{"id":1233,"date":"2018-12-11T18:05:39","date_gmt":"2018-12-11T18:05:39","guid":{"rendered":"http:\/\/www.idot.com.br\/blog\/?p=1233"},"modified":"2022-03-16T16:32:36","modified_gmt":"2022-03-16T16:32:36","slug":"tratamento-osteopatico-estudo-de-caso-em-paciente-com-dor-lombar","status":"publish","type":"post","link":"https:\/\/www.idot.com.br\/blog\/tratamento-osteopatico-estudo-de-caso-em-paciente-com-dor-lombar\/","title":{"rendered":"Tratamento osteop\u00e1tico: Estudo de caso em paciente com dor lombar"},"content":{"rendered":"<p><b>Identifica\u00e7\u00e3o do paciente<\/b><\/p>\n<p><span style=\"font-weight: 400;\">Paciente: R.N.S.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Sexo: Feminino.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Idade: 45 anos.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Estado Civil: Casada.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Profiss\u00e3o: Auxiliar Administrativo (atualmente em licen\u00e7a m\u00e9dica).<\/span><\/p>\n<p><b>QP<\/b><b>: <\/b><i><span style=\"font-weight: 400;\">\u201cSinto dor na coluna, essa dor caminha para as pernas (principalmente direita) e dificulta para andar\u201d.<\/span><\/i><\/p>\n<p><strong>Hist\u00f3ria da doen\u00e7a pregressa<\/strong><\/p>\n<ul>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Paciente relata que frequentemente caminhava como pr\u00e1tica de exerc\u00edcios. Em agosto de 2013, ap\u00f3s retornar para casa, sentiu dor lombar exacerbada e no dia seguinte ao ocorrido, sentiu incapacidade ao movimentar-se, tendo que ser levada ao hospital (diagn\u00f3stico de h\u00e9rnia de disco lombar).<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">A \u00faltima crise ocorreu em 29.09.17 e segundo seu m\u00e9dico, se n\u00e3o houvesse melhora em seu quadro cl\u00ednico, teria de passar por procedimento cir\u00fargico. Retorno em 09.11.17.<\/span><\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<p><strong>Hist\u00f3ria da doen\u00e7a atual<\/strong><\/p>\n<ul>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Atualmente, a dor \u00e9 mais intensa no per\u00edodo da manh\u00e3 ao se movimentar para levantar da cama, irradiando para a regi\u00e3o posterior da coxa em dire\u00e7\u00e3o \u00e0 planta p\u00e9, e tem sensa\u00e7\u00e3o de queima\u00e7\u00e3o.<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Sente muita dificuldade ao realizar atividades como agachar, ajoelhar, bem como subir e descer escadas.<\/span><\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<p><b>Caso cl\u00ednico:<\/b><\/p>\n<p><b>QS<\/b><b>:<\/b> <i><span style=\"font-weight: 400;\">\u201cSinto dor no ombro direito que irradia para o bra\u00e7o<\/span><\/i><span style=\"font-weight: 400;\">\u201d. <\/span><\/p>\n<p><span style=\"font-weight: 400;\">Paciente relata sentir dor apenas durante o esfor\u00e7o, por\u00e9m ultimamente n\u00e3o tem manifestado o sintoma. <\/span><\/p>\n<p><b>Demais Queixas<\/b><b>:<\/b><span style=\"font-weight: 400;\"> Constipa\u00e7\u00e3o Intestinal.<\/span><\/p>\n<p><b>Cirurgias<\/b><b>:<\/b><span style=\"font-weight: 400;\"> Duas ces\u00e1reas; laqueadura; retirada de cisto ovariano; histerectomia (aos 23 anos).<\/span><\/p>\n<p><b>Uso de Medicamentos<\/b><b>: <\/b><span style=\"font-weight: 400;\">Codex<\/span><span style=\"font-weight: 400;\">\u00ae<\/span><span style=\"font-weight: 400;\">, Tramal<\/span><span style=\"font-weight: 400;\">\u00ae<\/span><span style=\"font-weight: 400;\"> e Gabaneurin<\/span><span style=\"font-weight: 400;\">\u00ae<\/span><span style=\"font-weight: 400;\">.