Stabilometric changes due to exposure to firearm noise in the Brazilian Army / Alterações estabilométricas produzidas na exposição ao ruído de arma de fogo em militares do Exército Brasileiro

Success in precision activities such as shooting depends on the subtle control of body motion. This study aimed to evaluate the influence on stabilometric signal responses for the motor task of aiming a pistol with different cognitive demands and levels of exposure to high sound pressure in Brazilian Army personnel. This cross-sectional analytical study used stabilometry to quantify the behavior of the body during motor, cognitive, and auditory tasks. Twenty-five volunteers recruited to participate in the study completed a questionnaire, underwent anthropometric evaluation and cinemetry, and scored the perceived difficulty during exposure to a sound pressure of 132 dB while using protective equipment. A significant increase in the displacement (p=0,02), anteroposterior amplitude (p=0,01), anteroposterior velocity (p=0,01), and the perceived difficulty scale (p=0,03) between Situation 1 (aiming without other cognitive action or environmental noise) and Situation 3 (shooting noise and progressive counting) was confirmed. number of shots heard). Correlation between the perceived difficulty scale and the variables of displacement (p=0,01), anteroposterior amplitude (p=0,01), area (p=0,006) and anteroposterior mean frequency (p=0,01) were observed. The accuracy of aiming events correlated with the median lateral median frequency (p=0,02). Stabilometric signals demonstrated increased total displacement, anteroposterior amplitude, and anteroposterior velocity in the presence of high sound pressure levels. These results indicate the need for future studies to investigate the underlying mechanisms of possible vestibular damage induced by noise.

O sucesso em atividades de precisão, como o tiro, depende do sutil controle das oscilações corporais.Analisar a influência nas respostas do sinal estabilométrico para a tarefa motora de pontaria com pistola, acrescidas de diferentes demandas cognitivas e exposição ao nível de pressão sonora elevado, em militares do Exército Brasileiro.Estudo de caráter transversal analítico utilizou a estabilometria para quantificar o comportamento do corpo durante três situações de pontaria distintas (variando tarefas motoras, cognitivas e auditivas). Vinte e cinco voluntários foram submetidos à pesquisa e utilizou-se: questionário, avaliação antropométrica, cinemetria, escala de dificuldade percebida e exposição ao nível de pressão sonora de 132 dB, com uso do equipamento de proteção individual. Confirmou-se um aumento significativo nas variáveis de deslocamento (p=0,02), amplitude anteroposterior (p=0,01), velocidade anteroposterior (p=0,01) e a escala de dificuldade percebida (p=0,03) entre a Situação 1 (pontaria sem outra ação cognitiva ou ruído ambiental) e a Situação 3 (pontaria com ruído de tiros e contagem progressiva do número de disparos ouvidos). Observou-se correlação entre escala de dificuldade percebida e as variáveis deslocamento (p=0,01), amplitude anteroposterior (p=0,01), área (p=0,006) e frequência média anteroposterior (p=0,01). A precisão dos eventos de pontaria se correlacionou com a frequência mediana médio lateral (p=0,02).Os sinais estabilométricos demonstraram um aumento nas oscilações do deslocamento total, amplitude ântero-posterior e a velocidade ântero-posterior, na presença de um nível de pressão sonora elevado. O resultado motiva a expansão de estudos futuros, visando averiguar os mecanismos subjacentes dos possíveis danos vestibulares induzidos por ruído.

Influence of subcutaneous fat on mechanomyographic signals at three levels of voluntary effort

Abstract Introduction This study aims to assess the influence of different skinfold thicknesses (ST) and their relation to the attenuation of the mechanomyographic (MMG) signal at different force levels (maximal voluntary contraction – MVC, 40% of MVC and 70% of MVC) of the rectus femoris muscle. Methods Fifteen volunteers were divided in two groups: ST lower than 10mm (G<10) (8 participants) and ST higher than 35mm (G>35) (7 participants). Student t tests were employed to investigate differences between G<10 and G>35 regarding MMG analysis parameters (acceleration root mean square – aRMS, zero crossing – ZC, and median frequency – MDF), for the X, Y and Z axes, as well as for the modulus of these three axes. Results We found that thicker layers of body fat act as attenuator filters for the MMG signal [MDFMVC: X (p = 0.005), Z (p = 0.003); MDF70%MVC: X (p = 0.034); ZCMVC: Z (p = 0.037), modulus (p = 0.005); ZC70%MVC: Z (p = 0.047)]. We found significant correlation between ST values and aRMS in three levels, in the Yaxis (p = 0.591), for the group G<10. For the modulus, the aRMS value showed correlation with ST values for group G>35 in 40%MVC (R2 = 0.610), and 70%MVC (R2 = 0.592). The MDF parameter showed correlation with ST values only in the Yaxis in 70%MVC (R2 = 0.700) for G>35. Conclusions We observed MMG signal attenuation in at least one of the parameters analyzed for each level of the rectus femoris muscle force, indicating that MMG signals are significantly attenuated with increasing thickness of the subcutaneous fat layer.

