Hybrid maneuver for benign paroxysmal positional vertigo in individuals with limited neck mobility: Case series.

INTRODUCTION: Mobility limitation of the cervical spine compromises the adequate execution of the canalith repositioning maneuver (CRM) in cases of posterior semicircular canal benign paroxysmal positional vertigo (PSC-BPPV-GEO). Thus, novel therapeutic options are required for such individuals. OBJECTIVES: This study describes the effects of a change in the biomechanical position for the execution of the CRM on symptoms of dizziness and mobility limitation regarding flexion-extension of the cervical spine in older people with unilateral PSC-BPPV-GEO. METHODS: A quasi-experimental viability study was conducted with 15 older adults (11 women; mean age: 72.2 ± 8.1 years). Treatment consisted of a hybrid CRM. The participants were evaluated before and after the intervention using the modified Dix & Hallpike test, Dizziness Handicap Inventory (DHI) and a visual analog scale (VAS) for vertigo. RESULTS: The modified Dix & Hallpike test was negative in all cases after the execution of the hybrid CRM. A significant reduction was found for dizziness measured using the DHI (mean difference: -39.3 ± 9.4, p < 0.001) and VAS (mean difference: -2.9 ± 0.8, p = 0.04) after the intervention. CONCLUSION: The hybrid CRM proved executable and satisfactory for resolving symptoms of dizziness in older adults with PSC-BPPV. The present findings are promising and randomized controlled clinical trials should be conducted to evaluate the effectiveness of the hybrid CRM in this population.

Prediction models for physical function in COVID-19 survivors.

BACKGROUND: The burden of caring for patients who have survived COVID-19 will be enormous in the coming years, especially with respect to physical function. Physical function has been routinely assessed using the Post-COVID-19 Functional Status (PCFS) scale. AIM: This study built prediction models for the PCFS scale using sociodemographic data, clinical findings, lung function, and muscle strength. METHOD: Two hundred and one patients with post-COVID-19 syndrome (PCS) completed the PCFS scale to assess physical function. Their levels of general fatigue were also assessed using the Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F) scale, handgrip strength (HGS), and spirometry. RESULTS: The number of participants who scored 0 (none), 1 (negligible), 2 (slight), 3 (moderate), and 4 (severe) on the PCFS scale was 25 (12%), 40 (20%), 39 (19%), 49 (24%), and 48 (24%), respectively. The PCFS scale was significantly correlated with the following variables: FACIT-F score (r = -0.424, P < 0.001), HGS (r = -0.339, P < 0.001), previous hospitalization (r = 0.226, P = 0.001), body mass index (r = 0.163, P = 0.021), and sex (r = -0.153, P = 0.030). The regression model with the highest coefficient of regression (R = 0.559) included the following variables: age, sex, body mass index, FACIT-F, HGS, and previous hospitalization. CONCLUSIONS: Worse general fatigue and HGS are associated with more severe physical function impairments in PCS patients. Furthermore, a history of prior hospitalization results in worse physical function. Thus, prediction models for the PCFS scale that incorporate objective measures enable a better assessment of the physical function of these patients, thus helping in the selection of candidates for a program of physical reconditioning.

Cognitive functional therapy compared with core exercise and manual therapy in patients with chronic low back pain: randomised controlled trial.

ABSTRACT: Cognitive functional therapy (CFT) is a physiotherapy-led intervention that has evolved from an integration of foundational behavioral psychology and neuroscience within the physiotherapist practice directed at the multidimensional nature of chronic low back pain (CLBP). The current evidence about the comparative effectiveness of CFT for CLBP is still scarce. We aimed to investigate whether CFT is more effective than core training exercise and manual therapy (CORE-MT) in pain and disability in patients with CLBP. A total of 148 adults with CLBP were randomly assigned to receive 5 one-hour individualized sessions of either CFT (n = 74) or CORE-MT (n = 74) within a period of 8 weeks. Primary outcomes were pain intensity (numeric pain rating scale, 0-10) and disability (Oswestry Disability Index, 0-100) at 8 weeks. Patients were assessed preintervention, at 8 weeks and 6 and 12 months after the first treatment session. Altogether, 97.3% (n = 72) of patients in each intervention group completed the 8 weeks of the trial. Cognitive functional therapy was more effective than CORE-MT in disability at 8 weeks (MD = -4.75; 95% CI -8.38 to -1.11; P = 0.011, effect size= 0.55) but not in pain intensity (MD = -0.04; 95% CI -0.79 to 0.71; P = 0.916). Treatment with CFT reduced disability, but the difference was not clinically important compared with CORE-MT postintervention (short term) in patients with CLBP. There was no difference in pain intensity between interventions, and the treatment effect was not maintained in the mid-term and long-term follow-ups.

