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1.
BMC Musculoskelet Disord ; 22(1): 872, 2021 Oct 12.
Artigo em Inglês | MEDLINE | ID: mdl-34641836

RESUMO

BACKGROUND: Neck and shoulder pain is common in the general population, but studies on factors related to the risk of neck and shoulder pain have produced inconclusive results. Known factors related to pain include general physical activity, exercise, sleep disorders, and lifestyle, but further research is needed to improve our ability to prevent neck and shoulder pain. The aim was to investigate whether neck and shoulder pain are associated with physical domains (i.e., aerobic physical activities, general physical activities, and sitting time), sleep disturbances, general health, job satisfaction, and/or working time. METHODS: This population-based, cross-sectional study was conducted in Sweden in 2017 and included 16,167 individuals, aged 18 to 63 years. We administered a questionnaire to determine neck and shoulder pain, the time spent in general physical activity or aerobic physical activity, the time spent sitting, sleep disturbances, general health, job satisfaction, and the time spent working. Factors associated with neck and shoulder pain were explored using logistic regression. RESULTS: Significant factors associated with neck and shoulder pain were: overall health, sleep quality, and aerobic exercise. The odds of sustaining neck and shoulder pain increased with moderate or poor health (odds ratios [ORs]: 2.3 and 2.8, respectively) and sleep disorders (OR: 1.7). Conversely, aerobic physical activity performed more than 60 min/week at a level that enhanced respiratory and heart rate was associated with a reduced risk of experiencing neck and shoulder pain (OR: 0.8). CONCLUSIONS: Although no causal relationships could be determined in the present study, the results highlight important associations between aerobic exercise, undisturbed sleep, good health, and the absence of upper body pain. Exercises that enhance breathing and heart rate were associated with a reduced risk of experiencing neck or shoulder pain, but there was no association between general physical activity and upper body pain. Therefore, clinicians may not recommend low-intensity activities, such as walking, for preventing or improving neck and shoulder pain.


Assuntos
Cervicalgia , Dor de Ombro , Adulto , Estudos Transversais , Humanos , Cervicalgia/diagnóstico , Cervicalgia/epidemiologia , Prevalência , Dor de Ombro/diagnóstico , Dor de Ombro/epidemiologia , Suécia/epidemiologia
2.
Aerosp Med Hum Perform ; 92(10): 815-824, 2021 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-34642002

RESUMO

BACKGROUND: Neck pain (NP) is common among high performance aircrew, yet evidence remains insufficient to guide examination, treatment, and prevention. The purpose of this randomized pilot study was to collect baseline data for neck function for F-15E aircrew and determine efficacy and feasibility of two separate exercise protocols in measuring short-term outcomes of subjective and objective neck function in order to inform future study design. METHODS: Randomized to either progressive (PRO) or general (GEN) exercise groups were 41 F-15E aircrew. Data collection occurred at baseline, 3 wk, and 3 mo. RESULTS: At baseline, 39% of the subjects reported current NP, 79.5% reported a history of NP attributed to flying, 12.8% reported being removed from flying duties due to NP, and 10% reported receiving medical care for NP. PRO and GEN group randomization showed similar baseline assessment data. Blinding was successful and exercise logs showed 31.6% compliance with prescribed exercise regimens. There were small but statistically significant increases in neck range of motion in both groups over the course of the study. Aircrew with current NP had significantly higher F-15E flight hours. DISCUSSION: This study supports the high prevalence of NP in aircrew, yet low frequency of seeking care for NP. Future studies to assess NP prevention and treatment in aircrew require an integrated approach that includes operational exercise policy and long-term data collection in flying units with dedicated resources for assessment and analysis. Lee MS, Briggs R, Scheirer V, Kearby G, Young BA. Exercise effects on neck function among F-15E aircrew. Aerosp Med Hum Perform. 2021; 92(10):815824.


Assuntos
Exercício Físico , Cervicalgia , Dor no Peito , Humanos , Cervicalgia/epidemiologia , Cervicalgia/prevenção & controle , Projetos Piloto , Amplitude de Movimento Articular
3.
Neurosurg Focus ; 51(4): E11, 2021 10.
Artigo em Inglês | MEDLINE | ID: mdl-34598127

RESUMO

Ankylosing spondylitis (AS) is an inflammatory disorder leading to ossification of joints and ligaments, resulting in autofusion throughout the spinal column. In patients with fixed, kyphotic cervical deformities, which cause an impaired horizontal gaze and severe neck pain, surgical intervention is warranted. Although several articles have described the anterior and/or posterior surgical treatments used to address the fixed kyphosis, few sources present the key operative steps and technical nuances. The purpose of this technical report was to provide detailed surgical steps, representative photographs, and an operative video demonstrating multilevel anterior cervical osteotomies, uncinatectomies, and a posterior osteotomy for the correction of a fixed cervical deformity secondary to AS.


