Postural alignment of patients with Chronic Obstructive Pulmonary Disease

Abstract Introduction: In chronic obstructive pulmonary disease (COPD), airflow resistance impairs respiratory mechanics that may compromise postural alignment. There is a lack of studies that have investigated compromised postures and their possible associations with pulmonary function. Objectives:...

Ausführliche Beschreibung

Gespeichert in:
Bibliographische Detailangaben
Veröffentlicht in:Fisioterapia em movimento 2017-09, Vol.30 (3), p.549-558
Hauptverfasser: Gonçalves, Márcia Aparecida, Francisco, Davi de Souza, Medeiros, Caroline Semprebom de, Brüggemann, Ana Karla Vieira, Mazo, Giovana Zarpellon, Paulin, Elaine
Format: Artikel
Sprache:eng
Schlagworte:
Online-Zugang:Volltext
Tags: Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
container_end_page 558
container_issue 3
container_start_page 549
container_title Fisioterapia em movimento
container_volume 30
creator Gonçalves, Márcia Aparecida
Francisco, Davi de Souza
Medeiros, Caroline Semprebom de
Brüggemann, Ana Karla Vieira
Mazo, Giovana Zarpellon
Paulin, Elaine
description Abstract Introduction: In chronic obstructive pulmonary disease (COPD), airflow resistance impairs respiratory mechanics that may compromise postural alignment. There is a lack of studies that have investigated compromised postures and their possible associations with pulmonary function. Objectives: To compare the postural alignment of COPD patients with apparently healthy individuals; To correlate pulmonary function with postural alignment in the COPD group. Methods: 20 COPD patients and 20 apparently healthy individuals performed: anthropometry, spirometry and postural evaluation. The following postural changes were assessed: lateral head tilt (LHT), shoulder asymmetry (SA1), anterior pelvic asymmetry (APA), lateral trunk tilt (LTT), scapular asymmetry (SA2), posterior pelvic asymmetry (PPA), head protrusion (HP), shoulder protrusion (SP), anterior pelvic tilt (APT) and thoracic kyphosis (TK). Results: There was a statistically significant difference between COPD patients and apparently healthy individuals in the following variables: PPT (p= 0.021), APT (p=0.014) and TK (p=0.011). There was a correlation between pulmonary variables and postural alignment in the COPD group: Forced Volume in one second (FEV1% pred) and HP (°) (r=0.488, p=0.029), FEV1 (% pred) and APT (°) (r= -0.472, p= 0.036); Forced Vital Capacity (FVC % pred) and HP (°) (r=0.568, p=0.009); FVC (% pred) and APT (°) (r=-0.461, p=0.041). Conclusion: Postural alignment of the anterior tilt of the right and left pelvis and thoracic kyphosis is different when compared with COPD patients and healthy individuals. There is a relationship between pulmonary function and postural alignment in COPD patients. Resumo Introdução: Na doença pulmonar obstrutiva crônica (DPOC), a resistência ao fluxo aéreo prejudica a mecânica respiratória que pode comprometer o alinhamento postural. Existe uma escassez de estudos que tenham investigado os comprometimentos posturais e suas possíveis relações com a função pulmonar. Objetivos: Comparar o alinhamento postural entre pacientes com DPOC e indivíduos aparentemente saudáveis; correlacionar a função pulmonar com o alinhamento postural no grupo DPOC. Métodos: 20 pacientes com DPOC e 20 indivíduos aparentemente saudáveis realizaram: antropometria, espirometria e avaliação postural. Foram analisadas as alterações posturais: inclinação lateral da cabeça (ILC), desnivelamento dos ombros (DO), desnivelamento pélvico anterior (DPA), inclinação lateral do tronco (ILT), des
