Clinical trials

Introduction: Dengue and Chikungunya arboviral diseases are considered major public health challenges in tropical regions due to high infection rates and the occurrence of musculoskeletal sequelae that impair strength, balance, and functionality. After the acute phase, symptoms such as fatigue, joint pain, muscle weakness, and postural instability are common, reducing quality of life and hindering social and occupational reintegration.Objective: To analyze the effects of a rehabilitation protocol on muscle fatigue, muscle strength, and postural control in post-Dengue and Chikungunya patients.Methods: This is a non-randomized clinical trial conducted at the Integrated Laboratory for Research and Care in Infectious and Sequelae Diseases (LabDIS/UEPA). Individuals of both sexes, aged over 18 years, with a confirmed diagnosis of Dengue and/or Chikungunya within the last five years will be included. Data collection will include a clinical interview, surface electromyography of the flexor carpi radialis, tibialis anterior, lateral and medial gastrocnemius muscles, hydraulic and electronic dynamometry, manovacuometry, and baropodometry. The rehabilitation protocol will consist of twenty supervised sessions of aerobic, anaerobic, and respiratory exercises.Expected Results: Improvements in muscle strength, muscle fatigue, and postural control are expected following the intervention.Conclusion: The findings may support physiotherapeutic strategies aimed at improving strength, fatigue, and balance, expanding knowledge on the neuromuscular and respiratory consequences of arboviral diseases, and contributing to the development of evidence-based rehabilitation protocols, with potential positive impacts on healthcare delivery and public health policies.

The objective of this clinical trial is to evaluate the effects of transcranial direct current stimulation (tDCS) combined with constraint-induced therapy (CIT) on upper limb motor recovery in individuals after stroke. The main questions it aims to answer are: Does the combination of tDCS and CIT improve upper limb motor function compared to CIT alone? Does the combined intervention promote changes in muscle morphology and electromyographic activity? Researchers will compare the group receiving tDCS combined with constraint-induced therapy to the group receiving constraint-induced therapy alone to determine whether the addition of cortical neuromodulation enhances motor recovery outcomes. This is a randomized, controlled, and blinded clinical trial in which participants will be divided into two groups: one group will receive tDCS combined with CIMT, and the other will undergo only CIMT. The protocol will include 18 sessions over six weeks, three times a week. Clinical and instrumental assessments will be performed before, during, and after the intervention, including the Fugl-Meyer scale for the upper limb, musculoskeletal ultrasound for morphological analysis, and surface electromyography for muscle activity assessment.

Individuals with Chronic Obstructive Pulmonary Disease (COPD) present with respiratory muscle dysfunction, characterized by reduced diaphragmatic contractility and mobility due to pulmonary hyperinflation, oxidative stress, and systemic inflammation. Effective assessment of diaphragmatic function is crucial for monitoring progress in pulmonary rehabilitation programs. This study aims to evaluate diaphragmatic function and mobility in COPD patients undergoing pulmonary rehabilitation with inspiratory muscle training, using ultrasound, and to identify associations between diaphragmatic dysfunction and clinical symptoms such as dyspnea and fatigue. A randomized clinical trial will be conducted to investigate the impact of rehabilitation on diaphragmatic function, correlating it with pulmonary function and physical performance.

Introduction: Long COVID is characterized by persistent symptoms that persist for weeks or months after the acute phase of infection, with a significant impact on the cardiovascular and autonomic systems. Objectives: This study aims to evaluate the effects of a physiotherapeutic rehabilitation protocol on cardiovascular autonomic modulation and on inflammatory and cardiac biomarkers in patients with Long COVID. Methodology: This is a controlled clinical trial, carried out in a cardiorespiratory rehabilitation outpatient clinic, involving individuals with a clinical diagnosis of Long COVID undergoing a protocol of 20 aerobic, anaerobic and respiratory rehabilitation sessions. Heart rate variability (HRV) variables will be analyzed using linear and non-linear methods, in addition to serum levels of CKMB, LDH, ferritin and C-reactive protein. Expected results: Rehabilitation is expected to provide an improvement in autonomic function and a reduction in inflammatory and cardiac markers, contributing to the understanding of the pathophysiological mechanisms of Long COVID and helping to propose evidence-based therapeutic strategies.