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1.
Am Surg ; 85(9): 998-1000, 2019 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-31638513

RESUMO

Tension is one of the most discussed terms related to hernia surgery and repair. Despite the universally accepted opinion that tension and reduction of tension are important concepts in hernia repair, there is very little known about the physiologic tension of the abdominal wall related to ventral hernia repair. The purpose of this project was to attempt to measure physiologic tension in patients without hernia repair and help determine a normal baseline tension. Patients were enrolled in a prospective institutional review board-approved protocol to measure abdominal wall tension from February 2014 to present. Patients undergoing abdominal surgery without hernia repair were included. Demographic information and operative details were documented. Abdominal wall tensions were measured using scales attached to Kocher clamps that are clamped to the fascia and then brought together in the midline. Total tension, surgeon's estimation of tension, and grading of the fascia were recorded. Descriptive statistics were calculated. Eleven patients met the inclusion criteria and had tension measurements performed during surgery. The average age was 58 years, with 55 per cent of them being white and 82 per cent being male, with an average BMI of 27. Operations included exploratory laparotomy for small bowel pathology in six patients, colorectal surgery in three patients, and splenectomy in a trauma patient. Average tension measurements for these patients were 1.9 lbs. Surgeon grading of tension was an average of 2.2 (range, 1-5). Obtaining tension measurements is feasible during abdominal surgery. Physiologic tension seems to be approximately 2 pounds. Further study is needed with a larger sample of patients.


Assuntos
Parede Abdominal/fisiologia , Tono Muscular/fisiologia , Adulto , Idoso , Fáscia/fisiologia , Feminino , Hérnia Ventral/fisiopatologia , Hérnia Ventral/cirurgia , Herniorrafia/métodos , Humanos , Período Intraoperatório , Laparotomia , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Valores de Referência
2.
Medicina (Kaunas) ; 55(10)2019 Sep 21.
Artigo em Inglês | MEDLINE | ID: mdl-31546613

RESUMO

Background and objectives: Functional electrical stimulation (FES) has shown good results in improving static and dynamic sitting balance in persons with spinal cord injuries. There is limited information about how regular surface FES combined with therapeutic exercise (TE) affect dynamic sitting balance and muscle tone. The objective of this study was to evaluate the effectiveness of a six-week physical therapy program consisting of FES and TE on muscle tone and sitting balance in persons with spinal cord injury (SCI). It was also important to explore the relationship between muscle tone and dynamic sitting balance. The third objective was to assess the change of characteristics over a six month period, when no intervention was carried out. Material and methods: Five men with SCI were alternately allocated to two study groups: SCI_FES+TE and SCI_TE. Eight healthy control group participants were recruited to collect reference data. SCI participants' intervention lasted for six weeks in their homes. SCI_FES+TE conducted exercises with FES applied on erector spinae (ES) and rectus abdominis (RA) muscles. SCI_TE conducted exercises only. Muscle oscillation frequency (MOF; characterizing muscle tone) and limits of stability (LOS; characterizing sitting balance) were measured. A crossover study design was used. The time between the initial intervention and the crossover was seven months (ClinicalTrials registration ID NCT03517787). Results: MOF in SCI_FES+TE increased by 6.0% for ES and 6.1% for RA muscles. LOS of flexion increased 30.1% in SCI_FES+TE. Increase in lateral directions was similar for both study groups. Moderate to high negative correlation was found between MOF and LOS. After seven months, MOF of ES decreased 0.8%, MOF or RA decreased 1.4%, LOS of flexion decreased 31.9%, and LOS of lateral flexion to the left decreased 46.4%. Conclusions: The six-week therapy program combining FES and TE increased trunk muscle tone and dynamic sitting balance in flexion more than TE alone. Higher antagonist muscle tone negatively affects dynamic sitting balance and center of pressure (COP) trajectory distance in various directions. After seven months, a slight decline in trunk muscles tone values and an extensive decrease in sitting balance values were noticed.


Assuntos
Terapia por Estimulação Elétrica , Terapia por Exercício , Tono Muscular/fisiologia , Equilíbrio Postural/fisiologia , Postura Sentada , Traumatismos da Medula Espinal/terapia , Adulto , Estudos de Casos e Controles , Terapia Combinada , Estudos Cross-Over , Humanos , Masculino , Valores de Referência , Traumatismos da Medula Espinal/fisiopatologia
3.
IEEE Int Conf Rehabil Robot ; 2019: 957-962, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-31374753

RESUMO

Robot-assisted rehabilitation of hand function is becoming an established approach to complement conventional therapy after stroke, particularly in view of its possible unsupervised use to promote an increase in therapy dose. Given their intensive therapy regime, robots may promote a temporary increase in hand muscle tone and spasticity, which may cause pain and negatively affect recovery. To integrate hand muscle tone monitoring into an assessment-driven robot-assisted therapy concept, an online assessment of muscle tone is proposed and incorporated into an exercise. The exercise was preliminarily tested in a pilot study with five chronic stroke survivors (non-spastic at rest) and five healthy participants to identify the range of potential physiological muscle tone change that can happen also in a non-spastic population during a single exercise session. In both groups, the muscle tone level during hand opening was higher in fast 20 mm ramp-and-hold perturbations (150 ms) compared to slow (250 ms) perturbations, and corresponded to a force change of approximately 4-5 N. Despite not being statistically significantly different, in the stroke group the force change (and the speed dependency) increased with exercise time. This information could serve as a basis to develop strategies to continuously adapt the difficulty and activity level required in robot-assisted rehabilitation and to monitor or even control the muscle tone evolution over time.


