Controle postural na doença de Menière / Postural control in Menière's disease

RESUMO Objetivo Avaliar o controle postural na doença de Menière. Métodos 34 pacientes com doença de Menière definida (grupo experimental) e 34 indivíduos hígidos (grupo controle), homogêneos quanto à idade e ao gênero, foram submetidos à posturografia do Tetrax Interactive Balance System (Tetrax IBS TM) em oito condições sensoriais. Índice de estabilidade, índice de distribuição de peso, índice de sincronização da oscilação postural direita/esquerda e dedos/calcanhar, frequência de oscilação postural e índice de risco de queda foram analisados. Resultados O índice de estabilidade foi maior no grupo experimental, com diferença significativa entre os grupos, em todas as condições sensoriais testadas. O risco de queda foi maior no grupo experimental do que no grupo controle. A oscilação postural foi maior no grupo experimental em todas as faixas de frequência, com diferença significativa em algumas delas. Não houve diferença significativa entre os grupos nos índices de distribuição de peso e de sincronização, nas oito condições sensoriais avaliadas. Conclusão Pacientes com doença de Menière apresentam comprometimento do controle postural, caracterizado por alterações do índice de estabilidade, em frequências de oscilação postural e no índice de risco de queda.

ABSTRACT Purpose To evaluate postural control in Menière's disease. Methods 34 patients with Menière's disease (experimental group) and 34 healthy individuals (control group) were submitted to Tetrax Interactive Balance System posturography under eight sensory conditions. Stability, weight distribution, synchronization, risk of falling and postural oscillation frequency were analyzed. Results Stability index was higher in the experimental group with significant difference between the groups in all sensory conditions. Risk of falling was higher in the experimental group than in the control. Postural oscillation was higher in the experimental group in all frequency ranges, with significant difference in some of them. There was no significant difference between the groups in the weight distribution and synchronization indexes. Conclusion In this study, Menière's disease patients presented impaired postural control, characterized by postural instability and oscillation and risk of falling.

The influence of cognitive tasks on sensory organization test performance / A influência das tarefas cognitivas no desempenho do teste de organização sensorial

Abstract Introduction: Many static postural tasks requiring vestibular contributions are completed while dual- tasking. Objective: We investigated the influence of dual-tasks on sensory integration for postural control and cognitive performance during the sensory organization test and examined the relationship between cognitive function and dual-task cost during the sensory organization test. Methods: Twenty adults completed single and dual-task versions of the six conditions of the sensory organization test were completed during two visits separated by one week. A subset of 13 participants completed three National Institute of Health (NIH)-toolbox cognitive tests including the Flanker inhibitory control and attention test, dimensional change card sort test and pattern comparison processing speed test. Wilcoxon signed rank tests were used to compare postural sway during single and dual-task sensory organization test. Friedman's test, with pairwise comparison post-hoc tests, was used to compare single task serial subtraction performance to the 6 dual-task sensory organization test conditions. Spearman's correlation coefficients were used to assess the relationship between cognitive performance on NIH-toolbox test and postural and cognitive dual-task cost during the sensory organization test. Results: Performing a cognitive dual-task during the sensory organization test resulted in a significant increase in postural sway during condition 1 (Z = −3.26, p = 0.001, ES = 0.73), condition 3 (Z = −2.53, p = 0.012, ES = 0.56), and condition 6 (Z = −2.02, p = 0.044, ES = 0.45). Subtraction performance significantly decreased in during condition 6 (Z = −2.479, p = 0.011, ES = 0.55) compared to single-task. The dimensional change card sort test demonstrated moderate correlations with dual-task cost of serial subtraction performance in condition 5 (dimensional change card sort test: r = −0.62, p = 0.02) and condition 6 (dimensional change card sort test: r= −0.56, p = 0.04). Pattern comparison processing speed test scores were significantly correlated with dual-task cost of postural control during condition 2. Conclusion: Performing a cognitive task during the sensory organization test resulted in significantly increased postural sway during three conditions, particularly during visual environment manipulation oppose to vestibular and somatosensory manipulation. Cognitive performance decreased during the most complex sensory organization test condition. Additionally, we found participants with poorer executive function had greater dual-task cost during more complex sensory integration demands.

Resumo Introdução: Muitas tarefas posturais estáticas que requerem contribuições vestibulares são feitas durante a dupla tarefa. Objetivo: Investigamos a influência da dupla tarefa na integração sensorial para o controle postural e desempenho cognitivo durante o teste de organização sensorial e examinamos a relação entre a função cognitiva e o custo da dupla tarefa durante o teste de organização sensorial. Método: Vinte adultos completaram versões da tarefa única e dupla tarefa das seis condições do teste de organização sensorial, que foram concluídas em duas consultas com um intervalo de uma semana. Um subgrupo de 13 participantes completou três testes cognitivos do NIH-toolbox, inclusive o flanker inhibitory control and attention test, dimensional change card sort test e o pattern comparison processing speed test .O teste de postos sinalizados de Wilcoxon foi usado para comparar a oscilação postural durante o teste de organização sensorial de tarefa única e dupla. O teste de Friedman, com testes post hoc de comparação pareada, foi usado para comparar o desempenho da subtração em série de tarefa única para as 6 condições do teste de organização sensorial de dupla tarefa. Os coeficientes de correlação de Spearman foram usados para avaliar a relação entre o desempenho cognitivo no teste NIH-toolbox e o custo da dupla tarefa postural e cognitivo durante o teste de organização sensorial. Resultados: A feitura de uma dupla tarefa cognitiva durante o teste de organização sensorial resultou em um aumento significativo na oscilação postural durante a condição 1 (Z = -3,26, p = 0,001, TE = 0,73), condição 3 (Z = -2,53, p = 0,012, TE = 0,56) e condição 6 (Z = -2,02, p = 0,044, TE = 0,45). O desempenho de subtração diminuiu significativamente durante a condição 6 (Z =-2,479, p = 0,011, TE = 0,55) em comparação com a tarefa única. O dimensional change card sort test demonstrou correlações moderadas com o custo da dupla tarefa de desempenho de subtração em série na condição 5 (dimensional change card sort test: r=-0,62, p = 0,02) e condição 6 (dimensional change card sort test: r = -0,56, p = 0,04). Os escores do pattern comparison processing speed test foram significativamente correlacionados com o custo da dupla tarefa do controle postural durante a condição 2. Conclusão: A feitura de uma tarefa cognitiva durante o teste de organização sensorial resultou em um aumento significativo na oscilação postural em três condições, principalmente durante a manipulação do ambiente visual em oposição à manipulação vestibular e somatossensorial. O desempenho cognitivo diminuiu durante a condição de teste de organização sensorial mais complexa. Além disso, observamos que os participantes com função executiva pior apresentaram maior custo da dupla tarefa durante demandas de integração sensorial mais complexas.

