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Introducción: La artroplastia total de rodilla es el recurso terapéutico para pacientes con artrosis severa y gran incapacidad física. Sin embargo, muchos evolucionan con dolor y déficit funcional. En este estudio, se utiliza un tratamiento con movilización pasiva continua a partir de los 10 días de la cirugía. Materiales y Métodos: Se incluyó a 60 pacientes que fueron asignados, en forma aleatoria, a 2 grupos (30 en cada grupo). Al grupo 1 (G1, 23 mujeres) se le aplicó un protocolo de tratamiento convencional y, al grupo 2 (G2, 17 mujeres), el mismo programa y la adicción de un equipo de movimiento pasivo continuo a los 10 días de la intervención. Se evaluaron el dolor, la movilidad articular, la fuerza muscular y la función (WOMAC y prueba TUG). Resultados: No se observaron diferencias estadísticamente significativas en los parámetros estudiados, aunque sí una tendencia a la mejoría en el G2. En este grupo, la fuerza de extensión de la rodilla fue mayor y también hubo una correlación basal entre la fuerza y la prueba TUG. Conclusiones: El uso diferido de la movilización pasiva continua mejoró la fuerza de extensión de la rodilla y el rendimiento en la prueba TUG, aunque sin diferencias significativas entre ambos grupos. No se observaron efectos adversos. Nivel de Evidencia: I
Introduction: Total knee arthroplasty (TKA) is a valid therapeutic option for patients with severe arthritis and physical disability. However, many TKA patients develop pain and functional impairment. In our study, we used a continuous passive motion (CPM) device for exercise starting 10 days after surgery. Materials and Methods: The study population consisted of 60 patients, who were randomized into 2 groups. Group I (GI: 30 patients, 23 females) underwent the standard treatment and group II (GII, 30 patients, 17 females) underwent the standard treatment plus CPM starting 10 days after surgery. We evaluated pain, range of motion (ROM), extension muscle strength, and function (WOMAC and TUG tests). Results: All compared parameters yielded no statistically significant differences. A greater trend toward improvement was observed in GII regarding some parameters: greater extension muscle strength and a baseline correlation between flexion strength and the TUG test. Conclusions: The use of CPM starting 10 days after of surgery improved the extension muscle strength and produced better TUG test results, although without any statistically significant difference with the standard procedure. No adverse effects were observed. Level of Evidence: I
Assuntos
Adulto , Terapia Passiva Contínua de Movimento , Amplitude de Movimento Articular , Resultado do Tratamento , Artroplastia do JoelhoRESUMO
Early mobilization is beneficial for critically ill patients because it reduces muscle weakness acquired in intensive care units. The objective of this study was to assess the effect of functional electrical stimulation (FES) and passive cycle ergometry (PCE) on the nitrous stress and inflammatory cytometry in critically ill patients. This was a controlled, randomized, open clinical trial carried out in a 16-bed intensive care unit. The patients were randomized into four groups: Control group (n=10), did not undergo any therapeutic intervention during the study; PCE group (n=9), lower-limb PCE for 30 cycles/min for 20 min; FES group (n=9), electrical stimulation of quadriceps muscle for 20 min; and FES with PCE group (n=7), patients underwent PCE and FES, with their order determined randomly. The serum levels of nitric oxide, tumor necrosis factor alpha, interferon gamma, and interleukins 6 and 10 were analyzed before and after the intervention. There were no differences in clinical or demographic characteristics between the groups. The results revealed reduced nitric oxide concentrations one hour after using PCE (P<0.001) and FES (P<0.05), thereby indicating that these therapies may reduce cellular nitrosative stress when applied separately. Tumor necrosis factor alpha levels were reduced after the PCE intervention (P=0.049). PCE and FES reduced nitric oxide levels, demonstrating beneficial effects on the reduction of nitrosative stress. PCE was the only treatment that reduced the tumor necrosis factor alpha concentration.
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Estado Terminal/terapia , Citocinas/sangue , Terapia Passiva Contínua de Movimento/métodos , Estresse Nitrosativo/fisiologia , Respiração Artificial/métodos , Adulto , Idoso , Biomarcadores/sangue , Estado Terminal/reabilitação , Estimulação Elétrica/métodos , Feminino , Humanos , Inflamação/imunologia , Inflamação/metabolismo , Unidades de Terapia Intensiva , Masculino , Pessoa de Meia-Idade , Estresse Oxidativo/fisiologia , Músculo Quadríceps/fisiopatologiaRESUMO
Early mobilization is beneficial for critically ill patients because it reduces muscle weakness acquired in intensive care units. The objective of this study was to assess the effect of functional electrical stimulation (FES) and passive cycle ergometry (PCE) on the nitrous stress and inflammatory cytometry in critically ill patients. This was a controlled, randomized, open clinical trial carried out in a 16-bed intensive care unit. The patients were randomized into four groups: Control group (n=10), did not undergo any therapeutic intervention during the study; PCE group (n=9), lower-limb PCE for 30 cycles/min for 20 min; FES group (n=9), electrical stimulation of quadriceps muscle for 20 min; and FES with PCE group (n=7), patients underwent PCE and FES, with their order determined randomly. The serum levels of nitric oxide, tumor necrosis factor alpha, interferon gamma, and interleukins 6 and 10 were analyzed before and after the intervention. There were no differences in clinical or demographic characteristics between the groups. The results revealed reduced nitric oxide concentrations one hour after using PCE (P<0.001) and FES (P<0.05), thereby indicating that these therapies may reduce cellular nitrosative stress when applied separately. Tumor necrosis factor alpha levels were reduced after the PCE intervention (P=0.049). PCE and FES reduced nitric oxide levels, demonstrating beneficial effects on the reduction of nitrosative stress. PCE was the only treatment that reduced the tumor necrosis factor alpha concentration.
Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Respiração Artificial/métodos , Terapia Passiva Contínua de Movimento/métodos , Citocinas/sangue , Estado Terminal/terapia , Estresse Nitrosativo/fisiologia , Biomarcadores/sangue , Estado Terminal/reabilitação , Estresse Oxidativo/fisiologia , Estimulação Elétrica/métodos , Músculo Quadríceps/fisiopatologia , Inflamação/imunologia , Inflamação/metabolismo , Unidades de Terapia IntensivaRESUMO
OBJECTIVE:: To evaluate the addition of blood flow restriction to passive mobilization in patients in the intensive care unit. DESIGN:: The study was a within-patient randomized trial. SETTING:: Two intensive care units in Belém, from September to October 2017. SUBJECTS:: In total, 34 coma patients admitted to the intensive care unit sector, and 20 patients fulfilled the study requirements. INTERVENTIONS:: All participants received the passive mobilization protocol for lower limbs, and blood flow restriction was added only for one side in a concurrent fashion. Intervention lasted the entire patient's hospitalization time. MAIN OUTCOME MEASUREMENT:: Thigh muscle thickness and circumference. RESULTS:: In total, 34 subjects were enrolled in the study: 11 were excluded for exclusion criteria, 3 for death, and 20 completed the intervention (17 men and 3 women; mean age: 66 ± 4.3 years). Despite both groups presented atrophy, the atrophy rate was lower in blood flow restriction limb in relation to the control limb (-2.1 vs. -2.8 mm, respectively, in muscle thickness; P = 0.001). In addition, the blood flow restriction limb also had a smaller reduction in the thigh circumference than the control limb (-2.5 vs. -3.6 cm, respectively; P = 0.001). CONCLUSION:: The use of blood flow restriction did not present adverse effects and seems to be a valid strategy to reduce the magnitude of the rate of muscle wasting that occurs in intensive care unit patients.
Assuntos
Extremidade Inferior/irrigação sanguínea , Terapia Passiva Contínua de Movimento/métodos , Sarcopenia/prevenção & controle , Idoso , Cuidados Críticos , Feminino , Hospitalização , Humanos , Unidades de Terapia Intensiva , Extremidade Inferior/fisiopatologia , Masculino , Pessoa de Meia-IdadeRESUMO
BACKGROUND: The aim of this case series is to describe the experience of using the non-pneumatic anti-shock garment (NASG) in the management of severe Postpartum hemorrhage (PPH) and shock, and the value of implementing this concept in high-complexity obstetric hospitals. METHODS: Descriptive case series of 77 women that received NASG in the management of PPH with severe hypovolemic shock from June 2014 to December 2015. Vital signs, shock index (SI), the lactic acid value and the base deficit were compared before and after NASG application. RESULTS: Fifty-six (77%) women had an SI > 1.1 at the time shock management was initiated; 96% had uterine atony. All women received standard does of uterotonics. The average time between the birth and NASG applications was 20 min. Forty-eight percent of women recovered haemodynamic variables in the first hour and 100% within the first 6 h; 100% had a SI < 1.0 in the first hour. The NASG was not removed until definitive control of bleeding was achieved, with an average time of use of 24 h. There were no mortalities. CONCLUSIONS: In this case series of women in severe shock, the NASG was an effective management device for the control of severe hypovolemic shock. It should be considered a first-line option for shock management.
