Shoulder pain in spinal cord injury

The spinal cord injury (SCI) is one of the most severe forms of disabling syndromes. Patients with SCI usually apply an excessive overload on the upper limbs, especially the shoulders, using them more frequently and in a greater range of activities when compared to healthy subjects. Moreover, the search for the improvement of the quality of life in the last years has led an increasingly number of SCI patients to practice physical activities. Many SCI patients use wheelchairs for functional locomotion and sports practice. However, this functional demand on shoulder's joint may lead to a painful picture, interfering on these patient's daily activities. With the improvements on technology and healthcare life expectancy for SCI patients has been increased. Since then, issues regarding quality of life and age-related diseases are very important for this population. The purpose of this paper was to better understand shoulder pain in SCI patients by reviewing available literature.A lesão medular (LM) é uma das formas mais graves dentro das síndromes incapacitantes. O paciente com LM sobrecarrega excessivamente os membros superiores, especialmente os ombros, utilizando-os mais freqüentemente e em maior variabilidade de atividades que uma pessoa sem LM. Além disso, a busca da melhoria da qualidade de vida nos últimos anos, levou um número crescente de portadores de LM a procurar a prática de atividade física. Muitos pacientes com LM utilizam cadeira de rodas para locomoção funcional e realização de esportes. Porém, esta demanda funcional na articulação do ombro pode levar a presença de quadro álgico importante interferindo nas atividades de vida diária desses pacientes. Com os adventos da tecnologia e cuidados com a saúde, a expectativa de vida dos pacientes com LM tem aumentado. Desde então, questões relacionadas à qualidade de vida e doenças associadas com o envelhecimento são de grande importância para essa população. Este estudo busca um melhor entendimento da dor no ombro em pacientes com LM através de revisão da literatura.Universidade de São Paulo Faculdade de Medicina de Ribeirão Preto Departamento de Biomecânica, Medicina e Reabilitação do Aparelho LocomotorUNIFESP-EPM Departamento de Ortopedia e TraumatologiaCentro de Reabilitação Diretora Técnica do Lar Escola São FranciscoUNIFESP, EPM, Depto. de Ortopedia e TraumatologiaSciEL

The effect of hip abduction on the EMG activity of vastus medialis obliquus, vastus lateralis longus and vastus lateralis obliquus in healthy subjects

STUDY DESIGN: Controlled laboratory study. OBJECTIVES: The purposes of this paper were to investigate (d) whether vastus medialis obliquus (VMO), vastus lateralis longus (VLL) and vastus lateralis obliquus (VLO) EMG activity can be influenced by hip abduction performed by healthy subjects. BACKGROUND: Some clinicians contraindicate hip abduction for patellofemoral patients (with) based on the premise that hip abduction could facilitate the VLL muscle activation leading to a VLL and VMO imbalance METHODS AND MEASURES: Twenty-one clinically healthy subjects were involved in the study, 10 women and 11 men (aged X = 23.3 ± 2.9). The EMG signals were collected using a computerized EMG VIKING II, with 8 channels and three pairs of surface electrodes. EMG activity was obtained from MVIC knee extension at 90° of flexion in a seated position and MVIC hip abduction at 0° and 30° with patients in side-lying position with the knee in full extension. The data were normalized in the MVIC knee extension at 50° of flexion in a seated position, and were submitted to ANOVA test with subsequent application of the Bonferroni multiple comparisons analysis test. The level of significance was defined as p ≤ 0.05. RESULTS: The VLO muscle demonstrated a similar pattern to the VMO muscle showing higher EMG activity in MVIC knee extension at 90° of flexion compared with MVIC hip abduction at 0° and 30° of abduction for male (p < 0.0007) and MVIC hip abduction at 0° of abduction for female subjects (p < 0.02196). There were no statistically significant differences in the VLL EMG activity among the three sets of exercises tested. CONCLUSION: The results showed that no selective EMG activation was observed when comparison was made between the VMO, VLL and VLO muscles while performing MVIC hip abduction at 0° and 30° of abduction and MVIC knee extension at 90° of flexion in both male and female subjects. Our findings demonstrate that hip abduction do not facilitated VLL and VLO activity in relation to the VMO, however, this study included only healthy subjects performing maximum voluntary isometric contraction contractions, therefore much remains to be discovered by future researc

