Patients with patellofemoral pain have lower soft tissue flexibility of the kinetic chain compared to healthy controls: A case-control study.

INTRODUCTION: Patellofemoral pain (PFP) is a common musculoskeletal condition. Lower limb range of motion (LLROM) evaluates soft tissue flexibility over multiple joints as part of the kinetic chain. The aims were to study: 1) the reliability of a new LLROM test; 2) differences in LLROM between PFP patients and controls; and 3) the relationship between LLROM and pain-free knee function. METHODS: Patients with PFP and matched controls were recruited from a university campus and private physiotherapy clinics, while observers were blinded for health status. Testing LLROM for maximal knee flexion and hip adduction and the sum of these (total ROM) were performed. Measures of reliability (ICC2,1) were established. Univariate linear regression between LLROM and health status and multivariate analysis between LLROM and knee function were performed. RESULTS: Patients (n = 32 (7 male/25 female, age = 22, BMI = 22.7)) and controls (n = 32 (7 male/25 female, age = 20, BMI = 22.3)) were included. The ICC's for intra- and interobserver reliability ranged from 0.83 (95%CI 0.30-0.93) to 0.89 (0.72-0.95). Symptomatic legs had 7°(3-11, p = 0.014) lower knee flexion, 6°(4-8, p ≤ 0.001) lower hip adduction and 13°(8-17, p ≤ 0.001) lower total ROM than non-symptomatic legs. Multivariate analysis revealed an association between total ROM and pain-free knee function (R2 = 0.438, F = 6.544, p ≤ 0.001). CONCLUSIONS: The new LLROM test was found to be reliable. Patients with PFP had lower LLROM, which was associated with impaired pain-free knee function. Whether improving soft tissue flexibility results in enhanced pain-free knee function should be the subject of future research.

[The effectiveness of the use of non-drug treatment complexes and their impact on quality of life indicators, the psychosomatic status of patients with residual brucellosis with lesions of the musculoskeletal system]. / Effektivnost' primeneniya kompleksov nemedikamentoznogo lecheniya i ikh vliyanie na pokazateli kachestva zhizni, psikhosomaticheskii status patsientov s rezidual'nym brutsellezom s porazheniem oporno-dvigatel'nogo apparata.

Secondary focal lesions of the musculoskeletal system that occur with residual brucellosis are characterized by a variety of localizations and simultaneous damage to several groups of joints, a deterioration in the quality of life and a high percentage of disability in people of working age. At present, there are many different schemes for the treatment and rehabilitation of developed residual brucellosis, in which, in addition to the "basic" course, including systemic anti-inflammatory therapy, much attention is paid to physiotherapeutic procedures, but the choice of the most effective treatment tactics remains an unresolved problem. PURPOSE OF THE STUDY: To determine the effectiveness of the use of options for non-drug methods of treatment in the complex rehabilitation of patients with residual brucellosis with lesions of musculoskeletal system. MATERIAL AND METHODS: Study included 140 patients treated for osteoarthritis of brucellosis etiology, who were divided into three groups matched by age, gender, average duration and stage of the disease, place of residence. Patients of all groups received standard medical treatment and different sets of physiotherapeutic procedures: in the 1st group (45 patients) - electrophoresis of novocaine on the knee joints, therapeutic massage of the cervical-collar zone; in the 2nd group (45 patients) - magnetotherapy on the area of the knee joints, sinusoidal modulated currents (SMC) on the shoulder joints, decimeter wave therapy of the lumbosacral zone (DMW-therapy); in the 3rd group (50 patients) - magnetic laser therapy on the shoulder, elbow, knee joints, therapeutic massage of the lumbosacral zone. Complaints, clinical symptoms, goniometry results, and blood parameters were assessed: ESR, C-reactive protein, fibrinogen, before the start of treatment, immediately after the course of rehabilitation, and after 6 and 12 months. At the same time, testing was carried out according to the SF-36 Health Status Survey questionnaire to monitor the quality of life. RESULTS: The applied scheme of drug treatment in combination with magnetic laser therapy and therapeutic massage in the 3rd group made it possible to achieve a significant reduction in arthralgic syndrome, a statistically significant increase in the range of motion in the joints, positive dynamics of laboratory data and an improvement in the psychological state and quality of life of patients compared to other observation groups. CONCLUSION: The results of the study indicate the high efficiency of magnetic laser therapy in the complex treatment of patients with residual brucellosis with lesions of the musculoskeletal system.

