Efficacy and efficiency of a new therapeutic approach based on activity-oriented proprioceptive antiedema therapy (TAPA) for edema reduction and improved occupational performance in the rehabilitation of breast cancer-related arm lymphedema in women: a controlled, randomized clinical trial.

BACKGROUND: Breast cancer (BC) is a major public health issue. More than one out of five women treated for breast cancer will develop lymphedema in an upper extremity. Current evidence advocates transdisciplinary oncological rehabilitation. Therefore, research in this area is necessary since limited consensus having been reached with regard to the basic essential components of this rehabilitation. Consensus has, however, been reached on the use of decongestive lymphedema therapy (DLT), but due to a lack of tests, the necessary dosages are unknown and its level is moderately strong. This study attempts to verify both the efficacy of activity-oriented proprioceptive antiedema therapy (TAPA), as compared to conventional treatments such as DLT or Complex Physical Therapy (CPT), as well as its efficiency in terms of cost-effectiveness, for patients affected by breast cancer-related arm lymphedema. METHODS: Controlled, randomized clinical trial with dual stratification, two parallel arms, longitudinal and single blind. 64 women with breast cancer-related arm lymphedema will take part in the study. The experimental group intervention will be the same for stage I and II, and will consist of neuro-dynamic exercises oriented to the activity, proprioceptive neuromuscular facilitation activities and proprioceptive anti-edema bandaging. The control group intervention, depending on the stage, will consist of preventive measures, skin care and exercise-prescribed training in the lymphedema workshop as well as compression garments (Stage I) or conservative Complex Decongestive Therapy treatment (skin care, multi-layer bandaging, manual lymphatic drainage and massage therapy) (Stage II). RESULTS: Sociodemographic and clinical variables will be collected for the measurement of edema volume and ADL performance. Statistical analysis will be performed on intent to treat. DISCUSSION: It has been recommended that patient training be added to DLT, as well as a re-designing of patient lifestyles and the promotion of health-related aspects. In addition, clinical trials should be undertaken to assess neural mobilization techniques and proprioceptive neuromuscular facilitation should be included in the therapy. Cohesive bandaging will also be performed as an early form of pressotherapy. The proposed study combines all of these aspects in order to increased comfort and promote the participation of individuals with lymphedema in everyday situations. LIMITATIONS: The authors have proposed the assessment of the experimental treatment for stages I and II. One possible limitation is the lack of awareness of whether or not this treatment would be effective for other stages as well as the concern for proper hand cleansing during use of bandages, given the current COVID-19 pandemic situation. TRIAL REGISTRATION: This trial was registered in ClinicalTrials.gov ( NCT03762044 ). Date of registration: 23 November 2018. Prospectively Registered.

The effect of kinesio taping with the web strip technique on pain, edema, and trismus after impacted mandibular third molar surgery.

BACKGOUND: There are many methods used to alleviate edema, trismus, and pain after impacted third molar (3M) removal, one of which is Kinesio Taping (KT). AIMS: This study aimed to evaluate the effectiveness of Kinesio Taping with Web Strip technique on postoperative morbidity after impacted mandibular 3M extraction. METHODS: The study employed a split-mouth and controlled randomized clinical trial design. A total of 60 patients were scheduled for surgical extractions of bilateral lower 3Ms. They were randomly divided into two groups, and KT was applied to one group while the others was determined as a control group without KT application. Tape was applied directly after surgery and maintained for postoperative (post-op) 7 days. Pain intensity was recorded subjectively using a Visual Analogue Scale (VAS). Pain and analgesic usage were recorded on the post-op 1st, 2nd, 3rd, and 7th days. Trismus was evaluated before the surgery and on the post-op 2nd and 7th days. Facial edema was analyzed on the post-op 2nd and 7th days by VAS and by measuring the lengths of three lines using a flexible plastic tape measure. RESULTS: VAS pain scores were statistically lower in the KT group on the post-op 1st, 3rd and 7th days. Total analgesic usage was also significantly lower in the KT group. On the post-op 2nd day, measurement of the lengths of three lines showed a statistically less edema in the KT group. Similar results were obtained from the measurement of edema using VAS. Maximum mouth opening was statistically higher in the KT group on the post-op 2nd and 7th day. CONCLUSION: KT with the web strip technique should be considered more economic and less traumatic than other approaches, as it is free from systemic side effects and is a simple method to carry out to decrease morbidity.

