Background: Dyspraxia, also included under the term Developmental Coordination Disorder (DCD), is a condition characterised by an impairment in motor skills function which impacts negatively on other aspects of daily living such as athletic capability, handwriting, self-esteem and social interaction. However, no effective therapy currently exists to address all of these issues within this group. The aim of the present study therefore was to investigate whether a complementary therapy, called Fascia Bowen therapy, would improve neuromuscular function and psychological wellbeing in males aged 8-11 (at Primary School) diagnosed with this condition. Methods: A group of 10 participants meeting the criteria of 15th centile or below in motor skills functioning, received a Fascia Bowen therapy treatment session from a qualified Fascia Bowen practitioner each week for 6 weeks. All participants’ motor skills function were assessed by an occupational therapist before and after the end of the intervention using the Motor Skills Assessment Battery for Children test (MABC-2). Additionally, parents, teachers and participants completed questionnaires measuring self-esteem, social skills, social interaction, behaviour and scholastic function before and after the intervention. Results: The participants showed significant improvement in neuromuscular function over time using the MABC-2. However, no significant changes were shown in the other measures of functioning. Although parents did provide some anecdotal reports about positive changes in real life, these were not reflected in the measures. The results suggest that while improvements were shown as significant in the motor domain, which was the focus of the therapy, the results did not translate to other domains of life over time. 13 Conclusions: Further research is necessary to test the efficacy of the treatment’s effects using a larger sample, a control group and a longer intervention timescale. A six week intervention period may not be sufficient to show significant changes in self-esteem, social skills, social interaction, behaviour and scholastic functions which have deep-rooted constructs developed over many years. These may therefore take a long time to change.

Recorded by Eugene Barsky, Physiotherapy Outreach Librarian, UBC / This is a Systematic Review Presentation titled - "Effect of Manual Therapy on ROM Following Lateral Ankle Sprains: A Systematic Review", created by Master of Physical Therapy Graduating Students, University of British Columbia - 2006, Presented on September 14-15, 2006 , Vancouver, BC, Canada

Title: The effect of manual therapyof the cervical spine on standingbalance of violinists measured by CDP Objectives: The intention of this thesis is to describe most frequent functional changes of musculoskeletal apparatus of violinists. Secondly, to track and react to these changes with appropriate manual there of the cervical spine. Thirdly, to find out if this therapy has an effect maintaining postural stability by testing on a posturograph using the SOT protocol. Methods: This is a pilot study that uses subjective and objective examinations. Subjectively, the functional changes of the musculoskeletal apparatus were examined and then their frequency within the proband group was evaluated (n = 10, 2 men and 8 women). Within the objective examination, 15 parameters of postural stability were monitored under certain conditions. Using the Wilcoxon Pair Test, situations before and after manual therapy of the cervical spine were compared. The statistical significance level was set to α = 0.05 for this test. Results: The study has shown that violinists have some functional changes in the musculoskeletal apparatus in common. Their most frequent blockade is AO joint (9 out of 10 violins), the most common hypertonus can be found in flexors of the forearm of the left hand (9 out of10) andthetrapezius and...

