ABSTRACT
Abstract Objective: To evaluate and compare the sexual function and pelvic floor muscles (PFM) function of women with endometriosis and chronic pelvic pain (CPP) with and without Myofascial Pelvic Pain Syndrome (MPPS). Methods: Cross-sectional study conducted between January 2018 and December 2020. Women with deep endometriosis underwent assessments for trigger points (TP) and PFM function using the PERFECT scale. Electromyographic activity (EMG) and sexual function through Female Sexual Function Index (FSFI) were assessed. Statistical analyses included chi-square and Mann-Whitney tests. Results: There were 46 women. 47% had increased muscle tone and 67% related TP in levator ani muscle (LAM). Weakness in PFM, with P≤2 was noted in 82% and P≥3 in only 17%. Incomplete relaxation of PFM presented in 30%. EMG results were resting 6.0, maximal voluntary isometric contraction (MVIC) 61.9 and Endurance 14.2; FSFI mean total score 24.7. We observed an association between increased muscle tone (P<.001), difficulty in relaxation (P=.019), and lower Endurance on EMG (P=.04) in women with TP in LAM. Participants with TP presented lower total FSFI score (P=.02). TP in the right OIM presented increased muscle tone (P=.01). TP in the left OIM presented lower values to function of PFM by PERFECT (P=.005), and in MVIC (P=.03) on EMG. Conclusion: Trigger points (TP) in pelvic floor muscles (PFM) and obturator internus muscle (OIM) correlates with poorer PFM and sexual function, particularly in left OIM TP cases. Endometriosis and chronic pelvic pain raise muscle tone, weaken muscles, hinder relaxation, elevate resting electrical activity, lower maximum voluntary isometric contraction, and reduce PFM endurance.
Subject(s)
Humans , Female , Orgasm , Pelvic Pain , Pelvic Floor , Endometriosis , Trigger Points , Muscle Tonus , Myofascial Pain SyndromesABSTRACT
Este ensaio propõe que a Covid-19 pode operar como um analisador, dentro da perspectiva da análise institucional, iluminando um determinado modo de organização social que promove profundas desigualdades e ameaça a vida em diversos níveis e revelando as condições sociais, institucionais e políticas de produção de sofrimento no corpo profissional de Enfermagem. A pandemia desvelou um conjunto de marcas relacionadas à profissão, agravadas pela crise sanitária, reforçando a naturalização das relações de cuidado atribuídas ao feminino, bem como um conjunto de clivagens e hierarquias internas à profissão a partir da sinergia de marcadores da diferença, como gênero, cor/raça, classe e geração. Além disso, este trabalho mostra a presença de uma necropolítica nas respostas à pandemia que banaliza a vida e permite morrer determinados grupos sociais. A ideia de "profissionais de linha de frente" é criticada em suas metáforas bélicas, mas tomada como figura de linguagem em sua potência para afirmar que existem corpos que, pelas marcas sociais e históricas e pela interdependência do cuidado, são mais presentes e exigidos e, portanto, mais vulneráveis à doença e ao sofrimento dela decorrente.(AU)
The essay proposes that Covid-19 can operate as an analyzer, within the perspective of institutional analysis, illuminating a certain mode of social organization that promotes profound inequalities and threatens life at various levels, revealing the social, institutional and political conditions for the production of suffering in the professional nursing body. The pandemic would unveil a set of marks related to the profession, aggravated by the sanitary crisis, reinforcing the naturalization of the care relations attributed to the feminine, as well as a set of cleavages and internal hierarchies to the profession from the synergy of markers of difference as gender, color/race, class and generation. The work shows the presence of necropolitics in responses to the pandemic, which trivializes life and allows certain social groups to die. The idea of "front-line professionals" is criticized in its war metaphors, but taken as a figure of speech in its potency to affirm that there are bodies that by social and historical marks, and by the interdependence of care, are more present and demanded, and therefore more vulnerable to disease and the resulting suffering.(AU)
El ensayo propone que el Covid-19 puede funcionar como analizador, desde la perspectiva del análisis institucional, revelando las condiciones sociales, institucionales y políticas de producción de sufrimiento de enfermeras. La pandemia revela algunas marcas relacionadas con la profesión, agravadas por la crisis de salud, reforzando la naturalización de la atribución del cuidado a lo femenino y un conjunto de jerarquías internas de la profesión. El trabajo también muestra la presencia de una necropolítica en las respuestas a la pandemia. La idea de "profesionales de primera línea" es criticada, pero tomada como una figura del lenguaje en su potencia para afirmar que hay cuerpos que, por las marcas sociales e históricas y por la interdependencia del cuidado, están más presentes y demandados, y por lo tanto más vulnerables a la enfermedad.(AU)
Subject(s)
Humans , Female , Nursing , Psychological Distress , Gender Identity , Self-Testing , COVID-19 , Oxygen Inhalation Therapy , Pain , Patient Care Team , Patient Discharge , Patients , Politics , Primary Health Care , Psychology , Quality Assurance, Health Care , Quality of Life , Race Relations , Salaries and Fringe Benefits , Social Change , Social Isolation , Social Sciences , Socioeconomic Factors , Stress Disorders, Post-Traumatic , Women, Working , Behavior and Behavior Mechanisms , Population Characteristics , Nursing Theory , Occupational Risks , Burnout, Professional , Virus Diseases , Vaccines , Nursing Research , Accidents, Occupational , Carrier State , Mental Health , Mortality , Models, Nursing , Occupational Health , Workload , Professional Autonomy , Long-Term Care , Health Care Quality, Access, and Evaluation , Immunization Programs , Disease Transmission, Infectious , Continuity of Patient Care , Feminism , Critical Care , Disaster Vulnerability , Health Risk , Access to Information , Delivery of Health Care , Air Pollution , Health Care Economics and Organizations , Emergencies , Employment , Environment and Public Health , Essential Public Health Functions , Health Status Disparities , Ethics, Professional , Surveillance of the Workers Health , Program of Risk Prevention on Working Environment , Air Contamination Effects , Evidence-Based Nursing , Fear , Remuneration , Early Medical Intervention , Medicalization , Ambulatory Care , Personal Protective Equipment , Psychosocial Support Systems , Occupational Stress , Burnout, Psychological , Patient Care , Caregiver Burden , Models, Biopsychosocial , COVID-19 Serological Testing , Gender Equity , Vaccine Development , Community Resources , Intersectional Framework , Systemic Racism , Social Vulnerability , Humanitarian Crisis , Working Conditions , Post-Acute COVID-19 Syndrome , Accident Prevention , Health Occupations , Health Services , Health Services Accessibility , Helping Behavior , Hierarchy, Social , Hospitalization , Hospitals , Humanism , Life Support Care , Masks , Muscle Tonus , Night Care , Nursing Care , Nursing, Practical , Nursing, Team , Occupational DiseasesABSTRACT
Este discute a representatividade da disciplina Psicologia do Esporte nos cursos de Psicologia e Educação Física em instituições de ensino superior reconhecidas pelo MEC e situadas na região Sul do país. Foi realizado um estudo documental, com base nos currículos das Instituições. Os resultados revelaram que no Sul do Brasil 21,02% dos cursos de Psicologia, 41,96% dos cursos de bacharelado em Educação Física e apenas 14,83% dos cursos de licenciatura em Educação Física apresentam a disciplina Psicologia do Esporte em sua grade curricular. Observou-se que a disciplina é ofertada mais frequentemente em regime obrigatório nos cursos de bacharelado em Educação Física. Nos cursos de Psicologia, quando ofertada, costuma ser optativa. Os resultados evidenciam uma maior oferta da disciplina para os estudantes de Educação Física, em relação aos de Psicologia, o que pode estar relacionado ao próprio contexto de surgimento da disciplina e sua popularização no meio acadêmico. Para que esse panorama possa mudar e se possa oferecer uma formação adequada no curso de Psicologia para fomentar essa opção de carreira, há necessidade de se repensar o currículo e o próprio perfil do egresso, de forma a dar mais oportunidade aos estudantes para que conheçam as bases teóricas e os campos de aplicação da Psicologia do Esporte. Tal lacuna pode acarretar a fragilização da disseminação desse conhecimento aos estudantes de graduação e a consequente ocupação do mercado de trabalho.(AU)
