Efetividade do tratamento em fisioterapia na pubalgia num jogador de futsal

A pubalgia é uma inflamação que ocorre na região do osso púbis, ponto de origem – inserção de diversos músculos, como os adutores da coxa e os abdominais. É responsável pelo afastamento de atletas de diversas modalidades da sua prática desportiva. Objectivo: Analisar a efectividade do tratamento em fisioterapia num jogador de futsal profissional que apresenta sintomatologia de pubalgia. Método: Foi realizado um estudo de caso com um jogador de futsal de 28 anos atuante na posição ala/pivot. O atleta foi avaliado e tratado durante seis semanas. As sessões de tratamento incluíam electroterapia, crioterapia, termoterapia, exercícios de alongamento, de fortalecimento muscular e de mobilidade da pélvis, hidroterapia e ligaduras funcionais. Na avaliação da flexibilidade dos isquiotibiais, adutores da coxa, abdominais e iliopsoas (teste de Thomas) foi usado o goniómetro (marca Baseline), o teste muscular manual para avaliar a força muscular dos diversos músculos, a escala numérica para avaliar a dor e o teste de Gillet para avaliar a mobilidade sacro-ilíaca. Resultados: O jogador de futsal apresentou ganhos de flexibilidade de 6 graus nos isquiotibiais, abdominais, adutor (lado esquerdo) e iliopsoas (lado esquerdo), e de 7 graus no adutor (lado direito) e iliopsoas (lado direito). Houve também ganho de força muscular nos abdominais, porção superior e porção inferior atingindo o grau 5 (grau máximo) do teste muscular manual, aumento da mobilidade pélvica e diminuição do quadro álgico, passando de dor 5 para dor 1 na inserção do reto abdominal e nos adutores de dor 3 para dor 0 (sem dor) de acordo com a escala numérica. Conclusão: O tratamento proposto para este atleta foi eficaz, visto que, houve aumento da flexibilidade, força muscular e mobilidade pélvica, e diminuição da dor na região do púbis, o que possibilitou o retorno à actividade desportiva.

A eficácia entre duas intervenções na Síndrome do Canal Cárpico

A Síndrome do Canal Cárpico (SCC) é a neuropatia compressiva mais comum do membro superior, causada pela compressão direta sobre o nervo mediano no interior do canal cárpico.Os resultados deste estudo mostram em cada um dos grupos, após a intervenção, uma melhoria estatisticamente significativa da sintomatologia no G-AFN (p=0,02) e no GTRN/ EAA (p=0,004) e uma melhoria estatisticamente significativa do estado funcional no G-AFN (p=0,022). Verificamos também em cada um dos grupos, após a intervenção, uma melhoria estatisticamente significativa na “Força de preensão” (p=0,005), na “Pinça polegar/dedo indicador” (p=0,021), na “Pinça polegar/dedo médio” (p=0,026) e “Pinça polegar/dedo anular” (p=0,026) no G-AFN, e uma melhoria estatisticamente significativa na “Pinça polegar/indicador” (p=0,016), na “Pinça polegar/dedo médio” (p=0,035), na “Pinça polegar/dedo anular” (p=0,010), na “Pinça trípode” (p=0,005) e na “Pinça lateral” (p=0,051) no G-TRN/EAA. Após a intervenção, não verificamos diferenças estatisticamente significativas nos valores das escalas de gravidade de sintomas (p=0,853) e de estado funcional (p=0,148) entre os grupos, mas diferenças estatisticamente significativas nos valores dos testes neurofisiológicos (p=0,047) e força de preensão da mão (p=0,005). Do estudo, concluímos que a utilização da intervenção articular/fascial/neural (AFN) e a intervenção com tala de repouso noturna e exercícios de auto alongamento (TRN/EAA), beneficia os indivíduos com SCC não severa, como nos casos incipientes, ligeiros ou moderados. Os indivíduos com esta condição clínica apresentam sintomatologia caraterística de dor, parestesia, especialmente noturna e disfunção muscular da mão. Tais manifestações originam perda funcional com implicações nas áreas de desempenho ocupacional, nomeadamente, nas atividades da vida diária, produtivas e de lazer. O tratamento conservador na SCC não severa, como nos casos incipientes, ligeiros e moderados, apesar de controverso, é recomendado. O tema suscita o nosso interesse, razão pela qual nos propomos realizar um estudo experimental em indivíduos com o diagnóstico clínico de SCC não severa e aplicar num grupo a intervenção articular, fascial e neural (AFN) e noutro grupo a intervenção com tala de repouso noturna e exercícios de auto alongamento (TRN/EAA). O estudo tem como principais objetivos, por um lado, verificar o impacto das intervenções em cada um dos grupos e, por outro lado, comparar o seu impacto entre os grupos, no que respeita à gravidade de sintomas, ao estado funcional, à força de preensão da mão e força de pinças finas. Fomos também comparar os resultados dos testes neurofisiológicos (Velocidade de Condução Motora) antes e depois da intervenção AFN e da intervenção com TRN/EAA, e averiguar o seu impacto nos valores da latência motora distal e da velocidade de condução sensitiva, entre os grupos. Identificamos também quais as variáveis sócio demográficas e as que caraterizam a patologia que estão relacionadas com o problema em estudo e com os valores obtidos com as escalas do Boston Carpal Tunnel Questionnaire (BCTQ), no grupo articular, fascial e neural (G-AFN) e no grupo com tala de repouso noturna e exercícios de auto alongamento (G-TRN/EAA). Para a concretização do estudo, recorremos a uma amostra de 23 indivíduos de ambos os sexos do Hospital Curry Cabral, Empresa Pública Empresarial -Centro Hospitalar de Lisboa Central (HCC, EPE -CHLC).

