Subject(s)
Humans , Classification , Thinking , Glycogen Storage Disease Type V , Nursing , Critical CareABSTRACT
Fundamento: La fisioterapia se postula como un tratamiento eficaz tras la intervención de prótesis total derodilla (PTR) por osteoartritis. El objetivo fue valorarla eficacia de la hidroterapia frente a la cinesiterapia engimnasio durante la segunda fase de la rehabilitación depacientes intervenidos de PTR en relación a la mejora deltest de la marcha, el dolor, la rigidez, el balance articular,la fuerza muscular y la inflamación. Método: Se realizó un ensayo controlado y aleatorizado.Los pacientes intervenidos de PTR recibieron una primerafase rehabilitadora (15 sesiones de 60 minutos) en el gimnasio. En la segunda fase (15 sesiones de 40 minutos), ungrupo realizó fisioterapia en gimnasio y otro en piscina.Se valoraron (basal, tras 15 y tras 30 sesiones): capacidadfuncional, dolor y rigidez con índice WOMAC, balance articular con goniómetro, fuerza muscular con escala Lovett,y test de la marcha de 6 minutos. Resultados: Participaron 115 pacientes, 59 (51,3 %) en grupo sala y 56 (48,7 %) en grupo piscina. Tras la segunda fasede rehabilitación se observaron mejoras clínicas superiores en el grupo piscina, siendo las diferencias estadísticamente significativas respecto al dolor (p = 0,005), rigidez(p = 0,010), balance articular flexión (p = 0,027) y fuerzamuscular (p = 0,049) en la rodilla intervenida, y en el testde la marcha de 6 minutos (p = 0,002). Conclusiones: En pacientes intervenidos de PTR, la hidroterapia durante la segunda fase del tratamiento rehabilitador fue más eficaz que la fisioterapia en gimnasio enrelación a la mejora del dolor, rigidez, balance articular,fuerza muscular y resultado del test de la marcha.(AU)
Background: Physiotherapy is postulated as an effective treatment after total knee arthroplasty (TKA) due toosteoarthritis. The aim was to assess the efficacy of hydrotherapy versus gym kinesitherapy during the secondphase of treatment in TKA patients, with regard to theimproved gait test, pain, stiffness, joint balance, musclestrength and inflammation. Methods: A controlled and randomized trial was carriedout. TKA patients received a first rehabilitative phase (1560-minutes sessions) at the gym. In the second phase (1540-minute sessions), one group performed physiotherapyin a gym and another in a swimming pool. Different variables were assessed (basal, after 15 and after 30 sessions):functional capacity, pain and stiffness with WOMAC index, joint balance with goniometer; muscle strength withLovett scale, and result of 6-minute gait test. Results: A total of 115 patients participated, 59 (51.3%)in the gym group and 56 (48.7 %) in the pool group. After the second phase of rehabilitation, higher clinical improvements were observed in the pool group, with statistically significant differences in pain (p = 0.005), stiffness(p = 0.010), joint balance (p = 0.027) and muscle strength(p = 0.049) in the operated knee, and in the result of the6-minute gait test (p = 0.002). Conclusions: In TKA patients, hydrotherapy during thesecond phase of rehabilitative treatment was more effective than gym physiotherapy in terms of improved pain,stiffness, joint balance, muscle strength and gait testing.(AU)
Subject(s)
Humans , Male , Female , Aged , Hydrotherapy , Osteoarthritis , Osteoarthritis, Knee , Knee Prosthesis , Physical Therapy Specialty , Arthroplasty, Replacement, Knee , Joint Diseases , RehabilitationABSTRACT
BACKGROUND: Physiotherapy is postulated as an effective treatment after total knee arthroplasty (TKA). The objective of the study was to assess the efficacy of hydrotherapy versus gym kinesitherapy during the second phase of treatment in TKA patients, with regard to the improved gait test, pain, stiffness, joint balance, muscle strength and inflammation. METHODS: A controlled and randomized trial was carried out. TKA patients received a first rehabilitative phase (15 60-minutes sessions) at the gym. In the second phase (15 40-minute sessions), one group performed physiotherapy in a gym and another in a swimming pool. Different variables were assessed (basal, after 15 and after 30 ses-sions): functional capacity, pain and stiffness with WOMAC index, joint balance with goniometer; muscle strength with Lovett scale, and result of 6-minute gait test. RESULTS: A total of 115 patients participated, 59 (51.3%) in the gym group and 56 (48.7?%) in the pool group. After the second phase of re-habilitation, higher clinical improvements were observed in the pool group, with statistically significant differences in pain (p?=?0.005), stiffness (p?=?0.010), joint balance (p?=?0.027) and muscle strength (p?=?0.049) in the operated knee, and in the result of the 6-minute gait test (p?=?0.002). CONCLUSIONS: In TKA patients, hydrotherapy during the second phase of rehabilitative treatment was more effective than gym physiother-apy in terms of improved pain, stiffness, joint balance, muscle strength and gait testing.
