The effect of constraint-induced movement therapy assessed by accelerometry: the impact on daytime activity and sleep in children with cerebral palsy / O efeito da terapia por contensão induzida avaliada por meio de acelerômetros: o impacto na atividade diurna e no sono em crianças com paralisia cerebral

Abstract Introduction Spastic hemiparetic cerebral palsy (CP) is the most prevalent type of CP. Children with spastic hemiparesis experience difficulties when using their affected upper extremities, and one effective treatment is the Constraint-Induced Movement Therapy (CIMT). The study of rest-activity patterns provides information on children's daily activities with spastic hemiparetic CP during the day and sleep. Objective To investigate the effect of CIMT on the rest-activity patterns in children with spastic hemiparetic CP vs in a healthy group. Methods Nonrandomized controlled trial was conducted at the Neuropediatric Center of the Hospital de Clínicas Complex, in Curitiba, Brazil. Children with spastic hemi-paretic CP between 5 and 16 years old participated in the study group and receive the CIMT. The healthy group was composed of children between 5 and 15 years old. Both groups used accelerometer to record rest-activity patterns, that may be studied through nonparametric variables of accelerometer: M10 (an individual's most active 10h); L5 (an individual's least active 5h); and RA (relative amplitude of the circadian rest-activity patterns). Results Forty-five children were recruited, and 38 were included in the analyses (19 allocated to each group). In the study group, there was a significant increase in M10 and L5 (p < 0.001) after CIMT. The values of M10 and L5 were significantly higher (p < 0.001) in the healthy group compared to the study group after CIMT. Conclusion Our results showed that children with spastic hemiparetic CP became more active and participant in their daily life during the day as well as more efficient sleeping.

Resumo Introdução A paralisia cerebral (PC) hemiparética espástica é o tipo de PC mais prevalente. Crianças com hemiparesia es-pástica apresentam dificuldades ao usar as extremidades superiores afetadas e um tratamento eficaz é a Terapia por Contensão Induzida (TCI). O estudo dos padrões de atividade-repouso fornece informações sobre as atividades diárias de crianças com PC hemiparética espástica durante o dia e o sono. Objetivo Investigar o efeito da TCI nos padrões de repouso-atividade em crianças com PC hemiparética espástica versus um grupo saudável. Métodos Realizou-se um ensaio controlado não randomizado no Centro de Neuropediatria do Complexo do Hospital de Clínicas, Curitiba, Brasil. Crianças com PC hemi-parética espástica entre 5 e 16 anos participaram do grupo de estudo e receberam a TCI. O grupo saudável foi composto por crianças entre 5 e 15 anos. Ambos os grupos utilizaram um acelerômetro para registrar padrões de atividade-repouso, os quais podem ser estudados através de variáveis não paramé-tricas do acelerômetro: M10 (10h mais ativas de um indivíduo); L5 (5h menos ativas de um indivíduo); e AR (amplitude rela-tiva dos padrões de atividade-repouso). Resultados Foram recrutadas 45 crianças e 38 foram incluídas nas análises (19 alocadas em cada grupo). No grupo de estudo, houve aumento significativo de M10 e L5 (p < 0,001) após TCI. Os valores de M10 e L5 foram significativamente maiores (p < 0,001) no grupo saudável em comparação ao grupo de estudo após TCI. Conclusão Os resultados do presente estudo mostraram que crianças com PC hemiparética espástica tornaram-se mais ativas e participantes de sua vida diária durante o dia, bem como dormiram mais eficientemente.

Ankle Active Range of Motion as an Essential Factor of Footwork Technique in the Prevention of Overuse Injuries in Flamenco Dancers / Rango de movimiento activo del tobillo como factor esencial de la técnica de zapateado en la prevención de lesiones por sobreuso en bailarinas de flamenco

Flamenco dance is a performing art which is based on footwork technique where the foot and ankle play an important role.The objective of this study was to investigate the effect of ankle active range of motion on external load and its efficacy as apredictor during a flamenco footwork technique, with consideration of accelerometer positions and dance proficiency. Twelveflamenco dancers composed of 6 professional and 6 amateurs participated voluntarily in this study for whom no significantdifferences were detected regarding age, mass or height. Participants completed a 15-second Zap-3 footwork test at a speedof 160 bpm (beats per minute), 180 bpm and as fast as they could. Triaxial accelerometers were positioned at the dominantankle, 5th lumbar vertebrae and 7th cervical vertebrae to calculate accumulated PlayerLoad and uniaxial PlayerLoad of the3 planes (anteroposterior, mediolateral and vertical) for each speed level. Percentage contributions were also calculated. Theeffect of dorsiflexion on the external load of the dominant ankle of both professional and amateur dancers existed only in theanteroposterior axis while dorsiflexion was related to the external load at the 7th cervical vertebrae and only amateurs wereaffected. Plantarflexion only affected the uniaxial contribution of the vertical-axis of professional dancers. These programswould be applied to develop a technique feedback system for the flamenco dancer to follow their own model with respectto the ideal. This would allow intervention in the prevention of overuse injuries in flamenco dance artists.(AU)

El baile flamenco es un arte en el que el zapateado tiene un papel muy relevante. El objetivo de este estudio fue investigar elefecto del rango de movimiento activo del tobillo sobre la carga externa y su eficacia como predictor durante la realizaciónde un zapateado flamenco, en función de las posiciones del acelerómetro y el dominio técnico de los participantes. Un totalde doce bailaoras de flamenco, 6 profesionales y 6 amateurs, participaron voluntariamente en este estudio y en los que nose encontraron diferencias significativas respecto a edad, peso o estatura. Los participantes realizaron un test de zapateadodenominado Zap-3 durante 15 segundos a una velocidad de 160 pulsos por minuto, 180 y tan rápido como pudieron. Secolocaron acelerómetros triaxiales en el tobillo del pie dominante, en la 5ª vértebra lumbar y en la 7ª vértebra cervical paracalcular la PlayerLoad acumulada y la PlayerLoad uniaxial de los 3 planos (anteroposterior, medio-lateral y vertical) en funciónde cada nivel de velocidad, así como sus contribuciones porcentuales. Solamente se ha encontrado relación entre la flexióndorsal del tobillo dominante y la carga externa en el eje anteroposterior, tanto en profesionales como amateurs, mientras quea nivel de la 7ª vértebra cervical sólo se ha encontrado relación entre la dorsiflexión y la carga externa en el grupo de amateurs.Respecto a la flexión plantar solo se ha encontrado relación a nivel uniaxial con el eje vertical de los bailarines profesionales.Estos programas podrían servir de ayuda a desarrollar un sistema de retroalimentación de la técnica para que el practicantede baile flamenco pueda seguir su propio modelo respecto al ideal. Esto permitiría intervenir en la prevención de las lesionespor sobreuso en los artistas de baile flamenco.(AU)

Validity and reliability of the International Physical Activity Questionnaire (IPAQ) long-form in a subsample of female Mexican teachers / Validez y confiabilidad el Cuestionario Internacional de Actividad Física versión larga en una submuestra de maestras mexicanas

Abstract: Objective: To evaluate the test-retest reliability and validity of the long-form International Physical Activity Questionnaire (IPAQ-long form). Materials and methods: A subsample of 86 teachers underwent telephone interviews and clinic visits in Mexico City. Through 22 months, physical activity (PA) levels were obtained from accelerometers (months 6 and 22) and IPAQ long-form (months 1, 3, 6, 9 and 12). Minutes per week of moderate (MPA), walking (WPA), vigorous (VPA) and moderate-to-vigorous physical activity (MVPA) were calculated for each intensity and domain. Variables were logarithmically transformed. Intra-class and Pearson correlations were used to determine the relationship between instruments. Results: Test-retest reliability of the average IPAQs long-form varied across intensities and domains (ranged from r= 0.24 to r= 0.65). Minutes per week of VPA and MVPA accelerometer 1 (AC1) were fairly associated to International Physical Activity Questionnaire-long form 3 (IPAQ3) (r= 0.60 and r= 0.31, respectively) one week apart. Conclusions: IPAQ long-form is fairly reliable for MVPA and valid for assessing MVPA and VPA in a subsample of Mexican teachers.

