No. 381 Eficacia de la Toxina Botulínica Tipo A Aplicada en Vasto Lateral y Cintilla Iliotibial en...
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the end of 9 months. On the other hand there was not a statistically significant change between baseline and 9th month BMD values of total hip and L1-L4 spine. Conclusions: This study with a small sample size provides implications on the beneficial effects of plyometric exercise training on BMD at L1-L4 spine and the total hip. However it is not possible to make firm conclusions on the efficacy of high intensity jumping exercises on BMD in young sedentary males with a follow-up of 9 months. No. 379 Evaluation of Isokinetic Parameters of Trunk Flexors and Extensors of Healthy Adult Subjects in the State of Mexico. Adrian Tenorio Terrones, MD; Celia Itxelt Infante Castro, MD (Regional General Hospital no. 200, Tecamac State of Mexico). Disclosure: None. Objective: To obtain parameters isokinetic peak torque and total work averaged of trunk flexors and extensors of healthy subjects in state of Mexico. Design: Observational prospective longitu- dinal study. Participants: A total of 49 healthy subjects after clinical assessment: 22 men (45%) and 47 women (55%) with a mean age of 33.810.7 years mean BMI of 23.9. Each participant was assessed with isokinetic equipment module version mk2a tp500 2 times during 7 days a speed of 60 and 90 /s. Interventions: Not applicable. Main Outcome Measures: Flexors concentric average peak torque (FCAPT), extensors concentric average peak torque (ECAPT), extensors eccentric average peak torque (EEAPT), flexors concentric average total work (FCATW), extensors concentric average total work (ECATW) and extensors eccentric average total work (EEATW) at 60 /s and 90 /s. Level of Evidence: III. Results: The light work activity in 88% 51% commented sedentary physical activity 29% practiced aerobic exercise anaerobic 8% and combined 12%. EEAPT 60 /s for male 17756 nm and female 10835 nm. FCAPT 60 /s for male 18639nm and female 11236 nm. EEAPT 90 /s for male 13291 nm and female 7746 nm. FCAPT 90 /s for male 169215 nm and female 104153 nm. EEAPT 60 /s for male 399177 nm and female 263124 nm. EEAPT 90 /s for male 484257 nm and female 270147 nm. ECATW 60 /s for male 409235 J and female at 296144 J; FCAPT 60 /s for male 317281 J and female 227174J. ECATW 90 /s for male 607210 J and female 410131 J. FCATW 90 /s for male 388204 J and female 273139 J. ECATW 60 /s for male 322275 J and female 246193 J. Conclusions: The average of FCAPT and ECAPT at 60 and 90 /s was lower by 43%. FCAPT and ECATW was higher by 14% than the national and international literature. It is suggested extend the sample to obtain more conclusive data and perform multicenter studies to validate index applicable to Mexican healthy subjects. No. 380 Application of Botulinum Toxin Type A in a Patient With Wartenberg’S Syndrome: A Case Report. Trujillo Millán Alejandro; Olivas Ortiz Javier; Gutierrez Sandoval Jeanette. Location: Toluca Edo, México. Case Report: 29-year-old female patient right handed without history of trauma, fracture, nor use any kind of splint at the right wrist. Presents Wartenberg’s syndrome of 6 months of evolution corroborated by clinical evidence (Tinnel Dellon’s test and paresthesias in right dorso-radial region) without improvement even though physiotherapy was given. Botulinum toxin type A (TBA) was applied to the patient at motor point of extensor carpi radialis longus (ECRL), extensor carpi radialis brevis (ECRB) and brachioradialis. Likewise evaluation was performed with DASH questionnaire and the Michigan questionnaire (MHQ) before and 6 weeks after the application of TBA. Treatment was supple- mented by a program of physical therapy. Results: The patient had marked improvement of her symptoms especially decrease of paresthesias and Tinnel disappearance as well as DASH score reduction from 45 to 33 and MHQ improvement from 47% to 68%. Discussion: This is the first case report with the use of TBA as treatment of Wartenberg’s syndrome where good