RESUMEN
OBJECTIVE: To evaluate the effect of the addition of dynamic cervical electrical stimulation (electro-massage, ES) to manual therapy (MT), compared to MT by itself, in individuals with myofascial temporomandibular pain. METHODOLOGY: A total of 46 participants with bilateral myofascial temporomandibular pain for at least three months were distributed into two groups. Group 1 (n=21) received local MT consisting of soft tissue mobilization and release techniques over the neck and temporomandibular regions. Group 2 (n=25) received an ES procedure in the cervical region combined with the same intervention as group 1. All participants underwent a 2-week protocol. The primary outcomes were pain intensity (Visual Analogue Scale), pressure pain threshold (PPT) at the masseter and upper trapezius muscles (algometer), and pain-free vertical mouth opening (manual gauge). The secondary outcome was active cervical range-of-movement. Measurements were taken at baseline, immediately after intervention, and at a 4-week follow-up. RESULTS: The ANOVA revealed significant changes over group*time, with better results for group 2 (large effect sizes) regarding pain intensity (p< 0.001; η2>0.14), pressure pain sensitivity and mouth opening (p<0.001; η2>0.14). Similar findings were observed for active cervical range-of-movement in all directions (p<0.001; η2>0.14), except rotation (p≥0.05). CONCLUSION: Electrical stimulation therapy over the cervical region combined with a MT protocol over the neck and temporomandibular joint shows better clinical benefits than MT by itself in subjects with myofascial temporomandibular pain. Registration code: NCT04098952.
Asunto(s)
Terapia por Estimulación Eléctrica , Masaje , Dimensión del Dolor , Umbral del Dolor , Humanos , Femenino , Adulto , Masculino , Resultado del Tratamiento , Terapia por Estimulación Eléctrica/métodos , Masaje/métodos , Persona de Mediana Edad , Análisis de Varianza , Factores de Tiempo , Manipulaciones Musculoesqueléticas/métodos , Terapia Combinada , Síndrome de la Disfunción de Articulación Temporomandibular/terapia , Síndrome de la Disfunción de Articulación Temporomandibular/fisiopatología , Rango del Movimiento Articular/fisiología , Adulto Joven , Reproducibilidad de los Resultados , Estadísticas no Paramétricas , Músculo Masetero/fisiopatologíaRESUMEN
The objective of this study was to determine the effect of enhancing conventional care for people with chronic painful temporomandibular disorders (TMD) with an individualised contemporary pain science education (PSE) intervention. In this randomized controlled trial, a consecutive sample of 148 participants (18-55 years of age) was randomized into 2 groups: PSE-enhanced conventional care or Conventional care alone. Conventional care involved a 6-week, 12-session manual therapy and exercise program. The PSE enhancement involved 2 sessions of modern PSE, undertaken in the first 2 treatment sessions. Primary outcomes were pain intensity, assessed with a numeric pain rating scale, and disability, assessed with the craniofacial pain and disability inventory, post-treatment. Linear mixed model analyses were used to investigate between-group differences over time. There was a statistically and clinically meaningful effect of PSE enhancement on disability (Mean Difference = 6.1, 95% CI: 3.3-8.8), but not on pain intensity, post-treatment. Secondary analyses suggested clinically meaningful benefit of PSE enhancement on pain and disability ratings at 10-week and 18-week follow-ups, raising the possibility that preceding conventional care with a PSE intervention may result in long-term benefits. PERSPECTIVE: The addition of modern Pain Science Education (PSE) intervention improved disability for people with chronic TMD receiving manual therapy and exercise, but not pain. A mean difference in pain and disability favoring the PSE group at the 10- and 18-week follow-ups, respectively, suggests that PSE addition resulted in longer-lasting effects. Trial registration: NCT03926767. Registered on April 29, 2019. https://clinicaltrials.gov/ct2/show/NCT03926767.
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Dolor Crónico , Manipulaciones Musculoesqueléticas , Trastornos de la Articulación Temporomandibular , Humanos , Manipulaciones Musculoesqueléticas/métodos , Dolor Crónico/terapia , Terapia por Ejercicio/métodos , Escolaridad , Trastornos de la Articulación Temporomandibular/terapiaRESUMEN
Este artigo parte da abordagem onto-epistemológica relativista e interacionista para discutir a formação profissional de treinadores/as de esportes e práticas corporais. A partir da análise de programas com essa finalidade, ressalta contribuições da teoria de Lev Vygotsky, destacando: a interação entre a base biológica humana e o meio e as estratégias pedagógicas e avaliativas, o desenvolvimento potencial e as interações entre treinadores/as de experiências variáveis e a importância das vivências (perijivânie) e as relações de afeto entre aprendizes/as e mediadores/as. Para tanto, destaca iniciativas que contemplam estra-tégias pedagógicas afins e sugere a adoção de práticas que incentivem o diálogo, a aproximação com os contextos de atuação e o compartilhamento de conhecimentos (AU).
This article starts from a relativistic and interactionist onto--epistemological approach to discuss sports coach education. Starting from an analysis of coach education programmes, it discusses the con-tribution of Lev Vygotsky's cultural-historical theory, highlighting: the in-teraction between the human biological basis and the environment and the pedagogical and evaluative strategies, the potential development and the interactions among coaches with variable experiences levels, and the importance of the experiences and the affective relationships between coaches and mediators. For this, it emphasizes initiatives that contem-plate related pedagogical approaches and suggests adopting practices that promote dialogue, context approximation, and knowledge sharing (AU).
