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J Stroke Cerebrovasc Dis ; 28(11): 104341, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31542367


OBJECTIVE: To investigate the effects of water-based exercise on functioning and quality of life in poststroke persons. DATA SOURCES: We searched the following electronic database: MEDLINE, PeDro, Scielo, and the Cochrane Central Register of Controlled Trials up to September 2018 Study Selection: Only randomized controlled trials were included. Two review authors screened the titles and abstracts and selected the trials independently. DATA EXTRACTION: Two review authors independently extracted data of the included trials, using standard data-extraction model. We analyzed the pooled results using weighted mean differences, and standardized mean difference and 95% confidence intervals (CIs) were calculated. DATA SYNTHESIS: Twenty-four studies met the study criteria, but only 15 studies were included on meta-analyses. The studies presented moderate methodological quality, due to the lack of blinding of subjects and therapists and the nonperformance of the intention-to-treat analysis. Water-based exercise compared with land exercise had a positive impact on: muscle strength balance gait speed and mobility aerobic capacity and functional reach. Combined water-based exercise and land exercise was more effective than land exercise for improving balance, gait speed, and functional reach. The meta-analysis showed significant improvement in role limitations due to physical functioning and emotional problems, in vitality general mental health, social functioning, and bodily pain for participants in the water-based exercise and land exercise group versus land exercise group. CONCLUSIONS: Water-based exercise may improve muscle strength, balance, mobility, aerobic capacity, functional reach, joint position sense, and quality of life in poststroke persons and could be considered for inclusion in rehabilitation programs.

Terapia por Exercício/métodos , Hidroterapia/métodos , Reabilitação do Acidente Vascular Cerebral/métodos , Acidente Vascular Cerebral/terapia , Idoso , Avaliação da Deficiência , Tolerância ao Exercício , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Força Muscular , Equilíbrio Postural , Qualidade de Vida , Recuperação de Função Fisiológica , Acidente Vascular Cerebral/diagnóstico , Acidente Vascular Cerebral/fisiopatologia , Acidente Vascular Cerebral/psicologia , Resultado do Tratamento , Velocidade de Caminhada
Rev Chil Pediatr ; 90(3): 283-292, 2019 Jun.
Artigo em Espanhol | MEDLINE | ID: mdl-31344188


INTRODUCTION: Juvenile idiopathic arthritis (JIA) is a rheumatologic disease in children under 16 years old, which causes early physical disability. The use of hydrotherapy Watsu in these patients is propo sed. OBJECTIVE: To evaluate the effectiveness of Watsu compared to conventional hydrotherapy on health-related quality of life (HRQoL), functional health status, pain, and ranges of joint motion in patients with acute or subacute JIA. PATIENTS AND METHOD: Randomized (1:1) single-blind parallel controlled clinical trial in 46 patients with acute and subacute JIA between 8-18 years old. Pediatric Quality of Life Inventory 4.0 (PedsQL4.0), Childhood Health Assessment Questionnaire (CHAQ), and 10-joints Global range of motion score (GROMS) assessments were used at the beginning, post treatment, and after three months of follow-up. Patients were randomly assigned to the Watsu group (n = 24) and to the conventional hydrotherapy group (n = 22), participating in 10 sessions of 45 mi nutes once a week. RESULTS: Watsu therapy showed statistically significant improvements in physical functioning-HRQoL (p = 0.041), disability index (p = 0.015), distress index (p = 0.015), and functio nal health status-CHAQ (p = 0.013) after treatment compared to conventional hydrotherapy. Con clusions: Watsu therapy improved HRQoL, pain sensation, and functional health status compared to conventional hydrotherapy. Methodological adaptations are required in future studies to improve the external validity of these results.

Artrite Juvenil/terapia , Hidroterapia/métodos , Qualidade de Vida , Adolescente , Criança , Avaliação da Deficiência , Feminino , Nível de Saúde , Humanos , Masculino , Dor/etiologia , Método Simples-Cego , Resultado do Tratamento
Curr Urol Rep ; 20(8): 46, 2019 Jun 21.
Artigo em Inglês | MEDLINE | ID: mdl-31227924


PURPOSE OF REVIEW: To explore the potential applicability of a novel, heat-free, and robotically controlled ablative therapy for surgical management of benign prostatic enlargement. RECENT FINDINGS: With the emergence of new technology to provide personalized care and overcome the complications associated with options such as TURP, holmium laser enucleation of the prostate, GreenLight laser, or simple prostatectomy, Aquablation has been studied across a variety of prostate volumes. The functional outcome of Aquablation seems to be uncompromised by prostate volume. The sexual profile seems superior to TURP and the risk of retrograde ejaculation is lower. The robotic system provides a reproducible ablation, independent of prostate volume, without requiring extensive training for performing the procedure. The mean ablation time in the prostate as large as 150 ml does not exceed 9.1 min, and the blood transfusion rates do not seem to be higher than open prostatectomy.

