Roberto Sérgio de Tavares Canto

Postural alterations in children with mouth breathing assessed by computerized biophotogrammetry.

OBJECTIVES To determine and compare the posture of children with obstructive (OMB) and functional mouth breathing (FMB) and children with nasal breathing (NB) using computerized biophotogrammetry, as well as to determine the viability and efficacy of this method. METHODS Evaluative and personalized methods were used for the capture and analysis of angle images obtained from 19 NB, 26 FMB and 17 OMB children of either gender aged 8 to 10 years on anterior, posterior and profile views. The nonparametric Kruskal-Wallis test was applied to analyze the three groups as a whole and the Mann-Whitney test was used for pairwise comparison of the groups (p = 0.05). RESULTS The angle related to the lateral knee condyle, lateral ankle malleolus and 5th metatarsal diaphysis (KAM) was significantly greater in NB than in FMB children. With respect to the angle related to the nasal external acoustic meatus and pogonion (GMM), nasal external acoustic meatus and manubrium (GME), and 2nd cervical vertebra, major cervical curvature point and 7th cervical vertebra (C2C7), significantly higher values were observed for the OMB group compared to NB children. The angle formed by the 2nd thoracic vertebra, the major prominent thoracic point and the 9th thoracic vertebra (T2T9) was significantly greater in FMB than in OMB children. CONCLUSIONS Computerized biophotogrammetry was found to e a safe and reliable technique, allowing comparison between the children analyzed, as well as the detection of postural alterations in mouth breathing children.

Avaliação do equilíbrio estático em indivíduos amputados de membros inferiores através da biofotogrametria computadorizada

Background: To accomplish day-to-day functional activities, it is fundamentally important to maintain static balance, thereby enabling appropriate postures, movements and responses. Objective: The purpose of this study was to evaluate oscillations in static balance among amputees with lower limb prostheses, by means of an adapted Romberg test, and to compare such oscillations with those among individuals without amputations. Method: Thirty-three male individuals of mean age 33.38 years were evaluated, in three different groups. Group A was composed of 12 amputees who were utilizing a transfemoral prosthesis. Group B was formed by 9 individuals with a transtibial amputation. Group C (control) contained 12 normal individuals. All subjects were filmed in the frontal and sagittal planes, and their movements were evaluated frame by frame to select the moments of greatest oscillation. The images selected were quantified by means of computerized biophotogrammetry using the program ALCimage 2.1®. Results: The results showed significant differences among the anterior oscillations for the group A and among the left-side oscillations for group B. Conclusion: From these results, it was concluded that lower-limb amputees present a tendency towards more significant oscillations in the anterior direction and contralaterally to the prosthesis. With advancing age, a lesser tendency towards posterior oscillation was noted.

Evaluation of the health-related quality of life in elderly patients according to the type of hip fracture: femoral neck or trochanteric

OBJECTIVE To evaluate the effect the type of hip fracture (femoral neck or trochanteric) has on the Health-Related Quality of Life of elderly subjects. METHODS Forty-five patients with hip fractures (mean 74.30 +/- 7.12 years), 24 with a femoral neck fracture and 21 with a trochanteric fracture, completed the 36-item Short Form Health Survey (SF-36) at baseline and four months after fracture. The Health-Related Quality of Life scores were compared according to fracture type, undisplaced and displaced femoral neck fractures, and stable and unstable trochanteric fractures. RESULTS Compared to baseline, all patients scored lower in the physical functioning, role limitation-physical, bodily pain and vitality categories four months after the fracture had occurred. The SF-36 scores for all the scales did not differ significantly between patients with femoral neck versus trochanteric fractures, or between patients with displaced versus undisplaced femoral neck fractures and stable versus unstable trochanteric fractures. CONCLUSIONS The mental and physical quality of life of elderly patients with a hip fracture is severely impaired one month after fracture, with partial recovery by the end of the fourth month. The negative impact on the Health-Related Quality of Life did not differ significantly according to fracture type.

Avaliação da concavidade lombar pelo método radiográfico e pela cifolordometria

BACKGROUND: Clinical evaluation is the basis for making decisions regarding treatments. When radiographic images cannot be obtained, few resources allow physical therapists to quantitatively evaluate an individuals condition. One of these is the kypholordometer, a low-cost noninvasive instrument proposed for measuring spinal curvature in the sagittal plane. OBJECTIVES: To evaluate the intra- and inter-examiner reliability of the kypholordometer, to investigate its agreement with radiography, and to determine whether there is any correlation between measurements of lumbar curvature using the radiographic method and the kypholordometer. METHODS: Twenty healthy individuals of both sexes aged between 21 and 27 years were evaluated. They underwent radiographic examination of the lumbar spine in right lateral view while standing up. The radiographic images were evaluated by a radiologist using Cobbs method, with T12 and S1 as the reference points. The kypholordometry was carried out in the same position by three evaluators on two occasions, with the same vertebrae as the reference points. A straight line was drawn from T12 to the least prominent vertebra and another from S1 to the same vertebra, thus identifying the degree of lumbar concavity. RESULTS: The results demonstrated that kypholordometry presented excellent levels of reliability (both intra- and inter-examiner), but low agreement with radiography. However, there was a statistically significant positive correlation between the two methods studied (r=0.88). CONCLUSION: Kypholordometry is a quantitative method with excellent intra- and inter-examiner reliability for evaluating lumbar curvature. It may contribute greatly towards the clinical practice of physical therapists.

