Assessment of the ergonomic design of diagnostic ultrasound transducers through wrist movements and subjective evaluation

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

Comparative analysis between three methods of bone estimating age in individuals with down syndrome by mode of the hand and wrist ray

The wrist and hand region has been the most commonly used for estimating age and osseous development due to the great number of ossification centers. The aim was to determine which method, Tanner & Whitehouse's (TW3), Greulich & Pyle's (GP) or Eklof & Ringertz's, more closely relates to the chronological age in subjects with Down syndrome with chronological ages between 61 and 180 months, using wrist and hand radiographs. The sample consisted of 85 radiographs, 52 of males and 33 of females. Eklof & Ringertz's method was computerized (Radiomemory). Greulich & Pyle's atlas was used and compared with the wrist and hand radiographs. For the TW3 method, 13 ossification centers were evaluated; for each one of them, there are seven or eight development stages to which scores are assigned; these scores are then added and the results are transformed into osseous age values. No statistically significant differences were observed between the male and female genders for methods TW3 and GP, contrasting with the observed differences for the Eklof & Ringertz method. Correlation (r2) between osseous and chronological ages was 0.8262 for TW3 and 0.7965 for GP, while for the method of Eklof & Ringertz, it was 0.7656 for females and 0.8353 for males. The author concluded that the osseous age assessment method that better related to the chronological age was the TW3, followed by Greulich & Pyle's and Eklof & Ringertz's.

Correlation between hand/wrist and panoramic radiographs in severe secondary hyperparathyroidism

Objectives: Hand/wrist and dental radiographs are important for osteoporosis analysis in secondary hyperparathyroidism (SHPT). This study evaluated whether a correlation exists between the effects of the disease on the hands and jaws, and investigated the association between osteoporosis progression in the hands and parathyroid hormone (PTH) levels in chronic kidney disease (CKD) patients. Materials and methods: Four panoramic radiographic parameters (mental index, mandibular cortical index, trabecular bone pattern, and calcification/resorption) and four corresponding hand/wrist radiographic parameters (metacarpal cortical thickness, phalangeal cortical index, trabecular bone pattern, and calcification/resorption) were applied to investigate possible correlation between the effects of SHPT on the jaws and hands/wrists, by Spearman's correlation coefficient. PTH levels and the hand/wrist radiographic parameters were also tested by spearman's correlation coefficient (p < 0.05). The presence of brown tumors, vascular calcifications, and acroosteolysis on the hands was also evaluated. Results: Mandibular cortical index was strongly correlated with the phalangeal cortical index (p = 0.000). Phalangeal cortical index and trabecular bone pattern of hand/wrist correlated with PTH levels (0.002 and 0.000, respectively). Brown tumors occurred in four CKD patients, while both vascular calcifications and acroosteolysis were observed in 19 patients. Conclusion: There is a significant correlation between the morphological changes caused by secondary hyperparathyroidism in hand and jaw bones. The morphological status can be assessed using the mandibular cortical index, besides the phalangeal cortical index. The latter correlates well with parathyroid hormone levels of advanced chronic kidney disease. Clinical relevance: Panoramic images reveal morphological changes in the jaw bone, indicating likewise changes in the hand/wrist in severe secondary hyperparathyroidism. The severity of the bone changes may be a reflection of the parathyroid hormone levels in advanced chronic kidney disease. © 2012 Springer-Verlag.

Are cutout handles used when available in real occupational settings? Description of grips and upper extremities movements during industrial box handling

In order to achieve better postures and decrease musculoskeletal risks adequate design of hand/box couplings for manual materials handling (MMH) are still needed. No studies evaluating upper limb movement thorough direct measurements during box handling in workplace were identified in the literature. In this study we describe the types of grip and movements adopted by ten workers when handling redesigned boxes with cutout handles between different heights on industrial pallets. The new handles were used by 90% of the workers through different types of grip. Electrogoniometric measurements showed relatively safe forearm and wrist movements, although elbow inadequate range of movement was recorded. Despite the good acceptance of the cutout by workers, the new design requires extra internal space in the boxes reducing applications for this alternative of box.

