Musculoskeletal disorders (MSDs) in dancers and former dancers participating in the largest dance festival in the world

Objective: To verify the presence of musculoskeletal disorders (MSD) in dancers and former dancers participating in the 27th Joinville Dance FestivalMaterial and methods: The research was conducted at the 27th Joinville Dance Festival in Santa Catarina, Brazil, with 173 participants in the competition, where 139 were dancers and 34 were former dancers with at least ten years of practiceIn order to obtain information related to MSDs, dancers answered a specific questionnaireResults: The study group consisted of adults (28±9 years) with body mass index within the normal range (21.3±2.3) with high weekly training time (955.7±837.2) and featuring long-time experience in dancing (18±7years)The lumbar spine and knees were the most affected by MSDsThe pain of high intensity was the symptom that most often appeared in reports among survey participantsConclusion: It is important to have deeper knowledge of the prevalence of pain among professional dancers, the factors associated with pain conditions and its impact on everyday life in order to plan new forms of prevention and plan new forms of prevention and treatment within a multidisciplinary approach© 2012 Elsevier Masson SAS.

Sobre a analgesia pós-operatória da morfina, cetamina ou da associação em cadelas submetidas à ovariossalpingohisterectomia eletiva

This study aimed to evaluate the post operative analgesic effects of morphine or ketamine alone or their combination in 24 healthy bitches, weighing 11.01±8.69kg and aging 27±17 months, submitted to elective ovariohysterectomy. The animals were distributed to one of the three treatments after the anaesthetic induction: morphine (GM, n=8, 0.5mg kg-1 IM), ketamine (GK, n=8, 2.5mg kg-1 IM) or ketamine combined to morphine (GKM) using the same doses previously described. Sedation score and pain assessment were performed blindly two hours before surgery and at 1, 2, 4, 8, 12, and 24 hours after extubation, using the Dobbins scale (sedation) and visual analogue scale (pain) and Glasgow modified pain scale (GMPS). Rescue analgesia was performed with 1.0mg kg-1 of morphine and if not sufficient, followed by 0.2mg kg-1 of meloxicam, both IM, when the GMPS reached above 33% of the total score. Non parametric data were analyzed using Friedmańs test followed by Dunńs test for differences in time. Kruskal-Walliś test followed by Dunńs test were used to investigate differences in the number of analgesic rescues and among groups at each time. Parametric data were evaluated by ANOVA followed by Tukey's test (P<0.05). Except for GMPS, where the values of GM were greater than for GKM at 1h post-extubation, there were no other differences among groups. The number of rescue analgesia was greater in GM (11 in total; twice in 3 animals,) when compared to GKM (3; twice in 1 animal) and GK (2; twice in 1 animal). Analgesia provided by pre-incisional ketamine was more effective when compared to morphine. According to that, ketamine alone may be used as a preemptive analgesic in bitches undergoing ovariohysterectomy; however, rescue analgesia may be necessary.

Efeitos analgésicos pós-operatórios de cetamina e/ou morfina em cadelas submetidas à OSH eletiva

Pós-graduação em Anestesiologia - FMB

Proposição de escala clínica para avaliação da dor em equinos

Pós-graduação em Medicina Veterinária - FMVZ

Análise de fatores de dor intra-operatória na cirurgia ambulatorial no câncer de mama

Pós-graduação em Psicologia do Desenvolvimento e Aprendizagem - FC

Clinical assessment of the efficacy of low-level laser therapy on muscle pain in women with temporomandibular dysfunction, by surface electromyography

The use of low-level laser (LLL) may be an useful tool to promote reduction of muscular pain caused by TMD. Aim: This study evaluated the immediate efficacy of low-level laser therapy on women reporting pain and diagnosed with temporomandibular dysfunction (TMD). Methods: Diode laser (GaAlAs) at 790 nm wavelength (infrared spectrum) was applied as experimental treatment. Irradiations of 1.5 J/cm2 were made at 4 points of the temporomandibular joint (TMJ) and of 3 J/cm2 at 3 points in the temporal muscle. An electromyographic (EMG) evaluation of the masseter and anterior temporal was done at the following intervals: before, immediately after, 5 min and 20 min after laser application. Results: Comparison of the electrical activity at the times of measurement revealed a statistically significant difference in masseter muscles before (P=0.025) and immediately after (P=0.013) LLLT. Conclusions: Both masseter and temporal muscles showed a reduction in the measured EMG activities at all times after LLLT, and the temporal muscle showed higher EMG activity than the masseter muscle at all the evaluation times. LLLT caused significant immediate relaxation of the masseter muscles.

