Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 998
Filtrar
1.
Rev. bras. med. esporte ; 29: e2022_0150, 2023. tab, graf
Artigo em Inglês | LILACS | ID: biblio-1394842

RESUMO

ABSTRACT Introduction: Meniscal injury is a common condition that can lead to disability due to pain and proprioceptive failure, requiring immediate attention. Combination therapies involve advanced approaches aiming to accelerate rehabilitation in athletes, and electroacupuncture presents therapeutic benefits, although there is still no evidence of its combination with sports therapy. Objective: This paper analyzes the performance of sports rehabilitation in athletes with meniscal lesions using electroacupuncture combined with sports therapy. Methods: The intervention in the control group was based on a traditional range of motion work, muscle strength, proprioceptive training, and other exercise therapies, while the experimental group received a 30 min electro-acupuncture protocol three times a week for four consecutive weeks. The surrogate data (gender, age, disease course, location) are the same. Before treatment, joint activity, muscle strength, total joint scale score of the LYSHOLM questionnaire, and other observational indices were measured during the 6th and 12th week of treatment. The non-parametric statistical method and T-test were used to analyze the changes of each index before and after treatment. After 12 weeks of treatment, the difference between the experimental group and the combination before treatment was significant. Results: The treatment effect of the experimental group was significantly better than the control group. Conclusion: The effect of sports rehabilitation of athletes with meniscus injury based on electroacupuncture combined with sports therapy showed high resolutive application value, indicating an alternative for non-surgical treatment in knee meniscus injuries. Level of evidence II; Therapeutic studies - investigation of treatment outcomes.


RESUMO Introdução: A lesão meniscal é um acometimento comum que pode gerar incapacitação por dor e falha proprioceptiva, exigindo atenção imediata. Terapias combinadas envolvem abordagens avançadas com o objetivo de acelerar a reabilitação nos atletas, e a eletroacupuntura apresenta benefícios terapêuticos, embora ainda não possua evidencias de sua combinação com a terapia esportiva. Objetivo: Analisar o desempenho da reabilitação esportiva em atletas com lesão meniscal utilizando eletroacupuntura combinada à terapia esportiva. Métodos: A intervenção no grupo controle baseou-se no trabalho tradicional de amplitude de movimento, força muscular, treinamento proprioceptivo e outros tipos de terapias de exercício enquanto que ao grupo experimental foi adicionado um protocolo de eletro-acupuntura de 30 minutos de duração, 3 vezes por semana durante 4 semanas consecutivas. Os dados de substituição (sexo, idade, curso de doença, localização) são basicamente os mesmos. Antes do tratamento, a atividade articular, a força muscular, o escore total da escala articular do questionário LYSHOLM e outros índices de observação foram medidos na 6ª e 12ª semana do tratamento. O método estatístico não paramétrico e teste-T foram utilizados para analisar as alterações de cada índice antes e depois do tratamento. Após 12 semanas de tratamento, a diferença entre o grupo experimental e a combinação antes do tratamento foi significativa. Resultados: O efeito de tratamento do grupo experimental foi significativamente melhor do que o grupo controle. Conclusão: O efeito de reabilitação esportiva de atletas com lesão meniscal baseada em eletroacupuntura combinada à terapia esportiva demonstrou alto valor de aplicação resolutiva, indicada como alternativa para o tratamento não cirúrgico em lesões no menisco do joelho. Nível de evidência II; Estudos terapêuticos - investigação dos resultados do tratamento.


Resumen Introducción: La lesión meniscal es una lesión común que puede causar incapacidad por dolor y fallo propioceptivo, requiriendo atención inmediata. Las terapias combinadas implican enfoques avanzados con el objetivo de acelerar la rehabilitación en los deportistas, y la electroacupuntura presenta beneficios terapéuticos, aunque todavía no hay pruebas de su combinación con la terapia deportiva. Objetivo: Analizar el rendimiento de la rehabilitación deportiva en atletas con lesión meniscal utilizando electroacupuntura combinada con la terapia deportiva. Métodos: La intervención en el grupo de control se basó en el trabajo tradicional de amplitud de movimiento, fuerza muscular, entrenamiento propioceptivo y otros tipos de terapias de ejercicio, mientras que al grupo experimental se le añadió un protocolo de electroacupuntura de 30 minutos de duración, 3 veces a la semana durante 4 semanas consecutivas. Los datos sustitutivos (sexo, edad, evolución de la enfermedad, localización) son básicamente los mismos. Antes del tratamiento, se midieron la actividad articular, la fuerza muscular, la puntuación total de la escala articular del cuestionario LYSHOLM y otros índices de observación en la 6ª y 12ª semana de tratamiento. Se utilizó el método estadístico no paramétrico y la prueba T para analizar los cambios de cada índice antes y después del tratamiento. Tras 12 semanas de tratamiento, la diferencia entre el grupo experimental y la combinación antes del tratamiento era significativa. Resultados: El efecto del tratamiento del grupo experimental fue significativamente mejor que el del grupo de control. Conclusión: El efecto de la rehabilitación deportiva de atletas con lesión de menisco basada en la electroacupuntura combinada con la terapia deportiva mostró un alto valor de aplicación resolutiva, indicada como alternativa de tratamiento no quirúrgico en las lesiones de menisco de rodilla. Nivel de evidencia II; Estudios terapéuticos - investigación de los resultados del tratamiento.


