13 research outputs found
How do elite female athletes cope with symptoms of their premenstrual period? A study on Rugby Union and Football players’ perceived physical ability and well-being
No full textWomen’s participation in sports has recently grown worldwide, including in sports typically associated with men (e.g., rugby and football). Similarly, literature on female athletes has increased, but how they cope with premenstrual (PM) physical and affective symptoms remains a poorly studied topic. Our study aimed to explain which coping strategies elite female rugby and football players use during their PM period to maintain perceived physical ability (PPA) and well-being. A mediation model analysis considering coping strategies (i.e., avoiding harm, awareness and acceptance, adjusting energy, self-care, and communicating) as independent variables, PPA and well-being as dependent variables, and PM physical and affective symptoms and PM cognitive resources as mediators was run on the data collected via an anonymous online survey. A dysfunctional impact of avoiding harm (indirect) and adjusting energy (both direct and indirect) and a functional indirect influence of awareness and acceptance, self-care, and communicating as coping strategies were found on PPA and well-being during the PM period. As predicted, PM physical and affective symptoms as mediators reduced PPA and well-being, while PM cognitive resources enhanced them. These results may inform practitioners on how to support elite female athletes’ PPA and well-being by knowing and reinforcing the most functional PM coping strategies for them
Epidemiological study of sports injuries in basketball, futsal and volleyball among young athletes: aspects of training and clinical monitoring
No full textO objetivo deste estudo foi verificar a incidência das principais lesões esportivas comuns em atletas jovens de 16 a 19 anos de idade, que participaram de treinamento regular ou federado no ano de 2002, nas modalidades esportivas basquetebol, futsal e voleibol. Foram identificados, também, alguns aspectos de treinamento e estrutura médica. Para isso, aplicou-se um questionário para 323 atletas e entrevistas com 26 técnicos e 8 médicos, de 20 clubes esportivos de São Paulo. Os resultados do estudo indicaram um total de 343 lesões ou 1,7 lesão/atleta/ano. No basquetebol, as lesões mais comuns foram as entorses; a região corporal mais acometida de lesão foi a do tornozelo, seguida do joelho, coluna e dedos da mão; os armadores foram os mais afetados. No futsal, a lesão mais comum foi a entorse de tornozelo e houve ocorrência de lesão nas regiões da coxa e joelho; pivôs foram os mais afetados. No voleibol, a lesão mais comum foi a tendinite, principalmente na região do joelho, seguida das entorses e lesões musculares; a posição de meio de rede foi a mais afetada. As lesões ocorreram com uma maior freqüência em situações de treinamento. Dos 20 clubes avaliados, apenas oito possuem um médico especializado plantonista. Tal fato indica que alguns fatores de risco, como medidas preventivas em situações de treinamento, exame de pré-participação esportiva e acompanhamento médico especializado, não são devidamente organizados para os atletas jovens nos clubes avaliadosThe objective of this study was to evaluate the incidence of the main sports injuries commonly found in young athletes in the 16-19 year age group who participated in regular or federate trainings during 2002 in sports modalities such as basketball, futsal and volleyball. Also identified were some aspects of training and clinical structure. To obtain these data, a questionnaire was applied to 323 athletes and surveys were performed among 26 coaches and 8 physicians from 20 sports clubs located in Sao Paulo (Brazil). The results of the study showed a total of 343 injuries or 1.7 injury/athlete/year. In basketball, the most common injuries were sprains, the most affected body regions in terms of injury being the ankles, followed by knees, backbones and fingers; point guards being the most affected athletes. In futsal, the most common injuries were ankle sprains, the thigh and knee regions being also affected by injuries; pivots were the most affected among the team. In volleyball, the most common injury was tendonitis, mainly in the knee region, followed by sprains and muscle injuries; the most affected position being the forward-center\'s. The frequency of injuries was higher during trainings. Only eight of the 20 sports clubs evaluated actually hire specialized emergency physicians. This fact indicates that some risk factors such as preventive measures during trainings, sports preparation evaluation, and specialized clinical monitoring are not appropriately organized for young athletes in the assessed sports club
