Impact des troubles musculosquelettiques sur les mécanismes du contrôle postural chez les adolescents-hockeyeurs de niveau élite et intervention en Reconstruction Posturale®

Les adolescents-hockeyeurs peuvent être affligés de troubles musculosquelettiques (TMS) résultant d’un excès de tension musculaire lequel peut mener à des déformations ou déséquilibres musculaires ainsi qu’à une attitude posturale inadéquate. Les conséquences de ces changements mènent souvent à une surcharge inutile du système musculosquelettique (SMS), à la perturbation des mécanismes du contrôle postural et éventuellement à l’apparition de douleurs musculaires et articulaires. Les interventions qui s’attaquent aux TMS par une rééquilibration de la tension musculaire sont peu nombreuses. Les interventions qui s’attaquent aux TMS par une normalisation de la tension musculaire sont peu nombreuses. La Reconstruction Posturale® (RP), testée cliniquement, est l’une d’entre elles. Dans un premier temps, cette thèse visait à identifier les caractéristiques du contrôle postural chez les adolescents-hockeyeurs de niveau élite lorsque le système somatosensoriel est mis à l’épreuve en position debout quasi statique pieds nus et en patins. Dans un deuxième temps, nous avons évalué l’impact d’une intervention en RP sur des variables cliniques et biomécaniques, chez ces athlètes qui souffrent de TMS. Soixante-sept adolescents-hockeyeurs de niveau élite âgés de 15 à 18 ans ont participé à l’étude. Le contrôle postural de cinquante-sept joueurs a été évalué en position debout sur deux plateformes de force les yeux ouverts et les yeux fermés, pieds nus sur une surface dure et sur une mousse. De ce groupe, trente-cinq sujets ont également été évalués en patins, les yeux ouverts et les yeux fermés. Par la suite, neuf adolescents-hockeyeurs souffrant de TMS, ont été sélectionnés pour participer au protocole d’intervention thérapeutique en RP qui consistait en l’application de six séances de thérapie prodiguées sur une période de six semaines. Le déplacement du centre de pression (CP) sous les pieds a été calculé dans les directions antéro-postérieure (AP) et médio-latérale (ML). La vélocité moyenne du CP, le déplacement moyen du CP et l’étendue du CP ont été retenus pour rendre compte de la performance du contrôle posturale. D’autre part, l’asymétrie de mise en charge, la trajectoire du CP sous les pieds gauche et droit, le CPc pour rendre compte de la stratégie de chevilles et le CPv pour rendre compte de la stratégie de hanches ont été retenues pour identifier les stratégies utilisées pour maintenir l’équilibre. L’impact de l’intervention en RP a été évalué à l’aide de trois variables cliniques soit la douleur à l’aide de l’échelle visuelle analogue (ÉVA), la capacité fonctionnelle à l’aide d’un un questionnaire autoadministré et des photographies de la posture debout pour rendre compte des variables posturales biomécaniques. Nos résultats montrent que chez les adolescents-hockeyeurs la performance du contrôle postural en position debout statique est davantage perturbée par les changements somatosensoriels en direction ML alors qu’en AP, la perte d’informations visuelles ainsi que des changements somatosensoriels affectent la performance. Dans toutes les conditions expérimentales et dans les deux directions, nous avons observé une vélocité du CP remarquablement élevée, variant entre 18 et 22 mm/s. Au niveau des stratégies et indépendamment de la condition expérimentale, nous avons observé une dominance presque complète de la stratégie de cheville en AP alors qu’en ML, la stratégie de hanche dominait avec une contribution de la stratégie de cheville de plus de 20 %. En patins, en direction ML, aucun changement significatif de la performance n’a été observé. Toutefois en AP, nous avons observé une augmentation significative de la vélocité du CP, yeux ouverts et yeux fermés ainsi qu’une augmentation significative de l’étendue, yeux ouverts seulement. Au niveau des stratégies, la stratégie de cheville domine en AP et la stratégie de hanche domine en ML avec une contribution plus modeste de la stratégie de cheville qui était inférieure à 12 %. Chez les adolescents-hockeyeurs souffrant de TMS, post-intervention, nos résultats indiquent une diminution significative de la douleur et une amélioration des capacités fonctionnelles ainsi que de l’attitude posturale. Pré intervention en direction ML, nous avons observé une contribution significativement plus élevée de la stratégie de cheville au contrôle du CPnet et un retour vers des valeurs normales post-intervention. L’impact de l’intervention thérapeutique sur la performance du contrôle postural s’est avéré non significatif en ML et en AP.

