Guaracy Carvalho Filho

Lesões desportivas no atletismo: comparação entre informações obtidas em prontuários e inquéritos de morbidade referida

To understand sports injuries is necessary to quantify and associate them with specific risks factors from sports. Although, formal records about sports injuries are rare overcoat in Brazilian track and field athletes where few clubs have health care service. This fact could not be a problem, because public health researchers adapt with epidemiological methods, like report inquires morbidity, to collect data. From this fault of control about sports injuries records and the facility to have information together athletes, the aim of this study was to collect information about sports injuries, reported by high performance athletes, going back until eight months and compare them with their records. Twenty-five athletes were analyzed (sixteen men and nine women), age 25.7 ± 4.4 (years), height 1.74 ± 0.10 (m), weight 70.4 ± 13.15 (kg) and time of practice 8.38 ± 4.06 (years). Two physiotherapists were trained separately to collect information about sports injuries, one in records and another with the athletes in interview. The binomial proportion test by agreement was used to compare the information with 95% of confidence. After analyzed the agreement between that two collect forms, that variables values were within the limits of confidence established for statistics tests with the following values: 88.33% to the variables injury tip and injury mechanism or high of symptoms, 90% to the variable quality of return to the sports practice and 91.67% to the variables anatomical place and period of training. There was high rate of agreement between collected information, showing reported morbidity inquire efficiency in collect data about sports injuries.To understand sports injuries is necessary to quantify and associate them with specific risks factors from sports. Although, formal records about sports injuries are rare overcoat in Brazilian track and field athletes where few clubs have health care service. This fact could not be a problem, because public health researchers adapt with epidemiological methods, like report inquires morbidity, to collect data. From this fault of control about sports injuries records and the facility to have information together athletes, the aim of this study was to collect inf ormation about sports injuries, reported by high performance athletes, going back until eight months and compare them with their records. Twenty-five athletes were analyzed (sixteen men and nine women), age 25.7 ± 4.4 (years), height 1.74 ± 0.10 (m), weight 70.4 ± 13.15 (kg) and time of practice 8.38 ± 4.06 (years). Two physiotherapists were trained separately to collect in

Lesões desportivas na elite do atletismo brasileiro: estudo a partir de morbidade referida

Os processos de quantificacao e associacao das lesoes do esporte aos seus possiveis fatores causais sao importantes para melhor entendimento sobre assunto. Assim constituiu-se como objetivo do presente estudo a observacao das lesoes desportivas (LD) em atletas da elite brasileira do atletismo, associando-as aos seus mecanismos de instalacao e caracteristicas da modalidade. Foram entrevistados 86 atletas (47 homens e 39 mulheres) convocados para representar o Brasil durante o ano de 2003. Utilizou-se um inquerito de morbidade referida, validado anteriormente, para obtencao dos dados referentes aos atletas e suas lesoes. Para a analise dos resultados adotou-se o teste de Goodman para contrastes entre e dentro de proporcoes binomiais, sendo todas as conclusoes discutidas para 5% de significância estatistica. Os resultados mostraram que ha maior taxa de lesao por atleta (l/a), nas provas combinadas (3,5 l/a), seguidas por eventos de velocidade (2,6 l/a), resistencia (1,9 l/a) e saltos (1,9 l/a) respectivamente. O principal mecanismo causal e a alta intensidade acometendo preferencialmente velocistas e fundistas. Outra forte associacao foi observada entre lesoes musculares e provas de velocidade, que tambem apresentam preferencia para ocorrencia de lesao na regiao da coxa. As atividades com elevada intensidade foram o principal responsavel por lesoes musculares, enquanto as osteoarticulares e tendinopatias ocorrem com excesso de repeticoes. Concluiu-se, a partir dos achados, que existem associacoes entre lesoes e fatores causais, como entre provas e lesoes, mecanismos de lesao e local anatomico.The sports injuries (SI) quantification and association processes to their possible causal factors are important for a better understanding on the subject. The objective of the present study was the observation of SI in athletes of the Brazilian elite of the athletics, associating them to their installation mechanisms and characteristics of the modality. Eighty-six athletes were interviewed (47 men and 39 women) summoned to represent Brazil during the season of 2003. A previously validated inquiry of referred morbidity was used for the attainment of data regarding the athletes and their injuries. For the analysis of the results the test of Goodman was adopted for contrasts among and within binomial proportions, being all of the conclusions discussed for 5% of statistical significance. The results showed that there is a higher rate of injuries for athlete (I/a), in the combined events (3.5 I/a), followed by events of intensity (2.6 I/a), resistance (1.9 I/a) and jumps (1.9 I/a), respectively. The main causal mechanism is the high intensity, attacking preferentially sprinters and endurance runners. Another strong association was observed between muscular injuries and intensity events, that also present preference for injury occurrence in the thigh’s region. The mechanism of high intensity was the main responsible for muscular injury while bone or joint injuries and tendinopathies occur in high training volume. It is concluded, based on those findings, there are associations between types of injuries and causal factors, as among events and injuries, injuries mechanisms and anatomical place.

