RESUMO

Introdução: O retalho transverso do músculo reto abdominal (TRAM) é um método de reconstrução mamária com bons resultados estéticos e dispensa o uso de próteses de silicone para melhor contorno corporal. Foi originalmente descrito por Holmstrom em 1979, como uma elipse de pele e gordura com base em um músculo isolado no seu pedículo vascular. A reconstrução sistematizada do defeito da parede instalado após a transposição do retalho com o uso de tela de polipropileno foi descrita em estudo prévio por Cunha. O artigo tem como objetivo avaliar as alterações na parede abdominal, após a sistematização da colocação da tela de polipropileno durante a cirurgia de reconstrução com TRAM. Método: É um trabalho de coorte retrospectivo que avalia as possíveis alterações da parede abdominal de pacientes submetidos ao retalho TRAM com tomografia computadorizada de abdome pré e pós-operatórias. Resultados: Foi evidenciada uma redução do tamanho da cavidade abdominal de, em média, 14,5% e 14,2% na espessura da parede abdominal submetidas ao TRAM. A maior redução da espessura da parede abdominal foi de um paciente submetido ao retalho bipediculado, com 50,7%. As complicações apresentadas foram hérnia umbilical, seroma tardio, fibrose peritela e granuloma de fio. Conclusão: Nesse estudo, a tomografia após a cirurgia demonstrou a redução no volume da cavidade abdominal e espessura da parede abdominal, o que não influenciou estatisticamente no aparecimento de hérnia abdominal, abaulamentos, extrusão da malha ou outras deformidades.

Introduction: The transverse rectus abdominis muscle flap (TRAM) is a method of breast reconstruction with good aesthetic results and does not require the use of silicone implants for better body contouring. It was originally described by Holmstrom in 1979 as an ellipse of skin and fat based on an isolated muscle on its vascular pedicle. The systematic reconstruction of the wall defect installed after flap transposition using polypropylene mesh was described in a previous study by Cunha. The article aims to evaluate changes in the abdominal wall, after the systematization of polypropylene mesh placement during TRAM reconstruction surgery. Method: This is a retrospective cohort study that evaluates possible changes in the abdominal wall of patients undergoing the TRAM flap with preand postoperative abdominal computed tomography. Results: A reduction in the size of the abdominal cavity of, on average, 14.5% and 14.2% in the thickness of the abdominal wall subjected to TRAM was evidenced. The greatest reduction in abdominal wall thickness was in a patient who underwent a bipedicled flap, with 50.7%. The complications presented were umbilical hernia, late seroma, perithellal fibrosis, and thread granuloma. Conclusion: In this study, tomography after surgery demonstrated a reduction in the volume of the abdominal cavity and thickness of the abdominal wall, which did not statistically influence the appearance of abdominal hernia, bulging, mesh extrusion, or other deformities.

RESUMO

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.

Assuntos

RESUMO

Although quadruped exercises (QE) have been a part of rehabilitation and sports programs, there is no clarity on how these exercises challenge the musculoskeletal system. Therefore, this cross-sectional study investigated the perceived exertion, postural demands, and muscle recruitment profiles imposed by three QE postures. Surface electromyographic (sEMG) signals were recorded from transverse abdominis, longissimus dorsi, multifidus, and iliocostalis lumborum from 30 sedentary healthy women, bilaterally. They performed the classic quadruped exercise (CQ), a variation with shoulder flexion (FQ), and the homolateral quadruped (HQ). Borg scores (BS) and the center of pressure (CoP) from the palmar statokinesiogram were also recorded. Surface EMG signals were normalized using the myoelectric activity recorded from two other postures while performing isometric voluntary contractions (IVC). Results were analyzed using one- (CoP) and three-way (sEMG data) ANOVA with Bonferroni post hoc tests (α = 0.05). The Borg scale was analyzed using the Friedman test. The CQ provided lower BS and CoP than HQ (p < 0.05), followed by a higher sEMG activity (∼51% of IVC) than FQ (∼47% of IVC; p = 0.53) and HQ (∼44% of IVC; p = 0.01). In turn, HQ provided greater BS (p > 0.05) than CQ and FQ. The results suggested that the HQ was the most challenging exercise regarding CoP and BS, although CQ presented a higher symmetrical sEMG activity. Since QE are often prescribed in exercise programs, specific knowledge of the characteristics of each QE makes prescribing safer and more efficient.