Development and validation of low back pain knowledge questionnaire u LKQ
No full textBV UNIFESP: Teses e dissertaçõe
Epidemiological study of sports injuries in basketball, futsal and volleyball among young athletes: aspects of training and clinical monitoring
No full textO objetivo deste estudo foi verificar a incidência das principais lesões esportivas comuns em atletas jovens de 16 a 19 anos de idade, que participaram de treinamento regular ou federado no ano de 2002, nas modalidades esportivas basquetebol, futsal e voleibol. Foram identificados, também, alguns aspectos de treinamento e estrutura médica. Para isso, aplicou-se um questionário para 323 atletas e entrevistas com 26 técnicos e 8 médicos, de 20 clubes esportivos de São Paulo. Os resultados do estudo indicaram um total de 343 lesões ou 1,7 lesão/atleta/ano. No basquetebol, as lesões mais comuns foram as entorses; a região corporal mais acometida de lesão foi a do tornozelo, seguida do joelho, coluna e dedos da mão; os armadores foram os mais afetados. No futsal, a lesão mais comum foi a entorse de tornozelo e houve ocorrência de lesão nas regiões da coxa e joelho; pivôs foram os mais afetados. No voleibol, a lesão mais comum foi a tendinite, principalmente na região do joelho, seguida das entorses e lesões musculares; a posição de meio de rede foi a mais afetada. As lesões ocorreram com uma maior freqüência em situações de treinamento. Dos 20 clubes avaliados, apenas oito possuem um médico especializado plantonista. Tal fato indica que alguns fatores de risco, como medidas preventivas em situações de treinamento, exame de pré-participação esportiva e acompanhamento médico especializado, não são devidamente organizados para os atletas jovens nos clubes avaliadosThe objective of this study was to evaluate the incidence of the main sports injuries commonly found in young athletes in the 16-19 year age group who participated in regular or federate trainings during 2002 in sports modalities such as basketball, futsal and volleyball. Also identified were some aspects of training and clinical structure. To obtain these data, a questionnaire was applied to 323 athletes and surveys were performed among 26 coaches and 8 physicians from 20 sports clubs located in Sao Paulo (Brazil). The results of the study showed a total of 343 injuries or 1.7 injury/athlete/year. In basketball, the most common injuries were sprains, the most affected body regions in terms of injury being the ankles, followed by knees, backbones and fingers; point guards being the most affected athletes. In futsal, the most common injuries were ankle sprains, the thigh and knee regions being also affected by injuries; pivots were the most affected among the team. In volleyball, the most common injury was tendonitis, mainly in the knee region, followed by sprains and muscle injuries; the most affected position being the forward-center\'s. The frequency of injuries was higher during trainings. Only eight of the 20 sports clubs evaluated actually hire specialized emergency physicians. This fact indicates that some risk factors such as preventive measures during trainings, sports preparation evaluation, and specialized clinical monitoring are not appropriately organized for young athletes in the assessed sports club
A relação entre o acompanhamento médico e a incidência de lesões esportivas em atletas jovens de São Paulo
No full textThe development and validation of a low back pain knowledge questionnaire - LKQ
No full textOBJECTIVE: The objective of this study was to develop and validate a questionnaire on specific knowledge about low back pain entitled "The Low Back Pain Knowledge Questionnaire". INTRODUCTION: There is a need for instruments to assess patient knowledge regarding chronic illness. Such methods can contribute to the education of patients. METHODS: The Low Back Pain Knowledge Questionnaire was developed through five focus groups. The questionnaire was distributed to 50 patients to assess their comprehension of the terms. To assess the reproducibility, 20 patients were surveyed by two different interviewers on the same day and twice by a single interviewer with a one-to-two