Effects of A Short-term Cardio Tai Chi Program on Cardiorespiratory Fitness and Hemodynamic Parameters in Sedentary Adults: A Pilot Study.

This study evaluates the effects of a short-term Cardio Tai Chi program on the cardiorespiratory fitness and hemodynamic parameters in sedentary adults. Thirty-one sedentary participants (age: 58 ± 9 years, body mass: 63 ± 12 kg) were subjected to an exercise program during 10 sessions over a 10-day period within 2 weeks. The Cardio Tai Chi program consisted in a series of three to five intervals lasting 90 s each at ∼70% maximal heart rate separated by 2-min of low-intensity recovery. Primary outcome measures were cardiorespiratory fitness (peak oxygen uptake, V˙O2peak) assessed by the Rockport walking test and resting hemodynamic parameters (systolic, diastolic, mean, and pulse pressures). We observed a significant difference of means on post-pre V˙O2peak [4.5 ml/kg/min, 95% confidence interval (CI): 3.1 to 5.8, p = 0.004], systolic blood pressure (-5.5 mmHg, 95% CI:-7.3 to -3.8, p = 0.010) and pulse pressure (-3.7 mmHg, 95% CI: -5.2 to -2.3, p = 0.028). No significant differences were observed for diastolic pressure (-1.8 mmHg, 95% CI: -2.6 to -1.0, p = 0.226), mean blood pressure (2.5 mmHg, 95% CI: 1.4 to 3.6, p = 0.302), or resting heart rate (-0.9 beat/min, 95% CI: -2.0 to 0.1, p = 0.631). Our findings suggest that engaging in a short-term Cardio Tai Chi program can improve cardiorespiratory fitness and hemodynamic parameters in sedentary adults.

Development of a multivariate model of the six-minute walked distance to predict functional exercise capacity in hypertension.

BACKGROUND: Hypertension is associated with deterioration of musculoskeletal function and functional capacity. Existing prediction models for assessment of the 6-min walk test (6MWT) do not capture the disease-related functional capacity. This study developed a multivariate prediction model of the measured 6-min walked distance (6MWDM) in hypertension and proposed target-values based on optimal therapeutic aims. METHODS: Seventy-six patients (38 men, 56.1 ±â€¯14.3 years, systolic pressure 156.7 ±â€¯17.5 mmHg, diastolic pressure 92.9 ±â€¯6.9 mmHg) underwent anamnesis, physical examination, and laboratory analysis. Functional capacity was assessed using the 6MWT, being the 6MWDM considered as the dependent variable. Independent variables included sex (S, coded 'male' = 1, 'female' = 0), age (A), body height (H), body mass, mean blood pressure (MBP), and physical activity (IPAQ, coded 1-5). Target-values were derived from theoretical scenarios of optimal blood pressure and physical activity, separately and combined. RESULTS: Patients walked 324.5 ±â€¯10.1 m in the average of two trials 30-min apart. Pearson's correlation coefficient showed moderate-to-weak significant associations between 6MWDM and all independent variables. The final multivariate model was 6MWDP = 611.347-4.446 × MBP + 267.630 × H - 1.511 × A + IPAQcode + Scode (adjusted R2 = 0.680, SE of bias = 6.3 m), suggesting that clinical, anthropometric, and hemodynamic information determines functional capacity. Predicted values yielded a group-average of 325 ±â€¯87 m. Target-values under the optimal scenario resulted in 420 ±â€¯60 m. CONCLUSIONS: Sex (men), higher body height, higher physical activity, lower mean blood pressure, and lower age are independently correlated with higher 6MWDM in patients with hypertension. Target-values can be estimated for therapeutic aims related to hemodynamics and lifestyle.

Predictive models of six-minute walking distance in adults with sickle cell anemia: Implications for rehabilitation.

