Eficácia da reabilitação perineal combinada com biofeedback e diatermia por radiofrequência (RDF) em síndromes de dor funcional anorretal associadas à contração paradoxal dos músculos elevadores do ânus. Um estudo prospectivo / Effectiveness of perineal pelvis rehabilitation combined with biofeedback and radiofrequency diathermy (rdf) in anorectal functional pain syndromes associated with paradoxical contraction of the levator ani muscles. a prospective study

ABSTRACT Background: Anorectal functional pain syndrome, also called chronic proctalgia, represents a neglected clinical entity and often confused with other syndromes such as vulvodynia or acute proctalgia. It is a very often disabling disease with a consequent significant negative impact on the patient's quality of life. Chronic proctalgia, in many patients, is secondary to the paradoxical contraction of the pelvic floor and associated with a dissynergy between the thorax-abdomen and the pelvic floor. To improve symptoms in functional anorectal pain syndromes, various rehabilitation techniques are used with the aim of promoting relaxation of the pelvic floor; however, to improve defecatory dynamics in patients with levator ani syndrome, only biofeedback has shown efficacy in a randomized study. The aim of this work is to evaluate whether a rehabilitation protocol with manometric biofeedback and radiofrequency diathermy (mt100 Fremslife emotion Tecar) reduces pain and paradoxical contraction of the levator ani and improves the quality of life in patients with anorectal pain syndromes. functional. Methods: This was a prospective study on 30 patients (20 women and 10 men) with anorectal functional pain syndrome and paradoxical contraction of the pelvic floor enrolled at the UOC of General, Minimally Invasive, Oncological and Obesity Surgery of the AOU "Luigi Vanvitelli" of Naples, Italy, from September 2021 to May 2022. All patients were evaluated with a coloproctological specialist visit followed by anorectal manometry and evaluation of altered clinical physiatric parameters (Brusciano Score). The protocol consisted of 10 rehabilitation sessions of the pelvic floor once a week and lasting approximately 45 minutes. During the sessions the patients were subjected to diathermy / radiofrequency treatment (10 minutes) with a static resistive electrode on the diaphragm, during which they were required to breathe diaphragmatically and to become aware of the perineal muscles, under the supervision of a physiotherapist; followed by application of diathermy with static capacitive (5 minutes) and resistive (10 minutes) electrode at the lumbar level. This was followed by the use of manometric biofeedback (15 minutes of tonic / phasic exercises) in order to instruct the patient on the reflex mechanism to obtain a voluntary relaxation of the external anal sphincter. The variables evaluated were Pain (VAS 0-10) and the questionnaire on the impact of colorectal and anal pathologies on the quality of life (CRAIQ-7) at the beginning, after 3 months and at the end of the treatment. Results: After 10 weeks, the rehabilitation treatment combined with diathermy and manometric biofeedback proved effective in the short term with a reduction in the scores of the Vas scale and CRAIQ-7 questionnaire and an increase in the percentage of release of the anal muscles on anorectal manometry. Conclusion: The use of radiofrequency diathermy with a system of static electrodes associated with biofeedback represents a valid rehabilitation option for those patients suffering from anorectal functional pain syndrome because it reduces pain and paradoxical contraction of the levator ani and improves quality of life of the patient.

RESUMO Contexto: A síndrome de dor funcional anorretal, também conhecida como proctalgia crônica, representa uma entidade clínica negligenciada e frequentemente confundida com outras síndromes, como vulvodinia ou proctalgia aguda. Trata-se de uma doença frequentemente incapacitante, com um consequente impacto negativo significativo na qualidade de vida do paciente. A proctalgia crônica, em muitos pacientes, é secundária à contração paradoxal do assoalho pélvico e está associada a uma dissinergia entre o tórax-abdômen e o assoalho pélvico. Para melhorar os sintomas em síndromes de dor anorretal funcional, são utilizadas diversas técnicas de reabilitação com o objetivo de promover o relaxamento do assoalho pélvico. No entanto, para melhorar a dinâmica de evacuação em pacientes com síndrome do elevador do ânus, apenas o biofeedback demonstrou eficácia em um estudo randomizado. Objetivo: O objetivo deste trabalho é avaliar se um protocolo de reabilitação com biofeedback manométrico e diatermia por radiofrequência (mt100 Fremslife emotion Tecar) reduz a dor e a contração paradoxal do elevador do ânus e melhora a qualidade de vida em pacientes com síndromes de dor anorretal funcional. Métodos: Realizado estudo prospectivo com 30 pacientes (20 mulheres e 10 homens) com síndrome de dor anorretal funcional e contração paradoxal do assoalho pélvico inscritos na UOC de Cirurgia Geral, Minimamente Invasiva, Oncológica e de Obesidade da AOU "Luigi Vanvitelli" de Nápoles, Itália, de setembro de 2021 a maio de 2022. Todos os pacientes foram avaliados com uma consulta especializada em coloproctologia, seguida de manometria anorretal e avaliação dos parâmetros fisiátricos clínicos alterados (Escore de Brusciano). O protocolo consistiu em 10 sessões de reabilitação do assoalho pélvico, uma vez por semana, com duração aproximada de 45 minutos. Durante as sessões, os pacientes foram submetidos a tratamento de diatermia / radiofrequência (10 minutos) com um eletrodo resistivo estático no diafragma, durante o qual foram solicitados a respirar através do diafragma e a tomar consciência dos músculos perineais, sob a supervisão de um fisioterapeuta; seguido pela aplicação de diatermia com eletrodo capacitivo estático (5 minutos) e resistivo (10 minutos) no nível lombar. Isso foi seguido pelo uso de biofeedback manométrico (15 minutos de exercícios tônicos /fásicos) com o objetivo de instruir o paciente sobre o mecanismo reflexo para obter um relaxamento voluntário do esfíncter anal externo. As variáveis avaliadas foram Dor (EVA 0-10) e o questionário sobre o impacto das patologias colorretais e anais na qualidade de vida (CRAIQ-7) no início, após 3 meses e no final do tratamento. Resultados: Após 10 semanas, o tratamento de reabilitação combinado com diatermia e biofeedback manométrico mostrou-se eficaz a curto prazo, com uma redução nos escores da escala VAS e do questionário CRAIQ-7, e um aumento na porcentagem de relaxamento dos músculos anais na manometria anorretal. Conclusão: O uso de diatermia por radiofrequência com um sistema de eletrodos estáticos associado ao biofeedback representa uma opção de reabilitação válida para pacientes que sofrem com a síndrome de dor anorretal funcional, pois reduz a dor e a contração paradoxal do elevador do ânus, melhorando a qualidade de vida do paciente.