Assuntos
Vestuário , Trajes Gravitacionais , Hipovolemia/terapia , Procedimentos Cirúrgicos Obstétricos/instrumentação , Hemorragia Pós-Parto/terapia , Choque/terapia , Adolescente , Adulto , Colômbia/epidemiologia , Emergências , Feminino , Humanos , Hipovolemia/epidemiologia , Terapia Passiva Contínua de Movimento/instrumentação , Terapia Passiva Contínua de Movimento/métodos , Procedimentos Cirúrgicos Obstétricos/métodos , Hemorragia Pós-Parto/epidemiologia , Gravidez , Resultado da Gravidez/epidemiologia , Estudos Retrospectivos , Choque/epidemiologia , Adulto JovemRESUMO
OBJECTIVE:: The passive cycle ergometer aims to prevent hypotrophy and improve muscle strength, with a consequent reduction in hospitalization time in the intensive care unit and functional improvement. However, its effects on oxidative stress and immune system parameters remain unknown. The aim of this study is to analyze the effects of a passive cycle ergometer on the immune system and oxidative stress in critical patients. METHODS:: This paper describes a randomized controlled trial in a sample of 19 patients of both genders who were on mechanical ventilation and hospitalized in the intensive care unit of the Hospital Agamenom Magalhães. The patients were divided into two groups: one group underwent cycle ergometer passive exercise for 30 cycles/min on the lower limbs for 20 minutes; the other group did not undergo any therapeutic intervention during the study and served as the control group. A total of 20 ml of blood was analysed, in which nitric oxide levels and some specific inflammatory cytokines (tumour necrosis factor alpha (TNF-α), interferon gamma (IFN-γ) and interleukins 6 (IL-6) and 10 (IL-10)) were evaluated before and after the study protocol. RESULTS:: Regarding the demographic and clinical variables, the groups were homogeneous in the early phases of the study. The nitric oxide analysis revealed a reduction in nitric oxide variation in stimulated cells (p=0.0021) and those stimulated (p=0.0076) after passive cycle ergometer use compared to the control group. No differences in the evaluated inflammatory cytokines were observed between the two groups. CONCLUSION:: We can conclude that the passive cycle ergometer promoted reduced levels of nitric oxide, showing beneficial effects on oxidative stress reduction. As assessed by inflammatory cytokines, the treatment was not associated with changes in the immune system. However, further research in a larger population is necessary for more conclusive results.
Assuntos
Estado Terminal/terapia , Exercício Físico/fisiologia , Terapia Passiva Contínua de Movimento/métodos , Estresse Oxidativo/fisiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Citocinas/sangue , Ensaio de Imunoadsorção Enzimática , Feminino , Humanos , Unidades de Terapia Intensiva , Lipopolissacarídeos/uso terapêutico , Masculino , Pessoa de Meia-Idade , Força Muscular/fisiologia , Atrofia Muscular/prevenção & controle , Óxido Nítrico/imunologia , Óxido Nítrico/metabolismo , Estresse Oxidativo/imunologia , Reprodutibilidade dos Testes , Respiração Artificial/métodos , Estatísticas não Paramétricas , Fatores de Tempo , Resultado do TratamentoRESUMO
OBJECTIVE: The passive cycle ergometer aims to prevent hypotrophy and improve muscle strength, with a consequent reduction in hospitalization time in the intensive care unit and functional improvement. However, its effects on oxidative stress and immune system parameters remain unknown. The aim of this study is to analyze the effects of a passive cycle ergometer on the immune system and oxidative stress in critical patients. METHODS: This paper describes a randomized controlled trial in a sample of 19 patients of both genders who were on mechanical ventilation and hospitalized in the intensive care unit of the Hospital Agamenom Magalhães. The patients were divided into two groups: one group underwent cycle ergometer passive exercise for 30 cycles/min on the lower limbs for 20 minutes; the other group did not undergo any therapeutic intervention during the study and served as the control group. A total of 20 ml of blood was analysed, in which nitric oxide levels and some specific inflammatory cytokines (tumour necrosis factor alpha (TNF-α), interferon gamma (IFN-γ) and interleukins 6 (IL-6) and 10 (IL-10)) were evaluated before and after the study protocol. RESULTS: Regarding the demographic and clinical variables, the groups were homogeneous in the early phases of the study. The nitric oxide analysis revealed a reduction in nitric oxide variation in stimulated cells (p=0.0021) and those stimulated (p=0.0076) after passive cycle ergometer use compared to the control group. No differences in the evaluated inflammatory cytokines were observed between the two groups. CONCLUSION: We can conclude that the passive cycle ergometer promoted reduced levels of nitric oxide, showing beneficial effects on oxidative stress reduction. As assessed by inflammatory cytokines, the treatment was not associated with changes in the immune system. However, further research in a larger population is necessary for more conclusive results.
Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Estado Terminal/terapia , Exercício Físico/fisiologia , Terapia Passiva Contínua de Movimento/métodos , Estresse Oxidativo/fisiologia , Citocinas/sangue , Ensaio de Imunoadsorção Enzimática , Unidades de Terapia Intensiva , Lipopolissacarídeos/uso terapêutico , Força Muscular/fisiologia , Atrofia Muscular/prevenção & controle , Óxido Nítrico/imunologia , Óxido Nítrico/metabolismo , Estresse Oxidativo/imunologia , Reprodutibilidade dos Testes , Respiração Artificial/métodos , Estatísticas não Paramétricas , Fatores de Tempo , Resultado do TratamentoRESUMO
INTRODUCTION: Early mobilization can be performed in critically ill patients and improves outcomes. A daily cycling exercise started from day 5 after ICU admission is feasible and can enhance functional capacity after hospital discharge. In the present study we verified the physiological changes and safety of an earlier cycling intervention (< 72 hrs of mechanical ventilation) in critical ill patients. METHODS: Nineteen hemodynamically stable and deeply sedated patients within the first 72 hrs of mechanical ventilation were enrolled in a single 20 minute passive leg cycling exercise using an electric cycle ergometer. A minute-by-minute evaluation of hemodynamic, respiratory and metabolic variables was undertaken before, during and after the exercise. Analyzed variables included the following: cardiac output, systemic vascular resistance, central venous blood oxygen saturation, respiratory rate and tidal volume, oxygen consumption, carbon dioxide production and blood lactate levels. RESULTS: We enrolled 19 patients (42% male, age 55 ± 17 years, SOFA = 6 ± 3, SAPS3 score = 58 ± 13, PaO2/FIO2 = 223 ± 75). The median time of mechanical ventilation was 1 day (02), and 68% (n=13) of our patients required norepinephrine (maximum concentration = 0.47 µg.kg(-1).min(-1)). There were no clinically relevant changes in any of the analyzed variables during the exercise, and two minor adverse events unrelated to hemodynamic instability were observed. CONCLUSIONS: In our study, this very early passive cycling exercise in sedated, critically ill, mechanically ventilated patients was considered safe and was not associated with significant alterations in hemodynamic, respiratory or metabolic variables even in those requiring vasoactive agents.
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Estado Terminal/terapia , Terapia Passiva Contínua de Movimento/métodos , Adulto , Idoso , Gasometria , Débito Cardíaco , Feminino , Hemodinâmica , Humanos , Masculino , Pessoa de Meia-Idade , Monitorização Fisiológica , Norepinefrina/uso terapêutico , Oximetria , Consumo de Oxigênio/fisiologia , Segurança do Paciente , Troca Gasosa Pulmonar/fisiologia , Respiração Artificial , Simpatomiméticos/uso terapêutico , Volume de Ventilação Pulmonar/fisiologia , Fatores de TempoRESUMO
El presente estudio tiene como objetivo principal determinar los efectos del Kinesio Taping en la funcionalidad manual de pacientes con hemiplejia post accidente cerebro vascular en el Hospital Nacional Dos de Mayo. Se aplicó la técnica Kinesio Taping, utilizando rollos de KIN TAPE (vendaje neuromuscular) a los pacientes seleccionados. El estudio fue de tipo analítico-observacional, sin grupo control, prospectivo, longitudinal. Se incluyeron 8 paciente de ambos sexos, cuyas edades oscilaban entre los 40 y 75 años, los cuales asistían al servicio de Terapia Ocupacional del Hospital Nacional Dos de Mayo, con una valoración inicial de Brunnstrom (Etapa 3, 4, y 5, según la escala de recuperación de la hemiplejia de Signe Brunnstrom). De las personas en estudio, el 50 por ciento (4 pacientes), corresponden a casos que tienen como diagnóstico hemiplejia, el resto pertenecen a hemiparesia; el 62,50 por ciento (5 pacientes) son de sexo masculino, mientras que el 37,50 por ciento (3 pacientes) mujeres. En relación al hemicuerpo afectado, el 63,5 por ciento (5 pacientes) tienen el lado derecho afectado, siendo el 100 por ciento (8 pacientes) diestros. Para la evaluación de la funcionalidad manual se utilizó el Test de Sollerman (versión adaptada), Para el análisis de los tipos o formas de prensión, se seleccionó del Test de Sollerman (versión adaptada), 8 subtest que representan dichas prensiones. Mientras que para evaluar en qué estadío en las etapas de Brunnstrom se encuentran los pacientes, se usó un formato de evaluación de Brunnstrom, luego se hizo un seguimiento de tres meses, obteniendo resultados iniciales (no hay aplicación de KIN TAPE) y finales (si hubo aplicación de KIN TAPE). De ésta manera se determinó: funcionalidad manual (antes), funcionalidad manual (después), tipos o formas de prensión (antes), tipos o formas de prensión (después), estadío en las etapas de Brunnstrom (antes) y estadío en las etapas de Brunnstrom (después). Los resultados que se...
This study aims to determine the effects of main Kinesio Taping on hand function of patients with hemiplegia post-stroke at Hospital Dos de Mayo. Technique was applied Kinesio Taping, using KIN TAPE rolls (Kinesio Taping) selected patients. The type of study was analytical-observational, no control group, prospective, longitudinal. We included eight patients of both sexes, aged between 40 and 75 years, who were attending the Occupational Therapy service at National Hospital Dos de Mayo, with an initial assessment of Brunnstrom (Phase 3, 4, and 5 as the scale recovery of Signe Brunnstrom hemiplegia). Of individuals in the study, 50 per cent of the cases had a diagnosis hemiplegia (4 patients), while the rest belongs to hemiparesis; 62.50 per cent (5 patients) are male with 37.50 per cent (3 patients) women. In relation to the affected side of the body, 63.5 per cent (5 patients) have the right affected, with 100 per cent (8 patients) skilled. For evaluating the manual functionality was used the Sollerman's test, to analyze the types or forms of grip, was selected of the Sollerman's test, 8 subtest representing these grips. While assessing that stage in Brunnstrom stages are patients, we used a Brunnstrom assessment format, then followed up three months, obtaining initial results (no application of KIN TAPE) and final (if there application KIN TAPE). Determined in this way: manual functionality (before), manual functionality (after), types or forms of grip (before), types or forms of grip (Iater) stage in the stages Brunnstrom (before) and stage in the stages Brunnstrom (after). The results obtained were: four patients who started with Brunnstrom 3 including three patients with poor manual dexterity (two Brunnstrom April evolved with regular manual dexterity, while one remained in Brunnstrom 3 and evolved to a poor manual dexterity), a patient with a poor manual dexterity Brunnstrom step 4 and evolved into a regular manual dexterity, four patients started with...
