ABSTRACT
Objetivo: evaluar la rehabilitación funcional de la ATM en pacientes con osteoartrosis, con abordaje neuromuscular. La osteoartrosis se caracteriza por la degeneración del cartílago articular y la cortical ósea, que conduce a dolor e inmovilidad. Se incluyó a 8 mujeres entre 20 y 42 años de edad con dolor en la región orofacial, signos de oclusión disfuncional e imágenes compatibles con trastornos degenerativos en ATM. Clínicamente se evaluó el dolor y la oclusión y, mediante tecnología electrónica, se obtuvieron datos objetivos de los movimientos de apertura-cierre y lateralidades, la velocidad de apertura-cierre mandibulares y de los ruidos articulares. Las mediciones fueron realizadas al inicio y al finalizar el tratamiento de estabilización mandibular con una ortosis neuromuscular. Para determinar la significación estadística se utilizaron el Student`s test de comparaciones múltiples y el análisis de varianza, ANOVA, de un factor. Las diferencias entre medias se consideraron significativas con p <0.05. Los resultados demostraron ausencia de dolor en el 100% de los casos al primer mes de tratamiento. Se incrementaron la apertura bucal (6,73 mm promedio), ambas lateralidades (P=0.0023), velocidad en apertura y en cierre (no estadísticamente significativo). Después de estabilizar la mandíbula se redujo la frecuencia de los ruidos. En conclusión, la oclusión dental disfuncional es el principal factor etiológico de la artrosis de la ATM. El establecimiento de una oclusión fisiológica produce la descompresión de la ATM, aumenta el rango de los movimientos mandibulares y disminuye significativamente el dolor (AU)
Objective: to evaluate the functional rehabilitation of the TMJ in patients with osteoarthritis, with a neuromuscular approach. Osteoarthrosis is characterized by degeneration of articular cartilage and bone cortex, which leads to pain and immobility. Eight women between 20 and 42 years of age with pain in the orofacial region, signs of dysfunctional occlusion, and images consistent with degenerative TMJ disorders were included. Clinically, pain and occlusion were evaluated and, using electronic technology, objective data were obtained on the opening-closing movements and lateralities, the opening-closing speed of the jaws and joint noises. Measurements were made before and at the end of the mandibular stabilization treatment with a neuromuscular orthosis. To determine the statistical significance, the Student`s multiple comparisons test and the analysis of variance, ANOVA, of one factor were used. The differences between means were considered significant with p <0.05. The results showed absence of pain pain in 100% of cases in the first month of treatment. Mouth opening (6.73 mm average), both lateralities (P = 0.0023), opening and closing speed (not statistically significant) were increased. After stabilizing the jaw the noise frequency value was reduced. In conclusion, dysfunctional dental occlusion is the main etiologic factor of TMJ osteoarthritis. Establishing a physiological occlusion causes TMJ decompression, increases the range of mandibular movements, and significantly decreases pain (AU)
Subject(s)
Humans , Female , Adult , Osteoarthritis/rehabilitation , Facial Pain , Temporomandibular Joint Disorders , Orthotic Devices , Argentina , Analysis of Variance , Range of Motion, Articular , Masticatory Muscles/physiopathologyABSTRACT
The aim of this study was to investigate the influence of a specific, kinesiotherapy-based rehabilitation program on the various symptoms of osteoarthrosis (OA), following group treatment. Thirty-one individuals, of both sexes, aged over 50 years and with medical diagnosis of OA, underwent 16 sessions, twice a week, totaling eight weeks, of a specific rehabilitation protocol based on group kinesiotherapy. Primary OA symptoms were assessed (directly related to the disease: OA symptoms, trunk flexibility, balance and pain), and so were secondary ones (indirectly related to the disease: signs of depression and anxiety, and quality of life). Data were tested through Student's t test or Wilcoxon's test, and contingencies of categorical data were analyzed using McNemar's test. There was an improvement in all primary symptoms of OA after the kinesiotherapy protocol was applied. Signs of anxiety and depression improved only in contingency, when risk stratification was taken into account. In addition, physical components of quality of life also showed improvement, which did not occur with mental components though. Therefore, the kinesiotherapy-based rehabilitation program was capable of positively influencing all primary symptoms, and only some aspects of secondary OA symptoms.
