Juliana Alves Souza

Impact of the mouth breathing occurred during childhood in the adult age: Biophotogrammetric postural analysis

OBJECTIVE This study aims to evaluate the impact of the mouth breathing occurred during childhood on the body posture in the adult age. METHODS 24 adults, of both genders, aged from 18 to 30 years old with report of clinical manifestations of mouth breathing during the childhood composed the study group (SG). The control group (CG) was composed by 20 adults in the same age, without any respiratory problem since the childhood up to the present time. All the volunteers underwent a physiotherapeutic evaluation consisted of anamnesis and postural biophotogrammetry (SAPo v 0.68(®)). The comparison between the data of the SG and CG was accomplished by Students t-test. RESULTS The biophotogrammetric analysis demonstrated that the SG showed more forward head posture confirmed by the angles A9 (p = 0.0000) and CL (p = 0.0414) and also by the cervical distance (p = 0.0079). Additionally, this group presented a larger angular measure of the lumbar lordosis (p = 0.0141) compared to the CG. CONCLUSION The results indicate that adults with mouth-breathing childhood have postural alterations, mainly in the head and lumbar column, which keeps for the whole life.

Temporomandibular disorder and generalized joint hypermobility: application of diagnostic criteria

UNLABELLED Generalized joint hypermobility (GJH) has been considered a predisposing factor for the development of temporomandibular disorder (TMD). AIM To evaluate clinical and psychosocial aspects in individuals diagnosed with TMD with or without GJH. MATERIALS AND METHODS Clinical and experimental study, which enrolled 34 women, from 18 to 35 years of age with TMD diagnosed by RDC/TMD. The GJH was assessed by the Beighton score and volunteers were broken down into 2 groups: with GJH (n = 22) and without GJH (n = 12). RESULTS We found a high percentage of GJH (64. 71%). All participants had myofascial pain; 79. 41% had arthralgia and 41% had disk displacement. There was a correlation between higher GJH scores and higher passive mouth opening amplitude (p = 0.0034), with pain (p = 0.0029) and without pain (p = 0.0081). Greater mandibular range of motion was observed in the group with GJH, except for protrusion. Painful mouth opening was statistically higher in the GJH group (p = 0.0279). CONCLUSIONS Individuals with TMD associated or not to GJH do not differ significantly regarding clinical and psychosocial aspects, except in the mandibular opening range of motion, which if kept at physiological levels can lead to a late diagnosis of TMD in these individuals.Generalized joint hypermobility (GJH) has been considered a predisposing factor for the development of temporomandibular disorder (TMD). Aim: To evaluate cli...

Tipo facial e postura de cabeça de crianças respiradoras nasais e orais

PURPOSE: To verify the facial type and the head posture of nasal and mouth-breathing children from habitual and obstructive etiologies, as well as to correlate the morphological facial index to the head angulation position in the sagittal plane. METHODS: Participants were59 children with ages between 8 years and 11 years and 10 months. All subjects were undergone to speech-language pathology screening, otorhynolaryngologic evaluation, and nasopharyngoscopy, allowing the constitution of three groups: nasal breathers - 15 children; mouth breathers from obstructive etiology - 22 children; and habitual mouth breathers - 22 children. In order to determine facial type and morphological facial index, the height and the width of the face were measured using a digital caliper. The head posture was assessed through physical examination and computerized photogrammetry. RESULTS: It was verified the predominance of short face in nasal breathers, and long face in mouth breathers. There was an association among facial type and breathing mode/mouth breathing etiology: the brachyfacial type was more frequent among nasal breathers, and less frequent in subjects with obstructive nasal breathing. Head posture was similar in all three groups. No correlation was found between morphological facial index and head posture. CONCLUSION: The brachyfacial type favors the nasal-breathing mode and the head posture is not influenced by breathing mode and by the etiology of mouth breathing, as well as it is not related to facial type.

Global body posture and plantar pressure distribution in individuals with and without temporomandibular disorder: a preliminary study.

OBJECTIVE The aim of this study was to evaluate body posture and the distribution of plantar pressure at physiologic rest of the mandible and during maximal intercuspal positions in subjects with and without temporomandibular disorder (TMD). METHODS Fifty-one subjects were assessed by the Diagnostic Criteria for Research on Temporomandibular Disorders and divided into a symptomatic group (21) and an asymptomatic group (30). Postural analysis for both groups was conducted using photogrammetry (SAPo version 0.68; University of São Paulo, São Paulo, Brazil). The distribution of plantar pressures was evaluated by means of baropodometry (Footwork software), at physiologic rest and maximal intercuspal positions. RESULTS Of 18 angular measurements, 3 (17%) were statistically different between the groups in photogrammetric evaluation. The symptomatic group showed more pronounced cervical distance (P = .0002), valgus of the right calcaneus (P = .0122), and lower pelvic tilt (P = .0124). The baropodometry results showed the TMD subjects presented significantly higher rearfoot and lower forefoot distribution than those in the asymptomatic group. No differences were verified in maximal intercuspal position in the between-group analysis and between the 2 mandibular positions in the within-group analysis. CONCLUSIONS Subjects with and without TMD presented with global body posture misalignment. Postural changes were more pronounced in the subjects with TMD. In addition, symptomatic subjects presented with abnormal plantar pressure distribution, suggesting that TMD may have an influence on the postural system.