Técnicas de Ablação/métodos , Sintomas do Trato Urinário Inferior/cirurgia , Prostatectomia/métodos , Hiperplasia Prostática/cirurgia , Humanos , Hidroterapia/métodos , Sintomas do Trato Urinário Inferior/etiologia , Masculino , Hiperplasia Prostática/complicações
Cuad. Hosp. Clín ; 60(1): 17-23, jun. 2019. ilus.
Artigo em Espanhol | LILACS | ID: biblio-1006594


OBJETIVOS: conocer la efectividad del Protocolo de Durán Modificado en las Lesiones Tendinosas Flexoras de la Mano determinando el grado de discapacidad funcional en pacientes atendidos por el Servicio de Medicina Física y Rehabilitación del Hospital de Clínicas en el periodo agosto ­ diciembre de 2016. MATERIAL Y MÉTODOS: se incluyeron dos grupos paralelos: al primer grupo (9 pacientes) se aplicó el protocolo de Durán Modificado y al segundo (9 pacientes) el tratamiento rehabilitador convencional. La valoración de la funcionalidad fue a través de la fórmula de Strickland, el sistema de Bruck Gramcko y la Distancia Pulpejo-Palma. Se realizó en 36 sesiones de 30 minutos aproximadamente para cada modalidad terapéutica con la correspondiente evaluación al finalizar los 3 meses de terapia. RESULTADOS: los que realizaron el protocolo de Durán Modificado finalizaron el tratamiento con una funcionalidad excelente en 4 casos, bueno en 3 y regular en 2 según la fórmula de Strickland. Según el sistema de Buck Gramcko la funcionalidad fue excelente para 5 pacientes y regular para 4. Y finalmente con la evaluación de la distancia pulpejo - palma se determinó que 4 pacientes obtuvieron un rango excelente, 4 bueno y 1 regular. CONCLUSIONES: la aplicación del protocolo de Durán modificado como rehabilitación precoz en pacientes con lesiones tendinosas flexoras de la mano es de mayor efectividad que el tratamiento rehabilitador convencional siendo una herramienta que puede ser aplicada de manera temprana en pacientes postoperados por esta afección

OBJECTIVES: to determine the effectiveness of the Modified Duran Protocol on flexor tendon injuries of the hand determining the degree of functional disability in patients treated by the Department of Physical Medicine and Rehabilitation at the Hospital de Clinicas during term August - December 2016.MATERIAL AND METHODS: we included two parallel groups: The Duran Modified protocol was applied on the first group (9 patients) and the Conventional Rehabilitation (9 patients) Treatment on the second. The assessment of the functionality was carried out with the formula Stricklan, Bruck Gramcko System and Pulpejo-Palma Distance. It was conducted in 36 sessions of approximately 30 minutes for each treatment modality with the corresponding evaluation at the end of 3 months of therapy. RESULTS: those who carried out the Modified Duran protocol completed treatment with excellent functionality in 4 cases, good in 3 and fair in 2 according to the formula Strickland. According Gramcko Buck system functionality was excellent for 5 patients and Fair for 4. Finally the evaluation of the pulpejo - palm distance showed that four patients had an excellent range, 4 good and 1 fair. CONCLUSIONS: the application the Modified Duran protocol as immediate rehabilitation in patients with flexor tendon injuries of the hand is more effective than conventional rehabilitation treatment being a tool that can be applied early in patients after surgery for this injury

Humanos , Masculino , Feminino , Adolescente , Pessoa de Meia-Idade , Contenções , Hidroterapia/métodos , Traumatismos dos Tendões/diagnóstico , Estimulação Elétrica Nervosa Transcutânea/métodos , Dedo em Gatilho/diagnóstico por imagem
J Strength Cond Res ; 33(6): 1488-1495, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31008862


Ahokas, EK, Ihalainen, JK, Kyröläinen, H, and Mero, AA. Effects of water immersion methods on postexercise recovery of physical and mental performance. J Strength Cond Res 33(6): 1488-1495, 2019-The aim of this study was to compare the effectiveness of 3 water immersion interventions performed after active recovery compared with active recovery only on physical and mental performance measures and physiological responses. The subjects were physically active men (age 20-35 years, mean ± SD 26 ± 3.7 years). All subjects performed a short-term exercise protocol, including maximal jumps and sprinting. Four different recovery methods (10 minutes) were used in random order: cold water immersion (CWI, 10° C), thermoneutral water immersion (TWI, 24° C), and contrast water therapy (CWT, alternately 10° C and 38° C). All these methods were performed after an active recovery (10-minute bicycle ergometer; heart rate [HR] 120-140 b·min, 60-73% from age-calculated maximum HR), and the fourth method was active recovery (ACT) only. Within 96 hours after exercise bouts, recovery was assessed through a 30-m maximal sprint test, maximal countermovement jump (CMJ), self-perceived muscle soreness and relaxation questionnaires, and blood lactate, creatine kinase, testosterone, cortisol, and catecholamine levels. The self-perceived feeling of relaxation after 60-minute recovery was better (p < 0.05) after CWI and CWT than ACT and TWI. Statistically significant differences were not observed between the recovery methods in any other marker. In the 30-m sprint test, however, slower running time was found in ACT (p < 0.001) and CWT (p = 0.005), and reduced CMJ results (p < 0.05) were found in ACT when the results were compared with baseline values. Based on these findings, it can be concluded that CWI and CWT improve the acute feeling of relaxation that can play a positive role in athletes' performance and well-being.