Determinación de la carga física de trabajo mediante pulsometría en una planta de coque en el municipio de Cucunubá, Cundinamarca

El trabajo exige en el individuo una serie de esfuerzos fisiológicos que implican el uso de los componentes del sistema osteo-muscular, cardiovascular y metabólico, definiéndose así la carga física de trabajo. El objetivo fue determinar la respuesta fisiológica a la exposición a calor y carga física en trabajadores operadores de hornos de coquería. El estudio se realizó en once trabajadores expuestos a carga física y a calor en hornos de coquería. Se realizó la medición de capacidad máxima de trabajo (VO2máx), medición de consumo calórico y respuesta cardiovascular a la carga térmica y medición de niveles de hidratación. No obstante de su alta capacidad de trabajo y desempeño físico de los horneros, el trabajo de deshorne se califica como extremadamente duro muy duro o intenso. Se recomienda intervenir tecnológicamente el sistema de trabajo de deshorne mediante mecanización de las tareas.

Herramienta de detección y medición de las condiciones de riesgo laborales asociadas a la presentación de los desórdenes por trauma acumulativo en hombro

El movimiento en el complejo articular de hombro, al igual que en las demás partes del cuerpo se realiza gracias a los sistemas óseo, articular y muscular. Cuando se presentan movimientos repetitivos, posturas y fuerzas en el lugar de trabajo al desarrollar las tareas, se pueden originar una serie de patologías profesionales en los trabajadores ocupacionalmente expuestos. Estas patologías no solamente se asocian a estos factores de riesgo, sino también, a una concepción inadecuada del diseño del puesto de trabajo en dónde los trabajadores desarrollan su actividad laboral. se pretende a través de este proyecto de investigación dar a conocer una herramienta de observación, detección de éstos, y medición tridimensional de los movimientos que puedan llegar a representar un riesgo, facilitando la recolección de datos de forma precisa y rápida, así como la apreciación de las condiciones de trabajo, por parte de los profesionales interesados en Salud Ocupacional.

Manipulación manual de cargas y presencia de lumbalgia en los trabajadores de desempaque armada en General Motors Colmotores

Trabajo de grado enfocado a determinar la asociaciónexistente entre manipulación manual de cargas y la presencia de lumbalgia entrabajadores de un área determinada en una empresa ensambladora devehículos. Se abordan temas como anatomía y biomecánica de la columnalumbar, levantamiento manual de carga, lumbalgia y factores que contribuyen ala presencia de esta, los cuales sirvieron de soporte teórico en este trabajo.Esta es una investigación de tipo descriptivo, la cual se desarrolló en tres fases:revisión teórica, trabajo de campo y análisis y procesamiento de la información;concluyendo que existe una asociación entre la manipulación manual de cargasy la presencia de lumbalgia en los trabajadores del área estudiada, teniendoademás como resultados adicionales que la lumbalgia tiene un origenmultifactorial y los factores psicosociales juegan un papel importante en lapresencia de esta.

Riscos profissionais e lesões musculosqueléticas : na Indústria dos Moldes da Marinha Grande

As Lesões Musculosqueléticas Relacionadas com o Trabalho (LMERT) são patologias inflamatórias e degenerativas do sistema musculosquelético desenvolvidas pelos trabalhadores quando sujeitos a determinados riscos profissionais. O crescente número de trabalhadores tem vindo a aumentar com lesões musculosqueléticas, embora não tenhamos encontrado estudos que analisem as LMERT na indústria dos moldes. Este estudo teve como finalidade avaliar o grau de incidência das lesões musculosqueléticas bem como as localizações mais relatadas. A amostra constituiu-se por 196 trabalhadores masculinos inquiridos por questionário. Os dados permitiram caracterizar a amostra quanto a hábitos de vida, condições de trabalho, ambiente de trabalho, posturas adotadas nas tarefas laborais bem como retirar informações quanto a queixas relativas às LMERT, as causas, a localização, a frequência da dor. Os resultados revelam que os trabalhadores desempenham tarefas de caráter repetitivo, fundamentalmente de pé e com poucas pausas. Os sintomas musculosqueléticos mais frequentes situam-se na zona lombar, nos joelhos, nos braços e na cabeça, sendo nos trabalhadores com mais idade que se registam mais sintomas, assim como dores mais intensas e permanentes. O trabalho termina com algumas recomendações para trabalhos futuros.