The surface electromyography analysis of the non-plegic upper limb of hemiplegic subjects

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

Neurophysiological patterns of ulnar nerve neuropathy in leprosy reactions

Background: Leprosy neuropathy, despite being primarily demyelinating, frequently leads to axonal loss. Neurophysiological examination of the nerves during Type 1 (T1R) and Type 2 reactions (T2R) may give some insight into the pathophysiological mechanisms.Methods: Neurophysiological examinations were performed in 28 ulnar nerves during a clinical trial of steroid treatment effectiveness, 19 patients with T1R and nine with T2R. The nerves were monitored during a period of 6 months; there were eight assessments per nerve, for a total of 224 assessments. Nine neurophysiological parameters were assessed at three sites of the ulnar nerve. The compound motor action potential amplitudes elicited at wrist, elbow and above, as well as the conduction velocity and temporal dispersion across the elbow, were chosen to focus on the changes occurring in the parameters at the elbow tunnel.Results and Conclusion: Neurophysiological changes indicating axonal and demyelinating processes during both T1R and T2R were detected across the elbow. Changes in demyelination, i.e. a Conduction Block, as a primary event present during T2R, occurring as an acute phenomenon, were observed regularly; in T1R Temporal Dispersion, a subacute phenomenon, was seen. During treatment remyelination occurred after both types of reactions.

Análise preditiva da densidade mineral óssea em adolescentes brasileiros eutróficos do sexo masculino

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

Morfologia das 3ª e 4ª vértebras cervicais representativa do surto de crescimento puberal

OBJETIVOS: determinar a morfologia das 3ª e 4ª vértebras cervicais representativa dos estágios de pré-pico, pico e pós-pico de velocidade de crescimento estatural, definidos previamente pelos centros de ossificação do primeiro dedo em radiografias carpais ou do dedo polegar. MÉTODOS: foram utilizadas 120 telerradiografias em norma lateral de 106 pacientes selecionados da clínica de Ortodontia Preventiva e Interceptiva da Faculdade de Odontologia de Araçatuba-UNESP e Profis/HRAC-USP que apresentavam as correspondentes radiografias carpais ou do dedo polegar. As telerradiografias foram divididas em três grupos de 40 radiografias, de acordo com os estágios maturacionais pré-pico, pico e pós-pico, definidos pela imagem do primeiro dedo. A morfologia dos corpos das 3ª e 4ª vértebras cervicais foi determinada por dois examinadores devidamente calibrados em dois tempos diferentes. CONCLUSÕES: concluiu-se que o formato retangular horizontal com borda inferior reta foi representativo do estágio de pré-pico, independentemente da vértebra analisada. Já o formato retangular horizontal com borda inferior curva, especialmente se encontrado em C4, ou o formato quadrado com borda inferior reta caracterizaram o pico de velocidade de crescimento. O formato quadrado ou, principalmente, o retangular vertical com borda inferior curva determinaram o estágio de pós-pico de velocidade de crescimento da adolescência.

Skeletal muscles with antagonistic muscular actions: morphological, contractile and metabolic characteristics

The muscles can perform the same function in a specific segment (muscles of fast and slow contraction), and at the same time be antagonistic in relation to muscular action (flexors or extensors). The present research aimed to study the morphology, frequency and metabolism of fiber types and the contractile characteristics of extensor and flexors muscles of rabbit. We studied muscles anterior tibialis (AT), flexor digitorum supeficialis (FDS), extensor digitorum longus (EDL) and posterior tibialis (PT). The muscles were submitted to the techniques HE, NADH-TR and myofibrillar ATPase. In EDL and PT extensor muscles, the frequencies of red (SO + FOG) and white fibers (FG) were 68.77% and 31.23% versus 58.87% and 41.13%, respectively. In the AT and FDS flexor muscles, these frequencies were 75.14% and 24.86% versus 73.89% and 26.11%, respectively. In extensor muscles, the percentage of slow contraction fibers was 8.05% in EDL and 9.74% in PT, and in fast contraction, 91.95% in EDL and 90.26% in PT. In flexors, the slow contraction frequencies were 12.35% in AT and 8.17% in FDS, and in fast contraction, 87.65% and 91.83%, respectively. Skeletal muscles with antagonistic muscular actions (flexors and extensors) the morphological, contractile and metabolic characteristics are identical.

Efeito protetor após sessões de exercício excêntrico: comparação entre membros superiores e inferiores

O objetivo foi comparar a magnitude do efeito protetor (EP) contra o dano muscular (DM) induzido por uma sessão de exercícios excêntricos (EEM) entre os extensores do joelho e os flexores do cotovelo. Doze sujeitos do gênero masculino foram divididos em 2 grupos, braços (GB) e pernas (GP), e realizaram 2 sessões de EEM. Foram coletados 3 marcadores de DM, sendo eles, pico de torque isométrico (PTI), creatina quinase (CK) e percepção subjetiva de dor (PSD), antes, imediatamente após (com exceção da CK) e 48 horas após cada sessão de EEM. Foi encontrada queda significante de PTI e aumento significante de CK e PSD tanto imediatamente e 48 horas após a primeira sessão de EEM para o GB. No GP houve aumento significante de CK 48 horas após os EEM e da PSD imediatamente após os EEM, decorrentes da primeira sessão. No GB, a segunda sessão apenas provocou queda de PTI imediatamente após os EEM, enquanto no GP houve aumento significante apenas na PSD imediatamente após a segunda sessão de EEM. Apenas a CK apresentou EP para ambos os grupos. Pudemos concluir que o EP foi maior para o GB em comparação com o GP. Esse fenômeno pode ter ocorrido em detrimento da existência de um EP prévio para o GP, uma vez que este membro realiza contrações excêntricas intensas com maior freqüência no dia-a-dia, quando comparados com os GB.

