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Pesquisa : E02.760.169.063.500.387.500 [Categoria DeCS]
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[PMID]:28355359
[Au] Autor:França EE; Ribeiro LC; Lamenha GG; Magalhães IK; Figueiredo TG; Costa MJ; Elihimas UF; Feitosa BL; Andrade MD; Correia MA; Ramos FF; Castro CM
[Ad] Endereço:Universidade Católica de Pernambuco (UNICAP), Fisioterapia, Recife/PE, Brazil.
[Ti] Título:Oxidative stress and immune system analysis after cycle ergometer use in critical patients.
[So] Source:Clinics (Sao Paulo);72(3):143-149, 2017 Mar.
[Is] ISSN:1980-5322
[Cp] País de publicação:Brazil
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE:: The passive cycle ergometer aims to prevent hypotrophy and improve muscle strength, with a consequent reduction in hospitalization time in the intensive care unit and functional improvement. However, its effects on oxidative stress and immune system parameters remain unknown. The aim of this study is to analyze the effects of a passive cycle ergometer on the immune system and oxidative stress in critical patients. METHODS:: This paper describes a randomized controlled trial in a sample of 19 patients of both genders who were on mechanical ventilation and hospitalized in the intensive care unit of the Hospital Agamenom Magalhães. The patients were divided into two groups: one group underwent cycle ergometer passive exercise for 30 cycles/min on the lower limbs for 20 minutes; the other group did not undergo any therapeutic intervention during the study and served as the control group. A total of 20 ml of blood was analysed, in which nitric oxide levels and some specific inflammatory cytokines (tumour necrosis factor alpha (TNF-α), interferon gamma (IFN-γ) and interleukins 6 (IL-6) and 10 (IL-10)) were evaluated before and after the study protocol. RESULTS:: Regarding the demographic and clinical variables, the groups were homogeneous in the early phases of the study. The nitric oxide analysis revealed a reduction in nitric oxide variation in stimulated cells (p=0.0021) and those stimulated (p=0.0076) after passive cycle ergometer use compared to the control group. No differences in the evaluated inflammatory cytokines were observed between the two groups. CONCLUSION:: We can conclude that the passive cycle ergometer promoted reduced levels of nitric oxide, showing beneficial effects on oxidative stress reduction. As assessed by inflammatory cytokines, the treatment was not associated with changes in the immune system. However, further research in a larger population is necessary for more conclusive results.
[Mh] Termos MeSH primário: Estado Terminal/terapia
Exercício/fisiologia
Terapia Passiva Contínua de Movimento/métodos
Estresse Oxidativo/fisiologia
[Mh] Termos MeSH secundário: Adulto
Idoso
Idoso de 80 Anos ou mais
Citocinas/sangue
Ensaio de Imunoadsorção Enzimática
Feminino
Seres Humanos
Unidades de Terapia Intensiva
Lipopolissacarídeos/uso terapêutico
Masculino
Meia-Idade
Força Muscular/fisiologia
Atrofia Muscular/prevenção & controle
Óxido Nítrico/imunologia
Óxido Nítrico/metabolismo
Estresse Oxidativo/imunologia
Reprodutibilidade dos Testes
Respiração Artificial/métodos
Estatísticas não Paramétricas
Fatores de Tempo
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Nm] Nome de substância:
0 (Cytokines); 0 (Lipopolysaccharides); 31C4KY9ESH (Nitric Oxide)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170906
[Lr] Data última revisão:
170906
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170330
[St] Status:MEDLINE


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[PMID]:28278477
[Au] Autor:Trujillo P; Mastropietro A; Scano A; Chiavenna A; Mrakic-Sposta S; Caimmi M; Molteni F; Rizzo G
[Ti] Título:Quantitative EEG for Predicting Upper Limb Motor Recovery in Chronic Stroke Robot-Assisted Rehabilitation.
[So] Source:IEEE Trans Neural Syst Rehabil Eng;25(7):1058-1067, 2017 Jul.