Assuntos
Mãos/fisiopatologia , Tono Muscular/fisiologia , Robótica , Equipamentos de Autoajuda , Idoso , Fenômenos Biomecânicos , Terapia por Exercício , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Projetos Piloto
4.
Acta Neurol Scand ; 140(6): 399-404, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31411727

RESUMO

OBJECTIVES: REM (rapid eye movement) sleep without atonia (RSWA) is a polysomnographic finding used in diagnosis of REM sleep behavior disorder (RBD). Clinical significance of idiopathic RSWA (iRSWA) unaccompanied by RBD is not known. We designed a prospective study to investigate whether iRSWA constitutes an increased risk for developing neurodegenerative disorders. MATERIALS AND METHODS: Between January 2010 and December 2014, a total of 4362 patients underwent a full-night video-polysomnography. Upon detailed clinical and polysomnographical examination, patients with iRSWA and idiopathic RBD (iRBD) were enrolled into this study and followed up at every six months for at least 4 years up to 9 years. RESULTS: We had a total of 31 patients with iRBD and 67 patients with iRSWA. Mean age was higher in iRBD group than those in iRSWA group (P = .016). Restless legs syndrome/Willis-Ekbom disease was significantly more common in patients with iRBD than those in patient with iRSWA (P < .001). Eighteen patients with iRSWA (26.8%) developed iRBD after 2.6 + 2.2 years. Six patients with iRSWA (8.9%) developed neurodegenerative disorders following 2.4 + 1.5 years; four were diagnosed as Parkinson's disease (PD) and two developed probable Alzheimer-type dementia. In patients with iRBD, eight patients (25.8%) developed neurodegenerative disorders-all was Parkinson's disease-following 2.6 + 2.2 years. Development of neurodegenerative diseases was positively correlated with age (P < .001) and periodic leg movements in sleep in both groups (P < .010). CONCLUSIONS: These results show that iRSWA may also be accepted as a risk factor in the development of PD or neurodegenerative diseases. Advanced age and periodic leg movements in sleep seem to be correlated with higher risk.


Assuntos
Doenças Neurodegenerativas , Transtorno do Comportamento do Sono REM/complicações , Sono REM/fisiologia , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Tono Muscular/fisiologia , Doenças Neurodegenerativas/epidemiologia , Polissonografia , Estudos Prospectivos , Transtorno do Comportamento do Sono REM/diagnóstico
5.
Biomed Res Int ; 2019: 8329306, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31080830

RESUMO

Background: Inconsistent data have been reported for the effectiveness of intramuscular botulinum toxin type A (BTXA) in patients with limb spasticity after stroke. This meta-analysis of available randomized controlled trials (RCTs) aimed to determine the efficacy and safety of BTXA in adult patients with upper and lower limb spasticity after stroke. Methods: An electronic search was performed to select eligible RCTs in PubMed, Embase, and the Cochrane library through December 2018. Summary standard mean differences (SMDs) and relative risk (RR) values with corresponding 95% confidence intervals (CIs) were employed to assess effectiveness and safety outcomes, respectively. Results: Twenty-seven RCTs involving a total of 2,793 patients met the inclusion criteria, including 16 and 9 trials assessing upper and lower limb spasticity cases, respectively. For upper limb spasticity, BTXA therapy significantly improved the levels of muscle tone (SMD=-0.76; 95% CI -0.97 to -0.55; P<0.001), physician global assessment (SMD=0.51; 95% CI 0.35-0.67; P<0.001), and disability assessment scale (SMD=-0.30; 95% CI -0.40 to -0.20; P<0.001), with no significant effects on active upper limb function (SMD=0.49; 95% CI -0.08 to 1.07; P=0.093) and adverse events (RR=1.18; 95% CI 0.72-1.93; P=0.509). For lower limb spasticity, BTXA therapy was associated with higher Fugl-Meyer score (SMD=5.09; 95%CI 2.16-8.01; P=0.001), but had no significant effects on muscle tone (SMD=-0.12; 95% CI -0.83 to 0.59; P=0.736), gait speed (SMD=0.06; 95% CI -0.02 to 0.15; P=0.116), and adverse events (RR=1.01; 95% CI 0.71-1.45; P=0.949). Conclusions: BTXA improves muscle tone, physician global assessment, and disability assessment scale in upper limb spasticity and increases the Fugl-Meyer score in lower limb spasticity.