Fine-needle diathermy for corneal vascularisation

Background: Corneal angiogenesis occurs as a sequel to an insult and it brings with it cells that mediate immunity as well as repair and aids in flushing toxins out. These vessels are formed in haste and leak lipid and cells, ultimately resulting in loss of transparency, lipid keratopathy and immunogenicity. So, they may need treatment prior to an optical keratoplasty. Purpose: To demonstrate the procedure of Fine Needle Diathermy (FND) to treat corneal neovascularization, its indications and contraindications. Synopsis: FND uses coagulating current from a monopolar cautery unit to occlude the afferent and efferent blood vessels. FND works best at the stage of mature vessel formation. The needle is placed across a tuft of vessels or parallel to a single large vessel, being mindful of the depth and direction. FND is avoided in necrotic tissue where the blood vessel is needed for healing process. Occlusion of the vessel in these situations may result in tissue melt. Highlights: Corneal neovascularization follows the stages of latent phase, active neovascularization, mature vessel formation and then regression. The treatment modality depends on the stage of angiogenesis. FND works best for neovascularization due to infectious keratitis. Keratoplasty is best performed 3 to 4 months later when regression of corneal vascularization occurs.

Um estudo randomizado controlado sobre a eficácia da diatermia de ondas longas na dor, incapacidade e amplitude de movimento em pacientes com dor cervical / A randomized controlled trial on the efficacy of longwave diathermy on pain, disability and range of motion in the patients with neck pain

INTRODUÇÃO: A cervicalgia é uma importante causa de incapacidade em todo o mundo, causada por várias condições como doenças de base, anormalidades mecânicas e neuropáticas. A Diatermia por Ondas Longas (LWD) é uma modalidade de aquecimento terapêutico usada para tratar muitas condições musculoesqueléticas. OBJETIVO: Avaliar a eficácia da LWD na dor, incapacidade e amplitude de movimento (ADM) na dor no pescoço. MÉTODOS E MATERIAIS: O estudo foi conduzido após aprovação ética da universidade e registro em registro de ensaio clínico (PTY/2022/155 e CTRI/2022/06/043033). 30 pacientes com cervicalgia de 20-60 anos foram alocados aleatoriamente em dois grupos. O grupo controle (n=15) realizou exercícios domiciliares simples, enquanto no grupo experimental (n=15) a diatermia de ondas longas também foi administrada juntamente com exercícios domiciliares, 3 vezes/semana por 2 semanas. As medidas de resultado, como a escala visual analógica (EVA), índice de incapacidade do pescoço (IIP) e amplitude de movimento do pescoço, foram avaliadas na linha de base, no final de 2 semanas (pós-tratamento) e após um acompanhamento de 2 semanas. RESULTADOS E CONCLUSÃO: Houve melhora significativa da dor, incapacidade e ADM pós-intervenção no grupo controle e no grupo experimental. Além disso, houve diferença significativa na dor após o acompanhamento em ambos os grupos. A comparação entre os grupos sugeriu que houve uma diferença significativa para EVA, IIPe ADM de extensão do pescoço (p<0,05), mas não para ADM em outras direções. Portanto, pode-se concluir que a LWD é uma intervenção terapêutica eficaz para melhorar a dor, a incapacidade do pescoço e a amplitude de movimento do pescoço, juntamente com exercícios de pescoço em pacientes com dor no pescoço.

INTRODUCTION: Neck pain is a significant cause of disability worldwide, caused by various conditions like underlying diseases, mechanical and neuropathic abnormalities. Longwave Diathermy (LWD) is a therapeutic heating modality used to treat many musculoskeletal conditions. OBJECTIVE: To evaluate the efficacy of LWD on pain, disability, and range of motion (ROM) in neck pain. METHODS AND MATERIALS: The study was conducted after ethical approval from the university and registration in clinical trial registry (PTY/2022/155 & CTRI/2022/06/043033). Thirty patients with neck pain of 20-60 years were randomly allocated into two groups. The control group (n=15) performed simple home-based exercises, while in the experimental group (n=15) longwave diathermy was also given along with home exercises, 3 times/week for 2 weeks. The outcome measures like the Visual analogue scale (VAS), neck disability index (NDI), and Neck range of motion were assessed at baseline, at the end of 2 weeks (post-treatment), and after a followup of 2 weeks. RESULTS AND CONCLUSION: There was a significant improvement in pain, disability, and ROM post-intervention in the control group and experimental group. Additionally, there was a significant difference in pain after follow-up in both groups. The between-group comparison suggested that there was a significant difference for VAS, NDI, and neck extension ROM (p<0.05) but not for ROM in other directions. Therefore, it can be concluded that LWD is an effective therapeutic intervention for improving pain, neck disability, and neck range of motion along with neck exercises in patients with neck pain.

Efficacy observation of deep hyperthermia combined with recombinant human vascular endothelial inhibitor injection and AP regimen in treatment of advanced non-small cell lung cancer / 肿瘤研究与临床

