posture strength and muscle resistance thereby reducing pain and tension Lumbar segmental stabilization LSS is a therapeutic approach that aims to improve the neuromuscular control strength and resistance of muscles that provide spinal stability Objective Compare the effect of CD and LSS on pain and functional disability of women with nonspecific chronic low back pain NCLBP Method The nbsp sample nbsp will nbsp consist nbsp of nbsp nbsp women nbsp aged nbsp between nbsp nbsp and nbsp nbsp years nbsp with nbsp nonspecific chronic low back pain and intensity ge points on the Numerical Pain Scale NPS divided into groups CD group participants LSS group participants Sixteen nbsp minutes nbsp sessions nbsp will nbsp be nbsp held nbsp twice nbsp a nbsp week nbsp for nbsp both nbsp groups nbsp The nbsp primary nbsp outcomes will be assessed using the Numerical Pain Scale and Rolland Morris Disability Questionnaire and the secondary outcomes by the Beck Depression Inventory Numerical Anxiety Scale Global Perceived Effect GPE scale Report of Symptoms and Adverse Events or Side Effects and the SF Quality of Life Questionnaire at pre treatment and and weeks post treatment Results It is hoped to obtain results that allow defining the possibility of using CD as a simple alternative to be applied inexpensive viable to be used in the public health system with nbsp results nbsp equivalent nbsp if nbsp compared nbsp to nbsp a nbsp treatment nbsp already nbsp founded nbsp in nbsp the nbsp literature nbsp as nbsp an nbsp effective nbsp treatment nbsp for nbsp chronic nbsp back nbsp pain Statistical nbsp analysis nbsp will nbsp be nbsp conducted nbsp using nbsp Statistical Package for the Social Sciences software SPSS applying descriptive and inferential statistics Discussion This study is expected to broaden the use of CD in the national health system as an effective and efficient therapy which could benefit women with NCLBP to have improved motor functions and emotional aspect of this population as well and ameliorate the quality of life

The study aimed to analyze the effect of different levels of blood flow restriction (BFR) on energy expenditure (EE) and subjective perceptions of discomfort (SPD) during aerobic exercises. A sample group of 24 young men was required to walk on a treadmill for 14 min at 40% of their maximum speed, with 4 different percentages of BFR (0, 50, 80 and 100%) applied in the lower limbs (LL) once a week with a 7-day interval between the 4 evaluations. EE data were collected during the exercise periods; SPD data were collected after the exercises. There was a significant increase in EE at 50, 80 and 100% BFR compared to the condition without BFR, and between 50 and 100% BFR; however, there were no differences between 50 and 80% and 80 and 100% BFR. Discomfort showed a significant increase according to the increase in BFR. During the walking exercises with BFR, the EE strongly increased until 50% of BFR; after this level the additional increases slowed. It can be concluded that when performing aerobic exercises with BFR, there is no need to use BFR levels above 50% to reach satisfying level of EE with only a moderate level of discomfort to the practitioner. This study was registered in the Brazilian Registry of Clinical Trials (REBEC) under number RBR-3XHSJX.

Objective To analyze the effects of electrolysis, through a medium frequency current, associated to aerobic physical activity in the body composition of young women. Methods The study was composed of 34 sedentary women (24.35 ± 4.43 years, 71.30 ± 7.08 kg, 1.61 ± 0.06 m, 27.31 ± 1.67 kg/m2) which were evaluated for their anthropometric measures and body composition. The volunteers were randomly assigned to two group: Electrolyphysis plus Aerobic Exercise (gEEA): 17 volunteers were submitted to the application, for 60 minutes, of the Aussie current, followed by aerobic physical activity (77% of HRmax) on the trampoline for 40 minutes, through video-lessons of Jump; and Aerobic Exercise group (gEA): 17 volunteers performed only physical activity following the same parameters mentioned above. Each group performed its protocols twice weekly, for 5 weeks, totaling 10 sessions. For the data analysis, measures repeated ANOVA was performed to compare the means of the variables analyzed before and after the treatment protocols using the SPSS - 21.0 software, adopting a p ≤ 0.05. Results Although gEEA decreased suprailiac skinfold (p = 0.04), abdominal skinfold (p = 0.03) and circumference at umbilical scar (p = 0.02) in a intragroup analysis, these means differences in anthropometric measures were not important between-groups (p > 0.05). Furthermore, there were no effect of treatment on body composition (p > 0.05). Conclusion To this studied condition, our results suggested that application of medium frequency electrolysis did not enhance the losses on anthropometric measures and body composition.

The purpose of this study was to compare the effects of nonelastic adhesive tape, dynamic bracing, and no-tape/brace on static and dynamic balance during single-leg stance in women’s college volleyball. Seventeen young uninjured players (18.94 ± 2.49 years; 1.71 ± 0.05 m; 65.45 ± 9.49 kg; 9.2 ± 4.1 years played; 4 ± 1 weekly training frequency) were submitted to three conditions presented in randomized order: dynamic bracing; nonelastic adhesive tape and no-tape/brace. In all conditions, the center of gravity displacement (total displacement, TD; anteroposterior displacement, APD and mediolateral displacement, MLD) of the dominant and non-dominant lower limb (DLL and NDLL) was assessed using the static and dynamic platform of the Biodex Balance System. The ANOVA (three-way) test with repeated measures was applied, considering a 5% significance level. The results showed no interaction between any of the independent factors in all displacements (p > 0.05). However, there was a significant main level effect for TD (p = 0.001, mean difference = 1.1°) and MLD (p = 0.013, mean difference = 0.30°), with greater displacement in the dynamic level compared to its static counterpart. There was also a significant main limb effect for APD (p = 0.003, mean difference = 0.73°) and MLD (p ≤ 0.001, mean difference = 0.60°), with a higher degree of instability in MND when compared to MD. In conclusion, the data indicated that the use of nonelastic tape and bracing was not superior to the no-tape/brace condition in controlling center of gravity displacement during single-leg stance.