Assuntos
Toxinas Botulínicas Tipo A/efeitos adversos , Toxinas Botulínicas Tipo A/uso terapêutico , Extremidades/fisiopatologia , Espasticidade Muscular/tratamento farmacológico , Espasticidade Muscular/etiologia , Acidente Vascular Cerebral/complicações , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Espasticidade Muscular/fisiopatologia , Tono Muscular/efeitos dos fármacos , Tono Muscular/fisiologia , Ensaios Clínicos Controlados Aleatórios como Assunto , Acidente Vascular Cerebral/fisiopatologia , Resultado do Tratamento
6.
Complement Ther Med ; 43: 312-318, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30935551

RESUMO

OBJECTIVES: This study aimed to compare the amount of deep tissue pressure and muscle relaxation between a soft inflatable rubber ball (SIRB) and a hard massage ball (HMB). DESIGN: Crossover experimental design study. INTERVENTIONS: Thirty participants with neck pain (age: 65.9 ± 3.4, Neck Disability Index score: 34.0% ± 15.2) pillowed a SIRB or an HMB beneath the suboccipital region in the supine position. For the baseline condition, participants pillowed a foam block without a ball. MAIN OUTCOME MEASURES: To quantify the amount of deep-tissue pressure by a ball, compressed soft tissue thickness was measured with lateral cervical radiographs. To assess muscle relaxation, the amount of muscle tension was determined using electromyography of the sternocleidomastoid and upper trapezius muscles. To monitor the cervical lordosis in each condition, the extension angles of the cervical vertebrae were quantified using the relative rotation angles. RESULTS: The compressed soft tissue thickness in the SIRB condition was significantly lower than that in the HMB condition. The normalised muscle activities exhibited that right sternocleidomastoid muscle activity in the HMB condition was significantly higher than that in the baseline and SIRB conditions. In the SIRB and HMB conditions, Numeric Rating Scale for pain was 0.2 ± 0.5 and 5.2 ± 1.4, respectively. CONCLUSIONS: Our findings demonstrate that a SIRB is more advantageous than an HMB for pressing the soft tissue deeply. This finding would be related to reduced muscle tension and discomfort in the SIRB condition when compared with the HMB condition.


Assuntos
Massagem/métodos , Síndromes da Dor Miofascial/terapia , Cervicalgia/terapia , Idoso , Vértebras Cervicais/fisiopatologia , Estudos Cross-Over , Feminino , Humanos , Masculino , Relaxamento Muscular/fisiologia , Tono Muscular/fisiologia , Músculos do Pescoço/fisiopatologia , Limiar da Dor/fisiologia , Pressão , Amplitude de Movimento Articular/fisiologia , Músculos Superficiais do Dorso/fisiopatologia , Pontos-Gatilho/fisiopatologia
7.
Proc Natl Acad Sci U S A ; 116(9): 3837-3846, 2019 02 26.
Artigo em Inglês | MEDLINE | ID: mdl-30760592

RESUMO

Extraocular muscles contain two types of muscle fibers according to their innervation pattern: singly innervated muscle fibers (SIFs), similar to most skeletal muscle fibers, and multiply innervated muscle fibers (MIFs). Morphological studies have revealed that SIF and MIF motoneurons are segregated anatomically and receive different proportions of certain afferents, suggesting that while SIF motoneurons would participate in the whole repertoire of eye movements, MIF motoneurons would contribute only to slow eye movements and fixations. We have tested that proposal by performing single-unit recordings, in alert behaving cats, of electrophysiologically identified MIF and SIF motoneurons in the abducens nucleus. Our results show that both types of motoneuron discharge in relation to eye position and velocity, displaying a tonic-phasic firing pattern for different types of eye movement (saccades, vestibulo-ocular reflex, vergence) and gaze-holding. However, MIF motoneurons presented an overall reduced firing rate compared with SIF motoneurons, and had significantly lower recruitment threshold and also lower eye position and velocity sensitivities. Accordingly, MIF motoneurons could control mainly gaze in the off-direction, when less force is needed, whereas SIF motoneurons would contribute to increase muscle tension progressively toward the on-direction as more force is required. Anatomically, MIF and SIF motoneurons distributed intermingled within the abducens nucleus, with MIF motoneurons being smaller and having a lesser somatic synaptic coverage. Our data demonstrate the functional participation of both MIF and SIF motoneurons in fixations and slow and phasic eye movements, although their discharge properties indicate a functional segregation.


Assuntos
Movimentos Oculares/fisiologia , Neurônios Motores/fisiologia , Fibras Musculares Esqueléticas/fisiologia , Músculos Oculomotores/fisiologia , Animais , Gatos , Humanos , Tono Muscular/fisiologia , Músculo Esquelético/inervação , Músculo Esquelético/fisiologia , Músculos Oculomotores/inervação , Movimentos Sacádicos/fisiologia
8.
Medicine (Baltimore) ; 98(7): e14444, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30762754

