Assessment and indicators of kinematic behavior and perceived fatigability

SUMMARY OBJECTIVE: The objective of this study was to investigate the relationship between upper limb kinetics and perceived fatigability in elderly individuals during an upper limb position sustained isometric task. METHODS: A total of 31 elderly participants, 16 men (72.94±4.49 years) and 15 women (72.27±6.05 years), performed a upper limb position sustained isometric task. Upper-limb acceleration was measured using an inertial measurement unit. Perceived fatigability was measured using the Borg CR10 scale. RESULTS: Higher mean acceleration in the x-axis throughout the activity was associated with higher final perceived fatigability scores. Moderate correlations were observed between perceived fatigability variation and mean acceleration cutoffs in all axes during the second half of the activity. In women, significant correlations were found between all perceived fatigability cutoffs and mean acceleration in the y- and x-axes. However, in men, the relationships between perceived fatigability variation and mean acceleration were more extensive and stronger. CONCLUSION: The acceleration pattern of the upper limb is linked to perceived fatigability scores and variation, with differences between sexes. Monitoring upper limb acceleration using a single inertial measurement unit can be a useful and straightforward method for identifying individuals who may be at risk of experiencing high perceived fatigability or task failure.

Post-COVID-19 functional capacity assessed with ring and walk tests: cross-sectional study / Capacidade funcional pós-COVID-19 com teste de argola e de caminhada: estudo transversal

Abstract Introduction COVID-19 can cause persistent symptoms even in mild cases, such as fatigue and dyspnea, which can reduce functional capacity and make it difficult to perform activities of daily living. Objective To compare functional capacity using the pegboard and ring test and the six-minute walk test responses in post-COVID-19 patients according to the ventilatory support used. Methods Cross-sectional study including 40 adults of both sexes after SARS-CoV2 infection between June 2020 and June 2021, with assessment of functional capacity using the pegboard and ring test (upper limbs) and the six-minute walk (lower limbs). Those who reported comprehension deficit or neuromuscular disease were excluded. All participants were evaluated between 15 and 90 days after the onset of symptoms, diagnosed by nasal swab and classified according to the ventilatory support used during the infection. Results The mean age of the participants (n = 40) was 54.30 (±12.76) years, with BMI 28.39 (±4.70) kg/m2 and pulmonary involvement in 51.49 (±17.47)%. A total of 37 participants were hospitalized with a stay of 14.33 (±15.44) days, and 30% were previously immunized, while 7.5% reached the predicted distance covered. The average achieved was 46.44% (398.63 ± 130.58 m) in the distance covered and 39.31% (237.58 ± 85.51) in the movement of rings. Participants who had invasive mechanical ventilation (n = 10) had the worst functional capacity in both tests 265.85 ± 125.11 m and 181.00 ± 90.03 rings, compared to 472.94 ± 88.02 m and 273.25 ± 66.09 rings in non-invasive ventilation (n = 8), 410.32 ± 90.39 m and 257.68 ± 62.84 rings in oxygen therapy (n = 19), 569.00 ± 79.50 m and 203.00 ± 169.00 rings when there was no hospitalization (n = 3). Conclusion Participants who required invasive mechanical ventilation had worse functional capacity, 46% of what was expected in the walk test and 39% of what was expected in the pegboard and ring test.

Resumo Introdução A COVID-19 pode causar sintomas per-sistentes mesmo nos casos leves, como fadiga e dispneia, que podem reduzir a capacidade funcional e a realização das atividades de vida diária. Objetivo Comparar a avaliação da capacidade funcional a partir do teste da argola e caminhada dos 6 minutos pós-COVID-19 con-forme o suporte ventilatório utilizado. Métodos: Estudo transversal com 40 adultos, de ambos os sexos, pós-infecção por SARS-CoV2 entre julho/2020 e julho 2021, com avaliação da capacidade funcional pelos testes da argola (membros superiores) e caminhada (membros inferiores) de 6 minutos. Todos os participantes foram avaliados entre 15 e 90 dias do princípio dos sintomas, diagnosticados por swab nasal, e classificados conforme o suporte ventilatório utilizado durante a infecção. Resultados A média de idade dos participantes (n = 40) foi 54,30 (±12,76) anos, índice de massa corporal 28,39 (±4,70) kg/m2 e acometimento pulmonar em vidro fosco 51,49 (±17,47)%. Trinta e sete participantes foram hospitalizados com permanência de 14,33 (±15,44) dias, 30% previamente imunizados; 7,5% atingiram o predito da distância percorrida. A média alcançada foi de 46,44% (398,63 ± 130,58 m) na distância percorrida e 39,31% (237,58 ± 85,51) em movimento de argolas. Os participantes que utilizaram ventilação mecânica invasiva (n = 10) apresentaram pior capacidade funcional em ambos os testes: 265,85 ± 125,11 m e 181,00 ± 90,03 argolas comparado a 472,94 ± 88,02 m e 273,25 ± 66,09 argolas em ventilação não invasiva (n = 8), 410,32 ± 90,39m e 257,68 ± 62,84 argolas em oxigenoterapia (n = 19), 569,00 ± 79,50 m e 203,00 ± 169,00 argolas sem internação (n = 3). Conclusão Os participantes que necessitaram de ventilação mecânica invasiva apresen-taram pior capacidade funcional, com 46% do esperado no teste de caminhada e 39% no teste de argola de 6 minutos.

Clinical assessment of upper limb impairments and functional capacity in Parkinson's disease: a systematic review / Avaliação clínica de comprometimentos de membros superiores e capacidade funcional na doença de Parkinson: uma revisão sistemática

Abstract Background Parkinson's disease (PD) may progressively reduce the upper limb's functionality. Currently, there is no standardized upper limb functional capacity assessment in PD in the rehabilitation field. Objective To identify specific outcome measurements to assess upper limbs in PD and access functional capacity. Methods We systematically reviewed and analyzed the literature in English published from August/2012 to August/2022 according to PRISMA. The following keywords were used in our search: "upper limbs" OR "upper extremity" and "Parkinson's disease." Two researchers searched independently, including studies accordingly to our inclusion and exclusion criteria. Registered at PROSPERO CRD42021254486. Results We found 797 studies, and 50 were included in this review (n = 2.239 participants in H&Y stage 1-4). The most common upper limbs outcome measures found in the studies were: (i) UPDRS-III and MDS-UPDRS to assess the severity and progression of PD motor symptoms (tremor, bradykinesia, and rigidity) (ii) Nine Hole Peg Test and Purdue Pegboard Test to assess manual dexterity; (iii) Spiral test and Funnel test to provoke and assess freezing of upper limbs; (iv) Technology assessment such as wearables sensors, apps, and other device were also found. Conclusion We found evidence to support upper limb impairments assessments in PD. However, there is still a large shortage of specific tests to assess the functional capacity of the upper limbs. The upper limbs' functional capacity is insufficiently investigated during the clinical and rehabilitation examination due to a lack of specific outcome measures to assess functionality.

