RESUMEN
BACKGROUND: Palatal lengthening is becoming a first-line treatment choice for cleft patients with velopharyngeal insufficiency (VPI). As cleft palate-related surgical outcomes are age dependent, speech outcomes may be similarly affected by patient age at the time of treatment. The primary goal of this study is to determine whether there are age-related speech outcome differences when double opposing buccinator myomucosal flaps are used as part of a palatal lengthening protocol and whether these outcome differences preclude utilization of this technique for specific patient age groups. METHODS: A retrospective study was performed on consecutive nonsyndromic patients with VPI who underwent treatment using double opposing buccinator myomucosal flaps at our hospital between 2014 and 2021. Patients who completed the 15-month follow-up were stratified by age. Group A aged between 2 and 7 years (n = 14), group B aged 8 and 18 years (n = 23), and group C aged older than 18 years (n = 25) were included. Standardized perceptual speech evaluations and nasopharyngoscopy were performed. Hypernasality, soft palate mobility, and lateral palatal wall mobility were assessed both preoperatively and at a 15-month postoperative interval. Complications were also recorded. The χ2 test was used for statistical comparison. RESULTS: All of the age-stratified patient groups in this study showed significant improvement in hypernasality, soft palate mobility, and lateral wall mobility (P < 0.01), with no statistically significant differences between the different patient age groups. Overall speech success was achieved in 69.4% of patients. Patients in group A achieved 78.6% speech success, patients in group B achieved 78.3% speech success, and patients in group C achieved 56% speech success, with no statistically significant differences being shown regarding speech success between the different patient age groups (P > 0.05). CONCLUSIONS: Regardless of age, palatal lengthening via double opposing buccinator myomucosal flaps similarly improves speech outcomes.
Asunto(s)
Fisura del Paladar , Procedimientos de Cirugía Plástica , Insuficiencia Velofaríngea , Humanos , Preescolar , Niño , Habla , Estudios Retrospectivos , Colgajos Quirúrgicos/cirugía , Fisura del Paladar/cirugía , Fisura del Paladar/complicaciones , Insuficiencia Velofaríngea/etiología , Paladar Blando/cirugía , Resultado del TratamientoRESUMEN
In recent decades, body practices and physical activities (PCAF) have become part of the public health agenda. Actions to combat sedentary lifestyle in primary care are developed through body practices, physical exercises, physical activities and guided walks. The main objective of this study is to verify which interventions are being carried out by the Physical Education Professional (PEF) in primary care. This study comprises an integrative review. After consulting the databases and applying the search strategies, studies that were duplicated between the databases were identified and excluded. To compose this study, 7 articles were selected. With regard to the types of exercises found in the articles, 3 studies performed only resistance exercise, in which it was the Pilates method and Chinese gymnastics Liang Gong. Still, 4 studies combined aerobic and resistance exercises. Other important findings of this study, that the elderly population are the ones that most participated in the interventions and that the interventions were concentrated in the South and Southeast regions. In the interventions portrayed in this review, the diversification of physical exercises offered in Primary Care was noticed. All interventions brought positive health benefits at the physiological, social and/or psychological levels. This fits into the perspective of health promotion among the population that performs physical activity and/or physical exercise in Primary Care programs. (AU)
Nas últimas décadas as práticas corporais e atividades físicas (PCAF) passaram a compor a agenda da saúde pública. As ações para aumentar a prática de atividade física na Atenção Primária, são orientadas e desenvolvidas por meio de práticas corporais, exercícios físicos, atividades físicas e caminhadas. O presente estudo tem como objetivo principal verificar quais intervenções realizadas pelo Profissional de Educação Física (PEF) na Atenção Primária à Saúde. Este estudo compreende uma revisão integrativa. Após a consulta às bases de dados e a aplicação das estratégias de busca, foram identificados e excluídos estudos que apresentavam duplicidade entre as bases e foram selecionados sete artigos para compor este estudo. No que se refere aos tipos de exercícios físicos encontrados nos artigos, o exercício Resistance foi o mais prevalente (OU utilizado) nas intervenções, seguido pelas práticas integrativas e exercícios aeróbicos. Outros achados importantes neste estudo, foi a maior participação da população idosa nas intervenções, concentradas nas regiões do Sul e Sudeste. Nas intervenções retratadas nesta revisão percebeu-se a diversificação dos exercícios físicos oferecidos na Atenção Básica. Todas as intervenções trouxeram benefícios positivos para a saúde, nos níveis fisiológicos, sociais e/ou psicológicos, bem como o ponto de maior destaque foi a utilização do exercício Resistance. O que se enquadra numa perspectiva de promoção da saúde junto à população que realiza atividade física e/ou exercício físico nos programas da Atenção Primária à Saúde. (AU)
RESUMEN
INTRODUCTION: Elderly individuals with neurodegenerative diseases, such as Parkinson's disease (PD), may experience difficulties when performing functional tasks. OBJECTIVE: To analyze the handgrip strength, pulling force, and ground reaction forces (GRF) of individuals with and without PD when boarding a bus while performing both simple (ST) and dual tasks (DT). METHOD: This case-control study addressed 31 individuals with PD (GPD) and 30 healthy individuals (GHI). Assessments were performed in ST and DT situations using a bus model (prototype). Handgrip strength and pulling force were measured in both upper limbs using a dynamometer, and GRF was measured using a force platform. The GPD's and GHI's performances were compared in both ST and DT, and the individuals were classified as fallers according to the Falls Efficacy Scale. RESULTS: In the inter-group comparison, the GPD presented significantly lower maximum force using their right hand, in handgrip strength (30.43 vs. 36.62, P = .022), and pulling force (10.77 vs 12.81, P = .037). The left hand's pulling force proved to be the most demanding for the GPD, during ST (6.35 vs. 4.76, P = .006) and DT (6.32 vs 4.74, P = .008). The GPD also took longer to perform ST (6.14 vs. 4.67, P < .001) and DT (6.08 vs. 4.81, P = .002). Additionally, the GPD was more afraid of falling compared to the GHI (34.74 vs. 24.77, P < .001). CONCLUSION: Boarding a bus is a complex task for individuals with PD because they present lower maximum strength in the upper limbs and more significant functional expenditure than their healthy counterparts.