Comparação da pressão plantar e dos sintomas osteomusculares por meio do uso de palmilhas customizadas e pré-fabricadas no ambiente de trabalho

OBJECTIVES: To compare the effect of the use of custom and prefabricated insoles on the behavior of plantar weight load and musculoskeletal symptoms in assembly line workers. METHODS: A randomized trial was carried out with 27 women who worked in a static standing position and had musculoskeletal symptoms. The mean age was 30.3±7.09 years and the weight 64.85±13.65 Kg. The Nordic Musculoskeletal Questionnaire was administered, and plantar pressure was determined using a computerized baropodometric system (FootWork). The sample was then divided into control group, which wore pre-fabricated insoles, and intervention group, which wore ethylvinylacetate insoles for eight weeks. Baropodometric data were collected and the questionnaire was administered once again. RESULTS: There was no statistically significant difference in the comparison between groups and baropodometric data. However, a change was noted in the behavior of the load variables between evaluations, with an increase in mean load pressure and maximal plantar pressure (p<0.05). No statistically significant difference was found between groups for any anatomical site in the different evaluations. Within each group, there was a reduction in foot pain and back pain between evaluations (p<0.05). CONCLUSIONS: Both types of insole reduced pain symptoms in the lumbar region and feet. After eight weeks of use, there was an increase in maximal and mean plantar pressure and a reduction in plantar surface area with both types of insole.

Queixas osteomusculares relacionadas ao trabalho relatadas por mulheres de centro de ressocialização

Considering work-related complaints as a public health problem, the current study aimed to analyze the frequency of musculoskeletal complaints and the association between their occurrence and severity and anthropometric and work variables. The sample included 146 women from a social rehabilitation center who answered a validated questionnaire with anthropometric data and history of work-related musculoskeletal complaints. The Goodman test was used to analyze the association between and within variables. We observed a high rate of complaints after beginning work activity (94.19%). Subjects that required sick leave showed higher mean age and weight. The most severe complaints related to back pain. Sick leave was more common among women who had worked longer. The study concluded that there was a high frequency of work-related complaints and an association between: higher weight and height values and severity; higher age and sick leave; more serious complaints and back pain; and longer time on the job and need for sick leave.

Correlação entre padrão postural em jovens praticantes do atletismo

The aim of this study was to observe the body alignment of young athletes practicing athletics and analyze the combination of such patterns within and between groups of this modality. The sample was composed of 63 athletes of both sexes and the postural analysis protocol was based on observation and photographic record with markings on bone’s accidents to verify the alignment of these structures. The segments considered in the analysis were: trunk, pelvis, knee and ankle. The Goodmann’s test for contrasts between and within binomial proportions was used for data analysis. The results showed that jumpers (58.33%) and throwers/ launchers (50.00%) presented the trunk in more balanced position than resistance athletes (5.56%). At the hip region, throwers/ launchers presented predominance of pelvis with left rotation (66.67%), while in jumpers was observed high frequencies for pelvic anteversion (58,33%). The knee observation revealed that resistance athletes presented normality and recurvatum, valgus in throwers/ launchers (50,00%) and varus for the other groups. For the ankle, except for jumpers, all groups showed predominance of valgism. It is concluded that to reach the specific characteristics of each population, different levels of posture are established.

Pelvic ring fractures: epidemiological study

De fevereiro de 2000 a setembro de 2001, 84 pacientes apresentando fratura do anel pelvico foram avaliados, segundo determinado protocolo aplicado. Houve predominio do sexo masculino (67%), a maioria dos pacientes eram brancos (86%) e a idade media foi de 37 anos. Quanto ao tipo de acidente, os mais frequentes foram os relacionados ao trânsito (58%) - carro, moto e atropelamento - pacientes vitimas de traumas de alta energia. As fraturas foram classificadas de acordo com Tile(13) em estaveis, em 55% (fraturas do tipo A); rotacionalmente instaveis, em 30% (fraturas do tipo B) e rotacional e verticalmente instaveis, em 15% (fraturas do tipo C). A fratura mais frequentemente encontrada foi a dos ramos isquiopubicos. O tratamento cirurgico foi realizado em 29% dos pacientes. Houve necessidade de transfusao sanguinea em 20% dos pacientes, utilizando-se uma media de cinco unidades de sangue total; exceto dois pacientes (2,4%) com lesao arterial intra pelvica que necessitaram mais de 10 unidades de sangue nas primeiras 48 horas. A mortalidade foi de sete por cento tendo relacao significativa com traumas extra pelvicos.

