Effect of low-level LASER therapy versus CAD/CAM Michigan splint on patients with Temporomandibular Muscle Disorders: a randomized clinical trial / Efeito da terapia LASER de baixa potência versus placa de Michigan CAD/CAM em pacientes com Distúrbios Temporomandibulares musculares: um ensaio clínico randomizado

Objective: This study aimed to evaluate the efficacy and sustainability of using low level LASER therapy and CAD/CAM Michigan splint on improving the range of mandibular movements, muscle activity and reducing the pain. Material and Methods: 56 female patients were randomly divided into two groups. Group A: Patients received applications of low-level LASER therapy using semiconductor InGaAsp diode LASER type 940 nm with continuous mode of operation, applied for 180 sec per session for 12 sessions. Group B: Patients received Michigan splint of 2 mm thickness constructed on their upper teeth, the splint was 3D digitally printed. Electromyography was used to evaluate muscle activity, visual analogue scale was used to evaluate the pain intensity, ARCUS digma facebow was used to evaluate range of mandibular movements, and maximum mouth opening was taken using a millimeter ruler. They were measured before the beginning of the treatment, and at three and six month follow-up periods. Results: The results revealed that both low-level LASER therapy and Michigan splint reduce the myofascial pain, improved the range of the mandibular movements, and the muscles activity, but the effect of the low-level LASER therapy was more profound and sustainable. After 6 months from the beginning of the treatment, changes in masseter muscle activity (P= 0.001; effect size= 1.757), pain intensity (P= 0.003; effect size= 3), and range of mandibular movement (P= 0.001, effect size= 1.729) differed significantly between the two groups. Conclusions: Low-level LASER therapy had a better and more sustainable effect on reducing the pain intensity and improving the muscle activity as well as the mandibular movement when compared to Michigan splint (AU)

Objetivo: Este estudo teve como objetivo avaliar a eficácia e a durabilidade do uso da terapia LASER de baixa potência e da placa de Michigan CAD/CAM na melhora da amplitude dos movimentos mandibulares, atividade muscular e redução da dor. Material e Métodos: 56 pacientes do sexo feminino foram divididos aleatoriamente em dois grupos. Grupo A: os pacientes receberam aplicações de terapia LASER de baixa potência utilizando diodo semicondutor InGaAsp LASER tipo 940 nm em modo contínuo de operação, aplicado por 180 segundos por sessão durante 12 sessões. Grupo B: os pacientes receberam a placa de Michigan com uma espessura de 2 mm confeccionada sobre a arcada superior, a placa foi impressa digitalmente em 3D. A eletromiografia foi utilizada para avaliar a atividade muscular, a escala visual analógica foi utilizada para avaliar a intensidade da dor, o arco facial ARCUS digma foi utilizado para determinar a amplitude dos movimentos mandibulares e a abertura máxima da boca foi medida com uma régua milimétrica. Todas as medidas foram realizadas antes do início do tratamento e nos períodos de acompanhamento de três e seis meses. Resultados: Os resultados revelaram que tanto a terapia LASER de baixa potência como a placa de Michigan reduziram a dor miofascial, aumentaram a amplitude dos movimentos mandibulares e melhoraram a atividade muscular, mas o efeito da terapia LASER de baixa potência foi mais profundo e duradouro. Após 6 meses do início do tratamento, as alterações na atividade do músculo masseter (P= 0. 001; tamanho do efeito= 1,757), intensidade da dor (P= 0,003; tamanho do efeito= 3), e amplitude de movimento mandibular (P= 0,001, tamanho do efeito= 1,729) diferiram significativamente entre os dois grupos. Conclusão: A terapia com LASER de baixa potência teve um efeito melhor e mais duradouro na redução da intensidade da dor e na melhora da atividade muscular, bem como do movimento mandibular, quando comparada à placa de Michigan(AU)

Dystroglycanopathies: Genetic Bases of Muscular Dystrophies Due to Alteration in the O-Glycosylation of α-Dystroglycan

Abstract Congenital muscular dystrophies (CMDs) are inherited, progressive and heterogeneous muscle disorders. A group of CMDs are dystroglycanopathies, also called α-dystroglycanopathies, where there is an abnormal glycosylation of protein α-dystroglycan. Hypoglycosylation of α-DG results in different severities of congenital muscular dystrophies and they present with progressive muscle weakness and loss of motor functions. This article first focuses on the CMDs, their classification according to the observed symptoms or the protein involved in the resulting phenotype. We then focus on dystroglycanopathies, the importance of its correct O-glycosylation of the α-dystroglycan given its important structural function, considering the enzymes involved in said glycosylation and the phenotypes that can result, to finally address current therapeutics for these diseases with the aim of increasing current knowledge.

