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1.
Isr Med Assoc J ; 22(1): 37-42, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31927804

RESUMO

BACKGROUND: There is a need for standardized and objective methods to measure postural instability (PI) and gait dysfunction in Parkinson's disease (PD) patients. Recent technological advances in wearable devices, including standard smartphones, may provide such measurements. OBJECTIVES: To test the feasibility of smartphones to detect PI during the Timed Up and Go (TUG) test. METHODS: Ambulatory PD patients, divided by item 30 (postural stability) of the motor Unified Parkinson's Disease Rating Scale (UPDRS) to those with a normal (score = 0, PD-NPT) and an abnormal (score ≥ 1, PD-APT) test and a group of healthy controls (HC) performed a 10-meter TUG while motion sensor data was recorded from a smartphone attached to their sternum using the EncephaLog application. RESULTS: In this observational study, 44 PD patients (21 PD-NPT and 23 PD-APT) and 22 HC similar in age and gender distribution were assessed. PD-APT differed significantly in all gait parameters when compared to PD-NPT and HC. Significant difference between PD-NPT and HC included only turning time (P < 0.006) and step-to-step correlation (P < 0.05). CONCLUSIONS: While high correlations were found between EncephaLog gait parameters and axial UPDRS items, the pull test was least correlated with EncephaLog measures. Motion sensor data from a smartphone can detect differences in gait and balance measures between PD with and without PI and HC.


Assuntos
Doença de Parkinson/diagnóstico , Equilíbrio Postural , Smartphone , Idoso , Estudos de Casos e Controles , Estudos de Viabilidade , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Doença de Parkinson/fisiopatologia
2.
J Sports Sci ; 38(1): 21-28, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31613188

RESUMO

Subjective evaluations of balance performance, like the modified Balance Error Scoring System (mBESS), are highly popular. Alternatively, quantitative measures may offer additional clarity in identifying balance dysfunction. A novel measure to define balance impairments is time to boundary (TTB), which represents the amount of time available to make corrective postural adjustments prior to the centre of pressure (CoP) reaching the edge of the base of support. The purpose of this investigation was to assess TTB and traditional measures of CoP displacement of young adults performing the mBESS on a BTrackS balance plate. Path length and TTB were calculated in anterior-posterior (AP) and medio-lateral (ML) directions, respectively. AP and ML path lengths were largest in Single stance (109.2 & 118.1 cm, respectively) and smallest in Dual stance (27.1 & 36.4 cm, respectively). The average AP and ML TTBs were higher in Dual (10.67 & 7.27 s, respectively) compared to Single (3.54 & 1.20 s, respectively) or Tandem (10.11 & 1.94 s, respectively) stances, and lower in Single stance compared to Tandem. Given the effect sizes for TTB were greater than those of path length in both directions, TTB more adequately differentiates these stance conditions than path length or subjective scores.


Assuntos
Ergometria/métodos , Equilíbrio Postural/fisiologia , Concussão Encefálica/diagnóstico , Feminino , Humanos , Masculino , Movimento/fisiologia , Fatores de Tempo , Adulto Jovem
3.
J Sports Sci ; 38(1): 86-93, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31707915

RESUMO

The predictive value of the multiple hop test for first-time noncontact lateral ankle sprains. BACKGROUND: Lateral ankle sprains (LAS) are very common sports injuries, cause high health care costs and are associated with postural control deficits. From a preventive point of view, clinicians should dispose valid field tests to identify athletes at risk for a LAS. The aim of this study is to evaluate the predictive value of the multiple hop test (MHT) for first-time noncontact LAS. METHODS: Non-elite athletes (n = 232) performed the MHT at baseline. During a 12-month follow-up period, all noncontact LAS related to health care costs were recorded. Outcomes of the MHT (completion time, balance errors and perceived difficulty) between the injured and uninjured group were compared and odds ratios (OR) and relative risks (RR) were calculated using a logistic regression analysis. RESULTS: Ten first-time noncontact LAS were recorded (4.3%). Injured athletes made significantly more change-in-support strategy (CSS) errors when compared to uninjured athletes (p = .04). The OR of the number of CSS errors was 1.14 (p = .03), the RR 4.1 (p = .04). CONCLUSIONS: Athletes scoring > 12 CSS errors, have a four times increased risk for a first-time noncontact LAS. The MHT is a valid field test to identify athletes at risk for a first-time noncontact LAS.