Este artículo se basa en el enfoque onto-epistemológico re-lativista e interaccionista para discutir la educación profesional de los entrenadores de deportes y prácticas corporales. A partir del análisis de los programas de este propósito, se destacan las contribuciones de la teoría de Lev Vygotsky: la interacción entre la base biológica humana y el medio ambiente, el desarrollo potencial y las interacciones entre los/las entrenadores/as, la importancia de las experiencias (perijivânie), las rela-ciones de afecto entre aprendices y mediadores/as. Para ello, destaca las iniciativas que incluyen estrategias pedagógicas relacionadas y sugiere la adopción de prácticas que fomenten el diálogo, el acercamiento a los contextos de actuación y el intercambio de conocimiento (AU).
Asunto(s)
Humanos , Difusión de la Información , Formación del Profesorado , Deportes/educación , Manipulaciones Musculoesqueléticas/métodosRESUMEN
PURPOSE: To systematically review the evidence about the effectiveness of manual therapy (MT) on pain intensity, frequency and impact of headache in individuals with tension-type headache (TTH). METHODS: Medline, Embase, Scopus, Web of Science, CENTRAL, and PEDro were searched in June 2020. Randomized controlled trials that applied MT not associated with other interventions for TTH were selected. The level of evidence was synthesized using GRADE, and Standardized Mean Differences (SMD) were calculated for meta-analysis. RESULTS: Fifteen studies were included with a total sample of 1131 individuals. High velocity and low amplitude techniques were not superior to no treatment on reducing pain intensity (SMD = 0.01, low evidence) and frequency (SMD = -0.27, moderate evidence). Soft tissue interventions were superior to no treatment on reducing pain intensity (SMD = -0.86, low evidence) and frequency of pain (SMD = -1.45, low evidence). Dry needling was superior to no treatment on reducing pain intensity (SMD = -5.16, moderate evidence) and frequency (SMD = -2.14, moderate evidence). Soft tissue interventions were not superior to no treatment and other treatments on the impact of headache. CONCLUSION: Manual therapy may have positive effects on pain intensity and frequency, but more studies are necessary to strengthen the evidence of the effects of manual therapy on subjects with tension-type headache.Implications for rehabilitationSoft tissue interventions and dry needling can be used to improve pain intensity and frequency in patients with tension type headache.High velocity and low amplitude thrust manipulations were not effective for improving pain intensity and frequency in patients with tension type headache.Manual therapy was not effective for improving the impact of headache in patients with tension type headache.
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Punción Seca , Manipulaciones Musculoesqueléticas , Cefalea de Tipo Tensional , Cefalea/terapia , Humanos , Manipulaciones Musculoesqueléticas/métodos , Dolor , Cefalea de Tipo Tensional/terapiaRESUMEN
O Programa Academia na Saúde (PAS) é considerado como um programa estratégico para a execução das Política Nacional de Promoção da Saúde (PNPS) e da Política Nacional de Atenção Básica (PNAB), e o programa é apontado como uma das ações de prevenção e controle que integram o Plano de Ações Estratégicas para o Enfrentamento das Doenças Crônicas Não Transmissíveis (DCNT).
Asunto(s)
Programas y Políticas de Nutrición y Alimentación , Promoción de la Salud/métodos , Programas Nacionales de Salud/legislación & jurisprudencia , Encuestas y Cuestionarios , Manipulaciones Musculoesqueléticas/métodos , Política de Salud/legislación & jurisprudenciaRESUMEN
NOMBRE DE LA TÉCNICA CON PRETENDIDA FINALIDAD SANITARIA Reflexología podal (del pie) DEFINICIÓN DE LA TÉCNICA E INDICACIONES CLÍNICAS La reflexología podal consiste en la aplicación de presión o masaje sobre la planta del pie con la finalidad de producir efectos terapéuticos diversos en otras zonas del cuerpo u órganos, presumiblemente interconectados reflexológicamente. La literatura científica informa de su uso para numerosas y diferentes indicaciones clínicas, entre las que se incluyen: ansiedad ante una cirugía, tratamiento del dolor, depresión, menopausia y manejo de las emociones en personas con cáncer. CALIDAD DE LA EVIDENCIA La calidad de los estudios evaluados sobre la reflexología podal es baja, por lo que existe poca confianza en que los resultados obtenidos sean válidos. RESULTADOS CLAVES Se han realizado un buen número de estudios analizando la eficacia de la reflexología podal en problemas de salud muy diversos. Los resultados de los estudios publicados muestran que los pacientes tratados con reflexología podal no presentan diferencias en los niveles de dolor, fatiga, depresión, calidad de vida, calidad de sueño y presión arterial cuando se comparan con los pacientes tratados con masaje no reflexológico del pie (placebo). Únicamente se obtiene una mejora de dolor, fatiga, calidad del sueño y presión arterial cuando la reflexología se compara con tratamiento habitual o no intervención. En el caso de los niveles de ansiedad, se obtiene un beneficio de la reflexología frente a cualquier comparador, aunque atenúado cuando es comparado con placebo. Muy pocos estudios informan sobre la seguridad de la reflexología podal, no observandose eventos adversos de importancia relacionados con la aplicación de la técnica. CONCLUSIÓN FINAL La aplicación de la reflexología podal produce una pequeña mejora en los niveles de ansiedad de los pacientes en comparación con el masaje no reflexológico del pie (placebo). Para el resto de variables no se observan cambios comprobados científicamente. Las pruebas científicas disponibles parecen indicar que la reflexología podal es una técnica segura. La gran diversidad y baja calidad de los estudios, así como el reducido número de personas incluidas en estos estudios, no permiten establecer conclusiones definitivas en ningún caso.
