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1.
Stud Health Technol Inform ; 272: 249-252, 2020 Jun 26.
Artigo em Inglês | MEDLINE | ID: mdl-32604648

RESUMO

Manual patient handling is one of the physiological risk factors in care. The scientific focus so far, has primarily been on the analysis of lumbar compression during manual caregiving in order to improve the transfer facilitation of caregivers through technical systems. Reference is made in this context to the supportive functional role of the muscles of the lower limb. To assess biomechanical data for the quantification of lower limb and spine muscle activity in manual patient handling, an experimental study was conducted. A quantitative basis for the analysis of caregiving processes and its risk factors is established by evaluating caregivers' posture, ground reaction force components, and muscle activities during ergonomic and non-ergonomic manual patient handling in a laboratory setting.


Assuntos
Movimentação e Reposicionamento de Pacientes , Fenômenos Biomecânicos , Humanos , Extremidade Inferior , Região Lombossacral , Postura
2.
Pol Merkur Lekarski ; 48(285): 174-178, 2020 Jun 17.
Artigo em Inglês | MEDLINE | ID: mdl-32564042

RESUMO

Idiopathic scoliosis is one of the most difficult problems of contemporary orthopaedics and physiotherapy, and its unknown etiology hinders initiation of effective causative therapy. A tendency for progression of scoliosis, and failure of many conservative treatment methods stimulated a search for new and more effective methods which will not only stop a progress of the deformation, but actually correct it. The FED method is a relatively new, but promising method used for conservative treatment of idiopathic scoliosis. It is based on the use of a special device, which enables corrective forces to act at a level of the scoliotic curve. AIM: The aim of this study was a comparative analysis of effectiveness of idiopathic scoliosis treatment using the FED method versus FITS, during 3 weeks of observations of girls aged 11 to 15 years. MATERIALS AND METHODS: The study was conducted in 60 girls, aged from 11 to 15 years (mean 13.58 ± 1.33 years) randomly qualified which were suffered with double-curve scoliosis of the 2nd degree according to Cobb. According to the randomization, the girls were assigned to two groups based on the therapeutic strategy, the study group of patients treated with the FED method, and the control group treated with the FITS method. The therapy results were evaluated by computer examination of the posture using the Zebris CMS10 system. The degree of the spine deformity in the frontal plane was described with the total scoliotic deformation (SD) angle. RESULTS: In the conducted study, no statistically significant difference was noted between groups for any of the analyzed variables. It means that these groups did not differ statistically in terms of subjects' number, age, type of scoliosis, Cobb angle value for primary and secondary scoliosis, Risser sign, Raimondi rotation, and scoliosis type. Statistically significant differences were found between the two groups for the scoliosis degree, however, after the therapy, the girls treated with the FED method were characterized by a greater improvement in this parameter versus the control group. CONCLUSIONS: Both FED and FITS methods significantly influence the improvement in the scoliotic deformation degree in the Zebris computer examination during a 3-week follow-up; however, when both treatment methods are compared, it can be concluded that the therapy by the FED method is statistically more effective. The treatment of the 2nd degree scolioses with the FED method requires further analyses supplemented with other parameters of postural examination, as well as long-term diagnostics in a larger group of patients.


Assuntos
Tratamento Conservador , Modalidades de Fisioterapia , Escoliose , Adolescente , Criança , Progressão da Doença , Feminino , Humanos , Postura , Escoliose/terapia
3.
PLoS One ; 15(5): e0232135, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32392270

