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.

Proposta de avaliação da simetria e transferencia de peso e a relação dessa condição com a atividade funcional do hemiplegico

Universidade Estadual de Campinas . Faculdade de Educação Física

Fotogrametria na identificação de assimetrias posturais em cadetes e pilotos da academia da força aérea brasileira

Objective: To identify whether flight training activities cause postural changes in cadets and pilots of the Brazilian Air Force Academy (AFA). Methods: Eighty subjects were assessed through photographic images in anterior and right side views. Four groups of cadets (n=20 per group) divided according to the year since enlistment and a fifth group of fifteen pilots from the Air Demonstration Squadron (ADS) were included. Pictures were analyzed using the Postural Analysis Program (SAPO) and angles related to head vertical alignment (HVA), head horizontal alignment (HHA), acromion horizontal alignment (AHA) and anterior-superior iliac spine horizontal alignment (HAS) were plotted. Results: We did not find statistical significant differences in the angles: HVA, HHA and AHA. However, a significant difference was found for the HAS angle with pilots having lower values than cadets, suggesting greater postural stability for this variable in pilots. Conclusion: The horizontal alignment of the anterior-superior iliac spine was the only measure that showed significant difference in the comparison between pilots and cadets. The remaining alignments were not different, possibility because of the strict criteria used for admission of cadets at the AFA and the efficiency of the physical training that is performed periodically.

Fotogrametria na identificação de assimetrias posturais em cadetes e pilotos da academia da força aérea brasileira

OBJETIVO: Identificar se a atividade de treino de voo pode desencadear alterações posturais em cadetes e pilotos da Academia da Força Aérea Brasileira (AFA). MÉTODOS: Os sujeitos foram avaliados por meio de registro fotográfico em vista anterior e lateral direita, tendo como casuística 80 cadetes da AFA, divididos em quatro grupos, 20 em cada, e 15 pilotos do Esquadrão de Demonstração Aérea (EDA), formando o quinto grupo. As fotos foram transferidas para o Software de Avaliação Postural (SAPO), sendo traçados ângulos relacionados ao alinhamento vertical da cabeça (AVC), alinhamento horizontal da cabeça (AHC), alinhamento horizontal dos acrômios (AHA) e alinhamento horizontal das espinhas ilíacas ântero-superiores (AHE). RESULTADOS: Os resultados mostraram que, após comparação das médias das assimetrias posturais entre os grupos, não houve diferença estatisticamente significante em relação aos ângulos AVC, AHC e AHA. No entanto, na variável AHE, observou-se que o grupo de pilotos apresentou valores significativamente menores que os dos cadetes, sugerindo maior estabilidade postural em relação a essa variável. CONCLUSÃO: O AHE foi a única medida que apresentou diferença estatisticamente significate na comparação entre os pilotos e cadetes dos diferentes anos. Quanto aos demais alinhamentos, não houve diferença, podendo atribuir esse fato aos critérios exigentes de ingresso dos cadetes na AFA e a eficiência do treinamento físico realizado periodicamente.

Assimetria no controle postural em idosos caidores e não caidores neurologicamente sadios e com doenã de Parkinson em diferentes posições estáticas

Individuals with Parkinson's disease (PD) seem to present asymmetric postural control, and the commitment to postural control that is a big factor of falls in this population. However, the asymmetry in the postural control of fallers and non fallers with PD and neurologically healthy elderly is not too much studied. The objective of the study is to analyze the asymmetry in postural control in different static positions of elderly patients with PD and healthy elderly fallers and non fallers. The study included 70 older adults with PD and 70 neurologically healthy (CG). The groups were matched for age, gender, height, weight and cognitive condition. It was evaluated the clinical, cognitive status and incidence of falls among its participants through weekly prospective follow-up of 4 months. Then, for each group, CG and PD, it was selected 12 elderly fallers and 12 elderly non fallers to evaluate postural control. Participants were evaluated through two force platforms in conditions of bipedal support, unipedal and tandem position. It was realized 3 attempts of 30s for each condition. For unipedal and tandem condition it was made 3 attempts for each lower limb. The parameters of interest of the center of pressure (CoP), were analyzed for each condition and compared by MANOVAs with factor group, fall and asymmetry. Post hoc Tukey tests were used to determine the relationships between them. The results show that CG individuals showed greater velocity and CoP area in relation to PD. It was verified that at the control group that non fallers individuals (CGN) had more displacement and RMS in the average lateral direction in the dominant limb when compared to the less affected limb of non fallers with PD (PDN). Faller individuals in the control group (CGF) had larger area in the non dominant limb when compared to the most affected leg of fallers individuals with PD (PDF). Still, the PDF individuals had higher RMS in anteroposterior feeling....