This study discusses the representativeness of Sports Psychology in Psychology and Physical Education courses at higher education institutions from Southern Brazil. A documentary study was conducted based on the institutions' curricula. Results show that 21.02% of the Psychology major, 41.96% of the bachelor's in Physical Education, and only 14.83% of the license in Physical Education offer Sports Psychology in their curricula. Sports Psychology is most often offered as a compulsory subject in the bachelor's program in Physical Education, whereas Psychology courses offer it mainly as an elective. Physical Education students have greater contact with the discipline when compared with Psychology students, which may be explained by its context of development and popularization in the academic environment. To change this scenario and offer adequate education in the Psychology programs to foster this career option, institutions must rethink their curriculum and the graduate profile itself. This would give students better opportunity to get to know its theoretical bases and fields of application. Such a gap can hinder the dissemination of this knowledge to undergraduate students and the consequent labor market occupation.(AU)
El objetivo de este estudio es discutir la representatividad de la materia Psicología del Deporte en los cursos de Psicología y Educación Física en instituciones de educación superior de la región Sur de Brasil, reconocidas por el Ministerio de Educación (MEC). Se realizó un estudio documental, basado en los planes de estudio de las instituciones. Los resultados revelaron que, en el Sur de Brasil, el 21,02% de los cursos de Psicología, el 41,96% de los cursos de licenciatura en Educación Física y sólo el 14,83% de los cursos de profesorado en Educación tienen la materia Psicología del Deporte en sus planes de estudio. Se observó que la materia Psicología del Deporte se ofrece con mayor frecuencia como asignatura obligatoria en los cursos de licenciatura en Educación Física. Cuando se ofrece en los cursos de Psicología, es una materia optativa. Los resultados muestran una mayor oferta para los estudiantes de Educación Física en comparación con Psicología, lo que puede estar relacionado con el contexto del surgimiento de la Psicología del Deporte como materia y su popularización en el ámbito académico. Para que este escenario cambie y sea posible ofrecer una formación adecuada en el curso de Psicología con el fin de fomentar esta opción de carrera, es necesario repensar el plan de estudios y el perfil del egresado, así los estudiantes tendrán más oportunidades de conocer sus bases teóricas y sus campos de actuación. Tal brecha puede debilitar la difusión de este conocimiento a los estudiantes de grado y la consecuente ocupación en el mercado laboral.(AU)
Subject(s)
Humans , Male , Female , Physical Education and Training , Psychology , Curriculum , Educational Measurement , Psychology, Sports , Anxiety , Perception , Appetite , Personal Satisfaction , Personality , Aptitude , Physiology , Professional Competence , Professional Practice Location , Psychology, Educational , Quality of Life , Rehabilitation , Attention , Self Concept , Self-Evaluation Programs , Soccer , Social Change , Social Control, Formal , Specialization , Sports , Sports Medicine , Stress, Physiological , Stress, Psychological , Track and Field , Vocational Guidance , Wounds and Injuries , Bicycling , Biomechanical Phenomena , Cognitive Behavioral Therapy , Health , Mental Health , Physical Fitness , Liability, Legal , Walking , Relaxation Therapy , Staff Development , Guidelines as Topic , Disabled Persons , Cognition , Cultural Diversity , Creativity , Credentialing , Cultural Characteristics , Decision Making , Government Regulation , Depression , Diet , Education , Emotions , Innovation and Development Policy , Higher Education Policy , National Organizations of Higher Education , Professional Training , Fatigue , Mental Fatigue , High-Throughput Screening Assays , Sedentary Behavior , Athletes , Disease Resistance , Sports Nutritional Sciences , Self-Control , Return to Sport , Cardiorespiratory Fitness , Mentoring , Academic Performance , Physical Functional Performance , Burnout, Psychological , Social Defeat , Psychological Well-Being , Group Dynamics , Overtraining Syndrome , Habits , Health Promotion , Homeostasis , Ergonomics , Jurisprudence , Leadership , Leisure Activities , Life Style , Memory , Motivation , Motor Activity , Muscle Relaxation , Muscle Tonus , NeuroanatomyABSTRACT
ABSTRACT Introduction: Synchronized swimming is a sport of artistic expression, skill, and physical fitness. Explosive, high-intensity movements rely mainly on the athlete's good basal strength. Although China attaches great importance to the physical training of synchronized swimming athletes, there is no theoretical achievement in consolidating specific training. Objective: To analyze the impact of CORE strengthening on the physical training of synchronized swimming athletes. Methods: This article selects 30 synchronized swimmers as volunteers for the research. A basal metabolism test was used to verify the maximal oxygen consumption (VO2max), ventilatory anaerobic threshold (VT), and other indicators. The isokinetic force measurement system measured the athletes' maximum lumbar-abdominal muscle flexion/extension torque, explosive strength, fast muscle strength capacity, total work, and anti-fatigue capacity. Results: The synchronized limb training results of the swimming team were positively correlated with the stability of the CORE muscles. There is a positive relationship between 30 years old and maximal strength training and performance in athletes. Abdominal muscular endurance showed the highest correlation coefficient with synchronized swimming performance. Conclusion: Coaches should organize adequate strength training according to the growth and development characteristics of athletes and the characteristics of synchronized swimming movements. In this way, an excellent physical training effect can be achieved by CORE training. Level of evidence II; Therapeutic studies - investigation of treatment outcomes.
RESUMO Introdução: O nado sincronizado é um esporte de expressão artística, habilidade e aptidão física. Movimentos explosivos, de alta intensidade, dependem principalmente da boa força basal do atleta. Embora a China atribua grande importância ao treinamento físico de atletas do nado sincronizado, não há conquista teórica na consolidação de um treinamento específico. Objetivo: Analisar o impacto da aplicação do fortalecimento do core sobre o treinamento físico de atletas do nado sincronizado. Métodos: Este artigo seleciona 30 nadadores sincronizados como voluntários para a pesquisa. Um teste de metabolismo basal foi utilizado para verificar o consumo máximo de oxigênio (VO2max), o limiar anaeróbico ventilatório (VT) e outros indicadores. Utilizou-se o sistema de medição de força isocinética para medir o torque máximo de flexão/extensão muscular lombar-abdominal dos atletas, força explosiva, capacidade de força rápida muscular, trabalho total e capacidade anti-fadiga. Resultados: Os resultados de treinamento dos membros sincronizados da equipe de natação foram positivamente correlacionados com a estabilidade dos músculos do core. Há uma relação positiva entre os 30 anos de idade e o melhor desempenho no treinamento de força máxima em atletas. A resistência muscular abdominal apresentou o maior coeficiente de correlação com desempenho sincronizado de natação. Conclusão: Os treinadores devem organizar o treinamento de força adequado de acordo com as características de crescimento e desenvolvimento dos atletas e as características dos movimentos sincronizados de natação. Desta forma, um excelente efeito de treinamento físico pode ser alcançado pelo treino do core. Nível de evidência II; Estudos terapêuticos - investigação dos resultados do tratamento.
