High frequency transcutaneous electrical stimulation in the immediate postoperative period of anterior cruciate ligament reconstruction: a randomized clinical trial / Estimulação elétrica transcutânea de alta frequência no pós operatório imediato de reconstrução do ligamento cruzado anterior: um ensaio clínico randomizado

INTRODUCTION: The anterior cruciate ligament (ACL) is an important structure for knee stability. Transcutaneous electrical nerve stimulation (TENS) is an electrical current applied for significant pain relief. OBJECTIVE: To evaluate the effects of high-frequency TENS on the immediate postoperative period of ACL reconstruction. METHODS: 46 patients in the postoperative period of ACL reconstruction were randomly assigned to a control group (CG=23) and a TENS group (TG=23). Knee range of motion (ROM), pain, muscle strength, and drug intake were assessed before surgery and 24 and 48 hours after surgery. The TENS intervention protocol started in the recovery room, shortly after surgery, and was maintained continuously for the first 48 hours after surgery. RESULTS: The TENS group (TG) significantly controlled the increased level of postoperative pain (p<0.05) and significantly increased flexion ROM (p<0.05). When compared to the Control group (CG), the TENS group had a lower intake of ketoprofen (48.27%), diazepam (256.98%), and dipyrone (121.21%), morphine (320.77%), and tramadol (437.46%). CONCLUSION: Continuous high-frequency TENS significantly reduced pain intensity and significantly improved ROM, muscle strength, and drug intake in the postoperative period of ACL reconstruction.

Efeito agudo da estimulação elétrica nervosa transcutânea (TENS) na lombalgia / Acute effect of transcutaneous nerve electric stimulation (TENS) on lombalgy

A lombalgia é um problema extremamente comum, que afeta mais pessoas do que qualquer outra afecção. Acarreta em um quadro de dor, perda de função e redução da qualidade de vida. Isto posto, o tratamento conservador é de suma importância para a reabilitação de pacientes com lombalgia. Objetivo: Avaliar o efeito agudo da estimulação elétrica transcutânea (TENS) em portadores de lombalgia. Métodos: Série de casos, no qual participaram 66 pacientes. Foi realizado uma única intervenção com TENS no modo acupuntural, frequência de 70 Hz, tempo de pulso de 150 us, com duração de 40 minutos. Foram avaliados o nível de dor, flexibilidade de isquiotibiais, força muscular e estabilização do complexo lombopélvico pré, imediatamente após e 24 horas após a intervenção. Resultados: O nível de dor, flexibilidade de isquiotibiais e força muscular dos extensores de tronco apresentaram melhora imediatamente após intervenção (p<0,05). Após 24 horas, houve aumento significativo da dor em comparação ao pós intervenção (p<0,05), porém ainda se verificou um efeito analgésico e de melhora da flexibilidade em comparação a avaliação pré. A força muscular melhorou de forma significativa pós intervenção e manteve-se 24 horas após (p<0,05). Os testes de estabilidade apresentaram maior tempo de manutenção da postura imediatamente após a aplicação da TENS, porém com redução deste feito pós 24 horas (p<0,05). Conclusão: A TENS demonstrou redução do quadro álgico, melhora da força de tronco, flexibilidade de isquiotibiais e da estabilização lombopélvica imediatamente após a intervenção. Estes efeitos se mantiveram 24 horas após, porém não com a mesma intensidade.

Low back pain is an extremely common problem that affects more people than any other condition. It causes pain, loss of function and reduced quality of life. That said, conservative treatment is of paramount importance for the rehabilitation of patients with low back pain. Objective: To evaluate the acute effect of transcutaneous electrical stimulation (TENS) in patients with low back pain. Methods: Case series, in which 66 patients participated. A single intervention with TENS was performed in acupuncture mode, frequency of 70 Hz, pulse time of 150 us, lasting 40 minutes. The level of pain, hamstring flexibility, muscle strength and stabilization of the lumbopelvic complex pre, immediately after and 24 hours after the intervention were evaluated. Results: The level of pain, hamstring flexibility and muscle strength of the trunk extensors improved immediately after intervention (p <0.05). After 24 hours, there was a significant increase in pain compared to the post-intervention period (p <0.05), but there was still an analgesic effect and improved flexibility compared to the pre evaluation. Muscle strength improved significantly after the intervention and was maintained 24 hours later (p <0.05). The stability tests showed a longer posture maintenance time immediately after the application of TENS, but with a reduction of this done after 24 hours (p <0.05). Conclusion: TENS demonstrated a reduction in pain, improvement in trunk strength, hamstring flexibility and lumbopelvic stabilization immediately after the intervention. These effects were maintained 24 hours later, but not to the same degree.

