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Introdução: Síndrome da Pessoa Rígida (SPR) é uma doença neurológica autoimune rara caracterizada pela rigidez e espasmos musculares episódicos dolorosos, especialmente no tronco e extremidades do corpo, gerando comprometimento funcional importante. Existe uma lacuna de conhecimento sobre os possíveis efeitos do tratamento manipulativo osteopático (TMO) nos sintomas motores de pessoas com SPR. Objetivos: Descrever os efeitos do TMO na tontura, equilíbrio e amplitude de movimento (ADM) cervical em uma pessoa com a SPR e miastenia gravis. Método: Relato de caso baseado no TMO em uma mulher com SPR e miastenia grave. As seguintes avaliações foram utilizadas: Inventário de Brazilian Version of the Dizziness Handicap Inventory (DHI), Fall Efficacy Scale (FES I Brazil), Timed Get Up and Go Test (TUG), Teste de Sentar e Levantar 5 vezes, goniometria dos movimentos da coluna cervical. Resultados: Nenhum resultado expressivo foi obtido pela FES-I (-1,8%) e DHI (0%). Para os testes funcionais (TUG e Sentado para de pé 5 vezes) observamos melhora de 5,8% e 6,7%, respectivamente, após o tratamento. A ADM cervical melhorou substancialmente em todos os movimentos avaliados (flexão: 60%, extensão: 28%, rotação direita: 33%, rotação esquerda:38%, inclinação lateral direita: 77%, inclinação lateral esquerda: 87%). Conclusão: O TMO proposto pareceu ser importante para melhora da ADM cervical no caso relatado. Medo de quedas, impacto da tontura na qualidade de vida e funcionalidade de membros inferiores não demonstrou melhoras após o TMO.
Introduction: Stiff Person Syndrome (SPS) is a rare neurological autoimmune disease characterized by stiffness and painful episodic muscle spasms, especially in the trunk and extremities of the body, causing significant functional impairment in affected individuals. There is a gap in knowledge about the possible effects of an osteopathic manipulative treatment (OMT) on the motor symptoms of people with SPS. Objectives: To describe the effects of an OMT on dizziness, balance deficit, and cervical range of motion (ROM) in a patient with SPS and myasthenia gravis. Methods: This is a case report on an OMT intervention in a woman with SPS and myasthenia gravis. The following assessments were used: Brazilian Version of the Dizziness Handicap Inventory (DHI), Fall Efficacy Scale (FES I Brazil), Timed Get Up and Go Test (TUG), Stand Up Test 5 times, goniometry of cervical movements. Results: No expressive results were obtained for FES I Brazil (-1.8%) and DHI (0%). For the functional tests (TUG and Sit and stand up 5x) we observed an improvement of 5.8% and 6.7%, respectively, after treatment. The cervical ROM improved substantially in all movements tested (flexion: 60%, extension: 28%, right rotation: 33%, left rotation: 38%, right side bending: 77%, left side bending: 87%). Conclusion: The proposed OMT appears to be important for the improvement of cervical ROM in this case. Fear of falls, impact of dizziness on quality of life, and lower limb functionality did not demonstrate meaningful improvements after the OMT.
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Urinary retention is a common complication of bedridden patients in traumatic orthopedics. The severe condition can even cause permanent bladder injury and renal failure, which brings great pain and psychological pressure to patients and seriously hinders their rehabilitation. The traditional Chinese medicine appropriate technologies have the characteristics of safety, effectiveness, low cost, simplicity and easy learning and achieve good clinical effects in the prevention and treatment of bedridden patients with urinary retention in traumatic orthopaedics, including Chinese herbal medicine, acupuncture and moxibustion, massage, etc. The authors summarize the research progress in appropriate technologies of traditional Chinese medicine in the prevention and treatment of bedridden patients with urinary retention in traumatic orthopedics from aspects of action principles, operation methods and effects of acupuncture points, moxibustion therapy, manipulation therapy, external treatment of traditional Chinese medicine and acupoint injection, so as to provide a reference for further nursing research and clinical application.