RESUMEN Introducción: La natación sincronizada es un deporte de expresión artística, de habilidad y de condición física. Los movimientos explosivos y de alta intensidad dependen principalmente de la buena fuerza basal del deportista. Aunque China atribuye una gran importancia a la preparación física de las atletas de natación sincronizada, no existe ningún logro teórico en la consolidación de un entrenamiento específico. Objetivo: Analizar el impacto de la aplicación del fortalecimiento del core en la preparación física de las atletas de natación sincronizada. Métodos: En este artículo se seleccionan 30 nadadores de sincronizados como voluntarios para la investigación. Se utilizó una prueba de metabolismo basal para verificar el consumo máximo de oxígeno (VO2max), el umbral anaeróbico ventilatorio (VT) y otros indicadores. Fue aplicado el sistema de medición de la fuerza isocinética para medir el par máximo de flexión/extensión de los músculos lumbares-abdominales de los atletas, la fuerza explosiva, la capacidad de fuerza muscular rápida, el trabajo total y la capacidad antifatiga. Resultados: Los resultados del entrenamiento de las extremidades sincronizadas del equipo de natación se correlacionaron positivamente con la estabilidad de los músculos del core. Existe una relación positiva entre los 30 años de edad y la fuerza máxima de entrenamiento y el rendimiento en los atletas. La resistencia muscular abdominal mostró el mayor coeficiente de correlación con el rendimiento de la natación sincronizada. Conclusión: Los entrenadores deben organizar un entrenamiento de fuerza adecuado en función de las características de crecimiento y desarrollo de los deportistas y de las características de los movimientos de la natación sincronizada. De este modo, se puede conseguir un excelente efecto de entrenamiento físico entrenando el core. Nivel de evidencia II; Estudios terapéuticos - investigación de los resultados del tratamiento.
Subject(s)
Humans , Oxygen Consumption/physiology , Swimming/physiology , Athletic Performance , Resistance Training/methods , Muscle Tonus , Muscle StrengthABSTRACT
O objetivo dessa carta resposta foi tecer algumas considerações sobre o ponto de vista do manuscrito "A densidade como uma nova métrica da quantificação de cargas no treinamento de força", publicado nessa tradicional revista brasileira. Erroneamente, os autores apontaram que o termo work to rest ratio utilizado no estudo Blood Pressure Response During Resistance Training of Different Work-to-Rest Ratio e publicado no Journal of Strength Conditioning Research estaria equivocado. Os autores também sugerem que a densidade seja calculada apenas pela fórmula: total de peso levantado/total de pausa. Isso limitaria o cálculo da densidade em métodos isométricos de treinamento de força, que podem ter a densidade calculada pela fórmula: tempo de tensão muscular/total de pausa. Essa breve comunicação amplia o contexto conceitual e de aplicação prática dessa métrica que é pouco conhecida no treinamento de força. (AU)
The aim of this reply letter was to present some considerations about the point of view of the manuscript "Density as new metric to quantify strength training loads", published in this traditional Brazilian journal. The authors erroneously pointed out that term "work to rest ratio" used in the study "Blood Pressure Response During Resistance Training of Different Work-to-Rest Ratio" and published in Journal of Strength Conditioning Research, would be wrong. The authors also suggest that density must be calculated only by the formula: total weight lifted / total rest interval. This would limit density calculation in isometric strength training methods, which can have density calculated by the formula: muscle tension time / total rest interval. This brief communication broadens the conceptual context and practical application of this metric that is little known in strength training. (AU)
Subject(s)
Humans , Rest , Weight Lifting , Physical Exertion , High-Intensity Interval Training , Resistance Training , Muscle TonusABSTRACT
Abstract: Purpose: The objective of this study is to evaluate and compare the microtensile bond strength (μTBS) of four different self-adhesive resin cements to a resin-based ceramic CAD/CAM block, at the baseline, and after subjecting them to 5,000 thermo-cycles.Materials and Methods: Four self-adhesive dual-cured resin cements; G-CEM LinkAce (GC EUROPE, Leuven, Belgium), RelyX U200 (3M ESPE, Seefeld, Germany), Maxcem Elite (Kerr, CA, USA), TheraCem (Bisco, Schaumburg, USA) were applied to Cerasmart CAD/CAM blocks (GC EUROPE, Leuven, Belgium). CAD/CAM blocks were sectioned into sticks and subjected to µTBS tests at 24 hours, and the other half were subjected to tests after 5000 thermo-cycles. The data were tested by one-way variance analysis (p<0.05). Results: The highest bond strength values were observed in TheraCem, followed by G-CEM LinkAce and RelyX U200, respectively (p<0.05). At the baseline, G-CEM LinkAce, RelyX U200, and Maxcem Elite showed statistically similar results. After 5,000 thermal-cycles, a significant decrease was observed in the bond strength values of G-CEM LinkAce (p<0.05). Conclusion: Between the adhesive cements used in the study, TheraCem showed the highest micro-tensile bond strength values both in the baseline (24h) results, and after the 5,000 thermal- cycle aging procedures.
Resumen: Propósito: Evaluar y comparar la resistencia adhesiva microtensil (μTBS) de cuatro cementos de resina autoadhesivos diferentes con un bloque CAD/CAM de cerámica a base de resina, antes y después de 5.000 ciclos de termociclado. Materiales y métodos: cuatro cementos de resina de doble curado autoadhesivos; G-CEM LinkAce (GC EUROPE, Lovaina, Bélgica), RelyX U200 (3M ESPE, Seefeld, Alemania), Maxcem Elite (Kerr, CA, EE. UU.), TheraCem (Bisco, Schaumburg, EE. UU.) fueron aplicados a bloques Cerasmart CAD/CAM (GC EUROPE, Lovaina, Bélgica). Los bloques CAD/CAM se seccionaron en barras y se sometieron a pruebas µTBS a las 24 horas, y la otra mitad se sometió a pruebas después de 5000 ciclos térmicos. Los datos fueron probados por análisis de varianza unidireccional (p<0.05). Resultados: Los valores más altos de fuerza de unión se observaron en TheraCem, seguido de G-CEM LinkAce y RelyX U200, respectivamente (p<0.05). En la línea de base, G-CEM LinkAce, RelyX U200, Maxcem Elite mostró resultados estadísticamente similares. Después de 5.000 procesos de ciclo térmico, se observó una disminución significativa en los valores de resistencia de la unión de G-CEM LinkAce (p<0.05). Conclusión: entre los cementos adhesivos utilizados en el estudio, TheraCem mostró los valores más altos de resistencia de la unión micro-extensible tanto en la línea de base (24 h) como después de 5,000 procedimientos de envejecimiento térmico.