Resumen: Objetivo: Evaluar la confiabilidad y validez del Cuestionario Internacional de Actividad Física versión larga (por sus siglas en inglés IPAQ-long form). Material y métodos: Un total de 86 maestras realizaron entrevistas y visitas a clínicas en la Ciudad de México. En un periodo de 22 meses, se obtuvieron los niveles de actividad física (AF) por medio de un acelerómetro (AC) (meses 6 y 22) y autorreporte de actividad física por medio del IPAQ versión larga (meses 1, 3, 6, 9 y 12). Se estimaron los minutos por semana de actividad física moderada (AFM), caminando (AFC), vigorosa (AFV) y actividad física moderada-vigorosa (AFMV) para cada intensidad y dominio. Las variables se transformaron logarítmicamente. Se utilizaron correlaciones de intraclase y de Pearson para determinar la relación de los minutos por semana de AFM, AFC, AFMV entre instrumentos. Resultados: La confiabilidad entre el promedio de los IPAQs varió entre intensidades y dominios (de r = 0.24 a r = 0.65). Los minutos por semana de AFV y AFMV del acelerómetro 1 (AC1) se asociaron con los del Cuestionario Internacional de Actividad Física 3 (IPAQ3) (r = 0.60 y r = 0.31, respectivamente) reportado una semana después. Conclusiones: La versión larga del IPAQ es confiable para estimar AFMV y válido para evaluar AFMV y AFV en una submuestra de maestras mexicanas.

Comparação entre processamentos de dados do acelerômetro gt3x+ para atividade física moderada e vigorosa / Comparison between data processing from gt3x+ accelerometer for vigorous and moderate physical activity

RESUMO O uso do acelerômetro para mensurar a atividade física em pesquisas epidemiológicas, apresenta desafios para aumentar a comparabilidade entre os estudos que utilizam esse equipamento. Nesse sentido o objetivo deste trabalho é comparar estimativas de tempo em AFMV para adultos provenientes de diferentes métodos de processamentos de dados, através do acelerômetro Actigraph GT3X+. Trata-se de um estudo transversal, da linha de base do estudo piloto do Estudo Longitudinal dos Determinantes da Atividade Física. Amostra contou com 31 funcionários terceirizados de ambos os sexos, com idade média de 47.05anos (DP=9.35). Os participantes utilizaram acelerômetros do modelo GT3X+ durante sete dias consecutivos. A estimativa de tempo de AFMV foi gerada através de software Actilife e R-package GGIR. Análises estatísticas descritivas, ANOVA e pos-hoc de Bonferroni para comparabilidade foram realizadas no software R. Análise de Bland-Altman foi realizado no SigmaPlot para avaliação de viés e concordância. Houve diferença significativa no tempo médio de AFMV entre os dados baseados em counts e dados brutos (p<0,001). O tempo médio em AFMV foi menor a partir do processamento por dados brutos do que o em counts (-264,81min/dia; p<0,001). Concluindo que os achados sugerem não haver, estatisticamente, equivalência entre os métodos comparados para estimar tempo de AFMV.

ABSTRACT The use of accelerometers to measure physical activity in epidemiological research presents challenges to increase comparability between studies that use this equipment. In this sense, the objective of this work is to compare time estimates in MVPA for adults from different data processing methods, using the Actigraph GT3X+ accelerometer. This is a cross-sectional study, from the baseline of the pilot study of the Longitudinal Study of the Determinants of Physical Activity. Sample had 31 outsourced employees of both genders, with an average age of 47.05 years (SD=9.35). Participants used GT3X+ model accelerometers for seven consecutive days. The MVPA time estimate was generated using Actilife and R-package GGIR software. Descriptive statistical analyses, ANOVA and Bonferroni post-hoc for comparability were performed in the R software. Bland-Altman analysis was performed in SigmaPlot to assess bias and agreement. There was a significant difference in the mean time of MVPA between count-based data and raw data (p<0.001). The average time in MVPA was shorter from processing by raw data than in counts (-264.81 min/day; p<0.001). Concluding that the findings suggest that there is no statistically equivalence between the methods compared to estimate MVPA time.

The triglyceride/glucose index as an insulin resistance marker in the pediatric population and its relation to eating habits and physical activity.

INTRODUCTION: To examine the triglyceride/glucose index (TyG) as an insulin resistance marker in obese children and adolescents and its relation to clinical and biochemical parameters, body composition and lifestyle. PATIENTS AND METHOD: Sixty patients aged 7-16 years of age were enrolled. Anthropometric variables were recorded, together with pubertal stage, blood pressure and body composition assessed by bioimpedance. The TyG index was calculated as ln (fasting glucose (mg/dL) × triglycerides (mg/dL))/2 and the HOMA (homeostatic model assessment) index as fasting insulin (µU/mL) × fasting glucose (mmol/L)/22.5. Feeding habits were documented by adherence to the Mediterranean dietary pattern questionnaire, while physical activity was assessed using the International Sedentary Assessment Tool (ISAT), as well as accelerometry (Actigraph wGT3X+). RESULTS: The mean TyG index was 4.45 ±â€¯0.18, and proved higher in the pubertal group. We found a positive correlation with the HOMA index (r = 0.39; P = 0.03) and TG/HDL-c index (r = 0.53; P < 0.001). The best cut-off point of the TyG index for predicting insulin resistance was 4.21 in prepubertal children (sensitivity 84%, specificity 100%; AUC: 0.84) and 4.33 in pubertal children (sensitivity 89%, specificity 69%; AUC: 0.61). A positive correlation was found with screen time (r = 0.39; P = 0.01), as well as a negative correlation with caloric expenditure (Kcal/day) in the prepubertal group (r = -0.81; P = 0.005). CONCLUSIONS: The TyG index could be a useful insulin resistance marker in the pediatric population. Moderate to vigorous physical activity should be encouraged, as well as restricting screen time for leisure purposes, mainly in the prepubertal group.