Resumo: O presente estudo teve por objetivo estimar a pressão plantar em indivíduos com e sem dor temporomandibular, antes e após a intervenção fisioterapêutica manual na porção cervical. Na metodologia, utilizou-se uma plataforma de força para aquisição da distribuição das pressões plantares dos pés em duas etapas: antes e após a intervenção. Foram comparadas as forças plantares das porções ântero-medial, ânterolateral, postero-medial e postero-lateral dos pés, as quais foram quantificadas e comparadas entre os pés direito e esquerdo dos indivíduos com e sem dor antes e após a manobra fisioterapêutica. Nas comparações entre as médias dos ensaios anteriores e posteriores à intervenção fisioterapêutica para as situações com e sem sintomatologia dolorosa foi utilizado o teste não paramétrico Mann-Whitney Wilcoxon, através do programa SSPS 15.0. As comparações dos valores médios do grupo com e sem sintomatologia dolorosa foram feitas comparando a força em cada sensor antes e depois do pé direito e esquerdo e para sensores de mesma localização antes e depois de pés diferentes. O nível de significância estatística adotado foi = 10%. Participaram 20 indivíduos de ambos os sexos, sendo 8 com dor e 12 sem dor, com idade entre 16 e 60 anos, sem qualquer queixa ou indício de outras doenças ortopédicas e/ou neurológicas. Nas comparações entre as médias de mesma posição em pés diferentes para os sujeitos com e sem dor houve maior significância estatística em detrimento das comparações entre as médias antes e depois da intervenção, isto é, dos mesmos pés. Além disso, houve um aumento na pressão plantar no retropé, o que leva a uma hipótese de menor carga distribuída nas demais porções dos pés, mesmo que não se saiba se a compensação se deu em porção dos mesopés ou do antepés. / Abstract: The present study has the aim of making a research into the plantar pressure, by investigating those ones with or without temporomandibular pain, before and after a manual physicaltherapy intervention in cervical portion. In the methodology, it was used a force plataform for the acquisition of the plantar pressure distribution in two times: just before and just after the intervention. It was compared the plantar strength of the front-medial, front-lateral, back-medial e back-lateral portions of the feet. They were quantified and compared between the right and left feet of those with and without pain just before just after the manual therapy. It was used the non-parametric test Mann-Whitney Wilcoxon, using the SSPS 15.0 program to compare the medias of the essays. In the comparision of the medium values of the group with and without pain, it was compared each of the sensor stenght of the right and the left feet before and after and between them before and after in different feet. The statistic significance level was = 10%. Twenty people participated of both sexes, 8 with pain and 12 without it, between 18 e 60 years old, without any claim or symptom of orthopedic or neurological deseases. In the comparision of the medias of same position in different feet, for those with and without pain, there was more satistical significance than the comparision between the medias before and after the intervention of the same feet. More over, there was an increase of the plantar pressure of the back portions of the feet that could be compensed by the medium or front portion of one foot or the feet. / Orientador: Luiz Fernando Costa Nascimento / Coorientador: José Elias Tomazini / Banca: Mauro Pedro Peres / Banca: João Eliezer Ferri de Barros / Mestre

Orientadores: Regina Celia Spadari, Dora Maria Grassi-Kassisse / Dissertação (mestrado) - Universidade Estadual de Campinas, Instituto de Biologia / Made available in DSpace on 2018-08-13T08:58:41Z (GMT). No. of bitstreams: 1 Ferreira_HeloisaAparecida_M.pdf: 1416925 bytes, checksum: c164e67b3f6e3036b77bf57bb5259598 (MD5) Previous issue date: 2009 / Resumo: Certo nível de estresse é benéfico ao desempenho e à sobrevivência, mas a constante ou inadequada resposta de estresse pode trazer sérios riscos à saúde e prejudicar o desempenho. Estudos com vestibulandos justificam-se pela alta concentração de cortisol encontrada em amostras de saliva coletadas nos meses em que são feitas as inscrições e nos dias dos exames vestibulares. Este trabalho propõe não somente avaliar os índices de estresse, mas também uma alternativa de abordagem terapêutica não medicamentosa para reduzir os índices de estresse no período que antecede o vestibular e, com isso, melhorar o desempenho nas provas. Em um primeiro estudo, o índice de estresse percebido foi avaliado em estudantes matriculados em um curso pré-vestibular, nos meses de março, setembro e novembro utilizando-se o Questionário de Estresse em Adolescentes (QEA). Os escores obtidos no QEA foram mais baixos em março do que em setembro e novembro, maior nas meninas que nos meninos e ainda diferentes entre os turnos matutino, vespertino e noturno. No estudo 2 uma mostra de 32 voluntários foi submetida à terapia manual de mobilização muscular e da fáscia, em duas sessões semanais, de 40 minutos, de setembro a novembro. Outro grupo não recebeu o tratamento. O índice de estresse percebido foi avaliado em setembro e, juntamente com a memória declarativa de curto e longo prazo, também na semana que antecedeu o exame