Analysis of localized muscle fatigue in elderly women with and without a history of falls using electromyographic signal frequency parameters

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Relação entre projeção do centro de gravidade e equilíbrio em idosos

During the aging process, increase the postural asymmetries that can affect the control mechanism of balance leading to falls. To evaluate the static posture of elderly; measure the balance and correlate the results of the posture with balance. The study involved 28 elderly patients, 13 males and 15 females (71.8 ± 5.7 years). The volunteers were photographed, the images transferred to a computer for evaluation of static posture and calculating the projection of the center of gravity in the frontal and sagittal planes using the Postural Assessment Software. The balance was assessed by the Berg Balance Scale (BBS). Correlations were performed by Spearman test (p ≤ 0.05). Data were presented as mean ± standart deviation (SD). BBS scores = 50.5 ± 3.3; the sagittal plane (anterior asymmetry) = 45.5 ± 11.1%; frontal plane (right or left asymmetry) = 9.8 ± 7.9. We found a correlation between BBS and asymmetry of the sagittal plane (r = -0.46, p = 0.01) and between BBS and asymmetry of the frontal plane (r = -0.41, p = 0.03). The data suggest that the higher the previous projection (asymmetry of the sagittal plane) and lateral projection (asymmetry of the frontal plane), scores of the BBs will be lower, indicating an increase of unbalance in elderly.

Relação entre postura, queixa dolorosa e lesão em bailarinas clássicas

Introduction: Due to the high recurrence of pain complaints and the increasing incidence of musculoskeletal injuries and postural changes in dance practice, researches related to this issue gained greater importance in scientific community. Objective: This study aimed to evaluate complaints and pain threshold, postural misalignments and the incidence of injuries in dancers noting if there is a relationship between these variables. Method: Participants were 15 ballet dancers in Marília - SP. We used photogrammetry for postural analysis, the McGill Pain Questionnaire for pain location of the volunteer, algometry pressure for measuring the threshold of pain perception and Referred Morbidity to verify and characterize the incidence of injuries this population. In the data analysis we use to percentage to quantify the data from questionnaires and Pearson correlation test angles of photogrammetry correlating with the values of the threshold of pain perception. Results: 73.33% of dancers reported to have suffered some kind of injury in the last year. The area of greatest pain complaint checked at McGill, was the region of the foot (73.30%). Conclusion: There was an agreement between regions of injury and pain, however, there wasn’t a correlation between the threshold of pain tolerance and postural angles.

Tratamento fisioterapêutico na síndrome do respirador bucal

Introdução: A síndrome do respirador bucal é caracterizada pelo indivíduo que substitui o padrão correto da respiração nasal por um padrão inadequado, de maneira bucal ou mista. É definida por um conjunto de sintomas que constitui um quadro geral de doenças e pelas alterações que podem acontecer nas vias aéreas superiores, modificando o padrão respiratório e levando a alterações faciais e corporais. Objetivo: Apresentar um caso e demonstrar o tratamento fisioterapêutico de um paciente com a síndrome do respirador bucal, permitindo possível melhora da condição respiratória, do padrão postural e das atividades de vida diárias do paciente. Método: Estudo de caso de uma paciente com 10 anos, sexo feminino, com síndrome do respirador bucal. A paciente foi submetida a uma avaliação inicial que constava de anamnese e exame físico, além de avaliação postural, índice de massa corpórea, manuvacuometria, peak-flow e espirometria. O tratamento constou de técnicas de reeducação postural global (RPG), exercícios respiratórios e orientações, com frequência de três vezes na semana, por 60 minutos, num período de dois meses, totalizando 20 sessões. Resultados: Na avaliação inicial a paciente apresentou mais alterações em fechamento – cadeia anterior, portanto no tratamento foram realizadas posturas para abertura. Após o tratamento observou-se melhora da postura; da condição respiratória com melhora nos testes de manuvacuometria, peak-flow e espirometria; melhora também das atividades diárias. Conclusão: O tratamento fisioterapêutico proposto, RPG e exercícios respiratórios, contribuiu para melhora global da condição respiratória, do padrão postural e das atividades diárias.

