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- ItemSomente MetadadadosAjustes posturais antecipatórios e estratégias de equilíbrio em crianças com paralisia cerebral durante o pediatric reach test(Universidade Federal de São Paulo, 2014-08-27) Soares, Leiliane Monika dos Santos [UNIFESP]; Carvalho, Raquel de Paula [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Cerebral palsy (CP) characterizes a group of disorders of the development of posture and movement due to a non-progressive disturbance in immature brain. It is frequent that children show deficits in postural control. There is interest in knowledge about movement strategies used during anterior reaching until the limit of stability that justifies the lower performance of children with CP. The aim of this study was to evaluate the motor strategies used by children with CP during the Pediatric Reach Test (PRT). This cross-sectional, non probabilistic study was composed of a convenience selected sample of 28 children, aged between 6 and 14 years old, 14 with clinical diagnosis of CP, classified as I and II according to the Gross Motor Function Classification System (GMFCS) in CP group (CPG) and 14 with typical motor development in the control group (CG), paired by gender and age. After anthropometric data collected, children were evaluated by PRT, in combination with image capture and electromyographic for further analysis. Kinematic variables (displacement of the styloid process, time, mean velocity and deceleration index), angular variables (initial and final angle of the shoulder, hip, knee and ankle) and also electromyographic variables (latency and magnitude of muscle activation in anticipatory (APA) and compensatory postural adjustment (CPA) of the tibialis anterior, rectus femoris, lateral gastrocnemius, biceps femoris and erector spinae. For the kinematic analysis we used t-Student and for the electromyographic analysis the Mann-Whitney was used. Significance level of 5% was adopted. There was no difference between groups for weight and height variables, showing homogeneity of the sample. The CPG showed lower displacement, time and mean velocity, and higher deceleration index. The angular variables showed that both groups used the same strategy of motion, but the CPG showed greater initial flexion of shoulder, knee and ankle, characterizing the crouch posture. There were no differences between groups for muscle latency and magnitude of muscle activation in APA and CPA. We conclude that children with CP have lower performance in the PRT, with less motion control compared to their peers with typical motor development, and those changes of alignment evidenced by children with CP generate compensatory mechanisms that reflect the decreased efficiency of anterior reaching movement.
- ItemSomente MetadadadosArremesso em pré-escolares, escolares e adultos(Universidade Federal de São Paulo (UNIFESP), 2018-04-04) Padua, Raissa Felipe [UNIFESP]; Carvalho, Raquel de Paula [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)The Development Of Fundamental Motor Skills Is Related To The Interaction Of Biological, Environmental And Occupational Factors. Throwing Is One Of The Fundamental Motor Skills That Involves Sequential And Continuous Actions Of The Body Segments, Progressing Of The Stages: Initial, Elementary And Mature. It Is Interesting To Understand The Development Of The Throw In The Mature Stage In Terms Of Kinematics, Considering That This Information Can Support The Training Of The Skills In The School, Recreational, Sports And Injury Prevention Contexts. The Objective Of This Study Was To Evaluate The Throwing Movement In Typical Children And Adolescents During Acquisition And Improvement Of The Mature Stage Of The Throw, Comparing With Adults. This Cross-Sectional Study Included A Sample Of 15 Typical Children Aged 5 To 7 Years, 15 Typical Adolescents Aged 11 To 13 Years, And 15 Young Adults Aged 20 To 25 Years. Sample Selection Was For Convenience. The Experimental Protocol Consisted Of 10 Throwing Attempts With A F