[Is] ISSN:1558-0210
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Stroke is a leading cause for adult disability, which in many cases causes motor deficits. Despite the developments in motor rehabilitation techniques, recovery of upper limb functions after stroke is limited and heterogeneous in terms of outcomes, and knowledge of important factors that may affect the outcome of the therapy is necessary to make a reasonable prediction for individual patients. In this paper, we assessed the relationship between quantitative electroencephalographic (QEEG) measures and the motor outcome in chronic stroke patients that underwent a robot-assisted rehabilitation program to evaluate the utility of QEEG indices to predict motor recovery. For this purpose, we acquired resting-state electroencephalographic signals from which the power ratio index (PRI), delta/alpha ratio, and brain symmetry index were calculated. The outcome of the motor rehabilitation was evaluated using upper limb section of the Fugl-Meyer Assessment. We found that PRI was significantly correlated with the motor recovery, suggesting that this index may provide useful information to predict the rehabilitation outcome.
[Mh] Termos MeSH primário: Diagnóstico por Computador/métodos
Eletroencefalografia/métodos
Terapia Passiva Contínua de Movimento/métodos
Transtornos dos Movimentos/diagnóstico
Transtornos dos Movimentos/reabilitação
Robótica/métodos
Reabilitação do Acidente Vascular Cerebral/métodos
[Mh] Termos MeSH secundário: Adulto
Idoso
Idoso de 80 Anos ou mais
Desenho de Equipamento
Análise de Falha de Equipamento
Seres Humanos
Masculino
Meia-Idade
Reprodutibilidade dos Testes
Sensibilidade e Especificidade
Acidente Vascular Cerebral/complicações
Acidente Vascular Cerebral/diagnóstico
Extremidade Superior
[Pt] Tipo de publicação:CLINICAL TRIAL; JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171026
[Lr] Data última revisão:
171026
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170310
[St] Status:MEDLINE
[do] DOI:10.1109/TNSRE.2017.2678161


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[PMID]:28258329
[Au] Autor:Drews BH; Kessler O; Franz W; Dürselen L; Freutel M
[Ad] Endereço:Center of Surgery, Department for Orthopedic Trauma, Hand and Reconstructive Surgery, University of Ulm, Albert-Einstein-Allee 23, 89081, Ulm, Germany. bjoern.drews@uniklinik-ulm.de.
[Ti] Título:Function and strain of the anterolateral ligament part I: biomechanical analysis.
[So] Source:Knee Surg Sports Traumatol Arthrosc;25(4):1132-1139, 2017 Apr.
[Is] ISSN:1433-7347
[Cp] País de publicação:Germany
[La] Idioma:eng
[Ab] Resumo:PURPOSE: Because reconstruction of the anterior cruciate ligament (ACL) in a double-bundle technique did not solve the problem of persistent rotatory laxity after surgery, new potential answers to this issue are of great interest. One of these is an extraarticular stabilization based on the rediscovery of the anterolateral ligament (ALL). Knowledge about its biomechanical function and benchmark data for an optimal reconstruction remain lacking. Therefore, the purpose of this study was to assess the function of the ALL under passive motion, anterior tibial translation and tibial rotational moments. METHODS: Continuous passive motion (0°-120° flexion), ap-translation and static pivot shift tests were performed on eight cadaveric knees. The knees were measured in intact, ACL-resected (ACL ) and ACL + ALL-resected (ALL ) conditions. Ap-translation and static pivot shift under 134 N anterior shear load were determined at 0°, 30°, 60° and 90° flexion. Strain of the ALL was recorded in intact and ACL conditions. RESULTS: During continuous passive motion under unloaded conditions, no significant difference in internal rotation between ACL and ALL was observed. With an additional internal tibial torque of 1-4 Nm, internal rotation increased significantly between 60° and 120° after resection of the ALL (p ≤ 0.05). Anterior tibial translation was significantly higher at 30° in ALL (p = 0.01) and for a simulated pivot shift at 60° and 90° in ACL (p ≤ 0.01). The ALL was not strained under unloaded passive motion. Adding different internal tibial torques led to strain starting at 60° flexion (1 N m internal torque) and 15° flexion (4 N m internal torque) in intact ligaments. In ACL , significantly greater ALL strains under lower flexion angles were seen for each condition (p ≤ 0.05). CONCLUSIONS: This study demonstrated the ALL to be without function under passive motion and with no influence on tibial rotation. On application of extrinsic loads, the ALL had a low but significant stabilizing effect against anterior tibial shear load at low flexion angles. For this reason, it can be concluded that the ALL is supporting the ACL against internal tibial loads to a minor degree. A relationship between the ALL and the pivot shift cannot be concluded. With these results ALL-reconstruction cannot be recommended at the moment without further biomechanical investigations.