Assuntos
Humanos , Traumatismos em Atletas/reabilitação , Eletroacupuntura , Terapia por Exercício/métodos , Lesões do Menisco Tibial/reabilitação , Traumatismos do Joelho/reabilitação , Medição da Dor , Força Muscular
2.
Afr Health Sci ; 22(2): 565-572, 2022 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-36407341

RESUMO

Background: Gait speed and postural stability are indicators of community level ambulation and may be a valuable measure of disability. Objectives: to investigate the relation between the distribution of weight on both lower extremities and gait speed in children with spastic cerebral palsy. Methods: Evaluation for weight distribution on both lower limbs and speed during gait for sixty children with spastic diplegia and forty-five children with hemiplegia was carried out by the Biodex gait trainer. Pearson correlation test was conducted to determine the relation of the symmetry index and the percent of weight bearing to speed. Results: A significant weak positive correlation was found between speed and symmetry index in diplegic group, while there was a non-significant weak negative correlation between speed and symmetry index was noticed in hemiplegic group. Nonsignificant weak positive correlation between speed and weight on most affected side was recorded in diplegic group. While in hemiplegic group, there was significant weak negative correlation between weight on affected side and speed. Conclusion: Children with cerebral palsy demonstrate asymmetrical weight distribution during walking. Physical therapy training should be directed to enhance weight bearing distribution thus improving gait and postural stability.


Assuntos
Paralisia Cerebral , Humanos , Criança , Velocidade de Caminhada , Hemiplegia , Marcha , Caminhada
3.
Children (Basel) ; 9(11)2022 Oct 31.
Artigo em Inglês | MEDLINE | ID: mdl-36360401

RESUMO

The lack of knowledge by health professionals in the management of scoliosis can lead to an erroneous diagnosis. The aim of the current study was to understand the influence of length of professional experience on the knowledge of Brazilian physical therapists regarding international guidelines for the treatment of adolescent idiopathic scoliosis. The study was conducted using an online questionnaire consisting of 23 questions, divided into 8 questions on sociodemographic data and 15 questions based on information provided by the guidelines in the SOSORT 2016. In total, 506 physiotherapists were interviewed, and they comprised the study sample. The results showed that professionals who have been working for more than 6 years in the field have greater knowledge of AIS, seek to become more professional, and with that, have an understanding of AIS that is more aligned with the SOSORT. Length of experience made a difference when considering knowledge of the treatment of idiopathic scoliosis. The present study showed that a time since graduation of 6 years or more was satisfactory.

4.
BMC Musculoskelet Disord ; 23(1): 975, 2022 Nov 11.
Artigo em Inglês | MEDLINE | ID: mdl-36368960

RESUMO

BACKGROUND: Lateral ankle sprain (LAS) is a common and burdensome injury. However, the quality of its management is scant. Nowadays, physiotherapy management of musculoskeletal diseases seems to be generally not based on research evidence. Studies that investigated the knowledge-to-practice gap in LAS management are yet to be carried out. Therefore, this research investigated physiotherapists' knowledge of and adherence to LAS Clinical Practice Guidelines (CPGs) and recommendations. METHODS: A cross-sectional study based on an online survey structured in three sections. The first section collected demographic data. The second section showed two clinical cases (with positive and negative Ottawa Ankle Rules (OAR), respectively). The participants indicated which treatments they would adopt to manage them. Participants were classified as 'following', 'partially following', 'partially not following' and 'not following' the CPGs and recommendations. In the third section, participants expressed their agreement with different CPG and recommendation statements through a 1-5 Likert scale. RESULTS: In total, 483 physiotherapists (age: 34 ± 10; female 38%, male 61.5%, other 0.5%) answered the survey: 85% completed the first two sections, 76% completed all three sections. In a case of acute LAS with negative OAR, 4% of the participants were considered as 'following' recommended treatments, 68% as 'partially following', 23% as 'partially not following', and 5% as 'not following'. In a case of acute LAS with positive OAR, 37% were considered 'following' recommended treatments, 35% as 'partially following', and 28% as 'not following'. In the third section, the consensus was achieved for 73% of the statements. CONCLUSION: This study showed that although there is a good knowledge about first-line recommended treatments, a better use of CPGs and recommendations should be fostered among physiotherapists. Our results identify an evidence-to-practice gap in LAS management, which may lead to non-evidence-based practice behaviors.


