MARTA IMAMURA
Projetos de Pesquisa
Unidades Organizacionais
Departamento de MedicinaLegal, Ética Médica e Medicina Social e do Trabalho, Faculdade de Medicina - Docente
Instituto de Ortopedia e Traumatologia, Hospital das Clínicas, Faculdade de Medicina - Médico
LIM/41 - Laboratório de Investigação Médica do Sistema Músculoesquelético, Hospital das Clínicas, Faculdade de Medicina
LIM/40 - Laboratório de Imunohematologia e Hematologia Forense, Hospital das Clínicas, Faculdade de Medicina
Instituto de Ortopedia e Traumatologia, Hospital das Clínicas, Faculdade de Medicina - Médico
LIM/41 - Laboratório de Investigação Médica do Sistema Músculoesquelético, Hospital das Clínicas, Faculdade de Medicina
LIM/40 - Laboratório de Imunohematologia e Hematologia Forense, Hospital das Clínicas, Faculdade de Medicina
61 resultados
Resultados de Busca
Agora exibindo 1 - 10 de 61
- Paraspinous Lidocaine Injection for Chronic Nonspecific Low Back Pain: A Randomized Controlled Clinical Trial(2016) IMAMURA, Marta; IMAMURA, Satiko Tomikawa; TARGINO, Rosa Alves; MORALES-QUEZADA, Leon; TOMIKAWA, Luis C. Onoda; TOMIKAWA, Luis G. Onoda; ALFIERI, Fabio M.; FILIPPO, Thais R.; ROCHA, Ivan D. da; NETO, Raul Bolliger; FREGNI, Felipe; BATTISTELLA, Linamara RizzoIn this large, sham-controlled, randomized trial, we examined the efficacy of the combination of standard treatment and paraspinous lidocaine injection compared with standard therapy alone in subjects with chronic low back pain. There is little research-based evidence for the routine clinical use of paraspinous lidocaine injection for low back pain. A total of 378 subjects with nonspecific chronic low back pain were randomized to 3 groups: paraspinous lidocaine injection, analgesics, and exercises (group 1, LID-INJ); sham paraspinous lidocaine injection, analgesics, and exercises (group 2, SH-INJ); and analgesics and exercises (group 3, STD-TTR). A blinded rater assessed the study outcomes at 3 time points: baseline, after treatment, and after 3 months of follow-up. There were increased frequency of pain responses and better low back functional scores in the LID-INJ group compared with the SH-INJ and STD-TTR groups. These effects remained at the 3-month follow-up but differed between all 3 groups. There were significant changes in pain threshold immediately after treatment, supporting the effects of this intervention in reducing central sensitization. Paraspinous lidocaine injection therapy is not associated with a higher risk of adverse effects compared with conventional treatment and sham injection. Its effects on hyperalgesia might correlate with changes in central sensitization. (C) 2016 Published by Elsevier Inc. on behalf of the American Pain Society
- 2012-An ISPRM Landmark Year(2013) IMAMURA, Marta; GUTENBRUNNER, Christoph; LI, Jianan; LAINS, Jorge; FRONTERA, Walter; OLVER, John; STUCKI, Gerold
- Physical Medicine and Rehabilitation in Latin America: Development and Current Status(2019) SCHIAPPACASSE, Carolina; GUZMAN, Juan Manuel; DEAN, Maria Herrera; CORLETTO, Sandra; BATTISTELLA, Linamara Rizzo; IMAMURA, Marta; GUTIERREZ, Jorge; BORELLI, Graciela; MUZIO, Diana; MICHEO, WilliamDisability disproportionately affects women, older individuals, and ethnic minorities in low-income countries, many of which are located in Latin America. Physical Medicine and Rehabilitation (PM&R) is the medical specialty that manages disability and works on restoring function, and over the past 6 decades has significantly expanded its importance in Latin America. The specialty has developed graduate and postgraduate educational programs, provides services to individuals of all ages in inpatient and outpatient settings, has increased its research productivity, and has become an advocate for patients with disabling conditions, which has resulted in improved access to care for many patients.