RESUMO

Postural dysfunction is one of the most common community health symptoms and frequent chief complaints in hospitals. Sarcopenia is a syndrome characterized by degenerative loss of skeletal muscle mass, muscle quality, and muscle strength, and is the main contributor to musculoskeletal impairment in the elderly. Previous studies reported that loss of muscle mass is associated with a loss of diverse functional abilities. Meanwhile, there have been limited studies concerning postural dysfunction among older adults with sarcopenia. Although sarcopenia is primarily a disease of the elderly, its development may be associated with conditions that are not exclusively seen in older persons. Also, recent studies recognize that sarcopenia may begin to develop earlier in life. The objective of this paper was to investigate the association between the prevalence of sarcopenia and postural dysfunction in a wide age range of adults using data from a nationally representative cohort study in Korea. Korean National Health & Nutrition Exhibition Survey V (KNHANES V, 2010-2012) data from the fifth cross-sectional survey of the South Korean population performed by the Korean Ministry of Health and Welfare were used. Appendicular skeletal muscle mass (ASM)/height (ht)2 was used to define sarcopenia, and the Modified Romberg test using a foam pad ("foam balance test") was performed to evaluate postural dysfunction. ASM/ht2 was lower in women and significantly decreased with age in men. Subjects with sarcopenia were significantly more likely to fail the foam balance test, regardless of sex and age. Regression analysis showed a significant relationship between sarcopenia and postural dysfunction (OR: 2.544, 95% CI: 1.683-3.846, p<0.001). Multivariate regression analysis revealed that sarcopenia (OR: 1.747, 95% CI: 1.120-2.720, p = 0.014) and age (OR: 1.131, 95% CI: 1.105-1.158, p<0.001) are independent risk factors for postural instability. In middle age subjects, the adjusted OR for sarcopenia was 3.344 (95% CI: 1.350-8.285) (p = 0.009). The prevalence of postural dysfunction is higher in sarcopenia patients, independent of sex and age.


Assuntos
Postura , Sarcopenia/fisiopatologia , Estudos de Casos e Controles , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
4.
Zhongguo Dang Dai Er Ke Za Zhi ; 22(5): 488-493, 2020 May.
Artigo em Chinês | MEDLINE | ID: mdl-32434646

RESUMO

OBJECTIVE: To study the clinical features of vasovagal syncope (VVS) and postural orthostatic tachycardia syndrome (POTS) in children with neurological symptoms at disease onset. METHODS: A retrospective analysis was performed on the medical data of 88 children with the initial symptoms of the nervous system, such as transient loss of consciousness, dizziness, headache, and convulsion, who were finally diagnosed with VVS or POTS. RESULTS: Of the 88 children, there were 35 boys (40%) and 53 girls (60%), with an age of 4-15 years. The peak age of onset was between 10 and 13 years. All the children had the initial symptoms of transient loss of consciousness, dizziness, headache, and convulsion. Nervous system diseases were excluded by electroencephalography, cerebrospinal fluid examination, and cranial MRI. Of the 88 children, 53 (60%) were confirmed with VVS, and 35 (40%) with POTS, according to the results of head-up tilt test (HUTT). Five children with the initial symptom of transient loss of consciousness were misdiagnosed with epilepsy. Predisposing factors were determined for 59 children (67%), and prolonged standing was the most common factor, followed by change in body position and strenuous exercise. Premonitory symptoms were observed in 66 children (75%), among which chest discomfort was the most common symptom, followed by gastrointestinal symptoms (nausea, vomiting, and abdominal pain) and pale complexion. All 88 children received health education and exercise for autonomic nerve function, among whom 53 children with VVS were given oral rehydration salts and 35 children with POTS were given oral rehydration salts and metoprolol. All 88 children were followed up for 18 months, and the response rates to the above treatment at 3, 6, 12, and 18 months of follow-up were 87%, 93%, 93%, and 90% respectively. CONCLUSIONS: In addition to nervous system diseases, functional cardiovascular diseases including VVS and POTS should be considered for children with the initial symptoms of transient loss of consciousness, dizziness, headache, and convulsion. HUTT can be used to make a confirmed diagnosis, and the early treatment can achieve a good outcome.