<\/span><\/p>\n<p><b>Tratamentos Concomitantes<\/b><b>: <\/b><span style=\"font-weight: 400;\">Realiza tratamento fisioterap\u00eautico duas vezes por semana, por\u00e9m n\u00e3o tem percebido melhoras. <\/span><\/p>\n<p><b>Exames Complementares<\/b><b>:<\/b><\/p>\n<p><span style=\"font-weight: 400;\">Laudo da RM (29.09.2017)<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Artrose Facet\u00e1ria Incipiente em L3\/L4, L4\/L5 e L5\/S1. <\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Abaulamentos Discais Difusos em L3\/L4, L4\/L5 e L5\/S1 associados a protrus\u00f5es discais centro-medianas.<\/span><\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<p><b>Dor eva\/question\u00e1rio SF-36<\/b><\/p>\n<p><img loading=\"lazy\" class=\"wp-image-1234 aligncenter\" src=\"http:\/\/www.idot.com.br\/blog\/wp-content\/uploads\/2018\/12\/dor_eva_questionario_sf36-1170x465.png\" alt=\"\" width=\"893\" height=\"355\"\/><\/p>\n<p>&nbsp;<\/p>\n<p><b>Testes de exclus\u00e3o:<\/b><\/p>\n<ul>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Andar sobre os Calcanhares: Negativo. <\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Andar na Ponta do P\u00e9: Negativo. <\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Teste de Reflexo do Tend\u00e3o Patelar: Negativo.<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Teste de Reflexo do Tend\u00e3o de Aquiles: Negativo.<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Teste de Eleva\u00e7\u00e3o da Perna Estendida: Negativo.<\/span><\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<p><b>Diagn\u00f3stico osteop\u00e1tico<\/b><\/p>\n<ul>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Teste Referencial (Teste do Parietal)<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">&#8211; Sistema Craniano.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">&#8211; Sistema Visceral.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">&#8211; Sistema Musculoesquel\u00e9tico e Neural.<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Teste Relacional Funcional<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">&#8211; TFP.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">&#8211; Eleva\u00e7\u00e3o da Perna Estendida. <\/span><\/p>\n<p><span style=\"font-weight: 400;\">&#8211; Andar sobre os calcanhares. <\/span><\/p>\n<p>&nbsp;<\/p>\n<p><b>1\u00aa Consulta &#8211; dia 17\/10\/17<\/b><\/p>\n<ul>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Avalia\u00e7\u00e3o Cl\u00ednica.<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">EVA \/ Question\u00e1rio SF-36.<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Testes de Exclus\u00e3o.<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">TR: Parietal.<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Sistemas: Musculoesquel\u00e9tico e Neural, Visceral e Craniano.<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">TRF: Eleva\u00e7\u00e3o da Perna Estendida \/ Andar sobre os calcanhares \/ TFP.<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">Observa\u00e7\u00e3o: N\u00e3o houve avalia\u00e7\u00e3o e tratamento de nenhum dos sistemas.<\/span><\/p>\n<p>&nbsp;<\/p>\n<p><b>1\u00aa Consulta &#8211; Avalia\u00e7\u00e3o est\u00e1tica<\/b><\/p>\n<p><img loading=\"lazy\" class=\" wp-image-1238 aligncenter\" src=\"http:\/\/www.idot.com.br\/blog\/wp-content\/uploads\/2018\/12\/primeira_consulta01-1170x465.png\" alt=\"\" width=\"776\" height=\"291\"\/><\/p>\n<p><b>1\u00aa Consulta \u2013 Testes relacionado funcionais (TFP e eleva\u00e7\u00e3o da pena)<\/b><\/p>\n<p><img loading=\"lazy\" class=\"wp-image-1239 aligncenter\" src=\"http:\/\/www.idot.com.br\/blog\/wp-content\/uploads\/2018\/12\/primeira_consulta02-1170x465.png\" alt=\"\" width=\"789\" height=\"301\"\/><\/p>\n<p>&nbsp;<\/p>\n<p><span style=\"font-weight: 400;\">*V\u00eddeo 1 \u2013 Andar sobre os calcanhares<\/span><\/p>\n<p>&nbsp;<\/p>\n<p><b>2\u00aa CONSULTA \u2013 DIA 18.10.17<\/b><\/p>\n<ul>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">EVA inicial \u2013 6.