EMG of the transverse abdominus and multifidus during pilates exercises

The purpose of this research study was to evaluate the intensity of muscle activation of Transverse Abdominus /Oblique Internal (TrA/OI) and Multifidus (Mu) during the performance of four Pilates exercises (and variations), compared, in order to understand the importance of these exercises in the lumbopelvic stability in healthy subjects. The sample consisted of 8 individuals. Using the surface electromyography (EMG), it was found that there are differences in the intensity of muscle activation in the analyzed exercises and, therefore, “Shoulder bridge” and “ShoulderBridge_extension (right and left legs)“ are the more appropriate exercises for co-activation between TrA/OI and Mu muscles for the reeducation of lumbopelvic stability.

Pubalgia num atleta de futebol: estudo de caso

Introdução: No fu tebol os atletas são submetidos a um grande número de treinos e jogos, não havendo muitas vezes tempo necessário para o repouso ou alongamentos, estes factores predispõem o aparecimento de lesões incapacitantes como a pubalgia. O fisioterapeuta deverá realizar uma correcta avaliação e interpretação dos sintomas e das alterações posturais e biomecânicas do paciente com pubalgia. Objectivo: Através deste estudo de caso pretende-se descrever a avaliação e intervenção num caso de um jogador de fu tebol com pubalgia, salientando o processo de raciocínio clín ico desenvolvido ao longo do tratamento. Intervenção: Após a avaliação inicial, foi estabelecido, em conjunto com o atleta, um plano de tratamento por um períodlo de cinco semanas com três sessões semanais e exercícios durante os restantes dias. A intervenção visou a diminuição da dor, normalização das alterações articu lares, reforço da musculatu ra enfraquecida, promoção da estabilidade lombopélvica, restabelecimento da mobilidade das cadeias musculares encurtadas e retorno à actividade desportiva. Resultados: Verificou-se uma diminuição da dor, associada a um aumento de flexibilidade e de força. Conclusão: Através da abordagem pelo conceito de cadeias lesionais associado ao tratamento global de fisioterapia (exercícios terapêuticos, electroterapia, massagem), obteve-se melhorias clinicamente importantes num período de cinco semanas, verificando-se no fim do tratamento a ausência de sintomatologia, o que permitiu o retorno do atleta à actividade desportiva.

BabeLO : an extensible converter of programming exercises formats

In the last two decades, there was a proliferation of programming exercise formats that hinders interoperability in automatic assessment. In the lack of a widely accepted standard, a pragmatic solution is to convert content among the existing formats. BabeLO is a programming exercise converter providing services to a network of heterogeneous e-learning systems such as contest management systems, programming exercise authoring tools, evaluation engines and repositories of learning objects. Its main feature is the use of a pivotal format to achieve greater extensibility. This approach simplifies the extension to other formats, just requiring the conversion to and from the pivotal format. This paper starts with an analysis of programming exercise formats representative of the existing diversity. This analysis sets the context for the proposed approach to exercise conversion and to the description of the pivotal data format. The abstract service definition is the basis for the design of BabeLO, its components and web service interface. This paper includes a report on the use of BabeLO in two concrete scenarios: to relocate exercises to a different repository, and to use an evaluation engine in a network of heterogeneous systems.

