RESUMO
OBJECTIVE: This study aimed to compare the effects of therapeutic ultrasound and paraffin with or without vacuum massage on the biomechanical properties of grafted skin after a burn. METHODS: A total of 44 patients with deep second- and third-degree burns, with a mean age of 35.89 (±11.53) years, who visited the Hospital Burn Unity, were included in the study. The therapeutic interventions were randomly defined by drawing lots, with a crossover design (crossover), and a minimum interval of 7 days (washout) between interventions. Skin biomechanical parameters such as distensibility (R0) and viscoelasticity (R6) were noninvasively evaluated by Cutometer before and after 0, 10, 20, and 30 min of intervention with therapeutic ultrasound and paraffin alone, as well as associated with negative pressure therapy of the skin (vacuum therapy). In this study, all groups showed increased distensibility (R0) in the period immediately after the application of the resources and a progressive reduction in the effects in the consecutive tests. Participants with skin grafts showed a decrease in viscoelasticity (R6) in all groups, except therapeutic paraffin and therapeutic ultrasound and vacuum massage. CONCLUSION: The biomechanical properties of grafted skin after a burn are altered after therapeutic intervention with ultrasound alone or associated with vacuum massage, such as intervention with paraffin associated with vacuum massage, for both parameters evaluated, skin distensibility (R0) and skin viscoelasticity (R6). However, the same did not occur for the intervention with isolated paraffin. There was no significant difference between the interventions therapeutic ultrasound and therapeutic paraffin.
Assuntos
Queimaduras , Terapia por Ultrassom , Humanos , Adulto , Parafina , Pele , Queimaduras/terapia , MassagemRESUMO
OBJECTIVE: The aim of this study was to evaluate the relationship between the range of motion and lower-limb hemodynamic indices in the tibiotarsal joint of individuals with diabetic neuropathy. METHODS: Twenty volunteers of both sexes, with a mean age of 61.45±7.05 years, were diagnosed with type 2 diabetes mellitus and diabetic peripheral neuropathy. Arterial blood flow was assessed using Doppler ultrasound, and the variables such as average velocity, pulsatility index, and resistivity index were also evaluated. A range of dorsiflexion and plantar flexion joint movements were assessed using digital goniometry before and after exercise. Data distribution was assessed using the Shapiro-Wilk test, followed by Pearson's correlation for normal data and Spearman's correlation for non-normal data, in order to verify the association between variables. RESULTS: A moderate correlation was found between dorsiflexion and pulse rate on two occasions before (rs=0.497) and after initial evaluation (rs=0.511). A low correlation was found between plantar flexion and mean velocity (rs=-0.357), pulsatility index (rs=0.439), and resistivity index (rs=0.328); dorsiflexion and mean velocity (rs=0.374), pulse rate (rs=0.332), and resistance index (rs=0.327) before evaluation, and peak (rs=0.346) was observed after the evaluation of blood circulation. CONCLUSION: There is a correlation between the range of motion of the tibiotarsal joint and the blood circulation of diabetics, ranging from moderate to poor for the different variables evaluated.
Assuntos
Diabetes Mellitus Tipo 2 , Neuropatias Diabéticas , Idoso , Articulação do Tornozelo , Diabetes Mellitus Tipo 2/complicações , Feminino , Humanos , Extremidade Inferior , Masculino , Pessoa de Meia-Idade , Amplitude de Movimento Articular/fisiologiaRESUMO
OBJECTIVE: The main objective of this study was to evaluate intra- and inter-rater reliability in the analysis of digital images of donor areas for skin in burn patients using the CaPAS plugin in the ImageJ®. METHODS: Donor sites were reviewed by two independent reviewers in duplicate. The capture of images was standardized on the same device and distance (with a millimeter ruler), without a flash. The evaluators were trained to capture the images and use the plugin. RESULTS: We selected 70 images from donor areas, from men and women between 18 and 60 years old. In the analysis of intra-examiner reliability, eight of the nine variables exhibited excellent reliability (0.985-0.998) and one (entropy) exhibited good reliability (0.525). The same was true for the inter-examiner analysis: excellent reliability for eight variables (0.824-0.993) and good reliability for entropy (0.501). CONCLUSIONS: The CaPAS plugin has proven to be a reliable tool for use in research in skin donor areas in burns, as demonstrated by its excellent intra- and inter-examiner reliability values. This is a pioneering study in the quantitative assessment of skin donor areas in burn patients using the CaPAS plugin.
