Introduction: Identifying effective assessment instruments for predicting falls, speci􀏐ically in older women with low bone mineral density (BMD) that are more susceptible to fractures remains a challenge. Objective: To evaluate risk factors for falls at baseline, to identify the falls occurrence over six months of follow-up and to investigate the predictive validity of the Quickscreen Clinical Falls Risk Assessment for predicting multiple falls among low BMD older women. Methods: A methodological study with 110 older women with diagnosis of osteoporosis or osteopenia (70.26 ± 6.24 years). The presence of two or more of the eight risk factors assessed by the QuickScreen characterized the risk of falling (baseline) and monthly phone calls identi􀏐ied the occurrence of falls during the six months of follow-up. Results: The most prevalent falls risk factors were self-reported previous falls, polypharmacy and impairment in shifting weight and lateral instability. Most of the older women (67.3%) had two or more risk factors, 24.5% reported a single fall and 13.6% reported multiple falls over the six months. The QuickScreen (cutoff ≥ 2 risk factors) showed good sensitivity (73.3%) and high negative predictive value (88.89%) for predicting multiple falls among low BMD older women. Conclusions: The results indicated a high frequency of falls among low BMD older women. Additionally, the results highlighted that the QuickScreen instrument was able to predict multiple falls in the six months of follow-up among these older women.

Introduction: Functional disability is an important health indicator associated with worse quality of life. Objective: To estimate the prevalence of functional disability for mobility and to identify factors associated with difficulty going up and down stairs in adults aged 40 years or over. Methods: Cross-sectional, population- based study, with residents of the Municipality of Cambé, PR, interviewed in 2011. The dependent variable was the difficulty of going up and down stairs. Analysis of associated factors was performed using Poisson regression for each subgroup (40 - 59 years and 60 years or older). Results: In total, 24% of the subjects presented some kind of difficulty going up stairs (p < .01). In both subgroups, a significantly higher prevalence in women, among those inactive during leisure time and those with a history of cerebrovascular disease was observed. In the subgroup aged 40 to 59 years, age 50 - 59 years, hypertension, diabetes and falls in the previous 12 months were also associated with the outcome. Conclusion: The results suggest the need to expand the actions of health promotion, prevention and control of chronic conditions, especially among middle-aged people.

Introduction: Chronic non-progressive encephalopathy (CNPE) is one of the most common causes of physical deformities in childhood. It is characterized by non-progressive neuropathological abnormalities of the developing brain, which results in neuromotor impairments and changes in posture and movement. Objective: To evaluate foot deformities in children with CNPE, by measuring the joint amplitude and correlating these measures with the scores of the Gross Motor Function Measure (GMFM-88), using all its five dimensions. Methods: Cross-sectional and descriptive study with a sample of 17 children. The data collection instruments used were manual goniometer and the Gross Motor Function Measure test (GMFM-88). Data were analyzed using the program SPSS version 18, and the Pearson correlation test as a measure of association. Results: Children with chronic encephalopathy and a reduced amplitude motion have lower capacity in motor function. Statistically signi􀏐icant correlation was found for the right dorsi􀏐lexion angle (p = 0.023), left dorsi􀏐lexion angle (p = 0.019), right inversion (p = 0.040), left inversion (p = 0.034) and left eversion (p = 0.018). There was no statistically signi􀏐icant correlation for the right eversion (p > 0.05). Conclusion: Musculoskeletal disorders associated with CNPE and foot deformities interfere negatively in motor function, compromising the functional performance of these children.

Introduction: Diabetes Mellitus is a chronic disease with high prevalence in the population in particular among the elderly. The longer time of diabetes, increased the chances of developing complications such as peripheral neuropathy, which is an important factor in the genesis of plantar lesions by changing the distribution and formation of plantar pressure peaks. Objective: Evaluate the influence of an Assistive Technology, therapeutic footwear for diabetics, in the peaks of plantar pressure of elderly. Methods: This was an experimental study of transversal type, composed by 10 elderly, diabetic, with peripheral neuropathy, using as an instrument to measure a baropodometry platform. Were measured peaks of plantar pressure, static and dynamic in three situations: barefoot, the participants’ own standard footwear and with therapeutic footwear for diabetics. Data analysis by normal distribution as a single paired sample, applying the ANOVA test. Results: The use of therapeutic footwear for diabetics promoted a reduction in media of peak plantar pressure in the order of 22% in static analysis, and 31% in dynamic analysis. Conclusion: The therapeutic footwear for diabetics was able to produce significant reductions in peak plantar pressure, being more efficient than a common footwear. This effect may contribute to the prevention of injuries associated with the diabetic foot.