Objective:To investigate the efficacy of deep hyperthermia combined with recombinant human vascular endothelial inhibitor injection and AP (pemetrexed + cisplatin) regimen in the treatment of advanced non-small cell lung cancer (NSCLC) and its effects on serum tumor marker levels and immune function of patients.Methods:In this prospective randomized controlled study, 106 patients with advanced NSCLC who were admitted to the Seventh People's Hospital of Hebei Province from January 2016 to January 2022 were included, and were divided into two groups according to the random number table method, with 53 cases in each group. The control group was treated with recombinant human vascular endothelial inhibitor injection combined with AP regimen. The observation group was given recombinant human vascular endothelial inhibitor injection combined with AP regimen and deep hyperthermia. After 4 consecutive cycles of treatment, the short-term efficacy of the two groups was observed. Chemiluminescence assay was used to detect the serum levels of carcinoembryonic antigen (CEA), carbohydrate antigen 125 (CA125) and cytokeratin fragment 19 CYFR21-1 before and after treatment. T lymphocyte subsets in peripheral blood were detected by flow cytometry. The occurrence of adverse reactions was compared between the two groups.Results:The objective response rates in observation group and control group were 58.49% (31/53) and 37.74% (20/53), the disease control rates in observation group and control group were 92.45% (49/53) and 75.47% (40/53), the observation group was higher than the control group ( χ2 = 4.53, P = 0.033; χ2 = 5.62, P = 0.018). The differences in serum carcinoembryonic antigen (CEA), glycoantigen 125 (CA125) and CYFR21-1 levels between the two groups before treatment were not statistically significant (all P > 0.05), they were lower in both groups after treatment than before treatment (all P < 0.05), and they were lower in the observation group after treatment than in the control group after treatment (all P < 0.05). The differences in peripheral blood CD3 +, CD4 + and CD8 + T-cell levels and CD4 + to CD8 + T-cell ratio (CD4 +/CD8 +) between the two groups before treatment and in the observation group before and after treatment were not statistically significant (all P > 0.05). Peripheral blood CD3 + and CD4 + T-cell levels and CD4 +/CD8 + in the control group after treatment were lower than before treatment (all P < 0.05), and the peripheral blood CD8 + T-cell level was higher than before treatment ( P < 0.05). CD3 + and CD4 + cell levels and CD4 +/CD8 + in the observation group after treatment were higher than those in the control group after treatment, CD8 + T-cell level was lower than the control group after treatment, and the differences were statistically significant (all P < 0.001). There were different degree of gastrointestinal reactions, bone marrow suppression, liver and kidney damage and cardiotoxicity in both groups during treatment, but the differences in the incidence of each adverse reaction between the two groups were not statistically significant (all P > 0.05). Conclusions:Deep hyperthermia combined with recombinant human vascular endothelial inhibitor injection and AP regimen in the treatment of advanced NSCLC can effectively reduce the serum tumor marker levels, improve the immunosuppression status of the body and enhance the recent efficacy, and the overall adverse reactions are controllable and well tolerated by patients.

Effect of pulsed electromagnetic field therapy in patients with supraspinatus tendon tear

SUMMARY OBJECTIVE: The aim of this study was to compare the effect of transcutaneous electrical nerve stimulation (TENS), ultrasound (US), and pulsed electromagnetic field (PEMF) combination with TENS and US therapy alone in patients with supraspinatus tear. METHODS: Forty patients were included in this study. The patients were randomly divided into two groups as follows: PEMF (n=20) and Sham (n=20) groups. PEMF was applied to the first group at a frequency of 50 Hz, 25 G intensity, and 20 min/session. The device was turned off while PEMF was applied to the second group. Diathermy (US) and electrotherapy (TENS) were applied to both groups for 10 sessions. Numerical Rating Scale (NRS), University of California-Los Angeles (UCLA) Shoulder Scale, and Shoulder Pain and Disability Index (SPADI) were used as outcome measures. RESULTS: In both groups, there was a significant improvement in the NRS, UCLA Shoulder Scale, and SPADI scores after treatment compared with pretreatment (p<0.05). In the comparison of the difference between the pretreatment and posttreatment measurement values between the groups, no significant difference was found between PEMF and Sham groups according to the NRS (p=0.165), UCLA Shoulder Scale (p=0.141), and SPADI (p=0.839) scores. CONCLUSIONS: In our study, a combination of PEMF therapy with conventional physical therapy modalities was not found to be superior to the conventional therapy alone, and adding it to the routine treatment of symptomatic supraspinatus tear would not provide any additional benefit.

Multi-component plasma fluid approach to sparking enhanced burns as a complication of diathermy

Background: The effects of electric currents flowing through a human body vary from no perceptible to severe tissue injury caused by the electrosurgical spark. Although modern electrodes have been designed to minimize this complication, it was reported that burns have accounted for 70% of the injuries during electro surgery. Some risks of complications depend on a surgeon's knowledge of instruments and safety aspects of technical equipment. The use of alcohol and spirit-based skin preparation solutions brings another risk of burn injuries.Methods: Apart from the experimental methods, computer modelling is shown to be an effective approach to improve the performance of electrosurgical procedure. The benefits of simulation assisted electro surgery include no ethical approval, low cost, safe and the most important removing conditions that may lead to tissue burns. Here, the onset of sparking between the electrosurgical electrodes has been studied by using the multi-component plasma fluid model. Results: It was found that the electrode shape significantly affects the sparking formation. The minimum voltage required for sparking has been achieved for cylinder-cylinder configuration, while for other arrangements breakdown voltages are higher. Electrical sparks do not occur equally in both directions between active and passive electrodes due to electrical asymmetries.Conclusions: This study is dealing with application of multi-component plasma fluid model in simulating sparks produced between electrosurgical electrodes of various shapes, materials and dimensions. Our simulation model offers substantially greater physical fidelity as compared to simulators that use simple geometry. The obtained results are applicable for prevention of potential complications during diathermy procedure.

Short-wave diathermy in patients with chronic low back pain: a systematic review / Diatermia por ondas curtas em pacientes com dor lombar crônica: revisão sistemática / Diatermia por ondas cortas en pacientes con dolor lumbar crónico: revisión sistemática

ABSTRACT The aim of this study was to evaluate the evidence of application of short-wave diathermy (SWD) in individuals with chronic low back pain (CLBP) and its prescription parameters. The data sources (MEDLINE, PubMed, LILACS, DARE, PsycINFO, AusportMed, SciELO, PEDro and the Cochrane Central Register of Controlled Trials) were systematically searched for articles published up to December 2017. Randomized and non-randomized clinical trial studies that investigated the effect of the application of SWD on CLBP were selected. Two independent reviewers assessed the risk of bias in studies using the Jadad and the Downs & Black scales. Five studies (731 patients) were included, all of whom presented improvements in CLBP. The majority used continuous mode SWD, with only one using pulsed mode (82 and 200 Hz). SWD produced improvements in CLBP, but there is limited evidence for its application, and a lack of standardization of the parameters used. Furthermore, the results that address this topic should be interpreted with caution due to their low methodological quality and limited number. Level of evidence II; Systematic review.

RESUMO O objetivo do presente estudo foi avaliar a evidência de aplicação da diatermia por ondas curtas (DOC) em indivíduos com dor lombar crônica (DLC) e seus parâmetros de prescrição. As fontes de dados (MEDLINE, PubMed, LILACS, DARE, PsycINFO, AusportMed, SciELO, PEDro e Cochrane Central Register of Controlled Trials) foram pesquisadas sistematicamente quanto aos artigos publicados até dezembro de 2017. Estudos de ensaios clínicos randomizados e não randomizados que investigaram o efeito da aplicação da DOC na DLC foram selecionados. Dois revisores independentes avaliaram o risco de viés em estudos usando as escalas Jadad e Downs & Black. Cinco estudos (731 pacientes) foram incluídos e todos apresentaram melhora na DLC. A maioria usou a DOC de modo contínuo, com apenas um utilizando o modo pulsado (82 e 200 Hz). A DOC apresentou melhora na DLC, no entanto, há evidências limitadas para sua aplicação e ausência de padronização dos parâmetros utilizados. Além disso, os resultados que se referem a esse tópico devem ser interpretados com cautela devido à baixa qualidade metodológica e ao número limitado de estudos. Nível de evidência II; Revisão sistemática.