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OBJECTIVE@#To explore the clinical efficacy and safety of manual therapy combined with posterior percutaneous endoscopic cervical decompression(PECD) in the treatment of intractable cervical spondylotic radiculopathy.@*METHODS@#From May 2016 to May 2018, 23 CSR patients who responded poorly to conservative treatment for at least 6 weeks underwent the combination management. Firstly, the patients received the posterior percutaneous endoscopic cervical decompression routine care for the following 4 weeks and manual therapy for another 4 weeks. A total of 23 patients were followed up, including 14 males and 9 females, the age ranged from 29 to 78 years old with an average of (50.30±12.28) years, the course of disease was 3 to 24 months with an average of (9.74±5.76) months. The lesion segment involved C4,5 in 4 cases, C5,6 in 13 cases, C6,7 in 6 cases. The visual analogue scale (VAS), neck disability index (NDI), changes of cervical physiological curvature and interbody stability, adverse events were observed before and after operation. The follow-up time points were before operation, 1 day after operation and 1, 3 and 6 months after operation.@*RESULTS@#All patients successfully completed the operation and manual treatment for 4 to 8 times. Among the 29 cases, 23 patients were followed up for more than 6 months. There was no spinal cord and nerve root injury during the treatment and follow-up. Operation time was from 80 to 120 min with a median of 90 min;intraoperative blood loss was from 35 to 80 ml with a median of 50 ml. NDI, VAS of neck, shoulder and arm each period after operation were significantly lower than those before PECD(P<0.05), while there were no significant improvement in cervical physiological curvature and target segment intervertebral space height(P>0.05);there was no significant change in interbody stability (P>0.05). After received the manual therapy, NDI significantly decreased (P<0.05), however, there was no significant difference in VAS of neck, shoulder and arm, physiological curvature of cervical spine and intervertebral space height of target segment compared with that before manual treatment (P>0.05);there was no significant change in interbody stability (P>0.05).@*CONCLUSION@#Manual therapy combined with PECD in the treatment of intractable cervical spondylotic radiculopathy can not only quickly improve the symptoms, but also alleviate the residual symptoms after PECD safely and effectively, and can not cause obvious signs of accelerated instability of cervical adjacent segments in the short term.
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Child , Child, Preschool , Female , Humans , Male , Cervical Vertebrae/surgery , Decompression/adverse effects , Musculoskeletal Manipulations , Radiculopathy/surgery , Retrospective Studies , Spondylosis/surgery , Treatment OutcomeABSTRACT
BACKGROUND: Low back pain is one of the common orthopedic diseases, and nonspecific low back pain accounts for a very large proportion of all low back pains in clinic. In order to better treat the disease, in 2016, the American Orthopaedic Association developed a clinical guide for the osteopathic manipulative treatment of nonspecific low back pain. OBJECTIVE: To let orthopedic doctors, other doctors, other health professionals and third-party payers know the evidence of potential suggestions on the proper use of osteopathic manipulative treatment, so as to help clinical orthopedists to provide therapeutic reference for non-specific low back pain as well as to learn from the scientific and rigorous design ideas and evaluation methods in the guides. METHODS: The guideline is a revised version based on the previous guideline and the latest high-quality meta-analyses. It is determined that osteopathic manipulative treatment is an effective treatment for nonspecific low back pain with clear recommended level. In this paper, the definition, evaluation methods, specific contents of the guideline and results of evidence-based medicine regarding the clinical practice in China were analyzed and discussed. RESULTS AND CONCLUSION: Seventeen studies were included in the guidelines, which systematically evaluated the effect of osteopathic manipulative treatment for acute and chronic nonspecific low back pain, as well as for nonspecific low back pain in pregnant and postpartum women. After treatment, great improvement was achieved in pain relief and functional recovery. The final suggestion by the American Orthopaedic Association is to use osteopathic manipulative treatment for low back pain. The treatment method is safe and scientific, which can be generalized in China.