Assuntos
Cifose , Espondilite Anquilosante , Vértebras Cervicais/diagnóstico por imagem , Vértebras Cervicais/cirurgia , Humanos , Cifose/diagnóstico por imagem , Cifose/etiologia , Cifose/cirurgia , Cervicalgia , Osteotomia , Espondilite Anquilosante/complicações , Espondilite Anquilosante/diagnóstico por imagem , Espondilite Anquilosante/cirurgia
4.
BMC Musculoskelet Disord ; 22(1): 857, 2021 Oct 08.
Artigo em Inglês | MEDLINE | ID: mdl-34625083

RESUMO

BACKGROUND: Neck and back pain are musculoskeletal conditions with serious individual and societal consequences. Current evidence about the prognostic value for neck and back pain is limited and conflicting. This prospective cohort study aimed to assess the association between leisure-time physical activity (LPA) and improvement of neck and/or back pain in a working population receiving manual therapy or general care in one of two randomized controlled trials (RCTs). METHODS: Analyses of data from two RCTs evaluating the effect of manual therapies for neck and/or back pain was conducted. Participants (n = 1 464) answered questionnaires about frequency and effort level of LPA at baseline. LPA on moderate or vigorous levels was compared to no or low/irregular moderate and vigorous levels. Pain intensity was assessed with numerical scales at baseline and 3-, 6-, and 12-month follow-up. The outcome was minimal clinically important improvement in pain intensity, defined as ≥2 points improvement in mean pain intensity at follow-up. Crude- and adjusted risk ratios (RR) with 95% confidence intervals (CI) were calculated with Poisson regression analysis and stratified by pain location. RESULTS: Participants with neck and/or back pain performing vigorous LPA showed a minimal clinically important improvement after 12 months compared to the control group; RR 1.35 (95% CI; 1.06-1.73). No effect was observed at 3 or 6 months. Moderate LPA did not improve pain intensity in any follow-up. Stratified analyses revealed that the effect of vigorous LPA at 12 months in back pain was RR 1.83 (95% CI; 1.26-2.66) and neck pain RR 1.06 (95% CI; 0.75-1.49). CONCLUSIONS: Persons with neck and/or back pain receiving manual therapy or general evidence-based care have greater chance of improvement after 12 months if they prior to treatment frequently practice vigorous LPA. When analyzed separately, the effect was only present for back pain. TRIAL REGISTRATION: Registration in Current Controlled Trials (ISRCTN), Stockholm Manual Intervention Trial (MINT), ISRCTN92249294 BJORN-trial, ISRCTN56954776.


Assuntos
Dor nas Costas , Cervicalgia , Dor nas Costas/diagnóstico , Dor nas Costas/epidemiologia , Dor nas Costas/terapia , Exercício Físico , Humanos , Atividades de Lazer , Cervicalgia/diagnóstico , Cervicalgia/epidemiologia , Cervicalgia/terapia
5.
Artigo em Inglês | MEDLINE | ID: mdl-34639295

RESUMO

This is the first cost-effectiveness analysis of Chuna manual therapy (CMT) plus usual Korean traditional medicine for traffic accident victims using a randomized controlled trial. A total of 132 participants were equally allocated to the intervention group receiving 6-11 sessions of CMT plus usual Korean traditional medicine care for three weeks or usual care including acupuncture, cupping, herbal medicine, moxibustion, and traditional physiotherapy at three hospitals. At 12 weeks, from a healthcare perspective, the intervention group had significantly higher costs (mean (SD), $778 (435) vs. $618 (318); difference, $160; 95% CI, $15 to $289; p = 0.005). From a societal perspective, total costs were insignificantly lower in the intervention group (mean (SD), $1077 (1081) vs. $1146 (1485); difference, $-69; 95% CI, $-568 to $377; p = 0.761). The intervention group dominated, with significantly higher QALYs gained at lower overall cost with a 72% chance of being cost-effective. From a societal perspective, the intervention was cost-saving for individuals who had neck pain after car accidents, although it was not cost-effective from the healthcare perspective ($40,038 per QALY gained). Findings support use of CMT as an integrated care treatment for whiplash from a societal perspective. Further studies with larger sample sizes are needed to determine cost-effectiveness in other cultural contexts.


