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AnÃlise do impacto da correÃÃo cirÃrgica na qualidade de vida de 26 pacientes com incontinÃncia urodinÃmica de esforÃo / Analysis of the impact of the surgical correction in the quality of life of 26 patients with effort incontinence urodinÃmicaRaimundo CÃsar Pinheiro 31 March 2004 (has links)
Conselho Nacional de Desenvolvimento CientÃfico e TecnolÃgico / CoordenaÃÃo de AperfeiÃoamento de Pessoal de NÃvel Superior / A IncontinÃncia UrodinÃmica de EsforÃo à problema comum com impacto na qualidade de vida das pacientes. OBJETIVO:Comparar a qualidade de vida de 26 pacientes com incontinÃncia urodinÃmica de esforÃo antes e apÃs a correÃÃo cirÃrgica. A qualidade de vida foi avaliada com o QuestionÃrio de Impacto de IncontinÃncia e o InventÃrio de Estresse Urogenital, formas reduzidas . CASUÃSTICA e MÃTODO:Durante o perÃodo de marÃo de 2001 a dezembro de 2002 , quatorze pacientes foram submetidas à cirurgia de correÃÃo por tÃcnica de sling vaginal e doze pacientes realizaram uretrocistopexia de Burch. RESULTADOS: Com um seguimento pÃs-operatÃrio com mediana de nove meses (variaÃÃo de quatro a 22 meses) observou-se uma taxa de cura objetiva em vinte e cinco pacientes (96,2%), taxa de cura subjetiva em dezessete pacientes (65,4%), tendo vinte e cinco pacientes (96,2%) relatado cura ou melhora.Observaram-se no pÃs-operatÃrio trÃs casos de urgÃncia miccional , pacientes que realizaram cirurgia de Burch, duas pacientes com padrÃo miccional obstrutivo que haviam realizado cirurgia de sling e uma paciente que apresentou piora do quadro da incontinÃncia. Quanto Ãs caracterÃsticas demogrÃficas do grupo foram observadas:mediana de idade das pacientes de 56 anos (variaÃÃo de 41 a 77 anos), Ãndice de massa corpÃrea com mediana de 25 (variaÃÃo de 20 a 34). A paridade variou de zero a oito partos vaginais com mediana de trÃs partos. O tempo de internaÃÃo variou de dois a quatro dias com mediana de trÃs dias. No momento da alta hospitalar vinte e duas pacientes (84,6%) apresentaram resÃduo urinÃrio menor ou igual a 100ml. Quatro pacientes apresentaram volume residual urinÃrio maior que 100ml, uma que realizou cirurgia de Burch e trÃs que realizaram cirurgia de sling. A pressÃo de perda aos esforÃos no prÃ-operatÃrio apresentou mediana de 95 cmH20 (variaÃÃo de 40 a 140).No pÃs-operatÃrio apresentou mediana de 150 cm H20 (variaÃÃo de 60 a 213).O escore do QuestionÃrio de impacto de incontinÃncia apresentou variaÃÃo com significÃncia estatÃstica (p=0,00) entre o prà e pÃs-operatÃrio (mediana de 50 com variaÃÃo de 10 a 95 e mediana de zero com variaÃÃo de zero a 81 respectivamente).O escore do inventÃrio de estresse urogenital que no prÃ-operatÃrio apresentou mediana de 53 (variaÃÃo de 17 a 94), apresentou apÃs a cirurgia mediana de seis (variaÃÃo de 16 a 35), alteraÃÃo com significÃncia estatÃstica (p=0,07).O coeficiente do escore do questionÃrio de impacto de incontinÃncia apresentou melhora excelente em vinte e trÃs pacientes (88,5%), melhora moderada em uma paciente (3,8%) e piora em duas pacientes (7,7%). O coeficiente do escore do inventÃrio de estresse urogenital apresentou melhora excelente em vinte e duas pacientes (84,6%), melhora moderada em duas pacientes (7,7%) e piora em duas pacientes (7,7%).