<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">Avalia\u00e7\u00e3o e Tratamento do Sistema Craniano<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Palpa\u00e7\u00e3o Auscultat\u00f3ria: \u00d3ssea.<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Disfun\u00e7\u00f5es encontradas: Les\u00e3o Flex\u00e3o Bilateral do Esfenoide.<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">T\u00e9cnicas: Corre\u00e7\u00e3o de Flex\u00e3o do Esfenoide; Libera\u00e7\u00e3o dos Diafragmas Toracolombar e P\u00e9lvico.<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">TR (Parietal): Normalizado.<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">Avalia\u00e7\u00e3o e Tratamento do Sistema Visceral<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Palpa\u00e7\u00e3o Auscultat\u00f3ria Global: Alavanca Longa Anterior Levemente \u00e0 Direita.<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Teste de Exclus\u00e3o Palpa\u00e7\u00e3o Arterial: Negativo.<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Palpa\u00e7\u00e3o Auscultat\u00f3ria: Aumento de densidade tecidual em MID; Ausculta Local em dire\u00e7\u00e3o \u00e0 cicatriz suprap\u00fabica &#8211; Teste de Cicatriz Patol\u00f3gica Positivo; TR tamb\u00e9m positivo.<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">T\u00e9cnicas: Libera\u00e7\u00e3o de cicatriz, desenrolar fascial sobre a cicatriz e tecidos adjacentes \u2013 TRF foi eficaz.<\/span><\/li>\n<\/ul>\n<ul>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">EVA final &#8211; 5.<\/span><\/li>\n<li style=\"font-weight: 400;\"><i><span style=\"font-weight: 400;\">Lift<\/span><\/i><span style=\"font-weight: 400;\"> visceral (regi\u00e3o da cicatriz) &#8211; houve melhora consider\u00e1vel<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">A paciente foi orientada a realizar a massagem sobre a cicatriz com \u00f3leo essencial.<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">*In\u00edcio e Fim da 2\u00aa sess\u00e3o<\/span><\/p>\n<p><img loading=\"lazy\" class=\"aligncenter wp-image-1240 \" src=\"http:\/\/www.idot.com.br\/blog\/wp-content\/uploads\/2018\/12\/fim_da_sessao.png\" alt=\"\" width=\"379\" height=\"324\" srcset=\"https:\/\/www.idot.com.br\/blog\/wp-content\/uploads\/2018\/12\/fim_da_sessao.png 966w, https:\/\/www.idot.com.br\/blog\/wp-content\/uploads\/2018\/12\/fim_da_sessao-768x658.png 768w, https:\/\/www.idot.com.br\/blog\/wp-content\/uploads\/2018\/12\/fim_da_sessao-600x514.png 600w\" sizes=\"(max-width: 379px) 100vw, 379px\" \/><\/p>\n<p>&nbsp;<\/p>\n<p><b>3\u00aa Consulta &#8211; Dia 20\/10\/17<\/b><\/p>\n<ul>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">EVA inicial &#8211; 5 (houve melhora da irradia\u00e7\u00e3o para MID).<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">Tratamento do Sistema Visceral<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Manipula\u00e7\u00e3o da Art\u00e9ria Abdominal, Art\u00e9ria Mesent\u00e9rica Superior e Art\u00e9ria Mesent\u00e9rica Inferior.<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Nervos: Plexo Lombar (Mobiliza\u00e7\u00e3o de Ra\u00edzes em Dec\u00fabito Lateral).<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">TRF: Eficaz.<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">M\u00fasculo: Inibi\u00e7\u00e3o de Psoas (+ E).