RESUMO

BACKGROUND: Upper extremity functional impairments are common consequences of stroke. Therefore, continuous investigation of effective interventions for upper extremity functions after stroke is a necessity. Segmental muscle vibration (SMV) is one of the interventions that incorporate sensory stimulation to improve motor cortical excitability. The aim of this study was to investigate the influence of 5-minute SMV application along with supervised physical therapy (SPT) on improving activities of daily living and motor recovery on the hemiparetic upper extremity in patients with stroke. METHODS: A sample of 37 patients poststroke (29 males) was randomly allocated to either SPT control group (n = 18) or SPT and SMV (SPT-SMV) experimental group (n = 19). All patients received 3 sessions per week of SPT for 8 weeks. The SPT-SMV experimental group received SMV at the end of each SPT session. Outcome measures used were Barthel index (BI), modified Ashworth scale, manual muscle testing, and goniometry for range of motion (ROM) assessment. RESULTS: Thirty-four patients completed the study. Patients in both groups improved significantly after treatment in BI, elbow ROM, and elbow muscles strength. However, muscle tone in elbow joint of the hemiplegic upper extremity improved significantly after SMV only in the experimental group (SPT-SMV). CONCLUSION: The SPT intervention can improve functional outcomes of upper extremity in people after stroke. However, using SMV may have superior effect on improving muscle tone after stroke.


Assuntos
Modalidades de Fisioterapia , Reabilitação do Acidente Vascular Cerebral/métodos , Acidente Vascular Cerebral/fisiopatologia , Vibração/uso terapêutico , Atividades Cotidianas , Idoso , Cotovelo/fisiopatologia , Feminino , Hemiplegia/etiologia , Hemiplegia/fisiopatologia , Hemiplegia/reabilitação , Humanos , Masculino , Pessoa de Meia-Idade , Força Muscular/fisiologia , Tono Muscular/fisiologia , Músculo Esquelético/fisiopatologia , Amplitude de Movimento Articular/fisiologia , Recuperação de Função Fisiológica , Acidente Vascular Cerebral/complicações , Resultado do Tratamento , Extremidade Superior/fisiopatologia
9.
J Sports Sci Med ; 18(1): 13-20, 2019 03.
Artigo em Inglês | MEDLINE | ID: mdl-30787647

RESUMO

Dynamic stretching (DS) is often performed during warm-up to help avoid hamstring muscle injuries, increase joint flexibility, and optimize performance. We examined the effects of DS of the hamstring muscles on passive knee extension range of motion (ROM), passive torque (PT) at the onset of pain (as a measure of stretch tolerance), and passive stiffness of the muscle-tendon unit over an extended period after stretching. Twenty-four healthy subjects participated, with 12 each in the experimental and control groups. Stretching was performed, and measurements were recorded using an isokinetic dynamometer pre-intervention, and at 0, 15, 30, 45, 60, 75, and 90 min post-intervention. DS consisted of ten 30-s sets of 15 repetitions of extension and relaxation of the hamstrings. ROM increased significantly (range, 7%-10%) immediately after DS, and the increase was sustained over 90 min. PT at the onset of pain also increased immediately by 10% but returned to baseline by 30 min. Passive stiffness decreased significantly (range, 7.9%-16.7%) immediately after DS, and the decrease was sustained over 90 min. Post-DS values were normalized to pre-DS values for the respective outcomes in both groups. ROM was significantly higher (range, 7.4%-10%) and passive stiffness was significantly lower (range, 5.4%-14.9%) in the experimental group relative to the control group at all time points. Normalized PT values at the onset of pain were significantly higher in the experimental group at 0-15 min than in the controls, but the differences were smaller at 30-45 min and not significant thereafter. We conclude that DS increases ROM and decreases passive stiffness in a sustained manner, and increases PT at the onset of pain for a shorter period. Overall, our results indicate that when performed prior to exercise, DS is beneficial for the hamstring muscles in terms of increasing flexibility and reducing stiffness.


Assuntos
Músculos Isquiotibiais/fisiologia , Joelho/fisiologia , Exercícios de Alongamento Muscular/métodos , Amplitude de Movimento Articular/fisiologia , Feminino , Humanos , Masculino , Tono Muscular/fisiologia , Mialgia/fisiopatologia , Torque , Adulto Jovem
10.
J Sports Med Phys Fitness ; 59(10): 1676-1683, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-30758167

RESUMO

BACKGROUND: Posture and somatic structure could positively influence athletic gestures for their biomechanical implications. Working on neuromuscular activity, offers the possibility of intervention on postural control. The aim of this study was to demonstrate the possibility of interacting with the human body system through the spinal reflex pathway, starting from the stimulation of cutaneous receptors. METHODS: Twenty soccer players were recruited: all were male aged 25.5±10.6 years. Patients were divided using a single-blind criterion into two groups, each containing ten subjects. The experimental group was treated with 2 pre-set programs 4 times a week with an adaptive neuro-stimulation (ANS) able to interact with cutaneous receptors through an ENF Physio® device with a range of electrical frequency of about 15-350 Hz; the placebo-controlled group received the treatment with the device switched off. Patients performed a myometric evaluation with the MyotonPRO® system and a postural one with the Rarog software at T0 before the treatment and at T1 after the four-week treatment. RESULTS: After our intervention, we identified an improvement in muscular tone, in particular in the hamstring muscles (17.69%, right P<0.01 / left P<0.05) and a rebalancing of the principal bone points in the postural system (shoulder 71%, P<0.05, hips 65.6%, P=0.056, sagittal AP and frontal LL center of gravity, respectively 40%, P<0.05 and 52.7%, P=0.01). CONCLUSIONS: In conclusion, we could hypothesize the usefulness of an ANS to act on these parameters. ANS could be used not only for treatment of injuries but also in the field of prevention.