CONCLUSÃO:Os resultados mostraram que os resultados objetivos nem sempre se correlacionam com os achados subjetivos e que os questionÃrios de qualidade de vida sÃo instrumentos vÃlidos e importantes na avaliaÃÃo e escolha terapÃutica em pacientes com incontinÃncia urodinÃmica de esforÃo / The Stress Urinary Incontinence is a common problem with impact on the patientâs quality of life. OBJECTIVE- to evaluate the impact on the quality of life of 26 patients with stress urodynamic incontinence that realized vaginal sling and urethrocystopexia of Burch . Quality of life was assessed with the Questionnaire of Impact of Incontinence and the Inventory of Urogenital stress, short forms. METHODS -During the period of March of 2001 to December of 2002 14 patients (group 1) realized vaginal sling and 12 patients (group 2) realized urethrocystopexia of Burch.RESULTS- After a median follow up of nine months (variation of four to 22 months) it was observed an objective cure rate of 96,2% ,twenty five patients, a subjective cure rate of 65,4%, seventeen patients , twenty five patients related cure or improvement after the surgery . At the postoperative periodo it were observed three cases of de novo urgency , patients that realized surgery of Burch, two patients with obstructive urinary dysfunction that made sling and one patient that presented with worsening of incontinence.Some demographic characteristics of the patients : the median age of the patients were of 56 years (variation of 41 to 77 years), the median of the index of corporal mass was of 25 (variation of 20 the 34). The vaginal parity varied from zero to eight childbirths with a median of three childbirths.The hospital stay time varied from two to four days with a median of three days. At the moment of delivery twenty two patients (84,6%) presented with urinary residue equal or less than 100ml. Four patients presented with urinary residue greater than 100ml, one of them had done surgery of Burch and three had done vaginal sling.
The median leak point pressure at the preoperative period was of 95 cmH20 (variation of 40 to 140). At the postoperative period it was of 150 cm H20 (variation of 60 the 213).
The median score of the Questionnaire of impact of incontinence showed statistically significant difference (p=0,00) between the pre and postoperative period , median of 50 with variation of 10 the 95 and a median of zero with variation of zero to 81 respectively. The median score of the inventory of urogenital stress at the preoperative period was of 53 (variation of 17 the 94), after the surgery it was of six (variation of 16 the 35) wich was statistically significant (p=0,07). The coefficient of the questionnaire of impact of incontinence presented with excellent improvement in twenty-three patients (88,5%), moderate improvement in one patient (3,8%) and worsening in two patients (7,7%). The coefficient of the inventory of urogenital stress presented with excellent improvement in twenty-two patients (84,6%), moderate improvement in two patients (7,7%) and worsening in two patients (7,7%).
CONCLUSIONS- The findings of this prospective nonrandomized study showed that objective results not always are correlated with the subjective findings and that the questionnaires of quality of life are valid and important instruments in the evaluation and decision making of patients with stress urodynamic incontinence
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Analise do Impacto da CorreÃÃo CirÃrgica na qualidade de vida de 26 pacientes com incontinÃncia UrodinÃmica de esforÃo / Evaluation of impact of quality of life in 26 patients with stress urodynamic incontinence that realized surgical correctionRaimundo CÃsar Pinheiro 31 March 2004 (has links)
Conselho Nacional de Desenvolvimento CientÃfico e TecnolÃgico / CoordenaÃÃo de AperfeiÃoamento de Pessoal de NÃvel Superior / The Stress Urinary Incontinence is a common problem with impact on the patientâs quality of life. OBJECTIVE- to evaluate the impact on the quality of life of 26 patients with stress urodynamic incontinence that realized vaginal sling and urethrocystopexia of Burch . Quality of life was assessed with the Questionnaire of Impact of Incontinence and the Inventory of Urogenital stress, short forms. METHODS -During the period of March of 2001 to December of 2002 14 patients (group 1) realized vaginal sling and 12 patients (group 2) realized urethrocystopexia of Burch.RESULTS- After a median follow up of nine months (variation of four to 22 months) it was observed an objective cure rate of 96,2% ,twenty five patients, a subjective cure rate of 65,4%, seventeen patients , twenty five patients related cure or improvement after the surgery . At the postoperative periodo it were observed three cases of de novo urgency , patients that realized surgery of Burch, two patients with obstructive urinary dysfunction that made sling and one patient that presented with worsening of incontinence.Some demographic characteristics of the patients : the median age of the patients were of 56 years (variation of 41 to 77 years), the median of the index of corporal mass was of 25 (variation of 20 the 34). The vaginal parity varied from zero to eight childbirths with a median of three childbirths.The hospital stay time varied from two to four days with a median of three days. At the moment of delivery twenty two patients (84,6%) presented with urinary residue equal or less than 100ml. Four patients presented with urinary residue greater than 100ml, one of them had done surgery of Burch and three had done vaginal sling.
