Postural adjustment as a sign of attention in 7-month-old infants

Adjustments during postural control have been recognized in the process of the integration of movement and cognition. The objective of the present work was to describe postural changes and to verify if there is a correlation between postural adjustment and attention span in 7-month-old infants during 1 min of viewing an animated puppet. Method: Twenty-nine healthy infants (14 males) born from 31 to 39 weeks (median 36) were placed in a prone position and filmed watching a puppet during I min. The analysis of the images allowed us to catalogue the changes in position, the frequency of these changes, and the attention span. The following items were quantified: total number of infant positions, positions with weight transfer, changes in support, axis, decubitus, trunk and cervical movements, timing and pauses in visual attention. Results: Twenty-one infants stayed in the prone position during most of the recording, and eight chose sitting position before starting the session. Two groups were studied according to the main position throughout the filming, one in prone and the other in sitting positions, although they could rolling or crawling. For prone group the attention span was positively correlated with the number of positions with weight transfer (r = 0.53, p = 0.04), negatively correlated with trunk movements (r = -0.63, p = 0.01), and not correlated with birth or current weight. This work suggests that changes in the trunk movements and weight transfer are different traits related to the attention in 7-month-old infants. (C) 2008 Elsevier B.V.. All rights reserved.

GLOBAL POSTURAL REEDUCATION AND STATIC STRETCHING EXERCISES IN THE TREATMENT OF MYOGENIC TEMPOROMANDIBULAR DISORDERS: A RANDOMIZED STUDY

Objective: The purpose of this study was to compare 2 different interventions, global postural reeducation (GPR) and static stretching exercises (SS), in the treatment of women with temporomandibular disorders (TMDs). Methods: A total of 28 subjects with TMDs were randomized into 2 treatment groups: GPR, where therapy involved muscle global chain stretching, or SS, with conventional static stretching; but only 24 completed the study. Eight treatment sessions lasting 40 minutes each (weekly) were performed. Assessments were conducted at baseline, immediately after treatment end, and 2 months later. Measurements included pain intensity at the temporomandibular joint, headache, cervicalgia, teeth clenching, ear symptoms, restricted sleep, and difficulties for mastication, using a visual analogue scale. In addition, electromyographic activity and pain thresholds were measured at the masseter, anterior temporalis, stemocleidomastoid, and upper trapezius muscles. Two-way analysis of variance with Tukey post hoc test was used for between-group comparisons. Significance level was .05. Results: Comparing the pain assessments using the visual analogue scale, no significant differences were seen with the exception of severity of headaches at treatment end (GPR, 3.92 +/- 2.98 cm; SS, 1.64 +/- 1.66 cm; P < .024). In addition, no significant differences were seen for pain thresholds and for electromyographic activity (P > .05). Conclusions: For the subjects in this study, both GPR and SS were similarly effective for the treatment of TMDs with muscular component. They equally reduced pain intensity, increased pain thresholds, and decreased electromyographic activity. (J Manipulative Physiol Ther 2010;33:500-507)

Changes in motor planning of feedforward postural responses of the trunk muscles in low back pain

Changes in trunk muscle recruitment have been identified in people with low-back pain (LBP). These differences may be due to changes in the planning of the motor response or due to delayed transmission of the descending motor command in the nervous system. These two possibilities were investigated by comparison of the effect of task complexity on the feedforward postural response of the trunk muscles associated with rapid arm movement in people with and without LBP. Task complexity was increased by variation of the expectation for a command to either abduct or flex the upper limb. The onsets of electromyographic activity (EMG) of the abdominal and deltoid muscles were measured. In control subjects, while the reaction time of deltoid and the superficial abdominal muscles increased with task complexity, the reaction time of transversus abdominis (TrA) was constant. However, in subjects with LBP, the reaction time of TrA increased along with the other muscles as task complexity was increased. While inhibition of the descending motor command cannot be excluded, it is more likely that the change in recruitment M of TrA represents a more complex change in organisation of the postural response.