Assuntos
Terapia por Estimulação Elétrica/métodos , Tono Muscular/fisiologia , Equilíbrio Postural/fisiologia , Futebol/fisiologia , Adolescente , Adulto , Músculos Isquiotibiais/fisiologia , Humanos , Masculino , Método Simples-Cego , Adulto Jovem
11.
J Gerontol A Biol Sci Med Sci ; 74(3): 325-329, 2019 02 15.
Artigo em Inglês | MEDLINE | ID: mdl-30124776

RESUMO

The Hyperpolarization activated, cyclic nucleotide gated (HCN) channel is a candidate mediator of neuroendocrine influence over detrusor tonus during filling. In other tissues, HCN loss with aging is linked to declines in rhythmicity and function. We hypothesized that HCN has an age-sensitive expression profile and functional role in adrenergic bladder relaxation. HCN was examined in bladders from young (2-6 months) and old (18-24 months) C57BL/6 female mice, using qRT-PCR, RNAScope, and Western blots. Isometric tension studies were conducted using bladder strips from young wild-type (YWT), old wild-type (OWT), and young HCN1 knock-out (YKO) female mice to test the role HCN in effects of ß-adrenergic stimulation. Hcn1 is the dominant HCN isoform RNA in the mouse bladder wall, and is diminished with age. Location of Hcn RNA within the mouse bladder wall is isoform-specific, with HCN1 limited to the detrusor layer. Passively-tensioned YWT bladder strips are relaxed by isoproterenol in the presence of HCN function, where OWT strips are relaxed only in the presence of HCN blockade. HCN has an age-specific expression and function in adrenergic detrusor relaxation in mouse bladder strips.


Assuntos
Canais Disparados por Nucleotídeos Cíclicos Ativados por Hiperpolarização/metabolismo , Relaxamento Muscular/fisiologia , Tono Muscular/fisiologia , Bexiga Urinária/metabolismo , Bexiga Urinária/fisiopatologia , Agonistas Adrenérgicos beta/farmacologia , Animais , Feminino , Isoproterenol/farmacologia , Camundongos , Camundongos Endogâmicos C57BL , Relaxamento Muscular/efeitos dos fármacos , Tono Muscular/efeitos dos fármacos , Técnicas de Cultura de Tecidos
12.
Arch Dis Child ; 104(3): 275-279, 2019 03.
Artigo em Inglês | MEDLINE | ID: mdl-30072363

RESUMO

BACKGROUND: Obstructive sleep apnoea (OSA) is common in children with Down syndrome (DS), yet difficult to treat. As muscular hypotonia of the upper airway may cause OSA and is also common in DS, we tested whether intense myofunctional therapy improves OSA in children with DS. PATIENTS AND METHODS: Forty-two children underwent cardiorespiratory sleep studies immediately before and after a 1-week intensive training camp consisting of three daily 45 min sessions of myofunctional exercises according to Padovan. Primary outcome was the mixed-obstructive-apnoea/hypopnoea index (MOAHI), secondary outcomes the ≤3% oxygen desaturation index (DI3), the ≤90% desaturation index (DI90) and the lowest pulse oximeter saturation (SpO2nadir). RESULTS: Eighteen recordings had ≥3 hours of artefact-free recording in both the pretreatment and post-treatment sleep study and were therefore included in the analysis. Mean age was 6.3 years (SD 2.5); 83% had OSA prior to intervention. Mean MOAHI was 6.4 (SD 8.6) before and 6.4 (SD 10.8) after the intervention (p>0.05); the DI3 and SpO2nadir also did not change. Only the DI90 decreased significantly from 2.7 (SD 4.5) to 2.1 (SD 3.7) (p<0.05). CONCLUSION: The 1-week intense myofunctional training camp evaluated here in children with DS had only a marginal effect on OSA. Whether a longer follow-up period or duration of intervention would yield stronger effects remains to be determined.


Assuntos
Síndrome de Down/complicações , Terapia por Exercício/métodos , Apneia Obstrutiva do Sono/terapia , Exercícios Respiratórios/métodos , Criança , Feminino , Humanos , Estudos Longitudinais , Masculino , Tono Muscular/fisiologia , Polissonografia , Estudos Prospectivos , Músculos Respiratórios/fisiologia , Apneia Obstrutiva do Sono/complicações , Resultado do Tratamento
13.
Phys Sportsmed ; 47(1): 91-95, 2019 02.
Artigo em Inglês | MEDLINE | ID: mdl-30247085