O objetivo deste estudo foi analisar, qualitativamente, alterações na postura estática dos borracheiros de João Pessoa - PB, decorrentes de suas atividades de trabalho. A amostra constou de 9 sujeitos, do sexo masculino, com 30,5 ± 12,6 anos de idade, 10 ± 9,18 anos de trabalho, 73,2 ± 10,9kg de massa corporal, e 1,66 ± 0,07m de estatura. Eles se posicionaram sobre um estrado, alinhados a um simetrógrafo, e fotografados em posterior e perfi l. A análise e classifi cação das modifi cações do alinhamento corporal foram feitas por meio do New York Posture Rating Test, em diversas estruturas anatômicas (pés, joelhos, pelve, abdome, tronco, ombros e cabeça), de 13 pontos do corpo. Os sujeitos 1, 2, 3, 7 e 8 (55,5%) foram classifi cados como portadores de alterações severas (49 a 51 pontos), e os sujeitos 4, 5, 6 e 9 (44,5%) de alterações moderadas (53 a 59 pontos). A dor esteve presente em 55% dos sujeitos (1, 4, 7, 8 e 9). Os resultados sugerem que o método de avaliação se mostrou adequado, e que as posturas assumidas nas tarefas podem causar deformidades, desconforto, dores e incapacidades funcionais temporárias, alertando para a necessidade da elaboração de uma cartilha sobre orientação postural, e da aplicação de programas de fi sioterapia preventiva. Palavras-chave: avaliação, biomecânica, ergonomia, postura.

Introdução: Na natação, de modo geral, as estruturas que compõem o ombro são afetadas pelo gestual esportivo, porém, não se pode afirmar que isso promove o impingement. Objetivo: Avaliar o efeito da natação sobre o espaço subacromial, a amplitude de movimento e a força de rotação medial e lateral dos ombros de nadadores. Métodos: Foram analisados 52 sujeitos de ambos os gêneros, entre 12 e 17 anos e divididos em 2 grupos pareados: 1) grupo experimental: 26 nadadores (14 homens e 12 mulheres) e grupo controle: 26 sujeitos ativos não nadadores (13 homens e 13 mulheres). Resultados: Os dados foram analisados no SPSS (20.0) pelos testes t Student (independente) e Mann-Whitney, considerando-se α ≤ 0,05. A força de rotação medial foi 57 e 54% maior que a força de rotação lateral no grupo experimental (P

O objetivo deste estudo foi quantifi car forças e momentos na coluna lombar de borracheiros, durante suas atividades ocupacionais e diferenciá-los de acordo com suas massas corporais. Dois homens foram avaliados: sujeito 9 (46 anos; 95 kg; 1,59 m; 0,87 m da pelve ao chão; 10 anos de profi ssão) e sujeito 2 (18 anos; 61 kg; 1,57 m; 0,83 m da pelve ao chão; 3 anos de profi ssão). Ambos tiveram suas tarefas fi lmadas e avaliadas por meio do software Humanoid Articulation Reaction Simulation (HARSim). Foram selecionadas 11 posturas com fl exão de tronco a: 1) 90º + 700N de força; 2) 90º + 350N de força; 3) 45º + 700N de força; 4) 45º + 350N de força; 5) 20º + fl exão dos joelhos; 6) 45º + fl exão dos joelhos; 7) 45º; 8) 90º; 9) 90º + rotação 20º; 10) 90º + rotação 10º; 11) 0°; e calculados: pressão intradiscal (PID), momento de fl exão anterior (MFA), força de cisalhamento (Fcis) e força axial (Faxial). Em todas as posturas, o sujeito 9 apresentou maior Fcis (p = 0,023). Porém, a PID, o MFA, a Fcis e a Faxial foram, respectivamente, em média, 79,5% (8 posturas), 124% (7 posturas), 53,7% (6 posturas) e 43% (1 postura) acima dos limites estabelecidos pelo National Institute for Occupational Safety and Health (NIOSH), para o sujeito 9, e de 94,2% (4 posturas), 88,4% (5 posturas), 66,3% (3 posturas) e 21% (1 postura), para o sujeito 2. O aumento da fl exão do tronco e da massa corporal, aliados í rotação, na presença de cargas externas, podem gerar forças e momentos que promovam lesões vertebrais. Palavras-chave: postura, estresse, ergonomia, biomecânica ocupaciona

Introdução: O processo de envelhecimento é acompanhado pela diminuição do controle da coordenação e do equilí­brio, constituindo fator de risco para quedas e perda da independência. No entanto, a prática de atividade fí­sica moderada, como a desenvolvida na Escola de Posturas, tem se mostrado benéfica para a prevenção, manutenção e retardo das deficiências funcionais do envelhecimento. Objetivo: Verificar os efeitos de um programa de Escola de Posturas sobre o equilí­brio e a coordenação de idosos não institucionalizados. Métodos: Doze indiví­duos (67 ± 6,8 anos) participaram de um programa de Escola de Posturas (16 aulas teórico-práticas e 4 sobre o processo de envelhecimento), realizado duas vezes por semana durante 10 semanas. Para avaliar o equilí­brio e a coordenação foi utilizada a Avaliação da Mobilidade Orientada pelo Desempenho da Marcha e Equilí­bio - POMA, de Tinetti (adaptado), aplicada antes e após o término do programa. Para a comparação das variáveis entre as avaliações foi aplicado o teste não-paramétrico de Wilcoxon, com um ní­vel de significância de 5%. Resultados: Houve melhora no equilí­brio e na coordenação (p < 0,01) após o término do programa. Conclusão: A forma intervencionista teórico-prática do programa de Escola de Posturas melhorou o equilí­brio e a coordenação dos idosos.Palavras-chave: envelhecimento, terapia por exercí­cio, promoção da saúde

A UFPB tem o orgulho de promover o I CONCIFI – Congresso Cientí­fico de Fisioterapia. No perí­odo de 5 a 8 de novembro, estudantes e professores de graduação e pós-graduação de Fisioterapia estarão reunidos na cidade de JoãoPessoa para debater e divulgar o conhecimento cientí­fi co da Fisioterapia Brasileira.O CONCIFI foi idealizado com o propósito de facilitar o intercâmbio entre pesquisadores da Fisioterapia e promover a discussão sobre temas polí­ticos acerca da profi ssão e da formação acadêmica na área. Nesta perspectiva, a temática central do evento em sua primeira edição favorece a discussãosobre o papel da Fisioterapia, a sua inserção no Sistema Único de Saúde (SUS), e a diversidade de experiências em todos os ní­veis de atenção e complexidade.No intuito de conhecer os caminhos trilhados pelos egressos da UFPB e promover o congraçamento entre os Fisioterapeutas oriundos da instituição, o CONCIFI promove também o I Encontro de Ex-Alunos do Curso de Fisioterapia da UFPB. Nesta oportunidade, a temática do mercado de trabalho será abordada e o evento será fi nalizado com uma festa de confraternização.Agradecemos a confi ança e a participação de todos que tornam este evento uma realidade e convido aos acadêmicos, profi ssionais e pesquisadores da Fisioterapia do Brasil a compartilhar conosco desta atmosfera de crescimento cientí­fico e desfrutar dos encantos da cidade mais verde e o mar maislindo do Brasil – João Pessoa.Prof. Dr. José Jamacy de Almeida FerreiraPresidente do I CONCIFI