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)...

Metodo de reconstrução tridimensional para avaliação postural

Universidade Estadual de Campinas. Faculdade de Educação Física

Avaliação postural em escolares das redes estadual e particular de ensino de primeiro grau

Universidade Estadual de Campinas . Faculdade de Educação Física

Respostas da frequencia cardiaca e da pressão arterial sistemica as manobras postural passiva e de valsalva, em individuos sedentarios e atletas corredores de longa distancia

Universidade Estadual de Campinas . Faculdade de Educação Física

Postural changes in women with chronic pelvic pain: a case control study

Background: Chronic pelvic pain (CPP) is a lower abdominal pain lasting at least 6 months, occurring continuously or intermittently and not associated exclusively with menstruation or intercourse. Although the musculoskeletal system has been found to be involved in CPP, few studies have assessed the contribution of posture in women with CPP. We aimed to determine if the frequency of postural changes was higher in women with CPP than healthy subjects. Methods: A case-control study included 108 women with CPP of more than 6 months' duration (CPP group) who consecutively attended at the Hospital of the University of Sao Paulo and 48 healthy female volunteers (control group). Postural assessment was noninvasive and performed in the standing position, with the reference points of Kendall used as normal parameters. Factors associated with CPP were assessed by logistic regression analysis. Results: Logistic regression showed that the independent factors associated with CPP were postural changes in the cervical spine (OR 4.1; 95% CI 1.6-10.7; p < 0.01) and scapulae (OR 2.9; 95% CI 1.1-7.6; p < 0.05). Conclusion: Musculoskeletal changes were associated with CPP in 34% of women. These findings suggest that a more detailed assessment of women with CPP is necessary for better diagnosis and for more effective treatment.

Anticipatory and compensatory postural adjustments in sitting in children with cerebral palsy

The aim of this study was to examine postural control in children with cerebral palsy performing a bilateral shoulder flexion to grasp a ball from a sitting posture. The participants were 12 typically developing children (control) without cerebral palsy and 12 children with cerebral palsy (CP). We analyzed the effect of ball mass (1 kg and 0.18 kg), postural adjustment (anticipatory, APA, and compensatory, CPA), and groups (control and CP) on the electrical activity of shoulder and trunk muscles with surface electromyography (EMG). Greater mean iEMG was seen in CPA, with heavy ball, and for posterior trunk muscles (p < .05). The children with CP presented the highest EMG and level of co-activation (p < .05). Linear regression indicated a positive relationship between EMG and aging for the control group, whereas that relationship was negative for participants with CP. We suggest that the main postural control strategy in children is based on corrections after the beginning of the movement. The linear relationship between EMG and aging suggests that postural control development is affected by central nervous disease which may lead to an increase in muscle co-activation. (C) 2011 Elsevier B.V. All rights reserved.

Postural control during prolonged standing in persons with chronic low back pain

Prolonged standing has been associated with the onset of low back pain symptoms in working populations. So far, it is unknown how individuals with chronic low back pain (CLBP) behave during prolonged unconstrained standing (PS). The aim of the present study was to analyze the control of posture by subjects with CLBP during PS in comparison to matched healthy adults. The center of pressure (COP) position of 12 CLBP subjects and 12 matched healthy controls was recorded in prolonged standing (30 min) and quiet stance tasks (60 s) on a force plate. The number and amplitude of COP patterns, the root mean square (RMS), speed, and frequency of COP sway were analyzed. Statistical analyses showed that CLBP subjects produced less Postural changes in the antero-posterior direction with decreased postural sway during the prolonged standing task in comparison to the healthy group. Only CLBP subjects were influenced by the prolonged standing task, as demonstrated by their increased COP RMS, COP speed and COP frequency in the quiet standing trial after the prolonged standing task in comparison to the pre-PS trial. The present study provides additional evidence that individuals with CLBP might have altered sensory-motor function. Their inability to generate responses similar to those of healthy subjects during prolonged standing may contribute to CLBP persistence or an increase risk of recurrent back pain episodes. Moreover, quantification of postural changes during prolonged standing could be useful to identify CLBP subjects prone to postural control deficits. (C) 2008 Elsevier B.V. All rights reserved.

