Relatório de estágio. Terapia manual ortopédica

Objectivo: Descrever a intervenção em fisioterapia aplicada num paciente com o diagnóstico de entorse da Tíbio-társica de grau III. Participantes e Métodos: Paciente que em 1 de Dezembro de 2009 na sequência de uma disputa de bola, sofreu uma entorse da tíbio-társica. Iniciou fisioterapia a 4 de Janeiro de 2010, tendo sido utilizadas para o tratamento técnicas de Mulligan, nomeadamente MWM, mobilização articular, reforço muscular e treino proprioceptivo. O tratamento foi realizado diariamente durante 6 semanas. Resultados: Após a aplicação das técnicas de Mulligan MWM na 1ªsemana, o perónio encontra-se devidamente reposicionado, no entanto o calcâneo ainda se encontra posteriorizado. No fim da 2ªsemana, a amplitude articular aumentou significativamente, aproximando-se dos valores do membro contralateral, verificouse um ganho de força muscular progressivo. Na 3ª e 4ª semana progrediu-se o tratamento em termos de fortalecimento muscular e treino proprioceptivo. Na 5ª semana apresentava amplitudes de movimento de 17º de dorsiflexão, 43º de flexãoplantar, 15º de eversão e 18º de inversão. Relativamente à força, o músculo tibial anterior apresentava um grau 5 de força, longo e curto peronial e flexores plantares grau 4+. No fim de 6 semanas, terminada a sua recuperação encontrava-se sem qualquer limitação funcional, igual força muscular bilateral e proprioceptividade normal. Conclusão: Foi salientado o processo de raciocínio clínico desenvolvido pelo fisioterapeuta ao longo das 6 semanas de intervenção: a recolha e interpretação dos dados da história, levantamento das primeiras hipóteses, testes dessas hipóteses no exame objectivo, estabelecimento de um diagnóstico funcional e construção e implementação de um plano de intervenção com a colaboração do utente que permitiram uma recuperação funcional que foi de encontro aos objectivos traçados.

Intervenção em fisioterapia numa prótese total do ombro

Introdução: A artroplastia total do ombro é largamente aceite como tratamento para uma variedade de patologias do ombro com dor persistente e perda acentuada da funcionalidade. Em termos globais, os resultados obtidos após a intervenção cirúrgica são bastante bons, parecendo estar, no entanto, condicionados com a patologia subjacente e a qualidade da coifa dos rotadores. Objectivo: Pretende-se com este trabalho descrever e avaliar a eficácia de um plano de intervenção numa prótese total do ombro com integridade da coifa dos rotadores. Metodologia: Paciente sexo feminino, 61 anos, reformada, com dor acentuada no ombro esquerdo desde há três anos, submetida a uma cirurgia de colocação de prótese total do ombro. Apresentava limitação da amplitude articular, diminuição da força, alteração do ritmo escapulo-umeral e ligeira incapacidade funcional. Cinco semanas após a cirurgia, iniciou sessões diárias de fisioterapia durante 12 semanas. A intervenção incluiu a aplicação de modalidades anti-álgicas, mobilização articular, fortalecimento muscular e reeducação neuromuscular. Foi avaliada em quatro momentos: antes da intervenção (M1), 4 (M2), 7 (M3) e 12 (M4) semanas após. Resultados: A dor diminuiu de 4 para 0 (END) no final de 7 semanas e as amplitudes articulares passivas aproximaram-se dos valores definidos pelo protocolo com a flexão/elevação anterior a evoluir de 90º para 130º; a abdução/elevação lateral de 80º para 110º e a rotação medial de 35º para 70º. A força muscular inicial era de 3 nos grupos musculares flexores, extensores e rotadores do ombro atingindo no final grau 4. O ritmo escapulo-umeral demonstrou assincronia durante a elevação do ombro na primeira avaliação, ficando quase normalizado no final das sessões. Quanto à funcionalidade, antes da intervenção o score obtido foi de 30.8 atingindo um valor de 11.6 no final das sessões de tratamento. Conclusão: Após 12 semanas de tratamento, os objectivos delineados foram praticamente atingidos, uma vez que a utente já não refere dor no ombro e apresenta uma boa capacidade funcional, apesar de apresentar ligeiras diferenças nas amplitudes articulares e força muscular esperadas, apontando para o sucesso do protocolo de tratamento aplicado.