The median leak point pressure at the preoperative period was of 95 cmH20 (variation of 40 to 140). At the postoperative period it was of 150 cm H20 (variation of 60 the 213).
The median score of the Questionnaire of impact of incontinence showed statistically significant difference (p=0,00) between the pre and postoperative period , median of 50 with variation of 10 the 95 and a median of zero with variation of zero to 81 respectively. The median score of the inventory of urogenital stress at the preoperative period was of 53 (variation of 17 the 94), after the surgery it was of six (variation of 16 the 35) wich was statistically significant (p=0,07). The coefficient of the questionnaire of impact of incontinence presented with excellent improvement in twenty-three patients (88,5%), moderate improvement in one patient (3,8%) and worsening in two patients (7,7%). The coefficient of the inventory of urogenital stress presented with excellent improvement in twenty-two patients (84,6%), moderate improvement in two patients (7,7%) and worsening in two patients (7,7%).
CONCLUSIONS- The findings of this prospective nonrandomized study showed that objective results not always are correlated with the subjective findings and that the questionnaires of quality of life are valid and important instruments in the evaluation and decision making of patients with stress urodynamic incontinence / A IncontinÃncia UrodinÃmica de EsforÃo à problema comum com impacto na qualidade de vida das pacientes. OBJETIVO:Comparar a qualidade de vida de 26 pacientes com incontinÃncia urodinÃmica de esforÃo antes e apÃs a correÃÃo cirÃrgica. A qualidade de vida foi avaliada com o QuestionÃrio de Impacto de IncontinÃncia e o InventÃrio de Estresse Urogenital, formas reduzidas . CASUÃSTICA e MÃTODO:Durante o perÃodo de marÃo de 2001 a dezembro de 2002 , quatorze pacientes foram submetidas à cirurgia de correÃÃo por tÃcnica de sling vaginal e doze pacientes realizaram uretrocistopexia de Burch. RESULTADOS: Com um seguimento pÃs-operatÃrio com mediana de nove meses (variaÃÃo de quatro a 22 meses) observou-se uma taxa de cura objetiva em vinte e cinco pacientes (96,2%), taxa de cura subjetiva em dezessete pacientes (65,4%), tendo vinte e cinco pacientes (96,2%) relatado cura ou melhora.Observaram-se no pÃs-operatÃrio trÃs casos de urgÃncia miccional , pacientes que realizaram cirurgia de Burch, duas pacientes com padrÃo miccional obstrutivo que haviam realizado cirurgia de sling e uma paciente que apresentou piora do quadro da incontinÃncia. Quanto Ãs caracterÃsticas demogrÃficas do grupo foram observadas:mediana de idade das pacientes de 56 anos (variaÃÃo de 41 a 77 anos), Ãndice de massa corpÃrea com mediana de 25 (variaÃÃo de 20 a 34). A paridade variou de zero a oito partos vaginais com mediana de trÃs partos. O tempo de internaÃÃo variou de dois a quatro dias com mediana de trÃs dias. No momento da alta hospitalar vinte e duas pacientes (84,6%) apresentaram resÃduo urinÃrio menor ou igual a 100ml. Quatro pacientes apresentaram volume residual urinÃrio maior que 100ml, uma que realizou cirurgia de Burch e trÃs que realizaram cirurgia de sling. A pressÃo de perda aos esforÃos no prÃ-operatÃrio apresentou mediana de 95 cmH20 (variaÃÃo de 40 a 140).No pÃs-operatÃrio apresentou mediana de 150 cm H20 (variaÃÃo de 60 a 213).O escore do QuestionÃrio de impacto de