Hidroterapia/métodos , Imersão , Recuperação de Função Fisiológica/fisiologia , Água , Adulto , Desempenho Atlético , Ciclismo/fisiologia , Catecolaminas/sangue , Temperatura Baixa , Creatina Quinase/sangue , Exercício/fisiologia , Teste de Esforço , Frequência Cardíaca , Humanos , Hidrocortisona/sangue , Ácido Láctico/sangue , Masculino , Mialgia/psicologia , Percepção , Distribuição Aleatória , Relaxamento/psicologia , Corrida , Inquéritos e Questionários , Testosterona/sangue , Fatores de Tempo , Adulto Jovem
Rev. neurol. (Ed. impr.) ; 68(5): 181-189, 1 mar., 2019. graf, tab
Artigo em Espanhol | IBECS | ID: ibc-180387


Introducción. La inmersión vertical induce una variedad de respuestas fisiológicas en diferentes sistemas corporales, dependiendo de las propiedades de la mecánica de fluidos, las cuales son la base que sustenta los programas de terapia acuática en diferentes patologías. Objetivo. Realizar una revisión sistemática para analizar y describir los efectos que la inmersión vertical produce en el sistema nervioso en sujetos sanos. Sujetos y métodos. Se llevó a cabo una búsqueda sistemática de la bibliografía existente en las bases de datos BRAIN, PubMed, PEDro y Web of Science. Se evaluó metodológicamente la calidad mediante la guía CASPe y el nivel de evidencia se categorizó mediante la escala Oxford. Se incluyó un total de 12 artículos, con un rango de puntuación de 7-10 según CASPe, niveles de evidencia 1b-2b y grado de recomendación B. Resultados. Todos los estudios mostraron resultados positivos a las diferentes formas de exposición de la inmersión vertical en el agua y a la suma de estímulos empleados, sin referir efectos adversos en ningún caso. Conclusiones. La inmersión vertical en el agua genera efectos positivos sobre los flujos circulatorios cerebrales, la activación cortical, las funciones ejecutivas y la producción de neurotrofinas en sujetos sanos

Introduction. Vertical immersion induces a variety of physiological responses in different body systems, depending on the properties of fluid mechanics, which are the basis that underpins aquatic therapy programs in different pathologies. Aim. To perform a systematic review to analyze and describe the effects that vertical immersion produces on the nervous system in healthy subjects. Subjects and methods. A systematic search of the existing literature was conducted in the databases BRAIN, PubMed, PEDro and Web of Science. Quality was methodologically assessed using the CASPe guideline and the level of evidence was categorized using the Oxford scale. A total of 12 articles were included, with a score range of 7-10 according to CASPe, levels of evidence 1b-2b and grade of recommendation B. Results. All studies showed positive results to the different forms of exposure of vertical immersion in water and the summation of the stimuli used; no adverse effects were reported in any case. Conclusions. The vertical immersion in the water generates positive effects on cerebral blood flows, cortical activation, executive functions and the production of neurotrophins in healthy subjects

Humanos , Imersão , Hidroterapia/métodos , Doenças do Sistema Nervoso Central/terapia , Fatores de Crescimento Neural , Fenômenos Fisiológicos do Sistema Nervoso , Mecânica de Fluídos , Nível de Alerta/fisiologia
Int J Sports Med ; 40(4): 283-291, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30791079


Blood pressure (BP) and hemodynamic response to heated water-based (HEx) vs. land-based exercise (LEx) were assessed in 15 (6 men) older hypertensives (age 66.4±4.9 yr) under pharmacological treatment. Participants were randomly assigned to perform 30 min of moderate-intensity HEx (walking inside the pool), LEx (walking on a treadmill) and non-exercise control (CON) intervention. Resting BP, arterial stiffness, endothelial reactivity and heart rate variability (HRV) were measured before, immediately after, and 45 min after interventions. 24-h ambulatory BP monitoring was performed after interventions. Resting systolic (but not diastolic) BP reduced 9.9±3.1 mmHg (P<0.01) 45 min after HEx only. 24-h systolic and diastolic, daytime diastolic and nightime systolic BP were lower (P<0.05) after HEx than both LEx and CON. Daytime systolic BP was also lower (P<0.05) after HEx than CON. Nighttime diastolic was not different between interventions. HEx-induced ambulatory BP reduction ranged 4.5±1.3 mmHg (24-h diastolic BP) to 9.5±3.0 mmHg (nighttime systolic BP), and persisted for 18/11 h in systolic/diastolic BP, when compared with CON. No significant changes in arterial stiffness, endothelial reactivity and HRV were found during any intervention. These results suggest that HEx may have important implications for managing BP in older hypertensive under pharmacological treatment.

Terapia por Exercício/métodos , Hidroterapia/métodos , Hipertensão/terapia , Idoso , Anti-Hipertensivos/uso terapêutico , Pressão Sanguínea , Monitorização Ambulatorial da Pressão Arterial , Endotélio Vascular/fisiologia , Feminino , Frequência Cardíaca , Temperatura Alta , Humanos , Hipertensão/tratamento farmacológico , Hipertensão/fisiopatologia , Masculino , Pessoa de Meia-Idade , Rigidez Vascular
Burns ; 45(4): 983-989, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-30595542