Assuntos
Traumatismos do Tornozelo , Fisioterapeutas , Entorses e Distensões , Masculino , Feminino , Humanos , Adulto Jovem , Adulto , Estudos Transversais , Traumatismos do Tornozelo/diagnóstico , Traumatismos do Tornozelo/terapia , Tornozelo
5.
Artigo em Inglês | MEDLINE | ID: mdl-36360815

RESUMO

OBJECTIVE: Assess the effectiveness of physical therapy, including supervised physical exercise for body mass index (BMI) restoration; improving muscle strength and the psychological, behavioural, cognitive symptoms and quality of life in patients with anorexia nervosa (AN). METHODS: A Systematic Review (SR) was conducted in the following scientific databases: Medline, PubMed, PEDro, PsychInfo, Cochrane Library plus, Nursing and Allied Health database, Scopus and Web of Science databases, from inception until November 2021. An assessment of the risk of bias and the certainty of evidence across studies was conducted. Articles were eligible if they followed randomized and non-randomized control trial designs with treatments based on physical therapy or exercise or physical activity in AN patients. RESULTS: 496 records were screened, and after eligibility assessment, 6 studies from 8 articles were finally analysed. The studies, involving 176 AN patient (85.02% of patients), reported improvements in muscle strength, eating behaviour, eating attitude, mood and quality of life. Three studies included nutritional co-interventions and four studies included psychological therapy. None of the studies reported adverse effects. CONCLUSIONS: In two of the RCTs included in this SR, strength training and high intensity resistance improved the muscle strength of patients with AN. In addition, in two RCTs, improvements were observed in patients' attitudes towards their bodies after basic body awareness therapy or after full body massage and instruction to relax. In addition, quality of life improved in two studies, with stretching, isometrics, endurance cardiovascular and muscular exercising.


Assuntos
Anorexia Nervosa , Humanos , Anorexia Nervosa/terapia , Qualidade de Vida , Exercício Físico/fisiologia , Força Muscular , Modalidades de Fisioterapia
6.
Physiother Theory Pract ; 38(13): 2929-2937, 2022 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-36404768

RESUMO

PURPOSE: This study aimed at translating, culturally adjusting, and validating the Israeli version of the Physical Therapy Patient Satisfaction Questionnaire (PTPSQ-H). METHODS: Following the process of cross-cultural adaptation of self-report measures guidelines, we conducted a cross-cultural adaptation study among of adults completing outpatient physical therapy treatments. We formulated the PTPSQ-H using forward-backward translation procedures, a final review, and a pre-final version. The applied analyses were acceptability, reliability (measured by internal consistency; Cronbach's α), and factor analysis (exploring internal structure). Divergent validity was assessed by paralleling the PTPSQ-H with pain visual analogue scale (VAS), and a 5-point Likert scale evaluating the global perceived effect (GPE) of the physical therapy treatment. Preliminary analyses concluded that five items from the PTPSQ-H are irrelevant for the study population, thus these items were removed and the questionnaire was termed the PTPSQ-H[15]. RESULTS: The PTPSQ-H[15] exhibited high internal consistency (α = 0.883). Divergent validity was low for the GPE (r = 0.257, p < .0001) and insignificant for the VAS (r = -0.05, p = .480). A factor analysis indicated a significant two-factor structure related to "Overall Experience" and "Professional Impression", which explained nearly 60% of the total variance assuring its suitability to measure patient satisfaction. CONCLUSION: PTPSQ-H[15] was found to be a valid tool to measure physical therapy patient satisfaction.


Assuntos
Comparação Transcultural , Satisfação do Paciente , Adulto , Humanos , Psicometria , Reprodutibilidade dos Testes , Inquéritos e Questionários , Modalidades de Fisioterapia
7.
Ther Adv Chronic Dis ; 13: 20406223221136059, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36420043

RESUMO

Background: It is crucial to start an early intervention in unilateral cerebral palsy. Intensive therapies are focused on training based on activities. Objective: The objective of the study was to study the changes in the bimanual functional performance (BFP) after early intensive therapies at home compared with standard care in children with unilateral cerebral palsy from 9 to 18 months of age. Design: A single-blind comparative effectiveness study will be conducted. Methods and Analysis: Children will be randomized into four groups: infant-mCIMT, infant-BIT, infant-hybrid, and infant standard therapy (control group, CG). Each early intensive protocol will last 50 h and will be applied throughout a 10-week period with the family involvement at home. The main outcomes are BFP measure with mini-Assisting Hand Assessment (mini-AHA) scale, functional goals measure with Goal Attainment Scale (GAS), and satisfaction and expectations on intensive therapy from parents measure through specific questionnaire. Baseline characteristics between groups will be compared using independent t test and Fisher's exact test. Pre- and post-treatment outcomes of standard assessments will be compared using analysis of variance (ANOVA) for parametric and Kruskal-Wallis test for non-parametric variables. The Bonferroni correction is applied for multiple comparisons. An alpha level of p ⩽ 0.05 is considered significant. Discussion: In relation to other studies that have analyzed intensive therapies, although with fewer intervention groups, it seems that the application of any of the intensive interventions is effective with the applied dose to obtain changes in BFP and increase the spontaneous use of the affected upper limb. Registration: ClinicalTrials.gov Identifier: NCT04642872.

