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1.
Heliyon ; 10(7): e28113, 2024 Apr 15.
Artigo em Inglês | MEDLINE | ID: mdl-38560162

RESUMO

Background: Hemophilic arthropathy is caused by recurrent intra-articular bleeding, most commonly in the knee joints. In terms of physical impact, this arthropathy causes significant disability and hampers the physical activity and functionality of he affected individuals. Objective: This study intended to examine the effect of a physical rehabilitation program incorporating Kinect-based virtual reality (KBVR) on gait characteristics, functional ability, and physical activity level in adolescents diagnosed with hemophilic knee arthropathy (HKA). Materials and methods: In a randomized clinical trial, 56 boys, aged 10-14 years, with moderate HKA, were randomly allocated into two groups. The control group (n = 28) received conventional physical therapy (CPT), while the KBVR group (n = 52) received a 30-min KBVR exercise program in addition to the CPT. Training was conducted three times/week for 12 successive weeks. Gait characteristics (step length, cadence, velocity, peak knee extension moment during stance, and knee flexion amplitude during swing) were assessed using a gait analysis system, the functional ability was assessed through the 6-min walk test, and physical activity level assessed by the Adolescents' Physical Activity Questionnaire on the pre- and post-treatment occasions. Results: The KBVR group achieved more favorable changes in the gait characteristics [step length (P = 0.015), cadence (P = 0.004), velocity (P = 0.024), peak knee extension moment during stance (P = 0.018), and Knee flexion amplitude during swing (P = 0.032)], functional capacity (P = 0.002), and physical activity levels (P = 0.007) compared to the control group. Conclusion: The use of KBVR exercises within a rehabilitation program is a potentially effective therapeutic option for the total care of adolescents with HKA.

2.
PLoS One ; 19(3): e0300737, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38551917

RESUMO

BACKGROUND: There is ample evidence supporting the use of different manipulative therapy techniques for Cervicogenic Headache (CgH). However, no technique can be singled as the best available treatment for patients with CgH. Therefore, the objective of the study is to find and compare the clinical effects of cervical spine over thoracic spine manipulation and conventional physiotherapy in patients with CgH. DESIGN, SETTING, AND PARTICIPANTS: It is a prospective, randomized controlled study conducted between July 2020 and January 2023 at the University hospital. N = 96 eligible patients with CgH were selected based on selection criteria and they were divided into cervical spine manipulation (CSM; n = 32), thoracic spine manipulation (TSM; n = 32) and conventional physiotherapy (CPT; n = 32) groups, and received the respective treatment for four weeks. Primary (CgH frequency) and secondary CgH pain intensity, CgH disability, neck pain frequency, neck pain intensity, neck pain threshold, cervical flexion rotation test (CFRT), neck disability index (NDI) and quality of life (QoL) scores were measured. The effects of treatment at various intervals were analyzed using a 3 × 4 linear mixed model analysis (LMM), with treatment group (cervical spine manipulation, thoracic spine manipulation, and conventional physiotherapy) and time intervals (baseline, 4 weeks, 8 weeks, and 6 months), and the statistical significance level was set at P < 0.05. RESULTS: The reports of the CSM, TSM and CPT groups were compared between the groups. Four weeks following treatment CSM group showed more significant changes in primary (CgH frequency) and secondary (CgH pain intensity, CgH disability, neck pain frequency, pain intensity, pain threshold, CFRT, NDI and QoL) than the TSM and CPT groups (p = 0.001). The same gradual improvement was seen in the CSM group when compared to TSM and CPT groups (p = 0.001) in the above variables at 8 weeks and 6 months follow-up. CONCLUSION: The reports of the current randomized clinical study found that CSM resulted in significantly better improvements in pain parameters (intensity, frequency and threshold) functional disability and quality of life in patients with CgH than thoracic spine manipulation and conventional physiotherapy. TRIAL REGISTRATION: Clinical trial registration: CTRI/2020/06/026092 trial was registered prospectively on 24/06/2020.


Assuntos
Manipulação da Coluna , Cefaleia Pós-Traumática , Humanos , Cervicalgia/terapia , Qualidade de Vida , Cefaleia Pós-Traumática/terapia , Estudos Prospectivos , Vértebras Torácicas , Manipulação da Coluna/métodos , Vértebras Cervicais , Amplitude de Movimento Articular , Resultado do Tratamento
3.
Pain Ther ; 13(2): 251-268, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38315378