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Background:The aim of this paper is to introduce and evaluate the RSP design with two interventional and one response variable exemplified by estimating minimum efficacy dose (MED) of osteopathic manual therapy (OMT) in treatment of gastroesophageal reflux disease (GERD).Methods:15 GERD patients, divided in three design-level with three, five and seven patients. The study was performed as a randomized two-dimensional, between-patient RSP designed multicenter study with two interventional–and one response variable. The interventional variables “Number of OMT’s” and “Treatment Interval” with common response variable, formed two independent one-dimensional randomized between-patient RSP studies. The response variable was percent reduction in sum of the five GERD score from baseline. Three GERD patients were allocated on the first design level and given six OMT with five days’ interval. Based on results obtained in the first and second design level, five patients were included to the second design level and seven to the third.Results:The two-dimensional randomized between-patient RSP-design with the combined outcome procedure worked as expected. The percent reduction in GERD score increased with increasing number of OMT’s and time intervals. This increase leveled out after three to five OMT’s and three to four days between treatments. A clinical interaction between the two interventional variables was obtained. The estimated MED of OMT in treatment of GERD was three treatments with two days between treatments.Conclusions: The suggested two-dimensional, randomized between-patient RSP-design worked as expected and estimated MED of OMT in GERD patient sufficiently
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Objective@#To investigate the effect of peripheral nerve block combined with venous fast track anesthesia on elderly patients undergoing lower extremity orthopedic surgery.@*Methods@#From September 2015 to December 2017, 64 senile patients with lower extremity orthopedic surgery in the Fifth Hospital of Ningbo were selected in the research.According to the different methods of anesthesia, the patients were divided into observation group (30 cases, application of combined intravenous peripheral nerve block and fast track anaesthesia), and the control group (34 cases, application of simple intravenous general anesthesia). The heart rate, average arterial pressure, spontaneous breathing recovery time, extubation time, complication rate and cognitive function scores of the two groups were compared.@*Results@#The heart rate and average arterial pressure of T1 and T3 in the observation group were significantly lower than those in the control group (P<0.05). The spontaneous breathing recovery time[(8.32±3.26)min] and extubation time[(9.69±4.29)min] in the observation group were significantly shorter than those in the control group[(18.24±5.23)min and (27.24±4.58)min](t=8.961, 15.756, all P<0.05). The incidence rate of postoperative complications in the observation group (3.33%) was significantly lower than that in the control group (20.59%)(χ2=4.338, P<0.05). The cognitive function score of the observation group was significantly higher at 4 h and 8 h after surgery than that of the control group (t=6.745, 8.494, all P<0.05).@*Conclusion@#Peripheral nerve block combined with intravenous fast-track anesthesia is very feasible for elderly patients undergoing lower limb orthopedic surgery.The time for patients to recover from spontaneous breathing and extubation is shorter, and the risk of complications such as delirium, restlessness, nausea and vomiting is lower.
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With the traffic accident,sudden disaster and safety accidents occur year after year,the injured patients often complicated with multiple injuries,how to maximize the treatment of the injury to improve the survival rate,is an important problem faced by orthopedic surgeons.In recent years,damage control orthopaedics (DCO)technology has been gradually developed,DCO aims to control the patients'primary injury,to prevent further deterioration of the disease,compared with the traditional treatment,it can effectively reduce the second strike and complications,is conducive to the recovery of patients.In this paper,the development of DCO concept,the theoretical basis of DCO,the adaptation of DCO,the implementation steps of DCO and the best time,the application of DCO in the treatment of severe multiple injuries and the prospect of DCO application are reviewed.
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Objective To explore the effect of trauma control concept on severe multiple injuries.Methods From March 2016 to March 2018,74 emergency patients with severe multiple injuries were selected in Yiwu Central Hospital.The patients were divided into the observation group and the control group according to the digital table method,with 37 cases in each group.The control group was treated with one-time surgical treatment,and the observation group was given treatment measures for severe multiple trauma in emergency department under the concept of trauma control.The recovery time of body temperature,the recovery time of prothrombin (PT),the time of shock correction,the occurrence of complications,and the therapeutic effect were compared between the two groups.Results The body temperature recovery time,PT recovery time and shock correction time in the observation group were (6.73 ± 3.29) h,(5.18 ± 1.89) h and (5.84 ± 3.14) h,respectively,which were shorter than those in the control group [(9.85 ± 1.62) h,(9.86 ± 2.41) h,(8.45 ± 0.87) h],and the differences were statistically significant (t =5.175,9.295,4.873,all P ＜0.05).The incidence rate of complications in the observation group was 8.11％ (3/37),which was lower than that in the control group [32.43％ (12/37)],the difference was statistically significant(x2 =6.773,P ＜ 0.05).The cure rate of the observation group was 97.30％ (36/37),which was higher than that of the control group [91.89％ (34/37)],but there was no statistically significant difference (P ＞ 0.05).Conclusion The treatment effect of severe multiple injuries under the concept of trauma control is obvious.It is an effective and feasible method,which can effectively reduce the complications and fatality rate.