- Increased motor cortex inhibition as a marker of compensation to chronic pain in knee osteoarthritis(2021) SIMIS, Marcel; IMAMURA, Marta; MELO, Paulo S. de; MARDUY, Anna; PACHECO-BARRIOS, Kevin; TEIXEIRA, Paulo E. P.; BATTISTELLA, Linamara; FREGNI, FelipeThis study aims to investigate the associative and multivariate relationship between different sociodemographic and clinical variables with cortical excitability as indexed by transcranial magnetic stimulation (TMS) markers in subjects with chronic pain caused by knee osteoarthritis (OA). This was a cross-sectional study. Sociodemographic and clinical data were extracted from 107 knee OA subjects. To identify associated factors, we performed independent univariate and multivariate regression models per TMS markers: motor threshold (MT), motor evoked potential (MEP), short intracortical inhibition (SICI), intracortical facilitation (ICF), and cortical silent period (CSP). In our multivariate models, the two markers of intracortical inhibition, SICI and CSP, had a similar signature. SICI was associated with age (beta: 0.01), WOMAC pain (beta: 0.023), OA severity (as indexed by Kellgren-Lawrence Classification) (beta: - 0.07), and anxiety (beta: - 0.015). Similarly, CSP was associated with age (beta: - 0.929), OA severity (beta: 6.755), and cognition (as indexed by the Montreal Cognitive Assessment) (beta: - 2.106). ICF and MT showed distinct signatures from SICI and CSP. ICF was associated with pain measured through the Visual Analogue Scale (beta: - 0.094) and WOMAC (beta: 0.062), and anxiety (beta: - 0.039). Likewise, MT was associated with WOMAC (beta: 1.029) and VAS (beta: - 2.003) pain scales, anxiety (beta: - 0.813), and age (beta: - 0.306). These associations showed the fundamental role of intracortical inhibition as a marker of adaptation to chronic pain. Subjects with higher intracortical inhibition (likely subjects with more compensation) are younger, have greater cartilage degeneration (as seen by radiographic severity), and have less pain in WOMAC scale. While it does seem that ICF and MT may indicate a more acute marker of adaptation, such as that higher ICF and MT in the motor cortex is associated with lesser pain and anxiety.
- EXPLORING A LONG-TERM GLOBAL APPROACH FOR MUSCULOSKELETAL ULTRASOUND TRAINING: WORLD-MUSCULUS(2012) IMAMURA, Marta; OZCAKAR, Levent; FREGNI, Felipe; HSING, Wu Tu; BATTISTELLA, Linamara Rizzo
- Massage for low-back pain(2015) FURLAN, Andrea D.; GIRALDO, Mario; BASKWILL, Amanda; IRVIN, Emma; IMAMURA, MartaBackground Low-back pain (LBP) is one of the most common and costly musculoskeletal problems in modern society. It is experienced by 70% to 80% of adults at some time in their lives. Massage therapy has the potential to minimize pain and speed return to normal function. Objectives To assess the effects of massage therapy for people with non-specific LBP. Search methods We searched PubMed to August 2014, and the following databases to July 2014: MEDLINE, EMBASE, CENTRAL, CINAHL, LILACS, Index to Chiropractic Literature, and Proquest Dissertation Abstracts. We also checked reference lists. There were no language restrictions used. Selection criteria We included only randomized controlled trials of adults with non-specific LBP classified as acute, sub-acute or chronic. Massage was defined as soft-tissue manipulation using the hands or amechanical device. We grouped the comparison groups into two types: inactive controls (sham therapy, waiting list, or no treatment), and active controls (manipulation, mobilization, TENS, acupuncture, traction, relaxation, physical therapy, exercises or self-care education). Data collection and analysis We used standard Cochrane methodological procedures and followed CBN guidelines. Two independent authors performed article selection, data extraction and critical appraisal. Main results In total we included 25 trials (3096 participants) in this review update. The majority was funded by not-for-profit organizations. One trial included participants