Interventions against hearing loss as an integral component of successful tinnitus therapy.

Tinnitus very often develops from acute or chronic hearing loss, mainly inner ear deafness. The frequency of the tinnitus mostly corresponds to the frequency range of the hearing loss and is enhanced by down-regulation of inhibition in the central auditory pathway for these frequencies, in addition to focused attention and enhanced arousal for the disturbing sound. Therefore, interventions to improve hearing such as mid-ear surgery or-more often-electronic devices including hearing aids or cochlear implants (CI) are important for the treatment of tinnitus. In this review, the current German S3 guideline "Chronic tinnitus" and recent literature are discussed.

[Interventions against hearing loss are an integral component of successful tinnitus therapy. German version]. / Hörverbessernde Maßnahmen als integraler Bestandteil einer erfolgreichen Tinnitusbehandlung.

Tinnitus very often develops from acute or chronic hearing loss, mainly inner ear deafness. The frequency of the tinnitus mostly corresponds to the frequency range of the hearing loss and is enhanced by down-regulation of inhibition in the central auditory pathway for these frequencies, in addition to focused attention and enhanced arousal for the disturbing sound. Therefore, interventions to improve hearing such as mid-ear surgery or-more often-electronic devices including hearing aids or cochlear implants (CI) are important for the treatment of tinnitus. In this review, the current German S3 guideline "Chronic tinnitus" and recent literature are discussed.

Association of Dual Sensory Impairment with Declining Physical Function in Community-Dwelling Older Adults.

Few studies have investigated whether dual sensory impairment (DSI) adversely affects the deterioration of physical function in older adults compared to single sensory impairment (SSI, visual or auditory). We studied the association between DSI and declining physical function by analyzing the data of 2780 Korean community-dwelling adults aged 70-84 years. Sensory impairment was assessed through pure tone audiometry and visual acuity testing. Muscle strength (handgrip strength) and physical performance (timed up and go test and short physical performance battery (SPPB)) were evaluated. In the cross-sectional analysis, DSI was associated with higher odds of having low muscle strength (odds ratio (OR), 1.78; 95% confidence interval (CI), 1.27-2.48) and poor physical performance (SPPB: OR, 2.04; 95% CI, 1.38-3.00) than SSI. Among all sensory impairment groups in the longitudinal analysis, DSI at baseline increased the risk of deteriorating physical performance during the follow-up period (OR, 1.94; 95% CI, 1.31-2.88; p < 0.01) the most. DSI showed a more severe adverse effect on the decline in physical function among community-dwelling older adults than SSI. More comprehensive care is needed to prevent the deterioration of physical function in older adults due to DSI.

Sensory change after implant surgery: related factors for recovery.

Objectives: This retrospective study aimed to analyze data on nerve damage in patients who complained of sensory changes after dental implant surgery, the clinical results according to proximity of the implant fixture to the inferior alveolar nerve (IAN) canal, and the factors affecting recovery of sensation. Materials and Methods: The electronic medical records of 64 patients who had experienced sensory change after implant surgery were reviewed. Patients were classified by sex, age, implant installation sites, recovery rate and the distance between the implant fixture and IAN canal on computed tomography (CT). The distance was classified into Group I (D>2 mm), Group II (2 mm≥D>0 mm), and Group III (D≤0 mm). Results: The 64 patients were included and the mean age was 57.3±7.3 years. Among the 36 patients who visited our clinic more than two times, 21 patients (58.3%) reported improvement in sensation, 13 patients (36.1%) had no change in sensation, and 2 patients (5.6%) reported worsening sensation. In Group II, symptom improvement was achieved in all patients regardless of the removal of the implant fixture. In Group III, 8 patients (40.0%) had reported symptom improvement with removal of the implant fixture, and 2 patients (33.3%) of recovered patients showed improvement without removal. Removal of the implant fixture in Group III did not result in any significant difference in recovery (P=0.337), although there was a higher possibility of improvement in sensation in removal cases. Conclusion: Clinicians first should consider removing the fixture when it directly invades the IAN canal. However, in cases of sensory change after dental implant surgery where the drill or implant fixture did not invade the IAN canal, other indirect factors such as flap elevation and damage due to anesthesia should be considered as causes of sensory change. Removal of the implant should be considered with caution in these situations.