Correlation between spectral and temporal mechanomyography features during functional electrical stimulation

Abstract Introduction: Signal analysis involves time and/or frequency domains, and correlations are described in the literature for voluntary contractions. However, there are few studies about those correlations using mechanomyography (MMG) response during functional electrical stimulation (FES) elicited contractions in spinal cord injured subjects. This study aimed to determine the correlation between spectral and temporal MMG features during FES application to healthy (HV) and spinal cord injured volunteers (SCIV). Methods: Twenty volunteers participated in the research divided in two groups: HV (N=10) and SCIV (N=10). The protocol consisted of four FES profiles transcutaneously applied to quadriceps femoris muscle via femoral nerve. Each application produced a sustained knee extension greater than 65º up to 2 min without adjusting FES intensity. The investigation involved the correlation between MMG signal root mean square (RMS) and mean frequency (MF). Results: HV and SCIV indicated that MMGRMS and MMGMF variations were inversely related with -0.12 ≥ r ≥ -0.82. The dispersion between MMGMF and MMGRMS reached 0.50 ≤ r2 ≤ 0.64. Conclusion The increase in MMGRMS and the decrease in MMGMF may be explained by the motor units coherence during fatigue state or by motor neuron adaptation (habituation) along FES application (without modification on parameters).

Participation of nurses in the execution of clinical research protocol about technological innovation / Participación del enfermero en la ejecución de protocolo de investigación clínica de innovación tecnológica / Participação do enfermeiro na execução de protocolo de pesquisa clínica de inovação tecnológica

AbstractOBJECTIVETo report the nurse's experience of inclusion in interdisciplinary clinical study about technological innovation, involving people with spinal cord injury.METHODDescriptive experience report. The empirical support was based on notes about perspectives and practice of clinical research, with a multi-professional nursing, physical education, physiotherapy and engineering staff.RESULTThe qualification includes the elaboration of the document for the Ethics Committee, familiarization among the members of staff and with the studied topic, and also an immersion into English. The nurse's knowledge gave support to the uptake of participants and time adequacy for data collection, preparation and assistance of the participants during the intervention and after collection. Nursing theories and processes have contributed to reveal risky diagnoses and the plan of care. It was the nurse's role to monitor the risk of overlapping methodological strictness to the human aspect. The skills for the clinical research must be the object of learning, including students in multidisciplinary researches.CONCLUSIONTo qualify the nurse for clinical research and to potentialize its caregiver essence, some changes are needed in the educational system, professional behavior, attitude and educational assistance.

ResumenOBJETIVORelatar la experiencia de inclusión del enfermero en estudio clínico interdisciplinario de innovación tecnológica, involucrando a personas con lesión medular.MÉTODORelato de experiencia descriptivo. Las bases empíricas fueron apuntes de orientaciones y práctica de investigación clínica, con equipo multiprofesional de enfermería, educación física, fisioterapia e ingenierías.RESULTADOLa capacitación incluyó la elaboración del documento para el Comité de Ética, la familiarización con el equipo y el tema de estudio e inmersión en lengua inglesa. El conocimiento del enfermero ancló la captación de participantes y la adecuación temporal de la recolección de datos, preparación y seguimiento de los participantes durante la intervención y post recolección. Las teorías y el proceso de enfermería contribuyeron a evidenciar diagnósticos de riesgo y la planificación de cuidados.Fue papel del enfermero la vigilancia del riesgo de superposición del rigor metodológico al carácter humano. Las habilidades para la investigación clínica deberán ser objeto de aprendizaje incluyéndose a estudiantes en investigaciones multidisciplinarias.CONCLUSIÓNA fin de cualificar al enfermero para la investigación clínica y potenciar su esencia de cuidados son necesarios cambios en los sistemas de enseñanza, comportamiento profesional, actitud y soporte educativo.