NAME OF THE TECHNIQUE WITH HEALTH PURPOSES Foot reflexology DEFINITION OF THE TECHNIQUE AND CLINICAL INDICATIONS Foot reflexology involves the application of pressure or massage on the sole of the foot in order to produce various therapeutic effects in other body areas or organs, presumably interconnected reflexologically. Its use is reported in the scientific literature for numerous and different clinical indications, including: anxiety before surgery, pain treatment, depression, menopause and emotion management in people with cancer. QUALITY OF THE EVIDENCE The quality of assessed studies on foot reflexology is low so there is little confidence that the results obtained are valid. KEY RESULTS A good number of studies have been carried out analysing the efficacy of foot reflexology in very diverse health problems. The results of published studies show that patients treated with foot reflexology do not show differences in levels of pain, fatigue, depression, quality of life, quality of sleep and blood pressure when compared to those treated with non-reflexological foot massage. Only an improvement in pain, fatigue, sleep quality and blood pressure is obtained when reflexology is compared to usual care or non-intervention. In the case of anxiety levels, a benefit is obtained with foot reflexology compared to any comparator although attenuated when compared to non reflexological foot massage. Very few studies report on the safety of foot reflexology. No significant adverse events related to the application of the technique were observed. FINAL CONCLUSION The application of foot reflexology produces a small improvement in patient anxiety levels as compared with non-reflexological foot massage (placebo). For the rest of the variables no scientifically proven changes are observed. The available scientific evidence seems to indicate that foot reflexology is a safe technique. The great diversity and low quality of the studies, as well as the small number of people included in these studies, do not allow us definitive conclusions to be establish in any case.
Asunto(s)
Manipulaciones Musculoesqueléticas/métodos , Pie , Manipulaciones Musculoesqueléticas/efectos adversos , Manipulaciones Musculoesqueléticas/psicologíaRESUMEN
Objetivo: Descrever a importância da intervenção fisioterapêutica para mulheres com vaginismo. Fonte de dados: Foram utilizadas as bases de dados SciELO, PubMed, Biblioteca Virtual de Saúde (BVS) e Literatura Cinza, incluindo artigos nacionais e internacionais, sem delimitação temporal. Foram propostas para as buscas as seguintes palavras-chave e operadores boleanos: [("vaginismus") AND ("physiotherapy" OR "intervention" OR "efficiency")], sendo esses posteriormente adequados para as demais bases que foram utilizadas nesta revisão sistemática. Seleção dos estudos: A seleção dos estudos foi realizada por três examinadores independentes. Coleta de dados: Inicialmente foram excluídos estudos com base no título, em seguida os resumos foram analisados e, dos 353 artigos encontrados inicialmente, quatro foram elegíveis para esta revisão. Síntese dos dados: Os artigos incluídos descreveram que o tratamento fisioterapêutico é de extrema importância para as mulheres com vaginismo, pois aumenta a força e o controle sobre a musculatura do assoalho pélvico, diminuindo os sintomas do vaginismo e promovendo o incremento da satisfação sexual. Conclusão: A intervenção fisioterapêutica é imprescindível para mulheres que apresentam vaginismo, tendo em vista que suas técnicas têm efetividade na prevenção e tratamento do vaginismo, além de promover melhora importante na qualidade de vida e na satisfação sexual das mulheres.(AU)
Objective: To describe the importance of physical therapy intervention for women with vaginismus. Data source: The SciELO, PubMed, Virtual Health Library (BVS) and Gray Literature databases were used, including national and international articles, without temporal delimitation. The following keywords and Boolean operators were proposed for the searches: [("vaginismus") AND ("physiotherapy" OR "intervention" OR "efficiency")], which were later suitable for the other bases that were used in this systematic review. Study selection: Study selection was performed by three independent examiners. Data collection: Initially, studies were excluded based on the title, then the abstracts were analyzed and of the 353 articles found initially, 4 were eligible for this review. Data synthesis: The articles included described that physical therapy treatment is extremely important for women with vaginismus, as it increases strength and control over the pelvic floor muscles, decreasing the symptoms of vaginismus and promoting increased sexual satisfaction. Conclusion: Physical therapy intervention is essential for women who have vaginismus, considering that its techniques are effective in preventing and treating vaginismus, in addition to promoting an important improvement in women's quality of life and sexual satisfaction.(AU)
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Humanos , Femenino , Dolor Pélvico/terapia , Vaginismo/terapia , Toxinas Botulínicas/uso terapéutico , Terapia por Estimulación Eléctrica/métodos , Diafragma Pélvico/fisiopatología , Manipulaciones Musculoesqueléticas/métodosRESUMEN
Introdução: A manipulação visceral é atualmente um tratamento usado amplamente pelos osteopatas no mundo, contudo, sua base de mecanismos ainda é pouco esclarecida, havendo certa escassez de pesquisas publicadas sobre tais intervenções. O conceito para o tratamento se baseia na ação sobre aderências fáscias que supostamente afetam a hemodinâmica visceral, desregulação autonômica, fatores psicossomáticos e ptose visceral, repercutindo de maneira direta no bom funcionamento das demais estruturas do corpo. Objetivo: O estudo tem como objetivo mensurar as variações imediatas da resposta sintomática dolorosa por pressão na coluna lombar pela manipulação visceral. Métodos: Trata-se de um estudo experimental, com abordagem longitudinal e caráter quantitativo. Constituído por amostra de doze indivíduos divididos em G1 (uso de manipulação visceral), G2 (uso de placebo) e uso do algômetro de pressão nos músculos paravertebrais corresponde ao nível topográfico da quinta vértebra lombar. Para análise estatística dos dados obtidos, foi aplicado o teste t de Student para amostras pareadas no software Bioestat. Além disso, o nível de rejeição da hipótese de nulidade foi estabelecido em 0,05 ou 5%. Resultados: Obteve-se relevância em um ponto de vista estatístico na análise do grupo submetido a manipulação visceral. Quando comparado a outras evidências recentes, os resultados obtidos pelo estudo revelam dados condizentes. Conclusão: Os resultados deste estudo fornecem informações confiáveis que vão nortear a futura utilização da manipulação visceral na dor lombar crônica, mostrando bom prognóstico em curto prazo. (AU)
