Evaluation of quality of life in individuals with chronic stroke who underwent aquatic exercises: A case series.

BACKGROUND: Aquatic exercises are among the treatments available to improve the quality of life after stroke. OBJECTIVES: To investigate changes in the quality of life after 8-week of aquatic exercises in post-stroke individuals. METHODS: A case series study was designed, including four male participants. Exclusive aquatic exercise was performed for 8-week, 50 minutes per session, 2×/week. Their quality of life was evaluated before and after the intervention using the Stroke Impact Scale (SIS). RESULTS: Participant 1 improved in the mobility domain, achieving a Clinically Important Difference (CID). Participant 2 improved in the strength and mobility domain, achieving CID; his stroke recovery was 6%, and it reached 50% post-intervention. Participant 3 improved in the mobility domain, achieving a CID and a Minimal Detectable Change (MDC); his stroke recovery increased from 45 to 60% post-intervention. Participant 4 improved the strength, mobility, and activities of daily living domains, achieving a CID and a MDC, but his stroke recovery remained unchanged at 80%. CONCLUSIONS: All participants achieved a CID in the mobility domain; thus, the aquatic exercise intervention was considered meaningful. Moreover, the SIS is able to evaluate aspects of the recovery process regarding health-related quality of life after stroke, as demonstrated by the results of the overall recovery after aquatic exercises.

A review on muscle activation behaviour during gait in shallow water and deep-water running and surface electromyography procedures.

BACKGROUND: Surface electromyography (sEMG) can provide information on muscle activation patterns during gait. OBJECTIVES: To characterize electromyographic activity during gait in shallow water and during deep-water running compare to on land and to review and analyse underwater surface-electromyographic (sEMG) procedures. SEARCH METHODS: Eight databases (MEDLINE, EMBASE, WEB OF SCIENCE, SPORT Discus, CINAHL, SCOPUS, SCIELO, and LILACS) were searched from their inception to the December of 2019. SELECTION CRITERIA: The selected studies had to be related to electromyographic analysis of gait in an aquatic environment. DATA COLLECTION AND ANALYSIS: The studies that met the inclusion criteria were reviewed by two independent reviewers and divided into four groups. RESULTS: Ten studies met the inclusion criteria. Lower muscle activation was found with treadmill water walking compared to treadmill land walking. With deep-water running, the leg muscles (tibialis anterior and gastrocnemius lateralis) have lower muscle activation when compared to on land running, but the trunk and thigh muscles have higher activation. CONCLUSION: If gait is performed on an aquatic treadmill, the muscles assessed had lower muscle activation when compared to land. During deep-water running activities, lower activation of the distal leg muscles and a higher activation thigh muscles were found when compared to on land. Studies did not follow standard processes in sEMG procedures.

Joint angle and movement velocity effects on muscle activity of elderly with knee osteoarthritis - Categorized and probabilistic analysis.

The aim of the study was to determine the effects of joint angle position and angular velocity on concentric and eccentric knee muscles activity of elderly with osteoarthritis (OA) in a deterministic and probabilistic approach compared to matched controls. Concentric and eccentric muscle activation of vastus medialis (VM) and semitendinous (ST) muscles were recorded of eleven elderly women with knee OA (median (Md (25-75%)) age of 62 years (60-72) and Md of body mass index (BMI) of 26 kg/m2 (24.5-27.2)) and ten controls (Md 65 years (62-69) and Md of BMI 24.5 kg/m2 (23.6-28.9), during twenty-five knee extension-flexion movements. Activation type, angular velocities (90° s-1 and 240° s-1) and joint angle intervals were categorized into groups. The cumulative frequency distributions of the normalized sEMG envelope were computed and the probability to be out of specific norm-reference limits (controls) was calculated. No statistical differences between groups were found. Higher probabilities were found for VM and ST (concentric) and ST (eccentric) activation to be out of norm (55%, 53% and 84%, respectively) at 240 s-1 in different joint angles. During dynamic contractions, concentric and eccentric activity of medial knee muscles of elderly with OA were affected in a different way by joint angles and angular velocity compared to matched controls. The probabilistic analysis provided an additional understanding of the muscle activation between elderly with knee OA and healthy older people.

