Context: Ankle fractures (AFs) are the most common fractures of the lower limbs found in emergency services. Approximately 53% of these fractures are unstable and treated surgically. Objective: To conduct a systematic review evaluating functional outcomes and quality of life of patients with AFs surgically treated. Evidence Acquisition: A systematic review was conducted in accordance with the Preferred Reporting Items for Systematic reviews and Meta-Analyses statement. Five electronic databases were searched, without any limit on publication dates. Only patients with an unstable AF that was surgically treated were included; functional outcomes and the quality of life were controlled by the 36-Item Short-Form Health Survey instrument. Evidence Synthesis: Five studies were included in the analysis, including 267 patients. The values of the Physiotherapy Evidence Database scale ranged between a minimum of 5 and a maximum of 7 points. Patients with surgically treated AF reported less functionality and physical capacity compared with the nonfractured population. Some patients experienced vitality, emotional, and mental health limitations for a long period. Most surgically treated patients reported no pain and a good health and social status. Conclusion: Limitations in functionality and physical capacity represent the main threats to health-related quality of life in patients with surgically treated AFs.
Viviane Ribeiro de Ávila, Teresa Bento, Wellington Gomes, José Leitão and Nelson Fortuna de Sousa
Catarina Vasques, Pedro Magalhães, António Cortinhas, Paula Mota, José Leitão and Vitor Pires Lopes
This meta-analysis study aims to assess the efficacy of school-based and after-school intervention programs on the BMIs of child and adolescents, addressing the correlation between some moderating variables.
We analyzed 52 studies (N = 28,236) published between 2000–2011.
The overall effect size was 0.068 (P < .001), school (r = .069) and after-school intervention (r = .065). Programs conducted with children aged between 15–19 years were the most effective (r = .133). Interventions programs with boys and girls show better effect sizes (r = .110) than programs that included just girls (r = .073). There were no significant differences between the programs implemented in school and after-school (P = .770). The effect size was higher in interventions lasting 1 year (r = .095), with physical activity and nutritional education (r = .148), and that included 3–5 sessions of physical activity per week (r = .080). The effect size also increased as the level of parental involvement increased.
Although of low magnitude (r = .068), the intervention programs had a positive effect in prevention and decreasing obesity in children. This effect seems to be higher in older children’s, involving interventions with physical activity and nutritional education combined, with parent’s participation and with 1-year duration. School or after-school interventions had a similar effect.
Flávia Cavalcante Monteiro Melo, Kátia Kamila Félix de Lima, Ana Paula Knackfuss Freitas Silveira, Kesley Pablo Morais de Azevedo, Isis Kelly dos Santos, Humberto Jefferson de Medeiros, José Carlos Leitão and Maria Irany Knackfuss
Context: Physical training improves the strength of upper limbs, contributing directly to the performance of activities of daily life, confirming one more time that the strengthened muscle is imperative for a rapid rehabilitation. Objective: To investigate the scientific implications of the impact of physical training on the strength of the upper limbs of people with paraplegias. Evidence Acquisition: The search strategy with truncations and Boolean operator was defined as: (spinal cord inju* OR traumatic myelopat* OR paraplegi*) AND (physical exercise OR strength training OR resisted training) AND (upper limb* OR arm OR armrest), for all of the databases. There were included experimental and quasi-experimental studies, published in the English language and with the complete text available, with at least 1 physical exercise that worked with the strength of the upper limbs. Two independent evaluators extracted from each article data on study characteristics (publishing year, country of origin, and study design), of the subjects (gender and age), and of the disability (level of lesion and cause). Evidence Synthesis: Seven articles were included in the systematic revision. The procedure used the most for measuring the maximum strength was the 1-repetition maximum test, followed by the isokinetic dynamometer and Quantitative Muscle Testing System. Furthermore, the most commonly associated variables in the included studies were pain in the shoulder, cardiorespiratory capacity, and functionality, respectively. The results showed that all of the variables improved because of the training. Conclusions: The training improved the strength, the functionality, and reduced the pain in the shoulder of the people with paraplegia.