RESUMEN
Painful and disabling musculoskeletal disorders remain prevalent. In rats trained to perform repetitive tasks leading to signs and dysfunction similar to those in humans, we tested whether manual therapy would prevent the development of the pathologies and symptoms. We collected behavioral, electrophysiological, and histological data from control rats, rats that trained for 5 weeks before performing a high-repetition high-force (HRHF) task for 3 weeks untreated, and trained rats that performed the task for 3 weeks while being treated 3x/week using modeled manual therapy (MMT) to the forearm (HRHF + MMT). The MMT included bilateral mobilization, skin rolling, and long axis stretching of the entire upper limb. High-repetition high-force rats showed decreased performance of the operant HRHF task and increased discomfort-related behaviors, starting after training. HRHF + MMT rats showed improved task performance and decreased discomfort-related behaviors compared with untreated HRHF rats. Subsets of rats were assayed for presence or absence of ongoing activity in C neurons and slow Aδ neurons in their median nerves. Neurons from HRHF rats had a heightened proportion of ongoing activity and altered conduction velocities compared with control and MMT-treated rats. Median nerve branches in HRHF rats contained increased numbers of CD68 macrophages and degraded myelin basic protein, and showed increased extraneural collagen deposition, compared with the other groups. We conclude that the performance of the task for 3 weeks leads to increased ongoing activity in nociceptors, in parallel with behavioral and histological signs of neuritis and nerve injury, and that these pathophysiologies are largely prevented by MMT.
Asunto(s)
Trastornos de Traumas Acumulados/complicaciones , Trastornos Neurológicos de la Marcha/prevención & control , Manipulaciones Musculoesqueléticas/métodos , Nociceptores/fisiología , Dolor/etiología , Dolor/prevención & control , Animales , Antígenos CD/metabolismo , Antígenos de Diferenciación Mielomonocítica/metabolismo , Estudios de Casos y Controles , Trastornos de Traumas Acumulados/rehabilitación , Modelos Animales de Enfermedad , Electrofisiología , Ayuno , Femenino , Trastornos Neurológicos de la Marcha/etiología , Inflamación/complicaciones , Inflamación/patología , Nervio Mediano/fisiopatología , Proteína Básica de Mielina/metabolismo , Ratas , Ratas Sprague-Dawley , Estadísticas no ParamétricasRESUMEN
Achilles tendinopathy is a common overuse condition affecting the adult population. The incidence is on the rise because of greater participation of people in recreational or competitive sporting activities. There are several treatment options available both non-operative and operative. Ultrasound-guided dry needling and high-volume image-guided injection is relatively a new procedure. The aim of this study was to find out the effectiveness of dry needling and HVIGI in the management of mid-portion chronic Achilles tendinopathy by performing a literature review. Search strategy was devised to find the suitable articles for critical appraisal using the electronic databases. Four articles were selected for critical appraisal, and these papers showed good short- to long-term results of image-guided high-volume injection in the management of Achilles tendinopathy. We conclude that high-volume image-guided injection is effective in the management of Achilles tendinopathy. It provides good short- and medium-term relief of symptoms. It should be considered as one of the many options available for this condition.
Asunto(s)
Tendón Calcáneo , Terapia por Acupuntura/métodos , Anestésicos Locales/administración & dosificación , Trastornos de Traumas Acumulados/complicaciones , Tendinopatía/terapia , Adulto , Enfermedad Crónica , Trastornos de Traumas Acumulados/fisiopatología , Femenino , Estudios de Seguimiento , Humanos , Inyecciones Intralesiones , Masculino , Dimensión del Dolor , Recuperación de la Función , Medición de Riesgo , Índice de Severidad de la Enfermedad , Tendinopatía/diagnóstico por imagen , Tendinopatía/etiología , Resultado del Tratamiento , Ultrasonografía Intervencional/métodosRESUMEN
PURPOSE: The purpose of our study was to present options for the application of tensegrity massage to manage pain caused by the overload of soft tissues in musicians. DESIGN: Tensegrity massage was applied to a 34-year-old male violinist. METHODS: The methodology included a correct positioning and tensegrity massage with individually designed procedure. FINDINGS: After therapy, the patient achieved complete pain relief, and relaxation of muscles in the shoulder girdle and free part of the upper arm. The analgesic effect lasted for 6 months after the end of therapy. CONCLUSIONS: Massage is an effective method in eliminating pain caused by the overload of soft tissues. If used regularly before physical effort, it can prevent muscle overload. CLINICAL RELEVANCE: The presented massage procedure is an effective therapy in pain caused by the overload of soft tissues in musicians and it can be one of the elements of complex physiotherapy in active musicians.