Resumo Antecedentes A doença de Parkinson (DP) reduz progressivamente a funcionalidade do membro superior. Não existe uma avaliação padronizada da capacidade funcional do membro superior na DP na área da reabilitação. Objetivo Identificar medidas de resultados específicos para avaliar membros superiores na DP e avaliar capacidade funcional. Métodos Revisamos e analisamos sistematicamente a literatura publicada de agosto/2012 a agosto/2022 de acordo com PRISMA. Usamos as seguintes palavras-chave "membros superiores" OU "extremidade superior" e "doença de Parkinson." Dois pesquisadores fizeram a busca de forma independente, incluindo estudos de acordo com os critérios de inclusão e exclusão. Registro PROSPERO CRD42021254486. Resultados Encontramos 797 estudos, 50 foram incluídos no estudo(n = 2.239 participantes no estágio 1-4 de H&Y). As medidas de resultados de membros superiores mais comuns encontradas foram: (i) UPDRS-III e MDS-UPDRS, para avaliar a gravidade e a progressão dos sintomas motores da DP (tremor, bradicinesia, e rigidez); (ii) Nine Hole Peg Test e Purdue Pegboard Test para avaliar a destreza manual; (iii) Teste da Espiral e Teste do Funil para provocar e avaliar o congelamento de membros superiores; (iv) Avaliação de tecnologia, como sensores vestíveis, aplicativos e outros dispositivos também foram encontrados. Conclusão Encontramos evidências para dar suporte para as avaliações de deficiências de membros superiores na DP. No entanto, ainda há grande escassez de testes específicos para avaliar a capacidade funcional dos membros superiores. A capacidade funcional dos membros superior é insuficientemente investigada durante o exame clínico e de reabilitação devido à falta de medidas de resultados específicos para avaliar a funcionalidade.

Investigation of the effects of upper extremity home exercises on grip strength, range of motion, activity performance, and functionality in individuals with systemic sclerosis: a randomized controlled trial

SUMMARY OBJECTIVE: This study aimed to investigate the effects of upper extremity home exercises on grip strength, range of motion, activity performance, and functionality in individuals with systemic sclerosis and to compare with patient education. METHODS: A total of 46 individuals with systemic sclerosis (55.52±11.54 years) were included. Individuals were randomly assigned into intervention (n=23) and control (n=23) groups. Dynamometer, goniometer, Canadian Occupational Performance Measurement, Disabilities of the Arm, Shoulder, and Hand, Score for Assessment and Quantification of Chronic Rheumatic Affections of the Hands, and Duruoz Hand Index were used for evaluation. RESULTS: Post-treatment, in terms of delta (Δ) values, hand grip and pinch strengths (p: 0.000-0.016), active (p: 0.000-0.032) and passive (p: 0.000-0.043) total range of motions, Canadian Occupational Performance Measurement performance and satisfaction, Disabilities of the Arm, Shoulder, Score for Assessment and Quantification of Chronic Rheumatic Affections of the Hands, and Duruoz Hand Index (p: 0.000) were in favor of the intervention group. CONCLUSION: Upper extremity home exercises increase grip strength, range of motion, activity performance, and functionality in patients with systemic sclerosis. We recommend that rehabilitation programs include not only hand exercises but also upper extremity exercises.

Psychometric properties of The Maastricht Upper Extremity Questionnaire: systematic review and meta-analysis / Propriedades psicométricas do The Maastricht Upper Extremity Questionnaire: revisão sistemática e meta-análise

ABSTRACT BACKGROUND AND OBJECTIVES: With the necessity to assess musculoskeletal complaints caused by computer use, The Maastricht Upper Extremity Questionnaire (MUEQ) was created, which aims to assess musculoskeletal complaints of the upper limbs, shoulder complex and cervical spine in computer users. However, there is currently no comprehensive summary in the scientific literature on the psychometric properties of the MUEQ. The objective of this study was to conduct a synthesis of all available scientific evidence that has analyzed the psychometric properties of the MUEQ. CONTENTS: This study followed the PRISMA recommendations. The bibliographic search was carried out in the following databases: MEDLINE (via VHL), Embase, LILACS (via VHL), Pubmed, PsycINFO, Scielo, Academic Search Premier, CINAHL, Rehabilitation & Sports Medicine Source, MEDLINE Complete, Web of Science CENTRAL, Scopus and SPORTDiscus. Studies that addressed the psychometric properties of the MUEQ were included, as long as they were original articles of research carried out with human beings and indexed in the databases used. The studies were selected in two phases, with two independent reviewers. A total of 6 articles were included in the analysis. The evidence based on internal structure showed acceptable results. The reliability indexes ranged from α=0.52 to α=0.84, and ICC/composite reliability > 0.70 in the analyzed studies, classified as "good" and "excellent," respectively. CONCLUSION: In general, this research found a lack of detail on the process of content validity and evidence related to external variables and the description of the sample. These problems extended to the evidence based on the internal structure and reliability of the MUEQ, which did not reach levels considered acceptable to ensure its adequacy and accuracy.

RESUMO JUSTIFICATIVA E OBJETIVOS: Com a necessidade de avaliar as queixas musculoesqueléticas ocasionadas pelo uso de computadores, foi criado o The Maastricht Upper Extremity Questionnaire (MUEQ), cujo objetivo foi avaliar as queixas musculoesqueléticas relativas aos membros superiores, ao complexo do ombro e à cervical em usuários de computadores. No entanto, atualmente não existe uma sumarização abrangente, na literatura científica, sobre as propriedades psicométricas do MUEQ. O objetivo deste estudo foi realizar uma síntese de evidências científicas disponíveis que analisaram as propriedades psicométricas do MUEQ. CONTEÚDO: Este estudo seguiu as recomendações do PRISMA. A busca bibliográfica foi realizada nas bases de dados Medline (via BVS), Embase, LILACS (via BVS), Pubmed, PsycINFO, Scielo, Academic Search Premier, CINAHL, Rehabilitation & Sports Medicine Source, MEDLINE Complete, Web of Science CENTRAL, Scopus e SPORTDiscus. Foram incluídos estudos que abordaram as propriedades psicométricas do MUEQ, desde que fossem artigos originais de pesquisas desenvolvidas com seres humanos e indexados nas bases utilizadas. A seleção dos estudos ocorreu em duas fases, com dois revisores independentes. Foram incluídos 6 artigos/publicações na análise. A evidência baseada na estrutura interna apresentou resultados aceitáveis. Os índices de fidedignidade variaram de α=0,52 a α=0,84 e ICC/confiabilidade composta foram maiores que 0,70 nos estudos selecionados, classificados como "bom" e "excelente", respectivamente. CONCLUSÃO: De um modo geral, esta pesquisa constatou a falta de detalhamento sobre o processo de validade de conteúdo e de evidências relacionados a variáveis externas e à descrição da amostra. Esses problemas se estenderam à evidência baseada na estrutura interna e à confiabilidade do MUEQ, que não alcançaram níveis considerados aceitáveis para garantir sua adequação e precisão.