Subject(s)
Humans , Male , Female , Middle Aged , Aged , Aged, 80 and over , Osteoarthritis/rehabilitation , Exercise Therapy/instrumentation , Anxiety/psychology , Pain/physiopathology , Quality of Life/psychology , Chronic Disease/rehabilitation , Physical Therapy Modalities/instrumentation , Pliability , Depression/psychology , Postural BalanceABSTRACT
OBJECTIVE: to evaluate the results from surgery with computer-assisted navigation in cases of total knee arthroplasty. METHOD: a total of 196 patients who underwent total knee arthroplasty with computer-assisted navigation were evaluated. The extension and flexion spaces (gaps) were evaluated during the operation and the alignment after the operation was assessed. The Knee Society Score (KSS) questionnaire for assessing patient's function was applied preoperatively and postoperatively after a mean follow-up of 22 months. RESULTS: in all, 86.7% of the patients presented good alignment of the mechanical axis (less than 3◦ of varus or valgus in relation to the mechanical axis) and 96.4% of the patients presented balanced flexion and extension gaps. Before the operation, 97% of the patients presented poor or insufficient KSS, but after the operation, 77.6% presented good or excellent KSS. CONCLUSION: the navigation system made it possible to achieve aligned and balanced implants, with notable functional improvement among the patients. It was found to be useful in assessing, understanding and improving knowledge in relation to performing arthroplasty procedures...
OBJETIVO: avaliar os resultados das cirurgias assistidas por navegação (CAN) nas artroplastias totais de joelho. MÉTODO: foram avaliados 196 pacientes submetidos à artroplastia total de joelho com auxílio da navegação por computador. Avaliados no intraoperatório os espaços (gaps) de extensão e de flexão, o alinhamento pós-operatório e o questionário funcional da Knee Society Score (KSS) pré-operatório e pós-operatório com seguimento médio de 22 meses. RESULTADOS: dos pacientes, 86,7% apresentaram bom alinhamento do eixo mecânico (dentro de 3◦ de varo ou valgo em relação ao eixo mecânico) e 96,4% apresentaram ambos os gaps de flexão e extensão balanceados. No pré-operatório, 97% dos pacientes apresentavam KSS funcional ruim ou insuficiente, no pós-operatório 77,6% apresentavam KSS funcional bom ou excelente. CONCLUSÃO: a navegação proporcionou a obtenção de implantes alinhados e balanceados com importante melhoria da função nos pacientes. Foram evidenciados sua utilidade no estudo, o entendimento e o aperfeiçoamento do conhecimento na execução das artroplastias...
Subject(s)
Humans , Male , Female , Young Adult , Middle Aged , Aged, 80 and over , Arthroplasty, Replacement, Knee , Osteoarthritis/surgery , Osteoarthritis/rehabilitation , Osteoarthritis/therapy , Surgery, Computer-AssistedABSTRACT
Background: Hip and knee osteoarthritis are important causes of pain and disability among older people. Education and strength training can alleviate symptoms and avoid functional deterioration. Aim: To assess muscle strength, fall risk and quality of life of older people with osteoarthritis and the effects of physiotherapy education and strength training on these variables. Material and Methods: Thirty participants aged 78 ± 5 years (63% women) were randomly assigned to receive physiotherapy (Controls), physiotherapy plus education (Group 1) and physiotherapy plus strength training (group 2). At baseline and after 16 weeks of intervention, patients were evaluated with the Senior Fitness Test, Timed Up and Go and Quality of Life score short form (SF-36). Results: During the intervention period, Senior Fitness Test and Timed Up and Go scores improved in all groups and SF-36 did not change. The improvement in Senior Fitness Test and Timed Up and Go was more marked in Groups 1 and 2 than in the control group. Conclusions: Education and strength training improve functional tests among older people with osteoarthritis.
