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Eduarda Moretti

Bio: Eduarda Moretti is an academic researcher from Federal University of Pernambuco. The author has contributed to research in topics: Medicine & Systematic review. The author has an hindex of 5, co-authored 14 publications receiving 81 citations.

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Journal ArticleDOI
TL;DR: It is suggested that abdominal hypopressive gymnastics can activate the abdominal muscles and PFM and the position do not have influence on electromyographic activation level of the P FM and external oblique.

23 citations

Journal ArticleDOI
TL;DR: Very low quality of evidence shows that multiparity, age 35 years or older and high BMI (prepregnancy and during pregnancy) are risk factors for UI in pregnancy based on a very lowquality of evidence.
Abstract: Multiparity, age and high body mass index (BMI) are the most widely investigated factors associated with urinary incontinence (UI) during pregnancy. We hypothesized that multiparity, age 35 years or older and high BMI (prepregnancy and during pregnancy) are risk factors for the occurrence of UI in pregnant women. Searches were done on MEDLINE/PubMed (1966–2017), LILACS/BIREME (1982–2017), CINAHL/Ebsco (1981–2017) and Scopus/Elsevier (1950–2017). The following criteria were used for study eligibility: (1) population: low-risk pregnant women in any trimester and without age restriction; (2) exposure factors: multiparity (≥ 2 deliveries), age 35 years or older and high BMI (overweight and obesity); (3) outcome: UI during pregnancy; (4) study design: cohort, case-control or cross-sectional studies that used multivariate logistic analysis. Two independent reviewers performed the entire systematic review process. Data extraction of each article was done and, when possible, included in a meta-analysis. Risk of study bias was assessed by NOS and quality of evidence by GRADE. A significance level of p ≤ 0.05 was adopted. The PROSPERO registration number was CRD42014013193. Of 1176 articles identified through searches, 13 were included after screening and application of eligibility criteria. Very low quality of evidence shows that multiparity (OR = 2.09; 95% CI: 1.07 to 4.08), age 35 years or older (OR = 1.53; 95% CI: 1.45 to 1.62) and overweight and obesity during pregnancy (OR = 1.53; 95% CI: 1.28 to 1.83) are risk factors for UI in pregnancy. The exposure factors investigated are risk factors for UI in pregnancy based on a very low quality of evidence.

20 citations

Journal ArticleDOI
TL;DR: Moderate-quality evidence shows that results differ between self HR and control in terms of ROM gain, and does not allow to state if PNF is more or less effective than other stretches for improving ROM in healthy young adults.
Abstract: The objective of this study was to evaluate the efficacy of proprioceptive neuromuscular facilitation (PNF) on range of motion (ROM) gain in young healthy adults. We performed a systematic review of randomized controlled trials and quasi-randomized trials, including young healthy adults. The interventions were: PNF compared with different PNF techniques, control, other muscle stretching exercises and musculoskeletal manipulations. The outcome measures were: articular ROM and adverse effects. The final number of included studies was 46, involving 1,864 adults. There was difference on ROM comparing assisted hold-relax (HR) on diagonal plane to control, based on very low-quality evidence. There was also difference on ROM comparing assisted HR to self-HR; self-contract-relax (CR) to control; assisted CR contract to control; and assisted HR contract to control, based on low-quality evidence. Moderate-quality evidence shows that results differ between self HR and control (SMD: 0.95; 95%CI 0.03, 1.86; I2...

15 citations

Journal ArticleDOI
TL;DR: To compare the electromyographic signal of different surface electrodes and to identify the channel that presents the highest level of electromyography activity through the mean and peak of Root Mean Square (RMS).
Abstract: Aims To compare the electromyographic signal of different surface electrodes and to identify the channel that presents the highest level of electromyographic activity through the mean and peak of Root Mean Square (RMS). Methods Thirty healthy women participated in this study. Each woman completed three collections (on different days) of electromyographic data. Three maximal voluntary contractions of the pelvic floor muscles were requested. The electromyographic signal was recorded by intravaginal probe and surface electrodes placed on the perianal region and on the region immediately below the labia majora. To analyze the signal, an epoch of 500 ms was selected during the second contraction. The Kruskal-Wallis test followed by a post hoc Mann-Whitney test was used to compare means and to identify differences. The Bland-Altman method was used to verify the agreement between the measurements. A significance level of P ≤ 0.05 was adopted. Results There was agreement only between the measurements from perianal electrodes and intravaginal probe. Furthermore, there was no difference between the perianal electrodes and intravaginal probe in RMS mean (P = 0.225) and RMS peak (P = 0.315). However, these electrodes locations presented greater values than the electrodes in the region immediately below the labia majora (RMS mean: P < 0.001; P = 0.016. RMS peak: P < 0.001; P = 0.02). Conclusions The intravaginal probe and the surface electrodes in perianal region are equivalent for healthy nulliparous women. The choice must be done according to the values and preferences of the patient.

