Efeitos agudos dos exercícios posturais globais na dor e amplitude de movimento de abertura da boca em indivíduos com disfunção temporomandibular / Acute effects of global postural exercises on pain and range of motion opening in individuals with temporomandibular disorders

Introdução: a disfunção temporomandibular (DTM) é um conjunto de fatores que são associados aos ruídos articulares e dor nos músculos adjacentes, incluem também limitação de movimentos articulares da mandíbula, dores na face e cabeça. Objetivo: investigar os efeitos agudos na amplitude de movimento (ADM) de abertura da boca e intensidade da dor em indivíduos com DTM submetidos a exercícios posturais globais. Métodos: foram incluídos no estudo voluntários de ambos os sexos, com diagnóstico de DTM de acordo com os Critérios de Diagnóstico em Pesquisa para Disfunções Temporomandibulares (RDC/TMD). Para avaliar a dor, foi utilizado um dolorímetro Palpeter® com precisão de 0,5 kg e 1,0 kg nos músculos faciais definidos pelo RDC / TMD. Para mensurar a ADM de abertura da boca, foi utilizado um paquímetro com registro em uma casa decimal. Todas as medidas avaliativas foram realizadas antes e após o término do protocolo de intervenção com exercícios posturais globais. Resultados: em relação à intensidade da dor, houve diferença significativa no músculo masseter superior esquerdo e médio direito. Na ADM de abertura da boca houve diferença estatisticamente significante entre os momentos, mas não houve diferença quando comparado entre grupos. Conclusão: o programa de exercícios posturais globais contribuiu para a redução na limitação da ADM de abertura da boca e diminuição da dor no músculo masseter.

Introduction: temporomandibular disorder (TMD) is a set of factors that are associated with joint noises and pain in adjacent muscles, also include limitation of joint movements of the jaw, pain in the face and head. Objective: to investigate the acute effects on the range of motion (ROM) of mouth opening and intensity of pain in individuals with TMD undergoing global postural exercises. Methods: volunteers of both sexes with a diagnosis of TMD according to the Diagnostic Criteria for Temporomandibular Disorders (RDC / TMD) were included in the study. To assess pain, a Palpeter® painter with an accuracy of 0.5 kg and 1.0 kg was used in the facial muscles defined by RDC / TMD. To measure the mouth opening ROM, a pachymeter was used with one decimal place. All evaluative measures were performed before and after the end of the intervention protocol with global postural exercises. Results: in relation to the pain intensity, there was a significant difference in the left and right upper right masseter muscles. In the mouth opening ROM there was a statistically significant difference between the moments, but there was no difference when compared between groups. Conclusion: the global postural exercise program contributed to the reduction in the limitation of mouth opening ROM and decrease of pain in the masseter muscle.

Efectividad de las técnicas de movilización articular sobre el rango de movimiento de pacientes adultos con capsulitis adhesiva primaria de hombro: revisión sistemática y metanálisis / The effectiveness of joint mobilization techniques for range of motion in adult patients with primary adhesive capsulitis of the shoulder: a systematic review and meta-analysis

Resumen OBJETIVO: Determinar la efectividad de las técnicas de movilización articular en el rango de movimiento en pacientes adultos con capsulitis adhesiva primaria de hombro. MÉTODO: Revisión sistemática con metanálisis. La búsqueda fue realizada en las bases de datos MEDLINE/PubMed, PEDro, CENTRAL, LILACS, EMBASE, CINAHL, Scopus y Web of Science. Los criterios de elegibilidad fueron estudios que utilizaran una técnica de movilización articular oscilatoria y/o mantenida aplicada, sola o adicionada, a un programa de tratamiento en pacientes con capsulitis adhesiva primaria, en cualquier estadio. La selección de estudios y la extracción de datos fueron realizadas por dos autores de forma independiente. El riesgo de sesgo se evaluó según la herramienta propuesta por Cochrane. RESULTADOS: Se incluyeron 14 estudios con variados riesgos de sesgo. La movilización posterior versus otra técnica articular no presenta diferencia de media significativa (- 0,95 grados; intervalo de confianza de 95%; - 5,93 a 4,02), mientras que comparada con un grupo control la diferencia es de 26,80 grados (intervalo de confianza 95%; 22,71 a 30,89), además cuando se aplica un conjunto de técnicas articulares versus un grupo control, para la abducción la diferencia es de 20,14 grados (intervalo de confianza 95%; 10,22 a 30,05). En ambos casos, los resultados son estadísticamente significativos y se aprecia un tamaño de efecto moderado. CONCLUSIONES: La evidencia científica no es concluyente acerca de la efectividad de la movilización articular, dada la heterogeneidad en la metodología y sesgo de los artículos incluidos en esta revisión. Al compararla con tratamientos que no incluyen terapia manual, parecieran favorecer la mejoría del rango de movimiento y reducción del dolor, en pacientes con capsulitis adhesiva primaria de hombro.