incontinÃncia apresentou variaÃÃo com significÃncia estatÃstica (p=0,00) entre o prà e pÃs-operatÃrio (mediana de 50 com variaÃÃo de 10 a 95 e mediana de zero com variaÃÃo de zero a 81 respectivamente).O escore do inventÃrio de estresse urogenital que no prÃ-operatÃrio apresentou mediana de 53 (variaÃÃo de 17 a 94), apresentou apÃs a cirurgia mediana de seis (variaÃÃo de 16 a 35), alteraÃÃo com significÃncia estatÃstica (p=0,07).O coeficiente do escore do questionÃrio de impacto de incontinÃncia apresentou melhora excelente em vinte e trÃs pacientes (88,5%), melhora moderada em uma paciente (3,8%) e piora em duas pacientes (7,7%). O coeficiente do escore do inventÃrio de estresse urogenital apresentou melhora excelente em vinte e duas pacientes (84,6%), melhora moderada em duas pacientes (7,7%) e piora em duas pacientes (7,7%).
CONCLUSÃO:Os resultados mostraram que os resultados objetivos nem sempre se correlacionam com os achados subjetivos e que os questionÃrios de qualidade de vida sÃo instrumentos vÃlidos e importantes na avaliaÃÃo e escolha terapÃutica em pacientes com incontinÃncia urodinÃmica de esforÃo
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ATOMS (Adjustable Transobturator Male System) Is an Effective and Safe Second-Line Treatment Option for Recurrent Urinary Incontinence after Implantation of an AdVance/AdVance XP Fixed Male Sling? A Multicenter Cohort AnalysisQueissert, Fabian, Rourke, Keith, Schönburg, Sandra, Giammò, Alessandro, Gonsior, Andreas, González-Enguita, Carmen, Romero, Antonio, Schrader, Andres J., Cruz, Francisco, Martins, Francisco E., Dorado, Juan F., Angulo, Javier C. 04 May 2023 (has links)
(1) Background: This study examined outcomes of second-line ATOMS implantation after failure of the fixed male sling (FMS) AdVance/AdVance XP. (2) Methods: A retrospective multicenter cohort analysis was carried out in men implanted with an ATOMS between 2011 and 2020 after failure of an AdVance/AdVance XP. Success was assessed on the basis of objective (dryness, 0–1 pad/24 h or >20 g/24 h pad test) and subjective results (PGI-I). We performed the Wilcoxon rank sum test, Fisher’s exact test, logistic regression, and multivariate analysis. (3) Results: The study included 88 patients from 9 centers with a mean age of 71.3 years. No Clavien–Dindo > II complications occurred within the first 3 months after ATOMS implantation. A total of 10 cases (9%) required revision in the ensuing clinical course. After a mean follow-up of 42.5 months, 76.1% achieved social continence, and 56.8% used no pads at all. Mean urine leakage/24 h dropped from 422 g (3.9 pads) to 38 g (0.69 pads) and the mean ICIQ-SF decreased from 16.25 to 5.3 (p < 0.0001). PROMs (patient-reported outcome measures) showed improvement in 98.9% of cases, and 63.6% gave a “very much better” PGI-I rating. Multivariate analysis identified a lower probability of achieving maximum satisfaction for the following factors: the AdVance XP as first-line therapy (OR 0.35), a lower ICIQ-SF question 1 (OR 0.26), status post-irradiation (OR 0.14), and more severe pain prior to ATOMS implantation (OR 0.51). (4) Conclusions: Implantation of an ATOMS is an effective and safe second-line treatment option for recurrent urinary incontinence after implantation of an AdVance/AdVance XP sling. High patient satisfaction was demonstrated in a long-term follow-up.