ResumoOBJETIVORelatar a experiência de inclusão do enfermeiro em estudo clínico interdisciplinar de inovação tecnológica, envolvendo pessoas com lesão medular.MÉTODORelato de experiência descritivo. As bases empíricas foram anotações de orientações e prática de pesquisa clínica, com equipe multiprofissional da enfermagem, educação física, fisioterapia e engenharias.RESULTADOA capacitação incluiu a elaboração do documento para Comitê de Ética, familiarização com equipe e tema de estudo e imersão em língua inglesa. O conhecimento do enfermeiro ancorou a captação de participantes e adequação temporal da coleta de dados, preparação e acompanhamento dos participantes durante a intervenção e pós-coleta. As teorias e o processo de enfermagem contribuíram para evidenciar diagnósticos de risco e no planejamento de cuidados. Foi papel do enfermeiro a vigilância do risco de sobreposição do rigor metodológico ao caráter humano. As habilidades para a pesquisa clínica deverão ser objeto de aprendizagem incluindo estudantes em pesquisas multidisciplinares.CONCLUSÃOPara qualificar o enfermeiro para pesquisa clínica e potencializar sua essência de cuidador são necessárias mudanças nos sistemas de ensino, comportamento profissional, atitude e suporte educacional.

Advances and perspectives of mechanomyography

INTRODUCTION: The evaluation of muscular tissue condition can be accomplished with mechanomyography (MMG), a technique that registers intramuscular mechanical waves produced during a fiber's contraction and stretching that are sensed or interfaced on the skin surface. OBJECTIVE: Considering the scope of MMG measurements and recent advances involving the technique, the goal of this paper is to discuss mechanomyography updates and discuss its applications and potential future applications. METHODS: Forty-three MMG studies were published between the years of 1987 and 2013. RESULTS: MMG sensors are developed with different technologies such as condenser microphones, accelerometers, laser-based instruments, etc. Experimental protocols that are described in scientific publications typically investigated the condition of the vastus lateralis muscle and used sensors built with accelerometers, third and fourth order Butterworth filters, 5-100Hz frequency bandpass, signal analysis using Root Mean Square (RMS) (temporal), Median Frequency (MDF) and Mean Power Frequency (MPF) (spectral) features, with epochs of 1 s. CONCLUSION: Mechanomyographic responses obtained in isometric contractions differ from those observed during dynamic contractions in both passive and functional electrical stimulation evoked movements. In the near future, MMG features applied to biofeedback closed-loop systems will help people with disabilities, such as spinal cord injury or limb amputation because they may improve both neural and myoelectric prosthetic control. Muscular tissue assessment is a new application area enabled by MMG; it can be useful in evaluating the muscular tonus in anesthetic blockade or in pathologies such as myotonic dystrophy, chronic obstructive pulmonary disease, and disorders including dysphagia, myalgia and spastic hypertonia. New research becomes necessary to improve the efficiency of MMG systems and increase their application in rehabilitation, clinical and other health areas.

Iontophoresis: principles and applications / Iontoforese: princípios e aplicações

Introduction Iontophoresis is a noninvasive technique used to increase transdermal penetration of substances through the skin layer (epidermis, dermis and hypodermis) in a controlled manner. Technological advance in recent decades have provided reduced cost of equipment needed for implementation, which allowed for the expansion of this technique. Objective The aim of this paper is to present the state of the art on iontophoresis, ranging from the atomic characteristics of the ion formation to the current applications of the technique. Methods Were researched papers from databases: IOP publishing, ScienceDirect, Pubmed, Springer, IEEE Xplore, Google Scholar and books with keywords iontophoresis, ions, topical applications between 1967 and 2010. Results Were selected (number of papers and database) 1 IOP Publishing, 1 from ScienceDirect, Central, 1 from Springer, 2 from PubMed, 11 from IEEE Xplore, 35 from Google Scholar, and 15 books, totaling 66 references and websites with nationally marketed electrotherapy products. Conclusion Iontophoresis is suitable for applications such as acetic acid (calcific tendinitis and myositis ossificans), calcium chloride and magnesium sulfate (control of musculoskeletal spasms), dexamethasone (inflammation), lidocaine (inflammation of soft tissues), zinc oxide (rheumatoid arthritis). It is also used in cosmetic applications with devices attached to the skin and for eye treatment aimed at specific tissues of the eye, providing a treatment option for various eye diseases, reducing the complications secondary to traditional methods of treatment. The advantages are the significant increase in the release and control of therapeutic agents, including drugs with high molecular weight. The disadvantages of iontophoresis are the complexity of the drug release system and prolonged exposure of the skin to an electrical current. .

