Effets de l’utilisation d’un chien d’assistance sur les efforts aux membres supérieurs lors de la montée d’une pente en fauteuil roulant chez les individus ayant une lésion médullaire

Problématique. L'utilisation d'un chien d'assistance à la mobilité (CAM) représente une option novatrice pour préserver l’intégrité des membres supérieurs (MSs) chez les utilisateurs de fauteuil roulant manuel (FRM). Aucune étude biomécanique n’a quantifié les effets du CAM sur les efforts aux MSs lors de la montée d’un plan incliné. Objectif. Cette étude quasi-expérimentale vise à comparer les efforts aux MSs lors de la montée d’un plan incliné avec et sans l’assistance d’un CAM. Méthodologie. Dix participants avec une lésion de la moelle épinière (LME) qui utilisent un FRM et possèdent un CAM ont monté un plan incliné à trois reprises avec et sans l’assistance du CAM. Les forces appliquées sur les cerceaux, mesurées avec des roues instrumentées, et les mouvements du FRM et des MSs, enregistrés avec un système d'analyse du mouvement, ont permis de mesurer les efforts mécaniques aux MSs. Simultanément, l'activité électromyographique (EMG) des muscles grand pectoral, deltoïde antérieur, biceps et triceps a été enregistrée et normalisée avec sa valeur maximale pour mesurer les efforts musculaires aux MSs. Résultats. En général, le CAM réduit significativement les valeurs moyennes et maximales de la force totale appliquée aux cerceaux et de sa composante tangentielle, des moments nets de flexion, de rotation interne et d’adduction aux épaules et des taux d’utilisation musculaire du deltoïde antérieur, du biceps et du triceps. Conclusion. L’assistance d’un CAM réduit les efforts aux MSs lors de la montée d’un plan incliné chez les utilisateurs d’un FRM ayant une LME.

Sensibilidad del cuestionario anamnésico de síntomas de miembro superior y columna desarrollado por la unidad de investigación de ergonómica de postura y movimiento (EPM) desde la perspectiva de la fisioterapia en Colombia

El propósito de este estudio es evaluar la sensibilidad, especificidad y valores predictivos del Cuestionario Anamnésico de Síntomas de Miembro Superior y Columna (CASMSC) desarrollado por la Unidad de Investigación de Ergonomía de Postura y Movimiento (EPM). Se realizó un estudio descriptivo de tipo correlacional, mediante el análisis de datos secundarios de una base de datos con registros de trabajadores de la industria de alimentos (n=401) en el año 2013, a quienes se les había aplicado el CASMSC, así como una evaluación clínica fisioterapéutica enfocada en los mismos segmentos corporales; esta última utilizada como prueba de oro. Para analizar si existían diferencias estadísticas por edad, antigüedad y género se aplicó el análisis de varianza de una vía. La sensibilidad, especificidad y valores predictivos del CASMSC se informan con sus respectivos intervalos de confianza (95%). La prevalencia de umbral positivo para sospecha de Desorden Músculo Esquelético (DME) tanto de miembro superior como de columna se encontró muy por encima de la media nacional para el sector. La sensibilidad del CASMSC para miembro superior estuvo en el rango de un 80% a 94,57% y para columna cervical y lumbar fue de 36,4% y 43,4%, respectivamente. Para la región dorsal fue casi del doble de las otras dos regiones (85,7%). El CASMSC es recomendable en su apartado para miembro superior dado a su alto nivel de sensibilidad.

Are cutout handles used when available in real occupational settings? Description of grips and upper extremities movements during industrial box handling

In order to achieve better postures and decrease musculoskeletal risks adequate design of hand/box couplings for manual materials handling (MMH) are still needed. No studies evaluating upper limb movement thorough direct measurements during box handling in workplace were identified in the literature. In this study we describe the types of grip and movements adopted by ten workers when handling redesigned boxes with cutout handles between different heights on industrial pallets. The new handles were used by 90% of the workers through different types of grip. Electrogoniometric measurements showed relatively safe forearm and wrist movements, although elbow inadequate range of movement was recorded. Despite the good acceptance of the cutout by workers, the new design requires extra internal space in the boxes reducing applications for this alternative of box.

Efeitos do apoio dos membros superiores sobre a força muscular respiratória e função pulmonar de pacientes com doença pulmonar obstrutiva crônica

Objective: To analyze the effect of arm bracing posture on respiratory muscle strength and pulmonary function in patients with Chronic Obstructive Pulmonary Disease (COPD).Methods: 20 patients with COPD (11 male; 67 +/- 8 years; BMI 24 +/- 3 Kg . m(-2)) were submitted to assessments of Maximal Inspiratory and Expiratory Pressures (MIP and MEP, respectively) and spirometry with and without arm bracing in a random order. The assessment with arm bracing was done on standing position and the height of the support was adjusted at the level of the ulnar styloid process with elbow flexion and trunk anterior inclination of 30 degrees promoting weight discharge in the upper limbs. Assessment without arm bracing was also performed on standing position, however with the arms relaxed alongside the body. The time interval between assessments was one week.Results: MIP, MEP and maximal voluntary ventilation (MW) were higher with arm bracing than without arm bracing (MIP 64 +/- 22 cmH(2)O versus 54 +/- 24 cmH(2)O, p = 0,00001; MEP 104 +/- 37 cmH(2)O versus 92 +/- 37 cmH(2)O, p = 0,00001 and MW 42 +/- 20 L/min versus 38 +/- 20 L/min, p = 0,003). Other variables did not show statistical significant difference.Conclusion: The arm bracing posture resulted in higher capacity to generate force and endurance of the respiratory muscles in patients with COPD. (C) 2009 Published by Elsevier Espana, S.L. on behalf of Sociedade Portuguesa de Pneumologia. All rights reserved.

