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1.
Medicine (Baltimore) ; 100(14): e25431, 2021 Apr 09.
Artigo em Inglês | MEDLINE | ID: mdl-33832145

RESUMO

BACKGROUND: To our knowledge, there have been no published clinical trials to assess the synergistic effects of applying pulsed radiofrequency (PRF) stimulation of the suprascapular nerve (SSN) plus physical therapy on pain and function in patients with adhesive capsulitis. Therefore, we will conduct this present randomized, double-blind study to evaluate the synergistic effects of applying PRF stimulation of the SSN plus physical therapy on pain and function in patients with adhesive capsulitis. METHODS: The study protocol is a randomized, controlled, double-blind design. Recruitment will be started in March 2021 and completed in October 2022. The treating surgeon will assess 90 patients for eligibility. The study protocol was approved through Institutional Review Board in the People's Hospital of Beilun district of Ningbo. Each patient will be randomized into 3 treatment groups, receiving PRF stimulation of the SSN or physical therapy or both of them. After baseline examination, all patients will be given a full explanation of the treatment protocol and will be required to sign a written informed consent for study participation and for publication of the results. All the data collectors, surgeons, statistical analysts, as well as result assessors are not aware of grouping assignment. The outcomes include Constant score, visual analog scale score, range of motion, and strength. RESULTS: This protocol will provide a reliable theoretical basis for the following research. CONCLUSION: It is assumed that there will be a remarkable difference in postoperative outcomes between the intervention and control groups. TRIAL REGISTRATION NUMBER: 10.17605/OSF.IO/PZ9ES.


Assuntos
Bursite/terapia , Modalidades de Fisioterapia , Tratamento por Radiofrequência Pulsada/métodos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Bursite/complicações , Bursite/fisiopatologia , Protocolos Clínicos , Terapia Combinada , Método Duplo-Cego , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Dor Musculoesquelética/etiologia , Dor Musculoesquelética/terapia , Estudos Prospectivos , Recuperação de Função Fisiológica , Escápula/inervação , Resultado do Tratamento , Adulto Jovem
3.
Artigo em Inglês | MEDLINE | ID: mdl-33374537

RESUMO

The special situation brought about by the coronavirus pandemic and the confinement imposed by the Government, has given rise to numerous changes in working habits. The workers at the universities have had to start a period of teleworking that could give rise to consequences for the musculoskeletal system. The objective of this article is to analyze the impact of the confinement on the musculoskeletal health of the staff of two Spanish universities. A cross-sectional, observational study was carried out on the workers. Data was taken in April-May 2020 and included: The Standardized Kuorinka Modified Nordic Questionnaire, the Perceived Stress Scale and another one on sociodemographic data. This study comprised 472 people. The areas of pain noted during the confinement period concluded that it was less in all cases (p < 0.001). The frequency of physical activity carried out increased significantly during the period of confinement (p < 0.04), especially in women. The type of physical activity done was also seen to modify during this period (p < 0.001), with a preference for strength training and stretching exercises. In conclusion, the confinement gave rise to changes in the lifestyle and in the musculoskeletal pain of the workers at the universities. All of this must be taken into account by health institutions and those responsible for the Prevention of Occupational Risks at Spanish universities.


Assuntos
/epidemiologia , Dor Musculoesquelética , Adulto , Estudos Transversais , Exercício Físico , Feminino , Humanos , Estilo de Vida , Masculino , Pessoa de Meia-Idade , Exercícios de Alongamento Muscular , Dor Musculoesquelética/epidemiologia , Dor Musculoesquelética/etiologia , Treinamento de Resistência , Espanha/epidemiologia , Universidades
4.
JAMA Netw Open ; 3(12): e2028929, 2020 12 01.
Artigo em Inglês | MEDLINE | ID: mdl-33337492

