The aim of this study was to evaluate functional independence and trunk control during maximum-range tasks in individuals with spinal cord injuries, who were divided into sedentary (SSI, n=10) and ...physically active (PASI, n=10) groups .
Anamnesis was conducted and level and type of injury were identified (according to the American Spinal Injury Association protocol, ASIA) and the Functional Independence Measure (FIM) questionnaire was applied. For the forward and lateral reach task, the subjects were instructed to reach as far as possible. Mean data were compared using the unpaired t test and Mann-Whitney test and differences were considered significant when p<0.05 .
The PASI group performed better in self-care activities (PASI: 40.8±0.42 points, SSI: 38.0±3.58 points, p=0.01), sphincter control (PASI: 10.5±1.84 points, SSI: 8.2±3.04 points, p=0.02), transfers (PASI: 20.7±0.48 points, SSI: 16.9±4.27 points, p=0.04), and total FIM score (PASI: 104.0±2.30 points, SSI 105.1±8.56 points, p=0.01). On the maximum reach task, the PASI group had a greater average range in all directions evaluated (p<0.05) .
The continuous practice of exercise increased motor function independence and trunk control in individuals with complete spinal cord injury. Level of Evidence II, Prospective Comparative Study.
To investigate the longitudinal effects of wheelchair rugby (WR) training on body composition of subjects with tetraplegia.
Subjects were evaluated at baseline and after WR training.
Faculty of ...physical education settings.
Individuals with tetraplegia (N=13; age, 26.6±6.0y).
Four sessions per week of WR training composed by aerobic and anaerobic activities and technical and tactical aspects of WR. The average time of intervention was 8.1±2.5 months.
Body composition assessed by dual-energy x-ray absorptiometry.
After training, fat mass was significantly reduced in the whole body (15,191±4603 vs 13,212±3318 g, P=.016), trunk (7058±2639 vs 5693±1498 g, P=.012), and legs (2847±817 vs 2534±742 g, P=.003). Conversely, increased bone mineral content (183±35 vs 195±32 g, P=.01) and fat-free mass (2991±549 vs 3332±602 g, P=.016) in the arms and reduced bone mineral content in the trunk (553±82 vs 521±86 g, P=.034) were observed after training. Furthermore, no significant correlation between the duration of training and changes in body composition was detected.
Regular WR training increased lean mass and bone mineral content in the arms and decreased total body fat mass. Conversely, WR training was associated with decreased bone mineral content in the trunk. These results suggest that regular WR training improves body composition in subjects with tetraplegia.
The research on the effect of neuromuscular electrical stimulation (NMES) protocol on skin temperature (Tsk) in individuals with spinal cord injury (SCI) is a prospective non-controlled intervention ...study. 47 individuals with SCI were recruited from the outpatient clinic. NMES was applied to the tibial anterior (TA) muscles. Four assessments were performed: baseline, shortly after the end of NMES session (t0), 10 min after the end of NMES (t10) and 20 min after the end of NMES (t20). The intensity used was 1.5 mA RMS (root mean square) depending on the individuals. The variables were Tsk at forehead, dermatome C2 and L5 bilaterally. The dermatome C2 and forehead were measured only at baseline and t20. The measurement device was a noncontact infrared thermometer. Results of this study demonstrated that after NMES the stimulated dermatome (L5), showed an increase in local Tsk. In addition, the t20 showed that the Tsk did not drop to the baseline, being still significant in the analyzed group. The implications for rehabilitation practice and the positive effects of NMES are fundamental to improvement of the blood microcirculation and local metabolism.
This research assesses the effect of tibial nerve electrical stimulation on urinary incontinence in individuals with spinal cord injury (SCI) being a prospective noncontrolled intervention study. 8 ...individuals with SCI were recruited from the outpatient clinic. This study demonstrates results of tibial nerve stimulation (TNS) applied to the tibial nerves for 12 weeks. Two questionnaires were applied (Neurogenic Bladder Symptom Score-NBSS and Qualiveen- SF) and presented a tendency to improve symptoms and quality of life, however, without statistical significance. With the urodynamic data: maximum cystometric capacity increased with a mean of 285.6 ml pre, to 314.8 ml post TNS (P-Value: 0.554); compliance increased from 26.38ml/cmH2O pre TNS to 29.88ml/cmH2O post TNS (PValue: 0.461); detrusor hyperactivity in the filling phase occurred in all patients in the pre TNS assessment; the maximum amplitude of the detrusor pressure in mean detrusor overactivity after TNS increased from 62.0 to 66.6 cmH2 (PValue: 0.674); urinary leakage pressure during detrusor overactivity pre TNS were mean of 54.0 and 53.2 after (PValue: 1). The implications for rehabilitation practice and the positive effects of TNS are fundamental to improving the quality of life and reducing urinary incontinence on these individuals. Clinical outcomes, i.e., improvement on urinary incontinence can be achieved within a short period of intervention.
The inability of the spinal cord to propagate sensory and motor stimuli as a result of the disruption of the nerve tracts is called spinal cord injury.
This study analyzes clinically and ...radiologically the hands and wrists of spinal cord injured patients, evaluating their motor and sensitive functionality, in order to determine if these patients are more likely to develop degenerative alterations.