Assuntos
Traumatismos do Tornozelo/diagnóstico , Traumatismos em Atletas/diagnóstico , Teste de Esforço/métodos , Entorses e Distensões/diagnóstico , Adolescente , Adulto , Traumatismos do Tornozelo/fisiopatologia , Traumatismos em Atletas/fisiopatologia , Feminino , Humanos , Masculino , Equilíbrio Postural/fisiologia , Valor Preditivo dos Testes , Fatores de Risco , Entorses e Distensões/fisiopatologia , Adulto Jovem
4.
Zh Nevrol Psikhiatr Im S S Korsakova ; 119(9. Vyp. 2): 5-9, 2019.
Artigo em Russo | MEDLINE | ID: mdl-31825383

RESUMO

Persistent postural perceptual dizziness (PPPD) is a common cause of complaints to dizziness and unitability among patients of all-ages. The disease is characterized by a permanent feeling of non-rotatory dizziness or unsteadiness that at first can be caused by an acute vestibular dizziness, somatic disturbance that causes sudden unsteadiness and loss of balance or, for example, by a panic attack. Despite the permanent feeling of unsteadiness and dizziness, a regular instrumental examination cannot reveal important changes that can explain personal feeling. The diagnosis can be made according to the diagnostic criteria developed by the International Barani Society. Treatment consists of psychotherapy, drug therapy and vestibular rehabilitation.


Assuntos
Tontura , Equilíbrio Postural , Doenças Vestibulares , Idoso , Humanos , Vertigem
5.
Isr Med Assoc J ; 12(21): 773-778, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31814338

RESUMO

BACKGROUND: Falls are a common complication in persons with stroke (PwS). Reliable assessment of balance responses to unexpected loss of balance has the potential to identify risk for falls. OBJECTIVES: To examine inter-observer reliability of balance responses to unannounced surface perturbations in PwS and to explore the concurrent validity of a balance recovery assessment protocol. METHODS: Two observers evaluated balance recovery strategies and fall threshold (a fall into a harness system) in 15 PwS and 15 healthy adults who were exposed to forward, backward, right, and left unannounced surface translations in six increasing intensities while standing. RESULTS: Observer agreement was 100% for the fall threshold. Kappa coefficients for step strategies were 0.960-0.988 in PwS and 0.886-0.938 in healthy adults, 0.905-0.988 for arm reactions in PwS and 0.754-0.926 in healthy adults. Significant correlations were found between fall threshold and Berg Balance Scale (r = 0.691), 6-minute walk test (r = 0.599), and fall efficacy scale-international (r= -0.581). CONCLUSIONS: A trained examiner can reliably classify reactive balance responses to surface perturbations. The high frequency of falls observed in PwS highlights the importance of assessing reactive balance responses to different directions and intensities of surface translations.


Assuntos
Acidentes por Quedas/prevenção & controle , Exame Neurológico/métodos , Equilíbrio Postural , Posição Ortostática , Acidente Vascular Cerebral , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Posicionamento do Paciente/métodos , Recuperação de Função Fisiológica , Reprodutibilidade dos Testes , Medição de Risco/métodos , Acidente Vascular Cerebral/diagnóstico , Acidente Vascular Cerebral/fisiopatologia , Reabilitação do Acidente Vascular Cerebral/métodos , Teste de Caminhada/métodos
6.
Ideggyogy Sz ; 72(11-12): 419-425, 2019 Nov 30.
Artigo em Inglês | MEDLINE | ID: mdl-31834686

RESUMO

Background and purpose: - Our objectives were to determine the differences in the vestibular evoked myogenic potential (VEMP) responses in patients diagnosed with early staged idiopathic Parkinson's disease (PD) compared to the normal population and evaluate the vestibular system disorder causing balance-posture disorders. Second aim of this study was to investigate caloric test responses particularly in early staged PD compared to normal popu-lation. Methods: Thirty patients (14 females and 16 males; mean age, 60.6 ± 13.1 years) diagnosed with idiopathic PD and 28 healthy subjects (20 males and 8 females; mean age, 59.1 ± 6.4 years) were included. The patient and control groups were subdivided according to their age, gender and the patient group was subdivided according to onset time of the Parkinson symptoms, Hoehn-Yahr staging. The subgroups were compared for VEMP and caloric test responses. Results: There were no significant differences between the study and control groups for right and left VEMP measurements. Patients over 60 years and under 60 years did not show significant differences in terms of right and left mean VEMP measurements. However, P1 amplitude was significantly lower in patients over 60 years old (P = .004). Gender, disease duration, BERG balance scale and Hoehn-Yahr stage had no effect on the VEMP amplitudes. There was no significant correlation with the side of Parkinsonian symptoms to the side of canal paresis (P = .566) and the side on which no VEMP response was obtained in caloric test. Conclusion: VEMP responses were not different between PD and healthy subjects. VEMP P1 amplitude was decreased with age in PD group. Canal paresis and symptoms side were not statistically correlated in caloric test.


