Computherized Termography in the Identificacion of MIOFASCIAL TRIGGER POINTS

Luciane Fachin Balbinot

2009 — 1ª edição

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ISBN: 9788561209803
Páginas: 132
Formato: 17x24 cm
Ano de Publicação: 2009
Peso: 0.280 kg

Conteúdo

CHAPTER 1 - INTRODUCTION
1.1. PROBLEM
1.2. OBJECTIVES
1.2.1. General
1.2.2. Specifics
1.3. DEFINING VARIABLES
1.3.1. Depending variables
1.3.2. Independent variables
1.3.3. Controlled variables
1.3.4. Intervening variables
1.3.5. Categorical variables
1.4. DEFINITION OF TERMS
1.5. DELIMITATION OF THE STUDY
1.6LIMITATIONS OF THE STUDY

CHAPTER 2 - THEORETICAL FUNDAMENTS AND BIBLIOGRAPHIC REFERENCES
2.1. TRIGGER POINTS AND TENDER POINTS
2.2. MUSCLE-SKELETIC PAIN: MYOFASCIAL SYNDROME AND FIBROMYALGIA
2.2.1. Myofascial Syndrome
2.2.1.1. Epidemiology
2.2.1.2. Acute Myofascial Syndrome
2.2.1.3. Chronic Myofascial Syndrome
2.2.1.4. Treatment
2.3. PHYSICAL EXAM IN THE MYOFASCIAL SYNDROME AND PRESSURE ALGOMETRY
2.3.1. Pressure Algometry
2.3.2. Trapezius muscle, its trigger points and areas of reference of pain, symptoms and autonomic signs
2.4. DIFFERENTIAL DIAGNOSIS
2.4.1. Fibromyalgia
2.5. CENTRAL PAINFUL SENSITIVIZATION
2.6COMPUTERIZED THERMOGRAPHY
2.6.1. Clinical Thermography
2.6.2. Historic
2.6.3. Applications of the computerized thermography in the medical clinic
2.6.3.1. Thermography in the diagnosis of the Myofascial Syndrome
2.6.3.2. Rheumatic pathologies
2.6.3.3. Peripheral neuropathies and radiculopathy
2.6.3.4. Orthopedic pathologies and temporomandibular articulation disorders
2.6.3.5. Pain of sympathetic origin (Complex Regional Painful Syndrome with sympathetic component)
2.6.3.6Vascular diseases and cardiovascular surgeries
2.6.3.7. Oncology
2.7. PHYSIOLOGY OF THE ALTERATION OF THE SKIN TEMPERATURE AND ITS CLINICAL INTERPRETATION
2.7.1. Role of the Sympathetic Nervous System (SNS) in the regulation of temperature
2.7.2. The role of the nitrous oxide in the localized increase of the skin temperature
2.7.3. Causes of Hot Spots
2.7.4. Provocative maneuvers
2.8. THE NORMAL THERMOGRAPHY
2.9. HOW TO VALUE THE THERMOGRAPHIC EVENTS: THE COMPUTERIZED THERMOGRAPHY AS DIAGNOSTIC METHOD

CHAPTER 3 - MATERIALS AND METHODS
3.1. CHARACTERISTIC OF THE RESEARCH
3.2. CASUISTRY
3.2.1. Target audience
3.2.2. Invitation
3.2.3. Criteria of Inclusion
3.2.4. Criteria of Exclusion
3.2.5. Characteristics of the sample as to the threshold of tolerance to painful pressure
3.2.6Characteristics of the sample as to the time of pain and intensity of the painful complaint (VAS)
3.3. METHODS
3.3.1. Instruments utilized in the study
3.3.1.1. Clinical interview
3.3.1.2. Visual Analogical Scale (VAS)
3.3.1.3. The diagram of pain
3.3.1.4. Pressure algometry
3.3.1.5. Computerized Thermography
3.3.1.5.1. Description of the behavior of the thermographies in different positions of collect
3.4. PROCEDURES OF COLLECTION OF DATA
3.4.1. Clinical interview
3.4.2. Protocol of physical exam
3.4.3. Protocol for the collect of the thermograms
3.5. REPRODUCIBILITY OF THE TESTS
3.6PROCESSING AND TREATMENT OF THE DATA
3.6.1. Statistical Analysis
3.7. RADIOLOGICAL AND LABORATORY EXAMINATIONS
3.8. CONSENT FOR PARTICIPATION

CHAPTER 4 - PRESENTATION OF RESULTS AND DISCUSSION
4.1. DESCRIPTION OF THE DIAGRAM OF PAIN
4.2. DESCRIPTION OF THE MEASURES WITH PRESSURE ALGOMETER
4.2.1. Normal threshold of tolerance to pressure by algometry
4.3. IDENTIFICATION OF THE TRIGGER POINTS: COMPARISON WITH ALGOMETRY AND DIAGRAM OF PAIN
4.3.1. Subjects with trigger points identified by thermography and algometry
4.3.2. Subjects with the majority of the trigger points identified by the thermography and algometry and trigger point(s) identified only by thermography
4.3.3. Subjects with trigger points identified by the thermography and with invalid algometry (threshold of tolerance to painful pressure lower than normal standard)
4.3.4. Subjects with trigger points identified by the thermography and algometry and trigger point(s) not signaled in the diagram of pain (without algometry)
4.4. DISCUSSION

CHAPTER 5 - CONCLUSIONS AND SUGGESTIONS OF CONTINUITY

CHAPTER 6- REFERENCES

ATTACHMENTS

Sinopse

Computerized thermography, system with ability to capture the infrared light emissivity of any reflexive surface, is part of the current arsenal of instrumentation in biomechanics.  Using this methodology, it is possible to assess the physiology of thermical maintenance through its skin surface representation.  The aim of this work is to assess the thermography as the identification method of myofascial trigger points, been chosen the trapezius muscle as study focus since it is one of most affected body regions concerning myofascial syndrome.  This syndrome is highly prevalent and historically sub-diagnosticated as it requires expert professionals to establish its diagnostic, through physical examination. The participants of this study were gathered as a sample of thirty persons, fifteen men and fifteen woman, ages between twenty three and seventy years (32,5 years in average). The algometry by pressure, highly validated method on previous works, has been used as part of physical examination to confirm the thermography events. The equipment used to collect the thermograms was an infrared camera with digital image processing, with thermical sensitivity for spectral ranges from 7 to 12 micrometers, appropriate for medical diagnostic utilization; the error index for measurement on this equipment is either 2% or 2oC. It has been used a dynamometer, clock type, for the algometry, commercially available for clinical use, which makes it possible to assess the applied pressure to the focal point. The trigger point identification was based in a pain diagram filled by the own subject using previously validated parameters. The imaging assessment was done using a deive analysis, having been taking in consideration the thermographic event corresponding to the trigger point, the hot spot or a discoid shaped surface, with one or more degrees Celsius hotter if compared to the neighbor reference point. Algometry was used in this work as reference method. Deive statistics were applied to assess sensibility and specificity in trapezius Myofascial Syndrome diagnoses. A totality of 250 trigger points had been founded: 198 (79.20%) identified by algometry and thermography; 41 points (16.40%) by thermography only; 11(4.40%) identified by algometry only.  It was concluded that the thermograpy is an appropriated method for Myofascial Syndrome diagnostic on trapezius muscle.

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