Prevalência e fatores associados da síndrome de Osgood-Schlatter em uma amostra populacional de adolescentes brasileiros

Osgood-Schlatter (O-S) syndrome, a pathology of the musculoskeletal system, exhibits high incidence in adolescence, a phase of accelerated bone growth. Detection of physiopathological mechanisms that may cause disorders and dysfunctions in bone growth must be taken into account when planning physical activities, in order to promote normal physiological growth patterns. The aim of this epidemiological investigation was to identify and analyze the relationships between sociodemographic, anthropometric and clinical aspects and O-S. A cross-sectional design was used, with a representative sample of 956 subjects: 474 (49.6%) males and 482 (50.4%) females. Age range varied between 12 and 15 years (mean = 13.7±1.04). We used a battery of tests, previously applied in a pilot study, which met the aims of the investigation. Descriptive statistics (frequency, mean and standard deviation) were used and the odds ratio was calculated from bivariate and multivariate logistic regression (p<0.05). A prevalence of 9.8% was found (n = 94 cases): 11% males and 8.3% females. Hierarchized multivariate analysis showed a significant association between regular physical activities (OR= 1.94; CI 95%, 1.22-3.10) and shortening of the rectus femoris muscle (OR= 7.15; CI 95%, 2.86-17.86). The results may serve as a basis for therapeutic and prophylactic measures, in addition to increasing our knowledge of this syndrome in Brazilian adolescents. This investigation used a multidisciplinary approach, involving elements of anatomy, nutrition, physical education and physical therapy to elucidate the object under study related to Osgood-Schlatter syndrome

Efeitos do exercício aeróbio no músculo esquelético de ratos expostos à fumaça de cigarro

INTRODUÇÃO: Os fumantes sofrem redução da massa muscular e da resistência à fadiga e possivelmente a prática de atividade física contribua positivamente neste quadro. OBJETIVO: Este estudo teve por objetivo analisar as adaptações da musculatura esquelética frente à interação da prática de atividade física e exposição à fumaça de cigarro. MÉTODOS: 32 ratos machos foram divididos em grupos expostos à fumaça de cigarro, exercitados (G1) e sedentários (G3), e não expostos à fumaça, exercitados (G2) e sedentários (G4). A exposição à fumaça foi realizada mediante combustão de 10 cigarros em uma câmara de inalação durante 30 minutos, duas vezes ao dia, cinco dias por semana, durante 15 dias; o exercício aeróbio foi composto por sessões diárias de 60 minutos de caminhada em esteira, cinco dias por semana. Após o sacrifício, o músculo sóleo foi coletado e seus cortes foram corados pela técnica de HE e submetidos ao método histoquímico NADH-TR. RESULTADOS: O grupo G1 apresentou maior quantidade de alterações musculares, bem como ausência de atividade enzimática, o mesmo ocorrendo no G3, porém com menor intensidade; no G2 foi observado padrão normal para fibras exercitadas, estando as fibras do G4 preservadas. Quanto à morfometria, houve diferença significante para o fator exercício (p = 0,007), enquanto não foram observadas diferenças significantes para o fator exposição à fumaça (p = 0,668) e para a interação exposição à fumaça e exercício (p = 0,077). CONCLUSÃO: A interação entre inalação de fumaça de cigarro e exercício, realizada durante 15 dias em ratos machos Wistar adultos, acentuou as alterações histológicas do músculo sóleo, levando a uma alteração da atividade enzimática e acarretando em aumento do diâmetro das fibras musculares