Mensagem do PresidenteEm novembro de2009 aUFPB promoveu o I CONCIFI – Congresso Cientí­fico de Fisioterapia, reunindo estudantes, professores e profissionais de Fisioterapia na cidade de João Pessoa. O evento foi um sucesso, tendo a aprovação maciça dos congressistas, que puderam participar de momentos de troca de conhecimentos cientí­ficos de Fisioterapia nos mini-cursos, palestras, mesas-redondas e apresentações de temas livres e painéis.O CONCIFI foi idealizado com o propósito de facilitar o intercâmbio entre pesquisadores da Fisioterapia e promover a discussão sobre temas cientí­ficos e polí­ticos acerca da profissão e da formação acadêmica na área. Tendo em vista a importância de fomentar momentos que promovam o crescimento da Fisioterapia no Brasil, continuamos com o intuito de facilitar este intercâmbio entre professores, estudantes e profissionais que se interessam em produzir conhecimentos na área. Neste sentido, a UFPB tem o orgulho de realizar a segunda edição deste evento, que realizar-se-á no perí­odo de4 a7 de novembro de 2010.A temática da segunda edição do CONCIFI é "A Fisioterapia da pesquisa í prática clí­nica: convergências e divergências". Temos o interesse em abordar temas relacionados í prática clí­nica baseada em evidências, fortalecendo a aplicação dos conhecimentos em Fisioterapia por meio da reflexão sobre os achados atuais na área.Agradecemos a confiança e o comprometimento de todos que tornam este evento uma realidade e convidamos os acadêmicos, profissionais e pesquisadores da Fisioterapia do Brasil a compartilhar conosco da atmosfera de crescimento cientí­fico proposta pelo CONCIFI, além de desfrutar dos encantos da cidade mais verde e o mar mais lindo do Brasil – João Pessoa.Profa. Dra. Palloma Rodrigues de Andrade

The objective of the present study was to evaluate the reliability of intra-rater and inter-instrument measures during two flexibility programs. Fifty-three active and healthy males, aged between 18 and 28 years old, were randomly included in three groups: control (Cg, n = 18), static stretching (SSg, n = 17), and dynamic stretching (DSg, n = 18). All participants underwent measurements of their active range of knee extension using manual goniometry and computerized photogrammetry, measured in four separated assessments and analyzed using the SPSS, with ((5%. Both methodologies presented very strongintra-raterreliability (ICC: 0.91(0.99; P

The study aimed to investigate the change in the skin temperature after exercise-induced delayed onset muscle soreness (DOMS) and after cold water immersion during a recovery period. Randomized controlled trial. Thirty-nine participants were randomly divided into four groups: group 1 (G1) which performed aerobic exercise; group 2 (G2) only performed plyometric exercise; group 3 (G3) was submitted to plyometric exercise and cold water immersion (CWI) protocol; and group 4 (G4) was the non-exercised control group. Skin temperature (TsK) was collected in two regions of interest (forehead and anterior thigh) at rest (T-rest), immediately after exercise (T0), 10, 20, and 30 min (T10, T20, and T30), and 24 and 48 h (T24 and T48) after exercise using an infrared camera. In addition, isometric knee extension strength and DOMS were assessed at times T-rest, T0, T24, and T48 for all groups. A higher skin temperature was indicated in the anterior thigh muscles that performed plyometric exercise (G2). This thermographic change was accomplished by a decrease in the knee extensor strength immediately after performing exercises. In addition, it seems clear from our data that CWI was effective in reducing Thigh’s TsK until 30 min after exercise, but had no effect on the Thigh’s TsK 24 and 48 h after exercise. CWI attenuated pain inducted by muscle compression 48 h after plyometric exercise. This paper presents evidence that plyometric anaerobic exercise leads to a higher skin temperature on the exercised muscle groups than aerobic exercise and that the application of CWI has no influence on muscle temperature 24 h after exercise while minimizing DOMS and the deficit of isometric force.

Background:The response to treatment in spondylarthropaties is heterogeneous, due to factors yet to be better described. For that reason, it is important to find tools that might help clinicians to decide what is the best available therapeutic option for each patient.Objectives:The goal of this study is to use comprehensive molecular profiling to characterize clinical response to therapy in a real-world setting. Specifically, to identify molecular biomarkers differentiating good responders and non-responders to TNF inhibitors (TNFi) treatment, using adalimumab, in radiographic axial spondyloarthritis | ankylosing spondylitis (r-axSpA|AS) patients context.Methods:Whole-blood mRNA and plasma proteins were measured in a cohort of biologic naïve r-axSpA|AS patients (n = 35) from the Bioefficacy study (Biomarkers identification of anti-TNF alpha agent efficacy in AS patients using RNA sequencing and mass spectrometry), pre and post (14 weeks) TNFi treatment using adalimumab. Response to treatment was categorized according to ASAS20. Results of differential expression analysis were used to identify the most enriched pathways and in predictive models to distinguish responses to TNFi.Results:A treatment-related signature, independent of the type of response, suggests a reduction in inflammatory disease activity. We found genes and proteins robustly differentially expressed between baseline and week 14 in responders, including the GWAS AS-associated genes TNFRSF1A, FCGR2A, TYK2, TBKBP1, IL1R1, IL6R, ICOSLG, IL7R, HHAT and LTBR. Moreover, CRP and HP proteins showed strong and early decrease in the plasma of AS patients, while a cluster of apolipoproteins (APO1, APO2, APO3) showed an increased expression at week 14. Good responders to TNFi treatment tend to have higher expression of innate immunity genes at baseline, and lower expression of markers associated with adaptive immunity, particularly B-cells. A logistic regression model incorporating ASDAS-CRP, gender and Gene x, the top differentially expressed gene at baseline between responders and non-responders, enabled an accurate prediction of response to adalimumab in our cohort (AUC=0.97).Conclusion:Differences in disease activity and/or innate/adaptive immune cell type composition at baseline may be a major contributor to response to adalimumab in r-axSpA|AS. Alternatively, a model including clinical and gene expression variables could be considered, particularly in patients with mild disease activity.Disclosure of Interests:None declared

