Predicting discharge outcomes for stroke patients in Australia

Objective: This study aimed to describe discharge outcomes and explore their correlates for patients rehabilitated after stroke at an Australian hospital from 1993 to 1998. Design: Data on length of stay, discharge functional status, and discharge destination were retrospectively obtained from medical records. Patients' actual rehabilitation length of stay was compared with the Australian National Sub-Acute and Non-Acute Patient predicted length of stay. The change in length of stay over the 5-yr period from 1993 to 1998 was documented. Results: Patients' mean converted motor FIMTM scores improved from 53.1 at admission to 74.1 at discharge. Lower admission-converted motor FIM scores were related to longer length of stay, lower discharge-converted motor FIM scores, and the need for a change in living situation on discharge. Conclusion: The results of this study provide Australian data on discharge outcomes after stroke to assist in the planning and delivery of appropriate interventions to individual patients during rehabilitation.

Physiological and Stroke Parameters to Assess Aerobic Capacity in Swimming

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

Stroke phases responses around maximal lactate steady state in front crawl

The objective of this study was to analyze changes in stroke rate (SR), stroke length (SL) and stroke phases (entry and catch, pull, push and recovery) when swimming at (MLSS) and above (102.5% MLSS) the maximal lactate steady state. Twelve endurance swimmers (21±8 year, 1.77±0.10m and 71.6±7.7kg) performed in different days the following tests: (1) 200- and 400-m all-out tests, to determine critical speed (CS), and; (2) 2-4 30-min sub-maximal constant-speed tests, to determine the MLSS and 102.5% MLSS. There was significant difference among MLSS (1.22±0.05ms-1), 102.5% MLSS (1.25±0.04ms-1) and CS (1.30±0.08ms-1). SR and SL were maintained between the 10th and 30th minute of the test swum at MLSS and have modified significantly at 102.5% MLSS (SR - 30.9±3.4 and 32.2±3.5cyclesmin-1 and SL - 2.47±0.2 and 2.38±0.2mcycle-1, respectively). All stroke phases were maintained at 10th and 30th minute at MLSS. However, the relative duration of propulsive phase B (pull) increased significantly at 102.5% MLSS (21.7±3.4% and 22.9±3.9%, respectively). Therefore, the metabolic condition may influence the stroke parameters (SR and SL) and stroke strategy to maintain the speed during swim tests lasting 30min. © 2010 Sports Medicine Australia.

Assessment of beginners' front-crawl stroke efficiency

Efficiency in front-crawl stroke has been inferred primarily by means of the analysis of arm actions, specifically, stroke frequency and stroke length. The objective of the present study was to investigate whether swimming efficiency could be better assessed in children still learning the front-crawl stroke by analyzing the movement pattern as a whole. Forty-two children enrolled in private swimming programs volunteered to participate in the study. The task consisted of swimming 30 m as fast as possible. Three experts analyzed the movement pattern of the participants using a checklist. Both stroke frequency and stroke length were calculated. The correlation coefficients between the time taken to swim and both the stroke frequency and stroke length were not significant, but the total and components of the checklist scores were. Results indicate that the swimming efficiency of children learning the front-crawl stroke can be better assessed by analyzing their whole movement pattern.

Respostas agudas de parâmetros biomecânicos à utilização de diferentes tamanhos de palmar no nado crawl

Universidade Estadual de Campinas . Faculdade de Educação Física

A influência de palmares e parachute na coordenação dos nados

Universidade Estadual de Campinas . Faculdade de Educação Física

Influência da hipermobilidade articular na performance e incidência de lesões no atleta de natação = : Influence of articular hypermobility in the performance and incidence of injuries in the athlete swimming

Universidade Estadual de Campinas . Faculdade de Educação Física

Sistema de periodização em blocos : efeitos de um modelo de treinamento sobre o desempenho de nadadores velocistas de alto nivel

Universidade Estadual de Campinas . Faculdade de Educação Física

Programa perceptivo-motor aplicado a habilidade nadar na fase de aperfeiçoamento

Universidade Estadual de Campinas . Faculdade de Educação Física

Functional asymmetries in the movement kinematics of patients with Tourette's syndrome