Functional assessment using short tests in a patient with pompe disease receiving enzyme replacement therapy: case report

ABSTRACT Introduction: Pompe disease is characterized by the deficiency of the acid alfa glucosidase enzyme, which leads to a glycogen accumulation mainly in cardiac and skeletal muscles. Its onset may be early or late; the late form is more difficult to handle given the variety of presentations. Enzyme replacement therapy has shown to improve gross motor function and lung function in patients. Case description: Female patient who presented chronic quadriparesis. She was diagnosed with Pompe disease, which required enzyme replacement therapy that helped improve the symptoms, which was evident with the performance of rapid functional evaluation tests. Discussion: Enzyme replacement therapy in Pompe disease modifies the natural history of the disease. A brief review of the literature about the functional tests that can be used to assess a patient with this disorder is presented. Conclusion: The 10-meter walk test, one-leg stance test, cervical flexion in supine position, five times sit to stand test, and coin rotation task are useful for clinical evaluation in patients with Pompe disease receiving enzyme replacement therapy.

RESUMEN Introducción. La enfermedad de Pompe se caracteriza por una alteración de la enzima alfa glucosidasa ácida lisosomal que produce acumulación de glicógeno, principalmente en el músculo esquelético y cardiaco. Se presentan formas de inicio temprano y tardío, esta última de más difícil manejo dada la múltiple variedad de presentaciones. La terapia de reemplazo enzimático ha demostrado mejorar la función motora gruesa y pulmonar de los pacientes con esta patología. Presentación del caso. Paciente femenino quien presentó cuadro crónico de cuadriparesia y a quien se le documentó enfermedad de Pompe, por lo que requirió terapia de reemplazo enzimático con mejoría franca de sintomatología, objetivizada con la realización de pruebas rápidas de evaluación funcional. Discusión. La terapia de reemplazo enzimático en la enfermedad de Pompe modifica la historia natural de la enfermedad. Se realiza una breve revisión de la literatura acerca de las pruebas funcionales que pueden ser utilizadas dentro de la evaluación del paciente con este trastorno. Conclusiones. La prueba de caminata de 10m, de equilibrio monopodal, de flexión cervical en supino, de levantarse-sentarse cinco veces y de la moneda resultan útiles para la evaluación clínica de los pacientes con enfermedad de Pompe en terapia de remplazo enzimático.

Análisis de la disminución de fuerza de agarre en la mano por uso de guantes en actividades de aseo y cafetería / Hand Grip Strength Analysis Due to Glove Use in Cleaning and Cafeteria Activities / Análise da diminuição de força de preensão na mão por uso de luvas em atividades de asseio e cafetaria

Introducción: existen en la literatura estudios relacionados con la disminución de fuerza por el uso de guantes en actividades de riesgo, como aviación o mantenimiento eléctrico. Sin embargo, no ha sido estudiado este factor en tareas de aseo y cafetería, donde el uso de guantes es necesario. Se pretende entonces responder a la pregunta, si existe efecto en la fuerza de agarre por el uso de guantes y postura en esta población que se caracteriza por su vulnerabilidad e incidencia en lesiones musculo esqueléticas. Materiales y métodos: diseño experimental 2 x 3 con dos variables independientes: la postura en tres niveles diferentes (postura neutral, codo inclinado 90° y antebrazo extendido) y el uso o no de guantes, así la variable dependiente es la fuerza de agarre. El experimento se desarrolló con 11 mujeres pertenecientes al área de aseo y cafetería de una empresa de servicios. Resultados: el factor guante ejerce un efecto significativo sobre la fuerza de agarre con un nivel de significancia de 0,000. La disminución de fuerza de agarre oscila entre 18% y 54%, según la postura de medición de la fuerza. Discusión. la relación de la fuerza desarrollada con la naturaleza de la tarea y el uso de guantes genera recomendaciones para futuras investigaciones, como materiales, detalles en la fuerza y diseño de artefactos entre otros.

