Análisis del efecto de la fisioterapia temprana en la recuperación funcional de pacientes con quemaduras en miembros inferiores / Analysis of the effect of early physiotherapy on the functional recovery of patients with burns on lower limbs

Introducción: La recuperación de las actividades de la vida diaria de los pacientes quemados depende de una atención oportuna y eficaz, incluyendo la rehabilitación física. Objetivo: Evaluar la efectividad funcional de la rehabilitación temprana en pacientes con quemaduras en miembros inferiores. Métodos: Este es un estudio retrospectivo, longitudinal, observacional y analítico en el cual se evaluó la asociación que existe entre el número de sesiones de fisioterapia y diferentes variables de desenlace relacionadas con la funcionalidad del paciente quemado de miembros inferiores. Se realizaron de manera secuencial análisis uni-, bi- y multivariados para conocer las características de distribución en el primero, y la significación estadística en el segundo y tercero. Resultados: La información derivada de 32 pacientes que cumplieron con los criterios del estudio reveló una asociación simple entre la recuperación de los arcos de movilidad, sedestación, bipedestación y marcha con el número de sesiones de fisioterapia, sin que se favorezca la fuerza muscular. El análisis multivariado evidenció una correlación positiva entre el número de sesiones de fisioterapia y la sedestación, pero negativa cuando se asoció la ventilación mecánica con la bipedestación/marcha asistida. Conclusión: La aplicación de fisioterapia temprana contribuye directamente con la recuperación funcional del paciente quemado; sin embargo, es indispensable considerar que el estado catabólico de los individuos entorpece el progreso motriz

Introduction: Recovery of activities of daily living in burn patients depend on timely and effective care, including physical rehabilitation. Aim: To evaluate functional activity in lower limb burn patients after early rehabilitation. Methods: A retrospective, longitudinal, and analytic trial was conducted in order to assess the association between the number of physiotherapy sessions and the functional outcome in lower limb burn patients. Uni-, bi-, and multivariate analyses were performed in order to determine the distribution characteristics of the sample, and any significant association between variables. Results: After a review of data from 32 patients that fulfilled trial enrolment criteria, a simple association was shown between complete joint motion, sitting position, standing and walking vs. the number of physiotherapy sessions, but failed to maintain or improve muscle strength. Multivariate analysis demonstrated a positive correlation between the number of physiotherapy sessions and sitting position, but a negative one when mechanical ventilation was related to standing/walking. Conclusion: The early administration of physiotherapy helps in the functional recovery of burn patients; nevertheless it is critical to consider that catabolic processes impair motion

Motion deficit in nodal interphalangeal joint osteoarthritis by digital goniometer in housewives.

Range of motion (ROM) measured objectively in nodal hand osteoarthritis (NHOA) is missing. Evaluation of collateral ligaments by ultrasound (US) is unknown in NHOA also. To compare ROM in interphalangeal joints in housewives with nodal OA, with a control group by a digital system using angle to voltage (Multielgon). The second objective was to assess correlation between collateral radial and ulnar ligaments thickness and ROM. For this cross-sectional observational study, we assessed 60 hands with symptomatic NHOA and 30 hands of healthy housewives matched for age. We obtained clinical and demographic characteristics (a complete standardized physical examination of hand joints, DASH questionnaire, pain surveys, gross grasp hand goniometer, and ROM measurements by Multielgon. Presence of synovitis, power Doppler signal, osteophytes, and collateral ligaments thickness was evaluated by US. We used descriptive statistics, Spearman correlation, X2 test, t test and odds ratio. Significant less gross grasp and ROM in the right hand were observed in NHOA (p = 0.01 for both). Presence of OA, painful joints, disease duration, and score DASH were significant correlated with reduced ROM (OR 4.12, 4.12, 1.04 and 1.09, respectively). Reduced ROM was statistical significant in thumb MCP and IP joints, second and third DIP in dominant hand. There was no association between collateral radial and ulnar ligaments and reduced ROM. Synovitis and osteophytes were more prevalent in OA group. Multielgon demonstrated the pattern of reduced ROM in nodal OA of housewives particularly in MCP and IP thumb joints, second and third distal interphalangeal joints.