Effect of high-voltage electrical stimulation on the albumin and histamine serum concentrations, edema, and pain in acute joint inflammation of rats

BACKGROUND: The mechanism by which high-voltage electrical stimulation (HVPC) acts on edema reduction is unknown. OBJECTIVE: To assess the effect of HVPC with negative polarity (-) applied to the ankle of rats with acute joint inflammation. METHOD: Sixty-four rats were divided into four groups (n=16): inflamed+HVPC(-), 0.03 mL application of ι-carrageenan (3%) to the tibiotarsal joint plus HVPC(-); inflamed+HVPC placebo, carrageenan application and HVPC placebo; normal+HVPC(-), HVPC application(-); and normal control, no intervention. The HVPC(-) 100 Hz at a submotor level was applied daily for 45 min on three consecutive days. The variables were pain, hind-foot volume, and serum histamine and albumin assessed before and during the 48 hours following inflammation. The variables were compared using the t test, one-way ANOVA, nested ANOVA for repeated measures, and the post hoc Bonferroni test. Analysis of covariance was applied to adjust the effects of HVPC(-) by measurements of pain, inflammation, albumin, and histamine at 24 h, and the final weight was compared to the other groups. The significance level was set at p<0.05. RESULTS: There were no differences between the inflamed+HVPC(-) and inflamed+HVPC placebo groups in terms of pain or edema (p>0.05). Albumin was reduced in the groups that received the intervention, but there was no differences between them. There was only a 24 hour increase in histamine with the normal+HVPC(-) (p=0.0001) and inflamed+HVPC placebo groups (p=0.01) compared to the normal control group. CONCLUSIONS: The results of the present study suggest that HVPC(-) with the parameters employed did not reduce pain or edema and did not change serum albumin or histamine levels,, which indicates the inability of this resource to have a positive effect when treating treat acute joint inflammation. .

Effect of walking and resting after three cryotherapy modalities on the recovery of sensory and motor nerve conduction velocity in healthy subjects / Efeito da marcha e do repouso após aplicação de três protocolos de crioterapia na recuperação da velocidade de condução sensorial e motora em sujeitos saudáveis

BACKGROUND: Different cryotherapy modalities have distinct effects on sensory and motor nerve conduction parameters. However, it is unclear how these parameters change during the post-cooling period and how the exercise carried out in this period would influence the recovery of nerve conduction velocity (NCV). OBJECTIVES: To compare the effects of three cryotherapy modalities on post-cooling NCV and to analyze the effect of walking on the recovery of sensory and motor NCV. METHODS: Thirty six healthy young subjects were randomly allocated into three groups: ice massage (n=12), ice pack (n=12) and cold water immersion (n=12). The modalities were applied to the right leg. The subjects of each modality group were again randomized to perform a post-cooling activity: a) 30min rest, b) walking 15 min followed by 15 min rest. The NCV of sural (sensory) and posterior tibial (motor) nerves was evaluated. Initial (pre-cooling) and final (30 min post-cooling) NCV were compared using a paired t-test. The effects of the modalities and the post-cooling activities on NCV were evaluated by an analysis of covariance. The significance level was α=0.05. RESULTS: There was a significant difference between immersion and ice massage on final sensory NCV (p=0.009). Ice pack and ice massage showed similar effects (p>0.05). Walking accelerated the recovery of sensory and motor NCV, regardless of the modality previously applied (p<0.0001). CONCLUSIONS: Cold water immersion was the most effective modality for maintaining reduced sensory nerve conduction after cooling. Walking after cooling, with any of the three modalities, enhances the recovery of sensory and motor NCV.