BACKGROUND: Sickle cell anemia (SCA) is characterized by a broad spectrum of abnormalities that affect most body organs and systems. To date, there is few data on the influence of these patients' clinical characteristics on the functional exercise capacity. AIM: To investigate the effect of the clinical complications on the functional exercise capacity of adult SCA patients. METHOD: Cross-sectional study, where 45 SCA patients underwent clinical evaluations, echocardiography, pulmonary function testing, and determination of six-minute walking distance (6MWD). RESULTS: A significant correlation (P < 0.001) was found between 6MWD and hemoglobin (Hb) level, tricuspid regurgitation velocity, forced vital capacity, acute chest syndrome, and diffusing capacity for carbon monoxide. The prediction model for 6MWD explained 67% of the 6MWD variability (P < 0.001). CONCLUSIONS: Hemodynamics, cardiovascular function, pulmonary function, and episodes of acute lung injury seem to impact the 6MWD in adults with SCA.

Traditional Chinese medicine wrist pulse-taking is associated with pulse waveform analysis and hemodynamics in hypertension.

BACKGROUND: Pulse wave analysis (PWA) quantifies the phenomenon of pulse waveform propagation in patients with cardiovascular diseases, whereas pulse image analysis (PIA) is a subjective examination in traditional Chinese medicine. OBJECTIVE: This study evaluated the association of PIA with PWA and hemodynamics in patients with hypertension. DESIGN, SETTING, PARTICIPANTS AND INTERVENTIONS: This observational, cross-sectional study enrolled 45 patients (26 men, (55.2 ± 10.3) years, systolic blood pressure (155 ± 28) mmHg, diastolic blood pressure (93 ± 17) mmHg) for assessment of clinical and laboratorial data. MAIN OUTCOME MEASURES: Primary outcomes comprised: pattern differentiation based on an automated method; PIA at the radial artery using the 'simultaneous pressing' method for identification of factors such as strength (strong/weak), depth (superficial/deep), and speed (fast/moderate/slow); and PWA at the same artery using a noninvasive system. RESULTS: Significant multivariate main effects were observed for depth (λ=0.648, F5,29 =3.149, P=0.022, η(2) =0.352), strength (λ=0.608, F5,29 =3.736, P=0.010, η(2) =0.392), and speed (λ=0.535, F5,29 =5.302, P=0.002, η(2) =0.465). General effects comprised high values of PWA and blood pressure for superficial, strong, and fast pulse images. A strong pulse was found for pulse pressure ≥ 62.5 mmHg and systolic blood pressure ≥ 149.5 mmHg, whereas a superficial pulse was found for heart rate ≥ 58.25 beats/min; a fast pulse was found for heart rate ≥ 69.6 beats/min and pulse wave velocity ≥ 9.185 m/s. CONCLUSION: Associations were explained by LaPlace's law, arterial remodeling in hypertension, alongside the traditional criterion for classifying speed in pulse images. PIA is associated with PWA and hemodynamics in patients with hypertension. Systolic and pulse pressures, heart rate, and pulse wave velocity are quantitative variables that have information to describe the qualitative pulse images such as strength, depth and speed.

SimTCM: A human patient simulator with application to diagnostic accuracy studies of Chinese medicine.

OBJECTIVE: The aim of this work is to develop and implement the SimTCM, an advanced computational model that incorporates relevant aspects from traditional Chinese medicine (TCM) theory as well as advanced statistical and epidemiological techniques for simulation and analysis of human patients. METHODS: SimTCM presents five major attributes for simulation: representation of true and false profiles for any single pattern; variable count of manifestations for each manifestation profile; empirical distributions of patterns and manifestations in a disease-specific population; incorporation of uncertainty in clinical data; and the combination of the four examinations. The proposed model is strengthened by following international standards for reporting diagnostic accuracy studies, and incorporates these standards in its treatment of study population, sample size calculation, data collection of manifestation profiles, exclusion criteria and missing data handling, reference standards, randomization and blinding, and test reproducibility. RESULTS: Simulations using data from patients diagnosed with hypertension and post-stroke sensory-motor impairments yielded no significant differences between expected and simulated frequencies of patterns (P=0.22 or higher). Time for convergence of simulations varied from 9.90 s (9.80, 10.27) to 28.31 s (26.33, 29.52). The ratio iteration profile necessary for convergence varied between 1:1 and 5:1. CONCLUSION: This model is directly connected to forthcoming models in a large project to design and implement the SuiteTCM: ProntTCM, SciTCM, DiagTCM, StudentTCM, ResearchTCM, HerbsTCM, AcuTCM, and DataTCM. It is expected that the continuity of the SuiteTCM project enhances the evidence-based practice of Chinese medicine. The software is freely available for download at: http://suitetcm.unisuam.edu.br.