Effect of delayed photobiomodulation therapy on neurosensory recovery in patients with mandibular nerve neurotmesis following traumatic mandibular fracture: A randomized triple-blinded clinical trial.

INTRODUCTION: There is a possibility of neurotmesis of the inferior alveolar nerve (IAN) in mandibular fractures, which leads to neurosensory impairment. In this study, we aimed to investigate the efficacy of photobiomodulation therapy (PBMT) in patients with neurotmesis following trauma and mandibular fracture. MATERIALS AND METHODS: This triple-blind randomized trial was carried out on patients who suffered neurotmesis of the IAN following mandibular angle and body fracture at least for 6 months. In the intervention group, laser irradiation was applied with a low-level GaAlAs diode laser (continuous wave of 810 nm wavelength, power of 200 mW, and energy density of 12-14 J/cm2). In the control group, the laser probe was turned off and placed on the affected area. LLLT was done for 12 sessions (2 times/week for 6 weeks). Light touch sensations, two-point discrimination, thermal discrimination (cold and warm stimulus), electric pulp test (EPT), and oral health impact profile (OHIP)-14 questionnaire were performed before the intervention, immediately after each PBMT session, and after 3, 6, 9 and 12 months. RESULTS: In both groups, 3 and 23 patients were female and male, respectively. The results showed significantly improved light (cotton swab), light (wooden cotton swab), and sharp (dental needle) touch sensations, and two-point discrimination test in the PBMT group after the 10th, 11th, 10th, and 10th session, respectively. Two-way repeated measure ANOVA revealed that the trend of light touch sensation with cotton swab and two-point discrimination test was statistically significant (p-value = 0.002 and 0.001, respectively). The results of OHIP-14 test showed a significantly higher mean in the PBMT group 3 months after PBMT. There was no statistically significant difference in EPT and thermal discrimination tests regarding the patients' group. CONCLUSION: PBMT could be an effective treatment for late post-traumatic nerve neurotmesis following a traumatic mandibular fracture.

Transient unilateral lingual nerve injury following the use of laryngeal mask airway Supreme: a case report.

Lingual nerve injury rarely occurs after using the laryngeal mask airway (LMA). A 40-year-old woman with no comorbidities visited the hospital for left breast-conserving surgery. Anesthesia was performed using LMA Supreme™. She complained of decreased sensation in the right front part of the tongue postoperatively. She received prednisolone and tongue sensation returned on postoperative day 28. The lingual nerve could be damaged by the LMA, particularly the lateral edge of the tongue base and inner part of the mandible around the third molar. When using the LMA, it is necessary to check the cuff pressure to prevent lingual nerve damage.

Relação do processamento sensorial e sistema estomatognático de crianças respiradoras orais / Relation of sensory processing and stomatognical system of oral respiratory children

RESUMO Objetivo Verificar a relação entre o processamento sensorial e as alterações das funções do Sistema Estomatognático de crianças respiradoras orais, caracterizando o processamento sensorial destas e comparando-o com o de respiradoras nasais. Método Foram selecionadas 50 crianças (5 a 12 anos) que apresentaram diagnóstico de respiração oral e 50 sem sinais e sintomas de respiração oral ou rinite alérgica para fazer parte do grupo controle, pareadas por idade e sexo. As crianças respiradoras orais e nasais passaram por avaliação do processamento sensorial, através da Sensory Processing Measure - Home form, e as respiradoras orais por avaliação da motricidade orofacial através da Avaliação Miofuncional Orofacial com Escore. Os resultados foram apresentados em forma de tabela e com suas respectivas frequências absoluta e relativa. Resultados A maioria das crianças avaliadas foi do sexo masculino, estando com idade média de 8 anos. A maioria dos respiradores orais apresentou alteração no processamento de todos os sentidos, com relação estatisticamente significativa quando comparados com os respiradores nasais. Houve relação, nos respiradores orais, entre o processamento sensorial proprioceptivo e o movimento das bochechas, processamento sensorial visual e movimentação da cabeça durante a deglutição e entre o tipo de mastigação e o processamento sensorial tátil. Conclusão Após análise dos dados foi possível perceber que o processamento sensorial de todos os sistemas se apresenta com alteração nos respiradores orais e que esse mau processamento se relaciona a mobilidade orofacial, bem como com funções do Sistema Estomatognático, além do tipo de mastigação dessa população.