CONTEXTUALIZAÇÃO: Diferentes protocolos de crioterapia têm ação distinta nos parâmetros de condução neural sensorial e motora. No entanto, não se sabe como é o comportamento desses parâmetros no período pós-resfriamento e como o exercício físico realizado nesse período atuaria na recuperação da velocidade de condução nervosa (VCN). OBJETIVOS: Comparar o efeito de três protocolos de crioterapia na VCN pós-resfriamento e analisar o efeito da marcha pós-resfriamento na recuperação da VCN sensorial e motora. MÉTODOS: Trinta e seis sujeitos jovens e saudáveis foram alocados aleatoriamente em três grupos: criomassagem (n=12), pacote de gelo (n=12); imersão em água gelada (n=12). As modalidades foram aplicadas na perna direita. Os sujeitos de cada grupo foram novamente aleatorizados para realizar uma atividade pós-resfriamento: a) 30 min de repouso; b) 15 min de marcha seguidos de 15 min de repouso. Avaliou-se a VCN nos nervos sural (sensorial) e tibial posterior (motor). Comparações entre VCN inicial e final (30 min pós-resfriamento) foram realizadas com teste t de Student pareado. Os efeitos das modalidades e das atividades pós-resfriamento na VCN foram avaliados mediante análise de covariância. O nível de significância foi α=0,05. RESULTADOS: Houve efeito diferente entre imersão e criomassagem na VCN sensorial final (p=0,009). Pacote de gelo e criomassagem apresentaram efeitos similares (p>0,05). A marcha acelerou a recuperação da VCN sensorial e motora, independente da modalidade previamente aplicada (p<0,0001). CONCLUSÕES: Imersão em água gelada foi o procedimento mais eficaz para manter diminuída a condução nervosa sensorial após o resfriamento. A marcha pós-crioterapia, com qualquer um dos três protocolos, acelera a recuperação da VCN sensorial e motora.

Effect of high-voltage pulsed current plus conventional treatment on acute ankle sprain / Efeito da adição da estimulação de alta voltagem ao tratamento convencional do entorse de tornozelo numa etapa aguda

BACKGROUND: The effectiveness of high-voltage pulsed current (HVPC) treatments in humans as a means of controlling edema and post-traumatic pain has not yet been established. Objective: To analyze the effects of HVPC plus conventional treatment on lateral ankle sprains. METHODS: This was a randomized, controlled, double-blind clinical trial with three intervention groups: CG (control group with conventional treatment); HVPC(-) group (conventional treatment plus negative polarity HVPC); HVPC(+) group (conventional treatment plus positive polarity HVPC). Twenty-eight participants with lateral ankle sprain (2 to 96h post-trauma) were evaluated. Conventional treatment consisted of cryotherapy (20min) plus therapeutic exercises. Additionally, the HVPC(-) and HVPC(+) groups received 30min of electrical stimulation (submotor level; 120 pps). Pain, edema, range of motion (ROM) and gait were assessed before the first treatment session and after the last treatment session. RESULTS: At the final evaluation, there were no significant differences between groups. Nevertheless, the HVPC(-) group had greater values in all assessed parameters. The data analysis showed that the HVPC(-) group had greater reductions in volume and girth, and greater recovery of ROM and gait velocity. This group also reached the end of the treatment (1.7 weeks; range 1.2-2.2) faster than the HVPC(+) group and the CG (2.2 weeks; range 1.8-2.6). CONCLUSIONS: There were no differences between the study groups, but the results suggest that HVPC(-) can accelerate the initial phase of recovery from ankle sprain.

CONTEXTUALIZAÇÃO: A eficácia da estimulação elétrica de alta voltagem (EEAV) em humanos, como uma forma de tratamento para controlar o edema e a dor pós-traumáticos, ainda não foi estabelecida. OBJETIVO: Analisar o efeito da adição da EEAV ao tratamento convencional do pós-entorse de tornozelo em humanos. MÉTODOS: Ensaio clínico controlado e aleatorizado, duplo cego com três grupos de intervenção: grupo controle (GC) com tratamento convencional; tratamento convencional EEAV(-) e polaridade negativa EEAV (-); tratamento convencional e EEAV polaridade positiva EEAV(+). Vinte e oito portadores de entorse lateral do tornozelo (2 a 96 horas pós-trauma) foram avaliados. O tratamento convencional consistiu em crioterapia (20 minutos) e exercício terapêutico. Adicionalmente, os grupos EEAV(-) e EEAV(+) receberam 30 minutos de estimulação elétrica (nível submotor, 120pps). As variáveis de dor, edema, amplitude de movimento (ADM) e marcha foram avaliadas antes da primeira sessão de tratamento e após a última sessão de tratamento. RESULTADOS: Na avaliação final, não houve diferenças significativas entre os três grupos. Porém, os indivíduos do grupo EEAV(-) demonstraram valores superiores em todos os parâmetros de avaliação. A análise dos dados mostrou que o EEAV(-) apresentou maior redução do volume e do perímetro, maior recuperação da ADM e da cadência da marcha. Esse grupo também alcançou o término de tratamento mais rápido (1,7 semanas [1,2-2,2]), comparado com o EEAV(+) e o GC (2,2 semanas [1,8-2,6]). CONCLUSÕES: Não houve diferença entre os grupos estudados, mas os resultados sugerem que a EEAV(-) pode contribuir para acelerar a recuperação do entorse de tornozelo em sua fase inicial.

