The effects of training by virtual reality or gym ball on pelvic floor muscle strength in postmenopausal women: a randomized controlled trial

ABSTRACT Objective To evaluate the effectiveness of abdominopelvic training by virtual reality compared to pelvic floor muscle training (PFMT) using a gym ball (a previously tested and efficient protocol) on postmenopausal women’s pelvic floor muscle (PFM) strength. Method A randomized controlled trial was conducted with 60 postmenopausal women, randomly allocated into two groups: Abdominopelvic training by virtual reality – APT_VR (n=30) and PFMT using a gym ball – PFMT_GB (n=30). Both types of training were supervised by the same physical therapist, during 10 sessions each, for 30 minutes. The participants’ PFM strength was evaluated by digital palpation and vaginal dynamometry, considering three different parameters: maximum strength, average strength and endurance. An intention-to-treat approach was used to analyze the participants according to original groups. Results No significant between-group differences were observed in most analyzed parameters. The outcome endurance was higher in the APT_VR group (p=0.003; effect size=0.89; mean difference=1.37; 95% CI=0.46 to 2.28). Conclusion Both protocols have improved the overall PFM strength, suggesting that both are equally beneficial and can be used in clinical practice. Muscle endurance was higher in patients who trained using virtual reality.

Análise quantitativa do tratamento da escoliose idiopática com o método klapp por meio da biofotogrametria computadorizada / Quantitative photogrammetric analysis of the klapp method for treating idiopathic scoliosis

INTRODUÇÃO: Poucos trabalhos comprovam a eficácia das técnicas fisioterapêuticas para o tratamento da escoliose. OBJETIVO: Analisar a eficácia do Método Klapp no tratamento das escolioses por meio do estudo quantitativo pela biofotogrametria computadorizada. MÉTODOS: Dezesseis indivíduos com média de idade de 15±2,61 anos, portadores de escoliose idiopática, foram tratados com o método Klapp. Para análise dos resultados do tratamento, todos foram fotografados antes e após o tratamento, seguindo uma padronização fotográfica. Todas as fotografias foram analisadas quantitativamente por um mesmo experimentador, utilizando o software ALCimagem 2000. A análise estatística foi realizada, utilizando-se a o teste-t pareado com nível de significância de 5 por cento. RESULTADOS: Os resultados apontam para a melhora após o tratamento dos ângulos agromioclaviculares (AC-p=0,00) e esternoclavicular (EC-p=0,01), que avaliam a simetria dos ombros, e para o ângulo que avalia o triângulo de Tales esquerdo, (ΔTe-p=0,02). Em termos de flexibilidade, houve melhora dos ângulos tibiotársicos (ATT-p=0,01) e coxofemoral (CF-p=0,00). Não houve modificações das curvaturas vertebrais e nem melhora no posicionamento da cabeça, apenas na curvatura lombar, avaliada pelo ângulo lordose lombar (LL-p=0,00), sofreu modificação com o tratamento. CONCLUSÃO: O método Klapp foi uma técnica terapêutica eficaz para tratar as assimetrias de tronco e a flexibilidade. Não foi eficaz para assimetrias da pelve, modificações da posição da cabeça, da lordose cervical e cifose torácica.

INTRODUCTION: Few studies have proved that physical therapy techniques are efficient in the treatment of scoliosis. OBJECTIVE: To analyze the efficiency of the Klapp method for the treatment of scoliosis, through a quantitative analysis using computerized biophotogrammetry. METHODS: Sixteen participants of a mean age of 15±2.61 yrs. with idiopathic scoliosis were treated using the Klapp method. To analyze the results from the treatment, they were all of photographed before and after the treatments, following a standardized photographic method. All of the photographs were analyzed quantitatively by the same examiner using the ALCimagem 2000 software. The statistical analyses were performed using the paired t-test with a significance level of 5 percent. RESULTS: The treatments showed improvements in the angles which evaluated the symmetry of the shoulders, i.e. the acromioclavicular joint angle (AJ; p=0.00) and sternoclavicular joint angle (SJ; p=0.01). There were also improvements in the angle that evaluated the left Thales triangle (ΔT; p=0.02). Regarding flexibility, there were improvements in the tibiotarsal angle (TTA; p=0.01) and in the hip joint angles (HJA; p=0.00). There were no changes in the vertebral curvatures and nor improvements in head positioning. Only the lumbar curvature, evaluated by the lumbar lordosis angle (LL; p=0.00), changed after the treatments. CONCLUSIONS: The Klapp method was an efficient therapeutic technique for treating asymmetries of the trunk and improving its flexibility. However, it was not efficient for pelvic asymmetry modifications in head positioning, cervical lordosis or thoracic kyphosis.

Efectos del etanol sobre la epidermis de fetos de rata: estudio morfológico y morfométrico / Ethanol effects on the epidermis of rat fetuses: morphologic and morphometric study

Fueron estudiados los efectos de la intoxicación prenatal con etanol sobre la histología y los parámetros morfométricos de la epidermis de la región occipitofrontal de la bóveda del cráneo fetal. Una solución de etanol al 25 por ciento, administrada intraperitonealmente en dosis de 0,03 mllg de peso corporal, en los días 9, 10 y 11 de embarazo, en ratas Wistar, causó retardo en el crecimiento intrauterino de fetos y placentas. Fue demostrado que la epidermis de la bóveda del cráneo es más delgada en los fetos del grupo intoxicado. Los resultados del análisis morfométrico sugieren que el etanol causa retardo de crecimiento (hipoplasia) en las células epidérmicas de la bóveda craneal en los fetos de ratas intoxicadas con etanol