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Masculino , Feminino , Humanos , Adulto , Pessoa de Meia-Idade , Idoso , Acidente Vascular Cerebral/complicações , Bandagens , Hemiplegia/reabilitação , Neurofisiologia , Terapia Passiva Contínua de Movimento , Estudo Observacional , Estudos Longitudinais , Estudos ProspectivosRESUMO
INTRODUCTION: Physiological and psychological alterations in the climacteric period frequently influence women's quality of life. Hot flushes, nocturia, mood alterations, respiratory disturbances, insomnia and restless leg syndrome all affect sleep, and the altered hormonal state in this period impacts the aging process. As hormonal therapy is not indicated in some cases, the search for complementary therapies, such as massage therapy, to improve insomnia in the climacteric period is increasing. OBJECTIVE: To evaluate the effect of therapeutic massage on insomnia and climacteric symptoms in postmenopausal women. METHODS: Forty-four volunteers were randomly distributed into three groups: therapeutic massage (TM), passive movement (PM) and control (CTL). The women received 32 therapeutic massage sessions and passive movement twice a week. Questionnaires were given in the pre-trial and the 16th and 32nd sessions. The Insomnia Severity Index (ISI), Beck Anxiety Inventory (BAI), Beck Depression Inventory (BDI), Menopause Quality of Life questionnaire (MENQOL), Kupperman Menopausal Index and Lipp Symptoms of Stress Inventory were assessed. In addition, the women underwent polysomnography at baseline and post-treatment. Statistical analyses were calculated using Friedman and Wilcoxon non-parametric tests. The level of significance was fixed at p ≤ 0.05. RESULTS: There was an improvement in ISI in the TM group (p = 0.000) and in the PM group (p = 0.001). A decrease in the BDI occurred in the TM group (p = 0.004), and the MENQOL improved in the TM group (p = 0.015). Furthermore, there were no significant differences in polysomnography parameters in the TM group, with only an increase in minimal saturation (p = 0.053). CONCLUSION: The TM group exhibited improved subjective data considering the changes in symptoms according to the ISI and the MENQOL and a decrease in symptoms according to the BDI.
Assuntos
Massagem/métodos , Terapia Passiva Contínua de Movimento/métodos , Polissonografia/métodos , Pós-Menopausa , Distúrbios do Início e da Manutenção do Sono/terapia , Sintomas Afetivos/complicações , Sintomas Afetivos/fisiopatologia , Sintomas Afetivos/terapia , Idoso , Feminino , Fogachos/complicações , Fogachos/psicologia , Fogachos/terapia , Humanos , Pessoa de Meia-Idade , Monitorização Fisiológica/métodos , Qualidade de Vida , Insuficiência Respiratória/complicações , Insuficiência Respiratória/psicologia , Insuficiência Respiratória/terapia , Síndrome das Pernas Inquietas/complicações , Síndrome das Pernas Inquietas/psicologia , Síndrome das Pernas Inquietas/terapia , Índice de Gravidade de Doença , Distúrbios do Início e da Manutenção do Sono/etiologia , Distúrbios do Início e da Manutenção do Sono/fisiopatologia , Distúrbios do Início e da Manutenção do Sono/psicologia , Resultado do TratamentoRESUMO
OBJECTIVE: To investigate the effect of vaginal cones and pelvic floor muscle training (PFTM) in postmenopausal women with stress urinary incontinence. METHODS: This randomized, controlled study included postmenopausal women, who complained of stress urinary incontinence. Forty-five women were allocated to three groups: a group given therapy with vaginal cones (n = 15), a group receiving therapy with PFTM (n = 15), and the control group (n = 15). Subjects in the intervention groups were treated for 6 weeks with twice-weekly sessions of 40 min. Women in the vaginal cone group carried out the pelvic floor muscle strengthening with vaginal cones. The control group did not receive any treatment during the corresponding time. They were evaluated before, at the end of treatment and 6 weeks after treatment completion for primary outcomes (1-h pad test for urinary loss and pelvic floor muscle pressure) and secondary outcomes (quality of life with King's Health Questionnaire, satisfaction with treatment, and continuity of training). RESULTS: For urinary leakage, there were statistical differences between the treated groups and the control group at the end of treatment and 6 weeks after treatment (all p < 0.01; effect size: vaginal cone group 20.97; PFMT group 20.96). The same behavior was shown for treatment with pelvic floor muscle pressure (all p < 0.01; effect size: vaginal cone group 22.58; PFMT group 21.68). There were no differences between the vaginal cone and PFMT groups in any of the evaluations. In outcomes for quality of life, significant differences were observed for incontinence impact and gravity domains when both treated groups were compared with the control group after treatment. Both groups reported similar satisfaction levels and the vaginal cone group demonstrated lower training continuity. CONCLUSION: Based on this study, there were similar positive results for treatment with the vaginal cone and pelvic floor muscle training for urinary leakage, pelvic floor muscle pressure and quality of life for postmenopausal women with stress urinary incontinence after 6 weeks.