The present study aimed to analyse the effects of six weeks of strength training (ST), with and without blood flow restriction (BFR), on torque, muscle activation, and local muscular endurance (LME) of the knee extensors. Thirty-seven healthy young individuals were divided into four groups: high intensity (HI), low intensity with BFR (LI+BFR), high intensity and low intensity + BFR (COMB), and low intensity (LI). Torque, muscle activation and LME were evaluated before the test and at the 2nd, 4th and 6th weeks after exercise. All groups had increased torque, muscle activation and LME (p

Introduction: Low back pain leads to hypotrophy, changes in motor control and lumbar instability, requiring appropriate treatment. Objective: To analyze the effect of physiotherapy on the strength of upper body extension, electric activity of the TrA and ML muscles and pain in patients with chronic low back pain. Methods: Nineteen volunteers were pre and post physical therapy evaluated in the upper body extension strength, electric activity (TrA and ML) and pain. Results: There was no change in upper body extension strength (p=0.064); the was difference in ML electromyographic activity, on the right side (p

The purpose of this study was to analyze skin temperature (Tsk) responses after a short-term maximum effort test in middle-distance runners. A quasi-experimental study was conducted with ten men (age 23.5±5.10 years) who trained 5 days per week, 2 to 3 hours per day, and were submitted to thermographic evaluation before and after Cooper's 12-minute run test (CRT). The mean temperature of the anterior-superior, posterior-superior, anterior-inferior, and posterior-inferior regions was compared between the sides (i.e., left and right) before and after CRT. The paired t-test showed a significant decrease in Tsk after CRT in the following regions: right pectoralis major (-3.4%), left pectoralis major (-3.4%), and abdomen (-5%) in the anterior-superior view (p

Background:It has been common practice to start a second TNF inhibitor (TNFi) in patients with axial spondyloarthritis (axSpA) who discontinue their first TNFi. It remains unclear if the reason for discontinuation of the first TNFi influences the response to the second.Objectives:To assess if the reason of discontinuation of the first TNFi influences the response to the second TNFi.Methods:Patients with axSpA from the ReumaPt registry, who discontinued their first TNFi and started a second TNFi and who had complete data on Ankylosing Spondylitis Disease Activity Score (ASDAS) and Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) at baseline, 3 and 6 months for their first TNFi were included. Then, they were followed every 6 months up to 12 years. The main outcome was the ASDAS clinically important improvement (ASDAS CII). Secondary outcomes were ASDAS major important improvement (ASDAS MI); ASDAS low disease activity (ASDAS LDA); ASDAS inactive disease (ASDAS ID) and BASDAI 50. The reason for discontinuation of the first TNFi was defined as: i) Primary failure, ASDAS CII was not achieved at 3 or 6 months; ii) Secondary failure, ASDAS CII achieved at 3 or 6 months but lost in ≥1 follow-up visit; iii) Adverse events; iv) Other (e.g. pregnancy, surgery). The response to the first TNFi at 3 and 6 months was compared to the response to the second TNFi at the same visits, adjusting for age, gender and C-reactive protein (CRP). The association between the reason of discontinuation of the first TNFi and response the second TNFi over time was tested in generalized estimating equations (GEE) models, adjusted for age, gender and CRP.Results:In total, 193 patients (53% male, mean age 45 (SD:11) years) were included, with a median follow-up time on the second TNFi of 1.5 years. Patients had a lower response to the second TNFi compared to the first TNFi according to the main outcome (ASDAS CII) at 3 months (41% vs 51%) and 6 months (35% vs 56%). There was an association between the reason to discontinue the first TNFi and response to the second TNFi as defined by the most stringent outcomes (ASDAS MI and ASDAS ID), but not for ASDAS CII (Table). Compared to patients who discontinued their first TNFi due to primary failure, patients were more likely to achieve ASDAS ID with the second TNFi when they discontinued their first TNFi due to secondary failure (OR: 7.3 [(95%CI: 1.9; 27.7]), adverse events (OR: 9.1 [2.5; 33.3]), or other reasons (OR: 7.7 [1.6; 37.9]).Conclusion:In axSpA, response to the second TNFi is worse compared to the first TNFi. Patients with a secondary failure to the first TNFi have a better response to the second TNFi compared to those discontinuing the first TNFi due to primary failure, particularly for most stringent outcomes.Table.Association between the reason for discontinuation of the first TNFi and response to the second TNFiReason to discontinue first TNFi*Outcome for the second TNFiOR (95% CI)ASDAS-CII (N=135)ASDAS-MII (N=135)ASDAS-LDA (N=166)ASDAS-ID (N=166)BASDAI50 (N=147)(ref Primary failure) -Secondary failure1.9 (0.7;4.8)4.8 (1.3;18.2)1.2 (0.6;2.4)7.3 (1.9;27.7)1.4 (0.6;3.0) -Adverse events1.5 (0.6;3.5)2.4 (0.6;9.6)0.9 (0.5;1.7)9.1 (2.5;33.3)1.1 (0.5;2.3) -Other1.0 (0.3;3.8)1.7 (0.1;19.4)1.0 (0.4;2.4)7.7 (1.6;37.9)0.5 (0.1;1.7)*GEE models with the reason of discontinuation of the first TNFi as predictor (reference category: primary failure); all models adjusted for age, gender and C-reactive protein. OR in bold are statistically significant (pDisclosure of Interests:Santiago Rodrigues-Manica Speakers bureau: Jansse, MSD, Novartis, Alexandre Sepriano: None declared, Fernando Pimentel dos Santos Speakers bureau: Novartis, Pfizer, Biogen, Vitoria,, Nélia Gouveia: None declared, Anabela Barcelos Speakers bureau: Bene, Eli-Lilly, Pfizer, MSD, Novartis, Jaime Branco Speakers bureau: Vitoria, Miguel Bernardes Speakers bureau: Abbvie, Amgen, Biogen, Eli-Lilly, Glaxo-Smith-Kline, Pfizer, Janssen, Novartis, Raquel Ferreira: None declared, Elsa Vieira-Sousa: None declared, Sofia C Barreira: None declared, Filipe Vinagre: None declared, Raquel Roque: None declared, Helena Santos Speakers bureau: AbbVie, Eli-Lilly, Janssen, Pfizer, Novartis, Nathalie Madeira: None declared, João Rovisco: None declared, Alexandra Daniel: None declared, Sofia Ramiro Grant/research support from: MSD, Consultant of: Abbvie, Lilly, Novartis, Sanofi Genzyme, Speakers bureau: Lilly, MSD, Novartis

