Postural control during single leg stance in individuals with clinical indication for combined reconstruction of the anterior cruciate and the anterolateral ligaments of the knee: a cross-sectional study.

BACKGROUND: Several studies have shown persistent postural control deficits and rotatory instability in patients after isolated Anterior Cruciate Ligament (ACL) reconstruction. There is evidence to support that the Anterolateral Ligament (ALL) plays an important role in the remaining anterolateral rotatory laxity of the knee. There are no further evidences in order to understand how patients with a combined ACL + ALL reconstruction surgery indication behave regarding postural control. The aim of this cross-sectional study was to assess if patients with a clinical indication for the combined ACL + ALL surgery showed a deficient postural control in single leg stance compared to subjects with a regular ACL reconstruction indication and to a control group. METHODS: An assessment of static postural control on single leg stance was performed on a force plate, with eyes open and closed, and the center of pressure (COP) displacement variables were analyzed: maximum and mean amplitude in anteroposterior (AP) and in mediolateral (ML) direction; mean velocity of displacement and area of displacement. Eighty-nine male individuals participated and were divided into 3 groups: ACL Group, ACL + ALL Group and Control Group. RESULTS: The ACL+ ALL Group showed significantly greater COP displacement in most variables in the injured leg for the eyes closed test, compared to the ACL Group, as detailed: Total ML displacement (9.8 ± 6.77 vs. 13.98 ± 6.64, p < 0.001); Mean ML displacement (2.58 ± 2.02 vs. 3.72 ± 1.99, p < 0.001); Total AP displacement (9.5 ± 3.97 vs. 11.7 ± 3.66, p = 0.001); Mean AP displacement (1.77 ± 0.87 vs. 2.27 ± 0.86, p = 0.001); Area of displacement (111.44 ± 127.3 vs. 183.69 ± 131.48, p < 0.001). CONCLUSION: Subjects with a clinical indication for ACL + ALL combined reconstruction surgery showed increased COP displacement compared to patients with indication for an ACL isolated reconstruction surgery.

Anthropometric and musculoskeletal assessment of patients with Marfan syndrome.

BACKGROUND: Marfan syndrome (MS) is an autosomic dominant condition of the connective tissue that involves the ocular, cardiovascular and musculoskeletal systems. MS is caused by mutations in the fibrillin-1 gene, leading to joint ligaments flaccidity, joint hypermobility and an overgrowth of the long bones. OBJECTIVES: The aim of the present study was to assess anthropometry, musculoskeletal alterations and the prevalence of physical therapy treatments among patients with MS. METHODS: Twenty-six patients were included in this study [17 females (age: 13.23±2.77 years; body mass 51.5±24-68 Kg; height 1.70±1.40-1.81 m; arm span: 1.73±0.12 m) and 9 males (age: 14.44±2.18; body mass: 61.0±42-72 Kg; height: 1.83±1.66-1.97 m; arm span: 1.93±0.13 m)]. Anthropometric measurements and musculoskeletal abnormalities were determined in a standardized fashion: pectus and scoliosis were assessed through radiography and angulation (â) of the scoliosis curve using the Cobb method; arachnodactyly was assessed through the thumb sign and Walker-Murdoch test and dolichostenomelia was assessed by arm span in relation to height. Patients also responded to a questionnaire addressing participation in physical therapy. RESULTS: In comparison to values estimated for the Brazilian population, mass and height were greater among the patients with MS (females: p=0.001 e p<0.0005 e males p=0.019 e p=0.0001, respectively). The following musculoskeletal abnormalities were found: pectus in 3 patients (11%), pectus and scoliosis in 19 (73%), dolichostenomelia in 11 (42%) and arachnodactyly in 21 (80%). Eleven patients (42%) with MS had previously undergone physical therapy. CONCLUSIONS: Patients with MS exhibit altered musculoskeleto and anthropometry and have infrequent physical therapy treatment.

Avaliação antropométrica e musculoesquelética de pacientes com síndrome de Marfan / Anthropometric and musculoskeletal assessment of patients with Marfan syndrome

CONTEXTUALIZAÇÃO: A Síndrome de Marfan (SM) é uma doença autossômica dominante do tecido conjuntivo que envolve os sistemas ocular, cardiovascular e musculoesquelético, causada por mutações no gene da fibrilina1, gerando flacidez nos ligamentos articulares, favorecendo a hipermobilidade articular e redução na contenção do crescimento ósseo. OBJETIVOS: Avaliar as medidas antropométricas, alterações musculoesqueléticas e a frequência do tratamento fisioterapêutico nos pacientes com SM. MÉTODOS: Participaram deste estudo 26 pacientes, sendo 17 do gênero feminino, com idade de 13,23±2,77 anos, massa corpórea de 51,5±24-68 Kg, altura de 1,70±1,40-1,81 m e envergadura de 1,73±0,12 cm, e nove do gênero masculino, com idade de 14,44±2,18, massa corpórea de 61,0±42-72 Kg, altura de 1,83±1,66-1,97 m e envergadura de 1,93±0,13. Foram obtidas medidas antropométricas, alterações ME de forma padronizada, sendo o pectus e a escoliose, por avaliação radiológica, e a angulação (â) da curva escoliótica, pelo método de Cobb; a aracnodactilia, pelo sinal do polegar e teste de Walker-Murdoch, e a dolicostenomelia, pela envergadura em relação à altura. Os pacientes responderam a um questionário quanto à participação em tratamento de fisioterapia. RESULTADOS: Quando comparados com a estimativa brasileira, a massa corpórea e a altura apresentaram valores maiores no gênero feminino (p=0,001 e p<0,0005) e masculino (p=0,019 e p=0,0001). Das alterações musculoesqueléticas, encontrou-se pectus em 3 (11 por cento), pectus e escoliose em 19 (73 por cento), dolicostenomelia em 11 (42 por cento) e aracnodactilia em 21(80 por cento). Onze (42 por cento) pacientes com SM já haviam realizado tratamento de fisioterapia. CONCLUSÕES: As alterações antropométricas e musculoesqueléticas estão presentes na SM, e o tratamento fisioterapêutico é pouco frequente.