The use of foot pumps compression devices in the perioperative management of ankle fractures: Systematic review of the current literature.

BACKGROUND: Ankle fractures account for 9% of all fractures seen in the United Kingdom. 15,000 of these fractures undergo operative fixation each year. Soft tissue swelling impacts on timing of fixation due to fears of infection and wound dehiscence. The use of arterio-venous foot pumps (AVFP) is increasing in this population although the evidence for their efficacy is unclear. In order to address this, we present an overview of the evidence for AVFP device use following ankle fracture. METHODS: In September 2015 an electronic literature search was undertaken of studies comparing two or more methods of swelling reduction in patients with ankle fractures. Of 326 screened, 5 papers ultimately were included. RESULTS: Two studies reported a statistically significant reduction in swelling (p=0.03) and (p=0.03 at 24 hours, p=0.05 at 48 hours) after using AVFP devices compared to the controls (leg elevation +/ ice therapy). Stockle et al. reported a greater reduction in the preoperative ankle, midfoot and forefoot circumference at 24 hours in their AVFP group (53% versus 32% and 10% in their continuous cryotherapy and cool pack cryotherapy groups respectively). Whereas, Rohner-Spengler et al. observed improved preoperative swelling reduction in patients treated with a multilayer compression bandage when compared to their AVFP group. Keehan et al. reported that time to surgery was considerably reduced in patients treated with an AVFP device, (2.3 days) compared to those treated with leg elevation (4.6 days) (p=0.02). Length of stay (LOS) was not influenced by any of the tested interventions. CONCLUSIONS: AVFP devices have been shown to reduce time to surgery and degree of swelling before operative intervention better than other methods but the strength of evidence to support this remains poor.

Kinesiologic taping reduces morbidity after oral and maxillofacial surgery: a pooled analysis.

BACKGROUND: Postoperative morbidity is a major disadvantage after oral and maxillofacial (OMF) surgery, often caused by pain, trismus and swelling affecting patients' quality of life. The goal of this study was to examine the effect of kinesiologic taping (KT) on swelling, pain, trismus and patients' satisfaction after OMF surgery. MATERIALS AND METHODS: Performing a pooled analysis of 96 patients that were assigned for maxillofacial treatment (midface fractures n = 30, mandibular fractures n = 26, wisdom tooth removal n = 40) divided into treatment either with or without kinesiologic tape application. Tape was applied directly after surgery and maintained for at least 5 d postoperatively. Facial swelling was quantified at six specific points in time using a five-line measurement. Pain and degree of mouth opening was measured. Patients' objective feeling and satisfaction was queried. RESULTS: Application of KT after OMF surgery has a significant influence on the reduction of swelling decreasing the turgidity for 60% during the first 2 d after surgery. Evaluating all patients swelling was significantly lower in the KT treatment group (T2: 63.5 cm ± 4.3; T3: 62.5 cm ± 4.2; T4: 61.6 cm ± 4.2) than in the no-KT group (T2: 67.6 cm ± 5.0; T3: 67.0 cm ± 5.0; T4: 64.8 cm ± 4.8) at T2 (p < 0.001), T3 (p < 0.001), and T4 (p = 0.001). VAS Pain values were scored significantly lower for the KT group (T1: 2.5 ± 2.0 (p = 0.006); T2: 1.7 ± 2.0 (p < 0.001); T3: 1.5 ± 2.3 (p = 0.004); T4: 0.6 ± 1.1 (p = 0.001) compared to the no-KT group (T1: 3.8 ± 2.5; T2: 3.5 ± 2.7; T3: 2.9 ± 2.2; T4: 1.6 ± 1.7). A statistically significant amelioration in mean mouth opening ability was observed in the KT group (T1-BL: -0.08 cm ± 0.49 (p = 0.025); T2-BL: 0.07 cm ± 0.59 (p = 0.012); T3-BL: 0.20 ± 0.63 (p = 0.013); T4-BL: 0.42 ± 0.59 (p = 0.003)) compared to the no-KT group (T1-BL: -0.47 cm ± 0.86; T2-BL: -0.39 cm ± 0.84; T3-BL: -0.24 ± 0.89; T4-BL: -0.13 ± 1.02). CONCLUSION: KT after OMF surgery is a promising, simple, less traumatic, economical approach free from systemic adverse reaction upgrading patients' quality of life.