[Mh] Termos MeSH primário: Ligamentos Articulares/fisiologia
Terapia Passiva Contínua de Movimento
Rotação
[Mh] Termos MeSH secundário: Adulto
Idoso
Ligamento Cruzado Anterior/fisiologia
Fenômenos Biomecânicos/fisiologia
Cadáver
Feminino
Seres Humanos
Masculino
Meia-Idade
Exame Físico
Torque
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1706
[Cu] Atualização por classe:170920
[Lr] Data última revisão:
170920
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170305
[St] Status:MEDLINE
[do] DOI:10.1007/s00167-017-4472-3


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[PMID]:28114023
[Au] Autor:De Luca A; Giannoni P; Vernetti H; Capra C; Lentino C; Checchia GA; Casadio M
[Ti] Título:Training the Unimpaired Arm Improves the Motion of the Impaired Arm and the Sitting Balance in Chronic Stroke Survivors.
[So] Source:IEEE Trans Neural Syst Rehabil Eng;25(7):873-882, 2017 Jul.
[Is] ISSN:1558-0210
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Robot-assisted rehabilitation of stroke survivors mainly focuses on the impaired side of the body while the role of the unimpaired side in the recovery after stroke is still controversial. The goal of this study is to investigate the influence on sitting balance and paretic arm functions of a training protocol based on movements of the unimpaired arm. Sixteen chronic stroke survivors underwent nineteen training sessions, in which they performed active movements with the unimpaired arm supported by a passive exoskeleton. Performance of the trunk and upper limbs was evaluated before treatment, after treatment and at six months follow up with clinical scales and an instrumented evaluation. A reaching test executed with the exoskeleton was used to assess changes in performance of both arms. The treatment based on the unimpaired arm's movements executed with a correct body posture led to benefits in control of the trunk and of both the trained and the untrained arm. The amount of impaired arm improvement in the Fugl-Meyer score was comparable to the outcome of robotic treatments focused directly on this arm. Our results highlight the importance of taking into account all body schema in the rehabilitation robotic program, instead of focusing only on the impaired side of the body.
[Mh] Termos MeSH primário: Terapia Passiva Contínua de Movimento/métodos
Paresia/fisiopatologia
Paresia/reabilitação
Equilíbrio Postural
Robótica/métodos
Reabilitação do Acidente Vascular Cerebral/métodos
Acidente Vascular Cerebral/fisiopatologia
[Mh] Termos MeSH secundário: Adulto
Idoso
Braço/fisiopatologia
Doença Crônica
Feminino
Seres Humanos
Masculino
Meia-Idade
Destreza Motora
Movimento
Paresia/etiologia
Recuperação de Função Fisiológica
Acidente Vascular Cerebral/complicações
Sobreviventes
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171026
[Lr] Data última revisão:
171026
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170124
[St] Status:MEDLINE
[do] DOI:10.1109/TNSRE.2016.2635806


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[PMID]:27899754
[Au] Autor:Figlewski K; Blicher JU; Mortensen J; Severinsen KE; Nielsen JF; Andersen H
[Ad] Endereço:From the Hammel Neurorehabilitation Centre and University Research Clinic, Denmark (K.F., J.M., J.F.N., H.A.); Centre for Functionally Integrative Neuroscience, Aarhus University Hospital, Denmark (J.U.B.); and Department of Neurology, Aarhus University Hospital, Denmark (K.E.S., H.A.). kryfig@rm.dk
[Ti] Título:Transcranial Direct Current Stimulation Potentiates Improvements in Functional Ability in Patients With Chronic Stroke Receiving Constraint-Induced Movement Therapy.
