Reliability of two devices for shoulder strength assessment: Wii Fit Balance Board and hand-held dynamometer.

Background: The aim of this study was to compare the reliability and agreement between two devices - Wii Fit Balance Board (WBB) versus Hand-Held Dynamometer (HHD) to measure isometric strength during the athletic shoulder (ASH) test in healthy amateur rugby players. Methods: Fifteen males (23.73 ± 2.8 years) completed two testing sessions. Maximal isometric contractions using the dominant arm (D) and non-dominant arm (ND) against a WBB and HHD were assessed at three angles of abduction (180°, 'I'; 135°, 'Y' and 90°, 'T'), in a prone lying position. Results: The results indicate a very large correlation between the HHD and the WBB. WBB provides acceptable reliability at I-Test D (CV = 9.97%, ICC = 0.88) and HHD in the I-Test D (CV = 8.90%, ICC = 0.94), I-Test ND (CV = 8.60%, ICC = 0.95) in peak strength values. The HHD is most reliable in D ASH I-Y-T (CV = 10.94%) and WBB (CV = 11.05%). In the ND ASH I-Y-T test, the HHD is the most reliable (CV = 12.5%) compared to the WBB (CV = 14.43%). Conclusions: These results suggest that WBB is a reliable device to assess strength in the ASH test with a very large correlation with the HHD. WBB and HHD are two affordable devices to assess isometric shoulder strength.

Glucocorticoides en artritis reumatoide / Corticosteroide use in rheumatoid arthritis

El uso de los corticosteroides es común pero controversial en el tratamiento de la artritis reumatoide. Los esteroides suprimen la inflamación a través de múltiples mecanismos que interactuan. Aunque los efectos benéficos atiinflamatorios e inmunosupresores de estos medicamentos justifican su uso, los efectos colaterales son frecuentes. Las complicaciones resultan de alteraciones en la función celular, alteración en el balance de líquidos y electrolitos modificación del sistema inmune y supresión del funcionamiento normal del eje hipofisis adrenal. Mas que cual-quier droga utilizada para la artritis reumatoidea (AR), los esteroides son el arma de doble filo. El efecto inmediato de su uso es gratificante, pero su toxicidad a largo plazo es desalentadora. Una vez se ha tomado la decision de iniciar el uso de los esteroides deben hacerse esfuerzos para usarlos de la manera mas segura y efectiva posible.