vestibular. A concentração salivar de cortisol foi determinada em setembro e no dia do exame. Vestibulandos tratados não apresentaram aumento da concentração salivar de cortisol momentos antes da prova, ao contrário do que ocorreu com aqueles do grupo controle; apresentaram também menor escore no QEA, melhor desempenho nos testes de memória, e maior índice de aprovação na primeira fase do vestibular. Concluímos que a intervenção fisioterapêutica aplicada foi eficiente em reduzir o índice de estresse dos vestibulandos e resultou em melhor desempenho no exame. / Abstract: Although certain stress levels might be beneficial to the performance and survival, the constancy of stressors or an inadequate stress response may cause risks to health and may trigger or worsen a variety of diseases. In order to adopt preventive or curative strategies it is necessary to identify the high-risk groups by determining the stress levels. Studies in Brazilian adolescents during the year they are preparing to fight for a vacancy in the public universities are justified by the high concentration of cortisol, one of the stress hormones, found in these students? saliva samples, collected not only in the exams period but also during the period they do the option for the university they want to attend. The objective of this work is to determine the stress levels in students preparing to apply for the universities (study 1), and also to suggest an alternative of non-pharmacological therapy in order to reduce the stress levels in the students during the exam period and then, improving their performance (study 2). In the first study, we determined the perceived stress level in the students attending a preparatory course, in March (beginning of the school year), November (when they apply for the exams) and in November (in the week they do the exams) by using the Adolescent Stress Questionnaire (ASQ, Byrne, 2005). In the study 2, 32 volunteers were submitted to 40 min manual therapy, twice a week, from September to November. Another group of students not submitted to the therapy was evaluated as control. The cortisol concentrations were determined in four saliva samples collected during one day in the period of registration and on the day of the exam, the index of perceived stress and the performance in a memory test aimed to evaluate short and long term declarative memory were evaluated in the week before the exam. The results showed that the ASQ scores were lower in March than September and November. They also have shown that the students who had not undergone the manual therapy presented an increase in the concentration of salivary cortisol before the exam, what did not occurred with the students in the treated group. Moreover, the treated group also scored lower in the perceived stress questionnaire, exhibited a better performance in the short term memory tests and a higher rate of success in the exams. We concluded that the applied physiotherapy program was effective to reduce the students stress levels and improved their performance in the exam. / Mestrado / Fisiologia / Mestre em Biologia Funcional e Molecular

A migrânea está relacionada às disfunções das estruturas da coluna cervical, impulsos aferentes desse local podem ser facilitadores ou mesmo gatilhos da dor. Tratamentos com manipulação cervical isolada e combinada a medicação já foram testados, porém os resultados são conflitantes. O objetivo desse trabalho foi avaliar o efeito adicional da fisioterapia ao tratamento medicamentoso da migrânea na frequência, intensidade e duração da dor de cabeça. Foram inclusas mulheres com migrânea, na faixa etária de 18 e 55 anos, com mínimo de 06 dias de dor por mês, e que apresentasse dor na região craniocervical através do relato. Cinquenta mulheres foram igualmente randomizadas para um dos dois grupos de tratamento, Grupo Fisioterapia (terapia manual + medicação) e Grupo Controle (medicação). O diagnóstico de migrânea foi realizado por uma única neurologista, segundo a Classificação Internacional de Cefaleias. Foram realizadas 12 sessões de terapia manual, duas vezes por semana, durante 50 minutos, por uma única fisioterapeuta. A avaliação, a reavaliação e follow-up foram cegos. Os desfechos primários de frequência, intensidade e duração da dor de cabeça, foram avaliados por meio do diário de dor; e secundários, Limiar de dor por pressão (Algômetro), incapacidade relacionada à cefaleia (Migraine disability assessment program) e a coluna cervical (Neck disability índex), Patient Health Questionnaire eight-item depression scale (PHQ-8), alodinia com Allodynia Sympton Checklist (ASC- /12) e satisfação com Patients Global Impression of Change Scale (PGIC). A análise foi realizada por intenção de tratamento e foi utilizado o Modelo Linear de efeitos mistos e para atribuir relevância clínica o Effect size (ES) e Mínima mudança importante (MID). Não foram observadas diferenças entre os grupos na avaliação inicial. O GF apresentou redução de 37% na frequência de dias de dor de cabeça comparado ao GC que apresentou 22% (p<0.05 e ES 0,4) e (p<0.05 e ES 0,3) respectivamente. Não foram observadas diferenças clínicas significativas entre os grupos na duração e na intensidade da dor de cabeça. Também foi observado aumento significativo (p<0,05) do limiar de dor por pressão, bem como maior satisfação