<\/span><\/li>\n<\/ul>\n<ul>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Libera\u00e7\u00e3o de cicatriz (desenrolar fascial); Motilidade do C\u00f3lon Sigmoide; T\u00e9cnica para Raiz do Mesent\u00e9rio.<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">TRF: Eficaz.<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">EVA final &#8211; 3 (Houve ganho de amplitude no TFP; e a paciente conseguiu dar um passo sobre os calcanhares (ainda com apoio).<\/span><\/li>\n<\/ul>\n<p><img loading=\"lazy\" class=\"aligncenter wp-image-1241 \" src=\"http:\/\/www.idot.com.br\/blog\/wp-content\/uploads\/2018\/12\/fim_segunda_sessao.png\" alt=\"\" width=\"476\" height=\"288\" srcset=\"https:\/\/www.idot.com.br\/blog\/wp-content\/uploads\/2018\/12\/fim_segunda_sessao.png 1224w, https:\/\/www.idot.com.br\/blog\/wp-content\/uploads\/2018\/12\/fim_segunda_sessao-768x464.png 768w, https:\/\/www.idot.com.br\/blog\/wp-content\/uploads\/2018\/12\/fim_segunda_sessao-600x363.png 600w\" sizes=\"(max-width: 476px) 100vw, 476px\" \/><\/p>\n<p><span style=\"font-weight: 400;\">*Fim da 2\u00aa sess\u00e3o e Fim da 3\u00aa sess\u00e3o<\/span><\/p>\n<p><b>4\u00aa Consulta \u2013 Dia 23\/10\/17<\/b><\/p>\n<ul>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">EVA inicial &#8211; 4 (No fim de semana, relatou grande melhora durante a marcha, diminui\u00e7\u00e3o consider\u00e1vel da irradia\u00e7\u00e3o para os MMII e melhoria do tr\u00e2nsito intestinal).<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">Sistema Visceral<\/span><span style=\"font-weight: 400;\"> &#8211; normalizado.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Avalia\u00e7\u00e3o do Sistema Musculoesquel\u00e9tico<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">TFP:<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">&#8211; Aumento do \u00e2ngulo tibiot\u00e1rsico.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">&#8211; Aumento do \u00e2ngulo do quadril.<\/span><\/p>\n<p><img loading=\"lazy\" class=\"aligncenter wp-image-1242 \" src=\"http:\/\/www.idot.com.br\/blog\/wp-content\/uploads\/2018\/12\/inicio_quarta_sessao.png\" alt=\"\" width=\"253\" height=\"277\" srcset=\"https:\/\/www.idot.com.br\/blog\/wp-content\/uploads\/2018\/12\/inicio_quarta_sessao.png 766w, https:\/\/www.idot.com.br\/blog\/wp-content\/uploads\/2018\/12\/inicio_quarta_sessao-600x658.png 600w\" sizes=\"(max-width: 253px) 100vw, 253px\" \/><\/p>\n<p><span style=\"font-weight: 400;\">*In\u00edcio da 4\u00aa sess\u00e3o<\/span><\/p>\n<p>&nbsp;<\/p>\n<p><span style=\"font-weight: 400;\">Tratamento do Sistema Musculoesquel\u00e9tico<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Nervos: Plexo Lombar e Plexo Sacral (Satura\u00e7\u00e3o e Sidera\u00e7\u00e3o).<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">M\u00fasculo: Inibi\u00e7\u00e3o de Psoas (D) e <\/span><i><span style=\"font-weight: 400;\">Stretching<\/span><\/i><span style=\"font-weight: 400;\"> de Quadrado Lombar (D). <\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Articula\u00e7\u00e3o: PA para Les\u00e3o Unilateral Esquerda do Sacro. <\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Orienta\u00e7\u00e3o: Continuar a realizar massagem sobre a cicatriz e automobiliza\u00e7\u00e3o em <\/span><i><span style=\"font-weight: 400;\">Slump Test<\/span><\/i><span style=\"font-weight: 400;\"> (Plexo Lombossacral).<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">EVA &#8211; 2 (pontual na regi\u00e3o sacroil\u00edaca D).<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">TFP &#8211; Ganho significativo da amplitude; conseguiu andar sobre os calcanhares e sem apoio; e ganho de ADM na eleva\u00e7\u00e3o da perna estendida.