RESUMO
Background: spinal cord injury leaves as a sequel in the acute and chronic period, deficiencies in the stability of joint functions and in the function of voluntary movement control. Those with good trunk control have a greater probability of carrying out activities of daily living by themselves; up to now, we do not have reliable tools in Argentina that evaluate trunk control in these subjects. Objectives: to cross-culturally adapt the trunk control test to Argentinean Spanish in subjects with sequelae of spinal cord injury and to establish interobserver and intraobserver reliability. Methodology: the subjects were admitted using a non-probabilistic convenience sampling. Subjects who were between 15 and 75 years old and had a diagnosis of spinal cord injury were included. Subjects who had: another neurological diagnosis, alteration in sensory organs, conditions that prevent the performance of the test, and psychiatric illness were excluded. Results: 30 subjects were included for cross-cultural adaptation and 55 for reliability. Semantic modifications were made to all items and response options. The intraobserver and interobserver reliability of the scale or subdomains did not achieve a sufficient score. Conclusion: the trunk control test was adapted cross-culturally to Argentine Spanish and interobserver and intraobserver reliability was established. The adaptation was achieved through semantic changes and the reliability was not sufficient. In the future, studies should be carried out to improve the reliability and study the validity of the tool.
Introducción: la lesión de la médula espinal deja como secuela en el período agudo y crónico, deficiencias en la estabilidad de las funciones articulares y de la función del control de los movimientos voluntarios. Aquellos con buen control de tronco poseen una mayor probabilidad de realizar por sí mismos actividades de la vida diaria, hasta el momento, no contamos en Argentina con herramientas fiables que evalúen el control de tronco en estos sujetos. Objetivos: adaptar transculturalmente al castellano argentino el trunk control test en sujetos con secuela de lesión medular espinal y establecer la fiabilidad interobservador, intraobservador. Metodología: los sujetos fueron ingresados mediante un muestreo no probabilístico por conveniencia. Se incluyeron sujetos que: posean entre 15 años a 75 años y tengan diagnóstico de lesión medular espinal, se excluyeron sujetos que posean: otro diagnóstico neurológico, alteración en los órganos sensoriales, condiciones que impidan la realización de la prueba y enfermedad psiquiátrica. Resultados: 30 sujetos fueron incluidos para la adaptación transcultural y 55 para la fiabilidad. Se realizaron modificaciones semánticas en todos los ítems y opciones de respuesta. La fiabilidad intraobservador e interobservador de la escala o de los subdominios no logró un puntaje suficiente. Conclusión: se adaptó transculturalmente al castellano argentino el trunk control test y se estableció la fiabilidad interobservador, intraobservador. La adaptación se logró a través de cambios semánticos y la fiabilidad no fue suficiente. A futuro se deberán realizar estudios para mejorar la fiabilidad y estudiar la validez de la herramienta.
Assuntos
Traumatismos da Medula Espinal , Traduções , Humanos , Traumatismos da Medula Espinal/fisiopatologia , Traumatismos da Medula Espinal/complicações , Argentina , Adulto , Reprodutibilidade dos Testes , Pessoa de Meia-Idade , Feminino , Masculino , Adolescente , Idoso , Adulto Jovem , Comparação Transcultural , Variações Dependentes do Observador , Tronco/fisiopatologia , Avaliação da Deficiência , Inquéritos e Questionários/normas , Atividades CotidianasRESUMO
BACKGROUND: Adjusting trunk inclination from a semi-recumbent position to a supine-flat position or vice versa in patients with respiratory failure significantly affects numerous aspects of respiratory physiology including respiratory mechanics, oxygenation, end-expiratory lung volume, and ventilatory efficiency. Despite these observed effects, the current clinical evidence regarding this positioning manoeuvre is limited. This study undertakes a scoping review of patients with respiratory failure undergoing mechanical ventilation to assess the effect of trunk inclination on physiological lung parameters. METHODS: The PubMed, Cochrane, and Scopus databases were systematically searched from 2003 to 2023. INTERVENTIONS: Changes in trunk inclination. MEASUREMENTS: Four domains were evaluated in this study: 1) respiratory mechanics, 2) ventilation distribution, 3) oxygenation, and 4) ventilatory efficiency. RESULTS: After searching the three databases and removing duplicates, 220 studies were screened. Of these, 37 were assessed in detail, and 13 were included in the final analysis, comprising 274 patients. All selected studies were experimental, and assessed respiratory mechanics, ventilation distribution, oxygenation, and ventilatory efficiency, primarily within 60 min post postural change. CONCLUSION: In patients with acute respiratory failure, transitioning from a supine to a semi-recumbent position leads to decreased respiratory system compliance and increased airway driving pressure. Additionally, C-ARDS patients experienced an improvement in ventilatory efficiency, which resulted in lower PaCO2 levels. Improvements in oxygenation were observed in a few patients and only in those who exhibited an increase in EELV upon moving to a semi-recumbent position. Therefore, the trunk inclination angle must be accurately reported in patients with respiratory failure under mechanical ventilation.