week interval. For the construct validation, the Low Back Pain Knowledge Questionnaire was given to 20 healthcare professionals with knowledge on low back pain and 20 patients to determine whether the questionnaire would discriminate between the two different populations. To assess the sensitivity of the questionnaire to changes in the knowledge level of the patients, it was given to 60 patients who were randomly assigned to the Intervention Group and the Control Group. The Intervention Group answered the questionnaire both before and after attending a chronic back pain educational program (back school), whereas the Control Group answered the questionnaire twice with an interval of one month and no educational intervention. RESULTS: The focus groups generated a questionnaire with 16 items. The Spearman's correlation coefficient and the intra-class correlation coefficients ranged from 0.61 to 0.95 in the assessments of the intra-observer and inter-observer reproducibility (p< 0.01). In the construct validation, the healthcare professionals and patients showed statistically different scores (p< 0.001). In the phase regarding the sensitivity to change, the Intervention Group exhibited a significant increase in their specific knowledge over the Control Group (p< 0.001). CONCLUSION: The Low Back Pain Knowledge Questionnaire was validated and proved to be reproducible, valid and sensitive to changes in patient knowledge
Minimal suture associated with fibrin adhesive in microvascular arterial anastomosis: comparative experimental study with the conventional suture technique
No full textO domínio da técnica de microanastomose vascular é um pré-requisito essencial para a realização de procedimentos microcirúrgicos reconstrutivos, como reimplantes e transferência livre de tecidos. Até hoje, a técnica de sutura convencional é a mais aceita na prática clínica, por sua segurança e versatilidade. Apesar disso, ela apresenta alguns problemas por ser tecnicamente difícil, consumir tempo considerável e causar traumatismo adicional à parede do vaso. O objetivo deste estudo, foi testar um método alternativo de microanastomose arterial, reduzindo o número de pontos de sutura com aplicação do adesivo de fibrina. Sessenta ratos da raça Wistar foram submetidos a microanastomose vascular nas artérias femorais ou carótidas. Os animais foram divididos em quatro subgrupos de acordo com a artéria operada e a técnica de sutura empregada: FSC (femoral - sutura convencional), FAF (femoral - sutura mínima com adesivo de fibrina), CSC (carótida - sutura convencional) e CAF (carótida - sutura mínima com adesivo de fibrina). As duas técnicas de anastomose foram comparadas através de análise estatística dos parâmetros clínicos e histopatológicos. A média de pontos de sutura por anastomose nos subgrupos FSC e CSC foi de 7,7 e 9,5, respectivamente. No subgrupo FAF, as anastomoses foram realizadas com apenas quatro pontos de sutura e no subgrupo CAF, com apenas seis. O tempo de anastomose foi, em média: 15,81 minutos no subgrupo FSC, 13,62 minutos no subgrupo FAF, 18,87 minutos no subgrupo CSC e 17,33 minutos no subgrupo CAF. A aplicação do adesivo de fibrina reduziu, significativamente, o número de pontos e o tempo necessário para realização das anastomoses, nos subgrupos FAF e CAF. A intensidade do sangramento anastomótico também foi reduzida de maneira significativa nestes subgrupos. A freqüência da permeabilidade imediata e tardia foi de 100% em todos os subgrupos, exceto no subgrupo FAF, onde a permeabilidade tardia foi de 93,33%. Não foram observadas diferenças significativas entre as duas técnicas, em relação aos parâmetros histopatológicos avaliados (processo inflamatório, fibrose da camada média e hiperplasia subintimal). O autor concluiu que a técnica de sutura mínima com aplicação do adesivo de fibrina foi mais fácil e rápida que a técnica de sutura convencional, sem aumento da trombogenicidade das anastomoses, no modelo experimental utilizado.Mastering of the microvascular anastomosis technique is an essencial requirement to perform reconstructive microsurgical procedures, such as replantation surgery and free tissue transfers. Until now, the conventional suture technique is the most widely accepted in the clinical setting, for its safety and versatility. However, this technique presents some problems for being technically difficult, time consuming and causes additional trauma to the vessel wall. The aim of this study was to test an