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.

Chronic Stress Is Associated with High Cortisol Levels and Emotional Coping Mechanisms in Amnestic Mild Cognitive Impairment

Background/Aims: To investigate the association between cortisol levels, chronic stress and coping in subjects with amnestic-type mild cognitive impairment (aMCI). Methods: Cortisol levels were measured using morning saliva samples from 33 individuals with aMCI and from 41 healthy elderly. Chronic stress was evaluated with the Stress Symptoms List (SSL), whereas coping strategies were assessed using the Jalowiec Coping Scale. Results: aMCI subjects with high SSL scores presented higher cortisol levels (p = 0.045). Furthermore, aMCI subjects who employed emotion-focused coping had higher SSL scores (p = 0.023). Conclusion: The association between increased cortisol secretion, chronic stress and coping strategies may be modulated by the presence or absence of cognitive impairment, where memory deficit awareness constitutes an additional potential factor involved in high stress severity. Copyright (C) 2009 S. Karger AG, Basel

Association Between Urinary Incontinence in Elderly Patients and Caregiver Burden in the City of Sao Paulo/Brazil: Health, Wellbeing, and Ageing Study

Aim: Some elderly patients with incontinence require the care of third parties, known as caregivers. Such care can occur on a daily basis leaving little opportunity for the caregiver to take care of himself/herself. The aims are to assess the association between urinary incontinence in elderly patients and caregiver burden and identify independent factors for caregiver`s burden in the city of Sao Paulo, Brazil. Methods: The Pan-American Health Organization and World Health Organization coordinated a multicenter study named Health, Wellbeing and Aging (SABE Study) in elderly people living in seven countries of Latin America and the Caribbean. In Brazil, the study population carried out in Sao Paulo in the year 2000 and reassessed in 2006 (COHORT A). Urinary incontinence was assessed by ICIQ-SF and caregiver burden by means of Zarit Burden Scale. Results: A total of 327 patients with caregivers were included in the study. The general prevalence of urinary incontinence was 25.8%, higher among the women. There was a significant positive association between caregiver burden and incontinent patients, demonstrating that urinary incontinence in elderly patients produced greater caregiver burden. In the present study, the variables with significant correlations were assessed using the multivariate logistic regression model. Category 2 of the ICIQ-SF (incontinent patients) increased the chances of caregiver burden 1.96-fold in comparison to Category 1 (continent patients). Likewise, the category of impaired cognition increased the chances of caregiver burden 2.34-fold. Conclusions: Urinary incontinence and cognitive impairment in elderly patients were associated to an increase in caregiver burden. Neurourol. Urodynam. 30:1281-1285, 2011. (C) 2011 Wiley-Liss, Inc.

Relationship Between Cortisol Levels and Memory Performance may be Modulated by the Presence or Absence of Cognitive Impairment: Evidence from Healthy Elderly, Mild Cognitive Impairment and Alzheimer`s Disease Subjects

An inverted U-shape function between cortisol levels and memory performance has been reported in studies on both young animals and humans. Yet little is known about this relationship in normal aging or in older subjects with cognitive impairment. This issue is particularly significant since increased levels of cortisol have been reported in Alzheimer`s disease (AD). The present study examined the association between cortisol levels and visual memory performance in healthy subjects as well as in individuals presenting mild cognitive impairment (MCI) or AD. Salivary cortisol was measured in 40 healthy elderly subjects, 31 individuals with amnestic MCI, and 40 subjects with mild probable AD. Memory performance was evaluated using the Brief Cognitive Screening Battery. Higher cortisol levels were associated with better memory performance in healthy elderly (p = 0.005), while higher cortisol levels were correlated with poorer memory performance in MCI subjects (p = 0.011). No correlation between cortisol and memory was found in the AD group (p > 0.05). These results suggest that the relationship between cortisol levels and memory performance in the aging process could vary according to the presence or absence of cognitive impairment.

Age-related difference on weight transfer during unconstrained standing

The ability to transfer weight from one lower limb to the other is essential for the execution of daily life activities and little is known about how weight transfer during unconstrained natural standing is affected by age. This study examined the weight transfer ability of elderly individuals during unconstrained standing (for 30 mill) in comparison to young adults. The subjects (19 healthy elderly adults, range 65-80 years, and 19 healthy young adults, range 18-30 years) stood with each foot on a separate force plate and were allowed to change their posture freely at any time. The limits of stability and base of support width during standing, measures of mobility (using the timed up and go and the preferred walking speed tests), and fear of falling were also measured. In comparison to the young adults, during unconstrained standing the elderly adults produced four times fewer weight transfers of large amplitude (greater than,half of their body weight). The limits of stability and base of support width were significantly smaller for the elderly adults but there were no significant differences in the measures of mobility and in the fear of falling score compared to young adults. The observed significant age-related decrease in the use of weight transfer during unconstrained standing, despite any difference in the measured mobility of the subjects, suggests that this task reveals unnoticed and subtle differences in postural control, which may help to better understand age related impairments in balance that the elderly population experiences. (C) 2010 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.