14 citations

Journal ArticleDOI
TL;DR: The results, based on very low quality of evidence, were inconclusive regarding pain, and showed no clinically important effects on the control of fatigue and improvement of quality of life.
Abstract: Purpose: To determine the quality of evidence on the use of whole-body vibration (WBV) in controlling pain, fatigue and quality of life in women with fibromyalgia.Methods: The search involved MEDLINE/PubMed, LILACS, CINAHL, CENTRAL and PEDro, without temporal or language restriction. The terms “fibromyalgia” and “whole-body vibration” were used. Trials (randomized or quasi-randomized) that compared a group of women with fibromyalgia who received WBV to a control group with no intervention were included. The quality of evidence was assessed using the GRADE system. The quantitative evaluation by meta-analysis was also used, whenever possible.Results: Three studies were included. Regarding the outcome pain, it has not been possible to assess the magnitude of effect of treatment. The result of the outcome fatigue showed no difference between the groups after the proposed intervention (Mean Difference: 0.01; 95% CI: −0.11 to 0.09). The meta-analysis for the outcome quality of life showed a small differ...

13 citations


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ReportDOI
05 Sep 2018
TL;DR: This guide to treatments for low back pain, fibromyalgia, and tension headache can be helpful in finding the right treatment for individual patients.
Abstract: Objectives Many interventions are available to manage chronic pain; understanding the durability of treatment effects may assist with treatment selection. We sought to assess which noninvasive nonpharmacological treatments for selected chronic pain conditions are associated with persistent improvement in function and pain outcomes at least 1 month after the completion of treatment. Data sources Electronic databases (Ovid MEDLINE®, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews) through November 2017, reference lists, and ClinicalTrials.gov . Review methods Using predefined criteria, we selected randomized controlled trials of noninvasive nonpharmacological treatments for five common chronic pain conditions (chronic low back pain; chronic neck pain; osteoarthritis of the knee, hip, or hand; fibromyalgia; and tension headache) that addressed efficacy or harms compared with usual care, no treatment, waitlist, placebo, or sham intervention; compared with pharmacological therapy; or compared with exercise. Study quality was assessed, data extracted, and results summarized for function and pain. Only trials reporting results for at least 1 month post-intervention were included. We focused on the persistence of effects at short term (1 to Results Two hundred eighteen publications (202 trials) were included. Many included trials were small. Evidence on outcomes beyond 1 year after treatment completion was sparse. Most trials enrolled patients with moderate baseline pain intensity (e.g., >5 on a 0 to 10 point numeric rating scale) and duration of symptoms ranging from 3 months to >15 years. The most common comparison was against usual care. Chronic low back pain : At short term, massage, yoga, and psychological therapies (primarily CBT) (strength of evidence [SOE]: moderate) and exercise, acupuncture, spinal manipulation, and multidisciplinary rehabilitation (SOE: low) were associated with slight improvements in function compared with usual care or inactive controls. Except for spinal manipulation, these interventions also improved pain. Effects on intermediate-term function were sustained for yoga, spinal manipulation, multidisciplinary rehabilitation (SOE: low), and psychological therapies (SOE: moderate). Improvements in pain continued into intermediate term for exercise, massage, and yoga (moderate effect, SOE: low); mindfulness-based stress reduction (small effect, SOE: low); spinal manipulation, psychological therapies, and multidisciplinary rehabilitation (small effects, SOE: moderate). For acupuncture, there was no difference in pain at intermediate term, but a slight improvement at long term (SOE: low). Psychological therapies were associated with slightly greater improvement than usual care or an attention control on both function and pain at short-term, intermediate-term, and long-term followup (SOE: moderate). At short and intermediate term, multidisciplinary rehabilitation slightly improved pain compared with exercise (SOE: moderate). High-intensity multidisciplinary rehabilitation (≥20 hours/week or >80 hours total) was not clearly better than non–high-intensity programs. Chronic neck pain : At short and intermediate terms, acupuncture and Alexander Technique were associated with slightly improved function compared with usual care (both interventions), sham acupuncture, or sham laser (SOE: low), but no improvement in pain was seen at any time (SOE: llow). Short-term low-level laser therapy was associated with moderate improvement in function and pain (SOE: moderate). Combination exercise (any 3 of the following: muscle performance, mobility, muscle re-education, aerobic) demonstrated a slight improvement in pain and function short and long term (SOE: low). Osteoarthritis : For knee osteoarthritis, exercise and ultrasound demonstrated small short-term improvements in function compared with usual care, an attention control, or sham procedure (SOE: moderate for exercise, low for ultrasound), which persisted into the intermediate term only for exercise (SOE: low). Exercise was also associated with moderate improvement in pain (SOE: low). Long term, the small improvement in function seen with exercise persisted, but there was no clear effect on pain (SOE: low). Evidence was sparse on interventions for hip and hand osteoarthritis. Exercise for hip osteoarthritis was associated with slightly greater function and pain improvement than usual care short term (SOE: low). The effect on function was sustained intermediate term (SOE: low). Fibromyalgia : In the short term, acupuncture (SOE: moderate), CBT, tai chi, qigong, and exercise (SOE: low) were associated with slight improvements in function compared with an attention control, sham, no treatment, or usual care. Exercise (SOE: moderate) and CBT improved pain slightly, and tai chi and qigong (SOE: low) improved pain moderately in the short term. At intermediate term for exercise (SOE: moderate), acupuncture, and CBT (SOE: low), slight functional improvements persisted; they were also seen for myofascial release massage and multidisciplinary rehabilitation (SOE: low); pain was improved slightly with multidisciplinary rehabilitation in the intermediate term (SOE: low). In the long term, small improvements in function continued for multidisciplinary rehabilitation but not for exercise or massage (SOE: low for all); massage (SOE: low) improved long-term pain slightly, but no clear impact on pain for exercise (SOE: moderate) or multidisciplinary rehabilitation (SOE: low) was seen. Short-term CBT was associated with a slight improvement in function but not pain compared with pregabalin. Chronic tension headache : Evidence was sparse and the majority of trials were of poor quality. Spinal manipulation slightly improved function and moderately improved pain short term versus usual care, and laser acupuncture was associated with slight pain improvement short term compared with sham (SOE: low). There was no evidence suggesting increased risk for serious treatment-related harms for any of the interventions, although data on harms were limited. Conclusions Exercise, multidisciplinary rehabilitation, acupuncture, CBT, and mind-body practices were most consistently associated with durable slight to moderate improvements in function and pain for specific chronic pain conditions. Our findings provided some support for clinical strategies that focused on use of nonpharmacological therapies for specific chronic pain conditions. Additional comparative research on sustainability of effects beyond the immediate post-treatment period is needed, particularly for conditions other than low back pain.