Role of Early Fasciotomy and Skin Cover in the Management of Acute Electrical Burns of the Upper Limbs - A Prospective Case Series

Background: Electrical burn injuries are still amongst the highest accident-related morbidities. Aim: To assess the demographic profile as well as to study outcomes of early fasciotomy in salvage acute electrical burns involving upper limbs. Materials and Methods: The present study was a prospective case series study conducted in Department of Plastic and Reconstructive Surgery at Gandhi Medical College and Hospital, Secunderabad, from January 2020 to January 2022. Total 20 study subjects were evaluated. Electrical burn injury was assessed at the time of admission. Data was analyzed by using coGuide software, V.1.01. Results: In the study population, 55% belonged to age group of 30 years. Male predominance with 75% compared to female. Accidents 40% were major cause of injury. In majority, 65% of the cases fasciotomies were done within 48 hrs of electrical burn injuries. Conclusion: The results of the study concluded that younger generation is more prone to electrical burn injuries and males were majorly affected. Unsafe work areas and accidents are main reasons for injuries. High voltage affected the study population compared to low voltage. Amputations were required in fingers and below elbow. Early fasciotomy, repeated debridement's, definitive skin cover (SSG/flap) have helped in reducing the morbidity and improving the quality of life of the patient.

Prevalence, Onset, Evolution, and Prediction of Spasticity Poststroke: A Longitudinal Study / Prevalencia, inicio, evolución y predicción de la espasticidad posterior a un ACV: un estudio longitudinal / Prevalência, início, evolução e previsão de espasticidade após AVC: um estudo longitudinal

Introduction: Because of the the complex physiopathology of spasticity, it is distinguished as one of the most significant positive clinical signs of upper motor neuron syndrome, constituting a clinical feature that has great impact in the neurorehabilitation setting. Thus, the current study aimed to determine the prevalence, onset, evolution, and prediction of spasticity after a stroke. Materials and Methods: A correlational, longitudinal design was used. A total of 136 patients were evaluated at the following times: 10 days (T1), 3 months (T2), and 12 months (T3) poststroke. The initial evaluation included sociodemographic and clinical data (T1). Muscle tone was measured (T1, T2, and T3) using the Modified Ashworth Scale. Results: The prevalence of poststroke spasticity in the elbow was 37.5 % at T1 and 57.4 % at T2 and T3. Among patients with motor damage, the onset of spasticity occurred at T1 in 44.7 %, between T1 and T2 in 23.7 %, and between T2 and T3 in 0.9 %. Significant predictors of the alteration in muscular tone for at least two of the evaluation times were ethnic self-classification, type, area, extent of stroke, and number of sessions. Conclusions: Spasticity onset occurs during the first 10 days after a stroke. More clinical than sociodemographic variables predicted spasticity.

Introducción: la espasticidad se destaca como uno de los signos clínicos positivos más significativos del síndrome de motoneurona superior, por su compleja fisiopatología, y constituye una característica clí- nica de gran impacto en el ámbito de la neurorrehabilitación. Por lo tanto, el objetivo fue determinar la prevalencia, el inicio, la evolución y la predicción de la espasticidad después de un accidente cerebro- vascular. Materiales y métodos: se utilizó un diseño longitudinal correlacional. Se evaluaron 136 pacientes: 10 días (T1), 3 meses (T2) y 12 meses (T3) pos-ACV. La evaluación incluyó datos sociodemográficos y clínicos (T1) y se midió el tono muscular (T1, T2 y T3) mediante la Escala de Ashworth Modificada. Resultados: la prevalencia en el codo fue del 37.5 % en T1, y del 57.4 % en T2 y T3. Entre los pacientes con daño motor, el inicio de la espasticidad ocurrió en T1 para el 44.7 % de ellos, entre T1 y T2 para el 23.7 % y entre T2 y T3 para el 0.9 %. La autoclasificación étnica, el tipo, el área, la extensión del ictus y el número de sesiones predijeron significativamente la alteración del tono muscular en al menos dos ocasiones. Conclusiones: el inicio de la espasticidad ocurre durante los 10 primeros días después de un ACV. Más variables clínicas que sociodemográficas predijeron espasticidad.

Introdução: a espasticidade destaca-se como um dos sinais clínicos positivos mais significativos da síndrome do neurônio motor superior, devido à sua fisiopatologia complexa, e constitui uma característica clínica de grande impacto no campo da neurorreabilitação. Portanto, nosso objetivo foi determinar a prevalência, início, evolução e predição da espasticidade após o acidente vascular cerebral. Materiais e métodos: foi utilizado um desenho correlacional longitudinal. Foram avaliados 136 pacientes: 10 dias (T1), 3 meses (T2) e 12 meses (T3) pós-AVC. A avaliação incluiu dados sociodemográficos e clínicos (T1) e o tônus muscular (T1, T2 e T3) foi medido por meio da Escala Modificada de Ashworth. Resultados: a prevalência no cotovelo foi de 37,5 % em T1 e 57,4 % em T2 e T3. Entre os pacientes com prejuízo motor, o início da espasticidade ocorreu em T1 em 44,7 % deles, entre T1 e T2 em 23,7 % e entre T2 e T3 em 0,9 % dos pacientes. A autoclassificação étnica, o tipo, a área, a extensão do AVC e o número de sessões predisseram significativamente as anormalidades do tônus muscular em pelo menos duas ocasiões. Conclusões: o início da espasticidade ocorre durante os primeiros 10 dias após o acidente vascular cerebral. Mais variáveis clínicas do que sociodemográficas previram a espasticidade

Bloqueo de plexo braquial con ultrasonido: estudio descriptivo de práctica clínica habitual en 283 niños / Brachial plexus block with ultrasound: a descriptive study of routine clinical practice in 283 children

Resumen: Introducción: en años recientes con el renacimiento de la anestesia regional a causa de los avances técnicos en equipamiento como el ultrasonido, estos han permitido llevar a cabo bloqueos de plexo braquial con varias técnicas de abordaje, alta eficacia de éxito y disminución de complicaciones. Objetivo: conocer la eficacia y seguridad del bloqueo de plexo braquial con ultrasonido, en anestesiólogos con especialidad en anestesia regional. Material y métodos: se realizó el estudio observacional, descriptivo y retrospectivo de la práctica clínica habitual en 283 pacientes de 0 a 15 años, programados para cirugía electiva de ortopedia y traumatología, de extremidad superior (húmero tercio distal, codo, antebrazo y mano), con manejo anestésico: sedación más bloqueo de plexo braquial con ultrasonido abordaje supraclavicular o infraclavicular. Durante dos años, de enero de 2018 a diciembre de 2019. Resultados: los bloqueos fueron realizados por 11 anestesiólogos con especialidad en anestesia regional. Se evaluó la eficacia con 99.65% de éxito. En cuanto a la seguridad no se registraron complicaciones. Conclusiones: el uso de ultrasonido en bloqueo de plexo braquial con abordaje supraclavicular e infraclavicular es una técnica con éxito alto y sin complicaciones; sin embargo, es necesario tener capacitación y experiencia.