Subject(s)
Aged , Female , Humans , Male , Exercise Therapy/methods , Muscle Strength/physiology , Osteoarthritis/rehabilitation , Resistance Training/methods , Quality of Life , Treatment OutcomeABSTRACT
La osteoartrosis es la enfermedad articular más frecuente y una de las principales causas de discapacidad en el adulto mayor. Se realizó un estudio descriptivo en el Hospital Militar Docente Mario Muñoz Monroy, de Matanzas, con el objetivo de describir la utilización de los medios físicos en la osteartrosis, durante el año 2012. Se estudiaron las variables: sexo, edad, articulación afectada, factores de riesgo, intensidad del dolor (Escala Visual Analógica) e incapacidad funcional (test de Waddel). La artrosis predominó en el sexo femenino y en edades superiores a 65 años. La articulación más afectada fue la rodilla y el sobrepeso fue el factor de riesgo más frecuente. La evolución de los pacientes con artrosis fue buena en el 71,8 por ciento, regular en el 21,3 por ciento y mala en el 6,9 por ciento. En la fase aguda la magnetoterapia combinada con el láser alcanzó la mayor cantidad de pacientes con buena evolución, en las fases subaguda y crónica fue el calor infrarrojo combinado con corrientes analgésicas.
The ostearthritis is the most common articular diseases and one of the main causes of disability in elder people. We carried out a descriptive study in the Teaching Military Hospital Mario Muñoz Monroy, of Matanzas, with the objective of describing the usage of physical means in cases of osteoarthritis during 2012. We studied the variables of gender, age, afected joint, risk factors, pain intensity (Analogical Visual Scale) and functional disability (Waddel test). The osteoarthritis was predominant in the female sex and in ages more than 65 years. The most affected joint was the knee, and overweight the most frequent risk factor. The evolution of the patients with osteoarthritis was good in 71,8 per cent, regular in 21,3 per cent and bad in 6,9 per cent. In the acute phase, the laser-combined magnetotherapy reached the biggest quantity of patients with a good evolution; in the sub-acute and chronic stages infrared heat with analgesic power reached the highest quantity.
Subject(s)
Humans , Male , Female , Aged , Aged, 80 and over , Osteoarthritis/rehabilitation , Laser Therapy/methods , Complementary TherapiesABSTRACT
A osteoartrite (OA) é a causa mais frequente de doença crônica musculoesquelética, sendo sem dúvida a maior causa de limitação das atividades diárias entre os idosos. Atualmente, cerca de 40% dos adultos com idade superior a 70 anos sofrem de OA do joelho; destes, 80% apresentam limitações de movimento e em 25% as atividades diárias estão comprometidas. Nas últimas décadas têm ocorrido avanços na terapêutica da osteoartrite
Osteoarthritis (OA) is the most common cause of chronic musculoskeletal disease and the most prevalent reason for the limitation of daily activities of the elderly population. Currently, about 40% of adults aged over 70 suffer from OA of the knee. Of these, 80% suffer from limitations in motion and 25% are engaged to carry out their daily activities. In recent decades there have been advances in the treatment of osteoarthritis
Subject(s)
Humans , Male , Female , Osteoarthritis, Knee/physiopathology , Osteoarthritis, Knee/drug therapy , Osteoarthritis, Hip/physiopathology , Osteoarthritis, Hip/drug therapy , Anti-Inflammatory Agents , Acetaminophen/therapeutic use , Knee Joint , Glucosamine/administration & dosage , Osteoarthritis/rehabilitation , Patient Education as Topic , Viscosupplementation , Weight LossABSTRACT
Objetivo: Relatar os resultados com médio prazo de seguimento após a implantação de Arthrosurface-HemiCap em pacientes com diagnóstico de hállux rígidus (HR). Método: Onze pacientes foram submetidos à artroplastia parcial da primeira metatarso-falangeana. Seis mulheres e cinco homens com idade média de 51,9 anos (46 a 58 anos) e média de seguimento pós-operatório de 3,73 anos (3-4 anos); foram classificados através do sistema de Kravitz e avaliados pelas escalas da american orthopaedic foot and ankle society (AOFAS) para hállux, visual analog scale (VAS) analógico funcional de dor - e pela amplitude de movimento da primeira articulação metatarsofalangeana no periodo pré-operatório, pós-operatório de seis meses e pós-operatório atual. Resultados: Os resultados revelam melhora significativa dos três parâmetros analisados no estudo, tanto para análise global como para comparações pré e pós-operatórias individuais. A análise comparativa de cada variável nos períodos pós--operatórios de seis meses e atual não mostram diferença estatística o que indica manutenção dos parâmetros durante esse intervalo. Conclusão: A hemiartroplastia da primeira metatarsofalangeana é opção reprodutível e segura para o tratamento cirúrgico do hállux rígidus II e III, com significativa melhora dos parâmetros avaliados para a população estudada. Nível de Evidência IV, Série de casos.