Single-case design evaluation of compression therapy for edema of the stroke-affected hand.

OBJECTIVE. To explore the efficacy of low- and high-stretch compression bandaging for edema management in the stroke-affected upper limb. METHOD. A single-case, ABA-design study was conducted with 8 participants alternately allocated to receive low- or high-stretch bandaging. Edema was measured with circumferential tape at four specified points from the hand to the mid-forearm. All measurements were represented graphically for visual analysis, and celeration lines were calculated to indicate the degree of slope in each phase. RESULTS. Visual analysis indicated fluctuating edema volume in the first baseline phase, decreasing edema volume in the intervention phase, and increasing edema volume in the second baseline phase. The results did not clearly distinguish between the two bandaging groups. CONCLUSION. Compression bandaging may have benefits in the management of edema after stroke. Further research is required to identify factors contributing to the long-term maintenance of reductions gained after compression bandaging.

Working on my own terms.

Six months after being named nurse of the year in 2007, Justine Whitaker left the NHS in a blaze of publicity, citing her disillusionment with increasing red tape and a culture of fear. Now an independent nurse, lecturer and business owner, she says NHS reforms still directly affect her.

Functional electrical stimulation cycling has no clear effect on urine output, lower limb swelling, and spasticity in people with spinal cord injury: a randomised cross-over trial.

QUESTION: Does functional electrical stimulation (FES) cycling increase urine output and decrease lower limb swelling and spasticity in people with recent spinal cord injury? DESIGN: Randomised cross-over trial. PARTICIPANTS: Fourteen participants with a recent motor complete spinal cord injury were consecutively recruited from two spinal cord injury units in Sydney. INTERVENTION: Participants were randomised to an experimental phase followed by a control phase or vice versa, with a 1-week washout period in between. The experimental phase involved FES cycling four times a week for two weeks and the control phase involved standard rehabilitation for two weeks. Assessments by a blinded assessor occurred at the beginning and end of each phase. Allocation was concealed and an intention-to-treat analysis was performed. OUTCOME MEASURES: The primary outcome was urine output (mL/hr) and the secondary outcomes were lower limb circumference, and spasticity using the Ashworth Scale, and the Patient Reported Impact of Spasticity Measure (PRISM). In addition, participants were asked open-ended questions to explore their perceptions about treatment effectiveness. RESULTS: All participants completed the study. The mean between-group difference (95% CI) for urine output was 82mL/hr (-35 to 199). The mean between-group differences (95% CI) for lower limb swelling, spasticity (Ashworth), and PRISM were -0.1cm (-1.5 to 1.2), -1.9 points (-4.9 to 1.2) and -5 points (-13 to 2), respectively. All point estimates of treatment effects favoured FES cycling. Participants reported many benefits from FES cycling. CONCLUSION: There were no clear effects of FES cycling on urine output, swelling and spasticity even though all point estimates of treatment effects favoured FES cycling and participants perceived therapeutic effects. TRIAL REGISTRATION: ACTRN12611000923965.

Nutritional repletion of children with severe acute malnutrition does not affect VLDL apolipoprotein B-100 synthesis rate.