Efeitos da vibração do tendão muscular no equilíbrio após acidente vascular cerebral: revisão sistemática / Efectos de la vibración del tendón muscular en el equilibrio después del accidente cerebrovascular: una revisión sistemática / Effects of muscle tendon vibration on balance after stroke: systematic review

RESUMO Após o acidente vascular cerebral (AVC), as pessoas apresentam combinações complexas de déficits sensoriais, motores, cognitivos e emocionais que podem afetar o equilíbrio estático e dinâmico. O objetivo do estudo foi compilar e resumir as principais características e achados de protocolos utilizados em pesquisas que investigaram os efeitos da vibração no tendão muscular no equilíbrio estático e dinâmico em adultos com AVC. Trata-se de uma revisão sistemática, registrada na PROSPERO (CRD42022303874), em que foram realizadas buscas nas bases de dados PubMed, Cochrane, LILACS, SciELO, MEDLINE, Science Direct e PEDro, durante o mês de janeiro de 2022, por meio da combinação de palavras-chave relacionadas a "stroke", "balance", "muscle tendon vibration" e "randomized controlled trial". A qualidade metodológica foi avaliada através da escala PEDro. Foram identificados 1.560 estudos, dos quais 11 foram incluídos, publicados entre 1994 e 2020, envolvendo 242 adultos pós-AVC. Apenas cinco estudos utilizaram a vibração como intervenção e verificaram melhora no equilíbrio estático e dinâmico. Seis estudos analisaram a interferência da vibração no controle postural, observando que o equilíbrio foi afetado durante a aplicação da vibração e que os indivíduos precisaram de mais tempo para se recuperar ou não sofreram diferenças significativas. Verificou-se que os efeitos da vibração do tendão muscular podem melhorar o equilíbrio em pessoas com AVC e influenciar o controle postural através de mecanismos proprioceptivos da vibração. Entretanto, são necessários mais estudos de alta qualidade metodológica para atingir um consenso em relação aos protocolos de tratamento com vibração do tendão muscular e sua recomendação na prática clínica.

RESUMEN Después del accidente cerebrovascular, las personas tienen combinaciones complejas de déficits sensoriales, motores, cognitivos y emocionales que pueden afectar el equilibrio estático y dinámico. El objetivo de este estudio fue recopilar y resumir las principales características y hallazgos de los protocolos utilizados en los estudios que investigaron los efectos de la vibración del tendón muscular sobre el equilibrio estático y dinámico en adultos con accidente cerebrovascular. Se trata de una revisión sistemática, registrada en PROSPERO (CRD420223874), en la que se realizaron búsquedas en las Bases de Datos PubMed, Cochrane, LILACS, SciELO, MEDLINE, Science Direct y PEDro, durante el mes de enero de 2022, mediante la combinación de palabras clave relacionadas con "stroke", "balance", "muscle tendon vibration" y "randomized controlled trial". La calidad metodológica se evaluó mediante la escala PEDro. Se identificaron un total de 1.560 estudios, de los cuales se incluyeron 11, publicados entre 1994 y 2020, con 242 adultos después del accidente cerebrovascular. Solo cinco estudios utilizaron la vibración como intervención y verificaron la mejoría en el equilibrio estático y dinámico. Seis estudios analizaron la interferencia de la vibración en el control postural, señalando que el equilibrio se vio afectado durante la aplicación de la vibración y que los individuos necesitaron más tiempo para recuperarse o no sufrieron diferencias significativas. Se encontró que los efectos de la vibración del tendón muscular pueden mejorar el equilibrio en personas con accidente cerebrovascular e influir en el control postural a través de mecanismos propioceptivos de vibración. Sin embargo, se necesitan más estudios de alta calidad metodológica para llegar a un consenso con respecto a los protocolos de tratamiento con vibración del tendón muscular y su recomendación en la práctica clínica.

ABSTRACT After cerebrovascular accident (CVA), people have complex combinations of sensory, motor, cognitive, and emotional deficits, which can affect static and dynamic balance. This study aimed to compile and summarize the main features and findings of protocols used in research that investigated the effects of muscle tendon vibration on static and dynamic balance in adults with stroke. This is a systematic review, registered in PROSPERO (CRD42022303874), in which searches were performed in the databases PubMed, Cochrane, LILACS, SciELO, MEDLINE, Science Direct, and PEDro, during the month of January 2022, using the combination of keywords related to "stroke," "balance," "muscle tendon vibration," "randomized controlled trial." Methodological quality was assessed using the PEDro scale. A total of 1,560 studies were identified, 11 of which were included, between the years 1994 to 2020, involving 242 post-stroke adults. Only five studies used vibration as an intervention and found an improvement in static and dynamic balance. Six studies analyzed the interference of vibration on postural control, showing that balance was affected during the application of vibration and that individuals needed more time to recover or did not experience significant differences. We found that the effects of muscle tendon vibration may be able to improve balance in people with stroke and influence postural control by proprioceptive mechanisms of vibration. However, more studies of high methodological quality are needed to reach a consensus regarding muscle tendon vibration treatment protocols and their recommendation in clinical practice.

Efectos posturográficos de la maniobra de Epley en pacientes con vértigo posicional paroxístico del canal posterior / Posturographic effects of the Epley maneuver on patients with benign paroxysmal positional vertigo of the posterior canal

Resumen Introducción: El vértigo posicional paroxístico benigno (VPPB) es la afección periférica más común en las enfermedades otoneurológicas. Con el reposicionamiento de partículas se busca eliminar el vértigo y sus síntomas asociados como lo son el mareo residual y la inestabilidad. Objetivo: Determinar si la maniobra de reposicionamiento de Epley (MRE) produce una modificación significativa del control postural (CP) en aquellos pacientes con VPPB de canal semicircular posterior (VPPB-CSC-P). Material y Método: Se realizó un estudio descriptivo prospectivo en una muestra de 21 pacientes con diagnóstico de VPPB-CSC-P. Comparamos el desplazamiento, la velocidad y el área del centro de presión (CoP) antes y después de la MRE. Resultados: La velocidad y el área de la CoP estudiada por posturografía computarizada muestra una disminución significativa en sus valores después de la MRE, mientras que el desplazamiento de la CoP se mantuvo sin cambios. Conclusión: La MRE ejecutada en pacientes con VPPB-CSC-P produce una modulación en el control de la CoP, demostrada por la disminución de la velocidad y el área de desplazamiento de la CoP. El éxito de la MRE produce modulación del CP.

Abstract Introduction: Benign paroxysmal positional vertigo (BPPV) is the most common peripheral condition in otoneurologic diseases. With the repositioning of particles, the aim is to eliminate vertigo and its associated symptoms, such as residual dizziness and instability. Aim: To determine if the Epley repositioning maneuver (ERM) produces a significant modification of postural control (PC) in those patients with posterior semicircular canal BPPV (BPPV-CSC-P). Material and Method: A prospective descriptive study was carried out in a sample of 21 patients diagnosed with BPPV-CSC-P. We compared the displacement, velocity, and area of the center of pressure (CoP) before and after the Epley repositioning maneuver. Results: The velocity and the area of the CoP studied by computed posturography show a significant decrease in its values after the MRE, while the CoP shift remained unchanged. Conclusion: ERM performed in patients with BPPV-CSC-P produces an improvement in the control of the CoP, demonstrated by the decrease in the speed and the area of movement of the CoP. The success of the MRE produces modulation of the PC.

