AMELIA PASQUAL MARQUES
Projetos de Pesquisa
Unidades Organizacionais
Departamento de Fisioterapia, Fonoaudiologia e Terapia Ocupacional, Faculdade de Medicina - Docente
LIM/54 - Laboratório de Bacteriologia, Hospital das Clínicas, Faculdade de Medicina
LIM/54 - Laboratório de Bacteriologia, Hospital das Clínicas, Faculdade de Medicina
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- Comparison of the effects of low-level laser and pulsed and continuous ultrasound on pain and physical disability in chronic non-specific low back pain: a randomized controlled clinical trial(2019) RUBIRA, Ana Paula Fernandes De Angelis; RUBIRA, Marcelo Custodio; RUBIRA, Lucas De Angelis; COMACHIO, Josielli; MAGALHAES, Mauricio Oliveira; MARQUES, Amelia PasqualObjective To compare the short-term effects of pulsed laser and pulsed and continuous ultrasound on pain and functional disability in women with chronic non-specific low back pain. Methods The sample was composed of 100 volunteers randomly allocated into four groups: The Pulsed Laser Group (n = 26) was treated with 3 J/cm(2); the Pulsed Ultrasound Group (n = 24; 3 MHz) was treated with 1 W/cm(2); the Continuous Ultrasound Group (n = 26; 1 MHz) was treated with 1 W/cm(2); and a Control Group (n = 24), where the patients were still waiting for treatment. Before and after 10 sessions of treatment, the intensity of pain was assessed using the visual analogue scale (VAS), the quality of pain was evaluated using the McGill pain questionnaire and functional disability was investigated using the Roland-Morris questionnaire. Results The three treated groups exhibited a decrease in pain (p < 0.001); the Pulsed Laser Group showed the greater relative gain (91.2%), Meanwhile, the Control Group exhibited a worsening of - 5.8%. The three treated groups demonstrated improvement in the quality of pain (McGill) in the total, sensory and affective dimensions (p < 0.005; p < 0.002; p < 0.013, respectively). All treated groups showed a decrease in functional disability (p < 0.001), but the Pulsed Ultrasound Group showed the highest relative gain (83.3%). Conclusions The three modalities have significant effects to decreasing low back pain and improving functional disability in women with non-specific chronic low back pain, but the pulsed low-level laser had the best results on pain while the pulsed ultrasound had the best results on improve the functional disability.
- Low back pain prevalence in Sao Paulo, Brazil: A cross-sectional study(2021) GONZALEZ, Gabrielle Z.; SILVA, Tatiane da; AVANZI, Marina A.; MACEDO, Gabriel T.; ALVES, Shirley S.; INDINI, Luciana S.; EGEA, Luzinete M. P.; MARQUES, Amelia P.; PASTRE, Carlos M.; COSTA, Luciola da C. M.; COSTA, Leonardo O. P.Background: Low back pain (LBP) is the leading cause of disability worldwide, and the burden of LBP is expected to increase in coming decades, particularly in middle-income countries. There is a lack of large and high-quality studies investigating the prevalence of LBP in Brazil. Objective: To estimate the point, one-year, and lifetime prevalence of non-specific LBP in adults from the city of Sao Paulo, Brazil. Methods: This community-based, cross-sectional study recruited 3000 participants in flow point locations randomly selected from census sectors of Sao Paulo. Interviews and self-administered questionnaires were used to estimate point prevalence, one-year prevalence, and lifetime prevalence of LBP. Results: The estimate of point prevalence was 9.8% (95% CI: 8.8, 11.0), one-year prevalence was 48.1% (95% CI: 46.3, 49.9), and lifetime prevalence was 62.6% (95% CI: 60.8, 64.3). One-year and lifetime prevalence were higher in females, obese people, people insufficiently active and sedentary, current smokers, people who are exposed to repetitive movements, crouched or kneeling position, people dissatisfied with their job, people a little bit or very stressed, a little bit or very anxious, and a little bit depressed, and people with good and fair or poor general health. Lifetime prevalence was also higher in people exposed to standing positions and exposure to carrying weight. Conclusions: The high point, one-year, and lifetime prevalence of LBP in Brazil indicates that there is a need for coordinated efforts from government, the private sector, universities, health workers, and civil society to deliver appropriate management of LBP in middle-income countries.
