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1.
PLoS Negl Trop Dis ; 18(10): e0012537, 2024 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-39374305

RESUMO

INTRODUCTION: Leprosy is a chronic, slowly developing infectious disease that affects the peripheral nerves, specifically Schwann cells. Individuals with the multibacillary type exhibit a propensity for developing chronic pain and a decrease in sensitivity in the plantar region, which directly interferes with balance maintenance. The evaluation of static balance in this population is made through the measurement of the center of pressure (COP) oscillations. Therefore, there is a need to investigate the association between postural control and COP oscillations using a force platform and finding accelerations of the center of mass (COM) from inertial sensors for reliable and portable balance assessment in leprosy patients. OBJECTIVE: To validate the application of inertial sensors for patients with leprosy by establishing a correlation with the outcomes obtained from a force platform. METHODS: This is an observational study with a case-control design, in which 30 participants with leprosy and 30 healthy participants were recruited to evaluate static balance using an inertial sensor and a force platform. Participants underwent balance assessment under two conditions (Eyes Open: OE and Eyes Closed: CE), and data from the platform and sensor were processed using Matlab computational routines. The data were quantified using four parameters: Total Displacement (TD), Area, Antero-Posterior Displacement (APdisp), and Medio-Lateral Displacement (MLdisp). RESULTS: The evaluated parameters showed significantly different values between the groups, where the Leprosy group exhibited significantly higher values compared to the control group, both in the OE and CE conditions for all four parameters. The sensor corroborated the differences demonstrated by the platform and followed the same trend for medio-lateral displacements and accelerations. It can be observed that the evaluated parameters exhibited a varied correlation ranging from moderate to large between the platform and the sensor. Among the four variables, MLdisp had the lowest correlation. DISCUSSION: The results partially confirmed the first hypothesis of concurrent validation, showing a moderate to large correlation between the force platform and the inertial sensor. The second hypothesis of clinical validation was also partially confirmed, as not all group differences observed in the COP measurements from the force platform were reflected in the COM measurements from the inertial sensor. Specifically, the force platform indicated greater oscillations in participants with multibacillary leprosy compared to controls, a finding statistically confirmed by the sensor for all measures except MLdisp. CONCLUSION: This research confirmed the concurrent validity of the inertial sensor with the force platform and its clinical validation, demonstrating that this instrument can be applied in clinical settings due to its low cost and ease of use. The findings may contribute to public health by identifying postural control tools for patients with multibacillary leprosy.


Assuntos
Hanseníase Multibacilar , Equilíbrio Postural , Humanos , Equilíbrio Postural/fisiologia , Masculino , Adulto , Feminino , Pessoa de Meia-Idade , Hanseníase Multibacilar/diagnóstico , Hanseníase Multibacilar/fisiopatologia , Estudos de Casos e Controles , Adulto Jovem
2.
Arq Neuropsiquiatr ; 82(11): 1-10, 2024 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-39317226

RESUMO

BACKGROUND: Peripheral vestibular hypofunction (PVH) is characterized by balance and gait disorders and vestibulo-autonomic findings. The vestibular system and proprioceptive system work together to regulate sensorimotor functions. Vestibular exercises are effective in PVH, but their superiority over each other is still unclear. OBJECTIVE: This study aims to examine the effect of proprioceptive vestibular exercises on patients with PVH. METHODS: 30 individuals with unilateral PVH were assigned to 3 groups. Group 1 received proprioceptive vestibular rehabilitation, group 2 received standard vestibular rehabilitation. Both groups were given standard vestibular exercises as home exercises. No exercise was applied to the group 3. Patients were evaluated in terms of balance, functional mobility, posture, sensory profile, and quality of life. RESULTS: Although there was a significant intra-group difference in balance, functional mobility, and quality of life results in all groups (p < 0.05), the difference between groups was generally in favor of group 1 (p < 0.05). There was a significant difference between the groups in the posture analysis results (p < 0.05), while there was a significant difference in the 1st group (p < 0.05). There was a significant difference between the groups in the results of sensory sensitivity, sensory avoidance, and low recording (p < 0.05). There was no significant difference between the groups in sensory-seeking results (p > 0.05). There was a significant difference in quality of life between and within groups (p < 0.05). CONCLUSION: Proprioceptive vestibular rehabilitation is an effective method in PVH. We think that our study will guide clinicians and contribute to the literature. TRIAL REGISTRATION: NCT04687371.