Assuntos
Manipulações Musculoesqueléticas , Traumatismos em Chicotada , Acidentes de Trânsito , Análise Custo-Benefício , Humanos , Cervicalgia/terapia , Anos de Vida Ajustados por Qualidade de Vida
6.
Artigo em Inglês | MEDLINE | ID: mdl-34639355

RESUMO

Mental illness and psychological distress are global concerns. This study aimed to investigate the association between having non-preferred work and the incidence of spinal pain, psychological distress, and spinal pain with concurrent psychological distress, and if associations are modified by sleep disturbance. A prospective study of 4285 participants 23-62 years old was conducted, from years 2007 to 2010. Participants reported their work situation as preferred/non-preferred regarding profession/workplace with a high/low possibility to change. Psychological distress was measured with the General Health Questionnaire 12 and spinal pain with questions about neck/back pain. Binominal regression analyses calculated relative risk (RR) with 95% confidence interval (CI). Non-preferred work with a low possibility to change was associated with a higher incidence of spinal pain (RR 1.8; 95% CI 1.2-2.6) and psychological distress (RR 1.8; 95% CI 1.4-2.4) compared to preferred work. The RR was 1.4 (95% CI 0.9-2.1) for spinal pain and 1.3 (95% CI 1.0-1.7) for psychological distress among those with a high possibility to change. Non-preferred work yielded a higher incidence of spinal pain with concurrent psychological distress (RR 1.9; 95% CI 1.0-3.7). Sleep disturbance did not modify associations. A replication based on newer data is needed to confirm the results. In conclusion, non-preferred work is associated with a higher incidence of spinal pain and psychological distress, especially if the possibility to change job is low.


Assuntos
Angústia Psicológica , Adulto , Humanos , Incidência , Pessoa de Meia-Idade , Cervicalgia , Estudos Prospectivos , Estresse Psicológico/epidemiologia , Local de Trabalho , Adulto Jovem
7.
Trials ; 22(1): 716, 2021 Oct 18.
Artigo em Inglês | MEDLINE | ID: mdl-34663421

RESUMO

BACKGROUND: Research that has examined the effects of cervical spine mobilization on hypoesthesia and hypersensitivity characteristics in patients with cervical radiculopathy is scarce. The aim of this study was to examine the short-term effects of vertebral mobilization on the sensory features in patients with cervical radiculopathy. METHODS: Twenty-eight participants with chronic cervical radiculopathy were randomly allocated to (1) an experimental group [cervical vertebral mobilization technique and exercise] or (2) a comparison group [minimal superficial circular pressure on the skin and exercise]. Participants received a total of 6 sessions for 3-5 weeks. Numeric Pain Rating Scale (NPRS), Neck Disability Index (NDI), pressure pain threshold (PPT), heat/cold pain threshold (HPT/CPT), and active cervical range of motion (ROM) were measured at baseline immediately after the first session and after the sixth session. RESULTS: The experimental group showed improvements from baseline to session 6 in NPRS [mean difference 2.6; 95% confidence interval: -4.6, -0.7], NDI [14; -23.3, -4.3], and active cervical ROM in extension [14°; 2.3, 25.5], rotation [16°; 8.8, 22.5], and lateral flexion to the affected side [10°; 2.3, 16.8]. Improvements were also found in PPT at the neck [124 kPa; 57, 191.1] and C7 level at the hand [99 kPa; 3.6, 194.9]. There were no changes in the HPT and CPT at any tested area (P>0.050). CONCLUSIONS: Cervical vertebral mobilization for patients with chronic cervical radiculopathy reduced localized mechanical, but not thermal, pain hypersensitivity. TRIAL REGISTRATION: ClinicalTrials.gov ( NCT03328351 ). Registered on November 1, 2017, retrospectively registered.