Assessment of postoperative pain after unilateral mastectomy using two different surgical techniques in dogs

Background: There are few studies reporting pain and postoperative analgesia associated with mastectomy in dogs. The aim of this study was to evaluate postoperative pain after unilateral mastectomy using two different surgical techniques in the dog.Findings: Twenty female dogs were assigned (n=10/group) to undergo unilateral mastectomy using either the combination of sharp and blunt dissection (SBD) or the modified SBD (mSBD) technique, in which the mammary chain is separated from the abdominal wall entirely by blunt (hand and finger) dissection except for a small area cranial to the first gland, in a prospective, randomized, clinical trial. All dogs were premedicated with intramuscular acepromazine (0.05 mg/kg) and morphine (0.3 mg/kg). Anesthesia was induced with intravenous ketamine (5 mg/kg) and diazepam (0.25 mg/kg), and maintained with isoflurane. Subcutaneous meloxicam (0.2 mg/kg) was administered before surgery. Postoperative pain was evaluated according to the University of Melbourne pain scale (UMPS) by an observer who was blinded to the surgical technique.. Rescue analgesia was provided by the administration of intramuscular morphine (0.5 mg/kg) if pain scores were > 14 according to the UMPS. Data were analyzed using t-tests and ANOVA (P>0.05). There were no significant differences between the groups for age, weight, extubation time, and duration of surgery and anesthesia (P>0.05). There were no significant differences for postoperative pain scores between groups. Rescue analgesia was required in one dog in each group.Conclusions: The two surgical techniques produced similar surgical times, incidence of perioperative complications and postoperative pain. Multimodal analgesia is recommended for treatment of postoperative pain in dogs undergoing unilateral mastectomy.

Sleep, stress, neurocognitive profile and healthrelated quality of life in adolescents with idiopathic musculoskeletal pain

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Muscle strength assessment among children and adolescents with growing pains and joint hypermobility

OBJETIVO: Avaliar, por meio de teste quantitativo, a força muscular em crianças e adolescentes com dores de crescimento, associada ou não com hipermobilidade articular e comparadas com controles saudáveis. MÉTODO: Quarenta e sete casos de crianças e adolescentes acompanhados por dores de crescimento, sendo 24 com hipermobilidade articular (DC-HA), 23 sem hipermobilidade articular (DC) e 47 controles saudáveis pareados por idade e gênero foram submetidos a dois testes quantitativos para a avaliação da força muscular, o Childhood Myositis Assessment Scale (CMAS) e o Manual Muscle Strength Test (MMT). Os dados antropométricos como altura, peso, índice de massa corporal, prega cutânea tricipital, circunferência média do braço e a área muscular do braço foram comparados entre os três grupos. RESULTADOS: Os três grupos não apresentaram diferença estatística entre as medidas antropométricas. Houve diferença significante entre a mediana da pontuação do CMAS, sendo menores no grupo DC (47, mínimo e máximo 39-52) e DC-HA (46, mínimo e máximo 40-51), comparados com controles (50, mínimo e máximo 45-52; p<0,0001). Dois dos exercícios cronometrados do CMAS, a elevação da cabeça e a duração da elevação das pernas, tiveram menor pontuação nos pacientes comparados aos controles (p<0.0001). A pontuação mediana do MMT no grupo DC (79, mínimo e máximo 73-80) e DC-HA (78, mínimo e máximo 32-80) também apresentou diferença significante, sendo menor nos pacientes que nos controles (80, mínimo e máximo 78-80; p<0,0001). A melhor correlação entre a pontuação do CMAS e MMT foi no grupo DC-HA (Spearman r=0,65; p=0,0007). A aplicação do CMAS e MMT em duas ocasiões apresentou boa concordância e coeficiente de correlação intraclasse de 0,87 (IC 95% 0,64-0,96; p<0,0001) e 0,92 (IC 95% 0,76-0,97; p<0,0001), respectivamente. CONCLUSÃO: Os pacientes com dores de crescimento com ou sem hipermobilidade articular apresentaram fraqueza muscular de leve a moderada quando comparados com controles saudáveis.

The Brazilian version of the Childhood Health Assessment Questionnaire (CHAQ) and the Child Health Questionnaire (CHQ)

We report the cross-cultural adaptation and validation into Brazilian-Portuguese of the parent's version of two health related quality of life instruments. The Childhood Health Assessment Questionnaire (CHAQ) is a disease specific health instrument that measures functional ability in daily living activities in children with juvenile idiopathic arthritis (JIA). The Child Health Questionnaire (CHQ) is a generic health instrument designed to capture the physical and psychosocial well-being of children regardless the underlying disease. The Brazilian CHAQ was revalidated, while the CHQ has been derived from the Portuguese version. A total of 471 subjects were enrolled: 157 patients with JIA (27% systemic onset, 38% polyarticular onset, 9% extended oligoarticular subtype, and 26% persistent oligoarticular subtype) and 314 healthy children. The CHAQ discriminated clinically healthy subjects from JIA patients, with the systemic, polyarticular and extended oligoarticular subtypes having a higher degree of disability, pain, and lower overall well-being scores when compared to their healthy peers. Also the CHQ discriminated clinically healthy subjects from JIA patients, with the systemic onset, polyarticular onset and extended oligoarticular subtypes having a lower physical and psychosocial well-being score when compared to their healthy peers. In conclusion the Brazilian versions of the CHAQ-CHQ are reliable and valid tools for the combined physical and psychosocial assessment of children with JIA. © Copyright Clinical and Experimental Rheumatology 2001.

