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OBJECTIVE: To evaluate the efficacy of combined association instrument myofascial mobilization (IASTM) and stretching in patients with idiopathic bilateral carpal tunnel syndrome (CTS) operated on one hand and to analyze the response of the operated (OH) and non-operated (NH) hand according to the sequence of therapies. Research on these parameters has not yet been found in the literature. METHODS: Randomized controlled crossover study with 43 participants using the objective and subjective outcome variables. Patients were randomly assigned to two groups: starting with stretching followed by IASTM and starting with IASTM followed by stretching. Then patients underwent surgery on the hand with more severe involvement and physical therapy rehabilitation was started 30 days after for a period of 4 weeks. After the 1-week interval the participants who started with stretching were referred to IASTM and vice versa, following the same previous patterns. The outpatient reassessments took place at 3 to 6 months. Crossover ANOVA and effect sizes were used as analysis methods. RESULTS: Time was the most significant outcome for all variables both during therapies and at 6-month follow-up. Regarding response to the combined therapies between OH and NH, there were differences for both OH and NH, with the greatest impact on NH for the palmar grip and VAS variables. The treatment sequences were significant for pain on the NH and mental SF-12, suggesting that starting with IASTM followed by stretching had a superior outcome for these outcomes. CONCLUSION: The combination of IASTM with stretching, used in the postoperative period of bilateral idiopathic CTS, proved to be supplementary, with significant results and large effect sizes for most of the outcomes assessed, both during the time of application of the therapies and in the 6-month follow-up for both hands, and may constitute a viable therapeutic alternative for this population.
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Síndrome do Túnel Carpal , Humanos , Síndrome do Túnel Carpal/cirurgia , Síndrome do Túnel Carpal/reabilitação , Estudos Cross-Over , Período Pós-Operatório , Resultado do TratamentoRESUMO
OBJECTIVE: The purpose of this study was to examine the immediate effects of lumbosacral orthosis and the abdominal drawing-in maneuver on the trunk postural control of adults with chronic low back pain compared with asymptomatic controls during 1-legged and semi-tandem stances. METHODS: An experimental and comparative study (cross-sectional design) was conducted in a laboratory setting. Twenty adults with chronic low back pain and 20 asymptomatic controls randomly performed 2 postural balance tasks over a force platform, considering 3 experimental conditions: (1) natural posture (baseline-control), (2) lumbosacral orthosis, and (3) abdominal drawing-in maneuver. Linear variables (mean amplitude, ellipse area, and sway velocity) derived from the center of pressure were computed, and 2-way analysis of variance (group × condition) for repeated measures were conducted. RESULTS: No group × condition interactions (.139 ≤ P ≤.938) were detected in any center of pressure parameters. No condition effect was detected, but a group effect (P = .042) was observed for 1 center of pressure parameter. The chronic low back pain group presented with a lower mean anteroposterior center of pressure amplitude than asymptomatic controls (∆ = 0.31 ± 0.66 cm [95% confidence interval, 0.05-0.56], P = .019) during the semi-tandem stance balance task. CONCLUSION: Neither lumbosacral orthosis nor the abdominal drawing-in maneuver showed immediate improvement in trunk postural control in any group. Thus, clinicians should not expect immediate benefits or improvements yielded by lumbosacral orthosis or the abdominal drawing-in maneuver when patients with chronic low back pain undergo these interventions.