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Small Finds From Chogha Gavaneh Site in the Islamabad Plain, Central Zagros Mountains, IranForouzan, Firoozeh 07 December 2010 (has links)
This study examines small finds from the site of Chogha Gavaneh, Iran, including zoomorphic clay figurines, geometric-shaped objects, and sling bullets in order to deter-mine if they served an economic function during the Early Chalcolithic period (ca. 5000-4000 B.C.E.). A total of 104 animal figurines, sling bullets, and geometric-shaped objects have been found at Chogha Gavaneh. This research challenges previous archaeological interpretations of animal figurines that have interpreted them as being magical or lucky objects for hunting and religious rituals, or for use as game pieces, educational objects, or toys. Through the use of XRF (x-ray fluorescence spectrometry) analysis and the chaine opératoire approach, I suggest, contrary to the conventional wisdom, that some of these clay objects might represent another kind of social practice and may have had an economic function.
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Slingträning av nedre bålen : en väg tillbaka till löparslingan vid problem med löparknä?Edvardsson, Mia January 2011 (has links)
Syfte och frågeställningar: Syftet med studien var att undersöka om slingträning av nedre bålen för individer med löparknä kan ge en reducering av skadeproblematiken. Syftet var även att studera om upplevelsen av smärta och begränsning i aktivitet förändrats hos dessa individer i en subjektiv bedömning. Löparknä innebär smärta på den yttre sidan av knät, mest vanligt hos löpare men även andra idrottare drabbas. Frågeställningar: I vilken omfattning kan slingträning av nedre bålen för individer med löparknä ge en mer funktionell styrka och även större uthållighet? Hur upplever individer med löparknä vid en subjektiv skattning att denna träning leder till en förändring av smärta och begränsning i aktivitet? Metod: Studien genomfördes som en kvantitativ experimentell studie, där en interventionsgrupp på sex löpare med löparknäproblem genomförde slingträning av nedre bålen. Detta skedde två gånger i veckan under sex veckor. Tester av funktionell styrka och uthållighet genomfördes den första veckan, efter tre veckor och efter sex veckor. Testerna innebar ett isometriskt test av höftabduktorer, ett balanstest på ett ben och att samtidigt sträcka sig framåt på samma sida, ett balanstest på ett ben med sträckning över huvudet i frontalplan, och ett test av svag länk vid sidliggande höftabduktion. En kontrollgrupp på fyra löpare utan skador genomförde enbart testerna vid samma tidpunkter. Därtill följde en subjektiv bedömning, i form av skattning på en skala 0-10, av hur individen upplevde smärta av löparknät, samt hur det begränsade hans/hennes aktivitet. Resultat: En signifikant förbättring över tid erhölls i både det skadade och friska benet hos interventionsgruppen i tre av testerna, närmare bestämt isometriskt test av höftabduktorer (51 %), balanstest på ett ben med sträckning över huvudet i frontalplan (8 %), och test av svag länk vid sidliggande höftabduktion (27 %). Ingen förändring erhölls hos kontrollgruppen. Slutsats: Denna studie tyder på att slingträning av nedre bålen för individer med löparknäproblem kan ge en mer funktionell styrka och även större uthållighet. Denna träning kan också vara orsaken till att deras upplevelse av smärta och begränsning i aktivitet tenderade att minska.