alternative method of microvascular arterial anastomosis, by reducing the number of sutures with application of fibrin adhesive. Sixty Wistar rats underwent to microvascular anastomosis at the femoral or carotid arteries. The animals were divided into four subgroups, according to the operated artery and the employed suture technique: FCS (femoral - conventional suture), FFA (femoral - minimal suture with fibrin adhesive), CCS (carotid - conventional suture) and CFA (carotid - minimal suture with fibrin adhesive). Both anastomosis techniques were compared by means of statistical analisys of the clinical and histopathological parameters. The mean number of sutures required to complete the anastomosis was 7,7 in subgroup FCS and 9,5 in subgroup CCS. In subgroup FFA, the anastomosis was performed with only four sutures and in subgroup CFA, with only six. The mean anastomotic time was 15,81 minutes in subgroup FCS, 13,62 minutes in subgroup FFA, 18,87 minutes in subgroup CCS and 17,33 minutes in subgroup CCS. The application of fibrin adhesive, significantly reduced the number of sutures and the time taken to perform the anastomosis, in subgroups FFA and CFA. The amount of anastomotic bleeding was also significantly reduced in these subgroups. The immediate and late patency rates were 100% in all subgroups, except in subgroup FFA where it was 93,33%. No significant differences were observed among the two techniques, concerning the evaluated histopathological parameters (inflammatory process, medial fibrosis and subintimal hyperplasia). The author concluded that, the fibrin adhesive application with minimal suture technique was faster and easier than the conventional suture technique, without increasing the trombogenicity of the anastomosis, in this experimental model
Epidemiological profile of patients with cerebral palsy treated in the AACD-SP
No full textParalisia cerebral (PC) abrange um grupo de síndromes clínicas de causa multifatorial caracterizadas por déficit motor, algumas vezes com disfunção postural. Objetivos: Caracterizar a população dos novos pacientes da clínica de PC na instituição, de Janeiro-2012 a Dezembro-2014. Métodos: Estudo retrospectivo. Avaliados 743 prontuários eletrônicos de pacientes atendidos em consultas iniciais de PC, sendo elegíveis 614 casos. Resultados: Sexo: feminino = 47,4%, masculino = 52,6%. Idade em anos: 29,5% menores de 2; 34% de 2 a 4; 15,5% de 4 a 6; 16,3% de 6 a 12; 4,6% 12 a 18; 0,2% ≥ 18 anos. Ao nascimento 50,7% eram pré-termo e 45% termo. Peso: 9,1% classificados como extremo baixo peso, 16,8% muito baixo peso, 21,8% baixo peso, 43,6% peso adequado, 2,3% macrossômicos. Tipo de parto predominante: cesáreo (56,5%). Classificação clínica e topográfica dos pacientes: 13,4% Hemiparéticos espásticos, 33,9% Diparéticos espásticos, 12,2% Tetraparéticos espásticos, 0,5% Monoparéticos espásticos, 5,9% Discinéticos/atáxicos, 5,7% PC mista, 1% hipotônicos. Em 55,5% das famílias não recebiam auxílio doença. Sobre atendimentos especializados observou-se que para 97,7% dos pacientes tratava-se da primeira consulta com um médico Fisiatra. Conclusão: Maioria das gestantes realizaram pelo menos o número mínimo adequado de consultas de pré-natal. Parto cesariano predominou. Nascimentos pré-termo foi ligeiramente superior comparado com a termo. Tipo de PC predominou o tipo Diparético espástico, com GMFCS nas faixas de 1 a 5 equivalente. Mais da metade das famílias ainda sem acesso a benefício social.Cerebral palsy (CP) is a group of multifactorial clinical syndromes characterized by motor deficit, sometimes with postural dysfunction. Objective: To characterize a new series of clinical CP patients in the institution from January-2012 to December-2014. Method: Retrospective study of 743 electronic medical records of patients screened at CP outpatient facilities. Results: 614 cases were considered eligible. 47.4% female and 52.6% male subjects. 29.5% were under 2 years of age, 34% were from 2 to 4, 15.5% from 4 to 6, 16.3% from 6 to 12, 4.6% from 12 to 18 and 0.2% were above 18 years of age. At birth, 50.7% were preterm and 45% term. Regarding weight, 9.1% were classified as extreme low weight, 16.8% very low weight, 21.8% low weight, 43.6% adequate weight, 2.3% macrosomic. The predominant type of delivery were cesarean section (56.5%). Regarding clinical and topographic classification, 13.4% had spastic hemiplegia, 33.9% spastic diplegia,12.2% spastic tetraplegia, 0.5% spastic monoplegia, 5.9% Dyskinetic / ataxic, 5.7% mixed CP, and 1% were hypotonic. In 55.5% of the families they did not receive any social benefits. Regarding specialized care, for 97.7% of the patients that was the first appointment with a Physiatrist. Conclusion: Most pregnant women undertook at least the minimum number of prenatal visits. Cesarean delivery was predominant. Preterm births were slightly higher. The most prevalent type of CP was the spastic diplegic, with GMFCS ranging from 1 to 5. More than half of families did not manage to have access to social benefits