Effectiveness of aquatic exercises compared to patient-education on health status in individuals with knee osteoarthritis: a randomized controlled trial.

OBJECTIVE: To compare the effectiveness of aquatic exercises with patient-education in individuals with knee osteoarthritis. DESIGN: Randomized controlled trial with blinded assessor and intention-to-treat analysis. SETTING: Aquatic Physiotherapy Centre and Primary Health Care Unit. SUBJECTS: A total of 60 patients, aged 68.3 (SD = 4.8) with clinical symptoms and radiographic grading (Kellgren-Lawrence 1-4) of knee osteoarthritis were included. INTERVENTIONS: An eight-week treatment protocol of aquatic exercise ( n = 31) (16 individual sessions, twice a week) and an educational program (group sessions, once a week) ( n = 29). MAIN MEASURES: Before, after eight-week intervention, and a three-month follow-up with results for the following outcome measures: pain, function, quality of life, functional mobility, and depression. RESULTS: At the end of treatment, the WOMAC (Western Ontario and McMaster Universities Osteoarthritis Index) functional capacity values reduced in favour of the aquatic exercise group for both the total score MD (mean difference) = -14.2; 95% CI (confidence interval) (-18; -10.5), P = 0.04 and the pain domain MD = -3.8 points; 95% CI (-8.71; -1), P = 0.021. The total score also reduced in the follow-up: MD = -12.3 points; 95% CI (-24.7; -6.1), P = 0.017. No differences were found for the outcomes functional mobility or depression. CONCLUSION: Aquatic exercise improved pain and function after eight weeks, and function at the three-month follow-up compared to the patient-education program.

Postural Sway, Balance Confidence, and Fear of Falling in Women With Knee Osteoarthritis in Comparison to Matched Controls.

BACKGROUND: Osteoarthritis (OA) is a chronic degenerative disease that commonly affects the knee joints. Individuals older than 65 years of age with knee OA have a greater risk of falls. However, there has been limited examination of the parameters of postural sway (increased time, speed, and postural sway area [center of pressure{CoP}]), and OA of the knee. OBJECTIVES: The primary objective of this study was to determine whether the CoP variables discriminate between patients with knee OA and matched healthy volunteers, and to correlate the CoP variables with the Activities-Specific Balance Confidence Scale (ABC) and Falls Self-Efficacy Scale (FES). The secondary objective was to compare the CoP of older women with OA with a control group in bipedal support condition with eyes opened and closed. DESIGN: Cross-sectional study. SETTING: University Biomechanics Laboratory. PARTICIPANTS: A total of 22 participants were divided into the following 2 groups of 11 participants each: an OA group (mean = 68 years, standard deviation = 7.4 years) and a control group (mean = 66 years, standard deviation = 4.4 years). METHODS: Static postural balance was measured by a portable force platform. Data were collected in both visual conditions (eyes open and closed), in random order. Three attempts of 30 seconds were allowed for each participant on the force platform, with a 1-minute interval between attempts. MAIN OUTCOME MEASURE: Variables were the CoP total displacement of sway (TDS, in centimeters), anteroposterior amplitude displacement (APAD, in centimeters), medial-lateral amplitude displacement (MLAD, in centimeters), total mean velocity (TMV, in centimeters per second), and dispersion of the center of pressure (AREA, in centimeters squared). RESULTS: The postural sway analysis found statistically significant differences in the eyes open condition for the TDS (P = .020), APAD (P = .042), TMV (P = .010), and AREA (P = .045). In the discriminant analysis, none of the CoP variables were able to classify the groups (P = .15). The correlation analysis showed that only the AREA with eyes closed was associated with the ABC Scale (rho = -0.42). CONCLUSIONS: Women with knee OA had greater postural sway when compared with a control group for the eyes open condition. CoP variables could not discriminate between the groups. The AREA was negatively correlated with the ABC Scale, when the eyes were closed. LEVEL OF EVIDENCE: III.