ANTECEDENTES: A hipofunção vestibular periférica (HVP) é caracterizada por distúrbios do equilíbrio e da marcha e achados vestíbulo-autonômicos. O sistema vestibular e o sistema proprioceptivo trabalham juntos para regular as funções sensório-motoras. Os exercícios vestibulares são eficazes na HVP, mas sua superioridade entre si ainda não está clara. OBJETIVO: Este estudo tem como objetivo examinar o efeito de exercícios vestibulares proprioceptivos em pacientes com HVP. MéTODOS: Trinta indivíduos com HVP unilateral foram divididos em três grupos. O grupo 1 recebeu reabilitação vestibular proprioceptiva, o grupo 2 recebeu reabilitação vestibular padrão. Ambos os grupos receberam exercícios vestibulares padrão como exercícios caseiros. Nenhum exercício foi aplicado ao grupo 3. Os pacientes foram avaliados quanto a equilíbrio, mobilidade funcional, postura, perfil sensorial e qualidade de vida. RESULTADOS: Embora tenha havido uma diferença significativa intragrupo nos resultados de equilíbrio, mobilidade funcional e qualidade de vida em todos os grupos (p < 0,05), a diferença entre os grupos foi geralmente a favor do grupo 1 (p < 0,05). Houve diferença significativa entre os grupos nos resultados da análise postural (p < 0,05), embora tenha havido diferença significativa no 1° grupo (p < 0,05). Houve diferença significativa entre os grupos nos resultados de sensibilidade sensorial, esquiva sensorial e baixo registro (p < 0,05). Não houve diferença significativa entre os grupos nos resultados de busca sensorial (p > 0,05). Houve diferença significativa na qualidade de vida entre e dentro dos grupos (p < 0,05). CONCLUSãO: A reabilitação vestibular proprioceptiva é um método eficaz na HVP. Acreditamos que nosso estudo orientará os médicos e contribuirá para a literatura. REGISTRO DE TESTE: NCT04687371.


Assuntos
Terapia por Exercício , Equilíbrio Postural , Propriocepção , Qualidade de Vida , Doenças Vestibulares , Humanos , Masculino , Feminino , Equilíbrio Postural/fisiologia , Doenças Vestibulares/reabilitação , Doenças Vestibulares/fisiopatologia , Pessoa de Meia-Idade , Terapia por Exercício/métodos , Adulto , Propriocepção/fisiologia , Resultado do Tratamento , Idoso
3.
Clinics (Sao Paulo) ; 79: 100504, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-39321635

RESUMO

BACKGROUND: Acknowledging the relationship between postural control and muscle strength in lower limbs is important to find persons with high fall risk and to design fall prevention exercise programs. OBJECTIVE: To investigate the connection between knee muscle strength, semi-static postural balance, and functional mobility in irregularly active older women. METHODS: One hundred and ten older women aged 60 to 85 years underwent a semi-static postural balance test in a force and functional mobility measured by Timed Up & Go (TUG) with and without Cognitive Tasks (CT). Muscle strength of the knee was assessed by isokinetic dynamometry at 60°/s. RESULTS: A negative correlation between the functional mobility (TUG with and without CT) and the muscular strength of the knee was observed. Regarding semi-static balance, there was a low negative correlation with peak torque corrected for body weight of the extensors with the following variables with eyes open: Mean Velocity Dominant limb (D) (r = -0.19; p = 0.03); and anteroposterior range Non-Dominant limb (ND) (r = -0.19; p = 0.04); with eyes closed: mediolateral range ND limb (r = -0.21; p = 0.02) and Mean Velocity ND limb (r = -0.18; p = 0.05). CONCLUSIONS: This study found that better functional mobility was associated with greater muscle strength in the knee in elderly women. There were weak negative correlations between knee extensor strength and some measures of semi-static postural balance, suggesting that different motor control actions are required to maintain semi-static balance and mobility. In the case of semi-static balance, a lower level of muscle response is required than in functional mobility.


Assuntos
Acidentes por Quedas , Força Muscular , Equilíbrio Postural , Humanos , Equilíbrio Postural/fisiologia , Feminino , Força Muscular/fisiologia , Idoso , Estudos Transversais , Idoso de 80 Anos ou mais , Pessoa de Meia-Idade , Acidentes por Quedas/prevenção & controle , Avaliação Geriátrica/métodos , Valores de Referência , Joelho/fisiologia
4.
J Gerontol A Biol Sci Med Sci ; 79(11)2024 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-39329896

RESUMO

BACKGROUND: This study aimed to determine the threshold of muscle power and strength enhancements that lead to functional gains after exercise intervention in an acute care unit. METHODS: A total of 302 older patients (intervention: 169, control: 133) from 2 randomized clinical trials were included (mean age: 86.7 years). We measured maximal strength (1RM) and muscle power via a velocity transducer during leg press exercise at 30% and 60% of 1RM. A multicomponent exercise program, including power training, balance, and gait exercises performed over 3 to 6 consecutive days, served as the intervention. We used an anchor-based method to correlate muscle function increases with the Short Physical Performance Battery (SPPB) and gait velocity (GVT) to define clinically meaningful improvements. RESULTS: In the intervention group, marked differences were found in maximal power at 30% of 1RM between SPPB responders and nonresponders (relative 83.5% vs 34.8%; absolute 33.0 vs 12.8 W; p < .05) and at 60% of 1RM (relative 61.1% vs 22.4%; p < .05). GVT responders demonstrated significantly greater improvements in both relative and absolute maximal power than nonresponders at both 30% and 60% of 1RM (p < .05), as well as greater absolute 1RM gains (21.2 vs 15.2 kg, p < .05). Clinically meaningful improvements for muscle power based on SPPB and GVT ranged from 30.2% to 48.7%, whereas for 1RM, it was 8.2% based on GVT. CONCLUSIONS: Muscle power gains were most notable in patients with improvements in the SPPB and GVT, highlighting the critical role of muscle power in functional recovery in these patients.