Presença de retroversão umeral e discinesia escapular em praticantes de tiro de laço

RESUMO Objetivo: Avaliar a presença de retroversão umeral e discinesia escapular em praticantes de tiro de laço. Métodos: Estudo transversal com 129 sujeitos. Foram avaliados a presença de discinesia, a força muscular, a amplitude de movimento, o nível de funcionalidade e a dor no ombro. Resultados: A rotação externa foi maior (p = 0,005) e a rotação interna menor no ombro dominante (p = 0,0001). O movimento rotacional total do ombro dominante foi menor, em comparação com o não dominante (p = 0,0001). A presença de discinesia escapular foi de 32,6%, predominou a discinesia do tipo II (50%). A pontuação do Spadi foi significativamente maior nos praticantes com sintomas de dor (p < 0,05). Conclusão: Os praticantes de tiro de laço demonstraram retroversão umeral no ombro dominante e prevalência alta de discinesia escapular.

ABSTRACT Objective: The objective of the present study was to evaluate the presence of humeral retroversion and scapular dyskinesis in these practitioners. Methods: This cross-sectional study enrolled 129 subjects. The state of dyskinesis, muscle strength, range of motion, level of functionality and shoulder pain were evaluated. Results: The external rotation was higher (p = 0,005) and minor internal rotation on the dominant shoulder (p = 0,0001). The total movement of the dominant shoulder was lower, compared to the non-dominant (p = 0.0001). The presence of Scapular dyskinesis was 32,6%, predominantly type II dyskinesis (50%). The Spadi score was significantly higher in those with pain symptoms (p <0.05). Conclusion: People who practice tie-down roping showed humeral retroversion on the dominant shoulder and higher prevalence of scapular dyskinesis.

RESUMEN Objetivo: el objetivo del estudio fue evaluar la existencia de retroversión humeral y discinesia escapular en las personas que practican esta actividad. Métodos: estudio transversal con 129 individuos. Se evaluaron la existencia de discinesia, la fuerza muscular, la amplitud de movimiento, el nivel de funcionalidad y el dolor en el hombro. Resultados: la rotación externa fue mayor (p = 0,005) y la rotación interna, menor en el hombro dominante (p = 0,0001). El movimiento total del hombro dominante fue menor en comparación con el no dominante (p = 0,0001). La existencia de discinesia escapular fue del 32,6%, sobre todo la discinesia de tipo II (50%). La puntuación del SPADI fue considerablemente mayor en los practicantes con síntomas de dolor (p < 0,05). Conclusión: los practicantes de tiro de lazo mostraron retroversión humeral en el hombro dominante y una elevada prevalencia de discinesia escapular.

Confiabilidade de um aplicativo de goniometria para dispositivo móvel (Android): Goniôapp / Reliability of a goniometry application for mobile device (Android): Goniôapp

A goniometria é uma técnica utilizada para avaliar a amplitude de movimento (ADM) das articulações do corpo humano. O goniômetro universal (GU) é o instrumento mais utilizado pelos fisioterapeutas para avaliar a ADM. O aplicativo Goniôapp foi desenvolvido com a função de um goniômetro universal para avaliar a ADM. Objetivo: Avaliar a confiabilidade do aplicativo Goniôapp para aparelho móvel (Android) na avaliação da ADM de indivíduos saudáveis. Método: Estudo de validação de tecnologia com 44 alunos de fisioterapia da Ulbra Torres RS sendo 10 alunos do sexo masculino e 34 do sexo feminino. Foi avaliado a ADM da articulação glenoumeral do lado direito através da goniometria e do Goniôapp por três avaliadores previamente treinados com os instrumentos. Resultados: Foi verificado um nível de confiabilidade inter examinador moderado para extensão, flexão, abdução e rotação externa entre todos os avaliadores. Já na avaliação de confiabilidade intra examinador, o avaliador 1 e o 2 apresentaram um nível de confiabilidade alto para o movimento de extensão e os demais movimentos apresentaram nível moderado, porém, somente o avaliador 3 apresentou um nível alto para todos os movimentos. Conclusão: O aplicativo para dispositivo móvel (Android) Goniôapp apresenta nível de confiabilidade semelhantes a técnica do GU tanto intra quanto interavaliadores.

Goniometry is a technique used to evaluate a range of motion (ROM) of the joints of the human body. The universal goniometer is the instrument most used by physiotherapists to evaluate an ROM. The Goniôapp application was developed with a function of a universal goniometer to evaluate an ROM. Objective: To evaluate whether the goniometry application for mobile devices (Android), Goniôapp, presents results for the universal goniometer in the evaluation of healthy WMD. Method: An applied research was conducted in the technology validation modality, in physiotherapy students of Ulbra Torres RS. Primeved was signed the TCLE, and collected the demographic data. After having done an assessment of the glenohumeral joint on the right side in 10 male students and 34 female, by three evaluators who evaluate as two measures measured, universal goniometer and Goniôapp. Results: A moderate inter-examiner reliability level was verified for extension, flexion, abduction and external rotation among all the evaluators. In the intra-examiner reliability assessment, the evaluator 1 and 2 presented a high level of reliability for the movement of extension and the other movements presented moderate level, however, only the evaluator 3 presented a high level for all the movements. Conclusion: At the end of the present research, a goniometry application for mobile device (Android) was concluded, Goniôapp presents results similar to the GU technique, both results had a moderate IC both intra and between evaluators.

