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1.
Rev. Assoc. Med. Bras. (1992) ; 68(1): 56-60, Jan. 2022. tab
Article in English | LILACS | ID: biblio-1360702

ABSTRACT

SUMMARY OBJECTIVE: The objective of this study was to measure the intra- and inter-rater reliability of the quantitative sensory testing for measuring the thermal pain threshold on myofascial trigger points in the upper trapezius muscle of individuals with chronic neck pain. METHODS: Thirty female participants were included, aged between 18 and 45 years and with bilateral myofascial trigger points, active and centrally located in the upper trapezius muscle. Two measurements with quantitative sensory testing were performed by each examiner at an interval of 1 week between them. RESULTS: We observed substantial reliability for the intra-rater analysis (intraclass correlation coefficient ranging between 0.876 and 0.896) and excellent reliability for the inter-rater analysis (intraclass correlation coefficient ranging between 0.917 and 0.954). CONCLUSION: The measurement of the thermal pain threshold on myofascial trigger points in individuals with chronic neck pain has acceptable reliability values, supporting the use of the quantitative sensory testing in the research setting and the clinical environment.


Subject(s)
Humans , Female , Adolescent , Adult , Young Adult , Neck Pain/epidemiology , Trigger Points/physiopathology , Superficial Back Muscles/physiopathology , Myofascial Pain Syndromes/diagnosis , Myofascial Pain Syndromes/physiopathology , Reproducibility of Results , Chronic Pain , Middle Aged
2.
Autops. Case Rep ; 11: e2021316, 2021. tab, graf
Article in English | LILACS | ID: biblio-1285411

ABSTRACT

Myositis ossificans (MO) is a benign, ossifying lesion that usually affects the skeletal muscle. The rare non-traumatic form of MO can cause diagnostic dilemma and management issues. These lesions, however, have similar radiology and histopathological characteristics described in the more frequently encountered traumatic forms. Depending on the stage of the lesion, the inherent feature of myositis ossificans varies, and so does the management of the lesion. We describe a non-traumatic MO occurring in latissimus dorsi of a young girl and discuss the review of literature on this rare subtype.


Subject(s)
Humans , Female , Child , Superficial Back Muscles , Myositis Ossificans/pathology , Diagnostic Imaging
3.
Rev. bras. ortop ; 55(6): 787-795, Nov.-Dec. 2020. tab, graf
Article in English | LILACS | ID: biblio-1156189

ABSTRACT

Abstract Evaluate the results of a series of 28 cases of high obstetric paralysis treated with the Sever-L'Episcopo technique modified by Hoffer, between 2003 and 2016. Children (mean age, four years and seven months) with adduction contracture and internal rotation of the shoulder without secondary bone deformities (Mallet class II) underwent lengthening of the pectoralis major muscle and tenotomy of the subscapularis muscle associated with transfer of the latissimus dorsi and teres major muscle to the infraspinatus muscle, moving to the function of external rotators and elevators. The mean follow-up was three years and 10 months. At the end of the study, 24 patients achieved excellent functional assessment scores, mainly of the abduction and external rotation, passing from Mallet class II to class IV. Four patients still demonstrated some degree of global movement limitation, passing from class II to class III. Regardless of the final functional gain, all patients were able to perform tasks that were previously difficult. The data from this study suggest that Hoffer's surgery is an effective method in the treatment of the sequelae of high obstetric paralysis without secondary bone deformities.


Resumo Avaliar os resultados de uma série de 28 casos de paralisia obstétrica alta tratadas com a técnica Sever-L'Episcopo modificada por Hoffer, entre 2003 e 2016. As crianças (idade média, quatro anos e sete meses) com contratura em adução e rotação interna do ombro sem deformidades ósseas secundárias (Mallet classe II) foram submetidas ao alongamento do músculo peitoral e tenotomia do músculo subescapular associada à transferência do latissimus dorsi e músculo redondo maior para o músculo infraespinhal, movendo-se para a função de rotadores externos e elevadores. O seguimento médio foi de 3 anos e 10 meses. Ao final do estudo, 24 pacientes obtiveram excelentes escores de avaliação funcional, principalmente de abdução e rotação externa, passando de Mallet classe II para classe IV. Quatro pacientes ainda demonstraram algum grau de limitação de movimento global, passando da classe II para a classe III. Independentemente do ganho funcional final, todos os pacientes foram capazes de realizar tarefas que antes eram difíceis. Os dados deste estudo sugerem que a cirurgia de Hoffer é um método eficaz no tratamento das sequelas de paralisia obstétrica alta sem deformidades ósseas secundárias.