Assuntos
Força Muscular , Humanos , Força Muscular/fisiologia , Masculino , Feminino , Idoso de 80 Anos ou mais , Idoso , Terapia por Exercício/métodos , Hospitalização , Equilíbrio Postural/fisiologia , Treinamento Resistido/métodos , Músculo Esquelético/fisiopatologia , Músculo Esquelético/fisiologia , Avaliação Geriátrica/métodos
5.
J Mot Behav ; 56(6): 655-664, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-39114919

RESUMO

Reciprocal inhibition and coactivation are strategies of the central nervous system used to perform various daily tasks. In automatic postural responses (APR), coactivation is widely investigated in the ankle joint muscles, however reciprocal inhibition, although clear in manipulative motor actions, has not been investigated in the context of APRs. The aim was to identify whether reciprocal inhibition can be observed as a strategy in the recruitment of gastrocnemius Medialis (GM), Soleus (So) and Tibialis Anterior (TA) muscles in low- and high-velocity forward and backward perturbations. We applied two balance perturbations with a low and a high velocity of displacement of the movable platform in forward and backward conditions and we evaluated the magnitude and latency time of TA, GM and So activation latency, measured by electromyography (EMG). In forward perturbations, coactivation of the three muscles was observed, with greater activation amplitude of the GM and lesser amplitude of the So and TA muscles. For backward, the pattern of response observed was activation of the TA muscle, a decrease in the EMG signal, which characterizes reciprocal inhibition of the GM muscle and maintenance of the basal state of the So muscle. This result indicates that backward perturbations are more challenging.


Assuntos
Tornozelo , Eletromiografia , Músculo Esquelético , Equilíbrio Postural , Humanos , Músculo Esquelético/fisiologia , Masculino , Adulto , Tornozelo/fisiologia , Equilíbrio Postural/fisiologia , Adulto Jovem , Feminino , Articulação do Tornozelo/fisiologia
6.
Codas ; 36(5): e20230241, 2024.
Artigo em Português, Inglês | MEDLINE | ID: mdl-39109754

RESUMO

PURPOSE: Propose normalization values of the Horus® computerized posturography platform, in children aged 4 to 6 years, without auditory and/or vestibular complaints. METHODS: Cross-sectional study, 216 children aged 4 to 6 years participated. All the children underwent to visual screening, audiological evaluation and computerized posturography, which consists of research on stability limits and seven sensory conditions. The results were statistically analyzed using the tests non-parametric Kruskal-Walli, post hoc Dunn-Bonferroni for pairwise age comparisons and the Mann-Whitney U for sex analysis. Categorical data were presented in relative frequency and quantitative data in mean and standard deviation. RESULTS: Standardization values were described for the stability limit and for the seven sensory conditions. There was a difference for the stability limit between sex at 4 years old(p<0.007) and, in the comparison between ages 4 and 5 (p=0.005) and 4 and 6 years old(p<0.001). In the residual functional balance, comparison between ages, there was a difference between 4 and 5, 4 and 6, 5 and 6 years, however for different data. The presence of statistical difference for different evaluation data also occurred in the analysis by sex. In the sensory systems, the findings between ages showed differences for the vestibular system, right and left optokinetic visual dependence, tunnel visual dependence and for the composite balance index. CONCLUSION: It was possible to establish normative values for the Horus® posturography in healthy children aged 4 to 6 years.


OBJETIVO: Propor valores de normatização da plataforma de posturografia computadorizada Horus®, em crianças de 4 a 6 anos, sem queixas auditivas e/ou vestibulares. MÉTODO: Estudo transversal. Participaram 216 crianças na faixa etária de 4 a 6 anos. Todas realizaram triagem visual, avaliação auditiva e posturografia computadorizada composta por pesquisa do limite de estabilidade e sete condições sensoriais. Analisaram-se os resultados estatisticamente por testes não paramétrico Kruskal-Walli, post hoc Dunn-Bonferroni para comparações par-a-par nas idades e U de Mann-Whitney para análise entre sexo. Os dados categóricos foram apresentados em frequência relativa e os dados quantitativos pela média e desvio padrão. RESULTADOS: Foram descritos valores de normatização para o limite de estabilidade e para as sete condições sensoriais. Houve diferença para o limite de estabilidade entre sexos aos 4 anos (p<0,007) e, na comparação entre as idades 4 e 5 anos (p=0,005) e 4 e 6 anos (p<0,001). No equilíbrio funcional residual, comparação entre idades, houve diferença entre 4 e 5, 4 e 6 e, 5 e 6 anos, entretanto para diferentes dados. A presença de diferença estatística para diferentes dados da avaliação, ocorreu também na análise por sexo. Nos sistemas sensoriais os achados entre idades mostraram diferença para o sistema vestibular, dependência visual optocinética direita e esquerda, dependência visual túnel e para índice de equilíbrio composto. Sugere-se que para esta população, as respostas na posturografia sejam analisadas por faixa etária e sexo. CONCLUSÃO: Foi possível estabelecer valores normativos para a posturografia Horus® em crianças hígidas na faixa etária de 4 a 6 anos.