Función de las vitaminas D, E y K en condiciones especiales: salud y enfermedad / Function of vitamins D, E and K in Special Conditions: Health and Disease

Resumen: Antecedentes: se cuenta con recomendaciones de energía y nutrientes para población sana; sin embargo, a nutrientes como las vitaminas D, E, K se les atribuyen funciones importantes en diferentes situaciones de salud. Objetivo: explorar la efectividad de dosis dietarias y de suplementos de las vitaminas D, E y K en condiciones especiales de salud y enfermedad. Materiales y métodos: se realizó una búsqueda de documentos en las bases de datos PubMed, Scopus, ScienceDirect, Lilacs, SciELO, Ebsco y en textos especializados utilizando palabras clave: "vitamin D", "vitamin E", "vitamin K", "health", "disease", "nutritional recommendations". Resultados: hay un importante número de estudios y revisiones sistemáticas que contribuyen a la evidencia y la discusión en cuanto a efecto, dosis y tiempo, los cuales arrojaron tanto desenlaces positivos como nulos. Conclusión: los efectos de la vitamina D dietaria en la salud ósea están bien documentados, y sus suplementos acompañados de calcio están indicados en grupos poblacionales con riesgo de osteoporosis, pero no en otras condiciones clínicas. No hay suficiente evidencia sobre los beneficios de la vitamina E en el manejo o prevención de enfermedad hepática, cardiovascular o cáncer. La vitamina K podría ser importante en la salud ósea, sobre otras condiciones clínicas.

Abstract: Background: There are energy and nutrient recommendations for a healthy population; however, important functions in different health situations are attributed to nutrients such as vitamins D, E, K, E and K. Objective: To explore the effectiveness of dietary doses and supplements of vitamins D, E and K in special conditions of health and disease. Materials and Methods: A document search was carried out in the PubMed, Scopus, Sciencedirect, Lilacs, Scielo and Ebsco databases, and in specialized texts using keywords: "vitamin D", "vitamin E", "vitamin K", "Health", "disease", "nutritional recommendations". Results: There is a significant number of studies and systematic reviews that contribute to the evidence and discussion regarding effect, dose and time, which yielded both positive and null outcomes. Conclusion: The effects of dietary vitamin D in bone health are well documented and its supplementation accompanied by calcium is indicated in population groups at risk for osteoporosis, but not in other clinical conditions. There is insufficient evidence on the benefits of vitamin E in the management or prevention of liver disease, cardiovascular disease, or cancer. Vitamin K could be important in bone health, over other clinical conditions.

[Correlation analysis of cervical spine dysfunction, pain and muscle strength in office workers].

Objective: To expore the correlation between neck disability, neck pain and muscle strength in cervical pondylosis of office worker, and to provide scientific basis for the prevention and treatment of cervical spondylosis. Methods: In April 2021 ,234 patients with cervical spondylotic myelopathy treated in the Subsidiary Rehabilitation Hospital of Fujian University of Traditional Chinese Medicine from April 2015 to April 2017 were selected, the correlation between Neck Disability Index (NDI) score, neck pain and muscle strength was analyzed using the Spearman rank correlation method. Mann-Whitney U test was used to compare the difference of maximum muscle strength of isometric contraction. Results: NDI score was negatively correlated with neck flexion, extension, and muscle strength in the left and right flexion directions (r(s)=-0.164, -0.169, -0.222, -0.176, P=0.012, 0.010, 0.001 , 0.007). In mild and moderate functional disorder patients, the muscle strength in flexion, extension and left and right flexion direction was greater, the difference was statistically significant (P <0.01). Conclusion: There is a negative correlation between cervical functional disorder and cervical muscle strength in office workers, suggesting that strengthening cervical muscle strength may be a way to improve cervical spine function.

Therapeutic Yoga for the Management of Chronic Nonspecific Neck Pain: Current Evidence and Mechanisms.

Chronic nonspecific neck pain (CNNP), which is neck pain in the absence of attributable structural and neurological findings, is often challenging for medical and rehabilitation professionals to treat. Conventional treatments such as medications and physical therapy often fail to provide lasting relief, which leads patients to pursue complementary therapies such as yoga. This review discusses the evidence from nine studies, including four randomized controlled trials, which suggests that a supervised yoga program may decrease pain intensity, disability, and mood symptoms in adults with CNNP. Cervical range of motion and quality of life (both physical and mental) may also improve with yoga intervention, although this is less consistent across studies. Evidence of yoga's superiority to other exercise-based practices such as pilates was conflicting. Adverse effects of yoga, such as exacerbation of neck pain, were relatively uncommon, minor, and often transient. This article also comprehensively reviews the pathophysiology of CNNP, therapeutic mechanisms of yoga, and limitations in the evidence (including risk-of-bias assessment). Future studies should attempt to: (1) compare the effectiveness of different lineages of yoga for individuals with CNNP, (2) determine the optimal length and duration of these yoga interventions, (3) better characterize the physical and psychological mechanisms of yoga, (4) compare yoga to other exercise- and mindfulness-based practices, (5) evaluate the effect of yoga on sleep in the CNNP population, and (6) explore the applicability/efficacy of virtual yoga instruction.

