Juliana Corrêa Soares

Cervical spine dysfunction signs and symptoms in individuals with temporomandibular disorder

PURPOSE To study the frequency of cervical spine dysfunction (CCD) signs and symptoms in subjects with and without temporomandibular disorder (TMD) and to assess the craniocervical posture influence on TMD and CCD coexistence. METHODS Participants were 71 women (19 to 35 years), assessed about TMD presence; 34 constituted the TMD group (G1) and 37 comprised the group without TMD (G2). The CCD was evaluated through the Craniocervical Dysfunction Index and the Cervical Mobility Index. Subjects were also questioned about cervical pain. Craniocervical posture was assessed by cephalometric analysis. RESULTS There was no difference in the craniocervical posture between groups. G2 presented more mild CCD frequency and less moderate and severe CCD frequency (p=0.01). G1 presented higher percentage of pain during movements (p=0.03) and pain during cervical muscles palpation (p=0.01) compared to G2. Most of the TMD patients (88.24%) related cervical pain with significant difference when compared to G2 (p=0.00). CONCLUSION Craniocervical posture assessment showed no difference between groups, suggesting that postural alterations could be more related to the CCD. Presence of TMD resulted in higher frequency of cervical pain symptom. Thus the coexistence of CCD and TMD signs and symptoms appear to be more related to the common innervations of the trigeminocervical complex and hyperalgesia of the TMD patients than to craniocervical posture deviations.

Mastigação e deglutição em mulheres jovens com desordem temporomandibular

PURPOSE To evaluate chewing and swallowing functions in women with and without temporomandibular disorder (TMD) and investigate the position of the mandible and the hyoid bone as they are important structures in the development of these functions. METHODS Seventy women were evaluated in relation to TMD diagnosis according to the Research Diagnostic Criteria, among them, 34 composed the study group (SG) with TMD and 36 took part in the control group (CG). Evaluation of the masticatory and swallowing functions was performed according to the Protocol of Orofacial Myofunctional Evaluation with Scores. Mandibular and hyoid bone position variables were measured by cephalometric analysis. RESULTS TMD subjects showed a significant difference on tongue (p=0.03) and lip (p=0.04) posture during swallowing function, and a more frequent adoption of a chronic unilateral chewing pattern as well (p=0.03). Moreover, they presented a lower position of the hyoid bone in relation to the mandible (p=0,00). CONCLUSION TMD presence resulted on a higher frequency of myofunctional alterations during masticatory and swallowing functions. A greater distance from hyoid bone to the mandible in addition with the presence of painful symptom can justify, partly, the atypical behaviors of the tongue and lips observed on TMD group. The TMD repercussion on alimentaires functions in a young age group justifies the importance of an earlier diagnosis and therapeutic intervention in these individuals.

Efeitos de duas técnicas de incentivo respiratório na mobilidade toracoabdominal após cirurgia abdominal alta

Upper abdominal surgery is associated to increased risk of pulmonary complications, which may be lessened by judicious use of therapeutic maneuvers aimed at lung expansion. The purpose here was to compare two respiratory incentive techniques on recovery of thoracic-abdominal dynamics in patients having undergone upper abdominal surgery. Sixteen patients in such condition were randomly divided into group 1 (n=10), who did respiratory training with the Voldyne device, and group 2 (n=6), submitted to a split-inspiration pattern training. Chest wall expansion was rated by measuring thorax circumferences before surgery and on the 1st, 3rd, and 5th post-operative (PO) days. In both groups a significant decrease was found in circumference values on the 1st PO day, which gradually recovered, until on the 5th PO day no significant differences were found as compared to pre-operative measures. Group 1 showed significantly better thoracic-abdominal expansion rates than group 2s, as well as higher recovery time rates all through. Though both breathing techniques used were effective, inspiratory incentive using the Voldyne device showed better results in recovering chest mobility after upper abdominal surgery.