Subject(s)
Dentin-Bonding Agents , Resin Cements/therapeutic use , Resins , Muscle TonusABSTRACT
OBJECTIVE@#To verify the superiority of motor imagery acupuncture in improving muscle tension for patients with upper limb hemiplegia in early stroke.@*METHODS@#A total of 64 patients of stroke hemiplegia with upper limb flaccid paralysis were randomly divided into an observation group (32 cases, 1 case dropped off ) and a control group (32 cases, 4 cases dropped off ). The observation group was treated with motor imagery acupuncture (both acupuncture and motor imagery therapy at affected upper limb were performed).The control group was treated with acupuncture plus motor imagery therapy at affected lower limb, 2 h later after acupuncture, motor imagery therapy was applied to upper limb. Baihui (GV 20) to Taiyang (EX-HN 5) of healthy side, Fengchi (GB 20) and Jianyu (LI 15), Jianjing (GB 21), Quchi (LI 11), Waiguan (TE 5) on the affected side, ect. were selected in both groups, once a day, 5 times a week for 4 weeks. Before and after treatment, 4, 8 weeks after treatment, the modified Ashworth scale (MAS) grade and Brunnstrom stage were compared in the two groups.@*RESULTS@#Compared before treatment, the muscle tension of shoulder, elbow and wrist each time point after treatment was increased in the two groups (@*CONCLUSION@#Motor imagery acupuncture could promote hemiplegia upper limb muscle tension recovery in patients of stroke hemiplegia with upper limb flaccid paralysis, make the patients gradually shift to the separate fine movement mode, inhibit and relieve the appearance and development of spasm.
Subject(s)
Humans , Acupuncture Therapy , Hemiplegia/therapy , Muscle Tonus , Stroke/therapy , Treatment Outcome , Upper ExtremityABSTRACT
RESUMO Objetivo identificar sinais e sintomas de DTM, bem como analisar os resultados de parâmetros vocais, do exame clínico físico de palpação muscular, da autopercepção de sintomas vocais, dor e fadiga vocal de mulheres com DTM e comparar com mulheres vocalmente saudáveis. Métodos estudo transversal com 45 mulheres (23 com DTM e 22 controles), mediana de idade similar entre os grupos. A avaliação fonoaudiológica e otorrinolaringológica determinaram o diagnóstico de DTM. Todas as participantes responderam aos protocolos Escala de Sintomas Vocais (ESV), Índice de Fadiga Vocal (IFV) e Questionário Nórdico de Sintomas Osteomusculares (QNSO). Elas também foram avaliadas pelo exame de palpação da musculatura perilaríngea, avaliação perceptivo-auditiva e análise acústica da voz da frequência fundamental. A amostra de fala incluiu vogais "a", "i" e "é" sustentadas e fala encadeada, gravada em ambiente silente, e submetida à avaliação perceptivo-auditiva por três juízes. Na análise acústica, a frequência fundamental e tempos máximos de fonação foram extraídos. Resultados O grupo DTM apresentou piores resultados na ESV, na IFV e no QNSO, além de maior resistência à palpação e posição vertical de laringe alta. Os parâmetros vocais também apresentaram maior desvio na DTM, exceto para a frequência fundamental. Não houve relação entre sintomas vocais, fadiga ou dor com o grau geral da disfonia no grupo DTM, indicando sintomas importantes em desvios vocais leves ou moderados. Conclusão mulheres com DTM apresentaram sintomas vocais, fadiga vocal, dor muscular, resistência à palpação e parâmetros vocais desviados quando comparadas às mulheres vocalmente saudáveis.
ABSTRACT Purpose To identify muscle tension dysphonia (MTD) signs and symptoms, as well as to analyze the results of vocal parameters, the physical clinical examination of muscle palpation, the self-perception of vocal symptoms, vocal pain, and fatigue of women with MTD and compare them with women with healthy voices. Methods a cross-sectional study with 45 women (23 with MTD and 22 controls), similar median age between groups. The speech-language and otorhinolaryngological evaluation determined the diagnosis of MTD. All participants responded to the Voice Symptoms Scale (VoiSS), Vocal Fatigue Index (VFI), and Nordic Musculoskeletal Questionnaire (NMQ) protocols. They were also assessed by a palpatory evaluation of the perilaryngeal musculature, auditory-perceptual evaluation, and acoustic analysis of the voice fundamental frequency. The speech sample included sustained vowels "a", "i" and "e" and connected speech, recorded in a silent environment, and submitted to auditory-perceptual evaluation by three judges. In the acoustic analysis, the fundamental frequency and maximum phonation times were extracted. Results The MTD group had worse results in VoiSS, VFI, and NMQ, in addition to greater resistance to palpation and a high vertical position of the larynx. The vocal parameters also showed greater deviation in the MTD group, except for the fundamental frequency. There was no relationship between vocal symptoms, fatigue, or pain with the general degree of dysphonia in the MTD group, indicating important symptoms in mild or moderate vocal deviations. Conclusion women with MTD presented vocal symptoms, vocal fatigue, muscle pain, resistance to palpation and deviated vocal parameters when compared to vocally healthy women.
Subject(s)
Humans , Female , Dysphonia/diagnosis , Pain , Palpation , Self Concept , Voice Quality , Cross-Sectional Studies , Muscle Tonus , MusclesABSTRACT
Introducción. La disfonía por tensión muscular fue definida, desde 1983, como un desorden que ocasiona un desbalance en las fuerzas de tensión muscular laríngea sin evidencia de patología estructural o neurológica. Denominado también disfonía por tensión muscular, tipo 1, este desorden aún no tiene estandarizadas las características que en la práctica han sido consideradas parte de su diagnóstico.Objetivo. Revisar la información actual, no mayor a cinco años, sobre disfonía por tensión muscular para unificar criterios y diagnósticos actuales.Metodología. Se realizó una búsqueda sistemática a través de las bases de datos PubMed, Google Scholar y Cochrane. Los términos MESH utilizados fueron: dis-fonía por tensión muscular, disfonía funcional, disfonía hipercinética y fatiga vocal. Criterios de inclusión: artículos publicados en revistas arbitradas, sin importancia del diseño y antigüedad no mayor a cinco años. Criterios de exclusión: artículos cuyo enfoque principal no fuera disfonía por tensión muscular y con idioma diferente al inglés o español.Resultados. Dos estudios refieren mayor patología en mujeres que hombres; cuatro investigaciones reportan presión subglótica aumentada (>90 mmHg); tres trabajos reportaron medidas fonatorias; un trabajo propone video de alta resolución como demostración de hiperfunción vocal; una investigación evaluó onda mucosa por elec-troglotografía; una investigación estudió el uso de resonancia magnética funcional; otro trabajo propuso un estudio piloto de evaluación de flujo sanguíneo de músculos infrahioideos. Otro trabajo hace una revisión del uso de métodos diagnósticos.Conclusiones. Los parámetros de mayor peso fueron pico cepstral y presión sub-glótica. Aún es necesario ampliar el conocimiento con nuevas investigaciones que permitan criterios universales
Introduction. Muscle tension dysphonia has been defined since 1983 as a disorder in which there is an imbalance in laryngeal muscle tension forces, without evidence of structural or neurological pathology; it has also been called type I muscle tension dysphonia. The characteristics that in practice have been considered part of the di-agnosis are not standardized.Objective. To review current information, not older than 5 years, on muscle tension dysphonia, unifying current diagnostic criteria.Methodology. A systematic search was carried out through the Pub Med, Google scholar and Cochrane databases. The MESH terms used were: muscle tension dys-phonia, functional dysphonia, hyperkinetic dysphonia, and vocal fatigue. Inclusion criteria: articles published in peer-reviewed journals, regardless of design and pub-lished no more than 5 years before. Exclusion criteria: articles whose main focus was not muscle tension dysphonia and with a language other than English or Spanish.Results. Two studies report more pathology in women than men; four investiga-tions report increased subglottic pressure (> 90 mmHg); three studies reported pho-natory measures; a work proposes high resolution video as a demonstration of vo-cal hyperfunction; an investigation evaluated mucosal wave by electroglottography; an investigation studied the use of functional magnetic resonance imaging; another work proposed a pilot study of infrahyoid muscle blood flow assessment: another work reviews the use of diagnostic methods.Conclusions. The parameters of greater weight were cepstral peak and subglottic pressure. It is still necessary to expand the knowledge with new research that allows universal criteria
Subject(s)
Voice Disorders/diagnosis , Dysphonia , Dysphonia/diagnosis , Vocal Cords/abnormalities , Voice , Voice/physiology , Laryngeal Muscles , Mucous Membrane , Muscle Tonus/physiologyABSTRACT
Introducción: El p-clorofenol alcanforado es un derivado clorofenólico de uso común como medicación intraconducto en Endodoncia. Son escasos los reportes científicos sobre sus efectos en la musculatura lisa vascular arterial y la regulación del flujo sanguíneo local. Objetivo: Determinar el efecto del p-clorofenol alcanforado sobre la dinámica contráctil del músculo liso vascular arterial en el tiempo. Método: Se realizó una investigación experimental preclínica utilizando 14 anillos de aorta obtenidos de ratas Wistar. Los anillos se colocaron en baño de órganos y se preactivaron con noradrenalina, registrándose luego la tensión desarrollada por el músculo liso vascular tras la adición de p-clorofenol alcanforado durante diferentes intervalos de tiempo. Resultados: El 51,4 porciento de la musculatura lisa vascular se relajó por la acción del p-clorofenol alcanforado. El mayor descenso del tono vascular se produjo entre el tercer y quinto minuto de añadido el medicamento. Las pruebas de Wilcoxon de los rangos con signos evidenciaron diferencias significativas entre la tensión base inicial y la registrada en los diferentes intervalos de tiempo estudiados. Conclusiones: el p-clorofenol alcanforado, induce in vitro, relajación del músculo liso arterial a través de un acoplamiento excitación-contracción de tipo farmacomecánico, la cual se incrementa en función del tiempo(AU).