Correlation analysis of cervical spine dysfunction, pain and muscle strength in office workers / 中华劳动卫生职业病杂志

Objective: To expore the correlation between neck disability, neck pain and muscle strength in cervical pondylosis of office worker, and to provide scientific basis for the prevention and treatment of cervical spondylosis. Methods: In April 2021 ,234 patients with cervical spondylotic myelopathy treated in the Subsidiary Rehabilitation Hospital of Fujian University of Traditional Chinese Medicine from April 2015 to April 2017 were selected, the correlation between Neck Disability Index (NDI) score, neck pain and muscle strength was analyzed using the Spearman rank correlation method. Mann-Whitney U test was used to compare the difference of maximum muscle strength of isometric contraction. Results: NDI score was negatively correlated with neck flexion, extension, and muscle strength in the left and right flexion directions (r(s)=-0.164, -0.169, -0.222, -0.176, P=0.012, 0.010, 0.001 , 0.007). In mild and moderate functional disorder patients, the muscle strength in flexion, extension and left and right flexion direction was greater, the difference was statistically significant (P <0.01). Conclusion: There is a negative correlation between cervical functional disorder and cervical muscle strength in office workers, suggesting that strengthening cervical muscle strength may be a way to improve cervical spine function.

Utilidad de la resonancia magnética como estudio imagenológico complementario al ultrasonido en el diagnóstico de malformaciones fetales. Experiencia de dos centros de Medicina Materno Fetal de Latinoamérica / Usefulness of magnetic resonance as a complementary imaging study to ultrasound in the diagnosis of fetal malformations. Experience in two Maternal-fetal Medicine centers in Latin America

Resumen OBJETIVO: Conocer los aportes de la resonancia magnética, como estudio complementario al ultrasonido, en el diagnóstico de malformaciones fetales en el sistema nervioso central, musculoesquelético y tórax en dos unidades de Medicina Materno Fetal. MATERIALES Y MÉTODOS: Estudio retrospectivo, observacional y comparativo, de corte transversal, efectuado con base en la revisión de las historias clínicas registradas durante tres años de pacientes con más de 18 semanas de embarazo remitidas a la Unidad de Medicina Materno Fetal del Hospital San José y la Clínica Colsubsidio por alguna malformación estructural fetal identificada en el sistema nervioso central, musculoesquelético y tórax diagnosticada con base en la ultrasonografía. RESULTADOS: Se revisaron 109 historias clínicas de pacientes embarazadas con fetos con diagnóstico de malformación congénita por ultrasonido. Las indicaciones más frecuentes fueron: anormalidades en el sistema nervioso central en 61.5%; hidrocefalia no comunicante en 36.6% por ultrasonido y 21% por resonancia magnética, seguida de las del tórax con 40.4% por ultrasonido y 36.7% por resonancia magnética y malformaciones del sistema musculoesquelético con 20.1% por ultrasonido y 2.8% por resonancia magnética. La concordancia diagnóstica entre el ultrasonido y el diagnóstico posnatal fue del 66% y el de la resonancia magnética de 76%. En comparación con el ultrasonido inicial la resonancia magnética aumentó la frecuencia de diagnóstico de malformación fetal. CONCLUSIÓN: La resonancia magnética, complementaria al diagnóstico por ultrasonido de malformaciones congénitas, fue más notable en los sistemas nervioso central y musculoesquelético donde permitió mejorar la caracterización de las alteraciones detectadas en el ultrasonido.