RESUMO

OBJECTIVE: To assess the effect of pelvic patterns of proprioceptive neuromuscular facilitation (PNF-concept) on pelvic floor muscles (PFM) recruitment, as well as the electromyographic activity of muscles synergic to the pelvic floor in healthy women. METHODS: Observational study conducted with 31 women aged between 18 and 35 years, with mean age of 23.3 ± 3.2 (22.1-24.4). PFM activity was monitored by surface electromyography during the combination of isotonics technique of four pelvic patterns of PNF-concept (i.e., anterior elevation, posterior depression, anterior depression, and posterior elevation). The electromyographic signal was analyzed using root mean square amplitude. Two-way repeated measures analysis of variance was performed to analyze differences in PFM activity between types of contraction (i.e., concentric, isometric, and eccentric) and the four pelvic patterns. RESULTS: PFM activity did not differ among the four pelvic pattens. However, PFM activity was significantly different between the combination of isotonics technique and baseline, F(1.6, 48.2) = 71.5; p < 0.000, with a large effect size (partial ƞ² = 0.705). Concentric (22.4 µV ± 1.1), isometric (17.3 µV ± 0.6), and eccentric (15 µV ± 0.5) contractions of combination of isotonics technique increased PFM activity compared with baseline (10.8 µV ± 0.4) in all pelvic patterns. By analyzing the electromyographic activity of the muscles synergistic to the pelvic floor, there is effect of the interaction of the type of contraction, the pelvic pattern of the PNF concept, and the synergistic muscles on the myoelectric activity of the external anal sphincter, F(3.2, 96.5) = 5.6; p < 0.000, with a large magnitude of effect (partial ƞ² = 0.15). In the anterior elevation pattern, the muscles synergistic to the pelvic floor present synergy in phase with the PFM, and in the posterior patterns there was a decrease in the activity level of all synergistic muscles, without changing the activity level of the PFM. CONCLUSION: PFM activity did not differ among the four pelvic patterns of PNF-concept. Nonetheless, the combination of isotonics technique showed a significant effect on PFM compared with baseline, with greater PFM activity during concentric contraction. Pelvic patterns of PNF-concept may be used to increase PFM recruitment in young healthy women.

Assuntos

RESUMO

ABSTRACT Objective: To evaluate the effect of abdominal electrical stimulation (EE) on bowel movement frequency and feces consistency and expelled amount in people with constipation due to spinal cord injuries (SCI). Method: This is an experimental, crossover, randomized pilot study with two treatment groups: conventional intestinal rehabilitation and conventional rehabilitation associated with EE via 8- and 20-Hz Functional Electrical Stimulation (FES) of the abdominal muscles. Both groups were followed for two weeks with daily 30-minute EE sessions. Participants were hospitalized in a rehabilitation institute in the municipality of São Paulo. Data were analyzed using descriptive and inferential statistics. Results: This study included 10 people with SCI, of which most were male (70%), with a mean age of 39 years (SD = 16.37). EE, associated with conventional treatment, was more effective in increasing defecation frequency (p = 0.029) and amount of feces expelled (p = 0.031). Conclusion: Abdominal EE, associated with conventional treatment, helped to increase defecation frequency and amount of feces expelled in people with constipation due to SCI. This pilot study will serve as the basis for a future clinical trial with greater sampling and statistical evidence.