Effects of hearing aids in the balance, quality of life and fear to fall in elderly people with sensorineural hearing loss

Summary Introduction: The aging process provokes structural modifications and functional to it greets, compromising the postural control and central processing. Studies have boarded the necessity to identify to the harmful factors of risk to aged the auditory health and security in stricken aged by auditory deficits and with alterations of balance. Objective: To evaluate the effect of auditory prosthesis in the quality of life, the balance and the fear of fall in aged with bilateral auditory loss. Method: Carried through clinical and experimental study with 56 aged ones with sensorineural auditory loss, submitted to the use of auditory prosthesis of individual sonorous amplification (AASI). The aged ones had answered to the questionnaires of quality of life Short Form Health Survey (SF-36), Falls Efficacy International Scale- (FES-I) and the test of Berg Balance Scale (BBS). After 4 months, the aged ones that they adapted to the use of the AASI had been reevaluated. Results: It had 50% of adaptation of the aged ones to the AASI. It was observed that the masculine sex had greater difficulty in adapting to the auditory device and that the variable age, degree of loss, presence of humming and vertigo had not intervened with the adaptation to auditory prosthesis. It had improvement of the quality of life in the dominance of the State General Health (EGS) and Functional Capacity (CF) and of the humming, as well as the increase of the auto-confidence after adaptation of auditory prosthesis. Conclusion: The use of auditory prosthesis provided the improvement of the domains of the quality of life, what it reflected consequently in one better auto-confidence and in the long run in the reduction of the fear of fall in aged with sensorineural auditory loss.

Avaliação do tratamento cirúrgico da fratura-luxação de Lisfranc

Estudo retrospectivo de 19 casos de fratura-luxacao de Lisfranc tratados cirurgicamente no periodo de 1995 a 2003. O tempo de acompanhamento foi de 35 meses (variando de 4 a 97 meses). O tratamento cirurgico foi realizado no dia do trauma em 14 casos, com media de demora de 4,78 horas. Ocorreram 5 lesoes expostas (36,32%) e 5 pacientes foram vitimas de politraumatismo. O mecanismo de lesao mais frequente foi o acidente motociclistico, seguido da queda de animais e de altura. Utilizou-se a avaliacao funcional proposta pela AOFAS (The American Orthopaedic Foot And Ankle Society), que apresentou media de 77,53 (variou de 44 a 100). Houve relacao entre a qualidade da reducao obtida e o resultado do tratamento (p = 0,0449) e entre o fato do pacientes ser vitima de politraumatismo e um resultado inferior do escore AOFAS (p= 0.0143). Houve como complicacao a presenca de Osteoartrose em 8 casos (42,10%), confirmando-a como a principal complicacao radiografica destas lesoes. Sua ocorrencia foi analisada comparando-se com a qualidade da reducao e com os diferentes tipos de lesao (exposta,lesao ligamentar ou fratura, se lesao isolada ou politraumatismo) nao encontrando relacao com significância estatistica (p < 0,005).

Comparação do processo de reparo ósseo em tíbias de ratas normais e osteopênicas

SUMMARY The purpose was to compare tibial bone union in normal and osteopenic female rats. Forty-nine Wistar albino female rats weighing 160 g (±20g) and 100 days were distributed into 2 groups: Oophorectomized (OOF) and Pseudo-oophorectomized (SHAM). Thirty days later, a cortical injury was produced in all the animals. They were sacrificed in the 2nd, 4th, 6th and 8th weeks. Osteoblasts count was performed. Progressive weight increase was observed, but the OOF group was shown to have gained more weight (p£0.05) than the SHAM group, at the time of the second surgery. After 15 days post-injury, the animals in the OOF group presented a higher number of osteoblasts (p£0.05) compared to the SHAM group. Thirty days after in- jury, the number of osteoblasts was reduced, but both groups showed similar amounts. Forty-five days after injury, despite a constant reduction, the number of osteoblasts in the OOF group remained high when compared to SHAM (p£0.05) group. After 60 days, we found less osteoblasts in the SHAM group, suggesting an advanced bone repair process. The osteopenic animals showed an early accelerated response, which became equivalent between both groups 30 days after injury. However, after that period, they showed a delayed osteoid mineralization, suggesting delayed late bone repair process.

