O ultrassom terapêutico na medula espinhal acelera a regeneração do nervo ciático de ratos / Therapeutic ultrasound on the spinal cord accelerates regeneration of the sciatic nerve in rats

OBJETIVO: Estudar os efeitos da irradiação ultrassônica de baixa intensidade aplicada sobre a medula espinhal na regeneração do nervo ciático de ratos após lesão por esmagamento controlado, avaliando os resultados pelo índice funcional do ciático (SFI), medido nas imagens vídeo-filmadas das plantas das patas. MÉTODOS: Dezoito ratos foram submetidos a esmagamento controlado (do nervo ciático direito e divididos em dois grupos de acordo com o tratamento: Grupo 1 (n=9), irradiação simulada; Grupo 2 (n=9), irradiação efetiva. Irradiação ultrassônica de baixa intensidade foi iniciada no 7º dia pós-operatório e aplicada diariamente por 6 semanas. Imagens das plantas das patas dos animais foram vídeo-filmadas em uma esteira transparente sob velocidade controlada a intervalos semanais até a 6ª semana de irradiação e o correspondente SFI medido com um programa de computador específico. RESULTADOS: O SFI durante a 1ª e a 6ª semana de tratamento foi de -59,12 e -12,55 no Grupo 1, e -53,31 e -1,32 no Grupo 2, indicando uma melhora de 79 por cento e 97 por cento, respectivamente, mas as diferenças entre os grupos somente foram significantes (p<0,05) durante a 3ª semana de tratamento. CONCLUSÃO: Os autores concluem que o ultrassom terapêutico de baixa intensidade estimula a regeneração nervosa, com significância durante a 3ª semana de tratamento. Nivel de Evidência II, Prospectivo Comparativo.

OBJECTIVE: To study the effects of low intensity ultrasound irradiation applied on the spinal cord on the regeneration of the rat's sciatic nerve after a controlled crush injury, evaluating the functional results of the sciatic functional index as measured on the video recorded images of the foot sole. METHODS: Eighteen rats were submitted to a controlled crush injury of the right sciatic nerve and divided into two groups according to the treatment: Group 1 (n=9), simulated irradiation; Group 2 (n=9), effective irradiation. Low-intensity ultrasound irradiation was started on the 7th postoperative day and applied daily for 6 weeks. Images of the animals´ foot sole were video recorded on a see-through treadmill type walking belt machine at weekly intervals until the 6th week of irradiation and the corresponding sciatic functional index (SFI) was measured with specific software. RESULTS: The SFI during the first and last week of treatment was -59.12 and -12.55 in Group 1, -53.31 and -1.32 in Group 2, indicating a 79 percent and 97 percent improvement, respectively, but differences between groups were only significant (p<0.05) during the third week. CONCLUSION: The authors conclude that low intensity therapeutic ultrasound enhances nerve regeneration, with significance during the 3rd week of treatment. Level of Evidence: Level II, prospective comparative study.

Tratamiento conservador en pacientes con síndrome de pinzamiento subacromial e inestabilidad glenohumoral. (Evaluación de resultado funcional con programa de ejercicio) / Conservative treatment in patients with subacromial impingement syndrome and glenohumeral instability. (Evaluation of functional result with a program of exercise)

Se realiza una evaluaciación del resultado del programa de ejercicios de fortalecimiento y elongación en pacientes con dolor crónico de hombro con diagnóstico de síndrome de pinzamiento subacromial (SPS), inestabilidad glenohumeral (IGH) y pacientes postquirúrgico con estas afecciones. Tres grupos fueron conformados: Grupo I (IGM) 30 pacientes, Grupo II (SPS) 25 pacientes y grupo III (Postquirúrgicos) 20 pacientes. Dos fueron buenos resultados en los tres grupos principalmente en los pacientes más jóvenes, con una utilidad importante en recuperación temprana en los pacientes postquirúrgicos. La evaluación del resultado se realizó de acuerdo con los parámetros establecidos por Rowe y col. (función dolor estabilidad y rangos de movimientos)

Posttraumatic childhood lumbosacral plexus neuropathy.

A 13-month-old male received crush injury to the abdomen resulting in paraparesis due to lumbosacral plexus neuropathy. The child was monitored with serial clinical examinations and electromyography/nerve conduction studies. He had complete clinical recovery. Lumbosacral plexus neuropathy is unusual in childhood and has not been previously reported as a result of abdominal trauma. This patient is presented with details of the clinical course, electrodiagnostic studies, discussion, and literature review.

[Use of infrared ray laser irradiation in the rehabilitation treatment of patients with long-term crush syndrome in an emergency care hospital]. / Primenenie infrakrasnogo lazernogo izlucheniia pri vosstanovite'l- nom lechenii bo'lnykh s sindromom dlite'lnogo razdavlivaniia v usloviiakh statsionara skoroi pomoshchi.

The principle 'rehabilitation starts in a resuscitation ward' has been realized in the resuscitation treatment of 34 patients with the prolonged crush syndrome (PCS) who were injured during the earthquake in Armenia. Laser therapy has been fairly effective, normalizing the external respiration function and central hemodynamics and reducing the blood coagulability. Instrumental vibration massage and acupuncture are recommended to be added to rehabilitation treatment of PCS patients.