RESUMEN El objetivo del presente estudio fue evaluar la evidencia de la diatermia por ondas cortas (DOC) en individuos con dolor lumbar crónico (DLC) y sus parámetros de prescripción. Las fuentes de datos (MEDLINE, PubMed, LILACS, DARE, PsycINFO, AusportMed, SciELO, PEDro y Cochrane Central Register of Controlled Trials) fueron utilizadas para búsquedas sistemáticas de artículos publicados hasta diciembre de 2017. Fueron seleccionados los estudios de ensayos clínicos aleatorizados y no aleatorizados que investigaron el efecto de la aplicación de DOC en DLC. Dos revisores independientes evaluaron el riesgo de sesgo en estudios usando las escalas Jadad y Downs & Black. Fueron incluidos cinco estudios (731 pacientes) y todos presentaron mejora en DLC. La mayoría usó la DOC de modo continuo, con sólo uno usando el modo pulsado (82 y 200 Hz). La DOC produjo mejoras en DLC, sin embargo, hay evidencias limitadas para su aplicación y ausencia de estandarización de los parámetros utilizados. Además, los resultados que se refieren a ese tópico deben interpretarse con cautela debido a la baja calidad metodológica y al número limitado de estudios. Nivel de evidencia II; Revisión sistemática.

Comparative Study of Diode Laser versus Diathermy in Soft Tissue Surgical Procedures of Oral Cavity

Aims andObjectives:To evaluate wound healing and patient’s comfort after oral soft tissue surgical procedures performed by diode laser in comparison with diathermy Methods:This study includes 20 patients requiring oral soft tissue surgical procedures are randomly categorized into group A and group B of 10 patients each. Group A patients will undergo diathermy and group B patients will undergo laser therapy. Clinical assessment and photographs of patients will be done preoperatively and postoperatively on 1st day, 3rd day, 7th day, 2nd week and 4th week. Evaluation of postoperative bleeding, pain, infection and healing will be carried out. Results:At the end of the studythe assessment of parameters such as bleeding, swelling, wound healing, presence of infection were approximately similar in both the treatment methods to be insignificant, 70% of the patients included in this study under the laser group were very satisfied with the procedure & the pain experience by the patients in the same group was comparatively less, when compared to the diathermy group Conclusion:The observations suggest that both the treatment options were effective although laser proves better in terms of minimal bleeding, pain, reduced swelling, faster healing and patient’s comfort. Further research and a longer follow up period is desirable for a definitive conclusion

Comparison of Diathermy versus Scalpel Skin Incision in Oncological Surgeries

Introduction: Surgical incisions are usually made with scalpel. Usage of scalpel usually results in skin bleeding which obscuresthe operating field resulting in wastage of operating time. Although diathermy is increasingly used for underlying tissue dissection,cutting, and hemostasis, its use for making skin incisions is not gaining favor.Aim: The aim of our study was to compare the value outcome of diathermy incisions versus scalpel incisions in abdominalsurgeries.Materials and Methods: This prospective comparative study was conducted to compare the outcome of diathermy incisionsversus scalpel incisions in oncological surgeries. Total of 80 patients who divided into Group A (scalpel incision) for 39 patientsand Group B (diathermy incision) for 41 patients. Treatment protocol and follow-up protocol were followed and the results werestatistically analyzed and discussed.Results: Out of 80 patients, 39 patients had scalpel incision and 41 patients had diathermy incision. In the scalpel group outof 39 patients, 21 patients were male and 18 patients were female, the mean duration of incision time in the scalpel group is116 sec, the mean value of incisional blood loss in the scalpel group is 1.9/ml, the mean operating time in the scalpel group is36.42 min, and the mean value of post-operative pain in day 1 is 6.42, day 2 is 5.18, and day 3 is 3.66. In the diathermy groupout of 41 patients, 26 patients were male and 15 patients were female, the mean duration of incision time in the diathermy groupis 88.52 sec, the mean value of incisional blood loss in the diathermy group is 1.4/ml, the mean operating time in the diathermygroup is 38.75 min, and the mean value of post-operative pain in day 1 is 5.12, day 2 is 3.88, and day is 2.01.Conclusion: The findings of the present study show that diathermy seems to provide some benefit with respect to post-operativewound pain, less incision time, and less incisional blood loss and has obvious safety advantages to the surgical team comparedwith scalpel.

Scalpel versus diathermy skin incision: a randomised clinical trial

Background: Scalpel skin incision produces a clean, incised wound with minimal tissue destruction. Cutting diathermy also produces an incised wound that heals as well as the one that is created by cold scalpel but with an added advantage of achieving quick hemostasis and saving operative time. The main thing of the present study is to verify and compare the usefulness of diathermy skin incision vs. scalpel skin incision in general surgical patients.Methods: The study was conducted in Medical College and Hospital, in 60 patients randomly selected for diathermy and scalpel incision, between 14-65 years age group, between January 2011-June 2012. Post operative pain, seroma, hematoma, discharge were observed and results were analyzed and compared for the two groups using Mann-Whitney U Test.Results: Diathermy group, with incision related time of 6.20±0.97 sec/cm, was significantly quicker (p=0.003) than scalpel incision, with incision time of 6.76±0.84 sec/cm. Postoperative pain scores, recorded daily over five days, showed insignificant difference between the two groups.Conclusions: We demonstrate that the diathermy provides efficient cutting of skin, with no superior wound-healing profile, comparable to that of the traditional scalpel blade.