Introduction: Camphorated p-chlorophenol is a chlorophenolic derivative commonly used as an intra-oral medication in endodontics. Scientific reports on its effects in arterial vascular smooth muscle and local blood flow regulation are scarce. Objective: To determine the effect of camphorated p-chlorophenol on the contractile dynamics of arterial vascular smooth muscle. Method: An experimental and preclinical research was conducted with the use of 14 aortic rings of Wistar rats. The rings were placed in an organ bath and preactivated with noradrenaline, and the tension developed by the vascular smooth muscle at different time intervals was recorded after induction of camphorated p-chlorophenol. Results: Most of the vascular smooth muscle (51.4 percent) relaxed with the use of camphorated p-chlorophenol. The greatest decrease in vascular tone occurred between the third and fifth minute after use the drug. Wilcoxon rank tests showed significant differences between tension observed at baseline and those recorded at the different time intervals studied. Conclusions: Camphorated p-chlorophenol, induces in vitro, relax the arterial smooth muscle through a pharmacomechanical excitation-contraction link, which increases according to the time(AU).
Introdução: O cânfora-clorofenol é um derivado clorofenólico comumente utilizado como medicamento intracanal em Endodontia. Relatórios científicos sobre seus efeitos no músculo liso vascular arterial e na regulação do fluxo sanguíneo local são escassos. Objetivo: Determinar o efeito da cânfora-clorofenol na dinâmica contrátil do músculo liso vascular arterial ao longo do tempo. Método: Foi realizada investigação experimental pré-clínica com 14 anéis aórticos obtidos de ratos Wistar. Os anéis foram colocados em banho de órgãos e pré-ativados com norepinefrina, em seguida, a tensão desenvolvida pela musculatura lisa vascular foi registrada após a adição de cânfora-clorofenol em diferentes intervalos de tempo. Resultados: 51,4 porcento dos músculos lisos vasculares estavam relaxados pela ação do cânfora-clorofenol. A maior diminuição do tônus vascular ocorreu entre o terceiro e o quinto minuto após a adição do medicamento. Os testes de Wilcoxon das faixas com sinais mostraram diferenças significativas entre a tensão base inicial e a registrada nos diferentes intervalos de tempo estudados. Conclusões: O cânfora-clorofenol induz, in vitro, relaxamento da musculatura lisa arterial por meio de um acoplamento excitação-contração do tipo farmacomecânico, que aumenta em função do tempo(AU).
Subject(s)
Animals , Rats , Chlorophenols/administration & dosage , Muscle, Smooth, Vascular/drug effects , Muscle Tonus/drug effects , Rats, Wistar , GermanyABSTRACT
Introdução: Durante sua carreira o cantor lírico sofre grande demanda e consequente alteração da coordenação dos músculos respiratórios, porém não se sabe se estas exigências podem alterar a mobilidade e tonicidade no principal músculo da respiração, o diafragma. Objetivos: Avaliar e comparar a tonicidade e a mobilidade do diafragma de cantores líricos profissionais e de não-cantores. Participaram do estudo 15 cantores líricos profissionais em plena carreira e 24 adultos não-cantores com idades e IMCs equivalentes. Métodos: Duas avaliações foram empregadas: para avaliar a mobilidade costal foi utilizada a parte referente a avaliação desse parâmetro da Manual Evaluation of the Diaphragm Scale (MED Scale); para avaliar a tonicidade diafragmática a avaliação descrita por Rial e Pinsach em 2015. Resultados: Os resultados mostraram que a distribuição da avaliação manual do diafragma no grupo dos cantores apresentou distribuição significativamente diferente, tendo p < 0,05, com relação à tonicidade bilateral do diafragma, apresentando maior hipertonicidade em relação ao grupo controle, e que não houve diferenças significativas em relação à mobilidade. Conclusão: Os gestos artísticos usados pelos cantores líricos profissionais afetam a tonicidade do diafragma. (AU)
Introduction: The professional lyrical singers during their careers suffer great demand and consequent alteration of the coordination of the respiratory muscles, however it is not known if these requirements can alter the mobility and tonicity in the main muscle of the breath, the diaphragm. Objectives: To evaluate and compare diaphragm tonicity and mobility of professional lyric singers and non-singers. The study included 15 professional lyric singers in their full careers and 24 non-singing adults of equivalent ages and BMIs. Methods: Two forms of manual evaluation of the diaphragm were used: to assess costal mobility, the part of the manual evaluation to evaluate this parameter was used the Manual Evaluation of the Diaphragm Scale (MED Scale); and to evaluate the diaphragmatic tonicity the evaluation described by Rial and Pinsach in 2015. Results: The results showed that the distribution of the manual evaluation of the diaphragm in the group of singers presented a significantly different distribution, with p < 0,05, in relation to the bilateral diaphragm tonicity, presenting them with greater hypertonicity in relation to the control group, and that there were no significant differences regarding mobility. Conclusion: The artistic gestures used by professional lyric singers affect the tone of the diaphragm. (AU)
Subject(s)
Humans , Diaphragm , Muscle Tonus , SingingABSTRACT
Introdução: A paralisia cerebral (PC) é uma condição permanente causada por uma lesão encefálica estática, multifatorial e não progressiva dos movimentos e postura. A equoterapia aparece como método terapêutico e educacional que utiliza o cavalo para melhoria do desenvolvimento de pessoas portadoras de necessidades especiais. Objetivos: Revisar sistematicamente os efeitos da equoterapia sobre o desempenho funcional em crianças com paralisia cerebral. Métodos: Trata-se de uma revisão sistemática revisada por dois revisores independentes, conforme recomendações PRISMA, nas bases de dados PubMed e Biblioteca Cochrane. Incluídos estudos originais que utilizaram a equoterapia em pacientes com paralisia cerebral publicados em português e na língua inglesa. A Escala PEDro foi utilizada para analisar a qualidade metodológica dos estudos e a Cochrane Collaboration para análise de risco de viés. Resultados: Foram incluídos cinco artigos, publicados entre os anos 2012 e 2019. Todos estudos evidenciaram resultados satisfatórios em pacientes com paralisia cerebral após o tratamento com a equoterapia, melhorando a marcha, o equilíbrio, o tônus, a simetria e a qualidade de vida independente se ela foi associada a outro método. Conclusão: A equoterapia é uma modalidade terapêutica eficaz no tratamento das crianças com paralisia cerebral, melhorando os déficits motores e neurológicos, além da espasticidade muscular. (AU)
