BackgroundThe present study aimed to investigate the prevalence of scoliosis and to analyze the factors associated with scoliosis in schoolchildren aged between 7 and 17 years.MethodsThis is a cross-sectional and quantitative study with stratified random selection of public school students in the city of Santa Cruz, Brazil. The presence of scoliosis was examined, as well as the flexibility of the posterior muscle chain, socioeconomic characteristics, anthropometry, lifestyle habits, sexual maturation, and ergonomics of school furniture. In order to identify factors associated with scoliosis, the variables were divided in biological, socioeconomic, lifestyle, and ergonomic factors, and crude and adjusted prevalence ratios (PRs) were estimated by means of Poisson regression analysis.ResultsTwo hundred and twelve pupils participated in this study (mean age 11.61 years, 58% female). The prevalence of scoliosis was 58.1% (n = 123) and associated with female sex (PR 2.54; 95% CI, 1.33–4.86) and age between 13 and 15 years (PR 5.35; 95% CI, 2.17–13.21). Sleeping in a hammock was inversely associated with scoliosis (PR 0.44; 95% CI, 0.23–0.81).ConclusionsScoliosis seems to be positively associated with female sex and age between 13 and 15 years, whereas the habit of sleeping in a hammock is negatively associated with the onset of scoliosis.
[Purpose] To estimate the effect of Klapp method on idiopathic scoliosis in school students. [Subjects and Methods] A single-blind randomized clinical trial with 22 students randomly divided into intervention group (n=12) and inactive control group (n=10). Exercise protocol consisted of Klapp method, 20 sessions, three times a week for intervention group, and inactivity for control group. Dorsal muscle strength was measured by dynamometer; body asymmetries and gibbosity angles were measured by biophotogrammetry. Data were obtained by Generalized Estimated Equation, with 5% significance level. Clinical impact for dependent variables was estimated by “d” Cohen. [Results] There was no change in intragroup analysis and intergroup for all postural symmetry variables. However, it was detected intergroup difference in extensor muscle strength and intergroup difference with marginal significance of gibbosity angles. Regarding extensor muscle strength, intervention group produced average improvement of 7.0 kgf compared to control group. Gibbosity angles progressed less in intervention group, with 5.71° average delay compared to control group. [Conclusion] Klapp method was effective for gibbosity stabilization and it improves spine extensor muscle strength.
Objetivo: Avaliar a influência do uso da rede de descanso sobre o desenvolvimento neuromotor de lactentes nascido a termo aos seis meses de idade. Método: Foram incluídos 26 lactentes, nascidos a termo, de parto único e com peso > 2500g, 19 foram inseridos no grupo que faziam uso da rede de descanso e sete foram incluídos no grupo que não faziam uso da rede de descanso. Os 26 lactentes estavam com seis meses de idade quando tiveram seu desenvolvimento neuromotor avaliado por meio da Alberta Infant Neuromotor Scale. Todas as avaliações foram registradas em vídeo-gravações e as performances neuromotoras foram reavaliadas e pontuadas por dois avaliadores capacitados e cegos ao estudo. Resultados: O desenvolvimento neuromotor dos lactentes que fazem uso da rede apresentou pior escore quando comparado ao desenvolvimento neuromotor dos lactentes que não fazem uso da rede (p < 0,03). Dentre as quatro posturas avaliadas na AIMS a postura em pé foi à única que apresentou diferença estatisticamente significativa entre os dois grupos (p < 0,01). Na análise de correlação, a idade da mãe apresentou relação negativa (r = -0,42; p < 0,03;) e o valor de Apgar no 1º minuto relação positiva com o desenvolvimento neuromotor (r = 0,49; p < 0,05;). Conclusão: Os lactentes que fazem uso da rede de descanso apresentam um desenvolvimento neuromotor mais lento quando comparado ao desenvolvimento de lactentes de mesma idade que não fizeram uso da rede de descanso.