clinical and DASH/MHQ response were obtained. Application of TBA in the ECRB, ECRL and brachioradialis could decrease the compression of the sensory branch of the radial nerve which has been described between the muscle bellies of the ECRB, ECRL and brachioradialis by causing muscle atrophy and partial decrease in strength by the known mechanism of the TBA. Conclusions: The application of TBA could represent an alternative of easy application treatment low cost and reproducible in the conservative management of Wartenberg’s syndrome when the compression is suspected between the ECRB, ECRL muscles and brachioradialis and there is no history of distal radius fracture, Quervain’s disease or any other cause of external compression. No. 381 Eficacia de la Toxina Botulínica Tipo A Aplicada en Vasto Lateral y Cintilla Iliotibial en el Manejo Del Síndrome Doloroso Patelofemoral. A. Trujillo Millán; A. Izquierdo Heredia; E. Díaz Jaimes; Gutiérrez Sandoval J. Objetivo: Evaluar la eficacia del tratamiento con toxina botulínica tipo A (TBA) en pacientes con síndrome doloroso patelofemoral (SDPF) aplicado en vasto lateral y cintilla iliotibial. Diseño: Se realizó un estudio pro- spectivo longitudinal experimental aleatorizado. Ubicación: Toluca. Participantes: 11 pacientes de entre 24 a 48 años de edad 18 rodillas en total con diagnóstico de sdpf sin antecedente de traumatismo enfermedad articular degenerativa o lesión derivada de prácticas deportiva. Inter- venciones: Los pacientes fueron asignados en forma aleatoria para la aplicación de tba en cintilla iliotibial y vasto lateral y en los pacientes con SDPF bilateral en una de las rodillas se aplico placebo. Ambos grupos pasaron a un programa de rehabilitación física de 12 sesiones. Para la evaluación de los pacientes se aplicó la escala: anterior knee pain score (AKPS) antes y dos meses después de la aplicación de TBA. Nivel de evidencia: I. Resultados: De acuerdo al AKPS los valores obtenidos antes de la aplicación de tba fueron: promedio 48.81 puntos del grupo experimental y 55.77 puntos promedio del grupo control y a los 2 meses después de la aplicación de TBA promedio 64.18 puntos para el grupo experimental (diferencia de 15.37) y de 64.55 puntos promedio para el grupo control (diferencia de 8.78). La mejoría observada fue en el grupo experimental que en el grupo placebo principalmente en: uso de escaleras permanecer sentado con las rodillas flexionadas dolor inflamación y movi- mientos anormales y dolorosos de la rótula. Conclusiones: La aplicación de TBA junto con un programa de estiramientos y fortalecimientos puede tener un rol importante restableciendo el balance muscular en pacientes con SDPF disminuyendo así la sintomatología. Este estudio proporciona una alternativa novedosa en el tratamiento de los pacientes con SDPF en los cuales otras alternativas no han sido suficientes. No. 383 Multidisciplinary Care of Muscle Strain Grade 2 in Left Gastrocnemius of a Football Center: A Case Report. Luis Gerardo Vázquez Villarreal; Jaime García Rodríguez, MD. Patient: A 28-year-old male football center under sport medical supervi- sion with muscle strain grade 2 on the left gastrocnemius. Case Description: Post-ultrasound diagnosis and clinical symptoms the athlete received multidisciplinary attention from sports medicine, physiotherapy and nutrition. In a period of 4 weeks; every 2 days he received cryomassage sessions, laser to 11000 Hz 18.0 joules for 6 minutes, kinesiology taping applications with 5-10% tensions. On the 2nd week closed kinetic chain exercises involving eccentric heel drop exercises were added. On the 3rd week functional exercises to the race and to maintain cardiovascular fitness were added. As an additional measure a reduction of daily caloric intake associated with the rest period was made. Oral supplementation was added with 1 gram daily of vitamin “C” for a month and 200 mg every 8 hours of PM&R Vol. 6, Iss. 8S2, 2014 S167
Transcript of No. 381 Eficacia de la Toxina Botulínica Tipo A Aplicada en Vasto Lateral y Cintilla Iliotibial en...