Objective: To report the results of medium-term follow-up after deploying arthrosurface-Hemicap in patients with diagnosis of hállux rígidus (HR). method: eleven patients underwent partial arthroplasty of the first metatarsal-phalangeal joint. six women and five men with an average age 51.9 years (46 to 58 years) and average postoperative follow-up of 3.73 years (3-4 years); were classified through the Kravitz system and evaluated by the american orthopaedic foot and ankle society (aofas) scales for hallux, visual analogical scale (vas) analog functional pain - and motion range in the first metatarsal joint in preoperative, postoperative after six months and present post-operative. Results: the results show significant improvement of the three analyzed parameters, both for overall analysis and for pre and post-operative comparisons individually. the comparative analysis of each variable in the six months and the current postoperative periods do not show statistically significant differences, indicating maintenance of parameters during this interval. conclusion: hemiarthroplasty of first metatarsophalangeal joint is a reproducible and safe option for the surgical treatment of hállux rígidus II and III, with significant improvement of the evaluated parameters for the studied population. Level of Evidence IV, Case Series.
Subject(s)
Humans , Male , Female , Middle Aged , Range of Motion, Articular/physiology , Metatarsophalangeal Joint/physiopathology , Arthroplasty, Replacement, Finger/rehabilitation , Hallux Rigidus/surgery , Osteoarthritis/surgery , Osteoarthritis/rehabilitation , Radiography , Data Interpretation, StatisticalABSTRACT
Objetivos: Avaliar a correlação entre os parâmetros radiográficos e as avaliações funcionais de pacientes com osteoartrose do ombro submetidos à artroplastia do ombro e descrever os resultados funcionais deste procedimento em nosso serviço. Métodos: Foram avaliados 21 pacientes (22 ombros) que realizaram artroplastias do ombro entre 1998 e 2010 e que apresentassem tempo mínimo de seguimento de 12 meses. A avaliação clínica foi realizada através das escalas de Constant-Murley, UCLA, EVA e da medida do arco de movimento ativo. Aferimos parâmetros radiográficos pré-operatórios (distância entre o topo da cabeça e o úmero e o acrômio, migração superior, inclinação do colo,offset medial, subluxação do úmero, erosão da glenóide) e pós-operatórios (inclinação da haste, migração dos componentes e sinais de soltura). Resultados: Os pacientes apresentaram melhora significativa em todos os parâmetros avaliados: flexão (p=0,0083), abdução (p=0,0266), rotação externa (p=0,0062), Constant-Murley (p=0,0001), UCLA (p<0,0001) e EVA (p=0,0002). A migração superior do úmero e as escalas de UCLA e de Constant-Murley apresentaram uma correlação significativa (p=0,0480 e p=0,0110, respectivamente). Os demais parâmetros radiográficos não demonstraram correlação com os resultados clínicos. Conclusão: a migração superior do úmero está relacionada a uma piora dos indicadores funcionais. Nível de Evidência IV, Série de Casos.