SimTCM: A human patient simulator with application to diagnostic accuracy studies of Chinese medicine / 中西医结合学报

The aim of this work is to develop and implement the SimTCM, an advanced computational model that incorporates relevant aspects from traditional Chinese medicine (TCM) theory as well as advanced statistical and epidemiological techniques for simulation and analysis of human patients.

Asserted and neglected issues linking evidence-based and Chinese medicines for cardiac rehabilitation.

High blood pressure is among the most prevalent chronic disease in adults that impacts on the quality of life of patients, which are often subjected to physical rehabilitation. Chinese medicine intervention in patients with hypertension presents promising albeit inconclusive results, mostly due to methodological issues. This paper discusses asserted and neglected issues linking evidence-based and Chinese medicines as related to systemic arterial hypertension, as well as their impact on the physical rehabilitation of those patients. On the one hand, natural history of hypertension, pulse palpation, and herbal therapy are among the asserted issues because of the scientific evidence collected about them, either in favor or against its integration to the current medical practice. On the other hand, anatomical variations of vessels and comparative physiology are among the most commonly neglected issues because previous researches on integrative medicine ignored the possible effects of these issues as related to the study's outcome. The asserted issues highlighted in this paper stimulate the increasing use of Chinese medicine for health care and the continuity of research on integrative medicine in the cardiovascular field for rehabilitation. The neglected issues poses additional challenges that must not be overlooked in future research on this topic so that the integration of both traditional and current knowledge may be of benefit to the population with cardiovascular disease.

Equilíbrio estático e dinâmico em bailarinos: revisão da literatura / Static and dynamic balance in ballet dancers: a literature review / Equilibrio estático y dinámico en bailarines: revisión de la literatura

A dança envolve integração de movimento, equilíbrio postural e aspectos relacionados ao controle postural. Informações sobre o equilíbrio em bailarinos são de grande importância, pois eles são considerados modelos de controle postural. O objetivo foi revisar estudos sobre equilíbrio postural estático e dinâmico em bailarinos, caracterizando o controle e a dependência visual desses atletas para a manutenção do equilíbrio. Para isso, foi realizada uma revisão nas bases de dados PubMed, SciELO, Lilacs e Science Direct, considerando o período entre 1997 a 2013, utilizando os descritores equilíbrio, controle postural, plataforma de forças, ballet, bailarinos clássicos e aferência visual. Foram selecionados 18 artigos capazes de fornecer dados quantitativos para avaliação do equilíbrio nesses atletas classificados pelo nível de evidência científica Oxford. A literatura revisada mostra completa concordância quanto ao efeito da retirada da informação visual sobre a estabilidade postural de bailarinos considerados como executantes altamente treinados. Estudos mostrando a comparação do equilíbrio de bailarinos com outras técnicas desportivas confirmaram um padrão específico de equilíbrio nesses indivíduos. Entretanto, associando-se à restrição visual, bailarinos apresentaram maior deslocamento do centro de pressão comparado a outras modalidades desportivas, sugerindo maior dependência visual para a manutenção do equilíbrio. Bailarinos apresentam menor oscilação postural em relação a indivíduos não treinados e indivíduos treinados em outras práticas desportivas, com maior dependência visual para manutenção do equilíbrio...