A reliability and validity study on upper limb range of motion measurement using mobile sensor compared with goniometers / Estudio de confiabilidad y validez sobre la medición del rango de movimiento de las extremidades superiores utilizando un sensor móvil en comparación con goniómetro

Introduction: The use of tele-rehabilitation devices to aid physiotherapy has gained popularity in recent years. In particular, measuring limb range of motion with a wearable mobile sensor can facilitate rehabilitation therapies by providing more efficient progress monitoring and reducing clinicians’ workload. This study aimed to examine the test-retest reliability and validity of using a wearable mobile sensor to measure upper limb range of motion (ROM).Materials and methods: Participants were recruited by convenient sampling. They were instructed to perform four kinds of upper limb movements including shoulder flexion, abduction, external rotation and elbow flexion, from which the ROM was measured by Mobile sensors REBEE (XCLR8 Technologies) and a standard goniometer (Model 12-1000) in each movement. Each kind of movements and the two ROM measurements were performed twice for the evaluation of test-retest reliability using Intraclass Correlation Coefficients (ICC). Pearson's correlations were computed between the ROM measured by the mobile sensors and the goniometer in each movement to assess construct validities of the mobile sensors. The agreement (95% mean difference) between the two sets of measurement was illustrated by Bland-Altman plots.Results: Thirty-four asymptomatic young Asian adults (15 males) participated in this study (Mage ± SD, 24.2 ± 3.82 years). The ICC for the ROM measured by the sensors were between 0.94 and 0.99, p <0.01 and for the goniometer measurements were between 0.95 and 0.98, p <0.01 in the four movements, indicating excellent reliability in both measurement methods. The Pearson's correlation between the sensor’s and goniometric ROM measurements in four kinds of movements ranged from r =0.96 to 0.99, p <0.01, indicating a very strong construct validity for using the mobile sensors to measure upper limb ROM. The mean difference between the two measurements ranged from 0.13 degrees to 7.6 degrees...(AU)

Introducción: El uso de dispositivos de tele-rehabilitación para ayudar a la fisioterapia ha ganado popularidad en los últimos años. En particular, medir el rango de movimiento de las extremidades con un sensor móvil portátil puede facilitar las terapias de rehabilitación al proporcionar una supervisión del progreso más eficiente y reducir la carga de trabajo de los médicos. Este estudio tuvo como objetivo examinar la confiabilidad y la validez test-retest del uso de un sensor móvil portátil para medir el rango de movimiento de las extremidades superiores (ROM).Materiales y métodos: Los participantes fueron reclutados mediante muestreo conveniente. Se les indicó que realizaran cuatro tipos de movimientos de las extremidades superiores, incluida la flexión del hombro, la abducción, la rotación externa y la flexión del codo, a partir de los cuales se midió el ROM con los sensores móviles REBEE (XCLR8 Technologies) y un goniómetro estándar (Modelo 12-1000) en cada movimiento. . Cada tipo de movimientos y las dos mediciones de ROM se realizaron dos veces para la evaluación de la confiabilidad test-retest utilizando coeficientes de correlación intraclase (ICC). Se calcularon las correlaciones de Pearson entre el ROM medido por los sensores móviles y el goniómetro en cada movimiento para evaluar la validez de constructo de los sensores móviles. La concordancia (diferencia media del 95%) entre los dos conjuntos de medidas se ilustró mediante gráficos de Bland-Altman.Resultados: Treinta y cuatro adultos jóvenes asiáticos asintomáticos (15 hombres) participaron en este estudio (Mage ± SD, 24,2 ± 3,82 años). El ICC para el ROM medido por los sensores estuvo entre 0.94 y 0.99, p <0.01 y para las mediciones del goniómetro estuvo entre 0.95 y 0.98, p <0.01 en los cuatro movimientos, lo que indica una excelente confiabilidad en ambos métodos de medición...(AU)

The triglyceride / glucose index as an insulin resistance marker in the pediatric population and its relation to eating habits and physical activity. / El índice triglicéridos-glucosa como marcador de insulinorresistencia en población pediátrica y su relación con hábitos de alimentación y actividad física.

INTRODUCTION: To examine the triglyceride/glucose index (TyG) as an insulin resistance marker in obese children and adolescents and its relation to clinical and biochemical parameters, body composition and lifestyle. PATIENTS AND METHOD: Sixty patients aged 7-16 years of age were enrolled. Anthropometric variables were recorded, together with pubertal stage, blood pressure and body composition assessed by bioimpedance. The TyG index was calculated as ln (fasting glucose (mg/dL)×triglycerides (mg/dL))/2 and the HOMA (homeostatic model assessment) index as fasting insulin (µU/mL)×fasting glucose (mmol/L)/22.5. Feeding habits were documented by adherence to the Mediterranean dietary pattern questionnaire, while physical activity was assessed using the International Sedentary Assessment Tool (ISAT), as well as accelerometry (Actigraph wGT3X+). RESULTS: The mean TyG index was 4.45±0.18, and proved higher in the pubertal group. We found a positive correlation with the HOMA index (r=0.39; P=.03) and TG/HDL-c index (r=0.53; P<.001). The best cut-off point of the TyG index for predicting insulin resistance was 4.21 in prepubertal children (sensitivity 84%, specificity 100%; AUC: 0.84) and 4.33 in pubertal children (sensitivity 89%, specificity 69%; AUC: 0.61). A positive correlation was found with screen time (r=0.39; P=.01), as well as a negative correlation with caloric expenditure (Kcal/day) in the prepubertal group (r=-0.81; P=.005). CONCLUSIONS: The TyG index could be a useful insulin resistance marker in the pediatric population. Moderate to vigorous physical activity should be encouraged, as well as restricting screen time for leisure purposes, mainly in the prepubertal group.

Comparación entre el auto-reporte de actividad física y la medición con acelerómetro según factores sociodemográficos / Comparison of self-reported and accelerometer-measured physical activity according to sociodemographic factors

RESUMEN Introducción: La determinación del nivel de actividad física (AF) puede realizarse a través de acelerómetro o mediante cuestionario de auto-reporte. El objetivo de este estudio fue comparar los niveles de AF entre un cuestionario de auto-reporte y la medición con acelerómetro de movimiento según factores sociodemográficos en la población chilena. Métodos: Estudio de corte transversal que incluyó a 230 adultos chilenos participantes del proyecto Genes, Ambiente, Diabetes y Obesidad (GENADIO). Niveles de AF fueron medidos mediante el cuestionario Internacional Physical Activity Questionnaire (IPAQ) y acelerómetro de movimiento (ActiGraph). Resultados: IPAQ subestimó los niveles de AF total en comparación a la medición con acelerómetro (delta [IPAQ-Acel.]= −55,7 min/día). Según nivel educacional, se evidenció que el cuestionario IPAQ sobreestimó los niveles de AF total en personas con bajo nivel educacional (delta [IPAQ-Acel.]= 70,4 min/día), pero subestimó la AF total en personas con enseñanza media o técnico universitaria (delta [IPAQ-Acel.]= −67,9 y −135,6 min/día, respectivamente). Resultados similares fueron observados para los distintos niveles de ingreso socioeconómico (NSE). Conclusión: El cuestionario de auto-reporte IPAQ subestimó los niveles de AF total en comparación a la medición por acelerómetro; sin embargo, estas diferencias variaron según factores sociodemográficos.