Postural control performance of active and inactive older adults assessed through postural tasks with different levels of difficulty

Abstract Aim: To investigate postural control between active (AOA) and inactive (IOA) older adults and active young adults (YA) due to the difficulty level of the postural task. Methods: 25 active YA, 31 AOA, and 30 IOA were invited to perform postural tasks with eyes open and closed: bipedal stance on a rigid surface, bipedal stance on an unstable surface, semi-tandem stance on a rigid surface, and semi-tandem stance on an unstable surface. Results: IOA (0.74 cm) presented higher COP displacement amplitude in the mediolateral direction than AOA (0.64 cm) only in bipedal stance on an unstable surface with eyes closed condition (p ≤ 0.0001). In relation to frequency variables, IOA (0.37 Hz) presented a greater frequency band with 50% of the spectral power in the mediolateral direction than AOA (0.28 Hz) in all experimental conditions, except for semi-tandem stance on a rigid surface (p ≤ .0001). AOA (0.62 cm - 0.28 Hz) and IOA (0.67 cm - 0.37 Hz) presented an increase in time/frequency variables in both directions (anterior-posterior and mediolateral) than YA (0.52 cm - 0.17 Hz) (p ≤ 0.0001) that indicates a worse performance of postural control as the level of task difficulty increased, such as unstable base with eyes open and closed. Conclusion: Older adults tend to present greater COP sway and velocity when subjected to complex tasks compared with younger, which is more evident in older adults physically inactive. This could be considered an adaptive strategy by older adults to minimize the risk of losing balance and, consequently, falling.

Efecto de un programa de realidad virtual para mejorar la estabilidad de tronco en lanzadores de bala y jabalina paralímpicos. Un estudio de casos / Effect of a virtual reality program to improve trunk stability in Paralympic shot put and javelin throwers. A case study

Introducción: El deporte paralímpico se originó como parte de procesos de re-habilitación para personas que tuvieran discapacidad. Durante la ejecución de las disciplinas paralímpicas el control motor en la región del tronco y en especial del abdomen es de gran importancia para prevenir lesiones y mejorar el registro de la marca deportiva. Son muchas las herramientas utilizadas por los entrenadores de-portivos para mejorar la fuerza muscular y por consiguiente la estabilidad de tronco, buscando disminuir el riesgo en el ámbito deportivo. Sin embargo, las investigaciones sobre el uso de realidad virtual, junto con plataformas de estabilometría para el en-trenamiento de deportistas paralímpicos con lesiones físicas, son escasas.Objetivo: Establecer el efecto de un programa de entrenamiento del tronco apoya-do en realidad virtual en deportistas de alto rendimiento paralímpicos, lanzadores de bala y jabalina con lesiones físicas y que compiten en sillas de lanzamiento. Materiales y método: La investigación fue diseñada como un estudio cuasiex-perimental intrasujeto. Se evaluaron cinco sujetos deportistas paralímpicos de alto rendimiento con discapacidad física. Se empleó un software de realidad virtual que incluye patrones y juegos lúdicos ajustables en tiempo e intensidad y una platafor-ma de bipedestación dinámico como parte del equipo de intervención, ajustable al paciente, que permite reeducar el equilibrio, la propiocepción, fortalecer y lograr el control del tronco. Las variables de análisis fueron el nivel del desplazamiento ante-roposterior y lateral del tronco y los cambios en el volumen de acción. Se realizó una evaluación inicial, una intervención que duró de seis semanas y la evaluación final. Resultados: En las evaluaciones iniciales de todos los atletas se observó una ten-dencia al desplazamiento en sentido posterior. En la evaluación final, los rangos de desplazamiento aumentan en casi todos los sujetos con excepción del sujeto 5, cuyos valores permanecen casi estables tanto en las evaluaciones iniciales como las finales. La diferencia en el desplazamiento entre la prueba inicial y final en promedio de los participantes fue de 6.26 grados. Conclusiones: los resultados positivos del entrenamiento del tronco apoyado en realidad virtual para los participantes constituyen un aporte al conocimiento sobre el tema y abren la posibilidad de incluir esta tecnología en protocolos de entrenamiento en deporte paralímpico.

Introduction: Paralympic sport originated as part of rehabilitation processes for people with disabilities. During the execution of Paralympic disciplines, motor con-trol in the trunk region and especially in the abdomen is of great importance to prevent injuries and improve the registration of the sports record. There are many tools used by sports coaches to improve muscle strength and therefore trunk stability to reduce the risk in the sports field. However, research on the use of virtual reality along with stabilometry platforms for the training of Paralympic athletes with phys-ical injuries are scarce.Objective: To establish the effect of a trunk training program supported by virtual reality in high performance Paralympic athletes, shot put and javelin throwers with physical injuries who compete in throwing frames. Materials and method: The research was designed as an intrasubject quasi-ex-perimental study. Five high-performance Paralympic athletes with physical disabili-ties were evaluated. A virtual reality software that includes patterns and playful games adjustable in time and intensity and a dynamic standing platform were used as part of the intervention equipment, adjustable to the patient, which allows reeducating balance, proprioception, strengthening, and achieving trunk control. The variables of analysis were the level of anteroposterior and lateral displacement of the trunk and changes in the volume of action. An initial evaluation, an intervention that lasted six weeks, and a final evaluation were carried out. Results: In the initial evaluations of all athletes, a tendency towards posterior dis-placement was observed. In the final evaluation, the displacement ranges increase in almost all subjects except for subject 5, which showed values that remain almost sta-ble in both the initial and final evaluations. The difference in displacement between the initial and final test on average of the participants was 6.26 degrees. Conclusions: the positive results of trunk training supported by virtual reality for the participants constitute a contribution to the knowledge on the subject and open the possibility of including this technology in training protocols in Paralympic sports.

Postural control in football players with vision impairment: Effect of sports adaptation or visual input restriction?

Abstract Aim: To assess the postural control performance of football 5-a-side (FFS) players, comparing them with sighted players. Methods: Eight FFS players and 7 sighted futsal players were included. Postural control tests included feet together stance (FTS) and single-leg stance (SLS) tasks, performed on rigid and foam surfaces. Sighted players performed the tests with open (EO) and closed (EC) eyes. Area of displacement (Area) and average velocity (Vavg) were calculated from the center of pressure time-series coordinates. Results: On both surfaces conditions, a significant difference between visually impaired football 5-a-side players and sighted EO players was observed during FTS (higher Vavg for visually impaired football 5-a-side players; p < 0.04) and SLS (higher Area and Vavg for visually impaired football 5-a-side players; p < 0.01). No differences between visually impaired football 5-a-side players and sighted EC players were found. Differences between sighted EO vs. sighted EC were observed during FTS on the foam surface, and in SLS on both surface conditions (p < 0.03). Conclusion: FFS players' postural control performance is similar to sighted players with EC but worse than sighted players with EO, suggesting their postural control performance can be simply explained in terms of visual restriction.