ABSTRACT Purpose To verify the relationship between sensory processing and changes in the functions of the stomatognathic system in mouth breathing children, characterizing their sensory processing and comparing it with that of nasal breathing children. Methods 50 children (5 to 12 years) who were diagnosed with mouth breathing and 50 without signs and symptoms of mouth breathing or allergic rhinitis were selected to be part of the control group, matched for age and sex. Oral and nasal breathing children underwent sensory processing evaluation, through the Sensory Processing Measure - home form, and mouth breathers, through the evaluation of orofacial motricity through the Orofacial Myofunctional Evaluation with score. The results were presented in table form and with their respective absolute and relative frequencies. Results Most of the children evaluated were male, with an average age of eight years. Most mouth breathers presented alteration in the processing of all senses, with a statistically significant relationship when compared to nasal breathers. There was a relationship, in mouth breathers, between proprioceptive sensory processing and the movement of the cheeks, visual sensory processing and head movement during swallowing, and between the type of chewing and tactile sensory processing. Conclusion After analyzing the data, it was possible to see that the sensory processing of all systems presents with changes in mouth breathers and that this poor processing is related to orofacial mobility, as well as functions of the stomatognathic system, in addition to the type of chewing of this population.

Características Psicomotoras e Sensoriais de crianças com Transtorno do Espectro Autista (TEA) em atendimento terapêutico ocupacional / Características psicomotoras y sensoriales de niños con trastorno del espectro autístico (TEA) en atención de Terapia Ocupacional / Psychomotoral and sensory characteristics of children with autistic spectrum disorder (tea) in occupational therapeutic care

Atualmente o autismo tem sido classificado como Transtorno do Espectro Autista (TEA), podendo apresentar como critério diagnóstico os atrasos no desenvolvimento psicomotor e alterações sensoriais, além das características típicas. Objetivo: Identificar as características psicomotoras e sensoriais de crianças com diagnóstico de TEA atendidas no setor de Terapia Ocupacional na Unidade Saúde Escola da Universidade Federal de São Carlos (USE-UFSCar). Método: Trata-se de uma pesquisa exploratória e descritiva, de abordagem quantitativa. Participaram nove crianças de quatro a dez anos de idade com diagnóstico de TEA, e seus responsáveis. Os instrumentos utilizados para coleta de dados foram um Questionário de dados gerais da criança; Perfil sensorial e Bateria Psicomotora. A coleta dos dados ocorreu na própria Unidade,sendo que os dados dos instrumentos padronizados foram analisados a partir das instruções pré-existentes, e os dados do Questionário de forma descritiva. Resultados: Identificou-se que as crianças participantes apresentam déficits psicomotores nos seguintes aspectos: noção do corpo, estruturação espaço-tempo, praxia global e fina. Em relação ao sistema sensorial, as alterações identificadas no presente estudo foram na audição, sistema vestibular e multissensorial, constante procura sensorial, inatenção e na motricidade fina. Conclusão: Aponta-se para a importância de maiores investimentos nesse campo, uma vez que pode favorecer as intervenções voltadas a esse público.

Actualmente, el autismo se ha clasificado como trastorno del espectro autista (TEA), y puede presentarse como criterio de diagnóstico de retrasos en el desarrollo psicomotor y cambios sensoriales, además de las características típicas. Objetivo: identificar las características psicomotoras y sensoriales de los niños diagnosticados con TEA tratados en el sector de terapia ocupacional en la Unidad de la Escuela de Salud de la Universidad Federal de São Carlos (USE-UFSCar). Método: Esta es una investigación exploratoria y descriptiva, con un enfoque cuantitativo. Participaron nueve niños de cuatro a diez años diagnosticados con TEA y sus padres. Los instrumentos utilizados para la recopilación de datos fueron un cuestionario de datos generales del niño; Perfil sensorial y batería psicomotora. La recopilación de datos tuvo lugar en la propia Unidad, y los datos de los instrumentos estandarizados se analizaron utilizando instrucciones preexistentes y los datos del Cuestionario de manera descriptiva. Resultados: Se identificó que los niños participantes tienen déficits psicomotores en los siguientes aspectos: noción del cuerpo, estructuración espacio-tiempo, praxis global y fina. Con respecto al sistema sensorial, los cambios identificados en el presente estudio fueron en el sistema auditivo, vestibular y multisensorial, búsqueda sensorial constante, falta de atención y en el motricidad fina. Conclusión: señala la importancia de mayores inversiones en este campo, ya que puede favorecer intervenciones dirigidas a esta audiencia.