Asunto(s)
Trastornos de Traumas Acumulados/terapia , Masaje/métodos , Música , Manejo del Dolor/métodos , Enfermería en Rehabilitación/métodos , Adulto , Trastornos de Traumas Acumulados/complicaciones , Humanos , Masculino , Dolor/etiología , Resultado del TratamientoAsunto(s)
Trastornos de Traumas Acumulados/complicaciones , Trastornos de Traumas Acumulados/terapia , Trastornos Distónicos/etiología , Trastornos Distónicos/terapia , Estimulación Magnética Transcraneal/métodos , Toxinas Botulínicas Tipo A/uso terapéutico , Humanos , Masculino , Persona de Mediana Edad , Examen Neurológico , Fármacos Neuromusculares/uso terapéutico , Recuperación de la Función , Resultado del TratamientoAsunto(s)
Traumatismos en Atletas/terapia , Ligamento Rotuliano/fisiopatología , Tendinopatía/terapia , Traumatismos en Atletas/diagnóstico , Traumatismos en Atletas/etiología , Traumatismos en Atletas/fisiopatología , Fenómenos Biomecánicos , Terapia Combinada , Crioterapia , Trastornos de Traumas Acumulados/complicaciones , Diagnóstico por Imagen , Terapia por Estimulación Eléctrica , Terapia por Ejercicio , Ondas de Choque de Alta Energía/uso terapéutico , Humanos , Inyecciones Intraarticulares , Masaje , Plasma Rico en Plaquetas , Recuperación de la Función , Factores de Riesgo , Índice de Severidad de la Enfermedad , Cloruro de Sodio/administración & dosificación , Cloruro de Sodio/uso terapéutico , Tendinopatía/diagnóstico , Tendinopatía/etiología , Tendinopatía/fisiopatologíaRESUMEN
Musculoskeletal pain is one of the most common presenting symptoms at the pediatrician's office. Etiology ranges from benign conditions to serious ones requiring prompt attention. This article addresses entities that present as musculoskeletal pain but are not associated with arthritis. The most common nonarthritic conditions are benign limb pain of childhood (growing pains), hypermobility, overuse syndromes with or without skeletal abnormalities, malignancies, and pain amplification syndromes. The| initial decision process, diagnosis, and treatment options for each of these conditions are discussed.
Asunto(s)
Trastornos de Traumas Acumulados/diagnóstico , Inestabilidad de la Articulación/diagnóstico , Dolor Musculoesquelético/etiología , Neoplasias/diagnóstico , Antiinflamatorios no Esteroideos/uso terapéutico , Niño , Trastornos de Traumas Acumulados/complicaciones , Trastornos de Traumas Acumulados/terapia , Humanos , Inestabilidad de la Articulación/complicaciones , Inestabilidad de la Articulación/terapia , Masaje , Dolor Musculoesquelético/terapia , Neoplasias/complicaciones , Procedimientos Ortopédicos , Osteocondrosis/complicaciones , Osteocondrosis/diagnóstico , Osteocondrosis/terapia , Modalidades de Fisioterapia , PronósticoRESUMEN
Three cases of athlete's nodule on the feet are reported. In case 1, a 30-year-old man, who had been an amateur football player, presented with nodules on the lateral side of the feet and on the right lateral malleolus with a duration of 1 year. In case 2, a 22-year-old man, who had participated in karate and track-and-field, presented with nodules on the lateral side of the feet and on the right lateral malleolus with a duration of 10 years. In case 3, a 25-year-old man, who had skied, presented with a nodule on the right lateral malleolus with a duration of 4 years. The biopsy specimens from the lesion demonstrated hyperkeratosis, acanthosis of the epidermis and thickness of the dermis. In 1991, Cohen et al. proposed the concept of athlete's nodule which indicated an acquired cutaneous nodule caused by chronic stimuli with sports. Histopathology of the athlete's nodule shows hypertrophy of the epidermis and dermis. To the best of our knowledge the term "athlete's nodule" has not been used in Japan, but it is a useful term to refer to the lesion induced by athletics or the use of sporting equipment.