article 40 Citação(ões) na Scopus Postural control and balance self-efficacy in women with fibromyalgia: are there differences?(2015) MUTO, L. H. A.; SAUER, J. F.; YUAN, S. L. K.; SOUSA, A.; MANGO, P. C.; MARQUES, A. P.Background. Fibromyalgia (FM) is a rheumatic disease characterized by chronic widespread pain and symptoms such as fatigue, sleep disturbances, cognitive difficulties, and depression. Postural instability is a debilitating disorder increasingly recognized as part of FM. Objective. To assess and compare postural control and balance self-efficacy in women with and without FM and verify the association of these variables with pain, symptom severity, and strength. Design. Case-control study Setting. Physiotherapeutic Clinical Research and Electromyography Laboratory Department of Physical Therapy, Speech Therapy, and Occupational Therapy, School of Medicine, University of Sao Paulo, Sao Paulo, Brazil. Population. Case-control study of 117 women ranging from age 35 to 60 years. Of these, 67 had FM. Methods. Posture control was assessed with the modified clinical test of sensory interaction on balance with patients in forceplates, balance self-efficacy with the Activities-specific Balance Confidence Scale, pain severity with the Visual Analog Scale, tender point pain threshold with digital algometry, symptom severity with the fibromyalgia impact questionnaire, and lower limb strength with a dynamometer. Results. Individuals with FM had impaired postural control showing increased speed of oscillation of the center of gravity (P=0.004) and decreased balance self-efficacy (P<0.001). They had moderate to excellent correlations of balance self-efficacy with pain (r=0.7, P<0.01), muscle strength (r=0.52, P<0.01), and symptom severity (r=0.78, P<0.10) compared with the control group. Correlation of postural control with the same variables was weak. Conclusions. Patients with FM have impaired postural control and low balance self-efficacy that are associated with pain, muscle strength, and symptom severity. Clinical Rehabilitation Impact. Postural control and balance self-efficacy needs to be assessed in patients with FM and the treatment goals should be the improvement of postural control and balance self-efficacy.- Amigos de Fibro (Fibro Friends): development of an educational program for the health promotion of fibromyalgia patients(2022) ANTUNES, Mateus Dias; SCHMITT, Ana Carolina Basso; MARQUES, Amelia PasqualBackground: Educational practices are indicated to promote the health of people with fibromyalgia in primary health care. We aimed to develop an educative interdisciplinary program intended at the health promotion of individuals with fibromyalgia. Methods: It is a study protocol that was developed following three phases in the city of Sao Paulo city, Brazil. Qualitative research was carried out, through a focal group, with 12 individuals with fibromyalgia and 10 health professionals. A thematic content analysis was made according to the content proposed by Bardin. Results: Fibro Friends is an interdisciplinary program with educational approaches that must be performed in 15 meetings, once a week for 1 h and 20 min. Participants were the following professionals: a Physiotherapist, a Doctor, a Psychologist, a Nutritionist, a Nurse, a Pharmacist/Druggist, a Speech Therapist, an Occupational Therapist, a Naturopath, and a Social Worker. A physical exercise program will also be carried out. The professionals must discuss in a lecture, conversation hearing, and/or group dynamic, about strategies to promote health and pain control in fibromyalgia. Conclusion: Fibro Friends is a program presenting educational interdisciplinary information to individuals with fibromyalgia, being considered a trend to future care. Fibro Friends is a practical guide, logical, and efficient to patients with fibromyalgia at the basic attention to health.
- Effectiveness of different styles of massage therapy in fibromyalgia: A systematic review and meta-analysis(2015) YUAN, Susan Lee King; MATSUTANI, Luciana Akemi; MARQUES, Amelia PasqualThe systematic review aimed to evaluate the effectiveness of massage in fibromyalgia. An electronic search was conducted at MEDLINE, SCiELO, EMBASE, ISI, PEDro, SPORTDiscus, CINAHL, Cochrane CENTRAL and LILACS (Jan 1990-May 2013). Ten randomized and non-randomized controlled trials investigating the effects of massage alone on symptoms and health-related quality of life of adult patients with fibromyalgia were included. Two reviewers independently screened records, examined full-text reports for compliance with the eligibility criteria, and extracted data. Meta-analysis (pooled from 145 participants) shows that myofascial release had large, positive effects on pain and medium effects on anxiety and depression at the end of treatment, in contrast with placebo; effects on pain and depression were maintained in the medium and short term, respectively. Narrative analysis suggests that: myofascial release also improves fatigue, stiffness and quality of life; connective tissue massage improves depression and quality of life; manual lymphatic drainage is superior to connective tissue massage regarding stiffness, depression and quality of life; Shiatsu improves pain, pressure pain threshold, fatigue, sleep and quality of life; and Swedish massage does not improve outcomes. There is moderate evidence that myofascial release is beneficial for fibromyalgia symptoms. Limited evidence supports the application of connective tissue massage and Shiatsu. Manual lymphatic drainage may be superior to connective tissue massage, and Swedish massage may have no effects. Overall, most styles of massage therapy consistently improved the quality of life of fibromyalgia patients.
