Medical Express

ISSN (print): 2318-8111

ISSN (online): 2358-0429

Issue: 3(4)2016 - 6 Articles


1 - Effects of dual-task interventions on gait performance of patients with Parkinson’s Disease: A systematic review

Luís A. A. Santos; Carlos Campos; Teresa Bento; Eduardo Lattari; Antônio Egidio Nardi; Nuno Barbosa F. Rocha; Sérgio Machado

MEDICALEXPRESS 2016;3(4):M160401

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OBJECTIVE: Parkinson's disease is characterized by motor and non-motor symptoms that impair patients' gait performance, especially while performing dual/concurrent tasks. These deficits impair patients' daily function, because dual-tasking is a crucial ability in terms of everyday living. The aim of this study was to systematically review the effects of dual task interventions on gait performance of patients with Parkinson's disease.
METHOD: Studies were retrieved from MEDLINE/PubMed, LILACS and SciELO. We used the PICOS strategy to determine eligibility criteria. The search strategy included an advanced search on the included databases, using the following search query: "Parkinson's Disease" AND "Double Task" OR "Concurrent Tasks" OR "Gait" AND "Walk". Study selection was carried out by two independent researchers and a third one was called when consensus was needed.
RESULTS: A total of 188 articles were identified: 169 articles from Medline/PubMed, 10 articles in SciELO, 8 articles in LILACS and 1 item from manual searches. A total of 56 articles were analyzed regarding the eligibility and exclusion criteria based on full text. A final total of 7 studies were included in the systematic review.
CONCLUSION: The different types of dual-task interventions reported (dance, sound stimuli, visual and somatosensory) were associated to improvements in several gait performance indicators of Parkinson's disease patients, including gait speed, stride time and length, cadence and step length. External stimuli seem to play a critical role on specific training effects on dual-task gait performance.

Keywords: Parkinson's disease, dual-task, gait.


2 - Body image in a representative sample of overweight, obese and normal weight active older women living in the community: associations with body composition, physical fitness and function

Vagner Raso; Carol Ewing Garber; Rafael Benito Mancini; Sandra Marcela Mahecha Matsudo

MEDICALEXPRESS 2016;3(4):M160402

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OBJECTIVE: To compare and examine relationships between body image (BI), body composition and physical function in overweight and normal weight active older women.
METHOD: We measured body mass (BM), body mass index (BMI), waist circumference (WAIST), grip strength (GS), lower limb muscle strength [LLMS], arm curl, balance, step-in-place test (SIPT), usual walk (WALK), fast walking (fastWALK), single chair stand (CHAIRtime) and repeated chair stand (CHAIRreps) in 398 overweight or obese women (67.2 ± 8.5 years; BMI > 27 kg•m2) and 302 women with a BMI < 27 kg•m2 (67.3 ± 8.5 years). Current (CBI) and ideal body image (IBI), and body dissatisfaction (DS; current - ideal) were determined by participant's responses to standardized silhouettes.
RESULTS: Multiple regression analyses verified positive (CBI) and negative associations (DS) for balance in obese category. A positive association with WALK and fastWALK was observed for current (normal weight and obesity categories) and IBI (overweight). There were positive associations for SIPT, arm curl and CHAIRreps.
CONCLUSION: Physically active older women showed an elevated prevalence of dissatisfaction regardless of BMI which was mediated by age, and associated with worsened physical function; similar associations were seen for current body image.

Keywords: Body composition, body image, body mass index, physical function, walking.

3 - Neck circumference can differentiate obese from non-obese individuals

Raquel Eduardo Lucas; Ana Laura Ferreira Fonseca; Roberto Oliveira Dantas

MEDICALEXPRESS 2016;3(4):M160403

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BACKGROUND: Obesity is an important problem of public health with increasing prevalence in the population. The diagnosis is made based on body mass index (BMI) levels; the objective of this study was to determine whether the measurement of the neck circumference may be an option to differentiate non-obese from obese individuals.
METHOD: Neck circumference was measured using a graduated tape over the thyroid cartilage, in 50 non-obese individuals (66% women) and 97 obese individuals (65% women), diagnosed by BMI.
RESULTS: Neck circumference was higher for obese than for non-obese individuals and higher in men than in women. The values of neck circumferences greater than 42 cm for men and 36 cm for women were associated with obesity, with high sensitivity (98%) and specificity (96%). There is a positive association between neck circumference with weight and BMI in women. Age has a negative correlation with BMI in obese individuals. Obese women have less height than non-obese.
CONCLUSION: Neck circumference can differentiate obese from non-obese individuals, with high sensitivity and specificity. It is higher in obese than in non-obese individuals, higher in men than in women, and is associated with the grade of obesity.