RESUMO

INTRODUCTION: Frozen shoulder is a very common musculoskeletal condition and the evidence related to the additional effects of extracorporeal shockwave therapy (ESWT) with intra-articular (IA) lidocaine injection in individuals with frozen shoulder is rare. Therefore, this study aims to compare and investigate the additional effects of extracorporeal shockwave therapy (ESWT) with intra-articular (IA) lidocaine injection in a frozen shoulder. METHODS: Sixty eligible participants with frozen shoulder were included and the active group (n = 30, age 52.12 ± 5.2 years) received a lidocaine injection (1% lidocaine (Xylocaine) and 2cc (80 mg) methylprednisolone acetate) with active ESWT (3.5 bar air pressure and 2000 pulses with an energy flux density (EFD) » 0.16 mJ/mm2) three sessions a week for 4 weeks. The placebo group (n = 30, age 53.56 ± 5.5 years) received lidocaine injection with placebo treatment (a special head that blocked the shock waves) three sessions a week for 4 weeks. Both groups received progressive resistance exercises (PRE) to the shoulder muscles. The primary outcome was pain intensity, measured with the visual analogue scale. The other outcome measures were the thickness of the coracohumeral ligament (CHL) measured by magnetic resonance imaging (MRI), abduction, and lateral rotation range of motion (ROM), functional disability, kinesiophobia, depression status, and quality of life. Participants were assessed at baseline, after 4 weeks, 8 weeks, and at 6-month follow-up. RESULTS: The post-intervention at 4 weeks showed an improvement of 2.0 (CI 95% 1.71-2.28) in the active group compared to the placebo group. Similar effects were noted after 8 weeks (2.2) (CI 95% 1.91-2.48) and at the 6-month (1.9) (CI 95% 1.61-2.18) follow-up. Similar improvements were also found in the thickness of the CHL ligament (0.6) (CI 95% 0.46-0.73), abduction and lateral rotation (ROM) (- 23.6) (CI 95% - 27.47 to -19.72), (- 18.10) (CI 95% - 19.72 to - 16.47), functional disability (16.2) (CI 95% 14.85-17.54), kinesiophobia (11.0 (CI 95% 10.21-11.98), depression status (4.4) (CI 95% 4.03-4.76) and quality of life (0.9) (CI 95% 0.79-1.00) (p = 0.001) at the 6-month follow-up period, where mean estimates and their confidence intervals all included worthwhile effects. There were no adverse reactions or side effects noted in either the active or placebo groups during and after the treatment. CONCLUSIONS: The study concluded that the addition of extracorporeal shockwave therapy after intra-articular lidocaine injection improves pain, functional disability, range of motion, kinesiophobia, depression status, and quality of life in people with frozen shoulder. TRIAL REGISTRATION: https://ctri.nic.in , identifier; CTRI/2020/04/024834 prospectively registered on 24/04/2020.

4.
J Surg Case Rep ; 2024(2): rjae058, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-38370596

RESUMO

This study presents a rare case of unilateral slipped capital femoral epiphysis treated surgically in a 5-year-old boy with cerebral palsy who was born at 27 weeks' gestation and developed grade III intraventricular haemorrhage and periventricular leucomalacia and was on antiepileptic drugs, including valproic acid and levetiracetam for >3 years. The patient had no history of endocrine, renal, and significant familial diseases.

5.
Burns ; 49(7): 1643-1653, 2023 11.
Artigo em Inglês | MEDLINE | ID: mdl-37270393

RESUMO

BACKGROUND: Burns of the chest region constitute a common burn and develops skin contractures around the thorax region. Inhalation of toxic gases and chemical irritants during the fire leads to Acute Respiratory Distress Syndrome (ARDS). Breathing exercises are painful but are needed to help counteract contractures and increase lung capacity. These patients are usually in pain and extremely anxious about chest physiotherapy. Virtual reality distraction is one such technique that is gaining immense popularity when compared to other pain distraction techniques. However, studies examining the efficacy of the virtual reality distraction technique in this population are lacking. OBJECTIVES: To find and compare the effects of the virtual reality distraction technique as a pain alleviation tool for reducing pain during chest physiotherapy in chest burns patients with ARDS in middle-aged adults. METHODS: A randomized controlled study was conducted at the physiotherapy department between 1st Sep 2020 and 30th Dec 2022. The eligible sixty subjects were randomized into two groups: The virtual reality distraction group (n = 30) received virtual reality distraction technique and the control group (n = 30) received progressive relaxation technique before chest physiotherapy as a pain distraction technique. All the participants received chest physiotherapy as a common treatment (treatment as usual). Primary (Visual Analogue Scale - VAS) and secondary (forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1), FEV1/FVC, peak expiratory flow (PEF), residual volume (RV), functional residual capacity (FRC), total lung capacity (TLC), RV/TLC, and diffusing capacity for carbon monoxide of the lungs (DLCO) outcome measures were measured at baseline, after four weeks, eight weeks and at six months follow up. The effects between the two groups were analyzed using the independent t-test and chi-square test. The intra-group effect was analyzed with a repeated measure ANOVA test. RESULTS: Baseline demographic characters and study variables show homogenous distribution between the groups (p > 0.05). Four weeks following two different training protocols virtual reality distraction group shows more significant changes in pain intensity, FVC, FEV1, FEV1/FVC, PEF, RV, FRC, TLC, RV/TLC, and DLCO (p = 0.001) but not in RV (p = 0.541). The similar improvements were noted in the 8 weeks and 6 months follow up. CONCLUSION: The reports of the study concluded that virtual reality distraction is an effective and useful technique in reducing pain and increasing lung capacity in chest burn patient with ARDS following smoke inhalation in community-dwelling middle-aged adults. In the virtual reality distraction group, the patients reported significantly less pain and clinically meaningful changes in pulmonary functions as compared to the control group (physiotherapy + relaxation).


