RESUMO
La Inhibición Muscular Artrogénica (IMA) es la inhibición refleja continua de los músculos que rodean una articulación lesionada. Dicha condición impide o retarda el proceso de rehabilitación hasta tanto esta no sea resuelta. Dentro de las intervenciones terapéuticas estudiadas para el tra- tamiento de la IMA se encuentran la estimulación eléctrica neuromuscular (NMES), la estimula- ción eléctrica nerviosa transcutánea (TENS), el ejercicio terapéutico y la crioterapia. Teniendo en cuenta que la IMA es un factor limitante en la rehabilitación de lesiones articulares, es relevante conocer las intervenciones terapéuticas usadas por el fisioterapeuta que pueden contribuir a con- trolar esta condición para favorecer la recuperación funcional y mejorar la calidad de vida de los pacientes con patologías articulares. Objetivo: revisar las intervenciones fisioterapéuticas que po- drían ser más indicadas para disminuir el impacto de la IMA en la rehabilitación de pacientes con lesiones o patologías articulares. Método: Esta revisión incluyó el análisis de 9 artículos, los cuales fueron evaluados a través de la escala PEDro. Resultados: El TENS, el NMES, el ejercicio terapéu- tico y la crioterapia son las intervenciones terapéuticas que han mostrado cambios favorables en la activación y la fuerza muscular, contrarrestando los efectos perjudiciales de la IMA. La crioterapia es la modalidad física que mayores beneficios ofrece sobre el músculo inhibido. Conclusiones: Se requiere de estudios clínicos controlados que evalúen el efecto de las cuatro modalidades en con- diciones clínicas reales, así mismo respecto a la crioterapia se requieren estudios para determinar la dosis apropiada.
Arthrogenic Muscle Inhibition (AMI), is a continuous inhibitory reflex of the muscles surroun- ding an injured joint, this condition prevents or delays the rehabilitation process. Therapeutic interventions focused on the treatment of AMI are the Neuromuscular Electrical Stimulation (NMES), the Transcutaneous Electrical Nerve Stimulation (TENS), the therapeutic exercise and cryotherapy. Considering AMI as a limiting factor in the rehabilitation of joint injuries, it is im- portant to study the therapeutic interventions made by physiotherapists that might reduce that condition and improve functional recovery and the quality of life of patients with joint diseases. Objective: To review the physiotherapeutic methods that could be the most appropriate to diminish the impact of AMI in the rehabilitation of patients with joint injuries or pathologies. Method: This review included the analysis of 9 articles, which were evaluated using the PEDro scale. Results: The TENS, the NMES, the therapeutic exercise and the cryotherapy are the therapeutic interventions that have proven to be most effective in terms of activation, muscular strength and resistance to the harmful effects of AMI. According to the results, cryotherapy is the physical agent with the most positive effect on the inhibited muscle. Conclusions: Further clinical controlled studies that evaluate the effect of these four methods in clinical conditions are needed. More studies are also needed to establish the appropriate dose of cryotherapy.
Assuntos
Humanos , Crioterapia , Músculos , Patologia , Especialidade de FisioterapiaRESUMO
The Nuffield Council on Bioethics suggests that introgression of genetic material into related species in centres of crop biodiversity is an insufficient justification to bar the use of genetically modified crops in the developing world. They consider that a precautionary approach to forgo the possible benefits invokes the fallacy of thinking that doing nothing is itself without risk to the poor. Here we report findings relevant to this and other aspects of environmental biosafety for genetically modified potato in its main centre of biodiversity, the central Andes. We studied genetically modified potato clones that provide resistance to nematodes, principal pests of Andean potato crops. We show that there is no harm to many non-target organisms, but gene flow occurs to wild relatives growing near potato crops. If stable introgression were to result, the fitness of these wild species could be altered. We therefore transformed the male sterile cultivar Revolucion to provide a genetically modified nematode-resistant potato to evaluate the benefits that this provides until the possibility of stable introgression to wild relatives is determined. Thus, scientific progress is possible without compromise to the precautionary principle.