Introduction: Visceral manipulation is currently a treatment widely used by osteopaths worldwide, however, its basis of mechanisms is still poorly understood, and there is a lack of published research on such interventions. The concept for treatment is based on the action on fascia adhesions that supposedly affect visceral hemodynamics, autonomic dysregulation, psychosomatic factors, and visceral ptosis, directly affecting the proper functioning of other body structures. Objective: This study aimed to measure the immediate variations in the symptomatic painful response to pressure in the lumbar spine by visceral manipulation. Methods: This is an experimental study, with a longitudinal approach and quantitative character. Consisting of a sample of twelve individuals divided into G1 (use of visceral manipulation), G2 (use of placebo) and use of the pressure algometer in the paravertebral muscles corresponds to the topographic level of the fifth lumbar vertebra. For statistical analysis of the data obtained, the Student's t test was applied to paired samples using the Bioestat software. In addition, the level of rejection of the null hypothesis was set at 0.05 or 5%. Results: Relevance was obtained from a statistical point of view in the analysis of the groups submitted to visceral manipulation. When compared to other recent evidence, the results obtained by the study reveal consistent data. Conclusion: The results of this study provide reliable information that will guide the future use of visceral manipulation in chronic low back pain, showing a good prognosis in the short term. (AU)
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Humanos , Femenino , Dolor de la Región Lumbar/terapia , Manipulaciones Musculoesqueléticas/métodos , Estudios LongitudinalesRESUMEN
BACKGROUND: Myofascial mobilization has been used as an intervention for patients with fibromyalgia (FM) for acting on ascending nociceptive pathways possibly involved in the central sensitization process, modulating the pain experience. However, there is still a gap in its efficacy compared with another hands-on approach because manual therapy has nonspecific effects, such as placebo. OBJECTIVES: This systematic review aims to review the scientific literature for an overview of the efficacy of manual therapy in pain, disease impact, and quality of life in patients with FM compared with control or other treatments through randomized clinical trials. STUDY DESIGN: This study involved systematic review of published randomized controlled trials (RCTs). SETTING: This study examined all RCTs evaluating the effect of manual therapy on pain, impact of disease, and quality of life for patients with FM. METHODS: Systematic review. The research was performed in 9 databases: MEDLINE/PubMed, CINAHL, Web of Science, Scopus, ScienceDirect, Lilacs, SciELO, PEDro, and Cochrane. Searches were carried out from the end of the project until September 2019, with no language and year restrictions. Randomized controlled clinical trials that used the following outcome measures were included: Visual Analog Scale, Fibromyalgia Impact Questionnaire, and SF-36 Quality of Life Questionnaire. The risk of bias and quality of studies was assessed using the PEDro scale; the Cochrane risk-of-bias tool; and Grading of Recommendations Assessment, Development, and Evaluation System. RESULTS: Seven studies were included (368 patients). The quantitative analysis was performed on 4 studies because of the lack of data in the others. Myofascial release was the most used modality. The level of evidence ranged from very low to moderate, mainly because of the inconsistency and inaccuracy of results. LIMITATIONS: The present systematic review presented limitations because of the heterogeneity of the included studies and only a short-term analysis of the intervention results. It was observed that other information, such as pressure, repetition, and/or sustaining manual therapy techniques, could be better described in future protocols, aiming at a better comparison between the techniques and their subsequent reproducibility. CONCLUSIONS: Current evidence of manual therapy in patients with FM, based on a very low to moderate quality of evidence, was inconclusive and insufficient to support and recommend the use of manual therapy in this population. To date, only general osteopathic treatment has achieved clinically relevant pain improvement when compared with control.
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Fibromialgia/terapia , Manipulaciones Musculoesqueléticas/métodos , Manejo del Dolor/métodos , Resultado del Tratamiento , Fibromialgia/complicaciones , Humanos , Dolor/etiología , Calidad de VidaRESUMEN
OBJECTIVE: To systematically review current literature to determine the effectiveness of the ischemic compression (IC) technique on pain and function in individuals with shoulder pain. METHODS: This review was conducted according to recommendations of Preferred Reporting Items for Systematic Reviews and Meta-Analyses and the Cochrane Collaboration for Systematic Reviews; a search was performed in the electronic databases PubMed, Cumulative Index to Nursing and Allied Health Literature, SPORTDiscus, Physiotherapy Evidence Database, and Web of Science. Randomized clinical trials and quasi-randomized clinical trials were included, and the methodological quality was evaluated through the Physiotherapy Evidence Database scale. RESULTS: The search found 572 studies; of these, 71 were selected by title and, subsequently, 29 were selected through abstract analyses. After critical analyses, 5 studies were included. The methodological quality ranged from 4 (reasonable) to 9 (excellent) points. Pain was assessed by all studies using the visual analog scale, Global Perceived Effect scale, Numerical Rating Scale, pressure pain threshold, or Perceived Amelioration Numerical Scale. Function was evaluated by 3 studies through the Shoulder Pain and Disability Index; Neck Disability Index; American Shoulder and Elbow Surgeons Standardized Shoulder Assessment; and Disabilities of the Arm, Shoulder, and Hand questionnaires. The studies showed that the IC technique produces immediate and short-term positive effects for pain, and positive short-term effects for shoulder function in individuals with shoulder pain. CONCLUSION: The IC technique seems to be beneficial for pain and shoulder function. However, caution is needed when considering this evidence owing to the limited quality of some studies, the few articles found, and the lack of standardization of the application parameters of the technique to facilitate its reproducibility.
