E. Spyropoulos1, G.Moros2, G. Athanassiou3
Work Related Upper Limb Disorders (WRULDs) are long-lasting conditions which affect the muscles, tendons, ligaments, of the neck, shoulders, and arms [Ireland, 1998]. Even small loads maintained over a long period of time may increase the risk of WRULDs through accumulated fatigue and gradual reduction of tissue tolerance [Kumar, 2001]. The aim of the present work was to detect possible indicators of upper limb fatigue accumulation using data of kinematic parameters derived from a video recording repetitive task.
Laser και φυσικοθεραπεία – Επιστημονικό υπόβαθρο και κλινική εμπειρία
Γεώργιος Μώρος
Φυσικοθεραπευτής
Περίληψη
Σκοπός:
Σκοπός της παρούσας μελέτης είναι να αναδείξει, μέσα από τη διαθέσιμη βιβλιογραφία, αρθρογραφία και την κλινική εμπειρία την αποτελεσματικότητα της χρήσης των Low Level Laser Therapy (LLLT) σε ασθενείς που χρίζουν φυσικοθεραπείας.
Περίληψη
Σκοπός:
Σκοπός της παρούσας μελέτης είναι να αναδείξει, μέσα από τη διαθέσιμη βιβλιογραφία, αρθρογραφία και την κλινική εμπειρία την αποτελεσματικότητα της χρήσης των Low Level Laser Therapy (LLLT) σε ασθενείς που χρίζουν φυσικοθεραπείας.
Υλικό - Μέθοδος:
Κατά τη δευτερογενή έρευνα η άντληση των στοιχείων γίνεται από την υπάρχουσα βιβλιογραφία, αρθρογραφία και δικτυακούς τόπους μέσω της μηχανής αναζήτησης My Athens στις βιβλιοθήκες: ScienceDirect, Wiley Online Library και Google scholar. Οι λέξεις κλειδιά που συμπεριλήφθηκαν ήταν: LLLT, Low Level Laser Therapy, LLLT and musculoskeletal problems, LLLT and physiotherapy.
Αποτελέσματα – Συμπεράσματα:
Η παρούσα μελέτη άντλησε την επιχειρηματολογία της μέσα από μία ευρεία ανασκόπηση και μελέτη της υφιστάμενης βιβλιογραφίας και αρθρογραφίας την οποία προσπάθησε να αντιπαραβάλει με την κλινική και προσωπική εμπειρία του εισηγητή της. Παρά του ότι υπάρχουν επιστημονικά αντίθετες αναφορές, η πλειονότητα της αρθογραφίας που επιλέχθηκε δίνει σαφή υπεροχή της θεραπείας με LLLT έναντι εικονικών ή άλλων παρεμβάσεων σε ασθενείς που ακολουθούν προγράμματα φυσικοθεραπείας καταδεικνύοντας ταυτόχρονα την αποιδηματική, αναλγητική, αντιφλεγμονώδη, αντιοξειδωτική, επουλωτική κλπ. δράση της.
Καταλήγει σε συμπεράσματα μέσα από τα οποία, αφού πρώτα αναδειχτούν και επεξηγηθούν οι αντικρουόμενες απόψεις των άρθρων που ανασκοπήθηκαν, όσον αφορά την αποτελεσματικότητα της LLLT, γίνεται απόλυτα εμφανές ότι η θεραπεία με LLLT έχει άριστα αποτελέσματα, σε ασθενείς που χρίζουν φυσικοθεραπείας, υπό την προϋπόθεση ότι θα πληρούνται οι τεχνικές, θεραπευτικές και ιατρικές παράμετροι έτσι όπως αυτές τίθενται από την επιστημονική κοινότητα.