Influência do tratamento fisioterapêutico em grupo no equilíbrio, na mobilidade funcional e na qualidade de vida de pacientes com Parkinson

Introduction: Parkinson’s disease (PD) is a chronic disease of the nervous system, characterized by degeneration of neurons in the mesencephalic substantia nigra, leading to a clinical state of rest tremor, bradykinesia, muscular rigidity and postural instability. Physical therapy seeks to act by slowing the progression of the disease and when done in a group and maintain and / or improving the motor skills of the individual, can provide psychosocial benefi ts. Objective: examine the infl uence of the physical therapy group in balance, functional mobility and quality of life of individuals with PD. Method: participated in this study 04 subjects were female, mean age 67.75 (± 9.5) years, with medical diagnosis of PD, stages 1 to 3 of the Hoehn & Yahr. Before starting treatment, subjects underwent an assessment of the balance (BBS), functional mobility (TUG) and the quality of life (PDQ-39).The treatment was performed in groups, for a period of 10 weeks, lasting 60 minutes each session twice a week, totaling 20 sessions of physiotherapy. Upon completion of the treatment period the subjects were again assessed for balance, functional mobility and quality of life. The data were analyzed using the Student t-test, with signifi cance level of 5% (p ≤ 0.05). Results: statistical analysis showed signifi cant differences in three variables: equilibrium (p = 0.010), functional mobility (p = 0.029) and quality of life (p = 0.004), after physiotherapy intervention. Conclusion: physiotherapy treatment was group provides better balance, functional mobility and quality of life of patients with PD.

Influência do fortalecimento muscular na independência funcional de indivíduos parkinsonianos

Introduction: Parkinson’s disease is a chronic disease of the nervous system that leads to a clinical picture of resting tremor, bradykinesia, muscular rigidity and postural instability. These symptoms, in turn, directly influence the functional independence of the individual. Objective: To analyze the influence of muscle strengthening on functional independence of individuals with Parkinson’s disease. Method: A total of ten subjects of both genders participated in this study. We evaluated the functional independence, strength of lower limbs, grip strength testing and 1 repetition maximum. After the evaluation was performed muscle building program for 12 weeks. Results: There was improvement of functional independence (p = 0.007) and lower limb strength (p = 0.01), as well as an increase in grip strength, both of the dominant hand (p = 0.007) and the non-dominant one (p = 0.02). Conclusion: The muscle strength improved the functional independence of individuals with PD.

Equilíbrio funcional em indivíduos com doença de Parkinson e sua relação com a qualidade de vida

Introduction: Parkinson’s Disease (PD) is characterized by a set of four motor symptoms: tremor, rigidity, bradykinesia and postural instability. These defi cits may predispose individuals to limitations resulting from falls and their secondary consequences. Objective: To evaluate the functional balance and quality of life (QoL) in individuals with PD and determine whether there is correlation between performance on tests of balance with the QoL. Method: The project was referred to the Ethics Committee in Research of Universidade Estadual Paulista “Julio de Mesquita Filho” Campus de Marília and was approved under protocol number 1806/09. Participated in this study with individuals diagnosed with PD between levels one and four in the Hoen and Yahr scale. The subjects were evaluated according to functional balance and QoL, respectively by the instruments: Functional Balance Scale Berg (EEFB), Time Up and Go test (TUG), and Parkinson’s Disease Questionnaire-39 (PDQ-39). To perform the statistical analysis used the GraphPad Prism 5. To perform the correlation analysis for the variables passed normality by the Shapiro-Wilk. Since the variables were non-parametric test was used Spearman. During the analysis the statistical signifi cance level was considered p ≤ 0, 05. Results: We studied 25 individuals aged between 54 and 85 years (71.20 ± 8.50), time of diagnosis between one and 39 years (6.54 ± 7.71) disease. Moderate correlation was found between the EEFB with QoL (r =- 0.6), and TUG with QoL (r = 0.6836). Among the aspects of QoL balance showed a higher correlation with the domains “mobility” (TUG r = 0, 6768; EEFB r = -0.6155) and “Activities of daily living” (TUG r = 0, 7357, and EEFB r = -0.6521). Conclusion: Patients with Parkinson’s disease show defi cits in balance and QoL. The balance disorders have a high correlation among themselves and show how aspects of QoL.