ABSTRACT Introduction: Determining level of physical activitY (PA) can be done with objective measurement, through accelerometer, or by subjective measurement through self-report questionnaire. The aim of this study was to compare PA measurements derived from a self-reported questionnaire and accelerometer according to sociodemographic factors in the Chilean population. Methods: This was a cross-sectional study which included 230 Chilean adults participating in the GENADIO study (Genes, Environment, Diabetes and Obesity). PA levels were measured through the International Physical Activity Questionnaire (IPAQ) and GT1M accelerometer (ActiTrainer, ActiGraph). Results: IPAQ questionnaire underestimated the total PA levels compared to the accelerometer measurement (delta[IPAQ-Acel.]= −55.7 min/day). According to educational level, IPAQ questionnaire overestimated PA level in people with low educational level (delta[IPAQ-Accel.]= 70.4 min/day), but underestimated total PA in people with secondary education or university technician (delta[IPAQ-Accel.]=-67.9 and-135.6 min/day, respectively). Similar results were observed for the different levels of socioeconomic income. Conclusion: The IPAQ questionnaire underestimated total PA levels compared to accelerometer; however, these differences varied according to sociodemographic factors.

Measurement of pelvic retroversion during hip flexion: evaluation with accelerometers / Mensuração de retroversão pélvica durante flexão do quadril: avaliação com acelerômetros

ABSTRACT Objective: To quantify pelvic retroversion during clinical evaluation of hip flexion with accelerometers and to verify the reliability of these sensors to measure hip flexion. Methods: An accelerometer was positioned laterally in the pelvis to measure pelvic retroversion. Another accelerometer was positioned anteriorly on the thigh to evaluate hip flexion amplitude. The evaluations were performed with volunteers in supine position by three raters. For evaluation of pelvic retroversion, the mean ± SD (minimum-maximum) was calculated. Reliability of the accelerometer between raters was determined by intraclass correlation coefficients (ICC). The linear correlation coefficient between hip flexion was determined by using goniometer and accelerometer. Results: The mean pelvic retroversion was 7.3° ± 0.93° (6°-11°) in the clinical limit of the hip range of motion, which was 106.25° ± 10.46° (93°-130°). The ICC between two raters were 0.60, 0.71 and 0.74 (goniometer) and 0.46, 0.71 and 0.83 (accelerometer). The linear correlation between hip flexion measurements with goniometer and accelerometer was 0.87. Conclusion: During clinical evaluation of the final range of hip flexion, there was an associated pelvic movement of approximately 7.3º. Accelerometers have proven to be reliable for measurement of hip flexion. Level of Evidence III, Study of nonconsecutive patients with no gold reference standard applied uniformly.

RESUMO Objetivo: Quantificar a retroversão pélvica durante avaliação clínica da flexão do quadril com acelerômetros e verificar a confiabilidade destes sensores para mensurar flexão do quadril. Métodos: Posicionou-se um acelerômetro lateralmente na pelve para mensurar retroversão pélvica. Outro foi posicionado anteriormente sobre a coxa para avaliar flexão do quadril. As avaliações foram realizadas com voluntários, em decúbito dorsal, por três avaliadores. Para avaliação da retroversão pélvica, determinou-se a média ± DP (mínimo-máximo). Avaliou-se a confiabilidade dos acelerômetros entre avaliadores pelo coeficiente de correlação intraclasse (CCI). Determinou-se o coeficiente de correlação linear entre as mensurações de flexão do quadril com goniômetro e acelerômetro. Resultados: A retroversão pélvica média foi de 7,3° ± 0,93° (6°-11°), mensurada no limite clínico da flexão do quadril, que foi de 106,25° ± 10,46° (93°-130°), ambos com acelerômetro. Os CCI entre dois avaliadores diferentes nas avaliações de flexão do quadril foram de 0,60, 0,71 e 0,74 (goniômetro) e 0,46, 0,71 e 0,83 (acelerômetro). A correlação linear entre as mensurações de flexão do quadril com goniômetro e acelerômetro foi de 0,87. Conclusão: Durante avaliação clínica da amplitude final de flexão do quadril, houve movimentação associada da pelve aproximadamente de 7,3°. Acelerômetros mostraram-se confiáveis para mensuração da flexão do quadril. Nível de evidência III, Estudo de pacientes não consecutivos sem padrão de referência "ouro" aplicado uniformemente.

Nível de atividade física e sobrecarga cardiovascular em bombeiros militares durante combate a incêndio florestal: um estudo exploratório / Physical activity level and cardiovascular strain in wildland firefighters during forest fire suppression: an exploratory study

Resumo Introdução : combates a incêndios florestais expõem bombeiros a elevado risco cardiovascular. Objetivo : avaliar o nível de atividade física (ATF), o comportamento sedentário e a sobrecarga cardiovascular de bombeiros durante um combate a incêndio florestal de grande porte. Métodos : durante 9 dias de atividade, 24h/dia, avaliaram-se 7 bombeiros do sexo masculino. Os participantes tiveram a frequência cardíaca (FC) medida a cada segundo e a ATF registrada por um sensor de movimento, do tipo acelerômetro, a cada 60 segundos. Foram computadas as médias dos registros do 2º, 3º e 4º dias. A ATF e o comportamento sedentário foram avaliados pelo vetor magnitude do acelerômetro, e a sobrecarga cardiovascular, pelo comportamento da FC. Resultados : os participantes apresentaram média de 112 (DP 24) min/dia de ATF moderada/vigorosa (MV), acumularam em média 14.803 (DP 1.667) passos/dia e gasto energético de 1.860 (DP 481) kcal/dia. A sobrecarga cardiovascular permaneceu, em média, 47 (DP 42) min/dia em esforço vigoroso e 8 (DP 12) min/dia em esforço muito vigoroso. Conclusão: os bombeiros avaliados acumularam mais que o dobro da recomendação mínima de ATF-MV semanal em três dias, apresentaram mais de 50 min/dia de elevada sobrecarga cardiovascular e pouco tempo em comportamento sedentário, se comparados a outras profissões.

Abstract Introduction: wildland fire suppression exposes firefighters to high cardiovascular risk. Objective: to evaluate the physical activity level (PAL), sedentary behavior (SB) and cardiovascular strain of wildland firefighters during a large fire suppression. Methods: for 9 days, 24h/day, we evaluated 7 male wildland firefighters. Participants had their heart rate (HR) measured every second and physical activity recorded by an accelerometer sensor every 60 seconds. The mean records of the 2nd, 3rd and 4th days of fire suppression were computed for the analysis. PAL was evaluated by the vector magnitude and cardiovascular strain by HR intensity. Results: the volunteers spent on average 112 (SD 24) min/day in moderate to vigorous physical activity (MVPA), achieved 14,803 (SD 1,667) steps/day and spent 1,860 (SD 481) kcal/day. Cardiovascular strain remained on average at 47 (SD 42) min/day of vigorous effort and 8 (SD 12) min/day of very vigorous physical activity. Conclusion: the firefighters evaluated during a large-scale wildland fire suppression accounted for more than double of the minimum recommended MVPA/week in three days, showed more than 50 min/day of high cardiovascular strain, and little time on sedentary behavior compared to other professions.