Confiabilidade da medição do ângulo quadriciptal

A proposta deste estudo foi verificar a reprodutibilidade intrateste e a confiabilidade intertestes da mensuração clínica e radiológica do ângulo Q. Foram avaliadas 20 mulheres (40 joelhos), com idade média de 21±5 anos, por dois examinadores clínicos e um terceiro radiológico. As pessoas foram posicionadas na mesa radiológica em decúbito dorsal com um estabilizador podálico em U, com os membros inferiores relaxados. colhendo-se as mensurações clínicas e a tomada radiológica. Para a análise estatística foram utilizados os testes ANOVA, Coeficiente de Correlação Linear (R) e Coeficiente de Correlação Intraclasses (ICC), comníveis de significância de p&lt;0,05, R&gt;0,321 e ICC&gt;0,75. Na análise de variância obteve-se p=0,45 para intrateste, p=0,44 para intertestes, R = 0,42, enquanto o ICC intrateste foi de 0,81, o ICC intertestes de 0,89 e o ICC intra-sessão do intrateste, de 0,80. Considerando os dados obtidos, a metodologia proposta para mensuração clínica e radiológica do ânguloquadriciptal mostrou-se confiável, sendo comprovada sua reprodutibilidade intra e intertestes, podendo ser utilizada com segurança na prática clínica.This study was designed to assess intratest reproducibility and inter-test reliability of clinical and radiographic Q angle measurements. Subjects were 20 women (40 knees), 21±5 years old, whose Q angles were measured by two clinical examiners and one radiographic tester. Both measurements were taken on subjects laying supine on the radiography table with a Ushaped foot stabilizer; each subject was instructed to keep leg muscles relaxed. Data collected were subject to statistical analyses ANOVA, intraclass correlation coefficient (ICC), and R test, significance being respectively set at 5%, &gt;0.75, and &gt;0.321. Results showed intratest p=0.44, intertests p=0.45, intratest ICC=0.81, intertests ICC=0.89 and R=0.42. These findings suggest the methodology here proposed to measure Q angle is reliable and reproducible; it may hence be used in clinical practice

The use of resorcine adhesive in repairing osteochondral's defect in knees of rabbits O uso do adesivo de resorcina na reparação de defeito osteocondral em joelhos de coelhos

PURPOSE: To study the morphology of the articulation of the knee of rabbits after the repairing of the defect osteochondral standardized with resorcina adhesive or metallic synthesis. METHODS: The procedure was to the creation of the defect osteochondral in femoral medial condylus of the knee of 80 rabbits, The animals were distributed in two groups with continuations of 7 and 42 days and submitted to the technique G (resection and retreat of the fragment osteochondral of the femoral medial condylus and relocation with resorcina adhesive), technique S (resection and retreat of the fragment osteochondral of the femoral medial condylus and relocation and metallic synthesis) or technique C (resection and retreat of the fragment osteochondral of the femoral medial condylus, leaving the empty standard defect the control). It was Made clinical study, radiographic, macroscopic and histological in two groups. RESULTS: the resorcina adhesive provokes: necrosis of the fragment osteochondral in 100% and 95%, degeneration 90% and 100%, free body in 80% and 65% respectively in the group I and II; compared with the metallic synthesis that it presented: necrosis in 25% and 35%, degeneration 25% and 35%, free body in 35% and 10% respectively in the group I and II. CONCLUSION: the resorcinol adhesive, related with the necrosis, cartilaginous degeneration and detachment of the fragment osteochondral lives frequently that the metallic synthesis.<br>OBJETIVO: Estudar a morfologia da articulação do joelho de coelhos após a reparação de um defeito osteocondral padronizado com adesivo de resorcina ou síntese metálica. MÉTODOS: Procedeu-se à criação de um defeito osteocondral em côndilo femoral medial do joelho de 80 coelhos. Os animais foram distribuídos em dois grupos com seguimentos de 7 e 42 dias e submetidos à técnica G (ressecção e retirada do fragmento osteocondral do côndilo femoral medial e recolocação com adesivo de resorcina), técnica S (ressecção e retirada do fragmento osteocondral do côndilo femoral medial e recolocação e síntese metálica) ou técnica C (ressecção e retirada do fragmento osteocondral do côndilo femoral medial, deixando o defeito padrão vazio como controle). Fez-se estudo clínico, radiográfico, macroscópico e histológico nos dois grupos. RESULTADOS: o adesivo de resorcina provoca: necrose do fragmento osteocondral em 100% e 95%, degeneração 90% e 100%, corpo livre em 80% e 65% respectivamente no grupo I e II; comparado com a síntese metálica que apresentou: necrose em 25% e 35%, degeneração 25% e 35%, corpo livre em 35% e 10% respectivamente no grupo I e II. CONCLUSÃO: o adesivo de resorcina, está relacionado com a necrose, degeneração cartilaginosa e despreendimento do fragmento osteocondral com maior freqüência que a síntese metálica