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    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Introdu&#231;&#227;o</span><p id="par0005" class="elsevierStylePara elsevierViewall">A fibrose qu&#237;stica &#40;FQ&#41; &#233; uma patologia de car&#225;ter autoss&#243;mico recessivo que compromete o funcionamento de v&#225;rios &#243;rg&#227;os e sistemas do organismo<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a>&#46; A mediana de idade estimada de sobrevida para pessoas com FQ aumentou drasticamente nas &#250;ltimas d&#233;cadas&#44; sendo estimada atualmente em 38 anos na maioria dos pa&#237;ses desenvolvidos<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a>&#46; &#201; poss&#237;vel que o diagn&#243;stico precoce&#44; o manejo multiprofissional em centros especializados e o acesso a uma terap&#234;utica adequada tenham contribu&#237;do para esta mudan&#231;a<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a>&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">As principais repercuss&#245;es cl&#237;nicas da FQ est&#227;o relacionadas com o comprometimento do aparelho respirat&#243;rio&#44; onde a presen&#231;a de secre&#231;&#245;es espessas e infetadas desencadeia um processo inflamat&#243;rio cr&#243;nico&#46; O decl&#237;nio da fun&#231;&#227;o pulmonar sofre uma queda exponencial at&#233; configurar uma importante obstru&#231;&#227;o das vias a&#233;reas com consequente insufla&#231;&#227;o pulmonar e aprisionamento a&#233;reo<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a>&#46; Calcula-se que cerca de 90&#37; dos pacientes morrem devido &#224; progress&#227;o da patologia pulmonar<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a>&#46; Al&#233;m do comprometimento pulmonar&#44; a FQ acarreta altera&#231;&#245;es significativas em outros &#243;rg&#227;os e sistemas que podem culminar em importante limita&#231;&#227;o f&#237;sica&#46; Quando comparada com a popula&#231;&#227;o pedi&#225;trica&#44; os adultos portadores de FQ apresentam maior preval&#234;ncia de disfun&#231;&#227;o da musculatura esquel&#233;tica&#44; deple&#231;&#227;o nutricional&#44; diabetes e depress&#227;o&#46; Neste grupo de pacientes&#44; tamb&#233;m s&#227;o comuns a osteoporose&#44; as fraturas &#243;sseas e o comprometimento articular<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a>&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">A postura &#233; definida como um arranjo balanceado das estruturas corporais&#44; sendo determinada pelo posicionamento de todos os segmentos do corpo em um dado momento<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">6</span></a>&#46; Num alinhamento postural normal&#44; espera-se que os m&#250;sculos e articula&#231;&#245;es estejam em estado de equil&#237;brio e com quantidade m&#237;nima de esfor&#231;o e sobrecarga<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">7</span></a>&#46; A atitude postural do t&#243;rax insuflado pode levar a uma s&#233;rie de compensa&#231;&#245;es na coluna vertebral e na cintura escapular e p&#233;lvica&#46; Em adultos portadores de FQ&#44; as deformidades da coluna vertebral s&#227;o comuns&#44; incluindo o aumento da cifose tor&#225;cica e da lordose lombar<a class="elsevierStyleCrossRefs" href="#bib0040"><span class="elsevierStyleSup">8&#44;9</span></a>&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">A biomec&#226;nica da caixa tor&#225;cica influencia a mec&#226;nica corporal global&#46; Dessa forma&#44; qualquer anormalidade da caixa tor&#225;cica poder&#225; resultar em altera&#231;&#245;es na postura e no balan&#231;o de todo o corpo<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">10</span></a>&#46; Conforme a patologia progride em pacientes com FQ&#44; &#233; poss&#237;vel que a insufla&#231;&#227;o e o aumento do trabalho respirat&#243;rio causam um desequil&#237;brio muscular global devido &#224;s altera&#231;&#245;es dos mecanismos da respira&#231;&#227;o<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">11</span></a>&#46; Dessa forma&#44; &#233; poss&#237;vel que todas essas altera&#231;&#245;es possam resultar numa redu&#231;&#227;o da capacidade funcional&#46; Tal conhecimento pode ser uma importante ferramenta no planeamento de exerc&#237;cios terap&#234;uticos mais apropriados em pacientes com FQ&#46; Dessa forma&#44; nosso objetivo foi avaliar as correla&#231;&#245;es entre fun&#231;&#227;o pulmonar&#44; capacidade funcional e postura em pacientes adultos portadores de FQ&#46; Como segundo objetivo&#44; pretendeu-se avaliar a correla&#231;&#227;o entre a qualidade de vida &#40;QV&#41; e as vari&#225;veis obtidas na avalia&#231;&#227;o postural&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">M&#233;todos</span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Pacientes</span><p id="par0025" class="elsevierStylePara elsevierViewall">No per&#237;odo entre setembro de 2011 e fevereiro de 2012&#44; foi realizado um estudo transversal em que se avaliou 14 pacientes de FQ advindos da Policl&#237;nica Piquet Carneiro da Universidade do Estado do Rio de Janeiro&#46; Foram inclu&#237;dos os pacientes adultos &#40;idade superior ou igual a 18 anos&#41; que tinham o diagn&#243;stico cl&#237;nico e laboratorial de FQ &#40;teste do suor e&#47;ou an&#225;lise da muta&#231;&#227;o do &#225;cido desoxirribonucleico - DNA&#41;&#46; Foram utilizados os seguintes crit&#233;rios de exclus&#227;o&#58; incapacidade para realizar a avalia&#231;&#227;o funcional pulmonar ou o teste da caminhada dos 6&#160;min &#40;TC6<span class="elsevierStyleHsp" style=""></span>M&#41;&#59; presen&#231;a de patologia neurol&#243;gica&#44; cardiovascular&#44; metab&#243;lica&#44; reum&#225;tica ou vestibular&#59; dor tor&#225;cica aguda&#44; hist&#243;ria recente de hemoptise ou pneumot&#243;rax a pelo menos um ano antes do estudo&#59; e infe&#231;&#227;o respirat&#243;ria nas 4 semanas antes do estudo&#46; A participa&#231;&#227;o desses indiv&#237;duos ocorreu ap&#243;s o esclarecimento quanto ao objetivo do estudo e a assinatura do termo de consentimento&#44; 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que foi desenvolvido por investigadores da Universidade de S&#227;o Paulo e encontra-se dispon&#237;vel gratuitamente &#40;<a href="http://www.sapo.incubadora.fapesp.br/">www&#46;sapo&#46;incubadora&#46;fapesp&#46;br</a>&#41;<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">14</span></a>&#46; Para realizar as fotografias&#44; foram utilizadas as coordenadas dos pontos anat&#243;micos demarcados com marcadores passivos &#40;bolas de isopor com fita adesiva dupla face&#41;&#46; Os seguintes pontos anat&#243;micos foram identificados&#58; trago direito e esquerdo&#59; acr&#243;mio direito e esquerdo&#59; espinha il&#237;aca &#226;ntero-superior direita e esquerda&#59; troc&#226;nter maior do f&#233;mur direito e esquerdo&#59; tuberosidade das t&#237;bias direita e esquerda&#59; mal&#233;olos laterais direito e esquerdo&#59; e processo espinhoso da s&#233;tima v&#233;rtebra cervical&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">Atrav&#233;s do equipamento <span class="elsevierStyleItalic">Collins Plus Pulmonary Function Testing Systems</span> &#40;Warren E&#46; Collins&#44; Inc&#46;&#44; Braintree&#44; MA&#44; EUA&#41;&#44; foram realizadas as seguintes provas de fun&#231;&#227;o pulmonar&#58; espirometria&#44; pletismografia de corpo inteiro e medi&#231;&#227;o da capacidade de difus&#227;o do CO &#40;DLco&#41;&#46; Todos estes testes seguiram a padroniza&#231;&#227;o da American Thoracic Society &#40;ATS&#41;<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">15</span></a>&#46; Foram adotadas as equa&#231;&#245;es de Pereira &#40;espirometria&#41; e Neder &#40;volumes pulmonares e difus&#227;o&#41; na interpreta&#231;&#227;o dos par&#226;metros funcionais<a class="elsevierStyleCrossRefs" href="#bib0080"><span class="elsevierStyleSup">16&#8211;18</span></a>&#46; Nesse mesmo local&#44; tamb&#233;m foi realizado o teste da caminhada dos 6&#160;min &#40;TC6<span class="elsevierStyleHsp" style=""></span>M&#41; num corredor de 30&#160;m&#46; Foram calculados os preditos de cada paciente pelas equa&#231;&#245;es de Gibbons et al&#46;<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">19</span></a>&#44; seguindo as recomenda&#231;&#245;es da American Thoracic Society<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">20</span></a>&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">Os dados foram descritos atrav&#233;s da mediana e dos intervalos interquartis &#40;percentis 25&#37; e 75&#37;&#41;&#44; ou da frequ&#234;ncia &#40;percentagem&#41;&#46; Como as vari&#225;veis foram consideradas de distribui&#231;&#227;o n&#227;o normal pelo teste de Shapiro-Wilk&#44; o estudo de correla&#231;&#227;o foi realizado atrav&#233;s do teste de Spearman&#46; As an&#225;lises foram feitas atrav&#233;s do programa SAS 6&#46;11 <span class="elsevierStyleItalic">software</span> &#40;SAS Institute&#44; Inc&#46;&#44; Cary&#44; NC&#44; EUA&#41;&#46; Considerou-se signific&#226;ncia estat&#237;stica quando p&#160;&#60;&#160;0&#44;05&#46;</p></span></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Resultados</span><p id="par0050" class="elsevierStylePara elsevierViewall">Dos 38 pacientes eleg&#237;veis para avalia&#231;&#227;o&#44; 14 completaram o estudo &#40;<a class="elsevierStyleCrossRef" href="#fig0005">fig&#46; 1</a>&#41;&#46; Os dados antropom&#233;tricos&#44; fun&#231;&#227;o pulmonar&#44; capacidade funcional e dom&#237;nios do question&#225;rio de QV s&#227;o mostrados na <a class="elsevierStyleCrossRef" href="#tbl0005">tabela 1</a>&#46; A mediana da dist&#226;ncia no TC6<span class="elsevierStyleHsp" style=""></span>M foi de 636&#44;5&#160;m &#40;varia&#231;&#227;o&#58; 450-750&#160;m&#41;&#44; enquanto a mediana da porcentagem predita por Gibbons et al&#46; para essa dist&#226;ncia foi de 83&#44;3 &#40;67&#44;6-92&#44;3&#41;&#46; Os dados da avalia&#231;&#227;o postural est&#227;o presentes na <a class="elsevierStyleCrossRef" href="#tbl0010">tabela 2</a>&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0055" class="elsevierStylePara elsevierViewall">Houve somente 2 correla&#231;&#245;es significantes entre os dados da avalia&#231;&#227;o postural e o question&#225;rio de QV&#46; Estas correla&#231;&#245;es foram entre o dom&#237;nio &#171;f&#237;sico&#187; do QFQ-R e o alinhamento vertical do t&#243;rax &#40;vis&#227;o lateral direita&#41; &#40;&#961;&#160;&#61;&#160;&#8722;0&#44;74&#44; p&#160;&#60;&#160;0&#44;01&#41;&#44; e entre o dom&#237;nio &#171;&#8216;limita&#231;&#245;es&#187; do QFQ-R e o &#226;ngulo do quadril esquerdo &#40;&#961;&#160;&#61;&#160;&#8722;0&#44;55&#44; p&#160;&#60;&#160;0&#44;05&#41;&#46; As correla&#231;&#245;es dos dados da avalia&#231;&#227;o postural com as vari&#225;veis de fun&#231;&#227;o pulmonar e capacidade funcional s&#227;o mostradas na <a class="elsevierStyleCrossRef" href="#tbl0015">tabela 3</a> e <a class="elsevierStyleCrossRef" href="#fig0010">figura 2</a>&#46; Foram observadas correla&#231;&#245;es negativas e significantes do volume expirat&#243;rio m&#225;ximo no primeiro segundo &#40;VEMS&#41; e da dist&#226;ncia da caminhada dos 6&#160;min &#40;DC6<span class="elsevierStyleHsp" style=""></span>M&#41; com o alinhamento vertical do t&#243;rax &#40;vis&#227;o lateral direita&#41;&#46; Foram notadas correla&#231;&#245;es positivas e significantes entre a capacidade pulmonar total &#40;CPT&#41; e o alinhamento vertical do t&#243;rax &#40;vis&#227;o lateral direita&#41;&#44; e entre a resist&#234;ncia de vias a&#233;reas &#40;Rva&#41; e o alinhamento vertical do t&#243;rax &#40;vis&#227;o lateral esquerda&#41;&#46;</p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Discuss&#227;o</span><p id="par0060" class="elsevierStylePara elsevierViewall">A avalia&#231;&#227;o da postura em posi&#231;&#227;o ortost&#225;tica tem sido cada vez mais utilizada na pr&#225;tica cl&#237;nica&#44; pois&#44; a partir da observa&#231;&#227;o do alinhamento corporal&#44; pode-se utiliz&#225;-la no planeamento e no acompanhamento do tratamento fisioterap&#234;utico&#46;</p><p id="par0065" class="elsevierStylePara elsevierViewall">No presente estudo&#44; 7 dos 10 valores angulares obtidos na avalia&#231;&#227;o fotogr&#225;fica pelo protocolo do PAS mostraram-se em desacordo com os valores normais descritos por Ferreira et al&#46;<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">14</span></a>&#46; Em pacientes adultos com FQ&#44; h&#225; v&#225;rios mecanismos que podem justificar tais altera&#231;&#245;es posturais&#44; incluindo a menor mineraliza&#231;&#227;o &#243;ssea&#44; sendo a fratura um achado relativamente comum&#44; e o aumento do trabalho da musculatura respirat&#243;ria devido &#224; insufla&#231;&#227;o pulmonar<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">9</span></a>&#46; Os nossos dados&#44; quando comparados com os observados em pacientes com doen&#231;a pulmonar obstrutiva cr&#243;nica<a class="elsevierStyleCrossRef" href="#bib0105"><span class="elsevierStyleSup">21</span></a>&#44; mostram um valor angular semelhante no alinhamento horizontal da cabe&#231;a &#40;2&#44;80 e 2&#44;90&#44; respetivamente&#41;&#46; Apesar das diferen&#231;as nas faixas et&#225;rias&#44; ambas as afe&#231;&#245;es possuem um mecanismo fisiopatol&#243;gico de base semelhante &#40;aprisionamento a&#233;reo&#41;&#44; o que justifica uma an&#225;lise comparativa dos dados&#46; O desalinhamento da cabe&#231;a pode ser explicado&#44; pelo menos em parte&#44; pela eleva&#231;&#227;o do acr&#243;mio do mesmo lado&#44; possivelmente pela tens&#227;o aumentada dos m&#250;sculos do ombro<a class="elsevierStyleCrossRef" href="#bib0110"><span class="elsevierStyleSup">22</span></a>&#46; Nas patologias pulmonares obstrutivas&#44; essa modifica&#231;&#227;o pode ser decorrente das altera&#231;&#245;es na mec&#226;nica pulmonar&#46;</p><p id="par0070" class="elsevierStylePara elsevierViewall">Na presente investiga&#231;&#227;o&#44; todas as correla&#231;&#245;es estatisticamente significativas das vari&#225;veis de fun&#231;&#227;o pulmonar foram observadas com o valor angular do alinhamento vertical do t&#243;rax&#44; tanto na vis&#227;o lateral direita quanto na vis&#227;o lateral esquerda&#46; O valor angular do alinhamento vertical do t&#243;rax tem como refer&#234;ncias &#243;sseas o acr&#243;mio e o troc&#226;nter maior&#46; &#201; poss&#237;vel que o encurtamento dos m&#250;sculos acess&#243;rios &#40;principalmente os peitorais e o esternocleidomast&#243;ideo&#41;&#44; bem como da pr&#243;pria musculatura abdominal&#44; justifiquem essas correla&#231;&#245;es&#46; De forma interessante&#44; Dunk et al&#46;<a class="elsevierStyleCrossRef" href="#bib0115"><span class="elsevierStyleSup">23</span></a> observaram que o plano sagital&#44; de onde &#233; extra&#237;do esse par&#226;metro&#44; &#233; o que melhor reflete a evolu&#231;&#227;o cl&#237;nica postural&#44; pois nesse plano os valores angulares diferem de zero&#44; enquanto no plano frontal tendem a zero &#40;simetria&#41;&#46;</p><p id="par0075" class="elsevierStylePara elsevierViewall">Na FQ&#44; quando se avaliam os volumes pulmonares est&#225;ticos e a Rva&#44; o fen&#243;meno mais marcante &#233; o aprisionamento de ar consequente ao esvaziamento alveolar retardado&#46; A CPT tamb&#233;m pode estar aumentada como resultado da perda do recolhimento el&#225;stico&#46; Outro mecanismo respons&#225;vel pelo aumento da CPT &#233; a amputa&#231;&#227;o do tempo expirat&#243;rio&#44; de modo que a inspira&#231;&#227;o come&#231;a antes de terminada completamente a elimina&#231;&#227;o de ar nos pulm&#245;es<a class="elsevierStyleCrossRef" href="#bib0120"><span class="elsevierStyleSup">24</span></a>&#46; Esses achados podem explicar as correla&#231;&#245;es positivas e estatisticamente significantes da CPT e da Rva com as modifica&#231;&#245;es do alinhamento vertical do tronco&#46;</p><p id="par0080" class="elsevierStylePara elsevierViewall">Outro foco do nosso estudo foi a rela&#231;&#227;o entre capacidade funcional e postura corporal&#46; Testes mais simples e menos dispendiosos&#44; como o TC6<span class="elsevierStyleHsp" style=""></span>M&#44; t&#234;m sido usados para avaliar a toler&#226;ncia ao exerc&#237;cio em pacientes adultos com FQ&#44; uma vez que a dist&#226;ncia atingida no teste da caminhada permite uma estimativa da resposta individual no exerc&#237;cio m&#225;ximo incremental<a class="elsevierStyleCrossRef" href="#bib0125"><span class="elsevierStyleSup">25</span></a>&#46; O nosso estudo mostrou uma correla&#231;&#227;o negativa e significante entre a DC6<span class="elsevierStyleHsp" style=""></span>M e o alinhamento vertical do t&#243;rax na avalia&#231;&#227;o postural&#46; Esta correla&#231;&#227;o pode ser explicada atrav&#233;s dos mecanismos de perda da estabilidade da parede tor&#225;cica consequente &#224; hiperinsufla&#231;&#227;o que&#44; por sua vez&#44; acarreta uma piora da capacidade funcional&#46;</p><p id="par0085" class="elsevierStylePara elsevierViewall">H&#225; evid&#234;ncias de que a intoler&#226;ncia ao exerc&#237;cio em pacientes com FQ &#233; multifatorial&#44; sendo influenciada pela fun&#231;&#227;o pulmonar&#44; estado nutricional e ades&#227;o ao tratamento&#44; entre outros fatores<a class="elsevierStyleCrossRef" href="#bib0125"><span class="elsevierStyleSup">25</span></a>&#46; Nestes pacientes&#44; a diminui&#231;&#227;o da toler&#226;ncia ao exerc&#237;cio limita a realiza&#231;&#227;o das atividades da vida di&#225;ria e est&#225; associada a menor sobrevida<a class="elsevierStyleCrossRef" href="#bib0130"><span class="elsevierStyleSup">26</span></a>&#46; Ziegler et al&#46;<a class="elsevierStyleCrossRef" href="#bib0135"><span class="elsevierStyleSup">27</span></a>&#44; num estudo com 88 portadores de FQ com idade igual ou superior a 10 anos&#44; identificaram que 15&#37; dos pacientes apresentaram dessatura&#231;&#227;o de oxig&#233;nio no TC6<span class="elsevierStyleHsp" style=""></span>M&#46; Conforme mostram nossos resultados&#44; &#233; poss&#237;vel que as altera&#231;&#245;es posturais possam tamb&#233;m contribuir para a m&#225; <span class="elsevierStyleItalic">performance</span> durante o exerc&#237;cio&#46; As deformidades posturais causam um desequil&#237;brio do sistema muscular que impede o movimento normal<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">9</span></a>&#46; Isto sugere que programas de condicionamento e reeduca&#231;&#227;o postural possam desempenhar um papel importante na limita&#231;&#227;o da capacidade de exerc&#237;cio em pacientes com FQ<a class="elsevierStyleCrossRefs" href="#bib0140"><span class="elsevierStyleSup">28&#44;29</span></a>&#46;</p><p id="par0090" class="elsevierStylePara elsevierViewall">As avalia&#231;&#245;es de QV s&#227;o importantes para o planeamento e acompanhamento do tratamento&#44; assim como para a identifica&#231;&#227;o de fatores preditores de QV<a class="elsevierStyleCrossRef" href="#bib0150"><span class="elsevierStyleSup">30</span></a>&#46; Em rela&#231;&#227;o ao QFQ-R&#44; os nossos achados corroboram os de Cohen et al&#46;<a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">13</span></a> que avaliaram a qualidade de vida em pacientes com FQ&#44; incluindo adultos&#46; Ambos os estudos mostraram que o pior dom&#237;nio avaliado foi o &#171;social&#187;&#44; facto este que pode estar relacionado com a percep&#231;&#227;o negativa dos pacientes quanto ao seu desempenho e inser&#231;&#227;o social&#46; Vale ressaltar ainda que&#44; no presente estudo&#44; observamos apenas correla&#231;&#245;es inversas e significantes entre 2 dom&#237;nios do QFQ-R &#40;&#171;f&#237;sico&#187; e &#171;limita&#231;&#245;es&#187;&#41; e a avalia&#231;&#227;o postural&#46; A associa&#231;&#227;o entre <span class="elsevierStyleItalic">performance</span> funcional e QV &#233; bem estabelecida na literatura&#46; Devido &#224; associa&#231;&#227;o entre postura e <span class="elsevierStyleItalic">performance</span> funcional observada no nosso estudo&#44; as anormalidades posturais podem ter um papel direto ou indireto na qualidade de vida relacionada com a sa&#250;de desses pacientes&#46; S&#227;o necess&#225;rios novos estudos para avaliar os efeitos de exerc&#237;cios posturais corretivos na QV dos pacientes com FQ e de outras patologias respirat&#243;rias cr&#243;nicas&#46;</p><p id="par0095" class="elsevierStylePara elsevierViewall">&#201; pertinente uma an&#225;lise cr&#237;tica dos resultados e das suas limita&#231;&#245;es&#46; Esta investiga&#231;&#227;o foi conduzida com um n&#250;mero relativamente pequeno de indiv&#237;duos e n&#243;s n&#227;o utilizamos um grupo controle&#46; Apesar destas limita&#231;&#245;es&#44; este &#233; o primeiro estudo a avaliar a rela&#231;&#227;o entre os resultados da an&#225;lise postural e os par&#226;metros de fun&#231;&#227;o pulmonar em pacientes adultos com FQ&#46; Acreditamos que os nossos resultados trazem uma importante contribui&#231;&#227;o&#44; uma vez que h&#225; poucos estudos sobre postura corporal neste grupo de pacientes&#46; Estudos futuros poder&#227;o confirmar as nossas observa&#231;&#245;es usando uma an&#225;lise estat&#237;stica mais detalhada com uma amostra maior&#44; um grupo controle e o acompanhamento longitudinal desses indiv&#237;duos&#46;</p><p id="par0100" class="elsevierStylePara elsevierViewall">Em conclus&#227;o&#44; o presente trabalho mostra que os pacientes adultos com FQ possuem importantes anormalidades posturais&#46; O desalinhamento vertical do t&#243;rax correlaciona-se com as altera&#231;&#245;es nos par&#226;metros de fun&#231;&#227;o pulmonar&#44; QV e capacidade funcional&#46;</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Responsabilidades &#233;ticas</span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Prote&#231;&#227;o dos seres humanos e animais</span><p id="par0105" class="elsevierStylePara elsevierViewall">Os autores declaram que os procedimentos seguidos estavam de acordo com os regulamentos estabelecidos pelos respons&#225;veis da Comiss&#227;o de Investiga&#231;&#227;o Cl&#237;nica e &#201;tica e de acordo com os da Associa&#231;&#227;o M&#233;dica Mundial e da Declara&#231;&#227;o de Helsinki&#46;</p></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Confidencialidade dos dados</span><p id="par0110" class="elsevierStylePara elsevierViewall">Os autores declaram ter seguido os protocolos de seu centro de trabalho acerca da publica&#231;&#227;o dos dados de pacientes e que todos os pacientes inclu&#237;dos no estudo receberam informa&#231;&#245;es suficientes e deram o seu consentimento informado por escrito para participar nesse estudo&#46;</p></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Direito &#224; privacidade e consentimento escrito</span><p id="par0115" class="elsevierStylePara elsevierViewall">Os autores declaram ter recebido consentimento escrito dos pacientes e&#47;ou sujeitos mencionados no artigo&#46; O autor para correspond&#234;ncia deve estar na posse deste documento&#46;</p></span></span><span id="sec0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Conflito de interesses</span><p id="par0120" class="elsevierStylePara elsevierViewall">Os autores declaram n&#227;o haver conflito de interesses&#46;</p></span></span>"
