Papel do exercício combinado sobre a dor de dismenorréia primária em mulheres jovens: uma quase-experiência / Role of combined exercise on primary dysmenorrhea pain among girls: a quasi-experiment

INTRODUÇÃO: Dismenorréia primária é uma dor que atinge o abdômen inferior antes e durante a menstruação. A dismenorréia primária é dor que mais afeta mulheres durante a adolescência. Felizmente, para muitas, o problema alivia à medida que amadurecem, particularmente após uma gravidez. Embora possa ser doloroso e por vezes debilitante por breves períodos de tempo, não é prejudicial. OBJETIVO: Investigar os efeitos de exercícios selecionados sobre a dor de dismenorréia primária em mulheres jovens. MÉTODO: Mulheres jovens com idade de 21,1 ± 2,0 anos foram incluídas neste estudo. A intervenção com exercícios incluiu fortalecimento do grupo muscular central (Core), flexibilidade, exercícios do barril e de resistência. A duração da intervenção foi de nove semanas com frequência de duas sessões por semana e duração de 30 minutos. O projeto foi aprovado pelo comitê de ética no hospital de Kasturba Universidade de Manipal, Índia (número de registro: IEC315 / 2015) RESULTADOS: Os exercícios reduzem a intensidade da dor entre mulheres jovens com dismenorréia. A escala analógica visual (VAS) foi utilizada para medir a intensidade da dor. Houve uma diferença significativa na pontuação para as condições pré-teste (6.94 ± 1.33) e pós-teste (5.02 ± 1.15), p < 0,001. CONCLUSÃO: Este estudo mostra que o exercício misto de flexibilidade, estabilidade do centro de força e exercício do barril pode reduzir a dor primária da dismenorréia entre as meninas. [AU]

INTRODUCTION: Primary dysmenorrhea is the pain of lower abdominal before and during the menstruation. Primary dysmenorrhea is more likely to affect girls during adolescence. Fortunately for many women, the problem eases as they mature, particularly after a pregnancy. Although it may be painful and sometimes debilitating for brief periods of time, it is not harmful. OBJECTIVE: The purpose of this study was to investigate effects of selected exercise on primary dysmenorrhea pain among girl. METHOD: Young women aged (21.1±2.0) were included in this study. The intervention with exercises included core strengthening, flexibility, kegel and endurance exercises. The duration of the intervention was eigth weeks, two times per week with duration of 30 minutes per session. Visual Analogue Scale (VAS) was used to measure the intensity of pain. RESULTS: The results show that exercise effects to reduce pain intensity among young women with dysmenorrhea. There was a significant difference in the score for pre-test (M: 6.94, SD: 1.33) and post-test (M: 5.02, SD: 1.15) conditions; t (9.1) = 2.34, p= 0.000. CONCLUSION: This study shows that the mixed exercise of flexibility, core stability and kegle exercise can reduce the primary dysmenorrhea pain among girls. [AU]

Short-term balance training with computer-based feedback in children with cerebral palsy: A feasibility and pilot randomized trial.

OBJECTIVE: To assess the feasibility of using short-term balance training with computer-based visual feedback (BTVF) and its effect on standing balance in children with bilateral spastic cerebral palsy (BSCP). METHODS: Out of the fourteen children with BSCP (mean age = 10.31 years), seven children received four sessions of BTVF (two such sessions/day, each session = 15 min) in comparison to the control group that received standard care. Feasibility was measured as percentages of recruitment, retention and safety and balance was measured using a posturography machine as sway velocity (m/s) and velocity moment (m/s2) during quiet standing. RESULTS: No serious adverse events occurred in either group. There were no differences in the retention percentages and in any clinical outcome measure between both groups. CONCLUSION: Use of BTVF is feasible in children with BSCP but further investigation is required to estimate a dose-effect relationship.

Energy expenditure during standing in children with cerebral palsy: A brief report1.