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With the traffic accident, sudden disaster and safety accidents occur year after year, the injured patients often complicated with multiple injuries, how to maximize the treatment of the injury to improve the survival rate, is an important problem faced by orthopedic surgeons.In recent years, damage control orthopaedics (DCO) technology has been gradually developed, DCO aims to control the patients' primary injury, to prevent further deterioration of the disease, compared with the traditional treatment, it can effectively reduce the second strike and complications, is conducive to the recovery of patients.In this paper, the development of DCO concept, the theoretical basis of DCO, the adaptation of DCO, the implementation steps of DCO and the best time, the application of DCO in the treatment of severe multiple injuries and the prospect of DCO application are reviewed.
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OBJECTIVE@#To explore the clinical efficacy of exercise acupuncture and osteopathy in the treatment of traumatic knee arthritis.@*METHODS@#Fifty-one patients with traumatic knee arthritis were divided into three groups:routine group, exercise acupuncture group and osteopathy group. In the routine group, there were 17 cases, 12 males and 5 females, with a mean age of (49.4±8.9) years old; the averaged course of disease was (4.89±1.52) years; total WOMAC score before treatment was 100.77±15.48. Seventeen patients (11 males and 6 females) in the exercise acupuncture group were aged (48.6±10.1) years old; the course of disease was (4.21±1.37) years; and the total WOMAC score before treatment was 106.16±14.95. In the osteopathy group, there were 17 cases, 8 males and 9 females, with a mean age of (52.3±8.4) years old; the average course of disease was (4.79±1.50) years; total WOMAC score before treatment was 103.87±10.14. The patients in the routine group were treated with routine rehabilitation; the patients in the exercise acupuncture group were treated with routine rehabilitation combined with exercise acupuncture, and the patients in the osteopathy group were treated with osteopathy combined with routine rehabilitation. The changes of WOMAC score and ROM in three groups were compared before treatment and 4 weeks after treatment.@*RESULTS@#The overall effect of osteopathy group was better than that of routine group (=3.151, =0.005). The scores of WOMAC before and after treatment:pain of 23.84±4.66, 11.98±2.66, stiffness of 10.44±1.71, 6.42±0.74, daily life of 66.49±11.85, 35.80±4.44 in the routine group; pain of 22.64±3.22, 8.90±2.19, stiffness of 11.82±2.57 , 6.03±1.06, daily life of 71.72±13.59, 32.94±4.73 in the exercise acupuncture group; pain of 22.38±3.68, 10.66±2.75, stiffness of 11.81±2.08, 5.63±1.69, daily life of 69.69±8.96, 28.84±5.76 in the osteopathy group. Compared with the other two groups after treatment, the improvement of pain score in the exercise acupuncture group was better than those in the other two groups. There were no significant differences in stiffness score among the three groups. The degree of difficulty in daily life in the osteopathy group was better than that in the other two groups. The total score of WOMAC in the exercise acupuncture group and the osteopathy group were better than that in the conventional group, but there was no significant difference between the two groups.@*CONCLUSIONS@#On the basis of routine rehabilitation treatment, exercise needling and osteopathy have positive significance for the improvement of joint pain and dysfunction of joint movement in patients with traumatic knee arthritis, with certain popularlized value in the treatment of traumatic knee arthritis.
