Universidade Federal do Rio Grande do Norte

Exercise training is essential in pulmonary rehabilitation (PR) for individuals with chronic obstructive pulmonary disease (COPD). In Brazil, physical therapists typically deliver exercise in PR. This document presents ASSOBRAFIR recommendations for prescribing exercise training for patients with COPD.

To provide evidence-based recommendations for structuring exercise training programs for people with COPD.

The guideline panel followed the Guidelines International Network (GIN) principles and the Appraisal of Guidelines for Research & Evaluation (AGREE-II) to ensure methodological rigor. The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach was employed to assess the certainty of evidence (CoE). This method assessed evidence quality and developed recommendations for five key questions addressing aspects of exercise training for people with stable COPD. Treatment effects were evaluated using systematic reviews and meta-analyses.

The following conditional recommendations were drawn: 1. Combined exercise training (aerobic + resistance) is suggested over aerobic training alone (very-low CoE); 2. No suggestion for or against adding inspiratory muscle training, non-invasive ventilation, or supplemental oxygen to combined exercise training (moderate to very-low CoE); 3. Either interval or continuous training is suggested, with no preference for partitioned or nonlinear training (moderate to very-low CoE); 4. Maintenance exercise programs are suggested as an alternative to usual care after PR (very-low CoE); 5. Minimal resource exercise training, especially with elastic resistance, or conventional exercise training is suggested (very-low CoE).

The results of the present guideline can aid clinicians in structuring exercise training for people with COPD.

Efficacy of cupping is known to be controversial, and the heterogeneity of the studies contributes to the uncertainty about its real benefits.

To evaluate the effects of dry cupping therapy on pain, disability, functional capacity, and quality of life compared to sham cupping in women with knee osteoarthritis (KOA).

This is a randomized placebo-controlled trial. Women with KOA aged 50-75 years were randomized into two groups: an experimental group, (receiving dry cupping therapy) and a control group (receiving sham cupping). Treatments consisted of 12 sessions, for 15 min, 2 × /week, for 6 consecutive weeks. Groups were evaluated at baseline (T0), 3 weeks after randomization (T3), at post-intervention or 6 weeks after randomization (T6), and 10 weeks after randomization (follow-up: T10). The primary outcome was pain intensity at rest or during movement, and secondary outcomes were the Global Perceived Effect (GPE), 30-seconds sit-to-stand test (STS-30), disability, 40-meter Fast-paced Walk Test (40mFPWT), and 8-step stair climb test (8-step SCT).

A total of 62 women with KOA were recruited. We observed a significant within-group reduction for the primary outcome (i.e., pain intensity at rest and during movement) and for some secondary outcomes, there were no differences between groups for all variables in any of the timepoints.

Dry cupping therapy was not superior to sham cupping in improving pain, functional capacity, and quality of life, and in GPE in women with knee osteoarthritis.

NCT04331158.

Alcohol consumption during pregnancy is a major public health concern, as prenatal exposure to ethanol can disrupt embryonic development and lead to Fetal Alcohol Spectrum Disorders (FASD). These disorders are characterized by a wide range of morphological, behavioral, and cognitive impairments, which variability across individuals is strongly influenced by genetic background and environmental conditions. Animal models, particularly zebrafish, offer a powerful tool to investigate how such factors modulate susceptibility to alcohol. In this study, we examined the effects of embryonic alcohol exposure in three zebrafish populations (AB, TU, and OB), assessing developmental parameters, behavior, and gene expression. Results showed that the OB population exhibited higher mortality and pronounced alterations in genes related to metabolism and neurotransmission; AB displayed reduced body and eye growth, along with increased social cohesion under alcohol exposure; while TU was more vulnerable to behavioral effects despite showing morphological resilience. Furthermore, the expression of key genes such as sox2, th1, drd1b, gabra1, and bdnf varied according to both population and alcohol concentration. These findings emphasize the relevance of genetic differences in modulating alcohol's impact and reinforce zebrafish as a valuable translational model for FASD research, paving the way for more refined diagnostic and therapeutic approaches.