Artículos Seleccionados 1997 - FISIOTERAPIA

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Local heat effect on sympathetic skin responses after pain of electrical stimulus.

A comparative study of the effect of ultrasound and electrostimulation on wound healing in rats.

The effects of heating with ultrasound on knee joint displacement.

The suppressive effect of electrical stimulation on nociceptive responses in the rat.

The role of physical agents in modulating pain.

Effects of electrical stimulation on wound healing in patients with diabetic ulcers.

[The mechanism of action of low-intensity laser radiation]

Combined ultrasound, electrical stimulation, and laser promote collagen synthesis with moderate changes in tendon biomechanics.

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TITULO: Local heat effect on sympathetic skin responses after pain of electrical stimulus.

AUTOR/ES: On-AY; Colakoglu-Z; Hepguler-S; Aksit-R

DIRECCION: Department of Physical Therapy and Rehabilitation, Ege University Hospital, Izmir, Turkey.

FUENTE: Arch-Phys-Med-Rehabil. 1997 Nov; 78(11): 1196-9

IDIOMA: ENGLISH

CP: UNITED-STATES

RESUMEN: OBJECTIVE: To investigate the analgesic effort of local superficial heating by studying sympathetic skin responses. DESIGN: Randomized trial. SETTING: Electromyography laboratory in the department of physical therapy and rehabilitation of a university hospital. SUBJECTS: Twenty healthy volunteers participated with informed consent. INTERVENTIONS: Sympathetic skin response (SSR) amplitudes following electrical stimulation of the right peroneal nerve and skin temperatures in both hands were recorded simultaneously. All of the recordings were repeated at 5-minute intervals during local heat application over the right palm and within 15 minutes after heat application was stopped. RESULTS: SSR amplitudes in both hands decreased significantly during local heating (p < .05) and did not return to their initial levels within 15 minutes of the recovery period; the reductions remained statistically significant (p < .05). Amplitude reductions were statistically more significant on the heated hand compared with those on the contralateral hand (p < .05). CONCLUSION: Therapeutic local heat application reduces the sudomotor response to a painful stimulus. This analgesic effect may be due to suppression of cortical pain sensation resulting from increased levels of endorphins, and may also be a result of local inhibition of both afferent and efferent C fibres.

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TITULO: A comparative study of the effect of ultrasound and electrostimulation on wound healing in rats.

AUTOR/ES: Taskan-I; Ozyazgan-I; Tercan-M; Kardas-HY; Balkanli-S; Saraymen-R; Zorlu-U; Ozugul-Y

DIRECCION: Physical Therapy and Rehabilitation Center, Medical Faculty of Inonu University, Istanbul, Turkey.

FUENTE: Plast-Reconstr-Surg. 1997 Sep; 100(4): 966-72

IDIOMA: ENGLISH

CP: UNITED-STATES

RESUMEN: A comparative study has been carried out to investigate the effects of electrical stimulation and ultrasound on wound healing. Eighty-four female rats were divided into four groups depending on the treatment received. The first group was given electrical stimulation of 300 microA direct current, 30 minutes daily, starting with negative polarity and then changed after 3 days of treatment. Group 2 received sham electrostimulation treatment. The third group received 0.1 W/cm2 pulsed ultrasound using the moving applicator technique for 5 minutes a day. Group 4 received sham ultrasound treatment. A total of 7 days of treatment was given to all groups. Histopathologic and biochemical analyses on the fourth and seventh days and wound breaking strength on the twenty-fifth day were performed for all groups. By accelerating the inflammatory phase, electrical stimulation had progressed the proliferative phase of wound healing earlier than ultrasound had done. Both electrical stimulation and ultrasound have positive effects on proliferative phases, but electrical stimulation was superior to ultrasound at the maturation phase. There was no difference between the two experimental groups on the mast cell reduction effect. Although ultrasound treatment may seem to be efficient in terms of time, when the effects of electrical stimulation and ultrasound on wound healing with the methods employed in our study are considered, it is concluded that electrical stimulation is a means of treatment superior to ultrasound in wound healing.

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TITULO: The effects of heating with ultrasound on knee joint displacement.

AUTOR/ES: Reed-B; Ashikaga-T

DIRECCION: Department of Physical Therapy, University of Vermont, Burlington 05405, USA.