Introduction: Life habits such as physical activity, leisure, eating habits, stress, smoking, and alcohol consumption can directly affect individuals’ health. Objective: This study aimed to investigate the relationship between health behaviors and diseases self-reported by employees of a federal public university in southeastern Brazil. Methods: This cross-sectional study included 815 employees, of whom 347 were teachers and 468 were technical-administrative staff, aged between 20 and 65 years old. Data from this study were collected from a secondary database, from the Health Questionnaire (self-reported health conditions by teachers and technical-administrative employees), and from the institution’s Vice Dean of Community Affairs. Among the variables assessed, the relationship between eating habits, physical activity, smoking, alcohol consumption, and self-reported illnesses (chronic diseases and infectious and parasitic diseases diagnosed by a doctor within the last 12 months) was analyzed. Results: The mean prevalence of these diseases among teachers and technical-administrative staff was 3.1 and 2.9, respectively. This study showed a statistically significant association between unhealthy diet and cerebrovascular accidents; between irregular performance of physical activity/sedentary lifestyle and endocrine/nutritional/metabolic and digestive diseases; between overweight and cardiovascular diseases, endocrine/nutritional/metabolic diseases, diabetes mellitus, and hypertension; and between smoking and musculoskeletal diseases. Conclusion: We suggest the adoption of preventative measures and the control of risk behaviors among these employees.

Introduction: Massage can be defined as the rhythmic and smooth manipulation of body tissues, with the aim to promote health and well-being. Objective: To assess the influence of classic massage on cardiac autonomic modulation. Methods: Cross-sectional study that evaluated healthy participants, with mean age between 18 and 25 years, divided into two groups: test group (TG, n=11) and control group (CG, n=10). The TG had their heartbeat recorded for 5min before receiving a classic massage for 40min and during three periods after this procedure: 0-5min, 5-10min and 10-15min. The CG had their heartbeats recorded at the same time; without receive massage. Cardiac autonomic modulation was investigated by heart rate variability (HRV). Results: The mean values of HRV rates were: pNN50, respectively, for the TG: before massage (10.5 ± 9.5%), and after massage: 0-5min (11.6 ± 7.2%), 5-10min (12.1 ± 8.0%) and 10-15min (11.1 ± 7.9%), with no significant statistical difference. The same result was found for the mean values of rMSSD index of the TG; before massage: 52.1 ± 46.2 ms, and after massage: 0-5min (50.0 ± 21.6ms), 5-10min (52.0 ± 27.4 ms) and 10-15min (48.2 ± 21.1 ms). Also, the values of LFnuand HFnu indexes did not change significantly before and after massage, and they were not statistically different from the values presented by the control group. Conclusion: The study results suggest that one session of classic massage does not modify cardiac autonomic modulation in healthy young adults.

Introduction: Individuals with Down syndrome (DS) have alterations that affect the musculoskeletal system, causing abnormal patterns, and alter the morphological anatomical and mechanical axes that provide intrinsic stability to the skeleton, and can trigger misalignments and orthopedic disorders in adulthood. Objective: The objective of student to evaluate posture and postural alignment before and after the hippotherapyin individuals with DS. Methods: Posture of five individuals with DS was evaluated by the software SAPO before and after 27 sessions the hippotherapy. Data were subjected to qualitative descriptive analysis using cluster and statistical analysis with the aid of the software Sigma Stat 2.0, considering differences as statistically significant at p-value < 5%. Results: Improvements were achieved for the alignment of shoulder, head, hip, and lower limbs, in addition to decrease in kyphosis and head protrusion. Conclusion: Patients with DS demonstrated satisfactory changes in motor behavior reflected in improved static posture after treatment with hippotherapy.