with acute LBP, and the remaining trials included people with sub-acute or chronic LBP (CLBP). In three trials massage was done with a mechanical device, and the remaining trials used only the hands. The most common type of bias in these studies was performance and measurement bias because it is difficult to blind participants, massage therapists and the measuring outcomes. We judged the quality of the evidence to be ""low"" to "" very low"", and the main reasons for downgrading the evidence were risk of bias and imprecision. There was no suggestion of publication bias. For acute LBP, massage was found to be better than inactive controls for pain (( SMD -1.24, 95% CI -1.85 to -0.64; participants = 51; studies = 1)) in the short-term, but not for function ((SMD -0.50, 95% CI -1.06 to 0.06; participants = 51; studies = 1)). For sub-acute and chronic LBP, massage was better than inactive controls for pain ((SMD -0.75, 95% CI -0.90 to -0.60; participants = 761; studies = 7)) and function (SMD -0.72, 95% CI -1.05 to -0.39; 725 participants; 6 studies;) in the short-term, but not in the long-term; however, when compared to active controls, massage was better for pain, both in the short ((SMD -0.37, 95% CI -0.62 to -0.13; participants = 964; studies = 12)) and long-term follow-up ((SMD 0.40, 95% CI -0.80 to -0.01; participants = 757; studies = 5)), but no differences were found for function (both in the short and long-term). There were no reports of serious adverse events in any of these trials. Increased pain intensity was the most common adverse event reported in 1.5% to 25% of the participants. Authors' conclusions We have very little confidence that massage is an effective treatment for LBP. Acute, sub-acute and chronic LBP had improvements in pain outcomes with massage only in the short-term follow-up. Functional improvement was observed in participants with sub-acute and chronic LBP when compared with inactive controls, but only for the short-term follow-up. There were only minor adverse effects with massage.
- Concentration of cytokines in patients with osteoarthritis of the knee and fibromyalgia(2014) IMAMURA, Marta; TARGINO, Rosa Alves; HSING, Wu Tu; IMAMURA, Satiko; AZEVEDO, Raymundo Soares; BOAS, Lucy Santos Villas; TOZETTO-MENDOZA, Tania Regina; ALFIERI, Fabio Marcon; FILIPPO, Thais Raquel; BATTISTELLA, Linamara RizzoIntroduction: Fibromyalgia and osteoarthritis may present a relationship with the -concentration of cytokines. The aim of this study was to compare the serum concentrations of IL-12p70, tumor necrosis factor, IL-10, IL-6, IL-1 beta, and IL-8 in patients with knee osteoarthritis and fibromyalgia. Materials and methods: The study included 53 women (71.2 +/- 7.6 years old) diagnosed with knee osteoarthritis with moderate-to-severe pain (visual analog scale. 4) for at least 3 months. Sixty women (54.1 +/- 8.1 years old) diagnosed with fibromyalgia according to the American College of Rheumatology criteria and with moderate-to-severe pain (visual analog scale. 4) also participated in this study. For the dosage of cytokines, blood was collected in the morning: 5 mL from the cubital vein. The material was centrifuged at 4 degrees C, separated into 100 mu L aliquots and stored at -80 degrees C until processing. Serum concentrations of the studied cytokines were assessed using the BD Cytometric Bead Array method. Data were analyzed with Student's t-test and the Mann-Whitney U test. Results: We found higher levels of IL-6, IL-10, and IL-1 beta in fibromyalgia patients. After adjustment of age as a covariate, there was no statistically significant difference in the concentration of any cytokine between fibromyalgia and knee osteoarthritis patients. Conclusion: Patients with knee osteoarthritis and fibromyalgia with the same duration and intensity of pain demonstrate similar concentrations of cytokines. Aging may play a role in cytokine profile, a finding not so extensively addressed in the literature and one that should be further investigated.