Ensaios geomecânicos em rochas metassedimentares do maciço da Mina das Aveleiras (Mosteiro de Tibães): comparação, potencialidades e limitações

Mestrado em Engenharia Geotécnica e Geoambiente

Efetividade do conceito de Mulligan comparativamente ao exercício terapêutico supervisionado na diminuição da dor no ombro em atletas de Polo Aquático

Introdução: A aplicação das técnicas de Mulligan têm como objetivo reduzir a dor, aumentar as amplitudes articulares e melhorar a funcionalidade, assim como sobre a aplicação de um programa exercícios supervisionados ao complexo articular do ombro. O propósito de um programa de exercícios do ombro pode ser dirigido para o alívio da dor, para o equilíbrio e aumento da força muscular, assim como para restabelecer sem dor as amplitudes articulares de movimento. Objetivos: Este estudo teve como objectivo comparar a eficácia do conceito de Mulligan com um programa de exercícios terapêuticos na diminuição da dor no ombro em atletas de Polo Aquático. Métodos: Realizou-se um estudo quase-experimental, sendo a amostra composta por 13 atletas do sexo masculino e 11 atletas do sexo feminino, que apresentavam dor na região do ombro, com idades compreendidas entres os 19 e os 32 anos de idade (n=24). Foi aplicado um questionário para a recolha da informação relativa à caracterização do atleta e á presença de dor. A avaliação foi realizada em diversos momentos, nomeadamente avaliação pré tratamento, avaliação pós primeira, segunda e terceira semana de tratamento, utilizando o instrumento EVA. Estatística: Procedeu-se à análise estatística descritiva e recorreu-se ao teste de Willcoxon, Teste T para testar associação entre a intensidade da dor e os diferentes momentos da avaliação da dor, a Teste de Willcoxon para testar associação entre a intensidade da dor entre os diferentes momentos de avaliação. Foi usado um nível de significância de 0,05. Resultados: Os resultados demonstram que nos dois grupos os atletas tiveram diminuição da intensidade da dor no ombro, embora se tenha verificado que a intervenção com MVM produz resultados mais rápidos e eficazes na diminuição da intensidade da dor, comparativamente á intervenção com exercícios terapêuticos supervisionados em atletas de Polo Aquático com dor no ombro. Conclusão: A intervenção com mobilização com movimento teve maior eficácia na diminuição intensidade da dor comparativamente á intervenção com exercícios terapêuticos supervisionados em atletas com dor no ombro.

An integrated recycling approach for GFRP pultrusion wastes: recycling and reuse assessment into new composite materials using Fuzzy Boolean Nets

In this study, efforts were made in order to put forward an integrated recycling approach for the thermoset based glass fibre reinforced polymer (GPRP) rejects derived from the pultrusion manufacturing industry. Both the recycling process and the development of a new cost-effective end-use application for the recyclates were considered. For this purpose, i) among the several available recycling techniques for thermoset based composite materials, the most suitable one for the envisaged application was selected (mechanical recycling); and ii) an experimental work was carried out in order to assess the added-value of the obtained recyclates as aggregates and reinforcement replacements into concrete-polymer composite materials. Potential recycling solution was assessed by mechanical behaviour of resultant GFRP waste modified concrete-polymer composites with regard to unmodified materials. In the mix design process of the new GFRP waste based composite material, the recyclate content and size grade, and the effect of the incorporation of an adhesion promoter were considered as material factors and systematically tested between reasonable ranges. The optimization process of the modified formulations was supported by the Fuzzy Boolean Nets methodology, which allowed finding the best balance between material parameters that maximizes both flexural and compressive strengths of final composite. Comparing to related end-use applications of GFRP wastes in cementitious based concrete materials, the proposed solution overcome some of the problems found, namely the possible incompatibilities arisen from alkalis-silica reaction and the decrease in the mechanical properties due to high water-cement ratio required to achieve the desirable workability. Obtained results were very promising towards a global cost-effective waste management solution for GFRP industrial wastes and end-of-life products that will lead to a more sustainable composite materials industry.