Assuntos
Manipulações Musculoesqueléticas , Radiculopatia , Vértebras Cervicais , Humanos , Cervicalgia/diagnóstico , Cervicalgia/terapia , Medição da Dor , Radiculopatia/diagnóstico , Radiculopatia/terapia
8.
J Manipulative Physiol Ther ; 44(6): 475-486, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34607643

RESUMO

OBJECTIVE: The objectives of this study were to determine (1) if maximal intervertebral range of motion (IV-RoMmax) and laxity interactions exist in the cervical spine during flexion, (2) if there are differences in IV-RoMmax or laxity parameters between baseline and follow-up in both patients with neck pain and asymptomatic controls, and (3) if there is an effect on IV-RoMmax/laxity relationships in patients with neck pain after spinal manipulative therapy. METHODS: Twenty-nine patients with subacute or chronic neck pain and 33 asymptomatic controls were imaged during flexion and extension, pre and post a course of cervical chiropractic manipulation (patient group only), using a standardized quantitative fluoroscopy acquisition protocol. RESULTS: Significant correlations between IV-RoMs were found in both neck pain and neck pain-free populations at baseline and follow-up. Positive relationships were found between C2-C3 and C3-C4 and C4-C5 and C5-C6 IV-RoM in both populations. A negative correlation was found in the patient group at baseline between C1-C2 and C5-C6, but not at follow-up. Significant relationships were also found for segmental laxity, with a negative correlation found at C1-C2 and C5-C6 in the patient group only and at baseline only. CONCLUSION: Distinct relationships were found between both intraregional IV-RoM and laxity, many of which were present in both groups at baseline and follow-up, suggestive of normal kinematic behaviors. Changes in correlations unique to the patient group may be indicative of a change in regional kinematics resulting from the manipulation intervention. Spinal manipulative therapy may have a therapeutic effect by influencing cervical kinematics at the regional level.


Assuntos
Manipulação da Coluna , Cervicalgia , Fenômenos Biomecânicos , Vértebras Cervicais/diagnóstico por imagem , Humanos , Pescoço , Cervicalgia/terapia , Amplitude de Movimento Articular
9.
J Foot Ankle Res ; 14(1): 53, 2021 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-34470650

RESUMO

BACKGROUND: Occupational musculoskeletal injuries are prevalent in healthcare workers and are reported to be profession-specific. There is, however, a paucity of information around the injuries sustained from working as a podiatrist. This paper looks at the incidence of injury from working as a podiatrist, the aggravating factors to sustain these injuries and whether the changes in workload due to the COVID-19 pandemic altered the incidence. METHODS: A modified work based musculoskeletal injury questionnaire was distributed in the UK via podiatry led social media platforms. Open and Closed questions explored the demographics of the sample, perceived injury 12 months prior to the COVID-19 pandemic and then 6 months into the lockdown. Pre and post COVID-19 data were analysed for differences and thematic analysis was included to categorise reported experiences. RESULTS: 148 podiatrists representing 3 % of HCPC registered practitioners responded to the questionnaire. Employment status altered as a result of the COVID-19 pandemic with a 13 % reduction in those working full time. Environments also changed with domiciliary and telehealth significantly increasing (p > 0.00) and non-clinical roles being extended (p > 0.002). Pain frequency and intensity significantly (p > 0.04) increased as a result of the pandemic with shoulder pain being most frequent before lockdown altering to the neck during the lockdown. Two main themes were identified that were attributed to the causes of pain including physical demands and working in awkward spaces. CONCLUSIONS: Work-related musculoskeletal pain in podiatrists is common with the shoulder and neck being the most frequently affected. Changes in work practices due to the restrictions enforced from the COVID-19 pandemic increased the frequency and intensity of pain mostly associated with increased domiciliary and telehealth working environments.


Assuntos
Acidentes de Trabalho , COVID-19 , Cervicalgia , Doenças Profissionais , Podiatria , Dor de Ombro , Acidentes de Trabalho/prevenção & controle , Acidentes de Trabalho/estatística & dados numéricos , COVID-19/epidemiologia , COVID-19/prevenção & controle , Controle de Doenças Transmissíveis/métodos , Pesquisas sobre Serviços de Saúde/métodos , Pesquisas sobre Serviços de Saúde/estatística & dados numéricos , Humanos , Cervicalgia/epidemiologia , Cervicalgia/etiologia , Doenças Profissionais/classificação , Doenças Profissionais/epidemiologia , Podiatria/métodos , Podiatria/tendências , Prevalência , SARS-CoV-2 , Dor de Ombro/epidemiologia , Dor de Ombro/etiologia , Telemedicina/métodos , Reino Unido/epidemiologia , Carga de Trabalho/estatística & dados numéricos , Local de Trabalho/normas
10.
Physiother Res Int ; 26(4): e1923, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34585499

