Effectiveness of phototherapy incorporated into an exercise program for osteoarthritis of the knee: study protocol for a randomized controlled trial

BACKGROUND: Osteoarthritis is a chronic disease with a multifactor etiology involving changes in bone alignment, cartilage, and other structures necessary to joint stability. There is a need to investigate therapeutic resources that combine different wavelengths as well as different light sources (low-level laser therapy and light-emitting diode therapy) in the same apparatus for the treatment of osteoarthritis. The aim of the proposed study is to analyze the effect of the incorporation of phototherapy into a therapeutic exercise program for individuals with osteoarthritis of the knee. METHODS/DESIGN: A double-blind, controlled, randomized clinical trial will be conducted involving patients with osteoarthritis of the knee. Evaluations will be performed using functional questionnaires before and after the treatment protocols, in a reserved room with only the evaluator and participant present, and no time constraints placed on the answers or evaluations. The following functional tests will also be performed: stabilometry (balance assessment), dynamometry (muscle strength of gluteus medius and quadriceps), algometry (pain threshold), fleximeter (range of motion), timed up-and-go test (functional mobility), and the functional reach test. The participants will then be allocated to three groups through a randomization process using opaque envelopes: exercise program, exercise program + phototherapy, or exercise program + placebo phototherapy, all of which will last for eight weeks. DISCUSSION: The purpose of this randomized clinical trial is to analyze the effect of the incorporation of phototherapy into a therapeutic exercise program for osteoarthritis of the knee. The study will support the practice based on evidence to the use of phototherapy in individuals with a diagnosis of osteoarthritis of the knee. Data will be published after the study is completed. TRIAL REGISTRATION: The protocol for this study has been submitted to Clinical Trials, registration number NCT02102347, on 29 March 2014

Effect of Facial Massage on Static Balance in Individuals with Temporomandibular Disorder – a Pilot Study

Introduction: The influence of the neuromuscular system on the cervical region and mastication is directly associated with mandibular movements and neck posture. Normal occlusal homeostasis depends on complex sensory feedback mechanisms of the periodontal ligament, temporomandibular joint and other structures of the stomatognathic system. This feedback serves as a regulatory mechanism that helps determine the force and nature of muscle contractions. Alterations in the muscles of mastication, neck muscles, and occlusal characteristics constitute causal factors of imbalances in the postural muscle chains, leading to alterations in the center of pressure (CoP) of the feet. Thus, therapies that seek occlusal reestablishment, such as muscle relaxation techniques, may lead to a restructuring of the global equilibrium of the neuromuscular system and an improvement in body posture. Purpose: The aim of the present pilot study was to investigate the immediate effect of facial massage on the CoP in the anteroposterior (CoPAP) and mediolateral (CoPML) directions in individuals with temporomandibular disorder (TMD). Methods: Twenty individuals with a diagnosis of TMD based on the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) were submitted to a facial massage technique. CoPAP and CoPML were evaluated using a force plate. Evaluations were performed under two visual conditions (eyes open and eyes closed) prior to resting in dorsal decubitus (baseline), after 10 minutes of rest (premassage) and after the administration of the massage technique (postmassage). Results: No significant differences were found regarding CoPAP velocity with eyes open or the following aspects under either visual condition (eyes open or closed): CoPML velocity, RMS of CoPAP, RMS of CoPML, and sway area. The only significant difference was found for mean CoPAP velocity with eyes closed. Conclusions: While the results of the present study demonstrate the reliability of the reproduction of the data, facial massage had no immediate influence on postural control in individuals with TMD

Self-Estimated Functional Inability because of Pain questionnaire for Brazilian workers with musculoskeletal pain: face and content validity