Subject(s)
Humans , Male , Female , Child, Preschool , Paralysis, Obstetric , Pectoralis Muscles , Shoulder , Congenital Abnormalities , Rotator Cuff , Contracture , Tenotomy , Superficial Back Muscles , Movement , Muscles
4.
Fisioter. Bras ; 20(2): 185-195, Maio 1, 2019.
Article in Portuguese | LILACS | ID: biblio-1281144

ABSTRACT

Introdução: A contratura muscular ocorre quando o músculo se contrai de maneira incorreta e não volta ao seu estado normal de relaxamento, em resposta a uma sobrecarga de esforço. Objetivos: Comparou-se a utilização de duas técnicas e os benefícios proporcionados ao tratamento dos pacientes acometidos com contratura do músculo trapézio superior. Métodos: Tratou-se de um estudo transversal, intervencionista, comparativo e quantitativo no período de agosto de 2015 a junho de 2016, com 49 acadêmicos, que foram divididos em dois grupos (G1/G2). Os dados foram obtidos através da ficha de avaliação cinético-funcional desenvolvida para o estudo, que foi aplicada antes e ao término do tratamento fisioterapêutico, Escala dos Sintomas de Dyrek e Escala Visual Analógica. Resultados: Dos 49 acadêmicos, 80% eram do sexo feminino, sendo 95% solteiras, todos naturais de Fortaleza, todos cursando o ensino superior, com média de idade de 23,33 anos. No G1 (Compressão isquêmica) antes da aplicação a maior predominância foi a de nível de dor 7 e logo depois da aplicação o nível de maior predominância foi de dor 2, conforme Escala Visual Analógica. No G2 (Laserterapia) o nível de dor antes da aplicação foi de 7 e logo depois da aplicação, foi de dor 1 conforme Escala Visual Analógica. Conclusão: As técnicas de Laserterapia e a Compressão Isquêmica melhoraram o aporte sanguíneo da área tratada, porém na laserterapia houve a diminuição do limiar de dor e restabelecimento da normalidade funcional local. (AU)


Introduction: Muscle contracture occurs when the muscle contracts incorrectly and does not return to its normal state of relaxation in response to effort overload. Objectives: We compared the use of two techniques and the benefits provided to the treatment of patients with upper trapezius contracture. Methods: This was a cross-sectional, interventional, comparative and quantitative study between August 2015 and June 2016, with 49 academics divided into two groups (G1/G2). The data were obtained through the functional kinetic evaluation sheet developed for the study, which was applied before and at the end of the physiotherapeutic treatment, Dyrek Symptom Scale and Visual Analog Scale. Results: Of the 49 students, 80% were female, 95% single, all of them from Fortaleza/CE, all of them attending higher education, with a mean age of 23.33 years. In G1 (Ischemic Compression), before the application, the greatest predominance was pain level 7 and soon after the application the greater predominance was level pain 2, according to Visual Analog Scale. In G2 (Laser Therapy) the level of pain before the application was 7 and soon after the application was level pain 1 according to Visual Analog Scale. Conclusion: Laser therapy and ischemic compression improved the blood supply of the treated area, and laser therapy decreased th pain threshold and restored the local functional normality. (AU)


Subject(s)
Humans , Therapeutic Uses , Superficial Back Muscles , Lasers , Pain , Physical Therapy Modalities , Contracture , Laser Therapy , Trigger Points
5.
Article in Korean | WPRIM | ID: wpr-765441

ABSTRACT

PURPOSE: This study investigated the effects of shoulder protraction exercise according to weight by examining the surface electromyography (EMG) amplitude in the serratus anterior (SA), upper trapezius (UT), and pectoralis major (PM) as well as the activity ratio of each muscle. METHODS: Twenty three winging scapula subjects participated in the study. The subjects performed scapula protraction at shoulder 90° flexion and 60° horizontal abduction with up to four (none, 1kg, 1.5kg, and 2kg) dumbbells in the supine position. The EMG data were collected from the dominant side muscles during a shoulder protraction exercise according to weight in the supine position. One way repeated measures analysis of variance (ANOVA) was used to compare the normalized activities of the SA, UT, and PM and the ratios of PM/SA and UT/SA. RESULTS: The results showed that the activities of both the SA and UT were highest for the shoulder protraction exercise at 2kg in the supine position. The UT/SA ratio also was the lowest for exercise at 2kg. On the other hand, the activities of both the UT and PM/SA ratio were similar under all conditions. CONCLUSION: These results show that there is a need to selectively strengthen the SA muscle in the case of patients with the shoulder dysfunction. In particular, it is necessary to weigh 2kg when performing shoulder protraction exercises in the supine position to activate the SA muscle in patients with a winging scapula.