Effect of global postural re-education and isostretching in patients with nonspecific chronic low back pain: a randomized clinical trial / Efeitos da reeducação postural global e do isostretching em pacientes com lombalgia crônica não-específica: ensaio clínico aleatório

Abstract Introduction: Low back pain is one of the most prevalent musculoskeletal disorders, but little is known about postural methods in its treatment. Objective: Analyze changes in muscle strength, flexibility, function and pain in patients with chronic low back pain that underwent isostretching and global posture reeducation (GPR). Methods: Thirty-nine patients, aged between 40 and 59 years, were evaluated before and after treatment protocols regarding: flexibility for sit and reach, muscle strength, functional capacity using the Rolland-Morris Questionnaire, and intensity of pain by Visual Analog Scale. The sample was randomized into two groups (1-GPR; 2-Isostretching), all of whom were treated individually through 12 sessions lasting 45 minutes each, twice a week. Results: After treatment, median reduction in pain intensity of 28 mm in group 1 and 32 mm in group 2 was observed, and a median improvement in functional capacity in group 1 of 8.5 points and 7 points in group 2 (p < 0,05). A mean improvement of severn repetitions in trunk extensor muscle strength was observed in group 1 and in group 2; by dynamometry of 10 kg / f in group 1 and 12.5 kg / f in group 2 of ten abdominal repetitions strength in group 1 and four repetitions in group 2 (p < 0.05).In the Sit and Reach, Group 1 had a total mean increase of 3cm, and group 2 had 1.6cm (p < 0.05). Conclusion: Both groups were effective in improvement of muscle strength, flexibility, pain and functional capacity.

Resumo Introdução: A lombalgia é uma das mais prevalentes disfunções musculoesqueléticas, porém pouco se sabe sobre os métodos posturais no seu tratamento. Objetivo: Analisar as alterações de força muscular, flexibilidade, função e dor em pacientes com lombalgia crônica submetidos à Reeducação Postural Global (RPG) e Isostretching. Métodos: Trinta e nove pacientes com idade entre 40 e 59 anos foram avaliados antes e após os protocolos de tratamento quanto à flexibilidade pelo teste Sentar e alcançar, força muscular, capacidade funcional pelo Questionário Rolland-Morris e intensidade da dor pela Escala Visual Analógica. A amostra foi aleatorizada em dois grupos (1-RPG; 2-Isostretching), sendo todos tratados individualmente através de 12 sessões de 45 minutos, duas vezes por semana. Resultados: Foi observada mediana de redução na intensidade da dor de 28 mm no grupo 1 e de 32 mm no grupo 2; e melhora mediana na capacidade funcional no grupo 1 de 8,5 pontos e de 7 pontos no grupo 2 (p < 0,05). Observou-se mediana de melhora de 7 repetições na força muscular extensora de tronco no grupo 1 e no grupo 2; na Dinamometria de 10 kg/f no grupo 1 e de 12,5 kg/f no grupo 2; de 10 repetições da força abdominal no grupo 1 e 4 repetições no grupo 2 (p < 0,05). No teste Sentar e Alcançar o grupo 1 obteve aumento médio de 3 cm e o grupo 2 de 1,6 cm (p < 0,05). Conclusão: Ambos os grupos foram efetivos na melhora de força muscular, flexibilidade, da dor e da capacidade funcional.

Reliability of ground reaction forces in the aquatic environment.