CrimsonHex: a learning objects repository for programming exercises

A repository of learning objects is a system that stores electronic resources in a technology-mediated learning process. The need for this kind of repository is growing as more educators become eager to use digital educa- tional contents and more of it becomes available. The sharing and use of these resources relies on the use of content and communication standards as a means to describe and exchange educational resources, commonly known as learning objects. This paper presents the design and implementation of a service-oriented reposi- tory of learning objects called crimsonHex. This repository supports new definitions of learning objects for specialized domains and we illustrate this feature with the definition of programming exercises as learning objects and its validation by the repository. The repository is also fully compliant with existing commu- nication standards and we propose extensions by adding new functions, formalizing message interchange and providing a REST interface. To validate the interoperability features of the repository, we developed a repository plug-in for Moodle that is expected to be included in the next release of this popular learning management system.

Orchestration of e-learning services for automatic evaluation of programming exercises

Managing programming exercises require several heterogeneous systems such as evaluation engines, learning objects repositories and exercise resolution environments. The coordination of networks of such disparate systems is rather complex. These tools would be too specific to incorporate in an e-Learning platform. Even if they could be provided as pluggable components, the burden of maintaining them would be prohibitive to institutions with few courses in those domains. This work presents a standard based approach for the coordination of a network of e-Learning systems participating on the automatic evaluation of programming exercises. The proposed approach uses a pivot component to orchestrate the interaction among all the systems using communication standards. This approach was validated through its effective use on classroom and we present some preliminary results.

Specifying a programming exercises evaluation service on the e-Framework

The e-Framework is arguably the most prominent e-learning framework currently in use. For this reason it was selected as basis for modelling a programming exercises evaluation service. The purpose of this type of evaluator is to mark and grade exercises in computer programming courses and in programming contests. By exposing its functions as services a programming exercise evaluator is able to participate in business processes integrating different system types, such as Programming Contest Management Systems, Learning Management Systems, Integrated Development Environments and Learning Object Repositories. This paper formalizes the approaches to be used in the implementation of a programming exercise evaluator as a service on the e-Framework.

PExIL: Programming Exercises Interoperability Language

Several standards appeared in recent years to formalize the metadata of learning objects, but they are still insufficient to fully describe a specialized domain. In particular, the programming exercise domain requires interdependent resources (e.g. test cases, solution programs, exercise description) usually processed by different services in the programming exercise life-cycle. Moreover, the manual creation of these resources is time-consuming and error-prone leading to what is an obstacle to the fast development of programming exercises of good quality. This paper focuses on the definition of an XML dialect called PExIL (Programming Exercises Interoperability Language). The aim of PExIL is to consolidate all the data required in the programming exercise life-cycle, from when it is created to when it is graded, covering also the resolution, the evaluation and the feedback. We introduce the XML Schema used to formalize the relevant data of the programming exercise life-cycle. The validation of this approach is made through the evaluation of the usefulness and expressiveness of the PExIL definition. In the former we present the tools that consume the PExIL definition to automatically generate the specialized resources. In the latter we use the PExIL definition to capture all the constraints of a set of programming exercises stored in a learning objects repository.

Programming exercises evaluation systems: an interoperability survey

Learning computer programming requires solving programming exercises. In computer programming courses teachers need to assess and give feedback to a large number of exercises. These tasks are time consuming and error-prone since there are many aspects relating to good programming that should be considered. In this context automatic assessment tools can play an important role helping teachers in grading tasks as well to assist students with automatic feedback. In spite of its usefulness, these tools lack integration mechanisms with other eLearning systems such as Learning Management Systems, Learning Objects Repositories or Integrated Development Environments. In this paper we provide a survey on programming evaluation systems. The survey gathers information on interoperability features of these systems, categorizing and comparing them regarding content and communication standardization. This work may prove useful to instructors and computer science educators when they have to choose an assessment system to be integrated in their e-Learning environment.