Assuntos
Síndrome da Taquicardia Postural Ortostática , Síncope Vasovagal , Adolescente , Criança , Pré-Escolar , Feminino , Humanos , Masculino , Postura , Estudos Retrospectivos , Teste da Mesa Inclinada
5.
Rev Assoc Med Bras (1992) ; 66(2): 216-221, 2020 May 15.
Artigo em Inglês | MEDLINE | ID: mdl-32428158

RESUMO

OBJECTIVE: In diabetics, foot deformities are risk factors that increase the risk of amputation as a result of developing ulcers. However, knowledge of the influence of plantar stiffness is still limited. The main objective was to describe connections between the degree of stiffness of the ankle, atypical amputation, and the Foot Posture Index (FPI). METHODS: 62 diabetic patients, 58 with type 2 and 4 with type 1 (average age 63.35 years) were included. Records of foot deformities were included; A range of motion test of the ankle joint was used to determine the degree of stiffness. An exploratory analysis of the association of foot position and the degree of rigidity was performed. RESULTS: The dorsal flexion range of the ankle was 9.6 ± 5.1 0, 13.8 ± 5.9 0 and 17.2 ± 6.5 0 and 20.5 ± 6.8 0 to 45, 67, 89 and 111 N respectively in the amputated feet., And 14 patients (22.58%) had a high level of pronation of IPF with an average value of 3.7 ± 2.629, CI (3.032.-4.367) in amputated feet compared to non-amputees. We use the device "Iowa ankle range of motion" (IAROM) to determine the differences in ankle stiffness. Proper IPF was associated with the presence of amputation and an increase in stiffness. CONCLUSIONS: There was an increase in the degree of limitation of movement of the ankle, as a greater force was applied. Comparing FPI between the groups, there was a higher frequency of prone feet in the group of amputees.


Assuntos
Amputação , Articulação do Tornozelo/fisiopatologia , Diabetes Mellitus Tipo 1/fisiopatologia , Diabetes Mellitus Tipo 2/fisiopatologia , Amplitude de Movimento Articular/fisiologia , Idoso , Antropometria , Estudos Transversais , Feminino , Pé/fisiopatologia , Humanos , Masculino , Pessoa de Meia-Idade , Postura/fisiologia , Valores de Referência , Estatísticas não Paramétricas
7.
J Cataract Refract Surg ; 46(4): 654-655, 2020 04.
Artigo em Inglês | MEDLINE | ID: mdl-32271306
8.
PLoS One ; 15(4): e0231334, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32275736

RESUMO

Subthreshold stochastic vestibular stimulation (SVS) is thought to enhance vestibular sensitivity and improve balance. However, it is unclear how SVS affects standing and walking when balance is challenged, particularly when the eyes are open. It is also unclear how different methods to determine stimulation intensity influence the effects. We aimed to determine (1) whether SVS affects stability when balance is challenged during eyes-open standing and overground walking tasks, and (2) how the effects differ based on whether optimal stimulation amplitude is derived from sinusoidal or cutaneous threshold techniques. Thirteen healthy adults performed balance-unchallenged and balance-challenged standing and walking tasks with SVS (0-30 Hz zero-mean, white noise electrical stimulus) or sham stimulation. For the balance-challenged condition, participants had inflatable rubber hemispheres attached to the bottom of their shoes to reduce the control provided by moving the center of pressure under their base of support. In different blocks of trials, we set SVS intensity to either 50% of participants' sinusoidal (motion) threshold or 80% of participants' cutaneous threshold. SVS reduced medial-lateral trunk velocity root mean square in the balance-challenged (p < 0.05) but not in the balance-unchallenged condition during standing. Regardless of condition, SVS decreased step-width variability and marginally increased gait speed when walking with the eyes open (p < 0.05). SVS intensity had minimal effect on the standing and walking measures. Taken together, our results provide insight into the effectiveness of SVS at improving balance-challenged, eyes-open standing and walking performance in healthy adults.