The postural control of Brazilian children aged 6 to 9 years using a smartphone is similar to their posture with eyes closed / The postural control of Brazilian children aged 6 to 9 years using a smartphone is similar to their posture with eyes closed

INTRODUCTION: Electronic devices have been used by increasingly younger people, leading researchers to investigate the impact of these technologies on the health of developing childrenOBJECTIVE: To investigate the impact of smartphone use on the postural control of Brazilian children 6 to 9 years oldMETHODS: This cross-sectional study was conducted with 278 children from public schools in Goiânia (Goiás, Brazil). The children were assessed in an orthostatic posture with the computerized baropodometry system in three conditions: eyes open, eyes closed, and using a free smartphone applicationRESULTS: The children were 8.36 years old on average, 82% of them were well-nourished, and had a daily mean screen time of 2 hours. The postural control analyses revealed that the children made greater postural adjustments with their eyes closed than with them open. When using the smartphone application, the postural adjustments were similar to those with eyes closed. In the stabilometry, the postural displacements made by the children behaved similarly to the static assessment only in total feet surface areaCONCLUSION: Smartphone use and absence of visual stimulus in the orthostatic position caused postural instability in children 6 to 9 years old. These findings can contribute to understanding the impact of technologies on children's development of balance in daily tasks

INTRODUÇÃO: O uso de dispositivos eletrônicos móveis tem alcançado usuários cada vez mais jovens e tem levado pesquisadores a investigar o impacto dessas tecnologias na saúde da criança em desenvolvimentoOBJETIVO: Investigar o impacto do uso do smartphone no controle postural de crianças brasileiras de 6 a 9 anos de idadeMÉTODO: Estudo transversal realizado com 278 crianças de escolas públicas de Goiânia (GO, Brasil). As crianças foram avaliadas na postura ortostática pelo sistema de baropodometria computadorizada em três condições: olhos abertos, olhos fechados e manuseando um aplicativo gratuito para smartphoneRESULTADOS: As crianças tinham idade média de 8,36 anos, sendo 82% de eutróficas e com tempo médio de tela de duas horas diárias. As análises do controle postural revelaram que as crianças apresentaram maiores ajustes posturais com os olhos fechados em comparação com os olhos abertos e ao usar o aplicativo do smartphone o ajuste postural foi semelhante ao encontrado com olhos fechados. Na estabilometria, os deslocamentos posturais realizados pelas crianças se comportaram de modo semelhante à avaliação estática apenas na área total da superfície dos pésCONCLUSÃO: O uso do smartphone e a ausência do estímulo visual na posição ortostática promoveram instabilidade postural nas crianças de 6 a 9 anos de idade. Estes achados podem contribuir para o conhecimento do impacto de tecnologias no desenvolvimento do equilíbrio de crianças em atividades diárias

Alterações posturais associadas a distúrbios respiratórios e sua correlação com as desordens temporomandibulares: uma revisão de literatura / Postural changes associated with respiratory disorders and their correlation with temporomandibular disorders: a literature review

Objetivo: a presente revisão almeja fornecer à prática clínico-odontológica e ao meio científico uma compreensão atualizada acerca da correlação entre as alterações posturais geradas pela presença de distúrbios respiratórios e as desordens temporomandibulares (DTMs). Revisão de literatura: foi realizada uma busca entre o período de 2005 a 2021 nas seguintes bases de dados: Medline (via PubMed), Portal de Periódicos Capes e Scopus, utilizando-se dos termos "temporomandibular joint; temporomandibular disorders; posture control; postural control; breathing". Como resultado, foram encontrados 4.384 documentos, que foram analisados por títulos, resumos, texto completo e critérios de elegibilidade, até se chegar ao total de 5 estudos a serem incluídos nesta revisão. Considerações finais: os principais fatores observados foram a associação das DTMs com condições como padrão de respiração do tipo bucal, postura anterior da cabeça, hiperatividade de músculos acessórios da respiração, rotação posterior da mandíbula e apneia obstrutiva do sono. Os estudos ressaltaram a necessidade da abordagem completa desses pacientes, visto que os papéis dos distúrbios respiratórios e das alterações posturais podem representar desafios no diagnóstico e no tratamento das DTMs.(AU)

Objective: this review aims to provide to the clinical dental practice and the scientific community an updated understanding of the correlation between postural changes generated by the presence of respiratory disorders and temporomandibular joint disorders (TMD). Literature review: a search was carried out covering the period from 2005 to 2021 in the following databases: Medline (via PubMed), Portal de Periódicos Capes and Scopus using the terms temporomandibular joint; temporomandibular disorders; posture control; postural control; breathing. As a result, 4,384 documents were obtained and shortlisted by title, abstracts, full text and eligibility criteria, resulting in the five studies included in this review. Final considerations: the main factors observed were the association of TMD with conditions as mouth breathing, anterior head posture, hyperactivity of accessory breathing muscles, posterior rotation of the jaw and obstructive sleep apnea. The studies underscored the need for a complete approach to these patients, given that the role of respiratory disorders and postural changes may represent a challenge in the diagnosis and treatment of TMD.(AU)

Comparison of static and dynamic balance measurements among chronic and episodic migraine patients / Comparação de medidas de equilíbrio estático e dinâmico em pacientes com migrânea crônica ou episódica

ABSTRACT Background: Migraine is one of the most frequent and incapacitating headaches, with a high degree of impairment of balance control and postural stability. Objective: To investigate the effects of episodic and chronic migraine on postural balance through using static and dynamic balance tests. Methods: The study included 32 chronic and 36 episodic migraine patients and a control group of 36 healthy volunteers. Right/left single-leg static and dynamic balance tests were performed in each group with eyes open and closed using a posturographic balance platform (Techno-body Prokin). Results: No significant difference was found among episodic and chronic migraine patients and control subjects with regard to eyes-open and eyes-closed area values (eyes-open area values: p=0.559, p=0.414 and p=0.906; eyes-closed area values: p=0.740, p=0.241 and p=0.093, respectively). However, the area values were significantly higher in episodic and chronic migraine patients than in the control group, which indicates that migraine patients may have lower balance performance. Perimeter values were relatively higher which supports the idea that migraine patients have lower balance performance. Additionally, the average number of laps was significantly lower among migraine patients than in the control group, which also implies that migraine patients may have lower balance performance. Conclusion: Although no significant difference was detected between chronic and episodic migraine patients and the control group and between chronic and episodic migraine patients with regard to balance performance, chronic migraine patients seemed to have relatively lower performance than episodic migraine patients. Further studies with larger numbers of patients are needed, to investigate the relationship between these parameters and balance.