Subject(s)
Arthroplasty, Replacement, Knee , Hydrotherapy , Knee Prosthesis , Osteoarthritis, Knee , Exercise , Humans , Osteoarthritis, Knee/surgery , Treatment OutcomeABSTRACT
INTRODUCCIÓN: La enfermedad de McArdle o glucogenosis tipo V es una enfermedad rara debida al déficit de miofosforilasa muscular, lo que produce incapacidad para degradar el glucógeno a este nivel. Los pacientes presentan fatiga, dolor y calambres de forma habitual. Además, tras un ejercicio intenso o situación estresante, están expuestos a lisis celular. Esto se puede manifestar en forma de mioglobinuria y rabdomiólisis, síndrome clínico potencialmente grave si no se trata con rapidez. VALORACIÓN: Se presenta el caso de un varón de 38 años con enfermedad de McArdle y rabdomiólisis secundaria a la realización de ejercicio, que precisó atención en el Servicio de Urgencias durante 24 horas, así como su posterior ingreso en Unidad de Hospitalización. Se realizó una valoración enfermera siguiendo el modelo de cuidados de Virginia Henderson. DIAGNÓSTICO: Se priorizaron los diagnósticos enfermeros: (00016) deterioro de la eliminación urinaria, (00092) intolerancia a la actividad, (00093) fatiga y (00132) dolor agudo; y la complicación potencial: riesgo de fallo renal agudo. PLANIFICACIÓN: Se elabora Plan de Cuidados siguiendo la metodología NANDA-NIC-NOC, con especial atención a las alteraciones en la eliminación y en el sistema musculoesquelético. Se realiza monitorización de la diuresis. Se realiza reposición de líquidos y se administra medicación analgésica. DISCUSIÓN: Existe escasa literatura sobre los cuidados enfermeros de pacientes con enfermedad de McArdle, lo que ha limitado la comparación de nuestros resultados con los de otros autores, sin embargo, dada la buena respuesta del sujeto mediante reposición de líquidos, un óptimo control del dolor y el reposo demostraron una rápida recuperación del paciente
INTRODUCTION: McArdle's disease or glycogenosis type V is a rare disease due to deficiency of muscle myophosphorylase leading to inability to degrade glycogen at this level. Patients have fatigue, pain, and cramps on a regular basis. In addition, after intense exercise or stressful situation, they are exposed to cellular lysis. This can occur in the form of rhabdomyolysis and myoglobinuria, a potentially serious clinical syndrome if not treated quickly. CASE EVALUATION: We present the care plan of a 38-year-old man with McArdle's disease and secondary rhabdomyolysis on physical exercise, which required attention in the Emergency Department for 24 hours, as well as his subsequent admission to the ward. A nursing evaluation was performed following the care model of Virginia Henderson. DIAGNOSIS: Priority was given to nurse diagnoses: (00016) deterioration of urinary elimination, (00092) activity intolerance, (00093) fatigue and (00132) acute pain; and potential complication: risk of acute renal failure. PLANNING: The Care Plan is developed following the NANDA-NIC-NOC methodology, with special attention to alterations in the elimination and musculoskeletal system. The diuresis is monitored. Fluid replenishment is performed, and analgesic medication is given. DISCUSSION: There is little literature on the nursing care of patients with McArdle's disease, which has limited the comparison of our results with those of other authors. However, given the good response of the subject through fluid replacement, optimal pain control and rest, they made a rapid recovery
Subject(s)
Humans , Male , Adult , Glycogen Storage Disease Type V/complications , Rhabdomyolysis/nursing , Renal Insufficiency/prevention & control , Rare Diseases/nursing , Exercise Tolerance , Fatigue/physiopathologyABSTRACT
INTRODUCTION: McArdle's disease or glycogenosis type V is a rare disease due to deficiency of muscle myophosphorylase leading to inability to degrade glycogen at this level. Patients have fatigue, pain, and cramps on a regular basis. In addition, after intense exercise or stressful situation, they are exposed to cellular lysis. This can occur in the form of rhabdomyolysis and myoglobinuria, a potentially serious clinical syndrome if not treated quickly. CASE EVALUATION: We present the care plan of a 38-year-old man with McArdle's disease and secondary rhabdomyolysis on physical exercise, which required attention in the Emergency Department for 24 hours, as well as his subsequent admission to the ward. A nursing evaluation was performed following the care model of Virginia Henderson. DIAGNOSIS: Priority was given to nurse diagnoses: (00016) deterioration of urinary elimination, (00092) activity intolerance, (00093) fatigue and (00132) acute pain; and potential complication: risk of acute renal failure. PLANNING: The Care Plan is developed following the NANDA-NIC-NOC methodology, with special attention to alterations in the elimination and musculoskeletal system. The diuresis is monitored. Fluid replenishment is performed, and analgesic medication is given. DISCUSSION: There is little literature on the nursing care of patients with McArdle's disease, which has limited the comparison of our results with those of other authors. However, given the good response of the subject through fluid replacement, optimal pain control and rest, they made a rapid recovery.
ABSTRACT
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