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).

Neural mobilization reverses behavioral and cellular changes that characterize neuropathic pain in rats

Background: The neural mobilization technique is a noninvasive method that has proved clinically effective in reducing pain sensitivity and consequently in improving quality of life after neuropathic pain. The present study examined the effects of neural mobilization (NM) on pain sensitivity induced by chronic constriction injury (CCI) in rats. The CCI was performed on adult male rats, submitted thereafter to 10 sessions of NM, each other day, starting 14 days after the CCI injury. Over the treatment period, animals were evaluated for nociception using behavioral tests, such as tests for allodynia and thermal and mechanical hyperalgesia. At the end of the sessions, the dorsal root ganglion (DRG) and spinal cord were analyzed using immunohistochemistry and Western blot assays for neural growth factor (NGF) and glial fibrillary acidic protein (GFAP). Results: The NM treatment induced an early reduction (from the second session) of the hyperalgesia and allodynia in CCI-injured rats, which persisted until the end of the treatment. On the other hand, only after the 4th session we observed a blockade of thermal sensitivity. Regarding cellular changes, we observed a decrease of GFAP and NGF expression after NM in the ipsilateral DRG (68% and 111%, respectively) and the decrease of only GFAP expression after NM in the lumbar spinal cord (L3-L6) (108%). Conclusions: These data provide evidence that NM treatment reverses pain symptoms in CCI-injured rats and suggest the involvement of glial cells and NGF in such an effect.

Literature review and update of lower limb neural mobilization

Summarize the available literature descriptions of neural mobilization (NM) techniques and neural provocation tests (NPT) for the Lower Limb (LL). Compilation of data was performed in May 2016 using MEDLINE data base, Google Scholar and the library of the European University of Madrid. After application of inclusion/exclusion criterions 5 books and 14 journal publications where found to be of interest and used during data extraction.Results: a list of 8 different LLNM techniques are applied in a rhythmic alternating oscillatory cycle fashion, starting in the initial position from where the therapist proceeds to move the limb in order to achieve a final position. LL NPTs are useful tools for differential diagnose and selecting the proper LLNM procedure. There is no consensus about the time frame of repetition intervals or amount of tensile strength during NPT never the less it is found to normally be performed at a rate of 2-4 seconds per complete cycle of movement, during 1-5 minutes, 3-5 times a week. LLNM treatment techniques all thou increasingly popular in clinical practice are found to be frugally described and lack proper standardization in regards to therapeutic dosification.

Structural damage detection using frequency response functions and neural networks

This paper illustrates the damage identification and condition assessment of a three story bookshelf structure using a new frequency response functions (FRFs) based damage index and Artificial Neural Networks (ANNs). A major obstacle of using measured frequency response function data is a large size input variables to ANNs. This problem is overcome by applying a data reduction technique called principal component analysis (PCA). In the proposed procedure, ANNs with their powerful pattern recognition and classification ability were used to extract damage information such as damage locations and severities from measured FRFs. Therefore, simple neural network models are developed, trained by Back Propagation (BP), to associate the FRFs with the damage or undamaged locations and severity of the damage of the structure. Finally, the effectiveness of the proposed method is illustrated and validated by using the real data provided by the Los Alamos National Laboratory, USA. The illustrated results show that the PCA based artificial Neural Network method is suitable and effective for damage identification and condition assessment of building structures. In addition, it is clearly demonstrated that the accuracy of proposed damage detection method can also be improved by increasing number of baseline datasets and number of principal components of the baseline dataset.

Damage identification and condition assessment of building structures using frequency response functions and neural networks

This thesis investigated the viability of using Frequency Response Functions in combination with Artificial Neural Network technique in damage assessment of building structures. The proposed approach can help overcome some of limitations associated with previously developed vibration based methods and assist in delivering more accurate and robust damage identification results. Excellent results are obtained for damage identification of the case studies proving that the proposed approach has been developed successfully.

Dopamine transporter genotype predicts behavioural and neural measures of response inhibition

The ability to inhibit unwanted actions is a heritable executive function that may confer risk to disorders such as attention deficit hyperactivity disorder (ADHD). Converging evidence from pharmacology and cognitive neuroscience suggests that response inhibition is instantiated within frontostriatal circuits of the brain with patterns of activity that are modulated by the catecholamines dopamine and noradrenaline. A total of 405 healthy adult participants performed the stop-signal task, a paradigmatic measure of response inhibition that yields an index of the latency of inhibition, termed the stop-signal reaction time (SSRT). Using this phenotype, we tested for genetic association, performing high-density single-nucleotide polymorphism mapping across the full range of autosomal catecholamine genes. Fifty participants also underwent functional magnetic resonance imaging to establish the impact of associated alleles on brain and behaviour. Allelic variation in polymorphisms of the dopamine transporter gene (SLC6A3: rs37020; rs460000) predicted individual differences in SSRT, after corrections for multiple comparisons. Furthermore, activity in frontal regions (anterior frontal, superior frontal and superior medial gyri) and caudate varied additively with the T-allele of rs37020. The influence of genetic variation in SLC6A3 on the development of frontostriatal inhibition networks may represent a key risk mechanism for disorders of behavioural inhibition.

Classification of magnetic resonance brain images using wavelets as input to support vector machine and neural network

In this paper. we propose a novel method using wavelets as input to neural network self-organizing maps and support vector machine for classification of magnetic resonance (MR) images of the human brain. The proposed method classifies MR brain images as either normal or abnormal. We have tested the proposed approach using a dataset of 52 MR brain images. Good classification percentage of more than 94% was achieved using the neural network self-organizing maps (SOM) and 98% front support vector machine. We observed that the classification rate is high for a Support vector machine classifier compared to self-organizing map-based approach.

Optimization of Helicopter Rotor Using Polynomial and Neural Network Metamodels

This study aims to determine optimal locations of dual trailing-edge flaps and blade stiffness to achieve minimum hub vibration levels in a helicopter, with low penalty in terms of required trailing-edge flap control power. An aeroelastic analysis based on finite elements in space and time is used in conjunction with an optimal control algorithm to determine the flap time history for vibration minimization. Using the aeroelastic analysis, it is found that the objective functions are highly nonlinear and polynomial response surface approximations cannot describe the objectives adequately. A neural network is then used for approximating the objective functions for optimization. Pareto-optimal points minimizing both helicopter vibration and flap power ale obtained using the response surface and neural network metamodels. The two metamodels give useful improved designs resulting in about 27% reduction in hub vibration and about 45% reduction in flap power. However, the design obtained using response surface is less sensitive to small perturbations in the design variables.

Mathematical modelling of neurons and neural networks

The basic concepts and techniques involved in the development and analysis of mathematical models for individual neurons and networks of neurons are reviewed. Some of the interesting results obtained from recent work in this field are described. The current status of research in this field in India is discussed