Efeitos de uma informação sensorial adicional no controle postural: envelhecimento e doença de Parkinson

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Relação entre a disparidade de força entre membros inferiores e estabilidade postural em atletas de voleibol

Volleyball is a sport in which the laterality dominant limb shows superior strength and coordination because of its preferential use. Asymmetrical tendencies during the landing after the jump when striking or blocking actions are predominant for most part of game (ARRUDA; EDUARDO, 2008). Adaptations include imbalance of forces in static and dynamic motions at the knee joint, which increases risk for injury. Also, asymmetries in balance control during jumping and landing associate with a general postural instability that can be observed during static balance tasks. The purpose of this study was to investigate relationship between unequal lower limb strength (muscle imbalance) and postural stability levels in volleyball athletes and non-athletes. Nine female volleyball athletes and 10 active non-athletes participated in this study. Four encouters with participants were scheduled: three encounters in the bodybuilding gymnasium to collect anthropometric measures (weight, height for BMI, thigh circumference, which provided an initial diagnosis about asymmetry), and to perform the isometric strength test (i.e., leg press using a load cell and a force transducer to calculate uni an bilateral strength). The last encounter was in the laboratory where a balance test on a force platform was administered under five test conditions, with three repetitions each: baseline (natural standing position), one-leg standing, right side, with full vision (D_CV), and blindfolded (D_SV), one-leg standing, left side, with full vision (E_CV), and blindfolded (E_SV). The stability levels were evaluated using the path length parameters which was based on the total displacement of the center of pressure (DTCP). . Both groups shows asymmetric strength levels between legs, with better performance for the right leg. An ANOVA three way using the DTCP for the CV condition, legs (D x E), trials (3) with repeated measures for the first two factors and with a between (three)...

Reação postural de pacientes com doença de Parkinson e idosos sadios no teste de retropulsão instrumentado

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Mensuração da qualidade de vida de indivíduos com a doença de Parkinson por meio do questionário PDQ-39

INTRODUÇÃO: A doença de Parkinson (DP) é caracterizada por uma degeneração progressiva seletiva de neurônios localizados na pars compacta da substância negra. Ela compõe-se por um conjunto de quatro sintomas motores: tremor, rigidez, bradicinesia e instabilidade postural. OBJETIVO: O estudo objetivou investigar os fatores relacionados à queda na percepção da qualidade de vida de indivíduos com DP. MATERIAIS E MÉTODOS: Participaram deste estudo 25 indivíduos com diagnóstico de doença de Parkinson, classificados entre os estágios um e cinco da escala de estadiamento de Hoen e Yahr, tendo a sua qualidade de vida avaliada segundo o Parkinson Disease Questionary-39 (PDQ-39). RESULTADOS: Os 25 indivíduos (12 homens e 13 mulheres) apresentaram idade média de 71,2 ± 8,5 anos, variando entre 53 a 85 anos, e tempo de evolução da doença de 6,54 ± 7,71, variando entre 1 e 39 anos de doença. Verificou-se que as piores percepções sobre a qualidade de vida estão relacionadas ao domínio mobilidade, com média de 55% de comprometimento, e ao domínio atividade de vida diária, com 52,78% de comprometimento. Ficou também constatada uma alta correlação entre o escore total do PDQ-39 com os domínios atividade de vida diária, bem-estar emocional e mobilidade. CONCLUSÕES: A partir dos resultados obtidos, é possível constatar que carências de origem motora associadas aos sinais e sintomas e às complicações secundárias da DP interferem negativamente sobre a percepção da qualidade de vida dos indivíduos.

Efeitos da atividade física nas atividades da vida diária em indivíduos com doença de Parkinson

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

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.

Treinamento com vibração do corpo todo resulta em ganho de força muscular e mobilidade funcional em indivíduos com doença de Parkinson

Pós-graduação em Desenvolvimento Humano e Tecnologias - IBRC

Postural control and functional balance in individuals with diabetic peripheral neuropathy

A Neuropatia diabética periférica (NDP) cursa com redução somatossensitiva que pode levar a alterações no controle postural. O objetivo do estudo foi avaliar o controle postural na postura ereta, em diferentes condições, e o equilíbrio funcional em indivíduos com NDP, correlacionar os resultados obtidos na avaliação do controle postural com os valores do teste do equilíbrio funcional e comparar os resultados obtidos no grupo neuropata com o grupo controle, verificando as possíveis diferenças entre as condições de avaliação em ambos os grupos. Participaram do estudo 13 mulheres com NDP (GN) e 17 mulheres não diabéticas (GC). A avaliação do controle postural foi realizada por cinemetria nas condições: olhos abertos (OA), olhos fechados (OF) e semi tandem (ST). Após processamento no MATLAB, foram geradas as variáveis: amplitude média de oscilação (AMO) na direção ântero-posterior (AP) e médio-lateral (ML); e velocidade média de oscilação (VMO) na direção AP e ML. O equilíbrio funcional foi avaliado pelo Timed Up and Go Test. Houve diferença significante entre os grupos (p<0,005) na AMO-AP OA e OF, AMO-ML of e ST e VMO-ML ST. Houve diferença entre as condições OA e ST (p<0,005) e of e ST (p<0,005) para as variáveis AMO-ML e VMO-ML, com maior prejuízo para o GN, que também apresentou um menor equilíbrio funcional (p=0,001). A instabilidade ML foi correlacionada positivamente com o desequilíbrio funcional. Os resultados nos mostram uma alteração no sistema de controle postural na NDP, o que pode levar estes indivíduos a um maior risco a quedas e prejuízos funcionais.