160 citations

Journal ArticleDOI
TL;DR: It is observed that the evidence for improvement of pain level and quality of life was the strongest and future studies should analyze the long-term effects of exercise.

48 citations

Journal ArticleDOI
TL;DR: Evidence suggests positive effects ofWBVE on chronic musculoskeletal pain, and long durations of WBVE could be especially beneficial, however, WBVE does not significantly relieve chronicMusculoskletal pain compared with the traditional treatment.

27 citations

Journal Article
TL;DR: The meta-analysis showed a significant effect size and that the PNF is superior than conventional physical therapy in decreasing pain, increasing external rotation, and abduction ROM.
Abstract: This systematic review aims to determine the effectiveness of proprioceptive neuromuscular facilitation (PNF) treatment techniques in adhesive capsulitis for decreasing pain and disability and increasing range of motion (ROM) and function. A thorough, computerized search was done using database search engines by two reviewers. After meticulous scrutiny and screening of 410 studies, according to the selection criteria, 10 full-text articles were included in the review and meta-analysis. All 10 studies had undergone a methodological quality assessment by the Physiotherapy Evidence Database Scale. Meta-analysis was done for external rotation, abduction ROM and pain. The most common PNF techniques used by most of the studies were, hold-relax and contract-relax in upper limb D2 flexion, abduction, and an external rotation pattern, while some studies used scapular PNF patterns. Among the 10 included studies, nine showed that the PNF group is superior in decreasing pain and reducing disability, increasing ROM, improving function. The meta-analysis also showed a significant effect size and that the PNF is superior than conventional physical therapy in decreasing pain, increasing external rotation, and abduction ROM.

24 citations

Journal ArticleDOI
01 Feb 2014
TL;DR: The elderly presented high TMD prevalence, mostly in females, with mild severity and related to TMJ and masticatory/cervical muscles palpation, thus, the accomplishment of a detailed clinical examination to investigate the presence of such disorders is essential and it must not be neglected during the treatment of elderly patients.
Abstract: Objetivo: O objetivo deste estudo foi investigar a prevalencia de Transtornos Temporomandibulares (DTM) em idosos e sua associacao com a palpacao da articulacao temporomandibular (ATM), dos musculos mastigatorios e cervicais, bem como com a presenca de dores de cabeca e ruidos articulares Metodos: A amostra foi composta por 200 idosos, de ambos os generos (media de idade: 69,2±5,7 anos) A avaliacao clinica dos sinais e sintomas foi dividida em tres etapas: aplicacao de questionario anamnesico, avaliacao da ATM e exame muscular Os resultados foram avaliados por meio de estatistica descritiva, teste do χ2 e teste de tendencia Resultados: A presenca de DTM foi observada em 61% da amostra (leve: 43,5%, moderada: 13%, intensa/grave: 4,5%) Verificou-se prevalencia significantemente maior de DTM para as mulheres (72,4%) em comparacao aos homens (41,1%) (p<0,0001) Houve associacao significante entre a severidade da DTM e a presenca de dor a palpacao da ATM (p=0,0168), dos musculos mastigatorios (p<0,0001) e cervicais (p<0,0001) Observou-se associacao significante entre a frequencia de dores de cabeca e a presenca de DTM (p=0,0001) Nao houve associacao significante entre a presenca de ruidos articulares e a sensibilidade a palpacao da ATM Conclusao: Os idosos apresentaram alta prevalencia de DTM, em sua maioria no genero feminino, de grau leve, relacionada a palpacao na ATM e nos musculos mastigatorios e cervicais Assim, e essencial a realizacao de um completo exame clinico para investigar a presenca desses transtornos, especialmente durante o tratamento de idosos

22 citations