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Acupresión/métodos , Fuerza Muscular/fisiología , Manipulaciones Musculoesqueléticas/métodos , Dolor de Hombro/rehabilitación , Humanos , Dimensión del Dolor , Umbral del Dolor , Modalidades de Fisioterapia , Reproducibilidad de los Resultados , Puntos Disparadores/irrigación sanguíneaRESUMEN
Anterior mandibular dislocation (AMD) is defined as the displacement of the condylar head out of the glenoid fossa beyond the articular eminence, and that does not reduce spontaneously to its normal position. The Hippocratic method is the usual approach for condylar repositioning at most health centers although it is perceived by the patient as an unpleasant, brusque technique and outcomes are not always favorable. OBJECTIVE: The aim of this work is to describe a new simplified nontraumatic manual technique and its application in a series of cases. METHOD: A procedure based on gently and constantly guiding the patient's mouth opening and closing movements is described in detail. RESULTS: Forty-two patients were treated with a treatment success rate of 100%, and no pain associated with the procedure. Procedure time was 1.5-7 min in 40 of the 42 treated cases. CONCLUSION: The procedure presented here is an improvement on the original technique: it is simple, fast, effective, can be performed in any setting, and avoids use of brusque force, which is the factor that causes the patient most discomfort and fear.
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Luxaciones Articulares/terapia , Manipulaciones Musculoesqueléticas/métodos , Trastornos de la Articulación Temporomandibular/terapia , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Masculino , Persona de Mediana Edad , Adulto JovenRESUMEN
Background: Many bimanual activities are challenging for children with unilateral spastic cerebral palsy (USCP).Aims: To investigate hand use by children with USCP in daily activities of their interest.Material e methods: Sample included twenty children with USCP, aged 8 to 14 years old. Participants identified bimanual activities of their interest and no interest. Children's performance on these activities were videotaped. Videos were coded according to the affected extremity's forms and effectiveness of use, caregiver provision and types of assistance, and child's satisfaction. The relative proportions of each parameter were compared using the signed-rank test, considering the time spent in activities of interest and no interest.Results: We analyzed 116 activities. We found effects of interest in children's satisfaction (p = 0.003) and on the type of assistance (p = 0.03). Specifically, children demonstrated longer periods of satisfaction performing activities of their interest and caregiver physical assistance was provided for longer periods of time in activities of no interest. There were no effects on the other parameters.Conclusions: A model that illustrates the impact of a child's interest on the performance of daily bimanual activities is presented, grounded in our results and in the literature.
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Actividades Cotidianas/psicología , Cuidadores/psicología , Parálisis Cerebral/psicología , Parálisis Cerebral/rehabilitación , Niños con Discapacidad/psicología , Niños con Discapacidad/rehabilitación , Manipulaciones Musculoesqueléticas/métodos , Adolescente , Niño , Femenino , Humanos , MasculinoRESUMEN
Objetivo: Avaliar o efeito da terapia manual (TM) sobre os níveis de cortisol, intensidade de dor, qualidade de vida e aspectos psicológicos em pacientes portadores de disfunção temporomandibular ( DTM ). Metodologia: Foi realizado a série de casos com 5 pacientes portadores de DTM, diagnosticados pelo Critério de Diagnóstico em pesquisa em pacientes com Disfunção Temporomandibular (RDC/TMD). Os pacientes receberam sessões de TM 2 vezes por semana com duração de 30 minutos por um período de 1 mês, perfazendo um total de 8 sessões. Verificou-se o nível de cortisol salivar, intensidade de dor pela escala visual numérica (EVN), grau de sintomas de ansiedade pelos questionários: Escala Hospitalar de Ansiedade e Depressão (HADS ), Inventário de Ansiedade de Beck( BAI ) e Índice de Ansiedade Traço-Estado ( IDATE), grau de sintomas de depressão pelo questionário Escala Hospitalar de Ansiedade e Depressão (HADS ) e qualidade de vida pelo questionário World Health Organization Quality of Life (WHOQUOL bref ). Foram avaliados antes e após a aplicação da terapia. Resultados: Observou-se que após a TM todos os pacientes apresentaram-se sem dor (EVN =0), com diminuição no nível de cortisol salivar (1,98 µg/dl para 1,31 µg/dl), menos ansiosos (ansiedade média) e menos depressivos (depressão leve) e com melhora na qualidade de vida. Conclusão: Os resultados deste estudo demonstraram que a terapia manual apresentou efeitos satisfatórios no tratamento de pacientes com DTM na intensidade de dor, nível de cortisol salivar, ansiedade em relação ao questionário BAI , depressão e qualidade de vida (AU).
Objective: To evaluate the effect of manual therapy (TM) on cortisol levels, pain intensity, quality of life and psychological aspects in patients with temporomandibular disorders .Methodology: A series of cases was carried out with 5 patients with TMD, diagnosed by the Diagnostic Criterion in research in patients with Temporomandibular Disorders (RDC / TMD). Patients received TM sessions twice a week for 30 minutes for a period of 1 month, for a total of 8 sessions. The level of salivary cortisol, intensity of pain was verified on the numerical visual scale (EVN), degree of symptoms of anxiety by the questionnaires: Hospital Anxiety and Depression Scale (HADS), Beck Anxiety Inventory (BAI) and Anxiety Index State trait (STAI), degree of symptoms of depression using the Hospital Anxiety and Depression Scale questionnaire (HADS) and quality of life using the World Health Organization Quality of Life questionnaire (WHOQUOL bref). They were evaluated before and after the application of the therapy. Results: It was observed that after TM all patients were pain free (EVN = 0), with a decrease in the level of salivary cortisol (1.98 µg / dl to 1.31 µg / dl), less anxious (medium anxiety) and less depressive (mild depression) and with improved quality of life. Conclusion: The results of this study demonstrated that manual therapy had satisfactory effects in the treatment of patients with TMD on pain intensity, salivary cortisol level, anxiety in relation to the BAI questionnaire, depression and quality of life (AU).