Re-use assessment of thermoset composite wastes as aggregate and filler replacement for concrete-polymer composite materials: a case study regarding GFRP pultrusion wastes

Glass fibre-reinforced plastics (GFRP), nowadays commonly used in the construction, transportation and automobile sectors, have been considered inherently difficult to recycle due to both the cross-linked nature of thermoset resins, which cannot be remoulded, and the complex composition of the composite itself, which includes glass fibres, polymer matrix and different types of inorganic fillers. Hence, to date, most of the thermoset based GFRP waste is being incinerated or landfilled leading to negative environmental impacts and additional costs to producers and suppliers. With an increasing awareness of environmental matters and the subsequent desire to save resources, recycling would convert an expensive waste disposal into a profitable reusable material. In this study, the effect of the incorporation of mechanically recycled GFRP pultrusion wastes on flexural and compressive behaviour of polyester polymer mortars (PM) was assessed. For this purpose, different contents of GFRP recyclates (0%, 4%, 8% and 12%, w/w), with distinct size grades (coarse fibrous mixture and fine powdered mixture), were incorporated into polyester PM as sand aggregates and filler replacements. The effect of the incorporation of a silane coupling agent was also assessed. Experimental results revealed that GFRP waste filled polymer mortars show improved mechanical behaviour over unmodified polyester based mortars, thus indicating the feasibility of GFRP waste reuse as raw material in concrete-polymer composites.

Sustainable waste recycling solution for the glass fibre reinforced polymer composite materials industry

In this paper the adequacy and the benefit of incorporating glass fibre reinforced polymer (GFRP) waste materials into polyester based mortars, as sand aggregates and filler replacements, are assessed. Different weight contents of mechanically recycled GFRP wastes with two particle size grades are included in the formulation of new materials. In all formulations, a polyester resin matrix was modified with a silane coupling agent in order to improve binder-aggregates interfaces. The added value of the recycling solution was assessed by means of both flexural and compressive strengths of GFRP admixed mortars with regard to those of the unmodified polymer mortars. Planning of experiments and data treatment were performed by means of full factorial design and through appropriate statistical tools based on analyses of variance (ANOVA). Results show that the partial replacement of sand aggregates by either type of GFRP recyclates improves the mechanical performance of resultant polymer mortars. In the case of trial formulations modified with the coarser waste mix, the best results are achieved with 8% waste weight content, while for fine waste based polymer mortars, 4% in weight of waste content leads to the higher increases on mechanical strengths. This study clearly identifies a promising waste management solution for GFRP waste materials by developing a cost-effective end-use application for the recyclates, thus contributing to a more sustainable fibre-reinforced polymer composites industry.

Comparative analysis of drills for composite laminates

The characteristics of carbon fiber-reinforced plastics allow a very broad range of uses. Drilling is often necessary to assemble different components, but this can lead to various forms of damage, such as delamination which is the most severe. However, a reduced thrust force can decrease the risk of delamination. In this work, two variables of the drilling process were compared: tool material and geometry, as well as the effect of feed rate and cutting speed. The parameters that were analyzed include: thrust force, delamination extension and mechanical strength through open-hole tensile test, bearing test, and flexural test on drilled plates. The present work shows that a proper combination of all the factors involved in drilling operations, like tool material, tool geometry and cutting parameters, such as feed rate or cutting speed, can lead to the reduction of delamination damage and, consequently, to the enhancement of the mechanical properties of laminated parts in complex structures, evaluated by open-hole, bearing, or flexural tests.