Efeitos do sistema âncora sobre o controle postural de idosos

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Controle postural de idosos: efeito da perturbação visual com o uso do sistema âncora

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Estabilização postural do olhar: efeitos da distância do objeto

The aim of the present study was to analyze the effects of looking at targets located at different distances on body oscillation during tasks of distinct difficulties. In Experiment 1, ten participants in quiet stance fixated targets in three conditions: No object-far (fixation on far-target without near-target), Object-near (fixation on near target with fartarget), and Object-far (fixation on far-target with near-target). Mean oscillations of trunk in anterior-posterior axis were smallest in the Object-near condition; the No object-far and Object-far conditions were similar. In Experiment 2, seven participants in kiba-dachi, a karate stance, were submitted to three conditions: Blindfolded, No object-far, and Object-near. Mean oscillations of head and trunk in anterior-posterior axis were smaller in the Object-near as compared to blindfolded condition; trunk oscillated more during No object-far than Object-near condition. The results support the notion that a simple posture is not automatically regulated by the optical flow, but different amounts of visual instability may be tolerated according to the fixation distance, regardless the presence of non-fixated objects; the control of a more difficult posture may also accommodate the effects of fixation distance.

Visual conditions and postural directions affect postural sway variability in patients with Parkinson’s disease

Postural sway variability was evaluated in Parkinson’s disease (PD) patients at different stages of disease. Twenty PD patients were grouped into two groups (unilateral, 14; bilateral, 6) according to disease severity. The results showed no significant differences in postural sway variability between the groups (p ≥ 0.05). Postural sway variability was higher in the antero-posterior direction and with the eyes closed. Significant differences between the unilateral and bilateral groups were observed in clinical tests (UPDRS, Berg Balance Scale, and retropulsion test; p ≤ 0.05, all). Postural sway variability was unaffected by disease severity, indicating that neurological mechanisms for postural control still function at advanced stages of disease. Postural sway instability appears to occur in the antero-posterior direction to compensate for the stooped posture. The eyes-closed condition during upright stance appears to be challenging for PD patients because of the associated sensory integration deficit. Finally, objective measures such as postural sway variability may be more reliable than clinical tests to evaluate changes in balance control in PD patients.

Is the meander growth in the Brazil Current system off Southeast Brazil due to baroclinic instability?

Temporally-growing frontal meandering and occasional eddy-shedding is observed in the Brazil Current (BC) as it flows adjacent to the Brazilian Coast. No study of the dynamics of this phenomenon has been conducted to date in the region between 22 degrees S and 25 degrees S. Within this latitude range, the flow over the intermediate continental slope is marked by a current inversion at a depth that is associated with the Intermediate Western Boundary Current (IWBC). A time series analysis of 10-current-meter mooring data was used to describe a mean vertical profile for the BC-IWBC jet and a typical meander vertical structure. The latter was obtained by an empirical orthogonal function (EOF) analysis that showed a single mode explaining 82% of the total variance. This mode structure decayed sharply with depth, revealing that the meandering is much more vigorous within the BC domain than it is in the IWBC region. As the spectral analysis of the mode amplitude time series revealed no significant periods, we searched for dominant wavelengths. This search was done via a spatial EOF analysis on 51 thermal front patterns derived from digitized AVHRR images. Four modes were statistically significant at the 95% confidence level. Modes 3 and 4, which together explained 18% of the total variance, are associated with 266 and 338-km vorticity waves, respectively. With this new information derived from the data, the [Johns, W.E., 1988. One-dimensional baroclinically unstable waves on the Gulf Stream potential vorticity gradient near Cape Hatteras. Dyn. Atmos. Oceans 11, 323-350] one-dimensional quasi-geostrophic model was applied to the interpolated mean BC-IWBC jet. The results indicated that the BC system is indeed baroclinically unstable and that the wavelengths depicted in the thermal front analysis are associated with the most unstable waves produced by the model. Growth rates were about 0.06 (0.05) days(-1) for the 266-km (338-km) wave. Moreover, phase speeds for these waves were low compared to the surface BC velocity and may account for remarks in the literature about growing standing or stationary meanders off southeast Brazil. The theoretical vertical structure modes associated with these waves resembled very closely to the one obtained for the current-meter mooring EOF analysis. We interpret this agreement as a confirmation that baroclinic instability is an important mechanism in meander growth in the BC system. (C) 2008 Elsevier B.V. All rights reserved.