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        "resumen" => "<span><span class="elsevierStyleSectionTitle">Objetivos</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Avaliar as correla&#231;&#245;es entre fun&#231;&#227;o pulmonar&#44; capacidade funcional e postura em pacientes adultos portadores de fibrose qu&#237;stica &#40;FQ&#41;&#46; Como segundo objetivo&#44; avaliar a correla&#231;&#227;o entre a qualidade de vida e as vari&#225;veis obtidas na avalia&#231;&#227;o postural destes pacientes&#46;</p></span> <span><span class="elsevierStyleSectionTitle">M&#233;todos</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Foi realizado um estudo transversal em que 14 portadores de FQ se submeteram &#224; avalia&#231;&#227;o da an&#225;lise postural &#40;<span class="elsevierStyleItalic">software</span> de avalia&#231;&#227;o postural&#41; e provas de fun&#231;&#227;o pulmonar &#40;espirometria&#44; pletismografia de corpo inteiro e medi&#231;&#227;o da capacidade de difus&#227;o do CO&#41; e capacidade funcional &#40;teste da caminhada de 6<span class="elsevierStyleHsp" style=""></span>min&#41;&#46; Todos os pacientes responderam ao Question&#225;rio de Fibrose Qu&#237;stica com Vers&#227;o Revisada &#40;QFQ-R&#41;&#46;</p></span> <span><span class="elsevierStyleSectionTitle">Resultados</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">A maioria dos pacientes era do sexo masculino &#40;57&#37;&#41;&#44; com mediana da idade de 24&#44;5 anos &#40;22-34 anos&#41;&#46; Foram observadas correla&#231;&#245;es significantes de volume expirat&#243;rio m&#225;ximo no primeiro segundo&#44; dist&#226;ncia da caminhada dos 6&#160;min&#44; capacidade pulmonar total e resist&#234;ncia de vias a&#233;reas com o alinhamento vertical do tronco &#40;&#961;&#160;&#61;&#160;&#8722;0&#44;57&#44; p&#160;&#60;&#160;0&#44;05&#59; &#961;&#160;&#61;&#160;&#8722;0&#44;65&#44; p&#160;&#60;&#160;0&#44;01&#59; &#961;&#160;&#61;&#160;0&#44;54&#44; p&#160;&#60;&#160;0&#44;05&#59; e &#961;&#160;&#61;&#160;0&#44;67&#44; p&#160;&#60; 0&#44;01&#44; respetivamente&#41;&#46; Foram observadas correla&#231;&#245;es estatisticamente significantes entre o dom&#237;nio &#171;f&#237;sico&#187; do QFQ-R e o alinhamento vertical do t&#243;rax &#40;&#961;&#160;&#61;&#160;&#8722;0&#44;74&#44; p&#160;&#60;&#160;0&#44;01&#41;&#44; e entre o dom&#237;nio &#171;limita&#231;&#245;es&#187; do QFQ-R e o &#226;ngulo do quadril &#40;&#961;&#160;&#61;&#160;&#8722;0&#44;55&#44; p&#160;&#60;&#160;0&#44;05&#41;&#46;</p></span> <span><span class="elsevierStyleSectionTitle">Conclus&#245;es</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">O presente trabalho mostra que as anormalidades na fun&#231;&#227;o pulmonar e na capacidade funcional se associam &#224;s altera&#231;&#245;es posturais em adultos portadores de FQ&#46; Entretanto&#44; a gravidade das anormalidades posturais n&#227;o influenciam negativamente os dom&#237;nios do QFQ-R&#46;</p></span>"
      ]
      "en" => array:2 [
        "titulo" => "Abstract"
        "resumen" => "<span><span class="elsevierStyleSectionTitle">Aim</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">The purpose of this study was to evaluate the correlations within pulmonary function&#44; functional capacity&#44; and posture in adult patients with cystic fibrosis &#40;CF&#41;&#46; A secondary aim was to evaluate the correlation between patient quality of life and postural assessment variables&#46;</p></span> <span><span class="elsevierStyleSectionTitle">Method</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">A cross-sectional study was conducted on fourteen patients with CF&#46; Patients were subjected to a postural analysis &#40;postural assessment software&#41; and measurements of pulmonary function &#40;spirometry&#44; whole body plethysmography&#44; and carbon monoxide diffusing capacity&#41; and functional capacity &#40;6-min walking test&#41;&#46; All patients completed the <span class="elsevierStyleItalic">Cystic Fibrosis Questionnaire-Revised</span> &#40;CFQ-R&#41;&#46;</p></span> <span><span class="elsevierStyleSectionTitle">Results</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Most patients were male &#40;57&#37;&#41;&#44; and the median age of the patients was 24&#46;5 &#40;22&#8211;34&#41;&#46; The forced expiratory volume in one second&#44; the 6-min walking distance&#44; total lung capacity&#44; and airway resistance were significantly correlated with the vertical alignment of the chest &#40;&#961; &#61; &#8722;0&#46;57&#44; <span class="elsevierStyleItalic">P</span> &#60; 0&#46;05&#59; &#961; &#61; &#8722;0&#46;65&#44; <span class="elsevierStyleItalic">P</span> &#60; 0&#46;01&#59; &#961; &#61; 0&#46;54&#44; <span class="elsevierStyleItalic">P</span> &#60; 0&#46;05&#59; and &#961; &#61; 0&#46;67&#44; <span class="elsevierStyleItalic">P</span> &#60; 0&#46;01&#44; respectively&#41;&#46; The &#8216;physical&#8217; domain of the CFQ-R was significantly correlated with the vertical alignment of the chest &#40;&#961; &#61; &#8722;0&#46;74&#44; <span class="elsevierStyleItalic">P</span> &#60; 0&#46;01&#41;&#44; and the &#8216;limitations&#8217; domain of the CFQ-R was significantly correlated with the angle of the hip &#40;&#961; &#61; &#8722;0&#46;55&#44; <span class="elsevierStyleItalic">P</span> &#60; 0&#46;05&#41;&#46;</p></span> <span><span class="elsevierStyleSectionTitle">Conclusion</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">The present study shows that abnormalities in pulmonary function and functional capacity are associated with postural changes in adults with CF&#46; However the severity of the postural abnormalities does not negatively influence the CFQ-R domains&#46;</p></span>"
      ]
    ]
    "NotaPie" => array:2 [
      0 => array:3 [
        "etiqueta" => "1"
        "nota" => "<p class="elsevierStyleNotepara">Papel no estudo&#58; Contribui&#231;&#245;es para a concep&#231;&#227;o e o projeto&#44; revis&#227;o do artigo e aprova&#231;&#227;o final da vers&#227;o do manuscrito&#46;</p>"
        "identificador" => "fn0005"
      ]
      1 => array:3 [
        "etiqueta" => "2"
        "nota" => "<p class="elsevierStyleNotepara">Papel no estudo&#58; An&#225;lise e interpreta&#231;&#227;o dos dados&#44; revis&#227;o do artigo e aprova&#231;&#227;o final da vers&#227;o do manuscrito&#46;</p>"
        "identificador" => "fn0010"
      ]
    ]
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        "descripcion" => array:1 [
          "pt" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Diagrama mostrando as diferentes fases do processo de recrutamento&#46;</p>"
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      1 => array:7 [
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        "etiqueta" => "Figura 2"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
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          "pt" => "<p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Correla&#231;&#227;o entre o alinhamento vertical do tronco&#47;vista lateral esquerda &#40;VLEAVT&#41; e a dist&#226;ncia da caminhada dos 6<span class="elsevierStyleHsp" style=""></span>min &#40;DC6<span class="elsevierStyleHsp" style=""></span>M&#41; &#40;&#961;<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#8722;0&#44;65&#44; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;01&#41;&#46; A correla&#231;&#227;o foi determinada atrav&#233;s do teste de correla&#231;&#227;o de Spearman&#46;</p>"
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          "leyenda" => "<p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">Os resultados s&#227;o expressos como mediana &#40;intervalos interquartis&#41; ou n&#250;mero &#40;&#37;&#41;&#46;</p><p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">CPT&#58; capacidade pulmonar total&#59; CVF&#58; capacidade vital for&#231;ada&#59; DC6<span class="elsevierStyleHsp" style=""></span>M&#58; dist&#226;ncia da caminhada dos 6<span class="elsevierStyleHsp" style=""></span>min&#59; DLco&#58; capacidade de difus&#227;o do CO&#59; QFQ-R&#58; Question&#225;rio de Fibrose Qu&#237;stica com Vers&#227;o Revisada&#59; Rva&#58; resist&#234;ncia de vias a&#233;reas&#59; VEMS&#58; volume expirat&#243;rio m&#225;ximo no primeiro segundo&#59; VR&#58; volume residual&#46;</p>"
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                  <table border="0" frame="\n
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                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Vari&#225;veis&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Valores&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Sexo &#40;homens&#41;</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">24&#44;5 &#40;22&#8211;34&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Altura &#40;cm&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">170 &#40;160&#8211;170&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Peso &#40;kg&#41;</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">VEMS &#40;&#37; previsto&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">54 &#40;40&#44;3&#8211;76&#44;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">CVF &#40;&#37; previsto&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">84 &#40;59&#8211;88&#44;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">VEMS&#47;CVF &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">57&#44;5 &#40;55&#44;3&#8211;72&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">106&#44;5 &#40;102&#8211;121&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">178 &#40;148&#44;3&#8211;273&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">VR&#47;CPT &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">48 &#40;37&#44;3&#8211;61&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Rva &#40;cmH</span><span class="elsevierStyleInf"><span class="elsevierStyleItalic">2</span></span><span class="elsevierStyleItalic">O&#47;L&#47;s&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2 &#40;0&#44;95&#8211;3&#44;03&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">DLco &#40;&#37; previsto&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">80&#44;5 &#40;71&#44;8&#8211;89&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">DC6M &#40;&#37; previsto&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">83&#44;3 &#40;67&#44;6&#8211;92&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="2" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="2" align="left" valign="top"><span class="elsevierStyleItalic">Resultados QFQ-R</span></td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>F&#237;sico&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">64&#44;5 &#40;55&#44;2&#8211;77&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">80 &#40;70&#8211;86&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Social&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">61&#44;1 &#40;55&#44;6&#8211;87&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Imagem corporal&nbsp;\t\t\t\t\t\t\n
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          "pt" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Dados antropom&#233;tricos&#44; fun&#231;&#227;o pulmonar&#44; capacidade funcional e dom&#237;nios do Question&#225;rio de Fibrose Qu&#237;stica com Vers&#227;o Revisada nos pacientes com fibrose qu&#237;stica</p>"