Assuntos
Insuficiência Respiratória , Humanos , Insuficiência Respiratória/fisiopatologia , Insuficiência Respiratória/terapia , Respiração Artificial/métodos , Mecânica Respiratória/fisiologia , Postura/fisiologia , Posicionamento do Paciente/métodos , Tronco/fisiopatologia , Tronco/fisiologiaRESUMO
INTRODUCTION: Parkinson's disease (PD) causes gait abnormalities that may be associated with an arm swing reduction. Medication and freezing of gait (FoG) may influence gait characteristics. However, these comparisons do not consider differences in gait speed and clinical characteristics in individuals with PD. OBJECTIVE: This study aims to analyze the effect of FoG and medication on the biomechanics of the trunk and upper limbs during gait in PD, controlling for gait speed and clinical differences between groups. METHODS: Twenty-two people with a clinical diagnosis of idiopathic PD in ON and OFF medication (11 FoG), and 35 healthy participants (control) were selected from two open data sets. All participants walked on the floor on a 10-m-long walkway. The joint and linear kinematic variables of gait were compared: (1) Freezers and nonfreezers in the ON condition and control; (2) Freezers and nonfreezers in the OFF condition and control; (3) Group (freezers and nonfreezers) and medication. RESULTS: The disease affects the upper limbs more strongly but not the trunk. The medication does not significantly influence the joint characteristics but rather the linear wrist displacement. The FoG does not affect trunk movement and partially influences the upper limbs. The interaction between medications and FoG suggests that the medication causes more substantial improvement in freezers than in nonfreezers. CONCLUSION: The study shows differences in the biomechanics of the upper limbs of people with PD, FoG, and the absence of medication. The future rehabilitation protocol should consider this aspect.
Assuntos
Transtornos Neurológicos da Marcha , Marcha , Doença de Parkinson , Tronco , Extremidade Superior , Humanos , Doença de Parkinson/fisiopatologia , Doença de Parkinson/tratamento farmacológico , Fenômenos Biomecânicos , Masculino , Feminino , Idoso , Extremidade Superior/fisiopatologia , Pessoa de Meia-Idade , Tronco/fisiopatologia , Transtornos Neurológicos da Marcha/fisiopatologia , Transtornos Neurológicos da Marcha/tratamento farmacológico , Marcha/fisiologia , Dopaminérgicos , Antiparkinsonianos/uso terapêuticoRESUMO
Overhead sports overload the shoulder complex due to movement repetition and the great amount of force created during the athletic motion, which may cause adaptations in the shoulder and lead to shoulder pain. However, overhead movements include the kinetic chain, and alterations in some of the structures throughout the kinetic chain may increase stress on the shoulder complex and be associated with shoulder pain. PURPOSE: To compare kinetic chain components in overhead athletes with and without shoulder pain. METHODS: Forty-one volleyball and handball athletes (21 with and 20 without shoulder pain) were included and assessed for hip internal (IR) and external rotation (ER) range of motion (ROM), hip and trunk isometric strength, trunk endurance and neuromuscular control of the lower and upper limbs (Y balance test). RESULTS: Athletes with shoulder pain showed smaller IR ROM in both hips, lower endurance time for trunk extensors and flexors, decreased reach distance in the anterior and posteromedial direction, as well as a smaller composite score in the Y balance test (p < 0.05). CONCLUSION: Volleyball and handball athletes with shoulder pain showed changes in ROM throughout the kinetic chain in addition to lower core endurance, and decreased neuromuscular control of lower limbs.
Assuntos
Força Muscular , Amplitude de Movimento Articular , Dor de Ombro , Voleibol , Humanos , Amplitude de Movimento Articular/fisiologia , Masculino , Voleibol/fisiologia , Adulto Jovem , Feminino , Dor de Ombro/fisiopatologia , Força Muscular/fisiologia , Adulto , Fenômenos Biomecânicos/fisiologia , Rotação , Atletas , Adolescente , Tronco/fisiopatologia , Tronco/fisiologiaRESUMO
INTRODUCTION: The lateral medicine ball throw (LMBT) test is used to evaluate the throwing action, involving the entire kinetic chain and the principle of force transfer, with association between the strength of the lower limb and trunk muscles and the lower limb kinematics. The LMBT to investigate the association between lower limb kinematics and hip and trunk muscle strength. EXPERIMENTAL: This was a cross-sectional study with 84 healthy and physically active young people. Determinations were made of the maximum isometric strengths of the hip abductor, lateral rotator, extensor, and flexor muscles, and the trunk lateral flexors and extensors. Kinematic analyses (2D) of the hip, knee, and ankle in the sagittal and frontal planes were performed during the countermovement phase of the LMBT, together with quantification of LMBT. Statistical analysis of the associations employed multiple linear regression, with α = 5%. RESULTS: There were significant associations between the LMBT and the independent variables hip extensors strength, trunk flexors strength, valgus angle, and knee flexion angle and gender. The regression model presented adjusted R2 = 0.622. CONCLUSIONS: LMBT was influenced by the trunk flexor and hip extensor muscle strengths, knee flexion kinematics, lower limb valgus in the countermovement phase, and gender.