RESUMO

Importance: Despite appropriate treatment, many patients who sustain distal radius fractures (DRFs) report persistent wrist pain. Chronic musculoskeletal pain is among the leading health problems in the elderly population associated with significant personal and societal burden. Objective: To identify modifiable preoperative factors that are significantly associated with developing chronic pain. Design, Setting, and Participants: This is a secondary analysis of the Wrist and Radius Injury Surgical Trial (WRIST), a randomized multicenter clinical trial of 24 study sites in the United States, Canada, and Singapore that enrolled patients from April 10, 2012, to December 31, 2016. Adults older than 60 years who sustained closed extra-articular DRFs, were treated operatively, and completed 12-month Michigan Hand Outcomes Questionnaires (MHQs) were included in this study. Analysis was conducted from September to December 2019. Interventions: Volar locking plate internal fixation, external fixation, or percutaneous pinning. Main Outcomes and Measures: 12-month MHQ pain domain score. Inverse probability weighted logistic regression was used to identify factors associated with of chronic pain. Results: A total of 146 patients with DRF who were treated operatively and had 12-month MHQ scores met inclusion criteria. The mean (SD) patient age was 68.9 (7.2) years, 128 (87.6%) were women, and 93 (63.7%) were retired. Chronic pain was present in 87 patients (59.6%) and absent in 59 patients (40.4%) at 1-year follow-up. A 1-week delay in surgery was associated with more than triple the odds of developing chronic pain (odds ratio [OR], 3.65; 95% CI, 1.48-9.00), and each 10-point increase in preoperative pain was associated with a 17% increase in the odds of experiencing chronic pain (OR, 1.17; 95% CI, 1.02-1.34). Internal fixation was associated with decreased odds of developing chronic pain compared with the other 2 procedures (OR, 0.29; 95% CI, 0.10-0.90). Conclusions and Relevance: In this study, preoperative pain, time to surgery, and procedure type were modifiable factors associated with chronic pain 1 year after DRF treated with surgery. Adequate pain control in patients with acute DRFs even before definitive surgical management and earlier fixation for patients requiring surgery may decrease the risk of developing chronic pain. Internal fixation may decrease the risk of chronic pain after DRF surgery, compared with percutaneous pinning or external fixation. Trial Registration: ClinicalTrials.gov Identifier: NCT01589692.


Assuntos
Fixação de Fratura , Dor Musculoesquelética , Fraturas do Rádio/cirurgia , Traumatismos do Punho/cirurgia , Idoso , Dor Crônica , Modificador do Efeito Epidemiológico , Feminino , Fixação de Fratura/efeitos adversos , Fixação de Fratura/instrumentação , Fixação de Fratura/métodos , Humanos , Masculino , Dor Musculoesquelética/diagnóstico , Dor Musculoesquelética/epidemiologia , Dor Musculoesquelética/etiologia , Complicações Pós-Operatórias/diagnóstico , Complicações Pós-Operatórias/epidemiologia , Período Pré-Operatório , Recuperação de Função Fisiológica , Medição de Risco , Tempo para o Tratamento/estatística & dados numéricos
5.
PLoS One ; 15(10): e0238510, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33035215

RESUMO

We examine how solitary confinement correlates with self-reported adverse physical health outcomes, and how such outcomes extend the understanding of the health disparities associated with incarceration. Using a mixed methods approach, we find that solitary confinement is associated not just with mental, but also with physical health problems. Given the disproportionate use of solitary among incarcerated people of color, these symptoms are most likely to affect those populations. Drawing from a random sample of prisoners (n = 106) in long-term solitary confinement in the Washington State Department of Corrections in 2017, we conducted semi-structured, in-depth interviews; Brief Psychiatric Rating Scale (BPRS) assessments; and systematic reviews of medical and disciplinary files for these subjects. We also conducted a paper survey of the entire long-term solitary confinement population (n = 225 respondents) and analyzed administrative data for the entire population of prisoners in the state in 2017 (n = 17,943). Results reflect qualitative content and descriptive statistical analysis. BPRS scores reflect clinically significant somatic concerns in 15% of sample. Objective specification of medical conditions is generally elusive, but that, itself, is a highly informative finding. Using subjective reports, we specify and analyze a range of physical symptoms experienced in solitary confinement: (1) skin irritations and weight fluctuation associated with the restrictive conditions of solitary confinement; (2) un-treated and mis-treated chronic conditions associated with the restrictive policies of solitary confinement; (3) musculoskeletal pain exacerbated by both restrictive conditions and policies. Administrative data analyses reveal disproportionate rates of racial/ethnic minorities in solitary confinement. This analysis raises the stakes for future studies to evaluate comparative prevalence of objective medical diagnoses and potential causal mechanisms for the physical symptoms specified here, and for understanding differential use of solitary confinement and its medically harmful sequelae.


Assuntos
Avaliação do Impacto na Saúde , Prisioneiros/psicologia , Isolamento Social/psicologia , Adulto , Doença Crônica , Disparidades nos Níveis de Saúde , Humanos , Masculino , Grupos Minoritários , Saúde das Minorias , Dor Musculoesquelética/etiologia , Prisões , Autorrelato , Inquéritos e Questionários , Washington
6.
Medicine (Baltimore) ; 99(30): e21089, 2020 Jul 24.
Artigo em Inglês | MEDLINE | ID: mdl-32791682