Abstract: Introduction: in recent years with the revival of regional anesthesia due to technical advances in equipment such as ultrasound, have allowed to carry out brachial plexus blocks with several approach techniques with high efficiency of success and reduction of complications. Objective: to know the efficacy and safety of brachial plexus block with ultrasound, in anesthesiologists with a specialty in regional anesthesia. Material and methods: the observational, descriptive, retrospective study of the usual clinical practice was carried out in 283 patients from 0 to 15 years old, scheduled for elective orthopedic surgery and traumatology, of the upper extremity (distal third humerus, elbow, forearm and hand), with anesthetic management: sedation plus brachial plexus block with ultrasound supraclavicular or infraclavicular approach. For two years from January 2018 to December 2019. Results: the blocks were performed by 11 anesthesiologists specializing in regional anesthesia. Efficacy was evaluated with 99.65% success. In terms of safety, there were no complications. Conclusions: the use of ultrasound in brachial plexus block with supraclavicular and infraclavicular approach is a technique with high success and without complications however it is necessary to have training and experience.

Reliability, Validity, and Responsiveness of the Upper Extremity Test for Spinal Cord Injury / The Japanese Journal of Rehabilitation Medicine

Introduction：There are few detailed evaluations of upper extremity function in Japan, especially for cervical spinal cord injury (CSCI). The capabilities of upper extremity test (CUE-T) evaluates upper extremity function, is specialized for CSCI, and is internationally used；however, there are few reports from Japan. This study verified the reliability, validity, and responsiveness of the CUE-T in Japan.Methods：We determined the interrater reliability, internal consistency, weighted kappa coefficient, intraclass correlation coefficient, and Cronbach's α coefficient for acute and chronic CSCI. The correlation coefficient with other evaluations was calculated and validated. Furthermore, the evaluation was performed twice at regular intervals, and the correlation between the change in CUE-T and other evaluations and the sensitivity to change using the standardized response mean (SRM) were verified.Results：The weighted kappa coefficient was 0.61-1.00, intraclass correlation coefficient was ≥0.9, and Cronbach's α coefficient were ≥0.9. The CUE-T and other evaluation methods showed moderate to strong correlations. In addition, the amount of change between CUE-T and the other evaluations were significantly correlated, and the SRM was ≥0.8.Discussion：In Japan, the CUE-T has been suggested to have good reliability, validity, responsiveness, and interpretability as an evaluation of upper extremity function in patients with CSCI. We will continue to verify the interpretability of the CUE-T and consider its dissemination in Japan.

Reliability, Validity, and Responsiveness of the Upper Extremity Test for Spinal Cord Injury / The Japanese Journal of Rehabilitation Medicine

Introduction：There are few detailed evaluations of upper extremity function in Japan, especially for cervical spinal cord injury (CSCI). The capabilities of upper extremity test (CUE-T) evaluates upper extremity function, is specialized for CSCI, and is internationally used；however, there are few reports from Japan. This study verified the reliability, validity, and responsiveness of the CUE-T in Japan.Methods：We determined the interrater reliability, internal consistency, weighted kappa coefficient, intraclass correlation coefficient, and Cronbach's α coefficient for acute and chronic CSCI. The correlation coefficient with other evaluations was calculated and validated. Furthermore, the evaluation was performed twice at regular intervals, and the correlation between the change in CUE-T and other evaluations and the sensitivity to change using the standardized response mean (SRM) were verified.Results：The weighted kappa coefficient was 0.61-1.00, intraclass correlation coefficient was ≥0.9, and Cronbach's α coefficient were ≥0.9. The CUE-T and other evaluation methods showed moderate to strong correlations. In addition, the amount of change between CUE-T and the other evaluations were significantly correlated, and the SRM was ≥0.8.Discussion：In Japan, the CUE-T has been suggested to have good reliability, validity, responsiveness, and interpretability as an evaluation of upper extremity function in patients with CSCI. We will continue to verify the interpretability of the CUE-T and consider its dissemination in Japan.

Effects of occupational therapy on upper extremity for patients with stroke: a systematic review using WHO-FICs / 中国康复理论与实践

ObjectiveTo construct a framework of PICO for occupational therapy to improve upper extremity function in stroke patients based on World Health Organization Family of International Classifications (WHO-FICs), and to analyze the functional outcome of major occupational therapies to improve upper extremity in stroke. MethodsUsing the WHO-FICs framework, the databases such as Web of Science, PubMed, CNKI and SinoMed were searched for literature related to occupational therapy interventions for upper extremity function in stroke patients from the date of establishment to October, 2022, and the contents of the literature were extracted for a systematic review. ResultsTen randomized controlled trials from six countries were finally included, involving 382 participants (≥ 18 years old). The literatures were mainly from the fields of rehabilitation medicine, physics and rehabilitation medicine, neuroscience, bioengineering medicine, occupational therapy and other research fields, and were published mainly after 2013. The quality of the included literatures was evaluated using Physiotherapy Evidence Database (PEDro) scale with a mean score of 7.5. Based on the WHO-FICs framework, the types of diseases included intracerebral haemorrhage (8B00), cerebral ischemic stroke (8B11), subarachnoid hemorrhage (8B01), abnormality of tonus and reflex (MB47), and hemiplegia (MB53). The main dysfunctions of the upper extremity after stroke included mobility of joint functions (b710), stability of joint functions (b715), muscle power functions (b730), muscle tone functions (b735), motor reflex functions (b750), control of voluntary movement functions (b760), involuntary movement functions (b765). Activity and participation included activity of upper limb, such as lifting and carrying objects (d430), hand and arm use (d445), and fine hand use (d440); and the daily life activities and social participation, such as self-care (d510-d570), domestic life (d610-d660), major life areas (d810-d879), community, social and civic life (d910-d950). Therapeutic interventions on body functions included electrical stimulation of muscle functions (MU2.SC.BP), assistance and guidance of exercise for involuntary movement reaction (MV2.PG.ZZ); therapeutic interventions involving activity and participation were training in lifting and carrying (SIA.PH.ZZ), training in fine hand use (SIG.PH.ZZ), exercises of arm and hand use (SIJ.PH.ZZ), self care (SM1-SMH), household tasks (SO2-SOD), and playing games (SXD.PH.ZZ); 15 to 60 minutes a time, three to ten times a week, for three to eight weeks, in hospital or at home. The outcomes of the intervention were divided into three levels. At the body function level, patients had improved neuromotor conduction function, reflex function, casual motor control, coordination and speed, joint mobility, and grip strength. At the activity and participation level, there were enhancements in upper limb mobility and speed, fine hand function and speed, frequency and quality of upper limb activity participation, and the capacities of daily living and reduced difficulty in daily activity tasks. In terms of whole functioning, patients had acquired quality of life and well-being and acquainted a feeling of pleasure and accomplishment. ConclusionA PICO framework was constructed for occupational therapy based on WHO-FICs. The health conditions included intracerebral haemorrhage, cerebral ischemic stroke, subarachnoid hemorrhage, abnormality of tonus and reflex, and hemiplegia. Upper extremity motor dysfunction mainly included dysfunction of voluntary motor control, low or hyperactive motor reflexes, abnormalities in muscle tone, impaired muscle coordination, poor stability of joint activities, and reduced muscle strength, etc. Activity limitation and participation restriction were manifested as functioning in the fields of arm and hand activity participation, fine manual activity, and activities of daily living and social participation. Therapeutic interventions at body function level included brain-computer interface-based functional electrical stimulation and unimanual mirror therapy; therapeutic interventions at activity and participation level included action observation training, bimanual mirror therapy, task-oriented training, bilateral arm training and upper extremity robotics training. The health and functional benefits included the improvements in upper extremity motor function, upper extremity mobility and participation levels, activities of daily living and social participation, and quality of life and well-being.