Objectives: To evaluate the correlation between radiographic parameters and functional assessments of patients with osteoarthritis of the shoulder who underwent shoulder arthroplasty and describe the functional outcomes of this procedure in our institution. Methods: we evaluated 21 patients (22 shoulders) who underwent shoulder arthroplasty between 1998 and 2010 with a minimum follow-up of 12 months. Clinical evaluation was performed using the Constant-Murley scale, UCLA, VAS and measuring the arc of active motion. We analysed preoperative radiographic parameters (distance from the top of the head and the humerus and the acromion, superior migration, neck angulation, medial offset, subluxation, glenoid cavity erosion) and postoperatively we evaluated rod inclination, migration of components and loosening. Results: patients showed significant improvement in all parameters: flexion (p = 0.0083), abduction (p = 0.0266), external rotation (p = 0.0062), Constant-Murley (p = 0.0001 ), UCLA (p < 0.0001) and VAS (p = 0.0002). The superior migration of the humerus showed a significant correlation with UCLA and Constant-Murley scores (p = 0.0480 and p = 0.0110, respectively). The other radiographic parameters had no correlation with the clinical outcomes. Conclusion: the superior migration of the humerus is related to a worsening of clinical scores. Level of Evidence IV, Case Series.
Subject(s)
Humans , Male , Female , Middle Aged , Aged, 80 and over , Arthroplasty/rehabilitation , Shoulder/surgery , Osteoarthritis/rehabilitation , Range of Motion, Articular , Shoulder Joint , Medical Records , Radiography , Data Interpretation, StatisticalABSTRACT
Patient-reported outcome measures (PROMs) are disease specific questionnaires that are being increasingly used in clinical practice and research. The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), is a widely used PROM in patients with hip or knee osteoarthritis. A validated WOMAC was used by us, and significant challenges were faced in administering it as several questions did not have a cultural connect. Functionally equivalent items in the Indian context had then to be used to complete the score.
Subject(s)
Activities of Daily Living , Cross-Cultural Comparison , Disability Evaluation , Educational Status , Humans , India , Ontario , Osteoarthritis/rehabilitation , Surveys and Questionnaires , Reproducibility of Results , TranslatingABSTRACT
O objetivo deste estudo, de cunho empírico analítico do tipodescritivo exploratório, foi observar as características clínicofuncionaisde 15 idosos com diagnóstico médico de osteoartrose de joelho, com idade ≥ a 60 anos, de ambos os gêneros, voluntários,moradores de Florianópolis, selecionados de forma não probabilística intencional. Utilizou-se a escala linear de dor e o questionário de McGill para verificar a intensidade e a qualidade da dor e ainda as medidas do ângulo Q e das amplitudes ativa e passiva de flexão e extensão do joelho de cada um dos sujeitos. Observou-se, pormeio de estatística descritiva, que a média de peso dos sujeitos foide 76,8 kg, caracterizando-os como idosos com excesso de peso, já que a média da altura do grupo foi de 1,50 m. A mediana da intensidade da dor foi de 7,5 (S = 2,94) com média do número de descritores de qualidade de dor de 19. Esses parâmetros de alta intensidade da dor, somados a mediana das medidas do ângulo Qdo joelho (21 graus), o quartil superior de 23 graus, e a média defl exão ativa de 111 graus e extensão ativa de 170 graus, caracterizam o grupo, como sujeitos que apresentam alteração postural e funcional mecânica desta articulação, com riscos de comprometera sua independência funcional, limitando-os significativamente na habilidade individual de levantar de uma cadeira, permanecer em pé confortavelmente, caminhar, subir e descer escadas. Identificar as alterações posturais, funcionais e de dor causadas por esta patologia é deveras relevante, possibilitando desta forma, a utilização destas medidas clínico-funcionais como parâmetro para o estudodos efeitos de tratamentos de correção e prevenção da evolução das deformidades posturais e da mecânica articular do joelho de idosos com osteoartrose de joelhos.