Subject(s)
Electromyography , Exercise , Hand , Humans , Muscles , Scapula , Shoulder , Superficial Back Muscles , Supine Position
6.
Article in English | WPRIM | ID: wpr-765429

ABSTRACT

PURPOSE: This study aimed to investigate the immediate effects of posture correction and real-time visual feedback using a video display on muscle activity and change of head position during overhead arm lift test in individuals with forward head posture. METHODS: Fifteen subjects with forward head posture and fifteen normal subjects who volunteered were included in this study. During both groups performed the overhead arm lift test, the muscle activity of the upper trapezius, serratus anterior, sternocleidomastoid, and lower trapezius muscle were measured using electromyography, and head position change was measured using photographs. Then, forward head posture group was asked to perform overhead arm lift test again after posture correction and real-time visual feedback using a video display respectively. One-way analysis of variance (ANOVA) was used to analyze four conditions: pre-test, posture correction, real-time visual feedback, and the control group. RESULTS: The upper trapezius and lower trapezius muscle activity significantly decreased posture correction, real-time visual feedback, and control group than pre-test of forward head posture group (p<0.05). The sternocleidomastoid muscle significantly decreased real-time visual feedback and control group than pre-test of forward head posture group. Head position change significantly decreased three conditions than pre-test of forward head posture group and real-time visual feedback and control group significantly decreased than posture correction. CONCLUSION: This study recommend for maintaining cervical stability during the overhead arm lift test, postural control using real-time visual feedback is more effective in subjects with forward head posture.


Subject(s)
Arm , Electromyography , Feedback, Sensory , Head , Posture , Superficial Back Muscles
7.
Article in Korean | WPRIM | ID: wpr-765417

ABSTRACT

PURPOSE: This study examined the most effective exercise while performing shoulder abduction below ninety degrees. METHODS: Thirty two healthy individuals (17 males, 15 females) participated and performed four exercises, 1) Posterior fly, 2) Prone row, 3) Modified prone cobra, and 4) External rotation in the prone position. Surface electromyography (sEMG) was used to measure the electrical activities for the lower, middle and upper fiber of trapezius and serratus anterior. RESULTS: A significant difference in the muscle activities of the upper/middle/lower trapezius and serratus anterior was observed among the three different positions in terms of the PF (posterior fly), PR (prone row), and MPC (modified prone cobra) (p<0.05). In post-hoc analysis, the activities of the lower and upper trapezius were significantly higher than those of the upper trapezius and serratus anterior (p<0.05). In addition, in ERP (external rotation in prone), there was a significant difference in each activity of the muscles. Post-hoc results indicated that the upper trapezius showed greater EMG activity than the other three muscles. CONCLUSION: External rotation in the prone position revealed the highest activation of the lower trapezius compared to upper trapezius muscle activity. This may be particularly useful in isolating the lower trapezius in cases where excessive scapular elevation is noted. Therefore, the most effective lower trapezius exercise should be performed below ninety degrees of shoulder abduction.


Subject(s)
Adult , Diptera , Elapidae , Electromyography , Exercise , Humans , Male , Muscles , Prone Position , Shoulder , Superficial Back Muscles
8.
Article in English | WPRIM | ID: wpr-762810

ABSTRACT

BACKGROUND: In immediate breast reconstruction using an extended latissimus dorsi musculocutaneous (eLDMC) flap, the volume of the flap decreases, which causes a secondary deformity of the breast shape. Since little research has investigated this decrease in muscle volume, the authors conducted an objective study to characterize the decrease in muscle volume after breast reconstruction using an eLDMC flap. METHODS: Research was conducted from October 2011 to November 2016. The subjects included 23 patients who underwent mastectomy due to breast cancer, received immediate reconstruction using an eLDMC flap without any adjuvant chemotherapy or radiotherapy, and received a computed tomography (CT) scan from days 7 to 10 after surgery and 6 to 8 months postoperatively. In 10 patients, an additional CT scan was conducted 18 months postoperatively. Axial CT scans were utilized to measure the volumetric change of the latissimus dorsi muscle during the follow-up period. RESULTS: In the 23 patients, an average decrease of 54.5% was observed in the latissimus dorsi muscle volume between the images obtained immediately postoperatively and the scans obtained 6 to 8 months after surgery. Ten patients showed an average additional decrease of 11.9% from 6–8 months to 18 months after surgery. CONCLUSIONS: We studied changes in the volume of the latissimus dorsi muscle after surgery using an eLDMC flap performed after a mastectomy without adjuvant chemotherapy or radiotherapy. In this study, we found that immediate breast reconstruction using a latissimus dorsi muscle flap led to a decrease in muscle volume of up to 50%.