Introduction: Eccentric training and jump tests are widely used to recover and measure deficits in knee strength and functionality after anterior cruciate ligament (ACL) reconstruction. Objective: To correlate knee extension and flexion torque generated by eccentric isokinetic training, with functional jump tests in subjects with reconstructed ACL. Method: Sixteen men with unilateral ACL reconstruction were assessed before and after 12 weeks of eccentric isokinetic training of knee flexors and extensors (3×10 MVC, 2x/week) at 30°/s for extension and flexion torque (isometric; concentric and eccentric at 30 and 120°/s) and functional jump tests (single, triple, cross and figure of 8). Inter- and intra-limb pre- and post-training mean peak torque (MPT), distance and jump test times were compared along with the correlations between these variables, considering P

Background Tumour necrosis factor inhibitors (TNFi) lead to a dramatic improvement in the management of psoriatic arthritis (PsA). Nevertheless, a significant proportion of patients still do not respond and/or are intolerant to TNFis, requiring treatment switch for an adequate control of disease activity. Objectives To assess TNFis drug retention and the main reasons for TNFi discontinuation in PsA patients. Methods This was a non-interventional study of PsA patients registered at the Rheumatic Diseases Portuguese Registry (Reuma.pt), with at least one TNFi prescription. Drug retention for a first, second and third line TNFi was assessed by Kaplan-Meier survival analysis. The reasons for discontinuation were described as frequencies. Results 750 PsA patients were included, with a mean age of 47.6 years (±11.6); 50.3% (n=377) female. 200 patients (26.7%) treated with adalimumab, 335 (44.7%) with etanercept, 114 (12.2%) with golimumab and 101 (13.5%) with infliximab, as first line TNFi. The majority (67.6%) were receiving concomitantly conventional synthetic disease modifying anti-rheumatic drugs (62.3% MTX) and 33.9% corticosteroids. The mean duration of TNFi retention was of 48.5±40.1 months, when treated with a 1st TNFi, decreasing to 35.5±33 months for the 2nd TNFi, and to 22.7±22.9 months for the 3rd TNFi (figure 1). After being treated with a 1st TNFi, the majority of discontinuers (35,8% of the total population), withdraw due to lack or loss of effectiveness (53.5%) and due to adverse events (24.4%). The rates of discontinuation for the 2nd and 3rd TNFi were of 39% and 54%, respectively. Lack or loss of effectiveness and adverse events were maintained the two main reasons of withdrawal for the 2nd (62.3%; 21.6%) and 3rd TNFi (63%; 22.2%). Conclusions PsA patients registered at Reuma.pt treated with a 1st TNFi had an overall drug retention of 49 months. We observed a decrease in the average retention of TNFi therapy of 13.0 months in PsA patients who switched to a 2nd TNFi or a 3rd TNFi. Lack or loss of response were the main reason for TNFi discontinuation, independently of TNFi position, responsible for more than half of the discontinuations. The observed short survival of TNFis in PsA, and the inability to regain drug expectancy when switching to another TNFi, highlights the limitations from recycling between TNFi when aiming at long-term disease remission. Acknowledgements Financial support for statistics and report writing was provided by Novartis, Produtos Farmaceuticos S.A. Disclosure of Interest None declared

Background Psychological disturbances, frequently observed in inflammatory rheumatic diseases, seem to negatively influence patient’s clinical status and treatment response. Objectives The aim of this study was to examine the longitudinal impact of depression (D)/anxiety (A) in treatment response, disease activity, physical disability and quality of life in patients with Ankylosing Spondylitis (AS). Methods Data from patients who fulfilled the modified New York criteria for AS were collected at baseline, weeks 2 and 14 post-treatment with Adalimumab. The Hospital Anxiety and Depression Scale (HADS) was used to evaluate D/A symptoms severity. The primary outcomes were AS disease activity score – C reactive protein (ASDAS-CRP), Bath AS Disease Activity Index (BASDAI), Bath AS Functional Index (BASFI) and AS Quality of Life (ASQoL) Scale. Secondary outcomes were patient and physician global assessment by Visual Analogue Scale (VAS), erythrocyte sedimentation rate (ESR), CRP and BASDAI question 1 (fatigue). Difference-in-differences estimation took into account the covariates gender, age at baseline and disease duration. Results Data from 54 patients were included. At baseline, D/A symptoms significantly influenced the mean value of BASFI (p=0.006; p=0.003) and ASQoL (p Conclusions Psychological status does not seem to affect response to treatment with Adalimumab, even if the overall characteristics of the population are different at baseline between patients with/without D/A symptoms. Disclosure of Interest None declared