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Adult , Female , Humans , Male , Middle Aged , Acupuncture Therapy , Arthralgia , Knee Joint , Osteoarthritis, Knee , Therapeutics , Pain Measurement , Treatment OutcomeABSTRACT
Objective To analyze the application effect of nursing intervention under the guidance of pain care quality in pain management of patients undergone orthopedic surgery, and to provide reference for the standardized management of pain in patients undergone orthopedic surgery. Methods A total of 124 cases of patients who were to undergo orthopedic surgery and admitted to hospital from January 2015 to June 2016 were selected as the research objects,and divided into the observation group and the control group using the random number table method,with 62 cases in each group.Patients in the control group were performed routine pain nursing intervention after orthopedic surgery, including pain propaganda and education, pain prevention and pain symptomatic treatment. Patients in the observation group were performed nursing intervention under the guidance of pain nursing quality indexes.The pain related indicators, pain nursing quality related indexes and pain related complications of patients in the two groups were compared. Results The scores of visual analogue scale(VAS)0 d,1 d and 3 d after the operation in the observation group were respectively 2.82 ± 0.42, 2.45 ± 0.40 and 1.85 ± 0.32, the corresponding scores in the control group were respectively 4.14±0.56,3.25±0.52 and 2.21±0.36,and the difference between the two groups was statistically significant (t=14.848, 9.601, 5.885, P<0.05 or 0.01). The sleep hours 0d,1d and 3d after the operation in the observation group were respectively(5.16±0.71)h, (6.01 ± 0.82)h and (6.84 ± 1.02) h, the corresponding sleep hours in the control group were respectively (4.12±0.62)h,(4.65±0.72)h and(6.01±0.75)h,and the difference between the two groups was statistically significant (t=8.689, 9.613, 5.162, P<0.05 or 0.01). The unplanned anesthetic medication times in the observation group and the control group were respectively(2.32±0.45)times and(3.45±0.56)times,and the difference between the two groups was statistically significant (t=12.385, P<0.01). The observation timeliness rate,nursing record pass percent,pain intervention effective rate and management satisfaction degree in the observation group were respectively 98.39%(61/62), 96.77%(60/62), 96.77%(60/62) and 96.77%(60/62),the corresponding values in the control group were respectively 88.71%(55/62),87.10% (54/62), 85.48%(53/62)and 87.10%(54/62). The difference between the two groups was statistically significant (χ2=4.810, 3.916, 4.888, 3.916, all P<0.05). The incidence rates of delayed incision healing, insomnia and constipation in the observation group were respectively 0,9.68%(6/62)and 1.61%(1/62), the corresponding incidence rates in the control group were respectively 6.45%(4/62), 24.19%(15/62) and 11.29%(7/62), and the difference between the two groups was statistically significant(χ2=4.133, 4.644, 4.810, all P<0.05). Conclusions Nursing intervention under the guidance of pain care quality can help alleviate the pain degree of patients undergone orthopedic surgery, improve the sleep quality, reduce postoperative complications and enhance the management level of pain nursing.
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Objective To analyze the early diagnosis ,treatment methods and effect of pulmonary embolism in Department of Traumatic Orthopedics .Methods From October 2014 to October 2016, 100 patients with pulmonary embolism in trauma department of orthopedics of Datong Coal Group Co three hospital were selected as the research subjects.Combined with the basic data of patients and clinical manifestations ,the early diagnosis and clinical features were summarized.The chronic respiratory questionnaire(CRQ) and quality of life assessment table(QOL) were used to evaluate the respiratory status and living quality of the patients before and after treatment .At the same time, according to the different treatment methods , the effect of simple anticoagulant or combined with thrombolytic was compared.Results Before treatment,the CRQ total score,QOL total score were (5.9 ±1.3) points,(65.78 ± 23.91)points,respectively,which after treatment were (3.1 ±0.7) points,(30.92 ±13.45) points,respectively,the differences were statistically significant ( t =11.931, 20.104, all P <0.05 ).In 100 patients, after treated by anticoagulation alone or combined with anticoagulation and thrombolytic therapy ,there were significantly effective in 54 cases,effective in 33 cases,invalid in 9 cases,and 4 cases died,the total effective rate was 87.00％.The total effective rate of anticoagulant therapy was 81.58％,which of anticoagulation combined with thrombolytic therapy was 90.32％,the difference was not statistically significant (χ2 =1.593,P>0.05).Conclusion In the perioperative period of Department of Traumatic Orthopedics , pulmonary embolism should be timely diagnosed , and reasonable treatment can improve the respiratory function and life quality of patients ,anticoagulation combined with thrombolytic therapy can improve the efficacy.