RESUMEN Objetivo: Evaluar el efecto de la electroestimulación abdominal (EE) sobre la frecuencia de las evacuaciones, la consistencia y la cantidad de heces en personas con estreñimiento debido a una lesión de la médula espinal (LME). Método: Estudio piloto experimental de tipo crossover-aleatorizado en dos grupos de tratamiento: convencional rehabilitación intestinal y convencional asociado a EE con Functional Electrical Stimulation (FES) de 8 y 20 Hz aplicados a los músculos abdominales. Se realizó un seguimiento de ambos grupos durante dos semanas con 30 minutos de sesión diaria de EE. Los participantes estaban hospitalizados en un instituto de rehabilitación de la ciudad de São Paulo. Los datos se analizaron mediante estadística descriptiva e inferencial. Resultados: Diez personas con LME participaron en el estudio, la mayoría hombres (70%) con una edad media de 39 años (DE = 16,37). La EE asociada al tratamiento convencional demostró ser más eficaz en el aumento de la frecuencia de evacuación (p = 0,029) y la cantidad de heces (p = 0,031). Conclusión: La EE abdominal asociada al tratamiento convencional ayudó a aumentar la frecuencia de evacuación y la cantidad de heces en el contexto de estreñimiento en personas con LME. Este estudio piloto servirá de base para futuros ensayos clínicos con mayor muestreo y evidencia estadística.

RESUMO Objetivo: Avaliar o efeito da eletroestimulação (EE) abdominal sobre a frequência de evacuações, a consistência e a quantidade de fezes em pessoas com constipação decorrente da lesão medular (LM). Método: Estudo piloto experimental do tipo crossover-randomizado em dois grupos de tratamento: convencional de reabilitação intestinal e convencional associado à EE com Functional Electrical Stimulation (FES) de 8 e 20 Hz aplicados na musculatura abdominal. Ambos os grupos em seguimento por duas semanas, com 30 minutos de sessão diária de EE. Os participantes estavam internados em um instituto de reabilitação da cidade de São Paulo. Os dados foram analisados por meio de estatística descritiva e inferencial. Resultados: Participaram do estudo 10 pessoas com LM, a maioria do sexo masculino (70%), com média de idade de 39 anos (DP = 16,37). A EE, associada ao tratamento convencional, mostrou-se mais eficaz no aumento da frequência evacuatória (p = 0,029) e na quantidade de fezes (p = 0,031). Conclusão: A EE abdominal associada ao tratamento convencional auxiliou no aumento da frequência evacuatória e na quantidade de fezes no quadro de constipação em pessoas com LM. Este estudo piloto servirá como base para um futuro ensaio clínico com maior amostragem e comprovação estatística.

Assuntos

RESUMO

ABSTRACT Introduction Human motor dysfunction can affect the quality of life, especially waist dysfunction. And an effective means to improve muscle strength during exercise. Object This article compares and analyzes the effectiveness of human muscle exercise on the decline in quality of life caused by motor dysfunction. Method The article divides patients with motor dysfunction into trunk isokinetic training group (experimental group) and waist and abdominal muscle functional training group (control group), and comparative analysis of related indicators before and after treatment. Results Before treatment, the specific indicators of the two were different (P>0.05). After treatment, the patients' quality of life indicators and motor function indicators were significantly different (P<0.05). Conclusion Exercise has an obvious curative effect for patients with human motor dysfunction, and it is worthy of clinical promotion. Level of evidence II; Therapeutic studies - investigation of treatment results.

RESUMO Introdução A disfunção motora humana pode afetar a qualidade de vida, principalmente a disfunção da cintura. E um meio eficaz de melhorar a força muscular é o exercício. Objetivo este artigo compara e analisa a eficácia do exercício muscular humano no declínio da qualidade de vida causado por disfunção motora. Método O artigo divide os pacientes com disfunção motora em grupo treinamento isocinético de tronco (grupo experimental) e grupo treinamento funcional de cintura e músculos abdominais (grupo controle), e análise comparativa dos indicadores relacionados antes e após o tratamento. Resultados Antes do tratamento, os indicadores específicos dos dois eram diferentes (P> 0,05). Após o tratamento, os indicadores de qualidade de vida e indicadores de função motora dos pacientes foram significativamente diferentes (P <0,05). Conclusão O exercício tem um efeito curativo óbvio para pacientes com disfunção motora humana e é digno de promoção clínica. Nível de evidência II; Estudos terapêuticos - investigação dos resultados do tratamento.