doi_str_mv 10.1590/1980-5918.030.003.ao13
format Article
fullrecord <record><control><sourceid>scielo_doaj_</sourceid><recordid>TN_cdi_scielo_journals_S0103_51502017000300549</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><scielo_id>S0103_51502017000300549</scielo_id><doaj_id>oai_doaj_org_article_8ccea962a09f444eb62213c20bad4a8b</doaj_id><sourcerecordid>S0103_51502017000300549</sourcerecordid><originalsourceid>FETCH-LOGICAL-c2533-8f371acc8480228eb2811d28f499f6cc3bd14c5108beed622e0572b2128e78753</originalsourceid><addsrcrecordid>eNpNUV1LwzAUDaLgmPsL0j_QevPVJo8yvwaDDdTnkKbpltE1I2kV_72pE_G-3MPlnsPhHIRuMRSYS7jDUkDOJRYFUCgAaKE9phdoBhhozjGHy3_4Gi1iPEAaKoEJOUOrrY_DGHSX6c7t-qPth8y32UkPLsGYfbphny33wffOZJs6DmE0g_uw2Xbsjr7X4St7cNHqaG_QVau7aBe_e47enx7fli_5evO8Wt6vc0M4pbloaYW1MYIJIETYmgiMGyJaJmVbGkPrBjPDMYja2qYkxAKvSE1w-q1Exekcrc66jdcHdQrumEwor536OfiwUzoMznRWCWOsliXRIFvGmK2THKaGQK0bpkWdtIqzVjTOdl4d_Bj6ZF69TpGpKTICuJryAuBMJkJ5JpjgYwy2_TOAQU2FqKkQNRWiEkclopoKod-7LXu0</addsrcrecordid><sourcetype>Open Website</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype></control><display><type>article</type><title>Postural alignment of patients with Chronic Obstructive Pulmonary Disease</title><source>DOAJ Directory of Open Access Journals</source><source>EZB-FREE-00999 freely available EZB journals</source><creator>Gonçalves, Márcia Aparecida ; Francisco, Davi de Souza ; Medeiros, Caroline Semprebom de ; Brüggemann, Ana Karla Vieira ; Mazo, Giovana Zarpellon ; Paulin, Elaine</creator><creatorcontrib>Gonçalves, Márcia Aparecida ; Francisco, Davi de Souza ; Medeiros, Caroline Semprebom de ; Brüggemann, Ana Karla Vieira ; Mazo, Giovana Zarpellon ; Paulin, Elaine</creatorcontrib><description>Abstract Introduction: In chronic obstructive pulmonary disease (COPD), airflow resistance impairs respiratory mechanics that may compromise postural alignment. There is a lack of studies that have investigated compromised postures and their possible associations with pulmonary function. Objectives: To compare the postural alignment of COPD patients with apparently healthy individuals; To correlate pulmonary function with postural alignment in the COPD group. Methods: 20 COPD patients and 20 apparently healthy individuals performed: anthropometry, spirometry and postural evaluation. The following postural changes were assessed: lateral head tilt (LHT), shoulder asymmetry (SA1), anterior pelvic asymmetry (APA), lateral trunk tilt (LTT), scapular asymmetry (SA2), posterior pelvic asymmetry (PPA), head protrusion (HP), shoulder protrusion (SP), anterior pelvic tilt (APT) and thoracic kyphosis (TK). Results: There was a statistically significant difference between COPD patients and apparently healthy individuals in the following variables: PPT (p= 0.021), APT (p=0.014) and TK (p=0.011). There was a correlation between pulmonary variables and postural alignment in the COPD group: Forced Volume in one second (FEV1% pred) and HP (°) (r=0.488, p=0.029), FEV1 (% pred) and APT (°) (r= -0.472, p= 0.036); Forced Vital Capacity (FVC % pred) and HP (°) (r=0.568, p=0.009); FVC (% pred) and APT (°) (r=-0.461, p=0.041). Conclusion: Postural alignment of the anterior tilt of the right and left pelvis and thoracic kyphosis is different when compared with COPD patients and healthy individuals. There is a relationship between pulmonary function and postural alignment in COPD patients. Resumo Introdução: Na doença pulmonar obstrutiva crônica (DPOC), a resistência ao fluxo aéreo prejudica a mecânica respiratória que pode comprometer o alinhamento postural. Existe