Asunto(s)
Trastornos de Traumas Acumulados/patología , Hamartoma/patología , Queratosis/etiología , Queratosis/patología , Deportes , Adulto , Tobillo/patología , Atletas , Trastornos de Traumas Acumulados/complicaciones , Diagnóstico Diferencial , Estudios de Seguimiento , Fútbol Americano/lesiones , Hamartoma/etiología , Humanos , Japón , Rodilla/patología , Masculino , Artes Marciales/lesiones , Carrera/lesiones , Esquí/lesiones , Adulto JovenRESUMEN
The aim of this analytical cross-sectional study was to evaluate the presence of work-related musculoskeletal disorders (WMSD) among dental students in two Brazilian dental schools. The sample included 227 randomized subjects from fifth to ninth semesters who were developing clinical activities. Each student signed an informed consent form. A self-reporting questionnaire was used to obtain data on the practice of physical exercise, the presence of pain during or soon after treating patients, and the adoption of preventive measures related to clinical activities. Results were analyzed using the Statistical Package for Social Sciences 13.0. The chi(2) test was used to identify associations between variables. The presence of pain during or after clinical work was reported by 173 participants (76.2 percent). Statistically significant differences were found between gender and the occurrence of pain. Pain was present during clinical activities (p=0.006) and imposed limitations on the work routine (p=0.011). Among those who practiced physical exercise, eighty-eight (74.6 percent) reported pain. The high percentage of pain reported by dental students suggests the value of reviewing work conditions in dental practices in order to minimize the exposure of all workers to WMSD.
Asunto(s)
Enfermedades Musculoesqueléticas , Enfermedades Profesionales , Dolor/etiología , Estudiantes de Odontología , Adulto , Brasil , Estudios Transversales , Trastornos de Traumas Acumulados/complicaciones , Trastornos de Traumas Acumulados/prevención & control , Ergonomía , Ejercicio Físico , Femenino , Humanos , Masculino , Enfermedades Musculoesqueléticas/complicaciones , Enfermedades Musculoesqueléticas/etiología , Enfermedades Musculoesqueléticas/prevención & control , Enfermedades Profesionales/complicaciones , Enfermedades Profesionales/prevención & control , Postura , Terapia por Relajación , Encuestas y Cuestionarios , Adulto JovenAsunto(s)
Trastornos de Traumas Acumulados/fisiopatología , Distonía/fisiopatología , Antidiscinéticos/uso terapéutico , Fenómenos Biomecánicos , Toxinas Botulínicas/uso terapéutico , Trastornos de Traumas Acumulados/complicaciones , Distonía/etiología , Femenino , Dedos/fisiopatología , Humanos , Masaje , Persona de Mediana Edad , Espasmo/etiología , Espasmo/patologíaRESUMEN
Video-based task analysis in the workplace is often limited by equipment location and production line arrangement, therefore making it difficult to capture the motion in a single plane. The purpose of this study was to investigate the effects of camera placement on an observer's ability to accurately assess working postures in three dimensions and the resultant influence on the reliability and repeatability of calculated cumulative loading variables. Four video cameras were placed at viewing angles of 0 degrees, 45 degrees, 60 degrees and 90 degrees to the frontal plane, enabling the simultaneous collection of views of four lifting tasks (two symmetric and two asymmetric). A total of 11 participants were trained in the use of the 3DMatch 3-D posture matching software package (developed at the University of Waterloo) and were required to analyse 16 lifting trials. Four of the participants were randomly selected to return within 72 h and repeat the analysis protocol to test intra-observer repeatability. Posture matching agreement between camera views was higher when the body segments had a minimal range of motion during the task. There was no significant participant main effect; however, there was a significant (p < 0.05) task main effect. Intraclass correlation coefficients (ICC) were calculated to assess the between day reliability. Compression, reaction anterior shear and extension moment were all found to have excellent reliability (ICC > 0.75). Joint anterior shear and joint posterior shear both provided fair to good reliability (0.4 > ICC < 0.75). Overall, the impact of the camera viewing angle on an observer's ability to match working postural exposure was found to be small.
