Kinematic gait parameters for older adults with Parkinson's disease during street crossing simulation.

Safe street crossing is important for older adults' social inclusion. We assessed gait kinematic adaptation under different simulated street crossing conditions in older adults with Parkinson's disease (PD) and made comparisons with older adults without PD to understand how PD interferes in outdoor task performance, helping in the development of strategies to reduce road traffic accident risk. In 20 older adults without PD (control group - CG) and 20 with PD (GPD), we assessed usual gait (C1), gait during street crossing simulation (C2), and gait during reduced-time street crossing simulation (C3). Velocity, step length, and step, swing, stance, and double support time were analyzed. Spatiotemporal differences in gait between groups and conditions were analyzed. The GPD walked 16% slower in C1 and 12% slower in C2 and C3 than the CG. GPD also took 11% shorter steps in C1 and 9.5% shorter steps in C2. The double support time was 8.5% greater in C1. In intragroup comparisons, there were significant differences in all gait conditions. The CG showed increased velocity (C2 15% > C1; C3 13% > C2; C3 26% > C1), step length (C2 8% > C1; C3 5% > C2; C3 13% > C1), and swing time (C2 2% > C1; C3 3.7% > C2; C3 6% > C1), and decreased step time (C2 7.5% < C1; C3 8% < C2; C3 15% < C1), stance time (C2 1.3% < C1; C3 2.5% < C2; C3 3.6% < C1), and double support time (C2 6.3% < C1; C3 10.5% < C2; C3 16% < C1). GPD showed increased velocity (C2 19% > C1; C3 13.5% > C2; C3 29.7% > C1), step length, (C2 6% > C1; C3 7% > C2; C3 16% > C1), and swing time (C2 3% > C1; C3 3% > C2; C3 5.5% > C1) and decreased step time (C2 10.3% < C1; C3 7.7% < C2; C3 17% < C1), stance time (C2 1.7% < C1; C3 1.7% < C2; C3 3.4% < C1), and double support time (C2 7% < C1; C3 9.5% < C2; C3 16% < C1). Kinematic changes observed in the intergroup comparison show that participants with PD had lower velocity in all conditions. However, per the intragroup results, both participants with and without PD managed to significantly modify gait variables to attempt to cross the street in the given time. It is necessary to assess whether this increases fall risk by exposing them to road traffic accidents.

Everyday tasks impair spatiotemporal variables of gait in older adults with Parkinson's disease.

INTRODUCTION: Although it is known that individuals with Parkinson's disease (PD) have difficulties performing dual-task activities, most of the studies have verified the effect of dual tasks on gait using tasks that are uncommon to perform while walking. However, the realization of tasks involving gait that really represents the daily activities carried out by the participants, allow us to detect real fall risk situations of individuals with PD during their gait. OBJECTIVE: Our aim was to verify the influence of daily-life dual-tasks on gait spatiotemporal variables of the older adults with PD. METHODS: 20 older adults without PD and 20 older adults with PD participated in the study. Gait kinematic was analyzed under three different conditions: walking without dual task, walking carrying bags with weight, and walking talking on the cell phone. RESULTS: Older adults with PD presented lower speed (p = .001), cadence (p = .039), and shorter step length (p = .028) than older adults without PD during walking without dual tasks. When walking while carrying bags with weight, older adults with PD had a lower speed (p < .001), cadence (p = .015), shorter step length (p = .008), and greater double support time (p = .021) compared with older adults without PD. During walking while talking on the cell phone, older adults with PD walked with lower speed (p < .001), cadence (p = .013), shorter step length (p = .001) and swing time (p = .013), and increased double support time (p = .008) and support time (p = .014) in relation to older adults without PD. CONCLUSION: Daily-life dual tasks impair the spatiotemporal variables of gait in the older adults with PD, which was most evident during walking talking on the cell phone.

Muscle recruitment and co-contraction when walking in young women with chronic lumbar pain / Recrutamento e cocontração muscular durante a marcha em mulheres jovens com dor lombar crônica / Reclutamiento y co-contracción muscular durante la marcha en mujeres jóvenes con dolor lombar crónica