Τρόπος παρουσίασης: M.S Powerpoint
Μώρος Γεώργιος (1), Ντουραντώνης Δημήτρης (2)
ΕΙΣΑΓΩΓΗ: Τα προβλήματα του μυοσκελετικού αποτελούν μία από τις κυριότερες αιτίες προσέλευσης ασθενών για φυσικοθεραπεία. Η αντιμετώπισή τους καθίσταται πολλές φορές δύσκολη λόγω της διαφορετικότητας των περιπτώσεων αλλά και λόγω του ότι θα πρέπει να χρησιμοποιηθούν ολοένα και διαφορετικά θεραπευτικά πλάνα τα οποία να ανταποκρίνονται σε αυτές τις ιδιαιτερότητες.
Οι θεραπευτικές συνεδρίες αποτελούνται από συνδυασμό διαφορετικών φυσικοθεραπευτικών μέσων με πτωχά ή αμφισβητούμενα αποτελέσματα τα οποία μάλιστα εμφανίζονται μετά από την εφαρμογή αρκετών συνεδριών. Αυτό τις καθιστά ιδιαίτερα δαπανηρές, τόσο για τον θεραπευτή όσο και για τον ασθενή, μιας και για την πραγματοποίηση τους απαιτείται ιδιαίτερα μεγάλος καθημερινός χρόνος εκτέλεσης και εφαρμογής.
Η εφαρμογή των Lasers έρχεται να δώσει λύση σε όλα αυτά τα προβλήματα με σημαντικότερο όλων την άμεση αναλγησία και την επαναφορά στις καθημερινές δραστηριότητες του ασθενούς.
Η Φυσικοθεραπεία είναι η θεραπευτική προσέγγιση που βασίζεται στα φυσικά μέσα (φως, νερό, ηλεκτρικό ρεύμα κ.λπ.) που χρησιμοποιούνται από τον εξειδικευμένο επαγγελματία υγείας, πτυχιούχο φυσικοθεραπευτή, για θεραπευτικούς σκοπούς. Η φυσικοθεραπεία έχει εφαρμογή σε ασθενείς όλων των ιατρικών ειδικοτήτων (Ορθοπαιδική, Νευρολογία, Γενική Χειρουργική, Νευροχειρουργική, Καρδιοχειρουργική, Παιδιατρική, Πνευμονολογία, Παιδιατρική, Ουρολογία κ.λπ.). Η λέξη «φυσιοθεραπεία» δεν προσανατολίζει σε διαφορετική οντότητα και πιθανότατα προέκυψε από την επικρατούσα αγγλική λέξη Physiotherapy =Φυσιοθεραπεία είναι η θεραπευτική προσέγγιση που βασίζεται στα φυσικά μέσα (φως, νερό, ηλεκτρικό ρεύμα κ.λπ.) που χρησιμοποιούνται από τον εξειδικευμένο επαγγελματία υγείας, πτυχιούχο φυσικοθεραπευτή, για θεραπευτικούς σκοπούς.
Gael Guilhem, Christophe Cornu, Arnaud Guével
Context: Resistance exercise training commonly is performed against a constant external ioad (isotonic) or at a constant velocity (isokinetic). Researchers comparing the effectiveness of isotonic and isokinetic resistance-training protocols need to equalize the mechanical stimulus (work and velocity) applied.
Objective: To examine whiether the standardization protocol could be adjusted and applied to an eccentric training program.
Design: Controlled laboratory study.
Setting: Controlled research laboratory. Patients or Other Participants: Twenty-one sport science male students (age = 20.6±1.5 years, height = 178.0 ±4.0 cm, mass = 74.5 ±9.1 kg).
Intervention(s): Participants performed 9 weeks of isotonic (n = 11 ) or isokinetic (n = 10) eccentric training of knee extensors that was designed so they would perform the same amount of angular work at the same mean angular velocity.
Main Outcome Measure(s): Angular work and angular velocity.
Results: The isotonic and isokinetic groups performed the same total amount of work (-185.2 ±6.5 kJ and -184.4 ±8.6 kJ, respectively) at the same angular velocity (21 ± 17s and 22°/s, respectively) with the same number of repetitions (8.0 and 8.0, respectively). Bland-Altman analysis showed that work (bias = 2.4%) and angular velocity (bias = 0.2%) were equalized over 9 weeks between the modes of training.