BACKGROUND: In many parts of the world, hydrotherapy plays an important role in the management of patients with wounds including burns. Different centers practice hydrotherapy differently. At the University Teaching Hospital in Lusaka, Zambia, burn patients use a common bathtub for cleaning their wounds which theoretically increases the risk of cross-infection, an important source of morbidity and mortality. There is currently no evidence that hydrotherapy as practiced at our institution leads to cross infection among patients with burns. OBJECTIVE: The objective was to determine if our hydrotherapy practice and water plays a role in cross-infection and what organisms cause this infection. METHODS: This was a prospective analytical study. Patients meeting the selection criteria were recruited. Swabs from the burn wounds were collected on admission (day 0), day 4 and day 7. Weekly swabs of the bathtub were also collected, after the tub had been cleaned and declared ready for the next patient. Weekly water samples were also collected. Selected results, for Staphylococcus aureus and Klebsiella pneumoniae, were subjected to further analysis and PCR. Results were analyzed using statistics software, SPSS version 23. RESULTS: In this study, there were 96 participants of which 51 (53.1%) were males and 45 (46.9%) were females. Age distribution ranged from 5months to 91 years. The modal age range was 1 to 2 years. The modal burn percentage was 6%-10%, followed by 11%-15%. Hot water was the cause of burns in 65.6%. S. aureus and K. pneumoniae were the most common organisms isolated. Others were enteric organisms. In terms of readily available antibiotics, there was more sensitivity to Amikacin and Chloramphenicol than Ciprofloxacin (our commonly used antibiotic). The bathtub also had S. aureus and K. pneumoniae, besides enteric organisms. Sixty five point four percent (65.4%) of the Klebsiella were ESBL (Extended Spectrum Beta Lactamase) producers. The tub had samples that were both ESBL producers as well as widely resistant Klebsiella by other means. No growth was obtained from the water samples. Seventy-two point nine percent (72.9%) of the patients were discharged, 19.8% died, while 7.3% left against medical advice. CONCLUSION: Hydrotherapy as currently practiced at the University Teaching Hospital does contribute significantly to cross-infection among burn patients with widely resistant organisms. The main ones are S. aureus and K. pneumoniae. Switching care to a shower mechanism might help eliminate this problem as the study demonstrates that no bacteria were found in the water samples.

Queimaduras/terapia , Infecção Hospitalar/epidemiologia , Contaminação de Equipamentos/estatística & dados numéricos , Hidroterapia/métodos , Infecções por Klebsiella/epidemiologia , Infecções Estafilocócicas/epidemiologia , Microbiologia da Água , Infecção dos Ferimentos/epidemiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Desinfecção , Farmacorresistência Bacteriana/fisiologia , Feminino , Hospitais de Ensino , Hospitais Universitários , Humanos , Lactente , Klebsiella pneumoniae/isolamento & purificação , Klebsiella pneumoniae/fisiologia , Masculino , Pessoa de Meia-Idade , Prevalência , Estudos Prospectivos , Staphylococcus aureus/isolamento & purificação , Staphylococcus aureus/fisiologia , Adulto Jovem , Zâmbia/epidemiologia , beta-Lactamases
Burns ; 45(1): 88-96, 2019 02.
Artigo em Inglês | MEDLINE | ID: mdl-30322740


INTRODUCTION: During the last decade, the Versajet™ hydrosurgery system has become popular as a tool for tangential excision in burn surgery. Although hydrosurgery is thought to be a more precise and controlled manner for burn debridement prior to skin grafting, burn specialists decide individually whether hydrosurgery should be applied in a specific patient or not. The aim of this study was to gain insight in which patients hydrosurgery is used in specialized burn care in the Netherlands. METHODS: A retrospective study was conducted in all patients admitted to a Dutch burn centre between 2009 and 2016. All patients with burns that underwent surgical debridement were included. Data were collected using the national Dutch Burn Repository R3. RESULTS: Data of 2113 eligible patients were assessed. These patients were treated with hydrosurgical debridement (23.9%), conventional debridement (47.7%) or a combination of these techniques (28.3%). Independent predictors for the use of hydrosurgery were a younger age, scalds, a larger percentage of total body surface area (TBSA) burned, head and neck burns and arm burns. Differences in surgical management and clinical outcome were found between the three groups. CONCLUSION: The use of hydrosurgery for burn wound debridement prior to skin grafting is substantial. Independent predictors for the use of hydrosurgery were mainly burn related and consisted of a younger age, scalds, a larger TBSA burned, and burns on irregularly contoured body areas. Randomized studies addressing scar quality are needed to open new perspectives on the potential benefits of hydrosurgical burn wound debridement.

Queimaduras/cirurgia , Desbridamento/métodos , Adolescente , Adulto , Fatores Etários , Idoso , Traumatismos do Braço/cirurgia , Superfície Corporal , Criança , Pré-Escolar , Cicatriz , Estudos de Coortes , Traumatismos Craniocerebrais/cirurgia , Feminino , Humanos , Hidroterapia/métodos , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Lesões do Pescoço/cirurgia , Países Baixos , Estudos Retrospectivos , Transplante de Pele , Resultado do Tratamento , Adulto Jovem
Clin Res Cardiol ; 108(5): 468-476, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-30267153


