Efektivitas Friction Massage Terhadap Mengurangi Nyeri Pada Kasus Myofascial Trigger Point Syndrome Otot Upper Trapezius

Background: Myofascial trigger point syndrome is a musculoskeletal disorder characterized by the presence of a trigger point in a sensitive area within the skeletal muscle band linkages, if pressure is applied to the area it will cause specific pain at a point that is pressed (tenderness). Myofascial trigger point syndrome is influenced both by mechanism and by positioning factors. Myofascial trigger point syndrome upper trapezius muscle radiates along the upper back and neck, behind the ears and at the temples. Methods: The research method used is in the form of a case study with 1 patient who was given physiotherapy intervention and evaluation 4 times. To overcome the problem of muscle pain in bilateral trapezius m.upper in this study, using manual physiotherapy intervention therapy in the form of friction massage. Result: The results obtained, there was a decrease in tenderness in the upper trapezius muscle VAS 5 during the first evaluation to VAS 2 at the fourth evaluation with an average VAS value pre and post after one month for four interventions, namely 1.72. The MDC value (95) is 0.196 and the MCID range is 0.88-1.7, and 1.46-2.28. Conclusion: Based on these results, it can be concluded that physiotherapy intervention with the manual method of therapy, friction massage is considered effective in reducing pain in patients with myofascial trigger point syndrome, upper trapezius muscle with visual analogues scale (VAS) parameters. Keyword : Myofascial Trigger Point Syndrome, Manual Therapy, Friction Massage

A Woman with Double Chamber Right Ventricle

Introduction: An additional membrane or muscle band inside right ventricle divides it into two chambers, the proximal and distal one. It is a rare congenital malformation which makes up approximately 0.5-1 per cent of all congenital heart defects. The double chambers right ventricle most often present in children but rarely in adults. Transoesophageal Echocardiography is the most effective tool in diagnosing a DCRV.Case presentation: A 36 years old woman, diagnosed with large ventricular septal defect by transthoracic echocardiography, underwent a TOE to complement the preparation of surgical closure. The TOE finding instead revealed a septum or membrane that divide the right ventricle into two separate chambers, later confirmed by a cardiac computer tomographic scan and cardiac cathetherization. The patient underwent surgery with VSD closure and resection of the septum without complications. Echocardiography paramater became normal albeit still had some septal tissue left in order to limit sudden surge of blood flow into pulmonary artery. Follow up indicate patient has no symptom associated with the surgeryConclusion: The patient was diagnosed with double chamber right ventricle during preparation for surgery by TOE examination. We present this case in order to emphasize the rarity of this congenital heart disease

Assessment of the effect of stretching the muscles posterior thigh and shin onthe intensity of cervicalgia and patient′s posture