POSITIONING DURING RESISTANCE ELBOW FLEXOR EXERCISE AFFECTS ELECTROMYOGRAPHIC ACTIVITY, HEART RATE, and PERCEIVED EXERTION

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Heavy-intensity aerobic exercise affects the isokinetic torque and functional but not conventional hamstrings:quadriceps ratios

Running exercises are frequently related to muscular injuries, which may be a result of muscular imbalance. The present study aimed to verify the effects of heavy-intensity continuous running exercise on the functional and conventional hamstrings: quadriceps ratios, and also in the knee flexors and extensors EMG activity in active non-athletic individuals. Sixteen active males performed maximal isokinetic concentric and eccentric knee flexions and extensions at 60 degrees s(-1) and 180 degrees s(-1). In another session, the same procedure was conducted after a continuous running exercise at 95% onset of blood lactate accumulation. Torque and electromyographic ratios were calculated from peak torque and integrated electromyographic activity (knee flexor and extensors). Creatine kinase was measured before and 24 h after running exercise. Eccentric torque (knee flexion and extension) decreased significantly after running only at 180 degrees s(-1) (p < 0.05). No differences were found for the conventional torque ratios (p > 0.05), however, the functional torque ratios at 180 degrees s(-1) decreased significantly after running (p < 0.05). No effects on the electromyographic activity and electronnyographic ratios were found (p > 0.05). Creatine kinase increased slightly 24 h after running (p < 0.05). Heavy-intensity continuous running exercise decreased knee flexor and extensor eccentric torque, and functional torque ratios under fast velocities (180 degrees s(-1)), probably as result of peripheral fatigue. (C) 2008 Elsevier Ltd. All rights reserved.

Does muscle imbalance affect fatigue after soccer specific intermittent protocol?

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

Controle de movimentos voluntários no membro superior não plégico de portadores de paralisia cerebral hemiplégica espástica

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Análise cinemática e eletromiográfica do alcance em pacientes com acidente vascular encefálico

INTRODUÇÃO: O movimento de alcance é muito estudado na literatura, no entanto, poucos estudos realizam análise cinemática e eletromiográfica desse movimento em sujeitos hemiparéticos. OBJETIVO: Avaliar o alcance de indivíduos hemiparéticos pós-acidente vascular encefálico (AVE) em seus aspectos cinemáticos e eletromiográficos. MATERIAIS E MÉTODOS: Foram selecionados quatro indivíduos, idade média de 54,5 ± 10,7 anos, com diagnóstico de AVE associado à hemiparesia. Realizou-se a avaliação cinemática e eletromiográfica concomitantemente do movimento de alcance na postura sentada, tanto do lado parético quanto do não parético. RESULTADOS: Houve diferença significativa entre os sujeitos com relação ao deslocamento (F(3,63) = 3.081, p = 0.03), porém, não ocorreu diferença significativa entre os lados (F(1,63) = 1.441, p = 0.23). Com relação às articulações (ombro, cotovelo e punho), houve diferença significativa entre os deslocamentos de cada uma (F(2,63) = 27.496, p = 0.00), assim como entre as coordenadas x, y e z (F(2,63) = 36.702, p = 0.00). Na análise dos dados eletromiográficos, não houve diferença significativa entre os sujeitos (F(3,31) = 2.437, p = 0.08), entre os lados (F(1,31) = 3.384, p = 0.07) e entre os músculos (F(4,31) = 0.942, p = 0.45). Existiu diferença no tempo de execução dos movimentos quando comparado o lado não acometido com o acometido. CONCLUSÃO: As análises cinemática e eletromiográfica, de um modo geral, mostraram resultados semelhantes aos encontrados na literatura. No entanto, este estudo acrescenta uma visão mais sistematizada do movimento de alcance, considerando seus aspectos funcionais, diferindo de outros estudos por apresentar, concomitantemente, análises cinemática e eletromiográfica e por investigar ambos os membros superiores.