RESUMO

BACKGROUND: Ankylosing spondylitis (AS) is a very tricky orthopedic disorder. If such condition cannot be managed fairly well, it may significantly affect quality of life and even leads to disability among such population. A variety of studies have reported that alendronate is utilized for the treatment of AS. However, their results are still contrary, and no systematic review has addressed on this topic. Thus, this study will systematically assess the efficacy and safety of alendronate for the treatment of patients with AS. METHODS: A comprehensive literature search will be performed from the below electronic databases from their commencement to the January 31, 2020 without language and publication status limitations: PubMed, Embase, Cochrane Library, Web of Science, Allied and Complementary Medicine Database, WANGFANG, and China National Knowledge Infrastructure. Only randomized controlled trials focusing on the alendronate for the treatment of patients with AS will be considered for inclusion in this study. Two authors will independently select all identified records, extract essential data from all included studies, and appraise study quality for each eligible trial using Cochrane risk of bias. If any differences occur, another experienced author will be invited to solve them by discussion and a consensus decision will be made. We will implement RevMan 5.3 software to analyze the extracted data. RESULTS: This study will summarize high-quality randomized controlled trials to assess the efficacy and safety of alendronate for the treatment of patients with AS through primary outcome of bone densitometry; and secondary outcomes of pain intensity, quality of life, disease activity, functional status, and adverse events. CONCLUSION: This study will provide evidence to help determine whether alendronate is an effective and safe management for patient with AS or not. STUDY REGISTRATION: INPLASY202040153.


Assuntos
Alendronato/uso terapêutico , Conservadores da Densidade Óssea/uso terapêutico , Espondilite Anquilosante/tratamento farmacológico , Alendronato/efeitos adversos , Densidade Óssea , Conservadores da Densidade Óssea/efeitos adversos , Humanos , Metanálise como Assunto , Dor Musculoesquelética/etiologia , Medição da Dor , Qualidade de Vida , Ensaios Clínicos Controlados Aleatórios como Assunto , Projetos de Pesquisa , Espondilite Anquilosante/complicações , Revisões Sistemáticas como Assunto
7.
Medicine (Baltimore) ; 99(30): e21184, 2020 Jul 24.
Artigo em Inglês | MEDLINE | ID: mdl-32791693

RESUMO

BACKGROUND: Degenerative knee osteoarthritis (KOA) shows an increase in morbidity with improvement in the living conditions and extended lifespans. Treatment for degenerative KOA has been gaining attention since it significantly affects the life of the elderly population and is also associated with increased expenses for medical services and high socioeconomic costs. Treatments for degenerative KOA include nondrug therapy, drug therapy, and surgical treatment. For cases that show little response to conservative treatment but have not involved severe deformation of the knee, procedures such as arthroscopic surgery, autologous chondrocyte implantation, or autologous osteochondral transplantation can be performed. However, effective treatment is required for patients experiencing sustained knee pain after surgery. Although studies confirming the therapeutic effects of acupuncture or thread-embedding acupuncture (TEA) treatment for degenerative KOA have been reported, clinical studies on a combination of TEA and electroacupuncture (EA) in patients complaining of knee pain after arthroscopic surgery, autologous chondrocyte implantation, or autologous osteochondral transplantation have not yet been reported. Therefore, this study aimed to evaluate the effectiveness and safety of this combination treatment in patients with persistent knee pain after arthroscopic surgery, autologous chondrocyte implantation, or autologous osteochondral transplantation. METHODS/DESIGN: This study has been designed as a 2-group, parallel, single-center, randomized, controlled, assessor-blinded trial. Thirty-six patients with degenerative KOA who complained of pain even after arthroscopic surgery, autologous chondrocyte implantation, or autologous osteochondral transplantation will be randomized to either the (TEA + EA + Usual care) group or the (Usual care only) group in a 1:1 ratio. The patients in the (TEA + EA + Usual care) group will receive TEA treatment once a week for 4 weeks for a total of 4 sessions and EA twice a week for a total of 8 sessions while continuing usual care. The (Usual care only) group will only receive usual care for 4 weeks. To assess the efficacy of the TEA and EA combination treatment, the visual analogue scale, the Korean version of the Western Ontario and McMaster Universities Osteoarthritis Index, the EuroQol 5-Dimension 5-Level, and the doses of the rescue drug taken will be evaluated at baseline (1W) and weeks 2 (2W), 4 (4W), 6 (6W), and 8 (8W). The primary efficacy endpoint is the mean change in visual analogue scale at week 4 (4W) compared to baseline. Adverse events will be assessed at every visit. DISCUSSION: This study will provide useful data for evaluating the clinical efficacy and safety of TEA and electroacupuncture combination treatment for improving pain and quality of life after surgery for degenerative KOA. TRIAL REGISTRATION: Clinical Research Information Service of Republic of Korea (CRIS- KCT0004804), March 6, 2020.