PURPOSE: The aim of the study was to estimate the energy expenditure (EE) during a quiet standing task in children with bilateral spastic CP (BSCP) in comparison with typically developing (TD) children, using gas analyzer. METHODS: The study was an observational cross-sectional study of children with BSCP (Gross Motor Function Classification System [GMFCS] levels II and III; n = 30; 10 males, 20 females; mean weight 27.46 kgs; mean age 10 years) and TD children (n = 30; 16 males, 14 females; mean weight 25.35 kgs; mean age 9 years, 9 months). The energy expenditure during quiet standing task was measured by using Cosmed K4b2 gas analyzer and expressed in terms of peak oxygen consumption (VO2 max, ml/kg body weight/min). RESULTS: Children with BSCP expended 1.4 times higher energy during standing than TD children (p< 0.0001). CONCLUSION: We identified that standing puts an additional energy demand in ambulant children with BSCP. Findings suggest that both dependant and independent ambulating children with BSCP might need to exert more effort to maintain a static standing position. Therefore, clinicians must evaluate standing position for balance control and energy expenditure to evaluate the efficiency of physical therapy and rehabilitation.

Mobilization of patients in neurological Intensive Care Units of India: A survey.

CONTEXT: The rehabilitation needs of the patients in neurological Intensive Care Units (ICUs) vary from that of a medical ICU patient. Early mobilization is known to improve the various neurological outcomes in patients admitted to neurological ICUs, although little is known about the practice pattern among physiotherapists. The mobilization practice pattern may vary significantly than that of developed countries due to the reasons of differences in training of professionals, availability of equipment, and financial assistance by health insurance. AIM OF THE STUDY: To study the current mobilization practices by the physiotherapists in neurological ICUs of India. SUBJECTS AND METHODS: A cross-sectional survey was conducted with a content validated questionnaire about the mobilization practices. Online questionnaire was distributed to physiotherapists working in neurological ICUs of India. Descriptive statistics were used. RESULTS: Out of 185 e-mails sent, 82 physiotherapists completed the survey (survey response rate = 44%). Eighty participants (97.6%) mentioned that the patients received some form of mobilization during the day. The majority of the physiotherapists (58.5%), "always" provided bed mobility exercises to their patients when it was found appropriate for the patients. Many physiotherapists (41.5%) used tilt table "sometimes" to introduce orthostatism for their patients. CONCLUSION: Mobilization in various forms is being practiced in the neurological ICUs of India. However, fewer mobilization sessions are conducted on weekends and night hours in Indian Neurological ICUs.

Analysis of postural stability in children with cerebral palsy and children with typical development: an observational study.

PURPOSE: To analyze and compare postural stability during static upright standing between children with cerebral palsy (CP) and age-matched peers with typical development (TD). METHODS: Forty-five children with spastic CP (34 with diplegia and 11 with hemiplegia) and 45 children with TD aged 5 to 12 years were assessed using a posturography device. Postural stability was evaluated under 4 sensory conditions: eyes open and eyes closed on a firm surface; eyes open and eyes closed on a foam surface. RESULTS: Statistically significant differences were obtained between children with spastic diplegic CP and children with TD under all conditions involving visual and somatosensory conflicts (P < .05), but no significant differences were found between children with hemiplegic CP and children with TD. CONCLUSION: Children with spastic diplegic CP have increased postural instability under sensory conditions that involve both visual and somatosensory conflicts.

Chest physiotherapy techniques in neurological intensive care units of India: A survey.

CONTEXT: Neurological intensive care units (ICUs) are a rapidly developing sub-specialty of neurosciences. Chest physiotherapy techniques are of great value in neurological ICUs in preventing, halting, or reversing the impairments caused due to neurological disorder and ICU stay. However, chest physiotherapy techniques should be modified to a greater extent in the neurological ICU as compared with general ICUs. AIM: The aim of this study is to obtain data on current chest physiotherapy practices in neurological ICUs of India. SETTINGS AND DESIGN: A tertiary care hospital in Karnataka, India, and cross-sectional survey. SUBJECTS AND METHODS: A questionnaire was formulated and content validated to assess the current chest physiotherapy practices in neurological ICUs of India. The questionnaire was constructed online and a link was distributed via E-mail to 185 physiotherapists working in neurological ICUs across India. STATISTICAL ANALYSIS USED: Descriptive statistics. RESULTS: The response rate was 44.3% (n = 82); 31% of the physiotherapists were specialized in cardiorespiratory physiotherapy and 30% were specialized in neurological physiotherapy. Clapping, vibration, postural drainage, aerosol therapy, humidification, and suctioning were used commonly used airway clearance (AC) techniques by the majority of physiotherapists. However, devices for AC techniques such as Flutter, Acapella, and standard positive expiratory pressure devices were used less frequently for AC. Techniques such as autogenic drainage and active cycle of breathing technique are also frequently used when appropriate for the patients. Lung expansion therapy techniques such as breathing exercises, incentive spirometry exercises, and positioning, proprioceptive neuromuscular facilitation of breathing are used by majority of physiotherapists. CONCLUSIONS: Physiotherapists in this study were using conventional chest physiotherapy techniques more frequently in comparison to the devices available for AC.