Surgical treatment of the congenital dislocation of the hip after walking age: open reduction and Salter's osteotomy

A luxacao congenita do quadril (LCQ), apos a marcha, requer o tratamento cirurgico, sendo uma das opcoes a reducao aberta associada a osteotomia do osso inominado (tipo Salter). Neste estudo foram avaliados 18 pacientes, 22 quadris, que apresentavam LCQ tratados cirurgicamente, entre 1989 e 1995, utilizando a osteotomia do osso inominado, pela tecnica de Salter, pos reducao aberta. A idade dos pacientes, na epoca da cirurgia, variou de 12 a 30 meses, com media de 19 meses, sendo 15 do sexo feminino e 3 do masculino, 4 pacientes tinham acometimento bilateral, sendo que nos demais, 8 tinham o quadril esquerdo acometido e 6 o lado direito. Os resultados foram avaliados segundo criterios clinicos de Dutoit et al.(3) e radiograficos de Severin(12), apos um seguimento medio de 48 meses. Clinicamente foram obtidos 18% de resultados excelentes (4); 54% resultados bons (12); 14% regulares (3); e 14% ruins (3). Quanto aos criterios radiograficos, encontramos 36% dos quadris classificados como excelentes (8); 45% bons (10); 5% regulares (1); e 14% ruins(3). Como complicacoes foram constatados 3 casos de reluxacao, tratados com outra tecnica cirurgica. Nao foi observado nenhum caso de infeccao, fratura do enxerto e lesao vascular ou nervosa.

Afecção do tendão supra-espinal e afastamento laboral

As afeccoes do manguito rotador, dentre elas as relacionadas ao tendao supra-espinal, sao problemas comuns na populacao, sobretudo devido a sobrecarga ocupacional, o que leva a altos indices de afastamento do trabalho. Buscou-se, entao, comparar a necessidade de afastamento de trabalho entre os diferentes estados da afeccao do tendao supra-espinal e entre cinco diferentes grupos profissionais, tendo a participacao de pacientes que apresentavam diagnostico da afeccao. Os individuos foram agrupados quanto ao estado da doenca (tendinite, ruptura parcial, ruptura total) e quanto aos aspectos biomecânicos da ocupacao (ramo de servicos, construcao civil, trabalhadores domesticos, lavradores e segurancas). Teste qui-quadrado de Pearson, analise de dependencia e teste exato para uma proporcao foram realizados. Os resultados apontaram que 62 (55%) estavam afastados da atividade laboral e que os grupos com maior numero de afastados foram o do ramo de servicos (38,71%) e lavradores (22,58%), segundo Pearson. A maior frequencia de casos de afastamento foi registrada no estagio de tendinite (p<0,05) pela analise de dependencia e a ocupacao de lavrador parece deixar o individuo por mais tempo afastado (p=0,02), segundo teste de Pearson.

Rotator cuff Disease: Aspects and Implications

El objetivo del estudio fue analizar las caracteristicas de los portadores de la afeccion del manguito rotador y sus implicancias por el cuadro de la lesion. Fueron entrevistadas 112 personas, con diagnostico inicial de afeccion del manguito rotador, la mayoria compuesta por mujeres de alrededor de 51 anos, siendo el lado derecho mas afectado, con evidencia de ser el mas perjudicado (p=0,00) y con gran incapacidad de mover los miembros superiores (p<0,05). La patologia mas frecuente fue la ruptura parcial del tendon del musculo supraespinal, con tratamiento de 26,16 meses y sin asociacion con los estados de la patologia. La mayoria de los casos fueron tratados con fisioterapia, y solo el 19% fue sometido a procedimiento quirurgico. Se verifico que esta patologia provoca grandes perjuicios funcionales, afectando tanto el ambito social como laboral, produciendo altas incapacidades en los miembros superiores, aun despues del tratamiento

Avaliação do uso do Hylano GF-20 no pós-operatório de artroscopia de joelho por artrose

O presente estudo avaliou os beneficios do uso do Hylano GF-20 no pos-operatorio de artroscopias do joelho para lavagem e desbridamento por artrose.Foram estudados 20 pacientes submetidos a artroscopia em 20 joelhos que apresentavam artrose ate grau 3 da classificacao com sintomas de dor e bloqueio no referido joelho e nao obtiveram melhora ao tratamento conservador, sendo entao realizada lavagem associada a desbridamento leve condral e meniscal de acordo com a necessidade de cada caso.Os pacientes foram divididos em 2 grupos sendo que em um dos grupos foi feita apenas a artroscopia e noutro grupo artroscopia associada ao uso de 3 infiltracoes realizadas semanalmente de Hylano GF-20.Os pacientes foram avaliados nas variaveis dor em repouso noturna, dor durante movimento com sobrecarga de 10% do peso corporal, dor durante o movimento mais doloroso do joelho afetado com escala visual e a variavel quantidade diaria de diclofenaco potassico ingerida para alivio da dor no joelho afetado. Os resultados estatisticos mostraram melhora significativa em todas as variaveis estudadas nos pacientes do grupo submetidos ao uso de infiltracoes com o Hylano GF-20 no pos-operatorio de artroscopias do joelho por artrose no periodo de 6 meses.