RESUMEN
BACKGROUND: It is well accepted among craniofacial surgeons that surgery does not improve mental status but does prevent worsening or deterioration of cognitive and mental function. In this report, we describe significant improvement in behavioral, learning skills and visual acuity for a Crouzon patient who underwent late posteriorvault distraction osteogenesis. METHODS: A 9-year-old Crouzon patient was referred to our hospital, presenting severe intracranial hypertension. The patient had previously undergone a strip craniectomy in early infancy at another medical institution, but there was no subsequent follow-up. Magnetic resonance imaging showed Chiari type I malformation and fundoscopy revealed papilledema. At the time of referral, the patient was not attending a regular school, had not acquired reading skills, was unable to concentrate, and could not accomplish school-related tasks that were standard for children in his age group. RESULTS: The patient underwent posterior vault distraction osteogenesis and showed concentration improvement and acquisition of fluent reading skills. Chiari type I malformation resolved as well as papilledema. visual acuity improved at Snellen test preoperatively from 20/200 to 20/60 at postoperative test. Ventricle size remained unchanged subsequent to performance of the posterior cranial vault distraction. The occipital veins were less visible upon clinical examination and less pronounced when palpated, and the bruit had completely disappeared. CONCLUSION: Late posterior vault distraction osteogenesis can improve behavioral, learning skills and visual acuity as shown in this 9-year-old Crouzon patient.
Asunto(s)
Malformación de Arnold-Chiari , Disostosis Craneofacial , Craneosinostosis , Hipertensión Intracraneal , Osteogénesis por Distracción , Papiledema , Niño , Humanos , Osteogénesis por Distracción/métodos , Disostosis Craneofacial/cirugía , Cráneo/cirugía , Hipertensión Intracraneal/cirugía , Craneosinostosis/cirugíaRESUMEN
BACKGROUND: The aim of the present study was twofold: (1) to assess the reproducibility of two dynamometers in handrail format to measure handgrip strength and traction force in the young and older adults; (2) to compare the handgrip strength and traction of these two populations. APPROACH: Twenty-four volunteers (12 older adults and 12 young adults) performed a functional effort related to handgrip strength and traction force during stair climbing. The participants were evaluated two times (separated by one week) using a coupled dynamometer that quantifies the muscular effort in grip and traction simultaneously to simulate stair climbing in bus service. RESULTS: The young adults performed significantly better (p < 0.04) than the older adults in both handgrip and traction efforts (medium to large effect size), with excellent reliability (Intraclass Coefficient Correlation > 0.9) and low error of measure. The dynamometers were able to discriminate the two population groups (sensitive validity) and showed excellent reproducibility estimates for handgrip and traction strength in both young and older adults. CONCLUSION: These instruments could be useful in assessing handgrip and traction strength needed to climb stairs, especially for the older adults, who normally have more difficulty performing this task.
Asunto(s)
Fuerza de la Mano , Tracción , Anciano , Gravitación , Humanos , Dinamómetro de Fuerza Muscular , Reproducibilidad de los Resultados , Adulto JovenRESUMEN
Core stability exercises and exercises that stimulate sensory-motor information are recommended for the prevention of injuries and the maintenance and rehabilitation of deficits related to postural control (PC). However, the comparison of results between core stability and sensory-motor exercises in the literature is limited to sitting and standing positions. OBJECTIVE: To determine the acute effect of core stability and sensory-motor exercises on PC during sitting and standing in young adults. METHODS: A total of 39 participants, with a mean age of 23 years, were randomly divided into three groups (1) Core stability exercises; (2) Sensory-motor exercises; (3) Control. Each group performed a sequence of five specific exercises of core stability and sensory-motor exercises (except controls). PC was evaluated before and after exercise in the seated and the one-legged stance conditions using a force platform. RESULTS: No significant difference was found for any variables of postural oscillation (P > 0.05) among the three groups studied. The magnitude of the effect of interventions in general was a small to moderate effect (d = 0.02/-0.48). CONCLUSION: The findings show that acute intervention with core stability and sensory-motor exercises did not produce any significant effects (reduction of postural oscillation) on PC during sitting and standing positions in young adults.