- The effectiveness of aquatic physical therapy in the treatment of fibromyalgia: a systematic review with meta-analysis(2013) LIMA, Tarcisio Brandao; DIAS, Josilainne Marcelino; MAZUQUIN, Bruno Fles; SILVA, Carla Tassiana da; NOGUEIRA, Regiane Mazzarioli Pereira; MARQUES, Amelia Pasqual; LAVADO, Edson Lopes; CARDOSO, Jefferson RosaObjective: To assess the effectiveness of aquatic physical therapy in the treatment of fibromyalgia. Data sources: The search strategy was undertaken using the following databases, from 1950 to December 2012: MEDLINE, EMBASE, CINAHL, LILACS, SCIELO, WEB OF SCIENCE, SCOPUS, SPORTDiscus, Cochrane Library Controlled Trials Register, Cochrane Disease Group Trials Register, PEDro and DARE. Review methods: The studies were separated into groups: Group I - aquatic physical therapy x no treatment, Group II - aquatic physical therapy x land-based exercises and Group III - aquatic physical therapy x other treatments. Results: Seventy-two abstracts were found, 27 of which met the inclusion criteria. For the functional ability (Fibromyalgia Impact Questionnaire), three studies were considered with a treatment time of more than 20 weeks and a mean difference (MD) of -1.35 [-2.04; -0.67], P = 0.0001 was found in favour of the aquatic physical therapy group versus no treatment. The same results were identified for stiffness and the 6-minute walk test where two studies were pooled with an MD of -1.58 [-2.58; -0.58], P = 0.002 and 43.5 (metres) [3.8; 83.2], P = 0.03, respectively. Conclusion: Three meta-analyses showed statistically significant results in favour of the aquatic physical therapy (Fibromyalgia Impact Questionnaire, stiffness and the 6-minute walk test) during a period of longer than 20 weeks. Due to the low methodological rigor, the results were insufficient to demonstrate statistical and clinical differences in most of the outcomes.
- Effects of a six-week mobile app versus paper book intervention on quality of life, symptoms, and self-care in patients with fibromyalgia: a randomized parallel trial(2021) YUAN, Susan Lee King; COUTO, Leticia Assis; MARQUES, Amelia PasqualBackground: The ProFibro application (app) was developed as a Mobile Health resource to promote self-care in fibromyalgia management. Objective: This study aimed to assess the effects of the use of the ProFibro app for six weeks compared to the use of a traditional paper book of similar content to improve health-related quality of life, symptoms, and self-care agency in individuals with fibromyalgia. Methods: Forty individuals with fibromyalgia were included in this randomized, single-blind, parallel trial. One group received intervention content using the ProFibro app on a smartphone while the other received similar information using a paper book. Participants were assessed at baseline and after six weeks. The primary outcome was the Revised Fibromyalgia Impact Questionnaire. Secondary outcomes were Widespread Pain Index, Pain Visual Analog Scale, Symptom Severity Scale, and Appraisal of Self-Care Agency Scale - Revised. Results: No differences in changes were found between groups at the end of the treatment for any outcome. Both groups showed improvements in symptom severity. Conclusions: The use of the ProFibro app for six weeks was not more effective than the use of a traditional paper book with similar content for health-related quality of life, symptoms, or self-care agency in individuals with fibromyalgia. Both groups showed improvements from baseline on severity of symptoms, suggesting that the self-care program using a mobile app or a paper book may be beneficial for individuals with fibromyalgia.