VLDL apo B-100 is essential for the secretion of liver fat. It is thought that synthesis of this lipoprotein is impaired in childhood severe acute malnutrition (SAM), especially in the edematous syndromes, and that this contributes to the common occurrence of hepatic steatosis in this condition. However, to our knowledge, it has not been confirmed that VLDL apo B-100 synthesis is slower in edematous compared with nonedematous SAM and that it is impaired in the malnourished compared with the well-nourished state. Therefore, VLDL apo B-100 kinetics were measured in 2 groups of children with SAM (15 edematous and 7 nonedematous), aged 4-20 mo, at 3 stages during treatment. Measurements were done at 4 ± 1 d postadmission, mid- catch-up growth in weight, and at recovery (normal weight-for-length). VLDL apo B-100 synthesis was determined using stable isotope methodology to measure the rate of incorporation of (2)H(3)-leucine into its apoprotein moiety. The fractional and absolute synthesis of VLDL apo B-100 did not differ between the groups or from the initial malnourished stage to the recovery stage. Concentrations of VLDL apo B-100 were greater in the edematous than in the nonedematous group (P < 0.04) and did not differ from the initial stage to recovery. The data indicate that VLDL apo B-100 synthesis is not reduced when children develop either edematous or nonedematous SAM.

[The treatment of CRPS I from the occupational therapist's point of view]. / Die Behandlung des CRPS I aus ergotherapeutischer Sicht.

The therapeutic management of the complex regional pain syndrome (CRPS I) depends on its severity, and should take place in an interdisciplinary setting. In addition to medical and psychological intervention, occupational therapy plays a major role in the care of patients. Following a case review and patient interview, an assessment of hand function is obtained using a quantitative determination of pain levels, oedema, and overall hand function, mobility and strength, and, subsequently, therapeutic goals are set. Based upon the severity of the clinical presentation, a patient-tailored course of occupational therapy is designed and implemented. The present article provides an overview of the possibilities for CRPS management by the occupational therapist.

A randomized clinical controlled study comparing the effect of modified manual edema mobilization treatment with traditional edema technique in patients with a fracture of the distal radius.

STUDY DESIGN: Randomized controlled clinical trial. INTRODUCTION: Manual edema mobilization (MEM) is a method of edema reduction based on the lymphatic system's ability to drain and resolve subacute edema. PURPOSE OF THE STUDY: To investigate the effect of a modified MEM approach and compare it with a traditional edema technique in patients with subacute hand/arm edema after a distal radius fracture. METHOD: The patients were randomized into one of two treatment groups: a group that received traditional edema treatment and a group that received a modified MEM treatment. All patients were examined for edema, active range of motion (AROM), pain, and activities of daily living (ADL). The number of edema sessions and the number of all sessions were counted. RESULT: No statistically significant changes were observed in edema reduction, AROM, pain, and ADL at six and nine weeks between the treatment groups. A statistically significant improvement was observed in ADL after three weeks after inclusion (p=0.03) in the modified MEM group compared with the control group. Furthermore, fewer edema treatment sessions were needed (p=0.03) in the modified MEM group. At six weeks, we observed a difference between the two groups' needs for further edema treatment (p=0.04). CONCLUSION: Neither the traditional nor the modified MEM treatment program was superior in terms of edema reduction, although the modified MEM resulted in fewer sessions to decrease subacute hand/arm edema compared with using traditional edema reduction techniques in patients after distal radius fracture. LEVEL OF EVIDENCE: 1.

Loss of knee-extension strength is related to knee swelling after total knee arthroplasty.