This descriptive exploratory study aimed at observing clinical and functional characteristics of 15 elderly people diagnosed withknee osteoarthrosis, aged ≥ 60 years, both genders, voluntaries,residents in Florianópolis selected by nonprobability sampling. The linear scale of pain and the McGill questionnaire were used to verify the intensity and quality of pain, and also measurement of Q angle and active and passive amplitude of flexion and extension movement of the knee in each subject. It was observed through descriptive statistic that subjects mean weight was 76.8 kg, characterizing then as overweight elderly people, since mean height of the group was 1.50 m. The median pain intensity score was 7.5 (S = 2.94),and mean descriptors of pain quality was 19. These high intensity parameters of pain added up to the median of Qangles (21°), the superior quartile (23°) and mean of active fl exion (111°) and theactive extension (170°) showed that the group had knee postural and mechanical functional alterations, with risks to compromise their functional independence, limiting significantly their individualability to stand up from the chair, stand comfortably, walk, go upand down the stairs. To identify the postural, functional and painalterations caused by this pathology is indeed relevant, allowingthe use of clinical and functional measurements as a parameterfor the study of effects of corrective treatments and prevention of postural deformities and mechanical knee alterations of elderly with osteoarthritis of the knee.
Subject(s)
Osteoarthritis/classification , Osteoarthritis/pathology , Osteoarthritis/rehabilitation , Pain , Pain Measurement , Motor Skills Disorders/rehabilitation , Motor Skills Disorders/therapyABSTRACT
PURPOSE: Tai Chi exercise, an ancient Chinese martial art, has drawn more and more attention for its health benefits. The purpose of the study was to identify the effects of a Sun-style Tai Chi exercise on arthritic symptoms (joint pain and stiffness), motivation for performing health behaviors, and the performance of health behaviors among older women with osteoarthritis. METHODS: Total of 72 women with the mean age of 63 years old were recruited from outpatients clinic or public health centers according to the inclusion criteria and assigned randomly to either the Tai Chi exercise group or the control. A Sun-style Tai Chi exercise has been provided three times a week for the first two weeks, and then once a week for another 10 weeks. In 12 weeks of study period, 22 subjects in the Tai Chi exercise group and 21 subjects in the control group completed the posttest measure with the dropout rate of 41%. Outcome variables included arthritic symptoms measured by K-WOMAC, motivation for health behavior, and health behaviors. RESULTS: At the completion of the 12 week Tai Chi exercise, the Tai Chi group perceived significantly less joint pain (t=-2.19, p=0.03) and stiffness (t=-2.24, p=0.03), perceived more health benefits (t=2.67, p=0.01), and performed better health behaviors (t=2.35, p=0.02), specifically for diet behavior (t=2.06, p=0.04) and stress management (t=2.97, p=0.005). CONCLUSION: A Sun-style Tai Chi exercise was found as beneficial for women with osteoarthritis to reduce their perceived arthritic symptoms, improve their perception of health benefits to perform better health behaviors.
Subject(s)
Aged , Female , Humans , Middle Aged , Health Behavior , Korea , Life Style , Motivation , Osteoarthritis/rehabilitation , Quality of Life , Tai JiABSTRACT
Se presenta la segunda parte de un artículo publicado en julio de 1990. Se sigue la evolución durante 14 años y se cuenta que ha pasado durante este tiempo. se hace énfasis en el valor de un nuevo programa de ejercicios en el manejo de la artrosis y se evalúan los resultados obtenidos que se califican de muy buenos.
