Luciane Fernanda Rodrigues Martinho Fernandes

Correlações entre força de preensão manual e variáveis antropométricas da mão de jovens adultos

O objetivo do estudo foi correlacionar a forca de preensao palmar em diferentes posicoes de abertura, com variaveis antropometricas da mao. Participaram 73 voluntarios de ambos os sexos (40 homens e 33 mulheres), com idade media de 23±4,61 anos. As medidas antropometricas largura da palma, comprimento do dedo indicador, espessura da palma, largura da mao, circunferencia da palma e da mao foram realizadas bilateralmente. Para as medidas lineares, utilizou-se um paquimetro digital e, para as medidas de circunferencia, a fita metrica. As medidas de forca de preensao foram realizadas por meio de um dinamometro hidraulico (UFTM) Jamar®. Os valores antropometricos foram correlacionados com as medidas de forca nas cinco posicoes de abertura. Os homens e as mulheres tiveram maior forca na mao direita e, entre as posicoes, a maior forca dos homens foi na de numero 3 (45,5±15,53 kgf) e das mulheres, na de posicao 2 (25,5±6,28 kgf). Verificaram-se correlacoes significativas entre a forca e os valores antropometricos nas medidas da largura da mao e circunferencia da palma - que representam a maior medida transversal e o maior trofismo da mao, respectivamente, no grupo dos homens e a medida de comprimento do dedo, que representa a maior medida longitudinal no grupo das mulheres. Com isso, pode-se concluir que, para os homens, a maior forca esta relacionada a maior medida transversal e ao maior trofismo da mao e, para as mulheres, ao maior comprimento longitudinal da mao.

Stimulus electrodiagnosis and motor and functional evaluations during ulnar nerve recovery.

BACKGROUND: Distal ulnar nerve injury leads to impairment of hand function due to motor and sensorial changes. Stimulus electrodiagnosis (SE) is a method of assessing and monitoring the development of this type of injury. OBJECTIVE: To identify the most sensitive electrodiagnostic parameters to evaluate ulnar nerve recovery and to correlate these parameters (Rheobase, Chronaxie, and Accommodation) with motor function evaluations. METHOD: A prospective cohort study of ten patients submitted to ulnar neurorrhaphy and evaluated using electrodiagnosis and motor assessment at two moments of neural recovery. A functional evaluation using the DASH questionnaire (Disability of the Arm, Shoulder, and Hand) was conducted at the end to establish the functional status of the upper limb. RESULTS: There was significant reduction only in the Chronaxie values in relation to time of injury and side (with and without lesion), as well as significant correlation of Chronaxie with the motor domain score. CONCLUSION: Chronaxie was the most sensitive SE parameter for detecting differences in neuromuscular responses during the ulnar nerve recovery process and it was the only parameter correlated with the motor assessment.

Correlação entre alterações lombares e modificações no arco plantar em mulheres com dor lombar

Objective: Evaluate the probable relationship among plantar arch, lumbar curvature, and low back pain. Methods: Fifteen healthy women were assessed taking in account personal data and anthropometric measurements, photopodoscopic evaluation of the plantar arch, and biophotogrammetric postural analysis of the patient (both using the SAPO software), as well as evaluation of lumbar pain using a Visual Analog Scale (VAS). The average age of the participants was 30.45 (±6.25) years. Results: Of the feet evaluated, there were six individuals with flat feet, five with high arch, and four with normal feet. All reported algic syndrome in the lumbar spine, with the highest VAS values for the volunteers with high arch. Correlation was observed between the plantar arch and the angle of the lumbar spine (r = -0.71, p = 0.004) Conclusion: High arch was correlated with more intense algic syndrome, while there was moderate positive correlation between flat foot and increased lumbar curvature, and between high arch and lumbar correction. Level of Evidence IV. Case Series.OBJECTIVE : Evaluate the probable relationship among plantar arch, lumbar curvature, and low back pain. METHODS : Fifteen healthy women were assessed taking in account personal data and anthropometric measurements, photopodoscopic evaluation of the plantar arch, and biophotogrammetric postural analysis of the patient (both using the SAPO software), as well as evaluation of lumbar pain using a Visual Analog Scale (VAS). The average age of the participants was 30.45 (±6.25) years. RESULTS : Of the feet evaluated, there were six individuals with flat feet, five with high arch, and four with normal feet. All reported algic syndrome in the lumbar spine, with the highest VAS values for the volunteers with high arch. Correlation was observed between the plantar arch and the angle of the lumbar spine (r = -0.71, p = 0.004) Conclusion: High arch was correlated with more intense algic syndrome, while there was moderate positive correlation between flat foot and increased lumbar curvature, and between high arch and lumbar correction. Level of Evidence IV. Case Series.