14 patients (8 paraplegics and 6 tetraplegics) were evaluated, undergoing anamnesis and clinical examination - a scale of muscular strength (MRC - Medical Research Council) and the amplitude measurement of the movement with a manual goniometer (ROM), were used for objective evaluation - and x-ray exams. The results were compared with pre-existing data from other studies.
When asked, only one of the 14 observed patients complained about constant wrist pain, described as level 3 (weak to moderate), based on the visual analog scale (VAS). The motor evaluation, MRC and ROM divided the group of patients into two subgroups: paraplegic and tetraplegic patients. The x-ray analysis showed, based on Kellgren and Lawrence classification, that all exam images fit grades 1 or 2 of osteoarthritis and osteoarthrosis.
In conclusion, spinal cord injured patients showed none or minimal clinical and radiological signs of osteoarthritis on hands or wrists. Overall, the hands and wrists of spinal cord-injured patients behave similarly to noninjured patients.
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Trauma configures the main cause of spinal cord injuries. Patients with traumatic spinal cord injury often develop severe and debilitating outcomes that require multidisciplinary care to adapt ...patients to their new reality. Heterotopic ossification (HO) is one of the frequent comorbidities in these patients but it still lacks well-established treatments or a gold standard one. Thus, this systematic review aimed to search the current literature for HO treatment and prevention. This study was conducted following PRISMA recommendations (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) and searches were conducted in three databases (PubMed, Embase, and Web of Science). A total of 193 articles were found in an initial search. After screening following the established criteria, eight articles were included in this review; of these, two reported prevention and the others, treatments. Based on data analysis, the use of non-steroidal anti-inflammatory drugs in the acute post-traumatic period proved to be the best method of prevention. In cases of mature HO or accompanied by ankylosis, surgical resection proved to be the most effective treatment despite the high rate of postoperative infections.
Traffic-accidents are a public health problem with repercussions on population morbimortality.
To analyze the impact of the pandemic on the profile of motorcycle accidents assisted at the Tertiary ...Hospital in 2020.
Cross-sectional, descriptive retrospective study in 2017 and 2020 of 260 medical records of care for motorcycle accidents in the emergency room of the Tertiary Hospital. Statistical analysis of data and their correlations using the chi-square test (p < 0.05).
Of the 105 medical records in 2017, 83% are men, mean age 29.8 years, and death rate of 3.90%. Fractures in 98.10%, 64.10% exposed and predominantly the tibia (61.90%). Of the 155 medical records in 2020, 91.61% are men, mean age 31.21 years, and no deaths. Fractures in 94.84%, 37.42% exposed and predominantly the tibia (28.57%). Between 2017 and 2020, Infosiga-SP showed a relevant reduction (p < 0.001) of deaths in the hospital environment (52.46% to 31.91%).
The incidence of motorcycle accidents increased, in-hospital deaths dropped, but the epidemiological profile of accidents at the Hospital remained unchanged.
The plantar pressure distribution can be assessed quantitatively by computerized baropodometry such as carpet or insole. An insole-type system with wireless transmission was developed and plantar ...pressure results were previously validated by force platform. However, the reproducibility of the system had not been determined. Our objective was to evaluate the reliability of the results in different gait cycles, clinical characteristics and in different plantar anatomical sites.
41 healthy adults (age, 34 ± 13 years; body mass index, 25 ± 5 kg/m
; 26 63%, male, 26 63% practicing physical activity) were evaluated. Baropodometer evaluations were performed in 3 walking cycles with 100 m each, and the reliability between the cycles was examined. Pressure points on the heel, first metatarsal, fifth metatarsal and total plantar pressure were analyzed and compared.
Moderate agreement was identified between the second and third cycles (ICC, 0.66; 95% CI, 0.14-0.83). Physical activity practitioners showed higher total plantar pressure (70.8 vs 68.2 Kpa; p = 0.04) and higher pressure in the heel (70.7 vs 68.1 Kpa; p = 0.036) in relation to sedentary ones.
The insole was able to assess plant pressure with moderate reliability from the adaptation period.
Although osteonecrosis of the femoral head is a prevalent condition, its effects on gait parameters have not been thoroughly studied and are not well-established in the current literature. The ...primary aim of the present study is to describe gait in patients with a diagnosis of osteonecrosis.
This is a cross-sectional study. Nine patients diagnosed with osteonecrosis of the femoral head who were regularly followed-up at an outpatient clinic were selected for the present study and underwent gait analysis using Vicon Motion Capture Systems. Spatiotemporal data was obtained, and joint angles were calculated using an Euler angle coordinate system. Distal coordinate systems were used to calculate joint moments and force plates to obtain ground reaction forces.
Patients with osteonecrosis presented with slower velocity (0.54 m/s ± 0.19) and smaller cadence (83.01 steps/min ± 13.23) than healthy patients. The pelvic obliquity range of motion was of 10.12° ± 3.03 and rotation was of 18.23° ± 9.17. The mean hip flexion was of 9.48° ± 3.40. Ground reaction forces showed reduced braking and propelling forces. Joint moments were reduced for flexion and adduction (0.42 Nm/kg ± 0.2 and 0.30 Nm/kg ± 0.11, respectively) but the abduction moment was increased (0.42 Nm/kg ± 0.18).
The present study showed that osteonecrosis of the femoral head presents compensatory gait mechanisms, with increased pelvic motion and decreased knee flexion to protect the hip joint. Decreased moments for hip flexion and adduction were also identified and muscle weakness for those groups may be correlated to the disease.
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