The aim of this study was to verify the reliability of the kinetic parameters of gait using an underwater force platform. A total of 49 healthy participants with a median age of 21years were included. The kinetic gait data were collected using a 0.6×0.6×0.1m aquatic force plate (Bertec®), set in a pool (15×13×1.30m) with a water depth of 1.20m and water temperature of 32.5°C. Participants walked 10m before reaching the platform, which was fixed to the ground. Participants were instructed to step onto the platform with their preferred limb and data from three valid attempts were used to calculate the average values. A 48-h interval between tests was used for the test-retest reliability. Data were analyzed using interclass correlation coefficients (ICC) and results demonstrated that reliability ranged from poor to excellent, with ICC scores of between 0.24 and 0.87 and mean differences between (d¯)=-0.01 and 0.002. The highest reliability values were found for the vertical (Fz) and the lowest for the mediolateral components (Fy). In conclusion, the force platform is reliable for assessing the vertical and anteroposterior components of power production rates in water, however, caution should be applied when using this instrument to evaluate the mediolateral component in this environment.

Effects of transcutaneous electrical nerve stimulation (TENS) and interferential currents (IFC) in patients with nonspecific chronic low back pain: randomized clinical trial.

CONTEXT AND OBJECTIVE: Transcutaneous electrical nerve stimulation (TENS) and interferential current are the most used electrotherapy methods, although there is little scientific evidence to support their use. The aim of this study was to compare the effects of TENS and interferential current among patients with nonspecific chronic low back pain. DESIGN AND SETTING: Single-blind randomized controlled trial in the Department of Physiotherapy, Centro Universitário de Maringá. METHODS: One hundred and fifty patients were randomly divided into three groups: TENS (group 1), interferential current (group 2) and controls (group 3). The patients designated for electrotherapy received ten 30-minute sessions, while the control group remained untreated. All patients and controls were evaluated before and after treatment using a visual analog scale and the McGill Pain and Roland Morris questionnaires, and regarding their use of additional medications. RESULTS: There was a mean reduction on the visual analog scale of 39.18 mm with TENS, 44.86 mm with interferential current and 8.53 mm among the controls. In the Roland Morris questionnaire, group 1 had a mean reduction of 6.59; group 2, 7.20; and group 3, 0.70 points. In group 1, 84% of the patients stopped using medications after the treatment; in group 2, 75%; and in group 3, 34%. There was no statistically significant difference between the TENS and interferential current groups (P > 0.05); a difference was only found between these groups and the controls (P < 0.0001). CONCLUSION: There was no difference between TENS and interferential current for chronic low back pain treatment. CLINICAL TRIAL REGISTRATION: NCT01017913.

Effects of transcutaneous electrical nerve stimulation (TENS) and interferential currents (IFC) in patients with nonspecific chronic low back pain: randomized clinical trial / Efeitos da estimulação elétrica nervosa transcutânea (TENS) e da corrente interferencial (CI) em pacientes com lombalgia crônica não específica: ensaio clínico randomizado

CONTEXT AND OBJECTIVE: Transcutaneous electrical nerve stimulation (TENS) and interferential current are the most used electrotherapy methods, although there is little scientific evidence to support their use. The aim of this study was to compare the effects of TENS and interferential current among patients with nonspecific chronic low back pain. DESIGN AND SETTING: Single-blind randomized controlled trial in the Department of Physiotherapy, Centro Universitário de Maringá. METHODS: One hundred and fifty patients were randomly divided into three groups: TENS (group 1), interferential current (group 2) and controls (group 3). The patients designated for electrotherapy received ten 30-minute sessions, while the control group remained untreated. All patients and controls were evaluated before and after treatment using a visual analog scale and the McGill Pain and Roland Morris questionnaires, and regarding their use of additional medications. RESULTS: There was a mean reduction on the visual analog scale of 39.18 mm with TENS, 44.86 mm with interferential current and 8.53 mm among the controls. In the Roland Morris questionnaire, group 1 had a mean reduction of 6.59; group 2, 7.20; and group 3, 0.70 points. In group 1, 84 percent of the patients stopped using medications after the treatment; in group 2, 75 percent; and in group 3, 34 percent. There was no statistically significant difference between the TENS and interferential current groups (P > 0.05); a difference was only found between these groups and the controls (P < 0.0001). CONCLUSION: There was no difference between TENS and interferential current for chronic low back pain treatment. CLINICAL TRIAL REGISTRATION: NCT01017913.