Assuntos
Extremidade Inferior , Força Muscular , Músculo Esquelético , Tronco , Humanos , Estudos Transversais , Força Muscular/fisiologia , Masculino , Feminino , Fenômenos Biomecânicos/fisiologia , Extremidade Inferior/fisiologia , Adulto Jovem , Músculo Esquelético/fisiologia , Tronco/fisiologia , Quadril/fisiologia , Adulto , Amplitude de Movimento Articular/fisiologia , Fatores SexuaisAssuntos
Hiperpigmentação , Feminino , Humanos , Diagnóstico Diferencial , Extremidades , Hiperpigmentação/diagnóstico , Tronco , IdosoRESUMO
Objectives: This study aimed to assess the effects of different magnification systems on the angular deviations of the neck and trunk and the muscle activities of the upper back and neck during preclinical cavity preparation. Methods: This was an experimental laboratory study, with the angular deviations from the neutral positions of the neck and trunk and the activities of the bilateral upper back (the descending and ascending trapezius) and neck (sternocleidomastoid) muscles as the dependent variables. The independent variables were the different magnification systems used (Simple, Galilean, and Keplerian loupes, with direct vision as the control) and prepared teeth (teeth 16, 26, 36, and 46). A dental mannequin phantom head with artificial resin teeth was used, and Class I cavity preparations for composite resin were performed on teeth 16, 26, 36, and 46 using a 1012 round diamond bur at low speed. To analyze the angular deviations, the postures adopted during the procedure were recorded using a tripod-mounted camera positioned to provide a lateral view of the operator. A trained researcher measured the angular deviations using the software entitled "Software for Postural Assessment"-SAPO (version 0.69). Bilateral muscle activity was assessed using surface electromyography. Descriptive statistical analysis was performed, and after verifying the assumptions of normality and homoscedasticity, two-way analysis of variance and the Tukey and Games-Howell post-hoc tests were used to compare the data (α=0.05). Results: The angular deviation from the neutral position of the neck was found to be significantly higher during cavity preparations performed with the naked eye and the Simple loupe, irrespective of the prepared tooth. With regard to tooth location, the angular deviation of the neck was significantly greater during cavity preparation on teeth 16 and 26, and the angular deviation of the trunk was significantly greater during cavity preparation on tooth 26, regardless of the magnification system used. There were significant differences in right sternocleidomastoid muscle activity between the Simple, Galilean, and Keplerian loupes, with activity being the lowest for the Galilean loupe (p = 0.008). There were no significant differences in left sternocleidomastoid muscle activity between the loupes, regardless of the prepared tooth (p = 0.077). The activities of the bilateral descending trapezius and the right ascending trapezius muscles were significantly lower when the Galilean loupe was used (p < 0.010). Conclusion: These results suggest that the Galilean loupe resulted in lower muscle activity in the neck and back regions and that the Galilean and Keplerian loupes resulted in less angular deviations of the neck and trunk during cavity preparation.
Assuntos
Eletromiografia , Manequins , Músculos do Pescoço , Humanos , Músculos do Pescoço/fisiologia , Postura/fisiologia , Pescoço , Tronco/fisiologia , MasculinoRESUMO
PURPOSE: To compare the trunk biomechanical characteristics between the sit-to-stand and stand-to-sit performed at self-selected and fast speeds in stroke survivors and healthy-matched controls. METHODS: Thirty individuals (15 stroke survivors and 15 healthy-matched controls) were included. The following biomechanical characteristics were determined: peak of trunk forward flexion and time until the peak of trunk forward flexion, total duration, phase I (sit-to-stand: time spent from the beginning to seat-off; stand-to-sit: time spent from the beginning to seat-on) and II durations (sit-to-stand: time spent from seat-off to the end of the task; stand-to-sit: time spent from the seat-on to the end of the task). Two-way repeated measures ANOVA was used (α = 5%). RESULTS: The maximum angle of trunk forward flexion and time spent until the maximum angle of trunk forward flexion in both tasks were significantly higher in stroke survivors. For both groups and speeds, phase I duration and peak of trunk forward flexion of the stand-to-sit were significantly higher than that of the sit-to-stand (11.41≤F ≤ 33.60; 0.001 ≤ p ≤ 0.002) and, phase II duration was significantly higher during the sit-to-stand than that of the stand-to-sit (21.27 ≤ F ≤ 65.10; p ≤ 0.001). CONCLUSIONS: These results confirm specific trunk biomechanical characteristics between sit-to-stand and stand-to-sit in stroke survivors and healthy-matched controls.
