Ciencias de la Salud
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Item Fisioterapia para mejorar las respuestas sensoriales y funcionales en tobillo y pie en pacientes con neuropatía periférica diabética(Universidad Técnica de Ambato/ Facultad de Ciencias de Salud /Carrera de Fisioterapia, 2023-03-01) García Camacho, Víctor Manuel; Espín Pastor, Victoria Estefanía Lic. Msc.Diabetic peripheral neuropathy is one of the most common pathologies in the world, for this reason the present study had the purpose of determining the effect of physiotherapeutic intervention strategies on sensory and functional responses in the ankle and foot in patients with DPN. The evaluations were carried out on two occasions, before and after the intervention, the evaluations of the Michigan Neuropathy Screening Instrument test, which contains two parts, the first has a form of 15 questions about the symptoms, while the second part, itself is the physical examination, the following tests were the 10g SemmesWeinstein monofilaments and the manual dynamometer test in the ankle and foot. The research project included 17 patients, the physiotherapy intervention consisted of strengthening exercises for platiflexion, dorsiflexion and intrinsic foot muscles, and balance, for a period of 8 weeks, for one day of supervision and the rest for patients independently. The results consisted of the Michigan test, the results did not show significant changes, while the Monofilament test and the manual dynamometry test, the changes were significantlywith a value of p= <0.00. Concluding that the application of the exercisesof ankle and foot showed positive changes for foot and ankle sensitivity and strength, xii while there were no significant changes to improve symptoms and signs according to the Michigan test.Item Estrategias de intervención fisioterapéutica en muñeca y mano para mejorar las respuestas sensoriales y funcionales en pacientes con neuropatía periférica diabética(Universidad Técnica de Ambato/ Facultad de Ciencias de Salud /Carrera de Fisioterapia, 2023-03-01) Naranjo Quinteros, Juan Gabriel; Reales Chacón, Lisbeth Josefina Dra.Diabetic peripheral neuropathy (DPN) is a pathology that affects both sensory and motor neurons, causing a decrease in sensitivity, nerve conduction velocity, as well as affecting hand dexterity and maximum grip strength. The aim of this study was to perform a physiotherapeutic intervention on the hand and wrist for 8 weeks to improve their sensory and functional responses. It was performed under a quantitative - analytical, prospective longitudinal approach, applying the evaluation instruments whose results were statistically analyzed by means of the SPSS program. For this purpose, 34 patients with NPD were required at the beginning, but only 17 were able to complete the 8 weeks of intervention. They were subjected to evaluations which consisted of assessing their sensory responses (tactile, thermal, vibratory, pressure and reflex sensitivity) and functional responses (maximum grip strength by dynamometry) before and after the intervention. The intervention consisted of resistance exercises to strengthen wrist and hand flexor and extensor muscles. The results showed that the individuals significantly im proved their grip strength compared to their initial state (p=0.000) there was also a significant improvement in the percentage of reflex evaluation (17.6% normal at the beginning - 76.5% at the end). The data obtained from the evaluation of sensitivity had positive results; however, the initial and final relationship was not significant (p=0.323). The findings showed that it wasxii demonstrated that. The intervention with physiotherapeutic exercise in wrist and hand served to improve sensory and functional responses in the population with NPD.Item Estrategias de intervención con movilizaciones neurales para mejorar las respuestas sensoriales y funcionales en la neuropatía periférica diabética(Universidad Técnica de Ambato/ Facultad de Ciencias de Salud /Carrera de Fisioterapia, 2023-03-01) Mayorga Reinoso, Alba Selena; Reales Chacón, Lisbeth Josefina Dra.Type 2 diabetes mellitus is a condition in which glucose levels are not normal and cause damage to peripheral nerve fibers causing diabetic neuropathy, being the most frequent the sensory-motor, whose symptoms include altered tactile perception, temperature, loss of sensation in hands and feet. The evidence of treatments that include neural mobilization is limited, so the aim of this study is to determine whether intervention strategies with neural mobilization improve sensory and functional responses in diabetic peripheral neuropathy. A quantitative-analytical, prospective longitudinal study was carried out. Applying the instruments and whose results were statistically