Postural control of the trunk in response to lateral support surface translations during trunk movement and loading

The postural response to translation of the support surface may be influenced by the performance of an ongoing voluntary task. This study was designed to test this proposal by applying lateral perturbations while subjects handled a load in the frontal plane. Measurements were made of medio-lateral displacement of the centre of pressure, angular displacement of the trunk and thigh in the frontal plane and intra-abdominal pressure. Subjects were translated randomly to the left and right in a variety of conditions that involved standing either quietly or with a 5 kg load in their left hand, which they were required either to hold statically or to lift or lower. The results indicate that when the perturbation occurred towards the loaded left side the subjects were able to return their centre of pressure, trunk and thigh rapidly and accurately to the initial position. However, when the perturbation occurred towards the right (away from the load) this correction was delayed and associated with multiple changes in direction of movement, suggesting decreased efficiency of the postural response. This reduced efficiency can be explained by a conflict between the motor commands for the ongoing voluntary task and the postural response, and/or by the mechanical effect of the asymmetrical addition of load to the trunk.

Coexistence of stability and mobility in postural control: evidence from postural compensation for respiration

This study evaluated the extent to which movement of the lower limbs and pelvis may compensate for the disturbance to posture that results from respiratory movement of the thorax and abdomen. Motion of the neck, pelvis, leg and centre of pressure (COP) were recorded with high resolution in conjunction with electromyographic activity (EMG) of flexor and extensor muscles of the trunk and hip. Respiration was measured from ribcage motion. Subjects breathed quietly, and with increased volume due to hypercapnoca (as a result of breathing with increased dead-space) and a voluntary increase in respiration. Additional recordings were made during apnoea. The relationship between respiration and other parameters was measured from the correlation between data in the frequency domain (i.e. coherence) and from time-locked averages triggered from respiration. In quiet standing, small angular displacements (similar to0.5degrees) of the trunk and leg were identified in raw data. Correspondingly, there were peaks in the power spectra of the angular movements and EMG. While body movement and EMG were coherent with respiration (>0.5), the coherence between respiration and COP displacement was low (

Postural control and movement performance during upper limb tasks in children with developmental co-ordination disorder (DCD)

At least 6% of primary school aged children present with DCD, where co-ordination is substantially below the normal range for the child’s age and intelligence. Motor skill difficulties negatively affect academic achievement, recreation and activities of daily living. Poor upper-limb co-ordination is a common difficulty for children with DCD. A possible cause of this problem is deviant muscle timing in proximal muscle groups, which results in poor postural and movement control. While studies have been published investigating postural control in response to external perturbations, detail about postural muscle activity during voluntary movement is limited even in children with normal motor development. No studies have investigated the relationship between muscle timing, resultant arm motion and upper-limb coordination deficits. Objectives: To investigate the relationship between functional difficulties with upper-limb motor skills and neuromuscular components of postural stability and coordination. Specifically, to investigate onset-timing of muscle activity, timing of arm movement, and resultant three-dimensional (3D) arm co-ordination during rapid, voluntary arm movement and to analyse differences arising due to the presence of DCD. This study is part of a larger research program investigating postural stability and control of upper limb movement in children. Design: A controlled, cross-sectional study of differences between children with and without DCD. Methods: This study included 50 children aged eight to 10 years (25 with DCD and 25 without DCD). Children participated in assessment of motor skills according to the Movement ABC Test and a laboratory study of rapid, voluntary arm movements. Parameters investigated included muscle activation timing of shoulder and trunk muscles (surface electromyography), arm movement timing (light sensor) and resultant 3D arm motion (Fastrak). Results: A MANOVA is being used to analyse between-group differences. Preliminary results indicate children with DCD demonstrate altered muscle timing during a rapid arm raise when compared with the control group of children. Conclusion: Differences in proximal muscle timing in children with DCD support the hypothesis that altered proximal muscle activity may contribute to poor proximal stability and consequently poor arm movement control. This has implications for clinical physiotherapy.

Changes in postural stability in women aged 20 to 80 years

Background. A study of postural stability was undertaken to identify the relationship between vision and support surface across age decades. Understanding when reliance on vision for postural stability emerges and the support conditions contributing to this instability may provide the evidence required to introduce falls-prevention strategies in younger age decades. Methods. We measured postural stability in 453 women aged 20 to 80 years using the Balance Master force-plate system while the women performed the modified Clinical Test for the Sensory Interaction and Balance (firm and foam surfaces, eyes open and closed) and the Single-Limb Stance Test (eyes open and closed). Results. Women in their 60s and 70s were more unstable than younger women in bilateral stance on a firm surface with the eyes closed. This instability was evident from the 50s when a foam surface was introduced and from the 40s when single-limb stance was tested with eyes closed. A further decline in stability was demonstrated for each subsequent decade when the eyes were closed in single-limb stance. Conclusions. Age, visual condition, and support surface were significant variables influencing postural stability in women. Reliance on vision for postural stability was evident for women from the 40s when single-limb stance was tested, from the 50s when bilateral stance on foam was tested, and from the 60s when a firm surface was used. The cause(s) of this decline in stability requires further investigation, and screening for postural instability between the ages of 40 and 60 is advocated.