Subject(s)
Breast Neoplasms , Breast , Chemotherapy, Adjuvant , Congenital Abnormalities , Female , Follow-Up Studies , Humans , Mammaplasty , Mastectomy , Myocutaneous Flap , Radiotherapy , Superficial Back Muscles , Tomography, X-Ray Computed
9.
Article in English | WPRIM | ID: wpr-762724

ABSTRACT

In recent years, there has been a notable increase in the rate of refractory donor site seroma, defined as seroma that persists for at least 3 months postoperatively, as the number of breast reconstructions using a latissimus dorsi (LD) musculocutaneous flap has increased. Various factors have been proposed to be related, including smoking, obesity, flap mass, and body weight, and several studies have been conducted to explore treatment methods. Typically, surgical treatment, such as capsulectomy, has been considered for refractory seroma, but in this case report, we describe positive outcomes achieved by using Abnobaviscum to treat three female patients who developed a donor site seroma at least 3 months after breast reconstruction using an LD flap.


Subject(s)
Body Weight , Breast , Female , Humans , Mammaplasty , Myocutaneous Flap , Obesity , Seroma , Smoke , Smoking , Superficial Back Muscles , Tissue Donors
10.
Clinical Pain ; (2): 52-57, 2019.
Article in Korean | WPRIM | ID: wpr-785678

ABSTRACT

Spinal accessory neuropathy (SAN) is commonly caused by an iatrogenic procedure, and that caused by tumors is very rare. We present a case of a 49-year-old man suffering from weakness in the right trapezius and sternocleidomastoid muscle. An electrophysiology study confirmed proximal SAN. Fluorodeoxyglucose (FDG)-positron emission tomography (PET)/computed tomography (CT) revealed a diffuse large B-cell lymphoma compressing the right spinal accessory nerve. Ultrasonography showed definite atrophy on the trapezius and sternocleidomastoid muscles. In addition, post-chemotherapy FDG-PET/CT showed increased FDG uptake in the right upper trapezius, suggestive of denervation. This is the first report of SAN caused by direct compression by a diffuse large B-cell lymphoma, comprehensively assessed by an electrophysiology study, ultrasonography, and FDG-PET/CT.


Subject(s)
Accessory Nerve , Atrophy , B-Lymphocytes , Denervation , Electrophysiology , Humans , Lymphoma , Lymphoma, B-Cell , Middle Aged , Muscles , Superficial Back Muscles , Ultrasonography
11.
Article in English | WPRIM | ID: wpr-788056

ABSTRACT

PURPOSE: The purpose of this study was to assess the effect of quilting suture extent on the latissimus dorsi myocutaneous flap (LDMCF) donor site and the necessity of drainage.METHODS: Clinical data of 136 breast cancer patients, who underwent breast reconstruction using LDMCF between May 2014 and December 2015, were retrospectively reviewed. Patients were divided into three groups. Group A: quilting sutures were performed on half of the LDMCF donor site and a closed suction drain was inserted. Group B: quilting sutures were performed for the entire LDMCF donor site and a closed suction drain was inserted. Group C: quilting sutures were performed for the entire LDMCF donor site and no drain was inserted. The duration of drainage, total drainage, length of hospital stay, number of postoperative aspirations for seroma removal, and total aspirated volume were compared.RESULTS: In the comparison of groups A and B, group B showed better results including the total amount of drained seroma, drain maintenance period, number of aspirations for seroma removal after drainage tube removal, total aspirated seroma, and hospitalization period with statistical significance (P<0.05). In the comparison of groups B and C, group C without drain showed no difference in all other variables except mean total drained seroma volume. Therefore, group C was superior to group A and there was no difference compared to group B with drain, even though the drain was not inserted.CONCLUSION: Total quilting suture at LDMCF donor site can reduce seroma formation and eliminate the need for a drain tube.


Subject(s)
Aspirations, Psychological , Breast Neoplasms , Drainage , Female , Hospitalization , Humans , Length of Stay , Mammaplasty , Myocutaneous Flap , Retrospective Studies , Seroma , Suction , Superficial Back Muscles , Sutures , Tissue Donors
12.
Article in English | WPRIM | ID: wpr-719661