Effect of intensive hyperthermia combined with low-dose cisplatin plus radiotherapy in the treatment of patients with locally advanced NSCLC / 中国基层医药

Objective@#To investigate the effect and safety of intensive hyperthermia combined with low-dose cisplatin plus radiotherapy in the treatment of patients with locally advanced NSCLC.@*Methods@#From January 2012 to December 2015, 104 patients with locally advanced NSCLC were chosen in the Second People's Hospital of Weifang and randomly divided into two groups according to the digital table, with 52 patients in each group.The control group was given low-dose cisplatin plus radiotherapy, and the observation group was given intensive hyperthermia on the basis of control group.The ORR, DCR, median OS, median PFS, KPS score, the levels of coagulation function index and tumor markers before and after treatment and incidence of side effects in the two groups were compared.@*Results@#The DCR of the observation group was significantly higher than that of the control group(86.54% vs.69.23%, χ2=8.24, P<0.05). The median OS and median PFS of the observation group were significantly longer than those of the control group(11.9 months vs.8.3 months; 7.5 months vs.4.7 months, t=2.56, 3.01, P<0.05). The KPS scores after treatment of the observation group were significantly higher than those of the control group and before treatment[(75.49±8.94)points vs.(68.65±7.06)points; (75.49±8.94)points vs.(62.23±6.34)points, t=2.78, 5.11, all P<0.05]. The levels of coagulation function index and tumor markers after treatment of the observation group were significantly lower than those of the control group and before treatment(t=3.14, 2.67, 3.59, 7.31; 4.89, 4.02, 4.70, 9.21; 2.44, 2.60, 3.20; 3.15, 3.78, 4.06; all P<0.05). There was no statistically significant difference in the incidence of side effects between the two groups(P>0.05).@*Conclusion@#Intensive hyperthermia combined with low-dose cisplatin plus radiotherapy in the treatment of patients with locally advanced NSCLC can efficiently control disease progress, increase survival benefits, higher quality of life, improve coagulation function, reduce the levels of tumor markers and possess satisfactory safety.

A Comparative Analysis between Short Wave Diathermy and Infrared Radiation’s Effects on the Patients with Chronic Low Back Pain \r\nDue to Lumbar Spondylosis\r\n

Introduction: Low back pain is a symptom and not a disease.The low back pain is considered to incorporate dorsal painfound any place between the 12 thoracic vertebra and lowerbuttock up to gluteal folds or anus. Lumbar spondylosis is atypical reason for chronic low back pain and chronic disability.Objective: The main purpose of this research is to give acomparative analysis between short wave diathermy andinfrared radiation for treating lower back pain caused byspondylosis.Method: This was an observational study. A randomizedclinical trial study was conducted on Department of PhysicalMedicine and Rehabilitation, BSMMU, Shahbagh, Dhaka on153 patients who came to hospital with lower back pain andsuffered from spondylosis. The study duration was from 1stMarch 2010 to 15 September, 2010.Results: Out of 153 patients, irrespective of sex, it was foundthat most of the patients (50.98%) belong to 40-49 years agegroup followed by: 50-59 years (27.45%), 30-39 years(11.11%) and 60-70 years (10.46%) age group. in 72.2%patients prolonged sitting exacerbate the lower back pain.Prolonged standing was also found as another aggravatingfactor of pain among the study patients (17.6%). Prolongedwalking (5.9%) and leaning forward (3.3%) came next in theorder of aggravating factors for lower back pain. The study alsoshowed the performance difference between SWD and IRR onthe patients.Conclusion: Considering the information gathered from thisstudy, it can be concluded that all the tested therapies seemedto improve the patients with chronic low back pain. But IRR andSWD showed no significant difference in improvement for thepatients with chronic LBP due to lumbar spondylosis.

Focal Bone Marrow Lesions: A Complication of Ultrasound Diathermy

Ultrasound diathermy is widely used for the treatment of musculoskeletal disorders and other soft tissue injuries. Its use as a therapeutic modality is believed to be safe, with very few reported complications. Here, we report two patients who developed focal bone marrow abnormalities after receiving ultrasound diathermy. Both patients' magnetic resonance (MR) evaluations revealed linear subchondral bone lesions of the superolateral humeral head similar to those in osteonecrosis. The patients' symptoms subsequently improved, and available follow-up MR evaluation revealed near complete resolution of bone lesions. These findings suggest that ultrasound diathermy, and its interaction with bone tissue through thermal mechanisms, can cause focal bone marrow abnormalities. Furthermore, the bone marrow abnormalities seem to be transient, resolving upon cessation of ultrasound diathermy, therefore osteonecrosis should be differentiated from this temporal lesion.

Clinical value of neoadjuvant chemotherapy combined with cytoreductive surgery and intraperitoneal hyperthermia in advanced ovarian cancer / 中国基层医药

Objective@#To evaluate the efficacy of neoadjuvant chemotherapy combined with cytoreductive surgery and intraperitoneal hyperthermia in the treatment of advanced ovarian cancer.@*Methods@#From June 2014 to April 2017, 72 patients with advanced ovarian cancer who were treated in the Maternal and Child Health Care Hospital of Weihai were selected as the research subjects.According to the digital table method, the patients were randomly divided into two groups, with 36 cases in each group.The control group was treated with neoadjuvant chemotherapy combined with cytoreductive surgery.The observation group was treated with neoadjuvant chemotherapy combined with cytoreductive surgery and intraperitoneal hyperthermic perfusion.After 3 months of chemotherapy, the curative effect was statistically analyzed.@*Results@#The operation time, the amount of ascites and the amount of bleeding in the observation group were significantly less than those in the control group (all P<0.05). There were no statistically significant differences in surgical incision stage I healing rate and the rate of pelvic infection between the two groups (P>0.05). After treatment, the remission rate in the control group was 55.5%(20/36), which was significantly lower than 77.8%(28/36) in the observation group (χ2=4.92, P<0.05). All patients were followed up for 1 year.The recurrence rate of the control group was 33.3%, which was significantly higher than 22.2% of the observation group (χ2=5.71, P<0.05).@*Conclusion@#Neoadjuvant chemotherapy combined with cytoreductive surgery and intraperitoneal hyperthermia in the treatment of advanced ovarian cancer is effective and worthy of clinical application.

