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Biomedical subjects

L R Battistella

Publications and source records attributed to L R Battistella.

At least 19 recordsLinked to original sources
PubMed2006

Computerized pedobarography in the characterization of ankle-foot instabilities of haemophilic patients.

Among the most common clinical manifestations of haemophilia are joint haemorrhages. This study aimed to verify whether repetitive ankle haemarthrosis is associated with instability of the rear foot. We evaluated haemophilic patients with repetitive bleeding in the ankles, 39 of type A and four of type B, whose mean age was 16.1 years. All presented a functional gait, without the need for motion assistance devices. The number of rear-foot and ankle haemarthrosis episodes during the 6 months prior to the study was verified from the medical records of each patient. After verifying the alignment of the rear foot of the patients, we evaluated the subjects through computerized pedobarography with the f-scan system, emphasizing the study of the trajectory of the centre of pressure (COP) with each step taken. All patients received functional orthoses according to the results of these examinations, and were re-evaluated 1 week and 6 months after being fitted. The number of haemarthrosis episodes at the rear foot and the ankle was compared with the occurrence of joint bleeding within the previous 6 months. In the first examination, the COP trajectory showed that all the 43 patients studied had some sort of instability. Six months later, a significant reduction in the frequency of spontaneous bleeding events (P<0.001) concerning the rear foot and the ankle was observed. This method of evaluation was useful to identify joint instabilities, allowing the best prescription of orthoses to improve stability in the rear foot and the ankle.

Adolescent↗
PubMed2005

The effect of foot orthoses in rheumatoid arthritis.

OBJECTIVE: To evaluate the effectiveness of foot orthoses using the foot function index (FFI) in a group of patients with rheumatoid arthritis (RA) during a period of 6 months. METHODS: Thirty-six rheumatoid subjects with foot pain were examined and appropriate foot orthoses were prescribed according to each patient's needs. All the patients were evaluated 30, 90 and 180 days after the baseline visit. FFI values, daily time of wearing the orthoses and adverse effects were noted at each appointment. The Stanford Health Assessment Questionnaire (HAQ) was used at the initial visit to evaluate the influence of physical condition on FFI response. RESULTS: With the use of foot orthoses, FFI values decreased in all subscales (pain, disability and activity limitation). This reduction was noted in the first month and was maintained throughout the trial. Those using EVA (ethyl-vinyl acetate; n = 28) orthoses presented results similar to those for the total group. Patients wearing made-to-measure orthoses (n = 8) exhibited higher initial FFI values and worse evolution during the trial, significant for pain and disability but not for activity limitation. Minor adverse reactions were noted; none required interruption of treatment. There was no relation between HAQ and FFI evolution. CONCLUSIONS: Foot orthoses were effective as an adjuvant in the management of rheumatoid foot. They significantly reduced pain, disability and activity limitation, as measured by the FFI, with minor adverse effects.

Activities of Daily Living↗
PubMed2005

Effect of alendronate on bone mineral density in spinal cord injury patients: a pilot study.

STUDY DESIGN: Prospective, randomised controlled trial. OBJECTIVE: To evaluate the effect of alendronate on bone mineral density in chronic spinal cord injury (SCI) patients. SETTING: University-based rehabilitation centre in São Paulo, Brazil. METHODS: A total of 19 chronic SCI patients were evaluated, divided into a control group and an experimental group. Control group patients received 1000 mg of calcium daily, and experimental group patients received 1000 mg of calcium plus 10 mg of alendronate daily. The study duration was 6 months. In all, 12 densitometric parameters were analysed using whole-body dual-energy X-ray absorptiometry at baseline and after 6 months. RESULTS: The experimental group presented increases in nine densitometric parameters, although statistical significance was attained in only two of those parameters. In the control group, an increase was observed in only one parameter, whereas the remaining 11 presented either no alteration or a decrease. CONCLUSION: The use of alendronate had a positive effect on bone mineral density in SCI patients and therefore represents a potential tool for prevention and treatment of osteoporosis in this population.

Administration, Oral↗
PubMed1999

Non-operative treatment of flexion contracture of the knee in haemophilia.

For the non-operative treatment of flexion contracture of the haemophilic knee we have used serial casting and wedging in 58 patients, and extension/de-subluxation orthoses in 13 patients. On average it was possible to achieve -5 degrees of extension by 4 weeks, with only a little improvement in the following 4 weeks. The short--to medium-term results using either the extension/de-subluxation hinges or serial casting were similar. Both methods have been shown to result in significant improvement in joint contracture.

Adolescent↗
PubMed1998

Maintenance of musculoskeletal function in people with haemophilia.