Assuntos
Terapia por Acupuntura/métodos , Dor Musculoesquelética/terapia , Osteoartrite do Joelho/terapia , Polidioxanona/administração & dosagem , Artroscopia , Transplante Ósseo , Cartilagem/transplante , Condrócitos/transplante , Terapia Combinada , Eletroacupuntura , Humanos , Dor Musculoesquelética/etiologia , Osteoartrite do Joelho/complicações , Osteoartrite do Joelho/cirurgia , Medição da Dor , Projetos Piloto , Período Pós-Operatório , Ensaios Clínicos Controlados Aleatórios como Assunto , Índice de Gravidade de Doença , Método Simples-Cego
8.
Am Surg ; 86(8): 926-932, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32749863

RESUMO

BACKGROUND: Rib fractures are common injuries among traumatically injured patients, and elderly patients with rib fractures are at increased risk for adverse events and death. The purpose of this study was to determine if oral Per os (PO) acetaminophen is as effective as intravenous (IV) acetaminophen in treating the pain associated with rib fractures. METHODS: We performed a single-center, randomized, placebo-controlled, double-blinded study. Trauma patients who were ≥65 years old and had ≥1 rib fracture were included in this study. Patients were randomized into IV acetaminophen and oral placebo (n = 63) or IV placebo and oral solution acetaminophen (n = 75) groups. The primary outcome was a mean reduction in pain score at 24 hours, and secondary outcomes included opioid use, intensive care unit (ICU) length of stay (LOS), hospital LOS, hospital mortality, the difference in incentive spirometry, and development of pneumonia. RESULTS: Among the 138 patients included, there was no statistically significant difference between the 2 study groups in a mean reduction in pain score at 24 hours after injury (PO: 3.24, IV: 2.49; P = .230). Opioid pain medication use was equivalent between groups (P = .212), and there was no significant difference in hospital mortality rate between groups (P = .827). There was no statistically significant difference in ICU LOS, hospital LOS, or development of pneumonia. DISCUSSION: In elderly trauma patients (age ≥65 years) with 1 or more rib fractures, PO acetaminophen is equivalent to IV acetaminophen for pain control, with no difference in morbidity or mortality. Oral acetaminophen should be preferentially used over IV acetaminophen when treating the elderly trauma patient with rib fractures.


Assuntos
Acetaminofen/administração & dosagem , Dor Aguda/tratamento farmacológico , Analgésicos não Entorpecentes/administração & dosagem , Dor Musculoesquelética/tratamento farmacológico , Fraturas das Costelas/complicações , Acetaminofen/uso terapêutico , Dor Aguda/etiologia , Administração Intravenosa , Administração Oral , Idoso , Idoso de 80 Anos ou mais , Analgésicos não Entorpecentes/uso terapêutico , Método Duplo-Cego , Feminino , Humanos , Masculino , Dor Musculoesquelética/etiologia , Estudos Prospectivos , Resultado do Tratamento
9.
Saudi Med J ; 41(7): 740-745, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32601643

RESUMO

OBJECTIVES: To determine the prevalence of obstructive sleep apnea in female patients with fibromyalgia (FM)presenting to physical therapy outpatient clinics. METHODS: The 36-item short form health survey (SF-36) questionnaire, Berlin test, and epworth sleepiness scale were administered, along with a polysomnography to 38 female patients. This cross-sectional study comprised diagnosed with FM according to the diagnostic criteria of the American College of Rheumatology, between March 2017 and August 2019, at the Faculty of Medicine Hospital, Çanakkale Onsekiz Mart University, Çanakkale, Turkey. RESULTS: Of the participants, 65.9% were found to have obstructive sleep apnea (OSA). Patients with OSA were older and had a higher disease activity score for FM. A strong positive correlation was identified between the apnea-hypopnea index (AHI) and the FA disease activity score. A negative correlation was found between AHI and the subscales of SF-36. CONCLUSION: A clinical assessment of female patients with FM requires a multidisciplinary approach, and patients with excessive daytime sleepiness in particular are recommended to undergo polysomnography. The authors believe that the early detection and treatment of accompanying OSA will contribute not only to the quality of life, but also to the survival of patients with FM.