Introduction: The literature reports studies related to grip strength decrease due to gloves in risk activities such as aviation or electricity maintenance. However, this factor has not been studied in cleaning tasks where the use of gloves is needed. Therefore, the need arises for measuring the strength which may be lost by the use of gloves and its implications in the performance of duties in different positions, in a population characterized by their vulnerability and muskulosqueletal injuries. Materials and methods: A 2x3 experimental design was made with two independent variables: the position into three different levels (neutral position, leaning on elbow and keeping forearm extended) and the use / not use of gloves so that the dependent variable was the grip strength. The experiment was made among 11 women who belonged to the cleaning and cafeteria area in a services company. Results: The glove factor exerts meaningful effect over grip strength with a significance level of 0.000. In addition, the decrease of the grip strength fluctuates from 18% to 54% according to the position of the measuring. Discussion: the relation between the strength developed the nature of the task and the use of gloves produces suggestions to future researches such as, materials, strength detail measuring, and design of tools between others.

Introdução: existem na literatura estudos relacionados com a diminuição de força pelo uso de luva em atividades de risco, como aviação ou manutenção elétrica. No entanto, não tem sido estudado este fator em tarefas de asseio e cafetaria onde o uso de luvas é necessário. Pretende-se então responder à pergunta, se existe efeito na força de preensão pelo uso de luva e postura nesta população que se caracteriza pela sua vulnerabilidade e incidência em lesões musculoesqueléticas. Materiais e métodos: Desenho experimental 2x3 com duas variáveis independentes: a postura em três níveis diferentes (postura neutral, cotovelo inclinado 90° e antebraço estendido) e o uso ou não de luva, assim a variável dependente é a força de preensão. O experimento se desenvolveu com 11 mulheres pertencentes à área de asseio e cafetaria de uma empresa de serviços. Resultados: o fator luva exerce efeito significativo sobre a força de preensão com um nível de significância de 0.000. A diminuição de força de preensão oscila entre 18% e 54% segundo a postura de medição da força. Discussão: A relação da força desenvolvida com a natureza da tarefa e o uso de luva gera recomendações para futuras pesquisas, como materiais, detalhes na força e desenho de artefatos entre outros.

Diseño de sistema de vigilancia epidemiológica en desórdenes osteomusculares para una empresa de fabricación de refrigeradores en el distrito de Barranquilla / Design of epidemiological surveillance system in musculoskeletal disorders for refrigerators manufacturing company in the district of Barranquilla

Objetivo: Diseñar un sistema de vigilancia epidemiológica en desórdenes osteomusculares en trabajadores ope-rativos de una empresa de fabricación de refrigeradores del distrito de Barranquilla. Materiales y métodos: Este proyecto de investigación es de tipo transversal descriptivo. Se realizó un muestreo por conveniencia, constituido por 79 trabajadores. Los instrumentos utilizados fueron:PARQ, IMC, cuestionario nórdico y método REBA. Resul-tados: Del total de la población encuestada, se determinó que el 60,8 % refiere alguna sintomatología osteomus-cular; donde el 48,1 % manifestó tener afectado un solo segmento corporal, el 10,1 % relacionado a 2 segmentos y con 3 o 4 segmentos comprometidos un 1,3 % respectivamente. Además de evidenciar que el segmento corporal con mayor afectación es el dorsolumbar relacionado con cargos como operario de armado, operario de enchape, de inyección y soldador. Conclusión: El colectivo de trabajadores de las áreas de armado, enchape, inyección y soldadura está especialmente expuesto a factores de riesgo que aumentan la probabilidad de padecer molestias y daños musculoesqueléticos. Los movimientos repetidos de extremidades superiores y la manipulación manual de cargas destacan entre los riesgos ergonómicos y las exigencias de atención, los altos ritmos de trabajo y los plazos cortos entre los riesgos psicosociales a los que está expuesto este colectivo. Además, que el índice de masa corporal es un factor importante ante la aparición de desórdenes musculoesqueléticos.