Effects of different photobiomodulation dosimetries on temporomandibular dysfunction: a randomized, double-blind, placebo-controlled clinical trial.

Changes involving temporomandibular joint, masticatory musculature, and associated structures characterize temporomandibular dysfunction (TMD). The analgesic and anti-inflammatory effect produced by photobiomodulation has contributed to pain relief and functional improvement. However, the parameters to be used have not yet been well established. The aim of this study is to compare the efficacy of three different photobiomodulation dosimetries in the treatment of patients with TMD. A randomized, double-blind, placebo-controlled clinical trial with 44 subjects divided into the groups 8 J/cm2 (n = 11), 60 J/cm2 (n = 11), 105 J/cm2 (n = 11), and control (n = 11). Pain, symptom severity, and joint mobility were evaluated before and after a ten-session protocol of photobiomodulation with AlGaAs laser (830 nm), at a power density of 30 mW/cm2. The mouth opening increased in the 8-J/cm2 group from 10.49 ± 4.68 to 15.40 ± 6.43 degrees, and in the right protrusion from 9.80 ± 4.2 to 12.56 ± 5.40 degrees after the intervention protocol (p < 0.05). All groups significantly decreased pain (p < 0.05). 830-nm laser photobiomodulation was effective in reducing TMD pain and symptoms at all doses tested. Only the doses of 8 J/cm2 were effective regarding maximal opening and protrusion of the mandible.

Limited utility of Kinesio Taping® in the physiotherapy treatment for patients with chronic obstructive pulmonary disease exacerbation.

BACKGROUND: Kinesio Taping® has been used as a physiotherapy treatment in musculoskeletal disorders. However, few studies have evaluated its effectiveness in patients with chronic obstructive pulmonary disease (COPD). OBJECTIVES: To analyze the effects of Kinesio Taping® associated with conventional physiotherapy, on the maximal inspiratory and expiratory pressures (MIP and MEP), forced expiratory volume in 1 second (FEV1), peak expiratory flow (PEF), and pulse oxygen saturation (SpO2) of patients hospitalized for COPD exacerbation. METHODS: Prospective, randomized, single-blinded study. Sixty-two participants who were randomized into two groups: 1) control (medication and standard physiotherapy treatment); and 2) Kinesio Taping® (standard treatment plus application of Kinesio Taping® on the respiratory muscles). The outcomes were assessed 24 hours after the treatment. RESULTS: After the intervention, the Kinesio Taping® group showed a statistically significant increase in all outcomes assessed. However, when the mean differences between groups were analyzed, there were no statistically significant differences in MIP, MEP, FEV1, and PEF. Differences were found only in SpO2 that was improved in the Kinesio Taping® group. CONCLUSIONS: The application of Kinesio Taping® associated with physiotherapy improved SpO2 of non-hypoxemic patients with COPD exacerbation. Further studies should be conducted to evaluate the method in the long run and in another outcome.

Indicators of violence and asthma: An ecological study.

BACKGROUND: Global studies on asthma point to socioeconomic status as one of the main variables in terms of prevalence and disease severity in various parts of the world. Social factors related to community violence have been linked to higher incidence of asthma in the current studies. This study investigates the relationship between indicators of both community violence and development and hospital admissions due to asthma. METHODS: This was an analytical ecological study of multiple groups, using public databases with information up until 2006. All Brazilian municipalities with more than 100,000 inhabitants were considered as units of analysis. The main index used as socioeconomic indicator was the FIRJAN Index of Municipal Development (FIMD). The Index of Youth Vulnerability to Violence (IYVV) was used as indicators of community violence. The rate of admissions due to asthma was used as the outcome. Pearson's correlation was used for multivariate analyses. The coefficient of determination (R(2)) was calculated and the simple linear regression model adjusted for significant correlations. RESULTS: There was an inverse correlation between asthma admissions and FIMD (r = -0.354, p < 0.001), with statistical significance for all dimensions of the index. Admissions due to asthma were associated with the IYVV (r = 0.240, p < 0.001) and its component related to school attendance and employment (r = 0.315, p < 0.001), homicides (r = 0.112, p = 0.034), and poverty (r = 0.303, p < 0.001). CONCLUSIONS: There was a direct correlation between indicators of violence and rates of admission due asthma, and an inverse correlation with indicators of development. These results suggest that social detriment can act as a risk factor for hospital admissions due to asthma.