Background: In the last years, there has been an increase interest in using Patient Reported Outcomes (PROs) in clinical trials and daily clinical practice in Rheumatology to provide patient-centered care. The most frequently reported PROs are patient’s pain, patient’s global assessment (PGA) of disease activity and reports of functional capacity, fatigue, anxiety and depression. To date, studies that explore patient adherence to rheumatic medications are scarce. Objectives: To study the level of adherence to biologic therapy of Rheumatoid Arthritis (RA) patients, followed at a day care hospital of Rheumatology. Methods: Observational and cross-sectional study which took place in two months of consultation of day care hospital (5 periods per week). Patients with a diagnosis of RA according to 1987 American College of Rheumatology (ACR) and/or 2010 ACR/European League Against Rheumatism criteria, on biologic therapy, able to complete a questionnaire autonomously and who agreed to participate were included. Demographic and clinical data (DAS28, CDAI and SDAI to assess RA disease activity, HADS-A for anxiety, HADS-D for depression, FACIT-F for fatigue) were collected. To assess adherence, a Portuguese version of the Morisky Medication Adherence Scale (MMAS-8) was used and the patients were asked to apply it only to biologic therapy. Three levels of adherence were considered based on the following scores: 0 to Results: In total, 61 patients were included, 91.8% female, 82.0% on anti-Tumor Necrosis Factor (anti-TNF), the others on Tocilizumab (16.4%) or Abatacept (1.6%). Table 1 reports the means and medians of demographic and clinical variables included. The mean MMAS-8 score was 7.0±1.2, the median 7.0 (6.8–8.0), with a minimum of 2.5 and a maximum of 8. The adherence was medium in 50.8%, high in 36.1% and low in 13.1% patients. The median of current age was significantly higher for patients with high and medium levels of adherence compared to those with low levels (p=0.030). The time on treatment with the current biologic therapy was significantly different between the levels of adherence (p=0.028); the median of time on treatment for patients with medium levels of adherence was significantly higher comparatively to the other patients (p=0.009). No other significant difference was found among the levels of adherence for the studied variables. Conclusions: The adherence to biologic therapy was at least medium for 86.9% of patients. Differences between levels of adherence were found only for current age and time on treatment. Disease activity of RA does not seem to influence the levels of adherence. Disclosure of Interest: None declared

Background The ASAS-EULAR recommendations for the continuation of biological Disease-Modifying Anti-rheumatic Drugs (DMARD) suggest the evaluation of patients after at least 12 weeks of treatment by either the Ankylosing Spondylitis (AS) Disease Activity Score – C reactive protein (ASDAS-CRP) or by the Bath AS Disease Activity Index (BASDAI). For ASDAS-CRP, a Minimal Clinical Important Difference (MCID) ≥1.1 is necessary, while for the total BASDAI score a 50% reduction or a change of ≥2.0 points is considered clinically relevant. In clinical trials, the Assessment in Ankylosing Spondyloarthritis (ASAS) response criteria – ASAS 20, ASAS 40 and ASAS 70 – are still the most frequent primary outcome measures to evaluate improvement in treatment response. However, in clinical practice the BASDAI is still routinely used. Objectives The aim of this work was to assess the concordance/agreement between different therapeutic outcome measures, such as the ASAS response criteria, ΔASDAS-CRP and BASDAI 50. Methods Data from 54 patients who fulfilled the modified New York criteria for AS were collected at baseline, weeks 2 and 14 post-treatment with Adalimumab. Pearson’s correlation (PCCs) and the Cohen’s Kappa coefficients were calculated for the three scores. Results A strong correlation was found between the three scores throughout the visits: rho=−0.676 for ASDAS/ASAS, rho=−0.807 for ASAS/BASDAI, and rho=0.786 for BASDAI/ASDAS (all PCCs with p The individuals categorised as responders, by eitheir BASDAI50 or ΔASDAS ≥1.1, have shown similar clinical characteristics (Erythrocyte Sedimentation Rate, CRP, AS Quality of Life Scale and Bath AS Functional Index). Importantly, when more stringent measures of ASAS response criteria and ASDAS were used (i.e. ASAS 70 and ASDAS≥2.1) the agreement with BASDAI values decreased. Conclusions Our results suggest that the ASAS response criteria, ΔASDAS-CRP and BASDAI 50 report the same clinical information. Hence, the clinician’s decision should still be consistent independently of the score adopted. However, this study also highlights the importance of establishing a new and more stringent BASDAI cut-off, in alignment with ASDAS-CRP’≥2.1 and ASAS 70. Disclosure of Interest None declared

Background A BASDAI ≥4 has been often required to start TNFi therapy in patients with axSpA. However, this cut-off of high disease activity (HDA) is largely arbitrary. Unlike BASDAI, ASDAS incorporates objective measures (e.g. CRP) and has a validated definition of HDA (≥2.1). It has thus been suggested that ASDAS could also be used to guide treatment decisions, but evidence to support this is still scarce. Objectives To compare the impact of applying the ASDAS and BASDAI definitions of HDA in selecting patients for TNFi-treatment in daily clinical practice Methods Patients from Reuma.pt (Rheumatic Diseases Portuguese Register), with diagnosis of axSpA according to their rheumatologists (both treated and not treated with their first TNFi), with complete baseline BASDAI and ASDAS data, and complete 6 month of follow-up (i.e. baseline, 3 and 6 months visits available) were included. Four subgroups [cross-tabulation between ASDAS (≥2.1) and BASDAI (≥4) definitions of HDA], were compared according to baseline demographic and clinical characteristics in the ‘eligible population’ (i.e. irrespective of TNFi-treatment). In addition, for patients starting TNFi and with complete follow-up BASDAI/ASDAS data (‘efficacy population’), the subgroups were also compared according to different response criteria (see table 1), at 3 and 6 months. Results In total, 466 patients were included (59% males and 66% HLA-B27 positive). The large majority (n=382; 82%) fulfilled the definition of HDA according to both BASDAI and ASDAS at baseline (i.e. BASDAI≥4 and ASDAS≥2.1). The frequency of ASDAS≥2.1, if BASDAI Conclusions Our results show that the ASDAS-HDA definition (ASDAS≥2.1) is more inclusive than the BASDAI-HDA definition (≥4) in selecting axSpA patients for TNFi treatment. Importantly, the additionally ‘captured’ patients respond better and have higher likelihood of predictors thereof. These results support the use of ASDAS≥2.1 as a selection criterion for treatment decisions. Acknowledgements Supported in part by a research Grant from Investigator-Initiated Studies program of MSD Disclosure of Interest J. Marona Grant/research support from: MSD, A. Sepriano Grant/research support from: MSD, S. Rodrigues-Manica Grant/research support from: MSD, F. Pimentel-Santos Grant/research support from: MSD, A. Mourao Grant/research support from: MSD, N. Gouveia Grant/research support from: MSD, J. Branco Grant/research support from: MSD, F. Vinagre Grant/research support from: MSD, R. Roque Grant/research support from: MSD, J. Rovisco Grant/research support from: MSD, M. Marques Grant/research support from: MSD, J. Tavares-Costa Grant/research support from: MSD, J. Silva Grant/research support from: MSD, H. Santos Grant/research support from: MSD, N. Madeira Grant/research support from: MSD, E. Vieira-Sousa Grant/research support from: MSD, R. Machado Grant/research support from: MSD, M. Bernardes Grant/research support from: MSD, R. Ferreira Grant/research support from: MSD, S. Ramiro Grant/research support from: MSD