BACKGROUND: Patients with chronic conditions, such as heart failure, swim regularly and most rehabilitation exercises are conducted in warm hydrotherapy pools. However, little is known about the acute effects of warm water immersion (WWI) on cardiac haemodynamics in patients with chronic heart failure (CHF). METHODS: Seventeen patients with CHF (NYHA I and II; mean age 67 years, 88% male, mean left ventricular ejection fraction 33%) and 10 age-matched normal subjects were immersed up to the neck in a hydrotherapy pool (33-35 °C). Cardiac haemodynamics were measured non-invasively, and echocardiography was performed at baseline, during WWI, 3 min after kicking in the supine position and after emerging. RESULTS: In patients with CHF, compared to baseline, WWI immediately increased stroke volume (SV, mean ± standard deviation; from 65 ± 21 to 82 ± 22 mL, p < 0.001), cardiac output (CO, from 4.4 ± 1.4 to 5.7 ± 1.6 L/min, p < 0.001) and cardiac index (CI, from 2.3 ± 0.6 to 2.9 ± 0.70 L/min/m², p < 0.001) with decreased systemic vascular resistance (from 1881 ± 582 to 1258 ± 332 dynes/s/cm5, p < 0.001) and systolic blood pressure (132 ± 21 to 115 ± 23 mmHg, p < 0.001). The haemodynamic changes persisted for 15 min of WWI. In normal subjects, compared to baseline, WWI increased SV (from 68 ± 11 to 80 ± 18 mL, p < 0.001), CO (from 5.1 ± 1.9 to 5.7 ± 1.8 L/min, p < 0.001) and CI (from 2.7 ± 0.9 to 2.9 ± 1.0 L/min/m², p < 0.001).In patients with CHF, compared to baseline, WWI caused an increase in left atrial volume (from 57 ± 44 to 72 ± 46 mL, p = 0.04), without any changes in left ventricular size or function or amino terminal pro B-type natriuretic peptide. CONCLUSIONS: In patients with CHF, WWI causes an acute increase in cardiac output and a fall in systemic vascular resistance. CLINICAL TRIAL REGISTRATION: (Identifier: NCT02949544) .

Insuficiência Cardíaca/reabilitação , Hidroterapia/métodos , Imersão/fisiopatologia , Volume Sistólico/fisiologia , Resistência Vascular/fisiologia , Função Ventricular Esquerda/fisiologia , Idoso , Ecocardiografia , Feminino , Insuficiência Cardíaca/diagnóstico , Insuficiência Cardíaca/fisiopatologia , Humanos , Masculino , Pessoa de Meia-Idade , Projetos Piloto , Resultado do Tratamento
Medicine (Baltimore) ; 97(52): e13823, 2018 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-30593178


BACKGROUND: This study aimed to systemically review the effectiveness of aquatic exercise (AQE) compared to land-based exercise (LBE) in treating knee osteoarthritis (OA). METHODS: The Medline, Embase, Web of Science, Cochrane Central Register of Controlled Clinical Trials, CINAHL, and psyclNFO databases were comprehensively searched for randomized controlled trials (RCTs) evaluating the effectiveness of AQE and LBE for knee OA from their inception date to September 24, 2018. The risk of bias was examined using the Cochrane Collaboration Tool, and Review Manager 5.3 was used for data collation and analysis. RESULTS: Eight RCTs were included, involving a total of 579 patients. The meta-analysis showed that there was no significant difference between AQE and LBE for pain relief, physical function, and improvement in the quality of life, for both short- and long-term interventions, in patients with knee OA. However, the adherence and satisfaction level for AQE was higher than for LBE. Compared to no intervention, AQE showed a mild effect for elevating activities of daily living (standardized mean difference [SMD]: -0.55, 95% confidence interval [CI] [-0.94, -0.16], P = .005) and a high effect for improving sports and recreational activities (SMD: -1.03, 95% CI [-1.82, -0.25], P = .01). CONCLUSION: AQE is comparable to LBE for treating knee OA.

Terapia por Exercício/métodos , Hidroterapia/métodos , Osteoartrite do Joelho/terapia , Atividades Cotidianas , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Osteoartrite do Joelho/fisiopatologia , Ensaios Clínicos Controlados Aleatórios como Assunto , Resultado do Tratamento
Complement Ther Med ; 41: 287-294, 2018 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-30477855


OBJECTIVE: To analyze the short-term thermogenic effects of footbaths with warm water alone (WA) versus when combined with medicinal powders. DESIGN: Randomized controlled trial with cross-over. INTERVENTIONS AND OUTCOMES: Seventeen healthy volunteers (mean age 22.1 years, SD = 2.4; 11 female) received three footbaths with WA or WA combined with mustard (MU) or ginger (GI) in a randomized order. Self-perceived warmth (Herdecke warmth perception questionnaire) and actual skin temperatures (thermography) were assessed before (t0), immediately after footbaths (t1), and 10 minutes later (t2). The primary outcome was perceived warmth in the feet. Secondary outcomes were warmth perception in the face, hands and overall, as well as actual skin temperature in the feet, face, and hands. RESULTS: Perceived warmth at the feet (primary outcome) increased significantly (all p's < .001) for MU and GI at t1 as well as for GI at t2 when compared to t0 with high effect sizes. At t2, GI differed significantly from WA (p < .001) and MU (p = .048). With regards to the secondary measures of outcome, no significant effects were seen for perceived warmth at the face or hands. Overall warmth was significantly higher at t1 compared to t0 (p = .01). Thermography assessments of skin temperature at the feet at t1 increased after all conditions (p < .001). No effects were seen in the face. At the hands, temperature decreased at t1 (p = .02) and t2 compared to t0 (p < .001). CONCLUSION: The present study provides preliminary evidence that mustard and ginger increase warmth perception at the feet more than warm water alone, with only the effects for GI enduring at the brief follow-up.

