Occupational ergonomics: Work posture among Brazilian dental students

This study involved observational assessment of work posture in relation to recommended ergonomic posture the requirements necessary for ergonomic posture among students in the final year of a degree program at the School of Dentistry of Araraquara-UNESP/Brazil (n =73) and investigation of the association of work posture with sex, the type of procedure, four-handed dentistry, and the region of the mouth being treated. The work posture of the students during 250 clinical procedures was observed by means of pictures. Each procedure received a posture classification: Adequate, partially adequate, or inadequate. A descriptive statistical analysis was conducted. The prevalence of final posture classification was calculated using 95% confidence intervals and point estimate. Associations of interest were studied using the chi-square test, with a 5% significance level. It was concluded that the prevalence of procedures performed with partially adequate posture was high, and that the final work posture classification was not associated with the variables of interest. © 2013 Taylor & Francis Group.

Craniocervical posture and craniofacial morphology

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

Dyslexic children suffer from less informative visual cues to control posture

The goal of this study was to investigate the effects of manipulation of the characteristics of visual stimulus on postural control in dyslexic children. A total of 18 dyslexic and 18 non-dyslexic children stood upright inside a moving room, as still as possible, and looked at a target at different conditions of distance between the participant and a moving room frontal wall (25-150 cm) and vision (full and central). The first trial was performed without vision (baseline). Then four trials were performed in which the room remained stationary and eight trials with the room moving, lasting 60 s each. Mean sway amplitude, coherence, relative phase, and angular deviation were calculated. The results revealed that dyslexic children swayed with larger magnitude in both stationary and moving conditions. When the room remained stationary, all children showed larger body sway magnitude at 150 cm distance. Dyslexic children showed larger body sway magnitude in central compared to full vision condition. In the moving condition, body sway magnitude was similar between dyslexic and non-dyslexic children but the coupling between visual information and body sway was weaker in dyslexic children. Moreover, in the absence of peripheral visual cues, induced body sway in dyslexic children was temporally delayed regarding visual stimulus. Taken together, these results indicate that poor postural control performance in dyslexic children is related to how sensory information is acquired from the environment and used to produce postural responses. In conditions in which sensory cues are less informative, dyslexic children take longer to process sensory stimuli in order to obtain precise information, which leads to performance deterioration. (C) 2014 Elsevier Ltd. All rights reserved.

A interdependência da prática docente e a construção da héxis corporal de professores de Educação Física e suas consequências na unidade escolar

This article aims to show the interdependence between teaching practice and the construction of body hexis of Physical Education teachers and its consequences at schools. It can be observed by the social workers that teach it in a elementary school in the city of Araraquara- -SP. It was established, as basic assumption of this issue, that the social construction of body hexis of Physical Education teachers is a process in constant evolution, because it is the result of the life story with interventions from the social context in which the learner lives. The hexis is the dimension that allows the internalization of the consequences of social practices, and also its body exteriorization, through the way of speaking, gesturing, looking, walking, head posture, faces, ways of sitting, to handle instruments, more and more associated with the voice sound of social workers. Children are particularly attentive, in all societies, to these gestures and postures in which they express themselves in their eyes, anything that features an adult. Finally, it understands the importance of the body hexis in the learning process specifically in school physical education. This practice will incite important behavioral changes in their residence within the school and possibly in a higher education.

Professores de educação física e suas consequências na unidade escolar

This article aims to show the interdependence between teaching practice and the construction of body hexis of Physical Education teachers and its consequences at schools. It can be observed by the social workers that teach it in a elementary school in the city of Araraquara- -SP. It was established, as basic assumption of this issue, that the social construction of body hexis of Physical Education teachers is a process in constant evolution, because it is the result of the life story with interventions from the social context in which the learner lives. The hexis is the dimension that allows the internalization of the consequences of social practices, and also its body exteriorization, through the way of speaking, gesturing, looking, walking, head posture, faces, ways of sitting, to handle instruments, more and more associated with the voice sound of social workers. Children are particularly attentive, in all societies, to these gestures and postures in which they express themselves in their eyes, anything that features an adult. Finally, it understands the importance of the body hexis in the learning process specifically in school physical education. This practice will incite important behavioral changes in their residence within the school and possibly in a higher education.