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          "leyenda" => "<p id="spar0075" class="elsevierStyleSimplePara elsevierViewall">Os resultados s&#227;o expressos como mediana &#40;intervalos interquartis&#41;&#46;</p><p id="spar0080" class="elsevierStyleSimplePara elsevierViewall">ACEIAP&#58; &#226;ngulo entre o acr&#243;mio e a espinha il&#237;aca &#226;ntero-superior&#59; AHC&#58; alinhamento horizontal da cabe&#231;a&#59; AQD&#58; &#226;ngulo do quadril direito&#59; AQE&#58; &#226;ngulo do quadril esquerdo&#59; VLDAHC&#58; vista lateral direita - alinhamento horizontal da cabe&#231;a&#59; VLDAVC&#58; vista lateral direita - alinhamento vertical do corpo&#59; VLDAVT&#58; vista lateral direita - alinhamento vertical do t&#243;rax&#59; VLEAHC&#58; vista lateral esquerda - alinhamento horizontal da cabe&#231;a&#59; VLEAVC&#58; vista lateral esquerda - alinhamento vertical do corpo&#59; VLEAVT&#58; vista lateral esquerda - alinhamento vertical do t&#243;rax&#46;</p>"
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                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Valores&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">AHC &#40;<span class="elsevierStyleSup">o</span>&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">ACEIAP &#40;<span class="elsevierStyleSup">o</span>&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">8&#44;55 &#40;-3&#44;55&#8211;15&#44;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">VLDAVT &#40;<span class="elsevierStyleSup">o</span>&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&#44;15 &#40;-1&#44;03&#8211;5&#44;58&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">VLDAVC &#40;<span class="elsevierStyleSup">o</span>&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">15&#44;0 &#40;7&#44;70&#8211;18&#44;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">VLEAHC &#40;<span class="elsevierStyleSup">o</span>&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">-5&#44;60 &#40;-11&#44;0&#8211;3&#44;03&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">VLEAVT &#40;<span class="elsevierStyleSup">o</span>&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">8&#44;26 &#40;8&#44;13&#8211;8&#44;52&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">VLEAVC &#40;<span class="elsevierStyleSup">o</span>&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">13&#44;6 &#40;4&#44;6&#8211;19&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
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          "pt" => "<p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">Dados obtidos atrav&#233;s do <span class="elsevierStyleItalic">software</span> de avalia&#231;&#227;o postural nos pacientes com fibrose qu&#237;stica</p>"
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          "leyenda" => "<p id="spar0090" class="elsevierStyleSimplePara elsevierViewall">&#42; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;05&#59; &#42;&#42; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;01&#46;</p><p id="spar0095" class="elsevierStyleSimplePara elsevierViewall">ACEIAP&#58; &#226;ngulo entre o acr&#244;mio e a espinha il&#237;aca &#226;ntero-superior&#59; AHC&#58; alinhamento horizontal da cabe&#231;a&#59; AQD&#58; &#226;ngulo do quadril direito&#59; AQE&#58; &#226;ngulo do quadril esquerdo&#59; CVF&#58; capacidade vital for&#231;ada&#59; CPT&#58; capacidade pulmonar total&#59; Rva&#58; resist&#234;ncia de vias a&#233;reas&#59; DC6<span class="elsevierStyleHsp" style=""></span>M&#58; dist&#226;ncia da caminhada dos 6<span class="elsevierStyleHsp" style=""></span>min&#59; DLco&#58; capacidade de difus&#227;o do CO&#59; VEMS&#58; volume expirat&#243;rio m&#225;ximo no primeiro segundo&#59; VLDAHC&#58; vista lateral direita - alinhamento horizontal da cabe&#231;a&#59; VLDAVC&#58; vista lateral direita - alinhamento vertical do corpo&#59; VLDAVT&#58; vista lateral direita - alinhamento vertical do t&#243;rax&#59; VLEAHC&#58; vista lateral esquerda - alinhamento horizontal da cabe&#231;a&#59; VLEAVC&#58; vista lateral esquerda - alinhamento vertical do corpo&#59; VLEAVT&#58; vista lateral esquerda - alinhamento vertical do t&#243;rax&#59; VR&#58; volume residual&#46;</p>"
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                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Vari&#225;veis&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">VEMS &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">CVF &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">VEMS&#47;CVF &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">CPT &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">VR &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">VR&#47;CPT &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Rva &#40;cmH<span class="elsevierStyleInf">2</span>O&#47;L&#47;s&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">DLco &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">DC6M&#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">AHC &#40;<span class="elsevierStyleSup">o</span>&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8722;0&#44;25&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8722;&#8722;0&#44;01&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8722;0&#44;37&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8722;0&#44;05&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8722;0&#44;04&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;03&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;27&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;23&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8722;0&#44;19&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">ACEIAP &#40;<span class="elsevierStyleSup">o</span>&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8722;0&#44;28&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8722;0&#44;20&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8722;0&#44;01&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;03&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;36&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;41&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;02&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8722;0&#44;16&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;03&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">AQD &#40;<span class="elsevierStyleSup">o</span>&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8722;0&#44;26&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8722;0&#44;20&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8722;0&#44;22&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8722;0&#44;26&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;24&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;38&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;18&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8722;0&#44;36&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8722;0&#44;20&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">AQE &#40;<span class="elsevierStyleSup">o</span>&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;03&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;02&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8722;0&#44;11&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8722;0&#44;12&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8722;0&#44;07&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;06&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;05&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8722;0&#44;17&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;18&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">VLDAHC &#40;<span class="elsevierStyleSup">o</span>&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;15&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8722;0&#44;05&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;12&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;07&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8722;0&#44;06&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8722;0&#44;17&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8722;0&#44;01&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8722;0&#44;14&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8722;0&#44;18&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">VLDAVT &#40;<span class="elsevierStyleSup">o</span>&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8722;0&#44;11&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;04&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8722;0&#44;13&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;54&#42;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;39&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;20&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;08&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;08&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8722;0&#44;05&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">VLDAVC &#40;<span class="elsevierStyleSup">o</span>&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8722;0&#44;23&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8722;0&#44;09&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8722;0&#44;20&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;24&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;46&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;41&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;06&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8722;0&#44;27&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;14&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">VLEAHC &#40;<span class="elsevierStyleSup">o</span>&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;29&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;29&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;19&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8722;0&#44;13&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8722;0&#44;18&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8722;0&#44;25&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8722;0&#44;36&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;25&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;13&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">VLEAVT &#40;<span class="elsevierStyleSup">o</span>&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8722;0&#44;57&#42;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8722;0&#44;49&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8722;0&#44;52&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8722;0&#44;13&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;19&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;39&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;67&#42;&#42;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8722;0&#44;31&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8722;0&#44;65&#42;&#42;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">VLEAVC &#40;<span class="elsevierStyleSup">o</span>&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8722;0&#44;03&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8722;0&#44;18&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8722;0&#44;09&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;21&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;17&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;03&nbsp;\t\t\t\t\t\t\n
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Associação entre postura, função pulmonar e capacidade funcional na fibrose quística
Association among posture, lung function and functional capacity in cystic fibrosis
J.T.S. Penafortesa,1, F.S. Guimarãesa,1, V.J.R. Moçoa,2, V.P. Almeidaa,2, R.F. Diasa, A.J. Lopesa,b,1,
Corresponding author
phel.lop@uol.com.br

Autor para correspondência.