RESUMO Introdução: A enxaqueca é uma das dores de cabeça mais frequentes e incapacitantes, com alto grau de comprometimento do controle do equilíbrio e estabilidade postural. Objetivo: Investigar os efeitos da enxaqueca episódica e crônica no equilíbrio postural por meio de testes de equilíbrio estático e dinâmico. Métodos: O estudo incluiu 32 pacientes com enxaqueca crônica e 36 com enxaqueca episódica e um grupo controle de 36 voluntários saudáveis. Os testes de equilíbrio estático e dinâmico unipodal direito/esquerdo foram realizados em cada grupo, com os olhos abertos e fechados, por meio de uma plataforma de equilíbrio posturográfico (Techno-body Prokin). Resultados: Nenhuma diferença significativa foi encontrada entre pacientes com enxaqueca episódica e crônica e indivíduos controle em relação aos valores da área de olhos abertos e olhos fechados (valores de área de olhos abertos: p=0,559, p=0,414 e p=0,906; valores de área de olhos fechados: p=0,740, p=0,241 e p=0,093, respectivamente). No entanto, os valores de área foram significativamente maiores em pacientes com enxaqueca episódica e crônica do que no grupo controle, o que indica que pacientes com enxaqueca podem ter desempenho de equilíbrio inferior. Os valores do perímetro foram relativamente mais altos, o que sustenta a hipótese de que os pacientes com enxaqueca apresentam desempenho de equilíbrio inferior. Além disso, o número médio de voltas foi significativamente menor entre os pacientes com enxaqueca do que no grupo controle, o que também implica que os pacientes com enxaqueca possam ter um desempenho de equilíbrio inferior. Conclusão: Embora nenhuma diferença significativa tenha sido detectada entre os pacientes com enxaqueca crônica e episódica e o grupo controle e entre os pacientes com enxaqueca crônica e episódica no que diz respeito ao desempenho do equilíbrio, os pacientes com enxaqueca crônica parecem ter um desempenho relativamente inferior do que os pacientes com enxaqueca episódica. Outros estudos com maior número de pacientes são necessários para investigar a relação entre esses parâmetros e o equilíbrio.

The effect of cold water immersion on pain, muscle recruitment and postural control in athletes / Efeito da imersão em água fria sobre dor, recrutamento muscular e controle postural em atletas / Efecto de la inmersión en agua fría sobre el dolor, el reclutamiento muscular y control postural en atletas

ABSTRACT Introduction Numerous recovery strategies have been used to minimize performance loss related to delayed onset muscle soreness in athletes, and are part of prevention programs and training of most high-level sports. Objective To analyze the effects of cold-water immersion on delayed-onset muscle soreness, muscle recruitment, and postural control in soccer players. Objective The maximum load of the quadriceps femoris muscle strength was determined. After three days, the pain scale was used to measure the subject's pain intensity. The recruitment of the quadriceps muscle was determined at the moment of the kick, and was associated with postural control. Methods Randomized, blinded clinical trial study. Two repeated series of maximum load sets at 60% MVC, performed in a knee extension chair, were used to induce quadriceps fatigue in the athletes. Participants Twenty-eight soccer players were allocated to four intervention groups: cold water immersion (CWIG, n = 7), thermoneutral water immersion (TWIG, n = 7), active recovery (ARG, n = 7), and rest (RG, n = 7), with each intervention being carried out for ten minutes. Revaluations were carried out after 24, 48, and 72 hours of the fatigue protocol. Results Pain intensity in the CWIG returned to baseline after 72 hours, while the TWIG, ARG, and RG continued to feel greater pain. For the other outcomes, no differences were found between the groups. Conclusion With regard to muscle recruitment and postural control at the time of the kick, no significant differences were found for the time periods or intervention established. Level of evidence I; High-quality randomized clinical trial with or without statistically significant difference, but with narrow confidence intervals.

RESUMO Introdução Numerosas estratégias de recuperação têm sido usadas para minimizar a perda de desempenho decorrente de dor muscular de início tardio em atletas e fazem parte de programas de prevenção e treinamento da maioria dos esportes de alto nível. Objetivos Analisar os efeitos da imersão em água fria sobre a dor muscular tardia, o recrutamento muscular e o controle postural de jogadores de futebol. Métodos Estudo clínico randomizado e cego. Determinou-se a carga máxima da força muscular do quadríceps femoral. Depois de três dias, empregou-se a escala de dor para avaliar a intensidade da dor dos indivíduos. O recrutamento do quadríceps femoral foi determinado no momento do chute e associado ao controle postural. Duas séries repetidas de conjuntos de carga máxima a 60% da CVM, realizadas em uma cadeira extensora de joelho, foram usadas para induzir fadiga do quadríceps nos atletas. Vinte e oito jogadores de futebol foram randomizados em quatro grupos de intervenção: imersão em água fria (GIAF, n = 7), imersão em água termoneutra (GIAT, n = 7), recuperação ativa (GRA, n = 7) e repouso (GR, n = 7), sendo cada intervenção realizada por dez minutos. As reavaliações ocorreram depois de 24, 48 e 72 horas do protocolo de fadiga. Resultados A intensidade da dor no GIAF voltou para o valor basal após 72 horas, enquanto GIAT, GRA e GR continuaram a sentir dor acentuada. Não foram encontradas diferenças entre os grupos com relação aos outros desfechos. Conclusão Com relação ao recrutamento muscular e ao controle postural no momento do chute, não foram encontradas diferenças significativas para os períodos ou intervenções estabelecidas. Nível de evidência I; Estudo clínico randomizado de alta qualidade com ou sem diferença estatisticamente significante, mas com intervalos de confiança estreitos.

RESUMEN Introducción Se han utilizado numerosas estrategias de recuperación para minimizar la pérdida de rendimiento relacionada con el dolor muscular de aparición tardía en los atletas y son parte de programas de prevención y entrenamiento de la mayoría de los deportes de alto nivel. Objetivos Analizar los efectos de la inmersión en agua fría sobre el dolor muscular tardío, el reclutamiento muscular y el control postural en jugadores de fútbol. Métodos Estudio clínico aleatorizado y ciego. Se determinó la carga máxima de la fuerza muscular del cuádriceps femoral. Después de tres días, se usó la escala de dolor para evaluar la intensidad del dolor de los individuos. El reclutamiento del cuádriceps femoral se determinó en el momento de la patada y se asoció con el control postural. Se utilizaron dos series repetidas de conjuntos de carga máxima al 60% de la CVM en una silla de extensión de rodilla para inducir fatiga del cuádriceps en atletas. Veintiocho jugadores de fútbol fueron asignados al azar en cuatro grupos de intervención: inmersión en agua fría (GIAF, n = 7), inmersión en agua termoneutra (GIAT, n = 7), recuperación activa (RA, n = 7) y descanso (GD, n = 7), con cada intervención realizada durante diez minutos. Las reevaluaciones ocurrieron después de 24, 48 y 72 horas después del protocolo de fatiga. Las revaluaciones ocurrieron después de 24, 48 y 72 horas del protocolo de fatiga. Resultados La intensidad del dolor en el GIAF volvió a la línea de base después de 72 horas, mientras que GIAT, GRA y GD continuaron experimentando dolor intenso. No se encontraron diferencias entre los grupos con respecto a otros resultados. Conclusión Con respecto al reclutamiento muscular y el control postural en el momento de la patada, no se encontraron diferencias significativas para los períodos o la intervención establecida. Nivel de evidencia I; Ensayo clínico aleatorizado de alta calidad con o sin una diferencia estadísticamente significativa, pero con intervalos de confianza estrechos.