Conclusions: The procedure developed allows angular work and velocity to be standardized over 9 weeks of isotonic and isokinetic eccentric training of the knee extensors. This method could be useful in future studies in which researchers compare neuromuscular adaptations induced by each type of training mode with respect to rehabilitating patients after musculoskeletal injury.
Key Words: resistance exercise, muscle strength, knee extensors.
Uganet Hernández Rosa, Jorge Velasquez Tlapanco, Catalina Lara Maya S Enrique Villarreal Ríos, Lidia Martínez González, Emma Rosa Vargas Daza y Liliana Galicia Rodríguez
Reumatol Clin. 2012:8(1):10-14
Introduction: Osteoarthritis is a chronic joint disease; isometric exercise leads to the development of mechanical work and isokinetic exercise leads to better joint mobility.
Objectives: To compare the effectiveness of isometric versus isokinetic therapeutic exercises in patients with knee osteoarthritis.
Material and methods: Quasiexperimental study in a population of 45 to 75 year old patients with a diagnosis of knee osteoarthritis. Group 1 (experimental) was put under isokinetic exercises and group 2 (control) under isometric exercises. The sample size was of 33 patients per group; the allocation to the experimentation or control group was nonrandom, but stratified by degrees of knee osteoarthritis.
The effectiveness of the exercise was measured in three dimensions; muscle strength, joint range and pain. The intervention lasted eight weeks and the physical activity was carried out every third day. The statistical analysis included averages, standard deviation, pereentage, Chi square test, z test for two populations, t test for two independent populations and twin t test.
Results: The analysis of muselé strength comparing the eategories independently demonstrates differenees at 8 weeks; 33.3% of the isokinetie exercise is in the normal eategory and 15.2% in the isometric exercise (p= 0.04). There was not differenee of joint range between groups, despite finding a stage I range in 100.0% of the isokinetie group and 97.0% in the isometrie (p> 0.05) group. Pain was milder in the isokinetie exereise group at 8 weeks (p= 0.01 ).
Conclusions: Isokinetie exereises have a greater effectiveness than isometrie exercises for muscle strength and pain in patients with knee osteoarthritis. However, other studies with randomized designs are needed.
Andrew Wilcock, Matthew Maddocks, Mary Lewis, Paul Howard, Jacky Frisby, Sarah Bell, Bisharat El Khoury, Cathann Manderson, Helen Evans and Simon Mockett
BMC Palliative Care 2008, 7:3 doi:10.1186/1472-684X-7-3
Background: The cachexia-anorexia syndrome impacts on patients' physical independence and quality of life. New treatments are required and need to be evaluated using acceptable and reliable outcome measures, e.g. the assessment of muscle function. The aims of this study were to:
Methods: The test consisted of 25 repetitions of isokinetic knee flexion and extension at maximal effort while seated on a Cybex NORM dynamometer. Strength and endurance for the quadriceps and hamstrings were assessed as peak torque and total work and an endurance ratio respectively.
Thirteen patients and 26 volunteers completed the test on three separate visits. Acceptability was assessed by questionnaire, reliability by intraclass correlation coefficients (ICC) and tests of difference compared outcomes between and within groups.
Results: All subjects found the test acceptable. Peak torque and work done were reliable measures (ICC >0.80), but the endurance ratio was not. Muscle function did not differ significantly between the patient and a matched volunteer group or in either group when repeated after one month.
Conclusion: For patients with non-small cell lung cancer or mesothelioma, the Cybex NORM dynamometer provides an acceptable and reliable method of assessing muscle strength and work done. Muscle function appears to be relatively well preserved in this group and it appears feasible to explore interventions which aim to maintain or even improve this.
Διαθέσιμο για να το κατεβάσετε: http://www.biomedcentral.com/1472-684X/7/3.