uma escassez de estudos que tenham investigado os comprometimentos posturais e suas possíveis relações com a função pulmonar. Objetivos: Comparar o alinhamento postural entre pacientes com DPOC e indivíduos aparentemente saudáveis; correlacionar a função pulmonar com o alinhamento postural no grupo DPOC. Métodos: 20 pacientes com DPOC e 20 indivíduos aparentemente saudáveis realizaram: antropometria, espirometria e avaliação postural. Foram analisadas as alterações posturais: inclinação lateral da cabeça (ILC), desnivelamento dos ombros (DO), desnivelamento pélvico anterior (DPA), inclinação lateral do tronco (ILT), desnivelamento das escápulas (DE), desnivelamento pélvico posterior (DPP), protrusão da cabeça (PC), protrusão de ombro (PO), báscula anterior da pelve (BAP) e cifose torácica (CT). Resultados: Houve diferença estatisticamente significante entre os pacientes com DPOC e os indivíduos aparentemente saudáveis nas variáveis: DPP (0,021), BAP (p=0,014) e CT (p=0,011). Houve correlação entre as variáveis pulmonares e o alinhamento postural no grupo DPOC: volume forçado no primeiro segundo (VEF1 %prev) e PC (°) (r= 0,488, p=0,029), VEF1 (%prev) e BAP (°) (r= -0,472; p= 0,036); Capacidade Vital Forçada (CVF %prev) e PC (°) (r= 0,568; p= 0,009); CVF %prev) e BAP (°) (r= -0,461; p=0,041). Conclusão: O alinhamento postural da báscula anterior da pelve direita e esquerda e da cifose torácica é diferente quando comparados pacientes com DPOC e saudáveis. Existe relação entre a função pulmonar e o alinhamento postural no paciente com DPOC.</description><identifier>ISSN: 0103-5150</identifier><identifier>ISSN: 1980-5918</identifier><identifier>EISSN: 0103-5150</identifier><identifier>DOI: 10.1590/1980-5918.030.003.ao13</identifier><language>eng</language><publisher>Pontifícia Universidade Católica do Paraná</publisher><subject>Chronic Obstructive Pulmonary Disease ; ORTHOPEDICS ; Photogrammetry ; Posture ; REHABILITATION</subject><ispartof>Fisioterapia em movimento, 2017-09, Vol.30 (3), p.549-558</ispartof><rights>This work is licensed under a Creative Commons Attribution 4.0 International License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c2533-8f371acc8480228eb2811d28f499f6cc3bd14c5108beed622e0572b2128e78753</citedby><cites>FETCH-LOGICAL-c2533-8f371acc8480228eb2811d28f499f6cc3bd14c5108beed622e0572b2128e78753</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,780,784,864,885,27924,27925</link.rule.ids></links><search><creatorcontrib>Gonçalves, Márcia Aparecida</creatorcontrib><creatorcontrib>Francisco, Davi de Souza</creatorcontrib><creatorcontrib>Medeiros, Caroline Semprebom de</creatorcontrib><creatorcontrib>Brüggemann, Ana Karla Vieira</creatorcontrib><creatorcontrib>Mazo, Giovana Zarpellon</creatorcontrib><creatorcontrib>Paulin, Elaine</creatorcontrib><title>Postural alignment of patients with Chronic Obstructive Pulmonary Disease</title><title>Fisioterapia em movimento</title><addtitle>Fisioter. mov</addtitle><description>Abstract Introduction: In chronic obstructive pulmonary disease (COPD), airflow resistance impairs respiratory mechanics that may compromise postural alignment. There is a lack of studies that have investigated compromised postures and their possible associations with pulmonary function. Objectives: To compare the postural alignment of COPD patients with apparently healthy individuals; To correlate pulmonary function with postural alignment in the COPD group. Methods: 20 COPD patients and 20 apparently healthy individuals performed: anthropometry, spirometry and postural evaluation. The following