Estudio comparativo de reconstrucción de ligamento cruzado anterior entre las técnicas de Un Haz y U-Dos / Comparative study of anterior cruciate ligament reconstruction between the One Band and U-Two techniques

Resumen: Introducción: Las lesiones del LCA se encuentran dentro de las lesiones ligamentarias más frecuentes. Esto ha llevado al desarrollo de diferentes técnicas quirúrgicas para recuperar la estabilidad de la rodilla. Material y métodos: Estudio clínico, aleatorizado, ciego comparando técnicas de reconstrucción de LCA con Un Haz y «U-Dos¼ mediante escalas clínicas y artrometría con KT-1000 y Pivot Shift Meter. Resultados: De 36 pacientes, 52.94% fue sorteado para la técnica de Un Haz y 47.06% para «U-Dos¼. En 11.76% de los pacientes se presentó un desplazamiento mayor a 11 mm en la rodilla afectada con KT-1000. En 8.82% se mostró un desplazamiento anterior igual en ambas rodillas. Un paciente presentó un desplazamiento anterior mayor posterior a la cirugía de reconstrucción con la técnica de Un Haz, pero con mejoría en las escalas clínicas. En las mediciones de Pivot Shift se encontró una diferencia en el desplazamiento mayor a los 4,000 m/s en el eje de las X tras la técnica de Un Haz en comparación con la rodilla sana calculando integrales, mientras que con U-Dos la diferencia fue menor de 600 m/s. En el eje de «Y¼ se encontró una diferencia > 3,500 m/s entre la pierna sana y la lesionada, la cual disminuye a menos de 2,000 m/s tras la reconstrucción mediante técnica de U-Dos. Conclusiones: A lo largo del estudio se han encontrado diferencias en la evolución de los pacientes que indican que la reparación mediante la técnica de U-Dos tiene mejores resultados al lograr recuperar la estabilidad anteroposterior y rotacional del miembro afectado.

Abstract: Introduction: ACL injuries are found within the most common ligament injuries. This has led to the development of different surgical techniques to restore knee stability. Material y Methods: Clinical study, randomized, blind comparing ACL reconstruction techniques with One Band and «U-Two¼ using clinical scales and arthrometria with KT-1000 and Pivot Shift Meter. Results: Of 36 patients, 52.94% was drawn for the One Band technique and 47.06% for «U-Two¼. 11.76% of patients had a displacement greater than 11mm in the affected knee with KT-1000. 8.82% showed an equal anterior displacement on both knees. One patient had a major previous displacement after reconstruction surgery with the one band technique, but with improvement on clinical scales. Pivot Shift measurements found a difference in displacement greater than 4,000 m/s on the X axis following the One Band technique compared to the healthy knee calculating integrals, while with U-Two the difference was less than 600 m/s. On the Y axis a difference of > 3,500 m/s was found between the healthy and the injured leg, which decreases to less than 2,000 m/s after reconstruction using U-Two technique. Conclusions: Differences have been found throughout the study in patient evolution, indicating that repair using the U-Dos technique has better results in recovering the anteroposterior and rotational stability of the affected limb.

Habilidades motoras fundamentais e nível de atividade física de crianças: um estudo com escolares do ensino fundamental / Fundamental motor skills and level of physical activity in children: a study with elementary school students

Habilidades Motoras Fundamentais (HMFS) são movimentos básicos como correr e arremessar, cujo desenvolvimento ocorre na infância e deve ser mantida por toda vida. A proficiência nessas habilidades é desejável para a execução adequada das atividades diárias, recreativas e competitivas. A literatura relata uma associação entre as HMFS com um aumento do nível de atividade física (NAF), indicando que as pessoas mais habilidosas são mais confiantes para executar suas atividades e consequentemente, são mais ativas fisicamente. No entanto, não se conhece bem a relação e impacto das HMFS sobre o NAF. Quando se considera os benefícios conhecidos da atividade física (AF) e a natureza do desenvolvimento motor, é racional reconhecer que o professor de Educação Física (EF) é o principal responsável pelo desenvolvimento das HMFS com importante impacto no futuro estilo de vida dos seus alunos. Assim, o objetivo deste estudo foi descrever e investigar os níveis de HMFS e sua associação com NAF em escolares do ensino fundamental. Método: Participaram deste estudo 148 crianças saudáveis (70 meninos; 78 meninas) com idades entre seis e 10 anos. O teste TGMD-2 foi usado para classificar os níveis das HMFS (em sete escalas) nos subtestes (locomoção e controle de objetos) e no quociente do desenvolvimento motor grosso (QDMG). O NAF foi determinado por acelerometria (Actigraph wGT3X-BT) por meio de "counts", considerando o Vetor Magnitude (VM) Semanal de AF Moderada/Vigorosa (Total Semanal MV), para classificar o NAF Total Semanal MV como sedentário ou ativo, de acordo com as classificações de Chandler et al. (2015). A associação entre os escores padrões das HMFS com o QDMG e com o NAF foi verificada (Pearson). A influência das HMFS sobre o NAF Total Semanal MV foi estabelecida por regressão linear simples explicativa, considerando o NAF como variável dependente e os escores padronizados dos subtestes e o QDMG como variáveis independentes. Para todas as análises realizadas (SPSS 20.0) considerou-se ?=0,05. Resultados: Para o NAF Total Semanal MV foram identificadas baixas correlações estatisticamente significantes com QDMG (r=0,33: p<0,001), escore padrão da locomoção (r = 0,24; p=0,004) e escore padrão controle de objetos (r=0,32: p<0,001). A regressão linear (?) mostrou que o QDMG explica 33.3% da variância do NAF Total Semanal MV [FANOVA = 18,216, p=0.001; r2ajustado=0.105]. De modo semelhante, a variância do NAF Total Semanal MV é explicada em diferentes magnitudes pelo escore padrão da locomoção (?=23.8%; [FANOVA = 8.738, p=0.004; r2=0.050]) e pelo controle de objetos (?=32,3%; [FANOVA = 16,991, p=0.001; r2=0.098]). As HMFS apresentaram um impacto de 33% no NAF Total Semanal MV. Crianças com níveis mais altos de HMFS foram as mais ativas fisicamente. Conclusão: Assim, pode-se considerar que os níveis de proficiência das HMFS têm importante influência no NAF Total Semanal MV das crianças. Diante disso, as crianças das séries iniciais necessitam de planos de ensino enfatizando o desenvolvimento das HMFS, pois são prioritariamente desenvolvidas nessa fase da infância