Introduction: Temporomandibular disorders (TMD) comprise a group of diseases that affect not only the temporomandibular joint, but also different areas extrinsic to the joints. Quality of life has been the subject of numerous studies in the Health area, especially aimed at people with chronic diseases, such as TMD. Objective: To evaluate effects of a physical therapy protocol on the quality of life of patients with temporomandibular disorder. Methods: Blinded, prospective, clinical trial, with 60 patients of both genders, aged between 18 and 70 years with TMD diagnosis attended in the clinic of Ribeirão Preto School of Dentistry. The patients were divided into two groups, with one group, in addition to dental treatment, receiving a physical therapy protocol and the other group dental treatment only, for 5 weeks. The measurement of quality of life was obtained through the generic SF-36 questionnaire, at the beginning and end of the proposed protocol. Results: The patients to whom the physical therapy protocol was applied associated with dental care presented increased scores in all the domains of the questionnaire. In the group that received only dental treatment, improvements were only found in the domain related to pain. Conclusion: The application of a physical therapy protocol was able to improve the quality of life of patients with temporomandibular disorder.

Introduction: Low back pain is one of the most prevalent musculoskeletal disorders, but little is known about postural methods in its treatment. Objective: Analyze changes in muscle strength, flexibility, function and pain in patients with chronic low back pain that underwent isostretching and global posture reeducation (GPR). Methods: Thirty-nine patients, aged between 40 and 59 years, were evaluated before and after treatment protocols regarding: flexibility for sit and reach, muscle strength, functional capacity using the Rolland-Morris Questionnaire, and intensity of pain by Visual Analog Scale. The sample was randomized into two groups (1-GPR; 2-Isostretching), all of whom were treated individually through 12 sessions lasting 45 minutes each, twice a week. Results: After treatment, median reduction in pain intensity of 28 mm in group 1 and 32 mm in group 2 was observed, and a median improvement in functional capacity in group 1 of 8.5 points and 7 points in group 2 (p < 0,05). A mean improvement of severn repetitions in trunk extensor muscle strength was observed in group 1 and in group 2; by dynamometry of 10 kg / f in group 1 and 12.5 kg / f in group 2 of ten abdominal repetitions strength in group 1 and four repetitions in group 2 (p < 0.05).In the Sit and Reach, Group 1 had a total mean increase of 3cm, and group 2 had 1.6cm (p < 0.05).

Introduction: Temporomandibular Disorder (TMD) is caused by multiple factors and exhibits various symptoms. Its most common symptom is pain, a factor that can influence the quality of an individual’s sleep. Objective: The aim of the present study was to assess the correlation between TMD and sleep. Methods: A cross-sectional study was conducted with 60 women, aged between 18 and 40 years, who had been diagnosed with TMD based on the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD). Fonseca’s anamnestic index (FAI) was used to classify the severity of the dysfunction. To complete the assessment, each volunteer was assessed using the visual analogue scale (VAS) for pain. They also responded to two questions related to their quality of sleep and the average hours of sleep per night. Results: The more severe the TMD, the fewer hours of sleep per night (r = -0.5663). In total, 63.33% of the volunteers reported not sleeping well. Concerning pain, the greater the VAS score, the less hours of sleep (r = -0.516) and the more severe the TMD. Conclusion: It was found that the severityof TMD was correlated with pain symptoms and the number of hours of sleep per night.

Introduction: Childhood development represents a sequence of changes in behavior and underlying processes, influenced by biological and environmental factors. Screening and monitoring of neurodevelopment show effective procedures for early identification of different disorders of childhood development. Objective: To analyze the neurodevelopment, using the Denver Developmental Screening Test II, of children enrolled in preschools of Administrative Districts in Belém and to map the districts and the percentage of development evaluated as normal and suspected delay. Methods: This was a cross-sectional and exploratory descriptive study. A questionnaire was administered to parents to collect the personal, contextual and family data and an instrument to measure the level of family poverty. Results: Of the 319 children assessed, 77.7% showed a suspected delay in neuropsychomotor developmental and 59.2% in language. The family poverty level variable showed a statistically significant association with the overall level of development (p = .011) and of language (p = .003). Conclusion: It is hoped that this study will contribute to generate an impact in improving the ecological conditions of children and their families, reducing the risks to which they are exposed.

