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2.
Artigo em Inglês | MEDLINE | ID: mdl-29681973

RESUMO

BACKGROUND: There are a great number of interventions in physiotherapy, but with little evidence of their effectiveness in chronic low back pain. Therefore, this study assesses effectiveness of Massage Therapy and Abdominal Hypopressive Gymnastics and the combination of both to decrease pain and lumbar disability while increasing joint mobility and quality of life in patients with chronic nonspecific low back pain. METHODS: A randomized, single-blinded, controlled, clinical trial with sample (n = 27) was comprised of patients between 20 and 65 years, diagnosed with pain of mechanical origin characterized by having a duration of at least 12 weeks and no serious complications. Each group received 8 interventions of 30 minutes. RESULTS: Friedman ANOVA test obtained statistically significant differences of Oswestry, NRS, and Schober variables (p < 0.05) in the three measurements (pretest, posttest 1, and posttest 2), in each individual group. ANOVA Kruskal-Wallis test was used for comparison between groups, and Oswestry Disability values were significantly higher (p = 0.024) in the group receiving both treatments. CONCLUSION: Both individual groups reduce pain levels, improve disability, and increase the flexibility of the lumbar spine. The combination therapy provides greater benefits in terms of lumbar disability. This study is registered on March 8, 2016, with NCT02721914.

3.
J Eur Acad Dermatol Venereol ; 29(2): 315-324, 2015 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-24841370

RESUMO

BACKGROUND: Despite the existence of diverse instruments to assess cellulite, its high prevalence and the continuous advances in its treatment makes the development of new, more objective methods for evaluation necessary. AIM: To study intraobserver validity and reliability (test-retest) of textural analysis using co-occurrence matrices on photographic images in the evaluation of cellulite in a Spanish population and its possible relationship to the degree of cellulite. METHODS: Twenty-seven women were selected for this reliability study (mean age 26.41 SD = 6.16). Digital photographs were taken under standardized conditions in contraction and relaxation of the femoral gluteus region. The areas of interest of the photographs were selected at two different times a month apart. Textural parameters studied were energy (ASM), entropy, contrast, Homogeneity (IDM) and textural correlation. Reliability was analysed by the intraclass correlation coefficient (ICC). Differences between laterality and between contraction and relaxation were performed by analysis of variance for repeated measurements. Correlation between Cellulite Severity Scale (CSS) and the textural parameters by means of the Pearson correlation coefficient was studied. CSS was re-coded to a binary variable, performing a differentiate analysis for each laterality with this variable and the textural parameters. RESULTS: In the intraobserver reliability analysis ICC was high (≥0.80) in seven parameters and excellent (≥0.90) in 35 parameters. In general, CSS and textural parameters showed more cellulite severity in right areas than in left ones. Correlation coefficients showed a moderate correlation between textural parameters and CSS score. The multivariate discriminant model obtained with textural parameters classified a high percentage of images (96% right side and 82% left side). CONCLUSION: Textural analysis used to assess cellulite on the backs of thighs and buttocks proved to be an instrument that has excellent reliability, moderate correlation with CSS and a satisfactory power classification model.


Assuntos
Tecido Adiposo/patologia , Adulto , Feminino , Humanos , Fotografação , Reprodutibilidade dos Testes , Espanha , Adulto Jovem
4.
J Eur Acad Dermatol Venereol ; 27(3): 273-8, 2013 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-22758934

RESUMO

Cellulite, highly prevalent among women, represents a serious problem for many of them, and one of their main aesthetic concerns. It is difficult to pinpoint its aetiology and physiology/pathophysiology, as there are many factors that are involved in it, affect it, and many processes that are taking place simultaneously and sequentially. Our objective is therefore, to review the scientific scholarship on cellulite to explore the causes of its origin. We carried out a preliminary search of the Medline, Cochrane, and Web of Knowledge databases covering the period from 1978 to April 2011. As there is no specific key word for the phenomenon at hand, we used the following descriptors: adipose tissue, subcutaneous fat, subcutaneous tissue, connective tissue, skin, skin disease and dermis. This resulted in a retrieval of 26 articles contributing to relevant information on the aetiology of cellulite. As a result of our first research, we concluded that cellulite is a physiological phenomenon or at least, that it has a physiological origin, which is characteristic of women, and multi-causal, with the coexistence of a number of factors that trigger, perpetuate, or exacerbate it. The outstanding factors include, among others, connective tissue architecture, oestrogen action, microvascular alterations and certain genetic and hormonal characteristics. All of them provide us with future and novel clues to cellulite treatment, and is necessary to take some or all of these factors into account in developing an effective therapy. However, we are aware of the necessity of further investigation in this field.


Assuntos
Tecido Adiposo/patologia , Obesidade/patologia , Dermatopatias/etiologia , Tecido Adiposo/irrigação sanguínea , Feminino , Humanos , Inflamação/complicações , Masculino , Obesidade/complicações , Dermatopatias/genética
5.
J Eur Acad Dermatol Venereol ; 27(6): 694-8, 2013 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-22486949

RESUMO

BACKGROUND: 'Hexsel, dal'Forno and Hexsel Cellulite Severity Scale' (CSS) was developed to evaluate cellulite with an objective and easy to apply tool. Objective Study CSS intra- and inter-observer reliability in a Spanish female population by evaluating patients' cellulite through photographs of their overall gluteofemoral zone as opposed to its creators who distinguished between buttocks and thigh. METHODS: Cellulite Severity Scale was applied to 27 women, evaluating gluteofemoral cellulite, differentiating between left and right. Evaluations were made by three expert examiners each at three times with a 1-week separation. Variables were the five CSS dimensions (number of evident depressions; depth of depressions; morphological appearance of skin surface alterations; grade of laxity, flaccidity, or sagging skin; and the Nürnberger and Müller classification scale), and the overall CSS score. Cronbach's alpha, intra-class correlation and item total correlation were analysed. RESULTS: Cronbach's alpha values were 0.951 (right) and 0.944 (left). In the intra-observer reliability analysis, intra-class correlation coefficient ranged from 0.993 to 0.999 (P < 0.001) and in the inter-observer analysis were 0.937 (right) and 0.947 (left) (P < 0.001). Item total correlation showed all dimensions to be needed except grade of laxity, flaccidity or sagging skin (0.959 right; 0.955 left). CONCLUSION: Cellulite Severity Scale has excellent reliability and internal consistency when used to evaluate cellulite on the buttocks and back of the thighs considered together. Nevertheless, the dimension grade of laxity, flaccidity or sagging skin does not contribute positively to the final consistency of the scale. This dimension needs to be analysed in greater depth in future studies.


Assuntos
Tecido Adiposo , Obesidade/diagnóstico , Adulto , Feminino , Humanos , Obesidade/epidemiologia , Variações Dependentes do Observador , Índice de Gravidade de Doença , Espanha , Adulto Jovem
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