Diaphragmatic amplitude and accessory inspiratory muscle activity in nasal and mouth-breathing adults: A cross-sectional study

The purpose of this study was to evaluate the electromyographic activity of the accessory inspiratory muscles and the diaphragmatic amplitude (DA) in nasal and mouth-breathing adults. The study evaluated 38 mouth-breathing (MB group) and 38 nasal-breathing (NB group) adults, from 18 to 30years old and both sexes. Surface electromyography (sEMG) was used to evaluate the amplitude and symmetry (POC%) of the sternocleidomastoid (SCM) and upper trapezius (UT) muscles at rest, during nasal slow inspiration at Lung Total Capacity (LTC) and, during rapid and abrupt inspiration: Sniff, Peak Nasal Inspiratory Flow (PNIF) and Maximum Inspiratory Pressure (MIP). M-mode ultrasonography assessed the right diaphragm muscle amplitude in three different nasal inspirations: at tidal volume (TV), Sniff and inspiration at LTC. The SCM activity was significantly lower in the MB group during Sniff, PNIF (p<0.01, Mann-Whitney test) and MIP (p<0.01, t-test). The groups did not differ during rest and inspiration at LTC, regarding sEMG amplitude and POC%. DA was significantly lower in the MB group at TV (p<0.01, Mann-Whitney) and TLC (p=0.03, t-test). Mouth breathing reflected on lower recruitment of the accessory inspiratory muscles during fast inspiration and lower diaphragmatic amplitude, compared to nasal breathing.

Correlação entre postura da cabeça, intensidade da dor e índice de incapacidade cervical em mulheres com queixa de dor cervical

Neck pain is the most common symptom of cervical dysfunctions often being related to the maintenance of postures. Postural changes of the head are often associated with the occurrence of neck pain with an anterior approach was the most frequent. The purpose was to investigate the correlation between head posture, pain intensity and neck disability index. The study group (SG) was composed of women, aged between 20 and 50 years who complained of neck pain for more than three months, and the control group (CG) for asymptomatic women. Pain intensity was assessed by visual analogue scale (VAS), disability by neck disability index (NDI) and the head posture by the craniovertebral angle (CV). Normality of the data was verified by the Lilliefors test and the comparison between groups by the Students t-test for independent samples, and the association between variables by Spearman correlation test. Significance level was 5%. The SG had lower average CV for the angle (p=0.02). The CV angle was negatively correlated with the VAS (r=-0.48) and NDI (r=-0.15) suggesting that the smaller the angle, the greater the intensity of neck pain and disability. The NDI and VAS showed a positive correlation (r=0.59). The angle CV in subjects with neck pain was significantly lower than in healthy individuals association with the neck disability index and pain.

Equilíbrio corporal em crianças e adolescentes asmáticos e não asmáticos

The aim of this study was analyze and compare the balance in children and teenagers with and without asthma. Twenty-four subjects aging between 7 and 14 years old took part in this study divided into two groups: asthmatic group and control group. To evaluate the balance one force plate was used. Opened and closed eyes conditions were evaluated in three trials of 30 seconds each. The results showed significant differences between groups in opened eyes condition, with higher amplitude of displacement in the anterior-posterior direction (COPap) (p = 0,04), and medio-lateral direction (COPml) (p = 0, 02) in the asthmatic group. Whereas in closed eyes condition the difference was significant only in the amplitude of displacement in the anterior-posterior direction (COPap) (p= 0,02) and Ellipse Area higher (p = 0,03) in the asthmatic group. Therefore, asthma with its limitations and consequences seems to have a negative effect on postural balance of their patients when compared with normal children of similar age.

AVALIAÇÃO DA FORÇA MUSCULAR DE DIFERENTES POPULAÇÕES: UMA REVISÃO DE LITERATURA

Introduction: Muscle strength (MS) is the systems ability to produce skeletal muscle tension and torque. This is essential for daily living tasks and sporting activities. MS values are used to identify individuals at risk for musculoskeletal injuries and can also serve to evaluate physical fitness for sports practice, which makes it an important measure. Objective: To investigate the methods used for quantitative assessment of MS. Material and Methods: we performed bibliographic searches in the electronic database Scielo of articles published between 2007 and 2011. The descriptors “Muscle strength” and “forca muscular” were used in the searches of originals articles in Portuguese and English investigating quantitative MS of lower and upper limbs. A total of 37 articles were analyzed. Results: Among the studies analyzed, there was a heterogeneity regarding the MS procedure. The most commonly used MS assessment method was the dynamometer, followed by the test of 1 maximum repetition (MR) and 10 MR tests. Conclusion: The mostly used methods for MS quantitative assessment was the dynamometer and 1 MR test. However, it was not possible to establish a standard method to assess MS. DESCRIPTORS Muscle Strength, Biomechanics, Physical Therapy Specialty, Muscle Strength Dynamometer.