<\/span><\/li>\n<\/ul>\n<p><img loading=\"lazy\" class=\"wp-image-1243  aligncenter\" src=\"http:\/\/www.idot.com.br\/blog\/wp-content\/uploads\/2018\/12\/fim_quarta_sessao.png\" alt=\"\" width=\"564\" height=\"302\"\/><\/p>\n<p><span style=\"font-weight: 400;\">*Fim da 3\u00aa sess\u00e3o e Fim da 4\u00aa sess\u00e3o<\/span><\/p>\n<p>&nbsp;<\/p>\n<p><b>TRF \u2013 Eleva\u00e7\u00e3o da perna \/ Andar&nbsp;sobre os calcanhares<\/b><\/p>\n<p>&nbsp;<\/p>\n<p><b>5\u00aa Consulta \u2013 Dia 24\/10\/17<\/b><\/p>\n<ul>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">EVA inicial \u2013 3 (relatou dor na regi\u00e3o anterior da coxa).<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">Tratamento do Sistema Musculoesquel\u00e9tico<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Nervos: Plexo Lombar e Plexo Sacral (Satura\u00e7\u00e3o e Sidera\u00e7\u00e3o dos nervos).<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">M\u00fasculo: Inibi\u00e7\u00e3o de Psoas (D) e <\/span><i><span style=\"font-weight: 400;\">Stretching<\/span><\/i><span style=\"font-weight: 400;\"> de Reto Femoral (D); Inibi\u00e7\u00e3o dos MM. Pelvitrocant\u00e9ricos.<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Articula\u00e7\u00e3o: PA para Les\u00e3o Unilateral Esquerda do Sacro. <\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">EVA final \u2013 3 (relatou dor ainda na regi\u00e3o anterior da coxa e tamb\u00e9m na sacroil\u00edaca esquerda).<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Houve diminui\u00e7\u00e3o do movimento comparado \u00e0 sess\u00e3o anterior.<\/span><\/li>\n<\/ul>\n<p><img loading=\"lazy\" class=\"wp-image-1244  aligncenter\" src=\"http:\/\/www.idot.com.br\/blog\/wp-content\/uploads\/2018\/12\/fim_quarta_sessao_e_quinta_sessao.png\" alt=\"\" width=\"560\" height=\"306\"\/><\/p>\n<p><span style=\"font-weight: 400;\">*Fim da 4\u00aa sess\u00e3o e Fim da 5\u00aa sess\u00e3o<\/span><\/p>\n<p>&nbsp;<\/p>\n<p><b>6\u00aa Consulta \u2013 Dia 25\/10\/17<\/b><\/p>\n<ul>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">EVA inicial \u2013 2 (dor leve e pontual na sacroil\u00edaca D e dor \u00e0 palpa\u00e7\u00e3o na regi\u00e3o anterior da coxa D).<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">Tratamento do Sistema Musculoesquel\u00e9tico<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Nervos: Plexo Lombar e Sacral (Satura\u00e7\u00e3o e Sidera\u00e7\u00e3o dos nervos).<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">M\u00fasculo: Inibi\u00e7\u00e3o dos MM. Pelvitrocant\u00e9ricos; <\/span><i><span style=\"font-weight: 400;\">Stretching<\/span><\/i><span style=\"font-weight: 400;\"> M. Tensor da F\u00e1scia Lata.<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Articula\u00e7\u00e3o: T\u00e9cnica Articulat\u00f3ria para Anterioridade do Il\u00edaco D; PA Flex\u00e3o Bilateral da Base Sacra.<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">EVA final \u2013 1 (desconforto na regi\u00e3o sacroil\u00edaca D).<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Houve ganho de amplitude no TFP.<\/span><\/li>\n<\/ul>\n<p><img loading=\"lazy\" class=\"aligncenter wp-image-1245 \" src=\"http:\/\/www.idot.com.br\/blog\/wp-content\/uploads\/2018\/12\/fim_quinta_e_sexta_sessao.png\" alt=\"\" width=\"483\" height=\"385\"\/><\/p>\n<p><span style=\"font-weight: 400;\">*Fim da 5\u00aa sess\u00e3o e Fim da 6\u00aa sess\u00e3o<\/span><\/p>\n<p><b>Dor Eva \u2013 Comparativo<\/b><\/p>\n<p><img loading=\"lazy\" class=\"aligncenter wp-image-1246 \" src=\"http:\/\/www.idot.com.br\/blog\/wp-content\/uploads\/2018\/12\/dor_eva_comparativo.png\" alt=\"\" width=\"912\" height=\"277\"\/><\/p>\n<p><b>Question\u00e1rio SF &#8211; 