Introdução A iontoforese é uma técnica não invasiva utilizada para aumentar, de forma controlada, a penetração transdermal de substâncias através das camadas da pele (epiderme, derme e hipoderme). O avanço tecnológico nas últimas décadas proporcionou uma redução no custo dos equipamentos necessários à sua aplicação, o que possibilitou a expansão dessa técnica. Objetivo Apresentar o estado da arte sobre iontoforese, abrangendo desde as características atômicas da formação do íon até as atuais aplicações da técnica. Métodos Foram pesquisados artigos das bases de pesquisa: IOP publishing, ScienceDirect, Pubmed, Springer, IEEE Xplore, Google Scholar e livros com os unitermos: iontophoresis, ions, topical applications entre os anos de 1967 e 2010. Resultados Foram selecionados (número de artigos e base de pesquisa) 1 da IOP Publishing, 1 da ScienceDirect, 1 da Springer, 2 da PubMed, 11 da IEEE Xplore, 35 do Google Scholar e 15 livros, totalizando 66 referências, além de websites com produtos comerciais nacionais de eletroterapia. Conclusão A iontoforese é indicada para aplicações como de ácido acético (tendinite calcificante e miosite ossificante), cloreto de cálcio e sulfato de magnésio (controle de espasmos musculoesqueléticos), dexametasona (inflamação), lidocaína (inflamação de tecidos moles), óxido de zinco (artrite reumatóide). Também é utilizada em aplicações cosméticas com dispositivos aderidos à pele e em tratamento ocular visando tecidos específicos do olho, oferecendo uma forma de tratamento para diversas doenças oculares, diminuindo as complicações apresentadas em métodos clássicos de tratamento. As vantagens ...

Relationship between peak and mean amplitudes of the stimulating output voltage for functional control of the knee by spinal cord patients and healthy volunteers

INTRODUCTION: Functional electrical stimulation (FES) may evoke movements in people with movement impairments due to neurological lesion. The mean value of electrical current or voltage during FES depends on the stimulatory profile parameters. To investigate the relationship between peak and mean amplitudes of the stimulator output voltage while causing a knee extension angle change from 90º to 40º to choose the best and safest profile to be applied in people who have suffered a spinal cord injury. METHODS: Healthy (N = 10) volunteers and those with spinal cord injuries (N = 10) participated in this study. Each FES profile (P1, P2, P3 and P4) had 1-kHz pulses (100 µs or 200 µs on and 900 µs or 800 µs off) with burst frequencies of 50 Hz (3 ms on and 17 ms off) or 70 Hz (3 ms on and 11 ms off) and peak amplitudes set between 53-125V for healthy volunteers and 68-198 V for volunteers with spinal cord injury. RESULTS: The highest mean amplitude were obtained using a FES profile with active/total pulse period of 200 us/1000 us and burst frequency of 3ms/14ms. The best results of mean amplitude were observed using a FES profile duty cycle of 10% for pulses (100 µs/1000 µs) and 15% for bursts (3 ms/20 ms). CONCLUSION: The FES profile (100 µs - 50 Hz) seems to be the most suitable for both groups, inasmuch as it presents smaller mean amplitudes and peak amplitudes similar to other FES profiles.

Descrição do Protocolo PediaSuitTM / Description of the Pediasuit ProtocolTM

INTRODUCTION: PediaSuit ProtocolTM is an intensive therapy with a holistic approach to the treatment of individuals with neurological disorders like cerebral palsy (CP), developmental delays, traumatic brain injuries, autism and other conditions which affect a child's motor and/or cognitive functions. OBJECTIVE: The aim of the present work is to describe the PediaSuit ProtocolTM. METHODS: The authors team remained two months observing the care provided in a clinic with physical therapists trained by the PediaSuit ProtocolTM team (USA). RESULTS: The PediaSuitTM is a therapeutic protocol which uses a suit combined with intensive physical therapy and consists of up to four hours of therapy a day, five days a week, during three or four weeks. The PediaSuit ProtocolTM is customized to fit the needs of each child, with specific functional goals, and usually involves an intensive rehabilitation program. It combines the best elements of various techniques and methods, and has a sound rationale based on exercise physiology. CONCLUSION: This protocol anticipates results obtained only with long periods of conventional physical therapy.