RESUMO

BACKGROUND AND PURPOSE: Associations between dizziness, health-related quality of life, and musculoskeletal pain have not been systematically explored in patients with vestibular disorders. Such knowledge may be important for choice of treatments. The study objectives were to examine the extent and localization of musculoskeletal pain and explore whether pain was associated with dizziness and health-related quality of life. METHODS: The cross-sectional study investigated anonymized data from an earlier survey on patients with long-lasting dizziness (>3 months) examined in an oto-rhino-laryngological department. The sample includes patient between 18 and 70 years with Ménière's disease, vestibular schwannoma, benign positional paroxysmal vertigo, vestibular neuritis, non-otogenic dizziness, and cervicogenic dizziness. General musculoskeletal, that is, pain in muscles, tendons, and joints was registered by a yes/no question. A pain drawing registered localization of pain. Multiple binary logistic regression models were used to determine the association between pain and vertigo-balance and autonomic-anxiety related dizziness by the short Vertigo Symptom Scale (VSS) and sub-scales (VSS-V, VSS-A), and between pain and health-related quality of life by the SF-36, mental and physical component summary scale (SF-36 MCS, SF-36 PCS). RESULTS: The sample consisted of 503 patients, 60.2% were women, the median age was 50 years. General musculoskeletal pain was reported by 72.8% of patients, neck pain by 59.2% and widespread pain by 21.9%. Multiple binary logistic regression models demonstrated that all the pain measures were significantly associated with VSS-V and VSS-A and SF-36 PCS, but not SF-36 MCS. DISCUSSIONS: Musculoskeletal pain is prevalent in patients with long-lasting dizziness. The strong associations between pain, VSS, and SF-36 PCS could result in a self-sustaining complex condition. The findings imply that in addition to assessing and treating the vestibular symptoms, musculoskeletal symptoms and physical health should be addressed.


Assuntos
Tontura , Qualidade de Vida , Estudos Transversais , Tontura/diagnóstico , Tontura/epidemiologia , Feminino , Humanos , Pessoa de Meia-Idade , Cervicalgia/diagnóstico , Cervicalgia/epidemiologia , Vertigem/diagnóstico , Vertigem/epidemiologia
11.
Ugeskr Laeger ; 183(34)2021 08 23.
Artigo em Dinamarquês | MEDLINE | ID: mdl-34477084

RESUMO

In this case report, a nine-year-old girl was seen in the emergency department due to neck pain following a trampoline accident ten days ago. She had experienced paraesthesia in her left arm immediately after the accident, but these symptoms disappeared during the first day. A CT scan of the cervical spine was found to be normal. A supplementary MRI was done, showing compression fractures of four vertebrae C7-Th3 besides a torn interspinous ligament between C7 and Th1. The patient was kept in a neck collar for eight weeks. At the end of treatment, she was without any complaints.


Assuntos
Lesões do Pescoço , Fraturas da Coluna Vertebral , Vértebras Cervicais/diagnóstico por imagem , Vértebras Cervicais/lesões , Criança , Feminino , Humanos , Lesões do Pescoço/diagnóstico por imagem , Cervicalgia/diagnóstico por imagem , Cervicalgia/etiologia , Fraturas da Coluna Vertebral/diagnóstico por imagem , Tomografia Computadorizada por Raios X
12.
Spine (Phila Pa 1976) ; 46(19): 1344-1353, 2021 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-34517404

RESUMO

STUDY DESIGN: RAND/UCLA Appropriateness Method (RUAM) applied to chiropractic manipulation for patients with chronic low-back pain (CLBP) and chronic neck pain (CNP). OBJECTIVE: Determine the rate of appropriate care provided by US chiropractors. SUMMARY OF BACKGROUND DATA: Spinal manipulation has been shown effective for CLBP and CNP but may not be appropriate for all patients with these conditions. METHODS: Ratings of the appropriateness of spinal and cervical manipulation previously developed by two RUAM expert panels were applied to data abstracted from random samples of patient charts from chiropractors in six US regions to determine the appropriateness of manipulation for each patient. RESULTS: Of 125 chiropractors sampled, 89 provided charts that could be abstracted. Of the 2128 charts received, 1054 were abstracted. Charts received but not abstracted included 460 that were unusable (e.g., illegible), and 555 did not have CLBP or CNP. Across the abstracted charts 72% had CLBP, 57% had CNP, and 29% had both; 84% of patients with CLBP and 86% with CNP received manipulation. Patients with CLBP who had minor neurologic findings, sciatic nerve irritation, or no joint dysfunction were significantly less likely to receive manipulation. Patients with CNP who had substantial trauma etiology, no joint dysfunction, or no radiographs were significantly less likely to receive manipulation. Most manipulation for CLBP (64%) was appropriate and most manipulation for CNP (93%) was for patients where appropriateness was uncertain or equivocal. The proportions of patients receiving inappropriate manipulation for either condition were low (1%-3%) as were the numbers of patients presenting to these chiropractors for which manipulation was inappropriate. CONCLUSION: Chiropractors in this US sample tend to provide manipulation to very few patients with CLBP or CNP for which it is inappropriate. However, more research is needed to determine which patients with CNP benefit from manipulation.Level of Evidence: 4.