Assuntos
Testes Calóricos , Doença de Parkinson/diagnóstico , Potenciais Evocados Miogênicos Vestibulares/fisiologia , Testes de Função Vestibular/métodos , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Doença de Parkinson/fisiopatologia , Equilíbrio Postural
7.
ABCS health sci ; 44(3): 180-186, 20 dez 2019. ilus
Artigo em Inglês | LILACS | ID: biblio-1047750

RESUMO

INTRODUCTION: Motor changes are observed in people living with HIV/AIDS. These changes may be associated with the chronicity of infection, continued use of antiretroviral medication, and/or the presence of comorbidities. OBJECTIVE: The objective of the present study was to evaluate postural sway in people living with asymptomatic HIV/AIDS under treatment with highly active antiretroviral therapy. METHODS: Twenty-seven subjects, recruited at an HIV referral center, aged between 30 and 40 years, participated in the study, divided into two groups: HIV group (n=12) and non-HIV group (n=15). The participants performed an experimental task, remaining on a force platform in a static position, in bipedal support and semi-tandem positions, in conditions with and without vision. RESULTS: The results demonstrated that visual occlusion, when the bipedal base was adopted, generated significant differences in the area of oscillation and mean velocity in both groups. Differences were also observed in the area and mean velocity of both groups when the semi-tandem position was adopted without vision. When comparing the groups, it was possible to identify significant differences in the semi-tandem base with vision. CONCLUSION: Considering these results, it was found that postural oscillation was higher in the visual occlusion condition for both groups. Concomitant to this, we conclude that in the challenging condition, where the base of support is reduced, the HIV group presents greater oscillation (medial-lateral) than the non-HIV group.


INTRODUÇÃO: Alterações motoras são observadas em pessoas vivendo com HIV/AIDS. Essas alterações podem estar associadas à cronicidade da infecção, uso contínuo da medicação antiretroviral e ou pela presença de comorbidades. OBJETIVO: O objetivo do presente estudo foi avaliar a oscilação postural de pessoas vivendo com HIV/AIDS assintomáticos em tratamento com terapia antirretroviral altamente ativa. MÉTODOS: Vinte e sete indivíduos, recrutados em um centro de referência em HIV, com idade entre 30 e 40 anos, participaram do estudo, divididos em dois grupos: grupo HIV (n=12) e grupo não HIV (n=15). Os participantes realizaram uma tarefa experimental, permanecendo em uma plataforma de força em posição estática, em posições de apoio bipodal e semi-tandem, em condições com e sem visão. RESULTADOS: Os resultados demonstraram que a oclusão visual, quando adotada a base bipodal, gerou diferenças significativas na área de oscilação e velocidade média em ambos os grupos. Diferenças também foram observadas na área e velocidade média de ambos os grupos quando a posição semi-tandem foi adotada sem visão. Ao comparar os grupos, foi possível identificar diferenças significativas na base semi-tandem com visão. CONCLUSÃO: Considerando esses resultados, constatou-se que a oscilação postural foi maior na condição de oclusão visual para ambos os grupos. Concomitante a isso, concluímos que na condição desafiadora, onde a base de suporte é reduzida, o grupo HIV apresenta maior oscilação (médiolateral) que o grupo não HIV.


Assuntos
Humanos , Masculino , Feminino , Adulto , Síndrome de Imunodeficiência Adquirida , HIV , Equilíbrio Postural , Atividade Motora
8.
BMC Neurol ; 19(1): 280, 2019 Nov 12.
Artigo em Inglês | MEDLINE | ID: mdl-31718583

RESUMO

BACKGROUND: Parkinson's disease (PD) affects many physiological systems essential for balance control. Recent studies suggest that intensive and cognitively demanding physical exercise programs are capable of inducing plastic brain changes in PD. We have developed a highly challenging balance training (the HiBalance) program that emphasizes critical aspects of balance control through progressively introducing more challenging exercises which incorporates dual-tasking. Earlier studies have shown it to be effective in improving balance, gait and dual-tasking. The study design has thereafter been adjusted to link intervention-induced behavioral changes to brain morphology and function. Specifically, in this randomized controlled trial, we will determine the effects of the HiBalance program on balance, gait and cognition and relate this to task-evoked functional MRI (fMRI), as well as brain-derived neurotrophic factor (BDNF) in participants with mild-moderate PD. METHODS: One hundred participants with idiopathic PD, Hoehn & Yahr stage 2 or 3, ≥ 60 years of age, ≥ 21 on Montreal Cognitive Assessment will be recruited in successive waves and randomized into either the HiBalance program or to an active control group (the HiCommunication program, targeting speech and communication). Both interventions will be performed in small groups, twice a week with 1 h sessions for 10 weeks. In addition, a 1 h, once a week, home exercise program will also be performed. A double-blinded design will be used. At the pre- and post-assessments, participants will be assessed on balance (main outcome), gait, cognitive functions, physical activity, voice/speech function, BDNF in serum and fMRI (3 T Philips) during performance of motor-cognitive tasks. DISCUSSION: Since there is currently no cure for PD, findings of neuroplastic brain changes in response to exercise would revolutionize the way we treat PD, and, in turn, provide new hope to patients for a life with better health, greater independence and improved quality of life. TRIAL REGISTRATION: ClincalTrials.gov: NCT03213873, first posted July 11, 2017.


