No abstract

Changes in thoracoabdominal motion are highly prevalent in patients with chronic respiratory diseases. Home care services that use telemedicine techniques and Internet-based monitoring have the potential to improve the management of these patients. However, there is no detailed description in the literature of a system for Internet-based monitoring of patients with disturbed thoracoabdominal motion. The purpose of this work was to describe the development of a new telemedicine instrument for Internet-based home monitoring of thoracoabdominal movement. The instrument directly measures changes in the thorax and abdomen circumferences and transfers data through a transmission control protocol∕Internet protocol connection. After the design details are described, the accuracy of the electronic and software processing units of the instrument is evaluated by using electronic signals simulating normal subjects and individuals with thoracoabdominal motion disorders. The results obtained during in vivo studies on normal subjects simulating thoracoabdominal motion disorders showed that this new system is able to detect a reduction in abdominal movement that is associated with abnormal thoracic breathing (p < 0.0001) and the reduction in thoracic movement during abnormal abdominal breathing (p < 0.005). Simulated asynchrony in thoracoabdominal motion was also adequately detected by the system (p < 0.0001). The experimental results obtained for patients with respiratory diseases were in close agreement with the expected values, providing evidence that this instrument can be a useful tool for the evaluation of thoracoabdominal motion. The Internet transmission tests showed that the acquisition and analysis of the thoracoabdominal motion signals can be performed remotely. The user can also receive medical recommendations. The proposed system can be used in a spectrum of telemedicine scenarios, which can reduce the costs of assistance offered to patients with respiratory diseases.

The cervical spine is considered a possible source of headaches, however there are still some controversies regarding the pathophysiology, clinical presentation, and treatment. Objective: To propose a physical therapy treatment protocol with multimodal approach for cervicogenic headache and evaluate the effects of manual therapy on such patients. Method: This was an uncontrolled experimental study in which 9 patients from the UNIFESO Physical Therapy Clinic (Teresópolis, RJ) diagnosed with cervicogenic headache underwent 10 physiotherapy interventions with manual therapy techniques. The experimental protocol included joint techniques, fascial release, and muscle recruitment. The Neck Disability Index (NDI) and a visual analogic scale (VAS) were used as measurement tools and the pain pattern was recorded. Results: Of the nine selected patients, all were female and had an average age of 43.3 years (± 15.5). Significant differences were observed between the average intensity of pain (VAS) before treatment (8.0 ± 1.3) and after (2.2 ± 0.9, p < 0.01). The NDI also showed improvement after intervention 63.9% (p < 0.01). Regarding crises frequency, a decrease of 70% was observed after the intervention (p < 0.01) and a reduction was also shown in the duration of such crises before (4 hours ± 1.5) and after treatment (1 hour ± 0.5; p < 0.01). Conclusion: A multimodal approach by manual therapy techniques was beneficial in the reduction of the patients’ symptoms and it provided a decrease in cervical disability.

The cervical spine is considered a possible source of headaches, however there are still some controversies regarding the pathophysiology, clinical presentation, and treatment. Objective: To propose a physical therapy treatment protocol with multimodal approach for cervicogenic headache and evaluate the effects of manual therapy on such patients. Method: This was an uncontrolled experimental study in which 9 patients from the UNIFESO Physical Therapy Clinic (Teresópolis, RJ) diagnosed with cervicogenic headache underwent 10 physiotherapy interventions with manual therapy techniques. The experimental protocol included joint techniques, fascial release, and muscle recruitment. The Neck Disability Index (NDI) and a visual analogic scale (VAS) were used as measurement tools and the pain pattern was recorded. Results: Of the nine selected patients, all were female and had an average age of 43.3 years (± 15.5). Significant differences were observed between the average intensity of pain (VAS) before treatment (8.0 ± 1.3) and after (2.2 ± 0.9, p < 0.01). The NDI also showed improvement after intervention 63.9% (p < 0.01). Regarding crises frequency, a decrease of 70% was observed after the intervention (p < 0.01) and a reduction was also shown in the duration of such crises before (4 hours ± 1.5) and after treatment (1 hour ± 0.5; p < 0.01). Conclusion: A multimodal approach by manual therapy techniques was beneficial in the reduction of the patients' symptoms and it provided a decrease in cervical disability.

No abstract