36 &#8211; Comparativo<\/b><\/p>\n<p><img loading=\"lazy\" class=\"wp-image-1247  aligncenter\" src=\"http:\/\/www.idot.com.br\/blog\/wp-content\/uploads\/2018\/12\/questionario_sf_36.png\" alt=\"\" width=\"921\" height=\"605\" srcset=\"https:\/\/www.idot.com.br\/blog\/wp-content\/uploads\/2018\/12\/questionario_sf_36.png 1358w, https:\/\/www.idot.com.br\/blog\/wp-content\/uploads\/2018\/12\/questionario_sf_36-768x503.png 768w, https:\/\/www.idot.com.br\/blog\/wp-content\/uploads\/2018\/12\/questionario_sf_36-600x393.png 600w\" sizes=\"(max-width: 921px) 100vw, 921px\" \/><\/p>\n<p>&nbsp;<\/p>\n<p><b>TRF \u2013 Comparativo<\/b><\/p>\n<p><img loading=\"lazy\" class=\"wp-image-1248  aligncenter\" src=\"http:\/\/www.idot.com.br\/blog\/wp-content\/uploads\/2018\/12\/trt_comparativo.png\" alt=\"\" width=\"916\" height=\"383\"\/><\/p>\n<p><b>CONDUTA FINAL E ORIENTA\u00c7\u00d5ES<\/b><\/p>\n<ul>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Paciente foi remarcada para o pr\u00f3ximo grupo (+ 3 sess\u00f5es).<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Orienta\u00e7\u00e3o em rela\u00e7\u00e3o \u00e0 cicatriz patol\u00f3gica (\u00f3leo essencial).<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Automobiliza\u00e7\u00e3o <\/span><i><span style=\"font-weight: 400;\">Slump Test<\/span><\/i><span style=\"font-weight: 400;\">.<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Posicionamento ao dormir.<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Praticar atividade f\u00edsica regularmente (de prefer\u00eancia com supervis\u00e3o de um profissional especializado; voltar a fazer caminhada).<\/span><\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<p><b>Escrito por: Karina Cristina Fernandes <\/b>(Estudante do Idot)<\/p>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Identifica\u00e7\u00e3o do paciente Paciente: R.N.S. Sexo: Feminino. Idade: 45 anos. Estado Civil: Casada. Profiss\u00e3o: Auxiliar Administrativo (atualmente em licen\u00e7a m\u00e9dica). QP: \u201cSinto dor na coluna, essa dor caminha para as pernas (principalmente direita) e dificulta para andar\u201d. Hist\u00f3ria da doen\u00e7a pregressa Paciente relata que frequentemente caminhava como pr\u00e1tica de exerc\u00edcios. Em agosto de 2013, ap\u00f3s [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":2167,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_et_pb_use_builder":"","_et_pb_old_content":"","_et_gb_content_width":"","inline_featured_image":false,"_mi_skip_tracking":false},"categories":[375],"tags":[31,23,8,16,322],"_links":{"self":[{"href":"https:\/\/www.idot.com.br\/blog\/wp-json\/wp\/v2\/posts\/1233"}],"collection":[{"href":"https:\/\/www.idot.com.br\/blog\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.idot.com.br\/blog\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.idot.com.br\/blog\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.idot.com.br\/blog\/wp-json\/wp\/v2\/comments?post=1233"}],"version-history":[{"count":5,"href":"https:\/\/www.idot.com.br\/blog\/wp-json\/wp\/v2\/posts\/1233\/revisions"}],"predecessor-version":[{"id":2168,"href":"https:\/\/www.idot.com.br\/blog\/wp-json\/wp\/v2\/posts\/1233\/revisions\/2168"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.idot.com.br\/blog\/wp-json\/wp\/v2\/media\/2167"}],"wp:attachment":[{"href":"https:\/\/www.idot.com.br\/blog\/wp-json\/wp\/v2\/media?parent=1233"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.idot.com.br\/blog\/wp-json\/wp\/v2\/categories?post=1233"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.idot.com.br\/blog\/wp-json\/wp\/v2\/tags?post=1233"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}