Asunto(s)
Sedestación , Posición de Pie , Adulto , Estabilidad Central , Terapia por Ejercicio , Humanos , Equilibrio Postural , Adulto JovenRESUMEN
BACKGROUND: Venous thromboembolism (VTE) is a major cause of perioperative morbimortality. Despite significant efforts to advance evidence-based practice, prevention rates remain inadequate in many centres. OBJECTIVE: To evaluate the effectiveness of different strategies aimed at improving adherence to adequate VTE prophylaxis in surgical patients at high risk of VTE. METHOD: Before and after intervention study conducted at a tertiary hospital. Adherence to adequate VTE prophylaxis was compared according to three strategies consecutively implemented from January 2019 to December 2020. A dedicated hospitalist physician alone (strategy A) or in conjunction with a nurse (strategy B) overlooked the postoperative period to ensure adherence and correct inadequacies. Finally, a multidisciplinary team approach (strategy C) focused on promoting adequate VTE prophylaxis across multiple stages of care-from the operating room (ie, preoperative team-based checklist) to collaboration with clinical pharmacists in the postoperative period-was implemented. RESULTS: We analysed 2074 surgical patients: 783 from January to June 2019 (strategy A), 669 from July 2019 to May 2020 (strategy B), and 622 from June to December 2020 (strategy C). VTE prophylaxis adherence rates for strategies (A), (B) and (C) were (median (25th-75th percentile)) 43.29% (31.82-51.69), 50% (42.57-55.80) and 92.31% (91.38-93.51), respectively (p<0.001; C>A=B). There was a significant reduction in non-compliance on all analysed criteria (risk stratification (A (25.5%), B (22%), C (6%)), medical documentation (A (68%), B (55.2%) C (9%)) and medical prescription (A (51.85%), B (48%), C (6.10%)) after implementation of strategy C (p<0.05). Additionally, a significant increase in compliance with adequate dosage, dosing interval and scheduling of the prophylactic regimen was observed. CONCLUSION: Perioperative VTE prophylaxis strategies that relied exclusively on physicians and/or nurses were associated with suboptimal execution and prevention. A multidisciplinary team-based approach that covers multiple stages of patient care significantly increased adherence to adequate VTE prophylaxis in surgical patients at high risk of developing perioperative VTE.
Asunto(s)
Tromboembolia Venosa , Anticoagulantes/uso terapéutico , Hospitalización , Humanos , Prescripciones , Tromboembolia Venosa/epidemiología , Tromboembolia Venosa/etiología , Tromboembolia Venosa/prevención & controlRESUMEN
The canga of the Serra dos Carajás, in Eastern Amazon, is home to a unique open plant community, harboring several endemic and rare species. Although a complete flora survey has been recently published, scarce to no genetic information is available for most plant species of the ironstone outcrops of the Serra dos Carajás. In this scenario, DNA barcoding appears as a fast and effective approach to assess the genetic diversity of the Serra dos Carajás flora, considering the growing need for robust biodiversity conservation planning in such an area with industrial mining activities. Thus, after testing eight different DNA barcode markers (matK, rbcL, rpoB, rpoC1, atpF-atpH, psbK-psbI, trnH-psbA, and ITS2), we chose rbcL and ITS2 as the most suitable markers for a broad application in the regional flora. Here we describe DNA barcodes for 1,130 specimens of 538 species, 323 genera, and 115 families of vascular plants from a highly diverse flora in the Amazon basin, with a total of 344 species being barcoded for the first time. In addition, we assessed the potential of using DNA metabarcoding of bulk samples for surveying plant diversity in the canga. Upon achieving the first comprehensive DNA barcoding effort directed to a complete flora in the Brazilian Amazon, we discuss the relevance of our results to guide future conservation measures in the Serra dos Carajás.
RESUMEN
Abstract Introduction Sensorineural hearing loss (SNHL) is a serious public health problem. Some evidence suggests a significant relationship between SNHL and balance disorders. The inability to maintain balance associated with SNHL while standing further increases the risk of falls among older people. Objective To investigate the association between SNHL on the postural balance in elderly individuals of both genders. Methods The sample consisted of 247 (166 women) physically independent elderly individuals, (mean age = 68.4 ± 6.0). The instruments used were the anamnesis and the pure tone audiometry for hearing loss, and for balance a force platform based in measures of center of pressure area and of sway velocity in the anteroposterior and mediolateral directions. Results Presence of hearing loss (HL) was observed in 68% of the participants. We observed a significant association between SNHL and characteristics of balance between the groups with and without HL for center of pressure (COP) area (p = 0.010), anteroposterior velocity (p = 0.001) and mediolateral velocity (p = 0.020). There was a significant difference between the gender groups for center of pressure area (p = 0.004), anteroposterior velocity (p = 0.001) and mediolateral velocity (p = 0.001) with better performance in the female group. Amongst men, there was a difference between the ones with HL and those without it, for COP area (p = 0.049). Conclusion In the present study, elderly individuals with SNHL exhibited more instability on the postural balance, and elderly men presented worse results in the test.
RESUMEN
Introduction Sensorineural hearing loss (SNHL) is a serious public health problem. Some evidence suggests a significant relationship between SNHL and balance disorders. The inability to maintain balance associated with SNHL while standing further increases the risk of falls among older people. Objective To investigate the association between SNHL on the postural balance in elderly individuals of both genders. Methods The sample consisted of 247 (166 women) physically independent elderly individuals, (mean age = 68.4 ± 6.0). The instruments used were the anamnesis and the pure tone audiometry for hearing loss, and for balance a force platform based in measures of center of pressure area and of sway velocity in the anteroposterior and mediolateral directions. Results Presence of hearing loss (HL) was observed in 68% of the participants. We observed a significant association between SNHL and characteristics of balance between the groups with and without HL for center of pressure (COP) area ( p = 0.010), anteroposterior velocity ( p = 0.001) and mediolateral velocity ( p = 0.020). There was a significant difference between the gender groups for center of pressure area ( p = 0.004), anteroposterior velocity ( p = 0.001) and mediolateral velocity ( p = 0.001) with better performance in the female group. Amongst men, there was a difference between the ones with HL and those without it, for COP area ( p = 0.049). Conclusion In the present study, elderly individuals with SNHL exhibited more instability on the postural balance, and elderly men presented worse results in the test.