Comparative study on the posture of individuals with and without cervical pain

Posture can be defined as the overall position and spatial orientation of the human body and its members relative to each other. The study of posture can be applied either static, with the subject standing still. Objectives: to identify and quantify the static posture alignment of individuals who were either symptomatic or asymptomatic for cervical pain. Methods: A cross-sectional study was carried out on subjects with cervical pain and individuals with no complaints of pain. The procedure consists in placing markers on specific points. Several views, following the protocol of the Posture Assessment software, regarding the measurement of angles (in degrees) and differences in lower leg lengths (in centimeters). Angles were analyzed through the comparison of averages between the groups using test t Student, (alpha=5%). Results: There enrolled 27 subjects. There were differences in horizontal alignment of head (3.37x1.33), acromia (2.60x1.18), iliac spines (2.91x0.67), vertical alignment of head (25.70x18.26) and in length of lower limbs (1.36x0.75) in respect to cervical and asymptomatic subjects. Conclusions: Was possible identify and quantify the static posture alignment of individuals with and with no cervical pain. The data obtained suggest the presence of asymmetry in all the symptomatic individuals studied. The data obtained suggest the presence of overall asymmetry in all the symptomatic individuals studied. © 2009 Springer-Verlag.

The effect of manual therapy on masseter muscle pain and spasm

Introduction: Orofacial pain and pain in the muscles of mastication are frequent symptoms of temporomandibular disorder. The masseter is the closet masticatory muscle to the surface and has the function of raising and retracting the mandible. This muscle has considerable strength and is one of the main muscles involved in the shredding of food It is therefore of utmost importance in the masticatory cycle and generally the most affected by pain and spasms. Objectives: The aim of the present study was to analyze the effect of manual therapy with transversal and circular movements on pain and spasm in the masseter muscle, using electromyography and a visual analogue pain scale (VAPS). Eight women who experienced pain upon palpation of the masseter greater than 6 on the VAPS were selected for participation in the study, which employed electromyography and a VAPS for assessment, followed by manual oral physiotherapy and reevaluation. Results: The statistical analysis revealed a reduction in pain, but there was no significant difference in electromyographic activity (p < 0.05). Conclusion: It was concluded that massage therapy was effective on pain symptoms, but was not capable of altering the electrical activity of the masseter muscle.

Attitude of Brazilian veterinarians in the recognition and treatment of pain in horses and cattle

Objective: The objective of this study was to assess the use of analgesics, describe the attitudes of Brazilian veterinarians towards pain relief in horses and cattle and evaluate the differences due to gender, year of graduation and type of practice. Study design: Prospective survey. Methods: Questionnaires were sent to 1000 large animal veterinarians by mail, internet and delivered in person during national meetings. The survey investigated the attitudes of Brazilian veterinarians to the recognition and treatment of pain in large animals and consisted of sections asking about demographic data, use of analgesic drugs, attitudes to pain relief and to the assessment of pain. Descriptive statistics were used to analyze frequencies. Simple post hoc comparisons were performed using the chi-square test. Results: Eight hundred questionnaires were collected, but 87 were discarded because they were incomplete or blank. The opioid of choice for use in large animals was butorphanol (43.4%) followed by tramadol (39%). Flunixin (83.2%) and ketoprofen (67.6%) were the most frequently used NSAIDs by Brazilian veterinarians. Respondents indicated that horses received preoperative analgesics for laparotomy more frequently (72.9%) than cattle (58.5%). The most frequently administered preoperative drugs for laparotomy in horses were flunixin (38.4%) and xylazine (23.6%), whereas the preoperative drugs for the same surgical procedure in cattle were xylazine (31.8%) and the local administration of lidocaine (48%). Fracture repair was considered the most painful surgical procedure for both species. Most veterinarians (84.1%) believed that their knowledge in this area was not adequate. Conclusions and clinical relevance: Although these Brazilian veterinarians thought that their knowledge on recognition and treatment of pain was not adequate, the use of analgesic in large animals was similar in Brazil to that reported in other countries. © 2013 Association of Veterinary Anaesthetists and the American College of Veterinary Anesthesia and Analgesia.