Complexity of human postural control in young and older adults during prolonged standing

Aging is known to have a degrading influence on many structures and functions of the human sensorimotor system. The present work assessed aging-related changes in postural sway using fractal and complexity measures of the center of pressure (COP) dynamics with the hypothesis that complexity and fractality decreases in the older individuals. Older subjects (68 +/- 4 years) and young adult subjects (28 +/- 7 years) performed a quiet stance task (60 s) and a prolonged standing task (30 min) where subjects were allowed to move freely. Long-range correlations (fractality) of the data were estimated by the detrended fluctuation analysis (DFA); changes in entropy were estimated by the multi-scale entropy (MSE) measure. The DFA results showed that the fractal dimension was lower for the older subjects in comparison to the young adults but the fractal dimensions of both groups were not different from a 1/f noise, for time intervals between 10 and 600 s. The MSE analysis performed with the typically applied adjustment to the criterion distance showed a higher degree of complexity in the older subjects, which is inconsistent with the hypothesis that complexity in the human physiological system decreases with aging. The same MSE analysis performed without adjustment showed no differences between the groups. Taken all results together, the decrease in total postural sway and long-range correlations in older individuals are signs of an adaptation process reflecting the diminishing ability to generate adequate responses on a longer time scale.

Quantitative assessment of postural alignment in young adults based on photographs of anterior, posterior, and lateral views

Objective: Postural assessment through photography is a simple method that allows the acquisition of quantitative values to define the alignment of body segments. The purpose of this study was to quantitatively assess the postural alignment of several body segments in standing through anterior, posterior, and lateral views. Methods: In this cross-sectional study, 122 subjects were initially evaluated. Seven subjects were excluded from the study after cluster analysis. The final sample had 115 subjects, 75% women with a mean age of 26 + 7 years. Photographs were taken from anterior, posterior, and lateral views after placement of markers on specific anatomical points. Photographs were analyzed using free Postural Analysis Software/Software of Postural Analysis (PAS/SAPO). Quantitative values for postural analysis variables were ascertained for head, upper and lower limbs, and trunk, along with the frequency of inclinations to the left and to the right. Results: Regarding the head, 88% of the sample presented some inclination, 67% of which was to the right. There was a predominance of right inclination of the shoulder and pelvis in 68% and 43% of study subjects, respectively. Lower limbs presented mean alignment of 178 in the anterior view, and the trunk showed predominant right inclination in 66% of participants. Conclusion: Small asymmetries were observed in anterior and posterior views. This study suggests that there is no symmetry in postural alignment and that small asymmetries represent the normative standard for posture in standing. (J Manipulative Physiol Ther 2011;34:371-380)

On the functional integration between postural and supra-postural tasks on the basis of contextual cues and task constraint

In order to evaluate the effects of uncertainty about direction of mechanical perturbation and supra-postural task constraint on postural control young adults had their upright stance perturbed while holding a tray in a horizontal position Stance was perturbed by moving forward or backward a supporting platform contrasting situations of certainty versus uncertainty of direction of displacement Increased constraint on postural stability was Imposed by a supra-postural task of equilibrating a cylinder on the tray Performance was assessed through EMG of anterior leg muscles angular displacement of the main Joints involved in the postural reactions and displacement of the tray Results showed that both certainty on the direction of perturbation and Increased supra-postural task constraint led to decreased angular displacement of the knee and the hip Furthermore combination of certainty and high supra-postural task constraint produced shorter latency of muscular activation Such postural responses were paralleled by decreased displacement of the tray Thesi results suggest a functional integration between the tasks with central set priming reactive postural responses from contextual cues and Increased stability demand (C) 2010 Elsevier B V All rights reserved