A randomized comparative study of diathermy incisions and scalpel incisions in subacute appendicitis

Background: Treating injuries with heat can increase blood flow and make connective tissue more flexible. It can also help minimize inflammation and reduce the incidence of edema or fluid retention. By increasing blood flow to the site of an injury, the deep heat generated with diathermy can accelerate healing. Diathermy is used to treat arthritis, back pain, fibromyalgia, muscle spasms, neuralgia, sprains and strains, tenosynovitis, tendonitis, bursitis. In the second, as an adjunct to surgery, diathermy is used to coagulate, prevent excessive bleeding, and seal off traumatized tissues. It is particularly effective in eye surgery, neurosurgery and dermatology. However, there is still not a lot of evidence to prove that diathermy is the most effective treatment for these conditions. Aim of the study: Aim was comparison of Diathermy incision and Scalpel incision in elective open appendectomy surgery. Materials and methods: 25 patients per group irrespective of sex was sample size. Study Group was subdivided into Study Group A – Patients were subjected to Diathermy incision. Study Group B – Patients were subjected to Scalpel incision. After obtaining pre-anesthetic check-up patients were posted for surgery. Data was collected using a proforma meeting the objectives of the study. Results: The treatment group was split into two, Twenty-five cases used diathermy for skin incision and the other twenty-five cases used a traditional scalpel for skin incisions in open appendectomy Mithun Govind Dandapani, Bharathidasan Rajamanikkam, Maheshwari Narayanan. A randomized comparative study of diathermy incisions and scalpel incisions in subacute appendicitis. IAIM, 2019; 6(7): 59-66. Page 60 procedures. 50 patients in the study groups were compared, 4 developed wound gaping which accounts for 8%. Wound gaping was considerably seen in scalpel incision with a highly significant P value of 0.0297 using Pearson-Chi square test. A hypertrophic scar was seen in scalpel incision with a significant P value of 0.074 using Pearson-Chi square test. Keloid was considerably seen in scalpel incision with a highly significant P value of 0.0149 using Pearson-Chi square test. The pain in POD-1 was compared, the mean value was 7.44 and 6.16 in scalpel and diathermy respectively, with a highly significant P value of <0.0001. The pain in POD-2 was compared, the mean value was 6.28 and 4.72 in scalpel and diathermy respectively, with a highly significant P value of <0.0001. Conclusion: All the patients were followed every day in the postoperative period until they were discharged. The following parameters were observed, that is a comparison of the two procedures with relation to the duration of incision, postoperative pain, post-operative complications in both the procedures. Diathermy is the first choice of incision for open appendectomy procedures as there is less chance of postoperative wound complications.

Clinical value of neoadjuvant chemotherapy combined with cytoreductive surgery and intraperitoneal hyperthermia in advanced ovarian cancer / 中国基层医药

Objective To evaluate the efficacy of neoadjuvant chemotherapy combined with cytoreductive surgery and intraperitoneal hyperthermia in the treatment of advanced ovarian cancer .Methods From June 2014 to April 2017,72 patients with advanced ovarian cancer who were treated in the Maternal and Child Health Care Hospital of Weihai were selected as the research subjects.According to the digital table method ,the patients were randomly divided into two groups,with 36 cases in each group.The control group was treated with neoadjuvant chemotherapy combined with cytoreductive surgery.The observation group was treated with neoadjuvant chemotherapy combined with cytoreductive surgery and intraperitoneal hyperthermic perfusion.After 3 months of chemotherapy ,the curative effect was statistically analyzed.Results The operation time,the amount of ascites and the amount of bleeding in the observation group were significantly less than those in the control group ( all P＜0.05).There were no statistically significant differences in surgical incision stage I healing rate and the rate of pelvic infection between the two groups (P＞0.05).After treatment,the remission rate in the control group was 55.5%(20／36),which was significantly lower than 77.8%(28／36) in the observation group (χ2 ＝4.92,P＜0.05).All patients were followed up for 1 year.The recurrence rate of the control group was 33.3%,which was significantly higher than 22.2%of the observation group (χ2 ＝5.71, P ＜0.05 ).Conclusion Neoadjuvant chemotherapy combined with cytoreductive surgery and intraperitoneal hyperthermia in the treatment of advanced ovarian cancer is effective and worthy of clinical application .

Efeitos adversos da eletrotermofototerapia em clínicas da cidade de Cascavel - PR / Los efectos adversos del electrotermofototerapia en clínicas de la ciudad de Cascavel - PR / Adverse effects of electrothermal phototherapy in clinics in the city of Cascavel - PR

RESUMO Esta pesquisa teve como objetivo identificar os principais efeitos adversos observados por fisioterapeutas com o uso de aparelhos de eletrotermofototerapia em clínicas da cidade de Cascavel, Paraná. A amostra contou com 35 clínicas e destas, 25 foram alvo de coleta após triagem, cujos dados foram obtidos por questionários em forma de entrevista semiestruturada. Nestes se questionava aos responsáveis pelo serviço de eletrotermofototerapia sobre a ocorrência de efeitos adversos experienciados durante atividades laborais na clínica. Observou-se que a Neuroestimulação Elétrica Transcutânea (TENS) apresentou problemas em 64% dos casos, com 36% devido a irritações cutâneas e 28% a dor. O aparelho de ondas curtas apresentou efeitos adversos em 60%, em que 40% foram queixas de dor e 20% causaram queimaduras leves. Já acerca do ultrassom terapêutico foram relatados efeitos adversos em 52%, sendo 32% de quadros de dor e 20% de casos com náuseas. A laserterapia de baixa potência demonstrou efeito adverso em 36%, com relatos de aumento da sensibilidade local. Por fim, os aparelhos de média frequência apresentaram efeitos adversos em apenas 20% dos casos, de queixas de náuseas. A quantidade de tais efeitos encontrados foi importante, porém sua gravidade não causou grande preocupação.

RESUMEN Este estudio propone identificar los principales efectos adversos observados por fisioterapeutas con el uso de aparatos de electrotermofototerapia en clínicas de la ciudad de Cascavel, Paraná (Brasil). De la muestra han participado 35 clínicas, de las cuales restaron 25 después del triaje, cuyos datos fueron obtenidos por cuestionarios en forma de entrevista semiestructurada. Estos contenían preguntas al responsable del servicio de electrotermofototerapia sobre la ocurrencia de los efectos adversos ocurridos durante el trabajo en la clínica. Se observó que el Electroestimulación Transcutánea (TENS, en inglés) presentó problemas en un 64 % de los casos, con un 36 % debido a irritaciones de la piel y un 28 % al dolor. En el aparato de ondas cortas se verificó efectos adversos en un 60 %, de las cuales un 40 % fueron de quejas de dolor y un 20 % de quemaduras leves. Sobre el ultrasonido terapéutico, se han divulgado los efectos adversos en un 52 %, de los cuales un 32 % fueron síntomas de dolor y un 20 % casos con náuseas. La terapia con láser de baja intensidad resultó en efectos adversos en el 36 %, con informes de aumento de la sensibilidad local. Por último, los dispositivos de frecuencia media revelaron efectos adversos en sólo el 20 % de los casos de las quejas de náuseas. La cantidad de estos efectos encontrados es importante, pero su gravedad no demostró gran preocupación.

