Adaptation to the driving simulator and prediction of the braking time performance, with and without distraction, in older adults and middle-aged adults

Abstract Context: Many studies show the importance of evaluating the adaptation time of subjects in a virtual driving environment, looking forwards to a response as closest as a possible real vehicle. Objectives: This study aimed to identify and analyze the adaptation to the driving simulator in older adults and middle-aged adults with and without a distraction, and a secondary aim was to identify predictors of safe performance for older adults' drives. Design: Male and female middle-aged adults (n = 62, age = 30.3 ± 7.1 years) and older adults (n = 102, age = 70.4 ± 5.8 years) were evaluated for braking time performance in a driving simulator; cognition performance assessment included the Mini-Mental State Examination; motor evaluation included ankle flexor muscle strength with the isokinetic dynamometer and handgrip strength; the postural balance was evaluated with Timed Up and Go test, with and without a cognitive distraction task. Results: Older adults (men and women) and middle-aged adult women require more time to adapt to the driving simulator. The distractor increases the adaptation time for all groups. The main predictors of braking time for older women are age, muscle strength, and postural balance associated with distraction, and for older men, muscle strength. Conclusions: Age, sex, and distractor interfere in the adaptation of the virtual task of driving in a simulator. The evaluation model developed with multi-domains demonstrated the ability to predict which skills are related to braking time with and without the presence of the distractor.

Confiabilidade das mensurações de testes isocinéticos para articulação do tornozelo / Reliability of isokinetic test measurements for ankle joint

O teste isocinético do tornozelo tem uma grande relevância, já que é possível estabelecer protocolos com velocidades e modos de contração semelhantes aos das atividades funcionais e esportivas. Desta forma, são necessários estudos que mostram a confiabilidade desta ferramenta para auxiliarem na prevenção de lesões do tornozelo. Objetivo: Elaborar uma revisão de literatura sobre estudos que abordaram a confiabilidade de testes isocinéticos da articulação do tornozelo. Métodos: A busca na literatura foi realizada nas bases de dados Pubmed, Lilacs, Pedro, Scielo, Scopus e Cochrane com os descritores científicos ankle e isokinetic e reliability. Foram identificados 34 artigos, 4 foram excluídos por não estudarem humanos e 27 foram incluídos (10 referentes à confiabilidade de testes isocinéticos para inversores e eversores do tornozelo e 17 referentes à confiabilidade de testes para flexores-plantares e dorsiflexores). Resultados: A confiabilidade da avaliação isocinética dos flexores-plantares e dorsiflexores tem sido descrita para diferentes dinamômetros, posições, modos e populações. Os valores de coeficientes de correlação intraclasse variam de 0,55-0,98; e a de eversores e inversores, variam de 0,54-0,99, classificados na faixa de satisfatório a excelente. Conclusão: Os protocolos isocinéticos da articulação do tornozelo devem ser elaborados de acordo com a musculatura recrutada e com a população (com presença ou não de patologia).

Ankle isokinetic tests are importance because establish protocols with velocities and modes of contraction similar to functional and sport activities. Thus, studies that show the reliability of this tool are needed to help the ankle injury prevention. Objective: To develop a literature review about studies that show the reliability of ankle isokinetic test. Methods: The literature search was conducted in Pubmed, Lilacs, Peter, Scielo, Scopus and Cochrane with key words: isokinetic and ankle and reliability. 34 articles were identified, 4 were excluded because they did not study humans and 27 were included (10 about the reliability of ankle inverters and everter isokinetic tests and 17 about the reliability of tests for ankle flexor-plantar and dorsiflexors). Results: The reliability of isokinetic test has been described for different dynamometers, positions, modes and populations. The values of intraclass correlation coefficients ranged from 0.54 to 0.99, which were considered satisfactory to excellent. Conclusion: Ankle isokinetic protocols must be prepared in accordance with the recruited muscles and the population (with or without pathology).

The effects of motor adaptation on ankle isokinetic assessments in older drivers

OBJECTIVES: This study sought to analyze the extent of motor adaptation in ankle plantar flexors and dorsiflexors among older drivers during clinical isokinetic testing. METHODS: One hundred older adults (70.4±5.7 years) participated in two bilateral ankle plantar flexor and dorsiflexor isokinetic assessments at 30°/sec. Peak torque (PTQ), PTQ adjusted for body weight (PTQ/BW), and total work (TW) were analyzed. RESULTS: On the dominant side, PTQ/BW and TW were significantly greater for the second plantar flexion test than were those for the first such test (p<0.001), whereas PTQ, PTQ/BW, and TW (p<0.001) were significantly greater for the second dorsiflexion test than were those for the first such test. On the non-dominant side, plantar flexion PTQ and TW were significantly lower for the second test than were those for the first test (p<0.001). CONCLUSION: Older drivers demonstrated better performance with the dominant limb on the second test. The low variability in test execution showed the existence of a motor adaptation effect for the tested movements, despite the short recovery period between the assessments.