RESUMEN Introducción La disfunción motora humana puede afectar la calidad de vida, especialmente la disfunción de la cintura. Y un medio eficaz para mejorar la fuerza muscular es el ejercicio. Objeto Este artículo compara y analiza la efectividad del ejercicio muscular humano sobre el deterioro de la calidad de vida causado por la disfunción motora. Método El artículo divide a los pacientes con disfunción motora en grupo de entrenamiento isocinético del tronco (grupo experimental) y grupo de entrenamiento funcional de cintura y músculos abdominales (grupo control), y análisis comparativo de indicadores relacionados antes y después del tratamiento. Resultados Antes del tratamiento, los indicadores específicos de los dos eran diferentes (P> 0.05). Después del tratamiento, los indicadores de calidad de vida de los pacientes y los indicadores de función motora fueron significativamente diferentes (P <0,05). Conclusión El ejercicio tiene un efecto curativo obvio para los pacientes con disfunción motora humana y es digno de promoción clínica. Nivel de evidencia II; Estudios terapéuticos: investigación de los resultados del tratamiento.

Assuntos

RESUMO

ABSTRACT Introduction: Sports muscle injury is a common phenomenon in sports, and most of it is caused by intense exercise done for a long time. Objective: The effect of high intensity mode (HI) speed endurance training on the muscle injury of athletes. Methods: 14 sprinters were recruited; the muscle injury indexes of the subjects were tested 15 min before and 24 h, 48 h and 72 h after speed endurance training in HV mode and HI mode (high volume mode and high intensity mode, respectively). Results: The results of this study showed that both high amount and HI mode speed endurance training caused a certain degree of injury to the subjects' muscles, but the injury caused by HI mode speed endurance training to the muscles was more serious than that caused by high amount (P < 0.05). Conclusions: HI mode speed endurance training causes a certain degree of injury to the subjects' muscle, but it causes more serious injury than high volume mode speed endurance training. Level of evidence II; Therapeutic studies - investigation of treatment results.

RESUMO Introdução: As lesões musculares são fenômenos comuns no esporte e a maioria são causadas por exercícios intensos praticados por um longo período. Objetivo: O efeito do treinamento de resistência de velocidade de alta intensidade (AI) nas lesões musculares de atletas. Métodos: 14 corredores foram recrutados; os índices de lesão muscular dos indivíduos foram testados 15 minutos antes e 24h, 48h e 72h após o treino de resistência de velocidade em AV e AI (modos alto volume e alta intensidade, respectivamente). Resultados: Os resultados deste estudo mostram que tanto os treinamentos de resistência de velocidade nos modos alto volume e AI causaram certo grau de lesão aos músculos dos indivíduos, mas a lesão ao músculo por treino de resistência de velocidade no modo AI foi mais severa do que aquela no modo alto volume (P < 0.05). Conclusões: O treinamento de resistência de velocidade no modo AI causa certo grau de lesão aos músculos dos indivíduos, mas causa danos mais sérios do que o treino de resistência de velocidade no modo alto volume. Nível de evidência II; estudos terapêuticos - investigação de resultados de tratamento.

RESUMEN Introducción: Las lesiones musculares son fenómenos comunes en el deporte y la mayoría es causada por ejercicios intensos practicados por un largo periodo. Objetivo: El efecto del entrenamiento de resistencia de velocidad de alta intensidad (AI) en las lesiones musculares de atletas. Métodos: Se reclutaron 14 corredores; se testaron los índices de lesión muscular de los individuos 15 minutos antes y 24h, 48h y 72h después del entrenamiento de resistencia de velocidad en AV y AI (modos alto volumen y alta intensidad, respectivamente). Resultados: Los resultados de este estudio muestran que tanto los entrenamientos de resistencia de velocidad en los modos alto volumen y AI causaron cierto grado de lesión a los músculos de los individuos, pero la lesión al músculo por entrenamiento de resistencia de velocidad en el modo AI fue más severa que aquella en el modo alto volumen (P<0.05) Conclusiones: El entrenamiento de resistencia de velocidad en el modo AI causa cierto grado de lesión a los músculos de los individuos, pero causa daños más serios que el entrenamiento de resistencia de velocidad en el modo alto volumen. Nivel de evidencia II; Estudios terapéuticos - investigación de resultados de tratamiento.