Objective:To design a system of epidemiological surveillance in musculoskeletal disorders in workers of operating a company manufacturing refrigerators of the district of Barranquilla. Materials and methods: This research proj-ect is a descriptive cross-sectional. There was a convenience sample, consisting of 79 employees. The instruments used were:PAR-Q, BMI, Nordic questionnaire method and REBA. Results: Of the total population surveyed, it was determined that 60.8 % of the population refers any musculoskeletal symptoms; where the 48.1 % said have affected only a part of the body, the 10.1 % related to 2 segments and with 3 or 4 segments committed a 1.3 per cent respectively. In addition, demonstrate that the part of the body most affected is the dorsolumbar dealing with charges of armed as an operator, operator of enchape, injection and soldering iron. Conclusion: The group of workers in the areas of armed, enchape, injection, and welding are especially exposed to risk factors that increase the likelihood of suffering from discomfort and damage muscle-skeletal. Repetitive movements of the upper ex-tremities and the manual handling of loads are among the ergonomic hazards and the demands of attention, the high rates of work and the short periods between psychosocial risks to which it is exposed this collective. In addi-tion, that the body mass index is an important factor before the appearance of skeletal muscle disorders

The epidemiological profile of patients attended by the public physiotherapy service in the city of Boa Vista do Cadeado, RS / O perfil epidemiológico dos pacientes atendidos pelo serviço público de fisioterapia no município de Boa Vista do Cadeado, RS

Abstract Introduction : To understand the role of physiotherapy in Brazilian society, to know its responsibilities and challenges, is necessary to know the epidemiological profile of the population. Objective : The objective of this study was to identify the epidemiological profile of the patients treated by physiotherapy public service in Boa Vista Cadeado, RS. Materials and methods : This is a quantitative study of the descriptive retrospective epidemiological sort through the technical procedure of documentary research, through the analysis of evaluation sheets of all patients attended at the physiotherapy sector in the period of 2004 to 2011. Results : 623 records were analyzed by means of variables such as gender, age and pathology. The study showed that the population attended is mostly composed by female patients, aged between 51 and 60 years old in the treatment of skeletal muscle disorders predominantly related to the spine. Conclusion : We concluded that it is necessary to know the population as for its etiologic factors of pathologies for the elaboration of primary care strategies to health, aiming health promotion, disease prevention and quality of life.

Resumo Introdução : Para entender o papel da fisioterapia na sociedade brasileira, saber suas responsabilidades e seus desafios, é necessário conhecer o perfil epidemiológico da população. Objetivo : O objetivo deste estudo foi identificar o perfil epidemiológico dos pacientes atendidos pelo serviço público de fisioterapia no município de Boa Vista do Cadeado, RS. Materiais e métodos : Trata-se de um estudo quantitativo do tipo epidemiológico retrospectivo descritivo, através do procedimento técnico de uma pesquisa documental, por meio da análise das fichas de avaliação de todos os pacientes atendidos no setor de fisioterapia, no período de 2004 a 2011. Resultados : Foram analisados 623 prontuários, através das variáveis estudadas, como sexo, faixa etária e patologia. O estudo demonstrou que a população atendida é em sua maioria composta de pacientes do sexo feminino, com faixa etária entre 51 e 60 anos, em tratamento de patologias relacionadas a distúrbios musculoesqueléticos predominantemente ligados à coluna vertebral. Conclusão : Concluiu-se que é preciso conhecer a população quanto aos fatores etiológicos das patologias, para elaboração de estratégias de atenção primária à saúde, objetivando a promoção à saúde, a prevenção de doenças e a qualidade de vida.