Subject(s)
Osteoarthritis/rehabilitation , Osteoarthritis/therapyABSTRACT
Objetivo: Valorar un programa de rehabilitación integral de 6 meses de duración en gonartrosis mediante un estudio descriptivo, prospectivo, autocontrolado.Pacientes: Treinta y nueve mujeres con edad promedio de 57 años (variación 47-65) con gonartrosis unilateral y bilateral en 24 (61 por ciento) y 15 (39 por ciento) respectivamente.Medidas efectuadas: Velocidad de marcha, dolor con EVA, fuerza muscular isométrica de cuadríceps con diagrama de cuerpo libre, disminución de peso, gasto metabólico por sesión de ejercicio aeróbico, cuantificación del consumo de analgésicos. Métodos utilizados: Alineación articular, disminución de carga articular, incremento de absorbentes de carga, fortalecimiento de cuadríceps, acondicionamiento físico y enseñanza de protección articular. Resultados: Se incrementó la velocidad de la marcha inicial de 1.15 m/s en promedio a 1.29m/s a expensas de mayor longitud del paso; la disminución de peso en promedio alcanzó 7 por ciento en las pacientes con sobrepeso y/o obesidad; la fuerza muscular isométrica de cuadríceps se incrementó en 75 por ciento a los 3 meses y 120 por ciento a los 6 meses; el uso de analgésicos disminuyó de 3 tomas al día a 1 sola dosis en 54 por ciento de los casos, a 2 dosis en 15 por ciento y 31 por ciento dejaron de usarlo. Se consideró al programa con excelentes resultados en 30 por ciento de los casos, 35 por ciento como buenos, 25 por ciento regulares y 10 por ciento malos. Conclusiones: Es aconsejable que los programas de rehabilitación sean de tipo integral, tratando de modificar el mayor número de variables, ya que la gonartrosis es un problema cuya evolución depende de varios factores y su tratamiento no debería descansar sólo en medicación analgésica.
Subject(s)
Humans , Female , Middle Aged , Osteoarthritis/rehabilitation , Rheumatic Diseases/rehabilitation , Rehabilitation/methods , Comprehensive Health Care , Musculoskeletal Diseases/rehabilitationABSTRACT
Se presenta una serie de 5 casos que tenían alteraciones de la consolidación, que fue pseudoartrosis en 4 y retardo de consolidación en uno. El tratamiento consistió en aplicación percutánea de médula ósea autóloga en el foco de fractura. El resultado que se obtuvo después de 12 semanas fue satisfactorio clínicamente en 4 y regular en uno, mientras que el resultado radiológico fue satisfactorio solamente en 2 y regular en 3.
Subject(s)
Humans , Male , Female , Osteoarthritis/rehabilitation , Administration, Cutaneous , Fracture Healing , Bone Marrow , Fracture Fixation, Internal/trendsABSTRACT
Como a patogênese da osteoartrose continua ainda obscura, quaisquer tratamentos devem ser objeto de restriçoes. E, com maior razao, o tratamento fisiátrico deve ser encarado com cautela, pois muitos dos procedimentos fisiátricos nao sao de comprovada eficácia, sob o ponto de vista estatístico. Alguns, no entanto, sao úteis como coadjuvantes no contexto geral do planejamento terapêutico, quando o diagnóstico estiver correto e o procedimento adequadamente indicado. A nao observância deste fato implica em gastos desnecessários para o paciente e sobrecarga para o sistema de saúde pública, quando nao gera prejuízos ao incapacitado. Ao se conhecer o mecanismo da atuaçao dos exercícios, calor, órteses, exercícios aeróbicos, TENS (estimulaçao elétrica transcutânea), acupuntura, laser, certamente, mais certo e menos errado atuará o reumatologista ao indicar o tratamento fisiátrico da doença articular degenerativa
Subject(s)
Humans , Osteoarthritis/rehabilitation , Physical Therapy SpecialtySubject(s)
Humans , Rheumatic Diseases , Arthritis, Rheumatoid/diagnosis , Arthritis, Rheumatoid/rehabilitation , Arthritis, Rheumatoid/therapy , Joint Diseases/diagnosis , Joint Diseases/rehabilitation , Joint Diseases/therapy , Osteoarthritis/diagnosis , Osteoarthritis/rehabilitation , Osteoarthritis/therapyABSTRACT