Dance involves integration between movement, postural balance and the multiple aspects involved with postural control. Information regarding the balance of ballet dancers is of great importance, as they are considered models of great postural control. The aim was to review studies about static and dynamic postural balance of ballet dancers, characterizing visual dependency in the postural control of these athletes to maintain balance. A review of literature was performed on PubMed, SciELO, Lilacs, and Science Direct databases considering the period between 1997 and 2013, and using the descriptors balance, postural control, force plates ballet dancers, classical ballet dancers and visual afferences. Eighteen articles were considered able to provide the quantitative and qualitative data to assess the balance among those athletes, and were thus, selected. These papers were classified by Oxford level of evidence. The reviewed literature shows full consensus regarding the effect of removing visual information over postural stability according to the experience of subjects considered highly trained dancers. Studies comparing the balance of ballet dancers to other sporting techniques confirmed that they have a specific postural balance pattern. Nevertheless, in association with visual restriction, ballet dancers show a greater center of pressure dislocation and instability compared to other sports, which suggests that they have higher visual dependence to maintain balance. Ballet dancers have better static balance compared to non-trained subjects and other types of athletes, but greater visual dependence to maintain balance...

La danza envuelve integración de movimiento, equilibrio postural y aspectos relacionados al control postural. Informaciones sobre el equilibrio en bailarines son de gran importancia, pues ellos son considerados modelos de control postural. El objetivo fue revisar estudios sobre equilibrio postural estático y dinámico en bailarines, caracterizando el control y la dependencia visual de esos atletas para la manutención del equilibrio. Para eso, fue realizada una revisión en las bases de datos PubMed, SciELO, Lilacs y Science Direct, considerando el período entre 1997 y 2013, utilizando los descriptores equilibrio, control postural, plataforma de fuerzas, ballet, bailarines clásicos y aferencia visual. Fueron seleccionados 18 artículos capaces de proveer datos cuantitativos para evaluación del equilibrio en esos atletas clasificados por el nivel de evidencia científica Oxford. La literatura revisada muestra completa concordancia en cuanto al efecto de la retirada de la información visual sobre la estabilidad postural de bailarines considerados como ejecutantes altamente entrenados. Estudios mostrando la comparación del equilibrio de bailarines con otras técnicas deportivas confirmaron un estándar específico de equilibrio en esos individuos. Entre tanto, asociándose a la restricción visual, bailarines presentaron mayor desplazamiento del centro de presión comparado a otras modalidades deportivas, sugiriendo mayor dependencia visual para la manutención del equilibrio. Bailarines presentan menor oscilación postural en relación a individuos no entrenados e individuos entrenados en otras prácticas deportivas, con mayor dependencia visual para manutención del equilibrio...

Promoting integrative medicine by computerization of traditional Chinese medicine for scientific research and clinical practice: The SuiteTCM Project.

BACKGROUND: Chinese and contemporary Western medical practices evolved on different cultures and historical contexts and, therefore, their medical knowledge represents this cultural divergence. Computerization of traditional Chinese medicine (TCM) is being used to promote the integrative medicine to manage, process and integrate the knowledge related to TCM anatomy, physiology, semiology, pathophysiology, and therapy. METHODS: We proposed the development of the SuiteTCM software, a collection of integrated computational models mainly derived from epidemiology and statistical sciences for computerization of Chinese medicine scientific research and clinical practice in all levels of prevention. The software includes components for data management (DataTCM), simulation of cases (SimTCM), analyses and validation of datasets (SciTCM), clinical examination and pattern differentiation (DiagTCM, TongueTCM, and PulseTCM), intervention selection (AcuTCM, HerbsTCM, and DietTCM), management of medical records (ProntTCM), epidemiologic investigation of sampled data (ResearchTCM), and medical education, training, and assessment (StudentTCM). DISCUSSION: The SuiteTCM project is expected to contribute to the ongoing development of integrative medicine and the applicability of TCM in worldwide scientific research and health care. The SuiteTCM 1.0 runs on Windows XP or later and is freely available for download as an executable application.

Promoting integrative medicine by computerization of traditional Chinese medicine for scientific research and clinical practice: The SuiteTCM Project / 中西医结合学报

Chinese and contemporary Western medical practices evolved on different cultures and historical contexts and, therefore, their medical knowledge represents this cultural divergence. Computerization of traditional Chinese medicine (TCM) is being used to promote the integrative medicine to manage, process and integrate the knowledge related to TCM anatomy, physiology, semiology, pathophysiology, and therapy.

Statistical distribution of acupoint prescriptions for sensory-motor impairments in post-stroke subjects.