evaluated through the SSPSS program. The instruments applied correspond to a clinical record for the collection of relevant data such as age, sex, BMI, personal pathological history, the Michigan test that carries a questionnaire of 15 questions related to the symptoms in the last week and an exploratory physical examination to know the patient's condition (foot morphology, skin condition, ulcers, amputations), evaluation of tactile and thermal sensitivityxiv (dermatomas: C5, C6, C7, C8, T1, L2, L3, L4, L5, S1, S2) and vibratory (olecranon, radial styloid, external malleolus and hallux), dynamometry where the maximum hand grip strength and foot dorsiflexion strength are evaluated; these instruments applied pre and post treatment. Being a small sample, the entire population of 37 diabetic individuals was included in the intervention with neural mobilizations of sliding type for the median, radial, ulnar, sciatic and peroneal nerves, in daily sessions during 8 weeks. In the relationship of variables, the Student's T revealed data of a significant improvement in this group since the second evaluation obtained positive results after the intervention, where the strategies of sliding neural mobilization for upper and lower limb are optimal to reduce symptoms such as cramps, numbness, loss of sensitivity to touch, temperature and vibration in hands and feet. However, these strategies do not affect foot morphology and skin appearance. These results provide reliability of neural mobilization as a conservative treatment in diabetic peripheral neuropathyItem Programa de ejercicios para mejorar la biomecánica de la marcha en pacientes con neuropatía periférica diabética(Universidad Técnica de Ambato/ Facultad de Ciencias de Salud /Carrera de Fisioterapia, 2023-03-01) Gutiérrez Mestanza, Damián Alejandro; Espín Pastor, Victoria Estefanía Lcda. Mg.Diabetic peripheral neuropathy is one of the long-term complications of diabetes caused by dysfunction of the peripheral motor and sensory nerves because the sequelae of the disease can damage the biomechanics of gait. Therefore, the objective was to determine the effect of an exercise program to improve the biomechanics of gait in patients with diabetic peripheral neuropathy. The methodology used was a quantitative approach of analytical intervention since it has more than two variables, prospective and longitudinal. The intervention lasted 8 weeks with an initial and final evaluation. The population consisted of 17 patients. The intervention consisted of lower limb exercises and gait re-education. The results obtained with the Observational Gait Analysis test, in the different variables do not show significant changes, also in the characteristics of the march, the speed of the march, the cadence and stride were measured, where significant favorable changes were seen in the cade nce, where shows a value of p= >0.000 this in comparison of the initial and final evaluation. It was concluded that the exercises can help improve the biomechanics of gait in older adults with diabetic neuropathy by reducing the time between strides, cadence and gait speed, thus improving the quality of life.Item Estrategias de movilizaciones neurales para mejorar las respuestas sensoriales y funcionales en adultos mayores con neuropatía periférica diabética(Universidad Técnica de Ambato/ Facultad de Ciencias de Salud /Carrera de Fisioterapia, 2023-03-01) Arias Andrade, Katherin Michelle; Ortiz Villalva, Paola Gabriela Lcda. MscThe objective of the research was to determine the efficacy of neural m obilization strategies to improve sensory and functional response in older adults with diabetic peripheral neuropathy. The methodology was quantitative research approach because data we re collected with numerically measurable instruments, analytical prospective longitudinal type, descriptive because it had an evaluation under the parameters of: Michigan Neuropathy Screening Instrumental MNSI, sensitivity test and neural mobilization, the population consisted of 34 adults. The main conclusion, the exercise program performed to diabetic patients with peripheral neuropathy decreased the most common neuropathic symptoms such as pain and numbness in legs and feet, in turn improved the perception of thermal and tactile sensitivity in the L3-L4-S1 dermatomes which are the most affected in this population. There is also an increase in lower limb strength improving balance and gaitItem “Tratamiento quirúrgico y clínico y su incidencia en pacientes con pie diabético en el área de medicina interna del hospital provincial general docente Ambato en el período enero- diciembre 2009”(Universidad Técnica de Ambato - Facultad de Ciencias de la Salud - Carrera de Medicina, 2010-03-01) Pérez Ortiz, Jadira Alexandra; Dr. Bolívar Guerrero