Impaired postural compensation for respiration in people with recurrent low back pain

This study evaluated the degree to which the disturbance to posture from respiration is compensated for in healthy normals and whether this is different in people with recurrent low back pain (LBP), and to compare the changes when respiratory demand is increased. Angular displacement of the lumbar spine and hips, and motion of the centre of pressure (COP), were recorded with high resolution and respiratory phase was recorded from ribcage motion. With subjects standing in a relaxed posture, recordings were made during quiet breathing, while breathing with increased dead-space to induce hypercapnoea, and while subjects voluntarily increased their respiration to match ribcage expansion that was induced in the hypercapnoea condition. The relationship between respiration and the movement parameters was measured from the coherence between breathing and COP and angular motion at the frequency of respiration, and from averages triggered from the respiratory data. Small angular changes in the lumbopelvic and hip angles were evident at the frequency of respiration in both groups. However, in quiet standing, the LBP subjects had a greater displacement of their COP that was associated with respiration than the control subjects. The LBP group had a trend for less hip motion. There were no changes in the movement parameters when respiratory demand increased involuntarily via hypercapnoea, but when respiration increased voluntarily, the amplitude of motion and the displacement of the COP increased in both groups. The present data suggest that the postural compensation to respiration counteracts at least part of the disturbance to posture caused by respiration and that this compensation may be less effective in people with LBP.

Controle postural na síndrome de Pusher: influência dos canais semicirculares laterais

A síndrome de Pusher caracteriza-se por uma alteração do equilíbrio na qual pacientes com lesões encefálicas empurram-se em direção ao lado parético utilizando o membro não-afetado. O papel do sistema vestibular na alteração postural da síndrome de Pusher ainda não foi devidamente elucidado. OBJETIVO: Neste estudo objetivamos avaliar o papel dos canais semicirculares horizontais na expressão clínica da síndrome de Pusher, através da aplicação das provas calórica e rotatória. FORMA DE ESTUDO: Observacional, clínico e prospectivo. MATERIAL E MÉTODO: Avaliamos 9 pacientes com AVC e síndrome de Pusher internados na Enfermaria de Neurologia do HCFMRP-USP. Os pacientes foram submetidos à avaliação neurológica clínica e neuropsicológica, NIHSS, Scale for Contraversive Pushing - SCP, teste calórico e teste rotatório. RESULTADOS: Foram estudados 9 pacientes (5 homens) com idade média de 71,8 ± 5,9 anos e com NIHSS médio de 18.33. Três pacientes apresentaram preponderância direcional contralateral à lesão encefálica na prova calórica. Na prova rotatória, foram observados quatro pacientes com preponderância direcional na análise de velocidade da componente lenta. CONCLUSÃO: Os resultados do presente estudo indicam que a disfunção dos canais semicirculares não parece ser fundamental para a expressão da síndrome de Pusher.

DESENVOLVIMENTO DE UM CLASSIFICADOR PARA ANÁLISE BIOMÉTRICA DE UM COLETE INSTRUMENTADO PARA REEDUCAÇÃO POSTURAL

Ao longo dos tempos tem existido um avanço, nas empresas, dirigido à preocupação com o bemestar dos trabalhadores, adotando por isso medidas preventivas. A formação especializada em Medicina do Trabalho é indispensável para o exercício de atividades de prevenção dos riscos profissionais e de promoção da saúde. A postura corporal pode ser definida como a posição e a orientação global do corpo e membros relativamente uns aos outros. Qualquer desvio na forma da coluna vertebral pode gerar solicitações funcionais prejudiciais que ocasionam um aumento de fadiga no trabalhador e leva ao longo do tempo a lesões graves. Cada vez mais surgem doenças profissionais provocadas pela adoção de más posturas, na realização de tarefas diárias dos trabalhadores. A boa postura corporal é uma tarefa específica que representa uma interação complexa entre a função biomecânica e neuromuscular. No presente plano de dissertação foram estudados diferentes classificadores tendo como objetivo classificar boas e más posturas corporais de trabalhadores em contexto de trabalho. Assim foram estudados diferentes classificadores de machine learnig, redes neuronais artificiais, support vector machine, árvores de decisão, análise discriminante, regressão logística, treebagger e naíve bayes. Para treino de classificadores foi realizada a aquisição tridimensional da postura da espinha a 100 pessoas, passando por uma parametrização e treino de diferentes classificadores para a determinação automática do tipo de postura corporal. O classificador que obteve melhor desempenho foi o Treebagger com uma classificação para True Positive de 93,3% e True Negative de 96,2%.