Assuntos
Terapia por Exercício/métodos , Plasticidade Neuronal , Doença de Parkinson/reabilitação , Projetos de Pesquisa , Idoso , Encéfalo/fisiopatologia , Método Duplo-Cego , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Doença de Parkinson/fisiopatologia , Equilíbrio Postural/fisiologia , Qualidade de Vida
9.
Rev Assoc Med Bras (1992) ; 65(10): 1265-1274, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31721958

RESUMO

OBJECTIVE: We reported our multidisciplinary protocol for the management of fibromyalgia associated with imbalance. Our aim was to verify the effectiveness of a proprioceptive training program as a complementary therapy for a traditional protocol of education, mindfulness, and exercise training for the management of fibromyalgia associated with imbalance. METHODS: Retrospective cohort study on 84 women, with primary fibromyalgia associated to imbalance. A group of patients performed traditional exercise training; in a second group the training was supplemented with proprioception exercises. Each session lasted from 40 to 60 minutes and was performed three times a week for 12 weeks. RESULTS: After three months of training and eight months after the end of the training, the balance evaluation revealed significant differences in the comparison of the Timed Up and Go test, Berg Balance Scale, and Tinetti scale with the baseline, there was a better improvement in the proprioceptive training group (p<0.05). A reduction in pain and improvement in functional and muscular performance and quality of life were observed in both groups (p<0.05), but with no significant differences between them in the Numeric Pain Rating Scale, Fibromyalgia Impact Questionnaire, and Short Form Health Survey (p>0.05). Fifteen months after the end of the program, the effects of training were not maintained. CONCLUSION: The present study revealed that training supplemented with proprioception exercises has beneficial effects on clinical findings and improves balance in patients with fibromyalgia, even if the positive results did not persist after the interruption of the rehabilitative program in the long term.


Assuntos
Terapia por Exercício/métodos , Fibromialgia/terapia , Equilíbrio Postural , Transtornos das Sensações/terapia , Protocolos Clínicos , Feminino , Fibromialgia/complicações , Humanos , Estudos Retrospectivos , Transtornos das Sensações/etiologia , Inquéritos e Questionários
10.
Braz J Med Biol Res ; 52(12): e8474, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31778436

RESUMO

The management of nonspecific lumbar pain (NSLP) using laser irradiation remains controversial. A systematic review of recently published studies indicates that the effects of laser therapy are commonly assessed using only imperfect methods in terms of measurement error. The main objective of this study was to assess static postural stability using an objective tool in patients with chronic NSLP after laser irradiation at different doses and wavelengths. In total, 68 patients were included in the laser sessions and were randomly assigned into four groups: high-intensity laser therapy at 1064 nm and 60 J/cm2 for 10 min (HILT), sham (HILT placebo), low-level laser therapy at 785 nm and 8 J/cm2 for 8 min (LLLT), and sham (LLLT placebo). In addition, all patients were supplemented with physical exercises (standard stabilization training). To assess postural stability, a double-plate stabilometric platform was used. All measurements were performed pre- and post-laser sessions (three weeks) and at follow-up time points (one and three months). Laser procedures led to more balanced posture stability in patients, although these positive changes were significant mainly for short-term observation (after 4-week therapy). In the follow-up analysis, the parameters were gradually impaired. Kruskal-Wallis analysis of variance (ANOVA) for independent variables did not show any difference between the studied groups. Low- and high-intensity laser therapy does not lead to a significant improvement in postural sway in patients with NSLP compared with standard stabilization training based on short- and long-term observations.


Assuntos
Terapia a Laser/métodos , Dor Lombar/radioterapia , Equilíbrio Postural/efeitos da radiação , Adulto , Doença Crônica , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Medição da Dor , Resultado do Tratamento
11.
Medicine (Baltimore) ; 98(48): e17956, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31770204