Assuntos
Biorretroalimentação Psicológica , Terapia Passiva Contínua de Movimento , Exercícios de Alongamento Muscular/métodos , Pós-Menopausa , Incontinência Urinária por Estresse , Idoso , Biorretroalimentação Psicológica/instrumentação , Biorretroalimentação Psicológica/métodos , Protocolos Clínicos , Interpretação Estatística de Dados , Desenho de Equipamento , Feminino , Humanos , Incidência , Pessoa de Meia-Idade , Terapia Passiva Contínua de Movimento/instrumentação , Terapia Passiva Contínua de Movimento/métodos , Preferência do Paciente , Diafragma da Pelve/patologia , Diafragma da Pelve/fisiopatologia , Pós-Menopausa/fisiologia , Pós-Menopausa/psicologia , Qualidade de Vida/psicologia , Resultado do Tratamento , Incontinência Urinária por Estresse/epidemiologia , Incontinência Urinária por Estresse/etiologia , Incontinência Urinária por Estresse/patologia , Incontinência Urinária por Estresse/fisiopatologia , Incontinência Urinária por Estresse/terapiaAssuntos
Artroscopia/métodos , Cartilagem Articular/lesões , Cartilagem Articular/cirurgia , Adulto , Atletas , Desempenho Atlético , Condrócitos/transplante , Países em Desenvolvimento , Feminino , Humanos , Traumatismos do Joelho/diagnóstico , Traumatismos do Joelho/reabilitação , Imageamento por Ressonância Magnética , México , Terapia Passiva Contínua de Movimento , Recuperação de Função Fisiológica , Índice de Gravidade de Doença , Natação , Transplante Autólogo/métodosRESUMO
Reunir e sumarizar os benefícios e protocolos da terapia rotacional na prevenção e no tratamento das complicações pulmonares de pacientes internados em terapia intensiva. Trata-se de uma revisão sistemática da literatura, na qual foram consultadas as bases de dados Lilacs, MedLine, Cochrane, Divisão Bibliotecária da Universidade de Stanford e o Banco de Dados de Evidência em Fisioterapia. Os ensaios clínicos randomizados publucados entre 2000 e 3008 foram incluídos na análise. Sete estudos foram selecionados, sendo um multicêntrico, totalizando 573 pacientes. O objetivo da intervenção foi a prevenção e o tratamento de complicações pulmonares em três e quatro ensaios, respectivamente. A terapia rotacional foi adotada na forma de terapia cinética em dois estudos, e a terapia de rotação lateral contínua, nos demais. Dentre os principais defechos, foram observados menor incidência de pneumonia (n=3), menor ocorrência e risco de desenvolver atelectasia lobar (n=1), melhora da razão PaO2/FiO2 em pacientes com lesão pulmonar aguda (n=1) e maior volume de escarro expelido (n=1). A terapia rotacional pode ser uma terapêutica coadjuvante no tratamento e na prevenção de complicações pulmonares, uma vez que se observou melhora clínica e fisiológica nos pacientes críticos. Outros estudos são necessários, entretanto, para confirmação desses resultados
Assuntos
Unidades de Terapia Intensiva , Terapia Passiva Contínua de Movimento , Atelectasia Pulmonar , Terapia Respiratória , Estudos Multicêntricos como Assunto , Modalidades de Fisioterapia , Serviço Hospitalar de Fisioterapia , Pneumopatias/prevenção & controle , Pneumopatias/terapiaRESUMO
A Movimentação Passiva Contínua (CPM) é utilizada na reabilitação após trauma ou cirurgia articular, e sua aplicação pode gerar resultados positivos na reabilitação dos membros. Este estudo teve como objetivo analisar e discutir a utilização de equipamentos de CPM na reabilitação do cotovelo a partir de uma revisão bibliográfica de estudos publicados nos últimos 10 anos. Esta pesquisa bibliográfica foi realizada em banco de dados informatizado da Biblioteca Virtual em Saúde, EBSCO HOST, PeDRO, Biblioteca Cochrane e Science Direct. Para localizar os estudos, foram utilizadas palavras-chave: movimento passivo contínuo, cotovelo e CPM cotovelo, em Português e Inglês. Foram selecionados artigos completos em português, inglês e espanhol. A estratégia de pesquisa estava focalizada em estudos do tratamento de patologias do cotovelo utilizando a CPM como método isolado ou associado a outras técnicas fisioterapêuticas. A amostra foi composta de 16 publicações de periódicos. Em 11 dos artigos, a aplicação da CPM associada ou não a outros métodos fisioterapêuticos gerou resultados benéficos; um não apresentou diferença quando comparada a utilização ou não da CPM; dois demonstraram resultados positivos, ressaltando cuidados específicos; e dois afirmam ser necessário mais estudos para comprovação de resultados. Portanto, foi possível evidenciar que pesquisas estão explorando a utilização da CPM na reabilitação do cotovelo, porém os parâmetros utilizados e os modos de aplicação do equipamento não estão bem especificados. Além disso, foi possível perceber que a CPM está sendo utilizada como adjuvante aos métodos de reabilitação fisioterápica e prevalecemos resultados positivos.