Introduction: Cerebral palsy (CP) is a permanent condition caused by a static, multifactorial and non-progressive brain injury of the movements and posture. Equine therapy is a therapeutic and educational method that uses horse to improve the development of people with special needs. Methods: This is a systematic review reviewed by two independent reviewers, according to PRISMA recommendations, in the PubMed and Cochrane Library databases. Including original studies that used equine therapy in patients with cerebral palsy published in Portuguese and in the English language. The PEDro Scale was used to analyze the methodological quality of the studies and the Cochrane Collaboration for bias risk analysis. Results: Five articles published between the years 2012 and 2019 were included. All studies showed satisfactory results in patients with cerebral palsy after treatment with equine therapy, improving gait, balance, tone, symmetry and quality of life whether it was associated with another method. Conclusion: Equine therapy is an effective therapeutic modality in the treatment of children with cerebral palsy, improving motor and neurological deficits, as well as muscle spasticity, favors balance, postural control, reduction of joint deformities and gross motor function. (AU)
Subject(s)
Humans , Cerebral Palsy , Child , Equine-Assisted Therapy , Physical Functional Performance , Postural Balance , Muscle TonusABSTRACT
Un futbolista resulta vulnerable a sufrir lesiones a lo largo de su carrera profesional, por lo que resulta importante la prevención y tratamiento efectivo al respecto. Se realizó un estudio con enfoque cuantitativo y de tipo observacional descriptivo. Los investigadores trabajaron con la totalidad de la población objeto de estudio, la que estuvo constituida por 21 jugadores de la categoría sub 14 de la FDCH, durante el período de competición junioagosto 2018. Un 38,09% presentaron lesiones por contracturas musculares. La medición de la flexibilidad permitió apreciar que la mayoría de la población estuvo en las categorías de normal y deficiente (66,67%). En el 57,14% de los participantes se usó el KT para buscar relajación del tono muscular. Se estableció la existencia de un aumento de la flexibilidad en el 95,24% de los futbolistas. La evaluación pre y post competición del test sit and reach permitió determinar la importancia y viabilidad de la utilización del vendaje neuromuscular como una medida de intervención y prevención de lesiones, especialmente en la optimización de la flexibilidad isquiotibial y disminución de los factores de riesgo.
A footballer is predisposed to suffer injures throughout his professional career, it is important to perform a preventive approach in one of the most frequent affections that affect the athlete such as muscular distention. An analytical descriptive investigation was carried out. For demonstrating the importance of the use of the prevent neuromuscular bandage and its effects on the hamstring musculature. The population object of study was conformed, by 21 players of the category sub14 in Federación Deportiva de Chimborazo who during the year 2017 had incidence of 57% of hamstring atrain. At the end of the investigation 76% of footballer maintained good flexibility, decreasing the risk factors and reducing the incidence of the injury by 33 %.
Subject(s)
Humans , Male , Adolescent , Therapeutics , Bandages , Contracture , Athletic Tape , Athletes , Muscle TonusABSTRACT
Manual tests in clinical investigation must be supported by anatomical and physiological findings in order to obtain an objective information. The application of different mandibular positions in children obtains a variation in the 'hip rotators test' (p < 0.001). The possible relationships behind the muscle tone of the external rotators of the hips and the stomatognathic system are exposed, with special attention on the fascial tissue and its morphological characteristics. Despite these anatomical and physiological connections, there is no further evidence of a strong cause-effect relationship in this test.
Las pruebas manuales en la investigación clínica deben estar respaldadas por hallazgos anatómicos y fisiológicos para obtener una información objetiva. La aplicación de diferentes posiciones mandibulares en niños muestra una variación en la "prueba de rotadores de cadera" (p <0,001). Se exponen las posibles relaciones del tono muscular de los rotadores externos de las caderas y el sistema estomatognático, con especial atención en el tejido fascial y sus características morfológicas. A pesar de estas conexiones anatomofisiológicas, no existe una evidencia mayor de una relación importante causa-efecto en esta prueba.
Subject(s)
Humans , Male , Female , Child , Adolescent , Stomatognathic System/anatomy & histology , Fascia/anatomy & histology , Hip/physiology , Muscle Tonus , PostureABSTRACT
RESUMO O objetivo do presente estudo foi analisar a atividade mioelétrica (EMG), o tempo sob tensão (TST) e a projeção dos joelhos no exercício agachamento sem o uso de implementos (SI) e com o uso de physioball (PH) e banda elástica (BE) em diferentes intensidades de esforço. Dez homens realizaram o exercício nos três protocolos com a intensidade de 50 e 100% de 10 RM. A distância entre joelhos no protocolo controle (51,25cm) foi menor quando comparada com o SI 50% (84,38cm; p < 0,001), com o SI 100% (88,80cm; p < 0,001) e com BE 100% (67,41cm; p = 0,014). A distância entre os joelhos também foi menor para os protocolos PH 100% (53,10cm; p < 0,001) e BE 100% (67,41cm; p < 0,001) comparada ao SI 100% (88,80cm). O Vasto Medial Oblíquo (VMO) apresentou maior ativação nos protocolos SI 50% (p = 0,035) e PH 50% (p = 0,028) quando comparados ao protocolo BE 50%. A realização do agachamento com cargas submáximas parece aumentar e diminuir a ativação do VMO quando realizado com PH e BE, respectivamente.
ABSTRACT The objective of the present study was to analyze the myoelectric activity (EMG), the time under tension (TST) and the knee projection in the squat exercise without the use of implements (SI) and with the use of physioball (PH) and elastic band (EB) at different intensities of effort. Ten men performed the exercise in the three protocols with the intensity of 50 and 100% of 10 RM. The distance between knees in the control protocol (51.25 cm) was lower when compared to SI 50% (84.38 cm, p <0.001), with SI 100% (88.80 cm, p <0.001) and with EB 100% (67.41cm, p = 0.014). The distance between the knees was also lower for the protocols PH 100% (53.10cm, p <0.001) and EB 100% (67.41, p <0.001) compared to the SI 100% (88.80 cm) protocols. The Vasto Medial Oblique (VMO) presented greater activation in the SI 50% protocols (p = 0.035) and PH 50% (p = 0.028) when compared to the EB 50% protocol. The accomplishment of squatting with submaximal loads seems to increase and decrease the activation of VMO when performed with physioball and BE, respectively.