RESUMO

To investigate whether Kinesio tape (KT) application improves proprioception, balance, and functional performance in patients with anterior cruciate ligament rupture (ACLr).This retrospective analysis included 48 male patients with surgically-untreated ACLr who attended the Sports Medicine and Rehabilitation Center, Qingdao Municipal Hospital, China between June 2017 and June 2018. KT was applied to induce a detoning effect on the quadriceps muscle and toning effect on the ischiocrural muscles. Proprioception, balance, and functional performance were assessed before and 1 and 7 days after KT application using the Lysholm scale, anteroposterior shift of the tibia (APST), active angle reproduction test (AART), modified star excursion balance test (mSEBT), and single-hop distance (SHD).KT resulted in significant improvements in Lysholm scale at 1 day (83.00 [6.50] vs. 76.00 [5.25], P < .001) and APST (8.00 [2.00] vs. 10.00 [2.00] mm, P < .001), AART (3.00 [1.00] vs. 4.00 [1.75] degrees, P < .001), SEBT (96.08 [6.62] vs. 83.92 [7.31] %, P < .001) and SHD (120.96 [6.94] vs. 106.46 [9.03] %, P < .001) at 3 hours (median [interquartile range]). However, significant deficits remained when compared with the healthy side. Except for mSEBT posterolateral direction, those effects were maintained at 7 days.KT has benefits in people with ACLr but cannot fully compensate for functional deficits. KT could be used to assist knee strengthening during rehabilitation.


Assuntos
Lesões do Ligamento Cruzado Anterior/fisiopatologia , Lesões do Ligamento Cruzado Anterior/terapia , Fita Atlética , Desempenho Físico Funcional , Equilíbrio Postural/fisiologia , Propriocepção/fisiologia , Adolescente , Adulto , Humanos , Masculino , Estudos Retrospectivos , Ruptura , Resultado do Tratamento , Adulto Jovem
12.
Clin Interv Aging ; 14: 1567-1577, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31695345

RESUMO

Purpose: Exercise programs designed for falls prevention have been proven effective in reducing falls by approximately 21%. Virtual reality may provide a viable alternative intervention for falls prevention. This study compared the effects of virtual reality training using the Balance Rehabilitation Unit (BRU) versus exercise using a modified Otago Exercise Programme (EX) on improving balance and physical performance in the short-term restorative care setting of the Gait and Balance Gym (Gabagym). Patients and methods: This was a pre- and post-intervention study of 195 participants (median age 78 years, IQR 73-84; 67% female) who presented with a risk and/or history of falls. Participants were assigned to either EX (n=82) or BRU (n=63). Supervised sessions occurred twice a week for 6 weeks. Participants receiving interventions were compared to a separate group (n=50) with similar characteristics who did not receive any intervention. Balance and physical performance were assessed at initial and final attendance and included the 5 Times Sit to Stand (5STS) test, Timed Up and Go (TUG), gait speed and posturography assessment using the BRU. Fear of falling was assessed using the Falls Efficacy Scale. Handgrip strength and adherence were also monitored. Results: Post-intervention, EX and BRU groups achieved similar improvements and reported similar adherence rates (71% vs 72%, respectively). Both intervention groups improved in balance and physical performance measures. Both interventions showed significantly better improvement than the non-intervention group in TUG (p<0.001), gait speed (p=0.021), limits of stability in posturography assessment (p=0.008), FES-I score (p=0.013) and handgrip strength (p=0.021). Only the BRU group improved control of static posture in the eyes closed (p=0.002) and foam eyes closed (p=0.006) tasks. Conclusion: This study highlights the potential use of virtual reality as a practical alternative to improve outcomes of balance training for reduction of falls risk in older adults.


Assuntos
Acidentes por Quedas/prevenção & controle , Exercício , Condicionamento Físico Humano/métodos , Condicionamento Físico Humano/fisiologia , Equilíbrio Postural , Realidade Virtual , Idoso , Idoso de 80 Anos ou mais , Medo , Feminino , Força da Mão , Humanos , Masculino , Desempenho Físico Funcional , Velocidade de Caminhada
13.
Medicine (Baltimore) ; 98(45): e17880, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31702659

RESUMO

BACKGROUND: Osteoarthritis (OA) is a degenerative disease that not only causes knee pain in older adults, but also has an adverse effect on walking. Therefore, intervention for older patients with OA is important. To investigate the immediate effects of kinesiology taping (KT) on the pain and gait function of the older adults with knee OA. METHODS: This study enrolled 10 older adults individuals living in the community who were diagnosed with knee OA. All participants were assessed for knee pain, walking ability, and balance before and after application of knee KT. Knee pain was assessed in resting and walking conditions using the visual analog scale. Walking and balance were assessed using a 10-m walking test and a timed up and go test. RESULTS: In the present study, KT significantly improved gait and balance with reduction in knee pain during walking than non-KT (P < .05). CONCLUSIONS: This study demonstrated that knee KT has a positive effect on pain reduction and walking and balance ability of the older adults with OA. Therefore, this study suggests that KT can be used as an intervention to relieve knee pain and aid walking and balance ability in the older adult.