Abstract Introduction: The lumbar pain is the main musculoskeletal complaint reported by the active population, and it prevents daily activities such as walking. Objective: To assess muscle recruitment and the co-contraction of the trunk muscles during different walking speed in individuals with and without chronic lumbar pain. Method: Thirty-four sedentary young women attended the study, in which 18 belonged to the lumbar pain team (LPT) and 16 to the team without lumbar pain (WLP). We assessed the electromyography activity of the internal oblique (IO) local muscle and lumbar multifidus (MUL), and global external oblique (EO), abdominal rectus (AR) and lumbar iliocostalis (LIC), during walking. The electromyography analysis was performed from the average of the linear envelope value, normalized by the peak of muscle activation. The muscle co-contraction (IO/MUL, EO/LIC, AR/LIC, IO/EO, and the abdominal/paravertebral muscle groups) was calculated with the Falconer and Winter formula. The Shapiro-Wilk test, Multivariate Analysis, mixed Variance Analyses with Bonferroni post-hoc, and Pearson (p < 0.05) correlation coefficient were made by the statistical analysis. Results: In the WLP we could notice that the higher the speed, the higher the MUL activation. The co-contraction data demonstrated that IO/MUL muscles activate 20% more in the LPT, during the preferred speed; however, in the WLP, the results showed that the higher the walking speed, the higher the EO/LIC (21.8%) and IO/MUL (17.8%) muscles activation. Conclusion: The recruitment of local muscles doesn't differ among the evaluated groups and conditions; however, in WLP, the higher the MUL muscle action, the higher the walking speed.

Resumo Introdução: A dor lombar (DL) é a principal queixa musculoesquelética relatada na população ativa e incapacita atividades do cotidiano, como a marcha. Objetivo: Avaliar o recrutamento e co-contração dos músculos do tronco durante diferentes velocidades de marcha em indivíduos com e sem DL crônica. Método: Participaram 34 mulheres jovens, sedentárias, 18 compuseram o grupo DL (GDL) e 16 o grupo sem DL (GC). Foi avaliada a atividade eletromiográfica dos músculos locais oblíquo interno (OI) e multífido lombar (MUL), e globais oblíquo externo (OE), reto abdominal (RA) e iliocostal lombar (ICL), durante a marcha. A análise eletromiográfica foi realizada a partir da média do valor de envelope linear, normalizada pelo pico de ativação muscular. A co-contração muscular (OI/MUL, OE/ICL, RA/ICL, OI/OE e os grupos musculares abdominais/ paravertebrais) foi calculada com a fórmula de Falconer e Winter. A análise estatística foi feita por meio do teste Shapiro-Wilk, Análise Multivariada, Análise de Variância mista com pos-hoc bonferroni e coeficiente de correlação de Pearson (p < 0,05). Resultados: No GC podemos perceber que, quanto maior a velocidade, maior a ativação do MUL. Os dados de co-contração demonstraram que os músculos OI/MUL ativam 20% a mais no GDL, durante a velocidade de preferência, no GC, os resultados mostram que quanto maior a velocidade de marcha, maior a ativação dos músculos OE/ICL (21,8%) e OI/MUL (17,8%). Conclusão: O recrutamento dos músculos não difere entre os grupos e condições, contudo foi observado no GC que quanto maior a ação do músculo MUL maior é a velocidade de marcha.

Resumen Introducción: El dolor lumbar (DL) es la principal queja musculoesquelética relatada e incapacita actividades de lo cotidiano, como la marcha. Objetivo: Evaluar el reclutamiento y la co-contracción músculos del tronco durante diferentes velocidades de marcha en individuos con y sin DL. Método: Participaron 34 mujeres jóvenes, sedentarias, 18 compusieron grupo DL (GDL) y 16 grupo sin DL (GC). Se evaluó la actividad electromiográfica de los músculos oblicuo interno (OI) y externos (OE), multífido lumbar (MUL), recto abdominal (RA) e iliocostal lumbar (ICL) durante la marcha. El análisis electromiográfico fue realizado a partir del promedio del valor de sobre lineal, normalizado por el pico de activación muscular. La cocontracción muscular (OI/MUL, OE/ICL, RA/ICL, OI/OE y grupos de músculos abdominales/paravertebrales) se calculó utilizando la fórmula Falconer y Winter. El análisis estadístico fue realizado por Shapiro-Wilk, Análisis Multivariado, Análisis de Variedad mixta con pos-hoc bonferroni y coeficiente de correlación de Pearson (p < 0,05). Resultados: En el GC podemos percibir que, cuanto mayor es la velocidad, mayor es la activación del MUL. Los datos de co-contracción demostraron que los músculos OI/MUL activan un 20% más en el GDL, durante la velocidad de preferencia, sin embargo, en el GC, los resultados muestran que cuanto mayor la velocidad de marcha, mayor la activación de los músculos OE / ICL (21,8%) y OI/MUL (17,8%). Conclusión: El reclutamiento de los músculos no difiere entre los grupos y condiciones, contenido observado en el GC que cuanto mayor es la acción del músculo MUL mayor es la velocidad de marcha.