RESUMO

OBJECTIVES: The aim of the article is to investigate the passive stiffness (PS) of rectus femoris and hamstring muscles working for the knee joint in persons after anterior cruciate ligament (ACL) reconstruction surgery. METHODS: Thirty subjects (8 women and 22 men) aged 19-46 (x = 28.2 ± 7) participated in the investigation; an experimental group comprised 15 persons (4 women and 11 men) who underwent ACL reconstruction surgery. The other persons had no knee injury and described themselves as healthy. All the subjects underwent an investigation of the PS of the hamstrings and the rectus femoris on the injured as well as on the healthy leg. RESULTS: The data shows vital difference in the PS of the hamstring muscles between the healthy and injured limb (p < 0.05), a significant difference in the PS of the rectus femoris (p < 0.001) was noted. Furthermore, the PS level of the hamstring muscles of the operated limb in the experimental group is significantly different to the both legs in control group (p < 0.001). CONCLUSIONS: Injury of the ACL results in a considerable increase in passive stiffness of the hamstring and rectus femoris muscles in both the injured leg and the healthy leg.


Assuntos
Lesões do Ligamento Cruzado Anterior/fisiopatologia , Lesões do Ligamento Cruzado Anterior/cirurgia , Reconstrução do Ligamento Cruzado Anterior , Músculos Isquiotibiais/fisiologia , Tono Muscular/fisiologia , Músculo Quadríceps/fisiologia , Adulto , Feminino , Músculos Isquiotibiais/fisiopatologia , Humanos , Instabilidade Articular/fisiopatologia , Articulação do Joelho/fisiologia , Articulação do Joelho/fisiopatologia , Masculino , Músculo Quadríceps/fisiopatologia , Adulto Jovem
14.
Int J Geriatr Psychiatry ; 34(2): 249-257, 2019 02.
Artigo em Inglês | MEDLINE | ID: mdl-30353567

RESUMO

OBJECTIVES: The prevalence of generalized anxiety disorder (GAD) is supposed to decrease with age. Reasons suggested include that emotional control increases and that anxiety and worry are expressed differently in older adults. The aim of this study was to examine how the expression of anxiety and worry changes with age and how this influences diagnoses in current classification systems. METHOD: Semistructured psychiatric examinations were performed in population-based samples of 70- (n = 562), 75- (n = 770), 79/80- (n = 603), and 85-year-olds (n = 433). Individuals with dementia were excluded. GAD was diagnosed according to DSM-5 (DSM5 GAD) and ICD-10 (ICD10 GAD) criteria. Individual symptoms were assessed according to severity and frequency. Functioning was measured with Global Assessment of Functioning (GAF). RESULTS: The prevalence of clinical anxiety, autonomic arousal, muscle tension, and irritability decreased with age, while that of worry and fatigue increased. Concentration difficulties and sleep disturbances remained stable. The prevalence of ICD10 GAD tended to decrease, while that of DSM5 GAD did not change with age. Core symptoms and diagnoses of GAD were related to lower GAF scores. However, in those with autonomic arousal and ICD10 GAD, GAF scores increased with age. CONCLUSIONS: The prevalence of ICD10 GAD tended to decrease with increasing age while the prevalence of DSM5 GAD remained stable. This difference was partly due to a decreased frequency of severe anxiety and autonomic arousal symptoms, and that worries increased, suggesting changes in the expression of GAD with increasing age.


Assuntos
Envelhecimento/psicologia , Transtornos de Ansiedade/psicologia , Ansiedade/psicologia , Idoso , Idoso de 80 Anos ou mais , Transtornos de Ansiedade/fisiopatologia , Nível de Alerta/fisiologia , Estudos Transversais , Manual Diagnóstico e Estatístico de Transtornos Mentais , Feminino , Humanos , Classificação Internacional de Doenças , Masculino , Tono Muscular/fisiologia , Razão de Chances , Prevalência , Análise de Regressão , Projetos de Pesquisa
15.
Gait Posture ; 68: 220-226, 2019 02.
Artigo em Inglês | MEDLINE | ID: mdl-30517907

RESUMO

BACKGROUND: Muscular co-contraction is a strategy commonly used by elders with the aim to increase stability. However, co-contraction leads to stiffness which in turns reduces stability. Some literature seems to suggest an opposite approach and to point out relaxation as a way to improve stability. Teaching relaxation is therefore becoming the aim of many studies letting unclear whether tension or relaxation are the most effective muscular strategy to improve stability. Relaxation is a misleading concept in our society. It is often confused with rest, while it should be addressed during stressing tasks, where it should aim to reduce energetic costs and increase stability. The inability to relax can be related to sub-optimal neuro-motor control, which can lead to increased stresses. RESEARCH QUESTION: The objective of the study is to investigate the effect of voluntary muscle contraction and relaxation over the stability of human standing posture, answering two specific research questions: (1) Does the muscular tension have an impact on stability of standing posture? (2) Could this impact be estimated by using a minimally invasive procedure? METHODS: By using a force plate, we analysed the displacement of the center of pressure of 30 volunteers during state of tension and relaxation in comparison with a control state, and with open and closed eyes. RESULTS: We found that tension significantly reduced the stability of subjects (15 out of 16 parameters, p < 0.003). SIGNIFICANCE: Our results show that daily situations of stress can lead to decreased stability. Such a loss might actually increase the risk of chronic joint overload or fall. Finally, breathing has direct effect over the management of pain and stress, and the results reported here point out the need to explicitly explore the troubling fact that a large portion of population might not be able to properly breath.