Assuntos
Queimaduras , Contratura , Síndrome do Desconforto Respiratório , Lesão por Inalação de Fumaça , Realidade Virtual , Pessoa de Meia-Idade , Adulto , Humanos , Queimaduras/complicações , Queimaduras/terapia , Lesão por Inalação de Fumaça/complicações , Lesão por Inalação de Fumaça/terapia , Dor , Tórax , Fumaça
6.
Healthcare (Basel) ; 11(12)2023 Jun 17.
Artigo em Inglês | MEDLINE | ID: mdl-37372908

RESUMO

The use of tele-rehabilitation (TR) in type 2 diabetes mellitus (T2DM) following COVID-19 infection remains unexplored. Hence, the purpose of this study was to determine the clinical effects of tele-physical therapy (TPT) on T2DM following COVID-19 infection. The eligible participants were randomized into two groups, a tele-physical therapy group (TPG; n = 68) and a control group (CG; n = 68). The TPG received tele-physical therapy for four sessions a week for eight weeks, and the CG received patient education for 10 min. The outcome measures were HbA1c levels, pulmonary function (forced expiratory volume in the first second (FEV1), forced vital capacity (FVC), FEV1/FVC, maximum voluntary ventilation (MVV), and peak exploratory flow (PEF)), physical fitness, and quality of life (QOL). The difference between the groups in HbA1c levels at 8 weeks was 0.26 (CI 95% 0.02 to 0.49), which shows greater improvement in the tele-physical therapy group than the control group. Similar changes were noted between the two groups after 6 months and at 12 months resulting in 1.02 (CI 95% 0.86 to 1.17). The same effects were found in pulmonary function (FEV1, FVC, FEV1/FVC, MVV, and PEF), physical fitness, and QOL (p = 0.001). The reports of this study show that tele-physical therapy programs may result in improved glycemic control and improve the pulmonary function, physical fitness, and quality of life of T2DM patients following COVID-19 infection.

7.
J Shoulder Elbow Surg ; 32(9): e429-e436, 2023 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-37003428

RESUMO

BACKGROUND: Rotator cuff (RC) pathologies are considered the most common cause of shoulder disability and pain. Arthroscopic repair of RC tears has proven to be an effective operation. Nonhealing and retear remain significant clinical problems and a challenge to surgeons. In addition, the essential biological augment to enhance RC tendon-bone healing is still under research. The purpose of the study was to assess the safety and efficacy of injection of atelocollagen and acellular dermal matrix (ADM) allograft in arthroscopic repair of full-thickness RC tears. METHODS: From January 2018 to March 2020, a total of 129 patients with full-thickness RC tear were treated by arthroscopic repair only (group 1, n = 36, with a mean age = 63.2 years), arthroscopic repair together with atelocollagen 1-mL injection (group 2, n = 44, with a mean age = 63 years), or RC tears together with ADM allograft 1-mL injection (group 3, n = 49, with a mean age = 64.6 years). They were prospectively studied. This study included patients with a repairable full-thickness tear of the supraspinatus tendon size <5 cm. We excluded patients with isolated tears of the subscapularis tendon, those with a previous shoulder surgery, and those who had any type of injection for less than 6 weeks. American Shoulder and Elbow Surgeons Standardized Shoulder Assessment Form score, Constant Shoulder score, visual analog scale pain score, and range of motion were evaluated preoperatively, at 3, 6, and 12 months of the postoperative period and the final follow-up. In addition, magnetic resonance imaging was performed at 2 months and 12 months postoperatively. RESULTS: The mean follow-up period was 20 months. All groups showed improvement in functional and pain score at the final follow-up; however, there is no superior outcome among the 3 groups (P > .05). After 2 months, the nonhealing rate was 11% (4 of 36) for group 1, 4% (2 of 44) for group 2, and 2% (1 of 49) for group 3 (P > .05). The retear rates after 12 months was 19.4% (7 of 36) for group 1, 13.6% (6 of 44) for group 2, and 20.4% (10 of 49) for group 3 (P > .05). Adverse events were not detected in any groups. CONCLUSION: Our study did not show superior clinical or radiologic outcomes of atelocollagen and ADM allograft injections in arthroscopic RC repair over 12 months of follow-up in comparison to the control group. However, adverse events related to atelocollagen and ADM allograft injection were not observed.