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Objective To investigate the effect of stellate ganglion block ( SGB ) on early postoperative cognitive function in elderly patients undergoing orthopedic surgery .Methods 115 elderly patients with orthopedic surgery were selected as study objects ,and they were randomly divided into observation group (55 cases) and control group(60 cases) according to the digital table .The observation group received epidural anesthesia after SGB ,while the control group only received routine epidural anesthesia .Preoperation and postoperative 6h,3d and 7d,the mini mental state examination ( MMSE ) scores were measured and compared , the cognitive function was assessed .The MMSE score and postoperative cognitive dysfunction ( POCD) occurrence before and after surgery in the two groups were compared.Results In the observation group,the preoperative MMSE score was (29.36 ±2.54) points,the MMSE scores of 6h,3d and 7d after operation were (22.69 ±3.01) points,(25.33 ±2.69) points,(28.32 ± 3.04)points,respectively.The difference between preoperation and postoperation was statistically significant ( F =51.26,P <0.05).In the control group,the MMSE scores of before surgery and 6h,3d,7d after surgery were (29.69 ±2.17)points,(20.24 ±3.59)points,(21.87 ±2.02)points and (27.66 ±3.07)points,respectively,the difference was statistically significant (F=103.70,P<0.05).Before surgery,the MMSE score between the observa-tion group and control group had no statistically significant difference .6h and 3d after surgery,the MMSE scores of the observation group were higher than those of the control group (t=3.947,7.745,all P<0.05);7d after operation,the MMSE score between the two groups had no statistically significant difference (P>0.05).6h after surgery,the inci-dence rate of POCD of the observation group was 3.64％,which of the control group was 11.67％.3d after operation, the incidence rate of POCD was 1.82％ in the observation group and 3.33％ in the control group.There was no statistically significant difference in the incidence of POCD between the two groups at 6 and 3d after operation ( P>0.05).7d after operation,POCD was not detected in the observation group ,and the incidence rate of the control group was 3.33％.The total incidence rate of POCD was 5.45％ in the observation group and 18.33％ in the control group,and the incidence rate of the observation group was lower (χ2 =4.452,P<0.05).Conclusion SGB can improve the cognitive function of elderly patients after orthopedic surgery ,and it is worthy of clinical recommendation .
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PURPOSE: Peer assessment provides a framework for developing expected skills and receiving feedback appropriate to the learner's level. Near-peer (NP) assessment may elevate expectations and motivate learning. Feedback from peers and NPs may be a sustainable way to enhance student assessment feedback. This study analysed relationships among self, peer, NP, and faculty marking of an assessment and students' attitudes towards marking by those various groups. METHODS: A cross-sectional study design was used. Year 2 osteopathy students (n=86) were invited to perform self and peer assessments of a clinical history-taking and communication skills assessment. NPs and faculty also marked the assessment. Year 2 students also completed a questionnaire on their attitudes to peer/NP marking. Descriptive statistics and the Spearman rho coefficient were used to evaluate relationships across marker groups. RESULTS: Year 2 students (n=9), NPs (n=3), and faculty (n=5) were recruited. Correlations between self and peer (r=0.38) and self and faculty (r=0.43) marks were moderate. A weak correlation was observed between self and NP marks (r=0.25). Perceptions of peer and NP marking varied, with over half of the cohort suggesting that peer or NP assessments should not contribute to their grade. CONCLUSION: Framing peer and NP assessment as another feedback source may offer a sustainable method for enhancing feedback without overloading faculty resources. Multiple sources of feedback may assist in developing assessment literacy and calibrating students' self-assessment capability. The small number of students recruited suggests some acceptability of peer and NP assessment; however, further work is required to increase its acceptability.
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Humans , Australia , Cohort Studies , Cross-Sectional Studies , Educational Measurement , Learning , Literacy , Methods , Osteopathic Medicine , Peer Review , Self-AssessmentABSTRACT
Introdução: a constipação intestinal é considerada uma doença funcional do intestino, caracterizada por uma desordem da motilidade gastrointestinal e por evacuações difíceis ou diminuídas. O tratamento e a prevenção devem ser individualizados, considerando as orientações comportamentais, além da possível intervenção farmacológica ou de terapias complementares como a osteopatia. Objetivos: revisar a literatura sobre os efeitos do tratamento osteopático na constipação intestinal. Metodologia: a pesquisa da literatura foi realizada nas bases de dados eletrônicas Portal CAPES, Bireme, Cochrane Library, Lilacs, Medline, PubMed e Scielo. Os 112 estudos utilizados nesta pesquisa seguiram os seguintes critérios de inclusão: publicações no período de 1989 a 2017; escritos em português, inglês e espanhol; artigos apresentados na íntegra, sem restrições sobre o tipo de estudo ou amostra. Resultados: a abordagem osteopática aplicada no tratamento da constipação tem como objetivo a melhora do funcionamento do intestino, influenciando o tônus do músculo liso e a mobilidade visceral, melhorando a função gastrointestinal e, indiretamente, normalizando o suprimento nervoso autossômico para a víscera. A fáscia é formada por uma matriz intracelular tridimensional de contiguidade, rica em mecanorreceptores, envolvendo e protegendo os tecidos e órgãos do corpo. Assim, resultados obtidos após a realização de técnicas osteopáticas, possivelmente, são compreendidos pelas propriedades mecânicas, autonômicas e neuromusculares. Conclusão: a osteopatia é um tratamento complementar para a constipação intestinal, melhorando os sintomas, reduzindo a gravidade dos quadros, diminuindo o tempo do trânsito colônico, aumentando a motilidade intestinal e a qualidade de vida dos pacientes.