- ISPRM/ESPRM guidelines on Physical and Rehabilitation Medicine professional practice for adults with obesity and related comorbidities(2020) GIUSTI, Emanuele M.; SPATOLA, Chiara A.; BRUNANI, Amelia; KUMBHARE, Dinesh; ORAL, Aydan; ILIEVA, Elena; KIEKENS, Carlotte; PIETRABISSA, Giada; MANZONI, Gian Mauro; IMAMURA, Marta; CASTELNUOVO, Gianluca; CAPODAGLIO, PaoloBACKGROUND: The World Health Organization (WHO) has declared obesity as the largest global chronic health problem in adults. In the last years, attention has been drawn to rehabilitative interventions for patients with obesity. AIM: The aim of this manuscript is to provide Physical and Rehabilitation Medicine (PRM) physicians with evidence-based recommendations for the rehabilitation of patients with overweight or obesity and related comorbidities. DESIGN: Evidence-based guidelines. POPULATION : Adults with overweight or obesity. METHODS: Guidelines were based on GRADE and WHO recommendations. A comprehensive search of the available evidence about rehabilitation treatments for obesity was performed, and 17 separate systematic literature reviews were conducted. For each outcome, estimates of the effects of rehabilitation treatments were computed and employed along with an assessment of quality of evidence, desirable and undesirable effects, values and preferences to formulate the recommendations. Recommendations were reviewed by a consensus expert panel using a modified Delphi process. RESULTS : We strongly recommend providing comprehensive multiprofessional and multidisciplinary interventions including exercise, diet and behavioral or cognitive-behavioral therapy. The nutritional component of these treatments should include diets with either a high-protein or a low-fat content. It is strongly recommended to prescribe frequent moderate aerobic exercise. We strongly recommend providing cognitive-behavioral interventions as the behavioral component of rehabilitation programs. CONCLUSIONS: PRM physicians should lead multidisciplinary teams providing comprehensive and individualized rehabilitation programs for patients with overweight or obesity. These guidelines were endorsed by the International Society of Physical and Rehabilitation Medicine (ISPRM) and by the European Society of Physical and Rehabilitation Medicine (ESPRM).
- Electroencephalography as a Biomarker for Functional Recovery in Spinal Cord Injury Patients(2021) SIMIS, Marcel; CAMSARI, Deniz Doruk; IMAMURA, Marta; FILIPPO, Thais Raquel Martins; SOUZA, Daniel Rubio De; BATTISTELLA, Linamara Rizzo; FREGNI, FelipeBackground Functional changes after spinal cord injury (SCI) are related to changes in cortical plasticity. These changes can be measured with electroencephalography (EEG) and has potential to be used as a clinical biomarker. Method In this longitudinal study participants underwent a total of 30 sessions of robotic-assisted gait training (RAGT) over a course of 6 weeks. The duration of each session was 30 min. Resting state EEG was recorded before and after 30-session rehabilitation therapy. To measure gait, we used the Walking Index for Spinal Cord Injury Scale, 10-Meter- Walking Test, Timed-Up-and-Go, and 6-Min-Walking Test. Balance was measured using Berg Balance Scale. Results Fifteen participants with incomplete SCI who had AIS C or D injuries based on American Spinal Cord Injury Association Impairment Scale classification were included in this study. Mean age was 35.7 years (range 17-51) and the mean time since injury was 17.08 (range 4-37) months. All participants showed clinical improvement with the rehabilitation program. EEG data revealed that high beta EEG activity in the central area had a negative correlation with gait (p = 0.049; beta coefficient: -0.351; and adj-R-2: 0.23) and balance (p = 0.043; beta coefficient: -0.158; and adj-R-2:0.24) measured at baseline, in a way that greater high beta EEG power was related to worse clinical function at baseline. Moreover, improvement in gait and balance had negative correlations with the change in alpha/theta ratio in the parietal area (Gait: p = 0.049; beta coefficient: -0.351; adj-R-2: 0.23; Balance: p = 0.043; beta coefficient: -0.158; and adj-R-2: 0.24). Conclusion In SCI, functional impairment and subsequent improvement following rehabilitation therapy with RAGT correlated with the change in cortical activity measured by EEG. Our results suggest that EEG alpha/theta ratio may be a potential surrogate marker of functional improvement during rehabilitation. Future studies are necessary to improve and validate these findings as a neurophysiological biomarker for SCI rehabilitation.
bookPart Envelhecimento, Deficiência e Reabilitação(2016) IMAMURA, Marta; CECATTO, Rebeca Boltes; BATTISTELLA, Linamara Rizzo