Assuntos
Quiroprática , Dor Crônica , Dor Lombar , Manipulação Quiroprática , Manipulação da Coluna , Dor Crônica/diagnóstico , Dor Crônica/terapia , Humanos , Dor Lombar/diagnóstico , Dor Lombar/terapia , Cervicalgia/diagnóstico , Cervicalgia/terapia
13.
Trials ; 22(1): 586, 2021 Sep 03.
Artigo em Inglês | MEDLINE | ID: mdl-34479613

RESUMO

BACKGROUND: Non-specific chronic neck pain (NCNP) is a common musculoskeletal disorder which has caused a huge economic burden due to its expensive health costs and high re-occurrence rate. Yijinjing and Tuina are widely used for non-specific chronic neck pain in China. But there is little scientific evidence to evaluate their efficacy for NCNP. The aim of this research is to compare the efficacy of Yijinjng combined with Tuina versus Tuina for patients with NCNP. METHODS/DESIGN: A randomized controlled trial in which 102 patients with non-specific chronic neck pain will be recruited and randomly allocated to either the Tuina group or the Yijinjng combined with Tuina group in a 1:1 ratio. The interventions for both groups will be carried out three times a week for 8 weeks. The patients in the two groups will receive follow-up 1 month after the intervention. The primary outcome will be the changes in the visual analog scale (VAS). Secondary outcomes will be measured by the Neck Disability Index (NDI), Self-Rating Anxiety Scale (SAS), and Tissue Hardness and Active Range of Motion (AROM). The data will be analyzed at the baseline, 4 weeks during the intervention, at the end of the intervention, and 1 month after the intervention. The significance level sets as 5%. The safety of interventions will be evaluated after each treatment session. DISCUSSION: The purpose of this trial is to determine whether Yijinjing combined with Tuina is not inferior to Tuina for patients with NCNP. This study will provide clinicians and stakeholders much-needed knowledge for a complementary and alternative therapy for patients with non-specific chronic neck pain. TRIAL REGISTRATION: ChiCTR registry (ChiCTR) 2000036805 . Registered on August 25, 2020.


Assuntos
Dor Crônica , Cervicalgia , Dor Crônica/diagnóstico , Dor Crônica/terapia , Humanos , Cervicalgia/diagnóstico , Cervicalgia/terapia , Medição da Dor , Ensaios Clínicos Controlados Aleatórios como Assunto , Amplitude de Movimento Articular , Resultado do Tratamento
14.
Neurol India ; 69(4): 937-943, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34507416

RESUMO

Background: There is a paucity of data on outcomes following four-level anterior cervical discectomy and fusions (ACDFs), especially the sagittal balance (SB) parameters. Objective: We aimed to review the long-term clinical and radiographic outcomes for 41 consecutive patients that underwent instrumented four-level ACDF. Materials and Methods: Records of 27 men and 14 women, aged 40-68 years, who underwent instrumented four-level ACDF and plating at C3-C7 (n = 37) or C4-T1 (n = 4) were retrospectively analyzed. Clinical outcomes that were assessed were the visual analog scale (VAS) for pain, neck disability index (NDI), Odom's criteria, improvement of symptoms, intraoperative and postoperative complications, SB, and need for revision surgery. Results: The mean follow-up was 65 ± 36.3 months. The mean VAS for arm and neck pain significantly improved from 7.7 ± 1.4 to 3.5 ± 1.7 (P < 0.001). The NDI score significantly improved from 31 ± 8.2 to 19.3 ± 8.1 (P < 0.001). Concerning Odom's criteria, the grades were excellent (14), good (17), fair (9), and poor (1). Concerning intraoperative and postoperative complications, 10 cases developed dysphagia, 3 cases developed temporary dysphonia, 2 cases developed a postoperative hematoma, 1 patient developed C5 palsy, 1 vertebral artery (VA) injury, and 1 case had superficial infection. The average length of stay (LOS) was 2.9 ± 3.7 days. Three patients needed another surgery (one adjacent segment and two posterior foraminotomies). Regarding the mean change in SB parameters, Cobb's angle (CA) (C2-C7) was 14° ± 8.3°, fusion angle (FA) was 10.9 ± 10.9°, cervical straight vertical alignment (cSVA) was 0.6 ± 0.5 cm, T1 slope was 2.3° ± 3.4°, and disc height (DH) was 1.3 ± 0.9 mm. Conclusion: Instrumented four-level ACDF is safe with a satisfactory outcome and supplementary posterior fusion was not required in any case.