RESUMEN
Taking the average of different trials is recommended for better balance assessment, but few studies have really proven this point under different balance conditions. OBJECTIVE: To assess the effects of averaging trials of five different balance tasks on postural control measures in older women. METHODS: A total of 90 older women (means: Age: 68 years; Weight: 67â¯kg; Height: 1.56â¯m; Body mass index, 27â¯kg/m2) participated in this study. The participants completed five balance tasks with three performance trials for each task on a force platform in random order. The participants completed a total of three 30-s trials of tasks with 30â¯s of rest between trials. Repeated measure ANOVA and coefficient of variation were computed to compare differences for one trial vs. averaging across two or three trials on center of pressure (COP) sway values. RESULTS: There were no significant differences (Pâ¯>â¯0.05) in COP sway values when comparing one vs. the average of two or three trials for all balance tasks. However, the coefficient of variation was higher for three trials (10-40%) than two (6-37%) or one trial (3-23%) for COP parameters. CONCLUSIONS: Based on reduction of variability, the present study recommends the averaging of a minimum of two trials for balance assessment in older women. The results of the current study have implications for balance assessment in older people in fall prevention programs.
Asunto(s)
Evaluación Geriátrica/métodos , Equilibrio Postural/fisiología , Anciano , Anciano de 80 o más Años , Envejecimiento , Femenino , Humanos , Persona de Mediana Edad , Reproducibilidad de los ResultadosRESUMEN
Postural instability is a common problem among older people, and it is associated with mobility impairments, activity limitation and fear of falling. The evaluation of postural control can contribute to the early detection of balance deficits and help health professionals to manage this problem to prevent falls in older adults. The aim of this study was to identify center of pressure cut-offs to differentiate between older adults with and without falls in the past 12 months. The participants were 170 older adults (mean age 67 years, 50 fallers and 120 non-fallers). Center of pressure area and sway velocity in the anterior-posterior and medio-lateral directions were assessed using a force platform during three 30s one-legged stance trials with eyes open. The mean across trials was used for analysis. The time-limit (how long the participant was able to stay in one-legged stance, up to 30s) was also assessed. Fallers had poorer postural control than non-fallers (effect size ≥ 0.52, P <0.05). The cut-offs identified were 10.3 cm2 for Center of pressure area, 2.9 cm/s for velocity in the anterior-posterior, and 3.4 cm/s for medio-lateral velocity. The force platform parameters obtained an area under the curve of 0.72, with sensitivity of 78% and specificity of 68%. There were no significant differences between non-fallers and fallers for time-limit variable (17 seconds vs. 18 seconds). Force platform parameters during one-legged stance were associated with history of falls in older adults. The cut-offs obtained acceptable area under curve, sensitivity and specificity, with center of pressure area presenting the best performance to differentiate between fallers and non-fallers.
Asunto(s)
Accidentes por Caídas/prevención & control , Equilibrio Postural/fisiología , Anciano , Anciano de 80 o más Años , Estudios de Casos y Controles , Femenino , Humanos , Masculino , Persona de Mediana Edad , Valor Predictivo de las Pruebas , Sensibilidad y EspecificidadRESUMEN
RESUMO Introdução: O controle postural é um pré-requisito importante para o desempenho do atleta no esporte. Além disso, o sistema de controle postural contribui para a prevenção de lesões. Déficits nesse sistema podem levar a instabilidade corporal e sobrecarga das estruturas musculoesqueléticas, gerando disfunção e dor. Objetivos: A proposta deste estudo foi avaliar o controle postural em três diferentes modalidades esportivas: taekwondo, handebol e futebol americano. Métodos: Todos os atletas executaram o teste de equilíbrio unipodal sobre uma plataforma de força nos membros inferiores direito e esquerdo. Foram realizados três testes de trinta segundos cada, com os olhos abertos. A média dos três testes foi utilizada para mensurar os parâmetros de controle postural, centro de pressão e velocidade dos deslocamentos anteroposteriores e mediolaterais. Resultados: Diferenças significativas foram observadas entre os três grupos em todos os parâmetros analisados (P = <0,04). A análise post hoc revelou que os atletas de taekwondo tiveram melhor controle postural (P = < 0,035) dos membros inferiores em comparação com as outras duas modalidades. Não foram observadas diferenças significativas entre o handebol e o futebol americano. Conclusão: Os atletas do taekwondo têm melhor controle postural durante o teste de equilíbrio unipodal do que os atletas do handebol e do futebol americano.
ABSTRACT Introduction: Postural control is an important prerequisite for an athlete's performance in sport. In addition, the postural control system contributes to injury prevention. Deficits in this system can lead to body instability and overload of musculoskeletal structures generating dysfunction and pain. Objectives: The purpose of this study was to evaluate postural control in three different sports modalities: taekwondo, handball, and American football. Methods: All athletes performed a one-legged stance/balance test on a force platform in the right and left lower limbs. Three tests of thirty seconds each were performed with eyes open. The mean of the three tests was used to measure the parameters of postural control, pressure center and velocity of anteroposterior and mediolateral displacements. Results: Significant differences were observed among the three groups in all analyzed parameters (P=<0.04). Post-hoc analysis revealed that taekwondo athletes had better postural control (P=<0.035) of lower limbs compared to the other two modalities. There were no significant differences between handball and American football. Conclusion: Taekwondo athletes have better postural control during the one-legged stance/balance test than handball and American football athletes.