Assuntos
Queimaduras , Adolescente , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Reprodutibilidade dos Testes , Pele/diagnóstico por imagem , Adulto JovemRESUMO
The treatment of breast cancer is often complicated by lymphedema of the upper limbs. Standard lymphedema evaluation methodologies are not able to measure tissue fibrosis. The ultrasound aspects related to tissue microstructures of lymphedema are neglected in clinical evaluations. The objective of this study was to identify and measure the degree of impairment, topography, and biophysical alterations of subcutaneous lymphedema tissue secondary to the treatment of breast cancer by ultrasonography. Forty-two women at a mean age of 58 (±9.7) years, with unilateral lymphedema due to breast cancer treatment, were evaluated. The upper limbs were divided into affected (affected by lymphedema) and control (contralateral limb). Each limb was subdivided into seven areas, defined by perimetry, evaluated in pairs. The biophysical characteristics thickness, entropy, and echogenicity were evaluated by ultrasonography. The results showed a significant difference in the echogenicity and thickness variables between the affected and unaffected upper limb, in all the extent of the upper limb, while entropy showed no significant difference. The findings indicate that the data presented were consistent both in identifying and measuring the degree of impairment and biophysical changes in the subcutaneous tissue of lymphedema secondary to the treatment of breast cancer.
Assuntos
Neoplasias da Mama , Linfedema , Neoplasias da Mama/complicações , Feminino , Humanos , Linfedema/complicações , Linfedema/etiologia , Pessoa de Meia-Idade , Tela Subcutânea , Ultrassonografia/métodos , Extremidade Superior/diagnóstico por imagemRESUMO
PURPOSE: Daily clinical use of therapeutic light sources can lead to changes in light emission stability with potentially significant consequences for usage in photomedicine treatment. The aim of this study was to evaluate the average and maximum power and to describe the beam diameter of different low-power laser photobiomodulation devices in clinical use in Brazil. METHODS: The power and light-emitting beam diameter of twenty-four therapeutic devices with an average age of 11±5 years, with an average weekly use of fewer than thirty minutes, were measured. RESULTS: The analyzed power varied between 2% to 134% of the values declared by the manufacturers. Differences in beam diameter of between 38% and 543% of the nominal values were also observed. It is also noteworthy that even between the same brand and model, differences in diameter were obtained. Finally, differences were observed in the power output after one and three minutes of sequential emission for 830 nm and 904 nm (p < 0.05), but not when comparing the difference between wavelengths in factor time. CONCLUSION: There is a need for a shared effort on the part of laser manufacturers to improve standardization and consistency of laser output power and beam diameters. At the same time, medical laser operators should also consider development of standardized protocols for maintenance and monitoring equipment performance over time to correct for fluctuations that could ultimately impact on treatment outcomes.
Assuntos
Lasers , Terapia com Luz de Baixa Intensidade , Brasil , Terapia com Luz de Baixa Intensidade/métodos , Reprodutibilidade dos Testes , Resultado do TratamentoRESUMO
OBJECTIVE: To translate, cross-culturally adapt and assess measurement properties of the translated version of the Northwick Park Neck Pain Questionnaire into Brazilian Portuguese. DESIGN: Cross-sectional study. SETTINGS: University healthcare facility and online. PARTICIPANTS: People with chronic neck pain (n = 178). INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Participants answered the translated version of Northwick Park Neck Pain Questionnaire, the Neck Disability Index, the Numerical Rating Scale for pain, the Tampa Scale for Kinesiophobia and the Pain Catastrophizing Scale. Seven to ten days after that, a subset of 84 participants answered the Northwick Park Neck Pain Questionnaire again. The structural (exploratory and confirmatory factor analyses) and construct validities, internal consistency, reliability and concordance were assessed. Level of significance was set at 5%. RESULTS: Participants' (35.6 ± 13.5 years old) with symptoms duration of 54.4 ± 60.4 months scored 25.5 ± 14.0 on the Brazilian Northwick Park Neck Pain Questionnaire and 11.9 ± 5.8 on the Neck Disability Index. The structural analysis showed that the short version of the Northwick Park Neck Pain Questionnaire has an adequate structure to measure disability due to neck pain. Correlations with other questionnaires were between 0.268 and 0.678, Cronbach's alfa was 0.76, intraclass correlation coefficient was 0.96, standard error of measurement was 2.74 and minimal detectable change was 7.60. CONCLUSION: The short version of the Northwick Park Neck Pain Questionnaire is valid and reliable to be used in patients with chronic neck pain, as it presented adequate measurement properties of structural and construct validity, reliability and concordance.