BACKGROUND: Marfan syndrome (MS) is an autosomic dominant condition of the connective tissue that involves the ocular, cardiovascular and musculoskeletal systems. MS is caused by mutations in the fibrillin-1 gene, leading to joint ligaments flaccidity, joint hypermobility and an overgrowth of the long bones. OBJECTIVES: The aim of the present study was to assess anthropometry, musculoskeletal alterations and the prevalence of physical therapy treatments among patients with MS. METHODS: Twenty-six patients were included in this study [17 females (age: 13.23±2.77 years; body mass 51.5±24-68 Kg; height 1.70±1.40-1.81 m; arm span: 1.73±0.12 m) and 9 males (age: 14.44±2.18; body mass: 61.0±42-72 Kg; height: 1.83±1.66-1.97 m; arm span: 1.93±0.13 m)]. Anthropometric measurements and musculoskeletal abnormalities were determined in a standardized fashion: pectus and scoliosis were assessed through radiography and angulation (â) of the scoliosis curve using the Cobb method; arachnodactyly was assessed through the thumb sign and Walker-Murdoch test and dolichostenomelia was assessed by arm span in relation to height. Patients also responded to a questionnaire addressing participation in physical therapy. RESULTS: In comparison to values estimated for the Brazilian population, mass and height were greater among the patients with MS (females: p=0.001 e p<0.0005 e males p=0.019 e p=0.0001, respectively). The following musculoskeletal abnormalities were found: pectus in 3 patients (11 percent), pectus and scoliosis in 19 (73 percent), dolichostenomelia in 11 (42 percent) and arachnodactyly in 21 (80 percent). Eleven patients (42 percent) with MS had previously undergone physical therapy. CONCLUSIONS: Patients with MS exhibit altered musculoskeleto and anthropometry and have infrequent physical therapy treatment.

Age does not affect exercise intensity progression among women.

It has been recommended that the intensity of exercise training (ET) should progress slowly with lower increments in older than in young people. However, scientific evidence supporting this recommendation is lacking. Our aim was to examine possible influences of age on exercise intensity progression in healthy women. Seventeen young (29.1 ± 5.7 years) and 16 older women (64.5 ± 4.5 years) underwent 13 weeks of ET consisting of cycle ergometry (CE, 65-75% of reserve heart rate), whole-body resistance exercise (RE, 60% of 1 repetition maximum [1RM]), and stretching. Muscle strength was assessed before and after ET by the 1RM. Cycle ergometry and RE workloads were recorded for each exercise session, and increases of 5-10% were made whenever adaptation occurred. Absolute muscle strength after ET improved (p < 0.001) in both groups, and there were no significant differences between groups. Relative exercise intensity progression was not significantly different between groups for RE (Pearson's correlation = 0.98 ± 0.01), but it was greater in older women for CE (p = 0.047). The ET was safe because no injuries or major muscle pain was observed in either group. These results suggest that healthy older women are capable of exercising and increasing exercise intensity in the same way as young women.

Tratamento de massagem e acupuntura em corredores recreacionais com síndrome do piriforme / Massage and acupuncture treatment in runners with piriformis syndrome

Introdução: A síndrome do piriforme é caracterizada por uma condição na qual o músculo piriforme contribuipara a compressão ou irritação do nervo isquiático. A maior causa de lesões nos músculos da pelve e coxassão decorrentes de traumas por uso excessivo e podem ser observados com freqüência na corrida. O objetivodeste estudo foi propor um tratamento associando as duas técnicas, a massagem e a acupuntura, em corredorescom síndrome do piriforme. Métodos: Foram tratados nove corredores, de ambos os sexos, com média deidade de 44,5 anos, que apresentavam dores nas regiões lombar e glútea e/ou coxa; utilizando-se paraavaliação os testes clínicos; escala analógica de dor e testes de flexibilidade. O tratamento consistiu emmassagem (Shiatsu) e acupuntura. Resultados: Houve melhora significativa da dor (p = 0,007) e da flexibilidade(p = 0,018). Conclusão: As duas técnicas associadas proporcionaram aos corredores melhora da dor eflexibilidade restabelecendo a função muscular.

Introduction: The Piriformis syndrome is described as a condition in which the piriformis muscle compressesand irritates the Sciatic nerve. The most frequent reason of the Pelvic and Thigh Muscles injuries are traumafrom excessive use of these structures, and it can also be frequently observed in runners. The purpose of thisstudy was to suggest an associated treatment of two techniques, massage and acupuncture in runners withPiriformis syndrome. Methods: Nine runners from both genders have been treated; the mean age was 44.5years, and all of them refer pain in lumbar, gluteal, and/or femoral regions; evaluation was performed throughclinical tests, visual analog scale pain, and elasticity test. The treatment consists in shiatsu massage andacupuncture. Results: Pain (p=0,007) and muscular flexibility (p=0,018) have been improved. Conclusion: Theassociation of the two techniques provided improvement of the pain and a greater muscular flexibility, thusrestoring the muscular function.