RESUMEN Introducción: El control postural es un prerrequisito importante para el desempeño del atleta en el deporte. Además, el sistema de control postural contribuye a la prevención de lesiones. Los déficit en este sistema pueden llevar a la inestabilidad corporal y sobrecarga de las estructuras musculoesqueléticas, generando disfunción y dolor. Objetivos: La propuesta de este estudio fue evaluar el control postural en tres diferentes modalidades deportivas: taekwondo, handball y fútbol americano. Métodos: Todos los atletas ejecutaron la prueba de equilibrio unipodal sobre una plataforma de fuerza en los miembros inferiores derecho e izquierdo. Se realizaron tres pruebas de treinta segundos para cada una, con los ojos abiertos. El promedio de las tres pruebas se utilizó para medir los parámetros de control postural, centro de presión y velocidad de los desplazamientos anteroposteriores y mediolaterales. Resultados: Diferencias significativas se observaron entre los tres grupos en todos los parámetros analizados (P = < 0,04). El análisis post hoc reveló que los atletas de taekwondo tuvieron mejor control postural (P = <0,035) de las extremidades inferiores en comparación con las otras dos modalidades. No se observaron diferencias significativas entre el handball y el fútbol americano. Conclusión: Los atletas del taekwondo tienen mejor control postural durante la prueba de equilibrio unipodal que los atletas del handball y del fútbol americano.
RESUMEN
RESUMO O envelhecimento é um processo natural que acarreta mudanças intrínsecas e extrínsecas ao organismo. O objetivo é analisar cinco tarefas de equilíbrio postural em idosas através da Plataforma de força, correlacionando com o risco de quedas avaliado pelo teste Timed Up and Go (TUG). Participaram do estudo 43 idosos e 40 adultos jovens, todos do sexo feminino, que foram avaliadas em uma plataforma de força com um protocolo padrão: descalças, com os braços ao longo do corpo nas tarefas bipodal e semitandem, ambos olhos abertos e fechados, apoio unipodal utilizando o centro de oscilação postural (COP) e as velocidades nos eixos anteroposterior (Vel AP) e médio-lateral (Vel ML). Após 5 minutos de descanso, realizou-se o TUG. Os resultados mostraram que as idosas tiveram maior instabilidade postural (p<0.05) em relação às adultas jovens, e a tarefa que mais desafiou o equilíbrio foi o apoio unipodal COP 10,02 (cm2) Vel AP 3,00 (cm/s) e Vel ML 3,32 (cm/s), e as idosas tiveram um tempo médio no TUG de 9,01 segundos considerando um baixo risco de quedas. Conclusão: Idosas apresentam um maior déficit no equilíbrio em relação às jovens, sendo a tarefa de apoio UNP a que mais apresentou desafios no controle postural das duas populações. Idosas saudáveis apresentaram um baixo risco para as quedas, nenhuma correlação foi encontrada entre o equilíbrio postural através da plataforma de força e risco de quedas do TUG.
RESUMEN El envejecimiento es un proceso natural, lo cual conlleva cambios intrínsecos e extrínsecos en el organismo. El objectivo es analizar cinco tareas de equilibrio postural en ancianas por medio de la plataforma de fuerza, presentándose correlación con el riesgo de caídas evaluado por el Timed Up and Go Test (TUGT). Participaron del estudio 43 ancianas y 40 adultas jovenes, las cuales fueron evaluadas en una plataforma de fuerza con un protocolo patrón: descalzas, con los brazos al longo del cuerpo en las tareas bipodal y semi-tandem, ambos ojos abiertos y cerrados, apoyo unipodal utilizando el centro de oscilación postural (COP) y las velocidades en los ejes anteroposterior (Vel AP) y mediolateral (Vel ML). Después de 5 minutos de descanso, se realizó el TUGT. Los resultados presentaron que las ancianas tuvieron mayor inestabilidad postural (p<0.05) en relación a las adultas jovenes, y la tarea que más desafió el equilibrio fue el apoyo unipodal COP 10,02 (cm2) Vel AP 3,00 (cm/s) y Vel ML 3,32 (cm/s), y las ancianas tuvieron un tiempo medio en el TUGT de 9,01 segundos considerando bajo riesgo de caídas. La conclusión es que ancianas presentan mayor déficit en el equilibrio en relación a las jovenes, siendo la tarea de apoyo UNP la que más presentó desafíos en el control postural de las dos poblaciones. Ancianas saludables presentaron bajo riesgo para las caídas, ninguna correlación fue encontrada entre el equilibrio postural por medio de la plataforma de fuerza y riesgo de caídas del TUGT.