- ItemAcesso aberto (Open Access)Caracterização do comportamento biomecânico do pé pronado e neutro durante tarefas funcionais, em indivíduos assintomáticos, por meio da análise cinemática tridimensional(Universidade Federal de São Paulo (UNIFESP), 2015-03-09) Ferreira, Cintia Lopes [UNIFESP]; Yi, Liu Chiao [UNIFESP]; Lucareli, Paulo Roberto Garcia; http://lattes.cnpq.br/9905380373300754; http://lattes.cnpq.br/6106154677645509; http://lattes.cnpq.br/3078580296713478; Universidade Federal de São Paulo (UNIFESP)Introduction: The three-dimensional kinematic analysis has been allowed understand the multi-segmental biomechanical behavior of foot. However, little is known about their kinematic behavior in functional tasks even the gait. Objective: Analyze and compare the kinematic behavior between neutral and pronated feet during squat phase of Anterior and Lateral Step Down (ASD and LSD) tests, and during the stance phase of stair ascent and descent cycle. Methods: Forty-two feet were evaluated. According to the Foot Posture Index, Navicular Drop and Calcaneal Angle, and subdivided into neutral foot (18) and pronated foot (24). For kinematic analysis, nine movements of squat of each test (ASD and LSD) and three cycles of stair ascent and three cycles of stair descent were collected bilaterally for each participant using a three-dimensional capture system of motion, the Oxford Foot Model, and processed by Vicon Nexus® software. The range of motion (ROM) to the four tasks and the angle and temporal values during the stair ascent and descent were analyzed in the three planes of motion for the segments: hindfoot relative to the floor (HFTFL); hindfoot relative to the tibia (HFTBA); forefoot relative to the tibia (FFTBA); and forefoot relative to the hindfoot (FFHFA). For the statistical analysis the MANOVA test was used, adopting the alpha error of 5% (p <0.05). Results: Differences were found for the step down tests for the following segments: HFTFL and FFHFA with lower plantar flexion and dorsiflexion to the pronated foot, respectively, in both tests. For the ASD, the pronated foot, in the frontal plane, showed lower ROM of pronation to FFTBA and FFHFA, while the HFTFL presented ROM of eversion for the neutral foot, and the pronated foot an excursion near zero. During LSD was observed also high ROM of dorsiflexion for the FFTBA. For stair ascent no differences were found between the groups. For stair descent, the differences were concentrated in the sagittal plane, with lower ROM for the pronated foot during the first and second double support, and high ROM during simple support. Besides in the frontal plane was observed lower angular values to the forefoot and in the transversal plane high angular values for the FFHFA and FFTBA. Conclusion: The pronated and neutral feet differ in kinematic behavior during ASD, LSD and stair descent tasks. These kinematic differences found concentrated in the sagittal plane for the three analyzed tasks and in the forefoot segment for descend stairs.
- ItemAcesso aberto (Open Access)Cinemática angular após artroplastia total de joelho: plataforma tibial fixa versus móvel(Universidade Federal de São Paulo (UNIFESP), 2016-12-30) Amaro, Joicemar Tarouco [UNIFESP]; Cohen, Moises [UNIFESP]; http://lattes.cnpq.br/6174355233304675; http://lattes.cnpq.br/0863940323618050; Universidade Federal de São Paulo (UNIFESP)INTRODUCTION: Arthroplasty have been of great importance in the recovery of patients knees function when there is indication for surgical treatment. They can be divided according to the tibial component, in two types: total knee replacement tibial platform fixed and mobile platform arthroplasty. OBJETIVE: Through three-dimensional gait analysis, the angular kinematics of patients with osteoarthritis who underwent knee arthroplasty with tibial fixed and mobile platform. METHODS: We studied 64 patients randomized to two groups: group A (n = 32 - undergoing arthroplasty with fixed tibial platform) and group B (n = 32 - undergoing arthroplasty with mobile tibial platform). For the acquisition of the angular gait kinematics data, studying more specifically the movements of femorotibial axial rotation, we use the Vicon system mx 40 (oxford metrics group, UK). The kinematics was evaluated in five different activities: walking, up / down step ladder and sit / out of a chair. The rotation angles on the operated side were described according to groups with use of summary measures and compared between groups using t-student tests. RESULTS: the average angle of rotation of the patients with mobile prosthesis was statistically higher in walking, going up step and lift chair (p <0.05), just to step down and sit in the middle seat angles of rotation were statistically equal between the types of prosthesis (p = 0.160 and p = 0.209 respectively). CONCLUSION: Arthroplasty with mobile tibial platform has greater degrees of rotation when compared to the group undergoing arthroplasty with fixed platform, and this depends on the activity performed by the patient.