Assuntos
Fita Atlética , Marcha/fisiologia , Osteoartrite do Joelho/terapia , Manejo da Dor/métodos , Idoso , Estudos Controlados Antes e Depois , Teste de Esforço/métodos , Humanos , Pessoa de Meia-Idade , Equilíbrio Postural/fisiologia , Resultado do Tratamento , Escala Visual Analógica
14.
Medicine (Baltimore) ; 98(45): e17946, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31702684

RESUMO

BACKGROUND: Adaptive balance control is often compromised in children with developmental coordination disorder (DCD). Neuromuscular training (NMT) is commonly used in clinical settings to improve neuromuscular control and hence balance performance in these children. However, its effectiveness has not been proven scientifically. This randomized controlled study aimed to explore the effectiveness of NMT for improving adaptive balance performance and the associated leg muscle activation times in children with DCD. METHODS: Eighty-eight children with DCD were randomly assigned to the NMT or control group (44 per group). The NMT group received two 40-minute NMT sessions/week for 3 months, whereas the control group received no intervention. The outcomes were measured at baseline and 3 and 6 months. The primary outcome was the sway energy score (SES) in both the toes-up and toes-down conditions as derived using the Adaptation Test (ADT). Secondary outcomes included the medial gastrocnemius, medial hamstring, tibialis anterior and rectus femoris muscle activation onset latencies during ADT, measured using surface electromyography and accelerometry. Data were analyzed using a repeated measures analysis of covariance based on the intention-to-treat principle. RESULTS: At 3 months, no significant within-group or between-group differences were noted in the SESs for either group. At 6 months, the toes-down SES decreased by 6.8% compared to the baseline value in exclusively the NMT group (P = .004). No significant time, group or group-by-time interaction effects were observed in any leg muscle activation outcomes. CONCLUSIONS: Short-term NMT failed to improve adaptive balance performance and leg muscle activation times in children with DCD. Further studies should explore the clinical applications of longer-term task-specific interventions intended to improve the adaptive balance performance of these children.


Assuntos
Terapia por Exercício/métodos , Transtornos das Habilidades Motoras/reabilitação , Equilíbrio Postural , Adaptação Fisiológica , Criança , Eletromiografia , Feminino , Humanos , Masculino , Método Simples-Cego , Resultado do Tratamento
15.
J Sports Sci ; 37(24): 2853-2862, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31613172

RESUMO

The objective of this study was to determine the effect of Kinesio Taping (KT), alone or together with balance exercises (BE), on parameters related to postural control, such as dynamic balance, static balance and flexibility. Forty-four male amateur soccer players (mean age 24.45 (4.79) years) were randomly allocated to 3 groups: KT+BE that received KT and BE (n = 16); KTp+BE, in which the KT was used as a placebo (n = 15) and KT alone (n = 13). The intervention period lasted 4 weeks. Star Excursion Balance Test (SEBT), Unipedal Stance Test (UST) and the Toe Touch Test (TTT) were assessed at baseline (pre), two weeks after beginning the treatment (mid) and after the intervention (post). We observed a significant improvement on the SEBT (mid and post-treatment) and the UST (post-treatment), but not on the TTT in either KT+BE or KTp+BE groups post treatment. No differences were found either in KT group at any time point or between groups in any variable studied. In conclusion, KT functional correction technique does not improve static and dynamic balance when applied alone, whereas BE alone or combined with KT significantly improves these variables. None of these techniques has any effect on flexibility. Abbreviation: KT: Kinesiotaping; BE: Balance exercises; KTp: Placebo Kinesiotaping; UST: Unipedal Stance Test; SEBT: Star Excursion Balance Test; TTT: Toe Touch Test.


Assuntos
Fita Atlética , Equilíbrio Postural , Propriocepção , Futebol/fisiologia , Adulto , Atletas , Método Duplo-Cego , Humanos , Masculino , Adulto Jovem
16.
J Frailty Aging ; 8(4): 186-191, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31637404

RESUMO

BACKGROUND: With increasing interest in addressing quality of life of older individuals, tests such as the Functional Independence Measure (FIM) are widely used measures of infirmity and burden of care. However, these scales are largely qualitative and especially problematic when assessing movement-based tasks. While effective, reliable analysis of human movement is technically complicated and expensive; an infrared depth sensor is potentially a low-cost, portable devise which may provide a quantitative aspect to clinical testing. OBJECTIVE: to assess the utility of the KinectTM sensor in providing an objective evaluation of human movement using an oft measured ADL (chair stand). DESIGN: Cross-sectional study. SETTING: Community, geriatric day-care center in Japan. PARTICIPANTS: Men (n=136) and women (n=266) between 50 and 93 years of age, consisting of healthy (HE; n=312) and physically frail (FR; n= 90) individuals. MEASUREMENTS: Subjects completed two trials of the chair stand, conducted without assistance. Trials were timed and recorded with KinectTM v2. Coronal plane angle (CPA) was determined by a line transecting the shoulder-center and waist relative to the vertical axis and was used to assess quality of the chair stand movement pattern. RESULTS: Age, height, and body mass were not different between groups. CPA was significantly greater in FR (29.3 ± 8.3°) than HE (19.5 ± 6.5°). CPA and age were significantly related (r=0.148, p<0.01). An optimal threshold for CPA identifying frailty was determined by a receiver-operator characteristic curve with a CPA of 23.1° providing the greatest combination of sensitivity (79%) and specificity (73%). CONCLUSION: During the chair stand, frail older adults adopted a forward lean position (increased CPA) compared to healthy older adults. This compensatory posture appears to facilitate torso rotation while reducing lower-limb muscular effort during standing. As such, CPA serves as an indicator of reduced lower-body function in older, frail adults.