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Humanos , Masculino , Femenino , Adulto , Persona de Mediana Edad , Calidad de Vida , Dimensión del Dolor , Hidrocortisona , Síndrome de la Disfunción de Articulación Temporomandibular/terapia , Saliva , Ansiedad al Tratamiento Odontológico , Manipulaciones Musculoesqueléticas/métodos , DepresiónRESUMEN
O mapa apresenta uma visão geral das evidências sobre os efeitos da Reflexologia para diversas condições clínicas e de saúde das pessoas. A partir de uma ampla busca bibliográfica de estudos publicados e não publicados entre 2000 e 2019, foram incluídas no Mapa 18 revisões sistemáticas, que foram avaliadas, caracterizadas e categorizadas pelo Grupo de Pesquisa em Promoção da Saúde e Práticas Integrativas e Complementares da Universidade Federal de São Paulo (GPPIC/Unifesp).
El mapa proporciona una visión general de la evidencia sobre los efectos de la Reflexología para la salud y las condiciones clínicas de varias personas. A partir de una amplia búsqueda bibliográfica de estudios publicados y no publicados entre 2000 y 2019, se incluyeron 18 revisiones sistemáticas en el Mapa, que fueron evaluadas, caracterizadas y clasificadas por el Grupo de Investigación sobre Promoción de la Salud y Prácticas Integrativas y Complementarias de la Universidad Federal de São Paulo (GPPIC/Unifesp).
The map provides an overview of the evidence on the effects of Reflexology for various people's health and clinical conditions. From a wide bibliographic search of published and unpublished studies between 2000 and 2019, 18 systematic reviews were included in the Map, which were evaluated, characterized and categorized by the Research Group on Health Promotion and Integrative and Complementary Practices of the Federal University of São Paulo (GPPIC / Unifesp).
Asunto(s)
Humanos , Manejo de Caso , Manipulaciones Musculoesqueléticas/métodos , Atención al Paciente , Medicina Tradicional/métodos , Manipulaciones Musculoesqueléticas/instrumentación , Manipulaciones Musculoesqueléticas/tendenciasRESUMEN
OBJECTIVE: To investigate clinical curative effects of lumbar oblique-pulling manipulation in combination with sling-exercise-therapy training on chronic nonspecific lower back pain. METHODS: A total of 60 patients with chronic nonspecific lower back pain in the Outpatient Department were included in this study. These patients were randomly divided into two groups: the observation group and the control group. The control group adopted a single sling-exercise-therapy training three times a week, while the observation group adopted lumbar oblique-pulling manipulation in combination with manipulation treatment once a week. The course of treatment lasted for four weeks. RESULTS: (1) Before and after treatment, the ODI score was compared within the group. A remarkable statistical significance was observed from the third day (P<0.05). At the third month of follow-up, the difference in ODI scores between these two groups was statistically significant (P<0.05). (2) Before and after treatment, it was observed that differences in VAS scores from the third day were statistically significant (P<0.05). (3) The difference in muscle strength between these two groups had remarkable statistical significance in the third month of follow-up (P<0.05). CONCLUSION: The effective rehabilitation function of lumbar oblique-pulling manipulation in combination with sling-exercise-therapy training in patients with CNLBP is superior to that of sling-exercise-therapy training alone.
Asunto(s)
Terapia por Ejercicio/métodos , Dolor de la Región Lumbar/terapia , Manipulaciones Musculoesqueléticas/métodos , Adulto , Enfermedad Crónica , Femenino , Humanos , Dolor de la Región Lumbar/fisiopatología , Masculino , Fuerza Muscular , Reproducibilidad de los Resultados , Columna Vertebral/fisiopatología , Factores de Tiempo , Resultado del Tratamiento , Escala Visual Analógica , Adulto JovenRESUMEN
The purpose of this study is to investigate the effects of alternate nostril breathing (ANB) and foot reflexology (FR) on lower intraocular pressure (IOP) in patients with ocular hypertension (OHTN). This prospective pilot study recruited 11 patients from 2014 to 2016 from Temple opthamology outpatient clinic. Patients had OHTN with ages of 48-78 years. Patients were excluded if they currently performed ANB or FR, were unable to perform the task, had previous eye surgery or laser, were receiving other complementary and alternative medicine for OHTN, or were unable to complete drug washout period. After a 30-day drug washout, patients were randomly assigned to complete either ANB or FR for 5 min. After instruction, patients completed either ANB or FR, and completed the alternate task 2 weeks later. IOP was measured before the task, immediately after the task, and then every 30 min for 2 h. Decrease in IOP compared with baseline IOP was significant for ANB and FR at all time points. Baseline IOP was 25.86 ± 3.19 mmHg for ANB and 25.41 ± 3.54 mmHg for FR (N = 22 eyes). There was only one significant difference between IOP for the right and left eyes for FR at 120 min. Otherwise, there was no difference between eyes for both ANB and FR. There was a significant decrease in IOP at 30 min post task with IOP decrease of 1.98 ± 1.70 mmHg for ANB and 3.59 ± 1.89 mmHg for FR (both p < 0.0001) and at 60 min post task with IOP decrease of 2.39 ± 2.05 mmHg for ANB and 3.86 ± 1.89 mmHg for FR (both p < 0.0001). The decrease in IOP at 90 and 120 min post task was less but remained significant (p < 0.0001). Both FR and ANB had a small but significant IOP lowering effect. These alternative therapies could serve as possible adjunctive treatments for lowering IOP.