a Programa de Pós-graduação em Ciências da Reabilitação, Universidade Augusto Motta, Rio de Janeiro, Brasil
b Laboratório de Fisiologia Respiratória, Universidade do Estado do Rio de Janeiro, Programa de Pós-graduação em Ciências da Reabilitação, Universidade Augusto Motta, Rio de Janeiro, Brasil
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    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Introdu&#231;&#227;o</span><p id="par0005" class="elsevierStylePara elsevierViewall">A fibrose qu&#237;stica &#40;FQ&#41; &#233; uma patologia de car&#225;ter autoss&#243;mico recessivo que compromete o funcionamento de v&#225;rios &#243;rg&#227;os e sistemas do organismo<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a>&#46; A mediana de idade estimada de sobrevida para pessoas com FQ aumentou drasticamente nas &#250;ltimas d&#233;cadas&#44; sendo estimada atualmente em 38 anos na maioria dos pa&#237;ses desenvolvidos<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a>&#46; &#201; poss&#237;vel que o diagn&#243;stico precoce&#44; o manejo multiprofissional em centros especializados e o acesso a uma terap&#234;utica adequada tenham contribu&#237;do para esta mudan&#231;a<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a>&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">As principais repercuss&#245;es cl&#237;nicas da FQ est&#227;o relacionadas com o comprometimento do aparelho respirat&#243;rio&#44; onde a presen&#231;a de secre&#231;&#245;es espessas e infetadas desencadeia um processo inflamat&#243;rio cr&#243;nico&#46; O decl&#237;nio da fun&#231;&#227;o pulmonar sofre uma queda exponencial at&#233; configurar uma importante obstru&#231;&#227;o das vias a&#233;reas com consequente insufla&#231;&#227;o pulmonar e aprisionamento a&#233;reo<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a>&#46; Calcula-se que cerca de 90&#37; dos pacientes morrem devido &#224; progress&#227;o da patologia pulmonar<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a>&#46; Al&#233;m do comprometimento pulmonar&#44; a FQ acarreta altera&#231;&#245;es significativas em outros &#243;rg&#227;os e sistemas que podem culminar em importante limita&#231;&#227;o f&#237;sica&#46; Quando comparada com a popula&#231;&#227;o pedi&#225;trica&#44; os adultos portadores de FQ apresentam maior preval&#234;ncia de disfun&#231;&#227;o da musculatura esquel&#233;tica&#44; deple&#231;&#227;o nutricional&#44; diabetes e depress&#227;o&#46; Neste grupo de pacientes&#44; tamb&#233;m s&#227;o comuns a osteoporose&#44; as fraturas &#243;sseas e o comprometimento articular<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a>&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">A postura &#233; definida como um arranjo balanceado das estruturas corporais&#44; sendo determinada pelo posicionamento de todos os segmentos do corpo em um dado momento<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">6</span></a>&#46; Num alinhamento postural normal&#44; espera-se que os m&#250;sculos e articula&#231;&#245;es estejam em estado de equil&#237;brio e com quantidade m&#237;nima de esfor&#231;o e sobrecarga<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">7</span></a>&#46; A atitude postural do t&#243;rax insuflado pode levar a uma s&#233;rie de compensa&#231;&#245;es na coluna vertebral e na cintura escapular e p&#233;lvica&#46; Em adultos portadores de FQ&#44; as deformidades da coluna vertebral s&#227;o comuns&#44; incluindo o aumento da cifose tor&#225;cica e da lordose lombar<a class="elsevierStyleCrossRefs" href="#bib0040"><span class="elsevierStyleSup">8&#44;9</span></a>&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">A biomec&#226;nica da caixa tor&#225;cica influencia a mec&#226;nica corporal global&#46; Dessa forma&#44; qualquer anormalidade da caixa tor&#225;cica poder&#225; resultar em altera&#231;&#245;es na postura e no balan&#231;o de todo o corpo<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">10</span></a>&#46; Conforme a patologia progride em pacientes com FQ&#44; &#233; poss&#237;vel que a insufla&#231;&#227;o e o aumento do trabalho respirat&#243;rio causam um desequil&#237;brio muscular global devido &#224;s altera&#231;&#245;es dos mecanismos da respira&#231;&#227;o<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">11</span></a>&#46; Dessa forma&#44; &#233; poss&#237;vel que todas essas altera&#231;&#245;es possam resultar numa redu&#231;&#227;o da capacidade funcional&#46; Tal conhecimento pode ser uma importante ferramenta no planeamento de exerc&#237;cios terap&#234;uticos mais apropriados em pacientes com FQ&#46; Dessa forma&#44; nosso objetivo foi avaliar as correla&#231;&#245;es entre fun&#231;&#227;o pulmonar&#44; capacidade funcional e postura em pacientes adultos portadores de FQ&#46; Como segundo objetivo&#44; pretendeu-se avaliar a correla&#231;&#227;o entre a qualidade de vida &#40;QV&#41; e as vari&#225;veis obtidas na avalia&#231;&#227;o postural&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">M&#233;todos</span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Pacientes</span><p id="par0025" class="elsevierStylePara elsevierViewall">No per&#237;odo entre setembro de 2011 e fevereiro de 2012&#44; foi realizado um estudo transversal em que se avaliou 14 pacientes de FQ advindos da Policl&#237;nica Piquet Carneiro da Universidade do Estado do Rio de Janeiro&#46; Foram inclu&#237;dos os pacientes adultos &#40;idade superior ou igual a 18 anos&#41; que tinham o diagn&#243;stico cl&#237;nico e laboratorial de FQ &#40;teste do suor e&#47;ou an&#225;lise da muta&#231;&#227;o do &#225;cido desoxirribonucleico - DNA&#41;&#46; Foram utilizados os seguintes crit&#233;rios de exclus&#227;o&#58; incapacidade para realizar a avalia&#231;&#227;o funcional pulmonar ou o teste da caminhada dos 6&#160;min &#40;TC6<span class="elsevierStyleHsp" style=""></span>M&#41;&#59; presen&#231;a de patologia neurol&#243;gica&#44; cardiovascular&#44; metab&#243;lica&#44; reum&#225;tica ou vestibular&#59; dor tor&#225;cica aguda&#44; hist&#243;ria recente de hemoptise ou pneumot&#243;rax a pelo menos um ano antes do estudo&#59; e infe&#231;&#227;o respirat&#243;ria nas 4 semanas antes do estudo&#46; A participa&#231;&#227;o desses indiv&#237;duos ocorreu ap&#243;s o esclarecimento quanto ao objetivo do estudo e a assinatura do termo de consentimento&#44; de acordo com as normas &#233;ticas vigentes&#46; O protocolo foi aprovado pelo Comit&#233; de &#201;tica em Pesquisa do Centro Universit&#225;rio Augusto Motta&#44; sendo aprovado com o n&#250;mero de protocolo 010&#47;11&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Medidas</span><p id="par0030" class="elsevierStylePara elsevierViewall">Todos os pacientes responderam ao Question&#225;rio de Fibrose Qu&#237;stica com Vers&#227;o Revisada &#40;QFQ-R&#41;<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">12</span></a>&#46; Por meio desse instrumento&#44; foram avaliados os seguintes dom&#237;nios&#58; f&#237;sico&#44; limita&#231;&#245;es&#44; social&#44; imagem corporal e respirat&#243;rio&#46; Os resultados de cada dom&#237;nio variam de 0 a 100&#44; sendo esse &#250;ltimo a express&#227;o de muito boa QV&#46; Considera-se que os resultados superiores a 50 refletem boa QV<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">11</span></a>&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">A an&#225;lise postural foi realizada atrav&#233;s do <span class="elsevierStyleItalic">software</span> de avalia&#231;&#227;o postural &#40;SAPO&#41;&#44; que foi desenvolvido por investigadores da Universidade de S&#227;o Paulo e encontra-se dispon&#237;vel gratuitamente &#40;<a href="http://www.sapo.incubadora.fapesp.br/">www&#46;sapo&#46;incubadora&#46;fapesp&#46;br</a>&#41;<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">14</span></a>&#46; Para realizar as fotografias&#44; foram utilizadas as coordenadas dos pontos anat&#243;micos demarcados com marcadores passivos &#40;bolas de isopor com fita adesiva dupla face&#41;&#46; Os seguintes pontos anat&#243;micos foram identificados&#58; trago direito e esquerdo&#59; acr&#243;mio direito e esquerdo&#59; espinha il&#237;aca &#226;ntero-superior direita e esquerda&#59; troc&#226;nter maior do f&#233;mur direito e esquerdo&#59; tuberosidade das t&#237;bias direita e esquerda&#59; mal&#233;olos laterais direito e esquerdo&#59; e processo espinhoso da s&#233;tima v&#233;rtebra cervical&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">Atrav&#233;s do equipamento <span class="elsevierStyleItalic">Collins Plus Pulmonary Function Testing Systems</span> &#40;Warren E&#46; Collins&#44; Inc&#46;&#44; Braintree&#44; MA&#44; EUA&#41;&#44; foram realizadas as seguintes provas de fun&#231;&#227;o pulmonar&#58; espirometria&#44; pletismografia de corpo inteiro e medi&#231;&#227;o da capacidade de difus&#227;o do CO &#40;DLco&#41;&#46; Todos estes testes seguiram a padroniza&#231;&#227;o da American Thoracic Society &#40;ATS&#41;<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">15</span></a>&#46; Foram adotadas as equa&#231;&#245;es de Pereira &#40;espirometria&#41; e Neder &#40;volumes pulmonares e difus&#227;o&#41; na interpreta&#231;&#227;o dos par&#226;metros funcionais<a class="elsevierStyleCrossRefs" href="#bib0080"><span class="elsevierStyleSup">16&#8211;18</span></a>&#46; Nesse mesmo local&#44; tamb&#233;m foi realizado o teste da caminhada dos 6&#160;min &#40;TC6<span class="elsevierStyleHsp" style=""></span>M&#41; num corredor de 30&#160;m&#46; Foram calculados os preditos de cada paciente pelas equa&#231;&#245;es de Gibbons et al&#46;<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">19</span></a>&#44; seguindo as recomenda&#231;&#245;es da American Thoracic Society<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">20</span></a>&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">Os dados foram descritos atrav&#233;s da mediana e dos intervalos interquartis &#40;percentis 25&#37; e 75&#37;&#41;&#44; ou da frequ&#234;ncia &#40;percentagem&#41;&#46; Como as vari&#225;veis foram consideradas de distribui&#231;&#227;o n&#227;o normal pelo teste de Shapiro-Wilk&#44; o estudo de correla&#231;&#227;o foi realizado atrav&#233;s do teste