Avaliação dos efeitos da reeducação postural global (rpg) em pacientes com espondilite anquilosante

The Ankylosing Spondylitis (AS) is a chronic inflammatory disease that primarily affects the axial skeleton, leading to limitation of spine mobility and functional disability. Physical therapy, especially exercise, is an important part in your treatment. The Global Postural Reeducation(GPR),a method that uses stretching based on evaluation of muscular chains, with significant interference in postural changes may be a complementary alternative for the treatment of this disease. The aim was to evaluate the effects of Global Postural Reeducation (GPR) in patients with Ankylosing Spondylitis (AS) and compare GPR with group conventional segmental self-stretching and breathing exercises. This is a controlled interventional study of 38 patients divided into 2 groups: a GPR group (n = 22) and a control group (n = 16). Both groups were treated over four months. With the GPR group patients, positions that stretched the shortened muscle chains were used. With the control group patients, conventional segmental self-stretching and breathing exercises were performed. The variables analyzed were: pain intensity, morning stiffness, spine mobility, chest expansion, functional capacity (Health Assessment Questionnaire - Spondyloarthropathies - HAQ-S), quality of life (Medical Outcome Study Short Form 36 Healthy Survey-SF-36), and disease activity (Bath Ankylosing Spondylitis Disease Activity Index - BASDAI). Statistical analysis was used with a significance level of p < 0.05. There was a statistically significant difference for all the parameters analyzed between pre and post-treatment in both groups. In the inter-group comparison the GPR group showed a statistically significant improvement in morning stiffness (p = 0.01), spine mobility parameters, except finger-floor distance (p = 0.11), in chest expansion (p = 0.02), and in the physical aspect component of the SF-36 (p = 0.00).Finally, we observed that this sample of patients with AS ,treatment with RPG 60 seems to have a better response in some clinical measures, than the conventional self stretching performed in groups. Further studies are needed to further evaluate this therapeutic alternative in the EA

Desempenho muscular e equilíbriu postural em idosas frágeis residentes na comunidade

Human aging is physiological process causes alterations in several systems of the organism. In the musculoskeletal system, a main change is the decreased muscle strength, that in the lower extremity, compromises the ability to respond quickly with enough strength to prevent falls, causing alterations in postural balance. Currently, many researchers have study the human frailty, defined as a multifactorial syndrome, with excess of vulnerability to stressors, reducing ability in maintaining or regulating homeostasis. Its characteristics are directly related to physical function. Aim: To analyze muscle performance and postural balance in frail and pre-frail elderly women, and to compare them according with the frailty phenotypes criteria proposed by Fried 2001. Method: 39 frail elderly women living in the community, aged 65 years and older, were assessed muscle performance of lower extremity using isokinetic dynamometer and postural balance using Berg s balance scale and computerized baropodometry. Results: There was significant difference in plantar flexor, knee flexor and knee extensor strength, in anteroposterior (AP) oscillation with eyes open and on Berg s scores between groups. A weak correlation was observed between strength and balance. Conclusion: The results suggest that the frail elderly present worse muscle performance in lower extremity and worse postural balance compared to the pre-frail elderly. There were correlations between muscle performance and balance impairments in these elderly, but several variables are also involved in maintaining postural balance

Alterações de equilíbrio postural e qualidade de vida em mulheres no ciclo gravídico puerperal