- ItemEmbargoEfeito imediato do uso de órtese de punho na coordenação muscular e na cinemática da extremidade superior de indivíduos sem disfunção e com síndrome do túnel do carpo(Universidade Federal de São Paulo, 2023-10-30) Figueiredo, Danielle Soares [UNIFESP]; Carvalho, Raquel de Paula [UNIFESP]; Mochizuki, Luis; http://lattes.cnpq.br/8627721608275566; http://lattes.cnpq.br/7980384093582831; http://lattes.cnpq.br/6302722050056109; Universidade Federal de São Paulo (UNIFESP)Restringir a articulação do punho pode alterar a coordenação muscular e a cinemática proximal da extremidade superior de indivíduos sem disfunções. É fundamental avaliar esses efeitos em populações com disfunções que usam contenção articular no punho, como indivíduos com síndrome do túnel do carpo (STC) que comumente relatam dor no ombro. Assim, o objetivo geral dessa tese foi verificar os efeitos do uso da órtese de punho na coordenação muscular e na cinemática de indivíduos sem disfunção e com STC. Para isso, essa tese foi dividida em três estudos. O Estudo 1 foi uma Revisão Sistemática para primeiramente examinar a efetividade da órtese de punho na redução da dor de indivíduos com STC. A estratégia de busca foi realizada em sete importantes bases de dados. Após o processo de triagem e elegibilidade, três ensaios clínicos aleatorizados, dois ensaios não aleatorizados e um observacional foram incluídos e avaliados sobre o risco de viés pela ferramenta da Colaboração Cochrane. A amostra final variou entre 24 e 91 indivíduos com média de idade entre 42,4 e 58,2 anos. Os estudos utilizaram escalas de autorrelato da dor e mostraram que o uso isolado de órtese reduz a intensidade da dor em indivíduos com STC. O Estudo 2 foi uma Revisão Sistemática para identificar os efeitos da contenção articular de punho na atividade eletromiográfica e na cinemática da extremidade superior de adultos sem disfunções. O método foi semelhante ao Estudo 1, exceto que a avaliação metodológica dos estudos foi realizada pelo Strengthening the Reporting of Observational Studies in Epidemiology checklist e a Newcastle - Ottawa Quality Assessment Scale. Após o processo de triagem e elegibilidade, 13 estudos observacionais foram incluídos. A amostra compreendeu 254 indivíduos entre 18 e 50 anos de idade avaliados em tarefas com e sem diferentes tipos de contenção articular no punho, o que alterou a atividade eletromiográfica de músculos da extremidade superior e a cinemática linear e ângulos articulares de adultos sem disfunções. Esses resultados auxiliaram no delineamento do Estudo 3, que teve o objetivo de avaliar os efeitos imediatos da órtese de punho na coordenação muscular e na cinemática da extremidade superior de indivíduos sem disfunção e de indivíduos com STC. Cinco mulheres entre 22 e 44 anos foram alocadas no Grupo Controle, e três mulheres entre 53 e 64 anos foram alocadas no Grupo STC. O experimento foi realizado em uma única sessão, que iniciou com anamnese, aplicação de questionários, avaliação de pinças e intensidade de dor. Após, a cinemática e os sinais eletromiográficos de músculos da extremidade superior dominante direita foram amostrados durante tarefas de elevação no plano escapular e de alcance, em três procedimentos: (SO1) sem órtese, (CO) com órtese, e (SO2) imediatamente após retirar a órtese. Após, a intensidade de dor foi avaliada novamente. Os testes Kruskal-Wallis, Friedman e Anova foram utilizados com nível de significância adotado ≤0,05. Os resultados da tarefa de elevação mostraram que o Grupo STC apresentou menor duração, distância percorrida e pico de deslocamento comparado ao Controle. Ambos os grupos apresentaram maior número de sinergias musculares encontradas e maior informação mútua entre os sinais eletromiográficos na sessão SO2. Na avaliação da tarefa de alcance, o Grupo STC apresentou menor distância percorrida na sessão SO1 e SO2 e menor velocidade média na sessão SO1. As alterações encontradas na sessão SO2 podem sugerir que houve um aumento compensatório na coordenação muscular proximal como um mecanismo de estabilização dessas articulações como resposta imediata à restrição articular imposta pela órtese. Conclui-se que a órtese de punho pode alterar de maneira imediata a coordenação muscular e cinemática da extremidade superior de indivíduos com e sem STC. Os resultados devem ser interpretados com cautela visto que são preliminares.