article Effect of Different Frequencies of Electroacupuncture on Chronic Low Back Pain in Older Adults: A Triple-blind, Placebo-controlled, Randomized Clinical Trial(2023) TORRES, Sarina Francescato; MACEDO, Ana Carolina Brandt de; SAKAI, Regina Yassue; BRESSAN, Gabriele Cristina Seguro; SANTOS, Matheus Bieberbach Rodrigues dos; MARQUES, Amelia PasqualBackground: Acupuncture is one of the most widely used therapies to treat chronic low back pain, whose analgesic effect seems to be potentiated by the addition of electric current (electroacupuncture). However, we are not aware of any clinical trial that has evaluated the effectiveness of this technique in adults > 65 years. Objective: To evaluate the effect of electroacupuncture in the treatment of chronic low back pain in the elderly. Study Design: Triple-blind, controlled, and randomized clinical trial. Setting: Faculty of Medicine, University of Sao Paulo (USP); Sector of Biological Sciences Physiotherapy Course, Federal University of Parana (UFPR). Methods: The study included 125 elderly people with chronic nonspecific low back pain who were randomized to one of 5 study groups: 3 of electroacupuncture; one control; and one placebo, all of them treated for 5 weeks. The primary endpoint was pain intensity, and secondary endpoints included the qualitative aspect of pain, functional disability (Roland-Morris and sit and stand test), emotional functioning (depression and anxiety), and psychosocial factors. Data analysis followed the intention-to-treat principle. The confidence interval was set at 95% and the significance level at 5%. Results: All groups achieved a reduction in pain intensity; however, a significant difference was only detected between electroacupuncture and placebo, where the latter showed greater pain reduction. Regarding secondary outcomes, all groups showed good posttreatment results for all assessments but without statistical significance. Among the groups, the placebo was the one that obtained the best results between the pre- and post-treatment for depression, qualitative aspect of pain, and functional disability, but only for the qualitative aspect of pain and for the sit-and-stand test was a significant reduction found in the intergroup comparison. The analysis of the overall effect perceived by the participants in relation to low back pain revealed that individuals from all groups felt close to full recovery. Limitations: Absence of follow-up and a relatively small number of patients. Conclusions: This study provides evidence that there is no one frequency of electroacupuncture that is most effective in treating chronic low back pain in the elderly and that electroacupuncture is not superior to manual acupuncture or placebo treatment.- Effect of Physical Therapy in Bruxism Treatment: A Systematic Review(2018) AMORIM, Cinthia S. M.; SANTO, Adriana S. Espirito; SOMMER, Marjorie; MARQUES, Amelia P.Objective: The aim of this literature review was to examine the effect of physical therapy in bruxism treatment. Methods: The data sources used were Medline, Excerpta Medica Database, Cumulative Index of Nursing and Allied Health Literature, Physiotherapy Evidence Database, SPORTDiscus, Scientific Electronic Library Online, Web of Science, Cochrane Library, Scopus, and Literatura Latino-Americana e do Caribe em Ciencias da Saude. We included randomized and nonrandomized and controlled and noncontrolled clinical trials and interventions focused on physical therapy as treatment for sleep bruxism or awake bruxism. Two reviewers independently screened the records, examined full-text reports for compliance with the eligibility criteria, and extracted data. Results: The present review found 1296 articles. We excluded 766 duplicated articles and 461 irrelevant articles and selected 69 titles to read. Forty-five of these were excluded, leading to a total of 24 that met the eligibility criteria and were included in our analysis. The articles were grouped into 7 treatment methods used in physical therapy. The treatment methods were electrotherapeutic (14 articles), cognitive-behavioral therapy (3 articles), therapeutic exercises (2 articles), acupuncture (2 articles), postural awareness (1 article), muscular relaxation (1 article), and massage (1 article). Results and conclusions, methodological quality, and quality of evidence of each study were reported. Conclusions: These results suggest very low-quality evidence that diverse methods used in physical therapy improve muscle pain and activity, mouth opening, oral health, anxiety, stress, depression, temporomandibular disorder, and head posture in individuals with bruxism. This finding is mainly a result of the poor methodological quality of most of the studies.
- Effect of a telerehabilitation exercise program versus a digital booklet with self-care for patients with chronic non-specific neck pain: a protocol of a randomized controlled trial assessor-blinded, 3 months follow-up(2023) BARBOSA, Juliene Correa; COMACHIO, Josielli; MARQUES, Amelia Pasqual; SARAGIOTTO, Bruno Tirotti; MAGALHAES, Mauricio OliveiraBackgroundNeck pain is the fourth worldwide leading cause of disability and represents 22% of musculoskeletal disorders. Conservative intervention has been strongly recommended to treat chronic neck pain and Telerehabilitation is the alternative for the treatment of musculoskeletal conditions. There is a lack of high-quality research on the effects of telerehabilitation in patients with neck pain and functional disability. Therefore, this study aims to evaluate the effect of a telerehabilitation exercise program versus a digital booklet only with self-care information in individuals with non-specific chronic neck pain.MethodsThis is a prospectively registered, assessor-blinded, two-arm randomized controlled trial comparing a telerehabilitation exercise program versus a digital booklet with self-care information. Seventy patients will be recruited with non-specific chronic neck pain. Follow-ups will be conducted post-treatment, 6 weeks, and 3 months after randomization. The primary outcome will be disability at post-treatment (6 weeks) measured using neck pain disability. Secondary outcomes will be pain intensity levels, global perceived effect, self-efficacy, quality of life, kinesiophobia, and adherence to treatment. In our hypothesis, patients allocated to the intervention group experience outcomes that are similar to those of those assigned to the self-care digital booklet. Our hypothesis can then be approved or disapproved based on the results of the study.DiscussionThis randomized clinical trial will provide reliable information on the use of telerehabilitation to treat patients with chronic non-specific neck pain.Trial registrationThe study was prospectively registered at the Brazilian Registry of Clinical Trials (number: RBR-10h7khvk). Registered on 16 September 2022.