Assuntos
Lesões do Manguito Rotador , Articulação do Ombro , Humanos , Pessoa de Meia-Idade , Lesões do Manguito Rotador/cirurgia , Lesões do Manguito Rotador/patologia , Estudos Retrospectivos , Articulação do Ombro/cirurgia , Articulação do Ombro/patologia , Resultado do Tratamento , Artroscopia/métodos , Imageamento por Ressonância Magnética , Amplitude de Movimento Articular , Colágeno/uso terapêutico
8.
PLoS One ; 18(2): e0281206, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-36780557

RESUMO

BACKGROUND: The knowledge about the effective implementation of corticosteroid injection (CS) with deep transverse friction massage (DTFM) and Mill's manipulation (MM) on clinical and radiological changes (Magnetic resonance imaging-MRI and Ultra sound) in lateral epicondylalgia (LE) is lacking. Therefore, the objective of this study is proposed to find and compare the effects of corticosteroid injection (CS) DTFM and Mill's manipulation on clinical and radiological changes in lateral epicondylalgia. DESIGN, SETTING, PARTICIPANTS: Randomized, single-blinded, controlled study was conducted on 60 LE participants at university hospital. The active MM group (n = 30) received corticosteroid injection with DTFM and active Mill's manipulation (MM) three sessions a week for 4 weeks and the sham MM group received corticosteroid injection with sham manipulation. The primary outcome was pain intensity, measured with the visual analog scale. The other outcome measures were percentage of injury measured by MRI and ultrasound, functional disability, handgrip strength, patient perception, kinesiophobia, depression status and quality of life which were measured at 4 weeks, 8weeks and at 6 months follow up. RESULTS: The between-group difference in pain intensity at 4 weeks was 1.6 (CI 95% 0.97 to 2.22), which shows improvement in the active group than sham group. The similar effects have been noted after 8 weeks and at 6 months 2.0 (CI 95% 1.66 to 2.33) follow up in pain intensity. Similar improvements were also found on percentage of injury, functional disability, handgrip strength, patient perception, kinesiophobia, depression status and quality of life (p = 0.001). CONCLUSION: Corticosteroid injection with DTFM and Mill's manipulation was superior to sham group for improving pain, percentage of injury, functional disability, handgrip strength, patient perception, kinesiophobia, depression status and quality of life in people with lateral epicondylalgia. TRIAL REGISTRATION: Clinical trial registration: CTRI/2020/05/025135 trial registered prospectively on 12/05/2020. https://trialsearch.who.int/Trial2.aspx?TrialID=CTRI/2020/05/025135.


Assuntos
Força da Mão , Qualidade de Vida , Humanos , Estudos Prospectivos , Fricção , Corticosteroides/uso terapêutico , Massagem , Resultado do Tratamento
9.
Artigo em Inglês | MEDLINE | ID: mdl-36321229

RESUMO

AIMS AND BACKGROUND: The knowledge about the effective implementation of different exercise training methods on clinical and endocrinological responses in soccer players with chronic low back pain (LBP) is lacking. Hence the study is proposed to find the effects of different exercise training methods on clinical and endocrinological responses in soccer players with chronic low back pain. METHODS: Through the three-block randomization method, 60 chronic LBP participants were randomly divided into the isokinetic exercise group (IKE; n = 20), (CSE; n = 20), and conventional exercise group (n = 20). They received respective training for four weeks. Clinical (pain intensity & kinesiophobia) and endocrinological (glucose, insulin, HOMA-IR, growth hormone, prolactin, ACTH, and cortisol) values were measured at baseline, after 4 weeks, and at 3 months follow up. RESULTS: The baseline data between the groups showed no statistical difference (p ≥ 0.05). Four weeks following training IKE group showed significant changes in pain intensity and kinesiophobia than CSE and conventional training groups (p < 0.05). After 4 weeks of training, all the serum hormone variables show significant changes between the groups (glucose; p = 0.049, insulin; p = 0.005, HOMA-IR; p = 0.021, growth hormone; p = 0.006, prolactin; p = 0.001, ACTH; p = 0.001 and cortisol; p = 0.001). At 3 months follow up, the values for Glucose and Insulin (p > 0.05) variables did not show any statistical changes, but the rest of the variables (p = 0.001) showed significant differences. However, the maximum improvement was seen in the IKE group as calculated by the post hoc Tukey-Kramer's test. CONCLUSION: Our study suggested that strength training through isokinetic exercises improved pain, kinesiophobia status, and temporary changes in serum stress hormone levels than other training methods in soccer players with chronic low back pain.