Assuntos
Marcha , Equilíbrio Postural , Vestíbulo do Labirinto/fisiologia , Adulto , Feminino , Humanos , Masculino , Modelos Neurológicos , Postura , Limiar Sensorial , Processos Estocásticos , Potenciais Evocados Miogênicos Vestibulares
9.
Occup Environ Med ; 77(7): 462-469, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32253227

RESUMO

OBJECTIVES: The aim of this clustered, randomised controlled trial was to assess the effectiveness of a lumbopelvic postural feedback device for changing postural behaviour in a group of healthcare workers. We hypothesised that workers exposed to auditory postural feedback would reduce the number of times forward bending posture is adopted at work. METHODS: This was a participant and assessor blinded, randomised, sham-controlled trial with blocked cluster random allocation. We recruited healthcare workers from aged care institutions. Healthcare sites were randomly allocated to the feedback or sham group (SG). A postural monitoring and feedback device was used to monitor and record lumbopelvic forward bending posture, and provided audio feedback whenever the user sustained lumbopelvic forward bending posture that exceeded predefined thresholds. The primary outcome measure was postural behaviour (exceeding thresholds). We used a robust variant of repeated measures mixed-effect model for assessing within-group and between-group differences in postural behaviour. RESULTS: We recruited 19 sites, and 130 healthcare workers participated. There were no within-group changes on the number of times postural threshold was exceeded at 1-week follow-up (feedback group: -0.7, 95% CI -2.61 to 0.72; SG -0.3, -1.65 to 0.98), and no differences (0.05, 95% CI -1.83 to 1.94) between SG and feedback group. CONCLUSIONS: Findings from this trial indicate that audio feedback provided by a postural monitor device did not reduce the number of times healthcare workers exceeded the postural threshold. TRIAL REGISTRATION NUMBER: ACTRN12616000449437.


Assuntos
Retroalimentação Sensorial/fisiologia , Pessoal de Saúde , Postura/fisiologia , Adulto , Ergonomia , Feminino , Humanos , Dor Lombar/prevenção & controle , Região Lombossacral/fisiopatologia , Masculino , Pessoa de Meia-Idade , Monitorização Fisiológica/instrumentação , Nova Zelândia
10.
Phys Ther ; 100(6): 1008-1019, 2020 06 23.
Artigo em Inglês | MEDLINE | ID: mdl-32232372

RESUMO

Hypertension (HTN) is among the leading global preventable risk factors for cardiovascular disease and premature mortality. Early detection and effective management of HTN have demonstrated significant reductions in mortality, morbidity rate, and health care costs. Furthermore, screening for HTN by nonphysician health care providers improves detection rates and medical management. As physical therapist practice advances to a more independent care model, physical therapists may serve as the first point of contact into the health care system, thereby necessitating a need for routine blood pressure (BP) monitoring. This is especially relevant in the outpatient physical therapist practice setting, where there is evidence for elevated BP measures among patients, yet omission of routine screening in this setting is well documented. Leading physical therapy professional organizations include statements in their guidelines that suggest that physical therapists have a duty to provide a standard of care that protects the safety and optimizes the overall health of patients under their care. Therefore, it is imperative not only that physical therapists include BP examination into routine practice protocols but that the knowledge and skills to accurately measure and interpret BP at rest and during exercise be integrated into the standard of care. The authors suggest that the profession of physical therapy proactively embrace their potential to address the national and worldwide HTN epidemic through routine assessment of BP, appropriate referral for elevated BP measures, and exploration of HTN management by physical therapists.


Assuntos
Assistência Ambulatorial , Determinação da Pressão Arterial , Hipertensão/diagnóstico , Fisioterapeutas , Assistência Ambulatorial/ética , Pressão Sanguínea/fisiologia , Determinação da Pressão Arterial/ética , Determinação da Pressão Arterial/instrumentação , Determinação da Pressão Arterial/normas , Calibragem , Tomada de Decisão Clínica , Diagnóstico Precoce , Desenho de Equipamento , Exercício Físico/fisiologia , Terapia por Exercício , Humanos , Hipertensão/terapia , Fisioterapeutas/ética , Postura/fisiologia , Encaminhamento e Consulta , Padrão de Cuidado
11.
Medicine (Baltimore) ; 99(17): e19645, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32332608