Mechanical characterization of polyhydroxyalkanoate and poly (lactic acid) blends

In this work, the mechanical behavior of polyhyroxyalkanoate (PHA)/poly(lactic acid) (PLA) blends is investigated in a wide range of compositions. The mechanical properties can be optimized by varying the PHA contents of the blend. The flexural and tensile properties were estimated by different models: the rule of mixtures, Kerner–Uemura–Takayanagi (KUT) model, Nicolai–Narkis model and Béla–Pukánsky model. This study was aimed at investigating the adhesion between the two material phases. The results anticipate a good adhesion between both phases. Nevertheless, for low levels of incorporation of PHA (up to 30%), where PLA is expectantly the matrix, the experimental data seem to deviate from the perfect adhesion models, suggesting a decrease in the adhesion between both polymeric phases when PHA is the disperse phase. For the tensile modulus, a linear relationship is found, following the rules of mixtures (or a KUT model with perfect adhesion between phases) denoting a good adhesion between the phases over the composition range. The incorporation of PHA in the blend leads to a decrease in the flexural modulus but, at the same time, increases the tensile modulus. The impact energy of the blends varies more than 157% over the entire composition. For blends with PHA weight fraction lower than 50%, the impact strength of the blend is higher than the pure base polymers. The highest synergetic effect is found when the PLA is the matrix and the PHA is the disperse phase for the blend PHA/PLA of 30/70. The second maximum is found for the inverse composition of 70/30. PLA has a heat-deflection temperature (HDT) substantially lower than PHA. For the blends, the HDT increases with the increment in the percentage of the incorporation of PHA. With up to 50% PHA (PLA as matrix), the HDT is practically constant and equal to PLA value. Above this point (PHA matrix), the HDT of the polymer blends increases linearly with the percentage of addition of PHA.

Drilling delamination outcomes on glass and sisal reinforced plastics

Nowadays, fibre reinforced plastics are used in a wide variety of applications. Apart from the most known reinforcement fibres, like glass or carbon, natural fibres can be seen as an economical alternative. However, some mistrust is yet limiting the use of such materials, being one of the main reasons the inconsistency normally found in their mechanical properties. It should be noticed that these materials are more used for their low density than for their high stiffness. In this work, two different types of reinforced plates were compared: glass reinforced epoxy plate and sisal reinforced epoxy plate. For material characterization purposes, tensile and flexural tests were carried out. Main properties of both materials, like elastic modulus, tensile strength or flexural modulus, are presented and compared with reference values. Afterwards, plates were drilled under two different feed rates: low and high, with two diverse tools: twist and brad type drill, while cutting speed was kept constant. Thrust forces during drilling were monitored. Then, delamination area around the hole was assessed by using digital images that were processed using a computational platform previously developed. Finally, drilled plates were mechanically tested for bearing and open-hole resistance. Results were compared and correlated with the measured delamination. Conclusions contribute to the understanding of natural fibres reinforced plastics as a substitute to glass fibres reinforced plastics, helping on cost reductions without compromising reliability, as well as the consequence of delamination on mechanical resistance of this type of composites.

Mechanical behaviour analysis of polyester polymer mortars modified with recycled GFRP waste materials

In this study the effect of incorporation of recycled glass-fibre reinforced polymer (GFRP) waste materials, obtained by means of milling processes, on mechanical behaviour of polyester polymer mortars was assessed. For this purpose, different contents of recycled GFRP waste powder and fibres, with distinct size gradings, were incorporated into polyester based mortars as sand aggregates and filler replacements. Flexural and compressive loading capacities were evaluated and found better than unmodified polymer mortars. GFRP modified polyester based mortars also show a less brittle behaviour, with retention of some loading capacity after peak load. Obtained results highlight the high potential of recycled GFRP waste materials as efficient and sustainable reinforcement and admixture for polymer concrete and mortars composites, constituting an emergent waste management solution.