Assuntos
Insulinas , Dor Lombar , Humanos , Dor Lombar/diagnóstico , Dor Lombar/terapia , Hidrocortisona , Prolactina , Exercício Físico , Terapia por Exercício/métodos , Hormônio do Crescimento , Hormônio Adrenocorticotrópico
10.
J Pers Med ; 12(11)2022 Nov 11.
Artigo em Inglês | MEDLINE | ID: mdl-36422067

RESUMO

OBJECTIVE: The knowledge about the effective implementation of corticosteroid injection and extracorporeal shockwave therapy on radiological changes in chronic lateral epicondylitis is lacking. Therefore, the objective of this study is to find and compare the effects of corticosteroid injection and extracorporeal shockwave therapy on radiological changes in chronic lateral epicondylitis. METHODS: A randomized, double-blinded controlled study was conducted on 60 LE participants at a university hospital. The active extracorporeal shockwave therapy group (n = 30) received a corticosteroid injection with active extracorporeal shockwave therapy one session a week for 4 weeks, and the placebo extracorporeal shockwave therapy group received a corticosteroid injection with placebo extracorporeal shockwave therapy. The primary outcome was pain intensity, measured with the visual analog scale. The other outcome measures were the percentage of injury measured by magnetic resonance imaging and ultrasound, functional disability, handgrip strength, patient perception, kinesiophobia, depression status, and quality of life. RESULTS: The between-group difference in pain intensity at 4 weeks was 1.4 (CI 95% 0.77 to 2.02), which shows more improvement in the active group than in the placebo group. Improvements in the effects were noted after 8 weeks and at 6 months (1.8; CI 95% 1.50 to 2.09) follow-up. Similar improvements were also found in the percentage of injury, functional disability, handgrip strength, patient perception, kinesiophobia, depression status, and quality of life. CONCLUSION: Extracorporeal shockwave therapy has added effects on corticosteroid injection for improving pain, percentage of injury, functional disability, handgrip strength, patient perception, kinesiophobia, depression status and quality of life in people with chronic lateral epicondylitis.

11.
Artigo em Inglês | MEDLINE | ID: mdl-35742443

RESUMO

Objective: To find the clinical and biochemical effects of high-intensity aerobic training with a high-protein diet in children with obesity following COVID-19 infection. Methods: By using the block randomization method, the eligible participants were randomized into two groups. The first group received high-intensity aerobic training with a high-protein diet (Group A; n = 38) and the second group were allowed to do regular physical activities and eat a regular diet (Group B; n = 38) for 8 weeks. Clinical (basal metabolic index (BMI) and muscle-mass-cross-sectional area (CSA)) and biochemical (Adiponectin, leptin, TNF-α, and IL-6) measures were measured at baseline, on the 8th week, and at 6-months follow-up. Results: Baseline demographic and clinical attributes show homogenous presentation among the study groups (p > 0.05). After eight weeks of intervention, and at the end of 6-months follow-up, the basal metabolic index (BMI) (6.3) (CI 95% 4.71 to 7.88), mid-arm CSA (17) (CI 95% 14.70 to 19.29), mid-thigh CSA (13.10) (CI 95% 10.60 to 15.59), mid-calf CSA (11.3) (CI 95% 9.30 to 13.29), adiponectin (−1.9) (CI 95% −2.13 to −1.66), leptin (5.64) (CI 95% 5.50 to 5.77), TNF-α (0.5) (CI 95% 0.42 to 0.57), and IL-6 (0.21) (CI 95% 0.18 to 0.23) showed more improvement (p < 0.001) in Group A than Group B (p > 0.05). Conclusion: Overall, this trial found that high-intensity aerobic training with a high-protein diet decreased the BMI percentile and muscle mass (arm, thigh, and calf), and positively altered the biochemical variables in children with obesity.


Assuntos
COVID-19 , Dieta Rica em Proteínas , Adiponectina , Índice de Massa Corporal , Criança , Humanos , Interleucina-6 , Leptina , Imageamento por Ressonância Magnética , Obesidade , Fator de Necrose Tumoral alfa/metabolismo
12.
Orthop J Sports Med ; 10(1): 23259671211063922, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-35005051