Asunto(s)
Trastornos de Traumas Acumulados/complicaciones , Articulaciones/fisiología , Región Lumbosacra , Enfermedades Profesionales/complicaciones , Postura/fisiología , Traumatismos Vertebrales/etiología , Grabación en Video , Soporte de Peso , Adulto , Antropometría , Femenino , Humanos , Quinesiología Aplicada , Masculino , Reproducibilidad de los ResultadosRESUMEN
Various conservative treatment options for repetitive strain injury are widely used, despite questionable evidence of their effectiveness. This systematic review evaluates the effectiveness of these treatment options for relieving symptoms of repetitive strain injury and improving activities of daily living. Searches in Medline and Embase, with additional reference checking resulted in 15 eligible trials for this review. Methodological quality was assessed, and data-extraction was performed. With the use of a "best-evidence synthesis", no strong evidence was found for the effectiveness of any of the treatment options. There is limited evidence that multidisciplinary rehabilitation, ergonomic intervention measures, exercises, and spinal manipulation combined with soft tissue therapy are effective in providing symptom relief or improving activities of daily living. There is conflicting evidence for the effectiveness of behavioral therapy. In conclusion, little is known about the effectiveness of conservative treatment options for repetitive strain injury. To establish strong evidence, more high-quality trials are needed.
Asunto(s)
Trastornos de Traumas Acumulados/terapia , Terapia Conductista , Trastornos de Traumas Acumulados/complicaciones , Trastornos de Traumas Acumulados/rehabilitación , Terapia por Ejercicio , Humanos , Manipulación Quiropráctica , Enfermedades Musculoesqueléticas/etiología , Enfermedades Profesionales/etiología , Especialidad de Fisioterapia , Ensayos Clínicos Controlados Aleatorios como Asunto , Férulas (Fijadores) , Resultado del TratamientoRESUMEN
In the practice of dentistry, stress, tension, and postural practices can contribute to back and neck problems. Two hundred and four dentists and dental auxiliary (87 males and 117 females) in Riyadh city, Saudi Arabia were surveyed to determine the prevalence of postural problems. The candidates were interviewed and observed during practice. The data obtained showed that 111 (54.4%) of the subjects complained of neck pain and 150 (73.5%) complained of back pain. Only 37% of those complaining of back pain sought medical help. Within the limitations of this study, it might be concluded that neck and back pain among dental personnel are not of a severe nature.
Asunto(s)
Dolor de Espalda/etiología , Auxiliares Dentales , Odontólogos , Dolor de Cuello/etiología , Enfermedades Profesionales/etiología , Adulto , Dolor de Espalda/epidemiología , Dolor de Espalda/terapia , Trastornos de Traumas Acumulados/complicaciones , Trastornos de Traumas Acumulados/epidemiología , Trastornos de Traumas Acumulados/terapia , Ejercicio Físico , Femenino , Humanos , Masculino , Persona de Mediana Edad , Dolor de Cuello/epidemiología , Dolor de Cuello/terapia , Enfermedades Profesionales/epidemiología , Enfermedades Profesionales/terapia , Postura , Prevalencia , Terapia por Relajación , Arabia Saudita/epidemiologíaRESUMEN
Many women's expectancies when they assume the role of patient include the experiences of regression, helplessness, passivity and fear. This paper describes techniques for interrupting this negative set and for facilitating the development of a self-efficacious state in which the woman experiences herself as an active and informed participant in her encounters with medical personnel.