PM&R Vol. 6, Iss. 8S2, 2014 S167
the end of 9 months. On the other hand there was not a statisticallysignificant change between baseline and 9th month BMD values of total hipand L1-L4 spine. Conclusions: This study with a small sample sizeprovides implications on the beneficial effects of plyometric exercise trainingon BMD at L1-L4 spine and the total hip. However it is not possible to makefirm conclusions on the efficacy of high intensity jumping exercises on BMDin young sedentary males with a follow-up of 9 months.
No. 379 Evaluation of Isokinetic Parameters of TrunkFlexors and Extensors of Healthy Adult Subjects in theState of Mexico.Adrian Tenorio Terrones, MD; Celia Itxelt Infante Castro, MD(Regional General Hospital no. 200, Tecamac State of Mexico).
Disclosure: None. Objective: To obtain parameters isokinetic peaktorque and total work averaged of trunk flexors and extensors of healthysubjects in state of Mexico. Design: Observational prospective longitu-dinal study. Participants: A total of 49 healthy subjects after clinicalassessment: 22 men (45%) and 47 women (55%) with a mean age of33.8�10.7 years mean BMI of 23.9. Each participant was assessed withisokinetic equipment module version mk2a tp500 2 times during 7 daysa speed of 60 and 90�/s. Interventions: Not applicable.Main OutcomeMeasures: Flexors concentric average peak torque (FCAPT), extensorsconcentric average peak torque (ECAPT), extensors eccentric average peaktorque (EEAPT), flexors concentric average total work (FCATW), extensorsconcentric average total work (ECATW) and extensors eccentric averagetotal work (EEATW) at 60�/s and 90�/s. Level of Evidence: III.Results: The light work activity in 88% 51% commented sedentaryphysical activity 29% practiced aerobic exercise anaerobic 8% and combined12%. EEAPT 60�/s for male 177�56 nm and female 108�35 nm. FCAPT60�/s for male 186�39nm and female 112�36 nm. EEAPT 90�/s for male132�91 nm and female 77�46 nm. FCAPT 90�/s for male 169�215 nmand female 104�153 nm. EEAPT 60�/s for male 399�177 nm and female263�124 nm. EEAPT 90�/s for male 484�257 nm and female 270�147nm. ECATW 60�/s for male 409�235 J and female at 296�144 J; FCAPT60�/s for male 317�281 J and female 227�174J. ECATW 90�/s for male607�210 J and female 410�131 J. FCATW 90�/s for male 388�204 J andfemale 273�139 J. ECATW 60�/s for male 322�275 J and female246�193 J. Conclusions: The average of FCAPT and ECAPT at 60 and90�/s was lower by 43%. FCAPT and ECATW was higher by 14% than thenational and international literature. It is suggested extend the sample toobtain more conclusive data and perform multicenter studies to validateindex applicable to Mexican healthy subjects.
No. 380 Application of Botulinum Toxin Type A in a PatientWith Wartenberg’S Syndrome: A Case Report.Trujillo Millán Alejandro; Olivas Ortiz Javier;Gutierrez Sandoval Jeanette.
Location: Toluca Edo, México. Case Report: 29-year-old femalepatient right handed without history of trauma, fracture, nor use any kind ofsplint at the right wrist. Presents Wartenberg’s syndrome of 6 months ofevolution corroborated by clinical evidence (Tinnel Dellon’s test andparesthesias in right dorso-radial region) without improvement even thoughphysiotherapy was given. Botulinum toxin type A (TBA) was applied to thepatient at motor point of extensor carpi radialis longus (ECRL), extensorcarpi radialis brevis (ECRB) and brachioradialis. Likewise evaluation wasperformed with DASH questionnaire and the Michigan questionnaire (MHQ)before and 6 weeks after the application of TBA. Treatment was supple-mented by a program of physical therapy. Results: The patient had markedimprovement of her symptoms especially decrease of paresthesias andTinnel disappearance as well as DASH score reduction from 45 to 33 andMHQ improvement from 47% to 68%. Discussion: This is the first case
report with the use of TBA as treatment of Wartenberg’s syndrome wheregood clinical and DASH/MHQ response were obtained. Application of TBAin the ECRB, ECRL and brachioradialis could decrease the compression ofthe sensory branch of the radial nerve which has been described between themuscle bellies of the ECRB, ECRL and brachioradialis by causing muscleatrophy and partial decrease in strength by the known mechanism of theTBA. Conclusions: The application of TBA could represent an alternativeof easy application treatment low cost and reproducible in the conservativemanagement of Wartenberg’s syndrome when the compression is suspectedbetween the ECRB, ECRL muscles and brachioradialis and there is nohistory of distal radius fracture, Quervain’s disease or any other cause ofexternal compression.