Abstract OBJECTIVE: To determine the effectiveness of joint mobilization techniques in the range of motion in adult patients with primary adhesive shoulder capsulitis. METHODS: Systematic review with meta-analysis. The search was performed in the MEDLINE/PubMed, PEDro, CENTRAL, LILACS, EMBASE, CINAHL, Scopus and Web of Science databases. The eligibility criteria were studies that used an oscillatory and/or maintained joint mobilization technique applied alone or added-on to a treatment program in patients with primary adhesive capsulitis at any stage. Two authors carried out the selection of studies and the extraction of data, independently. Risk of bias was evaluated according to the tool proposed by Cochrane. RESULTS: We included 14 studies with variable risk of bias. Posterior mobilization compared to any other technique was not significantly different (0.95 degrees; 95% CI: - 5.93 to 4.02), whereas compared to a control group, the difference is 26.80 degrees (CI 95%: 22.71 to 30.89). When applying a set of joint techniques versus a control group, for abduction the difference is 20.14 degrees (95% CI: 10.22 to 30.05). In both cases, the results are statistically significant, and the effect size is moderate. CONCLUSIONS: The evidence is not conclusive about the effectiveness of joint mobilization. When compared with treatments that do not include manual therapy, joint mobilization seems to have a favorable effect on the range of motion and pain reduction in patients with primary adhesive shoulder capsulitis.

Balance and muscle power of children with Charcot-Marie-Tooth / Equilíbrio e potência muscular em crianças com doença de Charcot-Marie-Tooth

BACKGROUND: In certain diseases, functional constraints establish a greater relationship with muscle power than muscle strength. However, in hereditary peripheral polyneuropathies, no such relationship was found in the literature. OBJECTIVE: In children with Charcot-Marie-Tooth (CMT), to identify the impact of muscle strength and range of movement on the static/dynamic balance and standing long jump based on quantitative and functional variables. METHOD: The study analyzed 19 participants aged between 6 and 16 years, of both genders and with clinical diagnoses of CMT of different subtypes. Anthropometric data, muscle strength of the lower limbs (hand-held dynamometer), ankle and knee range of movement, balance (Pediatric Balance Scale) and standing long jump distance were obtained by standardized procedures. For the statistical analysis, Pearson and Spearman correlation coefficients were used. RESULTS: There was a strong positive correlation between balance and the muscle strength of the right plantar flexors (r=0.61) and dorsiflexors (r=0.59) and a moderate correlation between balance and the muscle strength of inversion (r=0.41) and eversion of the right foot (r=0.44). For the long jump and range of movement, there was a weak positive correlation with right and left plantar flexion (r=0.20 and r=0.12, respectively) and left popliteal angle (r=0.25), and a poor negative correlation with left dorsiflexion (r=-0.15). CONCLUSIONS: The data on the patients analyzed suggests that the maintenance of distal muscle strength favors performance during balance tasks, while limitations in the range of movement of the legs seem not to be enough to influence the performance of the horizontal long jump. .

