Proprioceptive Neuromuscular Facilitation (PNF) is a concept that has been applied to treating numerous disabling disorders. Among the basic PNF procedures, there is motor irradiation, in which resistance is applied to a body segment to generate muscle activation in another segment and thus obtain improvement in muscle strength. The generated muscular activation can be analyzed in several ways, one of them being Electromyography (EMG). Electromyographic analysis has suggested that target muscles of irradiation demonstrate electromyographic activity during irradiation in healthy individuals and in those with neurological disorders. Despite this, the neuromuscular activation profile (amplitude and temporality) resulting from the different stimuli and positions used in PNF has not yet been investigated.
To analyze the neuromuscular activation profile of upper limb muscles in healthy individuals during the application of different PNF irradiation protocols.
This is a cross-sectional study in which 32 healthy individuals of both sexes, aged between 18 and 45 years. After signing the consent form, the handedness of a subject in activities of daily living, level of physical activity, and sociodemographic characteristics will be identified. First, the EMG signals of the upper limb muscles (biceps brachii, brachioradialis, flexor carpi radialis, and triceps) will be collected during a maximum voluntary contraction (3 repetitions held for 3s with an interval of 30s between contractions). Then, the EMG signal of these muscles of the non-preferential limb will be collected, during 4 PNF irradiation techniques in a randomized order for each participant. Each irradiation will be applied 3 times, maintaining the contraction for 5s, with a 10s interval between them. After each irradiation will be checked the perceived exertion.
The study is in the data collection phase.
It is expected through this study to verify if the applied irradiation techniques activate the musculatures described anecdotally in the clinical literature.
The study can generate an understanding of motor irradiation and the use of the technique to improve the strength of a body segment.
According to the Uncontrolled Manifold (UCM) approach, motor synergies allow motor flexibility while ensuring stable task performance. The stronger the motor synergies, the greater performance stabilization. Thus, just before the start of a new motor task, the synergies need to be attenuated to facilitate the initiation or change of movement. This reduction in synergy during the preparation for movement initiation is called Anticipatory Synergy Adjustments (ASAs). In individuals with neurological deficits, changes in the timing or magnitude of ASAs can result in reduced movement agility or greater difficulty initiating a new task. Additionally, altered ASAs can serve as preclinical markers of neurological dysfunctions such as Parkinson's disease or multiple sclerosis.
The aim of this study was to characterize the behavior of ASAs in populations with neurological dysfunctions and analyze their clinical implications.
A narrative review of studies that used the UCM approach to quantify ASAs in individuals with neurological dysfunctions was conducted.
The review resulted in the inclusion of 9 exploratory studies. The study samples consisted of individuals with Parkinson's disease (PD), olivopontocerebellar atrophy (OA), stroke, multiple sclerosis (MS), and cerebral palsy (CP). The motor tasks analyzed in the studies were divided into manual tasks and standing postural control tasks. In individuals with PD, MS, and OA, delayed and smaller magnitude of ASAs were observed when compared to healthy individuals. In individuals with CP and stroke, ASAs in manual tasks differed from healthy individuals in small magnitudes.
In general, the observed changes in ASAs in the study lead to reduced agility during task execution and greater difficulty initiating new movements.
The use of the UCM method and the analysis of ASAs appears to be sensitive for the early detection of some neurological conditions and tracking disease progression and intervention effects, especially in individuals with subcortical disorders. However, using UCM to evaluate patients in the clinical context is still challenging. Its application requires specific technology and knowledge, which limits its use to the search environment. It would be interesting if future studies investigated the relationship between the behavior of ASAs and performance in commonly used functional instruments/questionnaires in clinical practice so that the understanding and application of the UCM method in the clinical context can be optimized.
Neck pain is a common disabling condition that directly affects the performance of daily life activities and participation in professional, social and sports activities, being one of the main causes of functional disability in the world. Telerehabilitation-based treatments have demonstrated their importance due to their ease of use, low cost, and tendency to improve clinical outcomes. However, in the current scientific evidence, there is a lack of studies that exemplify telerehabilitation protocols in individuals with chronic non-specific neck pain.
The study was to verify the effect of a telerehabilitation protocol versus an online self-care booklet in individuals with non-specific chronic neck pain.