How does completing an Ironman triathlon affect postural control? / Como a conclusão de um triatlo Ironman afeta o controle postural?

Abstract Despite the increase in the number of Ironman competitions worldwide, thousands of athletes have been joining Ironman experience but only a few studies have been published on the effects of this competition on postural control. This study aims to investigate the ability to maintain a static posture in three different positions before and after an Ironman competition and the blood glucose level behavior. Forty-nine volunteers underwent balance evaluation using the force plate VSRTM Sport. The area of the center of gravity (ACOG) was assessed pre- and post-competition in the bipodal, unipodal, and tandem postures. Glucose levels were also assessed concurrently. The ACOG findings showed a significant post-competition increase in the three postures assessed, with no significant interaction between the postures. The glucose test showed an increase in the post-competition glycemic levels. The findings showed reduced postural control, suggesting that prolonged exercise stimulation could lead to a disturbance in postural control.

Resumo Apesar do aumento no número de competições Ironman em todo o mundo e milhares de atletas se juntarem à experiência Ironman, apenas alguns estudos foram publicados sobre os efeitos dessa competição no controle postural. Este estudo tem como objetivo investigar a capacidade de manter uma postura estática em três posições diferentes antes e depois de uma competição de Ironman e o comportamento do nível de glicose no sangue. Quarenta e nove voluntários foram submetidos à avaliação do equilíbrio usando uma plataforma de força, VSRTM Sport. A área do centro de gravidade (ACOG) foi avaliada pré e pós-competição nas posturas bipodal, unipodal e tandem. Os níveis de glicose também foram avaliados simultaneamente. Os achados do ACOG mostraram um aumento significativo pós-competição nas três posturas avaliadas, sem interação significativa entre as posturas. O teste de glicose mostrou aumento nos níveis glicêmicos pós-competição. Os resultados mostraram decréscimo no controle postural, sugerindo que a estimulação prolongada ao exercício poderia levar a um distúrbio no controle postural.

Relationship between postural control in upright stance and virtual reality in post-stroke individuals / Relação entre desempenho do controle postural em pé e em realidade virtual em indivíduos pós-AVC

Abstract Introduction: Considered the second leading cause of death worldwide, stroke leads to several consequences resulting from the injury in regions responsible for the processing of sensorimotor information, leading to deficits in the maintenance and performance of postural control. Objective: To relate the performance of postural control during upright stance and a virtual reality task in post-stroke individuals. Method: Nine post-stroke individuals, aged 30 to 76 years, characterized by the Berg balance scale, Fugl - Meyer scale and Mini Mental State Examination participated in this study. Postural performance was measured by the center of pressure under bipedal conditions, in anteroposterior and mediolateral directions and unipedal with the affected and unaffected sides, using a force platform. Virtual reality performance was measured by distance and time required to perform a task in the Nintendo Wii®. Results: Revealed significant correlations between distance and displacement time of the affected side (distance x disc_affected = 0.667 - p = 0.025; time x disc_affected = 0.683 - p = 0.021) and between variables time and mean amplitude of mediolateral oscillation (time x amo_ml = -0.733 - p = 0.012), time and mediolateral and anteroposterior mean velocity (time x vm_ml = -0.617 - p = 0.038; time x vm_ap = -0.833 - p = 0.003) and between time and area (time x area = -0.633 - p = 0.034). Conclusion: the performance of standing postural control in post-stroke individuals, represented by measures of weight discharge and variables of postural control, presented a significant relation with the variables of virtual reality.

Resumo Introdução: Tido como a segunda maior causa de morte no mundo, o Acidente Vascular Cerebral tem suas consequências resultantes da lesão em regiões responsáveis pelo processamento das informações sensório-motoras, acarretando déficits na manutenção e desempenho do Controle Postural. Objetivo: Relacionar o desempenho do controle postural em pé e uma tarefa em realidade virtual em indivíduos pós-AVC. Método: Participaram 9 indivíduos em condição de pós-AVC com idades entre 30 a 76 anos, caracterizados por meio da escala de equilíbrio de Berg, Escala de Fugl-Meyer e Mini-Exame de Estado Mental. O desempenho postural foi medido através do deslocamento do centro de pressão nas condições bipodal, nas direções ântero-posterior e médio-lateral, e unipodal, com o lado afetado e não afetado, por meio de uma plataforma de força. O desempenho em realidade virtual, medido por distância e tempo, foi realizado por meio do console Nintendo Wii®. Resultados: Revelaram correlações significativas entre as variáveis distância e tempo de deslocamento do lado afetado (distância x desc_afetado=0,667 - p=0,025; tempo x desc_afetado=0,683 - p=0,021) e entre as variáveis tempo e amplitude média de oscilação médio-lateral (tempo x amo_ml= -0,733 - p=0,012), tempo e velocidade média médio-lateral e ântero-posterior (tempo x vm_ml= -0,617 - p=0,038; tempo x vm_ap= -0,833 - p=0,003) e entre tempo e área (tempo x área= -0,633 - p=0,034). Conclusão: Há relação entre o desempenho do controle postural, mensurado quantitativamente a partir de uma plataforma de força, e o desempenho em tarefa virtual pé em indivíduos pós-AVC.

Postural Control of People in treatment for substance use disorder

Abstract Aims: One of the common sequelae of chronic abuse of alcohol and/or illicit drugs is the impairment of body balance control, caused by long-term neurological damage. This study aimed to investigate the postural control of individuals hospitalized for the treatment of substance use disorder (initial phase) and to compare the results obtained by a control group. Method: For this, One-hundred fourteen individuals hospitalized for the treatment of substance use disorder and eighty-eight healthy controls, all males, were analyzed. Body mass, height, and waist circumference were measured. Were performed a balance test in a static upright position with feet side by side using a plantar pressure platform. Results: Individuals with substance use disorder have shown significantly lower results on body balance compared with controls. Individuals with chemical dependence showed balance results open-eyes, similar/lower than control subjects with close-eyes. Still, those who used only alcohol or alcohol combined with other illicit drugs presented worse results. Finally, impairments in body balance variables showed a significant correlation with age and substance time of use. Conclusion: Even in the early stage of treatment, substance use disorder considerably impairs the balance of the investigated men. The worst results were found in alcohol-dependents (alcohol alone or alcohol combined with other drugs).