Assuntos
Avaliação Geriátrica/métodos , Desempenho Físico Funcional , Equilíbrio Postural , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Feminino , Idoso Fragilizado , Humanos , Japão , Masculino , Pessoa de Meia-Idade
17.
Turk J Ophthalmol ; 49(5): 243-249, 2019 10 24.
Artigo em Inglês | MEDLINE | ID: mdl-31650790

RESUMO

Objectives: To investigate the impact of phacoemulsification surgery and intraocular lens implantation on the functional balance skills of adults. Materials and Methods: This prospective study included patients with cataract who were recommended phacoemulsification surgery and intraocular lens implantation between May and October 2016. The Berg Balance Scale and Tinetti Gait and Balance Test were performed by a physical therapy specialist before and 1 month after surgery. Patients were analyzed in terms of age, visual acuity, and balance. Balance scores before and after cataract surgery were compared. We also compared patients with high (≤2 LogMAR) and low (>2 LogMAR) visual acuity. P values below 0.05 were accepted as statistically significant. Results: Fifty-one patients (27 female and 24 male, mean age 66.96 years) were included in the study. One month after surgery, the patients' Berg Balance scores and Tinetti Gait and Balance scores were increased by 3.60±5.00% and 4.14±6.55%, respectively. Postoperative increase in visual acuity was significantly greater in the 16 patients with visual acuity less than 0.05 (>2 LogMAR) (p=0.036), but balance scores were not significantly different. Conclusion: Visual acuity is significantly improved one month after cataract surgery, which also leads to significant increases in low functional balance scores among patients with poorer vision. The rapid increase in vision after cataract surgery enhances balance skills, resulting in safer mobility and increased quality of life.


Assuntos
Extração de Catarata , Marcha/fisiologia , Equilíbrio Postural/fisiologia , Pseudofacia/fisiopatologia , Qualidade de Vida , Acuidade Visual , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Período Pós-Operatório , Estudos Prospectivos , Pseudofacia/psicologia , Inquéritos e Questionários
18.
Int J Sports Med ; 40(13): 871-875, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31590189

RESUMO

High amounts of sitting increase the risk of non-communicable disease and mortality. Treadmill desks make it possible to reduce sitting during the desk-based worker's day. This study investigated the acute effect on postural stability of interrupting prolonged sitting with an accumulated 2-h of light-intensity treadmill desk walking. Twenty-one sedentary adults participated in this randomized acute crossover trial, with two 6.5 h conditions: 1) uninterrupted sitting and 2) interrupted sitting with accumulated 2 h light-intensity treadmill desk walking. Pre- and post-condition, participants performed four postural stability tests on a pressure plate (bipedal and unipedal standing stance, eyes open and eyes closed). Anteroposterior center of pressure amplitude showed a significant condition x time interaction in bipedal eyes closed (F(1,20)=4.62, p=0.046) and unipedal eyes open (F(1,20)=9.42, p=0.006) tests, and mediolateral center of pressure amplitude in bipedal eyes closed (F(1,20)=6.12, p=0.023) and bipedal eyes open (F(1,12)=5.55, p=0.029) tests. In the significant interactions, amplitude increased pre to post condition in the uninterrupted sitting condition. The accumulated 2 h light-intensity treadmill desk walking ameliorated the negative effect of 6.5 h prolonged sitting on postural sway, supporting workplace treadmill desk use.


Assuntos
Ergometria/instrumentação , Equilíbrio Postural/fisiologia , Postura Sentada , Caminhada/fisiologia , Local de Trabalho , Adulto , Estudos Cross-Over , Feminino , Humanos , Decoração de Interiores e Mobiliário , Masculino , Pessoa de Meia-Idade , Saúde do Trabalhador , Análise e Desempenho de Tarefas
19.
Medicine (Baltimore) ; 98(39): e17317, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31574862