Continuous Passive Motion (CPM) is used in post-trauma or articulations surgery rehabilitation to articulate, and its application may produce positive results in members` rehabilitation. This study aimed to analyze and to discuss the use of CPM equipment in elbow rehabilitation through a bibliographical survey of studies published in the last 10 years. This bibliographical survey was done in a computerized databank of Virtual Library in Health, EBSCO HOST, PeDRO, Cochrane Library and Science Direct. For locating studies, we used the keywords continuous passive movement, elbow and elbow MPC/CPM in English, Portuguese and Spanish. Complete articles in Portuguese, English and Spanish were selected. The research strategy focused on studies of the treatment of elbow pathologies using CPM as an isolated method and associated to other physiotherapeutic techniques. The sample was composed by 16 newspaper articles. In 11 articles, CPM application associated or not to other physiotherapeutic methods, has produced beneficial results; 1 did not present differences in the comparison between the use of (CPM) and the use of other techniques; 2 presented positive results, emphasizing specific cares, and 2 called for more studies for result verification. Therefore, it was possible to shoe that researchs are now exploring the use of CPM in elbow rehabilitation, but parameters used and application methods are not well explained. In addition, it was possible to perceive that today CPM is used as an adjuvant method of physiotherapeutic rehabilitation, with the prevalence of positive results.
El Movimiento Pasivo Continuo (MPC) es utilizado en la rehabilitación post-trauma o cirugía articular y su aplicación puede generar resultados positivos en la rehabilitación de los miembros. Este estudio tuvo como objetivo analizar y discutir la utilización de equipamientos de MPC en la rehabilitación del codo a través de una revisión bibliográfica de estudios publicados en los últimos 10 años. Esta investigación bibliográfica fue realizada en un banco de datos informatizado de la Biblioteca Virtual en Salud, EBSCO HOST, PeDRO, Biblioteca Cochrane y Science Direct. Para localizar los estudios, fueron utilizadas las palabras-llave movimiento pasivo continuo, codo y CPM codo en Portugués y Inglés. Se seleccionaran artículos completos en portugués, inglés y español. La estrategia de investigación focalizó estudios del tratamiento de patologías del codo que utilizaban el CPM como método aislado o asociado a otras técnicas fisioterapéuticas. La muestra se compuso de 16 artículos de periódicos. En 11 de los artículos, la aplicación del CPM, asociada o no a otros métodos fisioterapéuticos, ha producido resultados benéficos; 1 no presentó diferencia en la comparación entre la utilización o no del CPM; 2 han demostrado resultados positivos, resaltando cuidados específicos, y 2 afirman se necesitar de más estudios para la comprobación de resultados. Por consiguiente, fue posible evidenciar que investigaciones exploran en la actualidad la utilización de la CPM en la rehabilitación del codo, mas los parámetros utilizados y los modos de aplicación del equipamiento non están bien especificados. Además, fue posible percibir que la CPM es hoy utilizado como adyuvante de los métodos de rehabilitación fisioterápica, prevaleciendo los resultados positivos.
Assuntos
Cotovelo/lesões , Terapia Passiva Contínua de Movimento/instrumentação , Especialidade de Fisioterapia , Reabilitação/métodosRESUMO
A paralisia cerebral é resultante de uma lesão não progressiva sobre o sistema nervoso central em desenvolvimento e que pode levar a disfunções motoras, distúrbios no movimento, deficiências mentais e alterações funcionais. A espasticidade é a anormalidade motora e postural mais comumente vista na paralisia cerebral. Considerando as múltiplas repercussões da espasticidade sobre a funcionalidade do indivíduo com paralisia cerebral, torna-se claro que uma avaliação do quadro clínico deve ser precisa e direcionar-se aos aspectos específicos que exigem intervenção. Este texto tem como objetivo servir de guia aos médicos ou terapeutas na escolha de instrumentos de medição quantitativa e qualitativa.
Cerebral palsy is the result of a non-progressive lesion on the developing central nervous system and can lead to motor dysfunction, movement disorders, mental and functional changes. Spasticity is a motor and postural abnormality most commonly seen in cerebral palsy. Considering the multiple spasticity effects on the functionality of the individual with cerebral palsy, it becomes clear that a clinical evaluation must be precise and direct itself to the specific aspects that require intervention. This text is intended as a guide to the doctors or therapists in choosing the quantitative and qualitative measurements.