Este estudo teve como objetivo verificar a validade de face e conteúdo do questionário Self-Estimated Functional Inability because of Pain (SEFIP) para trabalhadores, aqui chamado de questionário SEFIP-work. Este é um estudo de validade do questionário. Nosso grupo já traduziu e adaptou a versão original do SEFIP, que foi desenvolvido para investigar a dor musculoesquelética e disfunção a ser aplicada a dançarinos (SEFIP-dance). No entanto, devido ao amplo escopo da SEFIP-dance, fizemos mudanças e adaptações na versão traduzida e adaptada ao português brasileiro para permitir o seu uso com trabalhadores. Assim, a validade de face e conteúdo foram realizadas para o desenvolvimento do SEFIP-work baseadas em pareceres de especialistas em doenças ocupacionais e reabilitação. Após a validade de face e de conteúdo, esta versão da SEFIP-work foi aplicada a 30 indivíduos que trabalham com dor músculoesquelética. Os participantes eram falantes nativos de português brasileiro com idade igual ou superior a 18 anos. Assim, foram introduzidas três alterações no questionário. Todos os participantes entenderam os itens e alternativas da SEFIP-work. O escore total médio da SEFIP-work foi de 6,59 (DP=3,66), com o item “parte inferior das costas” sendo o mais marcado (n=28; 93,33%), pontuação média de 1,18 (SD=0,73). Em conclusão, a versão brasileira adaptada da SEFIP-work aprEste estudo teve como objetivo verificar a validade de face e conteúdo do questionário Self-Estimated Functional Inability because of Pain (SEFIP) para trabalhadores, aqui chamado de questionário SEFIP-work. Este é um estudo de validade do questionário. Nosso grupo já traduziu e adaptou a versão original do SEFIP, que foi desenvolvido para investigar a dor musculoesquelética e disfunção a ser aplicada a dançarinos (SEFIP-dance). No entanto, devido ao amplo escopo da SEFIP-dance, fizemos mudanças e adaptações na versão traduzida e adaptada ao português brasileiro para permitir o seu uso com trabalhadores. Assim, a validade de face e conteúdo foram realizadas para o desenvolvimento do SEFIP-work baseadas em pareceres de especialistas em doenças ocupacionais e reabilitação. Após a validade de face e de conteúdo, esta versão da SEFIP-work foi aplicada a 30 indivíduos que trabalham com dor músculoesquelética. Os participantes eram falantes nativos de português brasileiro com idade igual ou superior a 18 anos. Assim, foram introduzidas três alterações no questionário. Todos os participantes entenderam os itens e alternativas da SEFIP-work. O escore total médio da SEFIP-work foi de 6,59 (DP=3,66), com o item “parte inferior das costas” sendo o mais marcado (n=28; 93,33%), pontuação média de 1,18 (SD=0,73). Em conclusão, a versão brasileira adaptada da SEFIP-work apresenta um nível aceitável de compreensão por parte dos trabalhadores na investigação da dor ou desconforto músculoesqueléticos.Este estudio objetivó verificar la validez aparente y de contenido del cuestionario Self-Estimated Functional Inability because of Pain (SEFIP) destinado a trabajadores, aquí llamado cuestionario SEFIP-work. Este es un estudio sobre la validez del cuestionario. Nuestro grupo ya ha traducido y adaptado la versión original de SEFIP, que fue desarrollada para investigar el dolor musculoesquelético y su disfunción destinada a la aplicación a bailarines (SEFIP-dance). Debido al amplio alcance de SEFIP-dance, se realizó cambios y adaptaciones en la versión traducida y adaptada al portugués brasileño para permitir su aplicación a los trabajadores. Así se realizó la validez aparente y de contenido para desarrollar el SEFIP-work con base en dictámenes de expertos en enfermedades profesionales y en rehabilitación. Después de la validez aparente y de contenido, la versión de SEFIP-work se aplicó a 30 personas que trabajan con dolor musculoesquelético. Los participantes son hablantes nativos de portugués brasileño con edad igual o superior a 18 años. Se agregaron tres cambios al cuestionario. Todos los participantes entendieron los ítems y las alternativas de SEFIP-work. El promedio de la puntuación total de SEFIP-work fue de 6,59 (DE=3,66), con el ítem “parte inferior de la espalda” como el más marcado (n=28; 93,33%) y puntuación promedio de 1,18 (DE=0,73). Se concluye que la versión brasileña adaptada de SEFIP-work presenta un nivel aceptable de comprensión por parte de los trabajadores en la investigación del dolor o malestar musculoesquelético