RESUMO

INTRODUCTION: Stroke is the principal cause of impairment in the motor function and gait of adults. One of the resources used in rehabilitation to optimize gait is a prescription of ankle-foot orthosis (AFO), and the most prescribed AFOs are Fixed AFO and Articulated AFO; however, it is not known which of these options is more effective for these individuals. The aim of this study is to evaluate the impact of different types of ankle-foot orthosis functional mobility and dynamic balance in stroke patients. METHODS: Prospective randomized controlled clinical trial with 2 parallel groups will be conducted, and the aim is to recruit 50 patients with stroke diagnosis within 1 year, who indicated that they use both types of orthotics, who had a previous Rankin score less than or equal to 3, and who obtained AFO orthosis through the Hospital Clinics at the Botucatu Medical School (HCBMS) São Paulo, Brazil. After a specific evaluation by a physiotherapist, the patient will receive 1 of the AFO types via randomization. After 30 days, the patient will be reevaluated. The primary outcomes will be balance and mobility, which will be evaluated by the Time Up Go Test (TUG) and Tinetti's Scale of Mobility and Balance (TSMB). The secondary outcomes will be quality of life and the levels of anxiety and depression, which will be evaluated with the European (5D) Quality of Life Scale (Euroqol) and Hospital Anxiety and Depression Scale (HADS). Group allocation will be not concealed because the blinding of participants and of therapists that provide intervention is not possible, and all analyses will be based on an intention-to-treat principle. This study was approved by the Human Research Ethics Committee of the São Paulo State University UNESP, number 2.367.953. The results will be published in relevant journal. DISCUSSION: The results of this study will contribute to clinical practice by identifying the type of AFO orthosis that is more suitable for this condition, helping to standardize prescription of these orthoses by professionals, and guiding future research studies on this subject, which is still incompletely defined in the literature. TRIAL REGISTRATION: RBR-6SF2VV (March 5, 2018).


Assuntos
Tornozelo/fisiopatologia , Órtoses do Pé/normas , Transtornos Neurológicos da Marcha , Qualidade de Vida , Reabilitação do Acidente Vascular Cerebral , Adulto , Articulação do Tornozelo/fisiopatologia , Fenômenos Biomecânicos , Desenho de Equipamento , Feminino , Transtornos Neurológicos da Marcha/etiologia , Transtornos Neurológicos da Marcha/terapia , Humanos , Masculino , Equilíbrio Postural , Amplitude de Movimento Articular , Recuperação de Função Fisiológica , Acidente Vascular Cerebral/complicações , Reabilitação do Acidente Vascular Cerebral/instrumentação , Reabilitação do Acidente Vascular Cerebral/métodos , Reabilitação do Acidente Vascular Cerebral/psicologia
20.
Medicine (Baltimore) ; 98(42): e17505, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31626106

RESUMO

The purpose of the study was to identify risk factors of cage subsidence and evaluate surgical outcome by at least 12 months postoperative follow-up.We retrospectively investigated 113 consecutive patients who underwent anterior surgery to relieve spine cord compression resulted from localized heterotopic ossification, from July, 2011 to February, 2016. We divided the patients into 2 groups: cage subsidence <2 mm group and ≥2 mm group. According to magnetic resonance imaging (MRI), the severity of increased signal intensity (ISI) was classified into grade 0, 1, and 2. Clinical outcome was assessed by the Japanese Orthopedic Association (JOA) scoring system. Logistic regression analysis and receiver-operating characteristic (ROC) curve were utilized for predicting risk factors of cage subsidence, and the recovery rate was evaluated by Kruskal-Wallis test or Mann-Whitney U test.Logistic regression with cage subsidence as the dependent variable showed independent risks associated with a cervical sagittal malalignment (odds ratio [OR] 11.23, 95% confidence interval [CI] 3.595-35.064, P < .001), thoracic 1 (T1) slope angle (OR 1.59, 95% CI 1.259-1.945, P < .001), and excisional thickness (OR 2.38, 95% CI 1.163-4.888.0, P = .018). The cut-off values of T1 slope and excisional thickness were 19.65 angle and 3.7 mm, respectively. Patients with high occupying ratio (P = .001) and high ISI grade (P = .012) are more likely to occur lower recovery rate.Patients with high T1 slope angle or preoperative kyphotic deformity should avoid excessive removal of endplate and vertebral body so as to reduce the occurrence of cage subsidence. Poor outcome was closely related to cervical sagittal malalignment and higher ISI grade.


Assuntos
Discotomia/efeitos adversos , Ossificação Heterotópica/cirurgia , Complicações Pós-Operatórias/etiologia , Compressão da Medula Espinal/cirurgia , Fusão Vertebral/efeitos adversos , Vértebras Cervicais/cirurgia , Discotomia/métodos , Feminino , Seguimentos , Humanos , Cifose/fisiopatologia , Cifose/cirurgia , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Ossificação Heterotópica/fisiopatologia , Complicações Pós-Operatórias/epidemiologia , Equilíbrio Postural , Estudos Retrospectivos , Caixa Torácica/cirurgia , Fatores de Risco , Compressão da Medula Espinal/fisiopatologia , Fusão Vertebral/métodos , Resultado do Tratamento
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