Assuntos
Equilíbrio Postural , Humanos , Estudos Transversais , Pré-Escolar , Masculino , Feminino , Valores de Referência , Criança , Equilíbrio Postural/fisiologia , Testes de Função Vestibular/métodos , Testes de Função Vestibular/instrumentação , Testes de Função Vestibular/normas , Diagnóstico por Computador/normas , Diagnóstico por Computador/métodos
7.
PLoS One ; 19(8): e0306816, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-39172915

RESUMO

BACKGROUND: Exergames are a fun, viable, attractive, and safe way to engage in physical exercise for most patient populations, including older adults. Their use in the home environment enables an expanded understanding about its applicability and its impact on clinical outcomes that can contribute to improved functionality and quality of life in this population. This systematic review aimed to synthesize the evidence on the usability of exergames as a tool for home-based balance training in older adults. METHODS: The search was realized in 6 electronic databases and were included 1) randomized controlled trials with exergames home-based training as intervention, 2) studies involving older adults (aged 60 years or older) described as having impaired static or dynamic balance, 3) that compared the effects of exergames to usual care, health education or no intervention, and 4) reported usability and balance outcomes. The Cochrane Risk of Bias tool for randomized trials version 2 and the Grading of Recommendations Assessment, Development, and Evaluation were used to evaluate the methodological quality of studies and levels of evidence for outcomes. RESULTS: After screening 1107 records, we identified 4 trials were included. The usability score of exergames was classified as an acceptable, good, and feasible tool. The pooled effect indicated improvements in favor of the exergame group for functional balance by TUG test (MD = -5.90; 95%CI = -10.29 to -1.51) with low-certainty evidence and Tinetti scale (MD = 4.80; 95%CI = 3.36 to 6.24) with very low-certainty evidence. Analyzing the different immersion level, it was observed a significant difference in the experimental group for the immersive exergames (MD = -9.14; 95%CI = -15.51 to -2.77) with very low-certainty evidence. CONCLUSION: Exergames applied at home showed good usability and had significant effects on functional balance compared to usual care or no intervention, especially in the immersive modality. TRIAL REGISTRATION: PROSPERO registration number: CRD42022343290.


Assuntos
Terapia por Exercício , Equilíbrio Postural , Jogos de Vídeo , Humanos , Equilíbrio Postural/fisiologia , Idoso , Terapia por Exercício/métodos , Pessoa de Meia-Idade , Qualidade de Vida , Ensaios Clínicos Controlados Aleatórios como Assunto , Masculino , Exercício Físico/fisiologia , Feminino
8.
Phys Ther ; 104(10)2024 Oct 02.
Artigo em Inglês | MEDLINE | ID: mdl-39109828

RESUMO

OBJECTIVE: The objective was to describe the social, environmental, and cultural adaptations to an existing falls program and assess acceptability and preliminary effectiveness of the program in reducing fear, reducing falls, and improving function among individuals poststroke in Guyana. METHODS: A quasi-experimental pilot study with a pretest/posttest in-group design was developed through a collaboration of researchers in Guyana and the US. Participants took part in the falls prevention program for 8 weeks. Outcome measures included a 10-m walk test, the Five Times Sit to Stand Test, and subjective questionnaires for falls incidence and balance confidence at the beginning and end. RESULTS: Twenty participants completed the study. One participant experienced medical complications, and their data were excluded from analysis. Fifteen participants (78.9%) demonstrated improvements in comfortable and fast walking speed. Twelve participants completed the Five Times Sit to Stand Test. Eleven (91.67%) improved their time at the posttest, with 9 (81.8%) demonstrating a clinically important improvement. Nineteen participants had sustained at least 1 fall prior to the study. Only 1 participant reported a fall during the program. Initially, the majority of participants (11/19) were very concerned about falling. At the end, only 1 was very concerned about falling, and the majority (15/19) were not concerned at all. Posttest surveys of participants indicated acceptability of the program. CONCLUSIONS: This pilot program helped reduce fall risk and improve confidence, gait speed, and community mobility of the study participants. Future research at other rehabilitation departments in Guyana would help increase the generalizability of the program. IMPACT: The program can be used clinically by physical therapists in Guyana, both in departments and as a home program. Shared knowledge and experience of researchers considering research evidence and the environmental, social, and economic conditions of people living in Guyana were important in developing an effective program.


Assuntos
Acidentes por Quedas , Equilíbrio Postural , Reabilitação do Acidente Vascular Cerebral , Humanos , Acidentes por Quedas/prevenção & controle , Guiana , Masculino , Feminino , Projetos Piloto , Pessoa de Meia-Idade , Equilíbrio Postural/fisiologia , Reabilitação do Acidente Vascular Cerebral/métodos , Idoso , Cooperação Internacional , Acidente Vascular Cerebral/prevenção & controle , Estados Unidos
10.
Physiother Res Int ; 29(4): e2114, 2024 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-39138839

RESUMO

BACKGROUND AND PURPOSE: Assessing lower limb strength, balance, and fall risk are crucial components of rehabilitation, especially for the older adult population. With the growing interest in telehealth, teleassessment has been investigated as an alternative when in-person assessments are not possible. The Five Times Sit-to-Stand test (5TSTS) provides a quick measure of balance during chair transfers, muscle power, endurance, and the hability to change and maintain body position, and is highly recommended by guidelines. However, the literature is unclear about the viability and safety of teleassessment using the 5TSTS in older adults with and without Parkinson's disease (PD). This study aimed to evaluate the reliability of teleassessment using the 5TSTS and to determine its feasibility and safety for older adults with and without PD. METHODS: This cross-sectional study included older adults with and without PD who were evaluated remotely through a videoconference platform. To ensure effective and comprehensive instructions for the test, we developed a guideline called OMPEPE (an acronym for: Objective; Materials; Position-Start; Execution; Position-End; Environment). We assessed the 5TSTS intra- and inter-rater reliability by comparing scores obtained from the same examiner and from different examiners, respectively. Participants and examiners completed online surveys to provide information about feasibility and safety. RESULTS: Twelve older adults with PD and 17 older adults without PD were included in this study (mean ages 69.0 and 67.6 years, respectively). Based on the participants' perspectives and the absence of adverse effects, teleassessment using the 5TSTS is feasible and safe for older adults with and without PD. Excellent intra- and inter-rater reliability (intraclass correlation coefficient >0.90) was found for all measurements of the 5TSTS. DISCUSSION: This study demonstrated the feasibility, safety, and reliability of teleassessment using the 5TSTS. The guidelines developed may help health professionals minimize barriers and safely conduct an online assessment that includes a physical test such as the 5TSTS in older adults with or without PD. In addition to addressing technological barriers, the OMPEPE guideline might ensure the optimal execution of evaluations. CONCLUSION: Teleassessment using the 5TSTS for older adults with and without PD is feasible and safe. Both synchronous (i.e., live) and asynchronous (i.e., recorded) online 5TSTS tests demonstrate excellent intra- and inter-rate reliability.