Assuntos
Dor Crônica , Cervicalgia , Adulto , Brasil , Dor Crônica/diagnóstico , Comparação Transcultural , Estudos Transversais , Avaliação da Deficiência , Humanos , Pessoa de Meia-Idade , Cervicalgia/diagnóstico , Medição da Dor , Psicometria , Reprodutibilidade dos Testes , Inquéritos e Questionários , Adulto JovemRESUMO
OBJECTIVE: The objective of this study was to measure the intra- and inter-rater reliability of the quantitative sensory testing for measuring the thermal pain threshold on myofascial trigger points in the upper trapezius muscle of individuals with chronic neck pain. METHODS: Thirty female participants were included, aged between 18 and 45 years and with bilateral myofascial trigger points, active and centrally located in the upper trapezius muscle. Two measurements with quantitative sensory testing were performed by each examiner at an interval of 1 week between them. RESULTS: We observed substantial reliability for the intra-rater analysis (intraclass correlation coefficient ranging between 0.876 and 0.896) and excellent reliability for the inter-rater analysis (intraclass correlation coefficient ranging between 0.917 and 0.954). CONCLUSION: The measurement of the thermal pain threshold on myofascial trigger points in individuals with chronic neck pain has acceptable reliability values, supporting the use of the quantitative sensory testing in the research setting and the clinical environment.
Assuntos
Síndromes da Dor Miofascial , Cervicalgia , Músculos Superficiais do Dorso , Pontos-Gatilho , Adolescente , Adulto , Dor Crônica , Feminino , Humanos , Pessoa de Meia-Idade , Síndromes da Dor Miofascial/diagnóstico , Síndromes da Dor Miofascial/fisiopatologia , Cervicalgia/epidemiologia , Reprodutibilidade dos Testes , Músculos Superficiais do Dorso/fisiopatologia , Pontos-Gatilho/fisiopatologia , Adulto JovemRESUMO
SUMMARY OBJECTIVE: The aim of this study was to evaluate the relationship between the range of motion and lower-limb hemodynamic indices in the tibiotarsal joint of individuals with diabetic neuropathy. METHODS: Twenty volunteers of both sexes, with a mean age of 61.45±7.05 years, were diagnosed with type 2 diabetes mellitus and diabetic peripheral neuropathy. Arterial blood flow was assessed using Doppler ultrasound, and the variables such as average velocity, pulsatility index, and resistivity index were also evaluated. A range of dorsiflexion and plantar flexion joint movements were assessed using digital goniometry before and after exercise. Data distribution was assessed using the Shapiro-Wilk test, followed by Pearson's correlation for normal data and Spearman's correlation for non-normal data, in order to verify the association between variables. RESULTS: A moderate correlation was found between dorsiflexion and pulse rate on two occasions before (rs=0.497) and after initial evaluation (rs=0.511). A low correlation was found between plantar flexion and mean velocity (rs=-0.357), pulsatility index (rs=0.439), and resistivity index (rs=0.328); dorsiflexion and mean velocity (rs=0.374), pulse rate (rs=0.332), and resistance index (rs=0.327) before evaluation, and peak (rs=0.346) was observed after the evaluation of blood circulation. CONCLUSION: There is a correlation between the range of motion of the tibiotarsal joint and the blood circulation of diabetics, ranging from moderate to poor for the different variables evaluated.