Fundamental Motor Skills (FMS) are basic movements, such as running and throwing, whose development occurs in childhood and must be maintained throughout life. Proficiency in these skills is desirable for proper performance of daily, recreational and competitive activities. The literature reports an association between FMS with an increase in the level of physical activity (LPA), indicating that people who are more skilled are more confident to perform activities and consequently, are more physically active. However, it is not well understood the relationship and impact of FMS on LPA. When considering the known benefits of physical activity (PA) and the nature of motor development, it is rational to recognize that the Physical Education (PE) teacher is the most responsible for the development of FMS with important impact on the future lifestyle of his/her students. Thus, the objective of this study was to describe and investigate levels of FMS and their association with LPA in elementary school students. Method: A total of 148 healthy children (70 boys, 78 girls) with ages between six and 10 years participated in this study. The TGMD-2 test was used to classify FMS levels (on seven scales) in the subtests (locomotor and object control) and in the Gross Motor Quotient (GMQ). The LPA was determined by accelerometry (Actigraph wGT3X-BT) by means of "counts", considering the Magnitude Vector (MV) Weekly of Moderate/Vigorous PA (Total Weekly MV), to classify the LPA Total Weekly VM as sedentary or active, according to the classifications of Chandler et al. (2015). The association between FMS standard scores with GMQ and LPA was verified (Pearson). The influence of the FMS on the LPA Total Weekly MV was established by simple linear regression, considering the LPA as the dependent variable and the standardized scores of the subtests and the GMQ as independent variables. All analyzes were performed considering ? = 0.05. Results: For the LPA Total Weekly MV, low statistically significant correlations were identified with GMQ (r = 0.33: p <0.001), standard locomotor score (r = 0.24, p = 0.004) p <0.001) and standard object control score (r = 0.32: p <0.001). The linear regression (?) showed that the GMQ explains 33.3% of the variance of the LPA Total Weekly MV [FANOVA = 18,216, p = 0.001; r2 set = 0.105]. Similarly, the variance of the LPA Total Weekly MV is explained in different magnitudes by the standard locomotor score (? = 23.8%, [FANOVA = 8.738, p = 0.004, r2 = 0.050]) and object control (?=32, 3%; [FANOVA = 16,991, p=0.001; r2=0.098]). FMS had a 33% impact on LPA Total Weekly MV. Children with higher levels of FMS were the most physically active. Conclusion: Thus, it can be considered that FMS proficiency levels have an important influence on children's LPA Total Weekly MV. Faced with this, children in early grade need teaching plans emphasizing the development FMS, as they are primarily developed at this stage of childhood

IoT-based measurement system for classifying cow behavior from tri-axial accelerometer / Sistema de medição baseado em IoT para classificar o comportamento de vacas através de acelerômetro tri-axial

ABSTRACT: A cow behavior monitoring system based on the Internet of Things (IoT) has been designed and implemented using tri-axial accelerometer, MSP430 microcontroller, wireless radio frequency (RF) module, and a laptop. The implemented system measured cow movement behavior and transmitted acceleration data to the laptop through the wireless RF module. Results were displayed on the laptop in a 2D graph, through which behavior patterns of cows were predicted. The measured data from the system were analyzed using the Multi-Back Propagation-Adaptive Boosting algorithm to determine the specific behavioral state of cows. The developed system can be used to increase classification performance of cow behavior by detecting acceleration data. Accuracy exceeded 90% for all the classified behavior categories, and the specificity of normal walking reached 96.98%. The sensitivity was good for all behavior patterns except standing up and lying down, with a maximum of 87.23% for standing. Overall, the IoT-based measurement system provides accurate and remote measurement of cow behavior, and the ensemble classification algorithm can effectively recognize various behavior patterns in dairy cows. Future research will improve the classification algorithm parameters and increase the number of enrolled cows. Once the functionality and reliability of the system have been confirmed on a large scale, commercialization may become possible.

RESUMO: Um sistema de monitoramento de comportamento de vacas baseado na Internet das Coisas (IoT) foi projetado e implementado através do uso de acelerômetro tri-axial, Microcontrolador MSP430, módulo de rádio, frequência sem fio (RF), e um portátil. O sistema implementado mediu o comportamento do movimento da vaca e transmitiu dados de aceleração ao portátil através do módulo RF sem fio. Os resultados foram exibidos no portátil em um gráfico 2D, através do qual os padrões de comportamento das vacas foram previstos. Os dados medidos do sistema foram analisados usando o Multi-retropropagação-Adaptativa algoritmo de Boosting para determinar o estado comportamental específico das vacas. O sistema desenvolvido pode ser usado para aumentar a classificação de desempenho de vaca comportamento através da detecção de aceleração de dados. A precisão excedeu 90% de todas as categorias de classificação de comportamento e a especificidade do andar normal atingiu 96.98%. A sensibilidade foi boa para todos os padrões de comportamento, exceto em pé e deitada, com um máximo de 87.23% para ficar de pé. No geral, o sistema baseado em IoT fornece medição precisa e remota do comportamento da vaca, e o algoritmo de conjunto de classificação pode efetivamente reconhecer vários padrões de comportamento em vacas leiteiras. Pesquisas futuras irão melhorar os parâmetros do algoritmo de classificação e aumentar a quantidade de vacas matriculadas. Uma vez que a funcionalidade e confiabilidade do sistema foram confirmadas em larga escala, a comercialização pode se tornar possível.

Aumento en la efectividad de la identificación de cimas y pies en el pulso fotopletismográfico al reconstruirlo mediante filtrado adaptativo / Increase in the effectiveness of identifying peaks and feet of the photoplethysmographic pulse to be reconstructed it using adaptive filtering

Resumen: Objetivo: Mejorar la identificación de cimas y pies en el pulso fotopletismográfico (PPG, por sus siglas en inglés), deformado por efecto del ruido miocinético, mediante la implementación de un dedal modificado y filtrado adaptativo. Método: Se obtuvo el PPG en 10 voluntarios sanos empleando 2 sistemas de fotopletismografía colocados en el dedo índice de cada mano, y registrándolos simultáneamente durante 3 min. Durante el primer minuto de registro, ambas manos estuvieron en reposo, y durante los 2 min posteriores, solo la mano izquierda realizó movimientos cuasi-periódicos para añadir ruido miocinético. Se emplearon 2 metodologías para procesar las señales fuera de línea, en una se usó un filtro con el algoritmo de mínimos cuadrados promediados (LMS, por sus siglas en inglés) y en la otra se hizo un preprocesamiento adicional al filtrado LMS. Ambas metodologías fueron comparadas y la de menor error porcentual en la señal recuperada se utilizó para valorar la mejora en la identificación de cimas y pies del PPG. Resultados: El error promedio obtenido fue del 22.94% para la primera metodología, y del 3.72% para la segunda. Los errores en la identificación de cimas y pies antes de filtrar el PPG fueron del 24.26 y 48.39%, respectivamente, una vez filtrados, disminuyeron a 2.02 y 3.77%, respectivamente. Conclusiones: El filtrado adaptativo basado en el algoritmo LMS, más una etapa de preprocesamiento, permite atenuar el ruido miocinético en el PPG, y aumentar la efectividad en la identificación de cimas y pies de pulso, que resultan de gran importancia para una valoración médica.