Specific biomechanical characteristics between the sit-to-stand and stand-to-sit were confirmed in stroke survivors and healthy-matched controls at both speeds.Fast speeds showed differences that were not observed at self-selected speeds.Trunk biomechanical characteristics must be carefully evaluated and should be considered in rehabilitation programs that aim to improve sit-to-stand and stand-to-sit performance.
Assuntos
Reabilitação do Acidente Vascular Cerebral , Sobreviventes , Tronco , Humanos , Masculino , Fenômenos Biomecânicos , Feminino , Pessoa de Meia-Idade , Tronco/fisiopatologia , Estudos de Casos e Controles , Idoso , Acidente Vascular Cerebral/fisiopatologia , Postura Sentada , Posição Ortostática , Amplitude de Movimento Articular/fisiologia , AdultoRESUMO
BACKGROUND: Changes in the trunk and lower limbs' sagittal movements may cause patellofemoral pain (PFP) because they influence the forces acting on this joint. OBJECTIVES: To compare trunk and lower limb sagittal kinematics between women with and without PFP during functional tests and to verify whether sagittal trunk kinematics are correlated with those of the knees and ankles. METHODS: A total of 30 women with PFP and 30 asymptomatic women performed single-leg squat (SLS) and step-down (SD) tests and were filmed by a camera in the sagittal plane. The trunk inclination angle, forward knee displacement, and ankle angle were calculated. RESULTS: The PFP group exhibited less trunk flexion (SLS, p = .006; SD, p = .016) and greater forward knee displacement (SLS, p = .001; SD, p = .004) than the asymptomatic group; there was no significant difference in ankle angle (SLS, p = .074; SD, p = .278). Correlation analysis revealed that decreased trunk flexion was associated with increased forward knee displacement (SLS, r = -0.439, p = .000; SD, r = -0.365, p = .004) and ankle dorsiflexion (SLS, r = -0.339, p = .008; SD, r = -0.356, p = .005). CONCLUSION: Women with PFP present kinematic alterations of the trunk and knee in the sagittal plane during unipodal activities. Furthermore, the trunk and lower limb sagittal movements were interdependent.
Assuntos
Extremidade Inferior , Síndrome da Dor Patelofemoral , Tronco , Humanos , Feminino , Fenômenos Biomecânicos , Adulto , Síndrome da Dor Patelofemoral/fisiopatologia , Tronco/fisiopatologia , Tronco/fisiologia , Adulto Jovem , Extremidade Inferior/fisiopatologia , Movimento , Amplitude de Movimento Articular , Estudos de Casos e Controles , Articulação do Tornozelo/fisiopatologiaRESUMO
Los objetivos del presente estudio fueron primero evaluar la asociación de dimensiones antropométricas de tórax y tronco con índices espirométricos, segundo, ajustar una ecuación de predicción con dimensiones antropométricas de tronco y tercero, comparar nuestro modelo predictivo con dos ecuaciones diagnósticas. Se evaluaron 59 estudiantes universitarios entre 20 y 40 años, de ambos sexos, sin hábito tabáquico. Las variables consideradas fueron: edad, sexo, peso, estatura, diámetro transverso de tórax, diámetro anteroposterior de tórax, perímetro de tórax, altura de tórax, altura de tronco, flujo espiratorio máximo (FEM), volumen espiratorio forzado en el primer segundo (VEF1) y capacidad vital forzada (CVF). Se utilizó el análisis de regresión múltiple para estimar los valores espirométricos en función de las variables demográficas y antropométricas. La CVF y el VEF1 tienen asociación lineal directa con el diámetro transverso de tórax, altura de tórax, perímetro de tórax y altura de tronco. Se ajustó una ecuación de regresión lineal múltiple que indicó que es posible estimar la CVF y el VEF11 en función de la altura de tronco y el perímetro de tórax para ambos sexos. Estas variables son capaces de explicar el 74 % de los valores de CVF y el 68 % de los valores de VEF1. Al comparar los valores obtenidos por nuestras ecuaciones predictivas con las ecuaciones de referencia nacional observamos que nuestros resultados son más cercanos a los de Quanjer et al. (2012) que a los de Knudson et al. (1983). La altura de tronco y el perímetro de tórax tienen asociación directa con el VEF1 y CVF y son buenos predictores del VEF1 y CVF en estudiantes universitarios. Nuestros valores estimados son más cercanos a las ecuaciones de Quanjer et al. (2012) en comparación a las estimaciones de Knudson (1983).
