INTRODUCTION: Submaximal field walking tests are easy to apply and low cost, but it is necessary to standardize their application, especially in the pediatric population. The feasibility and its use in patients with congenital heart disease have been studied. To verify which are the submaximal field walking tests applied in the cardiopulmonary assessment of children and adolescents with CHD and to verify if they are being performed as recommended by the standardization protocols/guidelines. METHODS: Literature review through a search in six electronic databases, structured in PICO format, without date restrictions. Looking for studies that used submaximal field walking tests in children and adolescents with congenital heart disease aged 5 to 18 years. Methodological quality, effectiveness and safety and risk of bias were assessed. RESULTS: Five studies met the eligibility criteria with a sample of 160 individuals with congenital heart disease, and all used the six-minute walk test. Note that different methodologies and modifications are used. Only the clinical trial showed good methodological quality.Four studies had low risk of bias and one study had moderate risk. CONCLUSION: Although the six-minute walk test is the only test used as a field test found in our research, there is no standardization in the application of the test, making it difficult to compare the results. In this sense, reducing the limitations and heterogeneity in the application of the test will enable more concrete outcomes and facilitate their reproduction in clinical practice.
BACKGROUND: Temporomandibular disorder (TMD) is an umbrella term encompassing various clinical complaints involving the temporomandibular joints, masticatory muscles, and/or associated orofacial structures. Myogenous TMDs are the most frequent cause of chronic orofacial pain. Musculoskeletal pain is commonly associated with myofascial trigger points (MTPs), for which dry needling (DN) is a routine treatment. OBJECTIVE: To investigate muscle oxygenation and pain immediately after DN application on an MTP in the masseter muscle of patients with myogenous TMDs. METHODOLOGY: Masseter muscle oxygen tissue saturation indices (TSI%) were assessed by near-infrared spectroscopy (NIRS) pre- and post-interventions by a randomized, controlled, double-blind, crossover DN/Sham clinical trial (primary outcome). Pain was investigated by the visual analog scale (VAS). In total, 32 individuals aged from 18 to 37 years who were diagnosed with myogenous TMD and myofascial trigger points in their masseter muscles participated in this study. Relative deltas for the studied variables were calculated. Data normality was tested using the Shapiro-Wilk test. According to their distribution, data were analyzed by two-way ANOVA and the Student's t-, and Mann-Whitney tests. Statistical analyses were performed using Prism® 5.0 (GraphPad, USA). RESULTS: We found a significant difference (2,108% vs. 0,142%) between masseter muscle TSI% deltas after the DN and Sham interventions, respectively (n=24). We only evaluated women since men refused to follow NIRS procedures. Pain increased immediately after DN (n=32, 8 men), in comparison to Sham delta VAS. CONCLUSION: These findings show an increase in tissue oxygen saturation in the evaluated sample immediately after the DN intervention on the MTP of patients' masseter muscle. Pain may have increased immediately after DN due to the needling procedure.
Dry Needling , Temporomandibular Joint Disorders , Male , Humans , Female , Masseter Muscle , Trigger Points , Temporomandibular Joint Disorders/therapy , Pain
Introduction: Institutionalized young people may exhibit impaired development due to lack of support, correct guidance regarding their physiological changes, and knowledge about postural changes. Methods: This is a longitudinal observational case series study. Adolescents residing in shelters who could understand the entire protocol were invited to participate in the study. Ten meetings were held, once a week, with 8 theoretical-practical interventions and 2 pre and post-PEP evaluations. The evaluations were: static posture, dynamic balance, handgrip strength, self-esteem, quality of life, and a theoretical questionnaire on general knowledge. Results: From 18 adolescents, 11 (7 boys and 4 girls), with an average age of 14.8 (±1.3) years concluded the study. After the PEP intervention, a significant improvement was found in the knee angles (3.56º vs. 2.28º) and hip (-12.03º vs. -4.18º) in its plane lateral. The scores of the theoretical questionnaire were 4.75 vs. 11.63 and the handgrip strength was 22.91 vs. 28.54 kgf and 21.55 vs. 26.82 kgf for the right and left limbs. In the quality of life and self-esteem questionnaires, no statistically significant differences were obtained. Conclusion: PEP imparts benefits to socially vulnerable adolescents for postural angles, handgrip strength and theoretical knowledge. Self-esteem and quality of life did not change, probably due to their high vulnerability.
Introdução: Jovens institucionalizados podem apresentar comprometimento do desenvolvimento por falta de apoio, orientação correta quanto às suas alterações fisiológicas e conhecimento sobre alterações posturais. Métodos: Trata-se de um estudo observacional longitudinal de série de casos. Foram convidados a participar do estudo adolescentes residentes em abrigos que conseguissem compreender todo o protocolo. Foram realizados dez encontros, uma vez por semana, com 8 intervenções teórico-práticas e 2 avaliações pré e pós-PEP. (programa de educação postural). As avaliações foram: postura estática, equilíbrio dinâmico, força de preensão manual, autoestima, qualidade de vida e questionário teórico de conhecimentos gerais. Resultados: Dos 18 adolescentes, 11 (7 meninos e 4 meninas), com idade média de 14,8 (±1,3) anos, concluíram o estudo. Após a intervenção PEP, foi encontrada melhora significativa nos ângulos do joelho (3,56º vs. 2,28º) e quadril (-12,03º vs. -4,18º) no seu plano lateral. As pontuações do questionário teórico foram 4,75 vs. 11,63 e a força de preensão manual foi 22,91 vs. 28,54 kgf e 21,55 vs. 26,82 kgf para os membros direito e esquerdo. Nos questionários de qualidade de vida e autoestima não foram obtidas diferenças estatisticamente significativas. Conclusão: A PEP traz benefícios aos adolescentes em situação de vulnerabilidade social quanto aos ângulos posturais, força de preensão manual e conhecimento teórico. A autoestima e a qualidade de vida não se alteraram, provavelmente devido à sua elevada vulnerabilidade.