Franco M. Impellizzeri1, Mario Bizzini1, Ermanno Rampinini2, Ferdinando Cereda3 and Nicola A. Maffiuletti1
Clin Physiol Funct Imaging (2008) 28, pp113–119
The main aimof this study was to examine the absolute and relative reliability of some commonly used strength imbalance indices such as concentric hamstring-toconcentric quadriceps ratio, eccentric hamstring-to-concentric quadriceps ratio and bilateral concentric and eccentric strength ratios. An additional aim was to examine the reliability of the peak torque and work of the knee extensor and flexor muscles measured using the Cybex NORM dynamometer. Eighteen physically active healthy subjects (mean ± standard deviation, age 23 ± 3 years, height 176 ± 5 cm, body mass 74 ± 8 kg) were tested three times with 96 h between sessions. Peak torque, average work, unilateral and bilateral ratios were determined at 60, 120, 180 and )60 s)1. Low (0Æ34) to moderate (0Æ87) relative reliability (intraclass correlation coefficient, ICC) was found for strength imbalance ratios with eccentric hamstringto-concentric quadriceps ratio showing the greater ICC (>0Æ80). High ICC values (0Æ90–0Æ98) were found for peak torque and average work. Absolute reliability (standard error of measurement) ranged from 3Æ2% to 8Æ7% for strength imbalance ratios and from 4Æ3% to 7Æ7% for peak torque and average work measurements. This study established the reliability of the most common strength imbalance ratios and of absolute isokinetic muscle strength assessed using the Cybex NORM.
Περισσότερα (αρχείο .pdf)
Bρείτε το άρθρο:
doi: 10.1111/j.1475-097X.2007.00786.x
The purpose of this study was to examine the effects of continuous passive motion (CPM) immediately following an arthroscopically assisted anterior cruciate ligament reconstruction (ACL) utilizing a bone patella bone (BPTB) autograft on the clinical signs of the inflammatory phase of soft tissue healing. The clinical signs that were examined are acute pain, swelling, and knee function. During the inflammatory phase, the study investigated the relationship between CPM and blood loss when utilizing a hemovac drain during the first post-operative 24 hours. Another purpose of this study was to determine the effects of CPM during the fibroplastic phase of soft tissue healing. During this phase, the relationship between CPM and swelling, and CPM and knee function was also investigated.
Thirty patients (15-45 yrs. old) participated in this study. The patients in this study were randomly placed into one of four groups. The first (chronic ACL) (n = 11) and second (acute ACL) (n = 4) groups used the CPM and began knee motion immediately following surgery. The third (chronic ACL (n = 9) and fourth (acute ACL) (n = 6) groups did not use the CPM following the surgery. All groups followed an identical post-operative rehabilitation program with the exception of the CPM groups using a CPM device. The design of this study included the collection of data during the inflammatory (1-3 days postsurgery) and fibroplastic phases (4-21 days postsurgery) of soft tissue healing.
The results indicated that the initiation of CPM immediately following an ACL reconstruction had a significant ($<$.05) effect on decreasing the amount of medication consumed by the patient, and a significant ($<$.05) decrease in the patient's need for medication during the inflammatory phase. There was no statistical significance in the level of perceived pain between the groups. Patients that received CPM had a significantly ($<$.01) greater decrease in joint ellusion and hemarthrosis during the inflammatory phase. The use of CPM during the fibroplastic phase resulted in a significant ($<$.025) decrease in hemarthrosis. There was no statistically significant difference in the amount of blood that was collected in the hemovac between groups. There was a statistically greater ($<$.05) increase in the degrees of active and passive knee flexion attained by patients that utilized CPM during the inflammatory and fibroplastic phases. No statistically significant difference was found between groups in the degrees of knee extension during these phases of soft tissue healing.
Bρείτε το άρθρο:
McCarthy, M. R. (1990). The effects of immediate continuous passive motion on the clinical signs of soft tissue healing following an anterior cruciate ligament reconstruction. University of Virginia). ProQuest Dissertations and Theses, , 128-128 p.
Retrieved from http://search.proquest.com/docview/303900953?accountid=36196;