CONTEXTUALIZAÇÃO: Em algumas doenças, limitações funcionais têm maior relação com a potência do que com a força muscular, porém, nas polineuropatias periféricas hereditárias, tal relação não foi relatada na literatura. OBJETIVO: Identificar, a partir da análise de variáveis quantitativas e funcionais, o impacto da força dos músculos dos membros inferiores e das amplitudes de movimento (ADM) sobre o equilíbrio estático/dinâmico e o salto horizontal de crianças com doença de Charcot-Marie-Tooth (CMT). MÉTODO: Foram incluídos 19 participantes de seis a 16 anos, de ambos os sexos, com diagnóstico clínico de CMT de subtipos variados. Foram obtidos, de forma padronizada, dados antropométricos, força muscular dos membros inferiores (Hand-Held Dynamometer), ADM de tornozelos e joelhos, equilíbrio (Escala de Equilíbrio Pediátrica) e distância de salto horizontal (Long Jump). Para a análise estatística, utilizaram-se os Coeficientes de Correlação de Pearson e Spearman. RESULTADOS: Houve forte correlação positiva entre equilíbrio e força muscular de flexores plantares direito (r=0,61) e dorsiflexores (r=0,59) e correlação moderada com inversores dos pés (r=0,41) e eversores do pé direito (r=0,44). Considerando o Long Jump e as ADM, houve fraca correlação positiva para ADM de flexão plantar direita (r=0,20), esquerda (r=0,12) e ângulo poplíteo esquerdo (r=0,25) e fraca correlação negativa para dorsiflexão esquerda (r=-0,15). CONCLUSÕES: Os dados dos pacientes analisados sugerem que a manutenção de força muscular distal favorece o desempenho em tarefas de equilíbrio. E as restrições nas ADM passivas de membros inferiores parecem ...

Effects of Warm Neelding Moxibustion and Exercise Therapy on Scapulohumeral Periarthrits / 中国康复理论与实践

@#ObjectiveTo observe the effect of warm needle moxibustion and exercise therapy on scapulohumeral periarthrits.Methods90 scapulohumeral periarthrits cases were randomly divided into the synthetic treatment group and exercise therapy group with 45 cases in each group. Patients of the synthetic treatment group were treated with warm needle moxibustion and exercise therapy, but that of the exercise therapy group only with exercise therapy. Some local acupoints, for example Point LI15 (Jian Yu), Piont SJ14 (Jian Liao), Piont SI9 (Jian Zhen) and so on, were selected when warm needle moxibustion performed. Eexercise therapy includes joint mobilization and initiative function training. One course was 15 days. The effect was evaluated after two courses.ResultsApparent efficiency of synthetic treatment groups was 71% and 42% for exercise therapy groups. There was a significant difference between two groups (χ2=22.815,P<0.01). There was also a obvious difference between two groups in improving range of shoulder joint movement and alleviating extent of shoulder pain (P<0.05).ConclusionWarm needle moxibustion cooperated with exercise therapy can increase cure rate and reduce recrudescence of scapulohumeral periarthrits.

Risk factors of stiff knees after primary total knee arthroplasty / 中国矫形外科杂志

[Objective]To evaluate the incidence and predictors of stiff knees after primary TKA.[Method]A retrospective review was given to the data from 1216 patients undergoing primary total knee arthroplasty between October 1996 and October 2006.Forty-five stiff TKA patients with a 1-year postoperative flexion range of less than 90?was taken as treatment group.Forty-five TKA patients with greater than 90? flexion at 1 year postoperative as control group.The age,sex,body mass index,American Society of Anesthesiologists(ASA) rating,surgeon,implant type,and fixation of the control group were matched to those of the treatment group.A case-control study was conducted to determine predictive factors of stiff TKA.[Result]No significant differences were found with regard to the mean age,ratio of sex and preoperative medical comorbidities.Preoperative flexion and intraoperative flexion were predictive of ultimate postoperative flexion(P=0.001 and P=0.039,respectively).Preoperative and postoperative relatively decreased patellar heightwere significantly correlated with postoperative stiffness(P=0.001).[Conclusion]Stiffness post-TKA is multifactorial,careful attention to surgical exposure,restoring gap kinematics,minimizing surgical trauma to the patellar ligament/extensor mechanism,appropriate implant selection,and physiotherapy may all serve to reduce the incidence of post-TKA stiffness.