INTRODUCTION: The pregnancy and childbirth cause many changes in a woman's life, whether physical, hormonal, emotional or social. Such changes may affect the postural balance and the quality of life of women in pregnancy and may persist after delivery. To analyze changes in postural balance and quality of life in women in pregnancy and postpartum. METHODS: This study consisted of 47 women participants of the Course for Pregnant Women of the Department of Physical Therapy at UFRN, evaluated during pregnancy (2° or 3° trimester) and in the period 1-8 months postpartum. In all participants was evaluated the postural balance, the Balance Master® in five specific tests: (1) Modified Clinical Test of Sensory Interaction on Balance-MCTSIB; (2) Rhythmic Weight Shift Test - RWS (3) unilateral stance - US, (4) Sit to Stand - STS, and (5) Walk Across - WA. The quality of life (QoL) was assessed by applying the Quality Score of life Ferrans & Powers (IQVFP), both during pregnancy and in the postpartum period. For statistical analysis we used the Statistical Package for Social Sciences software for Personal Computer- SPSS (version 20.0), applying the tests: Shapiro-Wilk to assess the normality of the data; Chi-square to analyze the frequency of postural balance changes in the two groups of pregnancy and postpartum in both groups; McNemar test to analyze balance disorders frequency of related samples in the two time points; to compare the behavior of postural balance during pregnancy and postpartum, and to compare the QoL between the periods, we used the Wilcoxon test; and yet, the MannWhitney test to compare the QoL scores in the two groups of pregnancy and postpartum in both groups. We adopted p-value <0.05. RESULTS: Comparing the postural balance during pregnancy and postpartum in MSTSIB test has statistical difference in unstable surface with closed eyes (p=0.001) and in the US test, the speed of oscillation with right leg with eyes closed (p=0,03). Quality of life, there was statistical difference between the scores only among postpartum groups, the family domain (p=0.03); and to comparing pregnancy and postpartum in domain health and operation (p=0.02) and the Socioeconomic domain (p=0.01). CONCLUSIONS: It was observed that the balance changes present during pregnancy persist postpartum, and the quality of life is considered good by women, both during pregnancy and postpartum.

Ergonomia e Odontologia: determinantes da postura corporal dos estudantes da clínica-escola de uma Universidade Federal

Posture is one of the most worrying problems dentists face. That is because of the high incidence of low back pathologies regarding the professional activity, despite the development on the field of Dental Ergonomics. This work took place at the dental schoolclinic at a Federal University, and it was grounded on the Ergonomic Principles in the workplace. Its main objective was to analyze the determinants of inadequate posture adopted by students inasmuch as the adoption of non ergonomic methods at the school-clinic may influence them to develop inadequate postures in their working environment. The analysis of the activity showed us that it requires some complex procedures in the patient s mouth. Thus, when the students carry out the activity, they start to adopt, although unconsciously, inadequate postures which will make easier the visual accuracy and the access to the operation focus. In case there is no internal (body awareness) or external warning mechanisms (the professor s or the partner s counseling) regarding posture or possible risks which lead them to self-correction, the students become vulnerable to osteomuscle disorders. The time pressure, because the students are expected to perform their task in a predetermined clinical time. The facts related to each patient s variability as well as the stress caused by the expectations to get their work done in time make the students to advance it believing they will waste time if they help their partners or using an indirect view. We could also notice that there was no assistant to perform the job of minor ones, as well as there was no professor who could actually connect the knowledge on Ergonomics to its working practice. The conclusions of this work stand out the need of widen the discussion at the academic environment regarding health professionals in places such as universities. The ergonomic principles in the workplace aim a multidisciplinary analysis based on the experience of students, professors, staff members and janitors that can contribute to some reflection upon the issue and consequently actions which will bring positive changes at the working environment

Desenvolvimento de protótipo de cadeira de banho para indivíduos com paralisia cerebral tetraparética espástica