[So] Source:Stroke;48(1):229-232, 2017 Jan.
[Is] ISSN:1524-4628
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND AND PURPOSE: Transcranial direct current stimulation may enhance effect of rehabilitation in patients with chronic stroke. The objective was to evaluate the efficacy of anodal transcranial direct current stimulation combined with constraint-induced movement therapy of the paretic upper limb. METHODS: A total of 44 patients with stroke were randomly allocated to receive 2 weeks of constraint-induced movement therapy with either anodal or sham transcranial direct current stimulation. The primary outcome measure, Wolf Motor Function Test, was assessed at baseline and after the intervention by blinded investigators. RESULTS: Both groups improved significantly on all Wolf Motor Function Test scores. Group comparison showed improvement on Wolf Motor Function Test in the anodal group compared with the sham group. CONCLUSIONS: Anodal transcranial direct current stimulation combined with constraint-induced movement therapy resulted in improvement of functional ability of the paretic upper limb compared with constraint-induced movement therapy alone. CLINICAL TRIAL REGISTRATION: URL: http://www.clinicaltrials.gov. Unique identifier: NCT01983319.
[Mh] Termos MeSH primário: Terapia Passiva Contínua de Movimento/métodos
Recuperação de Função Fisiológica/fisiologia
Reabilitação do Acidente Vascular Cerebral/métodos
Acidente Vascular Cerebral/terapia
Estimulação Transcraniana por Corrente Contínua/métodos
[Mh] Termos MeSH secundário: Atividades Cotidianas
Idoso
Doença Crônica
Feminino
Seres Humanos
Masculino
Meia-Idade
Córtex Motor/fisiopatologia
Modalidades de Fisioterapia
Acidente Vascular Cerebral/diagnóstico
Acidente Vascular Cerebral/fisiopatologia
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Em] Mês de entrada:1705
[Cu] Atualização por classe:170512
[Lr] Data última revisão:
170512
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161201
[Cl] Clinical Trial:ClinicalTrial
[St] Status:MEDLINE
[do] DOI:10.1161/STROKEAHA.116.014988


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[PMID]:27695905
[Au] Autor:Gatewood CT; Tran AA; Dragoo JL
[Ad] Endereço:Department of Orthopaedic Surgery, Stanford University, Stanford, CA, USA.
[Ti] Título:The efficacy of post-operative devices following knee arthroscopic surgery: a systematic review.
[So] Source:Knee Surg Sports Traumatol Arthrosc;25(2):501-516, 2017 Feb.