Assuntos
Fibromialgia/epidemiologia , Apneia Obstrutiva do Sono/epidemiologia , Adulto , Idoso , Estudos Transversais , Feminino , Fibromialgia/complicações , Humanos , Pessoa de Meia-Idade , Dor Musculoesquelética/etiologia , Prevalência , Índice de Gravidade de Doença , Apneia Obstrutiva do Sono/etiologia , Turquia/epidemiologia
10.
Artigo em Inglês | MEDLINE | ID: mdl-32604978

RESUMO

The global obesity epidemic raises long-term health concerns which underline the importance of preventive efforts. We aimed to investigate individual and combined effects of common health problems in adolescence on the probability of obesity in young adulthood. This prospective population-based study included data from participants in the Nord-Trøndelag Health Study in Norway (Young-HUNT1 (1995-1997), age 13-19, baseline) who participated in HUNT3 as young adults 11 years later (age 23-31). Exposure variables at baseline included self-reported physical activity, musculoskeletal pain, and psychological distress. We examined associations between exposure variables and the main outcome of obesity in young adulthood (BMI ≥ 30 kg/m2) using univariate and multiple logistic regression, stratified by sex. Probabilities of obesity for given combinations of the exposure variables were visualized in risk matrixes. The study sample consisted of 1859 participants (43.6% boys). Higher probabilities of obesity in young adulthood were found across combinations of lower physical activity levels and presence of musculoskeletal pain in adolescence. Additional adverse effects of psychological distress were low. Proactive intervention strategies to promote physical activity and facilitate sports participation for all adolescents, whilst addressing musculoskeletal pain and its potential individual causes, could prove helpful to prevent development of obesity in young adulthood.


Assuntos
Dor Musculoesquelética , Adolescente , Adulto , Exercício Físico , Feminino , Humanos , Masculino , Dor Musculoesquelética/epidemiologia , Dor Musculoesquelética/etiologia , Noruega/epidemiologia , Obesidade/epidemiologia , Estudos Prospectivos , Angústia Psicológica , Adulto Jovem
11.
Ned Tijdschr Geneeskd ; 1642020 06 30.
Artigo em Holandês | MEDLINE | ID: mdl-32608925

RESUMO

A 12-year-old boy was referred by the general practitioner with a 3-week history of pain in the popliteal fossa. There was no sign of trauma or infection, physical examination was normal, and his CRP level was mildly elevated. X-ray and MRI revealed a Brodie's abscess, which was treated surgically and with antibiotics and he made a good recovery.


Assuntos
Abscesso/diagnóstico , Dor Musculoesquelética/diagnóstico , Osteomielite/diagnóstico , Abscesso/complicações , Abscesso/terapia , Antibacterianos/uso terapêutico , Criança , Diagnóstico Diferencial , Humanos , Imagem por Ressonância Magnética , Masculino , Dor Musculoesquelética/etiologia , Dor Musculoesquelética/terapia , Procedimentos Ortopédicos , Osteomielite/complicações , Osteomielite/terapia , Radiografia
12.
PLoS One ; 15(6): e0234609, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32555745

RESUMO

This study analyzed the longitudinal association of changes in leisure-time physical activity (LTPA) practice and television viewing (TV viewing) with chronic musculoskeletal pain (CMP). The data about LTPA, TV viewing, and CMP were obtained in 2012 and after 24 months through individual interviews with schoolteachers from elementary and secondary education public schools in a large city in the southern region of Brazil. The statistical analysis was performed using generalized estimating equation regression models adjusted for sex, age, body mass index and depression. A total of 527 schoolteachers were studied, among which 66.6% were women, and the median age was 42 years (interquartile range: 34 to 49). A total of 170 (32.3%) participants reported CMP at baseline and 130 (24.7%) at follow-up. Both LTPA and TV viewing were independently and significantly associated with CMP regardless of all adjustment variables. Concretely, increasing LTPA by 60 minutes/week was associated with a 6.2% lower likelihood of CMP, and increasing TV viewing by 30 minutes/day was associated with a 5.1% higher likelihood of having CMP among the participants. In summary, this study showed that LTPA and TV viewing have independent and opposite relationships with the longitudinal risk of CMP, which suggests that the potential benefits obtained from practicing more LTPA are insufficient to compensate for the potential detrimental effect of viewing TV for longer with respect to the CMP.


Assuntos
Exercício Físico , Dor Musculoesquelética/etiologia , Professores Escolares , Televisão , Adulto , Brasil , Doença Crônica , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Dor Musculoesquelética/prevenção & controle , Fatores de Tempo
13.
J Occup Health ; 62(1): e12125, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-32515892

RESUMO

OBJECTIVES: It has been reported that South Korea ranked as one of the longest-working nations among OECD countries. This study sought to examine the association between long working hours and musculoskeletal pain among Korean medical residents. METHODS: We analyzed a cross-sectional survey of 1,077 medical residents in South Korea. Working hours per week were categorized as follows: <60, 60-79, 80-99, and ≥100. Musculoskeletal pains (ie, upper limb, lower limb, and low back pain) over the past 3 months were categorized into three groups: no pain, pain without interfering with work, and pain interfering with work. Multinomial logistic regression was used to examine the association between long working hours and musculoskeletal pains after adjusting for covariates. RESULTS: We found that the average working hours of medical resident was 85.6 hours per week in South Korea. Compared to the medical residents working <60 hours, those working ≥100 hours per week were more likely to have upper limb pain (PR: 1.77, 95% CI: 1.37, 2.30) interfering with work or low back pain (PR: 2.15, 95% CI: 1.51, 3.06) interfering with work, whereas no statistically significant association was observed in the analysis of lower limb pain. CONCLUSIONS: This study suggests that extremely long working hours are associated with upper limb and low back pain interfering with their work among Korean medical residents.