Asunto(s)
Ejercicios Respiratorios/métodos , Presión Intraocular/fisiología , Manipulaciones Musculoesqueléticas/métodos , Hipertensión Ocular/terapia , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Proyectos Piloto , Estudios ProspectivosRESUMEN
SUMMARY OBJECTIVE: To investigate clinical curative effects of lumbar oblique-pulling manipulation in combination with sling-exercise-therapy training on chronic nonspecific lower back pain. METHODS: A total of 60 patients with chronic nonspecific lower back pain in the Outpatient Department were included in this study. These patients were randomly divided into two groups: the observation group and the control group. The control group adopted a single sling-exercise-therapy training three times a week, while the observation group adopted lumbar oblique-pulling manipulation in combination with manipulation treatment once a week. The course of treatment lasted for four weeks. RESULTS: (1) Before and after treatment, the ODI score was compared within the group. A remarkable statistical significance was observed from the third day (P<0.05). At the third month of follow-up, the difference in ODI scores between these two groups was statistically significant (P<0.05). (2) Before and after treatment, it was observed that differences in VAS scores from the third day were statistically significant (P<0.05). (3) The difference in muscle strength between these two groups had remarkable statistical significance in the third month of follow-up (P<0.05). CONCLUSION: The effective rehabilitation function of lumbar oblique-pulling manipulation in combination with sling-exercise-therapy training in patients with CNLBP is superior to that of sling-exercise-therapy training alone.
RESUMO OBJETIVO: Investigar os efeitos curativos da manipulação lombar com o movimento de puxar oblíquo combinado a terapia por exercícios de sling-training para dor lombar baixa crônica não específica. METODOLOGIA: Um total de 60 pacientes com dor lombar baixa crônica não específica no ambulatório foram incluídos neste estudo. Esses pacientes foram divididos aleatoriamente em dois grupos: o grupo de observação e o grupo de controle. O grupo de controle aderiu apenas à terapia por exercícios de sling-training três vezes por semana, enquanto o grupo de observação aderiu à manipulação lombar com o movimento de puxar oblíquo combinado à terapia por exercícios de sling-training uma vez por semana. O tratamento durou quatro semanas. RESULTADOS: (1) Antes e após o tratamento, o escore de ODI foi comparado no grupo. Uma significância estatística notável foi observada a partir do terceiro dia (P<0,05). No terceiro mês de acompanhamento, a diferença nos escores de ODI entre os dois grupos foi estatisticamente significante (P<0,05). (2) Antes e após o tratamento, observou-se que diferenças nos escores de VAS a partir do terceiro dia foram estatisticamente significantes (P< 0,05). (3) A diferença de força muscular entre os dois grupos apresentou significância estatística notável no terceiro mês de acompanhamento (p<0,05). CONCLUSÃO: A função de reabilitação efetiva da manipulação lombar com o movimento de puxar oblíquo combinada à terapia por exercícios de sling-training em pacientes com dor lombar baixa crônica não específica é superior à da terapia por exercícios de sling-training sozinha.
Asunto(s)
Humanos , Masculino , Femenino , Adulto , Adulto Joven , Dolor de la Región Lumbar/terapia , Manipulaciones Musculoesqueléticas/métodos , Terapia por Ejercicio/métodos , Columna Vertebral/fisiopatología , Factores de Tiempo , Enfermedad Crónica , Reproducibilidad de los Resultados , Resultado del Tratamiento , Dolor de la Región Lumbar/fisiopatología , Fuerza Muscular , Escala Visual AnalógicaRESUMEN
Objectives: To evaluate the clinical effect of sciatic neural mobilization in combination with the treatment of surrounding structures for sciatica patients. Secondly, we were also interested in identifying possible baseline characteristics that may be associated with improvements in pain and disability for sciatica patients. Methods: Twenty-eight patients with a clinical diagnosis of sciatica were treated with neural mobilization, joint mobilization and soft tissue techniques. Pain intensity and lumbar disability were assessed at baseline and after treatment using a Numerical Rating Scale (0-10) and the Oswestry Disability Index (0-100), respectively. The pre- and post-intervention data were compared. The research protocol was registered under the number NCT03663842. Results: Participants attended an average of 16 (SD±5.6) treatmentsessions over an average of 12 weeks. Decrease in pain scores (before median = 8, after median = 2; p < 0.001) and improvement in lumbar disability scores (before median = 33.3%, after median = 15.6%; p < 0.001) were observed. A multiple linear regression analysis showed that duration of pain and age of the patient predicted the disability improvement: F (2, 24) = 4.084, p < 0.030, R2 = 0.254. Discussion: Patients with sciatica may benefit from neural mobilization in combination with manual therapy for pain and lumbar disability. Longer pain duration and younger age had a negative influence on lumbar disability improvement.