FUENTE: J-Orthop-Sports-Phys-Ther. 1997 Sep; 26(3): 131-7

IDIOMA: ENGLISH

CP: UNITED-STATES

RESUMEN: Heating with continuous wattage ultrasound combined with mobilization procedures is often used to treat ligament "tightness," but the effects of heat on ligament extensibility have not previously been studied in vivo. To address this problem, 25 young adults underwent knee joint displacement tests on a Genucom arthrometer before and after continuous wattage ultrasound (1 MHZ, 1.5 W/cm2 x 8 min). Preultrasound intrarater reliability (ICC; N = 11) was 0.87-0.98 for varus/valgus and recurvatum tests and 0.70-0.73 for anterior-posterior drawer tests. Results: Continuous wattage ultrasound was associated with small increases in mean varus/valgus excursion at 0 degree and 20 degrees of knee flexion (p < or = .04) and in recurvatum excursion (p < or = .04) but not in anterior-posterior drawer excursion. The magnitude of the changes was 1.3 degrees or less and represented relative changes of 6.1-9.8%. Conclusion: Continuous wattage ultrasound at common clinical intensities made some knee ligaments slightly more extensible in normal subjects, although the magnitude of the effect was not deemed clinically significant.

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TITULO: The suppressive effect of electrical stimulation on nociceptive responses in the rat.

AUTOR/ES: Wang-SF; Chen-YW; Shyu-BC

DIRECCION: School of Physical Therapy, College of Medicine, National Taiwan University, Taipei, Republic of China.

FUENTE: Phys-Ther. 1997 Aug; 77(8): 839-47

IDIOMA: ENGLISH

CP: UNITED-STATES

RESUMEN: BACKGROUND AND PURPOSE: The aim of this investigation was to study the effect of electrical stimulation on nociceptive responses within the lumbar levels of the rat spinal cord. METHODS: A single high-energy thermal pulse produced by a surgical laser stimulator (5 W, 30 milliseconds) was applied on the plantar surface of the hind paws of male Sprague-Dawley rats. The spinal cord field potential evoked by the laser pulse was used as an indicator of thermosensitive nociceptive responses. Low-intensity single stimulation, high-intensity single stimulation, low-intensity train stimulation, and high-intensity train stimulation were applied on the common peroneal nerve with protected cuff electrodes in different trials. RESULTS: Neither low-intensity nor high-intensity single stimulation suppressed field potentials. In contrast, low-intensity train stimulation elicited partial inhibition of field potentials. Furthermore, high-intensity train stimulation elicited biphasic inhibition at a wider range of intervals lasting for 20 seconds. CONCLUSION AND DISCUSSION: The results demonstrate that two modes of train electrical stimulation can produce two patterns of fast-onset (within milliseconds), short-duration (within 20 seconds) inhibition of field potentials in the spinal cord. These results provide evidence that noxious heat-related impulses are modulated by the presence of specific electrical stimulation. The clinical application of transcutaneous electrical nerve stimulation to block pain is supported.

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TITULO: The role of physical agents in modulating pain.

AUTOR/ES: Fedorczyk-J

DIRECCION: Department of Physical Therapy, Allegheny University of the Health Sciences, Philadelphia, PA 19102, USA.

FUENTE: J-Hand-Ther. 1997 Apr-Jun; 10(2): 110-21

IDIOMA: ENGLISH

CP: UNITED-STATES

RESUMEN: This article presents a review of the literature on the use of physical agents in modulating pain associated the hand and upper extremity musculoskeletal conditions. The physical agents presented include superficial heating agents, cryotherapy, ultrasound, and transcutaneous electrical nerve stimulation. There has been increased interest in modes of transdermal drug delivery, including iontophoresis, phonophoresis, and the application of transdermal patches. Treatment applications, parameters, and integration strategies are suggested. The purposes of this article are to review which physical agents are used to treat pain or inflammation and to discuss their relevant application to hand therapy practice. Today's health care climate requires therapists to select treatment strategies that are efficient, safe, and clinically effective. Although physical agents are widely used to manage pain in hand therapy, there is little scientific evidence to support their efficacy. Most information regarding the rationale for the use of physical agents in pain management is based on tradition, data extrapolated from basic science research, and uncontrolled randomized clinical trials. This paper discusses the need for additional research to establish clinical efficacy and determine optimal treatment parameters for the physical agents used most often to modulate pain in hand therapy.

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TITULO: Effects of electrical stimulation on wound healing in patients with diabetic ulcers.