Introduction: Improving strength levels is important to women with osteoporosis. Resistance and aerobic exercise are effective means of reaching this goal; however, the use of low-load exercises with blood flow restriction is an alternative to traditional methods of exercise to achieve the same strength gains in this population. Objective: To analyze the chronic effects of aerobic and resistance training combined with blood flow restriction on the maximal dynamic strength (MDS) of women with osteoporosis. Methods: Twenty women (61.40±4.63 years of age, 61.82±12.54 kg, 1.51±0.05 m, 27.16±5.55 kg/m²) were randomly assigned to four groups: 1 - high-intensity resistance training (HI); 2 - low-intensity resistance training with blood flow restriction (LI-BFR); 3 - aerobic training with blood flow restriction (ABFR); and 4 - control group (CG). Unilateral knee extension MDS was assessed using the one-repetition maximum (1RM) strength test before and after the 6th and 12th weeks of intervention. The data were analyzed using repeated measures analysis of variance (ANOVA) with a Bonferroni post-hoc test performed using SPSS (version 21.0), considering a significance level of P0.05). Conclusions: ABFR and LI-BFR effectively increased the MDS of women with osteoporosis. RESUMO Introdução: Melhorar os níveis de força é importante para as mulheres com osteoporose. Os exercícios de força e aeróbicos são eficazes para atingir esse objetivo; no entanto, o uso de exercícios de baixa carga com restrição do fluxo sanguíneo é uma alternativa aos métodos tradicionais de exercício para atingir os mesmos ganhos de força nessa população. Objetivo: Analisar o efeito crônico do treinamento aeróbico e de força combinado com a restrição de fluxo sanguíneo sobre a força dinâmica máxima (FDM) de mulheres com osteoporose. Métodos: Vinte mulheres (61,40 ± 4,63 anos; 61,82 ± 12,54 kg; 1,51 ± 0,05 m; 27,16 ± 5,55 kg/m²) foram randomizadas em quatro grupos: 1 - treinamento de força de alta intensidade (AI); 2 - treinamento de força de baixa intensidade com restrição de fluxo sanguíneo (BIRFS); 3 - treinamento aeróbico com restrição de fluxo sanguíneo (ARFS) e 4 - controle (GC). A avaliação da força dinâmica máxima (FDM) da extensão unilateral do joelho foi realizada pelo teste de 1RM antes e depois da 6ª e 12ª semanas de intervenção. Para a análise dos dados realizou-se o teste ANOVA de medidas repetidas com teste de Bonferroni post-hoc no software SPSS (versão 21.0), considerando um nível de significância de P < 0,05 em todas as análises. Resultados: As comparações antes da intervenção mostraram que os grupos AI e GC tinham menores níveis de força que os grupos ARFS e BIRFS (P < 0,05). O grupo ARFS apresentou aumento significativo na FDM entre a 1ª e a 6ª (9%; P = 0,001) e entre a 1ª e a 12ª semana (21,6%; P = 0,008). O grupo BIRFS teve aumento da FDM entre a 1ª e a 6ª (10,1%; P = 0,001), entre a 1ª e a 12ª semana (24,2%; P = 0,003) e entre a 6ª e 12ª semana (12,8%; P = 0,030). O grupo AI teve diferença significativa entre a 1ª e a 6ª semana (38,7%; P < 0,001), entre a 1ª e a 12ª semana (62%; P < 0,001) e entre a 6ª e a 12ª semana (17,4%; P = 0,020), enquanto o GC não apresentou diferença entre os pontos do tempo (P > 0,05). Conclusões: ARFS e BIRFS aumentaram efetivamente a FDM em mulheres com osteoporose. RESUMEN Introducción: Mejorar los niveles de fuerza es importante para las mujeres con osteoporosis. Los ejercicios de fuerza y aeróbicos son eficaces para alcanzar ese objetivo; sin embargo, el uso de ejercicios de baja carga con restricción del flujo sanguíneo es una alternativa a los métodos tradicionales de ejercicio para alcanzar los mismos aumentos de fuerza en esa población. Objetivo: Analizar el efecto crónico del entrenamiento aeróbico y de fuerza combinado con la restricción de flujo sanguíneo sobre la fuerza dinámica máxima (FDM) de mujeres con osteoporosis. Métodos: Veinte mujeres (61,40 ± 4,63 años; 61,82 ± 12,54 kg, 1,51 ± 0,05 m; 27,16 ± 5,55 kg / m²) fueron aleatorizadas en cuatro grupos: 1 - entrenamiento de fuerza de alta intensidad (AI); 2 - entrenamiento de fuerza de baja intensidad con restricción del flujo sanguíneo (BIRFS); 3 - entrenamiento aeróbico con restricción del flujo sanguíneo (ARFS) y 4 - Control (GC). La evaluación de la fuerza dinámica máxima (FDM) de extensión unilateral de la rodilla se realizó mediante la prueba de 1RM antes y después de la 6ª y 12ª semana de intervención. Para el análisis de los datos se realizó la prueba ANOVA de medidas repetidas con prueba de Bonferroni post hoc en el software SPSS (versión 21.0), considerando un nivel de significación de P < 0,05 en todos los análisis. Resultados: Las comparaciones antes de la intervención mostraron que los grupos AI y GC tenían menores valores de fuerza que ARFS y BIRFS (P < 0,05). El grupo ARFS presentó un aumento significativo de la FDM entre las semanas 1 y 6 (9%; P = 0,001) y entre las semanas 1 y 12 (21,6%; p = 0,008). El BIRFS tuvo un aumento de la FDM entre las semanas 1 y 6 (10,1%; p = 0,001), entre las semanas 1 y 12 (24,2%; p = 0,003) y las semanas 6 y 12 (12,8%; P = 0,030). El grupo AI tuvo una diferencia significativa entre las semanas 1 y 6 (38,7%; P < 0,001), entre las semanas 1 y 12 (62%, P < 0,001) y entre las semanas 6 y 12 (17,4%; p = 0,020), mientras que el GC no presentó diferencia entre los puntos del tiempo (P > 0,05). Conclusiones: ARFS y BIRFS aumentaron efectivamente la FDM en mujeres con osteoporosis.