Assuntos
Vértebras Cervicais , Fusão Vertebral , Adulto , Idoso , Vértebras Cervicais/diagnóstico por imagem , Vértebras Cervicais/cirurgia , Discotomia , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Cervicalgia , Estudos Retrospectivos , Resultado do Tratamento
15.
BMC Musculoskelet Disord ; 22(1): 811, 2021 Sep 21.
Artigo em Inglês | MEDLINE | ID: mdl-34548044

RESUMO

BACKGROUND: This study analyzed neck pain estimates in Brazil and its states between 2000 and 2019, in view of the country's lacking epidemiological data. METHODS: An analysis was performed of the GBD 2019 estimates by location, sex, and age, per 100,000 population, with uncertainty intervals (95% UI). Brazilian estimates were compared to global, Mexican, English, and American rates. RESULTS: Global, Brazilian, and Mexican prevalence numbers were statistically homogeneous and stable in the period. Throughout the period analyzed in the study, Brazilian neck pain prevalence (2241.9; 95%UI 1770.5-2870.6) did not show statistical differences when compared to global (2696.5; 95%UI 2177.0-3375.2) or Mexican (1595.9; 95%UI 1258.9-2058.8) estimates. Estimates observed in the USA (5123.29; 95%UI 4268.35-6170.35) and England (4612.5; 95%UI 3668.8-5830.3) were significantly higher. In 2019, when compared to the USA and England, age-standardized prevalences were lower globally, in Brazil, and in Mexico. Prevalences in Brazilian states were similar, being that Roraima (1915.9; 95%UI 1506.5-2443.1) and the Federal District (1932.05; 95%UI 1515.1-2462.7) presented the lowest and highest values respectively. The exception was the state of São Paulo (3326.5; 95%UI 2609.6-4275.5). There was no statistical difference by sex, but the prevalence tended to increase with aging. In 2019, the Brazilian prevalence was 2478.6 (95% UI 1791.0-3503.8), 5017.2 (95%UI 3257.26-7483.8), and 4293.4 (95% UI 2898,8-6343.9), for those aged 15 to 49, 50 to 69, and 70+ years. There was no statistical difference among the YLDs in all locations and times. CONCLUSIONS: Brazil is going through a fast-paced process of populational aging; a higher prevalence of neck pain in middle-aged individuals and the elderly highlights the need for lifelong prevention initiatives. The higher rates observed among higher-income populations and the homogeneity of the Brazilian estimates suggest a lack of robust epidemiological data in lower-income countries.


Assuntos
Carga Global da Doença , Cervicalgia , Distribuição por Idade , Idoso , Brasil/epidemiologia , Saúde Global , Humanos , Pessoa de Meia-Idade , Cervicalgia/diagnóstico , Cervicalgia/epidemiologia , Anos de Vida Ajustados por Qualidade de Vida , Distribuição por Sexo
16.
Rev Assoc Med Bras (1992) ; 67(5): 708-712, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-34550260

RESUMO

OBJECTIVE: The aim of this study was to evaluate the intra- and inter-rater reliability of pressure pain threshold measurement on myofascial trigger points in the trapezius muscle in women with chronic neck pain. METHODS: This reliability study involved 30 volunteers with neck pain for more than 90 days. The assessment procedures were performed by blinded researchers. Two examiners, who were previously trained in the use of algometry, independently performed two assessments of the pressure pain threshold at two time intervals, one week apart. RESULTS: The study sample consisted of 30 young adult women. Excellent intra- and inter-rater reliability were found for the pressure pain threshold on myofascial trigger points, with intraclass correlation coefficient values ranging between 0.752 and 0.874, standard error of measurement ranging between 0.18 and 0.22 kg/cm2, and minimum detectable change ranging between 0.45 and 0.62 kg/cm2. CONCLUSION: The present study showed that the assessment of pressure pain threshold through algometry presents satisfactory intraclass correlation coefficient values, considering different time and examiners, contributing to the spread of the use of this tool as a quantitative method of pain evaluation in myofascial trigger points.