Effect of multisensory stimulation on neuromotor development in preterm infants.

OBJECTIVE: To investigate the effect of Auditory, Tactile, Visual and Vestibular stimulus (ATVV) on neuromotor development in preterm infants. METHODS: Fifty preterm infants born at 28-36 wk with a birth weight ranging from 1,000-2,000 g were recruited for the study. They were block randomized into a control group (n = 25) and study group (n = 25). New Ballard score was used for the baseline measurement of neuromaturity in both groups. In neonatal intensive care unit (NICU), the study group received multisensory stimulation for 12 min per session, 5 sessions per wk along with routine NICU care either from 33 wk corrected gestational age for infants born at 28-32 wk or from 48 h of birth for infants born at 33-36 wk until discharge from the hospital. The control group received the routine NICU care. At term age the preterm infants were assessed using Infant Neurological International Battery (INFANIB) and the groups were compared using independent t test. RESULTS: The multisensory stimulated infants showed higher neuromotor score (p = 0.001) compared to the control group. The french angle components of INFANIB including heel to ear (p = 0.016) and popliteal angle (p = 0.001) were statistically significant between the groups. CONCLUSIONS: Multisensory stimulation appears to have a beneficial effect on the tonal maturation in preterm infants. However, further studies are warranted to investigate the long-term effects of multisensory stimulation on neurodevelopmental outcome in preterm infants.

Bactericidal effect of ultraviolet C (UVC), direct and filtered through transparent plastic, on gram-positive cocci: an in vitro study.

The prevalence of wound infections caused by multidrug-resistant (MDR) bacteria is increasing along with concern about widespread use of antibiotics. In vitro studies have shown that ultraviolet radiation, especially UVC, is both an effective bactericidal and antifungal. However, evidence about its bactericidal effect on wounds covered with transparent dressings remains inconclusive. Transparent dressings are used to retain moisture over the wound as part of an intermittent negative pressure dressing-the Limited Access Dressing (LAD) technique. Because this dressing is designed to remain in place for a number of days, an in vitro study was conducted to explore the bactericidal effect of direct and indirect UVR through a transparent 0.15-mm thick transparent polythene sheet on Gram-positive cocci. Six bacterial strains were inoculated to sheep blood agar (SBA) plates and exposed to direct and filtered UVC (254 nm) for 5, 10, 15, 20, 25, and 30 seconds with one media serving as a control (no UVC exposure). Plates were subsequently incubated for 24 hours and bacterial growth observed. Each set of experiment was repeated three times. Direct UVC was shown to have good bactericidal effect (100% eradication of organisms inoculated) at durations ranging from a minimum of 5 seconds (methicillin-resistant, coagulase-negative Staphylococcus and Streptococcus pyogenes) to a maximum of 15 seconds (methicillin-susceptible Staphylococcus aureus and Enterococci species). No bactericidal effect was observed when UVC was filtered through a 0.15-mm thick transparent polythene sheet. The results confirm the bactericidal effect of UVC in vitro and suggest that this effect can be achieved after a very short period of time. At the same time, film dressings appear to filter UVC. This may help protect skin from exposure to UVC but also limits its utility for use with the LAD technique. In vivo studies to evaluate the shortest effective UVC treatment duration and follow-up clinical studies to ascertain treatment efficacy and effectiveness are needed.