ABSTRACT

PURPOSE: The creation of the nipple-areola complex is the final stage in breast reconstruction and highly affects patient satisfaction. The neo-nipple is well known to shrink over time, particularly in the nipple projection. Currently, no reconstruction technique is clearly superior in terms of nipple size maintenance. We evaluated nipple size changes among several methods of breast mound reconstruction. METHODS: Seventy-eight patients received nipple-areola complex reconstruction secondarily after breast reconstruction. C-V flap nipple reconstructions were performed using a free transverse rectus abdominis myocutaneous (TRAM) flap in 25 cases (TRAM group), a latissimus dorsi (LD) myocutaneous flap in 27 cases (LD group), and an implant in 26 cases (implant group). The circumference and projection of the neo-nipple were measured using a flexible ruler, immediately after reconstruction and average 10 months after surgery. RESULTS: The overall circumference and projection at the final measurement were 91.43% ± 7.11% and 62.16% ± 21.55%, respectively, of immediate postoperative values. The change in circumference did not significantly differ among the 3 groups. In contrast, the change in projection was significantly worse in implant group compared to that in TRAM and LD groups. In addition, among the patients in implant group, greater inflation was significantly associated with greater decrease in the nipple projection. CONCLUSION: Breast mound reconstruction with autologous musculocutaneous flap techniques achieves better long-term maintenance of the neo-nipple projection compared to that achieved with expanded tissue and implantation. Considering the prospective loss of long-term nipple dimension, the preoperative design should be oversized in accordance with its origin in mound reconstruction.


Subject(s)
Breast , Female , Humans , Inflation, Economic , Mammaplasty , Myocutaneous Flap , Nipples , Patient Satisfaction , Prospective Studies , Reconstructive Surgical Procedures , Rectus Abdominis , Superficial Back Muscles
13.
Article in English | WPRIM | ID: wpr-739754

ABSTRACT

BACKGROUND: Latissimus dorsi (LD) tendon transfer is used as a treatment option for massive irreparable posterosuperior rotator cuff tears, and recently, an arthroscopic-assisted technique was introduced. This study was undertaken to evaluate the clinical and radiological outcomes of arthroscopic-assisted LD tendon transfer for the management of irreparable rotator cuff tears in active middle-aged patients. METHODS: The records of five patients (two males) with irreparable tears involving the supraspinatus and infraspinatus tendons managed by arthroscopic-assisted LD tendon transfer were retrospectively reviewed. Clinical outcomes were assessed using the visual analogue scale (VAS) pain scale, American Shoulder and Elbow Surgeon's (ASES) scores, the University of California Los Angeles (UCLA) scale, and ranges of motion. Postoperative integrities of transferred tendon were evaluated by magnetic resonance imaging in 4 patients and by ultrasound in one. RESULTS: Mean patient age was 55 years (range, 48–61 years), and mean follow-up period was 20 months (range, 12.0–27.2 months). Mean VAS score significantly improved from 6.6 ± 2.6 preoperatively to 1.8 ± 2.5 postoperatively (p=0.009), mean ASES score increased from 67.6 ± 9.2 to 84.6 ± 15.1, and mean UCLA score from 18.0 ± 1.4 to 28.8 ± 8.5 (all p<0.001). Postoperative imaging of the transferred LD tendon showed intact repair in 4 patients. The remaining patient experienced LD transfer rupture and a poor outcome. CONCLUSIONS: Arthroscopic-assisted LD tendon transfer improved shoulder pain and function in patients with massive, irreparable rotator cuff tears, and may be an option for this condition, especially in physically active patients.


Subject(s)
California , Elbow , Follow-Up Studies , Humans , Magnetic Resonance Imaging , Retrospective Studies , Rotator Cuff , Rupture , Shoulder , Shoulder Pain , Superficial Back Muscles , Tears , Tendon Transfer , Tendons , Ultrasonography
14.
Säo Paulo med. j ; 136(6): 551-556, Nov.-Dec. 2018. tab
Article in English | LILACS | ID: biblio-991691

ABSTRACT

ABSTRACT BACKGROUND: Breast cancer is the second most frequent type of cancer worldwide and the most common type among women. The treatment for this condition has evolved over recent decades with therapeutic and technological advances. Breast reconstruction techniques using musculocutaneous flaps from the latissimus dorsi and rectus abdominis have aroused interest regarding patients' quality of life. Our goal here was to compare patients' satisfaction scores after they underwent breast reconstruction using musculocutaneous flaps from either the latissimus dorsi or the rectus abdominis. DESIGN AND SETTING: Primary, clinical, analytical, observational and cross-sectional study conducted in a federal university and a public hospital. METHODS: Demographic and clinical data were collected. The Mini-Mental State Examination was then applied, with testing for specificity and sensitivity. Lastly, a breast evaluation questionnaire was applied to evaluate breast satisfaction among 90 women, who were divided into three groups: mastectomy (control; n = 30); breast reconstruction using flap from the latissimus dorsi (n = 30); and reconstruction using flap from the rectus abdominis (n = 30). RESULTS: The groups were homogeneous regarding the main demographic data and the questionnaire responses (P < 0.05). Compared with the control group, the reconstruction groups showed significant improvement in satisfaction (P < 0.0002) after one year. CONCLUSION: Within our sample, women who underwent breast reconstruction with flaps from either the latissimus dorsi or the rectus abdominis had similar satisfaction scores.