8.
RMD Open ; 8(2)2022 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-36418088

RESUMO

OBJECTIVE: Adhesive capsulitis is a common painful shoulder condition. Treatment for the condition remains unsatisfactory. Suprascapular nerve block (SSNB) shows promise as a treatment option for adhesive capsulitis but there are no randomised controlled trials that examine its effect on pain or duration of the condition. The objective of this study was to examine the efficacy of SSNB for the management of adhesive capsulitis. METHODS: A randomised double-blind placebo-controlled trial of SSNB and standard therapy versus placebo and standard therapy was performed. In total, 54 patients were enrolled in the study. 27 patients received a glenohumeral joint (GHJ) injection and physiotherapy plus a 3-month SSNB, and 27 patients received a GHJ injection and physiotherapy plus a 3-month placebo injection. Patients were followed to resolution of their symptoms as measured by a combination of range of movement, pain scores, Shoulder Pain and Disability Index (SPADI) scores and perceived recovery scores. The primary outcome measure was time to resolution of symptoms. RESULTS: Participants who received the SSNB reduced the duration of their symptoms of adhesive capsulitis by an average of 6 months (mean time to resolution 5.4 (95% CI 4.4 to 6.3) months vs 11.2 (95% CI 9.3 to 13) months) in the placebo group. They also had reduced pain scores, improved range of movement and lower SPADI scores compared with the placebo group across all time points. CONCLUSION: SSNB reduced the duration of adhesive capsulitis and resulted in improved pain and disability experience for patients. TRIAL REGISTRATION NUMBER: Australian New Zealand Clinical Trials Registry (ANCTRN 12615001378516).


Assuntos
Bursite , Bloqueio Nervoso , Humanos , Resultado do Tratamento , Austrália , Bursite/terapia , Bursite/etiologia , Dor de Ombro/terapia , Dor de Ombro/tratamento farmacológico , Bloqueio Nervoso/efeitos adversos , Bloqueio Nervoso/métodos
9.
Int. braz. j. urol ; 48(5): 807-816, Sept.-Oct. 2022. tab, graf
Artigo em Inglês | LILACS-Express | LILACS | ID: biblio-1394382

RESUMO

ABSTRACT Purpose: to verify the effects of biofeedback (BF) and manual therapy (MT) associated with transcutaneous electrical nerve stimulation (TENS) or postural exercises (PE) in the treatment of bladder pain syndrome (BPS) in women regarding pain and urinary symptoms. Materials and Methods: a parallel-randomized controlled trial was conducted in BPS patients diagnosed according to NIH clinical criteria. Two specialized physiotherapists applied demographic and validated questionnaires of perineal and suprapubic pain (VAS), urinary symptoms and problems (ICSI and ICPI) and sexual function (FSFI) and a physical assessment was made to identify myofascial trigger points. Thirty-one women, mean age 51.8 ± 10.9 were randomized in three groups of treatment consisting of ten weekly sessions of BF and MT (Conventional group); BF, MT, and TENS (TENS group); and BF, MT, and PE (Postural group). Results: Postural group improved perineal and suprapubic pain after treatment (p<0.001 and p=0.001, respectively), and the suprapubic pain improvement remained persistent at 3 months of follow up (p=0.001). Postural group improved urinary symptoms and problems after treatment (p<0.001 and p=0.005, respectively) and during follow up (p<0.001 and p=0.001). Conclusions: Biofeedback and manual therapy associated with postural exercises showed a significant improvement in perineal and suprapubic pain and urinary symptoms after treatment and during follow-up. Both results suggest a possible role for the use of this physiotherapy technique to treat BPS patients. Longer follow-up and a larger number of patients are necessary to confirm these conclusions.

10.
Artigo em Inglês | MEDLINE | ID: mdl-36293852

RESUMO

Hemangiomas are the most common benign tumours affecting the spine, with an incidence of 10-12% of the general population. Although most hemangiomas are asymptomatic, there are aggressive forms which can develop symptoms, leading patients to show signs of disability. This case report aims to highlight the importance of red flags screening, and to report the physiotherapist's clinical reasoning that led him to refer his patient to other healthcare professionals. This case also illustrated the pre- and post-surgical treatment of a specific low back pain case in a patient affected by aggressive vertebral hemangioma and spinal cord compression. The patient is a 52-year-old man, who reported intense pain in his sacral region about three months prior, which worsened while in sitting position. The physiotherapist proceeded with a complete medical history investigation and clinical examination. After an impaired neurological examination, the patient was referred to another health professional, who diagnosed multiple vertebral hemangiomas in the patient's lumbosacral tract. The therapeutic intervention included the patient's post-surgical rehabilitation following a vascular embolization. This case report shows the importance of proper patient screening. Indeed, during patients' assessment, it is paramount to recognize red flags and to investigate them appropriately. An early referral of patients with conditions that require the support and expertise of other professionals can lead to a timely diagnosis and avoid costly and unnecessary rehabilitation procedures. In this case, the interdisciplinary collaboration between physiotherapist and neurosurgeon was crucial in guiding the patient towards recovery.


