RESUMO
OBJECTIVE: The purpose of this study was to investigate the effect of active vs passive scapular correction on pain and pressure pain threshold at the most symptomatic cervical segment in patients with chronic neck pain. METHODS: Twenty-three volunteers with chronic, idiopathic neck pain were recruited (age, 38.9 ± 14.4 years; sex [man/woman], 3/20; Neck Disability Index, 28.1% ± 9.9%). Subjects were randomly allocated to 2 groups: active scapular correction or passive scapular correction. Pressure pain threshold and pain intensity rated on a numerical rating scale during a posteroanterior glide over the most symptomatic cervical segment were measured before and immediately after the active or passive scapular intervention. RESULTS: Only the active scapular correction produced a reduction in pain (pre, 6.3 ± 1.2; post, 3.7 ± 2.4; P < .05) and increase in pressure pain threshold (pre, 8.7 ± 4.2 kg/cm(2); post, 10.1 ± 3.8 kg/cm(2); P < .05) at the most painful cervical segment. CONCLUSIONS: An active scapular correction exercise resulted in an immediate reduction of pain and pressure pain sensitivity in patients with chronic neck pain and scapular dysfunction.
Assuntos
Manipulação Quiroprática/métodos , Manipulação Ortopédica/métodos , Manipulação da Coluna/métodos , Terapia Passiva Contínua de Movimento/métodos , Cervicalgia/reabilitação , Limiar da Dor/fisiologia , Adolescente , Adulto , Mapeamento Encefálico , Dor Crônica/diagnóstico , Dor Crônica/reabilitação , Feminino , Seguimentos , Humanos , Imageamento por Ressonância Magnética/métodos , Masculino , Cervicalgia/diagnóstico , Medição da Dor , Percepção da Dor/fisiologia , Satisfação do Paciente/estatística & dados numéricos , Pressão , Escápula , Índice de Gravidade de Doença , Resultado do Tratamento , Adulto JovemRESUMO
PURPOSE: To study the induced refractive change caused by different 2.8-mm corneal incision locations in phacoemulsification. METHODS: One hundred ten patients were randomly assigned to nasal or temporal incision or to superior incision, depending on preexisting astigmatism. The authors fulfilled visual acuity, refraction, keratometry, and eye scanner analysis before and after phacoemulsification. Outcome measures were induced corneal refractive change (Fourier power vector analysis), index of surface variance (ISV) change, and visual acuity at 6 months. A comparative interventional case series was used for the study design. RESULTS: Induced refractive change caused by different incision locations showed differences in parameter J0 (JCC at axis 0 degrees ), which was smaller after temporal than after nasal or superior incision, with marginal clinical significance and influence in uncorrected visual acuity. ISV changes did not differ between incisional groups. CONCLUSIONS: Small differential effects of incisions by location may be useful, depending on preexisting astigmatism. Temporal incisions are recommended for negligible astigmatism, whereas nasal and superior incisions are preferable when the steep axis is located at approximately 180 degrees and 90 degrees, respectively. (ClinicalTrials.gov number, NCT00742950).