e percepção de mudança da doença ao paciente (p<0,05) no GF em comparação ao GC. Não foram observadas diferenças significativas nos demais parâmetros avaliados. A redução do limiar de dor dos músculos cervicais com o tratamento fisioterapêutico promoveu um efeito benéfico adicional ao medicamentoso, com maior redução da frequência de dias de dor de cabeça e maior satisfação e percepção de melhora dos pacientes. REBEC nº RBR-6kvx74 / Migraine is related to disorders of the cervical spine structures, afferent impulses that location can be facilitators or even triggers pain. Treatments with cervical manipulation alone and combined medication have been tested, but results are conflicting. The aim of this study was to evaluate the additional effect of physical therapy to drug treatment of migraine in frequency, intensity and duration of headache. Women with migraine were included, aged 18 to 55 years, with a minimum of 06 days of pain per month and report of pain in the craniocervical region. Fifty women were equally randomized to one of the two treatment groups, Physiotherapy Group (manual therapy and medication) and control group (medication). The diagnosis of migraine was performed according to the International Classification of headache by a single neurologist. All subjects received similar medications. 12 sessions of manual therapy, twice per week, during for 50 minutes, were done by same physical therapist. The assessment, revaluation and follow-up were blind. The primary endpoints of frequency, intensity and duration of headache were evaluated through diary pain, and secondary endpoints like pain threshold pressure (algometer), headache related disability (Migraine disability assessment program) and cervical spine (Neck disability index), patient Health Questionnaire eight- item depression scale (PHQ-8), with the severity of Allodynia Sympton Checklist (ASC-12) and patients Global Impression of Change Scale to assess satisfaction and perception of patient changes as its disease condition. The analysis was by intention to treat and we used the linear mixed effects model. To assign the clinical relevance Effect size (ES) and Minimum important change (MID) were used. No differences between groups were observed at baseline. The PG showed a 37% reduction in the frequency of headache days compared to GC showed that 22 % (p<0.05 to ES0.4) and (p<0.05 to ES0.3) respectively. No clinically significant differences were observed between groups regarding the duration and intensity of the headache. Significant increase (p<0.05) pain threshold pressure was also observed, as well as greater satisfaction and changing perception of the disease to the patient (p<0.05) in the PG compared with the CG. No significant differences were observed in the other parameters. The reduction of the pain threshold of cervical muscles with physical therapy promoted a beneficial additional effect to medication, with greater reduction in frequency of headache days and greater satisfaction and perceived improvement of patients. REBEC no RBR - 6kvx74

Orientador: Dora Maria Grassi Kassisse / Tese (doutorado) - Universidade Estadual de Campinas, Instituto de Biologia / Made available in DSpace on 2018-08-25T14:24:15Z (GMT). No. of bitstreams: 1 Ferreira_HeloisaAparecida_D.pdf: 2097137 bytes, checksum: 1a224a2d7aabc78ef67e541d8ebb6446 (MD5) Previous issue date: 2014 / Resumo: O processo seletivo para ingresso nas universidades públicas brasileiras é competitivo e um agente estressor para adolescentes. Técnicas de relaxamento, propostas pela terapia manual (TM), são utilizadas em diferentes populações para redução de sintomas de estresse. Objetivamos, neste trabalho, avaliar os efeitos de um programa de terapia manual (PTM) sobre a variabilidade da frequência cardíaca (VFC) e indicadores de estresse em vestibulandos. O estudo seguiu o desenho experimental longitudinal com análises pré-pós-programa em população única. Sessões de TM foram aplicadas, 40-50 min, 2x/semana, ao longo de nove semanas. O estudo da variabilidade da frequência cardíaca foi utilizado para avaliar o efeito do PTM sobre o tônus do sistema nervoso autonômico sobre o coração. Para o estudo da VFC, registramos a frequência cardíaca (FC, bpm) durante 15 min em 16 voluntários em posição supina (18 a 20 anos; 8 mulheres e 8 homens) antes e após a primeira e última sessão de TM, S810i - Polar® -Finlândia. A VFC foi avaliada nos 5 min centrais (Kubios HRV Analysis Software). Os indicadores de estresse escolhidos foram o instrumento psicológico ¿ questionário de estresse para adolescentes (QEA) e a concentração e ritmicidade de produção de cortisol (Alka, ng/mL). O estudo estatístico foi realizado utilizando o programa GraphPad Prism versão 5.00 para Windows. A normalidade dos resultados foi testada utilizando os testes de Kolmogorov Smirnov. Quando adequado, utilizamos os testes: ANOVA seguido de Tukey ou t Student pareado e não pareado ou Kruskal-Wallis seguido de Dunns. Os resultados foram considerados significativos quando os valores de p foram menores que 5%. PTM reduziu (p<0,05) os valores do QEA de 143,1±8,8 para 114±7,1 e da FC (bpm) de 80,68 (128,8-64,26) para 69,6 (93,44-56,86). A TM causou efeito agudo induzindo queda na concentração de cortisol após as sessões e crônico, pois a concentração de cortisol no