Carpal Tunnel Syndrome Mobilization and Segmental Stabilization

Objective: The objective of this study was to assess whether a protocol with an emphasis on motor control techniques consisting of segmental cervical stabilization and neural mobilization have better results in mechanical reorganization and reduction of symptoms when compared with classic therapeutic exercise techniques in the conservative treatment of carpal tunnel syndrome. Methodology: This was a double-blind, randomized pilot study for which we recruited 11 women with an average age of 54 (±6) years, allocated in classical Kinesiotherapy group or control group (CG) and experimental group (EG). A total of 63.6% were away from work. And 45.4% had completed elementary education degree. All volunteers had right dominance, and of them, 10 (90.9%) were diagnosed with carpal tunnel syndrome in both hands, all being treated conservatively, with an average dysfunction duration of 48 (±30) months. Randomization was performed in the presence of all patients and the physiotherapy team, using 15 envelopes distributed randomly on a table. Patients were directed to pick an envelope from the table in a random fashion, mark it with their name, and hand over to a staff member, without opening. Inside each envelope, the assignment to either the CG or EG was identified. Following the opening of envelopes, performed by a member responsible for allocation, the volunteers received information about the routine of intervention. Patients were unaware of the differences in treatment between the groups. To ensure double-blinding, the examiner was unaware of the composition of the groups before making final evaluations. The evaluation of sensitivity, strength, symptoms and function were performed using Semmes-Weinstein monofilaments, grip and pinch dynamometers of E-Link Kit Biometrics®, The Boston Carpal Tunnel Questionnaire (BCTQ), the Disabilities of the Arm, Shoulder and Hand (DASH), and the Patient Rated Wrist Evaluation (PRWE) respectively. Patients performed the treatment program for 12 weeks, at a frequency of twice a week and duration of 60 minutes per session. All treatment protocols were guided and accompanied by 2 previously trained staff members (called “instructors”). Treatment sessions for both groups were performed at the same time, and on the same days, but in different rooms. All patients received a static splint neutrally positioned. The patients of CG received a classic therapeutic exercise program and the patients of EG received an exercise protocol based on motor control principles and neural mobilization of the median nerve and neuraxis. The data showed normal distribution and the Test T Student was used. Results: In the intragroup analysis, we observed a higher gain in grip strength and pinch for the EG, but this gain was not statistically significant. For most variables, the best results were observed in the EG, but without statistical significance. The effect size for objective variables measured by means of instruments was greater than in the variables measured by questionnaires. Conclusion: The proposed protocol group showed better results in mechanical reorganization, reflected in increased strength, sensitivity, and improved functionality when confronted the group with conventional therapeutic exercise, but without the same impact on reducing symptoms.