de Spearman&#46; As an&#225;lises foram feitas atrav&#233;s do programa SAS 6&#46;11 <span class="elsevierStyleItalic">software</span> &#40;SAS Institute&#44; Inc&#46;&#44; Cary&#44; NC&#44; EUA&#41;&#46; Considerou-se signific&#226;ncia estat&#237;stica quando p&#160;&#60;&#160;0&#44;05&#46;</p></span></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Resultados</span><p id="par0050" class="elsevierStylePara elsevierViewall">Dos 38 pacientes eleg&#237;veis para avalia&#231;&#227;o&#44; 14 completaram o estudo &#40;<a class="elsevierStyleCrossRef" href="#fig0005">fig&#46; 1</a>&#41;&#46; Os dados antropom&#233;tricos&#44; fun&#231;&#227;o pulmonar&#44; capacidade funcional e dom&#237;nios do question&#225;rio de QV s&#227;o mostrados na <a class="elsevierStyleCrossRef" href="#tbl0005">tabela 1</a>&#46; A mediana da dist&#226;ncia no TC6<span class="elsevierStyleHsp" style=""></span>M foi de 636&#44;5&#160;m &#40;varia&#231;&#227;o&#58; 450-750&#160;m&#41;&#44; enquanto a mediana da porcentagem predita por Gibbons et al&#46; para essa dist&#226;ncia foi de 83&#44;3 &#40;67&#44;6-92&#44;3&#41;&#46; Os dados da avalia&#231;&#227;o postural est&#227;o presentes na <a class="elsevierStyleCrossRef" href="#tbl0010">tabela 2</a>&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0055" class="elsevierStylePara elsevierViewall">Houve somente 2 correla&#231;&#245;es significantes entre os dados da avalia&#231;&#227;o postural e o question&#225;rio de QV&#46; Estas correla&#231;&#245;es foram entre o dom&#237;nio &#171;f&#237;sico&#187; do QFQ-R e o alinhamento vertical do t&#243;rax &#40;vis&#227;o lateral direita&#41; &#40;&#961;&#160;&#61;&#160;&#8722;0&#44;74&#44; p&#160;&#60;&#160;0&#44;01&#41;&#44; e entre o dom&#237;nio &#171;&#8216;limita&#231;&#245;es&#187; do QFQ-R e o &#226;ngulo do quadril esquerdo &#40;&#961;&#160;&#61;&#160;&#8722;0&#44;55&#44; p&#160;&#60;&#160;0&#44;05&#41;&#46; As correla&#231;&#245;es dos dados da avalia&#231;&#227;o postural com as vari&#225;veis de fun&#231;&#227;o pulmonar e capacidade funcional s&#227;o mostradas na <a class="elsevierStyleCrossRef" href="#tbl0015">tabela 3</a> e <a class="elsevierStyleCrossRef" href="#fig0010">figura 2</a>&#46; Foram observadas correla&#231;&#245;es negativas e significantes do volume expirat&#243;rio m&#225;ximo no primeiro segundo &#40;VEMS&#41; e da dist&#226;ncia da caminhada dos 6&#160;min &#40;DC6<span class="elsevierStyleHsp" style=""></span>M&#41; com o alinhamento vertical do t&#243;rax &#40;vis&#227;o lateral direita&#41;&#46; Foram notadas correla&#231;&#245;es positivas e significantes entre a capacidade pulmonar total &#40;CPT&#41; e o alinhamento vertical do t&#243;rax &#40;vis&#227;o lateral direita&#41;&#44; e entre a resist&#234;ncia de vias a&#233;reas &#40;Rva&#41; e o alinhamento vertical do t&#243;rax &#40;vis&#227;o lateral esquerda&#41;&#46;</p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Discuss&#227;o</span><p id="par0060" class="elsevierStylePara elsevierViewall">A avalia&#231;&#227;o da postura em posi&#231;&#227;o ortost&#225;tica tem sido cada vez mais utilizada na pr&#225;tica cl&#237;nica&#44; pois&#44; a partir da observa&#231;&#227;o do alinhamento corporal&#44; pode-se utiliz&#225;-la no planeamento e no acompanhamento do tratamento fisioterap&#234;utico&#46;</p><p id="par0065" class="elsevierStylePara elsevierViewall">No presente estudo&#44; 7 dos 10 valores angulares obtidos na avalia&#231;&#227;o fotogr&#225;fica pelo protocolo do PAS mostraram-se em desacordo com os valores normais descritos por Ferreira et al&#46;<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">14</span></a>&#46; Em pacientes adultos com FQ&#44; h&#225; v&#225;rios mecanismos que podem justificar tais altera&#231;&#245;es posturais&#44; incluindo a menor mineraliza&#231;&#227;o &#243;ssea&#44; sendo a fratura um achado relativamente comum&#44; e o aumento do trabalho da musculatura respirat&#243;ria devido &#224; insufla&#231;&#227;o pulmonar<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">9</span></a>&#46; Os nossos dados&#44; quando comparados com os observados em pacientes com doen&#231;a pulmonar obstrutiva cr&#243;nica<a class="elsevierStyleCrossRef" href="#bib0105"><span class="elsevierStyleSup">21</span></a>&#44; mostram um valor angular semelhante no alinhamento horizontal da cabe&#231;a &#40;2&#44;80 e 2&#44;90&#44; respetivamente&#41;&#46; Apesar das diferen&#231;as nas faixas et&#225;rias&#44; ambas as afe&#231;&#245;es possuem um mecanismo fisiopatol&#243;gico de base semelhante &#40;aprisionamento a&#233;reo&#41;&#44; o que justifica uma an&#225;lise comparativa dos dados&#46; O desalinhamento da cabe&#231;a pode ser explicado&#44; pelo menos em parte&#44; pela eleva&#231;&#227;o do acr&#243;mio do mesmo lado&#44; possivelmente pela tens&#227;o aumentada dos m&#250;sculos do ombro<a class="elsevierStyleCrossRef" href="#bib0110"><span class="elsevierStyleSup">22</span></a>&#46; Nas patologias pulmonares obstrutivas&#44; essa modifica&#231;&#227;o pode ser decorrente das altera&#231;&#245;es na mec&#226;nica pulmonar&#46;</p><p id="par0070" class="elsevierStylePara elsevierViewall">Na presente investiga&#231;&#227;o&#44; todas as correla&#231;&#245;es estatisticamente significativas das vari&#225;veis de fun&#231;&#227;o pulmonar foram observadas com o valor angular do alinhamento vertical do t&#243;rax&#44; tanto na vis&#227;o lateral direita quanto na vis&#227;o lateral esquerda&#46; O valor angular do alinhamento vertical do t&#243;rax tem como refer&#234;ncias &#243;sseas o acr&#243;mio e o troc&#226;nter maior&#46; &#201; poss&#237;vel que o encurtamento dos m&#250;sculos acess&#243;rios &#40;principalmente os peitorais e o esternocleidomast&#243;ideo&#41;&#44; bem como da pr&#243;pria musculatura abdominal&#44; justifiquem essas correla&#231;&#245;es&#46; De forma interessante&#44; Dunk et al&#46;<a class="elsevierStyleCrossRef" href="#bib0115"><span class="elsevierStyleSup">23</span></a> observaram que o plano sagital&#44; de onde &#233; extra&#237;do esse par&#226;metro&#44; &#233; o que melhor reflete a evolu&#231;&#227;o cl&#237;nica postural&#44; pois nesse plano os valores angulares diferem de zero&#44; enquanto no plano frontal tendem a zero &#40;simetria&#41;&#46;</p><p id="par0075" class="elsevierStylePara elsevierViewall">Na FQ&#44; quando se avaliam os volumes pulmonares est&#225;ticos e a Rva&#44; o fen&#243;meno mais marcante &#233; o aprisionamento de ar consequente ao esvaziamento alveolar retardado&#46; A CPT tamb&#233;m pode estar aumentada como resultado da perda do recolhimento el&#225;stico&#46; Outro mecanismo respons&#225;vel pelo aumento da CPT &#233; a amputa&#231;&#227;o do tempo expirat&#243;rio&#44; de modo que a inspira&#231;&#227;o come&#231;a antes de terminada completamente a elimina&#231;&#227;o de ar nos pulm&#245;es<a class="elsevierStyleCrossRef" href="#bib0120"><span class="elsevierStyleSup">24</span></a>&#46; Esses achados podem explicar as correla&#231;&#245;es positivas e estatisticamente significantes da CPT e da Rva com as modifica&#231;&#245;es do alinhamento vertical do tronco&#46;</p><p id="par0080" class="elsevierStylePara elsevierViewall">Outro foco do nosso estudo foi a rela&#231;&#227;o entre capacidade funcional e postura corporal&#46; Testes mais simples e menos dispendiosos&#44; como o TC6<span class="elsevierStyleHsp" style=""></span>M&#44; t&#234;m sido usados para avaliar a toler&#226;ncia ao exerc&#237;cio em pacientes adultos com FQ&#44; uma vez que a dist&#226;ncia atingida no teste da caminhada permite uma estimativa da resposta individual no exerc&#237;cio m&#225;ximo incremental<a class="elsevierStyleCrossRef" href="#bib0125"><span class="elsevierStyleSup">25</span></a>&#46; O nosso estudo mostrou uma correla&#231;&#227;o negativa e significante entre a DC6<span class="elsevierStyleHsp" style=""></span>M e o alinhamento vertical do t&#243;rax na avalia&#231;&#227;o postural&#46; Esta correla&#231;&#227;o pode ser explicada atrav&#233;s dos mecanismos de perda da estabilidade da parede tor&#225;cica consequente &#224; hiperinsufla&#231;&#227;o que&#44; por sua vez&#44; acarreta uma piora da capacidade funcional&#46;</p><p id="par0085" class="elsevierStylePara elsevierViewall">H&#225; evid&#234;ncias de que a intoler&#226;ncia ao exerc&#237;cio em pacientes com FQ &#233; multifatorial&#44; sendo influenciada pela fun&#231;&#227;o pulmonar&#44; estado nutricional e ades&#227;o ao tratamento&#44; entre outros fatores<a class="elsevierStyleCrossRef" href="#bib0125"><span class="elsevierStyleSup">25</span></a>&#46; Nestes pacientes&#44; a diminui&#231;&#227;o da toler&#226;ncia ao exerc&#237;cio limita a realiza&#231;&#227;o das atividades da vida di&#225;ria e est&#225; associada a menor sobrevida<a class="elsevierStyleCrossRef" href="#bib0130"><span class="elsevierStyleSup">26</span></a>&#46; Ziegler et al&#46;<a class="elsevierStyleCrossRef" href="#bib0135"><span class="elsevierStyleSup">27</span></a>&#44; num estudo com 88 portadores de FQ com idade igual ou superior a 10 anos&#44; identificaram que 15&#37; dos pacientes apresentaram dessatura&#231;&#227;o de oxig&#233;nio no TC6<span class="elsevierStyleHsp" style=""></span>M&#46; Conforme mostram nossos resultados&#44; &#233; poss&#237;vel que as altera&#231;&#245;es posturais possam tamb&#233;m contribuir para a m&#225; <span class="elsevierStyleItalic">performance</span> durante o exerc&#237;cio&#46; As deformidades posturais causam um desequil&#237;brio do sistema muscular que impede o movimento normal<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">9</span></a>&#46; Isto sugere que programas de condicionamento e reeduca&#231;&#227;o postural possam desempenhar um papel importante na limita&#231;&#227;o da capacidade de exerc&#237;cio em pacientes com FQ<a class="elsevierStyleCrossRefs" href="#bib0140"><span class="elsevierStyleSup">28&#44;29</span></a>&#46;</p><p id="par0090" class="elsevierStylePara elsevierViewall">As avalia&#231;&#245;es de QV s&#227;o importantes para o planeamento e acompanhamento do tratamento&#44; assim como para a identifica&#231;&#227;o de fatores preditores de QV<a class="elsevierStyleCrossRef" href="#bib0150"><span