Anteversão do colo do fêmur: avaliação clínica versus radiológica

The purpose of the present study was to verify the correlation between the femoral anteversion angle measured by biplanes radiography and the values of internal and external rotation of the hip obtained by clinical assessment. Sixty-four hips of 32 individuals with no previous coxofemoral pathologies were studied by taking their hip rotation values with a proper instrument - the fleximeter - and taking radiographic images using the Rippstein- Muller method. The results obtained were statistically analyzed and it was concluded that there was no statistically significant correlation and that it is possible that other factors, in addition to the femoral anteversion angle, may be important in determining the range of rotation of the hip joint.

Altura percentual do centro de gravidade e número de quedas em idosos ativos e sedentários

Older adults present changes in energy metabolism that result in an increase of body fat and a decrease of muscle mass and height, leading to alterations in the position of the center of gravity (CG) and consequent falls. The objective of the present study was to compare the percent CG height and the number of falls (NF) over the last 12 months between active and sedentary older adults and to correlate them with anthropometric variables (body weight, height and BMI). The sample consisted of 102 men and women ranging in age from 60 to 84 years, including 64 active and 38 sedentary subjects. Anthropometric variables, NF, level of physical activity of sedentary subjects, and percent CG height were evaluated and the mean and standard deviation were calculated. Correlations between variables were estimated using Pearson’s correlation coefficient. The percent CG height was 57.54 ± 2.57% in active subjects and 57.47 ± 1.94% in sedentary subjects. No significant correlations were observed between percent CG height and anthropometric variables or NF in either group. In conclusion, older adults present a CG above the physiological value (55%). No significant association was observed between percent CG height, anthropometric variables and NF.Older adults present changes in energy metabolism that result in an increase of body fat and a decrease of muscle mass and height, leading to alterations in the position of the center of gravity (CG) and consequent falls. The objective of the present study was to compare the percent CG height and the number of falls (NF) over the last 12 months between active and sedentary older adults and to correlate them with anthropometric variables (body weight, height and BMI). The sample consisted of 102 men and women ranging in age from 60 to 84 years, including 64 active and 38 sedentary subjects. Anthropometric variables, NF, level of physical activity of sedentary subjects, and percent CG height were evaluated and the mean and standard deviation were calculated. Correlations between variables were estimated using Pearsons correlation coefficient. The percent CG height was 57.54 ± 2.57% in active subjects and 57.47 ± 1.94% in sedentary subjects. No significant correlations were observed between percent CG height and anthropometric variables or NF in either group. In conclusion, older adults present a CG above the physiological value (55%). No significant association was observed between percent CG height, anthropometric variables and NF.

Avaliação radiológica e funcional dos pacientes com fratura da coluna cervical subaxial

RESUMO Objetivo: Avaliar 17 pacientes portadores de fratura luxação da coluna cervical (C3 a C7), que foram tratados em um período de dois anos. Os pacientes foram avaliados com parâmetros radiológicos, clínicos e funcionais. Métodos: A indicação do tratamento utilizado em cada paciente foi baseada em seu quadro clínico e neurológico. Todos os pacientes foram tratados pela mesma técnica cirúrgica. O seguimento pósoperatório mínimo foi de seis meses. Resultados: Dez pacientes não apresentavam nenhum comprometimento neurológico e sete pacientes apresentavam algum grau de acometimento neurológico. Na avaliação radiográfica do seguimento ambulatorial, todos os pacientes apresentaram sinais de consolidação da artrodese. Todos ficaram relacionados entre os níveis excelente e regular, de acordo com os critérios de Odom. Treze pacientes apresentaram 20% de limitação pelo questionário Neck Pain Disability Index. EncontrouABSTRACT Objective: To evaluate 17 patients with cervical (C3-C7) traumatic injuries treated in a period of two years. Patients were evaluated based on clinical, radiological and functional parameters. Methods: The indication of treatment for different patients was based on their clinical and neurological situation. All patients were treated with the same surgical technique. The minimal surgical follow-up was of six months. Results: Ten patients didn’t have neurological problems and seven patients had some kind of neurological lesion. In the radiological evaluation during the ambulatory follow-up, all patient presented signs of consolidated spine fusion. All the patients received a grade between excellent and fair according to Odom’s criteria, 13 patients presented 20% of limitation with regard to the Neck Pain Disability Index. There was one RESUMEN Objetivo: Habían sido evaluados 17 pacientes que llevaban trauma de la columna cervical (C3 el C7) tratada en un período a dos años. Los pacientes con parámetros radiológicos, clínicos y funcionales fueron evaluados. Métodos: La indicación del tratamiento usado en cada paciente fue basada en el cuadro clínico y neurológico. Los pacientes fueron tratados por la misma técnica quirúrgica. El perseguir postoperatorio mínimo fuera de seis meses. Resultados: Diez pacientes no presentaron ningún comprometimento neurológico y siete pacientes presentaron un cierto grado de acometimento neurológico. En la evaluación radiográfica, los pacientes habían presentado señales de la consolidación de artrodese. Todos los pacientes estaban relacionados entre los niveles excelentes y regular de acuerdo con los criterios de Odom, 13 pacientes habían presentado el 20% de limitación para el cuestionario Neck Pain Disability