This study proposes to develop an equipment that attends the demands of tetraplegic people due to cerebral palsy and that promotes an adequate caregivers postural biomechanics during the shower activity of daily living. First, a bibliographic review was performed to define the terms refering to cerebral palsy, activity of daily living (specifically shower), and assistive technology, besides listing the wheelchairs made on the mainly national assistive technology companies. Therefore, this is a descriptive-exploratory study based on a literature review and on a based-field exploration research. On the field research a survey was adopted as a methodological procedure as it is related to a direct investigation related to a phenomenon, on the case, represented by the current shower situation of the people investigated in this study. Data were collected with the application of a form to the caregivers and consumers of the medical-therapeutic treatment and place used by the participants. Such form, which was made up of open and close questions, tried to identify, besides the personal data of evaluated users and consumers, the characteristics of the current shower activity, such as the place where it takes place in the house, the used equipmentS, in the case there is any, and how often it occurs. The form also was used to identify the caregivers and consumers desires and perceptions in relation to the present characteristics of the new dispositive besides the users and consumers anthropometric data. The evaluation of the results obtained through the form, together with the practice and clinical experience of the researchers and engineers involved in this study, made it possible to develop and make up a real shower chair prototype with the specific adjusts destined to adequate the equipment to be used according to the needs of each user and consumer

Oportunidades de melhoria ergonômica das exigências físicas da atividade jangadeira em Ponta Negra Natal-RN

The fishing is an activity with rafts marked by unpredictability, poor tools, physical stress, awkward postures, risk of accidents and incidents, which contribute to insecurity in the context of activity. This study aimed to contribute to reducing of physical effort and the biomechanical impacts in jangadeiro activity of artisanal fishing using jangadas on the beach of Ponta Negra, Natal-RN. To achieve this purpose the methodology of the Work Ergonomic Analysis - WEA became a reference using techniques such as observational and interactional observation notes, photographs, videos, action conversational and listening verbalizations. The resulting activity in health jangadeiro, discussed in this research were: static postural assessment, flexibility of movement of shoulder flexion-extension, flexibility of the hamstrings and lower back, grip and musculoskeletal pain. It was found from observations, interactions and activity analysis, that in carrying out fishing rafts are frequent awkward postures associated with demand for power and many are already feeling the jangadeiros reflections of years of life dedicated to this work. These have already adopted some measures to manage the activity, such as job rotation during the expedition of capture. Therefore, there is a need to expand these measures of activity management, as well as design and capabilities of the raft, seeking positive changes in the activity and consequently the quality of life jangadeiro

Correlação entre torque, equlíbrio e função do joelho após reconstrução do LCA

Background: Several studies emphasize the importance of assessing the knee function after anterior cruciate ligament (ACL) reconstruction. The influence of several variables on the function of these patients has been analyzed, but there is no consensus in the science literature. Purpose: To evaluate the correlation between the torque and balance on the knee function after ACL reconstruction. Methods: 23 males patients with ACL reconstruction were tested. The procedures of the study included analysis of concentric peak torque at 60o/s and 180o/s of quadriceps femoris and hamstring muscle with a isokinetic dynamometer. The balance in single-limb stance was measured with stabilometry. The functional performance were performed by two hop tests. To estimate the subjective function of the patients was applied Lysholm Knee Scoring Scale and a Global Rating scale. Results: The analysis of data showed a moderate positive correlation between knee extensor torque and functional performance tests (r= 0,48; p=0,02). A moderate negative correlation was found between the two variables of the stabilometry center of pressure and average speed of centre of pressure and the Global Rating scale (r = -0.4, p = 0,04 and r = -0,49, p = 0 ,02, respectively). No correlation was found between peak torque and balance in single-limb stance. Conclusion: The results of the present study suggest that knee extensor strength and postural balance have some influence on knee function in patients after ACL reconstruction

Efeitos do treinamento de dupla tarefa no controle do equilíbrio dinâmico e estático de idosas pré-frágeis: um estudo piloto