RESUMO
SUMMARY OBJECTIVE: The main objective of this study was to evaluate intra- and inter-rater reliability in the analysis of digital images of donor areas for skin in burn patients using the CaPAS plugin in the ImageJ®. METHODS: Donor sites were reviewed by two independent reviewers in duplicate. The capture of images was standardized on the same device and distance (with a millimeter ruler), without a flash. The evaluators were trained to capture the images and use the plugin. RESULTS: We selected 70 images from donor areas, from men and women between 18 and 60 years old. In the analysis of intra-examiner reliability, eight of the nine variables exhibited excellent reliability (0.985-0.998) and one (entropy) exhibited good reliability (0.525). The same was true for the inter-examiner analysis: excellent reliability for eight variables (0.824-0.993) and good reliability for entropy (0.501). CONCLUSIONS: The CaPAS plugin has proven to be a reliable tool for use in research in skin donor areas in burns, as demonstrated by its excellent intra- and inter-examiner reliability values. This is a pioneering study in the quantitative assessment of skin donor areas in burn patients using the CaPAS plugin.
RESUMO
SUMMARY OBJECTIVE: The objective of this study was to measure the intra- and inter-rater reliability of the quantitative sensory testing for measuring the thermal pain threshold on myofascial trigger points in the upper trapezius muscle of individuals with chronic neck pain. METHODS: Thirty female participants were included, aged between 18 and 45 years and with bilateral myofascial trigger points, active and centrally located in the upper trapezius muscle. Two measurements with quantitative sensory testing were performed by each examiner at an interval of 1 week between them. RESULTS: We observed substantial reliability for the intra-rater analysis (intraclass correlation coefficient ranging between 0.876 and 0.896) and excellent reliability for the inter-rater analysis (intraclass correlation coefficient ranging between 0.917 and 0.954). CONCLUSION: The measurement of the thermal pain threshold on myofascial trigger points in individuals with chronic neck pain has acceptable reliability values, supporting the use of the quantitative sensory testing in the research setting and the clinical environment.
Assuntos
Humanos , Feminino , Adolescente , Adulto , Adulto Jovem , Cervicalgia/epidemiologia , Pontos-Gatilho/fisiopatologia , Músculos Superficiais do Dorso/fisiopatologia , Síndromes da Dor Miofascial/diagnóstico , Síndromes da Dor Miofascial/fisiopatologia , Reprodutibilidade dos Testes , Dor Crônica , Pessoa de Meia-IdadeRESUMO
OBJECTIVE: What are the immediate, short-term, and long-term effects of complex physical therapy and multimodal approaches on lymphedema secondary to breast cancer? DATA SOURCES: Four electronic databases (MEDLINE, Embase, Cochrane Library, Physiotherapy Evidence Database) were searched from inception up to August 2020. STUDY SELECTION: Randomized controlled trials comparing complex physical therapy and multimodal approaches to the conservative treatment of lymphedema secondary to breast cancer. DATA EXTRACTION: Two independent researchers performed data extraction and assessed the risk of bias, respectively, using the predefined form and Cochrane Collaboration of Risk of Bias. The determination of evidence quality was carried out using the Grading of Recommendations Assessment, Development, and Evaluation tools. DATA SYNTHESIS: Fourteen studies were identified for the systematic review and 11 studies for the meta-analysis with standardized mean difference (SMD), 95% CI, and random-effect model. The common outcomes involved total volume, pain, and physical function of the upper limb. Complex physical therapy has shown a favorable tendency to control outcomes in the short- and long-term. The meta-analysis indicated a small effect for volume reduction (SMD, -0.18; 95% confidence interval [CI], -0.35 to 0.00) and a moderate effect for short-term pain reduction (SMD, -0.61; 95% CI, -1.19 to -0.02). CONCLUSIONS: High-quality evidence suggests a more significant effect of complex physical therapy on multimodal approaches to the control of the upper limb total volume, substantiating the absence of changes in the current clinical practice in the management of lymphedema secondary to breast cancer. Future research should aim to identify concrete effect of therapeutic modalities in the immediate-, short-, and long-term.