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Dor Lombar , Adulto , Humanos , Estudos Transversais , Dor Lombar/terapia , Aparelhos Ortopédicos , Equilíbrio Postural , PosturaRESUMO
INTRODUCTION: Low back pain (LBP) is a major cause of physical disability in the world. The origin of this condition can be due to differents causes, with a specific cause or of unknown mechanical origin,being characterized as unspecific. In this case a physical therapy treatment approach with manual therapy is relevant, which includes the muscle energy technique (MET) classified as a common conservative treatment for pathologies of the spine, mainly in LBP and disability. This study assessed the effectiveness of the muscle energy technique on nonspecific low back pain. EVIDENCE ACQUISITION: Patients with acute, subacute or chronic non-specific low back pain. The primary outcomes were pain and disability. This study was designed by a systematic review and meta-analysis, registered in PROSPERO (CRD42020219295). For the report and methodological definitions of this study, the recommendations of the PRISMA protocol and the Cochrane collaboration, were followed, respectively. EVIDENCE SYNTHESIS: The search yielded 164 citations, which 19 were eligible randomised trials were included in the review (N.=609 patients with low back pain). The methodological quality of the studies averaged 4.2 points, with an interval of 2 to 7 points. Three RCTs showed satisfactory methodological quality (PEDro Score ≥6). For patients with chronic LBP, a significant result on pain (but with a small and clinically unimportant effect) in favor of MET versus other (MD=-0.51 [95% CI,-0.93 to -0.09] P=0.02, N.=376, studies=11, I2=80%). In patients with subacute LBP, MET enabled a significant and moderate effect to reduce pain intensity when compared to the control group (MD=-1.32 [95% CI,-2.57 to -0.06] P=0.04, N.=120, studies=3, I2=88%). No significant effects were observed for the disability. CONCLUSIONS: MET is not considered an efficient treatment to improve the incapacity of the lumbar spine, but it may be beneficial in reducing the intensity of LBP, although showing a small clinical effect in chronic LBP and a moderate effect in subacute LBP.
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Dor Crônica , Dor Lombar , Manipulações Musculoesqueléticas , Humanos , Dor Lombar/reabilitação , Terapia por Exercício/métodos , Músculos , Dor Crônica/terapiaRESUMO
BACKGROUND: The aim of the present study was twofold: (1) to assess the reproducibility of two dynamometers in handrail format to measure handgrip strength and traction force in the young and older adults; (2) to compare the handgrip strength and traction of these two populations. APPROACH: Twenty-four volunteers (12 older adults and 12 young adults) performed a functional effort related to handgrip strength and traction force during stair climbing. The participants were evaluated two times (separated by one week) using a coupled dynamometer that quantifies the muscular effort in grip and traction simultaneously to simulate stair climbing in bus service. RESULTS: The young adults performed significantly better (p < 0.04) than the older adults in both handgrip and traction efforts (medium to large effect size), with excellent reliability (Intraclass Coefficient Correlation > 0.9) and low error of measure. The dynamometers were able to discriminate the two population groups (sensitive validity) and showed excellent reproducibility estimates for handgrip and traction strength in both young and older adults. CONCLUSION: These instruments could be useful in assessing handgrip and traction strength needed to climb stairs, especially for the older adults, who normally have more difficulty performing this task.
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Força da Mão , Tração , Idoso , Gravitação , Humanos , Dinamômetro de Força Muscular , Reprodutibilidade dos Testes , Adulto JovemRESUMO
It has been demonstrated that Kinesio Tape (KT) application has immediate positive effects on balance in healthy individuals, but its mid-term effects have not yet been investigated. OBJECTIVE: Evaluate the effects of KT on postural control in young women, using four strategies. METHODS: Forty-eight healthy women aged 18-35 years old were randomly assigned to four groups with different elastic bandages (G1: ankle; G2: hamstrings; G3: lumbar; G4: different taping applications) and their postural control was evaluated using stabilographic parameters obtained on a force platform during right and left unipodal (UNP-R and UNP-L) and semi-tamdem tests at pre-intervention (PRE), immediately after (IME), and 24 and 48 h after the application of bandages. RESULTS: G1 showed a significantly lower velocity in the antero-posterior direction for the PRE compared to the IME period (p = 0.0204) in the UNP-R task, and the same was observed in the medio-lateral velocity when comparing the results for PRE with IME (p = 0.0340 and p = 0.0244) in the UNP-L task. Regarding the frequency, G2 had a significantly lower mean for the PRE, compared to IME (p < 0.001) in the UNP-R in antero-posterior direction, and in medio-lateral direction in the UNP-R (p = 0.003) and in the UNP-L task (p = 0.020). CONCLUSIONS: The use of KT changed postural control, mainly considering the velocity and frequency of COP oscillations, and especially immediately after its application.