Subject(s)
Humans , Male , Resistance Training , Knee , Projection , Time , Exercise , Myoelectric Complex, Migrating , Physical Exertion , Genu Varum , Hip/anatomy & histology , Muscle Tonus , Muscles/anatomy & histologyABSTRACT
Abstract Introduction: The impairment of muscle strength and fatigue in leprosy remains a problem that requires careful attention to avoid or minimize its progression, as well as prevention of disabilities and deformities. Objective: To investigate the maximum voluntary contraction and time to muscle fatigue in leprosy patients. Method: A total of 21 leprosy patients and 21 healthy subjects completed the sample. The method used to determine the maximum voluntary contraction (MVC) of the handgrip followed the recommendation of the American Society of Hand Therapists with the use of a hydraulic hand grip dynamometer. The test was performed three times with each hand, with a time interval of 60 seconds between successive trials. The subject was instructed to perform a maximal isometric force against the dynamometer for 5 seconds. The peaks were recorded and used for the fatigue test. For the fatigue test, we recorded the electromyogram of the forearm muscles to offline determine the onset time for the muscle contraction (14 bits, Miograph 2 USB®, Miotec, Brazil). Results: Leprosy patients had lower MVC compared with healthy subjects (p > 0.05), both in the dominant and the non-dominant hands. The time to fatigue in the leprosy and control groups was similar (p < 0.05). We observed that leprosy patients had more contractions than the healthy subjects (22.6 ± 11.8 contractions for the leprosy group vs. 12.3 ± 6.9 contractions for the control group, p > 0.05). Conclusion: Multibacillary leprosy patients lost muscle force without modifying the resistance to fatigue.
Resumo Introdução: O comprometimento da força muscular e a fadiga na hanseníase continuam sendo problemas que requerem cuidadosa atenção para evitar ou minimizar sua progressão, bem como prevenir incapacidades e deformidades. Objetivo: Avaliar a força muscular e o tempo até a fadiga em pacientes com hanseníase Método: Vinte e um pacientes com hanseníase e 21 indivíduos saudáveis completaram a amostra. O método utilizado para determinar a contração voluntária máxima (CVM) da força de preensão palmar seguiu a recomendação da Sociedade Americana de Terapeutas da Mão com o uso de um dinamômetro de preensão manual. O teste foi realizado três vezes em cada mão, com intervalo de tempo de sessenta segundos entre tentativas sucessivas. O sujeito foi instruído a realizar força isométrica máxima contra o dinamômetro durante cinco segundos. Os picos foram registrados e usados para o teste de fadiga. Para o teste de fadiga, registrou-se o eletromiograma dos músculos do antebraço para determinar off-line o tempo de início da contração muscular (14 bits, Miograph 2 USB ® , Miotec, Brasil). Resultados: Os pacientes com hanseníase apresentaram menor CVM em relação aos saudáveis (p < 0,05) nas mãos dominante e não dominante. Não houve diferença no tempo de fadiga entre os grupos hanseníase e controle (p > 0,05). Foi observado que os pacientes com hanseníase tinham mais contrações do que os saudáveis (22,6 ± 11,8 contrações para o grupo com hanseníase vs. 12,3 ± 6,9 para o grupo controle, p < 0,05). Conclusão: Pacientes com hanseníase multibacilar apresentaram perda de força muscular sem modificação da resistência à fadiga.
Resumen Introducción: El compromiso de la fuerza muscular y la fatiga en la lepra sigue siendo un problema que requiere atención cuidadosa para evitar o minimizar su progresión, así como la prevención de incapacidades y deformidades. Objetivo: Evaluar la fuerza muscular y el tiempo hasta la fatiga de pacientes con lepra. Método: Veintiún pacientes con lepra y 21 sujetos sanos completaron la muestra. El método utilizado para determinar la contracción voluntaria máxima (CVM) de la fuerza de asimiento palmar siguió la recomendación de la Sociedad Americana de Terapeutas de la Mano con el uso de un dinamómetro de asimiento manual. La prueba se realizó tres veces con cada mano, con un intervalo de tiempo de 60 segundos entre intentos sucesivos. El sujeto fue instruido a realizar una fuerza isométrica máxima contra el dinamómetro durante 5 segundos. Los picos se registraron y se utilizaron para la prueba de fatiga. Para la prueba de fatiga, registramos el electromiograma de los músculos del antebrazo para determinar fuera de línea el tiempo de inicio de la contracción muscular (14 bits, Miograph 2 USB ® , Miotec, Brasil). Resultados: Los pacientes con lepra presentaron menor CVM con relación a los sanos (p < 0,05) en las manos dominante y no dominante. No hubo diferencia en el tiempo de fatiga entre los grupos de lepra y control (p > 0,05). Se observó que los pacientes con lepra tenían más contracciones que los sanos (22,6 ± 11,8 contracciones para el grupo con hanseniasis frente a 12,3 ± 6,9 para el grupo control, p < 0,05). Conclusión: Pacientes con hanseniasis multibacilar presentaron pérdida de fuerza muscular sin modificación de la resistencia a la fatiga.
Subject(s)
Humans , Male , Female , Muscle Fatigue , Leprosy , Musculoskeletal System , Muscle Strength , Muscle TonusABSTRACT
Objective: To evaluate the short-term effect of two hydrokinesiotherapy protocols on muscle tone and stress levels in children with SCZ. Method: A crossover, randomized, blinded study with children with microcephaly/SCZ between 3-36 months of age. Was evaluated by the Modified Tardieu Scale(EMT), analyzing the degree of muscle tone and the range of articular movement(ROM); the level of stress, through a visual analogue scale of faces ranging from a state without stress(1) to intense stress(4). Two hydrocinesotherapy protocols(PI and PII) were applied in a restricted aquatic environment, for 15 minutes with water temperature at 37ºC. Results: Twelve children participated in the study (mean age in months: 23.9+3.97), 58.7% female. After PI, we observed a reduction in the degree of tone of the extensor muscles of the elbow(p = 0.03) and knee(p = 0.04); in PII, there were no significant changes in the degree of tone. There were no significant changes in the level of stress in PI and PII, however 83.3% were without stress or mild stress before the interventions. Conclusions: Protocol I reduced the degree of muscle tone in the short term when compared to PII. It is emphasized that the protocols applied are of low cost, and can be a viable non-pharmacological technique option in the therapeutic follow-up of these children. It should be noted that the physiotherapist's experience should guide the choice of the appropriate protocol for the therapeutic objective of each child and the advantage of being a technique easily replicable in a therapeutic and home environment.
Objective: To evaluate the short-term effect of two hydrokinesiotherapy protocols on muscle tone and stress levels in children with SCZ. Method: A crossover, randomized, blinded study with children with microcephaly/SCZ between 3-36 months of age. Was evaluated by the Modified Tardieu Scale(EMT), analyzing the degree of muscle tone and the range of articular movement(ROM); the level of stress, through a visual analogue scale of faces ranging from a state without stress(1) to intense stress(4). Two hydrocinesotherapy protocols(PI and PII) were applied in a restricted aquatic environment, for 15 minutes with water temperature at 37ºC. Results: Twelve children participated in the study (mean age in months: 23.9+3.97), 58.7% female. After PI, we observed a reduction in the degree of tone of the extensor muscles of the elbow(p = 0.03) and knee(p = 0.04); in PII, there were no significant changes in the degree of tone. There were no significant changes in the level of stress in PI and PII, however 83.3% were without stress or mild stress before the interventions. Conclusions: Protocol I reduced the degree of muscle tone in the short term when compared to PII. It is emphasized that the protocols applied are of low cost, and can be a viable non-pharmacological technique option in the therapeutic follow-up of these children. It should be noted that the physiotherapist's experience should guide the choice of the appropriate protocol for the therapeutic objective of each child and the advantage of being a technique easily replicable in a therapeutic and home environment.