Assuntos
Hemangioma , Dor Lombar , Compressão da Medula Espinal , Neoplasias da Coluna Vertebral , Humanos , Masculino , Pessoa de Meia-Idade , Compressão da Medula Espinal/diagnóstico , Compressão da Medula Espinal/etiologia , Compressão da Medula Espinal/cirurgia , Neoplasias da Coluna Vertebral/complicações , Neoplasias da Coluna Vertebral/diagnóstico , Neoplasias da Coluna Vertebral/cirurgia , Dor Lombar/complicações , Hemangioma/diagnóstico , Hemangioma/cirurgia , Hemangioma/patologia , Vértebras Torácicas
11.
Phys Ther ; 2022 Oct 09.
Artigo em Inglês | MEDLINE | ID: mdl-36209432

RESUMO

OBJECTIVE: The purpose of this study was to investigate the effectiveness of fluoroscopy-guided manual lymph drainage (MLD) versus that of traditional and placebo MLD, when added to decongestive lymphatic therapy (DLT) for the treatment of breast cancer-related lymphedema (BCRL), on the suprafascial accumulation of lymphatic fluid and skin elasticity. METHODS: In this multicenter, 3-arm, double-blind randomized controlled trial (EFforT-BCRL trial), 194 participants (mean age = 61 [SD = 10] years) with unilateral BCRL were recruited. All participants received standardized DLT (education, skin care, compression therapy, exercises) and were randomized to fluoroscopy-guided, traditional, or placebo MLD. Each day participants received 60 minutes of treatment during the 3-week intensive phase and 18 sessions of 30 minutes during the 6-month maintenance phase. Participants were instructed to wear a compression garment, to perform exercises, and to perform a self-MLD procedure once daily. This study comprises secondary analyses of the EFforT-BCRL trial. Outcomes were the amount of fluid accumulation in the suprafascial tissues (local tissue water, extracellular fluid, and thickness of the skin and subcutaneous tissue) and skin elasticity at the level of the arm and trunk. Measurements were performed at baseline; after intensive treatment; after 1, 3, and 6 months of maintenance treatment; and after 6 months of follow-up. RESULTS: At the level of the arm, there was a significant improvement over time in the 3 groups for most of the outcomes. At the level of the trunk, no remarkable improvement was noted within the individual groups. No significant interaction effects (between-group differences) were present. Only skin elasticity at the level of the arm, evaluated through palpation, showed a significant interaction effect. CONCLUSIONS: All 3 groups showed similar improvements in response to DLT, regardless of the type of MLD that was added. The effect of the addition of MLD to other components of DLT for reducing local tissue water and extracellular fluid or skin thickness and for improving skin elasticity and fibrosis in participants with chronic BCRL was limited.

12.
Disabil Rehabil ; : 1-10, 2022 Oct 21.
Artigo em Inglês | MEDLINE | ID: mdl-36269093

RESUMO

PURPOSE: The systematic review aimed to investigate the effects of kinesio taping on the lower extremity kinetics and kinematics after a musculoskeletal disorder. METHOD: Randomized controlled studies reported kinetic or kinematic outcomes (such as joint moment force or angular displacement) in the lower extremity with musculoskeletal disorders were included. A systematic literature search of Web of Science, Scopus, PubMed, EBSCO, and PEDro databases was performed up to 28 February 2021. Meta-analysis was performed, when possible, by using mean difference (MD) and standard mean difference (SMD). RESULTS: Ten randomized controlled trials met the inclusion criteria. The results of a meta-analysis based on included studies show that the use of kinesio taping has similar effects on the kinetics of the lower extremities with musculoskeletal disorders or the control group. These effects do not change between 0 and 24 h, 1 and 15 days, and 15 and 30 days (SMD = 0.01, 95% CI -0.30 to 0.31, p = 0.21). CONCLUSION: This study provides insufficient evidence to prove the effect of kinesio taping on lower extremity kinetics and kinematics on patients with musculoskeletal disorders in shorter and longer terms. Methodologically well-designed studies are needed to show the effectiveness of kinesio tape on lower extremity kinetics and kinematics after a musculoskeletal disorder in short and longer terms.IMPLICATIONS FOR REHABILITATIONThe present evidence does not support the effects of Kinesio tape on lower extremity kinetics in patients with a musculoskeletal pathologyMore evidenced based studies are still needed to show the effects of kinesio taping on lower extremity kinetics in patients with a musculoskeletal pathologyThis meta-analysis demonstrated that kinesio taping had no effect for up to 30 days within the scope of the results obtained from the studies, except for the immediate effect of the application.