Effect of dual-task and visual manipulation on the balance of older physical exercise practitioners and sedentary older and young adults / Efeito da dupla-tarefa e da manipulação visual no equilíbrio de idosos praticantes de exercícios físicos, idosos e adultos jovens não praticantes

The objective was to compare the effect of dual-task and visual manipulation on postural balance of older physical activity practitioners and older and young adult non-practitioners. Fifty-one subjects were divided into four groups: Older Practitioners of Karate (OPK), Older Practitioners of Func-tional Gymnastics (OPG), Non-practicing Older Adult Group (ONP), and Non-practicing Young Adult Group (YNP). The task was to remain in an upright, static position on a force platform, for 40 seconds, with and without a cognitive dual-task, by means of an arithmetic sum, and visual manipulation, with and without a blindfold. The analyzed variables of the Center of Pressure (COP) were: area of oscillation and mean amplitude of oscillation, in the mediolateral and anteroposterior directions. The results showed similar performances among the physical exercise groups (OPK and OPG) and the young adults (YNP), while the ONP presented greater postural oscillation in all conditions. In the visual condition, blindfolded, in the condition with the dual-task, the OPK, OPG, and YNP groups oscillated less, when compared to the condition without dual-task. Thus, it can be inferred that the practice of physical exercises, regardless of the modality, is effective in improving the postural control of older adults, with similar performances to the group of young adults, even in conditions with dual-task and sensory manipulation of vision

O objetivo do estudo foi comparar o efeito da dupla-tarefa e da manipulação visual no equilíbrio postural em idosos praticantes de diferentes modalidades de exercícios físicos, idosos e adultos jovens não praticantes. Participaram do estudo 51 indivíduos, subdivididos em quatro grupos: grupo de idosos praticantes de karatê (GPK), grupo de idosos praticantes de ginástica funcional (GPF), grupo de idosos não praticantes (GNP) e grupo de adultos jovens (GNP). A tarefa consistiu em permanecer, na posição ereta, sob plataforma de força, por 40 segundos, sem e com dupla-tarefa, por meio de soma aritmética e com manipulação visual, com e sem visão. As variáveis analisadas do Centro de Pressão (COP) foram: área de oscilação e amplitude média de oscilação, nos sentidos médio-lateral e ântero-posterior. Os resultados foram desempenhos semelhantes entre os grupos que praticavam exercícios físicos (OPK e OPG) e o de adultos jovens ( YNP), enquanto o ONP apresentou maior oscilação postural, nas variáveis área e amplitude de oscilação. Na condição visual, com vi-são e com a dupla-tarefa, os grupos OPK, OPG e YNP oscilaram menos, quando comparados a condição sem dupla-tarefa. Dessa forma, pode-se inferir que a prática de exercícios físicos, independente da modalidade, é eficaz no equilíbrio postural de idosos, com desempenho semelhante no grupo de adultos jovens, mesmo em condições com dupla-tarefa e manipulação sensorial da visão

Dependencia visual en otoneurología: consideraciones clínicas para la rehabilitación vestibular / Visual dependence in otoneurology: clinical considerations for vestibular rehabilitation

RESUMEN Los sistemas vestibular, visual y somatosensorial coordinan el control postural y se adaptan a las actividades cotidianas en diferentes contextos, sin embargo, cuando existe un cuadro clínico con sintomatología vestibular, las ponderaciones de estos sistemas cambian mayoritariamente al sistema visual, creando una dependencia visual. El cerebelo, que es el principal encargado de generar una compensación vestibular en casos de hipofunción vestibular, juega un rol destacado en el aprendizaje motor generando comportamientos adaptativos que se transforman en puntos claves en la rehabilitación vestibular. Este artículo pretende exponer lo que la literatura informa en relación a la dependencia visual en pacientes con hipofunción vestibular.

ABSTRACT The vestibular, visual and somatosensory systems coordinate postural control and adapt to daily activities in different contexts, however, when there is a clinical picture with vestibular symptoms, the weights of these systems change mainly to the visual system, creating a visual dependence. The cerebellum, which is the main responsible for generating vestibular compensation in cases of vestibular hypofunction, plays a prominent role in motor learning generating adaptive behaviors that become key points in vestibular rehabilitation. This article aims to expose what the literature reports in relation to visual dependence in patients with vestibular hypofunction.

Posturographic analysis of older adults without dementia and patients with Alzheimer's disease: A cross-sectional study / Análise posturográfica de adultos idosos sem demência e com doença de Alzheimer: estudo de corte transversal

ABSTRACT. Additional clinical tools should be investigated to facilitate and aid the early diagnosis of cognitive decline. Postural control worsens with aging and this may be related to pathological cognitive impairment. Objective: to compare the balance of older adults without dementia in a control group (CG) and with Alzheimer's disease (AD), to observe the possible association with the independent variables (diagnosis, age, gender, and global cognition) and to verify the best posturographic analyses to determine the difference between the groups. Methods: 86 older adults (AD = 48; CG = 38) were evaluated using the Berg Balance Scale (BBS) and postural control was assessed by stabilometry on the Wii Balance Board ® (WBB). Independent T, Mann-Whitney U-tests, Effect Size (ES) and a linear regression were performed. Results: there was a significant difference for Elliptical Area, Total Velocity, Medio-Lateral displacements with closed eyes and open eyes, antero-posterior, with closed eyes and BBS between groups. These variables showed a large effect size for BBS (-1.02), Elliptical Area (0.83) with closed eyes, Medio-Lateral (0.80, 0.96) and Total Velocity (0.92; 1.10) with eyes open and eyes closed, respectively. Regression indicated global cognition accompanied by age, gender, and diagnosis influenced postural control. Conclusion: patients with AD showed impaired postural control compared to Control Group subjects. Total Velocity with closed eyes was the most sensitive parameter for differentiating groups and should be better investigated as a possible motor biomarker of dementia in posturographic analysis with WBB.

RESUMO. Ferramentas clínicas adicionais devem ser investigadas para facilitar e auxiliar o diagnóstico prévio do declínio cognitivo. O controle postural piora com o envelhecimento e este fato pode estar relacionado com o comprometimento cognitivo patológico. Objetivo: comparar o equilíbrio de adultos idosos sem demência no grupo controle (GC) e com doença de Alzheimer (DA), observar as possíveis associações com as variáveis independentes (diagnóstico, idade, sexo e estado cognitivo global) e verificar as melhores análises posturográficas para determinar a diferença entre os grupos. Métodos: 86 idosos (DA = 48; GC=38) foram avaliados utilizando a escala de equilíbrio Berg (EEB) e o controle postural pela estabilometria no Wii Balance Board ® (WBB). Testes T independente, Mann Whitney U, o tamanho de efeito (TE) e uma regressão linear foram realizados. Resultados: houve diferença significativa para AE, VT, ML com OA e OF, AP com OF e EEB entre os grupos. Estas variáveis mostraram um TE grande para EEB (-1.02), AE (0,83) com OF, ML (0,80; 0,96) e VT (0,92; 1,10) com OA e OF, respectivamente. A regressão indicou que a cognição global acompanhada da idade, gênero e diagnóstico contribuem para as alterações do controle postural. Conclusão: pacientes com DA apresentam comprometimento do controle postural quando comparados a idosos saudáveis. A VT com OF foi o parâmetro mais sensível para diferenciar os grupos e deve ser melhor investigada como possível biomarcador motor de demência na análise posturográfica com o WBB.