RESUMO

ABSTRACT Introduction: Phosphate (CP) its biosynthesis begins with the kidney. Glycocianine was synthesized from glycocianine, then methylated in the liver, and finally formed in each tissue. Objective: To study the effects of phosphatic acid in exercise training. Methods: This paper uses 50 pure male mice, 2 month old, weight at 22 ± 3 g, and mice per day, 5 minutes each time. After exercise training, dry dry with a towel and blow it with a hair dryer, and move it to the end of each other. Results: The average time of motion B mouse to give phosphate creatine is significantly longer than the average time of the non-administration of the A group, and the motion time is prolonged to extend 23.20%. Phosphate has improved motor endurance and promotes improvement in muscle microcirculation during exercise. Conclusions: Motion can be used to improve the maximum aerobic capacity of exercise in motion. Level of evidence II; Therapeutic studies - investigation of treatment results.

RESUMO Introdução: A biossíntese Its do fosfato começa no rim. Glicociamina foi sintetizado de glicocianina, e depois transformado em metilato no fígado; finalmente, desenvolve em cada tecido. Objetivo: Estudar os efeitos do ácido fosfato em treinamento de exercícios. Métodos: Este estudo usa 50 camundongos machos puros de dois meses de idade, pesando ± 3g aos 22 meses, e XXX camundongos por dia por cinco minutos cada vez. Após o treino, estes foram secos com uma toalha e secador de cabelo e colocados um do lado do outro. Resultados: O tempo médio de movimento para o grupo B de camundongos produzir fosfato de creatinina é consideravelmente mais longo do que o tempo médio do grupo A, onde não houve administração. O tempo de movimento se prolonga em 23,20%. O fosfato melhora a resistência motora e promove uma melhora na microcirculação durante o exercício. Conclusões: O movimento pode ser usado para melhorar a capacidade aeróbica máxima do exercício em movimento. Nível de evidência II; Estudos terapêuticos - investigação de resultados de tratamento.

RESUMEN Introducción: El biosíntesis del fosfato empieza en el riñón. La Glicociamina se sintetizó de Glicocianina, y después se transformó en metilato en el hígado; y finalmente, formó cada tejido. Objetivo: Estudiar los efectos del ácido fosfato en entrenamiento de ejercicios. Métodos: Este estudio utiliza 50 ratones machos puros de 2 meses de edad, pesando ± 3g a los 22 meses, y xxx ratones por día por 5 minutos cada vez. Tras el entrenamiento, se los secó con una toalla y secador de pelo y se los puso lado a lado. Resultados: El tiempo medio de movimiento para el grupo B de ratones producir fosfato de creatina es considerablemente más largo que el tiempo medio del grupo A, donde no hubo administración. El tiempo de movimiento se alarga en 23,20%. El fosfato mejora la resistencia motora y promueve una mejoría en la microcirculación durante el ejercicio. Conclusiones: El movimiento puede usarse para mejorar la capacidad aeróbica máxima del ejercicio en movimiento. Nivel de evidencia II; Estudios terapéuticos - investigación de resultados de tratamiento.

