Radiofrequency-based treatment in therapy-related clinical practice – a narrative review. Part I : acute conditions

This is an Accepted Manuscript of an article published by Taylor & Francis Group in Physical Therapy Reviews on 24 June 2015, available online at: https://www.tandfonline.com/doi/full/10.1179/1743288X15Y.0000000016Background: Radiofrequency electromagnetic field (RFEMF or simply RF)-based electrophysical agents (EPAs) have been employed in therapy-related clinical practice for several decades. They are used to reduce pain and inflammation and enhance tissue healing. Although these agents have generally become less popular in contemporary therapy practice, surveys have shown that some of these modalities are still reasonably widely used. Objective: To review the evidence for the use of non-invasive low frequency RFs (30 kHz–30 MHz) in therapy-related clinical practice. Major findings: All peer reviewed therapy-related clinical studies published in English and concerning low frequency RF were sought. Identified literature was divided into acute and chronic segments based on their clinical area and analysed to assess the volume and scope of current evidence. The studies on acute conditions were reviewed in detail for this paper. One hundred twenty clinical studies were identified, of which 30 related to acute conditions. The majority of studies employed Pulsed Shortwave Therapy (PSWT). Twenty-two studies out of 30 were related to conditions of pain and inflammation, seven to tissue healing and one to acute pneumothorax. No studies were identified on frequencies other than shortwave. Conclusions: Evidence for and against RF-based therapy is available. There is reasonable evidence in support of PSWT to alleviate postoperative pain and promote postoperative wound healing. Evidence for other acute conditions is sparse and conflicting. A general lack of research emphasis in the non-shortwave RF band is evident, with studies on acute conditions almost non-existent. Further and wider research in this area is warranted.Peer reviewe

Characterization of symptoms and edema distribution in premenstrual syndrome

Pascale Mutti Tacani,1 Danielle de Oliveira Ribeiro,1 Barbara Evelyn Barros Guimarães,1 Aline Fernanda Perez Machado,2 Rogério Eduardo Tacani1,2 1Physical Therapy Department, São Camilo University Center, 2Physical Therapy Department, São Paulo City University (UNICID), São Paulo, Brazil Background: Premenstrual syndrome is a group of symptoms linked to the menstrual cycle, and edema is among these symptoms. Physiotherapy is often sought by many patients for the treatment of edema; however, for an adequate prescription of physiotherapeutic procedures, the distribution of edema throughout the body has yet to be characterized. Objective: To determine the most frequent symptoms and body regions that present with edema in women during the premenstrual period.Subjects and methods: Sixty women with a mean age of 24.6±4.7 years were evaluated during their premenstrual (between days 21 and 28) and menstrual period (between days 1 and 3), and the collected data included body mass, height, biotype (body-fat distribution), face, breast, limb-circumference measurements, and limb-volume estimate, and an adapted version of the Premenstrual Symptoms Screening Tool was used. Statistical analysis was performed using Student’s t-test and the test for equality of two proportions (P≤0.05).Results: Premenstrual syndrome was identified in 91.7% of the women, and the most frequent symptoms were irritability (73.33%) and physical symptoms, including swelling (65%), and anxiety (58.3%). Edema was detected in the following areas: facial, epigastric, mammary, umbilical, and pubic, the mid-third of the arms, distal forearm, in both thighs and in the mid-third of the legs determined by circumference measurements, and in both upper and lower limbs, according to the estimated volume.Conclusion: In this study population, the most frequent symptoms were irritability, physical symptoms, and anxiety, with distribution of edema in the face, breast, abdomen, pubic area, distal upper limb, and proximal lower limb. Keywords: premenstrual syndrome, menstrual cycle, edema, women’s health, affective symptoms, body surface are

Os sentidos atribuídos à voz por mulheres após a menopausa The meanings attributed to the voice by menopause women