ABSTRACT This study aimed to identify the main adverse effects observed by physical therapists using electrothermal phototherapy devices in clinics in the city of Cascavel, Paraná. The sample comprised 35 clinics, of which 25 were submitted to data collection after sorting. Data were collected through questionnaires in the form of semi-structured interview. In these questionnaires, the responsible for providing the electrothermal phototherapy service were asked about the occurrence of adverse effects experienced during labor activities at the clinic. Transcutaneous electrical nerve stimulation (TENS) showed problems in 64% of cases, being 36% due to skin irritations and 28% due to pain. The shortwave apparatus showed adverse effects in 60% of cases, of which 40% consisted of complaints of pain and 20% caused minor burns. Regarding therapeutic ultrasound, adverse effects were reported in 52% of cases, of which 32% were episodes of pain and 20% of nausea. The low-power laser therapy showed adverse effect on 36% of cases, with reports of increased local sensitivity. Finally, the medium frequency devices had adverse effect in only 20% of cases, being complaints of nausea. The amount of such effects found was important, but their gravity did not cause major concern.

Efeito de ondas curtas por método indutivo na lombalgia crônica inespecífica em indivíduos sedentários / Effect of inductive shortwave on chronic non-specific low back pain in sedentary individuals

OBJETIVOS: Avaliar a eficácia do tratamento com ondas curtas por método indutivo em indivíduos sedentários com lombalgia crônica inespecífica. MÉTODOS: Um ensaio clínico quase-experimental e cruzado foi realizado com indivíduos lombálgicos e sedentários. A amostra foi recrutada entre acadêmicos da Universidade Estadual do Oeste do Paraná (Unioeste) na faixa etária entre 18 e 25 anos, que apresentavam dor lombar de origem postural não traumática há mais de três meses, eram sedentários, e aceitaram participar da pesquisa. O protocolo de intervenção consistiu na aplicação de ondas curtas por método indutivo por 15 minutos, uma vez ao dia, três vezes por semana, com intervalo de um dia entre cada aplicação. Na semana seguinte os voluntários recebiam tratamento placebo também por três vezes na semana, com tempo semelhante àquele realizado na semana tratamento, porém o equipamento era apenas ligado, sem emissão do campo eletromagnético. O protocolo foi aplicado por duas semanas. As variáveis analisadas foram o grau de incapacidade funcional, avaliado pelo Índice de Incapacidade de Oswestry (ODI) e pelo Questionário de Incapacidade de Roland-Morris (QIRM), no início do experimento e ao final de cada semana; e a dor, avaliada pela Escala Visual Analógica (EVA), antes e após cada sessão. Os dados foram apresentados em média e desvio-padrão ou mediana e quartis e o nível de significância aceito foi de 5%. RESULTADOS: Vinte voluntários participaram do estudo. Para a ODI houve redução dos valores de incapacidade ao longo da semana de tratamento, com retorno aos valores iniciais na semana placebo; já para o QIRM não houve diferenças entre o tratamento e o placebo. Pela EVA, houve redução na intensidade da dor ao longo dos três dias de terapia, fato que ocorreu apenas no segundo dia do placebo. CONCLUSÕES: O tratamento com ondas curtas na modalidade indutiva foi eficaz na diminuição da dor em pacientes sedentários com lombalgia crônica, contribuindo para melhora da capacidade funcional.

AIMS: To evaluate the efficacy of inductive shortwave treatment in sedentary individuals with non-specific chronic low back pain. METHODS: A quasi-experimental and cross-over trial was performed with sedentary individuals with chronic back pain. The sample was recruited among students from the State University of Western Paraná (Unioeste), aged between 18 and 25 years old, who had low back pain of non-traumatic postural origin for more than three months, were sedentary, and accepted to participate in the study. The intervention protocol consisted in the application of short waves by inductive method for 15 minutes, once a day, three times a week, with interval of one day between each application. In the following week, volunteers also received placebo treatment three times a week, with time similar to that performed in the treatment week, but the equipment was only switched on, without emission of the electromagnetic field. The protocol was applied for two weeks. The variables analyzed were the degree of functional disability, assessed by the Oswestry Disability Index (ODI) and the Roland-Morris Disability Questionnaire (QIRM), at the beginning of the experiment and at the end of each week; and pain, assessed by the Visual Analogue Scale (VAS), before and after each session. Data were presented as mean and standard deviation or median and quartiles, and the accepted level of significance was 5%. RESULTS: Twenty volunteers participated in the study. For ODI, there was a reduction in the disability values throughout the treatment week, with a return to previous values in the placebo week; there were no differences between treatment and placebo for the MIRR. By VAS, there was a reduction in pain intensity over the three days of therapy, which occurred only on the second day of the placebo. CONCLUSIONS: Treatment with short waves in the inductive modality was effective in reducing pain in sedentary patients with chronic low back pain, contributing to improve functional capacity

Impacto da criolipólise associada à radiofrequência na adiposidade localizada / Cryolipolysis impact associated to radiofrequency in localized adiposity

Introdução: A criolipólise e a radiofrequência estão entre as técnicas não invasivas mais procuradas que proporcionam a diminuição do tecido adiposo. Objetivo: Avaliar a influência da associação da criolipólise e radiofrequência no tratamento da adiposidade em abdômen inferior. Métodos: Participaram nove voluntárias com adiposidade em abdômen inferior, idade média de 27,44 ± 2,4 anos, submetidas ao tratamento de uma sessão de criolipólise durante 50 minutos, sucção de 40 mmHg, cinco sessões de radiofrequência com ponteira multipolar, potência 30 W, frequência de 3 Hz contínua, temperatura a 42°C, duas vezes na semana, totalizando 5 sessões, avaliadas através do índice de massa corpórea (IMC), perimetria e adipometria. Foram utilizados os testes de Shapiro Wilk seguido de Test T de Student para análises pré e pós-tratamento (p ≤ 0,05). Resultados: A média adipométrica abaixo da cicatriz umbilical e acima da espinha ilíaca ântero-superior à esquerda (p < 0,03; p = 0,001) e à direita (p < 0,02; p = 0,0001), no pós-tratamento, apresentou redução significativa quando comparada ao pré tratamento, com a variável a cinco centímetros acima da crista ilíaca esquerda e direita no pós tratamento se comparados ao pré-tratamento (p = 0,02; p = 0,04). As variáveis IMC, peso e perimetria não obtiveram diferença significativa (p > 0,05). Conclusão: O protocolo utilizado no estudo mostrou eficácia na redução da adiposidade localizada em abdômen inferior. (AU)