Abstract OBJECTIVE: To know the contributions of magnetic resonance imaging, as a complementary study to ultrasound, in the diagnosis of fetal malformations in the central nervous system, musculoskeletal and thorax in two units of Maternal Fetal Medicine. MATERIALS AND METHODS: Retrospective, observational and comparative cross-sectional study, based on the review of medical records recorded during three years of patients with more than 18 weeks of pregnancy referred to the Maternal Fetal Medicine Unit of Hospital San José and Clínica Colsubsidio, for any fetal structural malformation identified in the central nervous system, musculoskeletal and thorax diagnosed based on ultrasonography. RESULTS: We reviewed 109 clinical histories of pregnant patients with fetuses diagnosed with congenital malformation by ultrasound. The most frequent indications were abnormalities of the central nervous system in 61.5%: non-communicating hydrocephalus in 36.6% by ultrasound and 21% by MRI, followed by those of the thorax with 40.4% by ultrasound and 36.7 by MRI and malformations of the musculoskeletal system 20.1% by ultrasound and 2.8% by MRI. The diagnostic agreement between ultrasound and postnatal diagnosis was 66% and that of MRI was 76%. Compared to initial ultrasound, MRI increased the frequency of diagnosis of fetal malformation. CONCLUSION: MRI, complementary to ultrasound diagnosis of congenital malformations, was more notable in the central nervous and musculoskeletal systems where it allowed improving the characterization of the alterations detected by ultrasound.

Localised manual therapy treatment has a preferential effect on the kinematics of the targeted motion segment.

AIM: An observational cohort study to determine whether localised manual therapy results in a preferential increase in mobility of the targeted motion segment. METHOD: Eighteen participants with mechanical neck pain had three MRIs of their cervical spine. The first two were taken prior to treatment in neutral and at the end of active rotation in their more limited rotation. Participants received localised manual therapy targeting a motion segment deemed to be relevant to their presentation until either their range increased by > 10° or 8 min, whichever came first. A third MRI was performed immediately after treatment with their head in the same rotated position as pre-treatment. In the images, each vertebra was segmented using a semi-automated process. Movement between neutral and rotated positions was calculated as Euler angles and distance of facet translations for each motion segment. RESULTS: Rotation and lateral flexion at the targeted location increased by 40% (mean 0.86° (CI: 0.24-1.48) and 15% (mean 0.52° (CI: 0.17-1.21) respectively with only the CIs for rotation not containing zero. The mean changes for the non-targeted locations were less than 0.1° for each axis and all CIs contained zero. Facet translations at the targeted location increased by 25% (0.419 mm) and decreased by >4% (>0.01 mm) at the untreated locations but the wide CIs both contained zero. CONCLUSION: Localised manual therapy seems to have a preferential effect on mobility of the targeted motion segment. The findings support considering segmental dysfunction in clinical reasoning and the use of specifically targeted manual therapy interventions.

Effects of Exergames and Protein Supplementation on Body Composition and Musculoskeletal Function of Prefrail Community-Dwelling Older Women: A Randomized, Controlled Clinical Trial.

This study aimed to investigate the effects of exergames and protein supplementation on the body composition and musculoskeletal function of pre-frail older women. Methods: A randomized controlled clinical trial was conducted with 90 pre-frail older women (71.2 ± 4.5 years old) divided into five groups: control (CG); exergames training (ETG); protein supplementation (PSG); exergames combined with protein supplementation (ETPSG); exergames combined with isoenergetic supplementation (ETISG). The primary outcomes were pre-frailty status, body composition (appendicular muscle mass (ASM); appendicular muscle mass index (ASMI)) assessed by dual energy X-ray absorptiometry and gastrocnemius muscle architecture via ultrasound. Secondary outcomes were protein intake, plasma levels of interleukin (IL)-6, plantar and dorsiflexion isokinetic peak torque, and handgrip strength (HS). Data were analyzed using an ANOVA mixed model test and Bonferroni post hoc test (p < 0.05). The ETG showed a reduction of ASM (16.7 ± 3.4 vs. 16.1 ± 3.3 kg; Δ = -0.5; p = 0.02; d = 0.26) and ASMI (6.8 ± 0.9 vs. 6.5 ± 0.9 kg; Δ = -0.2; p = 0.03; d = 0.35), without changing ASM in other groups. The average protein intake in the supplemented groups (PSG and ETPSG) was 1.1 ± 0.2 g/kg/day. The dorsiflexion peak torque increased 11.4% in ETPSG (16.3 ± 2.5 vs. 18.4 ± 4.2 Nm; p = 0.021; d = -0.58). The HS increased by 13.7% in ETG (20.1 ± 7.2 vs. 23.3 ± 6.2 kg, Δ = 3.2 ± 4.9, p = 0.004, d = -0.48). The fatigue/exhaustion reduced by 100% in ETG, 75% in PSG, and 100% in ETPSG. Physical training with exergames associated with protein supplementation reversed pre-frailty status, improved the ankle dorsiflexors torque, and ameliorated fatigue/exhaustion in pre-frail older women.