Subject(s)
Humans , Female , Adult , Middle Aged , Patient Satisfaction , Mammaplasty/methods , Rectus Abdominis/surgery , Superficial Back Muscles/surgery , Breast Neoplasms/surgery , Case-Control Studies , Cross-Sectional Studies , Mammaplasty/psychology , Myocutaneous Flap
15.
Rev. Assoc. Med. Bras. (1992) ; 64(8): 700-709, Aug. 2018. tab, graf
Article in English | LILACS | ID: biblio-976849

ABSTRACT

BACKGROUND To date, there are no cross-sectional studies considering the influence of disability level in patients with non-specific chronic neck pain. Therefore, the main aim of this study was to determine kinesiophobia, active cervical range of movement (CROM), and pressure pain threshold (PPT) differences between different disability levels (mild, moderate, and severe) in subjects with non-specific chronic neck pain and asymptomatic subjects. METHODS A descriptive cross-sectional study. Subjects were recruited from a primary health care center and an outpatient department hospital. A total sample of 128 subjects, 96 of them with nonspecific chronic neck pain and 32 asymptomatic, were recruited. The NDI was used to divide the subjects with chronic neck pain into 3 groups (mild, moderate, and severe disability). The main outcome measurement was the Tampa Scale of kinesiophobia (TSK-11). The secondary outcome measurements were the Visual Analogue Scale (VAS), PPT (trapezius and tibialis anterior), CROM (flexion, extension, rotation, and lateral inclination) and pain duration. RESULTS The ANOVA results revealed, in the comparisons between groups, statistically significant differences for the VAS between the mild-severe (P < 0.01) and moderate-severe groups (P < 0.01), but not between the mild-moderate groups (P > 0.05); for the TSK, differences were not statistically significant (P > 0.05). CONCLUSION Kinesiophobia may not be influenced by disability level in patients with chronic non-specific neck pain. Nevertheless, pain intensity and chronicity of patients with severe neck disability are increased with respect to mild and moderate disability index.


RESUMO CONTEXTO Até a data, não há estudos transversais considerando a influência do nível de incapacidade em pacientes com dor de garganta crônica não específica. Portanto, o objetivo principal deste estudo foi determinar a diferença entre os níveis de diminuição do colesterol cervical (Crom) e o limiar por dor de pressão (PPT) entre diferentes níveis de incapacidade (leve, moderada e grave) em indivíduos com dor crônica não específica no pescoço e sujeitos assintomáticos. MÉTODOS Estudo descritivo transversal. Os indivíduos foram recrutados de um centro de saúde primário e de um hospital do departamento ambulatorial. Uma amostra total de 128 indivíduos, 96 indivíduos com dor no pescoço crônica não específica e 32 indivíduos assintomáticos, foi recrutada. O NDI foi usado para dividir os indivíduos com dor no pescoço crônica em três grupos (incapacidade leve, moderada e grave). A principal medida de resultados foi a Tampa Scale of Kinesiophobia (TSK-11). As medidas de resultado secundário foram a Escala Analógica Visual (VAS), PPT (trapézio e tibial anterior), Crom (flexão, extensão, rotação e inclinação lateral) e duração da dor. RESULTADOS Nos resultados da Anova revelados nas comparações entre os grupos, diferenças estatisticamente significativas para o VAS foram observadas entre os grupos leve-grave (P<0,01) e moderado-grave (P<0,01), mas não entre os grupos moderado-moderado (P>0,05). Para o TSK, as diferenças não foram estatisticamente significativas (P>0,05). CONCLUSÃO A cinesiofobia pode não ser influenciada pelo nível de incapacidade em pacientes com dor no pescoço crônica não específica. No entanto, a intensidade da dor e a cronicidade de pacientes com deficiência grave do pescoço são aumentadas em relação ao índice de incapacidade leve e moderada.


Subject(s)
Humans , Male , Female , Adult , Neck Pain/physiopathology , Disability Evaluation , Time Factors , Severity of Illness Index , Case-Control Studies , Cross-Sectional Studies , Analysis of Variance , Range of Motion, Articular , Pain Threshold , Fear , Self Report , Chronic Pain , Superficial Back Muscles/physiopathology , Visual Analog Scale , Middle Aged
16.
Rev. bras. cir. plást ; 33(1): 139-142, jan.-mar. 2018. ilus
Article in English, Portuguese | LILACS | ID: biblio-883654

ABSTRACT

Introdução: No presente trabalho, relatamos um caso de reconstrução do terço proximal do úmero direito e reanimação do cotovelo de um paciente masculino, de 20 anos, vítima de acidente automobilístico, com necrose óssea de 5 cm no terço proximal do úmero e avulsão do bíceps braquial. Métodos: Utilizamos o retalho ósseo da escápula, associado ao retalho miocutâneo do grande dorsal, tendo como pedículo os vasos subescapulares. Resultados: O paciente teve excelente evolução no pós-operatório, apresentando-se, no pós-operatório de 2 meses, com consolidação óssea e iniciando a flexão do cotovelo. Conclusões: Perante a utilização do retalho descrito, concluímos que esta modalidade de retalho se insere no arsenal dos retalhos ósseos de maior segurança nas reconstruções ósseas em geral.