Currently, autism has been classified as Autism Spectrum Disorder (ASD), and may present as a diagnostic criterion delays in psychomotor development and sensory changes, in addition to the typical characteristics. Objective: To identify the psychomotor and sensory profile of children diagnosed with ASD. Method: This is a survey study, exploratory and descriptive, with a qualitative and quantitative approach. Nine children from four to ten years old diagnosed with a diagnosis of ASD participated, linked to the School Health Unit (uSE)­UFSCar and their guardians. The instruments used for data collection were a questionnaire of general data of the child; Sensory profile and Psychomotor Battery. Data collection took place at the Unit itself, and data from standardized instruments were analyzed based on pre-existing instructions, and data from the Questionnaire were analyzed descriptively. Results: Children with ASD have psychomotor deficits in the following aspects: body notion, space-time structuring, global and global and fine praxis. Regarding the sensory system, the changes identified were in hearing, vestibular and multisensory system, constant sensory search, inattention and fine motor. Conclusion: It points to the importance of greater investments in this field, since it can favor interventions aimed at this audience.

Diagnostic properties of sensitivity changes in patients with maxillofacial fractures: a systematic review

Aim: Verify the accuracy of objective assessments compared to subjective tests in detecting changes in somatosensory perception in individuals affected by maxillofacial trauma. Methods: The review (PROSPERO n ° CRD42019125546) used the databases: MEDLINE, Cochrane, EMBASE, LILACS and other bibliographic resources. Prospective and retrospective studies that used objective and subjective methods of assessing facial sensitivity in maxillofacial fractures were included. There was no restriction on language or publication date. Risk of bias was assessed using the QUADAS-2. Data extraction and analysis were performed using a form developed for the study. Results: 21 studies were included. The clinical objective examination mainly includes assessments of: tactile sensitivity (95.24%) and nociceptive sensitivity (57.14%). The subjective assessment was based on the patient's report, spontaneously (61.90%), guided by structured questionnaires (33.33%) and/or using scales (9.52%) to measure the degree of impairment. In risk of bias assessment, were observed no adequate interpretation and classification of changes in subjective sensitivity, subject to inappropriate analysis of the data. In addition, the studies bring several instruments without standardization for assessing sensory modalities. Conclusion: The objective assessment is a complement to the subjective assessment, using the touch assessment as the main parameter in the profile of the facial peripheral integrity, associated or not with nociceptive assessment. Lack of consensus on the indication of specific instruments for testing is a limiting factor. Thus, based on the studies, is proposed a minimum battery of sensitivity assessment to obtain an overview of the patient's peripheral nervous situation

Inferior alveolar nerve dysfunction in mandibular fractures: a prospective cohort study.

OBJECTIVES: To assess the prevalence and recovery of inferior alveolar nerve dysfunction (IAND) in mandibular fractures. MATERIALS AND METHODS: : This was a prospective cohort study. Clinical neurosensory testing was done preoperatively and the IAND was categorized as mild, moderate or severe. Postoperatively, neurosensory testing was repeated at 1 day, 1 week, 1 month, 3 months and every 3 months thereafter. RESULTS: : A total of 257 patients with 420 fractures were included in the study with a mean age of 31.7 years. Body fractures (95.9%) had the highest incidence of IAND, followed by the angle fractures (90.1%) and symphysis fractures (27.6%). The condyle and coronoid fractures did not have any IAND and hence were excluded from further study. After eliminating those cases, 232 patients remained in the study with 293 fractures. The overall prevalence of IAND in fractures occurring distal to the mandibular foramen was 56.3%. The changes until 1 week were minimal. From 1 month to 6 months, there was a significant reduction in the severity of IAND. A significant number of cases (60.0%) were lost to follow-up between 6 and 9 months. At 6 months, 23.9% of cases still had some form of IAND and 95.0% of the symphysis, 59.0% of the angle and 34.8% of the body fractures with IAND had become normal. CONCLUSION: This study documents the reduction in the degree of severity of IAND in the first six months and provides the basis for future studies with longer periods of follow-up.

