Comparative study of two protocols of eccentric exercise on knee pain and function in athletes with patellar tendinopathy: randomized controlled study

INTRODUCTION: The eccentric squat on a slope has been proved effective in conservative treatment of patellar tendinopathy, especially in the athletic population. However, several aspects such as intensity and pain during therapy still differ among authors. OBJECTIVES: To compare the effectiveness of two protocols of eccentric exercise (performed with and without pain), in the improvement of knee function and pain intensity in athletes with patellar tendinopathy. METHODS: 7 athletes of both genders with diagnosis of patellar tendinopathy were selected and randomly assigned to two treatment groups. The first group of volunteers performed eccentric squat exercises on a slope with pain in the patellar tendon. The second group of volunteers was instructed to perform the same exercise, but without presenting pain in the patellar tendon during performance. The treatment lasted 12 weeks and the evaluation of pain and function was performed by the VISA-P and VAS before starting treatment, at eight weeks of intervention, and at treatment completion. RESULTS: There was improvement in both groups when results of evaluations carried out after eight and 12 weeks of beginning of the treatment were compared with the initial evaluation; however, no significant difference between the group that performed exercise with pain and the group that performed exercises without pain was found. Analysis of the probability of obtaining clinical improvement for VISA and VAS scores at eight and 12 weeks, there was no difference between the two groups. CONCLUSION: A program of eccentric exercise on an inclined plane using squat, performed with or without the presence of pain, was effective in improving pain and function in athletes with patellar tendinopathy.INTRODUÇÃO: O agachamento excêntrico em plano inclinado tem-se mostrado eficaz no tratamento conservador da tendinopatia patelar, especialmente na população atlética. Entretanto, diversos aspectos, como intensidade e dor durante a realização da terapia, ainda apresentam divergências entre autores. Objetivos: Comparar a eficácia de dois protocolos de exercício excêntrico (executado com e sem dor), na melhora da função do joelho e na intensidade da dor em atletas com tendinopatia patelar. MÉTODOS: Foram selecionados 17 atletas de ambos os gêneros com diagnóstico de tendinopatia patelar e aleatoriamente distribuídos em dois grupos de tratamento. Os voluntários do primeiro grupo realizaram exercícios de agachamento excêntrico em plano inclinado com dor no tendão patelar. Os voluntários do segundo grupo foram orientados a realizar o mesmo exercício, porém sem apresentar dor no tendão patelar durante a realização. O tratamento teve a duração de 12 semanas e a avaliação de dor e função foi realizada pelo VISA-P e pela EVA antes de iniciar o tratamento, com oito semanas de intervenção e ao término do tratamento. RESULTADOS: Houve uma melhora em ambos os grupos quando comparados os resultados das avaliações realizadas após oito e 12 semanas do início do tratamento com a avaliação inicial, porém não houve diferença significativa entre o grupo que realizou exercício com dor e o grupo que executou os exercícios sem dor. Na análise da probabilidade de obtenção de uma melhora clínica para os escores de VISA e EVA em oito e 12 semanas, não houve nenhuma diferença entre os dois grupos. CONCLUSÃO: Um programa de exercício excêntrico usando agachamento em plano inclinado, realizado com ou sem a presença de dor, foi eficaz na melhora da dor e da função em atletas com tendinopatia patelar.Universidade Federal de São Paulo (UNIFESP) Centro de Traumato-Ortopedia do EsporteUniversidade Cidade de São Paulo Programa de MestradoUNIFESP, Centro de Traumato-Ortopedia do EsporteSciEL

LOWER EXTREMITY POSITION INFLUENCE ON THE POSTURAL STABILITY INDEX REGISTERED BY THE BIODEX STABILITY SYSTEM

The Biodex Balance System is a multiaxial device that objectively measures and records an individual’s ability to stabilize the determined joint under dynamic stress. Some authors describe the importance of knee position strategy for stabilizing balance in this situation; however, the reliability of each knee position is underestimated. With this the objective of this study is to compare intrarater reliability of two knee position situations in the Biodex Balance System test

