Physical Examination of the Spine and Extremities

Inspiratory muscular training (IMT) increases the respiratory muscle strength, how- ever, there is no data demonstrating its superiority over the incentive spirometry (IS) in doing so. Values of muscle strength after IMT (Threshold IMT ® ) and by the IS (Voldyne ® ) in healthy females was compared. Subjects (n = 40) were randomly divided into control group (CG, n = 14), IS group (ISG, n = 13) and threshold group (TG, n = 13). PImax was measured before (pre-IMT), at 15 and 30 days of IMT. There was an increase in PImax of the TG at 15 days (p < 0.001) and 30 days of IMT (p < 0.001). The same occurred with the ISG, which increased the PImax at 15 days (p < 0.001) and 30 days of training (p < 0.001). After 30 days of IMT, the TG presented a PImax which was sig- nificantly higher than ISG and the CG (p = 0.045 and p < 0.001, respectively). It can be concluded that IMT by threshold was more effective in increasing muscle strength than the Voldyne. © 2014 Sociedade Portuguesa de Pneumologia. Published by Elsevier Espana, S.L.U. All rights reserved.

Inspiratory muscle training with threshold or incentive spirometry: Which is the most effective?

Examination of Synovial Fluid.- The Synovial Biopsy.- Tissue Reactions to Joint Prostheses and the Products of Wear and Corrosion.- Bone and Joint Diseases in Workers Exposed to Hyperbaric Conditions.- Experimental Models of Arthritis.- Electron Microscopy in Bone Tumor Diagnosis.- The Role of Particles in the Pathogenesis of Joint Disease.- HLA Systems and Rheumatic Diseases.- Experimental Models of Degenerative Joint Disease.

Bone and Joint Disease

https://www.thelancet.com/pdfs/journals/lanhae/PIIS2352-3026(18)30163-7.pdf

Moderate-intensity endurance-exercise training in patients with sickle-cell disease without severe chronic complications (EXDRE): an open-label randomised controlled trial.

Sickle cell disease (SCD) is the most frequent life-threatening genetic hemoglobinopathy in the world and occurs due to the synthesis of abnormal hemoglobin S (HbS). hemoglobin S-containing red blood cells (RBC) are fragile, leading to hemolysis and anemia, and adhere to the endothelium, leading to hemorheological and hemodynamical disturbances. In its deoxygenated form, HbS may polymerize, leading to sickling of red blood cells and potentially to vasoocclusive crises. Recent findings observed that SCD patients demonstrate significant skeletal muscle remodeling and display reduced muscle functional capacities, contributing to exercise intolerance and poor quality of life. Although acute high-intensity exercise is not recommended for SCD patients because it may increase the risk of sickling, regular moderate-intensity physical activity could have beneficial effects on skeletal muscle and more generally on the well-being of SCD patients. This article reviews the literature regarding the impact of the disease on muscular tissue characteristics and function, as well as the corresponding implications for SCD patients' quality of life.

How Sickle Cell Disease Impairs Skeletal Muscle Function: Implications in Daily Life.

Objective: To compare the effect of aquatic and land-based physiotherapy in reducing musculoskeletal hip and lower back pain and increasing overall physical capabilities of sickle cell disease patients. Methods: Informed written consent was obtained from all volunteers who were submitted to evaluations using different functional scales: Lequesne's Algofunctional Questionnaire and Oswestry Disability Index, trunk and hip range of motion, goniometry, trunk and hip muscle strength assessment using load cell, and surface electromyography of the iliocostalis, long dorsal (longissimus), gluteus maximus, gluteus medius and tensor fasciae latae muscles. Ten patients were randomized into two groups: aquatic physiotherapy with a mean age of 42 years (range: 25-67) and conventional physiotherapy with a mean age of 49 years (range: 43-59). Both groups were submitted to a twelve-week program of two sessions weekly. Results: After the intervention, signiﬁcant improvements were observed regarding the Lequesne index (p-value = 0.0217), Oswestry Disability Index (p-value = 0.0112), range of motion of trunk extension (p-value = 0.0320), trunk ﬂexion muscle strength (p-value = 0.0459), hip extension and abduction muscle strength (p-value = 0.0062 and p-value = 0.0257, respec- tively). Range of motion of trunk and hip ﬂexion, extension, adduction and abduction, trunk extensor muscle strength and all surface electromyography variables showed no signiﬁcant statistical difference. Conclusion: Physical therapy is efﬁcient to treat musculoskeletal dysfunctions in sickle cell disease patients, irrespective of the technique; however, aquatic therapy showed a trend toward improvement in muscle strength. Further studies with a larger patient sample and longer periods of therapy are necessary to conﬁrm these results.