Categories of manual asymmetry and their variation with advancing age

Manual asymmetries were analyzed in 18- to 63-year-old right-handers in different motor tasks. This analysis aimed at describing the asymmetry profile for each task and assessing their stability across ages. For this purpose, performance of the right and left hands were analyzed in the following aspects: simple reaction time, rate of sequential finger movements, maximum grip force, accuracy in anticipatory timing, rate of repetitive tapping, and rate of drawing movements. In addition, stability of manual preference across ages was assessed through the Edinburgh inventory (Oldfield, 1971). The results indicated different profiles of manual asymmetry, with identification of three categories across tasks: symmetric performance (asymmetry indices close to zero), inconsistent asymmetry (asymmetry indices variable in magnitude and direction), and consistent asymmetry (asymmetry indices favoring a single hand). The different profiles observed in the young adults were stable across ages with two exceptions: decreased lateral asymmetry for maximum grip force and increased asymmetry for sequential drawing in older individuals. These results indicate that manual asymmetries are task specific. Such task specificity is interpreted to be the result of different sensorimotor requirements imposed by each motor task in association with motor experiences accumulated over the lifetime. Analysis of manual preference showed that strength of preference for the right hand was greater in older individuals. (C) 2008 Elsevier Masson Srl. All rights reserved.

Strength training improves fall-related gait kinematics in the elderly: a randomized controlled trial

Background: Falls are one of the greatest concerns among the elderly. Among a number of strategies proposed to reduce the risk of falls, improving muscle strength has been applied as a successful preventive strategy. Although it has been suggested as a relevant strategy, no studies have analyzed how muscle strength improvements affect the gait pattern. The aim of this study was to determine the effects of a lower limb strength training program on gait kinematics parameters associated with the risk of falls in elderly women. Methods: Twenty seven elderly women were assigned in a balance and randomized order into an experimental (n = 14: age = 61.1 (4.3) years, BMI = 26.4 (2.8) kg m(-2)) and a control (n = 13; age = 61.6 (6.6) years; BMI = 25.9 (3.0) kg m(-2)) group. The EG performed lower limb strength training during 12 weeks (3 days per week), being training load increased weekly. Findings: Primary outcomes were gait kinematics parameters and maximum voluntary isometric contractions at pre- and post-training period. Secondary outcomes were training load improvement weekly and one repetition maximum every two weeks. The I maximal repetition increment ranged from 32% to 97% and was the best predictor of changes in gait parameters (spatial, temporal and angular variables) after training for the experimental group. Z-score analysis revealed that the strength training was effective in reversing age-related changes in gait speed, stride length, cadence and toe clearance, approaching the elderly to reference values for healthy young women. Interpretation: Lower limb strength training improves fall-related gait kinematic parameters. Thus, strength training programs should be recommended to the elderly women in order to change their gait pattern towards young adults. (C) 2009 Elsevier Ltd. All rights reserved.

Sigma phase morphologies in cast and aged super duplex stainless steel

Solution annealed and water quenched duplex and super duplex stainless steels are thermodynamically metastable systems at room temperature. These systems do not migrate spontaneously to a thermodynamically stable condition because an energy barrier separates the metastable and stable states. However, any heat input they receive, for example through isothermal treatment or through prolonged exposure to a voltaic arc in the welding process, cause them to reach a condition of stable equilibrium which, for super duplex stainless steels, means precipitation of intermetallic and carbide phases. These phases include the sigma phase, which is easily identified from its morphology, and its influence on the material`s impact strength. The purpose of this work was to ascertain how 2-hour isothermal heat treatments at 920 degrees C and 980 degrees C affect the microstructure of ASTM A890/A890M GR 6A super duplex stainless steel. The sigma phase morphologies were found to be influenced by these two aging temperatures, with the material showing a predominantly lacy microstructure when heat treated at 920 degrees C and block-shaped when heat treated at 980 degrees C. (C) 2009 Elsevier Inc. All rights reserved.

Hybrid Reinforcement of Sisal and Polypropylene Fibers in Cement-Based Composites

Several studies using vegetable fibers as the exclusive reinforcement in fiber-cement composites have shown acceptable mechanical performance at the first ages. However, after the exposure to accelerated aging tests, these composites have shown significant reduction in the toughness or increase in embrittlement. This was mainly attributed to the improved fiber-matrix adhesion and fiber mineralization after aging process. The objective of the present research was to evaluate composites produced by the slurry dewatering technique followed by pressing and air curing, reinforced with combinations of polypropylene fibers and sisal kraft pulp at different pulp freeness. The physical properties, mechanical performance, and microstructural characteristics of the composites were evaluated before and after accelerated and natural aging. Results showed the great contribution of pulp refinement on the improvement of the mechanical strength in the composites. Higher intensities of refinement resulted in higher modulus of rupture for the composites with hybrid reinforcement after accelerated and natural aging. The more compact microstructure was due to the improved packing of the mineral particles with refined sisal pulp. The toughness of the composites after aging was maintained in relation to the composites at 28 days of cure.