RESUMO

BACKGROUND: Reverse total shoulder arthroplasty (rTSA) is an established procedure for cuff tear arthropathy. More lateralized prostheses have been designed to overcome the reported adverse outcomes of Grammont-style rTSA. PURPOSE: To compare the clinical and radiological outcomes of medialized and lateralized center of rotation (COR) in rTSA. STUDY DESIGN: Systematic review; Level of evidence, 3. METHODS: This review followed the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Included were studies with a level of evidence ≥3 that compared medialized and lateralized rTSA with a minimum follow-up of 12 months. Functional scores including the American Shoulder and Elbow Surgeons (ASES) score and Constant score (CSS), range of motion at final follow-up, gain of external rotation (ER), visual analog scale (VAS) pain score, scapular notching, and heterotopic ossification (HO) were compared. Data were analyzed using random-effects or fixed-effects models in accordance with heterogeneity. RESULTS: Five retrospective cohort studies and 1 randomized controlled study (n = 594 patients) were included. Lateralized rTSA resulted in greater improvement in ER degree (P < .001), a lower VAS pain score (standardized mean difference [SMD], -0.39; P = .002), and a lower rate of scapular notching (risk ratio [RR], 0.40; P < .001) and HO (RR, 0.52; P < .001). Final forward flexion (SMD, -0.14; P = .629) and ER (SMD, 0.21; P = .238) did not differ significantly between the 2 groups. Overall functional scores, including ASES score (SMD, 0.22; P = .310) and CSS (SMD, 0.37; P = .077), also did not differ significantly (SMD, 0.28; P = .062). The overall complication rate did not differ significantly between the 2 groups (RR, 0.71; P = .339). CONCLUSION: Compared with medialized rTSA, lateralized COR rTSA results in greater improvement in ER and the VAS pain score, decreased rates of scapular notching and HO, and no significant changes in functional outcome scores or the complication rate.

13.
Artigo em Inglês | MEDLINE | ID: mdl-36612846

RESUMO

Chronic non-specific low back pain (CNLBP) is the most common musculoskeletal problem. The purpose of this study was to investigate the effects of advanced physiotherapeutic exercise programs on imaging findings and inflammatory biomarkers in soccer players with CNLBP. In total, 60 CNLBP participants were divided into virtual reality exercise (VRE; n = 20), isokinetic exercise (IKE; n = 20), and conventional exercise (n = 20) groups. Pain intensity, imaging findings (muscle cross-sectional area (CSA) and muscle thickness), and changes in inflammatory biomarkers (CRP, TNF-α, IL-2, IL-4, and IL-6) were measured at baseline and after four weeks. After four weeks of intervention, there was a significant improvement (p = 0.001) in pain intensity for the VRE vs. IKE (0.7; CI 95% 0.38 to 1.07) and VRE vs. conventional (3.0 CI 95% 2.68 to 3.31) groups. The IKE group showed a greater number of significant changes in muscle CSA and muscle thickness than the other two groups (p < 0.001). Moreover, the VRE group showed significant improvement in inflammatory biomarker measures compared with the other two groups (p < 0.001). In CNLBP, virtual and isokinetic exercises had equal effects on reducing pain intensity. Isokinetic exercise is beneficial in increasing the muscle CSA and thickness, and virtual exercises are helpful for attenuating the inflammation process in soccer players with CNLBP.


Assuntos
Dor Lombar , Futebol , Humanos , Exercício Físico , Terapia por Exercício/métodos , Jogos Eletrônicos de Movimento , Dor Lombar/diagnóstico por imagem , Dor Lombar/terapia , Futebol/fisiologia
14.
Clin Rehabil ; 36(1): 59-68, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34344230

RESUMO

OBJECTIVE: To find and compare the clinical and psychological effects of low and high-intensity aerobic training combined with resistance training in community-dwelling older men with post-COVID-19 sarcopenia symptoms. DESIGN: Randomized control trial. SETTING: University physiotherapy clinic. PARTICIPANTS: Men in the age range of 60-80 years with post-COVID-19 Sarcopenia. INTERVENTION: All participants received resistance training for whatever time of the day that they received it, and that in addition they were randomized into two groups like low-intensity aerobic training group (n = 38) and high-intensity aerobic training group (n = 38) for 30 minutes/session, 1 session/day, 4 days/week for 8 weeks. OUTCOMES: Clinical (muscle strength and muscle mass) and psychological (kinesiophobia and quality of life scales) measures were measured at the baseline, fourth week, the eighth week, and at six months follow-up. RESULTS: The 2 × 4 group by time repeated measures MANOVA with corrected post-hoc tests for six dependent variables shows a significant difference between the groups (P < 0.001). At the end of six months follow up, the handgrip strength, -3.9 (95% CI -4.26 to -3.53), kinesiophobia level 4.7 (95% CI 4.24 to 5.15), and quality of life -10.4 (95% CI -10.81 to -9.9) shows more improvement (P < 0.001) in low-intensity aerobic training group than high-intensity aerobic training group, but in muscle mass both groups did not show any significant difference (P > 0.05). CONCLUSION: Low-intensity aerobic training exercises are more effective in improving the clinical (muscle strength) and psychological (kinesiophobia and quality of life) measures than high-intensity aerobic training in post-COVID 19 Sarcopenia.