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Does Body Mass Index Impact Passing Voiding Trial After Midurethral Sling Procedures for Stress Urinary Incontinence?Huffaker, R. K., Livers, Nathan, Yandell, Paul M., Shull, Bobby L., Muir, Tristi W., Kuehl, Thomas J., Bird, Erin T. 01 January 2010 (has links)
Objective: To test the hypothesis that body mass index (BMI) is a factor associated with passing a voiding trial after midurethral sling procedures for stress urinary incontinence (SUI). Study Design: The medical records of 136 consecutive patients who underwent placement of either tension-free vaginal tape (TVT) or transobturator tape (TOT) for SUI during a 1-year period (September 1, 2007 to August 31, 2008) were retrospectively reviewed. Variables assessed were BMI, age, and passing or failing a postoperative urinary voiding trial. Patients with concomitant pelvic organ prolapse surgeries were not included in this analysis. Results: Sixty-seven patients underwent TVT, whereas 69 had TOT procedures. In the TVT group, 30 patients (42%) were unable to void immediately postoperatively compared with 11 patients (16%) in the TOT group (P = 0.0003). The mean (SD) age and BMI of patients who failed or passed voiding trials was 58.6 (12.0) years and 28.0 (4.9) kg/m2 or 53.5 (12.3) years and 29.8 (5.7) kg/m2, respectively. Of 38 patients who did not pass a voiding trial on the day of the procedure, 31 (82%) passed on postoperative day 1, and all patients had passed a voiding trial by postoperative day 11. The mean (SD) BMI for 7 patients who did not pass voiding trial by postoperative day 1 was 28.3 (5.2) kg/m2. Conclusions: Women with higher BMIs were more likely to pass voiding trials after midurethral sling procedures. Patients who had TOT placement had greater success passing a postprocedure voiding trial than did patients who had TVT placement.
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In vivo Biocompatibilty and Time-Dependent Changes in Mechanical Properties of Woven Collagen Meshes: Comparison to Xenograft and Synthetic Mid-Urethral Sling MaterialsChapin, Katherine Joan 30 May 2016 (has links)
No description available.
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Análise comparativa da fadiga muscular nos adultos após o transporte de bebês com e sem o auxílio de carregadores / Comparative analysis of muscle fatigue in adults after transport of infants with and without the aid of baby carriersGonçalves, Gabriela Rodrigues 28 July 2014 (has links)
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Previous issue date: 2014-07-28 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / The habit of carrying babies in baby carriers is in a significant expansion in modern culture, however there are gaps in knowledge about these new artifacts available in the market. This study aimed to evaluate and compare the feeling of weight carried and muscle fatigue perceived by adults after carry a baby with and without the aid of baby carriers. For this research we used the Soft Structured Carrier and Wrap Sling, which are considered contemporary baby carriers. A systematic literature review presented here covers concepts of ergonomics with a focus on transporting babies, as well as cultural, physical and emotional issues associated with the artifact. The results intended to add to the existing literature, new data, contributing to the construction of scientific knowledge and identifying the need for standardization of manufacturing standards and use as well as the elaboration of a recommendation of acceptable weight limits and other relevant issues order to benefit the population that chooses this type of resource. / O hábito de transportar bebês em carregadores está em significativa expansão na cultura moderna, entretanto existem lacunas no conhecimento acerca destes novos artefatos disponíveis no mercado. A presente pesquisa teve como propósito avaliar e comparar a sensação de peso transportado e a fadiga muscular percebida pelos adultos após o transporte de um bebê com e sem o auxílio de carregadores. Para a realização desta pesquisa foram utilizados o Soft Structured Carrier e o Wrap Sling, sendo estes considerados carregadores contemporâneos. A pesquisa bibliográfica sistemática apresentada neste trabalho contempla conceitos de Ergonomia com foco no transporte de bebês, além de questões culturais, físicas e emocionais associadas ao artefato. Os resultados obtidos pretendem acrescentar a bibliografia já existente, novos dados, contribuindo para a construção do conhecimento científico e identificando a necessidade de normalização dos padrões de fabricação e uso, bem como a elaboração de uma recomendação de limites aceitáveis de peso e outras questões relevantes a fim de beneficiar a população que opta por este tipo de recurso.