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Fita Atlética , Adolescente , Adulto , Tornozelo , Articulação do Tornozelo , Feminino , Humanos , Região Lombossacral , Equilíbrio Postural , Adulto JovemRESUMO
This study aimed to investigate the effects of free leucine supplementation on muscle recovery from resistance exercise (RE) in young adults. Fourteen untrained subjects (23.9 ± 3.6 years old) underwent RE sessions (leg press and hack squat: three sets of 8-12 reps at 70% 1RM) supplemented with leucine (LEU: two daily doses of 3g) or a placebo (PLA), separated by a seven-day washout period. Following each occasion, participants were evaluated in three subsequent days (24h, 48h, and 72h) for muscle recovery via a repetition-to-failure test. The following markers were assessed: repetition performance, perceived exertion, lactate, creatine kinase, muscle soreness (DOMS), testosterone, and cortisol. No significant difference was observed between LEU and PLA conditions (p > 0.05). Number of repetitions performed in the repetition-to-failure tests, perceived exertion, cortisol, and testosterone:cortisol ratio did not change over time (p > 0.05). Creatine kinase increased immediately after exercise, at 24h, and 48h, and was attenuated at 72h post-exercise, while testosterone, lactate, and DOMS increased at 24h post-exercise (p < 0.05) and remained elevated up to 72h. All outcomes were similar between LEU and PLA. Results indicate that a 6g daily dose of free leucine supplementation does not improve muscle recovery following lower-limb RE in untrained young adults.
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BACKGROUND: The Pilates exercises are popular for muscle conditioning among women. However, the effects on conditioning of healthy non-active adult women due to Pilates practicing are not fully explained. The aim of this randomized controlled trial was to assess the effects of equipment-based Pilates exercises on the percentage of body fat, weight, body mass index (BMI), functional capacity, and quality of life of adult healthy women. METHODS: Seventy-eight non-active women were randomly assigned to 2 groups (Pilates or Control). The Pilates group performed a total of 16 exercise sessions (60 minutes each, performed twice a week for 8 consecutive weeks). The control group was instructed to perform no exercise. Percentage of body fat (DXA scans), weight, BMI, distance covered in the incremental shuttle walk test, maximal oxygen uptake (VO
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Técnicas de Exercício e de Movimento/métodos , Terapia por Exercício/métodos , Qualidade de Vida , Adulto , Composição Corporal , Índice de Massa Corporal , Peso Corporal , Exercício Físico , Técnicas de Exercício e de Movimento/psicologia , Terapia por Exercício/psicologia , Feminino , Humanos , Teste de CaminhadaRESUMO
Functional surface coatings are a key option for biomedical applications, from polymeric supports for tissue engineering to smart matrices for controlled drug delivery. Therefore, the synthesis of new materials for biological applications and developments is promising. Hence, biocompatible and stimuli-responsive polymers are interesting materials, especially when they present conductive properties. PEDOT-co-PDLLA graft copolymer exhibits physicochemical and mechanical characteristics required for biomedical purposes, associated with electroactive, biocompatible, and partially biodegradable properties. Herein, the study of fibronectin (FN) adsorption onto PEDOT-co-PDLLA carried out by an electrochemical quartz crystal microbalance with dissipation is reported. The amount of FN adsorbed onto PEDOT-co-PDLLA was higher than that adsorbed onto the Au surface, with a significant increase when electrical stimulation was applied (either at +0.5 or -0.125 V). Additionally, FN binds to the copolymer interface in an unfolded conformation, which can promote better NIH-3T3 fibroblast cell adhesion and later cell development.