OBJETIVO: Analisar os sentidos atribuídos à voz por mulheres após a menopausa. MÉTODOS: Foram coletados dados de 148 mulheres nos prontuários médicos, entre fevereiro de 2000 e outubro de 2001, no Programa da Saúde da Mulher no Climatério, do ambulatório de ginecologia de um hospital na cidade de Curitiba, Estado do Paraná. Dentre a população total foram selecionadas intencionalmente 30 mulheres entre 48 e 59 anos, que não se consideravam profissionais da voz, no mínimo há 12 meses em amenorréia, e que foram entrevistadas com um roteiro temático, constituído de questões semi-estruturadas. Cada entrevista foi gravada e transcrita. A descrição, análise e interpretação foram fundamentadas pelas representações sociais, por meio do discurso do sujeito coletivo, com aproximações à hermenêutica-dialética. RESULTADOS: Os 27 discursos coletivos estruturados denotaram o relacionamento da voz às características biológicas, psicológicas e aspectos sociais do cotidiano, com a identificação de mudanças vocais no decorrer da vida. CONCLUSÕES: Foi possível observar representações sociais de natureza comunicacional e funcional, que salientaram a voz como elemento de constituição da identidade pessoal, concebida na pertinência social. A pesquisa sugere novas investigações fundamentadas nas ciências sociais, simultâneas aos estudos epidemiológicos, e a necessidade de se refletir sobre o processo de terapêutica vocal aplicado sobre uma laringe mais vulnerável, além de priorizar uma proposta de assistência integral à mulher no climatério, com enfoque sobre a saúde da voz.<br>OBJECTIVE: To analyze the meanings attributed to the voice by menopausal women. METHODS: Data were collected from 148 medical records of women seen in the Climacteric Women Health Program of the Irmandade Santa Casa de Misericórdia Gynecology Outpatient Clinic in Curitiba, Brazil, between February 2000 and October 2001. Of them, 30 women aged between 48 and 59 years who did not consider themselves as voice professionals and had been at least 12 months in amenorrhea were selected. They were interviewed using a thematic guide with semi-structured questions. Interviews were recorded and then transcribed. Their description, analysis, and interpretation were based on social representation of the collective individual's discourse through a hermeneutics-dialectics approach. RESULTS: The resulting 27 collective discourses showed that women related their voice to biological and psychological characteristics and social aspects of daily life, identifying vocal changes during their life course. CONCLUSIONS: Social representations of communicational and functional nature were observed and highlight voice as an element of personal identity construction conceived in the social sphere. There is a need for further research based on social sciences as well as epidemiological studies and to examine voice therapy in a frailer larynx and also prioritize voice health as part of comprehensive health care delivered to climacteric women

Efeito da massagem clássica estética em adiposidades localizadas: estudo piloto

Devido ao padrão de beleza imposto atualmente, tem aumentado a procura por tratamentos estéticos como a massagem clássica, porém sua suposta ação lipolítica ainda é uma questão controversa na literatura. O objetivo deste estudo foi verificar o efeito da massagem clássica estética nas adiposidades localizadas, por meio de perimetria do abdome, quadril e coxas e pela estimativa da espessura da tela subcutânea da parede abdominal (ETS) por ultrassonografia. Oito voluntárias (idade 33,9±8,9 anos, peso 65,1±8,4 kg) foram avaliadas quanto a MC, IMC e ETS 30 dias antes, logo antes do início da intervenção e após esta. Foram efetuadas 12 sessões de massagem clássica estética em coxas, glúteos e abdome por 30 minutos, três vezes por semana. Foi encontrada redução significativa apenas da perimetria na região do quadril (p=0,012), mas não da ETS (p=0,301). A massagem clássica estética contribuiu apenas para a redução da perimetria do quadril, e não modificou outras medidas nem a espessura da tela subcutânea da região abdominal.Due to current beauty standards, the search for aesthetic treatments, including classical massage, has increased; however, its presumed lipolytic action is still controversial in literature. The purpose of this study was to assess the effect of classical massage on localized adiposity, by means of abdomen, hip and thigh perimeter measuring, nd by estimating thickness of abdominal wall fat by ultrasonography. Eight volunteers (33.9±8.9 years old, 65.1±8.4 kg) were assessed as to weight, body mass index, body perimeter measures and by abdomen ultrasonography at three moments: control (30 days before treatment), just before, and after treatment. The latter consisted of 12 thrice-weekly, 30-minute massage sessions on thighs, buttocks, and abdomen. Results showed a significant reduction at hip perimeter (p=0.012), but none of subcutaneous fat tissue thickness (p=0.301). Classical aesthetic massage hence did not modify abdominal wall fat, but did reduce hip perimeter