Reusability assessment of thermoset polymeric composite wastes as reinforcement and filler replacement for polymer concrete materials

The development and applications of thermoset polymeric composites, namely fiber reinforced polymers (FRP), have shifted in the last decades more and more into the mass market [1]. Production and consume have increased tremendously mainly for the construction, transportation and automobile sectors [2, 3]. Although the many successful uses of thermoset composite materials, recycling process of byproducts and end of lifecycle products constitutes a more difficult issue. The perceived lack of recyclability of composite materials is now increasingly important and seen as a key barrier to the development or even continued used of these materials in some markets.

New recycling approaches for thermoset polymeric composite wastes – an experimental study on polyester based concrete materials filled with fibre reinforced plastic recyclates

In this study, a new waste management solution for thermoset glass fibre reinforced polymer (GFRP) based products was assessed. Mechanical recycling approach, with reduction of GFRP waste to powdered and fibrous materials was applied, and the prospective added-value of obtained recyclates was experimentally investigated as raw material for polyester based mortars. Different GFRP waste admixed mortar formulations were analyzed varying the content, between 4% up to 12% in weight, of GFRP powder and fibre mix waste. The effect of incorporation of a silane coupling agent was also assessed. Design of experiments and data treatment was accomplished through implementation of full factorial design and analysis of variance ANOVA. Added value of potential recycling solution was assessed by means of flexural and compressive loading capacity of GFRP waste admixed mortars with regard to unmodified polymer mortars. The key findings of this study showed a viable technological option for improving the quality of polyester based mortars and highlight a potential cost-effective waste management solution for thermoset composite materials in the production of sustainable concrete-polymer based products.

Experiments on new polymer based mortars filled with FRP waste recyclates - a quantitative analysis

Glass fibre-reinforced plastics (GFRP) have been considered inherently difficult to recycle due to both: cross-linked nature of thermoset resins, which cannot be remolded, and complex composition of the composite itself. Presently, most of the GFRP waste is landfilled leading to negative environmental impacts and supplementary added costs. With an increasing awareness of environmental matters and the subsequent desire to save resources, recycling would convert an expensive waste disposal into a profitable reusable material. In this study, efforts were made in order to recycle grinded GFRP waste, proceeding from pultrusion production scrap, into new and sustainable composite materials. For this purpose, GFRP waste recyclates, were incorporated into polyester based mortars as fine aggregate and filler replacements at different load contents and particle size distributions. Potential recycling solution was assessed by mechanical behaviour of resultant GFRP waste modified polymer mortars. Results revealed that GFRP waste filled polymer mortars present improved flexural and compressive behaviour over unmodified polyester based mortars, thus indicating the feasibility of the waste reuse in polymer mortars and concrete. © 2011, Advanced Engineering Solutions.

Hybrid thermoset polymeric composites – an Innovation towards sustainability

In this study, a new waste management solution for thermoset glass fibre reinforced polymer (GFRP) based products was assessed. Mechanical recycling approach, with reduction of GFRP waste to powdered and fibrous materials was applied, and the prospective added-value of obtained recyclates was experimentally investigated as raw material for polyester based mortars. Different GFRP waste admixed mortar formulations were analyzed varying the content, between 4% up to 12% in weight, of GFRP powder and fibre mix waste. The effect of incorporation of a silane coupling agent was also assessed. Design of experiments and data treatment was accomplished through implementation of full factorial design and analysis of variance ANOVA. Added value of potential recycling solution was assessed by means of flexural and compressive loading capacity of GFRP waste admixed mortars with regard to unmodified polymer mortars. The key findings of this study showed a viable technological option for improving the quality of polyester based mortars and highlight a potential cost-effective waste management solution for thermoset composite materials in the production of sustainable concrete-polymer based products.