Introduction. The human body is a single system of interconnected organs that are connected not only anatomically, but also functionally. The most extensive fascial-muscular associations are called «anatomical trains» (the concept of Thomas Myers), the impact on which can cause changes at a significant distance from the point of application of force. The available literature describes the effect of stretching hamstrings (an important component of the «surface posterior muscle band») on changes in the function of the temporomandibular joint, lumbodynia, mobility of the lumbosacral spine and hip joints. However, the values of stretching hamstings on human posture and reducing cervicalgia were not evaluated.The goal of research — investigate the effect of active isolated stretching of the muscles posterior thigh and shin on the intensity of cervicalgia and patient posture.Materials and methods. The material for this work is the results of observation of 17 patients aged 15–17 years with cervicalgia of various genesis, who are under inpatient treatment for spinal deformities with a distinct increase in the severity of thoracic physiological kyphosis (juvenile osteochondrosis, dysplastic kyphoscoliosis, cervical spine dysplasia, etc.). Patients performed daily physical exercises for 12 days with active isolated stretching of the muscles of the posterior surface of the thigh and lower leg (according to the concept of Thomas Myers — «surface posterior muscle band»). The orthopedic status and clinical condition of patients were evaluated. Instrumental diagnostics was performed by the method of topography of optical deformities of the spine (TODS) (Novosibirsk, «Medical topographic systems» — LLC «METOS»), as well as using a standard tablet computer with a software application (patent RU 2638644) «Smart-Ortho 2D» for Android. The intensity of pain in the cervical spine was assessed by the doctor using a dynamometer-algometer, as well as by the patients themselves on the VAS scale.Results. During the initial clinical examination, 14 out of 17 (or 82 % of cases) observed patients with complaints of cervicalgia registered femoral-lumbar rigidity. It was most pronounced in the limitations of the Tomayer test (the forward tilt of the torso). In 15 patients (88 %), the value of thoracic physiological kyphosis exceeded the norm (20–23 mm according to TODS data) by 6–43 mm. Active isolated stretching of the posterior thigh and lower leg muscles resulted in complete elimination of pain syndrome in all patients in the study group. With regard to kyphotic posture, we note that these therapeutic measures did not cause significant changes in the parameters of the sagittal profile of the vertebral column, but there was a clear trend to reduce the severity of thoracic kyphosis with simultaneous deepening of lumbar lordosis. The angle of the anterior pelvic tilt changed (increased) according to the TODS data. The Tomayer test began to approach the norm in 12 people (70,5 %).Conclusion. The use of active isolated exercises aimed at stretching the «surface posterior muscle band» in the observed group of patients contributed to the complete relief of pain in 100 % of cases. At the same time, these therapeutic measures did not have a significant effect on the severity of physiological sagittal bends and pelvic tilt. The results of clinical observation of patients with cervicalgia of various genesis, being treated and using a set of exercises with active isolated stretching of muscles posterior thigh and shin, make it possible to recommend this complex for using. The simplicity of the exercises does not cause any difficulties in performing, which makes it understandable and accessible for general prophylaxis.

Detailed Anatomy of the Lateral Rectus Muscle-Superior Rectus Muscle Band

Background. To elucidate the detailed anatomy of the lateral rectus muscle-superior rectus muscle (LR-SR) band by cadaver eye investigation. Methods. In total, 48 eyes of 24 cadavers were observed macroscopically. The lateral rectus muscle (LRM) and superior rectus muscle (SRM) were dissected from their origins to their insertions under the dissecting microscope, and the location, width, length, and tensile strength of the LR-SR bands were measured. Results. The LR-SR band is the thick ligament interconnecting LRM pulleys with SRM pulleys. The LR-SR band was covered by the orbital part of the lacrimal gland superiorly, and the intermuscular septum between the LRM and SRM was shown anterior to the LR-SR band. The length of the attachment site between the LR-SR band and the SRM was less at 8.64 ± 1.52 mm (p=0.040), its thickness was thinner at 0.74 ± 0.16 mm (p=0.002), and its tensile strength was weaker at 7.64 ± 1.82 N (p=0.028) compared to the attachment site between the LR-SR band and the LRM. Conclusions. This study revealed the detailed anatomy of the LR-SR band and provided helpful information to understand heavy eye syndrome and sagging eye syndrome.

Isolated Infundibular Pulmonary Stenosis in Adult

Isolated infundibula pulmonary stenosis (UPS) in adult is an uncommon cardiac abnormality. Infundibula pulmonary stenosis leading to right ventricular hypertrophy is a big problem. Early excision of hypertrophied muscular band can overcome this problem. In our case report we have done excision of pulmonary infundibula muscle band of a late case of isolated pulmonary infundibula stenosis. And our patient showed a good response after excision of infundibula muscle band.University Heart Journal Vol. 13, No. 2, July 2017; 65-66

Isolated Infundibular pulmonary Stenosis in adult: a case report

Isolated infundibular pulmonary stenosis (IIPS) in adult is an uncommon cardiac abnormality. Infundibular pulmonary stenosis leading to right ventricular hypertrophy is a big problem. Early excision of hypertrophied muscular band can overcome this problem. In our case report we have done excision of pulmonary infundibular muscle band of a late case of isolated pulmonary infundibular stenosis. And our patient showed a good response after excision of infundibular muscle band. DOI: http://dx.doi.org/10.3329/jdmc.v23i1.22711 J Dhaka Medical College, Vol. 23, No.1, April, 2014, Page 140-142