Asunto(s)
Manipulaciones Musculoesqueléticas/métodos , Modalidades de Fisioterapia , Ciática/terapia , Tratamiento de Tejidos Blandos/métodos , Factores de Edad , Anciano , Femenino , Articulación de la Cadera , Humanos , Masculino , Persona de Mediana Edad , Dimensión del Dolor , Rango del Movimiento Articular , Ciática/fisiopatología , Factores de Tiempo , Resultado del TratamientoRESUMEN
The effectiveness of photobiomodulation (PBM) and manual therapy (MT), alone or combined (CT), were evaluated in pain intensity, mandibular movements, psychosocial aspects, and anxiety symptoms of temporomandibular disorder (TMD) patients. Fifty-one TMD patients were randomly assigned to three groups: the PBM group (n = 18), which received PBM with 808 nm, 100 mW, 13.3 J/cm2, and 4 J per point; the MT group (n=16) for 21 minutes each session on masticatory muscles and temporomandibular joint TMJ; and the CT group (n = 17), applied during twelve sessions. Seven evaluations were performed in different moments using visual analogue scale (VAS), Research Diagnosis Criteria for Temporomandibular Disorders (RDC/TMD) Axis I and II, and Beck anxiety inventory (BAI). All groups demonstrated reductions in pain and improvement in jaw movements during treatment and at follow-up (< 0.001). The assessment of psychosocial aspects of TMD, comparing baseline and follow-up in all treatment groups, revealed that treatment did not promote modification in the intensity of chronic pain (p > 0.05). However, depression symptoms showed a reduction in PBM and CT groups (p≤0.05). All treatments promoted reduction in physical symptoms with and without pain and enhancement of jaw disabilities (p ≤ 0.05). MT promotes improvement in 5 functions, PBM in 2, and CT in 1 (p < 0.001). BAI analysis revealed that all treatments lead to a reduction in anxiety symptoms (p≤0.05). All protocols tested were able to promote pain relief, improve mandibular function, and reduce the negative psychosocial aspects and levels of anxiety in TMD patients. However, the combination of PBM and MT did not promote an increase in the effectiveness of both therapies alone.
Asunto(s)
Terapia por Luz de Baja Intensidad/métodos , Manipulaciones Musculoesqueléticas/métodos , Trastornos de la Articulación Temporomandibular/terapia , Adulto , Anciano , Ansiedad/fisiopatología , Ansiedad/prevención & control , Dolor Crónico/fisiopatología , Dolor Crónico/psicología , Dolor Crónico/terapia , Terapia Combinada/métodos , Depresión/fisiopatología , Depresión/prevención & control , Femenino , Estudios de Seguimiento , Humanos , Maxilares/fisiopatología , Masculino , Músculos Masticadores/fisiopatología , Persona de Mediana Edad , Manejo del Dolor/métodos , Dimensión del Dolor , Valores de Referencia , Reproducibilidad de los Resultados , Encuestas y Cuestionarios , Trastornos de la Articulación Temporomandibular/fisiopatología , Trastornos de la Articulación Temporomandibular/psicología , Factores de Tiempo , Resultado del Tratamiento , Escala Visual Analógica , Adulto JovenRESUMEN
Fundamentos: A importância da validação científica de técnicas coadjuvantes a diversos tratamentos de saúde é inquestionável. Desta forma, a influência da drenagem linfática manual (DLM) na natriurese e na lipólise sob interação de anticoncepcional oral precisa ser investigada. Objetivos: Avaliar o efeito agudo da DLM sobre a natriurese e lipólise de mulheres jovens usuárias ou não de anticoncepcional oral. Método: Participaram 29 mulheres não usuárias de anticoncepcional oral e 29 usuárias, autodeclaradas saudáveis, sedentárias e eutróficas. As análises foram realizadas em dois dias distintos, Controle (C), sem intervenção terapêutica e DLM. Nos dias C e DLM coletamos 4 amostras de urina com intervalos de 60 min. Seguimos o método de Leduc, abdomem e membros inferiores, durante 45 min. Analisamos o fluxo urinário e excreção urinária e sódio, glicerol e peptideo natriurético atrial. A normalidade dos dados foi analisada pelo teste Shapiro-Wilk. Os dados que não obedeceram à normalidade foram apresentados em mediana e intervalo interquartil (25%-75%), enquanto os que obedeceram foram apresentados em média ± erro padrão. O teste de Mann-Whitney foi usado para dados não pareados e Wilcoxon para dados pareados. Dados com normalidade foram avaliados pelo teste t-Student não pareado. O nível de significância estatística adotado foi de 5%. Resultados: O efeito agudo de uma sessão de DLM promove aumento da natriurese em mulheres não usuárias de anticoncepcional oral, por outro lado, em usuárias induz aumento na liberação de glicerol e de ANP
Background: The importance of scientific validation of supporting techniques to various treatments is unquestionable. In this context, the influence of manual lymphatic drainage (MLD) on natriuresis and lipolysis and its interaction with oral contraceptives still need to be investigated. Objectives: To evaluate the acute effect of MLD on natriuresis and lipolysis in young women using or not oral contraceptives. Methods: Twenty-nine non-users of oral contraceptives and 29 oral contraceptive users, self-reported healthy, sedentary, normal weight women were enrolled. Analyses were conducted on two different days control (C), without therapeutic intervention and MLD day. Four urine samples were collected at 60-minute intervals. MLD was performed in lower limbs and abdomen for 45 min following the Leduc method. Urinary flow rat e and urinary sodium, glycerol and atrial natriuretic peptide excretion were analyzed. Data normality was tested by the Shapiro-Wilk test. Data without normal distribution were expressed as median and interquartile range (25%-75%), while normally distributed data were expressed as mean ± standard error. Mann-Whitney test was used for unpaired data and Wilcoxon test for paired data. Data with normal distribution were evaluated by the unpaired t-Student test. Statistical significance was set at 5%. Results: One MLD session had an acute effect on both groups, increasing natriuresis in non-users of oral contraceptives and glycerol and atrial natriuretic peptide excretion in oral contraceptive users. Conclusion: Oral contraceptives influence the effect of MLD on natriuresis