Application of kinesiotherapy and electrothermotherapy in the treatment of elderly with knee osteoarthrosis: a comparative study / Aplicação da cinesioterapia e eletrotermoterapia no tratamento de idosas com osteoartrose de joelho: estudo comparativo

Abstract Introduction Among the treatment modalities in this disease , the surgical and conservative means stand out through therapy resources such as electro-thermotherapy and kinetic therapy. The general objective of this study was to evaluate the effects from two protocols of physical therapy in elder women with knee osteoarthritis. Methods An experimental clinical trial type study consisting of pre and post tests was performed, in which 30 female patients were selected, all between 61 and 80 years old, diagnosed with primary knee OA, treated at the Center for Comprehensive Health Care for the Elder (CAISI - Centro de Atenção Integral à Saúde do Idoso). They were divided into 2 groups of 15 persons for each type of treatment: Group I was treated with kinetic therapy, and group II was treated with electro-thermotherapy. Patients from both groups underwent 36 physical therapy sessions during 12 weeks. For data collection, protocol sheets with socio-demographic data, Body Mass Index (BMI) at kg/m2, visual analogue scale (VAS) and measurement of motion range (ADM) were used. For statistics analysis, the Mann-Whitney, Wilcoxon and Chi-square's non-parametric tests were used. Student's parametric tests were also applied as independent samples. Results The tests performed in both groups contributed to the reduction in the level of pain. There were differences in group I and II on the increase of ADM, except in bending the left knee in group II. Conclusion It was concluded that both treatment modalities showed effective therapeutic responses, but these benefits were even higher in OA treatment by kinetic therapy.

Resumo Introdução Dentre as modalidades de tratamento na Osteoartrose, destacam-se a forma cirúrgica e conservadora através dos recursos fisioterapêuticos como a eletrotermoterapia e a cinesioterapia. Objetivo Verificar os efeitos de dois protocolos terapêuticos em mulheres idosas com Osteoartrose de joelho. Métodos Realizou-se um estudo do tipo ensaio clínico não controlado com delineamento pré-teste e pós-teste, onde foram selecionadas para a pesquisa 30 pacientes do sexo feminino, com idade entre 61 a 80 anos, com diagnóstico de Osteoartrose de joelho primária, atendidas em um Centro de Referência Integral à Saúde do Idoso (CAISI), que foram divididas em 2 grupos de 15 pessoas para cada modalidade de terapias: o grupo I foi tratado com a cinesioterapia, e o grupo II foi tratado com eletrotermoterapia. Pacientes de ambos os grupos realizaram 36 atendimentos fisioterapêuticos durante 12 semanas. Para a coleta dos dados foi utilizada ficha protocolo contendo dados sócio-demográficos, índice de massa corporal (IMC), escala visual analógica (EVA) e medida da amplitude do movimento (ADM). Para análise estatística, foram utilizados os testes não paramétricos de Mann-Whitney e Wilcoxon, o teste paramétrico t de Student para amostras independentes e para verificar as associações o teste qui-quadrado. Resultados Os tratamentos realizados nos dois grupos contribuíram para a redução do nível de dor. Houveram diferenças nos grupo I e II quanto ao aumento da ADM, exceto na flexão do joelho esquerdo no grupo II. Conclusões Conclui-se que ambas as modalidades de terapias demonstraram respostas terapêuticas pela redução da dor e melhora da ADM, porém o grupo que foi tratado pela cinesioterapia obteve uma melhora mais acentuada.

Neural complications and physical disabilities in leprosy in a capital of northeastern Brazil with high endemicity / Complicações neurais e incapacidades em hanseníase em capital do nordeste brasileiro com alta endemicidade

INTRODUCTION: Leprosy is an infectious disease whose etiologic agent is Mycobacterium leprae, manifested by dermatological and neurological signs and symptoms. OBJECTIVE: To investigate neural changes and the degree of physical disability in the eyes, hands and feet before and after treatment, as well as sociodemographic and clinical profile of patients affected by leprosy. METHOD: A longitudinal epidemiological study comprising 155 patients with leprosy, from a spontaneous demand, diagnosed between March 2010 and February 2011, and treated with multidrug therapy (MDT) between March 2010 and July 2012 in a program for leprosy eradication in São Luis (MA), Brazil. RESULTS: Before treatment, 46.5% of patients were considered as borderline, 51.6% had some alteration in the eyes and 52.3% in the feet, and the radial nerve (18.7%) was the most affected. There was a statistically significant difference between the changes in the radial nerve at the beginning of and after treatment. CONCLUSIONS: The analysis points to late diagnosis, as some patients have had abnormal neural and physical disabilities before treatment. .