Carpal tunnel syndrome: mobilization and segmental stabilization

Introducao: Compreende a Sindrome do Tunel do Carpo (STC) uma neuropatia compressiva frequente em mulheres. No tratamento conservador, a enfase e dada ao controle da sintomatologia e ao trajeto nervoso devido a hipotese de dupla compressao. Objetivo: Avaliar se um protocolo com enfase nas tecnicas de controle motor, constituido por estabilizacao segmentar cervical e mobilizacao neural, apresentam melhores resultados na reorganizacao mecânica e reducao dos sintomas quando comparado com tecnicas de cinesioterapia classica. Metodos: Estudo piloto de um ensaio clinico randomizado duplo cego, em 11 mulheres, alocadas em Grupo Cinesioterapia classica (GC), e Grupo Experimental (GE). A intervencao foi de 12 semanas, com avaliacoes no pre e pos, por meio da estesiometria, dinamometria de preensao palmar e aplicacao dos questionarios BCTQ, DASH e PRWE. Resultados: Ambos aumentaram a forca de pinca com alivio da sintomatologia e melhora da funcionalidade. Houve diminuicao da sensibilidade no GC e aumento significativo da forca de preensao palmar no GE. Conclusao: O grupo do protocolo proposto apresentou melhores resultados na reorganizacao mecânica, com reflexo no aumento da forca, da sensibilidade e melhora da funcionalidade, quando confrontado ao grupo com cinesioterapia convencional, porem sem o mesmo impacto para a reducao dos sintomas.

Seguimiento de fatiga de miembros superiores mediante dinamometría electrónica

Objetivou-se identificar parâmetros da dinamometria eletronica de preensao palmar uteis para monitorar diferencas entre individuos treinados (TR) e nao treinados (UT) e entre membros dominantes (DO) e nao dominantes (ND) apos inducao de fadiga pelo teste de 10RM para biceps braquial. Tratou-se de estudo experimental, transversal, envolvendo 18 homens adultos jovens, 9 nao treinados e 9 experientes em treinamento resistido. Avaliou-se a forca isometrica de preensao palmar (por 30 segundos) antes e apos o teste de 10 RM por dinamometro de preensao com celula de carga de precisao modelo G200 (Biometrics(r)). Houve diferenca significativa entre valores iniciais e finais somente para treinados: Pico de forca para TR-DO (67,1 vs 55,5 kgf, p = 0,0277); media bruta para TR-DO (46,96 vs 42,22 kgf, p = 0,0464) e para TR-ND (40,34 vs 36,13 kgf, p = 0,0277). A dinamometria eletronica mostrou-se eficaz em identificar a fadiga de membros superiores nos participantes treinados, sendo a media bruta o melhor parâmetro.El objetivo fue identificar los parametros en la dinamometria electronica de presion palmar para comprobar las diferencias en individuos entrenados (TR) y no entrenados (UT) y en miembros dominantes (DO) y no dominantes (ND) despues de la fatiga inducida por la prueba de 10RM para biceps braquial. Fue estudio experimental, transversal que incluyo 18 hombres adultos jovenes, 9 no entrenados y 9 con experiencia en entrenamiento resistido. La fuerza isometrica de presion palmar (durante 30 segundos) despues de la prueba de 10RM fue evaluada por dinamometro de presion con celula de carga de precision modelo G200 (Biometrics(r)). Fue encontrada significativa entre los valores iniciales y finales solo para el grupo entrenados: fuerza maxima para TR-DO (67,1 vs 55,5 kgf, p = 0,0277); promedio bruto para TR-DO (46,96 vs 42,22 kgf, p = 0,0464) y para TR-ND (40,34 vs 36,13 kgf, p = 0,0277). El dinamometro electronico fue eficaz en la identificacion de la fatiga de los miembros superiores en los participantes entrenados, con el mejor parametro promedio bruto.