Avaiação da Dor e da Postura em Pacientes com Lombalgia Submetidos a Dois Protocolos de Fortalecimento Abdominal

Introduction: the lumbar spine is the main part of the body responsible for the support of the loads, where approximately half of body weight is in stable balance. This support relates to the action of abdominal muscles, of great importance in the balance of that region. The existence of abdominal muscle weakness, such won’t perform its function, may induce pathological postural attitude, that predispose the pain. Objective: to compare the effects of two abdominal strengthening protocols on pain and postural alignment in individuals with low back pain. Method: participated of the study 21 individuals of both genders, with ages between 19 and 25 years old (average 21,8±1,5) and average Body Mass Index (BMI) 21,9 (±2,48), divided randomly in isometric abdominal stimulation group (n=8), abdominal strengthening group (n=7) and control group (n=6). They realized eight sessions of strengthening, when responded Visual Analogue Scale (VAS) before and after each intervention. The control group (n=6) had no intervention. The postural data had been analyzed by photogrammetry. Results: Pain and posture data were analyzed using paired t test, with signifi cance index of 5%. Postural angles had no signifi cant differences (p>0,05) from all angles analyzed after the intervention to none of the groups. For pain values, a signifi cant decrease (p<0,05) was observed since the fi fth session in patients who were treated by the abdominal exercises protocol, and the fi rst session in patients who were treated by the isometric abdominal stimulation protocol. However, this decrease in pain was immediate, not lasting along the treatment sessions, in both protocols. Conclusion: the proposed protocols did not interfere in postural alignment. They were effective to decrease pain in a same session, once the isometric was the most effective, but they weren’t effective in preserving the improves over time.

Correlação entre equilíbrio, assimetria de passos e descarga de peso em indivíduos hemiparéticos

Introduction: Hemiparesis is the most common sequels after Stroke. One of the side effects of the motor skills evident in hemiparesis is the tendency to remain in asymmetric posture, with lower distribution of weight on the side hemiparetic, which ends up leading to a deficit in balance. This set of changes can cause an asymmetrical type of gait, marked by difference between the lengths of the steps these individuals. Objective: The purpose of this study was to analyze the balance, the discharge of weight in the lower limbs and asymmetry of steps in hemiparetic individuals and sees if there is correlation between those variables. Method: A group of 12 hemiparetic individuals (55,33 ± 8,92 years), both sex, who suffered from strokes participated. All subjects performed the assessment of bilateral discharge of weight, the length of the steps and balance (Berg Balance Scale). The results for the difference in the discharge of weight of the lower limbs, asymmetry of the step and the performance on the test of balance were analyzed using the Sperman Correlation Coefficient with a significance level of 5% (p ≤ 0.05). Results: We found a significant correlation between balance and asymmetry of the steps (R = -0.72 and p = 0007), however, found no significant correlation between discharge of weight on each leg and the symmetry of the steps (R =- 0.07 and p = 0, 81) and between discharge of weight and balance (R =- 0.08 and p = 0.79) in these hemiparetic individuals. Conclusion: Can be conclude that hemiparetic individuals of these study show deficits in balance, difference in weight between the discharge of the lower limbs and asymmetry of step and correlation between the asymmetry of the step and balance.

Caracterização das lesões desportivas em atletas de Tênis de Mesa

Introduction: The table tennis is characterized by requiring of the athletes intense body movement. The gestures performed by athletes require continuous postural changes, in cases of any sway in body structures may produce postural changes or initiate processes of injuries. Objective: The aim of this study was to characterize the table tennis lesions. Method: Were evaluated 31 athletes (26 males and fi ve females) with mean age 22.35±6.67 years. The subjects were interviewed with the Reported Morbidity Inquires retroactive to the 2009 season. It was used techniques of descriptive and analytical statistics. Results: The largest number of injuries was muscular (74.35%), on the shoulder (43.58%) during the movement of top spin (33.33%) in the specifi c training phase (64.1%) with symptomatic return to the activities (69.23%). Conclusion: The weekly training workload infl uences the number of lesions.

Análise do equilíbrio estático e de deformidades nos pés de crianças com paralisia cerebral por meio de baropodometria computadorizada

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Mobiliários adaptados para pessoas com paralisia cerebral: um levantamento das teses e dissertações produzidas no Brasil

The Assistive Technology makes the lives of people without disabilities more practical, but for people with disabilities it can make things possible. For these individuals can provide the conditions, making their limitations are not obstacles to their social and personal empowerment, and may contribute to their effective participation in tasks that were previously impossible, such as remaining seated correctly. A segment on which the necessary assistive technology works, is the adaptation of furniture such as chairs, tables, chairs-to-wheels for individuals with disabilities, as well as cerebral palsy. The study aimed to conduct a survey and brief description of theses and dissertations produced in Brazil on furniture adapted for students with cerebral palsy. We made searching in databases of libraries of major universities and federal state national banks, theses and dissertations. Nine studies were selected for description. It was concluded that there is a considerable array of professionals, both in engineering as the field of rehabilitation, to contribute in the adaptation, creation and even the manufacture of furniture for children with cerebral palsy and that the securities most studied are the chairs and their components.