Bleeding affecting muscles and joints is the most common manifestation of haemophilia. In the long term, prevention of musculoskeletal abnormality in haemophilic patients is cost effective. Early diagnosis and proper treatment is fundamental to prevent disability. Prevention can be divided into secondary and tertiary levels. Secondary prevention concentrates on how to handle a haemophilic child, and on the education of the family so that they develop a safe and healthy lifestyle and awareness of the importance of early diagnosis and treatment. Tertiary prevention deals with minimizing the musculoskeletal consequences of muscle and joint bleeding. Coagulation factor replacement, appropriate care of the bleeding site and early physical therapy helps to prevent complications and yields the best results. Recurrent episodes of joint bleeding can lead to chronic synovitis. Initially synovitis demands conservative treatment. However, conservative methods are often not successful. Chronic synovitis is the most important cause of joint degeneration and the aim of rehabilitation is to achieve functional status using special casting techniques, orthoses or preventative surgery. Surgical, radioisotope or chemical synovectomy may be used. Technical requirements and availability of haemostatic cover limit the use of surgical and radioisotope synovectomy. The author has found chemical synovectomy with rifampicin to be an easier and more effective procedure than surgery. Problems related to joint deformities, muscle atrophy and chronicle pain demand comprehensive care. They are the main factors affecting the maintenance of musculoskeletal function and the social integration of people with haemophilia.

Adaptation, Physiological↗
PubMed1998

Rehabilitation in haemophilia--options in the developing world.

Musculoskeletal care is provided in many different settings by many different providers. Physicians are better prepared to treat acute diseases, acute manifestations and have problems in following chronic patients and to preventing losses of functional independence. Haematoma affecting muscles and joints is the most common musculoskeletal finding in haemophilic patients. Proper treatment is fundamental to prevent disability. Treatment aims at restoring the original muscle trophism and strength because joint stability is dependent on the uniform distribution of muscle power over different joint surfaces. Physical rehabilitation continues until complete anatomical and functional recovery is achieved. Coordination and proprioceptive stimulation complement the exercises to recover original muscle strength. Recurrent haemorrhages usually progress to chronic synovitis, the leading cause of motor disability and joint degeneration in haemophilic patients. Moreover, chronic synovitis is a predisposing factor for repetitive episodes of haemarthrosis, a leading cause of joint deformities and severe muscle atrophy. At this point, an efficient treatment alternative should be put into effect to restrain bleeding and prevent synovitis-related joint degeneration, which is synovectomy. Synovectomy is an effective alternative, less costly and easier to perform. Rifampicin synovectomy is advantageous because it is safe, not aggressive to the patient, can be repeated if necessary, and it does not prevent the use of either radiotherapy or surgery after, if necessary. Once the sequelae have set in, treatment tends to be conservative, and it aims at giving the patient functional independence for gait and other activities. The most common limb deformities seen in these patients are knee and elbow flexion, but the patient should also be assessed for compensatory scoliosis, hyperlordosis and lower limb length discrepancies. Chronic joint pain is a rather common complaint in this patient population with early arthrosis, and special drugs and physical treatment must be put into action. Rehabilitation is often inexpensive and very efficient.

Developing Countries↗
PubMed1995

[Early physical conditioning of patients surgically treated for myocardial revascularization. Influence on the functional capacity].

PURPOSE: To evaluate the early physical conditioning (PC) effect [initiated 15 days after the myocardial revascularization surgery (MRS)] in the functional capacity. METHODS: Twenty-two male patients (mean-age of 52y-o), divided in two groups (A and B, 11 patients each), were studied. Group A started PC 3 months after MRS (phase III), with a training intensity of about 70% of the maximum heart rate reserve, during three months, three sessions per week with one hour duration. Group B started PC 15 days after the MRS (fase II), with a training intensity up to five metabolic unities, three times a week, 1 hour and 15 duration. The post-MRS period of three months was designated as the time I (beginning of fase III) and six months as time 2. Stress test, Kraus-Weber flexibility test, coxo-femural flexibility test (flexion, elevation and abduction) and scapule-umeral flexibility test (flexion, extension and abduction) were applied. RESULTS: The maximum oxygen uptake and the total work increased significantly from time 1 to time 2 in both groups, but there was no significant difference between the two groups, either in time 1 or 2. Flexibility in the Kraus-Weber test and in the scapule-umeral flexibility test when in flexion, were significantly greater in group B than A, in both times (1 and 2). Other flexibility variables studied show no significant difference, neither between the studied groups nor in the times 1 and 2 of evaluation. CONCLUSION: Early PC after MRS increased the value of two variables that measure flexibility. However, it has not increased other flexibilities variables and the aerobic capacity.

Analysis of Variance↗
PubMed1993

[Chronotropic and pressoric response in myocardiopathy in patients with heart failure during ergometric test. Correlation of spirometry variables with effort].