Introduction: Tai-Chi-Chuan and Yoga have becoming popular practices. However is unclear the cardiovascular effects, and if they present similar behavior to aerobic and resistance sessions. Objective: To evaluate the cardiovascular responses during the session and post-exercise hypotension (PEH) of Tai Chi Chuan (TS) and Yoga (YS) in comparison to aerobic (AS) and resistance (SR) exercises. Methods: Fourteen young women (22.3 ± 2 years) apparently healthy performed four sessions (AS, RS, TS and YS). The heart rate (HR), systolic (SBP) and diastolic blood pressure (DBP) were recorded at resting, during (every 10 minutes) and until 50 minutes of recovery. Results: AS, RS, TS e YS showed significant increase in HR compared to resting. AS at 10, 30 e 50 minutes in relation to RS, TS e YS. The RS in relation to TS and YS at 10, 30 and 50 minutes. No significant difference between TS and YS. SBP was significantly increased in AS, RS, TS e YS at 10, 30 e 50 minutes during the session, in relation to rest. AS was significantly higher at 30 e 50 minutes than RS and higher than TS and YS at 10, 30 e 50 minutes. No significant difference in DBP. For PEH, AS, RS and TS significantly reduced at 10, 30 and 50 minutes. YS reduced at 50 minutes. No significant diastolic PEH. Conclusion: TS and YS showed as safe alternatives of exercising in the normotensive young adult woman, despite having lower values, they promote similar hemodynamic behavior to AS and RS.

Introduction: In neonatal therapy units, physical therapy is directed toward integral baby care. Objective: To describe the profile of newborns (NBs) hospitalized in a Neonatal Intensive Care Unit (NICU). Methods: Retrospective documentary study with data collection from medical records from July 2011 to July 2013. The sample consisted of NBs who performed motor and respiratory therapy. Data were grouped into five categories according to birth weight (≤ 1000g, 1001-1500g, 1501-2000g, 2001- 2500g, ≥ 2501g). Results: total of 1,884 newborns were admitted to the NICU within the stipulated period, 168 (13.9%) underwent physical therapy. Of the 168 NBs who underwent physical therapy, 137 were born in the hospital (81.5%) and 31 were transferred there (18.5%); 17 of these babies died during the neonatal hospital stay (10.1%). All newborns of the extremely low birth weight group (≤ 1000g)required mechanical ventilation, 72.7% non-invasive ventilation and 16.6% high-frequency oscillatory ventilation. The occurrence of pneumothorax in the extremely low birth weight group was 13.8% and 16% in the group with birth weight 1001-1500g. Conclusion: Infants with low birth weight (<2500g) constituted the profile of NBs who underwent physical therapy, which was directly related to higher incidence of death and pneumothorax, as well as increased use of mechanical and non-invasive ventilation.

Introduction: Stroke individuals have sensorimotor repercussions on their ipsilesional upper limb. Therefore, it is important to use tests that allow an adequate assessment and follow-up of such deficits. Physical and occupational therapists commonly use maximal grip strength tests to assess the functional condition of stroke individuals. However, one could ask whether a single test is able to characterize the hand function in this population. Objective: The aim of this study was to investigate the relationship among outcomes of different tests frequently used to describe the function of the hand in the ipsilesional upper limb of stroke individuals. Methods: Twenty-two stroke individuals performed four hand function tests: maximal handgrip strength (HGSMax), maximal pinch grip strength (PGSMax), Jebsen-Taylor Hand Function Test (JTHFT) and Nine Hole Peg Test (9-HPT). All tests were performed with the ipsilesional hand. Pearson’s correlation analyses were performed. Results: the results indicated a moderate and positive relationship between HGSMax and JTHFT (r = 0.50) and between JTHFT and 9-HPT (r = 0.55). Conclusion: We conclude that the existence of only moderate relationships between test outcomes demonstrates the need to use at least two instruments to better describe the ipsilesional hand function of stroke individuals.