INTRODUÇÃO: A hanseníase é uma doença infectocontagiosa cujo agente etiológico é o Mycobacterium leprae, que se manifesta por sinais e sintomas dermatoneurológicos. OBJETIVO: investigar as complicações neurais e o grau de incapacidades físicas nos olhos, mãos e pés antes e após o tratamento, bem como o perfil sociodemográfico e clínico dos pacientes acometidos pela hanseníase. MÉTODO: Estudo epidemiológico do tipo longitudinal constituído por 155 pacientes com hanseníase, a partir da demanda espontânea, diagnosticados no período de março de 2010 a fevereiro de 2011 e tratados com poliquimioterapia (PQT) entre março de 2010 a julho de 2012, em um programa de eliminação da hanseníase, no município de São Luís (MA). RESULTADOS: Antes do tratamento, 46,5% dos pacientes apresentaram forma dimorfa, 51,6% possuíam alguma alteração nos olhos e 52,3% nos pés, sendo o nervo radial (18,7%) o mais acometido. Houve diferença estatisticamente significante entre as complicações do nervo radial no inicio e após o tratamento. CONCLUSÕES: Evidenciou-se a presença do diagnóstico tardio, posto que alguns pacientes já apresentavam complicações neurais e incapacidades físicas antes do tratamento. .

Factors associated with neural alterations and physical disabilities in patients with leprosy in São Luis, State of Maranhão, Brazil

Introduction Leprosy is a chronic infectious disease that is caused by Mycobacterium leprae. The objective of this study was to evaluate the risk factors that are associated with neural alterations and physical disabilities in leprosy patients at the time of diagnosis. Methods A prospective cross-sectional study was conducted on 155 leprosy patients who participated in a program that aimed to eliminate leprosy from São Luis, State of Maranhão. Results Patients who were 31-45 years of age, were older than 60 years of age or had a partner were more likely to have a disability. Patients with partners were 1.14 times more likely (p = 0.025) to have disabilities of the hands. The frequency of disabilities in the feet among the patients with different clinical forms of leprosy was statistically significant. Conclusions The identification of risk factors that are associated with neural alterations and physical disabilities in leprosy patients is important for diagnosing the disease because this approach enables physicians to plan and prioritize actions for the treatment and monitoring of patients. .

A equoterapia no tratamento de crianças com paralisia cerebral no Nordeste do Brasil / The hippotherapy in the treatment of children with cerebral palsy in the North East Brazil

A equoterapia vem sendo utilizada como um tratamento desuporte focalizado no comprometimento do controle de troncoapresentado pelas crianças com paralisia cerebral. Este estudo temcomo propósito avaliar mudanças posturais em crianças com paralisiacerebral após participação em programa de equoterapia aolongo de um ano, em 2006 e 2007. Trata-se de um estudo descritivocom amostra composta de 27 crianças entre 2 a 12 anos. Avaliou-sealinhamento e simetria da cabeça, ombros, tronco, coluna vertebral epélvis, antes e após a prática de equoterapia. Os benefícios corporaismensuráveis para cada área corporal foram obtidos pela divisão dosvalores após (pós-teste) pelos valores prévios (pré-teste) à prática deequoterapia. Indicou-se quantas vezes a postura de segmento corporalfoi benefi ciada pelo tratamento. O teste de Wilcoxon foi usadopara a comparação de medianas. Os valores da avaliação posturalantes e depois da equoterapia foram: cabeça - 1,2 (± 1,0) e 2,1 (±1,1); ombros - 1,2 (± 0,9) e 2,2 (± 1,0); tronco -1,0 (± 0,8) e 1,9 (±1,0); coluna vertebral - 0,9 (± 1,0) e 1,7 (± 1,0); e pélvis - 0,8 (± 0,9)e 1,7 (± 0,8). As diferenças das avaliações antes e depois da equoterapiaforam signifi cantes (p < 0,05) para cada segmento corporal.Os menores benefícios posturais foram observados nos segmentoscabeça e pescoço (73%) e ombros e escápula (84%), enquanto queos maiores foram no tronco (93%) e na pélvis (114%). Conclusão:Mudanças posturais signifi cativas foram obtidas, o que pode servirde incentivo para que esta prática seja difundida pelo Sistema Únicode Saúde para o tratamento de crianças com paralisia cerebral...

Th e understanding of the motor limitations to which childrenand adolescents with cerebral palsy are exposed is important for theplanning of intervention investigations and for decisions regardingpublic health programs. Th e objective of the present study was toassess postural changes in children with cerebral palsy after theyparticipated in a hippotherapy program over a period of one year(2006-2007). Th is was a descriptive study of a sample of 27 children2 to 12 years old evaluated for alignment and symmetry of the head,shoulders, trunk, spine, and pelvis before and after the practice ofhippotherapy. Th e measurable body benefi ts for each body areawere determined by dividing the values obtained after hippotherapy(post-test) by the values obtained before therapy (pre-test). Weindicated how many times the posture of a body segment benefi tedfrom treatment. Th e Wilcoxon test was used for comparison of themedians. Th e values of postural assessment before and after hippotherapywere: head - 1.2 (± 1.0) and 2.1 (± 1.1); shoulders - 1.2 (±0.9) and 2.2 (± 1.0); trunk -1.0 (± 0.8) and 1.9 (± 1.0); spine - 0.9(± 1.0) and 1.7 (± 1.0); and pelvis - 0.8 (± 0.9) and 1.7 (± 0.8).Th e diff erences between the evaluations performed before and afterhippotherapy were signifi cant (p < 0.05) for each body segment.Th e lowest postural benefi ts were observed for the head and neck(73%) and shoulder and scapula (84%) segments, and the highestwere observed for the trunk (93%) and pelvis (114%). Conclusion:Signifi cant postural changes were obtained, which may serve toencourage the diff usion of this practice in public programs for thetreatment of children with cerebral palsy...