Assuntos
Neoplasias da Mama , Linfedema , Neoplasias da Mama/complicações , Feminino , Humanos , Linfedema/etiologia , Linfedema/terapia , Dor/complicações , Modalidades de Fisioterapia , Ensaios Clínicos Controlados Aleatórios como AssuntoRESUMO
SUMMARY OBJECTIVE: This study aimed to compare the effects of therapeutic ultrasound and paraffin with or without vacuum massage on the biomechanical properties of grafted skin after a burn. METHODS: A total of 44 patients with deep second- and third-degree burns, with a mean age of 35.89 (±11.53) years, who visited the Hospital Burn Unity, were included in the study. The therapeutic interventions were randomly defined by drawing lots, with a crossover design (crossover), and a minimum interval of 7 days (washout) between interventions. Skin biomechanical parameters such as distensibility (R0) and viscoelasticity (R6) were noninvasively evaluated by Cutometer before and after 0, 10, 20, and 30 min of intervention with therapeutic ultrasound and paraffin alone, as well as associated with negative pressure therapy of the skin (vacuum therapy). In this study, all groups showed increased distensibility (R0) in the period immediately after the application of the resources and a progressive reduction in the effects in the consecutive tests. Participants with skin grafts showed a decrease in viscoelasticity (R6) in all groups, except therapeutic paraffin and therapeutic ultrasound and vacuum massage. CONCLUSION: The biomechanical properties of grafted skin after a burn are altered after therapeutic intervention with ultrasound alone or associated with vacuum massage, such as intervention with paraffin associated with vacuum massage, for both parameters evaluated, skin distensibility (R0) and skin viscoelasticity (R6). However, the same did not occur for the intervention with isolated paraffin. There was no significant difference between the interventions therapeutic ultrasound and therapeutic paraffin.
RESUMO
OBJECTIVE: The objective of the study was to correlate the thermal pain threshold (heat and cold) on myofascial trigger points with measurements of pain and skin temperature in patients with chronic neck pain. METHODS: This is a cross-sectional study. We included participants of both genders, aged between 18-45 years, with chronic neck pain (>90 days), and with active bilateral myofascial trigger point centrally located in the upper trapezius muscle. Neck Disability Index, Numerical Rating Scale, Pain-Related Catastrophizing Thoughts Scale, algometry, infrared thermography, and quantitative sensory testing were used for the evaluation. RESULTS: A significant, weak, and negative association was observed between pain intensity and heat pain threshold on the myofascial trigger point to the right (rho -0.381, p=0.022) and to the left (rho -0.334, p=0.049), and a significant, weak, and positive association was observed between pain intensity and cold pain threshold on the myofascial trigger point to the right (rho 0.471, p=0.004) and to the left (rho 0.339, p=0.043). CONCLUSION: Thermal pain threshold (heat and cold) on myofascial trigger points is associated with pain intensity in individuals with chronic neck pain.
Assuntos
Síndromes da Dor Miofascial , Pontos-Gatilho , Adolescente , Adulto , Catastrofização , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Cervicalgia , Medição da Dor , Limiar da Dor , Temperatura Cutânea , Adulto JovemRESUMO
OBJECTIVE: The aim of this study was to evaluate the intra- and inter-rater reliability of pressure pain threshold measurement on myofascial trigger points in the trapezius muscle in women with chronic neck pain. METHODS: This reliability study involved 30 volunteers with neck pain for more than 90 days. The assessment procedures were performed by blinded researchers. Two examiners, who were previously trained in the use of algometry, independently performed two assessments of the pressure pain threshold at two time intervals, one week apart. RESULTS: The study sample consisted of 30 young adult women. Excellent intra- and inter-rater reliability were found for the pressure pain threshold on myofascial trigger points, with intraclass correlation coefficient values ranging between 0.752 and 0.874, standard error of measurement ranging between 0.18 and 0.22 kg/cm2, and minimum detectable change ranging between 0.45 and 0.62 kg/cm2. CONCLUSION: The present study showed that the assessment of pressure pain threshold through algometry presents satisfactory intraclass correlation coefficient values, considering different time and examiners, contributing to the spread of the use of this tool as a quantitative method of pain evaluation in myofascial trigger points.