OBJECTIVE: To compare peripheral muscle oxygenation levels and the prevalence of psychological stress in adolescents with and without temporomandibular disorder (TMD). METHODS: A cross-sectional study was performed with adolescents submitted into two groups: those diagnosed with TMD (DG) and control (CG). Muscle oxygenation was measured by near-infrared spectroscopy in the masseter and upper trapezius muscles. Symptoms of stress were assessed by Lipp's Stress Symptom Inventory for Adults or Child Stress Scale. A Student t-test was used for intergroup comparisons and association between categorical variables by chi-square test, phi coefficient of correlation, odds ratio, and two-way ANOVA. RESULTS: Fifty-three adolescents were evaluated and a significant reduction was observed in the oxyhemoglobin level in the masseter muscle at rest (p = 0.04) and contraction (p = 0.02). A greater total hemoglobin level was found in the upper trapezius muscle at rest in DG (p = 0.03), with a significant difference in the tissue saturation index during contraction (p = 0.05) intergroup. Individuals in the DG were 4.523 times more likely to exhibit signs and symptoms of stress than in CG. CONCLUSION: Adolescents from DG showed reduced masseter oxyhemoglobin values at rest and during contraction and showed more signs and symptoms of stress than healthy controls. In the upper trapezius, DG showed higher values of total circulating hemoglobin, essential for greater blood flow and efficient maximum voluntary contraction. CLINICAL RELEVANCE: Changes in tissue oxygenation and stress in adolescents with TMD prompted the earlier treatment of this population to prevent disease progression into adulthood.
Oxyhemoglobins , Temporomandibular Joint Disorders , Adult , Child , Humans , Adolescent , Cross-Sectional Studies , Masseter Muscle , Analysis of Variance
Abstract Background: Temporomandibular disorder (TMD) is an umbrella term encompassing various clinical complaints involving the temporomandibular joints, masticatory muscles, and/or associated orofacial structures. Myogenous TMDs are the most frequent cause of chronic orofacial pain. Musculoskeletal pain is commonly associated with myofascial trigger points (MTPs), for which dry needling (DN) is a routine treatment. Objective: To investigate muscle oxygenation and pain immediately after DN application on an MTP in the masseter muscle of patients with myogenous TMDs. Methodology: Masseter muscle oxygen tissue saturation indices (TSI%) were assessed by near-infrared spectroscopy (NIRS) pre- and post-interventions by a randomized, controlled, double-blind, crossover DN/Sham clinical trial (primary outcome). Pain was investigated by the visual analog scale (VAS). In total, 32 individuals aged from 18 to 37 years who were diagnosed with myogenous TMD and myofascial trigger points in their masseter muscles participated in this study. Relative deltas for the studied variables were calculated. Data normality was tested using the Shapiro-Wilk test. According to their distribution, data were analyzed by two-way ANOVA and the Student's t-, and Mann-Whitney tests. Statistical analyses were performed using Prism® 5.0 (GraphPad, USA). Results: We found a significant difference (2,108% vs. 0,142%) between masseter muscle TSI% deltas after the DN and Sham interventions, respectively (n=24). We only evaluated women since men refused to follow NIRS procedures. Pain increased immediately after DN (n=32, 8 men), in comparison to Sham delta VAS. Conclusion: These findings show an increase in tissue oxygen saturation in the evaluated sample immediately after the DN intervention on the MTP of patients' masseter muscle. Pain may have increased immediately after DN due to the needling procedure.
OBJECTIVE: To verify the difference between the masticatory muscles' electrical activity, stress signals and the posture of preadolescents and adolescents with and without temporomandibular dysfunction (TMD). METHODS: 24 preadolescents and adolescents aged between 11 and 18 years old were divided into two groups, TMD group (TMDG) and control group (CG). All subjects were submitted to anthropometric measurements, psychological stress analysis, temporomandibular joint clinical evaluation and TMD verification; postural evaluation and masseter and temporal muscles electrical activity analysis during chewing. For statistical analysis, the Student's t-test or Mann-Whitney U test were used according to data distribution. RESULTS: There was a significant difference between the groups for the electrical activity of the right temporal muscles (7.43% ± 2.92 vs. 11.71% ± 5.37) and left (7.70% ± 4.04 vs.11.44% ± 4.03) in the inactive period of chewing between CG and TMDG, respectively. There was no difference in stress or posture variables between groups. CONCLUSIONS: During the inactive period of chewing, there was greater activation of the temporal muscles in the TMDG. Female gender was prevalent in TMDG. The study participants showed signs of stress, regardless of the group. The posture and TMD relationship still need to be studied.
Temporomandibular Joint Disorders , Adolescent , Child , Electromyography , Female , Humans , Masticatory Muscles , Posture , Temporal Muscle