Bond strength between acrylic resin and maxillofacial silicone

The development of implant dentistry improved the possibilities of rehabilitation with maxillofacial prosthesis. However, clinically it is difficult to bond the silicone to the attachment system. OBJECTIVES: This study aimed to evaluate the effect of an adhesive system on the bond strength between acrylic resin and facial silicone. MATERIAL AND METHODS: A total of 120 samples were fabricated with auto-polymerized acrylic resin and MDX 4-4210 facial silicone. Both materials were bonded through mechanical retentions and/or application of primers (DC 1205 primer and Sofreliner primer S) and adhesive (Silastic Medical Adhesive Type A) or not (control group). Samples were divided into 12 groups according to the method used to attach the silicone to the acrylic resin. All samples were subjected to a T-peel test in a universal testing machine. Failures were classified as adhesive, cohesive or mixed. The data were evaluated by the analysis of variance (ANOVA) and the Tukey's HSD test (α=.05). RESULTS: The highest bond strength values (5.95 N/mm; 3.07 N/mm; 4.75 N/mm) were recorded for the samples that received a Sofreliner primer application. These values were significantly higher when the samples had no scratches and did not receive the application of Silastic Medical Adhesive Type A. CONCLUSIONS: The most common type of failure was adhesive. The use of Sofreliner primer increased the bond strength between the auto-polymerized acrylic resin and the Silastic MDX 4-4210 facial silicone

Musculoskeletal injuries in young handball players: a cross-sectional study

O objetivo deste estudo foi descrever a população, as características do treinamento e o histórico de lesões musculoesqueléticas em atletas de handebol do gênero feminino e investigar possíveis associações entre as características de treinamento com lesões musculoesqueléticas relacionadas ao handebol. Participaram deste estudo transversal 220 atletas, que responderam a um questionário autorreportado que abordava dados pessoais, características do treinamento e lesões prévias relacionadas ao handebol nos últimos 12 meses. Os dados foram analisados por estatística descritiva e modelos de regressão logística. Os resultados demonstram que a maioria era constituída de atletas com idade aproximada de 15 anos, com índice de massa corpórea classificado como normal, que realizavam 3 treinos por semana, com carga horária semanal de aproximadamente 8 horas e 30 minutos. As principais lesões encontradas foram as entorses e as tendinopatias, sendo o tornozelo e o joelho as regiões mais acometidas. Somente a experiência no esporte acima de 6 anos mostrou relação estatística com lesões prévias (p=0,032). A prevalência de lesões nos últimos 12 meses nesta população foi de 53,60%.This study aimed to describe the population, training features and history of musculoskeletal injuries in young female handball players and to investigate possible associations between these features and previous musculoskeletal injuries related to handball. The subjects of this cross-sectional study were 220 athletes who completed a self-reported questionnaire about personal data, training features and previous injuries related to handball in the last 12 months. Data were analyzed using descriptive statistics and logistic regression models. The results showed that most of the athletes were approximately 15 years old, had a body mass index was classified as normal, worked out at an average of 3 times a week and their weekly workload was approximately 8 hours and 30 minutes. The main injuries found were sprains and tendinopathies, with the ankle and knee being the most affected regions. Only the sport practice of over 6 years showed statistical relationship with previous injuries (p=0.032). The prevalence of injuries in the last 12 months in this population was 53.60%.Este estudio tuvo los propósitos de describir la población, las características de entrenamiento y el historial de lesiones musculo esqueléticas en atletas de balonmano del género femenino y de investigar posibles asociaciones entre las características del entrenamiento a este tipo de lesiones relacionadas con la práctica del balonmano. Han participado de este estudio transversal 220 atletas, que contestaron a un cuestionario auto reportado que contenían datos personales, características del entrenamiento y lesiones previas relacionadas con la práctica del balonmano en los últimos 12 meses. Se han evaluados los datos por estadística descriptiva y modelos de regresión logística. Los resultados muestran que la mayoría se constituía por atletas de edad cercana a los 15 años, con índice de masa corporal clasificado como normal, que hacían entrenamiento 3 veces por semana, con carga horaria semanal de cerca de 8 horas y 30 minutos. Se han encontrado las principales lesiones: esguinces y tendinopatías, en que el tobillo y la rodilla eran los más afectados. Se ha mostrado relación estadística con lesiones previas (p=0,032) solamente la experiencia de más de 6 años en la práctica del deporte. El 53,60% fue la prevalencia de lesiones en los últimos 12 meses en la población investigada