Assuntos
Internato e Residência , Dor Musculoesquelética/etiologia , Admissão e Escalonamento de Pessoal , Adulto , Estudos Transversais , Feminino , Humanos , Masculino , República da Coreia , Inquéritos e Questionários
14.
Fisioterapia (Madr., Ed. impr.) ; 42(3): 145-156, mayo-jun. 2020. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-191004

RESUMO

OBJETIVOS: Evaluar la eficacia de las técnicas de energía muscular en el tratamiento de síndromes musculoesqueléticos. ESTRATEGIA DE BÚSQUEDA: Se realizó una búsqueda bibliográfica de artículos publicados hasta noviembre de 2018 en las siguientes bases de datos: Medline (PubMed), Scopus, Web of Science, Cochrane Library y Science Direct. SELECCIÓN DE ESTUDIOS: Se seleccionaron 13 artículos con más de 6 puntos en la escala PEDro. RESULTADOS: Se seleccionaron 13 artículos con una muestra total de 694 sujetos y una media de 7,85 sobre 10 en la escala PEDro. Todos los estudios señalan que las técnicas de energía muscular disminuyen el dolor, aumentan los rangos articulares y también la funcionalidad. Se observaron diferencias significativas al comparar estas técnicas con otras intervenciones, como el concepto Mulligan, inyecciones de corticoesteroides intramusculares o tratamientos pasivos. Aplicar las técnicas de energía muscular junto con la punción seca o el método McKenzie ha demostrado ser más eficaz que su empleo de forma individual. CONCLUSIONES: Las técnicas de energía muscular muestran resultados positivos en la disminución del dolor, el aumento del rango articular y la funcionalidad en pacientes con síndromes musculoesqueléticos


OBJECTIVES: To assess the efficacy of muscle energy techniques in the treatment of musculoskeletal syndromes. SEARCH STRATEGY: A literature search was made for articles published up to November 2018 in the following databases: Medline (PubMed), Scopus, Web of Science, Cochrane Library, and Science Direct. STUDY SELECTION: A total of 13 articles with more than 6 points on the PEDro scale were selected RESULTS: The 13 articles selected had a total sample of 694 subjects, and a mean of 7.85 out of 10 on the PEDro scale. All studies indicated that muscle energy techniques decrease pain and increase ranges of motion, as well as motor function. Significant differences were observed when comparing these techniques with others interventions such as the Mulligan concept, intramuscular corticosteroid injections, or passive treatments. Applying muscle energy techniques in conjunction with dry needling or the McKenzie method has been shown to be more effective than using them individually. CONCLUSIONS: Muscle energy techniques show positive results in pain reduction, increased joint range, and functionality in patients with musculoskeletal síndromes


Assuntos
Humanos , Dor Musculoesquelética/etiologia , Dor Musculoesquelética/terapia , Modalidades de Fisioterapia , Resultado do Tratamento , Dor Musculoesquelética/epidemiologia , Manejo da Dor/instrumentação , Dor Musculoesquelética/reabilitação
16.
J Shoulder Elbow Surg ; 29(7): 1401-1405, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32418855

RESUMO

BACKGROUND: Although ulnar neuritis can occur secondary to ulnar collateral ligament pathology, stress fractures, and traction apophysitis, isolated ulnar nerve dysfunction can lead to medial elbow pain. The purpose of this study was to evaluate the short-term outcomes of overhead athletes undergoing anterior ulnar nerve transposition for ulnar neuropathy. METHODS: All overhead athletes who underwent isolated ulnar nerve transposition between 2009 and 2016 for refractory ulnar neuritis were identified. The primary outcome was return to sport, and secondary outcome measures included the Kerlan-Jobe Orthopaedic Clinic score; Mayo Elbow Performance Score; Quick Disabilities of the Arm, Shoulder and Hand score; Single Assessment Numeric Evaluation score; and visual analog scale score for pain. Complication and reoperation rates were recorded. RESULTS: A total of 26 overhead athletes (21 male and 5 female athletes) underwent ulnar nerve transposition at an average age of 18.4 years (range, 11-25 years). Of the patients, 24 (92%) returned to their sporting activity at an average of 2.7 months postoperatively, including 16 (62%) at the previous level of play. The average visual analog scale pain score improved from 4.7 (±2.5) to 0.4 (±1.5) (P = .015). The average postoperative patient-reported outcome scores were as follows: Kerlan-Jobe Orthopaedic Clinic score, 80 (95% confidence interval [CI], 72.7-87.0); Single Assessment Numeric Evaluation score, 85 (95% CI, 75.4-94.7); Quick Disabilities of the Arm, Shoulder and Hand score, 5 (95% CI, 2.1-7.7); and Mayo Elbow Performance Score, 91 (95% CI, 86.8-96.0). CONCLUSION: Cubital tunnel syndrome can cause medial elbow pain in overhead athletes in the presence of a normal ulnar collateral ligament. At mid-term follow-up, 92% of overhead athletes returned to sport after ulnar nerve transposition, with 62% resuming their previous level of performance.