Objectives-This study adopted a concurrent task design and aimed to quantify the efficiency and smoothness of voluntary movement in Tourette's syndrome via the use of a graphics tablet which permits analysis of movement profiles. In particular, the aim was to ascertain whether a concurrent task (digit span) would affect the kinematics of goal directed movements, and whether patients with Tourette's syndrome would exhibit abnormal functional asymmetries compared with their matched controls. Methods-Twelve patients with Tourette's syndrome and their matched controls performed 12 vertical zig zag movements, with both left and right hands (with and without the concurrent task), to large or small targets over long or short extents. Results-With short strokes, controls showed the predicted right hand superiority in movement time more strongly than patients with Tourette's syndrome, who instead showed greater hand symmetry with short strokes. The right hand of controls was less force efficient with long strokes and more force efficient with short strokes, whereas either hand of patients with Tourette's syndrome was equally force efficient, irrespective of stroke length, with an overall performance profile similar to but better than that of the controls' left hand. The concurrent task, however, increased the force efficiency of the right hand in patients with Tourette's syndrome and the left hand in controls. Conclusions-Patients with Tourette's syndrome, compared with controls, were not impaired in the performance of fast, goal directed movements such as aiming at targets; they performed in certain respects better than controls. The findings clearly add to the growing literature on anomalous lateralisation in Tourette's syndrome, which may be explained by the recently reported loss of normal basal ganglia asymmetries in that disorder.

Wear of PEEK-Ti6Al4V systems under micro-abrasion and linear sliding conditions

Dissertação de mestrado integrado em Engenharia Biomédica

Inter-limb coordination and energy cost in swimming.

OBJECTIVES: This study investigated the relationship between inter-arm coordination and the energy cost of locomotion in front crawl and breaststroke and explored swimmers' flexibility in adapting their motor organization away from their preferred movement pattern. DESIGN: Nine front-crawlers performed three 300-m in front crawl and 8 breaststrokers performed three 200-m in breaststroke at constant submaximal intensity and with 5-min rests. Each trial was performed randomly in a different coordination pattern: freely chosen, 'maximal glide' and 'minimal glide'. Two underwater cameras videotaped frontal and side views to analyze speed, stroke rate, stroke length and inter-limb coordination. METHODS: In front crawl, inter-arm coordination was quantified by the index of coordination (IdC) and the leg beat kicks were counted. In breaststroke, four time gaps quantified the arm to leg coordination (i.e., time between leg and arm propulsions; time between beginning, 90° flexion and end of arm and leg recoveries). The energy cost of locomotion was calculated from gas exchanges and blood lactate concentration. RESULTS: In both front crawl and breaststroke, the freely chosen coordination corresponded to glide pattern and showed the lowest energy cost (12.8 and 17.1Jkg(-1)m(-1), respectively). Both front-crawlers and breaststrokers were able to reach 'maximal glide' condition (respectively, +35% and +28%) but not 'minimal glide' condition for front crawl. CONCLUSIONS: The freely chosen pattern appeared more economic because more trained. When coordination was constrained, the swimmers had higher coordination flexibility in breaststroke than in front crawl, suggesting that breaststroke coordination was easier to regulate by changing glide time.

Coordination pattern adaptability: energy cost of degenerate behaviors.

This study investigated behavioral adaptability, which could be defined as a blend between stability and flexibility of the limbs movement and their inter-limb coordination, when individuals received informational constraints. Seven expert breaststroke swimmers performed three 200-m in breaststroke at constant submaximal intensity. Each trial was performed randomly in a different coordination pattern: 'freely-chosen', 'maximal glide' and 'minimal glide'. Two underwater and four aerial cameras enabled 3D movement analysis in order to assess elbow and knee angles, elbow-knee pair coordination, intra-cyclic velocity variations of the center of mass, stroke rate and stroke length and inter-limb coordination. The energy cost of locomotion was calculated from gas exchanges and blood lactate concentration. The results showed significantly higher glide, intra-cyclic velocity variations and energy cost under 'maximal glide' compared to 'freely-chosen' instructional conditions, as well as higher reorganization of limb movement and inter-limb coordination (p<0.05). In the 'minimal glide' condition, the swimmers did not show significantly shorter glide and lower energy cost, but they exhibited significantly lower deceleration of the center of mass, as well as modified limb movement and inter-limb coordination (p<0.05). These results highlight that a variety of structural adaptations can functionally satisfy the task-goal.