OBJECTIVE: To examine whether changes in knee-extension strength and functional performance are related to knee swelling after total knee arthroplasty (TKA). DESIGN: Prospective, descriptive, hypothesis-generating study. SETTING: A fast-track orthopedic arthroplasty unit at a university hospital. PARTICIPANTS: Patients (N=24; mean age, 66y; 13 women) scheduled for primary unilateral TKA were investigated 1 week before surgery and on the day of hospital discharge 2.4 days postsurgery. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: We assessed all patients for knee-joint circumference, knee-extension strength, and functional performance using the Timed Up & Go, 30-second Chair Stand, and 10-m fast speed walking tests, together with knee pain during all active test procedures. RESULTS: All investigated variables changed significantly from pre- to postsurgery independent of knee pain. Importantly, knee circumference increased (knee swelling) and correlated significantly with the decrease in knee-extension strength (r=-.51; P=.01). Reduced fast-speed walking correlated significantly with decreased knee-extension strength (r=.59; P=.003) and decreased knee flexion (r=.52; P=.011). Multiple linear regression showed that knee swelling (P=.023), adjusted for age and sex, could explain 27% of the decrease in knee-extension strength. Another model showed that changes in knee-extension strength (P=.009) and knee flexion (P=.018) were associated independently with decreased performance in fast-speed walking, explaining 57% of the variation in fast-speed walking. CONCLUSIONS: Our results indicate that the well-known finding of decreased knee-extension strength, which decreases functional performance shortly after TKA, is caused in part by postoperative knee swelling. Future studies may look at specific interventions aimed at decreasing knee swelling postsurgery to preserve knee-extension strength and facilitate physical rehabilitation after TKA.

Avaliação da confiabilidade interobservadores da volumetria das mãos em indivíduos sem alterações em membros superiores / Inter-tester reliability assessment of the volumetric measurement of the hand in subjects without any changes in their upper extremities

Os objetivos do presente estudo foram avaliar a confiabilidade interobservador do instrumento volúmetro e determinar o índice normativo em indivíduos adultos do sexo feminino e sexo masculino sem alterações em membros superiores. A amostra foi composta por cem indivíduos (200 membros), sendo 50 do sexo feminino e 50 do sexo masculino, com idades entre 21 e 50 anos, sem comprometimento em membros superiores. O volume das mãos de cada indivíduo foi avaliado por meio da volumetria e o instrumento de avaliação utilizado foi o volúmetro. Este método foi aplicado por duas examinadoras, de modo que cada participante foi avaliado duas vezes consecutivas. Nas comparações realizadas entre os membros, sexos e examinadoras pode-se observar que a média do membro direito foi sempre maior que a do membro esquerdo, a média do volume das mãos dos homens sempre maior que a das mulheres e a média da segunda examinadora sempre maior que a da primeira. A partir de análise realizada, considerando os valores obtidos por ambas examinadoras, pode-se notar que a média final foi significante (p<0,001) à diferença entre o membro direito e o membro esquerdo na população geral, no sexo feminino e sexo masculino. É possível concluir que os resultados estão coesos e com boa confiabilidade e foram estatisticamente significantes para as médias finais da volumetria no sexo feminino, membro direito 402,40ml e membro esquerdo 397,15ml; sexo masculino, membro direito 516,10ml e membro esquerdo 505,30ml; e na população geral, membro direito 459,25ml e membro esquerdo 451,23ml.

The purposes of the present study were to evaluate the intertester reliability of the volumeter and to determine the normative index in adults of both genders and without any changes in their upper limbs. The sample was composed of one hundred individuals (200 hands), 50 women and 50 men, with ages between 21 and 50, and with uncompromised upper limbs. The volume of each subject?s hand was randomly measured through the volumetric method and the instrument used to evaluate them was a volumeter. This method was applied by 2 examiners and each patient was evaluated twice. Comparing the hands, gender, and examiners, we can observe that the mean of the right hands was always greater than that of the left hands, the mean volume of men?s hands was always greater than the women?s, and the mean of the second examiner was always greater than the first. From this analysis, considering values obtained with both examiners, we can notice that the final average was significant (p<0.001) to the difference between the right and the left hand in the general population, for women and for men. We can conclude that the results statistically significant to the final averages of volumetry were: for women, right hand with 402.40ml and left with 397.15ml; for men, right hand with 516.10ml and left with 505.30ml, and, in the general population, right hand with 459.25ml and left hand with 451.23ml. We can also conclude that the results are cohesive and reliable.