13.
Artigo em Inglês | MEDLINE | ID: mdl-36294171

RESUMO

Shoulder pain is often attributable to a musculoskeletal disorder, but in some instances, it may be linked to pathologies outside the physiotherapist's area of expertise. Specifically, some intracranial problems can cause pain and disability to the shoulder complex. This case report aims to describe the clinical presentation, history taking, physical examination, and clinical decision-making procedures in a patient with an intracranial epidermoid cyst mimicking a musculoskeletal disorder of the shoulder girdle. A 42-year-old man complained of pain and disability in his left shoulder. Sudden, sharp pain was reported during overhead movements, associated with intermittent tingling of the left upper trapezius and left scapular area. Moreover, the patient reported reduced hearing in his left ear and left facial dysesthesia. The physical examination led the physiotherapist to hypothesize a pathology outside the physiotherapist's scope of practice and to refer the patient to another health professional to further investigate the patient through imaging. It is essential for the physiotherapist to recognize when the patient's clinical condition requires a referral to another healthcare professional. Therefore, the physiotherapist must be able to, in a timely manner, identify signs and symptoms suggesting the presence of medical pathology beyond his expertise, through appropriate medical history collection and physical evaluation.


Assuntos
Cisto Epidérmico , Ombro , Masculino , Humanos , Adulto , Cisto Epidérmico/diagnóstico , Cisto Epidérmico/complicações , Modalidades de Fisioterapia , Dor de Ombro/etiologia , Exame Físico/métodos
14.
Medicina (Kaunas) ; 58(10)2022 Oct 19.
Artigo em Inglês | MEDLINE | ID: mdl-36295645

RESUMO

Background and objectives: Urinary incontinence is any involuntary loss of urine. It may result in anxiety, depression, low self-esteem and social isolation. Perineal massage has spread as a prophylactic technique for treating complications during labor. Acknowledged effects of perineal massage are reduction of incidence and severity of perineal tear and use of equipment directly related to the intrapartum perineal trauma. The aim of this study was to determine the effectiveness of massage in urinary incontinence prevention and identification of possible differences in its form of application (self-massage or by a physiotherapist), with the previous assumption that it is effective and that there are differences between the different forms of application. Materials and Methods: A controlled clinical trial with a sample of 81 pregnant women was conducted. The participants were divided into three groups: a group that received the massage applied by a specialized physiotherapist, another group that applied the massage to themselves, and a control group that only received ordinary obstetric care. Results: No differences were identified in the incidence or severity of urinary incontinence among the three groups. The severity of the incontinence was only affected by the body mass index and the weight of the baby at the time of delivery. Conclusions: A relationship between perineal massage interventions and development of urinary incontinence has not been observed.


Assuntos
Trabalho de Parto , Complicações do Trabalho de Parto , Incontinência Urinária , Feminino , Humanos , Gravidez , Massagem/métodos , Complicações do Trabalho de Parto/prevenção & controle , Período Pós-Parto , Incontinência Urinária/prevenção & controle
15.
Neurología (Barc., Ed. impr.) ; 37(8): 668-681, octubre 2022. tab
Artigo em Espanhol | IBECS | ID: ibc-210175

RESUMO

Introducción: El dolor del miembro fantasma (DMF) es un dolor de tipo neuropático que afecta al territorio de una extremidad amputada o a otras partes del cuerpo extirpadas quirúrgicamente. El 60-90% de los amputados sufren DMF durante el seguimiento. Se han descrito opciones terapéuticas para DMF, farmacológicas (gabapentina, amitriptilina, antidepresivos tricíclicos...) y no farmacológicas (TENS, hipnosis, acupuntura...). Una hipótesis predominante considera este fenómeno consecuencia de la reorganización cortical postamputación, y, tras investigaciones innovadoras de Ramachandran en los 90, se han desarrollado nuevos enfoques de tratamiento como la terapia de espejo (TE). En la presente revisión se analiza la evidencia actual publicada sobre la eficacia de la TE para el tratamiento del DMF.DesarrolloSe realizó una revisión bibliográfica, abarcando desde 2012 a 2017, de publicaciones registradas en las bases de datos Cinahl, Cochrane, Scopus y Pubmed (incluyendo Medline). Los descriptores utilizados para la búsqueda fueron los términos Phantom Limb y Mirror Therapy. Se identificaron 115 publicaciones que abordaban TE en DMF. De estas, 17 (15%) aportaban información útil para el análisis conjunto.ConclusionesLa TE parece ser efectiva en el alivio del DMF, reduciendo la intensidad y duración de los episodios de dolor diarios. Por otra parte, constituye un método válido, sencillo y muy económico. La calidad metodológica de la mayoría de las publicaciones en este campo es muy limitada, destacando la necesidad de estudios adicionales de alta calidad para desarrollar protocolos clínicos que puedan maximizar los beneficios de TE en pacientes con DMF. (AU)


Introduction: Phantom limb pain (PLP) is a type of neuropathic pain that affects the territory of an amputated limb or other surgically removed body parts. Between 60% and 90% of amputees suffer from PLP during follow-up. There are a range of therapeutic options for PLP, both pharmacological (gabapentin, amitriptyline, tricyclic antidepressants, etc) and non-pharmacological (transcutaneous electrical nerve stimulation, hypnosis, acupuncture, etc). A widely accepted hypothesis considers PLP to be the consequence of postamputation cortical reorganisation. New treatment approaches, such as mirror therapy (MT), have been developed as a result of Ramachandran's groundbreaking research in the 1990s. This review analyses the current evidence on the efficacy of MT for treating PLP.DevelopmentWe performed a literature review of publications registered from 2012 to 2017 on the CINAHL, Cochrane, Scopus, and PubMed (including Medline) databases Using the descriptors “phantom limb‿ and “mirror therapy.‿ We identified 115 publications addressing MT in PLP. Of these, 17 (15%) contributed useful information for pooled analysis.ConclusionsMT seems to be effective in relieving PLP, reducing the intensity and duration of daily pain episodes. It is a valid, simple, and inexpensive treatment for PLP. The methodological quality of most publications in this field is very limited, highlighting the need for additional, high-quality studies to develop clinical protocols that could maximise the benefits of MT for patients with PLP. (AU)


