Effectiveness of cryotherapy after anterior cruciate ligament reconstruction.

OBJECTIVE: The purpose of this study was to evaluate cryotherapy effectiveness in the immediate postoperative period of ACL reconstruction to improve pain and range of motion (ROM) of the knee. METHODS: This is a pilot study of a prospective and randomized clinical trial. Patients (n=25) were divided into two groups: Intervention (A) group (n=10): patients were submitted to an inpatient physical therapy protocol and received ice compress for 20 minutes, twice a day; Control (B) group (n=9): patients had the same protocol, twice a day. The pain intensity was evaluated with the visual analogic scale (VAS) and range of motion was measured with a goniometer. RESULTS: The Intervention (A) group had important absolute and percentual improvement when compared with the Control (B) group regarding measures of pain and knee flexion/extension ROM. CONCLUSION: Cryotherapy in the immediate postoperative period of ACL reconstruction was effective to improve pain and range of motion of the knee. Level of Evidence I, Randomized Clinical Trial .

Efetividade da crioterapia após reconstrução do ligamento cruzado anterior / Effectiveness of cryotherapy after anterior cruciate ligament reconstruction

OBJETIVO: Avaliar a efetividade da crioterapia no pós-operatório imediato de reconstrução do ligamento cruzado anterior (LCA), em relação à redução da dor e melhora da amplitude de movimento (ADM) do joelho. MÉTODOS: Trata-se do estudo piloto de um ensaio clínico prospectivo randomizado. Os pacientes (n=25) foram randomizados em dois grupos: (A) Grupo Intervenção (n=10) que realizou um protocolo fisioterapêutico e fez uso do gelo por 20 minutos, duas vezes ao dia; e o Grupo (B) Controle (n=9), que realizou o mesmo protocolo, duas vezes ao dia. A intensidade da dor foi avaliada pela Escala Análoga Visual e a ADM pela goniometria. RESULTADOS: O Grupo (A) Intervenção obteve melhora absoluta e percentual quando comparado ao (B) Controle, tanto para os parâmetros de dor, ADM de flexão e extensão do joelho. CONCLUSÃO: A crioterapia no pós-operatório imediato de reconstrução do LCA foi efetiva para melhorar a dor e a ADM do joelho. Nível de Evidência I, Estudo Clínico Randomizado.

OBJECTIVE: The purpose of this study was to evaluate cryotherapy effectiveness in the immediate postoperative period of ACL reconstruction to improve pain and range of motion (ROM) of the knee. METHODS: This is a pilot study of a prospective and randomized clinical trial. Patients (n=25) were divided into two groups: Intervention (A) group (n=10): patients were submitted to an inpatient physical therapy protocol and received ice compress for 20 minutes, twice a day; Control (B) group (n=9): patients had the same protocol, twice a day. The pain intensity was evaluated with the visual analogic scale (VAS) and range of motion was measured with a goniometer. RESULTS: The Intervention (A) group had important absolute and percentual improvement when compared with the Control (B) group regarding measures of pain and knee flexion/extension ROM. CONCLUSION: Cryotherapy in the immediate postoperative period of ACL reconstruction was effective to improve pain and range of motion of the knee. Level of Evidence I, Randomized Clinical Trial.

Effect of the duration of daily aerobic physical training on cardiac autonomic adaptations.

The present study has investigated in conscious rats the influence of the duration of physical training sessions on cardiac autonomic adaptations by using different approaches; 1) double blockade with methylatropine and propranolol; 2) the baroreflex sensitivity evaluated by alternating bolus injections of phenylephrine and sodium nitroprusside; and 3) the autonomic modulation of HRV in the frequency domain by means of spectral analysis. The animals were divided into four groups: one sedentary group and three training groups submitted to physical exercise (swimming) for 15, 30, and 60min a day during 10 weeks. All training groups showed similar reduction in intrinsic heart rate (IHR) after double blockade with methylatropine and propranolol. However, only 30-min and 60-min physical training presented an increase in the vagal autonomic component for determination of basal heart rate (HR) in relation to group sedentary. Spectral analysis of HR showed that the 30-min and 60-min physical training presented the reduction in low-frequency oscillations (LF=0.20-0.75Hz) and the increase in high-frequency oscillations (HF=0.75-2.5Hz) in normalized units. These both groups only showed an increased baroreflex sensitivity to tachycardiac responses in relation to group sedentary, however when compared, the physical training of 30-min exhibited a greater gain. In conclusion, cardiac autonomic adaptations, characterised by the increased predominance of the vagal autonomic component, were not proportional to the duration of daily physical training sessions. In fact, 30-minute training sessions provided similar cardiac autonomic adaptations, or even more enhanced ones, as in the case of baroreflex sensitivity compared to 60-minute training sessions.