Tracking upper limbs fatigue by means of electronic dynamometry

Objetivou-se identificar parâmetros da dinamometria eletronica de preensao palmar uteis para monitorar diferencas entre individuos treinados (TR) e nao treinados (UT) e entre membros dominantes (DO) e nao dominantes (ND) apos inducao de fadiga pelo teste de 10RM para biceps braquial. Tratou-se de estudo experimental, transversal, envolvendo 18 homens adultos jovens, 9 nao treinados e 9 experientes em treinamento resistido. Avaliou-se a forca isometrica de preensao palmar (por 30 segundos) antes e apos o teste de 10 RM por dinamometro de preensao com celula de carga de precisao modelo G200 (Biometrics(r)). Houve diferenca significativa entre valores iniciais e finais somente para treinados: Pico de forca para TR-DO (67,1 vs 55,5 kgf, p = 0,0277); media bruta para TR-DO (46,96 vs 42,22 kgf, p = 0,0464) e para TR-ND (40,34 vs 36,13 kgf, p = 0,0277). A dinamometria eletronica mostrou-se eficaz em identificar a fadiga de membros superiores nos participantes treinados, sendo a media bruta o melhor parâmetro.El objetivo fue identificar los parametros en la dinamometria electronica de presion palmar para comprobar las diferencias en individuos entrenados (TR) y no entrenados (UT) y en miembros dominantes (DO) y no dominantes (ND) despues de la fatiga inducida por la prueba de 10RM para biceps braquial. Fue estudio experimental, transversal que incluyo 18 hombres adultos jovenes, 9 no entrenados y 9 con experiencia en entrenamiento resistido. La fuerza isometrica de presion palmar (durante 30 segundos) despues de la prueba de 10RM fue evaluada por dinamometro de presion con celula de carga de precision modelo G200 (Biometrics(r)). Fue encontrada significativa entre los valores iniciales y finales solo para el grupo entrenados: fuerza maxima para TR-DO (67,1 vs 55,5 kgf, p = 0,0277); promedio bruto para TR-DO (46,96 vs 42,22 kgf, p = 0,0464) y para TR-ND (40,34 vs 36,13 kgf, p = 0,0277). El dinamometro electronico fue eficaz en la identificacion de la fatiga de los miembros superiores en los participantes entrenados, con el mejor parametro promedio bruto.

Rastreamento de fadiga de membros superiores por meio da dinamometria eletrônica

Objetivou-se identificar parâmetros da dinamometria eletronica de preensao palmar uteis para monitorar diferencas entre individuos treinados (TR) e nao treinados (UT) e entre membros dominantes (DO) e nao dominantes (ND) apos inducao de fadiga pelo teste de 10RM para biceps braquial. Tratou-se de estudo experimental, transversal, envolvendo 18 homens adultos jovens, 9 nao treinados e 9 experientes em treinamento resistido. Avaliou-se a forca isometrica de preensao palmar (por 30 segundos) antes e apos o teste de 10 RM por dinamometro de preensao com celula de carga de precisao modelo G200 (Biometrics(r)). Houve diferenca significativa entre valores iniciais e finais somente para treinados: Pico de forca para TR-DO (67,1 vs 55,5 kgf, p = 0,0277); media bruta para TR-DO (46,96 vs 42,22 kgf, p = 0,0464) e para TR-ND (40,34 vs 36,13 kgf, p = 0,0277). A dinamometria eletronica mostrou-se eficaz em identificar a fadiga de membros superiores nos participantes treinados, sendo a media bruta o melhor parâmetro.El objetivo fue identificar los parametros en la dinamometria electronica de presion palmar para comprobar las diferencias en individuos entrenados (TR) y no entrenados (UT) y en miembros dominantes (DO) y no dominantes (ND) despues de la fatiga inducida por la prueba de 10RM para biceps braquial. Fue estudio experimental, transversal que incluyo 18 hombres adultos jovenes, 9 no entrenados y 9 con experiencia en entrenamiento resistido. La fuerza isometrica de presion palmar (durante 30 segundos) despues de la prueba de 10RM fue evaluada por dinamometro de presion con celula de carga de precision modelo G200 (Biometrics(r)). Fue encontrada significativa entre los valores iniciales y finales solo para el grupo entrenados: fuerza maxima para TR-DO (67,1 vs 55,5 kgf, p = 0,0277); promedio bruto para TR-DO (46,96 vs 42,22 kgf, p = 0,0464) y para TR-ND (40,34 vs 36,13 kgf, p = 0,0277). El dinamometro electronico fue eficaz en la identificacion de la fatiga de los miembros superiores en los participantes entrenados, con el mejor parametro promedio bruto.