Edema can be a handicap in treatment of anorexia nervosa.

Anorexia and bulimia nervosa are common in western civilized countries. They are among the psychiatric disorders in that they are often accompanied by a variety of life-threatening physical abnormalities. These patients need a close follow-up of the pediatrician in collaboration with the psychiatrist since the changes in bodily functions affect the psychiatric therapy. The challenge to the physician is to use the traditional tools of medicine to diagnose and treat these physical abnormalities using careful medical history, a complete physical examination and appropriate laboratory testing. Peripheral edema is seen as a physical finding in anorexia nervosa (AN) and it is not rare. The estimated frequency is up to 20% among adolescent patients. Peripheral edema in this setting can be easily confused as weight gain. There are five possible mechanisms for its occurrence: hypoproteinemia, electrolyte imbalance, hormonal changes, rapid refeedings, and abuse of laxative, diuretics and diet pills. Patients with eating disorders may ingest a large number of drugs in an attempt to control their weight. We present a case of a female adolescent with AN and peripheral edema who terminated her psychiatric treatment during the refeeding phase because of the unbearable anxiety caused by this edema that affected her body image dramatically. With this case study, we point out the importance of assessing peripheral edema and discriminating it from true weight gain.

Reliability and minimal detectable change for the figure-of-eight-20 method of, measurement of ankle edema.

STUDY DESIGN: Single-session, repeated-measures design, with 3 raters. OBJECTIVES: To determine the intrarater and interrater reliability and the minimal detectable change score for a modified version of the figure-of-eight method of measurement of ankle edema (figure-of-eight-20) developed for patients with severe injuries. BACKGROUND: The precise quantification of ankle edema is necessary to determine the relative effectiveness of interventions aimed at reducing swelling, and to monitor individual progress during treatment. METHODS AND MEASURES: Thirty subjects (mean +/- SD age, 46 +/- 16 years; 9 female and 21 male) with ankle edema following surgery for malleolar fracture took part in the study. Each of 3 raters performed 3 measurements of the affected ankle without marking landmarks and 3 measurements of both ankles using skin markings. The order of the raters was randomized and the raters were blinded to each other's results. RESULTS: The figure-of-eight-20 method showed high intrarater and interrater reliability (intraclass correlation coefficients greater than .99). The minimal detectable change (MDC95%) for the swollen ankle was 9.6 mm when measured without skin marks and 73 mm with marks. The difference in circumference of the affected and unaffected ankle (mean +/-SD, 33.8+/-12.1 mm) consistently exceeded the MDC95,, even in patients with only mild edema. CONCLUSIONS: The standardized figure-of-eight-20 offers a good option for reliably measuring ankle circumference in patients with severe ankle trauma. In repeated assessments, greater accuracy is likely to be obtained when the landmarks for measurement are marked and the same rater carries out the measurements.

[The use of Ginkor Fort in the program of multimodality rehabilitation treatment of CYI patients with edematous syndrome].

Edematous syndrome is one of the most frequently occurring manifestations of chronic venous insufficiency (CVI). This paper analyzes an experience with conservative treatment of CVI patients with edematous syndrome. A complex of rehabilitation measures was used in addition to therapy by the phleboprotector Ginkor Fort. Based on the study of microcirculatory changes, malleolar volume, the thickness of subcutaneous fat as well as on subjective sensations and the quality of life in 117 patients with the edematous forms of CVI the authors have demonstrated the high efficacy of combined pharmacotherapy by Ginkor Fort and rehabilitation treatment in the given patient group.

The impact of physical therapy on functional outcomes after stroke: what's the evidence?