Introduction: the intestinal constipation is considered a functional bowel disease, characterized by a gastrointestinal motility disorder and difficult or reduced evacuation. The treatment and prevention must be individualized, taking into consideration the behavioral orientation, besides a possible pharmacological intervention or complementary therapies such as osteopathy. Objective: review the literature on the effects of osteopathic treatment in intestinal constipation. Methodology: the research on literature was done using database of Portal CAPES, Bireme, Cochrane Library, Lilacs, Medline, PubMed and Scielo. The 112 studies used in this research followed these criteria of inclusion: publications from 1989 to 2017, in Portuguese, English and Spanish; articles presented in full, with no restrictions about the type of study or sample. Results: the osteopathic approach applied in the constipation treatment aims at a better functioning of the intestine, influencing the smooth muscle tonus and visceral mobility, thus improving the gastrointestinal function and indirectly normalizing the autosomal nervous supply for the viscera. A three-dimensional intracellular matrix forms the fascia in contiguity, which is abundant in mechanoreceptors, covering and protecting the tissues and organs in the body. Therefore, the results obtained after performing the osteopathic techniques are possibly understood by the mechanical, autonomic and neuro- muscular proprieties. Conclusion: osteopathy is a complementary treatment for intestinal constipation, improving the symptoms, reducing the severity of the condition, decreasing the time of colon transit and increasing the intestinal motility as well as the patients quality of life.
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Humans , Male , Female , Osteopathic Medicine , Treatment Outcome , Constipation , Constipation/physiopathology , Manipulation, Osteopathic , FasciaABSTRACT
Abstract Introduction: The high demand level in sports has encouraged the search for strategies to increase the yield. In this context, manual therapy through high-velocity low-amplitude (thrust) has been employed in many sports. Despite the adhesion of manual therapists in clinical practice, there were no systematic reviews on this topic. Objective: To evaluate the effects of thrust on the performance of athletes in relation to the outcomes hand-grip strength, jump height and running speed. Methods: The databases used in the search were MEDLINE / PUBMED, LILACS, CINAHL, PEDro, WEB OF SCIENCE, CENTRAL and SCOPUS, and Randomized controlled trials were included, whose participants were professionals or recreational athletes and had thrust as intervention. The methodological quality of the studies was assessed using the PEDro scale of 10 points. Intervention effects were determined by the mean difference and confidence interval. The data analysis was done in the descriptive form due to the heterogeneity found among studies. Results: Five trials were included with a total of 95 individuals. The methodological quality of studies was low, with an average value of 5.6 on the PEDro scale. It was found two articles for each outcome, but in none of them was presented differences between the experimental and control groups considering the confidence interval. Conclusion: The current evidence is insufficient to determine the use or nonuse the MAVBA in sports in order to improve performance.
Resumo Introdução: O elevado nível de exigência no meio esportivo tem incentivado a busca por estratégias para aumentar o rendimento. Nesse contexto, a terapia manual através da Manipulação em Alta e Velocidade e Baixa Amplitude (MAVBA) tem sido empregada em vários esportes. Apesar da adesão dos terapeutas manuais na prática clínica, não foram encontradas revisões sistemáticas acerca do tema. Objetivo: Avaliar os efeitos da manipulação de alta velocidade e baixa amplitude sobre o desempenho de atletas. Métodos: As bases de dados utilizadas na busca foram MEDLINE/PUBMED, LILACS, CINAHL, PEDro, WEB OF SCIENCE, CENTRAL e SCOPUS. Foram incluídos Ensaios Randomizados e Controlados, cujos participantes eram atletas profissionais ou recreacionais, que aplicaram a MAVBA como intervenção. A qualidade metodológica dos estudos foi avaliada por meio da Escala PEDro. Os efeitos da intervenção foram determinados através da diferença de média e do respectivo intervalo de confiança (IC). A análise dos dados foi realizada de maneira descritiva, em virtude da heterogeneidade encontrada entre os estudos. Resultados: Cinco ensaios foram incluídos com um total de 95 indivíduos. A qualidade metodológica dos estudos foi baixa, com uma média de 5.6 na Escala de PEDro. Foram encontrados dois artigos para cada desfecho, e em nenhum deles foi detectada diferença entre o grupo experimental e controle quando levado em consideração o IC. Conclusão: A evidência atual é insuficiente para determinar o uso ou o não uso da MAVBA em com objetivo de melhorar o desempenho esportivo.