Eficácia de mobiliário escolar adaptado de baixo custo no desempenho funcional de criança com paralisia cerebral

Indivíduos com Paralisia Cerebral apresentam desenvolvimento motor atípico, caracterizado por alterações posturais, de coordenação motora e de tônus muscular, que resulta em limitações no desempenho de atividades funcionais. Neste contexto destaca-se a prescrição e confecção de recursos de tecnologia assistiva com objetivo de maximizar as habilidades funcionais destas pessoas e prover sua inclusão social. Os indivíduos com paralisia cerebral, muitas vezes, têm dificuldade para a manutenção da dinâmica corporal, principalmente na postura sentada. O objetivo deste estudo foi o de confeccionar uma cadeira e mesa escolar adaptadas com material de baixo custo e verificar sua eficácia no desempenho grafomotor de uma criança com paralisia cerebral. O participante foi uma criança com diagnóstico de paralisia cerebral diplégica, do gênero masculino. A coleta e registro dos dados foram feitos em três momentos, com a criança posicionada no mobiliário adaptado, no mobiliário escolar comum e novamente no mobiliário adaptado, para se estabelecer a comparação. A análise de dados se deu por meio de testes estatísticos não paramétricos. Não houve significância estatística e foi verificada uma inconstância nos dados apresentados, já que não se pode afirmar ao certo qual mobiliário foi mais eficaz na realização da atividade proposta e nem se houve aprendizado motor com a sua repetição. Esse fato não invalida a adequação de mobiliário escolar ao aluno com paralisia cerebral, visto que este é um fator importante para favorecer o controle e estabilidade postural ao individuo, o que interfere na coordenação motora fina destes indivíduos, influenciando no seu desempenho em atividades escolares.

Stabilometric parameters analysis in children with visual disorder

Background: Although postural changes were already reported in blind adults, no previous study has investigated postural stability in blind children. Moreover, there are few studies which used a stabilometric instrument to measure postural balance. In this study we evaluated stabilometric paramaters in blind children. Methods: We evaluated children between 7 to 12 years old, they were divided into two groups: Blind (n = 11) and age-matched control (n = 11) groups by using computerized stabilometry. The stabilometric examination was performed taking the gravity centers displacement of the individual projected into the platform. Thirthy seconds after the period in which this information was collected, the program defined a medium-pressure center, which was used to define x and y axes displacement and the distance between the pressure center and the platform center. Furthermore, the average sway rate and the body sway area were obtained by dividing the pressure center displacement and the time spent on the task; and by an ellipse function (95% percentille), respectively. Percentages of anterior, posterior, left and right feet weight also were calculated. Variables were compared by using the Student’s t test for unpaired data. Significance level was considered for p <0.05. Results: Displacement of the x axis (25.55 ± 9.851 vs. -3.545 ± 7.667; p <0.05) and average sway rate (19.18 ± 2.7 vs. -10.55 ± 1.003; p <0.001) were increased in the blind children group. Percentage of left foot weight was reduced (45.82 ± 2.017 vs. 52.36 ± 1.33; p <0.05) while percentage of right foot weight was increased (54.18 ± 2.17 vs. 47.64 ± 1.33; p <0.05) in blind children. Other variables did not show differences. Conclusions: Blind children present impaired stabilometric parameters.

Analysis of the positioning of the head, trunk, and upper limbs during gait in children with visual impairment

Background: This study analyzed the positioning of the head, trunk, and upper extremities during gait in children with visual impairment. Methods: A total of 11 children participated in this study: 6 with blindness and 5 with low vision. The kinematics of the positioning of the head, trunk, shoulders, and elbows in each participant was analyzed during the four phases of the gait cycle: foot strike, support, toe-off, and swing. Results: There were significant differences between children with blindness and low vision in the positioning of the trunk in the sagittal plane during the foot strike, support, and swing phases. Conclusions: The analysis identified postural alterations of the head, trunk, shoulder, and elbow during the children’s gait, highlighting the relevance of appropriate stimulation at an early age in orientation and mobility programs, as well as the essential presence of professionals who work with movement.