Effect of the usual weight of a backpack on body sway during quiet standing

[Purpose] The purpose of this study was to verify the effect on body sway during quiet standing of the habitual weight carried by students in a backpack. [Subjects] Forty-six students between the ages of 8 and 14 years volunteered. [Method] The percentage of body weight (% BW) of each student's backpack was calculated and the students were separated into three groups based on the results: Group A (0-7% BW), Group B (7.01-14% BW) and Group C (14.01-21%BW). [Results] The use of the backpack increased the area of the CoP sway, displacement and mean speed of the CoP data in the antero-posterior and medial-lateral directions in Group C. [Conclusion] Therefore, observed responses in the body posture changes caused by the weight of the backpack were similar to those reported in other studies conducted with different methodos of investigation

Knowledge and interest in Public Health: opinions of undergraduate students in Physical Therapy

Objective: To analyze the opinions of undergraduate students in Physical Therapy on acquired knowledge and interest in the study of Public Health. Methods: This is a crosssectional and qualitative study conducted in a private higher education institution, inMaceió-AL, Brazil, from June to December 2010. It comprised students from 5th and 10th period, which were allocated by convenience sampling, resulting in a final sample of 40 students with 20 students from each period. Later, each student was individually interviewedin a private, lit, air conditioned place, without time limit, being collected through a digital voice recorder the answers to the following questions: “How do you judge your knowledgeabout Public Health?” and “What is your interest in the study of Public Health?”. Collective subject discourse was used to analysis of qualitative variables. Results: Students considered their knowledge of Public Health as “limited”. Regarding their interest, the students in 5th period declared “little interest”, while the academics of the 10th period reported themselves as “very interested”. Conclusions: From the point of view of undergraduate students in Physical Therapy, their knowledge about Public Health is limited. Interest in the study of Public Health is greater among the academics closer to graduation

Análise comparativa entre dois ângulos cervicais com a oclusão em crianças com e sem DTM Comparative analysis between two cervical angles with occlusion in children with and without TMD

OBJETIVO: comparar dois ângulos cervicais com as classificações oclusais em crianças de 6 a 10 anos com e sem Disfunção Temporomandibular (DTM),identificar se há prevalência de DTM quanto ao gênero, e se há influencia da oclusão sobre os ângulos estudados. MÉTODO: realizou-se um estudo observacional transversal com 91 crianças de ambos os gêneros de uma Instituição de Ensino privado, dispostas em Grupo A (sem DTM) e Grupo B (com DTM). Todas as crianças foram avaliadas seguindo uma ficha cadastral constituída de dados referentes a sexo, idade, peso, altura e exame clínico intra-oral para classificação oclusal de Angle. O diagnóstico e a severidade da DTM, foram verificados pelo questionário proposto por Fonseca. Para avaliação dos ângulos cervicais (A1 e A2) foi utilizada a fotogrametria e o Software Alcimagem®. RESULTADOS: entre as crianças avaliadas, 52 (57,14%) apresentaram maloclusão, sendo 29 com DTM e 23 sem DTM, 39 (42,85%) apresentaram normoclusão, sendo 18 sem DTM e 21 com DTM. Quando comparados os ângulos (A1 e A2) a classe oclusal, foi encontrada diferença significante entre as crianças normoclusivas e maloclusivas com o ângulo A1 (p=0,04). CONCLUSÃO: esse estudo demonstrou que o ângulo A1 (C7, ATM e Ápice do Mento) foi estatisticamente significante quando associado com a condição oclusal. Não foi encontrado associação, na população estudada, entre ângulo cervical e DTM. Além disso, também foi possível observar que, a prevalência de crianças do gênero feminino com DTM é significantemente maior que a do gênero masculino. Esse estudo demonstrou que a maloclusão pode alterar somente o ângulo A1 e que a DTM não interfere nos ângulos cervicais estudados.<br>PURPOSE: to compare two cervical angles with occlusal classifications in children between 6 and 10 years old with and without Temporomandibular Disorders (TMD), to identify if there is a prevalence of TMD according to gender, and if there is influence of occlusion on the studied angles. METHOD: it was conducted a cross sectional observational study with 91 children of both gender in Group A (without TMD) and Group B (TMD). All children were evaluated following a registration form consisted of sex, age, weight, height data and intra-oral clinical examination for occlusal classification of Angle. The diagnosis and severity of TMD were scanned by the questionnaire proposed by Fonseca. For the cervical angles evaluation (A1 and A2) it was used the photogrammetry and the Alcimagem® software. RESULTS: among the evaluated children, 52 (57.14%) presented malocclusion, 29 with TMD and 23 without TMD. 39 (42,85%) presented normal occlusion, 18 without TMD and 21 with TMD. When the angles were compared, it was found a difference between normal occlusion and malocclusion children with the angle A1 (p=0.04). CONCLUSION: this study demonstrated that the angle A1 (C7, TMJ and Mentum Vertex) was statistically significant when associated to the occlusal condition. No association was found in the evaluated population, between TMD and cervical angle. Besides, it was also observed that the prevalence of female children with TMD is significantly larger than the male. This study demonstrated that malocclusion can change only the angle A1 and the TMD does not interfere with the studied cervical angles