El proposito de este estudio fue evaluar el efecto de los apoyos externos de tobillo en la propiocepcion y el equilibrio dinamico en atletas de voleibol. Diecisiete jugadores de voleibol (18,94±2,49 anos; 65,45±9,49 kg, 1,71±0,05 m, IMC=22,0±2,67 kg/m²). El equilibrio dinamico fue evaluado por el Star Excursion Balance Test(SEBT). Comparacion de los modos de estabilizacion (Si Estabilizador/SE, Ortesis/ORT y Vendaje Funcional/VF) y las lineas de cuadricula SEBT, y inter-miembros se fuera realizado. Evaluacion del SEBT mostro una diferencia significativa entre los grupos (p< 0,01), SE x ORT, SE x BF y entre lineas (p < 0,01), ademas de la interaccion linea/miembro en el MD y MND (p < 0,01). Los medios de estabilizacion externa probados (ORT x BF) se comportaron de manera similar, lo que restringe el alcance de las extremidades inferiores en la ejecucion del SEBT en algunas de las direcciones probadas.

Objective: To analyze the thermographic changes in patients with chronic low back pain under different physical therapy interventions. Method: Thirty three chronic low back pain individuals were randomized into four groups: manual therapy (MTg; n=10), lumbar stabilization (LSg; n=7); combined therapy – MT + LS (CTg; n=7) and postural orientation/control (PGg; n=9). All individuals underwent ten physiotherapy sessions and evaluated pre- and post-treatment as skin temperature (infrared thermography), and pain in the lower back (Visual Analogue Scale – VAS). Anova (4x3x2) comparing four groups, three areas (LLA, CA and RLA) and two evaluations (preand post-treatment) for skin temperature; and Anova (4x2) between the four groups, preand post-treatment, were used for VAS, considering α ≤5%. Results: There was no significant difference in lower back temperature, comparing preand post-treatment; however, the VAS showed a significant reduction for all groups (P≤0.01). Conclusion: Although the treatments have not minimized the temperature in the lumbar region, they were able to decrease dramatically the level of pain, in all groups.

This study analysed the effect of low-intensity (LI) exercises with blood flow restriction (BFR) on bone metabolism compared with high-intensity (HI) exercises without BFR. The following databases were searched using the keywords therapeutic occlusion training OR BFR training OR vascular occlusion training OR KAATSU training OR ischaemia training AND osteogenesis OR bone biomarkers OR bone metabolic marker OR bone mass OR bone turnover OR osteoporosis OR osteopenia: PubMed, Web of Science, SPORTDiscus, CINAHL, Science Direct, Cochrane and Google Scholar. Two researchers, independently and blindly, selected the studies based on established inclusion and exclusion criteria. Electronic and manual searches located 170 articles published in English; after screening, only four studies showed that BFR training increases the expression of bone formation markers (e.g. bone-specific alkaline phosphatase) and decreases bone resorption markers (e.g. the amino-terminal telopeptides of type I collagen) after both aerobic and anaerobic exercise across several populations. The results of this study show that few studies have confirmed the positive effect of exercise with BFR on bone metabolism, formation and resorption. Furthermore, no methodological standardization of the samples, exercise type, intervention frequency or duration was observed.

Background PROs are especially useful in the management of rheumatic diseases in complement to physician evaluation. However they are time consuming and used in a limited manner in the daily clinical practice. Reuma.pt is the Portuguese national rheumatic diseases register and one of the few registries in Europe that allows the patient to do at home the PROs before the appointment. In our institute we have complemented that with the creation of a paper free day hospital with the use of touch screen computers that also allows the patient to do the PROs before the clinical evaluation by the rheumatologist. Objectives to compare the impact of the use off Reuma.pt at home PROs completion platform before and after the utilization of touch screen computers in the day hospital. Methods We determined the number of patients and appointments with the use at home of the PROs platform one year prior to the introduction of the touch screen computer at our day hospital (October 2014 –October 2015) and one year after the paper free day hospital was installed (November 2015-November 2016). To determine any change of pattern of the use at home of the platform and the relations between that and patients characteristics. Results When we analyse the available variables between the patients that performed the PROs at home we found for both periods considered that they were younger (45,2/49,8 vs 53,4/55,1 p Conclusions The use of technology could have a consider impact on the way we collected data from our patients. With the use of a touchscreen computer we have improved not only the overall completion of PROs but also increased the familiarity of patient to the online questionnaires. Number of appoitments with previous at home completion of the questionnaires more than double. This has a clear impact on patient participation, quality of data in the registry but even more impact on time and human resources at a day hospital. Disclosure of Interest None declared

Background Depression, anxiety and fatigue are common symptoms in rheumatoid arthritis (RA) patients, and seem to influence disease activity, pain, quality of life (QoL) and treatment response. Objectives To assess disease activity, function and QoL in RA patients with symptoms of anxiety/depression. Methods Observational, cross-sectional study including RA patients on bDMARD followed at our centre, registered at Reuma.pt with ≥1 evaluation from 2015/11 to 2016/07. Clinical data including DAS28, CDAI, SDAI, TJC, SJC, patients9 and physicians9 pain/global assessments (VAS), ESR, CRP, HAQ, EQ5D, HADS score (anxiety and depression domains, cutoff ≥8) and FACIT-F were collected. Data were analyzed using Mann-Whitney, Qui-Squared and Spearman correlation, p Results 182 patients enrolled, 84.6% female, mean: age at 1st bDMARD 53.8±11.1; time since diagnosis 16.2±9.3 years; DAS28 3.54±1.3; CDAI 10.2±9.6; SDAI 11.2±10.4; HAQ 0.97±0.6; HADS-Anxiety 7.13±4.5; HADS-Depression 6.62±4.54, FACIT-F 35.1±9.2, EQ-5D 0.36±0.2. 77 (44.5%) patients scored ≥8 in the HADS-Anxiety domain and 71 (41.0%) scored ≥8 in the HADS-Depression domain. Comparison of depressive vs non-depressive and anxious vs non-anxious groups appears on table 1. There was a correlation of HADS-Anxiety with DAS28 (r=0.391, p Conclusions Anxious or depressive patients showed higher disease activity, especially in measures with some subjectivity (such as TJC and PGA) but not regarding ESR or CRP and worse function and QoL. This fact must be taken into account when evaluating therapeutic efficacy. Disclosure of Interest None declared