ESTUDO DA POSTURA CORPORAL EM CRIANÇAS COM RESPIRAÇÃO PREDOMINANTEMENTE ORAL E ESCOLARES EM GERAL

Objetivo: avaliar a postura de respiradores predominantemente orais e comparar com achados, descritos na literatura, de escolares em geral. Metodos: a amostra foi composta por 30 escolares, respiradores orais, que foram submetidos a avaliacao postural subjetiva com analise da simetria e do posicionamento das estruturas, nas vistas anterior, posterior e lateral. Os achados obtidos foram comparados aos descritos na literatura sobre a postura corporal de escolares em geral. Resultados: na vista anterior predominou a elevacao do ombro direito, flexao de cotovelo e dedos. Na vista posterior, observou-se abducao e elevacao das escapulas e rotacao dos joelhos. E, na vista lateral, anteriorizacao da cabeca, protrusao e rotacao interna de ombros. Na literatura revisada predominaram: semiflexao de joelhos, protrusao de ombros, hiperlordose lombar. Conclusao: o modo respiratorio e essencial no equilibrio postural de criancas em idade escolar. Algumas alteracoes sao proprias do desenvolvimento postural normal, pois apareceram em ambos os grupos.

COLETA DE SECREÇÃO TRAQUEAL: ESTUDO COMPARATIVO DE TÉCNICAS

Objective: The objective of this study is to compare, by means of microbiological analysis, two techniques of tracheal aspirates in intubated or tracheostomized patients. Methodology: The study was conducted from May to June 2012, in HUSM at UFSM, becoming an experimental study, qualitative and quantitative, comparative trial. There were two data collection techniques in each hipersecretive patient, intubated or tracheostomized, requiring analysis of secretion, with the same random order. In technique 1 the secretion was aspirated until probe was with a sufficient amount of secretion, after the aspiration tube was cut with sterile scissors, into small pieces within the sterile flask. In technique 2, when the probe had a sufficient amount of secretion, it was clamped, the extender was disconnected and connected to the suction end of the oxygen flow meter. Following, the probe tip was placed into a sterile collection vial while the flow meter was connected to 15 l / min so that the secretion present inside the tube is pushed into the pot. Results: The bacteria most commonly found in the Intensive Care Unit were Pseudomonas aeruginosa (13.64%) and Acinetobacter baumannii (13.64%) also had the presence of Candida spp (18.18%). The relationship between both techniques is equal (Kappa coefficient), both as a Gram stain for bacteria. Conclusion: The microbiological analysis showed that the collection techniques with the tracheal secretion tube and cut the flow of oxygen are equivalent. Soon both can be used in hospital routine. Keywords: Infection, Artificial Respiration, Microbiological Analysis

Atividade elétrica dos músculos cervicais e amplitude de movimento da coluna cervical em indivíduos com e sem DTM

O objetivo da pesquisa foi avaliar a atividade eletrica e a dor a palpacao dos musculos cervicais, a amplitude de movimento (ADM) da coluna cervical e a relacao entre atividade eletrica e ADM cervical em individuos com e sem desordem temporomandibular (DTM). Participaram do estudo 53 voluntarios, sendo 24 com DTM e 29 sem, de ambos os generos, com 18 a 32 anos de idade. A DTM foi diagnosticada pelo criterio de diagnostico em pesquisa para DTM (Research Diagnostic Criteria for Temporomandibular Disorders). A eletromiografia dos musculos esternocleidomastoideo (ECOM) e trapezio superior foi realizada bilateralmente, na situacao de repouso, com frequencia de 2 KHz e filtro passa-faixa de 10-1000 Hz. As medidas de ADM de flexao, extensao, lateroflexao e rotacao foram realizadas com um fleximetro e a comparacao entre os grupos contou com o teste de Mann Whitney. O teste de Spearman foi aplicado para a correlacao entre as variaveis, com nivel de significância de 5%. Nao foi verificada nenhuma diferenca na ADM cervical entre os grupos. A atividade eletrica demonstrou-se significativamente maior nos musculos ECOM direito (p=0,0130), trapezio superior direito (p=0,0334) e esquerdo (p=0,0335) no grupo DTM em relacao ao grupo controle. Nao houve correlacao significante entre atividade eletrica e ADM cervical. A dor nos musculos cervicais apresentou-se significativamente maior apenas no musculo ECOM direito (p=0,0055). Conclui-se que os grupos estudados registraram diferenca na atividade eletrica dos musculos cervicais, sendo esta maior em individuos com DTM.