RESUMO

BACKGROUND: The Trachway Videolight Intubating Stylet is a video-assisted system with a rigid but malleable intubating stylet that facilitates endotracheal intubation. Minimizing cervical spine movement with manual in-line stabilization is essential for patients with cervical spine injuries such as multiple trauma. However, the intubation time of the Trachway Videolight Intubating Stylet and complications associated with intubation in patients with manual in-line stabilization in the neutral-head and head-lift positions remain unclear. METHODS: Patients (20-80 years old) who were scheduled to undergo surgery that required general anesthesia with tracheal intubation were randomly allocated to either a neutral-head (n = 62) or a head-lift position (n = 62) group. Manual in-line stabilization was performed to limit cervical spine mobility. We aimed to evaluate orotracheal intubation time and success rate in these 2 positions with the Trachway Videolight Intubating Stylet. RESULTS: Intubation was faster in the head-lift than in the neutral-head position (20 ±â€Š10 and 25 ±â€Š13 seconds, respectively, P = .000); intubation was equally successful in the 2 positions (96.8% vs 96.8%). Responses to intubation did not differ between positions (heart rate, P = .142; visual analog scale scores for throat soreness, P = .54). The only significant predictor of intubation time was the body mass index in the head-lift position group (P = .005). CONCLUSIONS: Intubation using the Trachway Videolight Intubating Stylet with manual in-line stabilization is faster in the head-lift position, and therefore preferable. However, if the head-lift position is not suitable, the neutral-head position is a sensible alternative, with comparable intubation success rate, heart rate change, and postoperative throat soreness.


Assuntos
Equipamentos e Provisões , Intubação Intratraqueal/instrumentação , Intubação Intratraqueal/métodos , Postura , Adulto , Idoso , Idoso de 80 Anos ou mais , Anestesia/métodos , Feminino , Cabeça , Humanos , Masculino , Pessoa de Meia-Idade , Pescoço , Fatores de Tempo , Adulto Jovem
12.
PLoS One ; 15(4): e0231860, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32315353

RESUMO

Many poststroke hemiplegic patients have an asymmetrical wheelchair-sitting posture. This study aimed to investigate the impact of different back support shapes on asymmetrical sitting posture and pressure points among poststroke hemiplegic patients during an activities of daily living-related reaching task. This study included 23 poststroke hemiplegic patients who performed tasks that involved the movement of objects using the unaffected upper limb to the affected side while sitting in a conventional wheelchair (C-WC) with a flat back support or a wheelchair providing pelvic and thoracic support (P-WC). Body alignment angles from video images and pressure distribution on supporting surfaces were measured using a two-dimensional motion analysis software (Dartfish) and a pressure mapping system (FSA). Regarding movement performance, although postural asymmetry increased in both wheelchair types, the degree of postural variation was smaller with P-WC use than C-WC use (p < 0.05), with partly reduced postural asymmetry. With P-WC, one-sided ischial asymmetrical pressure was significantly less after the movement (p < 0.05). In conclusion, P-WC's back support shape contributed to a decrease in postural asymmetry for pelvic girdle support both at rest and during movement. This highlights the importance of a wheelchair back support shape and may help to increase the quality of activities of daily living movement in poststroke hemiplegic patients in wheelchairs.


Assuntos
Pelve/fisiologia , Acidente Vascular Cerebral/patologia , Cadeiras de Rodas , Idoso , Idoso de 80 Anos ou mais , Desenho de Equipamento , Feminino , Hemiplegia/etiologia , Hemiplegia/patologia , Humanos , Masculino , Pessoa de Meia-Idade , Postura , Pressão , Postura Sentada , Acidente Vascular Cerebral/complicações
13.
Zhongguo Yi Liao Qi Xie Za Zhi ; 44(1): 33-37, 2020 Jan 08.
Artigo em Chinês | MEDLINE | ID: mdl-32343063

RESUMO

Accompanied by changes in modern work and lifestyle, the incidence of cervical spondylosis has increased year by year. In view of the fact long-term fixed posture of the head and neck is one of the main causes of cervical spondylosis, a set of wearable cervical spondylosis prevention system is developed. The system comprises a head and neck movement collection module based on the acceleration sensor and a head and neck motion recognition module based on artificial intelligence. Experimental results showed that the system can accurately identify long-term posture of the head and neck, and guide users to complete effective exercise therapy under the supervision of motion recognition module. Using this system can be beneficial for the prevention of cervical spondylosis.