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Effekter av slyngträning på smärta och funktionsförmåga hos patienter med långvarig ländryggssmärta : En Single System Experimental Design / Effects of sling exercise on pain and dysfunction in individuals with chronic low back pain : A Single System Experimental DesignVounelakis, Helena January 2023 (has links)
Syfte: Syftet med den här studien var att undersöka om 4 veckors övervakad slyngträning påverkar smärta och funktionsförmåga hos enskilda individer med långvarig ländryggssmärta. Metod: Studiens design är en Single-System Experimental Design med AB-design. Tre deltagare med långvarig ländryggssmärta inkluderades i studien genom ett ändamålsenligt urval. Interventionen bestod av övervakad slyngträning tre gånger i veckan under fyra veckor. Smärta mättes med Visual Analogue Scale (VAS 0–100 mm) och funktionsförmåga mättesmed Oswestry Disability Index (ODI). Mätningar utfördes tre gånger i veckan under baslinjefasen och tre gånger i veckan under interventionsfasen. Resultat: Hos två av deltagarna sågs effekt på smärta efter introduktion av interventionen medan ingen effekt kunde säkerställas för en. Hos två av deltagarna sågs effekt på funktionsförmåga efter introduktion av interventionen medan ingen signifikant effekt kunde indikeras för en. Följsamheten till interventionen var god och deltagarnas upplevelser visade att de kände sig starkare och upplevde minskad rörelserädsla. Slutsats: Interventionen uppvisade potential att förbättra smärta och funktionsförmåga hos enskilda individer med ländryggssmärta. Resultaten kan inte generaliseras till andra patienter och miljöer utan replikering. / Objective: The purpose of the current study was to assess the influence of 4 weeks supervised sling exercise on pain and dysfunction in subjects with chronic low back pain. Methods: A Single-System Experimental Design with AB-design was applied. Three participants with chronic lower back pain were recruited by purposive sample. The intervention consisted of 4 weeks of supervised sling exercises thrice a week. Pain was rated with Visual Analogue Scale (VAS 0-100 mm) and disability was rated with Oswestry disability Index (ODI). Measurements was performed trice a week during baseline phase and trice a week during the intervention phase. Results: The results showed a decrease in pain for two participants after introduction of the intervention while it showed no effect for one participant. Improvement in dysfunction was shown for two participants after introduction of the intervention while no effect was shown for one participant. Compliance was good and the participants experienced feeling stronger and reduced fear of movement. Conclusions: A 4 weeks supervised sling exercise programme indicates potential in improving pain and dysfunction in individuals with lower back pain. The results cannot be generalized to other patients or contexts without replication.
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Efeito da suspensão frontal com fáscia muscular na cinemática palpebral / The effect of frontalis slings with muscular fascia in the eyelid\'s kinematicsBaccega, Adriano Antonio 18 May 2018 (has links)
O objetivo do estudo foi avaliar parâmetros da cinemática palpebral durante o piscar espontâneo e movimentos sacádicos palpebrais em pacientes com ptose congênita submetidos à correção cirúrgica pela técnica de suspensão frontal com fáscia muscular. Com um sistema de câmeras de captação infravermelha para análise tridimensional de movimentos foi feito registro simultâneo de movimentos de supercílio e de pálpebra. Para análise do piscar espontâneo foram avaliados 17 pacientes com ptose congênita que realizaram correção cirúrgica pela técnica de suspensão frontal com utilização de fáscia muscular autógena (n=14), e fáscia lata preservada (n=3), e para o estudo do movimento sacádico palpebral, a avaliação foi dos 14 pacientes que utilizaram apenas fáscia autógena. Um grupo controle com 17 indivíduos normais também foi medido. Para análise do piscar espontâneo um programa foi utilizado para medidas de amplitude e velocidade máxima de movimento durante a observação de um filme comercial por 5 minutos. Para análise do movimento sacádico palpebral foram realizadas medidas em 