Muscular pressure pain threshold and influence of craniocervical posture in individuals with episodic tension-type headache / Limiar de dor muscular à pressão e influência da postura craniocervical em indivíduos com cefaleia tensional episódica / Umbral del dolor muscular por presión e influencia de la postura craneocervical en sujetos con cefalea de tipo tensional episódica

ABSTRACT Objective: The objective of this study was to analyze the pressure pain threshold (PPT) of the sternocleidomastoid (SCM), suboccipital (SO) and upper trapezius (UT) muscles and the craniocervical posture in individuals with episodic tension-type headache (ETTH). Methods: This study was a cross-sectional, non-randomized study with 60 young adults (77% female) comprising both sexes and an age range of 18-27 years. Individuals were distributed into a control group (G1) and individuals with ETTH (G2). The frequency of headaches per month was recorded. A pressure dynamometer was used to evaluate the PPT. Photogrammetry was used to evaluate the cervical lordosis (CL) and cephalic protrusion (CP). The data were statistically analyzed. Results: There were differences in the PPT, where the UT, SO and SCM muscles presented lower sensitivity to pain, respectively. The SCM muscle presented a lower PPT in G2. The CL and CP angles were significantly lower in G2. Conclusion: Individuals with ETTH exhibited a significantly lower PPT in the SCM and SO muscles than in the UT muscle. Nevertheless, individuals with ETTH presented with the SCM muscle being more sensitive to pain as well as higher CL and CP than individuals without symptomatology.

RESUMO Objetivo: Analisar o limiar de dor por pressão (LDP) nos músculos esternocleidomastóideo (ECM), suboccipital (SO) e trapézio superior (TS) e o posicionamento craniocervical em indivíduos com cefaleia do tipo tensional episódica (CTTE). Métodos: Estudo transversal, não randomizado com 60 adultos jovens (77% mulheres), faixa etária entre 18 e 27 anos. Os indivíduos foram distribuídos em um grupo controle (G1) e um com CTTE (G2). A frequência de dores de cabeça por mês foi coletada. Para a avaliação do LDP foi utilizado dinamômetro de pressão. Para avaliação da lordose cervical (LC) e protrusão cefálica (PC) foi utilizada a fotogrametria. Os dados foram submetidos à análise estatística. Resultados: Houve diferenças no LDP, sendo que os músculos trapézio superior (TS), suboccipital (SO) e esternocleidomastóideo (ECM) apresentaram, nessa ordem, menor sensibilidade à dor. O músculo ECM apresentou menor LDP no G2. Os ângulos de lordose cervical e protrusão cefálica foram significativamente menores no G2. Conclusão: Indivíduos com CTTE apresentam LDP significativamente menor nos músculos ECM e SO, nessa ordem, em comparação ao TS e indivíduos com CTTE têm músculo ECM mais sensível à dor, maior lordose cervical e protrusão cefálica do que indivíduos sem sintomas.

RESUMEN Objetivo: Analizar el umbral de dolor por presión (UDP) de los músculos esternocleidomastoideo (ECM), suboccipital (SO) y trapecio superior (TS) y el posicionamiento craneocervical en individuos con cefalea de tipo tensional episódica (CTTE). Métodos: Estudio transversal, no aleatorizado de 60 adultos jóvenes (77% mujeres), grupo etario entre 18 e 27 años. Los individuos fueron divididos en un grupo control (G1) y otro con CTTE (G2). Se recolectó la frecuencia de los dolores de cabeza por mes. Para la evaluación del UDP fue utilizado un dinamómetro de presión y para evaluar la lordosis cervical (LC) y la protrusión cefálica (PC) se utilizó la fotogrametría. Los datos fueron sometidos a análisis estadístico. Resultados: Hubo diferencias en el UDP, y los músculos trapecio superior (TS), suboccipital (SO) y esternocleidomastoideo (ECM) mostraron, en ese orden, menor sensibilidad al dolor. El músculo ECM mostró menor UDP en el G2. Los ángulos de lordosis cervical y de protrusión cefálica fueron significativamente menores en el G2. Conclusión: Los individuos con CTTE presentan UDP significativamente menor en los músculos ECM y SO, en ese orden en comparación al TS e individuos con CTTE tienen el músculo ECM más sensible al dolor, mayor lordosis cervical y protrusión cefálica que individuos sin síntomas.