Assuntos
Traumatismos em Atletas/cirurgia , Volta ao Esporte , Neuropatias Ulnares/cirurgia , Adolescente , Adulto , Criança , Síndrome do Túnel Ulnar/complicações , Síndrome do Túnel Ulnar/cirurgia , Articulação do Cotovelo/fisiopatologia , Feminino , Seguimentos , Humanos , Masculino , Dor Musculoesquelética/etiologia , Medição da Dor , Medidas de Resultados Relatados pelo Paciente , Reoperação , Neuropatias Ulnares/complicações , Adulto Jovem
17.
Ned Tijdschr Geneeskd ; 1642020 04 30.
Artigo em Holandês | MEDLINE | ID: mdl-32395953

RESUMO

A 14-year-old boy presented to the emergency department with pain in his right buttock after a breakdance move. He got injured while simultaneously hyperflexing his hip and extending his knee. Upon physical examination he had tenderness over his right ischial tuberosity and an inability to perform combined hip extension and knee flexion. Radiography and CT-imaging showed an avulsion fracture of the ischial tuberosity.


Assuntos
Nádegas , Dança/lesões , Fraturas Ósseas , Ísquio , Dor Musculoesquelética/diagnóstico , Tomografia Computadorizada por Raios X/métodos , Dor Aguda , Adolescente , Diagnóstico Diferencial , Fraturas Ósseas/diagnóstico , Fraturas Ósseas/etiologia , Fraturas Ósseas/fisiopatologia , Humanos , Ísquio/diagnóstico por imagem , Ísquio/lesões , Masculino , Dor Musculoesquelética/etiologia
18.
J Cardiothorac Surg ; 15(1): 91, 2020 May 12.
Artigo em Inglês | MEDLINE | ID: mdl-32398105

RESUMO

BACKGROUND: Thoracic surgeons have been incorporating enhanced recovery after surgery (ERAS) protocols into their practices, not only to reduce narcotic usage but also to improve complication rates and decrease lengths of stay. Here, we describe the utility of a regional block technique that can be used for patients undergoing urgent or elective thoracic surgical procedures or suffering from rib fractures. METHODS: We report our initial one-year experience with these erector spinae plane (ESP) blocks. RESULTS: ESP blocks were placed in 42 patients. The procedure was performed by a trained team of anesthesiologists and certified nurse practitioners. It included placement of a catheter on the ipsilateral chest, followed by a 20 ml of 0.2% ropivacaine bolus and continuous infusion. Patients were then followed by the regional team, as long as the catheter was in place. While it had some technical challenges, the block was effective in 83.3% of patients with no reported mortality or major complications. However, given the confounding factors of the study (such as simultaneous implementation of ERAS protocol) and heterogeneity of the patient population, a control group was difficult to ascertain and meaningful opioid consumption analysis was difficult to perform. CONCLUSIONS: Regional blocks, such as the ESP block, complement fundamental ERAS principles and serve as an adjunct to the available armamentarium for non-narcotic ways to control pain in thoracic surgical and chest trauma patients. Continued collaboration between the thoracic surgeons and anesthesiologists is needed for its success.


Assuntos
Anestésicos Locais , Dor Musculoesquelética/terapia , Bloqueio Nervoso/métodos , Manejo da Dor/métodos , Músculos Paraespinais , Ropivacaina , Adulto , Idoso , Idoso de 80 Anos ou mais , Recuperação Pós-Cirúrgica Melhorada , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Dor Musculoesquelética/etiologia , Fraturas das Costelas/complicações , Procedimentos Cirúrgicos Torácicos , Tórax
19.
J Athl Train ; 55(6): 608-614, 2020 Jun 23.
Artigo em Inglês | MEDLINE | ID: mdl-32348153