Assuntos
Humanos , Membro Fantasma , Dor , Amputação , Especialidade de Fisioterapia , Terapêutica , Pacientes
16.
Neurologia (Engl Ed) ; 37(8): 668-681, 2022 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-36195376

RESUMO

INTRODUCTION: Phantom limb pain (PLP) is a type of neuropathic pain that affects the territory of an amputated limb or other surgically removed body parts. Between 60% and 90% of amputees suffer from PLP during follow-up. There are a range of therapeutic options for PLP, both pharmacological (gabapentin, amitriptyline, tricyclic antidepressants, etc) and non-pharmacological (transcutaneous electrical nerve stimulation, hypnosis, acupuncture, etc). A widely accepted hypothesis considers PLP to be the consequence of postamputation cortical reorganisation. New treatment approaches, such as mirror therapy (MT), have been developed as a result of Ramachandran's groundbreaking research in the 1990s. This review analyses the current evidence on the efficacy of MT for treating PLP. DEVELOPMENT: We performed a literature review of publications registered from 2012 to 2017 on the CINAHL, Cochrane, Scopus, and PubMed (including Medline) databases using the descriptors "phantom limb" and "mirror therapy." We identified 115 publications addressing MT in PLP. Of these, 17 (15%) contributed useful information for pooled analysis. CONCLUSIONS: MT seems to be effective in relieving PLP, reducing the intensity and duration of daily pain episodes. It is a valid, simple, and inexpensive treatment for PLP. The methodological quality of most publications in this field is very limited, highlighting the need for additional, high-quality studies to develop clinical protocols that could maximise the benefits of MT for patients with PLP.


Assuntos
Membro Fantasma , Amitriptilina , Antidepressivos Tricíclicos , Gabapentina/uso terapêutico , Humanos , Terapia de Espelho de Movimento , Membro Fantasma/tratamento farmacológico
17.
Physiotherapy ; 117: 47-62, 2022 12.
Artigo em Inglês | MEDLINE | ID: mdl-36244273

RESUMO

BACKGROUND: Robust measurement tools are essential in guiding physiotherapy-delivered airway clearance techniques to ventilated infants and children. OBJECTIVE: To identify measurement tools used to evaluate effects of airway clearance techniques in ventilated infants and children and to determine the clinimetric properties of these tools. DATA SOURCES: Pubmed, CINAHL, Embase, The Cochrane Library, Physiotherapy Evidence Database and Web of Science, up to November 2020. STUDY SELECTION: Randomized and non-randomized clinical trials measuring any aspect of lung function during and/or after airway clearance techniques in mechanically ventilated infants and children from birth to sixteen years. DATA EXTRACTION AND DATA SYNTHESIS: Two independent reviewers identified tools measuring effects of airway clearance techniques including secretion clearance, respiratory mechanics, gas exchange and changes on lung imaging. Extracted data included details of the tool, airway clearance intervention being evaluated and aspects of lung function being measured. Assessment of quality and clinimetric properties, including validity, reliability and responsiveness, were evaluated for each tool using the COnsensus-based Standards for the selection of health status Measurement INstruments methodology. RESULTS: Nine measurement tools measured the effects of airway clearance techniques on secretion clearance, respiratory mechanics, gas exchange and lung imaging. Five tools reported clinimetric properties although the yield and overall quality of studies was low. Tools measured many different aspects of lung function. The CO2SMO Plus respiratory mechanics monitor reported the most clinimetric data. LIMITATIONS: Unpublished or in-progress studies were not included to ensure all data collected were peer-reviewed, therefore additional or novel tools may not have been identified. Included age ranges and definition of airway clearance techiques were kept broad to optimise study identification which may limit generalisability of results. CONCLUSION: Measurement tools used by physiotherapists to enhance airway clearance in ventilated infants and children lack high quality evidence of validity, reliability and responsiveness. Measurements gained through these tools should therefore be interpreted with careful consideration until further climimetric evidence is available. CONTRIBUTION OF PAPER.