Balance assessment after altering stimulation of the neurosensory system.

Aim Posture requires fine integrative elaboration, performed by the central nervous system, of neurosensory information originated from the visual, vestibular and spinal circuit. Many perturbing agents can influence this elaboration and then the postural stability. Several studies have evaluated only the effect of a single agent on the postural control. The study analysed the perturbing effect of several external agents on the different sensorial circuits in terms of postural balance loss in orthostatism. Methods The postural stability of 31 patients was evaluated with a static posturography platform in basal conditions and after exposure to an external agent in the following order: stroboscopic light projecting, mechanical rotations on a swivel chair, feet desensitization through ice, administration of an alcoholic drink at intervals which depended on the participant return to basic posturographic values. Tests were performed with open eyes (OE), closed eyes (CE) and reducing plantar perception through the use of a rubber pillow. Results The stroboscopic light altered the postural control. The swivel chair disturbed only with CE. Ice and alcohol increased the oscillation area. The alcohol test had a significant reduction in postural control with OE compared to CE. The rubber cushion increased the oscillation area in all OE tests and with CE in alcohol and ice tests. Conclusion The different agents did not trigger postural control deficits in the same way. A cold environment with psychedelic lights and the use of alcoholic beverages altered significantly the postural stability by influencing simultaneously all perceptions (visual, vestibular and somatosensory feedback).

Postural balance in children with Autism Spectrum Disorders / Equilíbrio postural em crianças com Transtorno do Espectro Autista

ABSTRACT Purpose: to characterize the performance of children with autism spectrum disorders in two postural balance assessment scales. Methods: an observational cross-sectional study with a descriptive, analytical profile. Seven to 11-year-old children with mild autism spectrum disorder, diagnosed by an interdisciplinary team, according to the DSM-5, were assessed. The protocols used were the Sensory Organization Test and Pediatric Balance Scale. Results: all the children obtained maximum performance in the Sensory Organization Test. As for the Pediatric Balance Scale, the participants had similar responses in 8 out of its 14 items; in the other 6, there was a standard deviation. Conclusion: the participants did not have difficulties performing the Pediatric Balance Scale and Sensory Organization Test, scoring quite close to the maximum value.

RESUMO Objetivo: caracterizar o desempenho de criança com Transtorno do Espectro Autista em duas escalas de avaliação do Equilíbrio Postural. Métodos: estudo de interferência observacional, com segmento transversal e de perfil descritivo analítico. Foram avaliadas crianças com diagnóstico de TEA de grau leve segundo o DSM-5, diagnosticadas por equipe interdisciplinar, com idade entre 7 e 11 anos. Os protocolos utilizados foram o Teste de Organização Sensorial e a Escala de Equilíbrio Pediátrica. Resultados: todas as crianças apresentaram desempenho máximo no Teste de Organização Sensorial. Na Escala de Equilíbrio Pediátrica, dos 14 itens presentes, os participantes apresentaram respostas semelhantes em oito deles, e nos seis demais houve desvio padrão. Conclusão: os participantes não demonstraram dificuldades na realização na EEP e no Teste de Organização Sensorial, mantendo escores muito próximos do valor máximo.

Intervención de terapia ocupacional en niños con dificultades de procesamiento sensorial: un estudio de caso múltiple en una escuela en Paris / Occupational therapy intervention for children with challenges in sensory processing: a multiple case study from a school in Paris

PROPÓSITO: El principal objetivo de este estudio fue describir el proceso y evaluar la eficacia de terapia ocupacional con abordaje de integración sensorial para 3 niños con dificultades de procesamiento sensorial, con el fin de ayudar a desarrollar modelos de practica apropiados en planificación e implementación de la intervención de terapia ocupacional. MÉTODO: Se utilizó un diseño de estudio de casos múltiples. Todos los participantes eran estudiantes de la misma escuela y fueron remitidos a terapia ocupacional debido a dificultades en escritura, torpeza motora y participación en clase. Los participantes recibieron sesiones individuales de 45 minutos de duración. La duración media de la intervención fue de 27 sesiones realizadas una vez por semana en el transcurso del año lectivo. Los niños fueron evaluados antes y después de la intervención con entrevistas a padres y maestros, observaciones clínicas y pruebas estandarizadas. RESULTADOS: Luego de la intervención se observaron mejores resultados en habilidades de desempeño de las evaluaciones estandarizadas Bruininks-Oseretsky Test of Motor Proficiency, Segunda Edición (BOT™-2) y Prueba de Desarrollo de la Percepción Visual - Tercera Edición (DTVP-3). Además, se observó mejora en la calidad de la escritura y la participación en los juegos de motricidad gruesa en todos los niños. CONCLUSIÓN: Los resultados de este estudio se adhieren a la literatura en el sentido de que la terapia ocupacional bajo un marco de integración sensorial parece ser un método efectivo para mejorar las habilidades de desempeño y la participación funcional de los niños con desafíos de procesamiento sensorial.