Effects of Manual Therapy on the Diaphragm in the Musculoskeletal System: A Systematic Review.

OBJECTIVES: To analyze the effects at the musculoskeletal level of manual treatment of the diaphragm muscle in adults. DATA SOURCES: Systematic review using 4 databases: PubMed, Science Direct, Web of Science, and Scopus. STUDY SELECTION AND DATA EXTRACTION: Two independent reviewers applied the selection criteria and assessed the quality of the studies using the Physiotherapy Evidence Database scale for experimental studies. A third reviewer intervened in cases where a consensus had not been reached. A total of 9 studies were included in the review. DATA SYNTHESIS: Manual therapy directed to the diaphragm has been shown to be effective in terms of the immediate increase in diaphragmatic mobility and thoracoabdominal expansion. The immediate improvement in the posterior muscle chain flexibility test is another of the most frequently found findings in the evaluated studies. Limited studies show improvements at the lumbar and cervical level in the range of motion and in pain. CONCLUSION: Manual diaphragm therapy has shown an immediate significant effect on parameters related to costal, spinal, and posterior muscle chain mobility. Further studies are needed, not only to demonstrate the effectiveness of manual diaphragm therapy in the long-term and in symptomatic populations, but also to investigate the specific neurophysiological mechanisms involved in this type of therapy.

Muscle, endocrine, and immunological markers of frailty in older people.

OBJECTIVE: To analyze muscle, endocrine, and immunological markers that influence frailty in older people assisted in primary care. MATERIALS AND METHODS: Cross-sectional, analytical, and probabilistic study were linked to the institutional research "Integrated Health Care for Older People." The study population consisted of males and females aged 60 years or more and assisted in primary health care. The research protocol included an interview and physical examination to evaluate the frailty criteria. Analysis of the following were done: serum calcium and creatinine as muscle markers; vitamin D, parathyroid hormone, and insulin-like growth factor - 1 as endocrine markers; and interleukin-6, C-reactive protein, leukocytes, and neutrophil-lymphocyte ratio as immunological markers. Statistical analysis included the Mann-Whitney test to compare means, and linear regression to analyze the relationship between dependent and independent variables. RESULTS: There was a relationship between creatinine and prediction of weight loss (p < 0.001), leukocytes and prediction of handgrip strength (p = 0.022), interleukin-6 and prediction of energy expenditure (p = 0.026), and vitamin D and prediction of gait time (p = 0.036). Also, sex influenced handgrip strength (p < 0.001), and age influenced handgrip strength (p < 0.001), gait time (p < 0.001) and energy expenditure (p < 0.001). CONCLUSION: The joint use of muscle, endocrine, and immunological markers may be useful to diagnose frailty and to propose resolutive interventions to reduce negative outcomes for older people.

Musculoskeletal disorders of older adults: an integrative literature review / Lesiones musculosqueléticas en cuidadores de ancianos: revisión integradora de la literatura / Agravos ao sistema musculoesquelético do cuidador de idosos: revisão integrativa da literatura

ABSTRACT Objective: to analyze in available scientific literature what problems are caused to the musculoskeletal system of caregivers of older adults in the home environment. Methods: an integrative literature review indexed in the PubMed, CINAHL, Web of Science, SCOPUS, BDENF, LILACS and SciELO databases. Results: the sample totaled 17 studies that showed three thematic categories: Care overload for caregivers' health; Caregivers' physical illness; Caregiver self-neglect. Conclusion: the evidence identified health problems for caregivers of older adults, regarding the musculoskeletal system, demonstrating the importance of considering intervention strategies that provide guidelines for self-care guidelines, in order to prevent musculoskeletal complications resulting from older adults' care activities at home.

RESUMEN Objetivo: analizar, en la literatura científica disponible, cuáles son las lesiones causadas al sistema musculoesquelético del cuidador de ancianos en el ámbito del hogar. Métodos: revisión integrativa de la literatura, indexada en las bases de datos PubMed, CINAHL, Web of Science, SCOPUS, BDENF, LILACS y SciELO. Resultados: la muestra totalizó 17 estudios que mostraron tres categorías temáticas: Sobrecarga de cuidados para la salud del cuidador; Enfermedad física del cuidador; Auto-negligencia del cuidador. Conclusión: la evidencia identificó problemas de salud para el cuidador de ancianos con respecto al sistema musculoesquelético, demostrando la importancia de considerar estrategias de intervención que brinden pautas para pautas de autocuidado, con el fin de prevenir las complicaciones musculoesqueléticas derivadas de las actividades de atención domiciliaria de los ancianos.

