ABSTRACT
Introduction: Institutionalized young people may exhibit impaired development due to lack of support, correct guidance regarding their physiological changes, and knowledge about postural changes. Methods: This is a longitudinal observational case series study. Adolescents residing in shelters who could understand the entire protocol were invited to participate in the study. Ten meetings were held, once a week, with 8 theoretical-practical interventions and 2 pre and post-PEP evaluations. The evaluations were: static posture, dynamic balance, handgrip strength, self-esteem, quality of life, and a theoretical questionnaire on general knowledge. Results: From 18 adolescents, 11 (7 boys and 4 girls), with an average age of 14.8 (±1.3) years concluded the study. After the PEP intervention, a significant improvement was found in the knee angles (3.56º vs. 2.28º) and hip (-12.03º vs. -4.18º) in its plane lateral. The scores of the theoretical questionnaire were 4.75 vs. 11.63 and the handgrip strength was 22.91 vs. 28.54 kgf and 21.55 vs. 26.82 kgf for the right and left limbs. In the quality of life and self-esteem questionnaires, no statistically significant differences were obtained. Conclusion: PEP imparts benefits to socially vulnerable adolescents for postural angles, handgrip strength and theoretical knowledge. Self-esteem and quality of life did not change, probably due to their high vulnerability.
Introdução: Jovens institucionalizados podem apresentar comprometimento do desenvolvimento por falta de apoio, orientação correta quanto às suas alterações fisiológicas e conhecimento sobre alterações posturais. Métodos: Trata-se de um estudo observacional longitudinal de série de casos. Foram convidados a participar do estudo adolescentes residentes em abrigos que conseguissem compreender todo o protocolo. Foram realizados dez encontros, uma vez por semana, com 8 intervenções teórico-práticas e 2 avaliações pré e pós-PEP. (programa de educação postural). As avaliações foram: postura estática, equilíbrio dinâmico, força de preensão manual, autoestima, qualidade de vida e questionário teórico de conhecimentos gerais. Resultados: Dos 18 adolescentes, 11 (7 meninos e 4 meninas), com idade média de 14,8 (±1,3) anos, concluíram o estudo. Após a intervenção PEP, foi encontrada melhora significativa nos ângulos do joelho (3,56º vs. 2,28º) e quadril (-12,03º vs. -4,18º) no seu plano lateral. As pontuações do questionário teórico foram 4,75 vs. 11,63 e a força de preensão manual foi 22,91 vs. 28,54 kgf e 21,55 vs. 26,82 kgf para os membros direito e esquerdo. Nos questionários de qualidade de vida e autoestima não foram obtidas diferenças estatisticamente significativas. Conclusão: A PEP traz benefícios aos adolescentes em situação de vulnerabilidade social quanto aos ângulos posturais, força de preensão manual e conhecimento teórico. A autoestima e a qualidade de vida não se alteraram, provavelmente devido à sua elevada vulnerabilidade.
ABSTRACT
Abstract Background: Temporomandibular disorder (TMD) is an umbrella term encompassing various clinical complaints involving the temporomandibular joints, masticatory muscles, and/or associated orofacial structures. Myogenous TMDs are the most frequent cause of chronic orofacial pain. Musculoskeletal pain is commonly associated with myofascial trigger points (MTPs), for which dry needling (DN) is a routine treatment. Objective: To investigate muscle oxygenation and pain immediately after DN application on an MTP in the masseter muscle of patients with myogenous TMDs. Methodology: Masseter muscle oxygen tissue saturation indices (TSI%) were assessed by near-infrared spectroscopy (NIRS) pre- and post-interventions by a randomized, controlled, double-blind, crossover DN/Sham clinical trial (primary outcome). Pain was investigated by the visual analog scale (VAS). In total, 32 individuals aged from 18 to 37 years who were diagnosed with myogenous TMD and myofascial trigger points in their masseter muscles participated in this study. Relative deltas for the studied variables were calculated. Data normality was tested using the Shapiro-Wilk test. According to their distribution, data were analyzed by two-way ANOVA and the Student's t-, and Mann-Whitney tests. Statistical analyses were performed using Prism® 5.0 (GraphPad, USA). Results: We found a significant difference (2,108% vs. 0,142%) between masseter muscle TSI% deltas after the DN and Sham interventions, respectively (n=24). We only evaluated women since men refused to follow NIRS procedures. Pain increased immediately after DN (n=32, 8 men), in comparison to Sham delta VAS. Conclusion: These findings show an increase in tissue oxygen saturation in the evaluated sample immediately after the DN intervention on the MTP of patients' masseter muscle. Pain may have increased immediately after DN due to the needling procedure.