Avaliação da regulação exteroceptiva e interoceptiva do equilíbrio corporal de idosas ativas / Evaluation of exteroceptive and interoceptive regulation of body balance of active seniors

O processo do envelhecimento humano traz consigo um conjunto de alterações para o organismo, dentre elas há a diminuição da eficácia das estratégias motoras do equilíbrio corporal e o aumento do tempo de reação muscular, o que torna o indivíduo mais suscetível à queda. O objetivo deste estudo foi avaliar o desempenho do equilíbrio de um grupo de idosas fisicamente ativas, com ênfase na regulação do sistema visual, vestibular e somatossensorial do equilíbrio estático e dinâmico, bem como sua performance em testes de marcha e flexibilidade. Trata-se de um estudo transversal analítico, realizado com 32 mulheres (67,48±4,88 anos), praticantes regulares de Pilates e hidroginástica. Os instrumentos utilizados foram: Escala do Equilíbrio de Berg (EEB), Timed Up and Go Test (TUG), Teste de Alcance Funcional (TAF) e o Teste de Equilíbrio Corporal (TEC). As idosas foram estratificadas em grupos: G1 (60-64 anos), G2 (65-69 anos), G3 (70-74 anos) e G4 (75-79 anos). A EEB atestou para um equilíbrio conservado [F(3,29)=1,766, p≥0,50], o TUG para independência funcional preservada [F(3,29)=0,418; p≥0,50] e o TAF sem risco para quedas [F(3,20)=2,228; p≥0,50]. O TEC identificou déficit da regulação interoceptiva do equilíbrio para todas as idades e comprometimento regulação interoceptiva do equilíbrio dinâmico para septuagenárias [F(3,29)= 0,301; p≥0,50]. Observou-se correlação moderada entre EEB-TEC (r=0,416; p=0,018), TEC-TUG (r=-345; p=0,013) e negativa entre EEB-TUG (r=-0,427; p=0,013). Sendo que, o TAF não se mostrou equivalente aos demais instrumentos. Conclui-se que mulheres sexagenárias e septuagenárias, praticantes regulares de exercícios físicos, apesar de indicarem bom desempenho nos testes de equilíbrio, marcha e flexibilidade, apresentaram comprometimento dos sistemas de regulação sensorial do equilíbrio estático e dinâmico...(AU)

The process of human aging brings with it a number of alterations to the organism, among them there is a decrease in the effectiveness of the motor strategies of the body balance and the increase of the time of muscular reaction, which makes the individual more susceptible to fall. The aim of this study was to evaluate the balance performance of a group of physically active elderly women, with emphasis on the regulation of the visual, vestibular and somatosensory systems of the static and dynamic balance, as well as their performance in gait tests and flexibility. This is a cross-sectional, analytical study of 32 women (67.48 ± 4.88 years), regular Pilates practitioners, and water aerobics. The instruments used were: Berg Balance Scale (BBS), Timed Up and Go Test (TUG), Functional Reach Test (TAF) and Body Balance Test (TEC). The elderly were stratified into groups: G1 (60-64 years), G2 (65-69 years), G3 (70- 74 years) and G4 (75-79 years). BBS attained a conserved equilibrium [F(3.29)=1.766, p≥0.50], the TUG for preserved functional independence [F(3.29)=0.418; p≥0.50] and TAF without risk of falls [F(3,20)=2,228; p≥0.50]. The TEC identified deficit of interoceptive regulation of balance for all ages and compromise interoceptive regulation of dynamic balance for septuagenarians [F(3,29)=0.301; p≥0.50]. It was observed a moderate correlation between BBS-TEC (r=0.416, p=0.018), TEC-TUG (r=-345, p=0.013) and negative between BBS-TUG (r=-0.427, p=0.013). The TAF did not prove to be equivalent to the other instruments. It was concluded that sexagenarian and septuagenarian women, regular physical exercise practitioners, despite indicating good performance in tests of balance, gait and flexibility, presented impairment of the systems of sensorial regulation of the static and dynamic balance...(AU)

Dual-task demands in various motor skills through Parkinson's disease progression

Aim: The aim of this study was to investigate the effects of adding a cognitive task on the performance of three different motor tasks with different demands, discrete skills, serial skills and continuous skills, by individuals with mild, moderate, and severe idiopathic Parkinson' disease (PD). We also investigate the effect of the cognitive task in the secondary task and the cost of the dual-task. Method: This is a cross-sectional study. Individuals with idiopathic PD were divided in three groups with respect to motor severity (mild, moderate and severe groups). Participants' performances were assessed in single and DT conditions including Sit-to-Stand test (SST), Timed Up and Go (TUG), and 10-meter Walk test (T10W). Cognitive task used was verbal fluency Results: The results show that dual task impact the performance of all primary tasks. DT negatively affects the performance of the motor tasks. And there is a different impact according the severity of the disease, severe ones are more affected than mild and moderate. Conclusion: In conclusion, adding a concurrent cognitive task negatively affected the performance of discrete, serial and continuous motor tasks, and this effect is more noticeable in severe than in mild patients. Under dual-task conditions, patients improved their cognitive task performance for gait and TUG, suggesting a prioritization of the secondary task for these tasks. There was no difference between the costs of the three tasks.Abstract Aim: The aim of this study was to investigate the effects of adding a cognitive task on the performance of three different motor tasks with different demands, discrete skills, serial skills and continuous skills, by individuals with mild, moderate, and severe idiopathic Parkinson' disease (PD). We also investigate the effect of the cognitive task in the secondary task and the cost of the dual-task. Method: This is a cross-sectional study. Individuals with idiopathic PD were divided in three groups with respect to motor severity (mild, moderate and severe groups). Participants' performances were assessed in single and DT conditions including Sit-to-Stand test (SST), Timed Up and Go (TUG), and 10-meter Walk test (T10W). Cognitive task used was verbal fluency Results: The results show that dual task impact the performance of all primary tasks. DT negatively affects the performance of the motor tasks. And there is a different impact according the severity of the disease, severe ones are more affected than mild and moderate. Conclusion: In conclusion, adding a concurrent cognitive task negatively affected the performance of discrete, serial and continuous motor tasks, and this effect is more noticeable in severe than in mild patients. Under dual-task conditions, patients improved their cognitive task performance for gait and TUG, suggesting a prioritization of the secondary task for these tasks. There was no difference between the costs of the three tasks.(AU)

Influence of age, sex, and visual information on postural control in children

Aim: This study aims to evaluate and identify the influence of age, sex, and visual information on postural control in children. Methods: Participants were 62 children (30 boys and 32 girls) divided into the following age groups (G): G1, aged 5-6 years (n = 23); G2, aged 7-8 years (n = 21); and G3, aged 9-10 years (n = 18). The analyzed variables were the center of pressure (COP) and anteroposterior (AP) and mid-lateral (ML) oscillation velocity (OV) obtained in the biped posture force platform with their open eyes (OE) and closed eyes (CE). Results: G3 COP, OV_AP, and OV_ML are smaller than those in G1 and G2 in OE (p < 0.00) and CE (p < 0.05). Girls demonstrated worse postural control than boys for COP, OV_AP, and OV_ML (p < 0.00) in G1. Conclusion: Age was the most influential factor of COP (21%), OV_AP (24%), and OV_ML (39%). Older children perform better, because of the positive contribution of visual information. Girls initially had worse postural control responses, but at age 7-8, they tend to outgrow boys. Advanced age provides more influence on postural control than visual information and sex.(AU)