Assuntos
COVID-19 , Treinamento Resistido , Sarcopenia , Idoso , Idoso de 80 Anos ou mais , Força da Mão , Humanos , Vida Independente , Masculino , Pessoa de Meia-Idade , Força Muscular , Qualidade de Vida , SARS-CoV-2
15.
Healthcare (Basel) ; 11(1)2022 Dec 29.
Artigo em Inglês | MEDLINE | ID: mdl-36611567

RESUMO

Background: There is ample evidence supporting the use of manual therapy techniques for the treatment of cervicogenic headache (CGH). Objective: The objective of this study was to find and compare the effects of different manual therapy approaches to cervicogenic headache. Methods: A randomized, controlled study was conducted on 84 CGH participants at the university hospital. The participants were divided into a Mulligan mobilization therapy group (MMT; n = 28), a spinal manipulation therapy group (SMT; n = 28), and a control group (Control; n = 28); they received the respective treatments for four weeks. The primary outcome (CGH frequency) and secondary outcomes (CGH pain intensity, CGH disability, neck pain frequency, pain intensity, pain threshold, flexion rotation (right and left), neck disability index, and quality of life scores) were measured at baseline, after 4 weeks, after 8 weeks, and at a 6-month follow-up. The one-way ANOVA test and repeated measures analysis of variance (rANOVA) test were performed to find the difference between the inter- and intra-treatment group effects. Results: Four weeks following training, the MMT group showed a statistically significant difference in the primary (CGH frequency) and secondary (CGH pain intensity, CGH disability, neck pain frequency, neck pain intensity, flexion rotation test, neck disability index, and quality of life) scores than those of the SMT and control groups (p < 0.001). The same difference was seen in the above variables at 8 weeks and at the 6-month follow-up. At the same time, the neck pain threshold level did not show any difference at the 4-week and the 8-week follow-up (p ≥ 0.05) but showed statistical difference at the 6-month follow-up. Conclusion: The study concluded that Mulligan's mobilization therapy provided better outcomes in cervicogenic headache than those of spinal manipulation therapy and conventional massage therapy.

16.
Artigo em Inglês | MEDLINE | ID: mdl-34422082

RESUMO

RESULTS: The results of the a-ACLR, c-ACLR, and control groups were compared. At 8 weeks following postoperative rehabilitation, the a-ACLR group shows more significant changes than the c-ACLR group (p < 0.001). At 6 and 12 months, there are normal values of kinematic and kinetic values in a-ACLR compared with the results of the control group (p < 0.001). CONCLUSION: The study showed that postoperative rehabilitation provides significant effects in the kinematic, kinetic, and EMG gait parameters in acute ACLR than chronic ACLR subjects. Early surgical intervention and postrehabilitation are mandatory to get the significant effects in the clinical parameters in acute and chronic ACL injury.

17.
BMC Med Educ ; 21(1): 452, 2021 Aug 28.
Artigo em Inglês | MEDLINE | ID: mdl-34454493

RESUMO

BACKGROUND: The COVID-19 pandemic and physical distancing have had a significant impact on the conversion of traditional teaching methods to online teaching methods, which although not uncommon in medical schools, has to date only been used for some aspects of the teaching process. Thus, we aimed to measure the effectiveness of e-learning during the COVID-19 pandemic, as well as medical students' preferences regarding e-learning and classroom teaching, and the possibility of applying it post-pandemic. METHODS: A cross-sectional online survey of medical students (N = 376) in six medical schools was carried out after their second semester, from August 15 to 20, 2020. Ten parameters were measured for the effectiveness of e-learning based on a 5-point Likert-scale and five parameters were measured for satisfaction. RESULTS: e-learning was more or equally effective in four parameters such as assignment submission and meeting individual needs, but less effective in six parameters, including building skills and knowledge, and interaction level. Satisfaction was either high or neutral in all five parameters. CONCLUSIONS: Our findings have shown that e-learning can assist the teaching process in medical schools in some respects, but cannot be used for the entire teaching process.


Assuntos
COVID-19 , Estudantes de Medicina , Estudos Transversais , Humanos , Pandemias , Satisfação Pessoal , SARS-CoV-2
18.
Medicine (Baltimore) ; 100(21): e26176, 2021 May 28.
Artigo em Inglês | MEDLINE | ID: mdl-34032779