Abstract: Objective: To improve the identification of peaks and feet in photoplethysmographic (PPG) pulses deformed by myokinetic noise, through the implementation of a modified fingertip and applying adaptive filtering. Method: PPG signals were recordedfrom 10 healthy volunteers using two photoplethysmography systems placed on the index finger of each hand. Recordings lasted three minutes andwere done as follows: during the first minute, both handswere at rest, and for the lasting two minutes only the left hand was allowed to make quasi-periodicmovementsin order to add myokinetic noise. Two methodologies were employed to process the signals off-line. One consisted on using an adaptive filter based onthe Least Mean Square (LMS) algorithm, and the other includeda preprocessing stage in addition to the same LMS filter. Both filtering methods were compared and the one with the lowest error was chosen to assess the improvement in the identification of peaks and feet from PPG pulses. Results: Average percentage errorsobtained wereof 22.94% with the first filtering methodology, and 3.72% withthe second one. On identifying peaks and feet from PPG pulsesbefore filtering, error percentages obtained were of 24.26% and 48.39%, respectively, and once filtered error percentageslowered to 2.02% for peaks and 3.77% for feet. Conclusions: The attenuation of myokinetic noise in PPG pulses through LMS filtering, plusa preprocessing stage, allows increasingthe effectiveness onthe identification of peaks and feet from PPG pulses, which are of great importance for medical assessment.

[Increase in the effectiveness of identifying peaks and feet of the photoplethysmographic pulse to be reconstructed it using adaptive filtering]. / Aumento en la efectividad de la identificación de cimas y pies en el pulso fotopletismográfico al reconstruirlo mediante filtrado adaptativo.

OBJECTIVE: To improve the identification of peaks and feet in photoplethysmographic (PPG) pulses deformed by myokinetic noise, through the implementation of a modified fingertip and applying adaptive filtering. METHOD: PPG signals were recordedfrom 10 healthy volunteers using two photoplethysmography systems placed on the index finger of each hand. Recordings lasted three minutes andwere done as follows: during the first minute, both handswere at rest, and for the lasting two minutes only the left hand was allowed to make quasi-periodicmovementsin order to add myokinetic noise. Two methodologies were employed to process the signals off-line. One consisted on using an adaptive filter based onthe Least Mean Square (LMS) algorithm, and the other includeda preprocessing stage in addition to the same LMS filter. Both filtering methods were compared and the one with the lowest error was chosen to assess the improvement in the identification of peaks and feet from PPG pulses. RESULTS: Average percentage errorsobtained wereof 22.94% with the first filtering methodology, and 3.72% withthe second one. On identifying peaks and feet from PPG pulsesbefore filtering, error percentages obtained were of 24.26% and 48.39%, respectively, and once filtered error percentageslowered to 2.02% for peaks and 3.77% for feet. CONCLUSIONS: The attenuation of myokinetic noise in PPG pulses through LMS filtering, plusa preprocessing stage, allows increasingthe effectiveness onthe identification of peaks and feet from PPG pulses, which are of great importance for medical assessment.

Influência da força muscular no volume e na intensidade da atividade física diária de idosos / Influence of muscle strength in the volume and intensity of daily physical activity in elderly

Resumo Diminuições no volume da atividade física diária (VAF - número de passos) e na intensidade da atividade física diária (IAF – velocidade média de caminhada) estão relacionadas com a maior incidência de quedas e aumento da incidência de doenças crônico-degenerativas em idosos. Portanto, identificar fatores que possam aumentar o VAF e a IAF torna-se essencial, principalmente para essa população. Desta forma, o objetivo do presente estudo foi investigar a influência da força muscular no VAF e na IAF de idosos saudáveis. Foram recrutados 18 participantes (10 homens e oito mulheres), com idade acima de 60 anos. Os participantes realizaram o teste de uma repetição máxima (1-RM) e utilizaram acelerômetro triaxial durante sete dias consecutivos, para mensurar o VAF e a IAF. Para analisar a influência da força no VAF e IAF realizou-se uma análise de regressão linear simples. Não foram observadas correlações significantes entre a força muscular e o VAF (p = 0,93; r2 = −0,06), assim como, entre a força muscular e a IAF (p = 0,08; r2 = 0,17). Conclui-se que a força muscular não influencia o VAF e a IAF de idosos saudáveis.(AU)

Abstract Reduction in the volume daily physical activity (VAF – number of steps) and in the intensity of daily physical activity (IAF- average walk velocity) are related with higher incidence of falls and increase of incidence of chronic diseases in elderly. However, the identification of factors which may increase the VAF and the IAF became essential, especially in this population. Therefore, the aim of the present study was to investigate the influence of muscle strength in VAF and the IAF of older healthy elderly. It were recruited 18 participants, ten men and eight women, aged above 60 years old. The participants performed the one repetition maximal test (1-RM) and afterwards they used the triaxial accelerometer, during seven consecutive days, to measure the VAF and the IAF. To analyze the influence of muscle strength in the VAF and IAF a simple linear regression analysis was performed. It was not observed significant correlations between the muscle strength and the VAF (p = 0.93; r2 = −0.06), or between muscle strength and the IAF (p = 0.08; r2 = 0.17). In conclusion the muscle strength does not influence the VAF and IAF of healthy older adults.(AU)

Diseño de dispositivo para detección de alteraciones del sistema vestibular / Design device for tamper detection of the vestibular system / Design de dispositivo para detecção de distúrbios do sistema vestibular

Los desórdenes vestibulares como el vértigo con mayor prevalencia en la población afectada pueden diagnosticarse con diferentes herramientas incluido el test de agudeza visual dinámica. Test que a nivel clínico únicamente incluye la monitorización de velocidad de movimiento de rotación de la cabeza sin mayores herramientas que permitan el diagnóstico puntual del canal semicircular horizontal acotado en la dinámica completa del movimiento. En el presente artículo se presenta una herramienta tecnológica completa para el desarrollo del test que permite el sensado de los movimientos de la cabeza en los ejes x, y, z y la interacción con una interfaz gráfica para la evaluación de la agudeza visual con errores encontrados al final de la implementación inferiores al 2% en ángulos de inclinación y flexión y del 4% al 15% para el ángulo máximo de rotación.

Vestibular disorders as the vertigo, with higher prevalence in the affected population, can be diagnosed using different tools including the dynamic vestibular acuity test. Test including at clinical level only the speed motorization of head without more tools to allow the specific diagnose of the horizontal semicircular canal bounded in the complete dynamic of movement. This article present a complete technologic tool to the development of the test, allowing the sensing of head movements in the x, y, z axis and the interaction with a graphical interface to evaluate the visual acuity, with found differences at the end of the implementation lower of 2% in flexion and inclination angles and of 4% to 15% to the maximum rotation angle.

Distúrbios vestibulares como a vertigem, com maior prevalência na população afetada, pode ser diagnosticada através de diferentes ferramentas, incluindo o teste de acuidade vestibular dinâmico. Incluindo o teste a nível clínico somente a motorização velocidade da cabeça sem mais ferramentas para permitir o diagnóstico específico do canal semicircular horizontal delimitada a dinâmica de movimentos. Este artigo apresenta uma ferramenta tecnológica completa para o desenvolvimento do teste, Permitindo que o sensor de movimentos da cabeça nos x, y, eixo z ea interação com uma interface gráfica para avaliar a acuidade visual, com diferenças encontradas no final da Implementação inferior de 2% em ângulos de flexão e de inclinação e de 4% a 15% para o ângulo de rotação máxima.