[Is] ISSN:1433-7347
[Cp] País de publicação:Germany
[La] Idioma:eng
[Ab] Resumo:PURPOSE: There is a wide array of device modalities available for post-operative treatment following arthroscopic knee surgery; however, it remains unclear which types and duration of modality are the most effective. This systematic review aimed to investigate the efficacy of device modalities used following arthroscopic knee surgery. METHODS: A systematic search of the literature was performed on: PubMed; Scopus; MEDLINE; EMBASE; PEDro; SportDiscus; and CINAHL databases (1995-2015) for clinical trials using device modalities following arthroscopic knee surgery: cryotherapy, continuous passive motion (CPM), neuromuscular electrical stimulation (NMES), surface electromyographic (sEMG) biofeedback and shockwave therapy (ESWT). Only level 1 and 2 studies were included and the methodological quality of studies was evaluated using Physiotherapy Evidence Database (PEDro) scores. Outcome measures included: muscle strength, range of motion, swelling, blood loss, pain relief, narcotic use, knee function evaluation and scores, patient satisfaction and length of hospital stay. RESULTS: Twenty-five studies were included in this systematic review, nineteen of which found a significant difference in outcomes. For alleviating pain and decreasing narcotic consumption following arthroscopic knee surgery, cryocompression devices are more effective than traditional icing alone, though not more than compression alone. CPM does not affect post-operative outcomes. sEMG biofeedback and NMES improve quadriceps strength and overall knee functional outcomes following knee surgery. There is limited evidence regarding the effects of ESWT. CONCLUSION: Cryotherapy, NMES and sEMG are recommended for inclusion into rehabilitation protocols following arthroscopic knee surgery to assist with pain relief, recovery of muscle strength and knee function, which are all essential to accelerate recovery. CPM is not warranted in post-operative protocols following arthroscopic knee surgery because of its limited effectiveness in returning knee range of motion, and additional studies are required to investigate the effects of ESWT. LEVEL OF EVIDENCE: II.
[Mh] Termos MeSH primário: Artroscopia/reabilitação
Articulação do Joelho/cirurgia
Cuidados Pós-Operatórios
[Mh] Termos MeSH secundário: Crioterapia
Terapia por Estimulação Elétrica
Ondas de Choque de Alta Energia
Seres Humanos
Terapia Passiva Contínua de Movimento
Força Muscular
Neurorretroalimentação
Dor Pós-Operatória/prevenção & controle
Recuperação de Função Fisiológica
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1706
[Cu] Atualização por classe:170920
[Lr] Data última revisão:
170920
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161004
[St] Status:MEDLINE
[do] DOI:10.1007/s00167-016-4326-4


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[PMID]:27337720
[Au] Autor:Ren Y; Wu YN; Yang CY; Xu T; Harvey RL; Zhang LQ
[Ti] Título:Developing a Wearable Ankle Rehabilitation Robotic Device for in-Bed Acute Stroke Rehabilitation.
[So] Source:IEEE Trans Neural Syst Rehabil Eng;25(6):589-596, 2017 Jun.
[Is] ISSN:1558-0210
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Ankle movement training is important in motor recovery post stroke and early intervention is critical to stroke rehabilitation. However, acute stroke survivors receive motor rehabilitation in only a small fraction of time, partly due to the lack of effective devices and protocols suitable for early in-bed rehabilitation. Considering the first few months post stroke is critical in stroke recovery, there is a strong need to start motor rehabilitation early, mobilize the ankle, and conduct movement therapy. This study seeks to address the need and deliver intensive passive and active movement training in acute stroke using a wearable ankle robotic device. Isometric torque generation mode under real-time feedback is used to guide patients in motor relearning. In the passive stretching mode, the wearable robotic device stretches the ankle throughout its range of motion to the extreme dorsiflexion forcefully and safely. In the active movement training mode, a patient is guided and motivated to actively participate in movement training through game playing. Clinical testing of the wearable robotic device on 10 acute stroke survivors over 12 sessions of feedback-facilitated isometric torque generation, and passive and active movement training indicated that the early in-bed rehabilitation could have facilitated neuroplasticity and helped improve motor control ability.
[Mh] Termos MeSH primário: Articulação do Tornozelo
Biorretroalimentação Psicológica/instrumentação
Terapia por Exercício/instrumentação
Exoesqueleto Energizado
Terapia Passiva Contínua de Movimento/instrumentação
Robótica/instrumentação
Reabilitação do Acidente Vascular Cerebral/instrumentação
[Mh] Termos MeSH secundário: Biorretroalimentação Psicológica/métodos
Desenho de Equipamento
Análise de Falha de Equipamento
Seres Humanos
Monitorização Ambulatorial/instrumentação
Reprodutibilidade dos Testes
Robótica/métodos
Sensibilidade e Especificidade
Terapia Assistida por Computador/instrumentação
Terapia Assistida por Computador/métodos
Jogos de Vídeo
[Pt] Tipo de publicação:EVALUATION STUDIES; JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171025
[Lr] Data última revisão:
171025
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160624
[St] Status:MEDLINE
[do] DOI:10.1109/TNSRE.2016.2584003


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[PMID]:27305683
[Au] Autor:Vlaar MP; Solis-Escalante T; Vardy AN; van der Helm FCT; Schouten AC
[Ti] Título:Quantifying Nonlinear Contributions to Cortical Responses Evoked by Continuous Wrist Manipulation.