AUTOR/ES: Baker-LL; Chambers-R; DeMuth-SK; Villar-F

DIRECCION: Department of Biokinesiology and Physical Therapy, University of Southern California, Los Angeles 90033, USA. llbaker@hsc.usc.edu

FUENTE: Diabetes-Care. 1997 Mar; 20(3): 405-12

IDIOMA: ENGLISH

CP: UNITED-STATES

RESUMEN: OBJECTIVE: To evaluate the effects of two stimulation waveforms on healing rates in patients with diabetes and open ulcers. The hypothesis was that stimulus waveforms with minimal polar characteristics would provide significant healing for this patient sample. RESEARCH DESIGN AND METHODS: This was a prospective study that enrolled 80 patients with open ulcers. Patients received stimulation with either an asymmetric biphasic (A) or symmetric biphasic (B) square-wave pulse. Amplitudes were set to activate intact peripheral nerves in the skin. Two other groups received either very low levels of stimulation current (MC), or no electrical stimulation (C). When combined these groups were referred to as the control group. Treatment was carried out daily until the wound healed, the patient withdrew from the study, or the physician changed the overall wound management program. Average healing rates were calculated from weekly measures of the wound perimeter and were used for statistical comparison through a one-way analysis of variance. RESULTS: Stimulation with the A protocol significantly increased the healing rate, enhancing healing by nearly 60% over the control rate of healing. Stimulation with the B protocol did not increase the healing rate when compared with control subjects. CONCLUSIONS: Electrical stimulation, given daily with a short pulsed, asymmetric biphasic waveform, was effective for enhancement of healing rates for patients with diabetes and open ulcers.

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TITULO: [The mechanism of action of low-intensity laser radiation]

TITULO ORIGINAL: O mekhanizme deistviia nizkointensivnogo lazernogo izlucheniia.

AUTOR/ES: Nemtsev-IZ; Lapshin-VP

FUENTE: Vopr-Kurortol-Fizioter-Lech-Fiz-Kult. 1997 Jan-Feb(1): 22-4

IDIOMA: RUSSIAN; NON-ENGLISH

CP: RUSSIA

RESUMEN: The authors review primary mechanisms of action of low-intensity laser radiation used in physiotherapy. The hypothesis suggested by the authors allows one to compare efficacy of bioenergetic action of electromagnetic radiation varying in ranges, of therapeutic lasers, in particular. However, animal experiments have shown greater than bioenergetic action efficacy of the mechanism used by the nervous system in response to laser radiation.

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TITULO: Combined ultrasound, electrical stimulation, and laser promote collagen synthesis with moderate changes in tendon biomechanics.

AUTOR/ES: Gum-SL; Reddy-GK; Stehno-Bittel-L; Enwemeka-CS

DIRECCION: Department of Physical Therapy, University of Kansas Medical Center, Kansas City 66160-7601, USA.

FUENTE: Am-J-Phys-Med-Rehabil. 1997 Jul-Aug; 76(4): 288-96

IDIOMA: ENGLISH

CP: UNITED-STATES

RESUMEN: The biomechanical, biochemical, and ultrastructural effects of a multitherapeutic protocol were studied using regenerating rabbit Achilles tendons. The multitherapeutic protocol was composed of low-intensity Ga:As laser photostimulation, low intensity ultrasound, and electrical stimulation. Achilles tendons of 63 male New Zealand rabbits were tenotomized, sutured, immobilized, and subjected to the multitherapeutic protocol for five days, after which casts were removed and the therapy was continued for nine more days without electrical stimulation. The tendons were excised and compared with control tendons. Multitherapy treatment produced a 14% increase in maximal strength, a 42% increase in load-at-break, a 20% increase in maximal stress, a 45% increase in stress-at-break, a 21% increase in maximal strain, and a 14% increase in strain-at-break. Similarly, multitherapy treatment was associated with an increase in Young's modulus of elasticity of 31%, an increase in energy absorption at maximum load of 9%, and an increase in energy absorption at load-at-break of 11%. Biochemical analysis of the tendons showed an increase of 23% in the total amount of collagen in the multitherapy-treated tendons, with fewer mature crosslinks (decrease of 6%). Electron micrographs revealed no ultrastructural or morphologic changes in the tendon fibroblasts or in the extracellular matrix. The improvements measured in tendons receiving multitherapy were consistent but less remarkable compared with our earlier works with single modality protocols. The results warrant the hypothesis that the beneficial effects of ultrasound and laser photostimulation on tendon healing may counteract one another when applied simultaneously.

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