- ItemSomente MetadadadosEstratégias motoras de crianças com paralisia cerebral na postura sentada durante o alcance anterior(Universidade Federal de São Paulo, 2015-02-09) Geraldini, Juliana Maria Savazzi [UNIFESP]; Carvalho, Raquel de Paula [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Cerebral paralysis (CP) describes a group of permanent disorders of the development of movement and posture, causing activity limitation, that are attributed to non-progressive disturbances that occurred in the developing fetal or infant brain. It is common to have deficits in postural control in these children. There is interest in knowing the movement strategies used during the previous range in the sitting posture, since this posture is widely used for children with CP to perform activities of daily living. The objective of this study was to evaluate the motor strategies used by children with CP during the Pediatric Reach Test (PRT) in the sitting posture. This crosssectional, no probabilistic study was composed of aconvenience selected sample of 40 children, aged 6 to 14 years, 20 with clinical diagnosis of CP, classified as I, II and III according to the Gross Motor Function Classification System (GMFCS) in the CP group (CPG)and 20 with typical motor development for the control group (CG), paired by age and gender. After anthropometric data colected, children were evaluated by PRT, which is the anterior reaching until to the limit of stability in sitting posture. The test was recorded and the captured images was used for subsequent three-dimensional reconstruction of the movement. Linear kinematic variables of the movement of the styloid process (displacement, time, mean velocity and deceleration index), and angles (initial and final angle of the shoulder, hip, knee and ankle joints) were analyzed. For the statistical analysis we applied the t-Student test for linear variables, and ANOVA with Bonferroni multiple comparison to the angular variables. The significance level of 0.05 was adopted. There was no difference between groups for the weight and height variables, showing the homogeneity of the sample. The CPG showed lower displacement, time, and mean velocity and higher deceleration index. The angular variables showed that both groups used the same movement strategy, but the children of CPG started the movement with higher shoulder flexion, and knees flexion, indicating that this posture with higher impairments can be a factor for lower distance reached, and negatively influences the level of functionality. We conclude that children with CP have lower performance in anterior reaching test in sitting posture, with lower displacement and motor control compared to their peers with typical motor development, and thechanges of alignment evidenced by children with CP generate compensatorymechanisms that reflected the decreased efficiency of anterior reaching movement.
- ItemAcesso aberto (Open Access)Manipulação da Restrição da Tarefa de Arremesso em Atletas Amadores de Handebol(Universidade Federal de São Paulo (UNIFESP), 2019-11-27) Ribeiro, Gabriel Aguado [UNIFESP]; Carvalho, Raquel de Paula [UNIFESP]; Tucci, Helga Tatiana [UNIFESP]; http://lattes.cnpq.br/0831002416556265; http://lattes.cnpq.br/7980384093582831; http://lattes.cnpq.br/9262825581139410; Universidade Federal de São Paulo (UNIFESP)No handebol, velocidade e precisão são características indispensáveis para o rendimento do arremesso, no entanto, a velocidade final da bola tem relação direta com o nível de rendimento de atletas. Este movimento, assim como os demais, está sujeito a restrições do organismo, do ambiente e da tarefa. Sendo assim, o objetivo deste estudo foi verificar como a manipulação da tarefa influencia o arremesso em atletas amadores de handebol. Para isso, 18 atletas amadores de handebol entre 18 e 27 anos foram recrutados e realizaram 10 arremessos para a tarefa de força, orientada pelo comando “com sua força máxima, no alvo”, e 10 arremessos para a tarefa de precisão, orientada pelo comando “no centro do alvo”. Foram fixados 8 marcadores em proeminências ósseas do voluntário para captura e posterior reconstrução 3D do movimento. As estratégias de movimento durante as fases de preparação e aceleração do arremesso foram analisadas através de variáveis cinemáticas angulares e espaço-temporais. Empregou-se o teste t de Student para amostras relacionadas. Foi usado o programa SPSS (Statistical Package for Social Sciences) e considerou-se nível de significância de p < 0,05. Foram encontradas diferenças significativas de variáveis espaço-temporais em ambas as fases de preparação (velocidade, trajetórias da mão, do acrômio, das espinhas ilíacas) e aceleração (velocidade, tempo, trajetória da espinha ilíaca póstero superior direita e razão entre as trajetórias de acrômio e espinha ilíaca póstero superior direita). Em geral, a tarefa de força apresentou maiores resultados que a tarefa de precisão, com exceção do tempo na fase de aceleração. As variáveis angulares também demonstraram alteração entre as tarefas, tanto para o início da preparação (ângulos de ombro e cotovelo), quanto para o fim da aceleração (ângulo de cotovelo). A tarefa de força apresentou maior índice de acerto e menor variação de desempenho em comparação à tarefa de precisão. Concluiu-se que as tarefas apresentam atratores distintos, modificadas pelo parâmetro de controle que envolvem a intencionalidade do movimento, ou aplicação de torque muscular motivado pelo comando verbal, e a demanda de precisão, representada pelo tamanho do alvo. Estes fatores influenciam o arremesso de atletas amadores de handebol de acordo com a demanda da tarefa.