This is a blinded, randomized, controlled clinical trial that compares a telerehabilitation program for neck pain with a control group that will receive an online self-care booklet. Seventy patients will be recruited. Assessments and measures will perform before treatment, after 6 weeks and at 3 months after randomization. For this purpose, assessments and follow-ups will be carried out completely remotely, through online platforms (Google Meet, smartphone messages, email) and telephone calls. The primary outcome will be functional disability measured by the Neck Disability Index questionnaire consisting of 10 items. Secondary outcomes will be pain intensity measured using the numeric rating scale, perceived global effect measured using the perceived global exertion scale, patient self-efficacy using the Pain Self Efficacy Questionnaire, quality of life using the SF-12, and kinesiophobia through the Scale of Kinesiophobia. This clinical trial was approved by the Research Ethics Committee (no. 5.458.454) and was registered in the Brazilian Registry of Clinical Trials (no. RBR-10h7khvk).
No results so far.
This study will examine whether the telerehabilitation treatment approach is superior to the self-care booklet in patients with chronic neck pain, functional disability, pain intensity, perceived global effect, patient self-efficacy, quality of life and kinesiophobia.
The study will impact clinical practice because telerehabilitation is a treatment option that aims to promote improvements in the functional disability and pain intensity of individuals with nonspecific chronic neck pain. This form of treatment appears as an alternative to ease the logistical and organizational conditions promoted by face-to-face care.
The Pediatric Intensive Care Unit of philanthropic public hospitals belonging to the Unified Health System serves children with the most varied pathologies, clinical and surgical, being a reference for many services in the metropolitan region. Technological advances in health and the improvement of public policies in the prevention, control, and fight against child injuries gradually contribute to reducing infant mortality rates.
To identify the epidemiological profile and clinical evolution of children and adolescents hospitalized in the Pediatric Intensive Care Unit of a reference hospital in Natal/RN in physiotherapeutic follow-up.
Descriptive and retrospective study carried out at the Pediatric Intensive Care Unit of the Hospital Infantil Varela Santiago (reference in Neurosurgical and Oncological care), Natal/RN, through quantitative analysis of data from medical records of children between 0 and 15 years old in physiotherapeutic follow-up in the first quarter of 2023 (January to March). Age, sex, evolution to discharge/death, length of hospital stays, need for mechanical ventilation, and duration of mechanical ventilation were obtained by descriptive and retrospective analysis of medical records, with categorical variables expressed in absolute frequencies and percentages and continuous variables, presented as averages and standard deviation.
Sixty-three (63) children were admitted to Physiotherapy, 34 boys (53.96%) with a mean age of 3.77±4.29 years. The length of stay in the ICU was 14.3 ± 22.8 days; 21 children (33.33%) required invasive mechanical ventilation, with a mean IMV time of 14.8±17.3 days. As an outcome, 15 children (23.80%) were transferred to other services or discharged straight home, 39 (61.90%) were discharged to the ward, 6 (9.52%) died, and 3 (4.76%) remained hospitalized.
We observed a predominance of male children in this Intensive Care Unit, with an average age of 3.7 years. The length of stay can be correlated with the complexity of the Unit in question (neurosurgical and oncology children), with a mortality rate below 10%.
Knowledge of the profile of this Unit implies improvement in care, optimization of treatment, reduction of expenses, and length of stay during hospitalization.
Work ability (WA) is considered the result of the interaction of personal, social, and other factors related to the work environment. To what extent WA can predict absenteeism at work due to occupational health in professional drivers remains poorly investigated.
To analyze the association between work ability and occupational health-related absenteeism at work in professional drivers.
From 2020 to 2021, 449 professional drivers were assessed for sociodemographic information, lifestyle (Baecke questionnaire, Work Stress Scale), and work ability (Work Ability Index, WAI) in Curitiba, Paraná (Brazil). Follow-up assessments were conducted at 6 and 12 months by telephone to answer 3 questions that aimed at information about professional performance, situations of occupational absenteeism, and accidents at work.
After 12 months of the initial interview, 270/449 drivers (60%) remained as research participants and the others did not remain active in the profession (n=29/449, 7%) or did not respond to telephone contact (n= 53/449, 12%). WAI was inversely associated (β=-0.119 CI 95% -0.233 to -0.006, P=0.039) with general absenteeism at 12 months, explaining better WAI variability and showing a better fit of the latter model (AIC=137, R²= 0.028, P=0.074 vs. R² = 0.050, AIC = 92, P=0.039). Separating the reasons for absenteeism between occupational health and accidents at work, we concluded that WAI was inversely associated with absenteeism due to occupational health at 6 months ((β=-0.096 CI95% -0.187 to -0.006, P=0.037) and accidents at work at 12 months (β=-0.189 95% CI -0.331 to -0.047, P=0.009).
Work ability can predict 1-year absenteeism due to occupational health in professional drivers.
Absenteeism due to occupational health can be detected using current work ability information in professional drivers. Further studies are required to test whether ergonomic interventions can promote occupational health and decrease absenteeism in this population.
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