Analysis of the level of swimming physical training based on limb strength / Análise do nível de treinamento físico de natação com base na força dos membros / Análisis del nivel de entrenamiento físico en natación en función de la fuerza de las extremidades

ABSTRACT Introduction Swimming has high criteria for physical ability and movement by athletes. Efficient strength training can not only improve the physical training level of athletes but also increase their sports ability. Therefore, it is an important link in swimming training. Objective Explore the effect of limb strength training on athletes' fitness in swimming. Methods In this experiment, 20 swimmers majoring in physical education at a university were selected to undergo limb strength training for six weeks. Before and after the sports training, the indices such as thigh circumference, calf circumference, lower limb jumping ability, lower limb maximal strength, and lower limb balance ability of the athletes were measured, and the results of butterfly, backstroke, breaststroke, and freestyle in 50m main events were recorded. Results Efficient limb strength training can significantly promote the changes in athletes' lower limb muscle strength, improve their endurance and explosive power, improve swimmers' balance ability and movement stability, and significantly improve competitive swimming performance. Conclusion It is necessary to intensify physical strength training in athletes to improve their physical training level and economic performance. This plan can be considered very useful. Level of evidence II;Therapeutic studies - investigation of treatment outcomes.

RESUMO Introdução A natação tem elevados critérios de capacidade física e de movimentação por parte dos atletas. O treinamento de força eficiente pode não apenas melhorar o nível de treinamento físico dos atletas, mas também aumentar suas capacidades esportivas. Portanto, é um importante elo no treinamento de natação. Objetivo Explorar o efeito do treinamento de força dos membros sobre a aptidão física dos atletas na natação. Métodos Nesta experiência, 20 nadadores formados em Educação Física em uma universidade foram selecionados para realizar o treinamento de força dos membros durante seis semanas. Antes e depois do treinamento esportivo, foram medidos os índices como circunferência da coxa, circunferência da panturrilha, capacidade de saltar dos membros inferiores, força máxima dos membros inferiores e capacidade de equilíbrio dos membros inferiores dos atletas, e foram registrados os resultados de borboleta, nado de costas, nado de peito e estilo livre em eventos principais de 50m. Resultados O treinamento eficiente da força dos membros pode promover significativamente as mudanças da força muscular dos membros inferiores dos atletas, melhorar sua resistência e poder explosivo, melhorar significativamente a habilidade de equilíbrio e estabilidade de movimento dos nadadores, além de melhorar significativamente o desempenho competitivo da natação. Conclusão É necessário intensificar o treinamento de força física nos atletas, no intuito de melhorar seu nível de treinamento físico e melhorar seu desempenho econômico. Este plano pode ser considerado de grande utilidade. Nível de evidência II; Estudos terapêuticos - investigação dos resultados do tratamento.

RESUMEN Introducción La natación tiene un alto criterio de capacidad física y de movimiento por parte de los deportistas. El entrenamiento de fuerza eficiente no sólo puede mejorar el nivel de entrenamiento físico de los atletas, sino también aumentar sus capacidades deportivas. Por lo tanto, es un eslabón importante en el entrenamiento de la natación. Objetivo Explorar el efecto del entrenamiento de fuerza de las extremidades en la aptitud física de los atletas en la natación. Métodos En este experimento, se seleccionaron 20 nadadores formados en Educación Física en una universidad para realizar un entrenamiento de fuerza de las extremidades durante seis semanas. Antes y después del entrenamiento deportivo, se midieron los índices como la circunferencia del muslo, la circunferencia de la pantorrilla, la capacidad de salto de las extremidades inferiores, la fuerza máxima de las extremidades inferiores y la capacidad de equilibrio de las extremidades inferiores de los atletas, y se registraron los resultados de las pruebas principales de mariposa, espalda, nado de pecho y estilo libre en 50 metros. Resultados El entrenamiento eficaz de la fuerza de las extremidades puede promover significativamente los cambios de la fuerza muscular de las extremidades inferiores de los atletas, mejorar su resistencia y su potencia explosiva, mejorar significativamente la capacidad de equilibrio y la estabilidad del movimiento de los nadadores y mejorar significativamente el rendimiento de la natación competitiva. Conclusión Es necesario intensificar el entrenamiento de la fuerza física en los deportistas, para mejorar su nivel de entrenamiento físico y mejorar su rendimiento económico. Este plan puede considerarse de gran utilidad. Nivel de evidencia II; Estudios terapéuticos - investigación de los resultados del tratamiento.

Dorsalis pedis neurovascular flap, our experience / Retalho neurovascular dorsal do pé, nossa experiência

ABSTRACT Objectives: Analyze the donor site morbidity of the dorsalis pedis neurovascular flap in traumatic injuries with hand tissue loss. Material and Methods: The study involved dorsalis pedis neurovascular flaps that were used to reconstruct the hands of eight male patients, between 1983 and 2003, aged between 21 and 53 years (mean 34.6, SD ± 10.5 years). The size of the lesions ranged from 35 to 78 cm2 (mean 53, SD ± 14.4 cm2). Surgical procedures were performed two to 21 days after the injuries had occurred. The patients were followed up for an average of 10.3 years (ranging 8-14, SD ± 2.1 years). Results: Regarding the donor site, in one case there was hematoma formation, which was drained; in another case, the skin graft needed to be reassessed. All patients experienced delayed healing, with complete healing from 2 to 12 months after the surgery (mean 4.3, SD ± 3.2 months). Conclusion: Despite the advantages of the dorsalis pedis neurovascular flap, we consider that the sequelae in the donor site is cosmetically unacceptable. Nowadays, this procedure is only indicated and justified when associated with the second toe transfer. Level of Evidence IV; Case series .