Body posture evaluations in subjects with internal temporomandibular joint derangement

The aim of this study was to verify possible relationships between global body posture and temporomandibular joint internal derangement (TMJ-id), by comparing 30 subjects presenting typical TMJ-id signs to 20 healthy subjects. Body posture was assessed using the analysis of muscle chains on several photographs. Results show a higher frequency of lifted shoulders (p=0.04) and of changes in the antero-internal hip chain (p=0.02) in the test group, but no further differences were found significant between the control and test groups. The test group was then divided into three subgroups according to the Helkimo index of temporomandibular disorder severity. Again, no significant differences were found between the subgroups. However, there was a trend noticed in the group with the most severe dysfunction, to present a forward head and shoulders posture. Results are discussed in light of previous studies using the same sample.

Comfort, stability and body posture in wheelchair cushions: a preliminary study with able bodied subjects

Long term wheelchair usage has been related to a number of problems, among which pressure ulcers are one of most concern. The design of wheelchair seat cushions has been of increasing interest among researchers, as it can influence seat interface pressure and user's comfort. The aim of this study was to investigate the subjects' perception comfort, stability and body posture of six different commercially available wheelchair cushions. The evaluation was through a questionnaire, where the subjects rate their perceptions on a ten point visual analog scale after staying seated in the cushion for two minutes. The results shows that the Roho^TM aircell cushion was preferred by the users, while the least preferred one was the water cushion. Individuals' subjective perceptions may compliment objective data on seat interface pressure, thus contributing to a more complete view of the users' experience during wheelchair cushion usage.

Inter-rater reliability of the evaluation of muscular chains associated with posture alterations in scoliosis

Background: In the Global postural re-education (GPR) evaluation, posture alterations are associated with anterior or posterior muscular chain impairments. Our goal was to assess the reliability of the GPR muscular chain evaluation. Methods: Design: Inter-rater reliability study. Fifty physical therapists (PTs) and two experts trained in GPR assessed the standing posture from photographs of five youths with idiopathic scoliosis using a posture analysis grid with 23 posture indices (PI). The PTs and experts indicated the muscular chain associated with posture alterations. The PTs were also divided into three groups according to their experience in GPR. Experts' results (after consensus) were used to verify agreement between PTs and experts for muscular chain and posture assessments. We used Kappa coefficients (K) and the percentage of agreement (%A) to assess inter-rater reliability and intra-class coefficients (ICC) for determining agreement between PTs and experts. Results: For the muscular chain evaluation, reliability was moderate to substantial for 12 PI for the PTs (% A: 56 to 82; K: 0.42 to 0.76) and perfect for 19 PI for the experts. For posture assessment, reliability was moderate to substantial for 12 PI for the PTs (% A > 60%; K: 0.42 to 0.75) and moderate to perfect for 18 PI for the experts (% A: 80 to 100; K: 0.55 to 1.00). The agreement between PTs and experts was good for most muscular chain evaluations (18 PI; ICC: 0.82 to 0.99) and PI (19 PI; ICC: 0.78 to 1.00). Conclusions: The GPR muscular chain evaluation has good reliability for most posture indices. GPR evaluation should help guide physical therapists in targeting affected muscles for treatment of abnormal posture patterns.

Respiratory inductive plethysmography: a comparative study between isovolume maneuver calibration and qualitative diagnostic calibration in healthy volunteers assessed in different positions

Objective: To compare two methods of respiratory inductive plethysmography (RIP) calibration in three different positions. Methods: We evaluated 28 healthy subjects (18 women and 10 men), with a mean age of 25.4 +/- 3.9 years. For all of the subjects, isovolume maneuver calibration (ISOCAL) and qualitative diagnostic calibration (QDC) were used in the orthostatic, sitting, and supine positions. In order to evaluate the concordance between the two calibration methods, we used ANOVA and Bland-Altman plots. Results: The values of the constant of proportionality (X) were significantly different between ISOCAL and QDC in the three positions evaluated: 1.6 +/- 0.5 vs. 2.0 +/- 1.2, in the supine position, 2.5 +/- 0.8 vs. 0.6 +/- 0.3 in the sitting position, and 2.0 +/- 0.8 vs. 0.6 +/- 0.3 in the orthostatic position (p < 0.05 for all). Conclusions: Our results suggest that QDC is an inaccurate method for the calibration of RIP. The K values obtained with ISOCAL reveal that RIP should be calibrated for each position evaluated.