Risk factors for overuse injuries in runners´ ankles: a literature review / Fatores de risco para lesões de esforço em tornozelos de corredores: revisão da literatura

INTRODUCTION: In spite of the numerous benefits to human health and given the increase of running as an exercise that has become popular worldwide, this type of sport may be the cause of a number of different injuries. The foot, ankle and lower leg comprise almost 40% of the injuries. However, the etiology of these types of injury is still not completely understood. OBJECTIVE: To investigate the causes of the onset of overuse injury in runners. METHODS: A systematic search of the electronic database was made: Bireme, Pubmed and PEDro, which were selected that addressed clinical trials, control cases, prospective and cross-sectional studies. RESULTS: The search through the descriptors yielded 324 references. Using our predefined inclusion criteria (case studies, clinical trials, prospective studies and cross studies that addressed adult runners, amateur or professional) 68 articles remained; 24 citations were excluded after reading the title, and 35 were excluded after reading the abstract and the full text. Therefore nine studies that met the criteria for analysis were included. CONCLUSION: The etiology of overuse injuries in runners is multifactorial. This review showed that distance, soil type and footwear, as well as a history of previous injuries, biomechanical changes such as increased dorsiflexion and eversion ankle, and greater knee flexion are risk factors that influence the occurrence of these injuries.

INTRODUÇÃO Apesar dos inúmeros benefícios para a saúde humana e considerando o aumento da corrida como exercício, atividade mundialmente popular, este tipo de esporte pode ser a causa de uma série de diferentes lesões. O pé, tornozelo e parte inferior da perna compreendem quase 40% das lesões. No entanto, a etiologia destas lesões permanece mal compreendida. OBJETIVO: investigar as causas do aparecimento da lesão de esforço em corredores. MÉTODOS: Uma busca sistemática foi realizada nas seguintes bases de dados: Bireme, PubMed e PEDro, selecionando-se ensaios clínicos, casos controle, estudos prospectivos e de corte transversal. RESULTADOS: A pesquisa através dos descritores rendeu 324 referências. Usando critérios de inclusão pré-definidos (estudos de casos, ensaios clínicos, estudos prospectivos e estudos transversais que abordavam adultos corredores indivíduos, amador ou profissional) permaneceram 68 artigos; 24 citações foram excluídos depois de ler o título, e 35 foram excluídos após a leitura do resumo e do texto integral. Portanto nove estudos que preencheram os critérios de análise foram incluídos. CONCLUSÃO: A etiologia das lesões de esforço em corredores é multifatorial. Esta revisão mostrou que a distância, tipo de solo e calçados, bem como uma história de lesões prévias, alterações biomecânicas como o aumento da dorsiflexão e eversão do tornozelo, e uma maior flexão do joelho são fatores de risco que influenciam a ocorrência dessas lesões.

Pressure pain threshold in the craniocervical muscles of women with episodic and chronic migraine: a controlled study / Limiar de dor por pressão de músculos craniocervicais em mulheres com migrânea episódica e crônica: um estudo controlado

OBJECTIVE: To estimate the pressure pain threshold (PPT) of the craniocervical muscles in women with episodic migraine (EM) n=15 and chronic migraine (CM) n=14, and in healthy volunteers (C) n=15. METHOD: A blinded examiner obtained the PPT bilaterally, by pressure algometry, for the following muscles: frontalis, temporalis, masseter, trapezius and sternocleidomastoid. ANOVA (p<0.05) was used for statistical purposes. RESULTS: Contrasted to controls, individuals with EM had significantly decreased PPT values for frontal muscle (EM: 2.01±0.67 vs. C: 2.85±0.71), posterior temporalis bilaterally (right and left, respectively) (EM: 2.72±0.89 vs. C: 3.36±0.72 and EM: 2.60±1.00 vs. C: 3.35±0.85), upper trapezius bilaterally (EM: 2.69±1.00 vs. C: 3.49±0.83 and EM: 2.54±0.93 vs. C: 3.32±0.97) and women with CM: on frontal muscle bilaterally (CM: 2.16±0.52 vs. C: 2.79±0.71 and CM: 2.01±0.67 vs. C: 2.85±0.71) and upper trapezius (CM: 2.66±0.84 vs. C: 3.32±0.97), however, it was not verified differences between PPT values between EM and CM groups. CONCLUSION: PPT is decreased in women with migraine relative to controls. Future studies should explore this parameter as a biological marker of the disease and a predictor of treatment.

OBJETIVO: Estimar os valores de limiar de dor por pressão (LDP) dos músculos craniocervicais de mulheres com migrânea episódica (ME) n=15 e crônica (MC) n=14, e em voluntários controles saudáveis (C) n=15. MÉTODO: O LDP foi obtido bilateralmente por examinadores cegos através da algometria de pressão nos seguintes músculos: frontal, temporal, masseter, trapézio e esternocleidomastóideo. Para análise estatística foi utilizada a ANOVA (p<0.05). RESULTADOS: Em relação aos controles, pacientes com ME apresentaram redução significativa do LDP para os músculos: frontal (ME: 2,01±0,67 vs. C: 2,85±0,71), temporal posterior bilateralmente (direito e esquerdo, respectivamente) (ME: 2,72±0,89 vs. C: 3,36±0,72 e ME: 2,60±1,00 vs. C: 3,35±0,85), trapézio superior bilateralmente (ME: 2,69±1,00 vs. C: 3,49±0,83 e ME: 2,54±0,93 vs. C: 3,32±0,97) e mulheres com MC: no músculo frontal bilateralmente (MC: 2,16±0,52 vs. C: 2,79±0,71 e MC: 2,01±0,67 vs. C: 2,85±0,71) e trapézio superior (MC: 2,66±0,84 vs. C: 3,32±0,97). Entretanto não foram verificadas diferenças entre os valores de LDP entre os grupos ME e MC. CONCLUSÃO: O LDP mostrou-se reduzido em mulheres com migrânea episódica ou crônica em relação aos controles. Em estudos futuros, esse parâmetro pode ser estudado como marcador da migrânea e indicador de efeito de tratamento.