10, 20, 30, 40 e 50 graus do olhar para baixo. A avaliação da superfície ocular em lâmpada de fenda com utilização de fluoresceína foi realizada nos pacientes que apresentavam ou não lagoftalmo. O número de piscadelas foi significativamente diminuído nos pacientes. A distribuição do intervalo entre as piscadelas foi similar nos dois grupos. A média de amplitude da fase descendente do piscar dos pacientes foi apenas 38% da média do grupo controle. A inclinação da reta da \"main sequence\" para o piscar espontâneo para os pacientes foi mais baixa. Nos controles o movimento do supercilio foi muito pequeno e insignificante durante o piscar espontâneo. Nos pacientes, a média de amplitude do movimento do supercílio foi cinco vezes maior que nos controles chegando a 45% da amplitude do piscar. Os movimentos sacádicos palpebrais mostraram uma importante restrição e não aumentou além de 30 graus do olhar para baixo. A velocidade máxima da pequena amplitude dos movimentos sacádicos palpebral foi muito baixa. Enquanto a movimentação do supercilio no grupo controle ficou entre 3,3 e 9,3% do movimento sacadico palpebral, nos pacientes a movimentação do supercílio foi responsável por 43,5 a 57,4% do movimento palpebral. Lagoftalmo foi encontrado em 13 (76,5%) dos pacientes. Apenas 3 (23%) mostraram sinais de ceratopatia superficial inferior, apesar da presença do fenômeno de Bell. A amplitude e velocidade do piscar espontâneo está severamente diminuída em pacientes com suspensão frontal com fáscia muscular. Esse tipo de material causa um efeito restritivo permanente nas propriedades elásticas das pálpebras. Após a cirurgia a amplitude do piscar é dependente da amplitude do movimento do supercílio. O lagoftalmo é uma consequência natural da suspensão frontal com fáscia muscular. / The purpose of the present investigation was to measure lid kinematics parameters in spontaneous blink metrics and downward eyelid saccadic movements in patients with congenital ptosis operated with frontalis slings with muscles fascia. A optoeletronic system was employed with infrared 3-dimensional video motion analyzer to simultaneously measure brow motion and spontaneous blinks in 17 patients with congenital ptosis who underwent frontalis sling with autogeneous muscle fascia (n=14) and banked fascia lata (n=3). Downward eyelid saccadic movements were analyzed only in the 14 patients with autogeneous muscle fascia. A control group of equal number of healthy subjects was also measured. For analyses of spontaneous blinks, a customized software identified and quantified the amplitude and maximum velocity during 5 minutes observation of a commercial movie. For downward eyelid saccadic movements, 10, 20, 30, 40 and 50 degrees of downgaze were measure. The corneal status of the patients with and without lagophthalmos was evaluated with slit lamp biomicroscopy with fluorescein staining. Blink rate was significantly diminished in the patients. The distribution of interblink time was similar in both groups. The mean amplitude of the down phase of the patients\' blinks was only 38% of the controls. The main sequence slope of the patients´ blinks was abnormally low. In controls brow motion was a minute and random event no related to blinks. In the patients, the means brow amplitude was 5 times higher than in controls reaching 45% of the blink amplitude. The lid saccades of the patients were severely restricted and did not increase beyond 30 degrees of downgaze. The maximum velocity of the small amplitude lid saccades was also abnormally low. While in controls brow motion accounted for about 3,3 to 9,3% of the lid saccades, in the patients brow motion was responsible for more than 43,5% to 57,4% lid movements. Lagophthalmos was detected on 13 (76,5%) patients. Out of these 3 (23%) showed signs of inferior superficial keratopathy despite the presence of normal. Spontaneous blink amplitude and velocity are severely impaired in patients with fascia slings. This material has a permanent restrictive effect on the elastic properties of the lids. After surgery blinking amplitude is linearly related to the amplitude of brow motion. Postoperative lagophthalmos is a natural consequence of the slings with muscle fascia.
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