Pé/fisiologia , Gengibre/química , Hidroterapia/métodos , Mostardeira/química , Extratos Vegetais/uso terapêutico , Adulto , Feminino , Humanos , Masculino , Temperatura Cutânea/efeitos dos fármacos , Temperatura Cutânea/efeitos da radiação , Termografia , Adulto Jovem
J Complement Integr Med ; 16(2)2018 Oct 17.
Artigo em Inglês | MEDLINE | ID: mdl-30335610


Background Hydrotherapeutic applications to the head and spine have shown to improve cardiovascular and autonomic functions. There is lack of study reporting the effect of either neutral spinal bath (NSB) or neutral spinal spray (NSS). Hence, the present study was conducted to evaluate and compare the effects of both NSB and NSS in healthy volunteers. Methods Thirty healthy subjects were recruited and randomized into either neutral spinal bath group (NSBG) or neutral spinal spray group (NSSG). A single session of NSB, NSS was given for 15 min to the NSBG and NSSG, respectively. Assessments were taken before and after the interventions. Results Results of this study showed a significant reduction in low-frequency (LF) to high-frequency (HF) (LF/HF) ratio of heart rate variability (HRV) spectrum in NSBG compared with NSSG (p=0.026). Within-group analysis of both NSBG and NSSG showed a significant increase in the mean of the intervals between adjacent QRS complexes or the instantaneous heart rate (HR) (RRI) (p=0.002; p=0.009, respectively), along with a significant reduction in HR (p=0.002; p=0.004, respectively). But, a significant reduction in systolic blood pressure (SBP) (p=0.037) and pulse pressure (PP) (p=0.017) was observed in NSSG, while a significant reduction in diastolic blood pressure (DBP) (p=0.008), mean arterial blood pressure (MAP) (p=0.008) and LF/HF ratio (p=0.041) was observed in NSBG. Conclusion Results of the study suggest that 15 min of both NSB and NSS might be effective in reducing HR and improving HRV. However, NSS is particularly effective in reducing SBP and PP, while NSB is particularly effective in reducing DBP and MAP along with improving sympathovagal balance in healthy volunteers.

Pressão Sanguínea , Frequência Cardíaca , Hidroterapia/métodos , Adulto , Fenômenos Fisiológicos Cardiovasculares , Feminino , Cabeça/fisiologia , Voluntários Saudáveis , Humanos , Masculino , Projetos Piloto , Coluna Vertebral/fisiologia , Adulto Jovem
Zhonghua Shao Shang Za Zhi ; 34(8): 516-521, 2018 Aug 20.
Artigo em Chinês | MEDLINE | ID: mdl-30157554


Objective: To study the effects of hydrotherapy with traditional Chinese medicine combined with magnetotherapy on treatment of scars after healing of deep partial-thickness burn wounds in children. Methods: Forty-eight children with scars after healing of deep partial-thickness burn wounds admitted to the Burn Department of Air Force General Hospital from January to December in 2016 met the criteria for inclusion in this study, and their medical records were analyzed retrospectively. Within one month after the wound was completely healed, 24 children were treated with silicone cream for 2 times per day and wore elastic sleeves all day long according to the wishes of the children and their families, and they were enrolled in routine treatment group. The other 24 children were treated by hydrotherapy with traditional Chinese medicine Fuchunsan No. 2 once every 2 days for 30 min each time on the basis of treatment methods of routine treatment group, plus magnetotherapy using pulse magnetotherapy apparatus in the morning and evening of each day for 30-60 min each time, and they were enrolled in hydrotherapy+ magnetotherapy group. Before treatment and 12 weeks after treatment, the Vancouver Scar Scale was used to assess the scar condition of children, the Wong-Baker Facial Expression Scale was used to assess the degree of scar pain of children, the Numerical Rating Scale was used to assess the degree of scar itching of children, the modified Barthel Index was used to assess the activity of daily living (ADL) of children, and the Motor Function Evaluation Scale was used to assess the dysfunction condition of limbs with scar. After 12 weeks of treatment, the incidence of deformity of children was calculated. Data were processed with t test and chi-square test. Results: Before treatment, the scores of scar condition of children between routine treatment group and hydrotherapy+ magnetotherapy group were similar (t=0.517, P=0.721). After 12 weeks of treatment, the score of scar condition of children in hydrotherapy+ magnetotherapy group was (2.8±0.8) points, which was significantly lower than (3.9±0.8) points of routine treatment group (t=5.725, P<0.01). Before treatment, the scores of scar pain and itching degree of children between routine treatment group and hydrotherapy+ magnetotherapy group were similar (t=0.373, 0.241, P=0.712, 0.631). After 12 weeks of treatment, the scores of scar pain and itching degree of children in hydrotherapy+ magnetotherapy group were (0.52±0.21) and (0.7±0.4) points, respectively, which were obviously lower than (1.13±0.32) and (1.3±0.4) points of routine treatment group (t=6.057, 5.259, P<0.01). Before treatment, the ADL scores of children between routine treatment group and hydrotherapy+ magnetotherapy group were similar (t=0.082, P=0.964). After 12 weeks of treatment, the ADL score of children in hydrotherapy+ magnetotherapy group was (67±13) points, which was significantly higher than (48±10) points of routine treatment group (t=5.378, P<0.01). Before treatment, the dysfunction scores of limbs with scar of children between routine treatment group and hydrotherapy+ magnetotherapy group were similar (t=0.261, P=0.720). After 12 weeks of treatment, the dysfunction score of limbs with scar of children in hydrotherapy+ magnetotherapy group was (62±9) points, which was significantly higher than (47±8) points of routine treatment group (t=14.463, P<0.05). After 12 weeks of treatment, the incidence of deformity of children in hydrotherapy+ magnetotherapy group was 8.3% (2/24), which was significantly lower than 37.5% (9/24) of routine treatment group (χ(2)=4.25, P<0.05). Conclusions: On the basis of topical anti-scarring drugs and compression therapy, supplementing hydrotherapy with traditional Chinese medicine and magnetotherapy can significantly reduce the hyperplasia degree, pain degree, itching degree of scars formed after healing of deep partial-thickness burn wounds in children, improve the ADL, promote functional recovery, and reduce the incidence of deformity of children.