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Clinical reasoning is situation-dependent and case-specific; therefore, assessments incorporating different patient presentations are warranted. The present study aimed to determine the reliability of a multi-station case-based viva assessment of clinical reasoning in an Australian pre-registration osteopathy program using generalizability theory. Students (from years 4 and 5) and examiners were recruited from the osteopathy program at Southern Cross University, Lismore, Australia. The study took place on a single day in the student teaching clinic. Examiners were trained before the examination. Students were allocated to 1 of 3 rounds consisting of 5 10-minute stations in an objective structured clinical examination-style. Generalizability analysis was used to explore the reliability of the examination. Fifteen students and 5 faculty members participated in the study. The examination produced a generalizability coefficient of 0.53, with 18 stations required to achieve a generalizability coefficient of 0.80. The reliability estimations were acceptable and the psychometric findings related to the marking rubric and overall scores were acceptable; however, further work is required in examiner training and ensuring consistent case difficulty to improve the reliability of the examination.
Subject(s)
Humans , Australia , Osteopathic Medicine , Physical Examination , Psychometrics , Reproducibility of ResultsABSTRACT
Objective To investigate the clinical efficacy of electroacupuncture plus osteopathic manipulation in treating thoracic facet joint disorder.Methods Sixty patients with thoracic facet joint disorder were randomly allocated to treatment and control groups, 30 cases each. The treatment group received electroacupuncture plus osteopathic manipulation and the control group, osteopathic manipulation alone. Treatment was given 15 days as a course for a total of two courses. The pain rating index (PRI) score, the visual analogue scale (VAS) score and the Present Pain Intensity (PPI) scale score were recorded in the two groups before and after treatment. The clinical therapeutic effects were compared between the groups.Results The cure rate and the total efficacy rate were 43.3% and 90.0%, respectively, in the treatment group and 26.7% and 73.3%, respectively, in the control group; there were statistically significant differences between the two groups (P<0.05). There were statistically significant pre-/post- treatment differences in the PRI score, the VAS score and the PPI score in the two groups (P<0.05). There were statistically significant post-treatment differences in the PRI score, the VAS score and the PPI score between the treatment and control groups (P<0.05).Conclusion Electroacupuncture plus osteopathic manipulation is an effective way to treat thoracic facet joint disorder.
ABSTRACT
Objective To improve the usage of foam dressing at the sacrococcygeal region and observe its application effect. Methods A total of 80 hospitalized patients with high risk of pressure ulcer were chosen during May to December 2015 as study objects. Patients were drawn into the observation group and the control group, each group contained 40 members. Proper-cutting foam dressings and normal foam dressing were applied in patients by the observation group and the control group individually. Researchers made records by comparing and analyzing the usage time of dressing and the skin intact of two groups. Results The observation group used foam dressing (1.88±0.12) blocks per person, foam dressing use time was (3.87±0.34) d per block, and in the control group, they were (2.60±0.38) blocks per person, (2.13±0.89) d per block, there was significant difference between two groups (t=11.427, 11.551, P<0.05). The skin integrity rate of the observation group and the control group were 95.0%(38/40) and 75.0%(30/40), the difference was statistically significant (χ2=6.275, P<0.05). Conclusions This study shows that the foam dressing need to be cut appropriately before pasting so that the clinical nurses can observe patient's skin conveniently. Once the skin has pressure red, the nurse can take timely measures to deal with it, which can decrease the incidence of pressure sores. The cutting dressing prolongs the period of using without removing the viscose part, which also can reduce the medical expenses.
ABSTRACT
We constructed a home care platform for orthopedics,and clinical nurse specialists in orthopedics in Jiangsu Province opened online clinics on it.Patients with knee or hip joint replacement could be added to the platform,and the clinical nurse specialists provided patients with professional home care service when discharged.In the interviews of clinical nurse specialists,they said that the application of the platform was conducive to enhance their own values,and expressed their willingness to continue to use it.The joint function and quality of life scores of the intervention group were significantly higher than those of the control group (P＜0.001).The application of the home care platform is conducive to give full play to the role of clinical nurse specialists to provide professional home care services for patients.