The increasing world population of older individuals has become a subject of growing research for prevention and reversibility of the frailty because it is a major risk factor for the occurrence of falls, especially when it involves everyday situations of dual task. Some rehabilitation programs have already used the methods of dual-task with general exercises for improving gait and postural control, but has been reported that these interventions have little specificity with limited success to improve certain aspects of static and dynamic position during the performance of functional tasks. This study aimed to verify the measures of postural control in a group of elderly women with fragility phenotype after physical therapy intervention program based on dual-task treadmill training. We selected six pre-frail elderly subjects, with a minimum age of 65, female, living in the community and randomly assigned to two groups. The survey was conducted twice a week for 45 minutes, for four weeks. The simple task intervention consisted only in training on a treadmill and the dual task consisted of in treadmill training associated with visual stimuli. The assessments were made with the use of the Berg Balance Scale (BBS) and the Balance Master® computerized posturography, static and dynamically. The effects of retention were observed after one month, using the same instruments earlier used. The results showed a tendency toward improvement or maintenance of the balance after training on a treadmill, especially with respect to static equilibrium. Both groups showed the most notable changes in the variables related to gait, as the length and speed. The BBS scores and the baropodometric variables showed that the experimental group could keep all values similar or better even one month after completion of training unlike the control group. We concluded that the dual-task performance had no additional value in relation to the improvement of balance in general, but we observed that the effectiveness of visual stimulation occurred in the maintenance of short term balancevariables

Efeitos da eletroestimulação percutânea na incontinência urinária e qualidade de vida pós-prostatectomia: registro de seis casos

Introduction: Radical prostatectomy surgery is the best treatment currently adopted by detecting prostate cancer. The urinary incontinence is one more common and difficult to treat postoperative complications, which causes a negative impact on quality of life of the individual prostatectomy . The surface electrical nerve stimulation involves the transmission of electrical impulses from an external stimulator for peripheral nerve through surface electrodes attached to skin. It is an easy and efficient technique, widely used for pain relief, rehabilitation and muscle strengthening. Objective: To analyze the effect of T10-L2 percutaneous electrical stimulation, in individuals with urinary incontinence who underwent radical prostatectomy by the laparoscopic technique. Methods: Six patients had previously undergone radical prostatectomy were submitted to 20 sections of surface electrical stimulation with frequency of 4 Hz, pulse width of 1ms during 20 minutes. All subjects fillid a quality of life - International Consultation on Incontinence Questionnaire- Short FormI - ICIQ-SF questionnaire evaluating. Results: Results showed reduction in the use of the number of pads, number of leaks before and after treatment, and reduced voiding frequency and consequent improvement in quality of life. No side effects were reported. Conclusion: Percutanous electrical stimulation in T10-L2 may be an effective technique to treat urinary incontinence (UI) after radical prostatectomy video laparoscopy

Influência do kinesio taping® no desempenho neuromuscular do quadríceps femoral e na função do membro inferior em sujeitos saudáveis: ensaio clínico, controlado, randomizado, cego

Objective:To analyze the immediate effects of the Kinesio Taping® application on the quadriceps neuromuscular performance, postural balance and lower limb function in healthy subjects. Materials andmethods:This is a randomized, controlled, blinded clinical trial. Sixtyfemale volunteers(age: 23.3±2.5 years old, BMI: 22.2±2.1kg/m2)wererandomly assigned intothreegroups with20memberseach,and performedone of these threeprotocols: control -10 minutesof rest,experimental 1- patch application ontherectusfemoris (RF), vastuslateralis(VL) and vastusmedialis(VM) and experimental 2-KT application on the same muscles. Allunderwent an evaluationfor singleand triple hop distance, postural balance (baropodometry), joint position sense(JPS), peak torque (concentric and eccentricevaluation at 60°/s)and electromyographic activityof VL,before andafter intervention.Results: There wasasignificant increasein the jump distanceof thethreestudied groups,with no differencebetween groups.There were nosignificant changesin postural balance,JPS, concentricpeak torqueand RMSof the VLin none of the groups. There was a reduction ineccentricpeak torquein all groups, without differencesbetween groups.Conclusion:The KT application on the RF, VL and VMmusclesis not able tosignificantly improvelower limbfunction and postural balance, as well as the kneeextensor peaktorque, JPSand the VL muscleactivation amplitudeof healthy women.

