Tratamiento sintomático de la fibromialgia mediante vibraciones mecánicas

[spa] DE LA TESIS: La presente Tesis Doctoral investiga los efectos del ejercicio físico con suplementación de vibraciones mecánicas de cuerpo completo (VMCC) sobre la principal sintomatología, funcionalidad diaria, actividad electromiográfica (EMG) y niveles séricos del factor de crecimiento similar a la insulina (IGF1) en pacientes con fibromialgia (FM). Se observa que las pacientes que son sometidas a un programa de 6 semanas consistente en ejercicio físico aeróbico y trabajo de amplitud de movimiento y relajación con suplementación de VMCC mejoran significativamente el dolor y la fatiga en comparación a pacientes que no son sometidas a ninguna terapia (grupo control), mientras que las pacientes sometidas al mismo programa de ejercicio físico convencional sin la suplementación de VMCC (grupo placebo) no modifican sus valores de dolor y fatiga de modo significativo con respecto a ninguno de los grupos. Existe además una tendencia hacia la mejora funcional (medida mediante el Fibromyalgia Impact Questionnaire) en el grupo con VMCC reales respecto al grupo control. La realización de ejercicios estáticos sobre una plataforma vibratoria disminuye la actividad EMG tras 6 semanas de exposición en pacientes con FM. Los niveles séricos de IGF1 ante la exposición aguda (durante una sesión) y crónica (durante 6 semanas) a VMCC no se modificaron en este estudio. Se concluye que las VMCC son un método seguro y efectivo para mejora la principal sintomatología de la enfermedad, pero no se encuentra una explicación fisiológica a estos resultados, sugiriéndose futuras investigaciones para determinar el mecanismo a través del cual esta modalidad de entrenamiento induce beneficios en pacientes con FM

Reverse shoulder arthroplasty. Part 2 : Systematic review of reoperations, revisions, problems, and complications

Many factors influence the reoperations, revisions, problems, and complications of reverse shoulder arthroplasty (RSA). The purpose of this study was to compare those depending on the surgical approach, type of prosthesis, and indication for surgery through a comprehensive, systematic review. A literature search was conducted (1985 to June 2012) using PubMed, CINAHL, EBSCO-SPORTDiscus, and Cochrane Central Register of Controlled Trials. Levels I-IV evidence, in-vivo human studies (written in English with minimum of 2 years of follow-up and sample size of 10 patients) reporting reoperations, revisions, problems, and complications after RSA were included. The data obtained were analyzed depending on the surgical approach, type of prosthesis (with medialized or lateralized center of rotation), or indication for surgery. About 37 studies were included involving 3150 patients (mean [SD] percentage of females, age, and follow-up of 72% [13], 71.6 years [3.8], and 45 months [20], respectively). Use of deltopectoral approach and lateralized prostheses had significantly higher risk of need for revision surgery (P = 0.008) and glenoid loosening (P = 0.01), but lower risk of scapular notch (P < 0.001), compared with medialized prostheses with same approach. RSA for revision of anatomic prosthesis demonstrated higher risk of reoperation (P < 0.001), revision (P < 0.001), hematoma (P = 0.001), instability (P < 0.001), and infection (P = 0.02) compared with most of the other indications. Lateralized prostheses had significantly higher glenoid loosening and need for revision surgery, but a significantly lower rate of scapular notching compared to medialized prostheses. The risk of reoperations, revisions, problems, and complications after RSA was increased in revision cases compared with other indications. Level IV

Anterior cruciate ligament reconstruction: A multicenter prospective cohort study evaluating 3 different grafts using same bone drilling method

To compare the clinical outcomes after anterior cruciate ligament (ACL) reconstruction with bone-patellar tendon-bone autograft (BPTBAu), BPTB allograft (BPTBAll), or hamstring (semitendinosus-gracilis) tendon autograft (HTAu), performing bone drilling with same methods in terms of transtibial drilling, orientation, positioning, and width of femoral and tibial tunnels. DESIGN: Multicenter prospective cohort study (level of evidence II). SETTING: Departments of Orthopedic Surgery of Centro Medico Teknon (Barcelona, Spain) Clinica Universitaria de Navarra (Navarra, Spain), and Clinica FREMAP (Gijon, Spain). PATIENTS: All patients with ACL tears attending 3 different institutions between January 2004 and June 2006 were approached for eligibility and those meeting inclusion criteria finally participated in this study. INTERVENTION: Each institution was assigned to perform a specific surgical technique. Patients were prospectively followed after undergoing ACL reconstruction with BPTBAu, BPTBAll, or HTAu, with a minimum follow-up of 24 months. MAIN OUTCOME MEASURES: Included knee laxity and International Knee Documentation Committee (IKDC) score. Knee laxity was assessed with the KT-1000 arthrometer (evaluated with neutral and external rotation positions) and both Lachman and pivot shift tests. Additional outcomes included main symptoms (anterior knee pain, swelling, crepitation, and instability), disturbance in knee sensation, visual analogue scale (VAS) for satisfaction with surgery, range of motion (ROM), and isokinetic knee strength. RESULTS: There were no significant differences among the 3 groups for any of the clinical outcomes, except for a slightly greater KT-1000-measured knee laxity in external rotation in the BPTBAu compared with the other groups. All patients demonstrated grade A or B of the IKDC. The mean VAS for satisfaction with surgery in all patients was 8.5. CONCLUSIONS: The selection of the surgical technique for ACL reconstruction may be based on the surgeon's preference