Evaluation of functionality and quality of life in critical patients: case series report

7 ABSTRACT Hospitalization in Intensive Care Unit (ICU) usually results in decreased functionality and quality of life. Risk long-term sequelae may result from factors related to disease, treatment performed and time staying in bed. Objective: To evaluate the functionality and quality of life of patients who received physiotherapy in the ICU and correlate these variables after 30 days of discharge. Methods: A case series report study was conducted with 15 patients. Evaluation of functionality by the Functional Independence Measure FIM (before ICU, at immediate release and after 30 days), evaluation of quality of life by Short-Form (SF-36) Health Survey (after 30 days). Results: The mean age was 43.20 ± 16.92 years, predominant causes of hospitalization were neurological, mechanical ventilation time was 14 (9-14) days and ICU 15.80 ± 7.16 days and all had complications. Before the ICU the patients were with full or modified independence (FIM 1=126), after discharge there was a decline to modified dependence (FIM 2=48) and after 30 days there was improvement, but functionality continued as modified dependence (FIM 3=92). The functionality areas like self-care, mobility and locomotion had major changes after the ICU and a significant improvement at 30 days; sphincter control, communication and social cognition had minor changes after the ICU and after 30 days the values approached the previous ones. The quality of life was affected 30 days after discharge with reduction in scores for all areas, the most affected ones were functional capacity, limitation by physical aspects, pain and social aspects. There were positive correlations between the areas of sphincters control, mobility and mobility (functionality) and functional capacity (quality of life). Conclusion: ICU negatively affected the functionality, especially at immediate release. After 30 days, there was an improvement, in part, that can be attributed to physical therapy, because all patients received this treatment in the ICU and many continued it after discharge. However, some deficits still remained, also affecting their quality of life.

Distribuição da pressão plantar e morfologia do pé de crianças com paralisia cerebral e crianças com desenvolvimento típico

Cerebral Palsy (CP) is characterized as movement and posture disorders that cause performance limitations in activities easily performed by children with typical development (TD). Our study aimed to compare plantar pressure distribution and foot morphology between children with CP and TD, using an observational analytical research, of cross-sectional and comparative type, with 32 children between 6 and 11 years old, paired by gender and age, distributed in study group (SG) and control group (CG). We assessed the plantar distribution with the Footwork electronic baropodometry system and classified foot type by the Chippaux-Smirak Index. The SG obtained greater values on anterior weight-bearing and lower on posterior weight-bearing (p=0.02). In addition, SG showed lower mean pressure values for right (p=0.00) and left feet (p=0.01), when compared with the CG. Most children showed the same type of foot bilaterally, with the prevalence of flat feet in SG and cavus feet in the CG. Children with spastic CP who presented preserved locomotor performance, or with some dysfunction, revealed antepulsion posture, smaller mean plantar pressures, and flat foot prevalence when compared with children with TD.

Distribution of plantar pressure and body posture in spastic cerebral palsy

Introduction: cerebral palsy (CP) describes a group of permanent disorders of movement and posture due to a non-progressive disorder that occurs during the fetal or infant brain, may contribute to limitations in the functionality. Objective: to investigate the distribution of plantar pressures and the body posture in spastic CP. Methods: a descriptive case series study conducted at the Sector Outpatient Pediatric Rehabilitation Neurofunctional the University Hospital of Santa Maria - RS. Seven children with spastic CP, level I and II were included in the Gross Motor Function Classification System. Plantar pressures were analyzed using a baropodometry system – Footwork - and the type of the foot was calculated by index-ChipauxSmirak. Postural alignment was assessed subjectively in anteroposterior and lateral views. Data were analyzed using descriptive statistics. Results: The asymmetric distribution of plantar pressures were evidenced in hemiparetic, diparetic and quadripareticos PC evaluated and the prevalence of flat foot occurred. The most frequent postural changes were the forward and head tilt, elevation, tilt and protrusion of shoulder, cervical and lumbar lordosis, thoracic kyphosis, the anterversion and unevenness of the hip and pronation of the feet. Conclusions: In this group of children plantar pressures and posture proved to be altered. These findings may influence the prognosis of deformities and functional rehabilitation outcomes. The use of photometry and baropodometry may assist in a more efficient therapeutic intervention.