Assuntos
Síndromes da Dor Miofascial , Músculos Superficiais do Dorso , Feminino , Humanos , Síndromes da Dor Miofascial/diagnóstico , Cervicalgia/diagnóstico , Limiar da Dor , Reprodutibilidade dos Testes , Pontos-Gatilho , Adulto JovemRESUMO
The aim of this study was to evaluate the correlation between tools commonly used in the detection of physiological changes, such as clinical complaints, a biochemical marker of muscle injury, and performance data during official matches, with infrared thermography, which has been commonly used in the possible tracking of musculoskeletal injuries in athletes. Twenty-two athletes from a professional soccer club (age 27.7 ± 3.93 years; BMI 24.35 ± 1.80 kg/cm2) were followed during the season of a national championship, totaling 19 matches with an interval of 7 days between matches. At each match, the athletes used a Global Positioning System (GPS) device to collect performance data. Forty-eight hours after each match, every athlete's perception of recovery, fatigue, and pain was documented. Blood was collected for creatine kinase (CK) analysis, and infrared thermography was applied. Only athletes who presented pain above 4 in either limb were included for thermographic analysis. Each thermographic image was divided into 14 regions of interest. For statistical analysis, we included only the images that showed differences ≥ 1° C. Data normality was verified by the Kolmogorov-Smirnov test with Dallal-Wilkinson-Lilliefors correction. We used the Pearson correlation coefficient to verify the correlation between infrared thermography and the biochemical marker, performance data, and clinical recovery scales. No correlation was observed between mean skin temperature and blood CK levels, pain level, perception of recovery, and fatigue perception (r <0.2, p>0.05). Thus, infrared thermography did not correlate with CK level, pain, fatigue perception, or recovery, nor with performance variables within the field.
Assuntos
Desempenho Atlético/fisiologia , Monitorização Fisiológica/métodos , Temperatura Cutânea/fisiologia , Termografia/métodos , Adulto , Atletas/estatística & dados numéricos , Biomarcadores/sangue , Creatina Quinase/sangue , Estudos Transversais , Feminino , Sistemas de Informação Geográfica , Humanos , Extremidade Inferior , Masculino , Monitorização Fisiológica/instrumentação , Monitorização Fisiológica/estatística & dados numéricos , Tecnologia de Sensoriamento Remoto/instrumentação , Futebol/fisiologia , Termografia/estatística & dados numéricos , Adulto JovemRESUMO
OBJECTIVE: Analyze postural control in the bipedal position as well as during gait and functional tests in patients with type 2 diabetes mellitus after supervised and unsupervised proprioceptive training. DESIGN: A three-group randomized controlled trial. SETTING: Physiotherapeutic Resources Lab, Department of Health Sciences, Ribeirão Preto Medical School, University of São Paulo. SUBJECTS: Eighty patients with type 2 diabetes allocated to three groups: control, home training, and supervised training. INTERVENTIONS: The supervised and home training groups performed two weekly sessions of proprioceptive exercises for 12 weeks. The control group was not submitted to any of treatment. MAIN MEASURES: Bipedal balance, gait, and performance on functional tests were evaluated before and after 12 weeks using the Balance Evaluation Systems Test (BESTest) and the force plate. RESULTS: No significant improvements were found regarding postural control, gait, or performance on the functional tests, as evidenced by the inter-group comparisons of the total BESTest score [control: 90.7 (81.5-92.6); home training: 85.2 (77.8-90.3); supervised training: 88.4 (82.6-91.4), P > 0.05] as well as the tests performed on the force plate (P > 0.05). The clinical effect size of the proposed intervention was less than 0.2, demonstrating no effect for the main outcome variable evaluated by the "Sensory Orientation" item of the BESTest and by the mCTSIB (pressure plate). CONCLUSIONS: The proposed proprioceptive training did not lead to improvements in postural control in patients with type 2 diabetes with no clinical signs of diabetic distal polyneuropathy when analyzed using the BESTest clinical evaluation and a force plate. TRIAL REGISTRATION: NCT01861392 (clinicaltrials.gov).