PURPOSE: The main purpose of this study was to describe the process and evaluate the effectiveness of occupational therapy under a sensory integration framework for 3 children with sensory processing challenges, in order to help develop models of good practice in planning and implementation of occupational therapy intervention. METHOD: A Multiple Case Study design was utilized. All participants were students at the same school and were referred to occupational therapy because of concerns with handwriting, clumsiness and class participation. Participants received individual, 45 minutes long intervention sessions. The mean length of intervention was 27 sessions delivered 1 time per week over the course of the academic year. Children were evaluated before and after intervention with parent/teacher interviews, clinical observations and standardized tests. RESULTS: After the intervention all participants obtained higher scores for performance skills in the standardized tests Bruininks-Oseretsky Test of Motor Proficiency, Second Edición (BOT™-2) and Developmental Test of Visual Perception ­ Third Edition (DTVP-3). Furthermore, improved handwriting quality and participation on gross motor games was reported for all participants. CONCLUSION: The results of this study adhere to the literature in that occupational therapy under a sensory integration framework seems to be an effective method for enhancing performance skills and functional participation of children with sensory processing challenges.

Is Sensory Loss an Understudied Risk Factor for Frailty? A Systematic Review and Meta-analysis.

BACKGROUND: Age-related sensory loss and frailty are common conditions among older adults, but epidemiologic research on their possible links has been inconclusive. Clarifying this relationship is important because sensory loss may be a clinically relevant risk factor for frailty. METHODS: In this systematic review and meta-analysis, we searched 3 databases for observational studies investigating 4 sensory impairments-vision (VI), hearing (HI), smell (SI), and taste (TI)-and their relationships with frailty. We meta-analyzed the cross-sectional associations of VI/HI each with pre-frailty and frailty, investigated sources of heterogeneity using meta-regression and subgroup analyses, and assessed publication bias using Egger's test. RESULTS: We included 17 cross-sectional and 7 longitudinal studies in our review (N = 34,085) from 766 records. Our cross-sectional meta-analyses found that HI and VI were, respectively, associated with 1.5- to 2-fold greater odds of pre-frailty and 2.5- to 3-fold greater odds of frailty. Our results remained largely unchanged after subgroup analyses and meta-regression, though the association between HI and pre-frailty was no longer significant in 2 subgroups which lacked sufficient studies. We did not detect publication bias. Longitudinal studies largely found positive associations between VI/HI and frailty progression from baseline robustness, though they were inconclusive about frailty progression from baseline pre-frailty. Sparse literature and heterogenous methods precluded meta-analyses and conclusions on the SI/TI-frailty relationships. CONCLUSIONS: Our meta-analyses demonstrate significant cross-sectional associations between VI/HI with pre-frailty and frailty. Our review also highlights knowledge gaps on the directionality and modifiability of these relationships and the impact of SI/TI and multiple sensory impairments on frailty.

Male genital sensation after spinal cord injury: a review.

Genital sensation (GS) is an essential component of male sexual function. Genital sensory disturbance (GSD) caused by spinal cord injury (SCI) has a severe impact on the patients' sexual function but has garnered little research focus. Under normal conditions, GS encompasses the erection, ejaculation, sexual arousal, and orgasm courses associated with physiological and psychological responses in male sexual activity. However, in SCI patients, the deficiency of GS makes the tactile stimulation of the penis unable to cause sexual arousal, disturbs the normal processes of erection and ejaculation, and decreases sexual desire and satisfaction. To provide an overview of the contemporary conception and management of male GS after SCI, we review the innervation and sexual function of male GS in this article, discuss the effects of GSD following SCI, and summarize the current diagnosis and treatment of GSD in male SCI patients.