Distal Clavicle Osteolysis after Modified Weaver-Dunn's Procedure for Chronic Acromioclavicular Dislocation : A Case Report and Review of Complications

Distal clavicle osteolysis after acromioclavicular joint stabilization has only been described after the use of hardware for clavicle stabilization or synthetic graft causing a foreign body reaction. This paper reports a very rare case of distal clavicle osteolysis after modified Weaver-Dunn procedure for the treatment of chronic acromioclavicular joint dislocation. The paper also provides a comprehensive review of complications of this surgical technique and discusses a potential vascular etiology and preventive strategies aimed at avoiding clavicle osteolysis

Case Report Distal Clavicle Osteolysis after Modified Weaver-Dunn&apos;s Procedure for Chronic Acromioclavicular Dislocation: A Case Report and Review of Complications

Distal clavicle osteolysis after acromioclavicular joint stabilization has only been described after the use of hardware for clavicle stabilization or synthetic graft causing a foreign body reaction. This paper reports a very rare case of distal clavicle osteolysis after modified Weaver-Dunn procedure for the treatment of chronic acromioclavicular joint dislocation. The paper also provides a comprehensive review of complications of this surgical technique and discusses a potential vascular etiology and preventive strategies aimed at avoiding clavicle osteolysis

Roturas “irreparables” del manguito rotador: trucos y consejos para conseguir una reparación artroscópica

Las roturas irreparables del manguito rotador son lesiones graves que pueden conllevar consecuencias drásticas en la calidad de vida de los pacientes. Pese a que su reparación es compleja y la tasa de re-rotura es alta, el intento de reparación se justifica por la ausencia de alternativas poco agresivas o paliativas. Cuando no se consigue una reparación, la alternativa es la transferencia tendinosa, la reconstrucción capsular superior o incluso la prótesis invertida de hombro. Por tanto, en muchos casos de cirugía primaria, se debe intentar la reparación artroscópica con el fin de “salvar” el manguito rotador gravemente lesionado. El objetivo de este artículo es resumir algunas de las técnicas artroscópicas para conseguir una reparación de roturas “irreparables” del manguito rotador

Repeated sprint ability and muscular responses according to the age category in elite youth soccer players

The aim of this study was to analyse the influence of age category on the performance and muscle response after a Repeated Sprint Ability (RSA) test in elite youth soccer players. 62 soccer players from three different age categories (Under 14 [n = 21], Under 16 [n = 20], and Under 18 [n = 21]) were selected to participate in this study. Players completed an RSA test (7 × 30 m) with a 20-s recovery between sprints. The muscular response to an electrical stimulus before and after the test of both the biceps femoris (BF) and the rectus femoris (RF) were evaluated using tensiomyography. A two-way ANOVA was used to analyse the differences in RSA parameters in each of the four distance-intervals (0–5; 5–25; 25–30; 0–30 m) between sprint and age category. The U14 age category (5.30 ± 0.30 s) showed higher mean sprint times than U16 (4.62 ± 0.20 s) and U18 (4.46 ± 0.17 s) throughout the entire test (p 0.05), although the delay time (Td) of the muscle was significantly lower after the RSA test in U16 players (−1.53 ms, CI95%: −2.607 to −0.452; ES: 0.38) and U18 players (−1.11 ms, CI95%: −2.10 to −0.12; ES: 0.22). In conclusion, this study revealed an increase in physical performance and muscle response variability after a repeated sprint ability test in the U16's and over. The fatigue induced by the RSA test did not show differences depending on the age of the players, although muscle mechanical properties were altered after the RSA test in U16 and U18 soccer players. Physical performance and muscle response can be complementary variables in managing fatigue according to the age category in soccer players.Sin financiación3.367 JCR (2019) Q1, 20/81 Physiology1.211 SJR (2019) Q2, 52/186 Physiology, 31/107 Physiology (medical)No data IDR 2019UE