class="elsevierStyleSup">30</span></a>&#46; Em rela&#231;&#227;o ao QFQ-R&#44; os nossos achados corroboram os de Cohen et al&#46;<a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">13</span></a> que avaliaram a qualidade de vida em pacientes com FQ&#44; incluindo adultos&#46; Ambos os estudos mostraram que o pior dom&#237;nio avaliado foi o &#171;social&#187;&#44; facto este que pode estar relacionado com a percep&#231;&#227;o negativa dos pacientes quanto ao seu desempenho e inser&#231;&#227;o social&#46; Vale ressaltar ainda que&#44; no presente estudo&#44; observamos apenas correla&#231;&#245;es inversas e significantes entre 2 dom&#237;nios do QFQ-R &#40;&#171;f&#237;sico&#187; e &#171;limita&#231;&#245;es&#187;&#41; e a avalia&#231;&#227;o postural&#46; A associa&#231;&#227;o entre <span class="elsevierStyleItalic">performance</span> funcional e QV &#233; bem estabelecida na literatura&#46; Devido &#224; associa&#231;&#227;o entre postura e <span class="elsevierStyleItalic">performance</span> funcional observada no nosso estudo&#44; as anormalidades posturais podem ter um papel direto ou indireto na qualidade de vida relacionada com a sa&#250;de desses pacientes&#46; S&#227;o necess&#225;rios novos estudos para avaliar os efeitos de exerc&#237;cios posturais corretivos na QV dos pacientes com FQ e de outras patologias respirat&#243;rias cr&#243;nicas&#46;</p><p id="par0095" class="elsevierStylePara elsevierViewall">&#201; pertinente uma an&#225;lise cr&#237;tica dos resultados e das suas limita&#231;&#245;es&#46; Esta investiga&#231;&#227;o foi conduzida com um n&#250;mero relativamente pequeno de indiv&#237;duos e n&#243;s n&#227;o utilizamos um grupo controle&#46; Apesar destas limita&#231;&#245;es&#44; este &#233; o primeiro estudo a avaliar a rela&#231;&#227;o entre os resultados da an&#225;lise postural e os par&#226;metros de fun&#231;&#227;o pulmonar em pacientes adultos com FQ&#46; Acreditamos que os nossos resultados trazem uma importante contribui&#231;&#227;o&#44; uma vez que h&#225; poucos estudos sobre postura corporal neste grupo de pacientes&#46; Estudos futuros poder&#227;o confirmar as nossas observa&#231;&#245;es usando uma an&#225;lise estat&#237;stica mais detalhada com uma amostra maior&#44; um grupo controle e o acompanhamento longitudinal desses indiv&#237;duos&#46;</p><p id="par0100" class="elsevierStylePara elsevierViewall">Em conclus&#227;o&#44; o presente trabalho mostra que os pacientes adultos com FQ possuem importantes anormalidades posturais&#46; O desalinhamento vertical do t&#243;rax correlaciona-se com as altera&#231;&#245;es nos par&#226;metros de fun&#231;&#227;o pulmonar&#44; QV e capacidade funcional&#46;</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Responsabilidades &#233;ticas</span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Prote&#231;&#227;o dos seres humanos e animais</span><p id="par0105" class="elsevierStylePara elsevierViewall">Os autores declaram que os procedimentos seguidos estavam de acordo com os regulamentos estabelecidos pelos respons&#225;veis da Comiss&#227;o de Investiga&#231;&#227;o Cl&#237;nica e &#201;tica e de acordo com os da Associa&#231;&#227;o M&#233;dica Mundial e da Declara&#231;&#227;o de Helsinki&#46;</p></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Confidencialidade dos dados</span><p id="par0110" class="elsevierStylePara elsevierViewall">Os autores declaram ter seguido os protocolos de seu centro de trabalho acerca da publica&#231;&#227;o dos dados de pacientes e que todos os pacientes inclu&#237;dos no estudo receberam informa&#231;&#245;es suficientes e deram o seu consentimento informado por escrito para participar nesse estudo&#46;</p></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Direito &#224; privacidade e consentimento escrito</span><p id="par0115" class="elsevierStylePara elsevierViewall">Os autores declaram ter recebido consentimento escrito dos pacientes e&#47;ou sujeitos mencionados no artigo&#46; O autor para correspond&#234;ncia deve estar na posse deste documento&#46;</p></span></span><span id="sec0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Conflito de interesses</span><p id="par0120" class="elsevierStylePara elsevierViewall">Os autores declaram n&#227;o haver conflito de interesses&#46;</p></span></span>"
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    "fechaRecibido" => "2012-04-19"
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          "palabras" => array:3 [
            0 => "Fibrose qu&#237;stica"
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            1 => "Respiratory function tests"
            2 => "Postural balance"
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        "resumen" => "<span><span class="elsevierStyleSectionTitle">Objetivos</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Avaliar as correla&#231;&#245;es entre fun&#231;&#227;o pulmonar&#44; capacidade funcional e postura em pacientes adultos portadores de fibrose qu&#237;stica &#40;FQ&#41;&#46; Como segundo objetivo&#44; avaliar a correla&#231;&#227;o entre a qualidade de vida e as vari&#225;veis obtidas na avalia&#231;&#227;o postural destes pacientes&#46;</p></span> <span><span class="elsevierStyleSectionTitle">M&#233;todos</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Foi realizado um estudo transversal em que 14 portadores de FQ se submeteram &#224; avalia&#231;&#227;o da an&#225;lise postural &#40;<span class="elsevierStyleItalic">software</span> de avalia&#231;&#227;o postural&#41; e provas de fun&#231;&#227;o pulmonar &#40;espirometria&#44; pletismografia de corpo inteiro e medi&#231;&#227;o da capacidade de difus&#227;o do CO&#41; e capacidade funcional &#40;teste da caminhada de 6<span class="elsevierStyleHsp" style=""></span>min&#41;&#46; Todos os pacientes responderam ao Question&#225;rio de Fibrose Qu&#237;stica com Vers&#227;o Revisada &#40;QFQ-R&#41;&#46;</p></span> <span><span class="elsevierStyleSectionTitle">Resultados</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">A maioria dos pacientes era do sexo masculino &#40;57&#37;&#41;&#44; com mediana da idade de 24&#44;5 anos &#40;22-34 anos&#41;&#46; Foram observadas correla&#231;&#245;es significantes de volume expirat&#243;rio m&#225;ximo no primeiro segundo&#44; dist&#226;ncia da caminhada dos 6&#160;min&#44; capacidade pulmonar total e resist&#234;ncia de vias a&#233;reas com o alinhamento vertical do tronco &#40;&#961;&#160;&#61;&#160;&#8722;0&#44;57&#44; p&#160;&#60;&#160;0&#44;05&#59; &#961;&#160;&#61;&#160;&#8722;0&#44;65&#44; p&#160;&#60;&#160;0&#44;01&#59; &#961;&#160;&#61;&#160;0&#44;54&#44; p&#160;&#60;&#160;0&#44;05&#59; e &#961;&#160;&#61;&#160;0&#44;67&#44; p&#160;&#60; 0&#44;01&#44; respetivamente&#41;&#46; Foram observadas correla&#231;&#245;es estatisticamente significantes entre o dom&#237;nio &#171;f&#237;sico&#187; do QFQ-R e o alinhamento vertical do t&#243;rax &#40;&#961;&#160;&#61;&#160;&#8722;0&#44;74&#44; p&#160;&#60;&#160;0&#44;01&#41;&#44; e entre o dom&#237;nio &#171;limita&#231;&#245;es&#187; do QFQ-R e o &#226;ngulo do quadril &#40;&#961;&#160;&#61;&#160;&#8722;0&#44;55&#44; p&#160;&#60;&#160;0&#44;05&#41;&#46;</p></span> <span><span class="elsevierStyleSectionTitle">Conclus&#245;es</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">O presente trabalho mostra que as anormalidades na fun&#231;&#227;o pulmonar e na capacidade funcional se associam &#224;s altera&#231;&#245;es posturais em adultos portadores de FQ&#46; Entretanto&#44; a gravidade das anormalidades posturais n&#227;o influenciam negativamente os dom&#237;nios do QFQ-R&#46;</p></span>"
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        "resumen" => "<span><span class="elsevierStyleSectionTitle">Aim</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">The purpose of this study was to evaluate the correlations within pulmonary function&#44; functional capacity&#44; and posture in adult patients with cystic fibrosis &#40;CF&#41;&#46; A secondary aim was to evaluate the correlation between patient quality of life and postural assessment variables&#46;</p></span> <span><span class="elsevierStyleSectionTitle">Method</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">A cross-sectional study was conducted on fourteen patients with CF&#46; Patients were subjected to a postural analysis &#40;postural assessment software&#41; and measurements of pulmonary function &#40;spirometry&#44; whole body plethysmography&#44; and carbon monoxide diffusing capacity&#41; and functional capacity &#40;6-min walking test&#41;&#46; All patients completed the <span class="elsevierStyleItalic">Cystic Fibrosis Questionnaire-Revised</span> &#40;CFQ-R&#41;&#46;</p></span> <span><span class="elsevierStyleSectionTitle">Results</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Most patients were male &#40;57&#37;&#41;&#44; and the median age of the patients was 24&#46;5 &#40;22&#8211;34&#41;&#46; The forced expiratory volume in one second&#44; the 6-min walking distance&#44; total lung capacity&#44; and airway resistance were significantly correlated with the vertical alignment of the chest &#40;&#961; &#61; &#8722;0&#46;57&#44; <span class="elsevierStyleItalic">P</span> &#60; 0&#46;05&#59; &#961; &#61; &#8722;0&#46;65&#44; <span class="elsevierStyleItalic">P</span> &#60; 0&#46;01&#59; &#961; &#61; 0&#46;54&#44; <span class="elsevierStyleItalic">P</span> &#60; 0&#46;05&#59; and &#961; &#61; 0&#46;67&#44; <span class="elsevierStyleItalic">P</span> &#60; 0&#46;01&#44; respectively&#41;&#46; The &#8216;physical&#8217; domain of the CFQ-R was significantly correlated with the vertical alignment of the chest &#40;&#961; &#61; &#8722;0&#46;74&#44; <span class="elsevierStyleItalic">P</span> &#60; 0&#46;01&#41;&#44; and the &#8216;limitations&#8217; domain of the CFQ-R was significantly correlated with the angle of the hip &#40;&#961; &#61; &#8722;0&#46;55&#44; <span class="elsevierStyleItalic">P</span> &#60; 0&#46;05&#41;&#46;</p></span> <span><span class="elsevierStyleSectionTitle">Conclusion</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">The present study shows that abnormalities in pulmonary function and functional capacity are associated with postural changes in adults with CF&#46; However the severity of the postural abnormalities does not negatively influence the CFQ-R domains&#46;</p></span>"