Efeito do método pilates no desempenho muscular e no equilíbrio corporal de mulheres idosas: ensaio clínico controlado randomizado

Background: The Pilates Method is a modality of exercise that has been growing in recent decades, but few researches has been conducted with elderly and little is known about its benefits in this population. Objective: To evaluate the effect of a program of Mat Pilates exercises in muscle performance and postural balance in elderly women. Materials and Method: This is a randomized controlled trial that evaluated the muscle performance (isokinetic dynamometer Biodex System 3 Pro®) and postural balance (Balance Master System®) of 33 women aged 65-80 years. The experimental group (EG) participated of a 12-week program of Mat Pilates exercises with two weekly sessions. Data normality was verified by the Shapiro - Wilk test and were adopted p value < 0.05 as significance level. Results: There were no differences between groups after training. However, the EG showed an increase in the values of extension and flexion average power to 60 ° / s after training (32.19 W to 37.04 W and 14.48 W to 17.56 W, respectively). Conclusion: The proposed exercise program was not effective in the total work and average power of flexor and extensor of the knee, as well as static and dynamic balance of participants

Grau de conhecimento de pacientes sobre o acidente vascular cerebral e a necessidade do uso de cartilha educativa para orientação fisioterapêutica

Stroke is a neurological dysfunction of vascular origin that causes physical impairments and disabilities. Brazil leads the statistics stroke mortality among Latin American countries, demonstrating still be a neglected disease in this country. The incidence is related to risk factors and still is great misinformation in our country about stroke, treatment and prophylaxis. The aim of this study was to assess the degree of knowledge about stroke and patients need to use educational booklet for physiotherapy. The sample consisted of 53 patients, 22 females and 31 males, mean age 56.2 ± 10.9 years. Patients were evaluated by completing questionnaires, observing the socio-demographic and clinical aspects, neurological assessment, functional assessment, knowledge of pathology and presenting educational booklet. The data were analyzed using the chi-square test. According to the results, it was observed that the patients had not enough knowledge about the terminology, complications and warning signs of stroke, were not aware and did not perform the proper positioning of the limb and transfers, however, were aware and performed the stretching maneuvers. This reveals the need to implement policies that lead to information about stroke population. Following discharge from outpatient physical therapy using educational booklets with guidelines on positioning, stretching exercises and transfer is important in functional rehabilitation and encouraging independence of the individual affected by stroke

Validade e reprodutibilidade do Wii Balance Board para avaliação do equilíbrio vertical estático: um novo método de avaliação.

The Wii Balance Board (WBB) began to be investigated as a low-cost alternative for assessing static balance in vertical posture. However, studies employed methodological procedures that did not eliminate result variability between the tests and equipment used. Objective: Determine the validity and reproducibility of the WBB as an instrument for assessing static balance in the vertical position, using simultaneous data analysis and superimposed equipment. Methods: This is an accuracy study of 29 healthy young individuals of both sexes aged 18 to 30 years. Subjects were assessed 24h apart (test-retest), using unipodal and bipodal support tests, with eyes closed and open. To that end the WBB was placed on top of a force platform (FP) and data (postural sway) were collected simultaneously on both devices. Validity and reproducibility were analyzed using the interclass correlation coefficient (ICC). Finally, Bland-Altman analysis was applied to assess agreement. Results: The sample was composed of 23 women and 6 men, with mean age of 24.2±6.3 years, 60.7±6.3 kg and 1.64±4.2 m. The validity of the WBB compared to the FP was excellent for all 4 tasks proposed (ICC = 0.93 0.98). The reproducibility analyzed by test-retest was excellent for the bipodal support tasks (ICC = 0.93-0.98) and only moderate for the unipodal support tests (ICC = 0.46 0.70). Graphic analysis exhibited good agreement between the devices, since most of the measures were within the limits of agreement. Conclusion: this study proved the validity and reproducibility of the Wii Balance Board as an instrument for assessing static balance in vertical posture, using simultaneous analysis with superimposed equipment. Thus, the WBB has been increasingly used by physical therapists and other health professionals in their clinical practice, as both a rehabilitation and assessment tool