CONTEXTO E OBJETIVO: Estimulação elétrica nervosa transcutânea (TENS) e corrente interferencial são os métodos de eletroterapia mais utilizados, embora haja poucas evidências científicas que suportem seu uso. O objetivo deste estudo foi comparar os efeitos da TENS e da corrente interferencial em pacientes com lombalgia crônica não específica. TIPO DE ESTUDO E LOCAL: Ensaio clínico randomizado, simples-cego, no Departamento de Fisioterapia do Centro Universitário de Maringá. MÉTODOS: Cento e cinquenta pacientes foram randomicamente divididos em três grupos: TENS (grupo 1), corrente interferencial (grupo 2) e controle (grupo 3). Os pacientes designados à eletroterapia receberam 10 sessões de 30 minutos, enquanto o grupo controle permaneceu sem tratamento. Todos os pacientes e os controles foram avaliados antes e depois do tratamento usando a escala visual analógica, os questionários McGill de dor e Roland Morris, e quanto ao uso de medicamentos. RESULTADOS: Houve redução média na escala visual analógica de 39,18 mm com TENS, de 44,86 mm com a corrente interferencial e 8.53 mm no grupo controle. No questionário Roland Morris, o grupo 1 teve redução média de 6,59, o grupo 2 de 7,20 e o grupo 3 de 0,70 pontos. 84 por cento dos pacientes do primeiro grupo, 75 por cento no segundo e 34 por cento no terceiro grupo cessaram a medicação depois do tratamento. Não foi encontrada diferença estatisticamente quando comparados os grupos de TENS e corrente interferencial (P > 0,05), apenas quando comparados estes grupos com o controle (P < 0,0001). CONCLUSÕES: Não há diferença entre TENS e corrente interferencial no tratamento de pacientes com lombalgia crônica. REGISTRO DE ENSAIO CLÍNICO: NCT01017913.

Fisioterapia aquática no tratamento da osteoartrite de joelho: série de casos / Aquatic therapy in knee ostearthritis treatment: series of cases

A osteoartrite de joelho é uma das doenças reumáticas mais prevalentes pelo fato de suportar grandes cargas de peso. O quadro clínico de dor, rigidez articular e perda da função frequentemente levam à redução de capacidade funcional e da qualidade de vida. Uma das principais intervenções terapêuticas no tratamento é a fisioterapia aquática, porém há poucos estudos que verificam os seus benefícios. Foi realizado um estudo com 10 pacientes com diagnóstico de osteoartrite de joelho, de ambos os sexos, com média de idade de 56 anos. Antes e após o tratamento, os pacientes foram avaliados por meio de uma ficha pré-elaborada que continha vários instrumentos. O tratamento consistiu de 20 sessões de fisioterapia aquática, com frequência de 3 vezes semanais e duração de 50 minutos por sessão. Considerando-se variáveis significantes com p-valor menor que 0,05. Ao término das 20 sessões, os pacientes apresentaram melhora da amplitude de movimento de flexão (ativo e passivo p-valor=0,0025) e extensão de joelho (ativo p-valor=0,0089) e passivo p-valor=0,0544, melhora significante tanto no Índice de Lequesne quanto no WOMAC (p-valor=0,00253). Em relação à força muscular de quadríceps, não houve dados estatisticamente significantes pós-tratamento (p-valor=0,0544). Por meio dos achados deste estudo, sugere-se que a fisioterapia aqu-atica possa ser uma boa alternativa de tratamewnto fisioterapêutico nos pacientes com osteoartrite de joelho

Análise da confiabilidade do teste de Lasègue e do teste de Slump para verificação da tensão neural / Analysis of the reliability of the Lasègue test and slump test for verification of the neural tension