ABSTRACT Aging is a natural process, which involves intrinsic and extrinsic changes in the organism. The objective is to analyze five tasks of postural balance in older women through the strength platform, correlating them with risk of falls evaluated by the Timed Up and Go (TUG) test. Participants of this study were 43 older women and 40 young adult women. They were evaluated on a force platform with a standard protocol: barefoot with arms along the body in Semi-Tandem and bipedal stances, with both eyes open and then closed, unipedal support using the postural sway of the center of pressure (COP) and the velocities in the anteroposterior axis (AP) and medial-lateral (ML). After 5 minutes of rest, TUGT was applied. The results showed that older women had greater postural instability (p<0.05) than younger women. The most challenging task for balance was unipedal support COP: 10.02(cm2); AP velocity: 3.00 (cm/s); ML velocity: 3.32 (cm/s). Older women needed a mean time of 9.01 seconds in the TUGT, considering a low risk of falls. Conclusion: Older women present a higher deficit in their balance compared with young women, so as Unipedal Stance Test (UPST) task was the most challenging for postural control of the two populations. Healthy older women presented a low risk for falls. No correlation was found between postural balance through the force platform and risk of falls during the TUGT.
RESUMEN
OBJECTIVE: The purpose of this study was to assess the effect of holding an external load on the standing balance of younger and older adults with and without chronic low back pain (CLBP). METHODS: Twenty participants with and 20 without CLBP participated in the study. Each group contained 10 younger (50% men) and 10 older adults (50% men). Participants were instructed to look straight ahead while standing on a force platform during two 120-second trials with and without holding an external load (10% of body mass). The center of pressure area, mean velocity, and mean frequency in the anteroposterior and mediolateral directions were measured. RESULTS: Older adults had worse standing balance than younger adults did (P < .001, d = 0.20). There were no significant balance differences between participants with and without CLBP within age groups during standing balance condition. However, holding the external load significantly increased postural instability for both age groups and CLBP status, with mean effect size across center of pressure variables of d = 0.82 for older participants without CLBP and d = 2.65 for younger participants without CLBP. These effects for people with CLBP were d = 1.65 for subgroup of older and d = 1.60 for subgroup of younger participants. CONCLUSION: Holding an external load of 10% of body mass increased postural instability of both younger and older adults with and without CLBP.
Asunto(s)
Dolor Crónico/diagnóstico , Dolor de la Región Lumbar/diagnóstico , Equilibrio Postural/fisiología , Postura/fisiología , Soporte de Peso , Adulto , Factores de Edad , Anciano , Envejecimiento/fisiología , Índice de Masa Corporal , Estudios de Casos y Controles , Femenino , Humanos , Masculino , Persona de Mediana Edad , Valores de Referencia , Levantamiento de Peso/fisiologíaRESUMEN
Postural instability can be related to functional limitations as a result of the aging process. This study aimed to compare functional exercise capacity and postural control in older adults. Participants were allocated into three groups according to their functional exercise capacity based on the six minute walking test (6MWT): 1) Low performance group (LP: distance walked ≤ 80% of the predicted value n = 19), 2) Normal performance group (NP: distance walked 81-100% of the predicted value n = 21) and, 3) High performance group (HP: distance walked >100% of the predicted value n = 23). All groups performed three trials of a one-leg stance for 30s on a force platform. LP showed worse postural control in comparison to NP and HP, and significant differences (p < .05) were found between groups for area, velocity antero-posterior of center of pressure and time limit variables during the one-leg stance task. These results have implications for rehabilitation management with regard to exercise, balance assessment and intervention in older adults.
Instabilidade postural pode estar relacionada com as limitações funcionais, como um resultado do processo de envelhecimento. Este estudo teve como objetivo comparar a capacidade funcional de exercício e o controle postural em indivíduos idosos. Os participantes foram separados em três grupos de acordo com sua capacidade funcional de exercício baseada no teste de caminhada de seis minutos (TC6min): 1) grupo baixo desempenho (BD: distância caminhada ≤ 80% do valor predito n = 19), 2) grupo normal desempenho (ND : distância caminhada 81-100% do valor predito n = 21) e, 3) grupo alto desempenho (AD: distância caminhada >100% do valor predito n = 23). Todos os grupos realizaram três testes com apoio unipodal permanecendo por 30s sobre a plataforma de força. BD apresentou pior equilíbrio postural em comparação com ND e AD; com diferenças significativas (p < 0,05) encontradas entre os grupos para os parâmetros de área e velocidade antero-posterior do centro de pressão e a variável tempo-limite durante a posição unipodal. Estes resultados têm implicações para estratégias de reabilitação no que diz respeito ao exercício, avaliação do equilíbrio e intervenção em idosos.
Inestabilidad postural puede estar relacionada con las limitaciones funcionales como resultado del proceso de envejecimiento. Este estudio tuvo como objetivo evaluar la comparación entre la capacidad funcional del ejercicio en el control postural de las personas de edad avanzada. Los participantes fueron divididos en tres grupos de acuerdo a su capacidad de ejercicio funcional basado en la Prueba de Caminada de seis minutos (PC6M): 1) grupo Bajo Rendimiento (BR: distancia recorrida ≤ 80% del valor predijo, n = 19), 2) grupo Normal Rendimiento (NR: distancia recorrida 81-100% del valor predijo, n = 21) y 3) grupo Alto Rendimiento (AR: distancia recorrida >100% del valor predijo, n = 23). Todos los grupos realizaron tres pruebas sobre un solo pie por 30s en la plataforma de fuerza. BR presentó un mal equilibrio postural en comparación con NR y AR; con diferencias significativas (p < 0,05) encontrado entre los grupos de los parámetros área y velocidad antero-posterior del centro de presión y el límite de tiempo para la postura de una sola pierna. Estos resultados tienen implicaciones para las estrategias de rehabilitación en relación con el ejercicio, la evaluación del equilibrio y la intervención en los ancianos.