Assuntos
Contração Muscular/fisiologia , Tono Muscular/fisiologia , Equilíbrio Postural/fisiologia , Posição Ortostática , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Mecânica Respiratória/fisiologia , Adulto Jovem
16.
Am J Case Rep ; 19: 1292-1300, 2018 Oct 31.
Artigo em Inglês | MEDLINE | ID: mdl-30377290

RESUMO

BACKGROUND The aim of the present study was to investigate the effect of horizontal whole-body vibration (WBV) training on trunk and lower-extremity muscle tone and activation, balance, and gait in a child with spastic diplegia cerebral palsy. CASE REPORT A 10-year-old male with spastic diplegia cerebral palsy received horizontal WBV training followed by conventional physiotherapy (50 min per day, 12 days per month), but only conventional physiotherapy during followup. Muscle tone was assessed using the Modified Ashworth Scale (MAS) and muscle activation with surface electromyography. Balance was assessed using the Timed Up and Go test (TUG) and Pediatric Balance Scale (PBS), and gait parameters were assessed using the GAITRite system. Assessment was performed at 3 points: pre-intervention, post-intervention, and follow-up. Following the intervention, MAS decreased in both the hip extensor and right ankle plantar flexor. Muscle activation increased post-intervention in the bilateral erector spinae (ES), rectus abdominis (RA), rectus femoris (RF), and right tibialis anterior (TA) during standing, and in the left RA, bilateral RF, gastrocnemius (GCM), and left TA during squatting. At follow-up, activation increased in the right ES, left RA, and RF during standing. At post-intervention and follow-up, improvement was observed in PBS score, gait velocity, right step length, and right stride length, with decreased single-leg support time, and double support and toe deviation angle. CONCLUSIONS Horizontal WBV training can safely and effectively maintain and improve physical performance and can be considered for inclusion in rehabilitation programs.


Assuntos
Paralisia Cerebral/reabilitação , Marcha/fisiologia , Tono Muscular/fisiologia , Equilíbrio Postural/fisiologia , Vibração/uso terapêutico , Paralisia Cerebral/diagnóstico , Criança , Seguimentos , Humanos , Extremidade Inferior , Masculino , Posicionamento do Paciente , Medição de Risco , Índice de Gravidade de Doença , Tórax , Resultado do Tratamento
17.
PLoS One ; 13(10): e0205763, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30335860

RESUMO

The pendulum test is a sensitive clinical assessment of spasticity where the lower leg is dropped from the horizontal position and features of limb motion are recorded. Three key kinematic features are associated with the degree of severity of spasticity in children with cerebral palsy: decreased initial limb excursion, reduced number of limb oscillations, and a non-vertical resting limb angle. While spasticity is attributed to increased velocity-dependent resistance to motion, prior models simulating increased sensorimotor feedback of muscle velocity fail to explain the key pendulum test kinematic outcomes in spastic individuals. Here we hypothesized that increased muscle tone, causing a transient increase in muscle force, i.e. short-range stiffness, could account for reduced first swing excursion and non-vertical resting limb angle. We further hypothesized that hyperreflexia modeled based on muscle fiber force, and not velocity, feedback would be necessary to reduce the number of oscillations because of its interaction with transiently increased muscle force due to short-range stiffness. We simulated the lower leg as a torque-driven single-link pendulum. Muscle tone was modeled as a constant baseline joint torque, short-range stiffness torque was dependent on the level of muscle tone, and delayed sensory feedback torque to simulate reflex activity was based on either muscle velocity or force. Muscle tone and transient short-range stiffness were necessary to simulate decreased initial swing excursion and non-vertical resting leg angle. Moreover, the reduction in the number of oscillations was best reproduced by simulating stretch reflex activity in terms of force, and not velocity, feedback. Varying only baseline muscle torque and reflex gain, we simulated a range of pendulum test kinematics observed across different levels of spasticity. Our model lends insight into physiological mechanisms of spasticity whose contributions can vary on an individual-specific basis, and potentially across different neurological disorders that manifest spasticity as a symptom.


Assuntos
Paralisia Cerebral/diagnóstico , Retroalimentação Sensorial/fisiologia , Modelos Biológicos , Tono Muscular/fisiologia , Músculo Esquelético/fisiopatologia , Adolescente , Adulto , Fenômenos Biomecânicos/fisiologia , Paralisia Cerebral/complicações , Paralisia Cerebral/fisiopatologia , Criança , Eletromiografia , Humanos , Pessoa de Meia-Idade , Espasticidade Muscular/diagnóstico , Espasticidade Muscular/etiologia , Espasticidade Muscular/fisiopatologia , Modalidades de Fisioterapia , Reflexo de Estiramento/fisiologia , Índice de Gravidade de Doença , Torque , Adulto Jovem
18.
J Med Invest ; 65(3.4): 177-183, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30282857