Alguns testes específicos, como o teste Lasègue e o teste Slump, têm sido elaborados para verificar a presença de tensão neural e, desta forma, direcionar a melhor alternativa de tratamento das síndromes compressivas da coluna lombar. Quarenta pacientes com queixas músculo-esqueléticas de diferentes diagnósticos clínicos foram selecionados no setor de ortopedia e reumatologia da clínica de fisioterapia do Cesumar. Após a inclusão, dois avaliadores aplicaram os testes de tensão neural Lasègue e Slump, para verificar a confiabilidade dos mesmos na determinação do diagnóstico de pacientes com queixa de dor lombar. Os resultados obtidos demonstraram respostas positivas dos testes em pacientes com queixa de dor lombar e, na maioria dos pacientes com ausência de tal queixa, foram negativos. A média da angulação obtida na aplicação foi de 42,46º (graus) no teste de Lasègue e de 45,70º (graus) no teste de Slump. Não foi verificada diferença significativa entre os resultados obtidos pelos examinadores em ambos os testes. Os resultados deste estudo confirmaram a confiabilidade dos testes de Lasègue e Slump no diagnóstico de comprometimento neural.

Some specified exams, as the Lasègue and Slump tests, have been created to check the presence of the neural tension and in this way, to conduct the best attempts of treatment from some compression syndromes of the low back column. Forty patients with some skeleton-muscles claims, from different medical diagnoses, were selected in the orthopedic and rheumatologic sections of the physical therapy office located at Cesumar. After the inclusion, two observers applied both tests of the neural tension, to check if they are really reliable in the diagnoses determination of the patients with some back pain complaints. The final results obtained showed positive answers from the exams in those patients and among the major part of them without it were negative. The average in this point of view marks were from 42,46° in the Lasègue test and 45,70° in the Slump one. It was not find any significant differences among the obtained results by the examiners from both exams. The final results from these studies confirmed the reliability of these mentioned tests into the diagnoses of the neural commitments.

Isostretching no tratamento da lombalgia crônica / Isostretching as treatment for chronic low back pain

A lombalgia e um mal que atinge milhares de pessoas, tornando-se responsável por limitações das atividades funcionais e comprometimento da qualidade de vida. Diante da grande variabilidade de métodos terapêuticos utilizados para o tratamento de tal afecção e da pouca fundamentação científica para o método Isostretching, objetivou- se avaliar os benefícios alcançados nos pacientes submetidos a técnica. Foram selecionados 20 pacientes, sendo 11 mulheres e 9 homens, tendo como queixa principal lombalgia crônica. Estes se submeteram a 12 sessões da técnica, três vezes semanais. Ao inicio e ao termino do tratamento foram utilizados vários instrumentos de avaliação para verificar melhora da dor, da qualidade de vida, da forca muscular de abdominais e extensores de coluna e flexibilidade. Foram encontrados benefícios estatisticamente significantes com relação a todos os aspectos investigados na maioria dos pacientes. No presente estudo, verificou-se a eficácia terapêutica do método Isostretching na melhora da dor e de flexibilidade de pacientes com dor lombar crônica.

The low back pain affects thousands of people and may cause limitation of functional activities and quality of life. Due to great variety of therapeutic methods of treating this disease, and the few scientific studies about the Isostretching method, the aim of this study was to evaluate improvement of patients submitted to this method. The sample was composed by twenty patients, eleven women and nine men with chronic low back pain. They were submitted to twelve Isostretching sessions, three times a week. Several methods of evaluation were used, at the beginning and at the end of treatment, in order to verify pain improvement, quality of life, abdominal muscle and column extensors strength and flexibility. Most patients showed a statistically significant improvement in all methods evaluated. In this study, therapeutic efficacy of Isostretching method was verified for improvement in pain and flexibility in patients with chronic low back pain.