Conhecimento e interesse em saúde pública: opiniões dos alunos de graduação em fisioterapia - doi: 10.5020/18061230.2012.p59

Objective: To analyze the opinions of undergraduate students in Physical Therapy on acquired knowledge and interest in the study of Public Health. Methods: This is a crosssectional and qualitative study conducted in a private higher education institution, in Maceió-AL, Brazil, from June to December 2010. It comprised students from 5th and 10th period, which were allocated by convenience sampling, resulting in a final sample of 40 students with 20 students from each period. Later, each student was individually interviewed in a private, lit, air conditioned place, without time limit, being collected through a digital voice recorder the answers to the following questions: “How do you judge your knowledge about Public Health?” and “What is your interest in the study of Public Health?”. Collective subject discourse was used to analysis of qualitative variables. Results: Students considered their knowledge of Public Health as “limited”. Regarding their interest, the students in 5th period declared “little interest”, while the academics of the 10th period reported themselves as “very interested”. Conclusions: From the point of view of undergraduate students in Physical Therapy, their knowledge about Public Health is limited. Interest in the study of Public Health is greater among the academics closer to graduation.Analisar as opiniões dos estudantes de graduação em Fisioterapia sobre o conhecimento adquirido e o interesse no estudo da Saúde Pública. Métodos: Trata-se de um estudo transversal e qualitativo realizado em uma instituição de ensino superior de Maceió – Alagoas, Brasil, entre junho e dezembro de 2010. Foram incluídos estudantes do 5º e 10º período, alocados através de amostragem por conveniência, resultando numa amostra final de 40 estudantes, com 20 alunos de cada período citado Posteriormente, cada aluno foi entrevistado individualmente em local reservado, iluminado, climatizado e sem limite de tempo, sendo coletadas por meio do gravador de voz digital as respostas para os seguintes questionamentos: “Como você julga o seu conhecimento acerca da Saúde Pública?” e “Qual o seu interesse no estudo da Saúde Pública?”. Empregou-se o discurso do sujeito coletivo para análise das variáveis qualitativas. Resultados: Os acadêmicos consideraram o seu conhecimento acerca da Saúde Pública como “limitado”. No que diz respeito ao interesse, os alunos do 5º período afirmaram apresentar “pouco interesse”, enquanto os do 10º período relataram “bastante interesse”. Conclusão: De acordo com as opiniões dos alunos de graduação em Fisioterapia, existe uma limitação no conhecimento dos mesmos acerca da Saúde Pública. Observa-se maior interesse no estudo da Saúde Pública pelos acadêmicos mais próximos da conclusão do curso