Assuntos
Doença de Parkinson , Equilíbrio Postural , Humanos , Idoso , Masculino , Doença de Parkinson/reabilitação , Doença de Parkinson/diagnóstico , Feminino , Reprodutibilidade dos Testes , Equilíbrio Postural/fisiologia , Estudos Transversais , Telemedicina , Força Muscular/fisiologia , Estudos de Viabilidade , Idoso de 80 Anos ou mais , Acidentes por Quedas/prevenção & controle , Pessoa de Meia-Idade
11.
Arch Gerontol Geriatr ; 127: 105579, 2024 12.
Artigo em Inglês | MEDLINE | ID: mdl-39032314

RESUMO

Systematic reviews support the benefits of inspiratory muscle training (IMT) for exercise performance. Recently, many health benefits from IMT have been reported in older adults. Therefore, this work reviewed the literature focusing on IMT effects beyond physical performance in older adults, such as cardiorespiratory, metabolic, and postural balance outcomes. Searches were conducted with the following terms: ("respiratory muscle training" OR "inspiratory muscle training") OR ("inspiratory muscle strength training") AND ("elderly" OR "older" OR "aging" OR "aging"), and using the databases: MEDLINE (PubMed), SCOPUS and EUROPE PMC. Of the 356 articles found, 13 matched the inclusion criteria after screening. Based on reviewed studies, four to eight weeks of IMT (Mostly from 50 % up to 75 % of MIP, 7 days/week) improve cardiac autonomic control at rest and post-exercise, cerebrovascular response to orthostatic stress, static and dynamic balance, blood pressure control, endothelial function, and oxidative stress in older adults. The benefits of IMT in cardiac autonomic and vascular functions are reversed after training cessation. It thus appears that IMT promotes broad physiological gains for the older population. It is necessary to carry out more randomized clinical trials on the subject to confirm the findings of this research.


Assuntos
Exercícios Respiratórios , Músculos Respiratórios , Humanos , Exercícios Respiratórios/métodos , Idoso , Músculos Respiratórios/fisiologia , Equilíbrio Postural/fisiologia , Envelhecimento/fisiologia
12.
BMC Geriatr ; 24(1): 607, 2024 Jul 16.
Artigo em Inglês | MEDLINE | ID: mdl-39014308

RESUMO

BACKGROUND: The interest in approaches that improve older individuals' functional fitness and autonomy is increasing. However, the effects of dual-task training on older women's functional fitness and the comparison with the functional training approach are unclear. Therefore, we compared dual-task and functional training on the functional fitness of older women and the effects of three months of detraining. METHODS: Sixty-one women performed 16 weeks of dual-task training or functional training. The functional fitness was measured pre-, post-training, and post-detraining, based on the ability to put on and take off a t-shirt, evaluating the mobility of the upper limb, standing-up from the prone position measuring the global functionality, five times sit-to-stand test to assess the lower limbs muscle power, timed up and go to measure the dynamic balance and agility, gallon-jug shelf-transfer to evaluate the global functionality emphasizing the upper limbs and 10 m walk test to analyze the gait ability. RESULTS: Dual-task training and functional training generally provided significant small to moderate magnitude performance increases in the put on and take off a t-shirt (dual-task training: d = 0.35 / functional training: d = 0.49), five times sit-to-stand test (dual-task training: d = 0.41 / functional training: d = 0.77), timed up and go (dual-task training: d = 0.34 / functional training: d = 0.78), and gallon-jug shelf-transfer (dual-task training: d = 0.76 / functional training: d = 0.82). Only the functional training improved the 10 m walk test (d = 0.32; p = 0.013), and both groups did not change the standing-up from the prone position performance. After the detraining period, both groups kept the adaptations for the gallon-jug shelf-transfer and five times sit-to-stand test. At the same time, only the dual-task training maintained the adaptations for the put on and take off a t-shirt and the functional training for the timed up and go. CONCLUSION: Sixteen weeks of dual-task and functional training are similarly effective in improving older women's functional fitness, maintaining their benefits even after three months of detraining. TRIAL REGISTRATION: RBR-10ny848z ( https://ensaiosclinicos.gov.br/rg/RBR-10ny848z ).