Assuntos
Inteligência Artificial , Terapia por Exercício/instrumentação , Postura , Espondilose/prevenção & controle , Dispositivos Eletrônicos Vestíveis , Aceleração , Vértebras Cervicais , Humanos , Movimento , Pescoço , Resultado do Tratamento
14.
PLoS One ; 15(4): e0225358, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32310944

RESUMO

Cognitive impairment is prevalent but still poorly diagnosed in hemodialysis adults, mainly because of the impracticality of current tools. This study examined whether remotely monitoring mobility performance can help identifying digital measures of cognitive impairment in hemodialysis patients. Sixty-nine diabetes mellitus hemodialysis patients (age = 64.1±8.1years, body mass index = 31.7±7.6kg/m2) were recruited. According to the Mini-Mental State Exam, 44 (64%) were determined as cognitive-intact, and 25 (36%) as cognitive-impaired. Mobility performance, including cumulated posture duration (sitting, lying, standing, and walking), daily walking performance (step and unbroken walking bout), as well as postural-transition (daily number and average duration), were measured using a validated pendant-sensor for a continuous period of 24-hour during a non-dialysis day. Motor capacity was quantified by assessing standing balance and gait performance under single-task and dual-task conditions. No between-group difference was observed for the motor capacity. However, the mobility performance was different between groups. The cognitive-impaired group spent significantly higher percentage of time in sitting and lying (Cohens effect size d = 0.78, p = 0.005) but took significantly less daily steps (d = 0.69, p = 0.015) than the cognitive-intact group. The largest effect of reduction in number of postural-transition was observed in walk-to-sit transition (d = 0.65, p = 0.020). Regression models based on demographics, addition of daily walking performance, and addition of other mobility performance metrics, led to area-under-curves of 0.76, 0.78, and 0.93, respectively, for discriminating cognitive-impaired cases. This study suggests that mobility performance metrics could be served as potential digital biomarkers of cognitive impairment among hemodialysis patients. It also highlights the additional value of measuring cumulated posture duration and postural-transition to improve the detection of cognitive impairment. Future studies need to examine potential benefits of mobility performance metrics for early diagnosis of cognitive impairment/dementia and timely intervention.


Assuntos
Disfunção Cognitiva/diagnóstico , Idoso , Técnicas Biossensoriais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Equilíbrio Postural , Postura , Diálise Renal , Caminhada , Dispositivos Eletrônicos Vestíveis
15.
Med Sci Monit ; 26: e920208, 2020 Mar 23.
Artigo em Inglês | MEDLINE | ID: mdl-32202262

RESUMO

BACKGROUND Neck pain is reported by many laborers who are at risk of experiencing musculoskeletal disorders due to muscle stiffness and hypokinetics. This study examined the effects of a lower trapezius exercise program on neck pain patients. MATERIAL AND METHODS The design of this study was a randomized controlled trial. A total of 40 neck pain patients participated in this study. Screening tests were performed and assigned to experimental group (n=20) and control group (n=20) using randomization program. Both groups underwent a scapula and thoracic spine stabilization exercise program. In addition, the experimental group implemented the lower trapezius strengthening exercise program. All interventions were applied 3 times per week for 4 weeks. Visual Analogue Scale (VAS), Neck Disability Index (NDI), postural alignment, muscle thickness and contraction rate were compared to evaluate the effect on intervention. RESULTS Both groups showed significant differences in VAS, NDI, and postural alignment before and after intervention (P<0.05). In addition, the experimental group showed more significant difference in the amount of change in NDI and postural alignment values than the control group. The experimental group showed significant improvement in muscle thickness and contraction (P<0.05). CONCLUSIONS A lower trapezius strengthening exercise program is an effective method with clinical significance for reducing the level of neck dysfunction, and improving the postural alignment, muscle thickness, and contraction rate of the lower trapezius muscle.