RESUMO Objetivo: analisar, na literatura científica disponível, quais os agravos causados ao sistema musculoesquelético do cuidador de idosos no ambiente domiciliar. Métodos: revisão integrativa da literatura, indexada nas bases de dados PubMed, CINAHL, Web of Science, SCOPUS, BDENF, LILACS e SciELO. Resultados: a amostra totalizou 17 estudos que evidenciaram três categorias temáticas: Sobrecarga do cuidado para a saúde do cuidador; Adoecimento físico do cuidador; Autonegligência do cuidador. Conclusão: as evidências identificaram agravos na saúde do cuidador de idosos no que tange ao sistema musculoesquelético, demonstrando a importância em considerar estratégias de intervenções que forneçam diretrizes para orientações de autocuidado, com intuito de prevenir as complicações osteomusculares decorrentes das atividades de cuidado ao idoso no domicílio.

Effects of Different Neck Manual Lymphatic Drainage Maneuvers on the Nervous, Cardiovascular, Respiratory and Musculoskeletal Systems in Healthy Students.

The aim of this study is to describe the short-term effects of manual lymph drainage (MLD) isolated in supraclavicular area in healthy subjects. A 4-week cross-sectional, double-blinded randomized clinical trial was conducted. Participants: 24 healthy participants between 18 and 30 years old were recruited from Universidad Europea de Madrid from December 2018 to September 2019. A total of four groups were studied: control, placebo, Vodder, and Godoy. The order of the interventions was randomized. Resting Heart Rate and Oxygen Saturation, blood pressure, pressure pain threshold of trapezius muscle, respiratory rate, range of active cervical movements were measured before and after every intervention. All the participants fulfilled four different interventions with a one-week-wash-out period. No statistically significant differences were found between groups in descriptive data; neither in saturation of oxygen, diastolic blood pressure and cervical range of motion. Significant differences were found in favor of Vodder (p = 0.026) in heart rate diminution and in cardiac-rate-reduction. A significant difference in respiratory rate diminution is found in favor of the Godoy group in comparison with the control group (p = 0.020). A significant difference is found in favor of the Godoy group in systolic blood pressure decrease (p = 0.015) even in pressure pain threshold (p < 0.05). MLD decreases systolic blood pressure in healthy participants. However, it does not produce any changes in other physiologic outcomes maintaining physiologic values, which may suggest the safety of the technique in patients suffering from other pathologies.

A Prospective Randomized Double-blind study of silicone gel plus Herbal Extracts Versus Placebo in Pre-sternal hypertrophic scar prevention and amelioration.

OBJECTIVE: Post-surgical hypertrophic scar is more frequently reported in Asians. Many modalities can treat scars but there have not been any publications to define the efficacy of silicone gel plus herbal extracts for scar prevention or amelioration. DESIGN: 48 patients, who underwent median sternotomy were randomized and double-blinded to 2 groups to use topical silicone gel plus herbal extract gel or placebo for 6 months. Patients were treated either with topical silicone gel plus herbal extract gel or control using only placebo for 6 months. The scars were observed by experienced plastic surgeons using the Vancouver scar scale. SETTING: A single tertiary care center at Khon Kaen University. PATICIPANTS: 48 patients who underwent median sternotomy were enrolled in this study. All patients were aged over 18 years. All the wounds were sutured with polyglycolic 4/0 subcuticular suture material and did not receive other scar management before participating in this study. INTERVENTION: The silicone gel plus herbal extract gel (Bangkok Botanica, Bangkok, Thailand) in semi-liquid form was formulated from 15% Herbal extract (Allium Cepa extract, Centella Asiatica extract, Aloe Vera extract and Paper Mulberry extract), 50% polydemethysiloxane, 30% cyclopentasiloxane and 5% silica. The placebo gel was a composite of water, acrylate, C10-30 alkyl acrylate cross-polymer, polysorbate 20 and fragrance that was similar in color and consistency as that of the active gel and packed in the similar sealed packages. MAIN OUTCOME MEASURES: The scar was assessed using the Vancouver scar scale to determine pigmentation, vascularity, pliability and height. RESULTS: the study showed the silicone gel plus herbal extract gel could improve scar amelioration in height (p = 0.005) and pliability (p < 0.001) when compared to the placebo. The vascularity and pigmentation showed improvement using silicone gel plus herbal extracts but the improvement was not statistically significant. CONCLUSION: The silicone gel plus herbal extracts gel was effective for scar improvement in median sternotomy wounds.