RESUMO

The purpose of this study was to evaluate the physical features of pediatric patients with lumbar spondylolysis (LS), factors that increase the load during compensatory movements at the lumbar spine, and the outcomes of rehabilitation. Twenty patients were included. Fifteen items were used:fingertip-to-floor distance (FFD), straight leg raising (SLR), heel-to-buttock distance (HBD), tightness of the rectus femoris, the lateral and medial rotator muscles, iliopsoas, tensor fascia lata, adductor muscles, soleus muscle, and latissimus dorsi, and trunk rotation, sit-ups and endurance of the abdominal and back muscles. Initial findings were judged as positive or negative using previously reported cut-off values and were re-evaluated 2 or 3 months later. Positive tests were found for HBD and tightness of the rectus femoris in 85% of the patients, for endurance of the abdominal muscles in 75%, SLR and sit-ups in 70%, and FFD and tightness of the external rotator muscles in 60%. The physical features varied according to the type of sport played, and some patients were refractory to rehabilitation. Only 17.6%, 33.3%, and 40.0% of patients with initially positive findings for HBD, tightness of the external rotator muscles, and endurance of the abdominal muscles, respectively, achieved improvements after rehabilitation. J. Med. Invest. 65:177-183, August, 2018.


Assuntos
Vértebras Lombares , Espondilólise/fisiopatologia , Espondilólise/reabilitação , Adolescente , Fenômenos Biomecânicos , Terapia por Exercício/métodos , Feminino , Humanos , Masculino , Força Muscular/fisiologia , Tono Muscular/fisiologia , Resistência Física/fisiologia , Amplitude de Movimento Articular/fisiologia , Resultado do Tratamento , Esportes Juvenis/fisiologia
19.
Pain Res Manag ; 2018: 7381973, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30344802

RESUMO

Headache is a common problem in the population, which decreases the quality of life and makes everyday functioning difficult. It often coexists with typical symptoms of temporomandibular disorders. The objective of the study was to clarify whether there is a relationship between the presence of headache in young volunteers and the mastication muscle tone. Material and Method. Volunteers aged 18 years who underwent general dental examination, clinical evaluation, and examination using the dual-axis diagnostic system Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) form in the Polish language version participated in the study. On the basis of the examination results, these individuals were divided into three groups according to RDC results. A group of healthy individuals (axis I value 0), a group of sick individuals (axis I diagnosis Ia, IIa, or IIIa), and a group of individuals suffering from depression (axis II values 1-3) were singled out. Then, volunteers were divided into two groups: group I reporting headache and group II without any pain. In each of these individuals, the contractile activity of the masseter muscles and anterior temporal muscles was recorded bilaterally as the surface electromyographic activity (sEMG) at rest, during swallowing, and maximum clenching. The activity index ranging between +100 (activity of the masseter muscles only) and -100 (activity of the anterior temporal muscles only) was used to indicate the predominance of activity of the study muscles. Results. The statistical analysis of data showed that there was a significant relationship between the presence of headache and a change in the mastication muscle tone, expressed as the predominant activity of the temporal muscles, only in the group of sick individuals during maximum clenching. Summary. The diversity of sEMG results implies that a change in the mastication muscle tone is not a direct consequence of headache, but it has to be modified by other factors.


Assuntos
Cefaleia/patologia , Músculo Masseter/fisiopatologia , Tono Muscular/fisiologia , Adolescente , Eletromiografia , Feminino , Humanos , Masculino , Mastigação/fisiologia
20.
Transfusion ; 58(10): 2352-2359, 2018 10.
Artigo em Inglês | MEDLINE | ID: mdl-30222861

RESUMO

BACKGROUND: Vasovagal reactions (VVRs) have a negative impact on donor safety and return. Applied muscle tension (AMT) increases blood pressure temporarily and has been suggested as a way to reduce donors' risk of VVRs. This study evaluated whether using AMT at three different time points during the donation procedure reduces the VVR symptoms reported by donors and the VVR reactions recorded by phlebotomists. STUDY DESIGN AND METHODS: A three-arm, multicenter, open-label randomized controlled trial was used to compare VVR symptoms and reaction rates between those practicing AMT during the entire donation (n = 244) to practicing AMT at VVR high-risk time points (n = 250) to a standard blood donation control group (n = 240). All participants were asked to drink 500 mL of water in the waiting area, and an even distribution of new and repeat donors was sought across conditions. RESULTS: Across all conditions, donors reported few VVR symptoms and the rate of reporting did not differ significantly across conditions. However, donors who practiced AMT at strategic time points had a significantly lower number of phlebotomist-registered VVRs in comparison to the other two study groups, with these rates not varying by sex or donor status. Greater compliance by donors with AMT instructions was observed in those asked to practice AMT at strategic time points compared to those asked to practice AMT during the entire donation. CONCLUSION: Practicing AMT at VVR high-risk time points reduces the number of phlebotomist-registered VVRs.


Assuntos
Doadores de Sangue , Tono Muscular/fisiologia , Síncope Vasovagal/prevenção & controle , Adolescente , Adulto , Feminino , Fidelidade a Diretrizes , Humanos , Masculino , Pessoa de Meia-Idade , Flebotomia , Fatores de Tempo , Adulto Jovem
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