OBJECTIVE: To statistically describe the characteristics of acupoint selection for therapeutic intervention in post-stroke subjects based on pre-modern and modern literatures. METHODS: Twelve classic textbooks in Chinese medicine and fourteen research articles had their acupoints listed and organized under each author in a chronological manner. A total of 84 different acupoints were collected from pre-modern and modern authors. Descriptive analysis of the frequency counts of acupoints was performed for both groups of premodern and modern authors. Association analysis on acupoint prescriptions was performed among pre-modern, modern, and pre-modern versus modern authors. RESULTS: No significant difference was observed between premodern and modern authors regarding the frequency of acupoints grouped by channel (P=0.482) or channel nature (pre-modern: yang=76.9%, yin= 23.1%; modern: yang=77.3%, yin=22.7%; P=0.966). Considering all authors, only 1 (1.2%) acupoint (LI-4) presented the highest frequency with 12 (44.4%) authors reporting its use for sensory-motor impairments, and 49 (58.3%) acupoints were prescribed only once. CONCLUSION: It was demonstrated that pre-modern and modern authors selected channels for intervention in a similar fashion. Variability among acupoint prescriptions is higher among pre-modern authors as compared to modern works for stroke-related sensory-motor impairments.

Evaluation of the immediate effects of manual acupuncture on brachial bicep muscle function in healthy individuals and post stroke patients: a study protocol of a parallel-group randomized clinical trial.

BACKGROUND: Stroke is a morbid entity in Chinese medicine recognized for over 2 000 years with sensory-motor impairments reported by several classical authors. However, the majority of controlled clinical trials of acupuncture in the treatment of post stroke recovery failed to obtain significant long-term results on functional recovery. Moreover, contradictory results have been obtained regarding the immediate effects of acupuncture stimulation on the electrical activity of human skeletal muscles as observed using surface electromyography. These results raise the question of whether acupuncture has any effect on the neuromuscular level. This study aims to evaluate the immediate effects of manual acupoint stimulation on the electrical activity and strength of the biceps brachii of healthy individuals and patients with chronic hypertonic hemiparesis. METHODS AND DESIGN: The study proposes a single-blinded randomized clinical trial with four parallel groups. Healthy subjects and post stroke patients with chronic spastic hemiparesis will be submitted to a single acupuncture intervention puncturing either Quchi (LI11) or Tianquan (PC2). The immediate effects on muscle function will be assessed by surface electromyography and isometric force of the biceps brachii muscle as the primary outcome. Secondary outcomes comprise the frequency of patterns in each group, as well as the frequency distribution of manifestations. DISCUSSION: The proposed study design includes some improvements on common methodological issues on clinical trials with an integrative design. This study design is expected to provide new insights on the neuromuscular effects of acupuncture stimulation in healthy subjects and post stroke patients. TRIAL REGISTRATION: Brazilian Clinical Trials Registry (www.ensaiosclinicos.gov.br) in English and Portuguese in October 2011. REGISTRATION NUMBER: RBR-5g7xqh.

Intervenção osteopática em idosos e o impacto na qualidade de vida / Osteopathic intervention in the elderly and its impact on quality of life

INTRODUÇÃO: O envelhecimento evidencia a necessidade do idoso do controle das doenças e do bem-estar físico, psíquico e social. OBJETIVO: Avaliar o impacto da intervenção osteopática na qualidade de vida de idosos. MATERIAIS E MÉTODOS: Vinte e um indivíduos (72,1 ± 4,7 anos, 18 mulheres) completaram este estudo. Foi aplicado o questionário de qualidade de vida WHOQOL-bref no primeiro e sexto atendimentos no intervalo de 48 [39; 66] dias. A avaliação e o tratamento das disfunções somáticas encontradas foram feitos em todas as sessões e as técnicas de domínio osteopático foram utilizadas. Os dados foram analisados por meio do teste de Wilcoxon com significância em p < 0,05. RESULTADOS: Foi encontrada diferença significativa no domínio físico (pré-tratamento: 58,67 ± 12,91 por cento; pós-tratamento: 64,64 ± 13,75 por cento; p < 0,05). Não foram encontradas diferenças significativas nos domínios: psicológico (pré-tratamento: 63,10 ± 15,38 por cento; pós-tratamento: 64,38 ± 11,67 por cento; p = 0,846), relações sociais (pré-tratamento: 62,30 ± 14,34 por cento; pós-tratamento: 62,50 ± 12,82 por cento; p = 1,000) e meio ambiente (pré-tratamento: 52,08 ± 11,91 por cento; pós-tratamento: 52,19 ± 11,02 por cento; p = 0,806). O nível de escolaridade apresentou associação significativa com a pontuação total do questionário antes (r = 0,457; p = 0,019) e após (r = 0,380; p = 0,049) a intervenção. CONCLUSÃO: A medicina osteopática, com sua ampla abordagem, interferiu positivamente no domínio físico da qualidade de vida. Outros domínios (meio ambiente, psicológico e relações pessoais) não foram modificados pela intervenção osteopática, contribuindo para a manutenção da qualidade de vida geral.