postural changes were assessed: lateral head tilt (LHT), shoulder asymmetry (SA1), anterior pelvic asymmetry (APA), lateral trunk tilt (LTT), scapular asymmetry (SA2), posterior pelvic asymmetry (PPA), head protrusion (HP), shoulder protrusion (SP), anterior pelvic tilt (APT) and thoracic kyphosis (TK). Results: There was a statistically significant difference between COPD patients and apparently healthy individuals in the following variables: PPT (p= 0.021), APT (p=0.014) and TK (p=0.011). There was a correlation between pulmonary variables and postural alignment in the COPD group: Forced Volume in one second (FEV1% pred) and HP (°) (r=0.488, p=0.029), FEV1 (% pred) and APT (°) (r= -0.472, p= 0.036); Forced Vital Capacity (FVC % pred) and HP (°) (r=0.568, p=0.009); FVC (% pred) and APT (°) (r=-0.461, p=0.041). Conclusion: Postural alignment of the anterior tilt of the right and left pelvis and thoracic kyphosis is different when compared with COPD patients and healthy individuals. There is a relationship between pulmonary function and postural alignment in COPD patients. Resumo Introdução: Na doença pulmonar obstrutiva crônica (DPOC), a resistência ao fluxo aéreo prejudica a mecânica respiratória que pode comprometer o alinhamento postural. Existe uma escassez de estudos que tenham investigado os comprometimentos posturais e suas possíveis relações com a função pulmonar. Objetivos: Comparar o alinhamento postural entre pacientes com DPOC e indivíduos aparentemente saudáveis; correlacionar a função pulmonar com o alinhamento postural no grupo DPOC. Métodos: 20 pacientes com DPOC e 20 indivíduos aparentemente saudáveis realizaram: antropometria, espirometria e avaliação postural. Foram analisadas as alterações posturais: inclinação lateral da cabeça (ILC), desnivelamento dos ombros (DO), desnivelamento pélvico anterior (DPA), inclinação lateral do tronco (ILT), desnivelamento das escápulas (DE), desnivelamento pélvico posterior (DPP), protrusão da cabeça (PC), protrusão de ombro (PO), báscula anterior da pelve (BAP) e cifose torácica (CT). Resultados: Houve diferença estatisticamente significante entre os pacientes com DPOC e os indivíduos aparentemente saudáveis nas variáveis: DPP (0,021), BAP (p=0,014) e CT (p=0,011). Houve correlação entre as variáveis pulmonares e o alinhamento postural no grupo DPOC: volume forçado no primeiro segundo (VEF1 %prev) e PC (°) (r= 0,488, p=0,029), VEF1 (%prev) e BAP (°) (r= -0,472; p= 0,036); Capacidade Vital Forçada (CVF %prev) e PC (°) (r= 0,568; p= 0,009); CVF %prev) e BAP (°) (r= -0,461; p=0,041). Conclusão: O alinhamento postural da báscula anterior da pelve direita e esquerda e da cifose torácica é diferente quando comparados pacientes com DPOC e saudáveis. Existe relação entre a função pulmonar e o alinhamento postural no paciente com DPOC.</description><subject>Chronic Obstructive Pulmonary Disease</subject><subject>ORTHOPEDICS</subject><subject>Photogrammetry</subject><subject>Posture</subject><subject>REHABILITATION</subject><issn>0103-5150</issn><issn>1980-5918</issn><issn>0103-5150</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>DOA</sourceid><recordid>eNpNUV1LwzAUDaLgmPsL0j_QevPVJo8yvwaDDdTnkKbpltE1I2kV_72pE_G-3MPlnsPhHIRuMRSYS7jDUkDOJRYFUCgAaKE9phdoBhhozjGHy3_4Gi1iPEAaKoEJOUOrrY_DGHSX6c7t-qPth8y32UkPLsGYfbphny33wffOZJs6DmE0g_uw2Xbsjr7X4St7cNHqaG_QVau7aBe_e47enx7fli_5evO8Wt6vc0M4pbloaYW1MYIJIETYmgiMGyJaJmVbGkPrBjPDMYja2qYkxAKvSE1w-q1Exekcrc66jdcHdQrumEwor536OfiwUzoMznRWCWOsliXRIFvGmK2THKaGQK0bpkWdtIqzVjTOdl4d_Bj6ZF69TpGpKTICuJryAuBMJkJ5JpjgYwy2_TOAQU2FqKkQNRWiEkclopoKod-7LXu0</recordid><startdate>201709</startdate><enddate>201709</enddate><creator>Gonçalves, Márcia