RESUMO

Abstract Introduction: Patellofemoral pain syndrome (PFPS) is one of the most common musculoskeletal disorders affecting the knee joint. Conservative treatment reduces pain and improves functional capacity in the short and medium-term. Objective: To determine the therapeutic effect of two muscle strengthening exercise programs in patients with PFPS from Bogotá, Colombia, aged between 15 and 40 years. Materials and methods: Experimental randomized controlled clinical trial conducted in 40 patients with PFPS from Bogotá, Colombia, aged 15-40 years, with a mild to moderate level of physical activity. Participants were randomly distributed into 2 intervention groups: Group A: 8-week-long core, hip and knee muscles strengthening exercises program; Group B: 8-week-long hip and knee muscles strengthening exercises program. The level of pain was measured using the Visual Analog Scale and the Kujala Anterior Knee Pain Scale. Results: The addition of core muscle strengthening exercises to the traditional treatment improved the quality of life of participants in the intervention group A, where a significant reduction of pain, with a statistically significant difference in the total score of the Kujala scale (p=0.025) was observed. Conclusions: Including core muscle strengthening exercises in the conservative management of PFPS increases its effectiveness to reduce pain and improve the quality of life of these patients. ClinicalTrials.gov Identifier: NCT04011436

Resumen Introducción. El síndrome de dolor pátelofemoral (SPF) es una de las alteraciones musculoesqueléticas más frecuentes que afectan la articulación de la rodilla. El tratamiento conservador reduce el dolor y mejora la capacidad funcional en el corto y mediano plazo. Objetivo. Establecer el efecto terapéutico de dos programas de ejercicios de fortalecimiento muscular en pacientes con SPF de Bogotá, Colombia, con edades entre 15 y 40 años. Materiales y métodos. Ensayo clínico controlado aleatorio experimental realizado en 40 pacientes con SPF de Bogotá, Colombia, con edades entre los 15 y 40 años, con nivel de actividad física leve a moderada y que fueron distribuidos de forma aleatoria en 2 grupos de intervención: Grupo A: programa de ejercicios de fortalecimiento de los músculos del core, la cadera y la rodilla con una duración de 8 semanas; Grupo B: programa de ejercicios de fortalecimiento de los músculos de la cadera y la rodilla con la misma duración. El nivel de dolor se midió a través de la Escala Visual Analógica y de la Escala de Kujala para dolor patelofemoral. Resultados. La adición de ejercicios de fortalecimiento de los músculos del core al tratamiento tradicional mejoró la calidad de vida de los participantes en el grupo de intervención A, donde se observó una reducción significativa del dolor con una diferencia estadísticamente significativa en la puntuación total de la escala Kujala (p=0.025). Conclusiones. Incluir ejercicios de fortalecimiento de los músculos del core al manejo conservador del SPF aumenta su efectividad para reducir el dolor y mejorar la calidad de vida de estos pacientes. ClinicalTrials.gov Identifier: NCT04011436

RESUMO

AIMS: To compare the strength of abdominal and pelvic floor muscles (PFM) between nulliparous female athletes (FAs) and non-athletes (FNAs), to determine the frequency of urinary incontinence (UI) in these groups. METHODS: This cross-sectional comparative study of nulliparous women included 39 professional FAs, who competed at the district level or above, and 34 FNAs. Participants underwent pelvic floor and abdominal muscle assessments. PFM function and strength were assessed using the modified Oxford scale and a manometer (PERINA 996-2 QUARK). Abdominal muscle function and strength were assessed using a 4-Pro isokinetic dynamometer. The International Consultation on Incontinence Questionnaire-Short Form was used to assess UI symptoms among the athletes, and the International Physical Activity Questionnaire-Short Form was used to establish the level of physical activity among the non-athletes. RESULTS: The prevalence of UIs in the FAs was 53.8%, while that for FNAs was 35.3%. There was no association between being an athlete and having UI (p = 0.112). FAs were found to weigh more (p = 0.012) and have increased abdominal muscle strength (p = 0.014) and maximum voluntary PFM contraction as recorded by the manometer (p = 0.035), as well as a decreased PFM contraction endurance time (p = 0.025) than FNAs. CONCLUSION: FAs had stronger abdominal muscles and PFM contraction, as assessed by a manometer, but less PFM endurance when compared to FNAs. Despite these differences, the prevalence of UI was similar between groups.

Assuntos