Assuntos
Aptidão Física , Humanos , Feminino , Idoso , Aptidão Física/fisiologia , Equilíbrio Postural/fisiologia , Terapia por Exercício/métodos , Força Muscular/fisiologia
13.
An Acad Bras Cienc ; 96(suppl 1): e20231244, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-39082591

RESUMO

It was compared smartphone-based measurements of static balance control and mobility of elderly population with and without type 2 diabetes mellitus (DM2). The present cross-sectional study investigated 73 participants grouped in a control group (n = 36) and a DM2 group (n = 37). Smartphone's built in inertial sensors were used to record inertial changes of the participants during static balance and mobility (Timed Up and Go test - TUG) tasks. The inertial variations as a function of the time were analyzed and compared between groups. Both groups were matched in age, body mass index, male-female proportion, but DM2 group had significant larger fasting glucose than control group. Additionally, DM2 group had worst static balance control with open and closed eyes than the controls (p < 0.05) as well as they also had longer duration to execute the different events of the mobility test than the controls (p < 0.05). DM2 patients had decline of motor functions compared to controls and the use of bult-in sensors of smartphones was feasible to identify these functional impairments. The easy access of smartphones could be improving the screening of functional impairments in DM2 patients.


Assuntos
Diabetes Mellitus Tipo 2 , Equilíbrio Postural , Smartphone , Humanos , Diabetes Mellitus Tipo 2/fisiopatologia , Masculino , Feminino , Estudos Transversais , Equilíbrio Postural/fisiologia , Idoso , Pessoa de Meia-Idade , Estudos de Casos e Controles
14.
Sci Rep ; 14(1): 17409, 2024 07 29.
Artigo em Inglês | MEDLINE | ID: mdl-39075219

RESUMO

Anticipatory postural adjustments (APAs) involve a complex coordination of sensorimotor information that can be impaired in diseases that affect nerve conduction. Assessing APAs typically requires costly video recording technology, posing a challenge to the study of postural changes. This hurdle is compounded in impoverished communities affected by diseases such as leprosy, which often receive limited government support. Recent years have seen the validation of inertial sensors in wearable devices and smartphones for APA analysis in diverse populations, including adults, the elderly and people with Parkinson's disease. This progress offers economically efficient alternatives for the study of APA in leprosy. Do patterns of activation of anticipatory postural adjustment differ between leprosy patients and healthy controls? We also investigated the validity and replicability of APAs recorded in leprosy patients using inertial measurements and video capture recordings. Thirty healthy individuals in the control group and 30 individuals with leprosy in the leprosy group performed ten gait initiation trials. To record the APA for gait initiation, the participants stood on a 2 m platform. Each participant was informed that the experimenter would give an signal, after which the participant would initiate a two-step walk on the platform. Inertial recordings (low-cost method) and video capture recordings (gold-standard method) from center of mass displacements were used to extract the APA before gait initiation. The results show that APAs are similar between groups (control and leprosy), but leprosy patients have less consistent APAs. In addition, this study highlights the reproducibility and high correlation between the values of variables obtained from both instruments, the video recording as gold standard method and portable digital inertial sensor as a low-cost alternative method. These promising findings support the use of affordable inertial sensors to track and record APAs in underserved populations that lack easy access to gold standard methods such as video recording. This approach has the potential to improve the therapeutic care and rehabilitation of these patients. Although not currently part of official protocols for leprosy patients, this assessment method could prove particularly valuable in situations where significant sensorimotor impairments are suspected or documented.


Assuntos
Acelerometria , Hanseníase , Humanos , Hanseníase/fisiopatologia , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Acelerometria/instrumentação , Acelerometria/métodos , Equilíbrio Postural/fisiologia , Marcha/fisiologia , Estudos de Casos e Controles , Dispositivos Eletrônicos Vestíveis , Idoso , Caminhada/fisiologia
15.
Ortodoncia ; 88(174): 16-23, ene.-jun. 2024. ilus
Artigo em Espanhol | LILACS | ID: biblio-1567490

RESUMO

En la literatura es posible encontrar numerosos estudios que han demostrado una estrecha relación anatómica, funcional, neurológica y fisiológica entre la oclusión, la mandíbula y las regiones del cuello.1,2,3,4 Se ha observado una coactivación entre los músculos mandibulares y el complejo cuello-hombros durante los movimientos mandibulares y al masticar. Un enfoque corporal más integral ha permitido demostrar que existen conexiones neuronales entre los sistemas sensoriales-motores de las aferencias trigeminales que provienen de las estructuras orales (oclusión, músculos, articulación temporomandibular, posición de la mandíbula) de la cara y de los músculos oculomotores, con el cuello,5,6 el sistema vestibular y el apoyo plantar, teniendo injerencia en la alineación corporal, estabilidad y control postural del cuerpo.7,8,9,10 A su vez, el sistema vestibular contribuye a la regulación de la actividad de los músculos maseteros.11,12,13,14,15 Cualquier alteración en el sistema de control postural puede influir sobre el sistema estomatognático.16,17 Desde este enfoque global neurofisiológico se analizará en este artículo la relación entre la mordida cruzada unilateral posterior y la laterodesviación mandibular con el sistema de control postural. La comprensión de la relación entre las disfunciones orales con las asimetrías y la función del control postural permite a la Odontología tener una mirada global del ser humano, poder establecer abordajes terapéuticos integrales y trabajar en interdisciplina con otros profesionales de la salud, alcanzando una mayor estabilidad, ergonomía postural y mayor eficiencia de gasto energético.18,19