RESUMO Objetivos: Analisar a morbidade da área doadora do retalho neurovascular do dorso do pé em lesões traumáticas com perda de tecido da mão. Material e métodos: O estudo envolveu retalhos neurovasculares do dorso do pé usados para reconstruir as mãos de oito pacientes do sexo masculino, entre 1983 e 2003, com idades entre 21 e53 anos (média de 34,6, DP ± 10,5 anos). O tamanho das lesões variou de 35 a 78 cm2 (média de 53, DP ± 14,4 cm2). Os procedimentos cirúrgicos foram realizados entre dois a 21 dias após a ocorrência das lesões. Os pacientes foram acompanhados por uma média de10,3 anos (variando de 8 a 14, DP ± 2,1 anos). Resultados: Quanto ao local doador, em um caso houve formação de hematoma, que foi drenado; em outro caso, o enxerto de pele precisou ser reavaliado. Todos os pacientes apresentaram retardo na cicatrização, com cicatrização completa de 2 a 12 meses após a cirurgia (média de 4,3, DP ± 3,2 meses). Conclusão: Apesar das vantagens do retalho neurovascular do dorso do pé, consideramos que as sequelas no local doador são cosmeticamente inaceitáveis. Atualmente, esse procedimento só é indicado e justificado quando associado à transferência do segundo dedo do pé. Nível de evidência IV; Série de casos .

Effects of upper limb strength training on physical fitness in table tennis / Efeitos do treinamento de força em membros superiores sobre a aptidão física no tênis de mesa / Efectos del entrenamiento de fuerza en miembros superiores sobre la aptitud física en tenis de mesa

ABSTRACT Introduction: Strength training is the basis for all sports and physical training. Evidence suggests that its benefit may extend to the athlete's general physical fitness, although few studies refer to the table tennis player. Objective: Study the effect of upper limb strength training on the physical fitness of table tennis players. Methods: Twenty sportsmen from a college were selected and randomly divided into two groups. The experimental group had the addition of an upper limb strength training protocol in their training, while the control group continued with conventional training. The experiment lasted eight weeks, with interventions three times a week, at intervals with a minimum of one day. Results: Specific fitness varied widely between groups: spinning technique in the experimental group increased from 36.66±6.85 per minute before the experiment to 41.03±7.06, P<0.05. In the control group, the turning technique was 61.41±4.73/min to 66.49±4.74/min after the experiment, P>0.05. Conclusion: Complementing the tennis training program with specific upper limb muscle strength training can effectively improve explosive muscle strength in its athletes, substantially increasing physical fitness for table tennis players. Level of evidence II; Therapeutic studies - investigation of treatment outcomes.

RESUMO Introdução: O treinamento de força é a base para todo o treinamento físico esportivo. Evidências sugerem que seu benefício possa estender-se para a aptidão física geral do atleta, embora haja poucos estudos referentes ao jogador de tênis de mesa. Objetivo: Estudar o efeito do treinamento de força dos membros superiores sobre a aptidão física dos jogadores de tênis de mesa. Métodos: Foram selecionados 20 esportistas de uma faculdade, divididos aleatoriamente em dois grupos. O grupo experimental teve em seu treinamento a adição de um protocolo de treinamento de força dos membros superiores, enquanto o grupo controle continuou com o treinamento convencional. O experimento teve duração de 8 semanas, com intervenções três vezes por semana, intervaladas com um mínimo de um dia. Resultados: A aptidão física específica variou bastante entre os grupos: a técnica de giro no grupo experimental elevou-se de 36,66±6,85 por minuto antes do experimento, para 41,03±7,06, P<0.05. No grupo controle, a técnica de giro foi 61,41±4,73/min para 66,49±4,74/min, após o experimento, P>0.05. Conclusão: Complementar o programa de treinamento de tênis com o treino específico de força muscular nos membros superiores pode efetivamente melhorar a força muscular explosiva em seus atletas, incrementando substancialmente a aptidão física para os tenistas de mesa. Nível de evidência II; Estudos terapêuticos - investigação dos resultados do tratamento.

RESUMEN Introducción: El entrenamiento de fuerza es la base de todo entrenamiento físico deportivo. Las evidencias sugieren que su beneficio puede extenderse a la condición física general del deportista, aunque existen pocos estudios referidos al jugador de tenis de mesa. Objetivo: Estudiar el efecto del entrenamiento de la fuerza de los miembros superiores sobre la forma física de los jugadores de tenis de mesa. Métodos: Se seleccionaron 20 deportistas de una universidad, divididos aleatoriamente en dos grupos. El grupo experimental tuvo en su entrenamiento la adición de un protocolo de entrenamiento de la fuerza de los miembros superiores, mientras que el grupo de control continuó con el entrenamiento convencional. El experimento duró 8 semanas, con intervenciones tres veces por semana, con un intervalo mínimo de un día. Resultados: La aptitud específica varió ampliamente entre los grupos: la técnica de giro en el grupo experimental aumentó de 36,66±6,85 por minuto antes del experimento a 41,03±7,06, P<0,05. En el grupo de control, la técnica de giro pasó de 61,41±4,73/min a 66,49±4,74/min después del experimento, P>0,05. Conclusión: Complementar el programa de entrenamiento de tenis con un entrenamiento específico de la fuerza muscular de las extremidades superiores puede mejorar eficazmente la fuerza muscular explosiva en sus atletas, aumentando sustancialmente la aptitud física de los jugadores de tenis de mesa. Nivel de evidencia II; Estudios terapéuticos - investigación de los resultados del tratamiento.

Upper limbs physical fitness training in volleyball players / Treinamento de aptidão física de membros superiores em jogadores de voleibol / Entrenamiento de aptitud física de los miembros superiores en jugadores de voleibol

ABSTRACT Introduction: Dedicated fitness training has greatly influenced many qualities required of volleyball players, but specific upper limb training is still poorly documented. Objective: Study the impacts of fitness training on upper limb strength and functional impacts during volleyball players' ball throws. Methods: Twenty volleyball students were randomly divided into experimental and control groups for a six-week experiment. The experimental group mainly performed a training protocol involving ball throws while the control group continued with traditional training methods. The data regarding functional kinematics and fitness performance were collected and statistically compared. Results: In the experimental group, shoulder flexor strength evidenced an increase from 0.41±0.19 J/kg to 1.29±0.19 J/kg; elbow flexor strength elevated from 0.38±0.23 J/kg to 1.61±0.02 J/kg. On the specific functional performance, the peak score increased from 4.84±1.44 to 7.47±1.43; The overall score increased from 9.05±1.70 to 13.31±1.72. It was noted that the rate of increase of each index was more significant than that of the control group. Conclusion: Dedicated fitness training can improve the upper limb strength and hitting effect of volleyball players, and its combination with special strength training is recommended to improve the overall skills of athletes. Level of evidence II; Therapeutic studies - investigation of treatment outcomes.