Queimaduras/complicações , Cicatriz/terapia , Hidroterapia/métodos , Imãs , Medicina Tradicional Chinesa , Cicatrização , Queimaduras/terapia , Criança , Humanos , Cuidados Pós-Operatórios/métodos , Estudos Retrospectivos , Resultado do Tratamento
NeuroRehabilitation ; 43(2): 237-246, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30040763


BACKGROUND: After the stroke, a number of changes occur in the neuromuscular system functions. OBJECTIVE: To determine whether the water based exercise (WBE) program applied in combination with the land-based exercises (LBE) compared to LBE alone contributes to the stroke patients' motor functions, walking, balance functions and quality of life (QoL). METHODS: In total, 60 patients participated in this study. Patients were randomly divided into two groups. WBE therapy (3/week) + LBE (2/week) combination was applied to the patients in the study group (n = 30) for six weeks. LBE was applied to the control group (n = 30) 5/week for six weeks. Patients were evaluated before and after the treatment. Functional independence measurement, Berg balance scale, timed up and go test, and short form (SF) -36 assessment questionnaire were performed. RESULTS: Posttreatment results showed significant improvements in all of the parameters (except SF - 36 pain parameter) in both groups. The improvement in the vitality parameter of SF-36 was higher in the study group (p < 0.05), and improvement in the BBS was significantly higher in the LBE group than the WBE group (p < 0.05). CONCLUSION: Applying WBE together with the LBE (except SF-36 vitality sub-parameter) in patients with hemiplegia did not make any additional contribution to the application of LBE alone.

Terapia por Exercício/métodos , Hemiplegia/reabilitação , Equilíbrio Postural , Reabilitação do Acidente Vascular Cerebral/métodos , Caminhada , Idoso , Feminino , Humanos , Hidroterapia/métodos , Masculino , Pessoa de Meia-Idade
Wounds ; 30(6): E60-E64, 2018 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30059332


INTRODUCTION: Live maggot infestation (myiasis) of wounds can present a host of ailments. Loosely associated with maggot excreta, Morganella morganii is a widespread, gram-negative rod bacterium commonly found in the intestinal tracts of humans. M morganii has been observed as being pathogenic, particularly in nosocomial and postoperative environments, as well as in immunosuppressed and elderly populations. CASE REPORT: Herein, the authors present a rare, previously unreported case of M morganii septicemia (as confirmed by positive blood culture), secondary to myiasis of the lower extremities. The patient was successfully treated with both systemic and topical interventions. Posttreatment examination revealed resolution of myiasis and negative blood cultures. CONCLUSIONS: Myiasis can be invasive, leading to severe systemic infection. In these cases, a broad-spectrum antibiotic combined with systemic and topical antiparasitic therapy should be considered.

Infecções por Enterobacteriaceae/patologia , Hiperceratose Epidermolítica/patologia , Extremidade Inferior/patologia , Morganella morganii/patogenicidade , Miíase/complicações , Síndrome Pós-Trombótica/complicações , Sepse/patologia , Administração Intravenosa , Administração Tópica , Idoso de 80 Anos ou mais , Carbapenêmicos/administração & dosagem , Infecções por Enterobacteriaceae/terapia , Humanos , Hidroterapia/métodos , Hiperceratose Epidermolítica/parasitologia , Hiperceratose Epidermolítica/terapia , Inseticidas/administração & dosagem , Extremidade Inferior/parasitologia , Masculino , Miíase/patologia , Miíase/terapia , Pomadas/administração & dosagem , Permetrina/administração & dosagem , Síndrome Pós-Trombótica/fisiopatologia , Síndrome Pós-Trombótica/terapia , Sepse/parasitologia , Sepse/terapia , Resultado do Tratamento
Midwifery ; 64: 110-114, 2018 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-29961561


OBJECTIVE: Though bathing (hydrotherapy) is widely used during labor to decrease anxiety and pain and to promote relaxation, the influence of cultural beliefs about bathing by parturients is virtually unknown. This pilot study explored pregnant women's experiences of bathing, bathing in labor, and cultural beliefs about bathing. DESIGN: An exploratory, descriptive design. SETTING: Low risk obstetrical clinics. PARTICIPANTS: Healthy Hispanic, Black, White, American-Indian and Asian women (N = 41) at >37 weeks gestation. METHODS: During a routine prenatal visit women responded to a brief openended questionnaire on the use of bathing. Data was captured using a modified ethnographic method involving observation and note taking with thematic analysis and quantification of percent response rates. FINDINGS: Forty-six percent (N = 41) of women used bathing for purposes other than hygiene but only 4.9% (N = 41) of these women bathed during a previous labor. The women described bathing as relaxing, easing, calming, and efficacious for relief of menstrual cramps and labor contractions. Ten percent of women reported cultural beliefs about bathing. CONCLUSIONS: Women who bathe, report relief of anxiety, menstrual and labor pain and promotion of mental and physical relaxation. The findings do not support the view that bathing is associated with identifiable cultural beliefs; rather, they suggest that bathing is a self-care measure used by women. This practice is likely transmitted from generation to generation by female elders through the oral tradition. Assumptions that race or ethnicity precludes the use of bathing may be faulty. Cautionary instructions should be given to pregnant women who are <37 completed weeks of gestation, to avoid bathing for relief of cramping or contractions and to seek immediate health care evaluation. Study of culturally intact groups may uncover additional themes related to bathing in labor and as a self-care measure for dysmenorrhea.