INTRODUCTION: The aging process evidence the need to provide to the elderly either disease control and physical, psychological, and social well-being. OBJECTIVE: To evaluate the osteopathic intervention and its impact in quality of life of aged people. MATERIALS AND METHODS: Twenty-one subjects (72.1 ± 4.7 years, 18 women) were enrolled in and completed this study. The WHOQOL-bref questionnaire was applied at first and sixth session with an average time interval of 48 [39; 66] days. At each session, screening tests and treatment were performed for somatic dysfunctions; treatment techniques were selected among osteopathic domain. Data from questionnaire were analyzed with Wilcoxon test with significance established at p < 0.05. RESULTS: Significant difference was found in the physical domain (before: 58.67 ± 12.91 percent; after: 64.64 ± 13.75 percent; p < 0.05). No significant difference was found in psychological domain (before: 63.10 ± 15.38 percent; after: 64.38 ± 11.67 percent; p = 0.846), social relations (before: 62.30 ± 14.34 percent; after: 62.50 ± 12.82 percent; p = 1.000) and environment (before: 52.08 ± 11.91 percent; after: 52.19 ± 11.02 percent; p = 0.806). Educational level presented significant association with total scoring of the questionnaire before (r = 0.457; p = 0.019) and after (r = 0,380; p = 0,049) osteopathic intervention. CONCLUSION: Osteopathic medicine, in a broad approach, positively contributed to the physical domain of quality of life. Other domains (environmental, psychological, and social relations) were not modified by osteopathic intervention, resulting in unchanged overall quality of life.

Mobilização do osso pisiforme no tratamento da neuropraxia do nervo ulnar no canal de Guyon: relato de caso / Pisiform bone mobilization for treating ulnar nerve neuropraxia at Guyon's canal: case report

As neuropraxias do nervo ulnar são lesões bastante freqüentes que provocam efeitos deletérios, como diminuição de força muscular e parestesias; geralmente ocorrem no nível do epicôndilo medial e do túnel ulnar (canal de Guyon). São escassos os relatos referentes a técnicas de terapia manual para compressões do nervo ulnar no canal de Guyon. Este trabalho relata o uso da técnica de mobilização do pisiforme na compressão do nervo ulnar no canal de Guyon de um homem que sofreu luxação do punho direito aos 8 anos e, aos 25, queixava-se de um deficit para adução do dedo mínimo, que atrapalhava a realização de algumas atividades de vida diária. O paciente foi submetido a uma única sessão de mobilização articular do pisiforme. Após a aplicação da técnica, o sinal positivo do teste foi eliminado, restabelecendo-se a função de adução do 5o dedo. Embora carecendo de maior fundamentação teórica, pode-se afirmar que a técnica usada, de mobilização articular do osso pisiforme, é eficaz para melhora do quadro de paresia por neuropraxia do nervo ulnar no canal de Guyon...

A common ulnar nerve neuropraxia is lesion that may result in muscle strength decrease and/or paresthesia; it usually takes place at medial epicondylelevel and the ulnar tunnel (Guyon’s canal). Studies on manual therapy techniques for ulnar nerve compression in Guyon’s canal are scarce. This paper reports the use of a technique of pisiform bone mobilization for relieving ulnar nerve compression in Guyon’s canal, in a man who had suffered a luxation of the right wrist at the age of 8 and, at 25, complained of adduction deficit of the fifth finger that interfered in his daily life activities. He was submitted to one session of pisiform mobilization; after the session, the positive test sign was eliminated, thus restoring the fifth finger function. Though lacking further grounding, it may be said that the technique used, of mobilizing the pisiform bone joint, is effective to restore normal function after ulnar nerve compression at the Guyon’s canal...