George Schayer Sabino

Confiabilidade intra e interexaminadores e erro da medição no uso do goniômetro e inclinômetro digital

INTRODUCAO: A amplitude de movimento articular (ADM) e um importante componente avaliado durante o exame fisico; porem, para que essa mensuracao possa ser utilizada, e necessario que ela seja confiavel e que suas propriedades de medida sejam conhecidas. OBJETIVOS: Verificar a confiabilidade inter e intraexaminadores das medidas realizadas pelo goniometro e inclinometro na avaliacao da ADM de flexao e extensao de joelho e cotovelo, e determinar o erro padrao da medicao (EPM) dos instrumentos em questao. METODOS: Foi avaliada ADM de flexao e extensao de cotovelo e joelho, bilateralmente, de uma amostra de individuos jovens saudaveis do genero masculino, com faixa etaria entre 18 e 30 anos, utilizando um inclinometro digital e um goniometro universal. RESULTADOS: A confiabilidade interexaminador variou de pequena a muito alta para os dois instrumentos, apresentando CCI de 0,24 a 0,96 para as medidas feitas com o goniometro, e de 0,02 a 0,98 para o inclinometro. O unico movimento que obteve confiabilidade muito alta para ambos os aparelhos e examinadores foi a flexao de joelho. O EPM determinado por meio da goniometria e inclinometria variou entre 0,21 e 12,75 graus. CONCLUSAO: O inclinometro digital apresenta melhores indices de confiabilidade que o goniometro para as medidas de ADM. Apenas quatro medidas obtiveram CCI alto e EPM abaixo de dois graus, e, assim, foram consideradas apropriadas para serem utilizadas clinicamente, todas essas realizadas com o inclinometro.

Redução do efeito analgésico da estimulação elétrica nervosa transcutânea de baixa freqüência em ratos tolerantes à morfina

OBJECTIVE: To investigate the effects of low (10 Hz) and high-frequency (130 Hz) transcutaneous electrical nerve stimulation (TENS) applied to inflamed paws of rats following chronic treatment with morphine. METHOD: 140 female Holtzman rats were utilized. Carrageenan (250 µg/0.1 ml) was administered to the right hind paws to induce inflammation. Two and a half hours after carrageenan injection, low and high frequency TENS was applied to the inflamed paw for 20 min, and its effect was measured via the Randall-Selitto method. The opioid antagonist naltrexone (3.0 mg/kg, subcutaneously) was administered 30 min before TENS, to verify the release of endogenous opioids. Morphine tolerance (10 mg/kg, subcutaneously) was induced by twice-daily injection over seven days. Low and high frequency TENS treatment was carried out on the eighth day, 2.5 hours after carrageenan injection. Statistical analysis was performed using one-way analysis of variance (ANOVA), followed by the post hoc Bonferroni test, with a significance level of p < 0.05. RESULTS: Both low and high frequency produced 100% inhibition of carrageenan-induced hyperalgesia. Naltrexone-treated animals showed complete reversion of analgesia induced by low but not high-frequency TENS. After attaining morphine tolerance, the low-frequency TENS values indicated complete absence of analgesia, whereas high-frequency TENS induced anti-hyperalgesia. CONCLUSION: The analgesic activity of low-frequency TENS is reduced following the development of morphine tolerance.

Fatores associados à adesão ao uso de palmilhas biomecânicas

Factors Related to Compliance with Biomechanical Insole Use Background: The benefits of biomechanical insoles for treating lower limb impairment have been reported. However, in clinical practice, low compliance with the use of such orthoses has been observed, which detracts from the possible benefits. Objective: To investigate the factors related to compliance with biomechanical insole use. Method: Thirty-three subjects (aged 44 ± 14.7 years) for whom biomechanical insoles had been molded took part in this study. A questionnaire asking about the insoles and their use was applied through interviews. The study variables were established from these questions. Based on the results obtained, the participants were divided into four groups according to their compliance level: full compliance, partial compliance, irregular compliance and non-compliance. The Kruskal-Wallis test was utilized to assess differences between these groups regarding the variables investigated. Spearman correlation coefficients were utilized to investigate possible relationships between these variables and the compliance. Results: Among the 33 participants, 15.2% were fully compliant, while 42.4% abandoned the insoles. Comparing the four compliance groups in relation to the variables investigated, significant differences were observed regarding insole comfort (p=0.003), improvement attributed to the insoles (p=0.006), and degree of knowledge of the problem (p<0.002). Significant correlations (r s =0.58; p<0.001; and r s =0.50; p<0.01) were observed between compliance and the comfort and improvement attributed to the insoles, respectively. Conclusion: The findings from this study revealed that the comfort and degree of improvement attributed to the insoles may influence the compliance with the use of these orthoses. These factors are important for the success of the treatment.

Validity analysis of one-repetition maximum strength test for determining the hamstrings-to-quadriceps ratio

One of the approaches to evaluate injury prediction is the hamstrings-to-quadriceps peak torque conventional ratio (H:Q ratio). The gold standard for assessment of muscle strength in vivo is by isokinetic dynamometry; however, the one-repetition maximum strength test (1-RM) presents high correlation with isokinetic data. This study aimed to compare measures of H:Q ratio in young adults obtained by dynamometry and 1-RM testing. No significant differences were observed in the H:Q ratio when comparing 1-RM and dynamometry testing. However, there was a significant and strong correlation between the measurements obtained in the two tests. Despite this correlation, data from both tests are not equal as the H:Q ratio obtained from 1-RM test presents a systematic error. Nonetheless, the results can enhance the applicability of 1-RM test in clinical settings.