ANALYSIS OF THE BALANCE CONTROL IN SURFERS DURING THE ERECT POSTURE

Background: Surfing is a sport that has become considerably popular, which increased interest in research about the aspects that can influence on the performance of these athletes, such as injuries, aerobic fitness and reaction time. Due to the ever-changing environment and high instability required for surfing, the surfers must develop some neuromuscular skills (agility, balance, muscle strength and flexibility) to acquire better performance in this modality. Nevertheless, there are still few scientific studies concerned about the investigation of these motor skills in surfing. Objective: The aim of this study was to evaluate the balance control in surfers compared to practitioners of other physical activities. Methods: Participants remained on a force platform while performing tasks involving visual deprivation (eyes open or closed) and somatosensory disturbance (steady surface or use of foam), with covariation of experimental conditions. The following variables were analyzed: speed and root mean square (RMS) displacement of the center of pressure in the anteroposterior (AP) and mediolateral (ML) directions. Results: The results showed no difference between groups during the experimental conditions, that is to say, both surfers and the control group varied over the conditions of eyes closed and on foam. Conclusion: Although surfing requires the surfer to have great balance control, the results did not reveal a relationship between this sport and better performance in balance control. However, we must consider the small sample size and the fact that this sport requires dynamic balance, while the study evaluated static balance.

Patent foramen ovale and neurosurgery in sitting position: a systematic review

We have conducted a systematic review of air embolism complications of neurosurgery in the sitting position and patent foramen ovale (PFO) closure. It assesses the risk and benefit of PFO closure before neurosurgery in the sitting position. The databases Medline, Embase, and Cochrane Controlled Trial Register were systematically searched from inception to November 2007 for keywords in both topics separately. In total, 4806 patients were considered for neurosurgery in sitting position and 5416 patients underwent percutaneous PFO closure. The overall rate of venous air embolism during neurosurgery in sitting position was 39% for posterior fossa surgery and 12% for cervical surgery. The rate of clinical and transoesophageal echocardiography detected paradoxical air embolism was reported between 0% and 14%. The overall success rate for PFO closure using new and the most common closure devices was reported 99%, whereas the average risk of major complications is <1%. On the basis of our systematic review, we recommend screening for PFO and considering closure in cases in which the sitting position is the preferred neurosurgical approach. Our proposed management including the time of PFO closure according to available data is presented. However, the conclusions from our systematic review may be limited due to the lack of level A evidence and from using data from observational cohort studies. Thus, definite evidence-based recommendations require prospective evaluation of the issue in well-designed studies.

The effects of impingement and dysplasia on stress distributions in the hip joint during sitting and walking: a finite element analysis

Soft tissue damage has been observed in hip joints with pathological geometries. Our primary goal was to study the relationship between morphological variations of the bony components of the hip and resultant stresses within the soft tissues of the joint during routine daily activities. The secondary goal was to find the range of morphological parameters in which stresses are minimized. Computational models of normal and pathological joints were developed based on variations of morphological parameters of the femoral head (Alpha angle) and acetabulum (CE angle). The Alpha angle was varied between 40 degrees (normal joint) and 80 degrees (cam joint). The CE angle was varied between 0 degrees (dysplastic joint) and 40 degrees (pincer joint). Dynamic loads and motions for walking and standing to sitting were applied to all joint configurations. Contact pressures and stresses were calculated and crosscompared to evaluate the influence of morphology. The stresses in the soft tissues depended strongly on the head and acetabular geometry. For the dysplastic joint, walking produced high acetabular rim stresses. Conversely, for impinging joints, standing-to-sitting activities that involved extensive motion were critical, inducing excessive distortion and shearing of the tissue-bone interface. Zones with high von Mises stresses corresponded with clinically observed damage zones in the acetabular cartilage and labrum. Hip joint morphological parameters that minimized were 20 degrees

Vaginal voiding: a common cause of daytime urinary leakage in girls

STUDY OBJECTIVE: To estimate the frequency of vaginal voiding as the cause of daytime urinary leakage in girls, and to study the effect of instructions intended to alleviate the problem. SETTING: Girls with vaginal voiding were identified in a group of girls referred because of daytime urinary leakage. They were evaluated by a noninvasive screening protocol. Girls with vaginal voiding were instructed on how to achieve better toilet habits. PARTICIPANTS: Twelve girls with vaginal voiding. RESULTS: Vaginal voiding was found in 12 of 39 girls with daytime urinary leakage. Their age ranged between 8.5 and 13.9 years. They all had history of small leakage immediately after voiding. A body mass index greater than the corresponding 85th percentile was noted in 5 girls, and labial fusion was noted in 2 girls. The complaint disappeared in 10 girls and improved in the remaining 2 girls after instructions on how to achieve better toilet habits. CONCLUSIONS: Vaginal voiding is common in girls. It occurs in girls at risk of overweight, in girls with labial fusion, and in girls adopting a hairpin posture while sitting on the toilet. The diagnosis is obtained by an adequate history. Proper voiding instructions resolve the problem.