Assuntos
Humanos , Criança , Espasticidade Muscular/terapia , Terapia Passiva Contínua de Movimento , Espasticidade Muscular , Paralisia , Paralisia Cerebral/complicações , Pesos e Medidas , Espasticidade Muscular/etiologia , Marcha , Avaliação em SaúdeRESUMO
UNLABELLED: The effects of different mobilization protocols for muscle regeneration after myotoxin injury was compared in the rat tibialis anterior (TA) muscle. Adult Wistar rats were divided into control (C); mobilized (M); injury (I); injury + late mobilization (LM) and injury + early mobilization (EM) groups. Muscle injury was induced by intramuscular lidocaine injection. The exercised animals were mobilized for 5 and 8 days during 15 and 45 minutes/session. The swimming started 1 hour or 3 days after injury. All animals were killed 8 days after the injury, together with the control group, when the TA muscles were weighted and excised. Cross sections were obtained by cryostat and submitted to Toluidine Blue stain. Qualitative morphological characterization of muscle regeneration and quantitative analysis of muscle fiber and non-muscle fiber area density were performed. The I and late mobilization groups showed decreased muscle mass when compared to all other groups. All injured animals showed signs of muscle fiber damage, although signs of early regenerated muscle fibers were more evident in injury + mobilization groups. Only the EM groups submitted to 45 minutes of exercise had increased muscle fiber and decreased non-muscle fiber area density values when compared to I group (p<0.05). CONCLUSION: the regeneration process is related to the onset of exercise, since animals submitted to early mobilization showed improved regeneration when comparted to LM groups. Besides, the length of session is also important for accelerating the regeneration process, as it was observed that 45 minutes was better than 15 minutes duration.
Assuntos
Terapia por Exercício , Músculo Esquelético/patologia , Condicionamento Físico Animal/fisiologia , Cicatrização/fisiologia , Animais , Modelos Animais de Doenças , Masculino , Terapia Passiva Contínua de Movimento , Fibras Musculares Esqueléticas/patologia , Fibras Musculares Esqueléticas/fisiologia , Músculo Esquelético/lesões , Músculo Esquelético/fisiopatologia , Tamanho do Órgão , Ratos , Ratos Wistar , Fatores de TempoRESUMO
OBJETIVO: Avaliar os efeitos da eletroestimulação por aparelhos de uso doméstico sobre o condicionamento neuromuscular. MÉTODOS: A amostra foi composta por 20 mulheres voluntárias, sedentárias, destras, com idades entre 18 a 25 anos em Maceió, estado de Alagoas, em 2006. As mulheres foram divididas aleatoriamente em dois grupos: as do grupo A foram submetidas a eletroestimulação passiva com aparelhos comerciais e as do grupo B, a exercício físico com resistência. O programa de treinamento dos grupos totalizou 16 sessões em dois meses, com duas sessões semanais. As comparações do peso corporal, da cirtometria, fleximetria, e da força muscular antes e após os exercícios, foram utilizadas utilizando-se o teste T pareado. Nas comparações entre os grupos A e B, foi utilizado o teste t de Student. O nível de significância adotado foi de 5 por cento. RESULTADOS: A comparação da força muscular medida de forma subjetiva antes e após cada um dos procedimentos, mostrou que ocorreu aumento da força em ambos os grupos. Foram observados aumentos significantes na massa e na força muscular apenas nos indivíduos que realizaram exercício voluntário. O exercício físico resistido de flexo-extensão dos joelhos foi efetivo em aumentar massa e força muscular, ao contrário das sessões de eletroestimulação com correntes de freqüência de pulsos de 87 Hz, que não tiveram o mesmo efeito. CONCLUSÕES: Os resultados encontrados mostraram que os aparelhos de eletroestimulação para ganho passivo de condicionamento físico comercializados são menos eficientes do que a prática de exercício físico voluntário.
OBJECTIVE: To evaluate the effects of electrical muscle stimulation with devices for home use on neuromuscular conditioning. METHODS: The study sample comprised 20 sedentary, right-handed, voluntary women aged from 18 to 25 years in the city of Maceió, Northeastern Brazil, in 2006. Subjects were randomly divided into two groups: group A included women who underwent muscle stimulation using commercial electrical devices; group B included those women who performed physical activities with loads. The training program for both groups consisted of two weekly sessions for two months, in a total of 16 sessions. Comparisons of body weight, cirtometry, fleximetry, and muscle strength before and after exercise were determined using the paired t-test. For the comparisons between both groups, Student's t-test was used and a 5 percent significance level was adopted. RESULTS: Muscle strength subjectively assessed before and after each intervention was increased in both groups. Significant increases in muscle mass and strength were seen only in those subjects who performed voluntary physical activity. Resisted knee flexion and extension exercises effectively increased muscle mass and strength when compared to electrical stimulation at 87 Hz which did not produce a similar effect. CONCLUSIONS: The study results showed that electrical stimulation devices for passive physical exercising commercially available are less effective than voluntary physical exercise.