Platelet-Rich Fibrin and its Emerging Therapeutic Benefits for Musculoskeletal Injury Treatment.

New therapies that accelerate musculoskeletal tissue recovery are highly desirable. Platelet-rich fibrin (PRF) is a leukocyte- and platelet-rich fibrin biomaterial that acts as a binding site for both platelets and growth factors. Through increasing the local concentration of growth factors at specific tissues, PRF promotes tissue regeneration. PRF has been frequently used in combination with bone graft materials to reduce healing times and promote bone regeneration during maxillofacial surgery. However, its benefits during muscle repair and recovery are less well-documented. Here, we perform a narrative review on PRF therapies and muscle injuries to ascertain its beneficial effects. We reviewed the factors that contribute to the biological activity of PRF and the published pre-clinical and clinical evidence to support its emerging use in musculoskeletal therapy. We include in vitro studies, in vivo animal studies and clinical articles highlighting both the success and failures of PRF treatment. PRF can promote the healing process when used in a range of orthopaedic and sports-related injuries. These include cartilage repair, rotator cuff surgery and anterior cruciate ligament surgery. However, conflicting data for these benefits have been reported, most likely due to inconsistencies in both PRF preparation protocols and dosing regimens. Despite this, the literature generally supports the use of PRF as a beneficial adjuvant for a range of chronic muscle, tendon, bone or other soft tissue injuries. Further clinical trials to confirm these benefits require consistency in PRF preparation and the classification of a successful clinical outcome to fully harness its potential.

Crochetagem miofascial no tratamento de cicatrizes de pacientes com sintomas musculoesqueléticos / Myofascial crocheting in the treatment of scars of patients with musculoskeletal symptoms

O Brasil apresenta altas taxas de cesariana, uma das maiores do mundo. Com essa predominância, ocorre consequentemente o aumento das cicatrizes. A técnica de crochetagem tem como objetivo tratar tensões musculares e fasciais, liberando aderências encontradas em patologias ortopédicas. O objetivo deste trabalho foi avaliar o efeito da crochetagem miofascial sobre a intensidade de dor, sensibilidade, amplitude de movimento e temperatura de superfície, quando aplicada sobre cicatriz de cesariana. Para o estudo foram selecionadas 26 mulheres, matriculadas em cursos da área da saúde da universidade, com idade ≥ 18 anos, que realizaram tal cirurgia. As mesmas foram avaliadas e receberam aplicação da técnica, retornando no dia subsecutivo para a reavaliação. A flexibilidade foi avaliada pelo teste de "Teste do Sentar e Alcançar", avaliação da dor do local através da algometria e para análise térmica foi utilizado um sistema imageador. Os resultados demonstraram uma diminuição da intensidade de dor (p = 0,0001), dor ao movimento (p = 0,0001), flexibilidade (p = 0,01) e a avaliação da temperatura no local dos sintomas não teve alterações (p = 0,70). A crochetagem miofascial contribuiu para a diminuição da sensação de dor, assim como a sensibilidade vertebral correspondente ao dermátomo, e foi observado um ganho considerável na flexibilidade da amostra estudada. (AU)

Brazil has high cesarean rates, one of the largest in the world. With this predominance, consequently, the scars increase. The technique of crocheting aims to treat muscular and fascial tensions, releasing adhesions found in orthopedic pathologies. The objective of this study was to evaluate the effect of myofascial crocheting on pain intensity, sensitivity, range of motion and surface temperature when applied on cesarean section. For the study, 26 women, students in health care courses, aged ≥ 18 years, who underwent cesarean surgery were evaluated, before and after 24 hours of the application of the technique. We assessed pain, with algometry and numerical scale, flexibility, with tape measure by the test of sit reaching and vascular changes and by thermography. For statistical analysis, the T-Student and Wilcoxon tests were used for parametric and non-parametric variables. The level of significance was 5%. The results showed a decrease in pain complaints in general (p = 0.0001), pain on movement (p = 0.0001), pain sensitivity (p = 0.005), flexibility (p = 0.01) did not change (p = 0.70). Myofascial sizing contributed to the reduction of reported pain sensation and movement, improved spinal pain sensitivity in the corresponding dermatome and increased overall flexibility in the studied sample.(AU)

How does yoga reduce stress? Embodied cognition and emotion highlight the influence of the musculoskeletal system.

