Effect of the association of infra-red and red wavelength photobiomodulation therapy on the healing of post-extraction sockets of third lower molars: a split-mouth randomized clinical trial

Lasers in Medical Science - The aim of this study was to evaluate the effect of photobiomodulation therapy (PBMT) with the association of red and infra-red laser therapy in the healing of the...     

The influence of tongue strength on children's performance in computer games reliant on lingual force generation

Oral motor exercises, for recovering tongue strength, can be integrated with computer games to increase motivation, especially for treatments in children. The aim of this study was to investigate the influence of tongue strength on motor performance in computer games reliant on lingual force generation. An observational study was carried out at a speech-language pathology outpatient university clinic. Twenty participants (10 with normal tongue strength and 10 with reduced tongue strength) aged 8-13 years used an intra-oral joystick controlled by the tongue to play six computer games during which they had to reach targets that appeared on the screen. Motor performance was measured by the number of attempts to score and the time during which the target force was maintained. Tongue motor performance was compared between groups and across directions of tongue movement, resistance force levels, order of target appearance, continuous force application time on the target, age and sex. Children with normal tongue strength had a lower number of attempts to score (P = .014) and maintained the target force for longer periods (P = .002) than those with reduced tongue strength. The performance was better for both groups (a) in the downward direction compared with the performance in other directions, (b) in games with the lowest resistive force level (0.5 N) compared to those with other levels of resistive force and (c) in the second and third rounds compared with the first round. There were no gender-related differences in performance. Older participants performed better than younger participants. Tongue strength, direction of movement, force to reach the target, time of continuous force application, order of target appearance and age influenced tongue motor performance.     

Knee isokinetic muscle strength and balance ratio in female soccer players of different age groups: a cross-sectional study

ABSTRACT

Background: As a consequence of years of soccer training and sexual maturation, there is an increase in lower body muscle mass and strength especially in the knee extensors and flexors muscles. In this context, the lack of knee joint stability, resulting from strength imbalance between knee extensor and flexors muscles, has been associated with knee injuries. The aim of this study was to compare the knee flexor and extensor muscle peak torque, average power, contralateral deficit, conventional and functional balance ratios of female soccer players from different age groups.

Methods: Sixty-six female soccer players were divided into four groups: under 13 (U13), under 15 (U15), under 17 (U17) years old and professional (PRO). Flexor and extensor knee muscle strength in concentric and eccentric actions of both limbs were assessed using isokinetic dynamometer.

Results: For the dominant limb, the knee concentric extensor muscles peak torques, assessed at 60 and at 240 deg/sec, and the average power of U15 group were significantly higher than U13 group. Extensor muscle average power of the PRO group was higher than U17. Dominant knee flexor average power of U15 was significantly higher than the U13 group. Peak torque at 60 deg/sec and 240 deg/sec and average power of the PRO group were higher than the U17 group. No differences were found regarding the eccentric action for flexor and extensor muscles. Conventional and functional balance ratios were similar among all age group, except for U13, which presented higher values than the U15 group for the dominant limb.

Conclusions: The greatest improvement in muscular performance occur when the athlete starts practicing soccer (after U13) and when they become professional (after U17) and the balance ratios, and muscle balance ratios remain stable in all age groups, although they are below the recommended level in the literature, which may increase the risk for lower limb injury.     

Deep Brain Stimulation Compared With Contingency Management for the Treatment of Cocaine Use Disorders: A Threshold and Cost-Effectiveness Analysis

ObjectivesCocaine is the second most frequently used illicit drug worldwide (after cannabis), and cocaine use disorder (CUD)-related deaths increased globally by 80% from 1990 to 2013. There is yet to be a regulatory-approved treatment. Emerging preclinical evidence indicates that deep brain stimulation (DBS) of the nucleus accumbens may be a therapeutic option. Prior to expanding the costly investigation of DBS for treatment of CUD, it is important to ensure societal cost-effectiveness.AimsWe conducted a threshold and cost-effectiveness analysis to determine the success rate at which DBS would be equivalent to contingency management (CM), recently identified as the most efficacious therapy for treatments of CUDs.Materials and MethodsQuality of life, efficacy, and safety parameters for CM were obtained from previous literature. Costs were calculated from a societal perspective. Our model predicted the utility benefit based on quality-adjusted life-years (QALYs) and incremental-cost-effectiveness ratio resulting from two treatments on a one-, two-, and five-year timeline.ResultsOn a one-year timeline, DBS would need to impart a success rate (ie, cocaine free) of 70% for it to yield the same utility benefit (0.492 QALYs per year) as CM. At no success rate would DBS be more cost-effective (incremental-cost-effectiveness ratio <$50,000) than CM during the first year. Nevertheless, as DBS costs are front loaded, DBS would need to achieve success rates of 74% and 51% for its cost-effectiveness to exceed that of CM over a two- and five-year period, respectively.ConclusionsWe find DBS would not be cost-effective in the short term (one year) but may be cost-effective in longer timelines. Since DBS holds promise to potentially be a cost-effective treatment for CUDs, future randomized controlled trials should be performed to assess its efficacy.