Task-state fMRI observation on impact of electrical stimulation numbness to central nervous system in normal people / 中国医学影像技术

Objective: To investigate the impact of electrical stimulation numbness to central nervous system in normal people. Methods: Electric stimulator was used to establish low-frequency, high-frequency numbness models with 22 healthy subjects. Scores for numbness and emotional valence for different electrical stimulations were recorded, and data of functional MRI (fMRI) in task state were also collected. The differences of numbness and emotional valence score of subjects under low frequency and high frequency electrical stimulation were compared, respectively. Then brain regions with significant differences in brain activation intensity under different frequencies of electrical stimulation were obtained, and the differences of activation effect values of activated brain regions under different electrical stimulations intensity were compared, respectively. The relationship of numbness and emotional valence scores under high frequency electrical stimulation were analyzed. Results: There were statistical differences of numbness (t=13.18) and valence score (t=10.77) under different electrical stimulations (both P<0.05). There was negative correlation between numbness and valence scores under high-frequency electrical stimulation (r=-0.53, P=0.01). The brain areas with significant differences of activation intensity under different electrical stimulation included left parietal operculum, left middle cingulate gyrus, left temporal gyrus, right parietal operculum, left postcentral gyrus, right central operculum, right posterior insula and left thalamus (all P<0.05). Conclusion: The activated brain regions under different electrical stimulations caused numbness include left parietal operculum, left middle cingulate gyrus, left temporal gyrus, right parietal operculum, left postcentral gyrus, right central operculum, right posterior insula and left thalamus in normal people. Block-designed BOLD-fMRI can be used to detect activity of brain areas associated with numbness.

Avaliação da sensibilidade em áreas de enxerto cutâneo do membro superior de pacientes queimados e sua repercussão na qualidade de vida / Assessment of skin graft areas sensibility of upper limb of burned patients and its repercussion on quality of life

OBJETIVO: Avaliar a sensibilidade de áreas que receberam enxerto de pele nos membros superiores de pacientes queimados e sua percepção de como a sensibilidade está relacionada à sua qualidade de vida. MÉTODO: Foram avaliados 30 indivíduos, com queimadura em membro superior, tratados com enxertia. Foram obtidos dados pessoais e histórico da lesão. Aplicava-se a escala de Vancouver para avaliar a sensibilidade da área enxertada e a mesma era medida. A sensibilidade tátil foi avaliada por meio de um estesiômetro, já a sensibilidade térmica foi avaliada por meio de um tubo de ensaio com água a 40°C, com água temperatura ambiente e aplicava-se gelo. Por meio da utilização do TENS, no modo convencional e com variação de intensidade e frequência (VIF), avaliou-se a sensação de prurido e sensibilidade nociceptiva, respectivamente. A qualidade de vida foi avaliada através do BSHS-R. RESULTADOS E CONCLUSÃO: Queimaduras nos membros superiores tratadas com enxerto de pele precisam de estímulos de intensidades maiores para despertar sensação nas áreas queimadas quando comparadas às sadias. A sensibilidade térmica tende a retornar mais rápido. As alterações da sensibilidade na área do enxerto interferem na qualidade de vida do paciente.

OBJECTIVE: To evaluate the sensitivity of areas that received skin grafts on the upper limbs of burned patients and their perception of how the sensitivity is related to their quality of life. METHODS: Thirty individuals with burns on the upper limbs, treated with grafting, were evaluated. Personal data and history of the injury were obtained. The Vancouver scale was applied to assess the sensitivity of the grafted area and it was measured. The tactile sensitivity was assessed by means of a stoichiometer, whereas the thermal sensitivity was assessed by means of a test tube with water at 40°C, with water at room temperature and ice was applied. Through the use of TENS, in the conventional way and with varying intensity and frequency (VIF), itching sensation and nociceptive sensitivity were evaluated, respectively. Quality of life was assessed using the BSHS-R. RESULTS AND CONCLUSION: Burns in the upper limbs treated with a skin graft need stimuli of greater intensity to arouse sensations when compared to healthy areas. Thermal sensitivity tends to return faster. Sensitivity changes in the graft area interfere with patients quality of life.