Asunto(s)
Hipnosis , Enfermedades Profesionales/psicología , Dolor/psicología , Relaciones Médico-Paciente , Embarazo/psicología , Salud de la Mujer , Adulto , Trastornos de Traumas Acumulados/complicaciones , Trastornos de Traumas Acumulados/diagnóstico , Trastornos de Traumas Acumulados/psicología , Femenino , Identidad de Género , Humanos , Enfermedades Profesionales/complicaciones , Enfermedades Profesionales/diagnóstico , Dolor/etiología , Rol del Enfermo , Estados UnidosRESUMEN
I describe a case of adolescent tibia vara, a contralateral nonossifying fibroma of the tibia, and bipartite patella, which occurred in an adolescent karate competitor of normal stature. The association of this unusual triad supports the hypothesis that each process has a shared traumatic etiology.
Asunto(s)
Enfermedades del Desarrollo Óseo/etiología , Enfermedades Óseas/etiología , Trastornos de Traumas Acumulados/complicaciones , Artes Marciales/lesiones , Rótula/patología , Tibia/patología , Adolescente , Niño , Humanos , Masculino , Estrés MecánicoRESUMEN
Brachial plexus irritation and other compression neuropathies can be diverse in their presentations and can cause a myriad of signs and symptoms. The purpose of this paper is to review the pertinent anatomy, kinesiology, and neurophysiology and to outline one possible cascade of events that may contribute to more diffuse upper extremity symptoms. Scapular instability and local myofascial trigger points resulting in possible secondary muscle imbalances are described. Their possible relationship to brachial plexus irritation in addition to the implications of the irritation are also discussed. The author postulates that proximal nerve irritation in the region of the thoracic outlet and shoulder may help to account for diffuse or unrelieved symptoms following conventional treatment of distal extremity problems in patients with occupational or cumulative trauma disorders. This paper outlines specific examination procedures for the therapist, which include upper limb tension testing, extensibility testing of the pectoralis minor, and gross manual muscle testing of the lower trapezius.
Asunto(s)
Plexo Braquial , Trastornos de Traumas Acumulados/complicaciones , Enfermedades Musculares/complicaciones , Síndromes de Compresión Nerviosa/etiología , Escápula/fisiopatología , Trastornos de Traumas Acumulados/fisiopatología , Humanos , Músculos/fisiopatología , Enfermedades Musculares/fisiopatología , Enfermedades Musculares/terapia , Síndromes de Compresión Nerviosa/diagnóstico , Síndromes de Compresión Nerviosa/fisiopatologíaRESUMEN
Current treatment for carpal tunnel syndrome may be ineffective or associated with complications or recurrence. In the case reported here, a myofascial release by the physician combined with the patient's self-stretch reduced pain and numbness and improved electromyographic results. The manipulative approach releases the transverse carpal ligament,-and "opens" or dilates the canal. The patient stretches the wrist, digits, and thumb, including myofascial components. An aggressive, conservative approach lessens the need for surgery in mild to moderate cases. Studies with magnetic resonance imaging may be helpful to document canal size before and after treatment.
Asunto(s)
Síndrome del Túnel Carpiano/terapia , Síndrome del Túnel Carpiano/etiología , Trastornos de Traumas Acumulados/complicaciones , Terapia por Ejercicio/métodos , Femenino , Humanos , Manipulación Ortopédica/métodos , Persona de Mediana Edad , Medicina Osteopática/métodos , Tendinopatía/complicacionesRESUMEN
The repetitive overhead use of the arm required by many sports may lead to impingement in the vulnerable avascular region of the supraspinatus and biceps tendons. The impingement syndrome may spill over at any time to involve the adjacent biceps tendon, subacromial bursa, and acromioclavicular joint and, as a continuum, with the passage of time, may eventuate in degeneration and partial, even complete thickness, rotator cuff tears later in life. Physical findings, particularly a positive impingement sign, confirm the diagnosis. In the young competing athlete, therapeutic measures consist of careful warm-up exercises, occasional rest by avoidance of the offending movement, and local modalities of ice, ultrasound, and transcutaneous stimulation along with anti-inflammatory medications. Surgical decompression achieved by resecting the coracoacromial ligament or a more definitive anterior acromioplasty may rarely be indicated.