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Materiais Biocompatíveis/química , Eletroquímica , Fibronectinas/química , Polímeros/química , Técnicas de Microbalança de Cristal de Quartzo , Adsorção , Animais , Módulo de Elasticidade , Estimulação Elétrica , Fibroblastos/citologia , Fibroblastos/ultraestrutura , Camundongos , Células NIH 3T3RESUMO
BACKGROUND: Low back pain is common during pregnancy. Lumbar stabilization and stretching exercises are recommended to treat low back pain in the general population. However, few studies have applied the effects of these two interventions in pregnant women with low back pain. AIM: To compare the effects of lumbar stabilization and stretching exercises for the treatment of gestational low back pain. DESIGN: A pilot randomized clinical trial. SETTING: Laboratory of Functional Evaluation and Human Motor Performance and physical therapy clinics. POPULATION: Initially, 30 pregnant women with low back pain were recruited, of which 24 met the following inclusion criteria: being between 19-29 weeks of gestation; being in prenatal clinical follow-up; having nonspecific mechanical low back pain started in pregnancy; not participating in specific low back pain treatment in the last 3 months. A total of 20 women completed the study (10 each group). METHODS: The main outcome measures were clinical (pain by Visual Analogue Scale (VAS) and McGill Pain Questionnaire and disability by Roland Morris Questionnaire), and secondary outcome measures were: postural balance (force platform); muscle activation level of multifidus, iliocostalis lumborum, rectus abdominis and external abdominal oblique (electromyography). The women were randomized into two groups for 6 weeks of intervention twice a week for a 50-minute treatment: 1) lumbar stabilization exercise protocol and 2) stretching exercise protocol. RESULTS: There was a significant reduction (P=0.03) in pain (1.68 in VAS and 4.81 for McGill questionnaire) for both interventions, but no change in disability score. In addition, both interventions were comparable for a significant improvement in postural stability (in mean d=0.77) for the velocity sway parameter, and significantly increased activation (P>0.05) of the external abdominal oblique muscle after intervention. CONCLUSIONS: Both modalities (lumbar stabilization and stretching) were efficient for pain reduction, improving balance and increasing one trunk activity muscle after 6 weeks of intervention in pregnant women with low back pain. CLINICAL REHABILITATION IMPACT: The present study has implications, especially for clinical decision-making with regard to therapy choice in pregnant women with LBP to reduce pain and improve trunk function as measured through balance performance.
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Terapia por Exercício/métodos , Dor Lombar/reabilitação , Exercícios de Alongamento Muscular , Músculo Esquelético/fisiologia , Modalidades de Fisioterapia , Equilíbrio Postural , Complicações na Gravidez/reabilitação , Adulto , Avaliação da Deficiência , Eletromiografia , Feminino , Humanos , Medição da Dor , Projetos Piloto , GravidezRESUMO
OBJECTIVE: The purpose of this study was to assess the test-retest reliability of different balance task outcomes, based on center of pressure (COP) measures in individuals with Parkinson's disease. METHOD: In this cross-sectional study, 19 older individuals with idiopathic Parkinson's disease (seven females, 71 ± 7.8 years) performed a set of seven balance tasks on two occasions (a week apart) on an electronic force platform. Each set consisted of: 1) Bipedal; 2) Romberg with open eyes (OE); 3) Romberg with closed eyes (CE); 4) Tandem with OE; 5) Tandem with CE; 6) Tandem with OE using a dual task (DT) condition (simple mathematic operations concomitant with testing); and 7) One-leg stance, with the leg of preference over the force platform, with OE. The test-retest reliability of COP measures was tested using intraclass correlation coefficient (ICC) and Bland-Altman plots. RESULTS: The ICC results for the different tasks showed that the most reliable para- meters were derived from a 95% confidence ellipse around the COP and mean velocity, with the most reliable task being the Romberg with CE. Conclusions: We confirmed that balance based on COP measures was reliable in individuals with Parkinson's disease, especially during the Romberg condition with closed eyes.