RESUMO

ABSTRACT: We aimed to establish the local prevalence of musculoskeletal pain among faculty members in Saudi Arabia and describe the patient's risk factors and preventive measures that may reduce its burden.An observational, quantitative, cross-sectional study was carried out to evaluate the prevalence of musculoskeletal pain and its risk factors among male faculty members in the College of Medicine and Dentistry, using a designed questionnaire based on the Standardized Nordic Musculoskeletal Questionnaire. Chi-square testing at a significance level of P < .05, was used for comparative analysis. SPSS version 26 was used for all analyses.Ninety responders participated in the survey analysis. The prevalence of musculoskeletal pain among faculty members was 77.8%, and the most common site of musculoskeletal pain occurred at two different sites of the three (low back, neck, and shoulder), with a prevalence of 38.9%. As for risk factors of musculoskeletal pain, only age group showed a significant correlation with the site of musculoskeletal pain (P = .024), where patients in the younger age group (25-35 years old) were at higher risk of lower back pain, while participants in the older age group (36 to 44 years old and 45 years or older) were at higher risk of musculoskeletal pain in two different sites.Musculoskeletal pain affects more than two-thirds of faculty members. In particular, low back pain is a common problem among faculty members. Age is a significant risk factor for the occurrence of musculoskeletal pain, with more than one site involvement in older age.


Assuntos
Docentes de Odontologia/estatística & dados numéricos , Dor Musculoesquelética/epidemiologia , Doenças Profissionais/epidemiologia , Adulto , Estudos Transversais , Humanos , Dor Lombar/epidemiologia , Dor Lombar/prevenção & controle , Masculino , Pessoa de Meia-Idade , Dor Musculoesquelética/prevenção & controle , Cervicalgia/epidemiologia , Cervicalgia/prevenção & controle , Doenças Profissionais/prevenção & controle , Prevalência , Fatores de Risco , Arábia Saudita/epidemiologia , Dor de Ombro/epidemiologia , Dor de Ombro/prevenção & controle
19.
Dis Markers ; 2021: 8866093, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33628339

RESUMO

Sarcopenia is the most common feature of hepatic cirrhosis characterized by progressive loss of muscle mass and function and increases permanently the mortality and morbidity rates among those patients. The incidence of sarcopenia in cirrhotic patients ranged 40-70% associating with impaired quality of life and augmented rates of infection. Based on these issues, this review is aimed at determining the prevalence and main causes of sarcopenia among cirrhotic patients and recognizing the recent diagnostic and physical treatment modalities that prevent risk factors for sarcopenia in those patients. No ideal modality is currently demonstrated for diagnosing sarcopenia in hepatic diseases, particularly cirrhosis; however, recent studies reported different diagnostic modalities for muscle function in different individuals including handgrip strength, skeletal muscle index, six-min walk test, liver frailty index, short physical performance battery, and radiological assessments for quadriceps and psoas muscles. Exercise training and therapeutic nutrition are strongly recommended for controlling sarcopenia in cirrhotic patients. The exercise program is designed and carried out on a frequent basis within an extensive scheduled time aimed at improving functional performance, aerobic capacity, and healthy conditions. Finally, a combination of exercise training and therapeutic nutrition is powerfully recommended to control sarcopenia in cirrhosis.


Assuntos
Exercício Físico/fisiologia , Cirrose Hepática/terapia , Fígado/patologia , Músculo Esquelético/patologia , Terapia Nutricional/métodos , Sarcopenia/terapia , Feminino , Força da Mão/fisiologia , Humanos , Cirrose Hepática/complicações , Cirrose Hepática/diagnóstico , Cirrose Hepática/patologia , Testes de Função Hepática , Masculino , Desempenho Físico Funcional , Qualidade de Vida/psicologia , Sarcopenia/complicações , Sarcopenia/diagnóstico , Sarcopenia/patologia , Fatores Sexuais
20.
Int J Surg Case Rep ; 77: 467-471, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33395827

RESUMO

INTRODUCTION: Heterotopic ossification (HO) is the abnormal bone formation in soft tissue where bone normally does not exist. HO can occur secondary to musculoskeletal trauma, burns, spinal cord injury, or traumatic head injury. The treatment of HO ranges from simple medical treatment to advance surgical intervention; it is largely dependent on the amount of bone formation, the location, the limitation of motion, and the severity of the joint disease. PRESENTATION OF CASE: We present the case of a 26-year-old man who presented to an orthopedic clinic with pain in the lower back and both knees, which was not relieved by conservative treatment. The clinical examination revealed a loss of motion in both hips. Radiography of the pelvis showed bilateral fused hips and Brooker type IV HO in both hips. The patient underwent HO resection and converted the fused hip to total hip arthroplasty (THA) through a direct lateral approach. The patient was satisfied with the outcome of over 18 months of follow-up. DISCUSSION: A direct lateral approach, as what we performed, is a simple approach that can expose the acetabulum and proximal femur. The presence of intraoperative fluoroscopy can help identify HO's extension with less damage to the soft tissue and blood loss. CONCLUSION: The surgery appears to be a doable, effective, and safe procedure to treat fused bilateral hip with HO. This is the first study to report staged bilateral THA for HO through a direct lateral approach to the best of our knowledge.

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