In the literature it is possible to find numerous studies that have demonstrated a close anatomical, functional, neurological and physiological relationship between occlusion, jaw and neck regions.1,2,3,4 Coactivation between the mandibular muscles and the neck-shoulder complex has been observed during mandibular movements and chewing. A more global body approach has allowed to demonstrate that there are neural connections between the sensory-motor systems of the trigeminal afference that come from the oral structures (occlusion, muscles, temporomandibular joint, jaw position), the face,the oculomotor muscles, the neck,5,6 the vestibular system, and plantar support, having an influence on body alignment, stability and postural control of the body.7,8,9,10 In turn, the vestibular system contributes to the regulation of the activity of the masseter muscles.11,12,13,14,15 Any alteration in the postural control system can influence the Stomatognathic System.16,17 From this global neurophysiological approach, the relationship between posterior unilateral crossbite and mandibular lateral deviation will be analyzed in this article in connection with the postural control System. Understanding the relationship between oral dysfunctions with asymmetries and the function of postural control allows Dentistry to have a global view of the human being, being able to establish integral therapeutic approaches ininterdisciplinary work with other health professionals, achieving better stability, postural ergonomics and greater energy expenditure efficiency.


Assuntos
Postura , Oclusão Dentária , Equilíbrio Postural , Má Oclusão , Assimetria Facial
16.
J Bodyw Mov Ther ; 39: 518-524, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-38876678

RESUMO

INTRODUCTION: Whole-Body Vibration (WBV) can be a therapeutic recovery strategy for patients hospitalized for COVID-19. OBJECTIVES: To evaluate the effects of a 36-session WBV protocol on the risk of falls, balance, mobility and heart rate variability (HRV). STUDY DESIGN: A randomized clinical trial. METHODS: 13 patients affected by COVID-19, trained with WBV, 3×/week on alternate days, totaling 36 sessions, were evaluated before and after the intervention. RESULTS: WBV training at 2 mm and 4 mm amplitude resulted in a reduction in the risk of falls when compared to Sham (p = 0.023), with effect size of 0.530. No changes were observed for mobility and balance outcomes (p = 0.127) or for any of the HRV variables (p = 0.386). CONCLUSION: WBV training reduced the risk of falls in post-COVID patients. No changes were observed regarding balance and mobility, nor for HRV.


Assuntos
Acidentes por Quedas , COVID-19 , Frequência Cardíaca , Equilíbrio Postural , Vibração , Humanos , Vibração/uso terapêutico , Frequência Cardíaca/fisiologia , Acidentes por Quedas/prevenção & controle , Equilíbrio Postural/fisiologia , Masculino , Feminino , Pessoa de Meia-Idade , Idoso , Modalidades de Fisioterapia , SARS-CoV-2
17.
J Bodyw Mov Ther ; 39: 598-605, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-38876693

RESUMO

INTRODUCTION: Whole-body vibration (WBV) is used to improve muscle function but is important to know if doses can affect the objective function outcomes. OBJECTIVE: To compare the effect of two frequencies of WBV on objective physical function outcomes in healthy young adults. METHODS: Forty-two volunteers were randomized into three groups: sham group (SG), and WBV groups with 30 (F30) and 45 Hz (F45). A 6-week WBV intervention protocol was applied by a vibrating platform twice a week, with the platform turn-off for SG and with two frequencies according to group, 30 or 45 Hz. The objective physical functions outcomes assessed were the proprioceptive accuracy, measured by proprioceptive tests, and quasi-static and dynamic balances, measured by Sensory Organization Test (SOT) and Y Balance Test, respectively. The outcomes were assessed before and after the WBV intervention. We used in the results comparisons, by GzLM test, the deltas percentage. RESULTS: After the intervention, no statistical differences were observed in percentage deltas for any outcomes (proprioceptive accuracy, quasi-static and dynamic balances). CONCLUSION: Objective physical function outcomes, after the 6-week WBV protocol, did not present statistically significant results in any of the intervention groups (F30 or F45) and SG.


Assuntos
Equilíbrio Postural , Vibração , Humanos , Vibração/uso terapêutico , Masculino , Feminino , Adulto Jovem , Equilíbrio Postural/fisiologia , Adulto , Propriocepção/fisiologia , Modalidades de Fisioterapia
18.
Gait Posture ; 113: 130-138, 2024 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-38879895

RESUMO

BACKGROUND: In daily life tasks of the upper limb, we must make quick corrections with our hands in unstable postural situations. Postural and reaching control mechanisms are involved in the accurate execution of upper-limb tasks. RESEARCH QUESTION: This research aimed to determine the effect of different postural stability conditions on the motor performance of the upper limb in a reaching task with non-static targets. METHODOLOGY: 19 young participants performed a reaching task toward targets that exhibited a change in position (at 200 or 600 ms) in different postural conditions (bipedal-firm, bipedal-foam, and unipedal-foam surface). Performance on the screen (motion time and spatial error), balance (center of pressure displacements, CoP), and index finger movements were recorded during the reaching task. RESULTS: The instability affects the finger kinematic (displacements) and CoP kinematic (displacements, speed, and smoothness) without affecting the performance on the screen (precision and duration). The timing of target change affects the performance on the screen, finger kinematic (speed and smoothness), and CoP kinematic (displacements, speed, and smoothness). SIGNIFICANCE: Postural and reaching control systems enable accurate hand motions in less stable situations, even in reaching tasks with non-static targets. The postural and reaching control systems can protect the end-effector performance during unstable conditions but not during trials with less time to correct the motion.