An explanatory mechanism for the different decline in limb strength in older women

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Astyanax pirapuan: a new characid species from the upper Rio Paraguay system, Mato Grosso, Central Brazil (Characiformes, Characidae)

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Dispositivo para avaliar a força muscular dos membros superiores

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Análise eletromiográfica e de acelerometria na manobra fisioterápica de vibração torácica manual

Pós-graduação em Engenharia Mecânica - FEG

Estudo comparativo entre o bloqueio interescalênico do plexo branquial e o bloqueio seletivo dos nervos supraescapular e axilar nas cirurgias artroscópicas de ombro

Pós-graduação em Anestesiologia - FMB

Comparação da análise miográfica sonora com a força muscular

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Atividade elétrica muscular e medida da força externa nos membros superiores de indivíduos saudáveis

Pós-graduação em Engenharia Mecânica - FEG

Lower limb muscle coactivation levels in healthy younger and older adults during functional dual-task gait

The purpose of this study was to investigate the influence of daily cognitive task on stiffness of old and young female adults during the gait. The study included 17 physically active younger and 18 older women, with low risk of falls. The volunteers were asked to walk on the treadmill at two different gait conditions: normal gait and functional dual-task gait. The electromyographic signals were collected of the lower limb muscles. The percentage of coactivation for the tibialis anterior/gastrocnemius lateralis and tibialis anterior/soleus were significantly higher in elderly than in younger in the normal gait and dual-task gait. Our results suggest that the elderly have a greater stiffness in the ankle joint during gait normal and daily dual task gait. Thus, we conclude that challenging cognitively situations during the gait may increase the risk of falls in this population.

The influence of the use of stabilizer bracelet in a child with choreoathetoid cerebral palsy

Introduction: The use of stabilizer bracelet is a frequent treatment for movement disorders to strengthen muscles and adjust coordination. Still questions remain regarding the benefi t of using loads to decrease involuntary movements and the best load and placement. Objective: To measure the infl uence of the stabilizer bracelet on the kinematics and spatiotemporal parameters in planar movements performed by the upper limb. Method: One child, who has the spastic diplegy type of cerebral palsy with choreoathetoid component, and a control child without cerebral palsy, both female and 7 years old, were subjected to analysis of movements in relation to displacement, velocity, linear acceleration, and the calculation of mean square error (MSE) with and without use of stabilizer bracelet with loads of 25, 50, and 75% of the supported maximum load. Results: After comparing data between subjects, a difference was found between patient and control in all situations and variables. An inter-individual comparison using 25% of the maximum load showed the smallest difference with the NDE. Discussion and Conclusion: This therapeutic option is low cost, easy to apply, and does not signifi cantly interfere in the aesthetic of the individual. Therefore, physiotherapists may prescribe this for activities that require greater control of the upper limb because for the case studied the upper limb movement was more effi cient with the use of the stabilizer bracelet.

Musculoskeletal disorders in upper limbs in dental students: exposure level to risk factors

Aim: This study assessed the risk factors of undergraduate students to develop musculoskeletal disorders (MSD) in the upper limbs, regarding gender, type of dental clinical procedure, mouth region treated, and the four-handed dentistry practice. Methods: Dental students enrolled in the 8th semester in the Araraquara School of Dentistry, UNESP, Brazil, were photographed while practicing 283 dental procedures. The Rapid Upper Limb Assessment (RULA) method was used to evaluate the working postures of each student. The photographs were evaluated and a final risk score was attributed to each analyzed procedure. The prevalence of risk factors of developing MSD was estimated by point and by 95% confidence interval. The association between the risk factor of developing disorders and variables of interest were assessed by the chi-square test with a significance level of 5%. Results: The risk factors of developing MSD were high, regarding most dental procedures performed by the undergraduate students (score 5: 7.07%, CI95%: 4.08- 10.06%; score 6: 62.54%, CI95%: 56.90-68.18%). There was no significant association between the RULA final score and gender (p=0.559), and type of dental procedure (p=0.205), and mouth regions by arch (p=0.110) or hemi-arch (p=0.560), and the use of four-handed dentistry (p=0.366). Conclusions: It can be concluded that gender, type of dental clinical procedure, mouth region treated, and practice of four-handed dentistry did not influence the risk of developing MSD in the upper limbs among the dental students evaluated; however, they are at a high risk of developing such disorders.

Risk muskuloskeletal disorders in upper limbs in dental students: concordance of different methods for estimation of body angle

The purpose of this paper was to evaluate the agreement among different methods used to estimate angular deviation of the body to determine the risk for development of upper limb musculoskeletal disorders in dentistry undergraduates. Materials and Methods: Students (n = 79) enrolled in the final year undergraduate course of the Araraquara School of Dentistry-Sγo Paulo State University-UNESP were evaluated. Photographs were taken of students performing clinical procedures. The work postures adopted by each student were evaluated by means of rapid upper limb assessment (RULA). The basis used to obtain the individual's final risk score is the measurement of the angular deviations in the neutral positions of the regions evaluated. Two methods were used to estimate the angular deviation of the body: Visual exam and Image Tool software. A RULA final risk score was attributed to each procedure the student performed (n = 333). Study of the agreement between the methods about risk of musculoskeletal disorders was conducted by means of Kappa (κ) statistics. The level of significance adopted was 5%. Results: Fair agreement (κ = 0.32) between the evaluated methods was verified. Conclusion: The risk for development of upper limb musculoskeletal disorders by dentistry undergraduates evaluated by using RULA was not in agreement with the results obtained by use of visual exam and Image Tool.