RESUMO Introdução: O treinamento dedicado de aptidão física tem mostrado grande influência sobre muitas qualidades requisitadas aos jogadores de voleibol, porém o treinamento específico em membros superiores ainda é pouco documentado. Objetivo: Estudar os impactos do treinamento de aptidão física sobre a força dos membros superiores e os impactos funcionais durante os arremessos de bola dos jogadores de voleibol. Métodos: Vinte estudantes de voleibol foram divididos aleatoriamente em grupo experimental e controle para uma experiência de 6 semanas. O grupo experimental realizou principalmente um protocolo de treinamento envolvendo arremessos de bola enquanto o grupo de controle prosseguiu com os métodos tradicionais de treinamento. Dados referentes a cinemática funcional e desempenho de aptidão física foram coletados e comparados estatisticamente. Resultados: No grupo experimental, a força do flexor do ombro evidenciou um aumento de 0,41±0,19 J/kg para 1,29±0,19 J/kg; a força do flexor do cotovelo elevou-se de 0,38±0,23 J/kg para 1,61±0,02 J/kg. Sobre o desempenho funcional específico, a pontuação do pico aumentou de 4,84±1,44 para 7,47±1,43; A pontuação geral aumentou de 9,05±1,70 para 13,31±1,72. Notou-se que a taxa de aumento de cada índice foi mais significativa do que a do grupo de controle. Conclusão: O treinamento dedicado de aptidão física pode melhorar a força dos membros superiores e o efeito de acertos dos jogadores de vôlei, sendo recomendada a sua combinação com o treinamento especial de força para melhorar as habilidades gerais dos atletas. Nível de evidência II; Estudos terapêuticos - investigação dos resultados do tratamento.

RESUMEN Introducción: El entrenamiento físico específico ha demostrado una gran influencia en muchas cualidades exigidas a los jugadores de voleibol, pero el entrenamiento específico de extremidades superiores está aún poco documentado. Objetivo: Estudiar las repercusiones del entrenamiento físico en la fuerza de los miembros superiores y los impactos funcionales durante los lanzamientos de balón de los jugadores de voleibol. Métodos: Veinte estudiantes de voleibol fueron divididos aleatoriamente en grupo experimental y de control para un experimento de 6 semanas. El grupo experimental realizó principalmente un protocolo de entrenamiento que incluía lanzamientos de balón, mientras que el grupo de control continuó con los métodos de entrenamiento tradicionales. Se recogieron y compararon estadísticamente los datos relativos a la cinemática funcional y el rendimiento físico. Resultados: En el grupo experimental, la fuerza flexora del hombro evidenció un aumento de 0,41±0,19 J/kg a 1,29±0,19 J/kg; la fuerza flexora del codo se elevó de 0,38±0,23 J/kg a 1,61±0,02 J/kg. Respecto al rendimiento funcional específico, la puntuación máxima aumentó de 4,84±1,44 a 7,47±1,43; la puntuación global aumentó de 9,05±1,70 a 13,31±1,72. Se observó que el índice de aumento de cada índice fue más significativo que el del grupo de control. Conclusión: El entrenamiento físico dedicado puede mejorar la fuerza de las extremidades superiores y el efecto de golpeo de los jugadores de voleibol, y se recomienda su combinación con un entrenamiento especial de fuerza para mejorar las habilidades generales de los atletas. Nivel de evidencia II; Estudios terapéuticos - investigación de los resultados del tratamiento.

The short-term outcomes of congenital radioulnar synostosis patients treated with modified reverse Sauvé-Kapandji technique / 中华骨科杂志

Objective:To evaluate the short-term outcomes of modified reverse Sauvé-Kapandji technique in treating the congenital radioulnar synostosis.Methods:A retrospective analysis was performed on the data of 46 congenital radioulnar synostosis patients were treated with modified reverse Sauvé-Kapandji technique in Beijing Jishuitan Hospital from December 2018 to January 2020, including 38 males (45 sides), 8 females (9 sides), average age 6.6 (3.2, 8.1) years old. All the patients were classified as type III according to Cleary-Omer classification and were followed up for at least 1 year. All the patients were treated with same operation, in which 1.5 cm shaft was resected at the proximal radius, allogeneic graft tendon was used as interposition, and rotational osteotomy was performed in the middle of the ulnar shaft, with intramedullary needle or Kirschner wire fixation, depending on the intramedullary width of ulnar shaft. The radiological features were collected and recorded preoperatively and at the latest follow-up, together with the following evaluation indexes: modified Morrey tasks score, subjective function score, active forearm rotation range without compensation, active forearm rotation range with wrist joint compensation, and active forearm rotation range with wrist and shoulder joint compensation.Results:All patients were followed up for 14.6±3.4 months (range, 11.2-19.5 months). The uncompensated forearm rotation Angle was 0.0°±0.0° before surgery and 62.3°±23.7° after surgery. The forearm rotation angles before and after surgery with wrist compensatory surgery were 86.9°±29.4° and 133.2°±27.9°, respectively. The forearm rotation angles before and after surgery with wrist and shoulder joint compensatory surgery were 205.2°±42.7° and 245.2°±35.8°, respectively. There were statistically significant differences in the above indexes before and after surgery ( t=8.71, P<0.001; t=2.54, P=0.030; t=5.05, P<0.001). Ulnar union was observed in 31 patients (37 sides) after the operation, and the union duration was 6.1±2.3 months. There were 15 patients (17 sides) ulnar shafts faced with postoperative delayed union, the union duration was 8.4±1.6 months and were recovered after prolonging brace fixation and orthopedic shock wave treatment. The scores of subjective function and improved Morrey tasks of the 43 sides with good pseudo-joint were 12.1 (0.0, 20.8) and 0.7 (0.0, 1.0) points, respectively, which were improved compared with 33.9 (25.0, 41.6) and 3.2 (2.0, 4.0) points before surgery. The differences were statistically significant ( Z=-2.44, P=0.015; Z=-2.83, P=0.005). There were 11 forearms with postoperative pseudo-joint re-ankylosis, the average forearm rotation ranges without compensation was 11.4°±10.5°(range, 0°-30°), the average forearm rotation ranges with wrist compensation was 98.6°±15.9° (range, 80°-120°), the average forearm rotation ranges with wrist and shoulder compensation was 231.7°±16.9° (range, 210°-255°). The average subjective function scores was 26.7 (8.3, 39.6). The average modified Morrey tasks scores was 1.2 (0, 2), and there were no other postoperative complications. Conclusion:The reverse Sauvé-Kapandji technique showed a satisfying short-term outcome, and can be a new choice of treatment for type III congenital radioulnar synostosis.

Effect of proprioceptive neuromuscular facilitation rope training and repetitive transcranial magnetic stimulation on upper limb motor function of stroke patients with hemiplegia / 中国康复理论与实践

ObjectiveTo investigate the effect of combination of proprioceptive neuromuscular facilitation (PNF) rope training and repetitive transcranial magnetic stimulation (rTMS) on upper limb motor function of stroke patients with hemiplegia. MethodsFrom March, 2021 to February, 2022, 90 stroke inpatients with hemiplegia in the Department of Rehabilitation Medicine, the Second Affiliated Hospital of Guangxi Medical University were divided into control group (n = 30), rope group (n = 30) and combination group (n = 30) randomly. All the groups received routine rehabilitation, while the control group received routine PNF training, the rope group received PNF rope training, and the combination group received PNF rope training and rTMS, for four weeks. They were assessed with Functional Test for the Hemiplegic Upper Extremity-Hong Kong version (FTHUE-HK), Fugl-Meyer Assessment-Upper Extremities (FMA-UE) and modified Barthel Index (MBI) before and after treatment. ResultsThe scores of FTHUE-HK, FMA-UE and MBI increased in all the three groups after treatment (t > 2.167, P < 0.05), and they were more in the combination group than in the rope group (P < 0.05), and in the rope group than in the control group (P < 0.05). ConclusionThe combination of PNF rope training and rTMS is more effective on motor function of upper limbs of stroke patients with hemiplegia than PNF training alone.