Assuntos
Equilíbrio Postural , Desempenho Psicomotor , Humanos , Equilíbrio Postural/fisiologia , Fenômenos Biomecânicos , Masculino , Feminino , Adulto Jovem , Desempenho Psicomotor/fisiologia , Dedos/fisiologia , Adulto , Movimento/fisiologia , Extremidade Superior/fisiologia
19.
Eur J Appl Physiol ; 124(11): 3365-3375, 2024 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-38935152

RESUMO

PURPOSE: We tested the hypothesis that heat stress influences the closed-loop cardio-postural control by an increased blood pressure (BP) drop and postural sway. METHODS: Fourteen healthy individuals (eight women) performed two orthostatic tests under thermal reference (TC; ~ 24 ºC) and HOT (~ 38 ºC) conditions. The center-of-pressure (COP) displacements and the electromyography (EMG) activity of the calf muscles (medial gastrocnemius and tibialis anterior) were recorded during the initial orthostasis (ORT onset) after the supine-to-stand challenge. At the same period, BP (beat-to-beat) was continuously monitored, and supine-to-stand variations (∆%) were calculated. Sublingual temperature (Tsl) was measured as a surrogate of internal temperature. RESULTS: Tsl increased in HOT compared to TC (TC 36.5 ± 0.3 vs. HOT 36.7 ± 0.3 ºC; p < 0.01). COP distance was greater in HOT compared to TC condition (TC 596.6 ± 242.4 vs. HOT 680.2 ± 249.1 mm; p < 0.01). EMG activity of the gastrocnemius decreased in HOT compared to TC condition (TC 95.5 ± 19.8 vs. HOT 78.4 ± 22.8%mV; p = 0.02). EMG of tibialis did not change between TC and HOT (TC 83.5 ± 42.9 vs. HOT 66.1 ± 31.9% mV; p = 0.29). BP showed a greater fall in HOT compared to TC condition (∆%TC - 24.5 ± 13.2 vs. ∆%HOT - 33.2 ± 20.2%; p = 0.01). CONCLUSION: Heat stress causes a greater fall in blood pressure and a reduction in musculoskeletal pump activity during orthostatic onset. These effects could be potential mechanisms that underlie augmented postural instability under a heated environment.


Assuntos
Pressão Sanguínea , Temperatura Alta , Equilíbrio Postural , Humanos , Feminino , Masculino , Pressão Sanguínea/fisiologia , Adulto , Equilíbrio Postural/fisiologia , Músculo Esquelético/fisiologia , Eletromiografia
20.
Sensors (Basel) ; 24(12)2024 Jun 15.
Artigo em Inglês | MEDLINE | ID: mdl-38931672

RESUMO

BACKGROUND: Sensory information obtained from the visual, somatosensory, and vestibular systems is responsible for regulating postural control, and if damage occurs in one or more of these sensory systems, postural control may be altered. OBJECTIVE: To evaluate and compare the postural sway velocity between children with normal hearing and with sensorineural hearing loss (SNHL), matched by sex and age group, and to compare the postural sway velocity between children with normal hearing and with SNHL, with and without vestibular dysfunction. METHODS: Cross-sectional study that evaluated 130 children (65 with normal hearing and 65 with SNHL), of both sexes and aged between 7 and 11 years, from public schools of the city of Caruaru, Pernambuco state, Brazil. The postural sway velocity of the center of pressure (COP) was assessed by a force platform, in two directions, anteroposterior (AP) and mediolateral (ML)), in three positions, namely bipedal support with feet together and parallel (parallel feet (PF)), bipedal support with one foot in front of the other (tandem foot (TF)), and single-leg support (one foot (OF)), evaluated with the eyes open and closed. RESULTS: Children with SNHL demonstrated greater postural sway velocity compared to children with normal hearing in all the positions evaluated, with significant differences in the AP direction, with the eyes open (PF: p = 0.001; TF: p = 0.000; OF: p = 0.003) and closed (PF: p = 0.050; TF: p = 0.005). The same occurred in the ML direction, with the eyes open (PF: p = 0.001; TF: p = 0.000; OF: p = 0.001) and closed (PF: p = 0.002; TF: p = 0.000). The same occurred in relation to vestibular function, where the children with SNHL with an associated vestibular dysfunction demonstrated greater postural sway velocity compared to children with normal hearing in all the positions evaluated, demonstrating significant differences in the AP direction, with the eyes open (TF: p = 0.001; OF: p = 0.029) and eyes closed (PF: p = 0.036; TF: p = 0.033). The same occurred in the ML direction, with the eyes open (TF: p = 0.000) and with the eyes closed (PF: p = 0.008; TF: p = 0.009). CONCLUSIONS: Children with SNHL demonstrated greater instability of postural control than children with normal hearing in all the directions assessed. Children with SNHL and an associated vestibular dysfunction demonstrated the greatest instability of postural control in this study.


Assuntos
Equilíbrio Postural , Doenças Vestibulares , Humanos , Criança , Equilíbrio Postural/fisiologia , Masculino , Feminino , Estudos Transversais , Doenças Vestibulares/fisiopatologia , Perda Auditiva Neurossensorial/fisiopatologia , Surdez/fisiopatologia
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