Assuntos
Terapia por Exercício/métodos , Cervicalgia/terapia , Músculos Superficiais do Dorso/fisiologia , Adulto , Feminino , Humanos , Masculino , Músculo Esquelético/fisiopatologia , Medição da Dor/métodos , Postura , Resultado do Tratamento
17.
Rev Med Liege ; 75(3): 180-184, 2020 Mar.
Artigo em Francês | MEDLINE | ID: mdl-32157844

RESUMO

Psychomotor disadaptation syndrome (PDS) was first described by the Geriatrics School of Dijon (France), three decades ago, under the name «psychomotor regression syndrome¼. Over time, the original clinical features remained unchanged. However, progress has been made in its pathophysiology understanding and care, hence the new name, PDS, appeared in the 1990s. The PDS is also called sub-cortico-frontal dysfunction syndrome since the 2000s. It corresponds to a decompensation of posture, gait and psychomotor automatisms, related to an alteration of the postural and motor programming, which is a consequence of sub-cortico-frontal lesions. The clinical features of PDS associate backward disequilibrium, nonspecific gait disorders and neurological signs (akinesia, reactional hypertonia, impaired reactive postural responses and protective reactions, etc.). Psychological disorders of PDS are a fear of standing and walking in its acute form (the post-fall syndrome), or a bradyphrenia and anhedonia in its chronic form. The PDS occurrence results from the combination of three factors implicated in the reduction in functional reserves related to the alteration of the sub-cortico-frontal structures: ageing, chronic afflictions and acute situations, which induce a decrease in cerebral blood flow. The PDS management must be multidisciplinary, including the physician, the physiotherapist, the psychologist, nurses and care assistants.


Assuntos
Acidentes por Quedas , Equilíbrio Postural , Postura , Adaptação Fisiológica , França , Marcha , Humanos , Transtornos das Sensações , Síndrome
18.
PLoS One ; 15(3): e0230145, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32163481

RESUMO

Previous studies on joint kinetics during track and field block starts have been limited to lower-limb sagittal kinetics; however, we hypothesised that lumbopelvic extensors, lateral flexors, and hip abductors also act as substantial energy generators. The present study aimed to examine the three-dimensional lumbo-pelvic-hip kinetics to better understand the generation of mechanical energy during a block start. 3D kinematic and force data during block starts of 10 m maximal sprinting in 12 male sprinters (personal best in a 100 m sprint, 10.78 ± 0.19 s [range, 10.43-11.01 s]) were captured using a motion capture system and force platform. The three-dimensional lumbo-pelvic-hip kinetics were calculated. The peak lumbosacral extension torque (3.64 ± 0.39 Nm/kg) was significantly larger than any other lower-limb and lumbosacral torques (<3.0 Nm/kg). It was suggested that large lumbopelvic extension torques are needed during the block start to anchor the pelvis by cancelling out both hip extension torques acting on the pelvis, leading to hip extensor-induced thigh sagittal rotations rather than pelvic posterior tilt. During the double-stance phase, the lumbosacral extensors generated mechanical energy (0.35 ± 0.16 J/kg, 14 ± 4% of the sum of lumbosacral and lower-limb net joint work). During the single-stance phase, the sum of the net mechanical work by lumbosacral lateral flexors and front hip abductors was 0.35 ± 0.14 J/kg, which comprised 9 ± 3% of the sum of the net joint work. The results lead to the speculation of the importance of strengthening not only the leg extensors, but also the lumbopelvic extensors, lateral flexors, and hip abductors for block starts. Further training studies to verify this speculation will improve training strategies for the track and field block start performance.