Proposta de teste incremental baseado na percepção subjetiva de esforço para determinação de limiares metabólicos e parâmetros mecânicos do nado livre

A percepção subjetiva de esforço (PSE) é determinada de forma não invasiva e utilizada juntamente com a resposta lactacidêmica como indicadores de intensidade durante teste incremental. em campo, especialmente na natação, há dificuldades nas coletas sanguíneas; por isso, utilizam-se protocolos alternativos para estimar o limiar anaeróbio. Assim, os objetivos do estudo foram: prescrever um teste incremental baseado na PSE (Borg 6-20) visando estimar os limiares metabólicos determinados por métodos lactacidêmicos [ajuste bi-segmentado (V LL), concentração fixa-3,5mM (V3,5mM) e distância máxima (V Dmáx)]; relacionar a PSE atribuída em cada estágio com a freqüência cardíaca (FC) e com parâmetros mecânicos de nado [freqüência (FB) e amplitude de braçada (AB)], analisar a utilização da escala 6-20 na regularidade do incremento das velocidades no teste e correlacionar os limiares metabólicos com a velocidade crítica (VC). Para isso, 12 nadadores (16,4 ± 1,3 anos) realizaram dois esforços máximos (200 e 400m); os dados foram utilizados para determinar a VC, velocidade de 400m (V400m) e a freqüência crítica de braçada (FCb); e um teste incremental com intensidade inicial baseada na PSE, respectivamente, 9, 11, 13, 15 e 17; sendo monitorados em todos os estágios a FC, lactacidêmia e os tempos de quatro ciclos de braçadas e das distâncias de 20m (parte central da piscina) e 50m. Posteriormente, foram calculadas as velocidades dos estágios, FB, AB, V LL, V3,5mM e V Dmáx. Utilizaram-se ANOVA e correlação de Pearson para análise dos resultados. Não foram encontradas diferenças entre VC, V Dmáx e V LL, porém a V3,5mM foi inferior às demais velocidades (P < 0,05). Correlações significativas (P < 0,05) foram observadas entre VC versus V400m, V Dmáx e V3,5mM; V400m versus V3,5mM e V Dmáx; V Dmáx versus V LL; e no teste incremental entre PSE versus velocidade, [Lac], FC, FB e AB (P < 0,05). Concluímos que a PSE é uma ferramenta confiável no controle da velocidade dos estágios durante teste incremental na natação.

Índices técnicos correspondentes à velocidade crítica e à máxima velocidade de 30 minutos em nadadores com diferentes níveis de performance aeróbia

O principal objetivo deste estudo foi verificar o efeito do nível de performance aeróbia na relação entre os índices técnicos correspondentes à velocidade crítica (VC) e à velocidade máxima de 30 minutos (V30) em nadadores. Participaram deste estudo, 23 nadadores do gênero masculino com características antropométricas similares, divididos segundo o nível de performance aeróbia em grupo G1 (maior performance) (n = 13) e G2 (menor performance) (n = 10). Os indivíduos tinham pelo menos quatro anos de experiência no esporte e treinavam um volume semanal de 30.000 a 45.000m. A VC foi determinada através do coeficiente angular da regressão linear entre as distâncias (200 e 400m) e seus respectivos tempos. A V30 foi determinada através da máxima distância realizada em um teste de 30 minutos. Todas as variáveis foram determinadas no nado crawl. A VC foi significantemente maior do que a V30 no grupo G1 (1,30 ± 0,04 vs. 1,23 ± 0,06m.s-1) e no G2 (1,17 ± 0,08 vs. 1,07 ± 0,06m.s-1). As duas variáveis foram maiores no grupo G1. As taxas de braçada correspondentes à VC (TBVC) e à V30 (TBV30) obtidas nos grupos G1 (33,07 ± 4,34 vs. 31,38 ± 4,15 ciclos.min-1) e G2 (35,57 ± 6,52 vs. 33,54 ± 5,89 ciclos.min-1) foram similares entre si. A TBVC foi significantemente menor no grupo 1 do que no grupo 2, enquanto que a TBV30 não foi diferente entre os grupos. Os comprimentos de braçada correspondentes à VC (CBVC) e à V30 (CBV30) foram significantemente maiores no grupo G1 (2,41 ± 0,33 vs. 2,38 ± 0,30m.ciclo-1) do que no G2 (2,04 ± 0,43 vs. 1,97 ± 0,40m.ciclo-1), e similares entre si nos dois grupos. As correlações (r) entre a VC e a V30 e as variáveis técnicas correspondentes às duas velocidades foram significantes em todas as comparações (0,68 a 0,91). Portanto, a relação entre a velocidade e as variáveis técnicas correspondentes à VC e à V30 não é modificada pelo nível de performance aeróbia.