Myofascial syndrome: comparison between infiltration of trigger points treatment and oral medication (cyclobenzaprine)
No full textObjetivo: Comparar os efeitos da infiltração de trigger points com xilocaína a 1% com o uso da ciclobenzaprina no tratamento a curto prazo da síndrome miofascial (SMF) de trapézio. Material e métodos: Estudo prospectivo controlado randomizado com avaliador “cego” em 38 pacientes com SMF de trapézio. Intervenção realizada no grupo teste (IF) (n = 18): infiltração com xilocaína a 1% em, no máximo, 06 trigger points de trapézio; no grupo-controle (CB) (n = 20) foi fornecido 10 mg/dia de ciclobenzaprina por 15 dias. Os pacientes foram avaliados no tempo zero (T0), em sete (T7), quinze (T15) e trinta dias (T30). Instrumentos de avaliação: escala visual analógica de dor global (EVA de dor global), escala visual analógica de dor à compressão digital de trigger points (EVA de dor à compressão), questionário resumido para dor de McGill. Foi realizada a avaliação da reprodutibilidade interobservador (RI) para EVA de dor à compressão digital. Resultados: Os pacientes apresentaram na avaliação inicial a média de trigger points de 2,0 (+ 0,5), taut band de 3,05 (+ 0,8) e tender spots de 4,64 (+ 1,15). A RI para EVA à compressão mostrou-se boa (pearson > 0,8). Observou-se tendência (p > 0,05) a maior variação do escore de dor (McGill) no grupo-teste, maior variação do tipo de dor e maior incidência de efeitos colaterais no grupo-controle. Ambos os grupos melhoraram ao término do acompanhamento (p < 0,05). A média das variações da EVA de dor global no T7 (-24,2% (+62,8 CB X -40% + 50,9 IF p = 0,19), T15 (-37,6% + 48,4 CB X -50% + 44,8 IF p = 0,3) e T30 (-50% + 60 CB X -70,8% +44,7 IF p = 0,14) foi maior no grupo-teste porém sem significância estatística. Esta tendência também se observou na média das variações da EVA de dor à compressão digital no T7 (-26,8% + 35,34 CB X - 46,5% ( 44,4 IF p = 0,24), no T15 (-38,8% + 38,2 CB X -56,2% + 34,3 IF p = 0,44) e no T30 (-46,6% + 38 CB X -53% + 34,4 IF – p = 0,38), porém mais uma vez sem significância estatística. Conclusão: A semelhança do efeito da ciclobenzaprina com o da infiltração de trigger points permite a indicação da primeira no tratamento de pacientes com SMF de trapézio e questiona a indicação invariável da infiltração de trigger points.Objective: To compare the effects of the infiltration of “trigger points” with lidocaine at 1% with the use of cyclobenzaprine in the short term treatment of trapezius myofascial syndrome (SMF). Material and methods: Randomized controlled prospective study with a “blind” evaluating 38 patients with trapezius SMF. Intervention accomplished in the test group (IF) (n = 18): infiltration with lidocaine at 1% in at the most 06 trapezius ”trigger points”; in the control group (CB) (n = 20) 10 cyclobenzaprine mg/dia was supplied for 15 days. The patients were appraised in the time zero (T0), in seven (T7), fifteen (T15) and thirty days (T30). Evaluation instruments: visual analogue scale of global pain (VAS of global pain), visual analogue scale of pain to the digital compression of “trigger points” (VAS of pain to the compression), short-form McGill pain questionnaire. The evaluation of the interobserver reprodutibility (RI) was accomplished for VAS of pain to the digital compression. Results: The patients presented, in the initial evaluation, AN average of “trigger points” of 2,0 (± 0,5), “taut band” of 3,05 (± 0,8) and to “tend spots” of 4,64 (± 1,15). The RI for VAS to the compression was shown satisfactory (pearson > 0,8). It was observed the largest variation (p > 0,05) of the pain score (McGill) in the IF, larger variation of the type pain and larger incidence of side effects in the CB. Both groups showed improvement at the end of the evaluation (p < 0,05). The average of the variations of VAS of global pain in T7 (-24,2% ± 62,8 CB X -40% ± 50,9 IF p = 