Study of postures in sugarcane cutters in the Pontal of Paranapanema-SP, Brazil

The expansion of sugarcane monoculture in Brazil in the last decades has pointed out to the necessity of considering the question of sugarcane cutters occupational health. In this work we present a cross-sectional study aiming to examine the occupational posture of a group of sugarcane cutters, which work in a cane field located in the region of Pontal do Paranapanema-SP, Brazil. The study was made using the Ergonomic Analysis of Work - EAW methodology and the postural analysis method by Win-OWAS. Through the obtained records of postures, it was observed that during a workday the sugarcane cutters remain standing erect on two legs or in one leg 66% of the time and that their trunk remain tilted and in rotation, according to 63% of the positions categorized. It was also observed that the sugarcane cutter trunk performs repetitive and boundless movements during his routine of work, which can expose this individual to additional wear of their musculoskeletal functions. The activities in which the individual engages have favorable or adverse influence on his posture. The repetitive movements involved in specialized occupations are equivalent to repeated exercises, thus may be responsible for the excessive development of certain muscle groups. The study suggests that the postures adopted by sugarcane cutters can overload their musculoskeletal system and predispose the cutters to work-related musculoskeletal diseases.

Desempenho muscular e equilíbriu postural em idosas frágeis residentes na comunidade

Human aging is physiological process causes alterations in several systems of the organism. In the musculoskeletal system, a main change is the decreased muscle strength, that in the lower extremity, compromises the ability to respond quickly with enough strength to prevent falls, causing alterations in postural balance. Currently, many researchers have study the human frailty, defined as a multifactorial syndrome, with excess of vulnerability to stressors, reducing ability in maintaining or regulating homeostasis. Its characteristics are directly related to physical function. Aim: To analyze muscle performance and postural balance in frail and pre-frail elderly women, and to compare them according with the frailty phenotypes criteria proposed by Fried 2001. Method: 39 frail elderly women living in the community, aged 65 years and older, were assessed muscle performance of lower extremity using isokinetic dynamometer and postural balance using Berg s balance scale and computerized baropodometry. Results: There was significant difference in plantar flexor, knee flexor and knee extensor strength, in anteroposterior (AP) oscillation with eyes open and on Berg s scores between groups. A weak correlation was observed between strength and balance. Conclusion: The results suggest that the frail elderly present worse muscle performance in lower extremity and worse postural balance compared to the pre-frail elderly. There were correlations between muscle performance and balance impairments in these elderly, but several variables are also involved in maintaining postural balance

Análise das condições de saúde e de vida da população urbana de Botucatu, São Paulo (Brasil): IV - Morbidade referida em entrevistas domiciliárias, 1983-1984

Objetivou-se estudar a morbidade referida pela população urbana amostrada, no Município de Botucatu, SP, Brasil, em 1983/84, segundo sexo, idade, escolaridade e renda per capita. O método consistiu em entrevistas domiciliárias, com aplicação de dois formulários pré-codificados. Os entrevistadores eram leigos treinados e supervisionados, e a pessoa entrevistada foi quase sempre a mãe de família. O período recordatório estabelecido em relação aos eventos informados (queixas, sintomas, acidentes comuns e diagnósticos) foi de três semanas. Das 7.075 pessoas amostradas (12% da população), 56% apresentaram episódios mórbidos, totalizando 6.649 episódios. As mulheres, bem como o grupo etário de 50 e mais anos apresentaram maior freqüência de queixas. A escolaridade e a renda per capita não diferenciaram os entrevistados quanto à ocorrência maior ou menor de episódios. A prevalência de episódios mórbidos foi de 939/1.000 entrevistados. Predominaram queixas do aparelho respiratório (20% do total de queixas), principalmente as infecções respiratórias agudas. em segundo lugar, os sinais e sintomas mal definidos (19%) e, a seguir, as doenças do sistema osteo-muscular, do sistema nervoso e do sistema circulatório, com proporções similares (ao redor de 9%) e, finalmente, as do sistema digestivo e as lesões e envenenamentos (ao redor de 8%). Foram estimados os coeficientes de prevalência por grupos de doença (pela CID), segundo as variáveis estudadas. São comentadas as dificuldades de comparação dos resultados obtidos com os de trabalhos congêneres, face às diferenças nos métodos usados, apontando-se para a necessidade de uma padronização metodológica dos estudos de morbidade referida, cuja importância epidemiológica e para o planejamento em saúde vem sendo amplamente reconhecida.