SUMMARY: The purposes of the present study were first to evaluate the association between anthropometric dimensions of the thorax and trunk with spirometric indices, second, to fit a prediction equation with anthropometric dimensions of the trunk, and third, to compare our predictive model with two diagnostic equations. Fifty-nine university students between 20 and 40 years old, of both sexes and non-smokers were recruited. Variables considered were age, sex, weight, height, chest transverse diameter, chest anteroposterior diameter, chest perimeter, chest height, trunk height, maximum expiratory flow (PEF), forced expiratory volume in the first second (FEV1) and forced vital capacity (FVC). Multiple regression analysis was used to estimate spirometric values based on demographic and anthropometric variables. FVC and FEV1 have a direct linear association with chest transverse diameter, chest height, chest circumference, and trunk height. A multiple linear regression equation was fitted, indicating that it is possible to estimate FVC and FEV1 as a function of trunk height and chest girth for both sexes. These variables can explain 74% of the FVC values and 68% of the FEV1 values. Comparing the values obtained by our predictive equations with the national reference equations, we observe that our results are closer to those of Quanjer et al. (2012) than to those of Knudson et al. (1983). Trunk height and chest circumference have a direct association with FEV1 and FVC and are good predictors of FEV1 and FVC in university students. Our estimated values are closer to Quanjer et al. (2012) than Knudson et al. (1983) prediction equations.
Assuntos
Humanos , Masculino , Feminino , Adulto , Adulto Jovem , Espirometria , Antropometria , Tronco/anatomia & histologia , Tronco/fisiologia , Tórax/anatomia & histologia , Tórax/fisiologia , Capacidade Vital/fisiologia , Volume Expiratório Forçado/fisiologia , Análise de RegressãoRESUMO
BACKGROUND: Depression is an important nonmotor symptom of Parkinson's disease (PD) and has been associated with the motor symptoms in these individuals. OBJECTIVES: To determine whether there are relationships between depressive symptoms and abnormalities in axial postural alignment and axial motor deficits, especially postural instability, and trunk rigidity in PD. METHODS: In this cross-sectional study, 65 individuals were evaluated using the Beck Depression Inventory-II (BDI-II) for the analysis of depressive symptoms and underwent a postural assessment of head, trunk, and hip sagittal alignment through computerized photogrammetry. The MDS-UPDRS was used to assess clinical aspects of PD, the Trunk Mobility Scale was used to assess axial rigidity, and the MiniBESTest to assess balance. To determine the relationship between depressive symptoms and postural alignment, multiple linear regression analysis was performed. RESULTS: The participants with depressive symptoms had more severe motor deficits as well as greater trunk rigidity and worse postural instability (p < 0.05). When the postural angles were compared between men and women using Student's t-test, it was found that men had greater flexion angles of the head (p = 0.003) and trunk (p = 0.017). Using multiple linear regression analysis corrected for the age and sex of the participants, we verified that the anterior trunk inclination was significantly larger in the PD population with depressive symptoms (R2 = 0.453, ß = 0.116, and p = 0.045). CONCLUSION: PD individuals with depressive symptoms have more severe flexed trunk posture, mainly in older men. Additionally, more severe depressive symptoms are associated with worsening postural instability, trunk rigidity and motor deficits in this population.
ANTECEDENTES: A depressão é um sintoma não motor importante da doença de Parkinson (DP) e tem sido associada aos sintomas motores nesses indivíduos. OBJETIVOS: Determinar se existem relações entre sintomas depressivos e anormalidades no alinhamento postural axial e déficits motores axiais, especialmente instabilidade postural e rigidez de tronco na DP. MéTODOS: Neste estudo transversal, 65 indivíduos foram avaliados pelo BDI-II para análise de sintomas depressivos e submetidos à avaliação postural do alinhamento sagital de cabeça, tronco e quadril por meio de fotogrametria computadorizada. A MDS-UPDRS avaliou os aspectos clínicos, TMS avaliou rigidez axial e o MiniBESTest equilíbrio. Para determinar a relação entre sintomas depressivos e alinhamento postural, realizou-se uma análise de regressão linear múltipla. RESULTADOS: Os participantes com sintomas depressivos apresentaram déficits motores mais graves, bem como maior rigidez de tronco e pior instabilidade postural (p < 0,05). Quando comparados os ângulos posturais entre homens e mulheres pelo teste t de Student, verificou-se que os homens apresentaram maiores graus de flexão da cabeça (p = 0,003) e do tronco (p = 0,017). Por meio da análise de regressão linear múltipla corrigida para a idade e sexo dos participantes, verificamos que a inclinação anterior do tronco foi significativamente maior nos indivíduos com DP com sintomas depressivos do que sem sintomas depressivos (R2 = 0,453, ß = 0,116 e p = 0,045) CONCLUSãO: Indivíduos com DP com sintomas depressivos apresentam postura de tronco flexionado mais severa, principalmente em homens mais idosos. Além disso, os sintomas depressivos mais graves pioram significativamente a instabilidade postural, a rigidez do tronco e os déficits motores nessa população.