Introduction: We report a case of reconstruction of the proximal third of the right humerus and rehabilitation of the elbow in a 20-year-old male patient who was injured in an automobile accident and developed bone necrosis of 5 cm at the proximal third of the humerus and avulsion of the brachial biceps. Methods: A scapular bone flap was used, together with a latissimus dorsi myocutaneous flap, using subscapular vessels for the pedicle. Results: The patient had excellent postoperative course, presenting in the 2-month postoperative period with bone consolidation and initiation of elbow flexion. Conclusions: This flap modality is a safe and useful option for bone reconstruction.


Subject(s)
Humans , Male , Adult , History, 21st Century , Osteonecrosis , Retrospective Studies , Reconstructive Surgical Procedures , Elbow , Superficial Back Muscles , Superficial Back Muscles/injuries , Myocutaneous Flap , Humerus , Osteonecrosis/surgery , Osteonecrosis/therapy , Reconstructive Surgical Procedures/methods , Elbow/surgery , Elbow/injuries , Superficial Back Muscles/surgery , Myocutaneous Flap/surgery , Humerus/surgery
17.
ABCD arq. bras. cir. dig ; 31(2): e1365, 2018. tab
Article in English | LILACS | ID: biblio-949218

ABSTRACT

ABSTRACT Background : The muscle-sparing thoracotomy (MST) has not yet been thoroughly studied and assessed in comparison to the traditional thoracotomy method in newborns. Aim : To compare the outcomes of MST and standard posterolateral thoracotomy (PLT) in newborns. Methods : Randomized, controlled, double-blind trial on 40 neonates with esophageal atresia, comparing the time of beginning a surgery until seeing the pleura, the duration of hospitalization in the neonatal intensive care unit, the time in ventilator, the time of returning the shoulder function, the time of returning the Moro reflex, and the mortality between the two techniques. Results : The data showed no differences between the two groups in basic information (weight, height, gender, numbers of prematurity neonates and caesarean). The results on the size of the scar in the MST group was significantly lower than in the PLT group. Also, the time of returning the shoulder function in MST group was earlier than in PLT group. There were no significant differences in the duration since the beginning the surgery to see the pleura, the time of being hospitalized in intensive unit, the time that the infant required ventilator, returning time of the Moro reflex in 1st and 3rd months after the operation, and the mortality rates between MST and PLT groups. Conclusion : It seems that the advantages of using MST over PLT procedure in neonates include the earlier shoulder function recovery and also superior cosmetic results.


RESUMO Racional : A técnica de toracotomia poupadora de músculo (MST) ainda não foi estudada e avaliada em relação ao método tradicional de toracotomia em recém-nascidos. Objetivo : Comparar os resultados da MST e toracotomia posterolateral padrão (PLT) em recém-nascidos. Métodos : Ensaio randomizado, controlado, duplamente cego em 40 neonatos com atresia esofágica, comparando o tempo de início da incisão até ver a pleura, a duração da hospitalização na unidade de terapia intensiva neonatal, o tempo em ventilador, o tempo da volta da função do ombro, tempo de retorno do reflexo Moro e mortalidade entre as duas técnicas. Resultados : Os dados não mostraram diferenças entre os dois grupos em informações básicas (peso, altura, gênero, número de neonatos de prematuridade e cesariana). Os resultados sobre o tamanho da cicatriz no grupo MST foram significativamente menores do que no grupo PLT. Além disso, o tempo de retorno da função do ombro no grupo MST foi mais precoce do que no grupo PLT. Não houve diferenças significativas na duração desde o início da operação até a pleura ser vista, o tempo de hospitalização em unidade intensiva, o tempo que a criança necessitou de ventilador, retorno do reflexo Moro nos 1º e 3º meses após a operação, e as taxas de mortalidade entre os grupos. Conclusão : As vantagens de usar o procedimento MST sobre PLT em neonatos incluem a recuperação da função do ombro e também resultados cosméticos superiores.