Discoloration and fungal growth on three fiber cement formulations exposed in urban, rural and coastal zones

Three formulations of fiber cement were evaluated for fungal colonization and color change after five years of exposure in aging stations located in urban (Sao Paulo), rural (Pirassununga) and coastal (Rio Grande) zones in Brazil. The lowest color change and fungal colonization were registered in Rio Grande, which has a temperate climate, as opposed to Sao Paulo and Pirassununga, which are tropical. The highest fungal colonization was recorded in Sao Paulo, one of the most air polluted cities in Brazil. Pirassununga samples had an intermediate fungal colonization, in spite of showing the highest color change with visible dark spots on the surfaces. These spots were identified as cyanobacteria, which significantly contributed to the darkening of the specimens. The fiber cement formulation, varying in proportion of organic fibers such as poly (vinyl alcohol) and cellulose, was less significant for fungal bioreceptivity than the characteristics of the exposure site. The most frequent fungal genus found in the tropical climate, in both urban and rural zones, and the main one responsible for the higher records in Sao Paulo, was Scytalidiurn sp. which was registered for the first time on this building material in Brazil. (C) 2010 Elsevier Ltd. All rights reserved.

Corrosion Versus Mechanical Tests for Indirect Detection of Alpha Prime Phase in UNS S32520 Super Duplex Stainless Steel

Alpha prime formation leads to material embrittlement and deterioration of corrosion resistance. In the present study, the mechanical and corrosion behavior of super duplex stainless steel UNS S32520 aged at 475 degrees C from 0.5 h to 1,032 h was evaluated using microhardness measurements, Charpy impact tests, electrochemical impedance spectroscopy, and cyclic polarization curves. The sensibility of these tests to the effects of alpha prime phase was investigated. The microhardness test showed a gradual increase in hardness with aging time, whereas the impact tests revealed losses of about 80% in the energy absorption capacity for the material aged for 12 h in comparison with the solution-annealed samples. The most responsive analysis was the impact test, which indirectly revealed the presence of this deleterious phase in samples aged for 0.5 h. The electrochemical impedance spectroscopy and polarization tests were not highly sensitive to the alpha prime phase unless these are present in large amounts in the stainless steel.

Investigation on the intergranular corrosion resistance of the AISI 316L(N) stainless steel after long time creep testing at 600 degrees C

The effect of precipitation on the corrosion resistance of AISI 316L(N) stainless steel previously exposed to creep tests at 600 degrees C for periods of up to 10 years, has been studied. The corrosion resistance was investigated in 2 M H(2)SO(4)+0.5 M NaCl+0.01 M KSCN solution at 30 degrees C by electrochemical methods. The results showed that the susceptibility to intergranular corrosion was highly affected by aging at 600 degrees C and creep testing time. The intergranular corrosion resistance decreased by more than twenty times when the creep testing time increased from 7500 h to 85,000 h. The tendency to passivation decreased and less protective films were formed on the creep tested samples. All tested samples also showed susceptibility to pitting. Grain boundary M(23)C(6) carbides were not found after long-term exposure at 600 degrees C and the corrosion behavior of the creep tested samples was attributed to intermetallic phases (mainly sigma phase) precipitation. (C) 2007 Elsevier Inc. All rights reserved.

Precipitation of Laves phase in a 28%Cr-4%Ni-2%Mo-Nb superferritic stainless steel

The main objective of the present work was to study the precipitation of the Laves phase in the X1 CrNiMoNb 28 4 2 (Werkstoff-Nr. DIN 1.4575) superferritic stainless steel employing several complementary techniques of microstructural analysis. The phase that precipitated in largest quantity in the DIN 1.4575 steel was the sigma (sigma) phase. However, along grain boundaries, after aging at 850 degrees C, a Laves phase of the MgZn2 type, with a hexagonal C14 crystal structure and chemical composition (Fe,Cr,Ni)(2)(Nb,Mo,Si), was also identified. Growth of the Laves phase is curtailed by exhaustion of niobium of the matrix and by the presence of the sigma phase, which also precipitates in the vicinity of the grain boundaries, however in larger amounts. No chi (chi) or austenite phases were detected in the temperature range studied. (C) 2007 Elsevier Inc. All rights reserved.

Use of SECM to study the electrochemical behavior of DIN 1.4575 superferritic stainless steel aged at 475 degrees C

In order to lower the excessive costs of metallic prosthesis materia Is alternatives to Ti and Ti alloys have been searched. in this study, the corrosion resistance of the DIN 1.4575 superferritic stainless steel, either solution annealed or solution annealed and aged at 475 degrees C for periods varying from 100 to 1080 h, was investigated by electrochemical impedance spectroscopy (EIS) and potentiodynamic polarization methods in Hanks` solution. The solution annealed and the aged for 1080 h samples were also tested using scanning electrochemical microscopy (SECM) in a 0.1 mol/L NaCl solution at 25 degrees C. The EIS results showed that the corrosion resistance of the DIN 1.4575 steel decreases with heat treatment time at 475 degrees C probably due to alpha prime formation. Besides the diminution of the overall impedance values, the low frequency limit of the Nyquist diagrams show a progressive change from an almost capacitive response to a resistive behavior as the heat treatment time increases. Pitting corrosion resistance also decreased with aging time at 475 degrees C.