Variabilidade da frequência cardíaca em mulheres com hipermobilidade articular

A hipermobilidade é a capacidade de desempenhar movimentos articulares com amplitude maior que o normal. A prevalência possui variações determinadas pela etnia, sexo, idade, atividade física e variações nos critérios de caracterização. Aproximadamente 30% dos adultos são portadores e apresentam feedback proprioceptivo, sensorial diminuído e espacial alterado da articulação levando a maior frequência de ativação e deformação dos mecanorreceptores nos músculos esqueléticos e na pele. O aumento dos impulsos aferentes dos mecanorreceptores sobre a área cardiovascular no bulbo altera o controle autonômico sobre o coração. O objetivo do estudo foi avaliar o balanço simpatovagal durante manobra de ortostatismo em mulheres com hipermobilidade. Participaram do estudo 27 voluntárias, com 19,97±1,79 anos, índice de massa corpórea abaixo de 25 kg/m², sedentárias e sem uso de medicação. Após diagnóstico da hipermobilidade articular, segundo o escore de Beighton, foram divididas em 2 grupos: 12 hipermóveis (GH) e 15 não hipermóveis (GC). O eletrocardiograma foi realizado durante 10 minutos em supino e em pé para análise da variabilidade da frequência cardíaca. A banda de alta frequência (un) apresentou diminuição da atividade vagal no GH, pJoint hypermobility is the ability to make joint movements greater than normal. The prevalence has large variations determined by race, sex, age, physical activity and variations in characterization criteria. Approximately 30% of adults are considered carriers and present proprioceptive feedback and sensory decreased and joint space positioning altered leading to greater frequency of activation and deformation on the mechanoreceptors in the skeletal muscles and skin. The increase of afferent impulses of the receptors on the bulb cardiovascular area alters the autonomic control on the heart. The objective of the study was to evaluate sympathovagal balance during orthosthatic maneuver in women with hipermobility. Twenty-seven sedentary volunteers participated in this study, with mean age of 19.97±1.79, body mass index below 25 kg/m² and without medication. After the joint hipermobility diagnosis according to Beighton score, they were divided into 2 groups: 12 with hipermobility (HG) and 15 without hipermobility (CG). The electrocardiogram was performed during 10 minutes at supine position and stand for analysis of heart rate variability. The band of high frequency (un) presented reduction in vagal activity in HG, p<0.03. The low frequency increment (un) was higher in HG when compared to CG in orthosthatic maneuver with increased sympathetic activity, p<0.03. The joint hypermobility volunteers presented autonomic cardiac response altered with low vagal responsiveness

Colorectal and uterine movement and tension of the inferior hypogastric plexus in cadavers

Background: Hypotheses on somatovisceral dysfunction often assume interference by stretch or compression of the nerve supply to visceral structures. The purpose of this study is to examine the potential of pelvic visceral movement to create tension of the loose connective tissue that contains the fine branches of the inferior hypogastric nerve plexus. Methods: Twenty eight embalmed human cadavers were examined. Pelvic visceral structures were displaced by very gentle 5 N unidirectional tension and the associated movement of the endopelvic fascia containing the inferior hypogastric plexus that this caused was measured. Results: Most movement of the fascia containing the inferior hypogastric plexus was obtained by pulling the rectosigmoid junction or broad ligament of the uterus. The plexus did not cross any vertebral joints and the fascia containing it did not move on pulling the hypogastric nerve. Conclusions: Uterine and rectosigmoid displacement produce most movement of the fascia containing the hypogastric nerve plexus, potentially resulting in nerve tension. In the living this might occur as a consequence of menstruation, pregnancy or constipation. This may be relevant to somatovisceral reflex theories of the effects of manual therapy on visceral conditions.Ian P Johnso