Mulher como sujeito da criminalidade: um estudo sobre a realidade de presidiárias do complexo Penal Dr. João Chaves Natal/ RN

This work presents itself as a result of the research: Women as the subject of crime: a study on the complex reality of the criminal inmates Dr. John Keys - Natal / RN, done with women incarcerated in the Women's Pavilion Complex Criminal Dr. John Keys. Aimed to investigate the key determinants that lead women to enter the institution to be subject of crime. To better understand the object of our study, we start to understand and analyze the social reality, economic and cultural these women, as well as seizure of their family relationships and emotional, within a gender perspective and consider the analysis of major crimes committed and their determinations. In our study, it appears from successive approximations and procedures theoretical and methodological quality and quantity, we were privileged to documentary research, observation and semi-structured, beyond the theoretical foundation on the subject - that the question of increase in recent years, women in the criminal occurs as a result of socioeconomic reality experienced by those. At the same time, the study has also believe that poverty and crime are not phenomena of cause and effect, however, it is undeniable that the large number of prisoners (as) are poor and live situation of denial of rights. The main focus of the research points to the socio-emotional relationships, both marital and family as the main determinant for inclusion of women in crime, breaking with the myth that the woman is "fragile sex." And, more, points out that the woman in the process of emancipation and achievement of public spaces to commit a crime seek equal to the male. Moreover, the research also denounced in a prison system collapsed, and totally abandoned by the public. That denies all rights provided to prisoners (as), both inside and outside the "walls". It is a system that criminalizes and no one wants to fulfill its role, which is the functional rehabilitation and resocialization of (the) inmates (those). It is hoped that this work could contribute to the unveiling of the reality of women in the criminal - no pretension of exhausting it - and can also contribute to further studies on the subject

Efeito do kinesio taping® no desempenho neuromuscular do quadríceps e no equilíbrio em sujeitos submetidos à reconstrução do ligamento cruzado anterior: ensaio clínico e randomizado

Objetivo: Investigar os efeitos imediatos do Kinesio Taping® no desempenho neuromuscular do Quadríceps Femoral (QF) de indivíduos submetidos à reconstrução do Ligamento Cruzado Anterior (LCA). Metodologia: trata-se de um ensaio clínico e randomizado composto por 45 indivíduos do sexo masculino que se encontravam entre 12ª e 17ª semanas após reconstrução do LCA. Todos foram submetidos a uma avaliação inicial composta pela análise do equilíbrio postural, através da baropodometria; determinação do Senso de Posição Articular (SPA), seguidas das avaliações isocinéticas excêntricas e concêntricas a 600/s, concomitante com a captação do sinal eletromiográfico do músculo Vasto Lateral (VL). Posteriormente foram alocados de forma aleatória em Grupo Controle (GC), Grupo Placebo (GP) e Grupo Experimental (GE). Os indivíduos do GE foram submetidos ao protocolo sugerido (aplicação do Kinesio Taping® no QF do membro acometido), enquanto os do GP utilizaram a aplicação do Kinesio Taping® sem as recomendações propostas pelo método. Já os indivíduos do GC permaneceram em repouso por dez minutos, sendo todos os indivíduos submetidos a uma reavaliação de forma idêntica à primeira. Foram analisadas as seguintes variáveis: pico de torque médio, pico de torque/peso corporal, potência muscular e erro absoluto do SPA para a dinamometria; amplitude ântero-posterior e médio-lateral para a baropodometria; e a amplitude de ativação muscular (Root Means Square - RMS) por meio da eletromiografia de superfície. Resultados: Nenhuma das variáveis analisadas apresentou diferenças intergrupo ou intragrupo. Conclusão: O Kinesio Taping® não altera o desempenho neuromuscular do quadríceps femoral de indivíduos submetidos à reconstrução do LCA para nenhuma das variáveis analisadas.