Subject(s)
Humans , Male , Female , Infant, Newborn , Thoracotomy/methods , Esophageal Atresia/surgery , Organ Sparing Treatments , Pectoralis Muscles , Double-Blind Method , Superficial Back Muscles
18.
J. appl. oral sci ; 26: e20170578, 2018. tab, graf
Article in English | LILACS, BBO | ID: biblio-954514

ABSTRACT

Abstract Objective The objective of this retrospective study was to evaluate the impact of myofascial trigger points (MTrPs) in patients with articular disc displacement with reduction (DDWR) and to identify which clinical variables are associated with the concomitant presence of DDWR and MTrPs. Material and Methods 130 patients were selected that sought treatment due to joint pain, with ages ≥18 years, of both genders, with DDWR confirmed by magnetic resonance imaging. The sample was divided into two groups: Group 1, patients with DDWR and MTrPs (N=101); and Group 2, patients with DDWR and no MTrPs (N=29). Information on gender, age, pain duration, pain scores, and maximal interincisal distance (MID) were collected. The logistic regression model was used and the odds ratios (OR) was calculated (p<0.05). Results Group 1 presented statistically significant higher mean pain scores (p=0.007), and smaller MID (p=0.0268) than Group 2. OR were significant for the pain scores (1.429), MID (0.937) and gender (women) (2.810). Conclusions Patients with DDWR and MTrPs had increased pain scores and a MID decrease compared to patients with DDWR and no MTrPs. The variables pain scores, MID, and gender (women) showed a significant association with the concomitant presence of DDWR and MTrPs.


Subject(s)
Humans , Male , Female , Adult , Young Adult , Temporal Muscle/physiopathology , Joint Dislocations/physiopathology , Trigger Points/physiopathology , Reference Values , Pain Measurement , Facial Pain/physiopathology , Logistic Models , Sex Factors , Cross-Sectional Studies , Multivariate Analysis , Retrospective Studies , Joint Dislocations/therapy , Superficial Back Muscles/physiopathology , Masseter Muscle/physiopathology , Middle Aged , Neck Muscles/physiopathology
19.
Article in English | WPRIM | ID: wpr-713751

ABSTRACT

PURPOSE: To find the effect of visual feedback of head angle with using a mobile posture-aware system on craniocervical angle and neck and shoulder muscles fatigue for preventing or decreasing the forward head posture. METHODS: Twenty-four healthy young adults in Chungbuk to participate in this study. The subjects started to watch a movie clip for 10 minutes with visual feedback in 0°, 30°, and 60° of head angles. During the task, surface electromyography (EMG) was used to collect data from the upper trapezius (UT), sternocleidomasetoid muscle (SCM), cervical erecter spinae (CES) during watching the smartphone. Craniocervical angles were measured using a sagittal-view photograph of the subject in a sitting posture. A one-way repeated analysis of variance with a significant level of 0.05 used for statistical analysis. RESULTS: Craniocervical angle with 0° visual feedback was significantly greater than 30°and 60°. Craniocervical angle with 30° visual feedback was significantly greater than 60°. In addition, MDF of UT muscles in 0° and 30° of visual feedback was significantly greater than 60°. CONCLUSION: We concluded that 0° visual feedback of head angle with using a mobile posture-aware system would be beneficial to prevent or decrease forward head posture during watching a smartphone. We also could recommend using of 30° visual feedback in case of caring UT muscle fatigue primarily.


Subject(s)
Electromyography , Fatigue , Feedback, Sensory , Head , Humans , Muscle Fatigue , Muscles , Neck , Posture , Shoulder , Smartphone , Superficial Back Muscles , Young Adult
20.
Article in English | WPRIM | ID: wpr-719217

ABSTRACT

Trichoblastic carcinoma usually occurs as a malignant transformation of the trichoblastoma, but is very rare. A 25-year-old man was admitted with trichoblastoma in the nuchal area with frequent recurrences since birth. The preoperative neck magnetic resonance image revealed lobulated soft tissue lesions involving superficial fascia and infiltrating into both proximal trapezius muscles. In our department, wide excision and reconstruction with a free anterolateral thigh flap were performed. Histological examination revealed skin adnexal carcinoma, originating from the hair follicles, consistent with trichoblastic carcinoma. There was no palpable mass 5 years postoperatively, and there was no recurrence on follow-up positron emission tomography-computed tomography. Trichoblastic carcinomas are rare and difficult to diagnose, but histopathological findings include atypical basaloid keratinocytes with crowded, hyperchromatic nuclei, and increased mitotic activity. The presence of hypercellular stroma is a criterion for distinguishing trichoblastic carcinoma from basal cell carcinoma. A rare giant trichoblastic carcinoma was reported, which was the biggest one in the literature.


Subject(s)
Adult , Carcinoma, Basal Cell , Electrons , Follow-Up Studies , Hair Follicle , Humans , Keratinocytes , Neck , Parturition , Recurrence , Skin , Subcutaneous Tissue , Superficial Back Muscles , Thigh
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