Objetivo: Verificar na literatura o impacto da deambulação associada à mobilização precoce em pacientes críticos internados em UTI. Métodos: Foram pesquisadas as bases de dados eletrônicas Cochrane, Pubmed, PEDro, Science Direct e SciELO, limitado aos últimos 10 anos incluindo ensaios clínicos randomizados, análises prospectivas e retrospectivas e estudos prospectivos controlados. A escala de Downs and Black e Downs and Black adaptada foi utilizada para avaliar a qualidade metodológica dos artigos. Resultados: Doze estudos foram revisados. Onze artigos utilizaram mobilização passiva e/ou ativa, exercícios ativos, sentar na cama e/ou poltrona, ortostatismo e deambular. Seis estudos avaliaram a morbimortalidade de um protocolo com enfoque em deambulação precoce, quatro avaliaram a segurança da mobilização precoce, dois o impacto na força muscular respiratória, e um investigou a relação da interrupção da sedação na mobilização precoce e outro artigo utilizou a prancha ortostática antes da deambulação. Conclusão: A deambulação impactou positivamente no tempo de internação hospitalar, de UTI e de ventilação mecânica em pacientes graves.
Introduction: The International Classification of Functioning, Disability and Health (ICF) considers multiples aspects of functionality. It is believed that this tool can help to classify the functionality of older adults with low back pain (LBP). Objectives: To describe the functionality of active older adults with LBP according to the ICF. Methods: A transversal study was conducted using the brief ICF core set for low back pain, to establish functional profiles of 40 older adults. The ICF categories were considered valid when ≥20% of participants showed some disability. Results: Thirty-two of the 35 categories of the brief ICF core set could be considered representative of the sample. Conclusion: The brief ICF core set for LBP results demonstrated that this classification system is representative for describing the functional profile of the sample.
Introduction: Neural mobilization is a technique that seeks the restoration of motion and elasticity of the nervous system; however, there are few studies evaluating its effectiveness on clinical variables. Objective: To assess handgrip strength among individuals undergoing intervention with neural mobilization. Methodology: a crossover study in which 20 subjects were sampled, mean age 19.5 ± 0.92 years, divided in two groups (G1 and G2) that received each week a single intervention session so that G1 received neural mobilization and G2 was submitted to conventional stretching exercises for the supraspinal in the first week. The opposite happened on the second week, in which G1 was submitted to conventional stretching exercises for the supraspinal and G2 received neural mobilization. Stretching for the supraspinal served only as placebo and did not impose tension to the nerves under study. The neural mobilization was applied in the radial, median and ulnar nerves. The hand grip strength was assessed using a grip dynamometer at various times: before and immediately after, 20 minutes and one hour after each intervention. Results: no significant results were found for the neural mobilization or the stretch. Conclusion: Neural mobilization was not effective to produce increase in handgrip strength in healthy subjects.
Background Given the rapid advances in communication technology and the need that emerged from the COVID-19 pandemic, telehealth initiatives have been widely used worldwide. This masterclass aims to provide an overview of telerehabilitation for musculoskeletal conditions, synthesizing the different terminologies used to describe telehealth and telerehabilitation, its effectiveness and how to use it in clinical practice, barriers and facilitators for the implementation in health services, and discuss the need of a curriculum education for the near future. Main body Telerehabilitation refers to the use of information and communication technologies provided by any healthcare professionals for rehabilitation services. Telerehabilitation is a safe and effective option in the management of musculoskeletal conditions in different models of delivery. There are many technologies, with different costs and benefits, synchronous and asynchronous, that can be used for telerehabilitation: telephone, email, mobile health, messaging, web-based systems and videoconferences applications. To ensure a better practice of telerehabilitation, the clinician should certify safety and access, and appropriateness of environment, communication, technology, assessment, and therapeutic prescription. Despite the positive effect of telerehabilitation in musculoskeletal disorders, a suboptimal telerehabilitation implementation may have happened due to the COVID-19 pandemic, especially in countries where telehealth was not a reality, and clinicians lacked training and guidance. This emphasizes the need to identify the necessary curriculum content to guide future clinicians in their skills and knowledge for telerehabilitation. There are some challenges and barriers that must be carefully accounted for to contribute to a health service that is inclusive and relevant to health professionals and end users. Conclusions Telerehabilitation can promote patient engagement in health care and plays an important role in improving health outcomes in patients with musculoskeletal conditions. Digital health technologies can also offer new opportunities to educate patients and facilitate the process of behavior change to a healthy lifestyle. Currently, the main needs in telerehabilitation are the inclusion of it in health curriculums in higher education and the development of cost-effectiveness and implementation trials, especially in low- and middle-income countries where access, investments and digital health literacy are limited.
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