Subject(s)
Rehabilitation , Zika Virus , Hydrotherapy , Muscle TonusABSTRACT
ABSTRACT BACKGROUND: Digital rectal examination (DRE) is part of the physical examination, is also essential for the colorectal surgeon evaluation. A good DRE offers precious information related to the patient's complaints, which will help in decision making. It is simple, quick and minimally invasive. In many centers around the world, the DRE is still the only method to evaluate the anal sphincter prior to patient's management. On the other hand, anorectal manometry (ARM) is the main method for objective functional evaluation of anal sphincter pressures. The discrepancy of DRE depending on the examiner to determine sphincter tonus in comparison to ARM motivated this study. OBJECTIVE: To compare the DRE performed by proficient and non-experienced examiners to sphincter pressure parameters obtained at ARM, depending on examiners expertise. METHODS: Thirty-six consecutive patients with complaints of fecal incontinence or chronic constipation, from the anorectal physiology clinic of the University of São Paulo School of Medicine, were prospectively included. Each patient underwent ARM and DRE performed by two senior colorectal surgeons and one junior colorectal surgeon prior to the ARM. Patient's history was blinded for the examiner's knowledge, also the impressions of each examiner were blinded from the others. For the DRE rest and squeeze pressures were classified by an objective scale (DRE scoring system) that was compared to the parameters of the ARM for the analysis. The results obtained at the ARM were compared to the DRE performed by the seniors and the junior colorectal surgeons. STATISTICAL ANALYSIS: Descriptive analysis was performed for all parameters. For the rest and squeeze pressures the Gamma index was used for the comparison between the DRE and ARM, which varied from 0 to 1. The closer to 1 the better was the agreement. RESULTS: The mean age was 48 years old and 55.5% of patients were female. The agreement of rest anal pressures between the ARM and the DRE performed by the senior proficient examiners was 0.7 (CI 95%; 0.32-1.0), while for the junior non-experienced examiner was 0.52 (CI 95%; 0.09-0.96). The agreement of squeeze pressures was 0.96 (CI 95%; 0.87-1.0) for the seniors and 0.52 (CI 95%; 0.16-0.89) for the junior examiner. CONCLUSION: More experienced colorectal surgeons used to DRE had a more significant agreement with the ARM, thereafter would have more appropriate therapeutic management to patients with sphincter functional problems. ARM, therefore, persists as an important exam to objectively evaluate the sphincter complex, justifying its utility in the clinical practice.
RESUMO CONTEXTO: Exame anorretal digital (EAD) faz parte do exame físico, também é essencial para a avaliação do cirurgião colorretal. Um bom EAD oferece informações preciosas relacionadas às queixas do paciente, que auxiliam na tomada de decisões. Sua realização é simples, rápida e minimamente invasiva. Em diversos centros ao redor do mundo, o toque retal ainda é o único método para avaliar o esfíncter anal antes do tratamento. Por outro lado, a manometria anorretal (MAR) é o principal método para avaliação funcional objetiva das pressões esfincterianas. A discrepância entre o EAD, dependendo do examinador para determinar o tônus esfincteriano em comparação à MAR motivou este estudo. OBJETIVO: Comparar o EAD com os parâmetros de pressão esfincteriana obtidos na MAR, dependendo da experiência dos examinadores. MÉTODOS: Trinta e seis pacientes consecutivos com queixas de incontinência fecal ou constipação crônica, do ambulatório de Fisiologia Anorretal da Faculdade de Medicina da Universidade de São Paulo, foram prospectivamente incluídos. Cada paciente foi submetido a MAR e EAD realizados por dois cirurgiões colorretais seniores e um júnior antes da MAR. A história dos pacientes propositalmente omitida dos examinadores, e os resultados de cada examinador foram cegos dos demais. Para o EAD, as pressões de repouso e contração foram classificadas por uma escala objetiva (EAD Scoring System), realizada pelos examinadores seniores e pelo júnior em todos os pacientes, que foi comparada com os parâmetros da MAR para a análise. ANÁLISE ESTATÍSTICA: A análise descritiva foi feita para todos os parâmetros. Para as pressões de repouso e contração, o índice Gamma foi utilizado para a comparação entre o EAD e a MAR, que variou de 0 a 1. Quanto mais próximo de 1 melhor a concordância entre os dois métodos de avaliação. RESULTADOS: A idade média foi de 48 anos e 55,5% dos pacientes eram do sexo feminino. A concordância das pressões anais de repouso entre a MAR e o EAD realizadas pelos examinadores seniores, proficientes, foi de 0,7 (IC 95%; 0,32-1,0), enquanto para o examinador júnior, menos experiente, foi de 0,52 (IC95%; 0,09-0,96). A concordância das pressões de contração foi de 0,96 (IC 95%; 0,87-1,0) para os examinadores seniores e de 0,52 (IC 95%; 0,16-0,89) para o júnior. CONCLUSÃO: Cirurgiões colorretais mais experientes, o EAD teve concordância mais significativa com a MAR, o que poderia levar a um manejo terapêutico mais adequado aos pacientes portadores de doença anorretais funcionais. A manometria anorretal permanece, portanto, como método de avaliação objetiva da função esfincteriana.
Subject(s)
Humans , Male , Female , Adult , Anal Canal/physiopathology , Digital Rectal Examination/methods , Manometry/instrumentation , Pressure , Severity of Illness Index , Predictive Value of Tests , Prospective Studies , Clinical Competence , Constipation/diagnosis , Constipation/physiopathology , Fecal Incontinence/diagnosis , Fecal Incontinence/physiopathology , Middle Aged , Muscle TonusABSTRACT
Stiff-person syndrome is a rare disorder, and the natural history of the syndrome has not been completely ascertained. The symptoms range from mild to severe and can progress over time: the final result can be significant disability. However, this syndrome is often misdiagnosed due to a lack of understanding of the clinical manifestations. We report the case of a patient who presented with slowly progressing gait disturbance and lower extremity pain and was later diagnosed as suffering from stiff-person syndrome. The patient experienced symptomatic improvement after the administration of benzodiazepines. No recurrence of symptoms has been reported. If the characteristic clinical features and electromyography findings of the syndrome are accurately interpreted, diagnosis of patients with abnormal muscle tension can be effectively done.
Subject(s)
Humans , Autoantibodies , Autoimmune Diseases , Benzodiazepines , Diagnosis , Electromyography , Gait , Leg , Lower Extremity , Muscle Tonus , Natural History , Recurrence , Spasm , Stiff-Person SyndromeABSTRACT
Solitary neurofibroma of the glottis is extremely rare and accounts for only 0.1–1.5% of benign laryngeal tumors. Aryepiglottic fold is the most frequent involved site followed by arytenoids and ventricular folds. There have been few reports of neurofibroma of the true vocal cord. We report a case of neurofibroma which was deeply embedded in the vocal cord and misdiagnosed as muscle tension dysphonia with a review of literatures.