OBJECTIVE: To determine the evidence for physical therapy interventions aimed at improving functional outcome after stroke. METHODS: MEDLINE, CINAHL, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, DARE, PEDro, EMBASE and DocOnline were searched for controlled studies. Physical therapy was divided into 10 intervention categories, which were analysed separately. If statistical pooling (weighted summary effect sizes) was not possible due to lack of comparability between interventions, patient characteristics and measures of outcome, a best-research synthesis was performed. This best-research synthesis was based on methodological quality (PEDro score). RESULTS: In total, 151 studies were included in this systematic review; 123 were randomized controlled trials (RCTs) and 28 controlled clinical trials (CCTs). Methodological quality of all RCTs had a median of 5 points on the 10-point PEDro scale (range 2-8 points). Based on high-quality RCTs strong evidence was found in favour of task-oriented exercise training to restore balance and gait, and for strengthening the lower paretic limb. Summary effect sizes (SES) for functional outcomes ranged from 0.13 (95% Cl 0.03-0.23) for effects of high intensity of exercise training to 0.92 (95% Cl 0.54-1.29) for improving symmetry when moving from sitting to standing. Strong evidence was also found for therapies that were focused on functional training of the upper limb such as constraint-induced movement therapy (SES 0.46; 95% Cl 0.07-0.91), treadmill training with or without body weight support, respectively 0.70 (95% Cl 0.29-1.10) and 1.09 (95% Cl 0.56-1.61), aerobics (SES 0.39; 95% Cl 0.05-0.74), external auditory rhythms during gait (SES 0.91; 95% Cl 0.40-1.42) and neuromuscular stimulation for glenohumeral subluxation (SES 1.41; 95% Cl 0.76-2.06). No or insufficient evidence in terms of functional outcome was found for: traditional neurological treatment approaches; exercises for the upper limb; biofeedback; functional and neuromuscular electrical stimulation aimed at improving dexterity or gait performance; orthotics and assistive devices; and physical therapy interventions for reducing hemiplegic shoulder pain and hand oedema. CONCLUSIONS: This review showed small to large effect sizes for task-oriented exercise training, in particular when applied intensively and early after stroke onset. In almost all high-quality RCTs, effects were mainly restricted to tasks directly trained in the exercise programme.

Efeitos da crioterapia e laser 904nm na redução de edema traumático em patas de ratas / Effect of the cryotherapy and laser 904nm in reduction of traumatic edema in rat´s paws

O edema inflamatório agudo é considerado um problema para a reabilitação, porque contribui para a dor, diminuição de movimento e futura formação de fibrose tecidual. Sendo, portanto, importante a sua diminuição, após processos traumáticos. Este trabalho objetivou comparar a analisar os efeitos da crioterapia e do laser em edema traumático agudo em patas de ratas wistar. O experimento incluiu o estudo de 15 ratas wistar com 176,25+-19,74g, divididas aleatoriamente em três grupos. Inicialmente o volume da pata posterior esquerda foi avaliado por hidropletismografia, e, depois foram submetidas à lesão traumática. Após cinco minutos da lesão foi novamente medido o volume da pata, evidenciando-se a formação de edema. Para G1 a pata esquerda foi posicionada durante dez minutos em crioterapia, num recipiente com água e gelo a 5 grau C. No G2 realizou-se aplicação a laser 904nm,3J/cm2 sobrea a lesão. O G3 foi o grupo controle. Houve reavaliações em 15 e 20 minutos depois da lesão Durante todo o experimento as ratas permaneceram sedadas. Para o G1, o volume deslocado inicialmente foi de 1,18+-0,11ml; após cinco minutos 1,34+-0,11; após 15 minutos 1,22+-0,13; e, após 20 min 1,30+-0,24. Para o G2 foi 1,3+-0,08; após 5 minutos 1,45+-0,17; depois de 10 minutos 1,40+-0,14; e, após 15 minutos 1,40+-0,14. Para o G3 os valores foram 1,3+-0,16; 1,52+-0,04; 1,58+-0,08; e 1,70+-0,007. Apesar da inexistência de diferença estatística, observou-se tendência de diminuição e estabilização do edema depois das aplicações nos dois grupos, sendo mais acentuado em G1.