https://www.scielo.br/pdf/rbhh/v37n2/1516-8484-rbhh-37-02-00082.pdf

Pilot randomized controlled trial to evaluate the effect of aquatic and land physical therapy on musculoskeletal dysfunction of sickle cell disease patients

O habito de fumar pode reduzir a capacidade aerobica, aumentar a resistencia ao fluxo aereo e afetar a funcao dos musculos respiratorios. O objetivo deste estudo foi comparar os efeitos do Treinamento Muscular Inspiratorio (TMI) entre dois grupos: tabagistas e nao tabagistas. Participaram 44 voluntarios universitarios, divididos em dois grupos: tabagistas (GT), composto por 20 individuos (25,60±7,01 anos) e nao tabagistas, constituindo o Grupo Controle (GC), composto por 24 voluntarios (24,08±7,52 anos). Ambos os grupos foram submetidos ao TMI, por meio do uso do manovacuometro aneroide, com duracao de 6 semanas, sendo 3 sessoes semanais, totalizando 18 sessoes. Os resultados mostraram diferenca estatisticamente significativa (p<0,05) pos-TMI no GC para as variaveis: Pressao Inspiratoria Maxima (PImax), Pico de Fluxo Expiratorio (PFE), Pressao Arterial Media ao repouso (PAM pre-TC6) e Teste de Caminhada de Seis Minutos (TC6). No GT, houve diferenca estatisticamente significativa pos-TMI para as variaveis: PImax, PFE, TC6 e saturacao periferica de oxigenio apos o TC6 (SpO2 pos-imediata). A comparacao das medias das variaveis entre GT e GC mostrou diferenca estatisticamente significativa no pos-TMI para as variaveis PImax e PFE. A variavel TC6 nao apresentou diferenca estatisticamente significativa. Conclui-se que o TMI proporcionou um aumento significativo da forca muscular inspiratoria, melhora da funcao pulmonar e melhora do desempenho fisico nos individuos estudados.

/pdf/efeitos-do-treinamento-muscular-inspiratorio-em-m2txdhov6t.pdf

Efeitos do treinamento muscular inspiratório em universitários tabagistas e não tabagistas

Physical therapy is an adjunct measure for treating osteo-articular disorders, with the objective of minimizing pain and limiting the progression of the disorder, thus improving functional capacity and quality of life of the patient. The aim of this short review is to describe the common techniques used for aquatic physical therapy and to comment a pilot study, comparing this technique to land-based physical therapy on musculoskeletal dysfunction of sickle cell disease patients. The results suggest that physical therapy is efficient, irrespective of the technique; however, aquatic therapy showed a trend towards an improvement in muscle strength. This preliminary report encourages further studies with a larger patient sample and longer periods of therapy.

https://www.longdom.org/open-access/is-aquatic-physical-therapy-a-feasible-treatment-for-musculoskeletaldysfunction-of-sickle-cell-disease-patients-2157-7595-1000216.pdf

Is Aquatic Physical Therapy a Feasible Treatment for Musculoskeletal Dysfunction of Sickle Cell Disease Patients

Effectiveness of a home-based therapeutic exercise program on lower back pain and functionality in Sickle Cell Disease (SCD) patients.

/pdf/effects-of-home-based-inspiratory-muscle-training-on-sickle-2mm48ss8lw.pdf

Camila Tatiana Zanoni

Papers

Pilot randomized controlled trial to evaluate the effect of aquatic and land physical therapy on musculoskeletal dysfunction of sickle cell disease patients

Efeitos do treinamento muscular inspiratório em universitários tabagistas e não tabagistas

Is Aquatic Physical Therapy a Feasible Treatment for Musculoskeletal Dysfunction of Sickle Cell Disease Patients

Effectiveness of a home-based therapeutic exercise program on lower back pain and functionality in Sickle Cell Disease (SCD) patients.

Effects of home-based inspiratory muscle training on sickle cell disease (SCD) patients.