Introduction: Carpal tunnel syndrome is a compressive neuropathy, frequently seen in women. Conservative treatment for carpal tunnel syndrome focuses on control of symptoms and the nervous path, due to the possibility of double compression. Objective: To assess whether a protocol with emphasis on motor control techniques, including segmental cervical stabilization and neural mobilization, has better results in mechanical reorganization and reduction of symptoms when compared with classic therapeutic exercise techniques in the conservative treatment of carpal tunnel syndrome. Methods: This pilot study was a randomized, double-blind clinical trial, involving 11 women with an average age of 54 (± 6) years, allocated to either a classical kinesiotherapy group (CG) or experimental group (EG). The intervention spanned 12 weeks, with assessments prior to and following therapy, using the monofilament test, handgrip dynamometer, and BCTQ, DASH, and PRWE questionnaires. All normally distributed data was analysed with Student’s T-tests. Results: Both groups exhibited an increase in grip strength and relief of symptoms with improved functionality. There was a significant reduction in sensitivity noted in the CG group, and a significant increase in grip strength observed in the EG group. Conclusion: The experimental protocol group exhibited better results in mechanical reorganization, reflected in increased strength, sensitivity, and improved functionality, when compared to the group with conventional therapeutic exercise, but without the same symptomatic reduction.

Introduction: Motor development is a continuous process of motor behavior changes throughout life, allowing for movement control. Premature birth can affect this process, with a greater risk of delays in acquiring these skills. Objective: Compare motor development during the fundamental movement phase of preterm infants submitted to early stimulation and full-term babies. Methods: An analytical cross-sectional study with convenience sampling, performed with twenty 3-year-old children of both sexes, distributed into two groups: the preterm group (n = 10), which received physical therapy in the first months of life, and the term group (n = 10). Motor development stages were assessed between January and April 2013, using the Motor Development Scale (Escala de Desenvolvimento Motor - EDM) developed by Francisco Rosa Neto, with an average execution time of thirty minutes. Statistical analysis was performed using BioEstat 5.0 software, and the Shapiro-Wilk test was applied to verify data normality. A significance level of p ≤ 0.05 was adopted, analyzed using the Mann-Whitney test. Results: The term group exhibited significant differences in relation to the preterm group for the variables Fine and Gross Motor Skills, and Spatial and Temporal Awareness, with no differences in Balance and Body Scheme. Conclusion: Only the premature infants submitted to early intervention achieved normal levels of Balance and Body Scheme on the EDM Scale.

Introduction: Osteoarthritis (OA), the most common form of arthritis, is considered the main cause of pain and disability in the elderly. Objective: To evaluate the effect of systematic muscle strength training on functional performance and quality of life in individuals with knee OA. Methods: Subjects with knee OA (n = 27, 46 - 76 years) completed the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Medical Outcomes Short-Form 36-item Health Survey (SF-36), and visual analog scale (VAS) questionnaires, musculoskeletal assessments, and 10-repetition maximum and timed 10-meter walk tests both before and after training. The training consisted of an exercise resistance program and stretches for 12 weeks (three sessions of 80 each per week). Results: Twenty-two subjects completed the training. Reduced overall scores and WOMAC physical function indicated improved functional performance (p < 0.001) as well as increased gait speed (p < 0.001). The perception of pain decreased after training, as evidenced by the VAS, WOMAC pain domain, and SF-36 scores (p < 0.001). Quality of life improvements occurred primarily in the areas of pain, functional capacity, and SF-36 physical aspects. No change in body mass index was noted (p = 0.93). Conclusion: Our results indicate that the combination of resistance training for the quadriceps, gluteus, and abdominal muscles could be a viable alternative to improving functionality and quality of life in patients with knee OA. However, more studies are necessary to confirm our findings.

Introduction: Sleep breathing disorders occur in 45% of patients with heart failure, with 36%–50% manifesting Cheyne-Stokes respiration with central sleep apnea and 12% exhibiting obstructive sleep apnea. Several studies have shown that sleep pathophysiology may negatively affect the cardiovascular system and that cardiac dysfunction alters sleep and respiration. Objective: The aim of this study was to examine oxyhemoglobin desaturation during sleep in patients with congestive heart failure (CHF) using overnight pulse oximetry. Methods: Overnight pulse oximetry was conducted in the patients’ homes with wrist pulse oximeters and finger probes that were placed around the forefingers of 15 patients with CHF and ejection fractions less than 50%, who were classified as New York Heart Association functional classes II and III. Results: The patients were divided into two groups. The first group consisted of seven patients with oxyhemoglobin desaturation indices of over 5 events/h, and the second group contained eight patients with oxyhemoglobin desaturation indices of 5 or less events/h. Student’s t-tests did not show any significant differences between the groups. The patients’ body mass indices correlated positively with the total desaturation episodes and desaturation time less than 90% and correlated negatively with the arterial oxygen saturation nadir. Conclusion: Pulse oximetry monitoring during sleep can be used to detect sleep breathing disorders in stable patients with CHF.