Respuesta hemodinámica con el entrenamiento en resistencia y fuerza muscular de miembros superiores en rehabilitación cardiaca / Hemodynamic response to training in resistance and muscular strength of upper limbs in cardiac rehabilitation

Antecedentes: el entrenamiento de la fuerza muscular en pacientes con eventos cardiovasculares, estaba totalmente contraindicado por el riesgo de incrementar las cifras de tensión arterial sistólica y diastólica, así como someter al miocardio a una sobrecarga. Objetivo: valorar la respuesta hemodinámica (frecuencia cardiaca, tensión arterial) durante el entrenamiento de resistencia a la fuerza muscular en los pacientes que asisten a un programa de rehabilitación cardiaca.Diseño: cuasi experimental prospectivo.Excenario: se realizó un entrenamiento de resistencia a la fuerza muscular en miembros superiores a pacientes durante la fase II de rehabilitación cardiaca.Sujetos: se incluyeron 175 pacientes, 135 hombres y 40 mujeres con un promedio de edad de 58,79 años, los cuales presentaron enfermedad coronaria con y sin procedimientos de revascularización, cirugía de cambios valvulares, síncope y corrección quirúrgica de anomalías congénitas...

Background: training of muscular strength in patients with cardiovascular events was totally contraindicated because of the risk of incrementing the systolic and diastolic arterial pressure values, as well as the submission to a myocardial overload. Objective: evaluate the hemodynamic response (heart rate, arterial pressure) during the resistance to muscular strength training in patients assisting to a heart rehabilitation program. Design: quasi experimental prospective study. Setting: resistance training to muscular strength in upper limbs to patients during stage II of cardiac rehabilitation was realized. Subjects: 175 patients were included. 135 men and 40 women with mean age 58.79 years with coronary disease, with or without revascularization procedures, valvular surgery, syncope and surgical correction of congenital heart disease. Procedure: previous aerobic training (treadmill or static bicycle), muscular strength evaluation was realized through maximal repetition and the strength training was initiated at 30%-50% of this, in a three different exercise circuit in upper limbs, 10 repetitions in three series with a twice a week frequency. Besides, monitoring of heart frequency, electrocardiogram by telemetry (V5), arterial pressure recording before, during and after the session, and subjective perception of the effort by the Borg scale were made, and signs and symptoms of intolerance to the activity or decompensation were observed. For the statistical analysis, measures of central tendency with the cardiovascular changes were used and in order to compare the change in muscular strength, a paired t test with significance level 0.05 was utilized. Results: mean muscular strength with maximal repetition evidenced a significant increase of 1.92 ± 2.49 lb (p<0.001) in the general population, with an increment of 2.03 ± 2.57 lb (p<0.001) in men and of 1.46 ± 2.1 lb...

Evaluación de tecnologías diagnósticas y tipos de muestreos / Sampling diagnostic techniques evaluation

La presente revisión y actualización tiene como objetivo mostrar al investigador de evaluación de tecnologías diagnósticas los diferentes tipos de muestreo que se pueden utilizar para disminuir costos y riesgos, y la manera de realizar los cálculos de las carcterísticas de las pruebas, a saber: sensibilidad, especificidad, valor predictivo positivo y valor predictivo negativo de una menera sin sesgo en una muestra representativa de la población en que la prueba sería utilizada y se dan algunas recomendaciones para evitar errores demasiado frecuentes en la evaluación de pruebas diagnósticas como el muestreo seudorretrospectivo