PURPOSE: To correlate the variables heart rate (HR), blood pressure (BP) and double product (DP) during the ergometric test with the variables oxygen consumption (VO2) and pulmonary ventilation (VE) of spiroergometry. METHODS: A study was carried out with 40 male patients suffering from cardiomyopathy with heart failure (functional class II-IV of NYHA)-of ischemic (IS), Chagas' disease (CH) and idiopathic (ID) etiology. These three groups were compared to a group of 10 normal individuals (N). The 4 groups were evaluated under 4 different conditions: rest (RES), anaerobic threshold (LA), power peak of exercise (P) and in the fourth minute recovery (REC). The investigation was carried out with the data obtained through spiroergometry (using a treadmill and spiroergometric equipment specific for the effort), as well as data related to HR, BP, DP, VO2 and VE. RESULTS: There were significant differences observed in the ergometric evaluate of the HR, BP and DP responses in the IS, CH and ID groups as compared with the N group. There were significant difference observed in the spirometric evaluation to the VO2 and VE efforts in the IS, CH and ID groups as compared with the N group. CONCLUSION: The HR, BP and DP variables studies, obtained by means of classic ergometry, unaided by direct methodology (spiroergometry) enabled them to infer valuable data for the control and evaluation of cardiomyopathies with IC, taking into consideration the low chronotropic and pressoric responses in the various phases of evaluation during this study, corresponding to the concomitant low performance of O2 consumption and pulmonary ventilation.

Adult↗
PubMedDate not supplied

Assessment of functional capacity during gait using a reciprocal propulsion orthosis (ARGO)--a comparative study with a conventional mechanical orthosis.

One subject (male, 24 years) with an incomplete motor and sensitive SCI, neurological level C6-C7 was submitted to a comparative study during gait using an advanced reciprocating gait othosis (ARGO) and a conventional mechanical orthosis (CMO) and respiratory and metabolic variables were compared at peak effort and in the second minute of recovery. We found that the ARGO, as with the CMO, not guarantee gait independence but the ARGO does enable a more functional gait pattern with a more efficient ventilation. The ratio of CO2/O2 showed that ARGO enable aerobic conditions of work and the energy expenditure using is significantly lower than CMO.

Adult↗
PubMedDate not supplied

[Functional electric stimulation (FES) in cerebral palsy].

Our study concerns a patient with cerebral palsy, submitted to conventional occupational therapy and functional electrical stimulation. The results as to manual ability, spasticity, sensibility and synkinesis were satisfactory.

Adolescent↗
PubMedDate not supplied

[Functional electrical stimulation in the reciprocal locomotion of paraplegic patients].

The functional electrical stimulations is employed for standing-up posture and reciprocal locomotion in paraplegic patients. Five male paraplegic patients, level D5-D12 mean age 32.4 years, were treated with functional electrical stimulation, during two months. The quadriceps and fibular nerves were stimulated for 30 minutes, twice a day. After the training period, two patients were able to remain in the stand-up position and walk in parallel bars; one of them was able to use a walker. In other patients the technique was without effect for standing and walking. This method is not the solution for locomotion of paraplegics and more research is needed for the improvement of the results of functional electrical stimulation.

Adult↗
PubMedDate not supplied

Evaluation of the physical fitness by the Bruno Balke protocol in sedentary and wheelchair trained paraplegic patients.

The Bruno Balke test is one of the methods available to measure the oxygen intake in wheelchair users. The equation of the test is:intake O2 = 33+ (speed average-133) x 0.17 ml/kg x min. (-1). The average speed represents the acceleration and may be used to measure the level of physical fitness. In order to verify the efficiency of this kind of evaluation, we selected ten male, sedentary paraplegic patients, level D5-D12 in an ordinary rehabilitation program and ten paraplegic athletes. All of them were submitted to the Bruno Balke test. The results demonstrated that the average speed, the covered distance and the oxygen intake were significantly greater in athletes than in sedentary individuals.

Disability Evaluation↗
PubMedDate not supplied

[H-reflex in spastic patients due to spinal cord injury before and after the use of diazepam and baclofen].

This paper concerns the "H" reflex in eleven patients with spastic spinal cord injury (C5-T10), treated with Baclofen (50 mg/day) or Diazepam (20 mg/day). The "H" reflex was tested in the tibial nerve before and 15 days after the interrupted use of the drugs. Five patients used Baclofen and 6 patients used Diazepam. The latency time was measured. All the patients showed normal latency time before the use of the drugs. After the use all but one didn't show any significant alterations of the latency time. The patient, who showed a greater latency after use of drugs, presented an improvement of the motor function.

Adult↗