Electromyographic study of the trapezius (pars media) and rhomboideus major muscles in movements of the arm (part 1)

The participation of the trapezius (pars media) and rhomboideus major muscles in free movements of abduction, adduction, flexion, extension and hyperextension of the arm was studied electromyographically. These muscles were active and synergic in all analysed movements, both acting with intensity that ranged from moderate to very marked.

Electromyographic study of the trapezius (pars media) and rhomboideus major muscles in movements of the arm (part 2)

The participation of the trapezius (pars media) and rhomboideus major muscles were studied electromyographically in movements of lateral and medial rotation (free and against resistance) of the arm. In the majority of cases both muscles were inactive during the performance of the analysed movements. Cases in which only one or both muscles acted in free rotation occurred only at the second half or ending of the movement. Records of electrical potentials during against resistance rotation were due to tensional efforts at the shoulder level.

Electromyographic study of the trapezius (pars superior) and levator scapulae muscles in circumduction and pendular oscillation of the arm

The trapezius (pars superior) and levator scapulae mm were studied in the arm movements of circumduction and pendular oscillation in 30 adult volunteers of both sexes. A two-channel TECA TE 4 electromyograph and single coaxial needle electrodes were used. It was found out that as arm conduction, both muscles show an activity that gradually increases and decreases the intensity at the elevation and lowering phases respectively. It was also noticed that between two consecutive circumductions a 'silent period' in the activity of the above mentioned muscles occurs. In pendular oscillation these muscles show electrical activity both in the forward and backward moving, and both muscles show a 'silent period' when the arm passes by the trunk. It was not observed in these movements any significant difference in activity of these muscles regarding sex.

Electromyographic study of the trapezius (pars superior) and levator scapulae muscles in the movements of the head

The electromyographic study of the trapezius (pars superior) and levator scapulae mm. in the head movements was carried out in 30 young, adult male volunteers of both sexes and with no antecedent muscular or articular problems. The analysis was carried out with a two-channel TECA TE4 electromyograph and with single coaxial needle electrodes. Inactivity of the trapezius (pars superior) and levator scapulae mm. was noticed in all cases, in flexion and extension movements, whereas in homolateral and heterolateral rotation movements, these muscles showed to be inactive in most cases.

O limiar de esforço percebido (LEP) corresponde à potência crítica e a um indicador de máximo estado estável de consumo de oxigěnio

The perceived exertion has been a target of several investigations, many times with association with objective physiological indicators in exercise. Recently, the identification of the perceived exertion threshold (PET) was proposed in the water running, which presented no difference in relation to the critical velocity. Theoretically, both parameters would be indicators of the maximum steady state of variables such as V̇O2 and blood lactate. The objective of this work was to verify the coincidence between PET, critical power (PCrit) and an indicator of maximum V̇O2 steady state (PCrit') in cycle ergometer. Eight male participants were submitted to progressive effort test in order to determine V̇O2peak (46.7 ± 8.5 ml/kg/min) and to four rectangular tests until exhaustion for the estimation of the critical power model parameters, PET and PCrit'. The hyperbolic relation between mechanical power and time spent for the V̇O2peak to be reached in each test was used for the PCrit' estimation, considered as the asymptote in the power axis, and the portion of the anaerobic work capacity (CTAnaer) depleted up to the establishment of the V̇O2peak (CTAnaer'). In order to identify PET, the straight lines angular coefficients of the perceived exertion in time (ordinate) and the powers used (abscissa) were adjusted to a linear function that provided a point in the power axis in which the perceived exertion would be kept indefinitely stable. The parameters PCrit and CTAnaer were estimated by means of the power-time non-linear equation. In order to compare the estimations of PET, PCrit and PCrit', the analysis of variance ANOVA for repeated measurements was employed, and the associations were established through the Pearson correlation. CTAnaer and CTAnaer' were compared through the t test. PET (180 W ± 61 W), PCrit (174 W ± 43 W) and PCrit' (176 W ± 48 W) were not significantly different and the correlations were of 0.92-0.98. CTAnaer' (14,080 ± 5,219 J) was lower than CTAnaer (22,093 ± 9,042 J). One concludes that the PET predicts the intensity of PCrit and PCrit' with accuracy.