Monitoramento remoto pervasivo da saúde utilizando dispositivo móvel / Pervasive remote monitoring of human health via mobile devices

Este trabalho aplica o método Sliding Window (SW) associado a uma Rede Neural Artifical (RNA) para consolidação de dados advindos de um acelerômetro para o monitoramento de movimentos humanos. A partir desses dados foi extraído um vetor de entrada, para o classificador, com quatro características. Foram feitas várias combinações entre os parâmetros da SW, otimizando a média de acertos, atingindo então 92,63%. Conclui-se que a Sliding Window associada a RNA é apropriada para detecção dos seis movimentos aqui estudados. Esta técnica pode ser amplamente utilizada no monitoramento remoto de pacientes de forma menos invasiva, onde uma central remota realiza o processamento offline dos dados recebidos através do dispositivo móvel.

This paper applies the method Sliding Window (SW) in association with Artificial Neural Network (ANN) for consolidation of data that is generated by an accelerometer, which monitors human movements. From the extracted data was created an input vector with four features to the classifier. Several combinations were made regarding the SWparameters, optimizing the mean hit, which reached 92.63%. It is concluded that a sliding window associated with ANNis appropriate to the detection of the six studied movements. This technique can be widely used in remote monitoring of patients in a less invasive way, while a remote central carries out an offline processing of the received data from a mobile device.

What is the intensity of exercise sessions of a physical exercise program for older adults? / Qual a intensidade das aulas de um programa de exercício físico para idosos?

Abstract The objectives of this study were to describe and determine the intensity of sessions of a physical exercise program (PEP) for older adults developed within the primary healthcare network of Florianópolis, and to compare the intensity of the sessions between groups using three cutoffs. Eight sessions involving 31 older adults divided into groups I and group II were analyzed. The total time spent during the sessions was considered. Intensity was measured with a triaxial accelerometer and classified according to three different cutoffs. Sociodemographic data, perceived health status, functional fitness, nutritional status and physical activity level at the beginning of the program were also evaluated. The majority of older adults was insufficiently active, was overweight, had low functional fitness, and reported that their health status did not impair physical activity. The mean time spent in moderate physical activity ranged from 1.4 and 16.3 min in group I and from 6.6 and 23.2 min in group II, with the difference being significant. The mean time spent in sedentary activities was 18.7 and 20.5 min for groups I and II, respectively. The findings suggest that the PEP sessions mainly consisted of light or sedentary activities and that the short time spent in more intense activities might be related to the characteristics of the group and to the teaching method adopted by the professionals.

Resumo O presente estudo objetivou descrever e verificar a intensidade das aulas de um programa de exercício físico (PEF) para idosos, desenvolvido na rede de atenção primária à saúde de Florianópolis - SC; e comparar os grupos quanto à intensidade das aulas, segundo três pontos de corte. Foram analisadas oito aulas, as quais envolveram 31 idosos, divididos nos grupos I e II. Utilizou-se tempo total despendido durante a aula, sendo a intensidade classificada por três diferentes pontos de corte e mensurada por acelerômetros triaxiais. Variáveis sociodemográficas; de saúde; aptidão funcional; estado nutricional e nível de atividade física (AF) ao iniciar o PEF também foram avaliados. Os resultados evidenciaram que ao iniciarem o PEF, a maioria dos idosos era pouco ativa, apresentava excesso de peso, baixa aptidão funcional e afirmou que o estado de saúde não dificultava a prática de AF. A média de tempo despendido por aula em AF moderada variou de 1,4 a 16,3 min no grupo I e de 6,6 a 23,2 min no grupo II, diferindo estatisticamente. O tempo médio geral das aulas em atividades sedentárias foi de 18,7 e 20,5 min para os grupos I e II, respectivamente. Os resultados indicam que as aulas do PEF caracterizaram-se, em sua maioria, por atividades de intensidade leve ou sedentárias e que o pouco tempo despendido em atividades mais intensas pode estar relacionado às características do grupo e à metodologia de ensino adotada pelos professores.

Interpretación de la maniobra de pivote mediante el uso de acelerómetros en pacientes que acuden a consulta ortopédica / Interpretation of the pivot test using accelerometers in the orthopedic practice

Los ligamentos cruzados (LC) de la rodilla, anterior (A) y posterior (P), localizados dentro de la articulación, unen fémur y tibia, dando estabilidad sobre la dirección anteroposterior de un hueso sobre otro. El LCA puede lesionarse mediante rotaciones provocadas en algún deporte que implique giro con el pie apoyado sobre el suelo. Las lesiones del LCA se determinan con maniobras como la de Lachman, cajón y pivote. Se utilizan acelerómetros que permiten graficar la maniobra de pivote en pacientes que acuden a consulta ortopédica, utilizando la prueba de KT1000 como estándar de oro. El trabajo ha sido aprobado por el Comité de Ética del Hospital. Estudio descriptivo entre casos y controles. Resultados: 92 pacientes aceptaron participar mediante consentimiento informado, nueve casos resultaron con KT1000 positivo, de los negativos, seleccionamos nueve controles afines a edad y género. Alteraciones de KT1000 fueron mayores en mujeres (78%) y en 67% de los casos la pierna alterada fue la derecha. Los resultados promedio de KT1000 en casos fue de 5.44 mm, en controles de 0.66 mm. Los acelerómetros permitieron graficar la maniobra de pivote y observamos gráficas similares tanto en casos y controles, solamente se muestran diferencias notables en un paciente masculino con KT1000 de 15 mm que fue sometido a reparación de LCA izquierdo, la maniobra se realizó al estar sedado. Concluimos que el paciente, en estado consciente, pone resistencia en la maniobra, a diferencia de la obtenida con anestesia, y que el uso de acelerómetros permite documentar la maniobra de pivote observando diferencias entre un LCA normal y uno lesionado.

The anterior (A) and posterior (P) cruciate ligaments (CL) of the knee, located inside the joint, connect the femur and the tibia and thus provide stability in the anteroposterior axis of one bone over the other. The anterior cruciate ligament (ACL) may be injured as a result of rotation when practicing a sport involving turning with the foot on the ground. ACL injuries are diagnosed with maneuvers like the Lachman, drawer and pivot. Accelerometers were used to plot the pivot maneuver in patients seeing the orthopedist surgeon using the KT1000 test as gold standard. This case-control descriptive study was approved by the Hospital's Ethics Committee. Results: 92 patients accepted to participate through an informed consent; nine cases were KT1000 positive, and nine age- and gender-matched controls were selected among KT1000 negative patients. KT1000 alterations were greater among females (78%) and in 67% of cases the right leg was affected. Mean KT1000 results were 5.44 mm in cases and 0.66 mm in controls. Accelerometers allowed plotting the pivot maneuver and the resulting charts for cases and controls were similar. Remarkable differences were seen only in one male patient with a 15 mm KT1000, who underwent repair of the left ACL; the maneuver was performed under sedation. We concluded that conscious patients oppose the maneuver, unlike anesthetized patients, and that the use of accelerometers helps document the pivot maneuver which, in turn, helps detect differences between a normal ACL and an injured one.