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          "leyenda" => "<p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">Os resultados s&#227;o expressos como mediana &#40;intervalos interquartis&#41; ou n&#250;mero &#40;&#37;&#41;&#46;</p><p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">CPT&#58; capacidade pulmonar total&#59; CVF&#58; capacidade vital for&#231;ada&#59; DC6<span class="elsevierStyleHsp" style=""></span>M&#58; dist&#226;ncia da caminhada dos 6<span class="elsevierStyleHsp" style=""></span>min&#59; DLco&#58; capacidade de difus&#227;o do CO&#59; QFQ-R&#58; Question&#225;rio de Fibrose Qu&#237;stica com Vers&#227;o Revisada&#59; Rva&#58; resist&#234;ncia de vias a&#233;reas&#59; VEMS&#58; volume expirat&#243;rio m&#225;ximo no primeiro segundo&#59; VR&#58; volume residual&#46;</p>"
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                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Vari&#225;veis&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Valores&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Sexo &#40;homens&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">8 &#40;57&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">24&#44;5 &#40;22&#8211;34&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Altura &#40;cm&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">170 &#40;160&#8211;170&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Peso &#40;kg&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">54 &#40;47&#44;5&#8211;68&#44;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">VEMS &#40;&#37; previsto&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">54 &#40;40&#44;3&#8211;76&#44;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">CVF &#40;&#37; previsto&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">84 &#40;59&#8211;88&#44;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">VEMS&#47;CVF &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">57&#44;5 &#40;55&#44;3&#8211;72&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">CPT &#40;&#37; previsto&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">106&#44;5 &#40;102&#8211;121&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">VR &#40;&#37; previsto&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">178 &#40;148&#44;3&#8211;273&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">VR&#47;CPT &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">48 &#40;37&#44;3&#8211;61&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Rva &#40;cmH</span><span class="elsevierStyleInf"><span class="elsevierStyleItalic">2</span></span><span class="elsevierStyleItalic">O&#47;L&#47;s&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2 &#40;0&#44;95&#8211;3&#44;03&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">DLco &#40;&#37; previsto&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">80&#44;5 &#40;71&#44;8&#8211;89&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">DC6M &#40;&#37; previsto&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">83&#44;3 &#40;67&#44;6&#8211;92&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="2" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="2" align="left" valign="top"><span class="elsevierStyleItalic">Resultados QFQ-R</span></td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>F&#237;sico&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">64&#44;5 &#40;55&#44;2&#8211;77&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Limita&#231;&#245;es&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">80 &#40;70&#8211;86&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Social&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">61&#44;1 &#40;55&#44;6&#8211;87&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Imagem corporal&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">77&#44;8 &#40;47&#44;2&#8211;88&#44;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Respirat&#243;rio&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">73&#44;8 &#40;59&#44;5&#8211;88&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
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          "pt" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Dados antropom&#233;tricos&#44; fun&#231;&#227;o pulmonar&#44; capacidade funcional e dom&#237;nios do Question&#225;rio de Fibrose Qu&#237;stica com Vers&#227;o Revisada nos pacientes com fibrose qu&#237;stica</p>"
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          "leyenda" => "<p id="spar0075" class="elsevierStyleSimplePara elsevierViewall">Os resultados s&#227;o expressos como mediana &#40;intervalos interquartis&#41;&#46;</p><p id="spar0080" class="elsevierStyleSimplePara elsevierViewall">ACEIAP&#58; &#226;ngulo entre o acr&#243;mio e a espinha il&#237;aca &#226;ntero-superior&#59; AHC&#58; alinhamento horizontal da cabe&#231;a&#59; AQD&#58; &#226;ngulo do quadril direito&#59; AQE&#58; &#226;ngulo do quadril esquerdo&#59; VLDAHC&#58; vista lateral direita - alinhamento horizontal da cabe&#231;a&#59; VLDAVC&#58; vista lateral direita - alinhamento vertical do corpo&#59; VLDAVT&#58; vista lateral direita - alinhamento vertical do t&#243;rax&#59; VLEAHC&#58; vista lateral esquerda - alinhamento horizontal da cabe&#231;a&#59; VLEAVC&#58; vista lateral esquerda - alinhamento vertical do corpo&#59; VLEAVT&#58; vista lateral esquerda - alinhamento vertical do t&#243;rax&#46;</p>"
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                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Vari&#225;veis&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Valores&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">AHC &#40;<span class="elsevierStyleSup">o</span>&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">ACEIAP &#40;<span class="elsevierStyleSup">o</span>&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&#44;30 &#40;1&#44;70&#8211;2&#44;80&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">VLDAVT &#40;<span class="elsevierStyleSup">o</span>&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">-5&#44;60 &#40;-11&#44;0&#8211;3&#44;03&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">VLEAVT &#40;<span class="elsevierStyleSup">o</span>&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">8&#44;26 &#40;8&#44;13&#8211;8&#44;52&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">VLEAVC &#40;<span class="elsevierStyleSup">o</span>&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">13&#44;6 &#40;4&#44;6&#8211;19&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
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          "pt" => "<p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">Dados obtidos atrav&#233;s do <span class="elsevierStyleItalic">software</span> de avalia&#231;&#227;o postural nos pacientes com fibrose qu&#237;stica</p>"
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      4 => array:7 [
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        "tabla" => array:2 [
          "leyenda" => "<p id="spar0090" class="elsevierStyleSimplePara elsevierViewall">&#42; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;05&#59; &#42;&#42; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;01&#46;</p><p id="spar0095" class="elsevierStyleSimplePara elsevierViewall">ACEIAP&#58; &#226;ngulo entre o acr&#244;mio e a espinha il&#237;aca &#226;ntero-superior&#59; AHC&#58; alinhamento horizontal da cabe&#231;a&#59; AQD&#58; &#226;ngulo do quadril direito&#59; AQE&#58; &#226;ngulo do quadril esquerdo&#59; CVF&#58; capacidade vital for&#231;ada&#59; CPT&#58; capacidade pulmonar total&#59; Rva&#58; resist&#234;ncia de vias a&#233;reas&#59; DC6<span class="elsevierStyleHsp" style=""></span>M&#58; dist&#226;ncia da caminhada dos 6<span class="elsevierStyleHsp" style=""></span>min&#59; DLco&#58; capacidade de difus&#227;o do CO&#59; VEMS&#58; volume expirat&#243;rio m&#225;ximo no primeiro segundo&#59; VLDAHC&#58; vista lateral direita - alinhamento horizontal da cabe&#231;a&#59; VLDAVC&#58; vista lateral direita - alinhamento vertical do corpo&#59; VLDAVT&#58; vista lateral direita - alinhamento vertical do t&#243;rax&#59; VLEAHC&#58; vista lateral esquerda - alinhamento horizontal da cabe&#231;a&#59; VLEAVC&#58; vista lateral esquerda - alinhamento vertical do corpo&#59; VLEAVT&#58; vista lateral esquerda - alinhamento vertical do t&#243;rax&#59; VR&#58; volume residual&#46;</p>"
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                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Vari&#225;veis&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8722;0&#44;37&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8722;0&#44;04&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;03&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;27&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;23&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8722;0&#44;19&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">ACEIAP &#40;<span class="elsevierStyleSup">o</span>&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;15&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8722;0&#44;57&#42;&nbsp;\t\t\t\t\t\t\n
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          "pt" => "<p id="spar0085" class="elsevierStyleSimplePara elsevierViewall">Coeficientes de correla&#231;&#227;o de Spearman entre os dados obtidos atrav&#233;s do <span class="elsevierStyleItalic">software</span> de avalia&#231;&#227;o postural&#44; fun&#231;&#227;o pulmonar e capacidade funcional em pacientes com fibrose qu&#237;stica</p>"
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                            3 => "M&#46;E&#46; Hodson"
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                            3 => "S&#46;S&#46; Menna-Barreto"
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                            3 => "C&#46;J&#46; Amino"
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Article information
ISSN: 08732159
Original language: Portuguese
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