Yoga is an increasingly popular activity, perhaps because of its association with stress reduction and relaxation - an association that is generally supported by empirical evidence. Understanding of the mediating variables is, however, limited. Given that, the purpose of this paper is to present a theoretical perspective that encourages systematic research regarding the relationship between yoga, stress, and musculoskeletal activity. This embodied perspective parallels popular interest in the mind-body connection and emphasizes the influence of body position on thinking as well as emotion. Those influences take on added meaning in the context of the Cognitive Appraisal Theory and the Biopsychosocial Model of Challenge and Threat. Investigations of embodied cognition suggest that yoga may reduce stress by affecting the way individuals appraise stressors. The combination of body position and common components of yoga practice may also contribute to that effect, particularly when considering thoughts about the self and feelings of confidence. Findings regarding embodied emotion make a similar contribution to understanding the implications of previous research findings and common yoga practices. Considering yoga and stress from an embodied perspective also highlights the role of the musculoskeletal system in the stress process, leading to the question of whether yoga influences stress by directly influencing the musculoskeletal system, indirectly by influencing awareness of that system, or through a combination of the two. Those questions, in turn, highlight the importance of expanding investigations of psychological processes, body position, musculoskeletal activity during yoga, and the interactions between those variables.

Revisiting Avicenna's (ad 980-1037) Anatomical Concepts of the Musculoskeletal and Peripheral Nervous Systems in the Canon of Medicine

Avicenna, as he is known in the West, was a famous Persian Muslim physician and influential philosopher-scientist of the medieval Islamic world. He wrote and compiled the Canon of Medicine text, a book which was adopted as the main text of medicine at the most Persian and Western universities. The book consists of basic medical sciences, applied clinical sciences and pharmacology. In the current study, we present an analysis of the anatomy of the musculoskeletal and peripheral nervous systems as viewed by Avicenna in the Canon of Medicine, and compare them with the relevant modern literature.

Long-Term Dietary Intake of Chia Seed Is Associated with Increased Bone Mineral Content and Improved Hepatic and Intestinal Morphology in Sprague-Dawley Rats.

Chia seeds (Salvia hispanica) provide an unusually high content of α-linolenic acid with several potential health benefits, but few studies have examined the long-term intake of n-3 fatty acid-rich plant foods such as chia. In this work, we investigated some of the effects of a diet containing 10% chia seeds versus a conventional isocaloric diet for 10 and 13 months on body measurements, musculoskeletal system, the liver, and the intestines of 20 male Sprague-Dawley rats assigned into two groups. The n-6/n-3 ratios for the control and chia diets were 7.46 and 1.07, respectively. For the first 10 months of the diet, the body parameters and weights were similar, but at 13 months, the bone mineral content (BMC) of the chia-fed rats was significantly higher than that of the controls whether in total or proximal areas of the left tibia. Also, significant positive correlations were found between the age of the chia group and the bone mineral density, BMC, weight of the musculoskeletal system, final body weight, and skin weight. Liver and intestinal examinations showed improved morphology associated with lower lipid deposit in hepatocytes and increased intestinal muscle layers and crypt size in the chia group. This study provides new data suggesting the potential benefits associated with the long-term intake of chia seeds.

A computer vision-based system for monitoring Vojta therapy.

A neurological illness is t he disorder in human nervous system that can result in various diseases including the motor disabilities. Neurological disorders may affect the motor neurons, which are associated with skeletal muscles and control the body movement. Consequently, they introduce some diseases in the human e.g. cerebral palsy, spinal scoliosis, peripheral paralysis of arms/legs, hip joint dysplasia and various myopathies. Vojta therapy is considered a useful technique to treat the motor disabilities. In Vojta therapy, a specific stimulation is given to the patient's body to perform certain reflexive pattern movements which the patient is unable to perform in a normal manner. The repetition of stimulation ultimately brings forth the previously blocked connections between the spinal cord and the brain. After few therapy sessions, the patient can perform these movements without external stimulation. In this paper, we propose a computer vision-based system to monitor the correct movements of the patient during the therapy treatment using the RGBD data. The proposed framework works in three steps. In the first step, patient's body is automatically detected and segmented and two novel techniques are proposed for this purpose. In the second step, a multi-dimensional feature vector is computed to define various movements of patient's body during the therapy. In the final step, a multi-class support vector machine is used to classify these movements. The experimental evaluation carried out on the large captured dataset shows that the proposed system is highly useful in monitoring the patient's body movements during Vojta therapy.