Rehabilitacion最新文献

Persistent knee pain in patients around the fifth decade of life is a frequent cause of attention in rehabilitation consultations. The most common cause of diagnosis is knee osteoarthritis, considering the existence of different degrees seen in simple radiographies. The advanced degrees present joint space reduction, osteophytosis and subchondral sclerosis; however, in the initial degrees, the findings are more subtle and sometimes nonexistent for conventional radiology. Clinical ultrasound has partly come to fill this «diagnostic gap», making it possible to detect meniscal extrusions and small osteophytes as signs of incipient osteoarthritis and to relate them as triggers of pain. In clinical practice we find a group of patients who, with little or no radiological alterations, present persistent and severe pain with medial predominance in most cases. These, until the appearance of the current evidence, were subsidiaries of meniscectomies. At this moment, when meniscectomies are not recommended, it is necessary to find a treatment for those cases in which conservative and non-ablative interventional treatment has failed. In this context, the possibility of using radiofrequency arises. Its use is widespread in the case of tricompartmental and advanced osteoarthritis. However, little data is available on its usefulness in cases of medial meniscal extrusion. It seems that thermal radiofrequency has greater effects than pulsed radiofrequency. We present a clinical case where thermal radiofrequency of the medial genicular nerves of the knee is proposed as a therapeutic alternative for chronic pain secondary to medial meniscal extrusion associated with incipient knee osteoarthritis, with the result of a decrease in pain (VAS 8 before treatment, VAS 1 after one year), subjective improvement of 80% and gait capacity.

Objective

To evaluate the efficacy of equine-assisted therapy for the static and dynamic balance in the rehabilitation of children and adolescents with cerebral palsy maintaining obtained improvement 8-weeks after the end of the intervention.

Method

The study lasted 28 weeks, of which the intervention lasted 12 weeks. Measurements were taken before, in the middle, after the end of the intervention and follow-up after 12 weeks. Paediatric Balance Scale and dynamic plate were used to evaluate the balance. Wechsler Intelligence Scale for Children (3rd edition) was used to assess mental capacity, and the Gross Motor Function Classification System for the assessment of functional capacity for the participants. Exercises on the horseback were individualised for every participant.

Results

The study comprised 27 participants with cerebral palsy. Statistically significant improvements were found for the Paediatric Balance Scale (p < 0.001) and the mean dynamic plate pressure for both feet (p < 0.05). The Paediatric Balance Scale results remained in the follow-up and were found clinically significant.

Conclusions

The results suggest that this type of approach in rehabilitation can be beneficial with clinical significance for improving the motor dysfunctions and quality of life in cerebral palsy.

The aim of the present systematic review was to determine the effect of communication in the health care setting on kinesiophobia. To this end, a literature search was conducted in seven databases between November 2022 and February 2023. The review was carried out following the PRISMA statement and for the analysis of methodological quality we used: PEDro Scale, Van Tulder criteria and risk of bias analysis of the Cochrane Collaboration. A total of 13 articles were included with a mean methodological quality of 7.1 out of 10. Significant results were obtained for at least one variable (kinesiophobia, disability or level of physical activity) in 12 articles. There is strong evidence that communication can influence a subject's kinesiophobia. This influence is most likely to be in a negative or disabling sense, but it can also act in a positive sense by decreasing it.

The COVID-19 pandemic has affected the world population, especially people from social groups in a situation of greater vulnerability among people with some functional dependency. Therefore, the aim of this review was to describe interventions during the pandemic to preserve general health, maintain function and independence, and prevent COVID-19 infection for functionally dependent adults (FDA). A systematic search in databases was carried out. Titles and abstracts of each publication were reviewed for relevance. Full-text articles were accessed by two independent reviewers. The information found was classified into three categories: 1) FDA during the COVID-19 pandemic, 2) FDA during the COVID-19 pandemic according to a specific condition (neurological conditions, sensory disabilities/impairments, and cognitive impairment), and 3) Older adults with functional dependence. The FDAs have faced difficulties and barriers during the COVID-19 pandemic. Strengthening strategies such as telerehabilitation is suggested to avoid deterioration or aggravation of the functionality of dependent people.

This study aimed to evaluate the effectiveness of early pelvic muscle training in reducing urinary incontinence symptoms, improving quality of life, sexual function, and increasing pelvic floor strength in post-radical prostatectomy patients. A search was carried out in 8 databases until October 26, 2022, the methodological quality and the risk of bias of 14 included studies (n = 1236) were evaluated, moreover, the evidence and the meta-analysis were calculated. The intervention significantly reduced urinary incontinence symptoms compared to a control group (SMD = −2.80, 95% CI = −5.21 to −0.39, P = .02), with significant heterogeneity (I² = 83%; P = < .0001) and moderate evidence. In addition, it presented moderate evidence to improve quality of life, and very low evidence to improve sexual function and pelvic floor strength. These results should be viewed with caution due to the significant heterogeneity of the studies analysed.

Introduction

The anterior cruciate ligament (ACL) is the most frequently injured ligament of the knee. However, quantitative studies on evaluate the postural control influence resulted from the ACL remnant preservation or not are scarce. The aim of this study is to evaluate the postural control of patients submitted to ACL reconstruction with and without preservation of the injured remnant in pre and postoperative periods.

Methods

Eighteen patients underwent ACL reconstruction and separated into 2 groups according to the preservation or not of the remnant: (I) submitted to ACL reconstruction with preservation of the remnant (10 patients); (II) submitted to ACL reconstruction without preservation of the remnant (8 patients). They were assessed using the Lysholm score and force plate, which evaluated the patient's postural stability for remnant and non-remnant preservation in ACL reconstruction surgery.

Results

Group I showed statistically significant subjective and objective improvements, both at 3 and 6 months. Additionally, improvement of the Lysholm test at 6 months in Group II was also statistically significant. Furthermore, the results of the Friedman test for the V_COP and V_Y variables of Group I, with support of the injured side in the force plate, showed a statistically significant difference both for pre and postoperative period at 3 months, compared to the 6-month postoperative period. The variables EAC and V_X were statistically different for Group II, considering the preoperative period, 3 and 6 months postoperatively.

Conclusion

Preserving the ACL remnant in patients with ACL injuries has a positive impact on postural stability during recovery.

Early motor intervention is essential in children with cerebral palsy; however, it is unknown its effectiveness between 3 to 5 years. The objective was to determinate the effectiveness of early motor intervention in the motor development of this population. A systematic literature search was performed in Pubmed/Medline, PEDro, OTSeeker, Embase, and LILACS. Finally, 18 articles were selected, of which 4 showed favorable changes in the experimental group in the outcomes of overall motor development and manual motor function, with sensory integration therapy and movement-induced restriction therapy, respectively; however, the results were not statistically significant, and the level of evidence was low. Early motor intervention could be cautiously considered for improving overall motor development and manual function. Higher-quality methodological studies are necessary.