PETCHA: a Programming Exercises Teaching Assistant

This paper presents a tool called Petcha that acts as an automated Teaching Assistant in computer programming courses. The ultimate objective of Petcha is to increase the number of programming exercises effectively solved by students. Petcha meets this objective by helping both teachers to author programming exercises and students to solve them. It also coordinates a network of heterogeneous systems, integrating automatic program evaluators, learning management systems, learning object repositories and integrated programming environments. This paper presents the concept and the design of Petcha and sets this tool in a service oriented architecture for managing learning processes based on the automatic evaluation of programming exercises. The paper presents also a case study that validates the use of Petcha and of the proposed architecture.

Bridging between programming exercises formats with BabeLO

Assessment plays a vital role in learning. This is certainly the case with assessment of computer programs, both in curricular and competitive learning. The lack of a standard – or at least a widely used format – creates a modern Ba- bel tower made of Learning Objects, of assessment items that cannot be shared among automatic assessment systems. These systems whose interoperability is hindered by the lack of a common format include contest management systems, evaluation engines, repositories of learning objects and authoring tools. A prag- matical approach to remedy this problem is to create a service to convert among existing formats. A kind of translation service specialized in programming prob- lems formats. To convert programming exercises on-the-fly among the most used formats is the purpose of the BabeLO – a service to cope with the existing Babel of Learning Object formats for programming exercises. BabeLO was designed as a service to act as a middleware in a network of systems typically used in auto- matic assessment of programs. It provides support for multiple exercise formats and can be used by: evaluation engines to assess exercises regardless of its format; repositories to import exercises from various sources; authoring systems to create exercises in multiple formats or based on exercises from other sources. This paper analyses several of existing formats to highlight both their differ- ences and their similar features. Based on this analysis it presents an approach to extensible format conversion. It presents also the features of PExIL, the pivotal format in which the conversion is based; and the function definitions of the proposed service – BabeLO. Details on the design and implementation of BabeLO, including the service API and the interfaces required to extend the conversion to a new format, are also provided. To evaluate the effectiveness and efficiency of this approach this paper reports on two actual uses of BabeLO: to relocate exercises to a different repository; and to use an evaluation engine in a network of heterogeneous systems.

Making programming exercises interoperable with PExIL

Several standards have appeared in recent years to formalize the metadata of learning objects, but they are still insufficient to fully describe a specialized domain. In particular, the programming exercise domain requires interdependent resources (e.g. test cases, solution programs, exercise description) usually processed by different services in the programming exercise lifecycle. Moreover, the manual creation of these resources is time-consuming and error-prone, leading to an obstacle to the fast development of programming exercises of good quality. This chapter focuses on the definition of an XML dialect called PExIL (Programming Exercises Interoperability Language). The aim of PExIL is to consolidate all the data required in the programming exercise lifecycle from when it is created to when it is graded, covering also the resolution, the evaluation, and the feedback. The authors introduce the XML Schema used to formalize the relevant data of the programming exercise lifecycle. The validation of this approach is made through the evaluation of the usefulness and expressiveness of the PExIL definition. In the former, the authors present the tools that consume the PExIL definition to automatically generate the specialized resources. In the latter, they use the PExIL definition to capture all the constraints of a set of programming exercises stored in a learning objects repository.

Effects of self-administered exercises based on Tuina techniques on musculoskeletal disorders of professional orchestra musicians: a randomized controlled trial

Background Musicians are frequently affected by playing-related musculoskeletal disorders (PRMD). Common solutions used by Western medicine to treat musculoskeletal pain include rehabilitation programs and drugs, but their results are sometimes disappointing. Objective To study the effects of self-administered exercises based on Tuina techniques on the pain intensity caused by PRMD of professional orchestra musicians, using numeric visual scale (NVS). Design, setting, participants and interventions We performed a prospective, controlled, single-blinded, randomized study with musicians suffering from PRMD. Participating musicians were randomly distributed into the experimental (n = 39) and the control (n = 30) groups. After an individual diagnostic assessment, specific Tuina self-administered exercises were developed and taught to the participants. Musicians were instructed to repeat the exercises every day for 3 weeks. Main outcome measures Pain intensity was measured by NVS before the intervention and after 1, 3, 5, 10, 15 and 20 d of treatment. The procedure was the same for the control group, however the Tuina exercises were executed in points away from the commonly-used acupuncture points. Results In the treatment group, but not the control group, pain intensity was significantly reduced on days 1, 3, 5, 10, 15 and 20. Conclusion The results obtained are consistent with the hypothesis that self-administered exercises based on Tuina techniques could help professional musicians controlling the pain caused by PRMD. Although our results are very promising, further studies are needed employing a larger sample size and double blinding designs.