Assuntos
Desempenho Atlético/fisiologia , Quadril/fisiologia , Pelve/fisiologia , Coxa da Perna/fisiologia , Atletismo/fisiologia , Adulto , Fenômenos Biomecânicos/fisiologia , Articulação do Quadril/fisiologia , Humanos , Cinética , Articulação do Joelho/fisiologia , Masculino , Postura/fisiologia , Corrida/fisiologia , Estudos de Tempo e Movimento , Torque , Adulto Jovem
19.
Am J Phys Med Rehabil ; 99(4): 330-337, 2020 04.
Artigo em Inglês | MEDLINE | ID: mdl-32195716

RESUMO

OBJECTIVE: The aims of the study were to investigate the kinetic effects of sit-to-stand training in various foot positions on the coronal plane in patients with strokes and to suggest appropriate exercises. DESIGN: Thirty-six poststroke subjects participated in this study. The subjects performed three sit-to-stand trials in the following foot positions: (a) symmetric foot positioning (symmetric), (b) affected foot placed to the side (asymmetric 1), and (c) and less affected foot placed to the side (asymmetric 2). They were asked to perform sit-to-stand training at a spontaneous velocity and remain standing for 5 secs, whereas the vertical ground reaction force was measured using force platforms. The activation of lower limb muscles was evaluated using surface electromyography, and the peak and mean vertical ground reaction force and weight-bearing symmetry ratio were evaluated using force platforms. RESULTS: Our results showed significant increases in the muscle activation, peak and mean vertical ground reaction force, and weight-bearing symmetry ratio of the lower limbs using the asymmetric 2 strategy (P < 0.05). CONCLUSIONS: Our results suggest that sit-to-stand training with the less affected foot placed to the side by the width of the subject's foot may be the most beneficial in the rehabilitation of patients with hemiparetic stroke.


Assuntos
Hemiplegia/reabilitação , Posicionamento do Paciente/métodos , Reabilitação do Acidente Vascular Cerebral/métodos , Acidente Vascular Cerebral/fisiopatologia , Eletromiografia , Feminino , Pé/fisiopatologia , Hemiplegia/etiologia , Hemiplegia/fisiopatologia , Humanos , Cinética , Extremidade Inferior/fisiopatologia , Masculino , Pessoa de Meia-Idade , Postura , Acidente Vascular Cerebral/complicações , Suporte de Carga
20.
Expert Rev Med Devices ; 17(4): 357-364, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32125194

RESUMO

Objectives: To compare the effects of percutaneous vertebroplasty (PVP) or percutaneous kyphoplasty (PKP) in treating Kümmell's disease (KD) patients.Methods: This prospective cohort study involved 19 KD patients (20 involved vertebrae). The surgical selection was dependent on clinical stages and postural correction status. The status of vertebral reduction, amount of cement injection, and amount of cement leakage during the surgery were recorded. The anterior vertebral height and kyphotic angle were measured by X-ray scan. The degree of low back pain and the quality of life were assessed by the visual analog scale and Oswestry disability index, respectively.Results: On the third-day post-operation and the last follow-up, anterior vertebral height was increased, kyphosis angle was reduced, low back pain was relieved, and life quality was improved in both groups compared with pre-operation. There was no significant difference between the two groups in cement amount, cement leakage rate, vertebral height correction, and kyphotic correction angle. The nerve function of stage III patients with spinal cord injury was improved from a Frankel grade D to E.Expert Opinion: PVP and PKP could be used in treating KD patients, and the surgical selection could be dependent on the clinical stages and status of postural correction.Conclusion: PVP and PKP could be used in treating KD patients, and the surgical selection could be dependent on the clinical stages and status of postural correction.


Assuntos
Cifoplastia , Fraturas por Osteoporose/cirurgia , Postura , Fraturas da Coluna Vertebral/cirurgia , Vertebroplastia , Idoso , Idoso de 80 Anos ou mais , Feminino , Seguimentos , Humanos , Masculino , Fraturas por Osteoporose/diagnóstico por imagem , Fraturas por Osteoporose/fisiopatologia , Estudos Prospectivos , Qualidade de Vida , Fraturas da Coluna Vertebral/diagnóstico por imagem , Fraturas da Coluna Vertebral/fisiopatologia
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