Se presenta una serie de 250 pacientes con patología de la rodilla, tratados entre 1987 y 1992, con seguimiento promedio postoperatorio de cuatro años, sometidos todos a artroscopia terapéutica, de acuerdo con un protocolo establecido por medio del cual la mayoría de los enfermos se somete a cirugía ambulatoria. Los resultados encontrados fueron los siguientes: la patología más común fue la condromalacia patelar en 22 casos, seguida de la lesión del menisco medial en sus variedades de asa de balde y en aleta con 92 casos y del lateral con 72; posteriormente se encontró enfermedad articular degenerativoa u osteoartritis con 31 casos; 24 con lesiones del ligamento cruzado anterior, y finalmente hubo 16 con diversas formas de patología sinovial. El resultado global del tratamiento se considera bueno en más de 80 por ciento de los casos
Subject(s)
Humans , Male , Female , Adolescent , Adult , Osteoarthritis/surgery , Arthroscopy , Chondromatosis, Synovial/surgery , Knee Joint/surgery , Osteoarthritis/rehabilitation , Chondromatosis, Synovial/rehabilitation , Anesthesia, Epidural , Knee Joint/physiopathologyABSTRACT
A osteoartrose e uma doenca de alta incidencia na populacao em geral, atingindo preferencialmente alguns grupos, como mulheres pos menopausa. A doenca se caracteriza por alguns aspectos clinicos que levam a niveis variados de incapacidade funcional. A incapacidade pode ser causada pelo processo doloroso ou por alteracoes articulares e peri-articulares secundarias a propria dor ou decorrentes da evolucao da doenca. Este artigo traz uma revisao sobre a fisiopatologia e abordagem terapeutica fisiatrica da dor, com indicacoes e limitacoes dos metodos.
Subject(s)
Humans , Osteoarthritis/rehabilitation , Physical Therapy Specialty , Analgesia , Osteoarthritis/physiopathology , Pain/therapyABSTRACT
A osteoartrose é uma doença potencialmente incapacitante pelas alteraçöes degenerativas e inflamatórias. A relativa imobilizaçäo gerada pela dor e modificaçöes intra-articulares leva a alteraçöes secundárias dos músculos, tendöes, ligamentos e cápsulas articular, que podem ser minimizadas se uma correta abordagem cinesioterápica for realizada nestes pacientes. Este artigo de revisäo bibliográfica relaciona as alteraçöes estruturais encontradas na osteoartrose, os princípios fisiológicos dos exercícios terapêuticos e a prescriçäo adequada destes exercicíos nos pacientes com osteoartrose
Subject(s)
Humans , Osteoarthritis/rehabilitation , Exercise Therapy/methods , Exercise , Osteoarthritis/physiopathologyABSTRACT
Aun no contamos con criterios diagnosticos de la osteoartritis formalmente establecidos y, hasta el momento el diagnostico generalmente se basa en los examenes fisico y radiologico y en la valoracion por el laboratorio del liquido sinovial. El trauma severo y probablemente los microtraumatismos a repeticion, la actividad excesiva, el sedentarismo y la obesidad pueden empeorar los sintomas.Los objetivos del tratamiento son reducir el dolor y mejorar o al menos preservar la funcion. Los antiinflamatorios no esteroides son de invaluable ayuda en muchos pacientes aunque su utilizacion puede complicarse con alteraciones gatrointestinales. Los antiespasmodicos ayudan a disminuir el dolor causado por espasmo muscular y las inyecciones intraarticulares de corticosteroides de deposito son muy utiles para disminuir la inflamacion. Los agentes analgesicos puros forman una parte muy importante del plan terapeutico. Se le debe ensenar a los pacientes a proteger sus articulaciones debilitadas mediante ortesis, ejercicios de estiramiento y una postura corporal adecuada.Un medico que propenda por un estilo de vida mas saludable y que mire de manera mas positiva el tratamiento de esta alteracion sera un apoyo muy valioso para su paciente y obtendra mejores resultados tanto fisicos como emocionales