Efeitos de um teste incremental de caminhada na marcha de indivíduos com Doença Pulmonar Obstrutiva Crônica

The objective of this study was to evaluate the functionality of gait and cardiorespiratory parameters in individuals with chronic obstructive pulmonary disease (COPD), before and after a walk test, in order to allow the development of strategies, aimed at maintaining autonomy and preservation of independence. In this study, were included individuals with COPD, aged between 50 to 80 years, and excluded those with orthopedic, neurological and cardiac problems, or any condition that would prevent the assessments proposed in this study. The variables measured were:1st peak force, mid peak low and 2nd peak force, time of 1st double support, the swing moment and 2nd double support; single support time, stride length and stride, speed and time gait cycle, heart rate, oxygen saturation and dyspnea/tiredness score, pre and post-test. The sample consisted of 14 individuals (8 females and 6 males), mean age 65.21±9.42 years. In the post-test patients had greater sensation of dyspnea / fatigue, increased speed and reduced time of the gait cycle, increase the 1st peak force and reduction of the mid peak low, reduction the time the 1st double support and the time of the 1st peak force. The physical effort had influenced the gait pattern and cardiorespiratory parameters in this group of individuals with COPD.O objetivo do estudo foi avaliar o padrao da marcha e os parâmetros cardiorrespiratorios em individuos com doenca pulmonar obstrutiva cronica (DPOC), antes e apos um teste de caminhada, para permitir o desenvolvimento de estrategias visando a manutencao da autonomia e preservacao da independencia. Foram incluidos individuos com DPOC, com idade entre 50 e 80 anos, e excluidos os com problemas ortopedicos, neurologicos, cardiacos, ou qualquer condicao que inviabilizasse as avaliacoes propostas neste estudo. As variaveis aferidas foram: 1o pico de forca, vale e 2o pico de forca; tempo do 1o duplo apoio, da fase de balanco e do 2o duplo apoio; tempo de apoio simples, comprimento do passo e da passada, velocidade e tempo do ciclo da marcha, frequencia cardiaca, saturacao periferica de oxigenio e escore dispneia/cansaco, nos periodos pre e pos-teste. A amostra foi constituida por 14 individuos (8 do sexo feminino e 6 do sexo masculino), media de idade de 65,21±9,42 anos. No pos-teste os individuos apresentaram maior sensacao de dispneia/cansaco; aumento da velocidade e reducao do tempo do ciclo da marcha; aumento do 1o pico de forca e reducao do vale; reducao do tempo do 1o duplo apoio e do tempo do 1o pico de forca. O esforco fisico influenciou o padrao de marcha e os parâmetros cardiorrespiratorios neste grupo de individuos com DPOC.

Effects of an incremental walking test in the gait of individuals with Chronic Obstructive Pulmonary Disease