0,19), T15 (- 37,6% ± 48,4 CB X -50% ± 44,8 IF p = 0,3) and T30 (-50% ± 60 CB X -70,8% ± 44,7 IF p = 0,14) it was higher in the IF, however without statistical significe. This tendency was also observed in the average of VAS variations of pain to the digital compression on T7 (-26,8% ± 35,34 CB X -46,5% ± 44,4 IF p = 0,24), on T15 (-38,8% ± 38,2 CB X -56,2% ± 34,3 IF p = 0,44) and on T30 (-46,6% ± 38 CB X -53% ± 34,4 IF - p = 0,38), however, once again without statistical significance. Conclusion: The similarity between the effect of the cyclobenzaprine an the infiltration of the trigger points allows the indication of the first in the patients’ treatment with trapezius SMF and it questions the invariable indication of the infiltration of trigger points
Photobiomodulation effect on the masseter muscle in children with cerebral palsy: a case report
No full textA espasticidade acarreta hipertonia nos músculos mastigatórios dos indivíduos com paralisia cerebral (PC), interferindo na amplitude de abertura bucal, dificultando a realização da higiene oral predispondo estes indivíduos a condições consideradas de risco para o desenvolvimento de doenças bucais. Objetivo: Avaliar o efeito da fotobiomodulação com laser de diodo, de baixa intensidade na espessura do músculo masseter em uma criança com PC do tipo espástico. Método: O relato do cuidador era que a criança apresentava grande dificuldade na realização da higiene bucal e com movimentos de fuga da cabeça quando a escova dental tocava a região de molares superiores. Com relação ao desconforto da criança, a mãe referiu como extremo. A 1ª avaliação ultrassonográfica foi realizada na avaliação inicial, e a 2ª avaliação após 6 sessões de aplicação de fobioestimulação. Foi empregado o Laser infravermelho, de Diodo, de baixa intensidade, As-Ga-Al, (λ = 808 ± 3 nm, 120 mW; Twin Flex Evolution Laser MMOptics São Paulo, Brazil), usando 5,0 J/cm2 energia dose/local, com 20 segundos de exposição/local. A área do músculo masseter irradiado bilateralmente foi o ponto médio no sentido da sua extensão e largura. Foram realizadas seis sessões, com intervalo de 7 dias entre elas. Resultados: Ao final da sexta sessão da fotobioestimulação, a responsável relatou que a criança dormia melhor, apresentava redução no número de movimentos involuntários realizados pela mandíbula e a realização da higiene bucal era possível sem expressão dolorosa da criança. Durante a palpação observou-se menor hipertonia em masseter bilateral, ganho em espessura, e aumento na distância inter-incisal de 7 mm. Conclusão: A fotobioestimulação com laser de diodo parece ser efetiva na redução da espasticidade no músculo masseter de crianças com PC do tipo espástico.Spasticity causes stiffness in the masticatory muscles of individuals with cerebral palsy (CP), affecting the amplitude of mouth opening, making oral hygiene conditions difficult and predisposing these individuals to the risk of developing oral diseases. Objective: To evaluate the effect of a low-intensity photobiomodulation diode laser on the thick part of the masseter muscle in a child with spastic type CP. Method: The caregiver reported that the child had great difficulty in performing the oral hygiene, making avoidance movements of the head when the toothbrush touched the mucosa of the upper molar region in the mouth. The mother described the child’s discomfort as extreme. The first ultrasound evaluation was performed at the first appointment, and the second evaluation after 6 sessions of photobiostimulation. The low-intensity Infrared Laser Diode, Ga-As-Al, was employed (λ = 808 ± 3 nm, 120 mW; Twin Flex Evolution Laser MMOptics São Paulo, Brazil), using 5.0 J/cm2 dose energy/location, with 20 seconds exposure/site. The area of the masseter muscle was bilaterally irradiated towards the midpoint of its length and width. Six sessions were performed, with an interval of 7 days between them. Results: At the end of the sixth session of photobiostimulation, the mother reported that the child slept better, had reduction in involuntary movements performed by the jaw, and oral hygiene was possible now with no painful expression of the child. During palpation there was less stiffness in the bilateral masseter and an increased masseter thickness and increase in the amplitude of the mouth opening of 7 mm. Conclusion: The diode laser photobiostimulation appears to be effective in reducing spasticity in the masseter muscle of children with spastic type CP