Assuntos
Diabetes Mellitus Tipo 2/fisiopatologia , Terapia por Exercício , Marcha/fisiologia , Equilíbrio Postural/fisiologia , Propriocepção/fisiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Método Simples-CegoRESUMO
BACKGROUND: In recent decades, low-level laser therapy (LLLT) has occupied a prominent position and has been studied in various fields of knowledge, and your effects have been widely observed in studies about numerous tissues, such as tendons, peripheral nerves, cutaneous tissue, bone, and muscle, in different fields of knowledge. PURPOSE: To analyze the power transmitted by low-level laser therapy (LLLT) to different tissue samples by using distinct wavelengths. METHODS: Skin samples of rat (n = 7, 1.17-1.63 mm) and pig (n = 10; 1.20-2.30 mm); pig fat (n = 10; 2.71-14.01 mm) and pig muscle (n = 10; 1.91-8.91 mm) were analyzed and interposed between the emitter and the power analyzer sensor. All the samples were irradiated sequentially three times, at five equidistant points and average power levels of 35.34(±1.03), 32.40(±0.70), and 42.32(±0.82) mW, for the wavelengths 660, 830, and 904 nm, respectively. Transmitted radiation was measured with a power analyzer connected to a laser emitter. Statistical analysis was performed with a Shapiro-Wilk test followed by ANOVA with Tukey's post hoc test, with a significance level of 5%. RESULTS: The transmitted power of LLLT on skin, fat, and muscle of tissues decreases with the increase of thicknesses, presenting minor attenuation on rat skin, pig fat, and pig muscle for 904 nm. The pig skin has the slight attenuation for 830 nm. CONCLUSION: The LLLT should be applied after considering the transmission loss taking place in different anatomical structures, following the Beer-Lambert law and attenuation coefficient presented for more practical application in many fields.
Assuntos
Terapia com Luz de Baixa Intensidade , Tecido Adiposo/efeitos da radiação , Animais , Músculo Esquelético/efeitos da radiação , Ratos , Pele/efeitos da radiação , SuínosRESUMO
The objective of the study was to evaluate the intra- and inter-rater reliability of bioimpedance in determining upper limb volume in women with lymphedema resulting from breast cancer treatment, as well as its correlation with the upper limb volume calculated by circumferential measurement. A blind cross-sectional study was performed in which 27 women (62.59 ± 10.50 years) were evaluated with upper limb lymphedema secondary to breast cancer treatment. Two examiners performed assessments in the same volunteers independently and twice, with an interval of 1 week between assessments. The collections were performed by the direct tetrapolar multifrequency segmental bioimpedance and by the circumference of the upper limb homolateral to the breast cancer. The results of the circumference showed that the homolateral limb had lymphedema. The intra- and inter-rater analysis showed excellent reliability with intraclass correlation coefficient (ICC) values ranging from 0.954 to 0.999 for the amount of liquid and excellent reliability with ICC values ranging from 0.852 to 0.999 for the electrical impedance of the upper limb with lymphedema. The correlation was strong and negative (p < 0.05) between intracellular, extracellular, and total water when associated with electrical impedance and moderate and positive (p < 0.05) when associated with upper limb volume for all frequencies. The correlations between upper limb volume and water quantities were moderate and positive (p < 0.05). The results indicate that bioimpedance is a reliable method for the evaluation of lymphedema, and the volume of the homolateral upper limb is associated with the amount of water in women with lymphedema secondary to the treatment of breast cancer.