Asunto(s)
Humanos , Masculino , Femenino , Anciano , Ejercicio Físico , Envejecimiento/fisiología , Esfuerzo Físico/fisiología , Equilibrio PosturalRESUMEN
AbstractIntroduction Cryotherapy is the use of cold as therapeutic approach. Although often used, its impact on the postural balance is not well-known.Objectives To analyze the effects of cold water immersion in the postural balance on single-leg balance in healthy subjects through the variables of center-of-pressure, velocity anteroposterior and medial-lateral oscillations, comparing conditions open and closed eyes in the moments before, immediately, 20 and 40 minutes after cold water immersion.Material and methods Cross-sectional study with 30 male subjects, cold water immersion at 5 °C during 15 minutes assessed in a force platform, protocol of 3 trials of 30 seconds each with 10 seconds of rest, the average of the 3 trials was used for analysis. The software GraphPad Prisma 5.0 was used for statistical analysis, with the ANOVA test for repeated measures and comparisons with test of Friedman and post-test of Dunn.Results It was observed improvement of the balance by the results of the following variables: in the condition Open Eyes (OE) it was observed significant difference only in the velocity anteroposterior (AP) in the moment before immersion when compared to the 40-minute moment. Significant differences were observed in the condition Closed Eyes (CE) in the following comparisons: in the Center-of-Pressure (COP) only at the immediate moment when compared to the 40-minute moment; in the velocity AP in the moment before when compared to the 40-minute moment, in the immediate moment when compared to the 20-minute and 40-minute moments; and in the medial-lateral velocity (Vel-ML) in two comparisons: in the moment before immersion when compared to the 20-minute and 40-minute moments after cryotherapy. Results show safety in performing activities after cryotherapy.Conclusion Improvement of the postural balance after cold water immersion on the predetermined conditions of this study.
ResumoIntrodução A crioterapia consiste na utilização local do frio como abordagem terapêutica. Embora frequentemente utilizada, seu impacto no equilíbrio corporal é pouco explorado.Objetivos Analisar a influência da crioimersão no equilíbrio estático em apoio unipodal em indivíduos saudáveis por meio de variáveis do centro de pressão, oscilações da velocidade anteroposterior e médio-lateral, comparando condições olhos abertos e fechados nos momentos prévios, imediatamente, 20 e 40 minutos após crioimersão.Materiais e métodos Estudo transversal realizado com 30 sujeitos do gênero masculino: crioimersão a 5 °C durante 15 minutos; avaliação na plataforma de força, protocolo de 3 tentativas de 30 segundos cada, com 10 segundos de descanso; média das 3 medidas foi adotada para análise. Utilizou-se o programa GraphPad Prisma 5.0, ANOVA de medidas repetidas e comparações com teste de Friedman e pós-teste de Dunn.Resultados Verificou-se melhora do equilíbrio por meio dos resultados das seguintes variáveis analisadas: na condição Olhos Abertos (OA) observou-se diferença significativa apenas na velocidade anteroposterior (Vel-AP) no tempo pré-imersão comparado com 40 minutos. Com Olhos Fechados (OF) observou-se diferenças significativas nas seguintes comparações: no Centro-de-Pressão (COP) apenas no momento imediato comparado com 40 minutos; na velocidade AP no momento pré-comparado com o tempo de 40 minutos e no momento imediato comparado com 20 e 40 minutos após; e na velocidade médio-lateral (Vel-ML) no tempo pré-imersão comparado com 20 e 40 minutos após. Os resultados demonstram segurança na realização de atividades após crioterapia.Conclusão Verificou-se melhora do equilíbrio postural após crioimersão nas condições predeterminadas neste estudo.
RESUMEN
[Purpose] The aim of this study was to compare age-related differences in balance and anthropometric posture measurements of the foot and to determine any relationship between them. [Subjects and Methods] Sixty-eight older and 42 younger adults participated in this study. Foot posture was tested for four domains: 1) hallux flexion and extension range of motion using a goniometer, 2) navicular height and 3) length of the foot using a pachymeter, and 4) footprint (width of forefoot, arch index and hallux valgus). Balance was tested under two conditions on a force platform: bipodal in 60-s trials and unipodal in 30-s trials. The sway area of the center of pressure and velocity in the anteroposterior and mediolateral directions were computed. [Results] Older individuals showed significantly poorer balance compared with younger adults under in the unipodal condition (center of pressure area 9.97 vs. 7.72â cm(2)). Older people presented a significantly lower hallux mobility and higher values for width of the forefoot and transverse arch index than younger adults. The correlations between all foot posture and center of pressure parameters varied across groups, from weak to moderate (r -0.01 to -0.46). Low hallux mobility was significantly related to higher center of pressure values in older people. [Conclusion] These results have clinical implications for balance and foot posture assessments.
RESUMEN
PURPOSE: The purpose of this study was to examine the effects of an additional set of exhaustive exercise before traditional hypertrophic training on quadriceps muscle performance in young men. METHODS: Subjects performed maximal dynamic strength (1RM), local muscular endurance (LME), and magnetic resonance imaging (MRI) tests before and after an 8-week hypertrophic training program using a knee extensor machine. After baseline testing, the subjects were divided into 3 groups: untrained control, traditional training (TR), and prior exhaustive training (PE). Both the TR and PE groups trained using the same training protocol (2 days week(-1); 3 sets of 8-12 repetitions at 75 % of 1RM); the only difference was that the PE group performed an additional set of exhaustive exercise at 20 % of 1RM before each training session. RESULTS: After 8 weeks, the PE group experienced a greater (P < 0.05) increase in 1RM, cross-sectional area, and LME than the TR group. Additionally, no changes (P > 0.05) in daily dietary intake were observed between groups. CONCLUSION: These results suggest that the inclusion of a single set of exhaustive exercise at 20 % of 1RM before traditional hypertrophic training can be a suitable strategy for inducing additional beneficial effects on quadriceps strength, hypertrophy, and endurance in young men.