Aparecida</creator><creator>Francisco, Davi de Souza</creator><creator>Medeiros, Caroline Semprebom de</creator><creator>Brüggemann, Ana Karla Vieira</creator><creator>Mazo, Giovana Zarpellon</creator><creator>Paulin, Elaine</creator><general>Pontifícia Universidade Católica do Paraná</general><general>Editora Champagnat</general><scope>AAYXX</scope><scope>CITATION</scope><scope>GPN</scope><scope>DOA</scope></search><sort><creationdate>201709</creationdate><title>Postural alignment of patients with Chronic Obstructive Pulmonary Disease</title><author>Gonçalves, Márcia Aparecida ; Francisco, Davi de Souza ; Medeiros, Caroline Semprebom de ; Brüggemann, Ana Karla Vieira ; Mazo, Giovana Zarpellon ; Paulin, Elaine</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c2533-8f371acc8480228eb2811d28f499f6cc3bd14c5108beed622e0572b2128e78753</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Chronic Obstructive Pulmonary Disease</topic><topic>ORTHOPEDICS</topic><topic>Photogrammetry</topic><topic>Posture</topic><topic>REHABILITATION</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Gonçalves, Márcia Aparecida</creatorcontrib><creatorcontrib>Francisco, Davi de Souza</creatorcontrib><creatorcontrib>Medeiros, Caroline Semprebom de</creatorcontrib><creatorcontrib>Brüggemann, Ana Karla Vieira</creatorcontrib><creatorcontrib>Mazo, Giovana Zarpellon</creatorcontrib><creatorcontrib>Paulin, Elaine</creatorcontrib><collection>CrossRef</collection><collection>SciELO</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>Fisioterapia em movimento</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Gonçalves, Márcia Aparecida</au><au>Francisco, Davi de Souza</au><au>Medeiros, Caroline Semprebom de</au><au>Brüggemann, Ana Karla Vieira</au><au>Mazo, Giovana Zarpellon</au><au>Paulin, Elaine</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Postural alignment of patients with Chronic Obstructive Pulmonary Disease</atitle><jtitle>Fisioterapia em movimento</jtitle><addtitle>Fisioter. mov</addtitle><date>2017-09</date><risdate>2017</risdate><volume>30</volume><issue>3</issue><spage>549</spage><epage>558</epage><pages>549-558</pages><issn>0103-5150</issn><issn>1980-5918</issn><eissn>0103-5150</eissn><abstract>Abstract Introduction: In chronic obstructive pulmonary disease (COPD), airflow resistance impairs respiratory mechanics that may compromise postural alignment. There is a lack of studies that have investigated compromised postures and their possible associations with pulmonary function. Objectives: To compare the postural alignment of COPD patients with apparently healthy individuals; To correlate pulmonary function with postural alignment in the COPD group. Methods: 20 COPD patients and 20 apparently healthy individuals performed: anthropometry, spirometry and postural evaluation. The following postural changes were assessed: lateral head tilt (LHT), shoulder asymmetry (SA1), anterior pelvic asymmetry (APA), lateral trunk tilt (LTT), scapular asymmetry (SA2), posterior pelvic asymmetry (PPA), head protrusion (HP), shoulder protrusion (SP), anterior pelvic tilt (APT) and thoracic kyphosis (TK). Results: There was a statistically significant difference between COPD patients and apparently healthy individuals in the following variables: PPT (p= 0.021), APT (p=0.014) and TK (p=0.011). There was a correlation between pulmonary variables and postural alignment in the COPD group: Forced Volume in one second (FEV1% pred) and HP (°) (r=0.488, p=0.029), FEV1 (% pred) and APT (°) (r= -0.472, p= 0.036); Forced Vital Capacity (FVC % pred) and HP (°) (r=0.568, p=0.009); FVC (% pred) and APT (°) (r=-0.461, p=0.041). Conclusion: Postural alignment of the anterior tilt of the right and left pelvis and thoracic kyphosis is different when compared with COPD patients and healthy individuals. There is a relationship between pulmonary function and postural alignment in COPD patients. Resumo Introdução: Na doença pulmonar obstrutiva crônica (DPOC), a resistência ao fluxo aéreo prejudica a mecânica respiratória que pode comprometer o alinhamento postural. Existe uma escassez de estudos que tenham investigado os comprometimentos posturais e suas possíveis relações com a função pulmonar. Objetivos: Comparar o alinhamento postural entre pacientes com DPOC e indivíduos aparentemente saudáveis; correlacionar a função pulmonar com o alinhamento postural no grupo DPOC. Métodos: 20 pacientes com DPOC e 20 indivíduos aparentemente saudáveis realizaram: antropometria, espirometria e avaliação postural. Foram analisadas as alterações posturais: inclinação lateral da cabeça (ILC), desnivelamento dos ombros (DO), desnivelamento pélvico anterior (DPA), inclinação lateral do tronco (ILT), desnivelamento das escápulas (DE), desnivelamento pélvico posterior (DPP), protrusão da cabeça (PC), protrusão de ombro (PO), báscula anterior da pelve (BAP) e cifose torácica (CT). Resultados: Houve diferença estatisticamente significante entre os pacientes com DPOC e os indivíduos aparentemente saudáveis nas variáveis: DPP (0,021), BAP (p=0,014) e CT (p=0,011). Houve correlação entre as variáveis pulmonares e o alinhamento postural no grupo DPOC: volume forçado no primeiro segundo (VEF1 %prev) e PC (°) (r= 0,488, p=0,029), VEF1 (%prev) e BAP (°) (r= -0,472; p= 0,036); Capacidade Vital Forçada (CVF %prev) e PC (°) (r= 0,568; p= 0,009); CVF %prev) e BAP (°) (r= -0,461; p=0,041). Conclusão: O alinhamento postural da báscula anterior da pelve direita e esquerda e da cifose torácica é diferente quando comparados pacientes com DPOC e saudáveis. Existe relação entre a função pulmonar e o alinhamento postural no paciente com DPOC.</abstract><pub>Pontifícia Universidade Católica do Paraná</pub><doi>10.1590/1980-5918.030.003.ao13</doi><tpages>10</tpages><oa>free_for_read</oa></addata></record>
fulltext fulltext
identifier ISSN: 0103-5150
ispartof Fisioterapia em movimento, 2017-09, Vol.30 (3), p.549-558
issn 0103-5150
1980-5918
0103-5150
language eng
recordid cdi_scielo_journals_S0103_51502017000300549
source DOAJ Directory of Open Access Journals; EZB-FREE-00999 freely available EZB journals
subjects Chronic Obstructive Pulmonary Disease
ORTHOPEDICS
Photogrammetry
Posture
REHABILITATION
title Postural alignment of patients with Chronic Obstructive Pulmonary Disease
url https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-24T20%3A15%3A39IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-scielo_doaj_&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Postural%20alignment%20of%20patients%20with%20Chronic%20Obstructive%20Pulmonary%20Disease&rft.jtitle=Fisioterapia%20em%20movimento&rft.au=Gon%C3%A7alves,%20M%C3%A1rcia%20Aparecida&rft.date=2017-09&rft.volume=30&rft.issue=3&rft.spage=549&rft.epage=558&rft.pages=549-558&rft.issn=0103-5150&rft.eissn=0103-5150&rft_id=info:doi/10.1590/1980-5918.030.003.ao13&rft_dat=%3Cscielo_doaj_%3ES0103_51502017000300549%3C/scielo_doaj_%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_id=info:pmid/&rft_scielo_id=S0103_51502017000300549&rft_doaj_id=oai_doaj_org_article_8ccea962a09f444eb62213c20bad4a8b&rfr_iscdi=true