INTRODUÇÃO: O Protocolo PediaSuitTM é uma terapia intensiva com uma abordagem holística para o tratamento de indivíduos com distúrbios neurológicos, como paralisia cerebral (PC), atrasos de desenvolvimento, lesões cerebrais traumáticas, autismo e outras condições que afetam as funções motoras e/ou cognitivas de uma criança. OBJETIVO: O objetivo do presente trabalho foi descrever o Protocolo PediaSuitTM. MÉTODOS: A equipe de autores permaneceu dois meses observando os cuidados prestados em uma clínica com fisioterapeutas treinados pela equipe PediaSuit ProtocolTM (EUA). RESULTADOS: O PediaSuitTM é um protocolo terapêutico que utiliza um traje especial combinado com a terapia física intensiva, com duração de até quatro horas por dia, cinco dias por semana, durante três ou quatro semanas. O Protocolo PediaSuitTM é personalizado para atender às necessidades de cada criança, com objetivos específicos, e, geralmente, envolve um programa intensivo de reabilitação. Ele combina os melhores elementos de várias técnicas e métodos e tem bons fundamentos com base na fisiologia do exercício. CONCLUSÃO: Esse protocolo antecipa resultados obtidos somente com longos períodos de fisioterapia tradicional.

Potencial de ação: do estímulo à adaptação neural / Action potential: from excitation to neural adaptation

INTRODUÇÃO: O potencial de ação (PA) origina-se graças a uma perturbação do estado de repouso da membrana celular, com consequente fluxo de íons, por meio da membrana e alteração da concentração iônica nos meios intra e extracelular. OBJETIVOS: Sintetizar o conhecimento científico acumulado até o presente sobre o potencial de ação neural e o seu processo de adaptação sob aplicação de um estímulo constante. MATERIAIS E MÉTODOS: Busca realizada nas bases Springer, ScienceDirect, PubMed, IEEE Xplore, Google Acadêmico, Portal de Periódicos da Capes, além de livros referentes ao assunto. O idioma de preferência selecionado foi o inglês, com as keywords: action potential; adaptation; accommodation; rheobase; chronaxy; nerve impulse. Efetuou-se a procura de artigos com uma janela de tempo de 1931 a 2010 e livros de 1791 a 2007. RESULTADOS: Dos trabalhos selecionados, foram extraídas informações a respeito dos seguintes tópicos: potencial de ação e suas fases; condução nervosa; reobase; cronaxia; acomodação; e adaptação neuronal. CONCLUSÃO: Um estímulo que crie PA, se aplicado de maneira constante, pode reduzir a frequência de despolarizações em função do tempo e, consequentemente, adaptar a célula. O tempo que a célula demora, na ausência de estímulos, para recuperar sua frequência original é definido como desadaptação.

INTRODUCTION: The action potential (AP) arises due to a disturbance of the resting state of the cell membrane with consequent flow of ions across the membrane and ion concentration changes in intra and extra cellular space. OBJECTIVES: This article aims to summarize the scientific knowledge accumulated to date on the action potential and neural adaptation in the process of applying a constant stimulus. MATERIALS AND METHODS: This is a literature review on the bases Springer, ScienceDirect, PubMed, IEEE Xplore, Google Scholar, Capes Periodicals Portal as well as books on the topic. The selected preferred language was English with the keywords: action potential; adaptation, accommodation; rheobase; chronaxy; nerve impulse. We conducted a search of articles with a wide time window from 1931 to 2010 and books from 1791 to 2007. RESULTS: In the selected studies was extracted information about the following topics: action potential and its stages; nerve conduction; rheobase; chronaxie, accommodation, and adaptation. CONCLUSION: A stimulus that creates AP, if applied consistently, can reduce the frequency of depolarization as a function of time and, consequently, to adapt the cell. The time it takes the cell in the absence of stimuli, to recover its original frequency, is defined as a disadaptation.