The objective of this study was to evaluate the functionality of gait and cardiorespiratory parameters in individuals with chronic obstructive pulmonary disease (COPD), before and after a walk test, in order to allow the development of strategies, aimed at maintaining autonomy and preservation of independence. In this study, were included individuals with COPD, aged between 50 to 80 years, and excluded those with orthopedic, neurological and cardiac problems, or any condition that would prevent the assessments proposed in this study. The variables measured were:1st peak force, mid peak low and 2nd peak force, time of 1st double support, the swing moment and 2nd double support; single support time, stride length and stride, speed and time gait cycle, heart rate, oxygen saturation and dyspnea/tiredness score, pre and post-test. The sample consisted of 14 individuals (8 females and 6 males), mean age 65.21±9.42 years. In the post-test patients had greater sensation of dyspnea / fatigue, increased speed and reduced time of the gait cycle, increase the 1st peak force and reduction of the mid peak low, reduction the time the 1st double support and the time of the 1st peak force. The physical effort had influenced the gait pattern and cardiorespiratory parameters in this group of individuals with COPD.O objetivo do estudo foi avaliar o padrao da marcha e os parâmetros cardiorrespiratorios em individuos com doenca pulmonar obstrutiva cronica (DPOC), antes e apos um teste de caminhada, para permitir o desenvolvimento de estrategias visando a manutencao da autonomia e preservacao da independencia. Foram incluidos individuos com DPOC, com idade entre 50 e 80 anos, e excluidos os com problemas ortopedicos, neurologicos, cardiacos, ou qualquer condicao que inviabilizasse as avaliacoes propostas neste estudo. As variaveis aferidas foram: 1o pico de forca, vale e 2o pico de forca; tempo do 1o duplo apoio, da fase de balanco e do 2o duplo apoio; tempo de apoio simples, comprimento do passo e da passada, velocidade e tempo do ciclo da marcha, frequencia cardiaca, saturacao periferica de oxigenio e escore dispneia/cansaco, nos periodos pre e pos-teste. A amostra foi constituida por 14 individuos (8 do sexo feminino e 6 do sexo masculino), media de idade de 65,21±9,42 anos. No pos-teste os individuos apresentaram maior sensacao de dispneia/cansaco; aumento da velocidade e reducao do tempo do ciclo da marcha; aumento do 1o pico de forca e reducao do vale; reducao do tempo do 1o duplo apoio e do tempo do 1o pico de forca. O esforco fisico influenciou o padrao de marcha e os parâmetros cardiorrespiratorios neste grupo de individuos com DPOC.

Efectos de un test adicional de caminada en la marcha de individuos con Enfermedad Pulmonar Obstructiva Crónica

The objective of this study was to evaluate the functionality of gait and cardiorespiratory parameters in individuals with chronic obstructive pulmonary disease (COPD), before and after a walk test, in order to allow the development of strategies, aimed at maintaining autonomy and preservation of independence. In this study, were included individuals with COPD, aged between 50 to 80 years, and excluded those with orthopedic, neurological and cardiac problems, or any condition that would prevent the assessments proposed in this study. The variables measured were:1st peak force, mid peak low and 2nd peak force, time of 1st double support, the swing moment and 2nd double support; single support time, stride length and stride, speed and time gait cycle, heart rate, oxygen saturation and dyspnea/tiredness score, pre and post-test. The sample consisted of 14 individuals (8 females and 6 males), mean age 65.21±9.42 years. In the post-test patients had greater sensation of dyspnea / fatigue, increased speed and reduced time of the gait cycle, increase the 1st peak force and reduction of the mid peak low, reduction the time the 1st double support and the time of the 1st peak force. The physical effort had influenced the gait pattern and cardiorespiratory parameters in this group of individuals with COPD.O objetivo do estudo foi avaliar o padrao da marcha e os parâmetros cardiorrespiratorios em individuos com doenca pulmonar obstrutiva cronica (DPOC), antes e apos um teste de caminhada, para permitir o desenvolvimento de estrategias visando a manutencao da autonomia e preservacao da independencia. Foram incluidos individuos com DPOC, com idade entre 50 e 80 anos, e excluidos os com problemas ortopedicos, neurologicos, cardiacos, ou qualquer condicao que inviabilizasse as avaliacoes propostas neste estudo. As variaveis aferidas foram: 1o pico de forca, vale e 2o pico de forca; tempo do 1o duplo apoio, da fase de balanco e do 2o duplo apoio; tempo de apoio simples, comprimento do passo e da passada, velocidade e tempo do ciclo da marcha, frequencia cardiaca, saturacao periferica de oxigenio e escore dispneia/cansaco, nos periodos pre e pos-teste. A amostra foi constituida por 14 individuos (8 do sexo feminino e 6 do sexo masculino), media de idade de 65,21±9,42 anos. No pos-teste os individuos apresentaram maior sensacao de dispneia/cansaco; aumento da velocidade e reducao do tempo do ciclo da marcha; aumento do 1o pico de forca e reducao do vale; reducao do tempo do 1o duplo apoio e do tempo do 1o pico de forca. O esforco fisico influenciou o padrao de marcha e os parâmetros cardiorrespiratorios neste grupo de individuos com DPOC.