Caracterização da função vascular periférica pela resposta hemodinâmica da alteração postural passiva do membro inferior

O estudo da função vascular periférica tem beneficiado do desenvolvimento de diversas técnicas e metodologias de avaliação o as quais permitem caracterizar a função com um mínimo de invasibilidade. O estudo do significado de diversas variáveis transcutâneas tem ajudado a melhor compreender as complexas relações que regem a perfusão dos tecidos in vivo. No presente estudo procurámos avaliar o perfil de resposta de um grupo de indivíduos saudáveis jovens de ambos os sexos (n=23, 22,4 ± 2,2 anos), a uma manobra dinâmica (provocação) envolvendo a variação postural passiva do membro inferior (A: elevação da perna e B: decúbito dorsal) de modo a caracterizar a função vascular periférica por meio de variáveis transcutâneas (tc). A perfusão local medida por Fluxometria de Laser Doppler (LDF) , a Perda Trans-epidérmica de água (PTEA) as pressões parciais de oxigénio e dióxido de carbono transcutâneos e a oximetria de pulso foram escolhidas e, um intervalo de confiança de 95% adoptado. LDF, PTEA e tcpO 2 são, manifestamente, as variáveis que melhor permitem seguir o processo em cada fase experimental. Em A foram registadas, durante a provocação, diferenças significativas na perfusão sanguínea e na pressão transcutânea de oxigénio e PTEA, especialmente nas mulheres, enquanto que o perfil de resposta obtido em B foi idêntico em ambos os grupos e comparável B hiperémia reactiva. Qualquer dos protocolos permitiu evidenciar uma relação inversamente recíproca entre a PTEA e o LD. Os resultados obtidos confirmam a utilidade destas metodologias na avaliação da função vascular periférica, confirmando as relações entre PTEA e LDF as quais devem ser adequadamente aprofundadas.

Intervenção da fisioterapia nas alterações de controlo postural em indivíduos pós AVC

Em Portugal, as doenças cerebrovasculares estão entre as principais causas de morbilidade e invalidez. AVC - Alterações sensitivas, alterações perceptivas, alterações cognitivas, alterações de comunicação. Estudo realizado entre Setembro de 2008 e Dezembro de 2010. Objectivo - Investigar os efeitos de um programa de fortalecimento do membro inferior afectado no controlo postural e na funcionalidade de indivíduos que sofreram um AVC.

Reorganização do controlo postural em indivíduos com AVE. Intervenção em fisioterapia

Objectivos: Identificar as alterações no controlo postural do tronco e repercussões na independência funcional de indivíduos com acidente vascular encefálico (AVE), bem como averiguar se ocorreram mudanças a esse nível após a intervenção, baseada na abordagem segundo o Conceito de Bobath. Metodologia: Foram seleccionados para este estudo dois indivíduos com alterações no controlo postural, resultantes de um AVE, em fase aguda. A avaliação foi realizada em dois momentos (M0 e M1), antes e após quatro semanas da realização da intervenção através da análise do movimento, da aplicação da Escala de Avaliação Postural para Pacientes com Sequelas de AVE (PASS), da Escala de Equilíbrio de Berg (EEB), da Escala Modificada de Barthel (BEM), do Teste Timed Up & Go (TUG) e da Classificação Internacional de Funcionalidade, Incapacidade e Saúde (CIF). Resultados: Os scores obtidos em M1 nos vários instrumentos aplicados, bem como a análise de movimento traduzem a evolução favorável no controlo postural do tronco e na independência nas actividades da vida diária (AVD), observada em ambos os casos clínicos. Verificou-se uma evolução mais evidente na EMB e EEB onde o indivíduo A evoluiu na EMB de 51 em M0 para 94 pontos em M1e o indivíduo B de 51 para 89 pontos. Na EEB o indivíduo A progrediu de 22 para 41 pontos e o indivíduo B de 10 para 36 pontos. Conclusão: Os participantes em estudo evidenciaram modificações no controlo postural com repercussões positivas na independência funcional, após a intervenção com base numa abordagem segundo o conceito de Bobath.