Banhos/psicologia , Assistência à Saúde Culturalmente Competente/métodos , Hidroterapia/psicologia , Adolescente , Adulto , Banhos/métodos , Assistência à Saúde Culturalmente Competente/normas , Feminino , Humanos , Hidroterapia/métodos , Trabalho de Parto/psicologia , Projetos Piloto , Gravidez , Autocuidado , Inquéritos e Questionários
Chemosphere ; 207: 742-752, 2018 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-29859486


In this study, hydrothermal method was applied for the treatment of five typical waste plastics (PC, HIPS, ABS, PP and PA6). The hydrothermal products of oils and solid residues were analyzed for the product slate and combustion behaviors. Some predominant chemical feedstock were detected in the oils, such as phenolic compounds and bisphenol A (BPA) in PC oils, single-ringed aromatic compounds and diphenyl-sketetons compounds in HIPS and ABS oils, alkanes in PP oils, and caprolactam (CPL) in PA6 oils. The hydrothermal solid residues were subjected to DSC analysis. Except the solid residues of PA6, all the solid residues had enormous improvement on the enthalpy of combustion. The solid residues of PC had the maximum promotion up to 576.03% compared to the raw material. The hydrothermal treatment significantly improved the energy density and facilitated effective combustion. Meanwhile, the glass fiber was recovered from the PA6 plastics. In addition, the combustion behaviors of the uplifting residues were investigated to provide the theoretical foundation for further study of combustion optimization. All the results indicated that the oils of waste plastics after hydrothermal treatment could be used as chemical feedstock; the solid residues of waste plastics after hydrothermal treatment could be used as potentially clean and efficient solid fuels. The hydrothermal treatment for various waste plastics was verified as a novel waste-to-energy technique.

Hidroterapia/métodos , Plásticos/química , Resíduos/análise
Int J Mol Sci ; 19(6)2018 06 06.
Artigo em Inglês | MEDLINE | ID: mdl-29882782


Balneotherapy is a clinically effective complementary approach in the treatment of low-grade inflammation- and stress-related pathologies. The biological mechanisms by which immersion in mineral-medicinal water and the application of mud alleviate symptoms of several pathologies are still not completely understood, but it is known that neuroendocrine and immunological responses­including both humoral and cell-mediated immunity­to balneotherapy are involved in these mechanisms of effectiveness; leading to anti-inflammatory, analgesic, antioxidant, chondroprotective, and anabolic effects together with neuroendocrine-immune regulation in different conditions. Hormesis can play a critical role in all these biological effects and mechanisms of effectiveness. The hormetic effects of balneotherapy can be related to non-specific factors such as heat­which induces the heat shock response, and therefore the synthesis and release of heat shock proteins­and also to specific biochemical components such as hydrogen sulfide (H2S) in sulfurous water and radon in radioactive water. Results from several investigations suggest that the beneficial effects of balneotherapy and hydrotherapy are consistent with the concept of hormesis, and thus support a role for hormesis in hydrothermal treatments.

Balneologia/métodos , Imunidade , Estresse Fisiológico , Animais , Hormese , Humanos , Hidroterapia/métodos , Resultado do Tratamento
J Drugs Dermatol ; 17(6): 657-662, 2018 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-29879253


BACKGROUND: La Roche-Posay Thermal Spring Water (LRP-TSW) exhibits both probiotic and prebiotic properties enhancing the diversity of the skin microbiota. METHODS: A review was undertaken to explore the role of LRP-TSW as a topical probiotic and prebiotic therapy in improving the diversity of the skin microbiota and reducing dryness and pruritus in inflammatory skin diseases. RESULTS: The concentration of minerals and non-pathogenic microbes in LRP-TSW may explain its therapeutic benefit when used for inflammatory skin diseases. Clinical studies have shown that topical LRP-TSW treatment results in increases in Gram-negative bacteria with reduction of Gram-positive bacteria, and improvements in skin microbial diversity. At the same time skin condition in atopic dermatitis, psoriasis, and general dryness in otherwise healthy skin, has been shown to improve. CONCLUSIONS: Enhancement of skin microbiota diversity using topical LRP-TSW may offer a valuable option for the treatment and maintenance of inflammatory skin diseases. J Drugs Dermatol. 2018;17(6):657-662.






Fontes Termais , Hidroterapia/métodos , Microbiota/fisiologia , Prebióticos/administração & dosagem , Probióticos/administração & dosagem , Dermatopatias/terapia , Antioxidantes/administração & dosagem , Dermatite Atópica/microbiologia , Dermatite Atópica/fisiopatologia , Dermatite Atópica/terapia , Humanos , Prurido/microbiologia , Prurido/fisiopatologia , Prurido/terapia , Psoríase/microbiologia , Psoríase/fisiopatologia , Psoríase/terapia , Dermatopatias/microbiologia , Dermatopatias/fisiopatologia