Assuntos
Transtornos Motores , Doença de Parkinson , Masculino , Humanos , Feminino , Idoso , Doença de Parkinson/complicações , Doença de Parkinson/diagnóstico , Estudos Transversais , Depressão/etiologia , Transtornos Motores/complicações , Tronco , Equilíbrio PosturalRESUMO
The three-dimensional movement of the horse in physical therapy is a valuable kinesio-therapeutic phenomenon that simultaneously affects several body systems, including particularly the neuromuscular system. However, the effects of equine-assisted services (EAS) on neuromuscular activation patterns in older adults have not been thoroughly investigated. In this study, we evaluated the impact of a 10-weeks EAS program on trunk muscles in older adults who used a saddle and placed their feet in stirrups for the first 15 minutes and out of stirrups for the remaining 15 minutes of 30-minute EAS sessions. We gathered electromyographic (EMG) data of the trunk muscles five times each on the first, fifth, and 10th sessions: pre-EAS and post-EAS on a stationary horse and at 1-minute, 15-minutes, and 30-minutes on a horse in motion. Participants were 20 adults, aged 60-79 years. We analyzed normalized EMG data with 5 (session time) by 3 (session number) analyses of variance (ANOVAs) with repeated measures and with Bonferroni's testing (p ≤ .05). There was a significant difference over the number of interventions for the right thoracic paravertebral muscle (p = .025) and session time effect for the left trapezius (p = .042), right thoracic paravertebral (p < .001), right and left multifidus (p < .001), and right and left rectus abdominis muscles (p < .001). Thus, trunk muscles in older adults showed complex neuromuscular activation synchronized with the horse's movement, which was influenced by session time and number of interventions. The practical implication of these findings is that EAS can reduce fall risk among elderly adults of both sexes.
Assuntos
Terapia Assistida por Cavalos , Animais , Eletromiografia , Terapia Assistida por Cavalos/métodos , Feminino , Cavalos , Humanos , Masculino , Movimento , Músculo Esquelético/fisiologia , TroncoRESUMO
Abstract Background: Poor flexibility is a predictor of reduced physical activity. The association between trunk flexibility and cardiovascular risk factors (CVRFs) is not well understood. Objective: To identify the prevalence of CVRFs and their association with trunk flexibility in individuals participating in a community-based health education program. Methods: Volunteers (51 men, 48 women) aged 20-85 years old, participants in a community-based health education program in the city of Santo Antônio de Goiás, Brazil, were selected for this study. Anthropometric measures including body mass, height, body mass index (BMI), waist circumference (WC) and waist/height ratio (WHtR) were evaluated. Physical activity level was evaluated based on leisure activity participation, and trunk flexibility was evaluated by the sit and reach test. Data distribution was assessed using the Shapiro-Wilk test; Pearson's chi-square or Fisher's exact and Student t tests were performed for comparisons. To analyze the association between trunk flexibility and concomitant CVRFs, Spearman's correlation test and linear regression were employed. Statistical significance was defined as p < 0.05. Results: 7.2% of the volunteers had no CVRF, 10.3% had only one CVRF and 82.5% had two or more CVRFs, with no differences between sexes. Increased abdominal adiposity, as assessed by WHtR (p = 0.0097), and systemic arterial hypertension (p = 0.0003) were the most prevalent CVRFs, with differences between age groups. A strong negative correlation was found between mean trunk flexibility and the number of concomitant CVRFs (r = -0.96, p < 0.0028). Conclusion: The strong negative correlation between trunk flexibility and concomitant CVRF indicates an increased risk for cardiovascular events. Therefore, trunk flexibility measurement may be an additional tool for health promotion and prevention of cardiovascular and associated diseases in community health programs.
Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Adulto Jovem , Maleabilidade , Fatores de Risco de Doenças Cardíacas , Estudos Transversais , Exercícios de Alongamento Muscular , Obesidade Abdominal , Tronco , Razão Cintura-EstaturaRESUMO
OBJECTIVE: Police officers, particularly the ones who are trained to be on "special forces", perform a wide range of hazardous and physically demanding activities when aiming to protect and serve. The purpose of this study was to investigate the association between lower limb and trunk muscle endurance with drop vertical jump (DVJ) height in a special military police force. METHODS: One hundred and three male military men (age: 36 ± 5.0 years; height: 1.76 ± 0.05 m; weight: 81.8 ± 9.7 kg) volunteered to take part in this study. SIX TESTS WERE PERFORMED: DVJ, McGill core battery (trunk flexion, trunk extension, and side bridge test-right and left), and single-leg squat repetitions. Correlations were analyzed using the Pearson correlation coefficient (r). The level of significance for all analyses was set at p ≤ 0.05. RESULTS: Single-leg squat repetitions were positively associated with DVJ height, contact time and flight time (p = 0.00093∗∗, p = 0.00085∗∗, and p = 0.00098∗∗ respectively). No correlation was observed between trunk muscle endurance and DVJ. CONCLUSION: Therefore, it was concluded that greater endurance of the lower limb muscles, as demonstrated by the single leg squat, was associated with better performance in a DVJ. Individuals should consider incorporating single leg squats into their fitness program to develop muscular endurance and possibly perform better in the DVJ.