[So] Source:IEEE Trans Neural Syst Rehabil Eng;25(5):481-491, 2017 May.
[Is] ISSN:1558-0210
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Cortical responses to continuous stimuli as recorded using either magneto- or electroencephalography (EEG) have shown power at harmonics of the stimulated frequency, indicating nonlinear behavior. Even though the selection of analysis techniques depends on the linearity of the system under study, the importance of nonlinear contributions to cortical responses has not been formally addressed. The goal of this paper is to quantify the nonlinear contributions to the cortical response obtained from continuous sensory stimulation. EEG was used to record the cortical response evoked by continuous movement of the wrist joint of healthy subjects applied with a robotic manipulator. Multisine stimulus signals (i.e., the sum of several sinusoids) elicit a periodic cortical response and allow to assess the nonlinear contributions to the response. Wrist dynamics (relation between joint angle and torque) were successfully linearized, explaining 99% of the response. In contrast, the cortical response revealed a highly nonlinear relation; where most power (  âˆ¼ 80 %) occurred at non-stimulated frequencies. Moreover, only 10% of the response could be explained using a nonparametric linear model. These results indicate that the recorded evoked cortical responses are governed by nonlinearities and that linear methods do not suffice when describing the relation between mechanical stimulus and cortical response.
[Mh] Termos MeSH primário: Eletroencefalografia/métodos
Potenciais Somatossensoriais Evocados/fisiologia
Terapia Passiva Contínua de Movimento/métodos
Dinâmica não Linear
Estimulação Física/métodos
Córtex Somatossensorial/fisiologia
Articulação do Punho/fisiologia
[Mh] Termos MeSH secundário: Adulto
Mapeamento Encefálico/métodos
Feminino
Seres Humanos
Masculino
Reprodutibilidade dos Testes
Sensibilidade e Especificidade
Articulação do Punho/inervação
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171025
[Lr] Data última revisão:
171025
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160616
[St] Status:MEDLINE
[do] DOI:10.1109/TNSRE.2016.2579118


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[PMID]:27751715
[Au] Autor:Ek ET; Paul SK; Hotchkiss RN
[Ad] Endereço:Melbourne Orthopaedic Group and Department of Orthopaedic Surgery, Monash University, Dandenong Hospital, Melbourne, VIC, Australia.
[Ti] Título:Outcomes after operative treatment of elbow contractures in the pediatric and adolescent population.
[So] Source:J Shoulder Elbow Surg;25(12):2066-2070, 2016 Dec.
[Is] ISSN:1532-6500
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: The role of elbow contracture release in the very young is unclear, with existing studies reporting conflicting results. This study evaluated the long-term results after open elbow contracture release in patients aged younger than 18 years. METHODS: Between 1994 and 2012, 32 patients underwent open elbow contracture release at a mean age of 13.8 years (range, 5-18 years), and their outcomes were reviewed. The primary cause was traumatic in 30 patients (4 radial head/neck fractures, 5 intra-articular distal humeral fractures, 11 extra-articular distal humeral fractures, 10 complex fracture-dislocations), and the mean time from the index injury to contracture release was 16.3 months (range, 3-82 months). The cause in 2 patients was nontraumatic (1 osteochondritis dessicans, 1 congenital). The mean follow-up period was 66 months (range, 7-202 months). RESULTS: At the latest follow-up, total arc of motion improved from 69° to 123° (P <.0001), with a mean increase of 54° (P <.0001). The function arc was >100° in 28 patients (88%), and 29 patients (91%) achieved >20° of improvement in their arc. Twelve patients (38%) underwent a gentle manipulation under anesthesia at a mean of 2.7 weeks (range, 1-5 weeks) for early recurrence of stiffness. There were 3 complications (1 deep infection, 1 hematoma, 1 humeral fracture through the external fixator pin site). No patients lost motion after surgery. CONCLUSION: Elbow contracture release in the pediatric and adolescent population can provide significant improvements in range of motion similar to that achieved in adults. The improvements in motion are durable.