- ItemSomente MetadadadosRede adaptada para população com paralisia cerebral(Universidade Federal de São Paulo (UNIFESP), 2017-11-29) Machado, Flavia Pantoja [UNIFESP]; Carvalho, Raquel de Paula [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)A tissue hammock is part of the life habits of the population of the North and Northeast of Brazil. In these regions, and is the formula for sending, and thus, it becomes an opportunity to carry out various activities. Cerebral Palsy (CP), a flexible structure of the hammock can cause postural instability, limiting its independence to perform activities in the immediate position, increasing its own capacity for upper limbs. In this sense, an adapted hammock was created and created, resulting from adjustments in the tissue hammock and insertion of a seat and backrest system with a rigid base for positioning in the classroom, besides favoring the alignment of trunk and control to carry out activities, such as the scope manual. The objective of this research is to verify the characteristics of the trunk and lower limb alignment during seat positioning and in the task of reaching the hammock adapted to the bank and to the hammock without adaptation, with the CP, comparing with its control pairs without neurological deficiency, as well as the level of parental satisfaction. Quasi experimental clinical trial, comparative statistical, with CP group (GCP) and Control Group (CG). The selection of the non-probabilistic clinical sample, composed by person aged between 5 and 16 years old. The GCP is composed of person with bilateral spastic CPs, level II and III according to a Gross Motor Function Classification System (GMFCS), while the GC, by control neurological semantic control, matched in relation to age, weight, height and width make hip. Participants were sent in three different conditions: in the adapted hammock, seat and net without seat / backrest support. Through the kinematic analysis, the trunk alignment in the posture sent without movements - static task - was evaluated through the analysis of the ankle, knee, hip, pelvis and trunk angles. In the scope task, spatial-temporal variables of the movement were analyzed: time, hand trajectory; the displacement of the acromion, an average labor force, the retirement rate and deactivation of the movement, in addition to the initial and final angles of the shoulder and elbow. In the static task, the results indicated the similarity of the lower limbs, pelvis and trunk angles in the three sitting conditions, inferring that an adapted hammock may be an option to sit for short periods of time. The results of the task and the range motion protocol in the GCP and GC, evidencing less control of the movement for GCP, besides the use of the inclination of the trunk forward to realize the reach. Parents, through the Quebec B-Quest satisfaction questionnaire, were satisfied with the dimensions of the product, however, pointed out the need for improvements in comfort and safety. It is concluded that an adapted hammock can be considered as a short-time sending option, since it promoted postural control in CP, and that it does not influence reach accomplishment.
- ItemSomente MetadadadosTerapia a laser de baixa intensidade na neuroplasticidade e recuperação funcional da lesão medular(Universidade Federal de São Paulo (UNIFESP), 2016) Campo, Paula Fernanda Gallani Martin Del [UNIFESP]; Aguiar, Odair [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Introduction: The spinal cord injury (SCI) consists of any damages to the structures in the medullary canal. This injury can be traumatic or non-traumatic, the latter being the most common. The central nervous system (CNS) has a low ability to get repaired, requiring the use of therapeutic approaches in order to favor neuroplasticity. In this context, low-level laser therapy (LLLT) has been proposed as a promising treatment for repairing central and peripheral nervous system injuries. Aim: to investigate the effects of LLLT, after traumatic injuries, on the regeneration and neuroplasticity of the spinal cord, as well as on the sensorial and motor functional recovery. Materials and methods: female wistar rats (n= 33), aging 10 weeks, were submitted to spinal cord injury contusion model (CEUA N: 9329290514). The animals were divided into two groups: control (C; n= 19) and laser (L; n= 14), and they were euthanized after 4 and 8 weeks. The L group was treated, for 15 consecutive days, with continuous emission of GaAlAs laser which was adjusted with the following parameters: λ = 808 nm, power of 100 mW, spot area = 0.028 cm²; t = 4'42 ''; dosage of 1000 J / cm²; E = 28 J; irradiance = 3.57 mW / cm². At days 1, 14, 28 and 56 after the surgery, the motor function (using BBB score and computed kinematics), the thermal sensitivity (using ice) and the tactile sensitivity (using Von Frey® monofilaments) were evaluated. Additionally, histological and immunohistochemical analysis were performed to investigate the lesion volume and the expression of GFAP respectively. Results: The main findings of this study demonstrate, based on the BBB score, that LLLT was able to improve the motor performance in the group L compared to group C after 56 days. Furthermore, LLLT was capable to decrease the immunoexpression of of GFAP marker and the lesion volume in the injury site after 56 days. Conclusion: Based on the results, it is suggested that the effect of LLLT in the lesion (i) assisted in the motor recovery; (ii) reduced the lesion volume and (iii) decreased the GFAP immunostaining. This study indicates that the LLLT is a promising therapeutic approach for the SCI treatment, justifying the need of further investigations utilizing other experimental models and other specific markers.