Assuntos
Linfedema Relacionado a Câncer de Mama/diagnóstico , Linfedema Relacionado a Câncer de Mama/fisiopatologia , Impedância Elétrica , Variações Dependentes do Observador , Idoso , Estudos Transversais , Feminino , Humanos , Pessoa de Meia-Idade , Reprodutibilidade dos Testes , Sensibilidade e Especificidade , Extremidade Superior/patologia , Extremidade Superior/fisiopatologiaRESUMO
PURPOSE: This study aimed to verify the immediate effect of low-frequency transcutaneous electrical nerve stimulation (TENS) and laryngeal manual therapy (LMT) in musculoskeletal pain, voice quality, and self-reported signs in women with dysphonia. METHOD: Thirty women with behavioral dysphonia were randomly divided into the TENS group and the LMT group. All participants fulfilled the pain survey and had their voices recorded to posterior perceptual and acoustic analysis before and after intervention. The TENS group received a unique low-frequency TENS session (20 minutes). The LMT group received LMT (20 minutes) with soft and superficial massage in the sternocleidomastoid muscle, suprahyoid muscles, and larynx. Afterward, the volunteers reported their voice, larynx, breathing, and articulatory signs. Pre and post data were compared by parametric and nonparametric tests. RESULTS: After TENS, a decrease in pain intensity in the posterior or anterior region of the neck, shoulders, upper or lower back, and masseter was observed. After LMT, a decrease in pain intensity in the neck anterior region, shoulders, lower back, and temporal region was observed. Also, after TENS, there was an improvement in vowel /a/ instability; after LMT, there was a general improvement in voice quality, decrease in tension, and decrease in breathiness in speech. Positive voice and laryngeal signs were reported after TENS, and positive laryngeal signs and articulation were reported after LMT. CONCLUSION: TENS and LMT may be used in voice treatment of women with behavioral dysphonia, and both may be considered important therapy resources that reduce musculoskeletal pain and cause positive laryngeal signs. Both TENS and LMT are able to partially improve voice quality, but TENS presented better results.
Assuntos
Disfonia/terapia , Nervos Laríngeos/fisiopatologia , Laringe/fisiopatologia , Manipulações Musculoesqueléticas , Dor Musculoesquelética/terapia , Acústica da Fala , Estimulação Elétrica Nervosa Transcutânea , Qualidade da Voz , Acústica , Adolescente , Adulto , Brasil , Disfonia/diagnóstico , Disfonia/fisiopatologia , Feminino , Humanos , Pessoa de Meia-Idade , Manipulações Musculoesqueléticas/efeitos adversos , Dor Musculoesquelética/diagnóstico , Dor Musculoesquelética/fisiopatologia , Medição da Dor , Recuperação de Função Fisiológica , Autorrelato , Medida da Produção da Fala , Fatores de Tempo , Estimulação Elétrica Nervosa Transcutânea/efeitos adversos , Resultado do Tratamento , Adulto JovemRESUMO
PURPOSE: To verify and compare the effect of transcutaneous electrical nerve stimulation (TENS) and laryngeal manual therapy (LMT) on laryngeal diadochokinesis (DDK) of dysphonic women. METHODS: Twenty women with bilateral vocal nodules participated and were equally divided into: LMT Group - LMT application; TENS Group - TENS application; both groups received 12 sessions of treatment, twice a week, with a duration of 20 minutes each, applied by the same therapist. The women were evaluated as to laryngeal DDK at three moments: diagnostic, pre-treatment, and post-treatment, which produced three groups of measurements. The DDK recording was performed with intersected repetition of vowels /a/ and / i/. The analysis of vowels was performed by the program Motor Speech Profile Advanced (MSP)-KayPentax. The DDK parameters of the three evaluations were compared by means of the paired t-test (p≤0.05). RESULTS: The measurements of laryngeal DDK parameters were similar in the phase without treatment, indicating no individual variability over time. There was no change with respect to the speed of DDK after intervention, but after LMT, DDK of the vowel /i/ was more stable in terms of the duration of the emissions and intensity of emissions repeated. These results show improved coordination of vocal folds movement during phonation. There were no changes in the DDK parameters following TENS. CONCLUSION: LMT provides greater regularity of movement during laryngeal diadochokinesis in dysphonic women, which extends knowledge on the effect of rebalancing the larynx muscles during phonation, although TENS does not impact laryngeal diadochokinesis.