No. 381 Eficacia de la Toxina Botulínica Tipo A Aplicadaen Vasto Lateral y Cintilla Iliotibial en el Manejo DelSíndrome Doloroso Patelofemoral.A. Trujillo Millán; A. Izquierdo Heredia; E. Díaz Jaimes;Gutiérrez Sandoval J.
Objetivo: Evaluar la eficacia del tratamiento con toxina botulínica tipo A(TBA) en pacientes con síndrome doloroso patelofemoral (SDPF) aplicadoen vasto lateral y cintilla iliotibial. Diseño: Se realizó un estudio pro-spectivo longitudinal experimental aleatorizado. Ubicación: Toluca.Participantes: 11 pacientes de entre 24 a 48 años de edad 18 rodillas entotal con diagnóstico de sdpf sin antecedente de traumatismo enfermedadarticular degenerativa o lesión derivada de prácticas deportiva. Inter-venciones: Los pacientes fueron asignados en forma aleatoria para laaplicación de tba en cintilla iliotibial y vasto lateral y en los pacientes conSDPF bilateral en una de las rodillas se aplico placebo. Ambos grupospasaron a un programa de rehabilitación física de 12 sesiones. Para laevaluación de los pacientes se aplicó la escala: anterior knee pain score(AKPS) antes y dos meses después de la aplicación de TBA. Nivel deevidencia: I. Resultados: De acuerdo al AKPS los valores obtenidosantes de la aplicación de tba fueron: promedio 48.81 puntos del grupoexperimental y 55.77 puntos promedio del grupo control y a los 2 mesesdespués de la aplicación de TBA promedio 64.18 puntos para el grupoexperimental (diferencia de 15.37) y de 64.55 puntos promedio para elgrupo control (diferencia de 8.78). La mejoría observada fue en el grupoexperimental que en el grupo placebo principalmente en: uso de escaleraspermanecer sentado con las rodillas flexionadas dolor inflamación y movi-mientos anormales y dolorosos de la rótula. Conclusiones: La aplicaciónde TBA junto con un programa de estiramientos y fortalecimientos puedetener un rol importante restableciendo el balance muscular en pacientes conSDPF disminuyendo así la sintomatología. Este estudio proporciona unaalternativa novedosa en el tratamiento de los pacientes con SDPF en loscuales otras alternativas no han sido suficientes.
No. 383 Multidisciplinary Care of Muscle Strain Grade 2 inLeft Gastrocnemius of a Football Center: A Case Report.Luis Gerardo Vázquez Villarreal; Jaime García Rodríguez, MD.
Patient: A 28-year-old male football center under sport medical supervi-sion with muscle strain grade 2 on the left gastrocnemius. CaseDescription: Post-ultrasound diagnosis and clinical symptoms the athletereceived multidisciplinary attention from sports medicine, physiotherapyand nutrition. In a period of 4 weeks; every 2 days he received cryomassagesessions, laser to 11000 Hz 18.0 joules for 6 minutes, kinesiology tapingapplications with 5-10% tensions. On the 2nd week closed kinetic chainexercises involving eccentric heel drop exercises were added. On the 3rdweek functional exercises to the race and to maintain cardiovascular fitnesswere added. As an additional measure a reduction of daily caloric intakeassociated with the rest period was made. Oral supplementation was addedwith 1 gram daily of vitamin “C” for a month and 200 mg every 8 hours of
