Controle postural em pacientes com lesão do ligamento cruzado anterior

A lesão do ligamento cruzado anterior (LCA) do joelho acarreta alterações somatosensoriais em função da perda de informações provenientes dos mecanorreceptores presentes no LCA. Esses receptores constituem importante fonte de informação sensorial, afetando o desempenho de vários atos motores, dentre os quais o controle postural. O estudo objetivou analisar o controle postural de indivíduos com joelhos normais e com lesão unilateral do LCA. Participaram 15 voluntários com lesão do LCA (grupo lesado) e 15 voluntários com joelhos normais (grupo controle). O controle postural foi analisado por plataforma de força, sendo o voluntário instruído a assumir a situação experimental em apoio unipodal direito e esquerdo, posicionado no centro da plataforma de modo estático e com os olhos fechados. A plataforma de força forneceu informações de forças e momentos no eixo vertical e horizontal, a partir das quais foi obtida a área de deslocamento do centro de pressão nas direções ântero-posterior e médio-lateral. Os resultados mostram que indivíduos com lesão do LCA apresentaram maior amplitude média de oscilação comparados aos do grupo controle, sugerindo que o deficit no controle postural seja devido à perda de informações proprioceptivas nos indivíduos com LCA. Esses resultados têm implicações para a abordagem clínica de indivíduos com lesão do LCA.

Avaliação postural em pacientes com doença pulmonar obstrutiva crônica

O objetivo deste estudo foi avaliar alterações posturais em pacientes com Doença Pulmonar Obstrutiva Crônica (DPOC), por meio do Software para Avaliação Postural (SAPO). Trinta indivíduos constituíram 2 grupos: 15 pacientes com DPOC e 15 idosos saudáveis (controle). Os grupos realizaram espirometria e foram fotografados para avaliação postural. As imagens obtidas foram digitalizadas e, posteriormente, avaliou-se dez alterações posturais com o SAPO [inclinação lateral da cabeça (ILC), desnivelamento dos ombros (DO), desnivelamento pélvico anterior (DPA), inclinação lateral do tronco (ILT), desnivelamento das escápulas (DE), desnivelamento pélvico posterior (DPP), protusão da cabeça (PC), protusão de ombro (PO), báscula anterior da pelve (BAP) e cifose torácica (CT)]. Essas alterações, obtidas no grupo controle, foram conferidas com o padrão de normalidade para adultos jovens, proposto em estudo prévio. Para a comparação das alterações posturais entre grupo controle e DPOC, foi utilizado o teste de Mann-Whitney em grupo controle, e em adultos jovens, o teste t de Student não pareado, ambos com nível de significância estatística de 5%. Dentre as dez alterações posturais, o grupo controle apresentou sete (ILC, DPA, DE, DPP, PC, PO, BAP) com valores angulares significativamente maiores em relação aos adultos jovens. Quando comparados a idosos saudáveis, indivíduos com DPOC apresentaram um aumento significante na angulação de BAP, DPP e CT. Pacientes com DPOC apresentam três alterações posturais que provavelmente estão relacionadas à doença.

Efeitos do sistema âncora sobre o controle postural de idosos

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Diferenças sensoriais e motoras entre jovens e idosos: contribuição somatossensorial no controle postural

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

Physical activity and postural control in the elderly: Coupling between visual information and body sway

Background: Aging is characterized by a decline in the postural control performance, which is based on a coherent and stable coupling between sensory information and motor action. Therefore, changes in postural control in elderlies can be related to changes in this coupling. In addition, it has been observed that physical activity seems to improve postural control performance in elderlies. These improvements can be due to changes in the coupling between sensory information and motor action related to postural control. Objective: the purpose of this study was to verify the coupling between visual information and body sway in active and sedentary elderlies. Methods: Sixteen sedentary elderlies ( SE), 16 active elderlies ( AE) and 16 young adults ( YA) were asked to stand upright inside a moving room in two experimental conditions: ( 1) discrete movement and ( 2) continuous movement of the room. Results: In the continuous condition, the results showed that the coupling between the movement of the room and body sway was stronger and more stable for SE and AE compared to YA. In the discrete condition, SE showed larger body displacement compared to AE and YA. Conclusions: SE have more difficulty to discriminate and to integrate sensory information than AE and YA indicating that physical activity may improve sensory integration. Copyright (C) 2005 S. Karger AG, Basel.

Task demand effects on postural control in older adults

The literature shows conflicting results regarding older adults' (OA) postural control performance. Differing task demands amongst scientific studies may contribute to such ambiguous results. Therefore, the purpose of this study was to examine the performance of postural control in older adults and the relationship between visual information and body sway as a function of task demands. Old and young adults (YA) maintained an upright stance on different bases of support (normal, tandem and reduced), both with and without vision, and both with and without room movement. In the more demanding tasks, the older adults displayed greater body sway than the younger adults and older adults were more influenced by the manipulation of the visual information due to the room movement. However, in the normal support condition, the influence of the moving room was similar for the two groups. These results suggest that task demand is an important aspect to consider when examining postural control in older adults. (c) 2006 Elsevier B.V. All rights reserved.

Developing an Anchor system to enhance postural control

This article uses an anchor metaphor to explain the dynamic interplay between the human body's active uses of nonrigid tools to mediate information about its adjacent environment to enhance postural control. The author used an anchor system (ropes attached to varying weights resting on the floor) to test blindfolded adults who performed a restricted-balance task (30 s one-foot standing). Participants were tested while holding the anchors under a variety of weight conditions (125 g, 250 g, 500 g, and I kg) and again during a baseline condition (no anchors). When compared with the baseline condition, there was a significant reduction in the amount of body sway across the anchor conditions. The author found that mechanical support provided by the anchor system was secondary to its haptic exploratory function and that an individual can use the anchoring strategy with a dual purpose: for resting and for reorientation after intrinsic disruptions.

Postural control as a function of self- and object-motion perception

The goals of this study were to examine the visual information influence on body sway as a function of self- and object-motion perception and visual information quality. Participants that were aware (object-motion) and unaware (self-motion) of the movement of a moving room were asked to stand upright at five different distances from its frontal wall. The visual information effect on body sway decreased when participants were aware about the sensory manipulation. Moreover, while the visual influence on body sway decreased as the distance increased in the self-motion perception, no effects were observed in the object-motion mode. The overall results indicate that postural control system functioning can be altered by prior knowledge, and adaptation due to changes in sensory quality seem to occur in the self- but not in the object-motion perception mode. (C) 2004 Elsevier B.V.. All rights reserved.

Physical and postural aspects of teachers during work activity

Studies indicate that teachers constitute a professional segment, in which the work characteristics and the demands originating from the act of teaching, favor the emergence of sickness, concerning physical or emotional aspects. The present work aimed to describe physical and postural aspects during the working activity of teachers. A total of 120 elementary school teachers (1st to 8th grade) took part in the survey. For data collection, a questionnaire was applied: it included personal and occupational information, perception of discomfort and being off work; physical strength activities; posture at work and physical conditioning activities. The average age of teachers of the present sample corresponds to 35,8 years. In relation to activities which generate more physical strength, the answer none of the activities was predominant with 30 answers; followed by writing on the board, standing up during the period of classes, explanation of the subjects, class elaboration, correction of homework and others. The area of the body with higher amount of occurrences and prevalent discomfort referred to the lower limbs and spinal cord. These data inform the necessity of investing in prevention programs for the teachers, in order to develop strategies into the organizational context and interventions at the work environment.