Tratamento fisioterapeutico da capsulite adesiva apos distensao hidraulica e manipulaçao / Physical therapy in shoulders adhesive capsulitis after hydraulic distention and manipulation

Este trabalho tem como objetivo mostrara atuaçao fisioterapeutica na capsulite adesiva apos a distensao hidraulica e manipulaçao. Foram mensuradas as amplitudes de movimento passiva e ativa e a força do ombro direito de uma mulher de 50 anos antes e apos o procedimento e apos 40 sessoes de fisioterapia. Ao final da pesquisa, foram obtidos os seguintes ganhos de amplitude de movimento passiva: 90º na abduçao, 20º na aduçao,80 na flexao,21 na extensao,50 na rotaçao interna e 64 na rotaçao externa com o ombro na posiçao 90 graus de abduçao, havendo um aumento gradativo da força dos musculos da cintura escapular. A partir dai, conclui-se que distensao hidraulica e manipulaçao seguidas da fisioterapia intensiva melhoram a funçao e possibilitam o retorno precoce as atividades de vida atraves do aumento da amplitude de movimento.

Síndromes dolorosas do ombro: análise de sua incidência e características / Painful syndromes of the shoulder: analysis of their incidence and characteristics

As síndromes dolorosas do ombro são comuns na população em geral, incidindo em 15 a 25 por cento dos pacientes com idade entre 40 e 50 anos. Os problemas no ombro afetam as atividades da vida diária e do trabalho, comprometendo a qualidade de vida de muitas pessoas. Muitas vezes refratário aos tratamentos, o entendimento pleno do acometimento em ombro se faz necessário para que melhor se fundamente a intervenção do fisioterapeuta. Justifica-se assim nosso interesse em verificar a incidência das patologias e correlacionar com fatores como sexo, idade, achados em exames complementares, alterações posturais e prática de atividade física. Foram avaliados 210 prontuários de pacientes que procuraram tratamento fisioterápico a partir de março e finalizaram até agosto de 1999. Setenta e quatro pacientes (35,2 por cento) apresentaram síndromes dolorosas de ombro. Quarenta e nove pacientes (66,21 por cento) eram do sexo feminino e vinte e cinco (33,78 por cento) do sexo masculino. A idade variou entre 13 e 78 anos, com média de 50,23 anos. Houve uma grande porcentagem (45,94 por cento) que apresentou alterações posturais associadas e 13,5 por cento dos pacientes relacionaram os sintomas com a prática esportiva. O diagnóstico mais freqüente foi o da Síndrome do Impacto (45,94 por cento), seguido da Ruptura de Manguito Rotador (31 por cento).

Relato do 1§ ano de existência do Projeto de Reabilitaçäo da mäo: atendimento a pacientes com lesöes traumáticas da mäo no Hospital Universitário Regional do Norte do Paraná (HURNPR) / Cse report of the first year of the Hand's Rehabilitation Project: patients with hand's injuries at the Hospital Regional do Norte do Paraná(HURNPR)

Este estudo descreve a implantaçäo do Projeto de Extensäo Reabilitaçäo de Mäo do Hospital Universitário Regional do Norte do Paraná(HURNP), da Universidade Estadual de Londrina, relatando as principais lesöes da mäo, suas causas, frequência, critérios de alta,intercorrências e o tratamento cirúrgico e fisioterápico adotados no seu primeiro ano de existência. A pesquisa estudou a reabilitaçäo de 43 pacientes no período de maio de 1997 a abril de 1998, tendo como lesäo mais frequente a de nervo ulnar(16,27 por cento), levando-se em consideraçäo que as lesöes associadas somaram uma grande parcela de incidência (23,25 por cento). Na busca do melhor prognóstico, o estudo concluiu que a interaçäo com a equipe médica comprova o valor do interprofissionalismo, e a importância do conhecimento detalhado das estruturas e biomecânica da mäo, fazendo necessário o fisioterapeuta especializado em mäo