Asunto(s)
Ejercicio Físico/fisiología , Contracción Muscular/fisiología , Fuerza Muscular/fisiología , Músculo Esquelético/fisiología , Resistencia Física/fisiología , Entrenamiento de Fuerza , Adaptación Fisiológica/fisiología , Adolescente , Adulto , Humanos , Masculino , Entrenamiento de Fuerza/métodos , Levantamiento de Peso/fisiología , Adulto JovenRESUMEN
INTRODUÇÃO: A ginástica rítmica (GR) é uma modalidade esportiva que combina arte a gestos biomecânicos de alta complexidade, que requer alto nível de desenvolvimento de qualidades físicas como: agilidade, flexibilidade, força, impulsão e destreza. Nessa modalidade, estudos comprovam que as lesões mais frequentes ocorrem nas articulações do joelho e tornozelo e, em alguns casos, nas extremidades do punho, sendo os entorses as mais registradas, principalmente em atletas de nível de competição. Diante disso, a propriocepção e o controle muscular possuem papel fundamental na estabilidade articular dinâmica, já que após lesões ortopédicas algumas características sensório-motoras são alteradas e devem ser o foco de programas de reabilitação para que se obtenha melhor retorno às atividades como antes da lesão. OBJETIVO: Avaliar o efeito do treinamento proprioceptivo sobre o equilíbrio postural de atletas de ginástica rítmica, a partir da utilização da plataforma de força. MÉTODOS: Foi realizado um treinamento proprioceptivo no período de 2 meses, subdividido em três fases, com progressão da complexidade dos exercícios a cada fase de treinamento. RESULTADOS: Podemos observar que houve uma melhora significativa dos resultados da última fase do treinamento, quando foram utilizados exercícios de maior complexidade e agilidade, de acordo com o protocolo. CONCLUSÃO: Por se tratarem de atletas de GR de alto desempenho e apresentarem predomínio de atividades em apoio unipodal, os protocolos de propriocepção devem ser mais intensos, gerando um maior nível de perturbações e desequilíbrios posturais. .
INTRODUCTION: Rhythmic gymnastics (RG) is a sport that combines art with biomechanical gestures of high complexity, which requires a high level of development of physical qualities such as agility, flexibility, strength, impulsion and dexterity. In this modality, studies show that the most frequent injuries occur in the knee and ankle joints, and in some cases in the ends of the wrist, being the sprains the most frequently recorded in competition level athletes. Therefore, proprioception and muscle control play a fundamental role in dynamic joint stability, since after some orthopedic injuries the sensorimotor characteristics are altered and should be the focus of rehabilitation programs in order to obtain the better return, as before the injury. OBJECTIVE: Evaluate the effect of proprioceptive training on postural balance of rhythmic gymnastics athletes through the use of a force platform. METHODS: Proprioceptive training was conducted during 2 months, in three stages, with progression of the complexity of the exercises in each training phase. RESULTS: We observed that there was a significant improvement in the results over the last phase of training when exercises of greater complexity and agility were used, according to the protocol. CONCLUSION: Because these athletes practice rhythmic gymnastics of high performance and predominance of activities on one-foot stance, the protocols should be more intense, generating a higher level of disturbance and postural imbalances. .
INTRODUCCIÓN: La gimnasia rítmica (RG) es un deporte que combina el arte con gestos biomecánicos de alta complejidad, que requiere un alto nivel de desarrollo de las cualidades físicas como la agilidad, flexibilidad, fuerza, impulsión y destreza. En esta modalidad los estudios muestran que las lesiones más frecuentes se producen en las articulaciones de la rodilla y del tobillo, y en algunos casos en los extremos de la muñeca, siendo los esguinces los registrados con mayor frecuencia en los atletas de nivel de competencia. Por lo tanto, la propiocepción y el control muscular juegan un papel fundamental en la estabilidad dinámica de la articulación, ya que después de algunas lesiones ortopédicas las características sensoriomotoras son alteradas y deben ser el foco de los programas de rehabilitación con el fin de obtener un mejor retorno a las actividades como eran antes de la lesión. OBJETIVO: Evaluar el efecto del entrenamiento propioceptivo sobre el equilibrio postural de los atletas de gimnasia rítmica, utilizando una plataforma de fuerza. MÉTODOS: El entrenamiento propioceptivo se llevó a cabo durante 2 meses, en tres etapas, con la progresión de la complejidad de los ejercicios en cada fase de entrenamiento.. RESULTADOS: Se observó que hubo una mejora significativa en los resultados de la última fase del entrenamiento cuando se utilizaron ejercicios de mayor complejidad y agilidad, de acuerdo con el protocolo. CONCLUSIÓN: Debido a que estos atletas practican gimnasia rítmica de alto rendimiento y predominio de actividades en la postura de un pie, los protocolos deberían ser más intensos, generando un mayor nivel de perturbación y los desequilibrios posturales. .