[Mh] Termos MeSH primário: Contratura/cirurgia
Articulação do Cotovelo/cirurgia
Amplitude de Movimento Articular
[Mh] Termos MeSH secundário: Adolescente
Criança
Pré-Escolar
Contratura/etiologia
Feminino
Seres Humanos
Masculino
Terapia Passiva Contínua de Movimento
Cuidados Pós-Operatórios
Estudos Retrospectivos
Rotação
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1704
[Cu] Atualização por classe:170817
[Lr] Data última revisão:
170817
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161019
[St] Status:MEDLINE


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[PMID]:27577057
[Au] Autor:Vér C; Emri M; Spisák T; Berényi E; Kovács K; Katona P; Balkay L; Menyhárt L; Kardos L; Csiba L
[Ad] Endereço:Department of Neurology, University of Debrecen, Debrecen, Hungary.
[Ti] Título:The Effect of Passive Movement for Paretic Ankle-Foot and Brain Activity in Post-Stroke Patients.
[So] Source:Eur Neurol;76(3-4):132-142, 2016.
[Is] ISSN:1421-9913
[Cp] País de publicação:Switzerland
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: This study aims at investigating the short-term efficacy of the continuous passive motion (CPM) device developed for the therapy of ankle-foot paresis and to investigate by fMRI the blood oxygen level-dependent responses (BOLD) during ankle passive movement (PM). METHODS: Sixty-four stroke patients were investigated. Patients were assigned into 2 groups: 49 patients received both 15 min manual and 30 min device therapy (M + D), while the other group (n = 15) received only 15 min manual therapy (M). A third group of stroke patients (n = 12) was investigated by fMRI before and immediately after 30 min CPM device therapy. There was no direct relation between the fMRI group and the other 2 groups. All subjects were assessed using the Modified Ashworth Scale (MAS) and a goniometer. RESULTS: Mean MAS decreased, the ankle's mean plantar flexion and dorsiflexion passive range of motion (PROM) increased and the equinovalgus improved significantly in the M + D group. In the fMRI group, the PM of the paretic ankle increased BOLD responses; this was observed in the contralateral pre- and postcentral gyrus, superior temporal gyrus, central opercular cortex, and in the ipsilateral postcentral gyrus, frontal operculum cortex and cerebellum. CONCLUSION: Manual therapy with CPM device therapy improved the ankle PROM, equinovalgus and severity of spasticity. The ankle PM increased ipsi- and contralateral cortical activation.
[Mh] Termos MeSH primário: Tornozelo/inervação
Encéfalo/fisiopatologia
/inervação
Terapia Passiva Contínua de Movimento/instrumentação
Manipulações Musculoesqueléticas
Paresia/fisiopatologia
Paresia/reabilitação
Reabilitação do Acidente Vascular Cerebral/instrumentação
Acidente Vascular Cerebral/fisiopatologia
[Mh] Termos MeSH secundário: Adulto
Idoso
Idoso de 80 Anos ou mais
Tornozelo/fisiopatologia
Artrometria Articular
Terapia Combinada
Desenho de Equipamento
Feminino
/fisiopatologia
Seres Humanos
Imagem por Ressonância Magnética
Masculino
Meia-Idade
Exame Neurológico
Oxigênio/sangue
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE
[Nm] Nome de substância:
S88TT14065 (Oxygen)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170906
[Lr] Data última revisão:
170906
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160901
[St] Status:MEDLINE



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