Introduction: Joseph Pilates created an authentic method of physical and mental conditioning, which he called Contrology and defined as the complete coordination of body, mind and spirit. Recent studies indicate that the Pilates Method is a useful tool in rehabilitation can improve overall health, sports performance and help in the prevention and attenuation of injuries and disorders of the musculoskeletal system. Musculoskeletal disorders are prevalent and costly conditions that develop gradually, presenting a chronic course and often remain untreated. Objective: This study aimed to identify the effects of the Pilates Method in the rehabilitation of musculoskeletal disorders through a systematic review. Methods: An active search was performed in the PubMed, PEDro, Scielo and Bireme databases. A total of 24 studies were pre-selected and their methodological quality was evaluated based on the PEDro scale. Of these, 14 fulfilled the selection criteria. Results: The studies analyzed indicate that Pilates can be effective both for the treatment of conditions such as scoliosis, back pain, ankylosing spondylitis and breast cancer, and for preventing injuries in adults, elderly people and athletes. Conclusion: The high methodological variability requires that these studies be viewed with caution. It indicates the need for the performance of new studies with high methodological quality and standardization of evaluation instruments.

Introduction: Prematurity is a public health problem. Despite many studies that aim to characterize the effects of premature birth on the various dimensions of child development, there is still little systematic evidence on the functional dimension. Objective: To characterize the functional development of preterm infants in early infancy. Methods: Searches were conducted in PubMed, Science Direct, Scopus, Cochrane, Joana Briggs Institute, Embase, Lilacs and SciELO databases, with the following key words in English and Portuguese and their combinations: preterm, functional performance, functional outcomes, functional limitations, functional skills, activities of daily living and disability. Inclusion criteria were articles published in the last seven years on the investigated subject. Results: The five articles in the sample were organized, analyzed and categorized, reaching up to three empirical categories of analysis: Functional Performance of Preterm, Cumulative Effects on Functional Development, and Environmental Context and Attitudes of Care. Conclusion: It was concluded that before age 6, children born premature have developmental delays in functional areas of self-care, mobility and social function. Their functional development suffers cumulative effects of various different factors and may be related to care practices and context.

Introduction: Urinary incontinence (UI) after prostatectomy is difficult to treat and causes profound adverse impacts on the individual’s quality of life. The main clinical treatments available for post-prostatectomy UI consist of behavioral techniques and physical therapy techniques, such as exercises, electrical stimulation and biofeedback for pelvic floor muscles (PFMs). Objective: To investigate the effectiveness of PFM exercises with or without electrical stimulation for reducing post-prostatectomy UI. Methods: We included only randomized controlled trials (RCTs) which used PFM exercises with or without electrical stimulation. The search was conducted in August of 2013 in the databases of the U.S. National Library of Medicine (MEDLINE), Scientific Electronic Library Online (SciELO), Physiotherapy Evidence Database (PEDro) and Virtual Health Library (VHL). We searched for RCTs published between 1999 and 2013. As keywords for our search, we used the following descriptors from the Health Sciences Descriptors (DeCS): urinary incontinence, pelvic diaphragm, prostatectomy, pelvic floor exercises, electrostimulation and electrical stimulation. We also used the following descriptors from the Medical Subject Headings (MeSH): electrical stimulation, pelvic floor, urinary incontinence, prostatectomy, physiotherapy and exercise therapy. Results: Of the 59 RCTs found, 26 were excluded as duplicates, and 28 were excluded for not displaying a minimum score of 5.0 on the PEDro Scale, which left us with five RCTs. Conclusion: PFM exercises can be effective for treating UI after radical prostatectomy, especially if begun soon after surgery. Associating electrical stimulation with PFM exercises did not show additional benefit for treating urinary incontinence. However, the selected studies presented some methodological weaknesses that may have compromised their internal validity.