RESUMO

CONTEXT: After knee-joint injury, pain, effusion, and mechanoreceptor damage alter afferent signaling, which can result in quadriceps inhibition and subsequent weakness. The individual contributions of each factor to inhibition remain unclear due to confounding knee-joint injuries and indirect experimental models. OBJECTIVE: To characterize the influence of naturally occurring knee damage and pain on quadriceps neuromuscular function in individuals with patellar tendinopathy. DESIGN: Cross-sectional study. SETTING: Research laboratory. PATIENTS OR OTHER PARTICIPANTS: Twenty participants who self-reported patellar tendinopathy (PT) and 10 healthy control individuals underwent ultrasonic tendon assessment. Injured participants were dichotomized by an orthopaedic surgeon into groups with (1) pain and structural tendon abnormality and (2) regional pain alone. MAIN OUTCOME MEASURE(S): Quadriceps inhibition was assessed with the Hoffman reflex and the central activation ratio via the superimposed-burst technique. Normally distributed measures were analyzed using a 1-way analysis of variance and post hoc independent t tests. Kruskal-Wallis tests with post hoc Mann-Whitney U tests were used to analyze nonnormally distributed data. An a priori α level of P ≤ .05 was set. RESULTS: Control participants presented with more spinal-reflex excitability (0.37 ± 0.23) than the PT (0.10 ± 0.06; P = .03) and regional-pain (0.18 ± 0.05; P = .02) groups. Knee-extension strength was greater in the control (3.37 ± 0.59 Nm/kg) than in the PT (2.41 ± 0.67 Nm/kg; P = .01) group but not the regional-pain group (3.05 ± 0.66 Nm/kg; P = .24). Control individuals presented with more quadriceps activation (97.93% ± 3.12) than the PT (84.44% ± 16.98; P < .01) and regional-pain (91.17% ± 10.56; P = .01) groups. No differences were present for any measures between the PT and regional-pain groups (P values > .05). CONCLUSIONS: Deficits in spinal-reflex excitability, quadriceps activation, and strength were present in both the PT and regional-pain groups. A combination of pain and structural damage appeared to have the greatest negative effect on quadriceps function, as only the PT group presented with neuromuscular outcomes that failed to meet clinical thresholds.


Assuntos
Traumatismos do Joelho , Debilidade Muscular , Dor Musculoesquelética , Ligamento Patelar/lesões , Músculo Quadríceps , Tendinopatia , Adulto , Estudos Transversais , Feminino , Humanos , Traumatismos do Joelho/complicações , Traumatismos do Joelho/fisiopatologia , Masculino , Mecanorreceptores/fisiologia , Debilidade Muscular/diagnóstico , Debilidade Muscular/etiologia , Debilidade Muscular/fisiopatologia , Dor Musculoesquelética/etiologia , Dor Musculoesquelética/fisiopatologia , Exame Neurológico/métodos , Avaliação de Resultados em Cuidados de Saúde , Músculo Quadríceps/diagnóstico por imagem , Músculo Quadríceps/fisiopatologia , Tendinopatia/diagnóstico , Tendinopatia/etiologia , Tendinopatia/fisiopatologia , Ultrassonografia/métodos
20.
Arch Phys Med Rehabil ; 101(8): 1437-1446, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32234411

RESUMO

OBJECTIVE: To evaluate the effect of extracorporeal shockwave therapy (ESWT) on pain and function in myofascial pain syndrome (MPS) of the trapezius. DATA SOURCES: PubMed, EMBASE, Web of Science, Physiotherapy Evidence Database, and The Cochrane Central Register of Controlled Trials were systematically searched from the time of their inception to September 2019. STUDY SELECTION: Randomized controlled trials comparing the effects of ESWT on MPS of the trapezius were included in this review. DATA EXTRACTION: Data related to study participants, intervention, follow-up period, measure time, and outcomes were extracted. The Physiotherapy Evidence Database scale and the Cochrane Collaboration Tool for Assessing Risk of Bias were used to assess study quality and risk of bias. DATA SYNTHESIS: In total, 10 articles (n=477 patients) met our criteria and were included in this study. The overall effectiveness was calculated using a meta-analysis method. The meta-analysis revealed that ESWT exhibited significant improvement in pain reduction compared with sham ESWT or ultrasound treatment, but no significant effect when compared with conventional treatments (dry needling, trigger point injection, laser therapy) as for pain intensity and neck disability index. CONCLUSIONS: ESWT appears to benefit patients with MPS of the trapezius by alleviating pain. ESWT may not be an ideal therapeutic method to replace conventional therapies but could serve as an adjunct therapeutic method to those treatments.


Assuntos
Tratamento por Ondas de Choque Extracorpóreas , Síndromes da Dor Miofascial/terapia , Humanos , Dor Musculoesquelética/etiologia , Síndromes da Dor Miofascial/complicações , Medição da Dor , Músculos Superficiais do Dorso
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