momento antes da última sessão estava abaixo daquela antes do início do programa. A concentração de cortisol (ng/mL) foi de 15,9±0,9 para 12,0±0,9 após todo o PTM. A ritmicidade de produção de cortisol, desta população, apresentou-se normal e foi preservada ao longo das 9 semanas. A concentração de cortisol avaliada em AUC (ng/mL) foi mais elevada no dia da prova de vestibular e as amostras do meio-dia e das 20 h apresentaram os valores mais elevados neste dia. Efeitos agudos da TM foram identificados nas análises do domínio da frequência e do tempo nos registros da VFC. Os efeitos na VFC foram devido ao aumento na atividade do tônus parassimpático e atividade global do coração. Os resultados deste estudo permitem concluir que a TM é eficaz em sessão única e ao longo de um programa induzindo efeitos agudos e crônicos. O efeito crônico, possível plasticidade neural, foi observado na redução na concentração de cortisol antes da última sessão de TM e este pode ser o fator responsável pela predominância do tônus do sistema nervoso parassimpático sobre o coração registrado nestes voluntários / Abstract: The selective process for admission to the Brazilian public universities is competitive and one stressor for adolescents. Relaxation techniques, proposed by manual therapy (MT) are used in different populations to reduce stress symptoms. We aim in this study evaluate the effects of a manual therapy program (MTP) on heart rate variability (HRV) and on indicators of stress in school students. The study followed a longitudinal experimental design with pre- post- analysis program in a single population. MT sessions, 40-50 min, twice a week were applied over nine weeks. The study of heart rate variability was used to assess the effect of MTP on the heart autonomic nervous system tonus. For the study of HRV, we recorded heart rate (bpm) for 15 min in 16 volunteers in the supine position (18 to 20 years, 8 women and 8 men) before and after the first and last session of MT, S810i - Polar ® - Finland. HRV was evaluated in 5 min stations (Kubios HRV Analysis Software). The stress indicators chosen were the psychological instrument - the questionnaire of stress for adolescents (ASQ) and the concentration and rhythm of cortisol production (Alka , ng/mL) . Statistical analysis was performed using the program GraphPad Prism version 5.00 for Windows. The normality of the results was tested using the Kolmogorov-Smirnov test. Where appropriate, we use the following tests: ANOVA followed by Tukey or t Student paired or unpaired or Kruskal-Wallis followed by Dunns. Results were considered significant when P values were less than 5 %. MTP reduced (p < 0.05) values of the ASQ 143.1±8.8 to 114±7.1 and HR (bpm) to 80.68 (from 128.8 to 64.26) to 69.6 (93.44 to 56.86). The MT induced acute decrease in cortisol concentration after the sessions and chronic effects since the concentration of cortisol in the time before the last session was below that observed before the beginning of the program. The concentration of cortisol (ng/mL) was 15.9±0.9 to 12.0±0.9 after the end of MTP. The rhythm of cortisol production of this population was normal and was preserved over 9 weeks. Cortisol levels measured in AUC (ng/mL) was higher on race day and vestibular samples noon and 20 h showed the highest values for this day. Acute effects of MT have been identified in the analysis of frequency and time domain of HRV. These alterations were due to an increase in parasympathetic tone and overall activity of the heart activity. The results of this study allow us to conclude that MT is effective in one session and throughout a program inducing acute and chronic effects. The chronic effect, possible neural plasticity was observed as a reduction in the concentration of cortisol before the last session of MT and this may be the cause for the predominance of the tone of the parasympathetic nervous system on the heart recorded in these volunteers / Doutorado / Fisiologia / Doutora em Biologia Funcional e Molecular

This diploma thesis deals with functional disorders of the musculoskeletal system. It discusses the possible causing factors of these disorders, their manifestations on the body, diagnostics and the possibilities of influencing them. Since this is a very common phenomenon on the human body, I chose mainly the muscle, fascia and joint structure, which I explored and described in more depth. The experimental part of this work aims to demonstrate the possible impact of the intervention of the 1.-3. ribs and claviculosternal joint as described by Ludmila Mojžíšová on the muscles of the neck (m. scalenus anterior, medius and sternocleidomastoideus). To obtain results, I used the ultrasound examination of the diameter of these muscles and Visual analogue scale (VAS) to obtain pain values before and after the intervention using this method. Title: Problematics of musculoskeletal dysfunction and chains Objectives: The first goal of this paper is to collect currently recognized sources about musculoscletal functional disorders. I have described origins of this kind of problems, manifestation of these disorders and kinds of therapy. I've focused on functional disorders of muscle, fascia and joint. Second goal of this thesis is to evaluate a top-rated Prague rehabilitation school's method. Part of Prague...