Swimmer's shoulder in young athlete: Rehabilitation with emphasis on manual therapy and stabilization of shoulder complex

Universidade Federal de São Paulo, Escola Paulista Med, Ctr Traumatol Esporte CETE, Dept Ortopedia & Traumatol, BR-04039060 São Paulo, BrazilUniversidade Federal de São Paulo, Dept Fisioterapia, BR-04039060 São Paulo, BrazilUniversidade Federal de São Paulo, Escola Paulista Med, Ctr Traumatol Esporte CETE, Dept Ortopedia & Traumatol, BR-04039060 São Paulo, BrazilUniversidade Federal de São Paulo, Dept Fisioterapia, BR-04039060 São Paulo, BrazilWeb of Scienc

Influence of knee position on the postural stability index registered by the Biodex Stability System

The importance of knee position for bodily stability is described by some authors, however Biodex Stability System (BSS) trials have not been used to assess the reliability and effects of different knee positions. the purposes of this study were to test the reliability of BSS indices using two knee positions in the measurement protocol (either permitting slight knee flexion or maintaining them locked in total extension) and to compare the BSS indices between these two knee positions. the measurements were taken of the Overall Stability Index (OSI), Anterior-Posterior Stability Index (APSI) and Medial-Lateral Stability Index (MLSI) during a 30 s protocol which gradually and automatically increased in difficulty among 21 healthy female subjects (22.8 +/- 1.0 years old). the subjects performed four trials which, without visual feedback, permitted knee flexion as well as four trials which did not, in a randomized order. the first two trials in each set were used for familiarization only. Permitting slight flexion yielded better reliability results (OSI Intra-class Correlation Coefficient [ICC] = 0.93, APSI ICC = 0.90, MLSI ICC = 0.89) than maintaining the knee in total extension (OSI ICC = 0.88, APSI ICC = 0.87, MLSI ICC = 0.79), with good agreement in the Bland and Altman test. Moreover, permitted knee flexion in BSS presented better balance stability values for OSI (P = 0.001) and APSI (P = 0.024), however the MLSI did not present significant difference between positions (P = 0.345). (C) 2008 Elsevier B.V. All rights reserved.Univ Estadual Londrina, Londrina, BrazilUniversidade Federal de São Paulo, Ctr Traumatol Esporte, São Paulo, BrazilUniversidade Federal de São Paulo, Ctr Traumatol Esporte, São Paulo, BrazilWeb of Scienc

Surgical-allogeneic facial reconstruction: facial transplants.

Several factors including cancer, malformations and traumas may cause large facial mutilation. These functional and aesthetic deformities negatively affect the psychological perspectives and quality of life of the mutilated patient. Conventional treatments are prone to fail aesthetically and functionally. The recent introduction of the composite tissue allotransplantation (CTA), which uses transplanted facial tissues of healthy donors to recover the damaged or non-existent facial tissue of mutilated patients, resulted in greater clinical results. Therefore, the present study aims to conduct a literature review on the relevance and effectiveness of facial transplants in mutilated subjects. It was observed that the facial transplants recovered both the aesthetics and function of these patients and consequently improved their quality of life