Assuntos
Músculo Esquelético , Tronco , Adulto , Exercício Físico/fisiologia , Humanos , Extremidade Inferior/fisiologia , Masculino , Músculo Esquelético/fisiologia , Amplitude de Movimento Articular , Tronco/fisiologiaRESUMO
OBJECTIVE: To demonstrate the associated use of progressive tension sutures (PTS) with negative pressure wound therapy (NPWT) in large torso degloving wounds. METHODS: This is a case report of two patients with large torso degloving wounds caused by trauma, both of whom were treated with combined PTS and NPWT. Statistics related to wound treatment responses are presented. RESULTS: Initial wound area for Patient 1 was 2400cm2 and 900cm2 for Patient 2. Within 21 and 12 days, respectively, using the combined method, the following data were observed: wound reduction of 94% and 99%, respectively; a closing speed rate of 98cm2/day and 75cm2/day, respectively; and a closing percentage of 4.45% per day and 8.25% per day, respectively. CONCLUSION: The use of combined PTS and NPWT techniques may be useful in the treatment of traumatic degloving injuries, reducing the wound area and facilitating reconstruction.
Assuntos
Avulsões Cutâneas , Tratamento de Ferimentos com Pressão Negativa , Avulsões Cutâneas/cirurgia , Humanos , Tratamento de Ferimentos com Pressão Negativa/métodos , Suturas , TroncoRESUMO
Detection of changes in dynamic balance could help identify older adults at fall risk. Walking on a narrow beam with its width, cognitive load, and arm position manipulated could be an alternative to current tests. Therefore, we examined additive and interactive effects of beam width, cognitive task (CT), and arm position on dynamic balance during beam walking in older adults. Twenty older adults (69 ± 4y) walked on 6, 8, and 10-cm wide beams (2-cm high, 4-m-long), with and without CT, with three arm positions (free, crossed, akimbo). We determined cognitive errors, distance walked, step speed, root mean square (RMS) of center of mass (COM) displacement and trunk acceleration in the frontal plane. Beam width decrease progressively reduced distance walked and increased trunk acceleration RMS. Step speed decreased on the narrowest beam and with CT. Arm crossing decreased distance walked and step speed. COM displacement RMS and cognitive errors were not affected by any manipulation. In conclusion, distance walked indicated that beam width and arm position, but less so CT, affected dynamic balance, implying that beam walking has the potential to become a test of fall risk. Stability measurements suggested effective trunk adjustments to control COM position and keep dynamic balance during the task.
Assuntos
Equilíbrio Postural , Caminhada , Aceleração , TroncoRESUMO
Young adults reduce their sway in both light touch (LT) and anchor systems (AS), however, the cognitive involvement in these tasks is unknown. This study investigated postural control in young adults standing upright using either LT or AS, concomitantly with a cognitive task (counting). Nine adults (26 ± 7.4 years) stood in the upright tandem stance with eyes closed, with/without LT, AS (force <2 N), and a cognitive task. The mean sway amplitude of the trunk, right wrist, and shoulder ellipse area, as well as the mean force during LT and AS were obtained. The cognitive task did not influence the magnitude of trunk sway or the mean force in the LT and AS conditions. The trunk sway magnitude was reduced in the AS and even further in LT. Wrist and shoulder variability was larger in the AS than in the LT. Based on these results, we conclude that enhanced sensory cues provided by LT and AS reduce trunk sway with little or no attentional demands.