Ullrich Congenital Muscular Dystrophy Possibly Related With COL6A1 p.Gly302Arg Variant

Ullrich congenital muscular dystrophy (UCMD) is characterized by congenital weakness, proximal joint contractures, and hyperlaxity of distal joints. UCMD is basically due to a defect in extra cellular matrix protein, collagen type VI. A 37-year-old woman who cannot walk independently visited our outpatient clinic. She had orthopedic deformities (scoliosis, joint contractures, and distal joint hyperlaxity), difficulty of respiration, and many skin keloids. Her hip computed tomography showed diffuse fatty infiltration and the 'central shadow' sign in thigh muscles. From the clinical information suggesting collagen type VI related muscle disorder, UCMD was highly considered. COL6A1 gene sequencing confirmed this patient as UCMD with novel c.904G>A (p.Gly302Arg) variant. If musculoskeletal and dermatologic manifestations and radiologic findings imply abnormalities in collagen type VI network, COL6A related congenital muscular dystrophy was to be suspected.

Effects of Western Massage Combined with Muscle Energy Technique on Masticatory Muscle Disorders / 中国康复理论与实践

Objective To observe the effect of the Western massage combined with muscle energy technique on masticatory muscle dis-orders. Methods 58 patients with masticatory muscle disorders were randomly divided into control group (n=29) and observation group (n=29). The control group accepted ultrashort wave therapy, while the observation group accepted the Western massage and muscle energy tech-nique. They were assessed with Visual Analogue Scale (VAS) of pain and Friction index of the temporomandibular joint (TMJ) before and 4 weeks after treatment. Results The scores of VAS and Friction index of the TMJ decreased in both groups (P<0.001), and decreased more in the observation group than in the control group (P<0.001). Conclusion The combination of Western massage and muscle energy technique is advanced for masticatory muscle disorders.

Alteraciones osteomusculares asociadas a factores físicos y ambientales en estudiantes de odontología / Musculoskeletal alterations associated factors physical and environmental in dental students

OBJETIVO: Describir las alteraciones osteomusculares y su asociación con factores físicos y ambientales en estudiantes de odontología. MÉTODOS: Estudio analítico de corte transversal. Se realizó muestreo aleatorio simple por fijación proporcional de acuerdo al ciclo académico cursado, seleccionado una muestra de 182 estudiantes. La recolección de la información de las exposiciones físicas, ambientales relacionadas con la práctica clínica odontológica y diferentes a estas fueron valoradas mediante un cuestionario validado tipo encuesta estructurada. La valoración muscular se realizó mediante un análisis visual con el Scan-test. Para los factores relacionados con la posición de trabajo, se utilizó el instrumento RULA. Para el análisis bivariable se utilizaron las razones de disparidad con intervalos de confianza del 95%. Para el análisis multivariable se utilizó la regresión logística nominal. RESULTADOS: El 58,2% de los estudiantes presentaron dolor a la palpación en trapecio superior y el 45,6% en zona cervical. En los movimientos de lateralidad cervical se encontró dolor en un 35,7%, junto con el de flexión cervical en 35,1%. La prevalencia de dolor estuvo relacionada con factores propios de la práctica clínica odontológica y no hubo relación con otros factores externos. CONCLUSIONES: La aparición de dolor muscular en esta población está influida por múltiples variables, la mayoría de éstas, relacionadas con la práctica odontológica de los estudiantes, las cuales al interactuar entre sí pueden desencadenar sintomatología a nivel de espalda y cuello.

OBJECTIVE: To describe the musculoskeletal disorders and association with physical and environmental in students of Dentistry. METHODS: Cross sectional study. Simple random sampling was conducted obtaining a proportional sample of 182 students per semester. Collecting information from physical and environmental exposures related to different clinical practice and this was assessed by a structured survey questionnaire type. The valuation muscle was performed by visual analysis with Scan-test. To assess factors related to working position, the instrument was used RULA. For the analysis of the association were used odds ratios with confidence intervals of 95%. For the multivariate analysis using logistic regression. RESULTS: 58.2% of students had pain tenderness in upper trapezius and 45.6% in area cervical. Lateral movements in the cervical found pain in 35.7%, with the bending cervical 35.1% related to all these factors own dental practice and not to other factors external. CONCLUSIONS: The onset of muscle pain in this population is influenced by multiple variables, most of them, related to dental practice of students to interact with each other can trigger symptoms at neck and back.