Colgajo adipofascial de flujo reverso del dorso del antebrazo para reconstrucción de la mano y muñeca: nuestra experiencia clínica / Back Forearm Reverse Flow Adipofascial Flap for hand and wrist reconstruction: our clinical experience

Los defectos cutáneos de la mano pueden ser difíciles de resolver. La cobertura cutánea es esencial para proveer una protección adecuada y permitir el funcionamiento correcto de las estructuras subyacentes. El objetivo de este estudio es reportar nuestra experiencia con el uso del colgajo adipofascial de flujo reverso del dorso del antebrazo para cobertura del dorso de la mano, dedos y muñeca en pacientes tratados en la ciudad de San Cristóbal, Estado Táchira, desde mayo de 2015 hasta enero de 2018. Se realizó un estudio longitudinal, descriptivo y prospectivo en pacientes con pérdidas cutáneas extensas de la mano, que fueron cubiertas con el colgajo adipofascial reverso del dorso del antebrazo. Se incluyeron 10 pacientes. 90% de sexo masculino. La edad promedio fue 41±12,32(13-69). La etiología de los defectos fue: 40% traumatismos de alta energía, 30% mano diabética tropical, 10% secuela de quemadura de segundo grado, 10% herida por arma de fuego artesanal, 10% carcinoma primario de piel. 100% de los colgajos sobrevivieron, logrando buena cobertura y cicatrización sin necesidad de otros procedimientos quirúrgicos y con mínimas complicaciones de la zona dadora. La función de la mano y muñeca se recuperó en todos los pacientes. En conclusión, el colgajo adipofascial de flujo reverso del antebrazo es un procedimiento útil, versátil y sencillo para la reconstrucción del dorso de la mano, dedos y cara volar de muñeca en pacientes de distintas edades(AU)

Hand skin defects can be difficult to resolve. Skin coverage is essential to provide adequate protection and allow proper function of the underlying structures. The objective of this study is to report our experience with the use of the Back Forearm Reverse Flow Adipofascial Flap to cover the back of the hand, fingers and wrist in patients treated in the city of San Cristóbal, Táchira State, since may 2015 to january 2018. A longitudinal, descriptive and prospective study was made in patients with extensive skin losses of the hand, which were covered with the Back Forearm Reverse Flow Adipofascial Flap. 10 patients were included. 90,0% male. Mean age 41±12.32(13-69) years. The etiology of the defects was: 40,0% high-energy trauma, 30,0% tropical diabetic hand, 10,0% second degree burn sequel, 10,0% handcrafted firearm wound, 10,0% primary skin carcinoma. 100,0% of the flaps survived, achieving good coverage and healing without the need for other surgical procedures and with minimal complications in the donor area. Hand and wrist function recovered in all patients. In conclusion, the reverse flow adipoascial flap of the forearm is a useful, versatile and simple procedure for the reconstruction of the back of the hand, fingers and volar face of the wrist in patients of different ages(AU)

Técnica de WALANT en cirugías ambulatorias de mano en pacientes post COVID-19 / Walant technique in outpatient hand surgeries in post COVID-19 patients

El objetivo de esta investigación es evaluar la utilidad de la Técnica de WALANT en cirugías ambulatorias de mano en pacientes post Covid-19 en el Hospital General del Sur "Dr. Pedro Iturbe", Maracaibo, Estado Zulia, durante el periodo de julio del 2020 a octubre del 2021. Se realizó un estudio pre-experimental, longitudinal y prospectivo. El muestreo fue probabilístico al azar simple. Se aplicó un análisis estadístico de tipo descriptivo. Se incluyeron 50 pacientes con edad promedio de 37,02+/- 14,1(18-64) años, 52% de sexo femenino y 48% masculino. De ocupación 46% comerciante y obrero. Ama de casa y oficinista 44%, otros 10%. Con diagnóstico de dedo en gatillo 20%, síndrome del túnel carpiano 24%. Con la técnica se realizaron procedimientos quirúrgicos tipo neuroadhesiolisis del nervio mediano 24%, exéresis 22%. Tiempo quirúrgico de 5 a 10 minutos de duración en 56,9% de los casos. Se encontró punta de EVA: preoperatorio 56% de 7-10 ptos, Intraoperatorio 64% 0 ptos y postoperatorio 66% 0 ptos. Analgesia de rescate 92%. 88% sin complicaciones. La estancia Hospitalaria en 92% de los casos fue 1 hora. Reintegro a sus actividades 90%. Tiempo de reintegro en 46% de los casos de 1-5 días. 86% de los pacientes se sintieron satisfechos. En conclusión, la Técnica de WALANT en pacientes post Covid-19 es de gran utilidad para la realización de cirugías ambulatorias de bajo riesgo de mano, presentó pocas complicaciones, el tiempo quirurgo fue corto, el reintegro a sus actividades fue rápido y la satisfacción del paciente fue buena(AU)

The objective of this study is to evaluate the usefulness of the WALANT Technique in ambulatory hand surgeries in post- Covid-19 patients at the Hospital General del Sur "Dr. Pedro Iturbe", Maracaibo, Estado Zulia, during the period from July 2020 to October 2021. A pre-experimental, longitudinal and prospective study was made. Sampling was simple random probabilistic. A descriptive statistical analysis was applied. 50 patients were included with an average age of 37,02+/-14,1(18-64) years, 52,0% female and 48,0% male. Occupation 46,0% merchant and worker. Housewife and office 44,0%, others 10,0%. With a diagnosis of trigger finger 20,0%, carpal tunnel syndrome 24,0%. With the technique, 24,0% median nerve neuroadhesiolysistype surgical procedures were performed, 22,0% exeresis. Surgical time from 5 to 10 minutes in 56,9% of cases. A VAS tip was found: preoperative 56,0% 7-10 points, intraoperative 64,0% 0 points and postoperative 66,0% 0 points. Rescue analgesia 92,0%. 88,0% without complications. Hospital stay in 92,0% of cases was 1 hour. Refund to their activities 90,0%. Refund time in 46,0% of cases from 1-5 days. 86,0% of the patients felt satisfied. In conclusion, the WALANT Technique in post-COVID-19 patients is very useful for performing low-risk outpatient hand surgeries, it presented few complications, the surgical time was short, the return to their activities was fast and the satisfaction of the patient. patient was good(AU)