Keywords: Obesity, Neck circumference, Body Mass Index.

4 - The contract-relax proprioceptive neuromuscular facilitation (PNF) stretching can affect the dynamic balance in healthy men

Amine Ghram; Mohamed Damak; Fatma Rhibi Paulo Henrique Marchetti

MEDICALEXPRESS 2016;3(4):M160404

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OBJECTIVE: This study aimed to investigate the effect of the contract-relax proprioceptive neuromuscular facilitation (CR PNF) stretching protocol on dynamic balance.
METHODS: Twenty healthy young male performed two sessions in a randomized order; a session with CR PNF stretching protocol, and a session without the stretching protocol. Bipedal dynamic balance was measured in anterior-posterior and medio-lateral directions before and after the completion the two experimental sessions with eyes opened and closed.
RESULTS: the present study showed that there is no significant difference between the two sessions (with vs without the CR PNF stretching protocol) in the anterior-posterior direction. However, in the medio-lateral direction, the CR PNF stretching protocol significantly enhanced dynamic balance, when compared with the no stretch protocol condition.
CONCLUSION: This study concluded that CR PNF stretching might be effective to improve dynamic balance control.

Keywords: Postural control, proprioceptive neuromuscular facilitation, Proprioception, Stretching.

5 - Anthropometric Risk Factors for Metabolic Syndrome in HIV patients

José Adalberto Leal; Maria Arlene Fausto; Mariângela Carneiro

MEDICALEXPRESS 2016;3(4):M160405

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OBJECTIVE: Metabolic syndrome, which affects the general population in epidemic proportions, is associated with a set of cardiovascular disease risk factors. The aims of this cross-sectional study were to determine the prevalence and investigate the risk factors associated with metabolic syndrome in outpatients living with HIV/AIDS using anthropometric and clinical evaluations.
METHOD: The study was carried out on 253 HIV infected outpatients. Metabolic syndrome was classified according to the National Cholesterol Education Program Adult Treatment Panel III (NCEP/ATPIII) and the International Diabetes Federation (IDF) criteria. Logistic regression was used to identify factors associated with the metabolic syndrome.
RESULTS: The prevalence of metabolic syndrome varied from 19.4% to 26.4%, according to the criterion used. The factors associated with it in the two classifications used, when adjusted by sex and BMI, were age (> 40years) and subscapular skinfold (> 12 mm). In the final model, using the NCEP/ATPIII criterion the risk factors associated with metabolic syndrome were age > 40 years (OR = 3.18; CI95% = 1.42; 7.14) and subscapular skinfold > 12 mm (OR = 2.85, CI95% = 1.13; 7.17). In the final model, using the IDF criterion the risk factors associated with metabolic syndrome were age (OR = 3.38, CI95% = 1.61; 7.10) and subscapular skinfold > 12 mm (OR = 4.37, CI95% = 1.84; 10.39).
CONCLUSION: In clinical practice, the regular monitoring of subscapular skinfold can help in the identification of HIV infected individuals in risk of MS.

Keywords: Metabolic Syndrome, HIV, Anthropometric.

6 - Is there a link between upper gastrointestinal polyps and colonic polyps? A retrospective study from a Turkish cohort

Meral Sozen; Metin Yalaza; Cansel Türkay

MEDICALEXPRESS 2016;3(4):M160406

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OBJECTIVE: To investigate the incidence and associated demographical and clinical factors related to lower GI polyps and neoplasms in patients with upper GI polyps and neoplasms.
METHODS: We investigated 99 patients who had upper GI polyps and neoplasms and who were screened with colonoscopy: the following data were collected: demographical and clinical data consisting of age, sex, smoking status, presence of H. pylori infection, placement of upper GI polyps or neoplasms, presence of gastric atrophy, usage of proton pump inhibitors (PPI), presence of lower GI polyp or neoplasm, type of colon polyp, pathological grade of colon polyp. The patients were grouped according to having/not having lower GI polyps and neoplasms; data was compared between groups.
RESULTS: Smoking rate was significantly higher in patients with lower GI polyps and neoplasms (χ2: 4.35, p: 0.03). Furthermore, there was a signifant association between presence of lower GI polyps and neoplasms vs. smoking (OR: 2.44 CI: 1.01-5.84, p: 0.04).
CONCLUSIONS: Patients with upper GI polyps and neoplasms who are smokers should be considered as candidates for having lower GI polyps and neoplasms and should be screened and followed more carefully. Additionally, we believe that large sampled and prospective studies are needed to higligt the association between upper GI polyps and presence of lower GI polyps and neoplasms.

Keywords: Gastric polyps, Colon polyps, Risc factor, Retrospective.