Assuntos
Tecnologia Háptica , Equilíbrio Postural , Cognição , Humanos , Posição Ortostática , Tronco , Adulto JovemRESUMO
Introdução: A sobrecarga corporal devida à obesidade contribui no surgimento de alterações no sistema musculoesquelético e respiratório. Objetivo: Analisar as evidências científicas referentes à influência da obesidade sobre a postura do tronco, a resposta cinético-funcional do diafragma e a função pulmonar em crianças e adolescentes. Métodos: Trata-se de uma revisão de literatura, utilizando as bases de dados Medline, Cochrane, Embase, Lilacs e Web of Sciences, nos idiomas inglês, português e espanhol, nos últimos 10 anos. Foram utilizados os descritores: "obesidade', "postura", "diafragma", "função pulmonar", "adolescentes", "adultos jovens". Os critérios de exclusão foram: estudos que abordaram distúrbios neuromusculares associados, cifoescoliose, fibrose cística, enfisema pulmonar, asma e DPOC e artigos não disponíveis na íntegra. Resultados: Foram identificados 226 estudos, porém 10 foram analisados. Os resultados apontaram que a postura do tronco nos obesos é hipercifótica, hiperlordótica e com anteversão pélvica, além de apontar indícios de repercussão na dinâmica respiratória, com redução da mobilidade do diafragma e dos volumes e capacidades pulmonares. Conclusão: A obesidade contribui para a ocorrência de hipercifose, hiperlordose e anteversão da pelve, bem como na diminuição da atividade do diafragma e função pulmonar. (AU)
Assuntos
Criança , Adolescente , Postura , Diafragma , Tronco , Sistema Musculoesquelético , Obesidade , Criança , AdolescenteRESUMO
To investigate the effect of a Trunk Training (TT) program on the general musculoskeletal pain (GMP) and physical performance of Military Police Officers. Twenty officers were divided into either control group (CG) or TT group (TTG). Both groups performed nine weeks of traditional physical training. However, the TTG had 25-minutes allocated to TT during each scheduled physical training period. Anthropometric, trunk endurance, and physical fitness tests were completed pre- and post-training for both groups. Both groups also answered a weekly questionnaire about their GMP. Post-training, trunk endurance performance was significantly higher (p < 0.05) and the GMP significantly lower (p < 0.05) in the TTG when compared to the CG. Improvement in side plank test scores was associated with a decreased in GMP (r = -0.495, p < 0.05). TT can reduce the perception of GMP in addition to increasing the endurance of the trunk muscles. The side plank was the only physical test associated with GMP. Practitioner summary: Trunk Training can reduce general musculoskeletal pain and increase the endurance of the trunk muscles without a concomitant loss in general fitness in elite Military Police Officers. This research lasted 11 weeks and presents real-world and pragmatic findings.
Assuntos
Dor Musculoesquelética , Polícia , Humanos , Músculo Esquelético , Resistência Física , Aptidão Física , Desempenho Físico Funcional , TroncoRESUMO
Objetivo: El lipoblastoma es una neoplasia benigna poco común que puede presentarse como un tumor localizado o difuso (lipoblastomatosis). Debido a su rareza, se han publicado, en su mayoría, solo reportes de casos. El objetivo de este estudio fue determinar la tasa de recurrencia local y las complicaciones después de la resección marginal de lipoblastomas ubicados en extremidades y tronco. Materiales y métodos: Se realizó una revisión retrospectiva multicéntrica de los registros de pacientes pediátricos sometidos a extirpación quirúrgica de lipoblastomas en cuatro instituciones, entre 2008 y 2018. Se registraron las siguientes variables: datos demográficos, método diagnóstico, volumen de la lesión, tipo de biopsia, complicaciones, recurrencia y necesidad de procedimientos adicionales. Resultados: Durante el período de estudio, 17 pacientes cumplieron los criterios de inclusión para la evaluación. La media de la edad era de 3.9 años y el 65% eran varones. Las ubicaciones más frecuentes fueron: muslos (n = 9), columna lumbar (n = 2) y glúteos (n = 2). El volumen de masa preoperatorio medio fue de 305,5 cm3 (rango: 10,2-1745,8). La duración media del seguimiento fue de 2.8 años (rango: de 8 meses a 5.6 años). Hubo una recurrencia (5,9%) y una cicatriz retraída en el área glútea como complicación. Ninguno requirió una nueva intervención. Conclusión: La resección quirúrgica marginal de lipoblastomas localizados en el dorso o las extremidades genera una baja tasa de recurrencia a los 2.8 años de seguimiento y mínimas complicaciones. Nivel de Evidencia: IV
Objectives: Lipoblastoma is a rare benign neoplasm that resembles white fat and can occur as a localized (lipoblastoma) or diffuse (lipoblastomatosis) tumor. Due to its rarity, the literature is mostly limited to case reports. The purpose of this study was to determine the local recurrence rate and complications after marginal resection of lipoblastomas located in the extremities or the back. Materials and methods: We performed a multicenter retrospective review of the records of pediatric patients who had undergone surgical excision of lipoblastomas at 4 tertiary care institutions from 2008 to 2018. We recorded the demographic data, diagnostic method, the volume of the lesion, type of biopsy, complications, recurrence, and the need for additional procedures. Results: Throughout the study, 17 patients met the inclusion criteria for evaluation. The average patient age was 3.9 years, and 65% were male. The most common locations included thighs (N 9), low back region (N 2), and buttocks (N 2). The mean preoperative mass volume was 305.5 cm3(range: 10.2 cm3 - 1745.8 cm3). The mean duration of follow-up was 2.8 years (range: 8 months to 5.6 years). One patient experienced recurrence (5.9%). One patient had a retracted skin scarring in the gluteal area. Conclusion: Marginal surgical resection of lipoblastomas located in the back or extremities showed a low recurrence rate at 2.8 years of follow-up and minimal complications. Level of Evidence: IV