Reabilitação sensório motora precoce na promoção do autocuidado higiene pessoal / Early sensorimotor rehabilitation in the promotion of self-care and personal hygiene

As alterações da sensibilidade, frequentemente observadas na pessoa com acidente vascular cerebral, influenciam o desempenho do motor e condicionam a recuperação da funcionalidade, reduzindo a qualidade de vida destas pessoas. Neste sentido, o enfermeiro especialista em Enfermagem de reabilitação assume um papel de relevo na reabilitação destas alterações. Deste modo pretende-se verificar se a intervenção precoce do enfermeiro especialista em enfermagem de reabilitação nas alterações sensório motoras promovem o autocuidado higiene pessoal. Para tal, institui-se um plano de reabilitação com treino sensorial ativo e passivo e compararam-se os resultados da avaliação da sensibilidade, da força muscular, do equilíbrio e do autocuidado antes e após a sua implementação As seis pessoas que constituíram a amostra conseguiram recuperar, em algum grau, as alterações da sensibilidade dolorosa e da propriocepção no membro inferior. Não houve repercussões na propriocepção do membro superior ou da estereognosia. Todas obtiveram ganhos funcionais no autocuidado higiene pessoal, duas das quais readquiriram a independência total.

Sensitivity changes, often seen in people with stroke, influence motor performance and condition recovery of functionality, reducing the quality of life of these people. In this sense, the nurse specialist in rehabilitation plays an important role in the rehabilitation of these changes That way, we intend to verify if the early intervention of the rehabilitation nurse in the sensorimotor changes promote the self-care personal hygiene. For such, a rehabilitation plan with active and passive sensory training was instituted and the results of the sensitivity evaluation, muscular strength, body balance and self-care, were compared before and after its implementation. The six people who constituted the sample were able to recover, in some degree, the changes in pain sensitivity and proprioception in the lower limb. There were no repercussions on proprioception of the upper limb or on stereognosis. All obtained functional gains in self-care personal hygiene, two of which regained total independence.

Alterações sensoriais em respiradores orais: revisão sistemática baseada no método prisma / Sensory changes in mouth breathers: systematic review based on the prisma method

RESUMO Objetivo: Revisar, na literatura, estudos que abordem alterações nos sistemas sensoriais apresentadas por respiradores orais. Fonte de dados: A busca foi realizada nas bases de dados PubMed, BIREME, LILACS, Web of Science e Scopus. A busca foi realizada independentemente por dois pesquisadores, seguindo os critérios de seleção. Foram selecionados artigos originais que abordaram a respiração oral e as alterações nos sistemas sensoriais publicados nos idiomas português, inglês e espanhol. Os artigos de revisão da literatura, as dissertações, os capítulos de livros, os estudos de caso e os editoriais foram excluídos. Síntese dos dados: Foram encontrados 719 artigos, dos quais 663 foram excluídos pelo título e 22 pelo resumo. Trinta e quatro manuscritos foram analisados, dos quais 23 estavam repetidos e 8 foram excluídos pelo texto lido na íntegra. Assim, três artigos foram selecionados para esta revisão. Conclusões: A maioria dos estudos apresenta a ocorrência de alterações dos sistemas sensoriais em crianças respiradoras orais. Contudo, observa-se maior preocupação na avaliação da recepção sensorial. Além disso, a avaliação dos sistemas sensoriais foi realizada de forma não padronizada, o que pode ter acarretado resultados menos precisos na população estudada.

ABSTRACT Objective: To review, in the literature, information regarding changes in the sensory systems of mouth breathers. Data sources: The search was conducted in the following databases PubMed, BIREME, LILACS, Web of Science and Scopus. The search was independently carried out by two researchers, following the selection criteria. Original articles that approached mouth breathing and changes in sensory systems published in Portuguese, English and Spanish were published. Literature review of articles, dissertations, book chapters, case studies and editorials were excluded. Data synthesis: We found 719 articles. Among them, 663 were excluded by the title and 22 by the summary. Among the 34 analyzed manuscripts, 23 were repeated and 8 were excluded by reading the full text. Thus, 3 articles were selected for this review. Conclusions: Most studies presents the occurrence of changes in sensory systems in mouth breathing children. However, sensory reception is a matter of more concern. Besides, the evaluation of sensory systems was not standardized, which may have led to less precise results in the studied population.