BACKGROUND AND OBJECTIVES: Chronic pain is considered a worldwide public health problem, can lead to physical and emotional stress, in addition to high financial and social costs for the population. The aim of this study was to produce a systematic review to identify the prevalence of chronic pain in Brazil, considering its geographical regions and mechanisms subclassifications by the International Association for the Study of Pain (IASP). CONTENTS: A systematic review was carried out on the following databases: Scielo, Pubmed, Periódicos Capes, Science Direct and Virtual Health Library. 35 studies that investigated the prevalence of chronic pain in Brazil were included. The prevalence ranged from 23.02 to 76.17%, presenting a national average of 45.33% between studies, affecting more women. The Brazilian region with the highest prevalence among the included studies was the Midwest region (56.25%), however the region with the most studies and the largest population analyzed was the Southeast region (42.2%). Regarding the classifications of IASP mechanisms, possibly nociceptive pain had a prevalence of 36,70%, whereas neuropathic pain was 14,5% and nociplastic pain 12,5%. CONCLUSION: The present study observed a high prevalence of chronic pain in Brazil, being the majority in women. Regarding chronic pain mechanisms, the possibly nociceptive predominance was the most prevalent. As for the national geographic region, the highlight of the highest prevalence of chronic pain was for the Midwest region, however the region with the most studies and the largest population analyzed was the Southeast region.
Immobilization, used in clinical practice to treat traumatologic problems, causes changes in muscle, but it is not known whether changes also occur in nerves. We investigated the effects of immobilization on excitability and compound action potential (CAP) and the ultrastructure of the rat sciatic nerve. Fourteen days after immobilization of the right leg of adult male Wistar rats (n=34), animals were killed and the right sciatic nerve was dissected and mounted in a moist chamber. Nerves were stimulated at a baseline frequency of 0.2 Hz and tested for 2 min at 20, 50, and 100 Hz. Immobilization altered nerve excitability. Rheobase and chronaxy changed from 3.13±0.05 V and 52.31±1.95 µs (control group, n=13) to 2.84±0.06 V and 59.71±2.79 µs (immobilized group, n=15), respectively. Immobilization altered the amplitude of CAP waves and decreased the conduction velocity of the first CAP wave (from 93.63±7.49 to 79.14±5.59 m/s) but not of the second wave. Transmission electron microscopy showed fragmentation of the myelin sheath of the sciatic nerve of immobilized limbs and degeneration of the axon. In conclusion, we demonstrated that long-lasting leg immobilization can induce alterations in nerve function.
RESUMOA imobilização é um recurso frequentemente utilizado na prática clínica, sendo comum em patologias álgicas e nas fraturas. O objetivo deste estudo foi analisar a influência do processo de imobilização em músculo do sistema respiratório, o diafragma. O experimento foi efetuado com 12 ratos Wistar machos divididos em dois grupos, controle e imobilizado. O procedimento de imobilização foi realizado através de um método alternativo de imobilização por fita adesiva, sendo mantida por duas semanas. Analisouse a morfometria das fibras do diafragma com coloração de hematoxilina e eosina. Ao compararmos o diâmetro médio das fibras musculares do diafragma dos animais imobilizados (47,15µm ± 0,329µm) em relação ao controle (54,67µm ± 0,396µm), encontramos diferença estatística entre os grupos (p < 0,0001). Considerando os dados encontrados, foi possível concluir que a imobilização de pata, no modelo utilizado, foi capaz de gerar hipotrofia da musculatura respiratória, assim como um quadro geral de redução de massa corporal do animal.Palavras-chave: hipocinesia, diafragma, histologia. ABSTRACTImmobilization is a frequently used procedure in clinical practice and common in pain diseases and fractures. This study examined the influence of immobilization in a muscle-related respiratory system, the diaphragm. This experiment was conducted with twelve male rats divided into two groups, control and immobilized with an alternative method of restraining by tape, kept for two weeks. We analyzed the morphometry of the diaphragm muscle fibers with hematoxylin/eosin staining. Statistical difference was found (p < 0.0001) when the average diameter of the diaphragm muscle fibers of immobilized animals (47.15µm ± 0.329µm) was compared to the ones in the control group (54.67µm ± 0.396µm). Considering the results, it can be concluded that the immobilization of the animal paw in the used model was able to produce hypotrophy of respiratory musculature, as well as a general framework for reducing the mass of the animal.Keywords: hypokinesia, diaphragm, histology. INTRODUÇÃOA imobilização é um recurso frequentemente utilizado na prática clínica, sendo comum em patologias álgicas e nas fraturas. Entretanto, o seu entendimento fisiológico ainda necessita ser buscado. Sabe-se que mesmo pequenos períodos acarretam diversos prejuízos à região imobilizada, especialmente a condição de hipotrofia/atrofia muscular (1) . Outra questão importante é que a imobilização causa transtornos em outras partes do organismo, interferindo inclusive no metabolismo (2)(3)(4) . O processo de atrofia muscular envolve alterações metabólicas, bioquímicas e estruturais que afetam a funcionalidade dos músculos envolvidos. A estrutura e a função dos músculos esqueléticos são condicionadas pela atividade proprioceptiva, pela inervação motora, pela carga mecânica imposta ao tecido, pela realização de ciclos de estiramento/encurtamento e pela mobilidade das articulações. O comprometimento de algum desses fatores certamente acarretará um quadro de hipotrofia ou atrofia ...
To carry out an integrative literature review on the postural analysis softwares available today. It is an integrative-narrative review of qualitative and methodological nature performed during April-July 2014. As inclusion criteria, the articles should be bibliographical or original research and available with full access. At first, we proceeded to the identification of the keywords for the softwares related to postural assessment commonly used in the health field, in such case "posture", "software", and "postural assessment". The search was narrowed by publication date from 2002 to 2014. Through the information acquired from the articles and from the software developers, information on 12 programs that assist the postural evaluation were obtained - Alcimage, All Body Scan 3D, Aplob, APPID, Biotonix, Corporis Pro, Fisimetrix, Fisiometer Posturograma, Physical Fisio, Physio Easy, Posture Print and SAPO. However, only one tool has more information and studies, namely SAPO. There are many postural analysis softwares available on the internet today, however, these are quite disparate in relation to possible answers and are still poorly widespread as research tools.
Two weeks of functional paw disuse leads to local and systemic harmful adaptive changes in sensorial and structural systems. This study brings new insights into nervous and motor system mechanism associated with therapeutic limb immobilization in muscle and skeletal pathological conditions.
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