Profile of Pneumopathic Elderly Persons Admitted to a Pulmonary Rehabilitation Center / Perfil de idosos pneumopatas admitidos em centro de reabilitação pulmonar

Abstract Introduction: Pneumopathies are defined as a group of respiratory diseases. Physiotherapy centers are a conventional treatment option which can help prevent and treat various pulmonary conditions. Objective: To characterize elderly persons with pneumopathies admitted for pulmonary rehabilitation. Methods: 84 elderly persons were admitted for pulmonary rehabilitation. Patients diagnosed with pulmonary disease and aged ≥60 years were included in the study. The following variables were analyzed: gender, age, marital status, profession, medical diagnosis, main medical complaint, associated diseases, and cardiovascular risk factors. Results: The most common lung disease is chronic obstructive pulmonary disease (COPD) (26.2%). Women showed a greater association with asthma [odds ratio (OR)=5.875; p=0.010]. Dyspnea was the most prevalent main complaint among this population (50%). Among the main complaints, difficulty walking was more associated with men (OR=2.85; p=0.055). Strokes were the main disease most commonly associated with pneumopathies (12.1%). Women had a greater association with other diseases (OR=5.34, p=0.068), especially when two diseases were presented simultaneously with lung disease (OR=2.32, p=0.041). Among the risk factors, physical inactivity (OR=3.33), alcohol consumption (OR=0.046) and history of smoking (OR=3.00) were significantly associated with men, while depression (OR=5.67) was significantly associated with women. Women exhibited a 3.28 greater association between allergies and pneumopathies than men (p=0.013). The practice of physical activity was more associated with women (OR=3.89; p=0.03). Osteoporosis was more prevalent among elderly women with pulmonary disease (OR=10.75; p<0.0001), and was also significantly associated with a history of smoking (OR=4.31; p=0.009). Conclusion: The most frequent diagnosis, main complaint and associated disease were COPD, dyspnea and strokes, respectively. Elderly woman exhibited a greater association with the diagnosis of bronchial asthma, and more diseases associated with lung disease. Physical inactivity, difficulty walking, and a history of alcohol consumption and smoking are more associated with men, while depression, the presence of allergies, regular physical activity and osteoporosis are more associated with women. Thus, the results demonstrate that these individuals have specific characteristics. AU

Resumo Introdução: Pneumopatias são definidas como grupo de doenças respiratórias. Centros de fisioterapia surgem como tratamento convencional que contribui para prevenir e tratar variadas condições pulmonares. Objetivo: Caracterizar idosos com pneumopatias admitidos para reabilitação pulmonar. Métodos: A amostra foi composta por 84 pacientes admitidos para reabilitação pulmonar no departamento de fisioterapia cardiopulmonar de uma clínica escola. Pacientes com diagnóstico de doença pulmonar e idade ≥60 anos foram incluídos no estudo. As seguintes variáveis foram analisadas: sexo, idade, estado civil, profissão, diagnóstico médico, queixa principal, doença associada, e fatores de risco cardiovascular. Resultados: A pneumopatia mais comum foi doença pulmonar obstrutiva crônica (DPOC) (26,2%). Mulheres mostraram maior associação com asma [Odds Ratio (OR)=5,875; p=0,010]. Dispneia foi a queixa principal mais prevalente na população (50%). Entre as queixas principais, dificuldade de deambular foi mais associada com homens (OR=2,85; p=0,055). Acidente vascular cerebral (AVC) foi a doença principal mais associada com pneumopatias (12,1%). Mulheres tiveram maior associação com outras doenças (OR=5,34, p=0,068), especialmente, quando apresentaram mais que dois quadros simultaneamente com a pneumopatia (OR=2,32, p=0,041). Entre os fatores de risco, a inatividade física (OR=3,33), o consumo de álcool (OR=0,046) e o histórico de tabagismo (OR=3,00) foram significativamente associados ao sexo masculino, enquanto depressão (OR=5,67) ao feminino. Mulheres apresentaram 3,28 mais associação entre alergias e pneumopatias que os homens (p=0,013). A prática de atividade física foi mais associada com o sexo feminino (OR=3,89; p=0,03). Osteoporose foi mais prevalente em mulheres idosas com doença pulmonar (OR=10,75; p<0,0001), e também significativamente, enquanto associada ao histórico de tabagismo (OR=4,31; p=0,009). Conclusão: O diagnóstico, a queixa principal e a doença associada mais frequentes foram DPOC, dispneia e AVC, respectivamente. Idosas apresentam maior associação com diagnóstico de asma brônquica e mais doenças associadas à pneumopatia. Sedentarismo, dificuldade de deambular, etilismo e histórico de tabagismo são mais associados ao sexo masculino, enquanto que depressão, presença de alergias, prática de atividade física e osteoporose, ao feminino. Assim, os resultados demonstram que esses idosos apresentam características específicas. AU