Introduction: Cryolipolysis and radiofrequency are among the most sought after non-invasive techniques that provide decreased adipose tissue. Objective: To evaluate the influence of the association of cryolipolysis and radiofrequency in the treatment of adiposity in the lower abdomen. Methods: Nine volunteers with adiposity in the lower abdomen, mean age of 27.44 ± 2.4 years, underwent treatment of a cryolipolysis session for 50 minutes, 40 mmHg suction, five radiofrequency sessions with multipolar tip, 30 W power, Frequency of 3 Hz continuous, temperature at 42°C, twice weekly, totaling 5 sessions, evaluated by body mass index (BMI), perimetry and adipometry. The Shapiro Wilk tests were used, followed by Student's T test for pre and post-treatment analysis (p ≤ 0.05). Results: The adipometric average below the umbilical scar and above the anterior superior iliac spine on the left (p < 0.03, p = 0.001) and right (p < 0.02, p = 0.0001), after treatment, showed a significant reduction when compared to the pre-treatment, as the variable was five centimeters above the left and right iliac crest in the post-treatment compared to the pre-treatment (p = 0.02; p = 0.04). The BMI, weight and perimetry variables did not show a significant difference (p > 0.05). Conclusion: The protocol used in the study showed efficacy in reducing localized adiposity in the lower abdomen. (AU)

A INFLUÊNCIA DA TERMOTERAPIA NO GANHO DE FLEXIBILIDADE DOS MÚSCULOS ISQUIOTIBIAIS / THE INFLUENCE OF THERMOTHERAPY IN THE FLEXIBILITY GAIN OF THE HAMSTRING MUSCLES / LA INFLUENCIA DE LA TERMOTERAPIA EN LA FLEXIBILIDAD DE LOS MÚSCULOS ISQUIOTIBIALES

RESUMO Introdução: A flexibilidade muscular é descrita como a capacidade do músculo realizar a extensão de suas fibras, influenciando a mobilidade articular. A diatermia aplicada à musculatura prepara o corpo para atividades físicas, por acelerar o metabolismo das fibras musculares e diminuir a resistência intramuscular, aumentando assim a variedade de movimento e a eficiência mecânica. A crioterapia tem diversas funções fisiológicas quando aplicada ao corpo humano, as quais, em conjunto, propiciam o relaxamento muscular. Objetivo: Avaliar o comportamento da flexibilidade dos músculos isquiotibiais frente à aplicação de alongamento passivo associado a termoterapias quente e fria. Métodos: Este estudo foi composto de 24 voluntários, de ambos os sexos, distribuídos aleatoriamente em três grupos, sendo eles: grupo alongamento passivo (G1), grupo crioterapia precedendo alongamento passivo (G2) e grupo diatermia precedendo alongamento passivo (G3). Os voluntários foram submetidos a avaliações de amplitude de movimento através da goniometria da flexão de quadril com o joelho estendido, sendo uma avaliação inicial realizada antes de iniciar o protocolo e reavaliações ao final de cada uma das quatro semanas de intervenção. Resultados: Verificou-se aumento significativo da flexão de quadril no G2 e G3 com relação ao G1. Não houve diferença estatística entre G2 e G3. Conclusão: O uso da diatermia, assim como da crioterapia, associado ao alongamento passivo é favorável para o ganho de flexibilidade muscular e, consequentemente, de amplitude de movimento em jovens saudáveis.

ABSTRACT Introduction: Muscle flexibility is described as the ability of the muscle to extend its fibers, influencing joint mobility. Diathermy applied to the muscles prepares the body for physical activity, by accelerating the metabolism of the muscle fibers and decreasing the intramuscular resistance, thereby increasing the range of motion and the mechanical efficiency. Cryotherapy has various physiological functions when applied to the human body, which, together, provide muscle relaxation. Objective: To evaluate the flexibility of hamstring muscles by applying passive stretching associated with hot and cold thermotherapy. Methods: This study consisted of 24 volunteers of both sexes randomly divided into three groups: passive stretching group (G1), cryotherapy preceding passive stretching group (G2) and diathermy preceding passive stretching group (G3). The volunteers were evaluated for range of motion by goniometry of hip flexion with the knee extended, with an initial assessment carried out before starting the protocol and revaluations at the end of each of the four weeks of intervention. Results: There was significant increase in hip flexion in G2 and G3 compared to G1. There was no statistical difference between G2 and G3. Conclusion: The use of diathermy and cryotherapy associated with passive stretching is favorable for increasing muscular flexibility and hence the amplitude of motion in healthy young adults.

RESUMEN Introducción: La flexibilidad muscular se describe como la capacidad del músculo para lograr la extensión de sus fibras, que afecta a la movilidad articular. La diatermia aplicada a los músculos prepara el cuerpo para la actividad física, mediante la aceleración del metabolismo de las fibras musculares y disminución de la resistencia intramuscular, lo que aumenta el rango de movimiento y la eficiencia mecánica. La crioterapia tiene diversas funciones fisiológicas cuando es aplicada al cuerpo humano, que, en conjunto, proporcionan la relajación muscular. Objetivo: Evaluar la flexibilidad de los músculos isquiotibiales frente a la aplicación de alongamiento pasivo asociado a termoterapia caliente y fría. Métodos: Este estudio se compone de 24 voluntarios de ambos sexos divididos aleatoriamente en tres grupos, a saber: grupo de estiramiento pasivo (G1), grupo de crioterapia antes del estiramiento pasivo (G2) y grupo de diatermia antes del estiramiento pasivo (G3). Los voluntarios fueron sometidos a evaluaciones de amplitud de movimiento a través de la goniometría de la flexión de cadera con la rodilla extendida, siendo una evaluación inicial realizada antes de iniciar el protocolo y reevaluaciones al final de cada una de las cuatro semanas de intervención. Resultados: No hubo aumento significativo de la flexión de la cadera en G2 y G3 en comparación con G1. No hubo diferencia estadística entre G2 y G3. Conclusión: El uso de diatermia y crioterapia asociado con el estiramiento pasivo es favorable para aumentar la flexibilidad muscular y por lo tanto el rango de movimiento en adultos jóvenes sanos.