Background: Individuals with Subacromial Pain Syndrome (SPS) often present with a variety of contributing factors. It is possible that a subgroup exists within SPS that has primary impairments of scapular mobility and/or muscle strength. In an attempt to better identify scapular contributions in SPS, the Scapular Assistance Test (SAT) and Scapula Reposition Test (SRT) have been described. Additionally, thoracic spine thrust manipulation has been shown to be effective for shoulder pain. Problem Statement: It is currently unknown whether or not there are impairments in scapulothoracic muscle force generation or scapular mobility in individuals with SPS who have positive results on the SAT and SRT. It also remains unknown whether individuals with SPS respond differently in the immediate effects on scapular motion, scapulothoracic muscle force generation, pain, or function following different manipulation techniques. Methodology: Sixty subjects with shoulder pain were enrolled in the study. Baseline measures were obtained for scapular upward rotation and posterior tilt, scapulothoracic muscle force generation, pectoralis minor muscle length, pain, and function. Participants were randomized to receive a seated thrust manipulation, supine thrust manipulation, or sham manipulation. Measures were reassessed immediately after treatment and the Penn Shoulder Score (PSS) was reassessed at 48 hours. Results: The results indicated no significant differences in scapular upward rotation or posterior tilt, or muscle force generation based on the results of the SAT or SRT. There was a small but significant difference in pectoralis minor muscle length based on the result of the SAT. There were no significant between-group differences in scapular motion, muscle force generation, or pectoralis minor muscle length based on the treatment received. There were no significant differences in 48-hour improvement in pain, function, satisfaction, and total PSS scores. Small but significant within group changes existed on several measures. Discussion: The SAT and SRT may be ineffective in differentiating scapular movement associated impairments. Thoracic spine thrust manipulation resulted in no greater immediate improvements in scapular motion, strength, pectoralis minor muscle length, pain, or function compared to a sham treatment. The improvements in pain and function are likely not biomechanical in nature and are likely not derived from the manipulative thrust.

Title of thesis: The effect of manual therapy on visual acuity. Goal: The main goal is to present theoretical facts about manual eye therapy, to examine the effect of manual therapy of oculomotor muscles on selected parameters: visual acuity, subjective evaluation using a questionnaire and eye muscle pain in patients with refractive errors and eye accommodation disorders. Methods: The research was completed by 20 patients with refractive errors and eye accommodation disorders, from aged 18 to 55 years. An initial and subsequent treatment and exit examination and of eye muscles with the help of manual techniques, in particular, reciprocal inhibition and mobilization of eyeball were performed. The initial examination was performed by an optometrist, who assessed visual acuity by using an Autorefractometr, Snellen optotype and Red-green test test. After than was performed the subjective evaluation questionnaire, then was performed palpation assessment of attachments of eye muscles. Palpation pain proband evaluated using the Numeric Pain Rating Scale.The resulting data were processed using statistical software R. A paired t-test was used to calculate p-values. Statistical significance was assessed at the critical significance level of 0.05 and 0.01. Results: Our measurement did not show a statically...