Assuntos
Síndromes da Dor Miofascial , Músculos Superficiais do Dorso , Feminino , Humanos , Síndromes da Dor Miofascial/diagnóstico , Cervicalgia/diagnóstico , Limiar da Dor , Reprodutibilidade dos Testes , Pontos-Gatilho , Adulto Jovem
17.
J Orthop Sports Phys Ther ; 51(9): 470-471, 2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-34465144

RESUMO

Letter to the Editor-in-Chief in response to JOSPT article "Dry needling adds no benefit to the treatment of neck pain: a sham-controlled randomized clinical trial with 1-year follow-up" by Gattie et al.J Orthop Sports Phys Ther 2021;51(9):470-471. doi:10.2519/jospt.2021.0202.


Assuntos
Agulhamento Seco , Humanos , Cervicalgia
19.
Work ; 69(4): 1261-1270, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34366308

RESUMO

BACKGROUND: The excessive use of hand-held mobile devices (HHMD) leads to a postural phenomenon known as text neck. OBJECTIVE: The aim of this paper is to discuss the anatomical, biomechanical and muscle activation changes within the cervical and thoracic regions associated with the sustained, forward, flexed neck posture, observed with excessive usage of hand-held mobile devices. Additionally, this paper examines the relationship of gender, as well as the effects of carrying backpack loads by youth, on this forward, flexed neck posture. METHODS: Multiple aspects of the text neck position that occur when an individual uses a HHMD are described. RESULTS: Prolonged use of hand-held mobile devices results in adverse anatomical and biomechanical changes in the cervical and thoracic spine, muscular imbalances, and postural compensations, all of which contribute to muscular overuse and fatigue resulting in pain. CONCLUSIONS: Physical therapists must educate their patients about proper posture while using hand-held mobile devices. Proper posture includes: holding the device close to eye level, using the device while standing or sitting and holding the device with a line of sight perpendicular to the surface of the device, using a larger screen, and texting with both hands. Also, because children are using hand held mobile devices at younger ages, parents and teachers must be educated about the dangers of prolonged use of hand-held devices.


Assuntos
Envio de Mensagens de Texto , Adolescente , Criança , Humanos , Pescoço , Cervicalgia/etiologia , Postura , Coluna Vertebral
20.
Artigo em Inglês | MEDLINE | ID: mdl-34444389

RESUMO

The INYBI is an instrument used to release the suboccipital myofascial area. There is scarce evidence of its efficacy. A randomized controlled, double-blinded, longitudinal and prospective trial was performed. Ninety-six subjects (aged 29.47 ± 5.16 years) (70 women) with chronic neck pain were randomly assigned to the manual suboccipital inhibition technique (MSIT), instrumental suboccipital inhibition (INYBI) or the INYBI plus upper cervical manipulation technique (INYBI + UCMT) groups and received two sessions with a week interval between them. The Neck Disability Index was used before the first intervention and two weeks after the second intervention. Pre- and post-measurements were taken on both intervention days for pressure pain threshold of the upper trapezius and suboccipital muscles, self-perceived pain and cervical range of motion. In spite of a significant general improvement in time that was found for the three groups for all of the outcome measurements (p < 0.05 in all cases), no between-groups differences were found (p > 0.05 in all cases), with the exception of self-perceived pain for left rotation (p = 0.024), with the MSIT group showing the lower improvement. However, the higher degree of within-group improvements was found for the INYBI + UCMT group. It was concluded that the myofascial release therapy in the suboccipital area is effective in patients with chronic neck pain, either through a manual application or by means of the INYBI tool. Moreover, the addition of craniocervical manipulation achieved the higher within-group improvements, but with no statistical significance.


Assuntos
Dor Crônica , Manipulação da Coluna , Dor Crônica/terapia , Feminino , Humanos , Cervicalgia/terapia , Estudos Prospectivos , Amplitude de Movimento Articular
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