Assuntos
Fisioterapeutas , Respiração Artificial , Lactente , Criança , Humanos , Respiração Artificial/métodos , Reprodutibilidade dos Testes , Modalidades de Fisioterapia
18.
Ann Rheum Dis ; 2022 Oct 19.
Artigo em Inglês | MEDLINE | ID: mdl-36261247

RESUMO

OBJECTIVE: To update the evidence of non-biological treatments for axial spondyloarthritis (axSpA), as a basis for the 2022 Assessment of SpondyloArthritis international Society-European Alliance of Associations for Rheumatology (ASAS-EULAR) recommendations for the management of axSpA. METHODS: A systematic literature review (2016-2021) on efficacy and safety of non-pharmacological and non-biological pharmacological treatments was performed, up to 1 January 2022. The research question was formulated according to the PICO format: Population: adult patients with r-axSpA and nr-axSpA; Intervention: non-pharmacological and non-biological pharmacological treatments; Comparator: active comparator or placebo; Outcomes: all relevant efficacy and safety outcomes. Type of studies included were: randomised controlled trials (RCTs), observational studies (for efficacy of non-pharmacological treatments, and safety), qualitative studies. Cohen's effect size (ES) was calculated for non-pharmacological and risk ratio (RR) for pharmacological treatments. RESULTS: Of 107 publications included, 63 addressed non-pharmacological interventions, including education (n=8) and exercise (n=20). The ES for education on disease activity, function, mobility was small to moderate (eg. Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), ES: 0.06-0.59). Exercise had moderate to high ES on these outcomes (eg. BASDAI, ES: 0.14-1.43). Six RCTs on targeted synthetic disease-modifying antirheumatic drugs (DMARDs) showed efficacy of tofacitinib, upadacitinib and filgotinib (phase 2 only) in r-axSpA (range RR vs placebo for ASAS20: 1.91-3.10), while apremilast and nilotinib were not efficacious. Studies on conventional synthetic DMARDs (n=3), non-steroidal anti-inflammatory drugs (NSAIDs, n=8) and other drugs (n=12) did not provide new evidence on efficacy/safety (efficacy of NSAIDs confirmed; limited efficacy of short-term glucocorticoids in one RCT). CONCLUSIONS: Education, exercise and NSAIDs confirmed to be efficacious in axSpA. JAKi were proved efficacious in r-axSpA.

19.
Sleep Sci ; 15(3): 326-333, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36158726

RESUMO

Introduction: Chronic pain, nocturnal cramps, and sleep alterations are prevalent symptoms and signals in Charcot-Marie-Tooth disease patients. Sleep and pain are bidirectionally related and physical therapy can improve the binomial sleep and pain/nocturnal cramps. Therefore, we hypothesized that the application of a specific physical therapy program for Charcot-Marie-Tooth disease would improve sleep quality, pain perception, and nocturnal cramps. Material and Methods: A non-randomized controlled study that included 9 Charcot-Marie-Tooth disease patients (intervention group - physical therapy program) and 8 controls (active control group - booklet on sleep hygiene). The intervention lasted 8 weeks, three sessions per week. The effects were evaluated ten days before (baseline) and ten days after the intervention (post). Our primary outcome was sleep quality (subjective and objective, assessed by Pittsburgh sleep quality index and actigraphy, respectively); and secondary outcomes were pain perception (brief pain inventory) and nocturnal cramps (self-report). Results: The program was able to improve the subjective sleep quality (p=0.005) and nocturnal cramps (p<0.001) but had no effect on actigraphy data (p>0.05) neither on pain perception (p>0.05). Conclusion: Our initial hypothesis was partially corroborated: the improvement in subjective quality of sleep and nocturnal cramps is already beneficial for the health promotion of the volunteers in this study affected by the disease. Our findings may serve as a basis for future research to develop a program focused on the treatment of analgesia, which can improve pain perception and alter the objective quality of sleep.

20.
Arch Plast Surg ; 49(5): 633-641, 2022 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-36159376

RESUMO

Introduction In chronic facial palsy, synkinetic muscle overactivity and shortening causes muscle stiffness resulting in reduced movement and functional activity. This article studies the role of multimodal therapy in improving outcomes. Methods Seventy-five facial palsy patients completed facial rehabilitation before being successfully discharged by the facial therapy team. The cohort was divided into four subgroups depending on the time of initial attendance post-onset. The requirement for facial therapy, chemodenervation, or surgery was assessed with East Grinstead Grade of Stiffness (EGGS). Outcomes were measured using the Facial Grading Scale (FGS), Facial Disability Index, House-Brackmann scores, and the Facial Clinimetric Evaluation scale. Results FGS composite scores significantly improved posttherapy (mean-standard deviation, 60.13 ± 23.24 vs. 79.9 ± 13.01; confidence interval, -24.51 to -14.66, p < 0.0001). Analysis of FGS subsets showed that synkinesis also reduced significantly ( p < 0.0001). Increasingly, late clinical presentations were associated with patients requiring longer durations of chemodenervation treatment ( p < 0.01), more chemodenervation episodes ( p < 0.01), increased doses of botulinum toxin ( p < 0.001), and having higher EGGS score ( p < 0.001). Conclusions This study shows that multimodal facial rehabilitation in the management of facial palsy is effective, even in patients with chronically neglected synkinesis. In terms of the latency periods between facial palsy onset and treatment initiation, patients presenting later than 2 years were still responsive to multimodal treatment albeit to a lesser extent, which we postulate is due to increasing muscle contracture within their facial muscles.

SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...